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In vivo motion of the rectus femoris muscle after tendon transfer surgery  

Microsoft Academic Search

Abstract Rectus femoris transfer surgery is performed,to convert the rectus femoris muscle,from a knee extensor to a knee flexor. In this surgery, the distal tendon of the rectus femoris is detached from the patella and reattached to one of the knee flexor tendons. The outcomes of this procedure are variable, and it is not known if the surgery successfully converts

Deanna S. Asakawa; Silvia S. Blemker; Garry E. Gold; Scott L. Delp


ASB pre-doctoral young investigator award 2001 In vivo motion of the rectus femoris muscle after tendon transfer surgery  

Microsoft Academic Search

Rectus femoris transfer surgery is performed to convert the rectus femoris muscle from a knee extensor to a knee flexor. In this surgery, the distal tendon of the rectus femoris is detached from the patella and reattached to one of the knee flexor tendons. The outcomes of this procedure are variable, and it is not known if the surgery successfully

Deanna S. Asakawa; Silvia S. Blemker; Garry E. Gold; Scott L. Delp


Rectus muscle recession and resection without scleral sutures  

Microsoft Academic Search

Purpose: To eliminate the risk of scleral perforation during strabismus surgery in susceptible patients, we introduce a technique to allow predictable rectus muscle recession and resection without the placement of scleral sutures. Methods: Three patients with thin sclera underwent rectus muscle surgery by use of a double-arm suture technique that avoids placement of sutures directly into the sclera. Two of

David K. Coats; Evelyn A. Paysse



Successful extraocular muscle re-resection for a strabismus surgery complication: a "snapped" [severed, inadvertently] and retrieved inferior rectus muscle: a case report.  


A 26- year-old woman who had a left head tilt since childhood was undergoing left inferior rectus resection to correct her left inferior rectus paresis. During the surgery, when the inferior rectus was isolated and engaged with an eye muscle hook, the muscle tore (snapped) completely into two pieces, 8 mm posterior to insertion. Fortunately, we were able to find the proximal portion of the muscle and, after a 3 mm resection, of the distal yet attached 8 mm portion, the proximal and distal portions were sutured together with a non-absorbable suture. After nine months followup there was significant diplopia, and the preoperative left head tilt and left hypertropia remained, so a left inferior rectus re-resection was done. At the end of 18 months followup after the second procedure there was no binocular deviation (strabismus) in primary position nor in any other gaze positions, but there was a mild ocular motility infraduction deficit present on left and down gaze. PMID:22404092

Akbari, Mahammad Reza; Jafari, Alireza Keshtcar; Ameri, Ahmed; Anvari, Faramarz; Eshraghi, Bahram; Masoomian, Babak



Bilateral recession of superior rectus muscles: Its influence on A and V pattern strabismus  

Microsoft Academic Search

Purpose: To determine whether bilateral superior rectus recession modifies A and V pattern strabismus. Patients and Methods: Three patients with V patterns and eight patients with A patterns underwent bilateral superior rectus recession with neither oblique muscle surgery nor vertical displacement of the horizontal rectus muscles. Another three patients with A patterns underwent simultaneous superior oblique tenotomy and superior oblique

Nélida B. Melek; Teodora Mendoza; Alberto O. Ciancia



[Unilateral congenital ptosis with ipsilateral superior rectus muscle overaction].  


Congenital ptosis may be frequently accompanied by weakness of the ipsilateral superior rectus muscle. We report a case of ptosis with ipsilateral superior rectus muscle overaction. The 45-year-old patient presented with unilateral congenital ptosis. Ipsilateral superior rectus muscle overaction was found in the upgaze, with an inferior sclera show. This can be found in 40% of congenital ptosis. The authors give two possible causes: either an exaggerated Bell reflex or misdirection innervations of the superior rectus muscle by the superior division of the oculomotor nerve, initially innervating the upper eyelid elevator muscle. Histological or electrophysiological studies can be useful to determine the physiopathology of this association. PMID:21665327

Ben Rayana, N; Knani, L; Touzani, F; Ben Hadj Hamida, F



Moderate intra-abdominal hypertension is associated with an increased lactate-pyruvate ratio in the rectus abdominis muscle tissue: a pilot study during laparoscopic surgery  

PubMed Central

Background The development of intra-abdominal hypertension [IAH] in critically ill patients admitted to the ICU is an independent predictor of mortality. In an attempt to find an early, clinically relevant metabolic signal of modest IAH, we investigated abdominal wall metabolite concentrations in a small group of patients undergoing laparoscopic surgery. We hypothesized that elevated intra-abdominal pressure [IAP] due to pneumoperitoneum leads to an increased lactate/pyruvate [L/P] ratio in the rectus abdominis muscle [RAM], indicating anaerobic metabolism. Method Six patients scheduled for elective laparoscopic gastric fundoplication were studied. Two hours before surgery, a microdialysis catheter (CMA 60, CMA Small Systems AB, Solna, Sweden) was inserted into the RAM under local anaesthesia. Catheter placement was confirmed by ultrasound. The microdialysis perfusion rate was set at 0.3 ?L/min. Dialysate was collected hourly prior to pneumoperitoneum, during pneumoperitoneum, and for 2 h after pneumoperitoneum resolution. IAP was maintained at 12 to 13 mmHg during the surgery. The glucose, glycerol, pyruvate and lactate contents of the dialysate were measured. Results The median (interquartile range) L/P ratio was 10.3 (7.1 to 15.5) mmol/L at baseline. One hour of pneumoperitoneum increased the L/P ratio to 16.0 (13.6 to 35.3) mmol/L (p = 0.03). The median pneumoperitoneum duration was 86 (77 to 111) min. The L/P ratio at 2 h post-pneumoperitoneum was not different from that at baseline (p = 1.0). No changes in glycerol or glucose levels were observed. Conclusions IAH of 12 to 13 mmHg, even for a relatively short duration, is associated with metabolic changes in the abdominal wall muscle tissue of patients undergoing laparoscopic surgery. We suggest that tissue hypoperfusion occurs even during a modest increase in IAP, and intramuscular metabolic monitoring could therefore serve as an early warning sign of deteriorating tissue perfusion.



[Isotonic contraction of rabbit superior rectus muscle].  


It is well known that the mammalian extraocular muscle has slow muscle fiber morphologically. But the contraction speed of slow muscle fiber has not been mentioned in previous reports. We studied the isotonic contraction of slow muscle fiber and compared it with fast muscle fiber. Each fiber bundle was isolated from the rabbit superior rectus muscle. Both light microscopic findings and the reaction to isotonic contraction in Ca2+ free Ringer's solution could identify each of the two muscle fiber types. Contraction speed depended on the frequency of stimuli (40-200 Hz) in both slow and fast muscle fiber. Maximum velocities of slow and fast fiber bundles were 4.3 +/- 1.53 mm/sec and 26.9 +/- 3.48mm/sec at 200Hz, respectively. It was suggested that the relaxation of slow muscle fiber did not interfere with the contraction of the fast muscle fiber. The relation between contraction velocity and afterload showed an approximately right angle hyperbolic curve. PMID:2248162

Umemoto, T; Sawa, M; Ohyachi, H; Takeda, M; Matsuda, S; Hasegawa, I



Ocular rectus muscle insertions revisited: an unusual anatomic approach.  


Twenty-five normal adult eyes, taken from fresh human cadavers, were specially prepared in view of the measurements of the arc length of different segments of the globe. The distances measured between the anterior limbus and the scleral insertions of the rectus muscles were similar to those in previous studies with respect to the 'spirale de Tillaux' and a high interindividual variability, i.e. medial rectus 6.2 +/- 0.6 mm, inferior rectus 7.0 +/- 0.6 mm, lateral rectus 7.7 +/- 0.7 mm, superior rectus 8.5 +/- 0.7 mm. The distance between each pair of opposite rectus muscle insertions shows a high interindividual variability (horizontal axis 25.45 +/- 1.38 mm, vertical axis 25.55 +/- 1.45 mm), but the ratio between both distances was always equal to 1 (0.997 +/- 0.031) with a statistically significant correlation (2-tailed p = 0.96). This new approach to rectus muscle insertions may be important for a better understanding of some possible anatomically related factors in strabismus. PMID:7740922

de Gottrau, P; Gajisin, S; Roth, A



Electromyography study of the portions of the abdominal rectus muscle.  


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

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


Bilateral anomaly of rectus capitis posterior muscles in the suboccipital triangle and its clinical implication.  


Rectus capitis posterior muscles are located in the suboccipital triangle and function in extension and lateral rotation of the head and neck. There are two of these muscles on each side: the rectus capitis posterior major and the rectus capitis posterior minor. In the present case we observed bilateral double rectus capitis posterior major muscle and bilateral absence of rectus capitis posterior minor muscle. The additional rectus capitis posterior major may put more strain to the spine of the axis and mean time the bilateral absence of rectus capitis posterior minor muscles will result in muscular in coordination in the suboccipital region while balancing the head. The present variation should be considered in the aetiology of cervicogenic headache. PMID:21912824

Nayak, S R; Swamy, R; Krishnamurthy, A; Dasgupta, H




Microsoft Academic Search

Abstract-The actions of extraocular muscles depend on their positions as a function of gaze. These positions vary with muscle forces, which are normal only in alert subjects making voluntary fixations. Magnetic Resonance Imaging (MRI) was used to view normal human orbits, with voluntary gaze varied over a circular fiemm. Contraction also tends to cause the planes of maximum,cross-section to move




Association between preoperative inferior rectus muscle swelling and outcomes in orbital blowout fracture  

Microsoft Academic Search

PurposeIn 18 patients with orbital blowout fracture who underwent reconstruction using a bone autograft, the association between preoperative inferior rectus muscle swelling and the outcome 1 year after the operation was evaluated.

Kazuhide Matsunaga; Shinichi Asamura; Tadaaki Morotomi; Mitsuhiro Wada; Yoshitaka Wada; Norifumi Nakamura; Noritaka Isogai



Activated Satellite Cells in Medial Rectus Muscles of Patients with Strabismus  

PubMed Central

PURPOSE The goal of this study was to determine whether the medial rectus muscles of patients with a history of medial rectus underaction or overaction show alterations in the process of satellite cell activation when compared with normal age-matched control muscles. METHODS Medial rectus muscles were obtained with consent from adult patients undergoing surgical resection due to medial rectus underaction or overaction and were prepared for histologic examination by fixation and paraffin embedding. Control muscles were obtained from cornea donor eyes of adults who had no history of strabismus or neuromuscular disease. Cross sections were obtained and stained immunohistochemically for the presence of activated satellite cells, as identified by MyoD immunoreactivity, and the presence of the total satellite cell population, as identified by Pax7 immunoreactivity. The percentages of MyoD- and Pax7-positive satellite cells per 100 myofibers in cross section were calculated. RESULTS As predicted from results in the literature, MyoD-positive satellite cells, indicative of activation, were present in both the control and resected muscles. In the underacting medial rectus muscles, the percentages of MyoD- and Pax7-positive satellite cells, based on the number of myofibers, were approximately twofold higher than the percentages in the control muscles. In the overacting medial rectus muscles, the percentage of MyoD-positive satellite cells was twofold less than in the control muscles, whereas the percentage of Pax7-positive satellite cells significantly increased compared with that in the control specimens. CONCLUSIONS The presence of an increased number of activated satellite cells in the resected underacting medial rectus muscles and the decreased numbers of activated satellite cells in the overacting muscles was unexpected. The upregulation in the number of MyoD-positive satellite cells in underacting muscles suggests that there is potential for successful upregulation of size in these muscles, as the cellular machinery for muscle repair and regeneration, the satellite cells, is retained and active in patients with medial rectus underaction. The decreased number of activated satellite cells in overacting MR muscle suggests that factors as yet unknown in these overacting muscles are able to affect the number of satellite cells and/or their responsiveness compared with normal age-matched control muscles. These hypotheses are currently being tested.

Antunes-Foschini, Rosalia S.; Miyashita, Denise; Bicas, Harley E. A.; McLoon, Linda K.



Comparison of rectus abdominis muscle and musculoperitoneal flap in closure of urinary bladder defects in a rat model  

Microsoft Academic Search

To study the histological differences between a muscle flap and a musculoperitoneal flap used as a urinary bladder wall substitute, we prospectively studied these flaps in 24 Wistar albino rats. In 12 rats a rectus abdominis muscle flap including the overlying peritoneum (RAMP flap) was sutured into a surgical defect of the bladder wall. The rectus abdominis muscle flap was

Pien S. A. Schwencke-König; J. Joris Hage; Moshe Kon



Extraocular Motor Unit and Whole-Muscle Responses in the Lateral Rectus Muscle of the Squirrel Monkey  

Microsoft Academic Search

Because primate studies provide data for the current experi- mental models of the human oculomotor system, we investi- gated the relationship of lateral rectus muscle motoneuron firing to muscle unit contractile characteristics in the squirrel monkey. Also examined was the correlation of whole-muscle contractile force with the degree of evoked eye displacement. A force transducer was used to record lateral

Stephen J. Goldberg; M. Alex Meredith; Mary S. Shall



Poor results after recession of both medial rectus muscles in unilateral small-angle Duane’s syndrome, type I  

Microsoft Academic Search

PurposeTo eliminate an abnormal face turn in unilateral Duane’s syndrome, type I, the medial rectus muscle of the Duane’s eye is commonly recessed. Additional recession of the normal contralateral medial rectus muscle has been advocated in selected cases, although little has been published regarding this technique. We present poor results in a small consecutive series.

Marc F Greenberg; Zane F Pollard



[Asymmetric recession of the horizontal rectus muscles for correction alphabetical incomitance: case report].  


The authors report a case of 21-year-old man with divergent noncomitant strabismus, "V" pattern anisotropy, right inferior oblique muscle overaction and right superior oblique muscle hypofunction, which was performed under topical anesthesia an asymmetrical recession of the horizontal rectus muscles fibers to correct alphabetical incomitance. The immediate surgical outcome was considered very good (orthotropic, no "V" or "A" pattern), since the success was not obtained through conventional surgical technique. PMID:23929085

Corrêa, Alyne Borges; Mendonça, Tomás Fernando Scalamandré


Neophalloplasty using a rectus abdominis muscle flap and a radial forearm free flap  

Microsoft Academic Search

A method for construction of a neopenis in female-to-male transsexual patients is described. The method consisted of inferior transposition of a rectus abdominis island muscle flap with resurfacing using a radial forearm free flap. Excellent internal support and a natural looking appearance was achieved. This technique was considered to be better than any other previously used method of neophalloplasty.

P. Santi; M. Adami; P. Berrino; A. Galli; M. Muggianu; J. Vesely



Extension of hepatoma to the rectus abdominis muscle via ligamentum teres hepatis  

Microsoft Academic Search

The ligamentum teres hepatis connects the umbilicus to the left lobe of the liver, and thus a hepatic lesion can spread through the ligament to the umbilicus and the anterior abdominal wall. We present a case of hepatoma of the left lobe which extended to the rectus abdominis muscle through the ligamentum teres.

Soon Y. Kim; Jae H. Lim



Pedicled Rectus Abdominis Muscle Flap Wrapped around the Penis for Enhanced Urethral Pressure: An Experimental Study in Dogs  

Microsoft Academic Search

Purpose: It was the aim of this study to investigate the possibility of pedicled rectus abdominis muscle fascial flap wrapped around the penis for enhanced urethral pressure in dogs. Materials andMethods: Ten adult male Beagle dogs underwent a procedure in which surrounding tissue of the penis at the site of the bulbomembranous urethra was dissected and a pedicled rectus abdominis

Ying-Long Sa; Yue-Min Xu; Zhang-Shun Liu; Chao Feng; Xion-Fang Fei



Validation of Biodex system 4 for measuring the strength of muscles in patients with rectus diastasis.  


To investigate the validity and reliability of the Biodex system 4 in the assessment of abdominal strength in patients with rectus diastasis, we studied 10 healthy volunteers and 10 patients with rectus diastasis of more than 3 cm. We assessed test-retest reliability at 30(o) and 60(o) of extension/flexion spinal angles, respectively, and isometric muscle strength with and without the abdominal girdle. Reliability was calculated using the interclass correlation coefficient (ICC). Validity was evaluated by correlation with the International Physical Activity Questionnaire (IPAQ) and a visual analogue scale (VAS) for self-assessment of abdominal muscular strength. The Kendall-Tau and Spearman tests were used. Reliability was excellent with ICC values ranging between 0.77 and 0.97. There was no significant difference in muscular strength for tests with or without a girdle except with 60(o) extension. The internal validity assessed as the correlation between VAS and isometric strength (p = 0.008) was excellent, whereas there was no correlation with IPAQ. The Biodex system 4 is a valuable and reliable instrument to measure abdominal wall strength in patients with rectus diastasis. The internal validity is excellent. The incongruence between abdominal muscle strength, as measured using the Biodex system 4, and IPAQ indicates that there is no relation between general physical activity (IPAQ) and muscular strength in patients with rectus diastasis. PMID:22471258

Stark, Birgit; Emanuelsson, Peter; Gunnarsson, Ulf; Strigård, Karin



Contractile properties and temperature sensitivity of the extraocular muscles, the levator and superior rectus, of the rabbit.  

PubMed Central

1. Contractile and fatigue-resistance characteristics, temperature sensitivity (10-37 degrees C) of contraction, and histochemical fibre types were determined for two of the extraocular muscles, the superior rectus and levator palpebrae superioris (levator), of the rabbit. 2. The levator displayed similar contractile characteristics (time to peak, half-relaxation time of twitch response, and twitch-tetanus force ratio) to mammalian fast-twitch limb muscle at room temperature (20 degrees C). However, normalized twitch and tetanic force levels were significantly less than those found in limb muscle. The superior rectus displayed the characteristics of even faster contraction than the levator at 20 degrees C, but generated lower maximum force levels than the levator. 3. The twitch response of the superior rectus showed a biphasic relaxation phase. This response was not due to non-twitch (tonic) fibres present in the superior rectus as it was unaffected by propranolol application during muscle stimulation. 4. The superior rectus and levator displayed significantly less fatigue in the tetanic force response than fast-twitch limb muscles did in response to a fatiguing electrical stimulation protocol. The levator was significantly more fatigue resistant than the superior rectus. 5. The force responses of both extraocular muscles displayed a similar dependence on temperature (10-37 degrees C) to limb skeletal muscles. 6. The superior rectus and levator exhibited a high proportion of fast-twitch muscle fibres (type II) as shown by myosin ATPase staining. Succinate dehydrogenase activity indicated that these muscles showed a high oxidative capacity, with a staining intensity typical of type I or type II A fibres of limb muscles. 7. The results emphasize the morphological and functional complexity of mammalian extraocular muscles. The combination of very fast contractile properties with high oxidative capacity make these muscles well suited to their role in eye/eyelid movement.

Frueh, B R; Hayes, A; Lynch, G S; Williams, D A



Rectus femoris muscle injuries in football: a clinically relevant review of mechanisms of injury, risk factors and preventive strategies.  


Quadriceps muscle strains frequently occur in sports that require repetitive kicking and sprinting, and are common in football in its different forms around the world. This paper is a review of aetiology, mechanism of injury and the natural history of rectus femoris injury. Investigating the mechanism and risk factors for rectus femoris muscle injury aims to allow the development of a framework for future initiatives to prevent quadriceps injury in football players. PMID:22864009

Mendiguchia, Jurdan; Alentorn-Geli, Eduard; Idoate, Fernando; Myer, Gregory D



[Myosonographic evaluation of rectus abdominis muscle function after DIEP flap breast reconstruction].  


Donor-site morbidity following autologous breast reconstruction is a well-known disadvantage of free or pedicled TRAM flaps. Bulging and weakness of the abdominal wall and sometimes even hernias occur. Due to recent technical advances in microsurgery, there are different possibilities for breast reconstruction like the deep inferior epigastric perforator (DIEP) flap which is harvested without rectus muscle. First studies describe good aesthetic results without the complication of hernias and disadvantage of abdominal wall weakness. Myosonography is a new method to test the dynamic rectus muscle function and evaluate the donor-site morbidity after DIEP flap breast reconstruction. This study aims to analyze the value of myosonographic measurements to evaluate the donor-site morbidity following perforator flap elevation of the abdominal wall. Between November 2000 and August 2001, 34 patients at the Markus Hospital in Frankfurt/Main, Germany received breast reconstruction with a DIEP flap. Myosonographic examinations pre- and postoperatively were performed. Furthermore, clinical testing of rectus muscle function with the Janda score in combination with a questionnaire about impairment in daily activities and subjective opinion about discomfort took place. Two months postoperatively, myosonography showed almost identical rectus muscle function at the side of the vessel preparation compared to the contralateral side. Good aesthetic results were also achieved. The absolute muscle thickness at maximum contraction and the difference of muscle thickness between relaxation and contraction were almost identical on both sides. Myosonography is a non-invasive and inexpensive method to test rectus muscle function providing exact and reliable data. Results of this study confirm the hypothesis of lower donor-site morbidity caused by DIEP flaps compared to free or pedicled TRAM flaps. The DIEP flap method for autologous breast reconstruction is highly accepted by patients because of good aesthetic results combined with the lowest possible donor-site morbidity. After more than 180 DIEP flaps with good aesthetic results without abdominal wall hernias this method has become the "gold standard" for autologous breast reconstruction in our department. PMID:12601605

Kässmann, C; Peek, A; Luxenhofer, F; Scheufler, O; Exner, K



Muscle architecture adaptations to knee extensor eccentric training: Rectus femoris vs. vastus lateralis.  


Introduction: Changes in muscle architecture induced by eccentric knee extensor training remain unclear, as well the adaptive responses of synergistic knee extensor muscles with different geometrical designs. Methods: Ultrasonography images were taken from rectus femoris (RF) and vastus lateralis (VL) of 20 male volunteers before and after a non-training control period of 4 weeks, and additional evaluations were performed after 4, 8, and 12 weeks of isokinetic eccentric training. Results: RF and VL had significant changes in muscle architecture within the first 4 training weeks, and the adaptive response throughout the intervention was similar. Muscle thickness increased by around 7-10%, fascicle length increased 17-19%, and pennation angle was unchanged. Conclusions: Increased muscle thickness due to eccentric training was related to increased fascicle length and not to pennation angle changes. Although RF and VL have a different fascicular geometry, they had similar morphological adaptations to eccentric training. Muscle Nerve 48: 498-506, 2013. PMID:23852989

Baroni, Bruno Manfredini; Geremia, Jeam Marcel; Rodrigues, Rodrigo; De Azevedo Franke, Rodrigo; Karamanidis, Kiros; Vaz, Marco Aurélio



Hydatid cyst in rectus abdominis muscle in a child: An unusual occurrence.  


Hydatid cysts usually involve the liver; extrahepatic localization is reported in 11% of all cases of abdominal hydatid disease. Cyst at unusual localization includes kidney, heart, spleen, pancreas and brain. Isolated involvement of muscle is also rare in children. Here is a case of hydatid cyst in a female child involving the rectus abdominis muscle, which is a very rare presentation. There were no cysts in any other location. Serological tests were negative for cystic echinococcosis. The patient was operated on and the cyst was completely excised. The pathologic examination confirmed the diagnosis of hydatid cyst. PMID:23508209

Nag, Chiranjib; Ghosh, Mrinalkanti; Ghosh, Taraknath; Dey, Shamik; Maji, Pallabhi



Hydatid cyst in rectus abdominis muscle in a child: An unusual occurrence  

PubMed Central

Hydatid cysts usually involve the liver; extrahepatic localization is reported in 11% of all cases of abdominal hydatid disease. Cyst at unusual localization includes kidney, heart, spleen, pancreas and brain. Isolated involvement of muscle is also rare in children. Here is a case of hydatid cyst in a female child involving the rectus abdominis muscle, which is a very rare presentation. There were no cysts in any other location. Serological tests were negative for cystic echinococcosis. The patient was operated on and the cyst was completely excised. The pathologic examination confirmed the diagnosis of hydatid cyst.

Nag, Chiranjib; Ghosh, Mrinalkanti; Ghosh, Taraknath; Dey, Shamik; Maji, Pallabhi



Dynamic Rectus Abdominis Muscle Sphincter for Stomal Continence  

Microsoft Academic Search

Some life-saving surgeries result in the necessity to establish permanent intestinal stomas; this outcome has an undeniable physical and emotional effect on the patient's life. Although patients with permanent stomas reasonably adjust, complications that include peristomal skin irritation, pouching system dysfunction, social inhibition, depression, and sexual dysfunction also have been reported. \\u000aThe quest for intestinal stomal continence has resulted in

J. W. J. M. Bardoel



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


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

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


Functional Morphometry of Horizontal Rectus Extraocular Muscles during Horizontal Ocular Duction  

PubMed Central

Purpose. We explored multiple quantitative measures of horizontal rectus extraocular muscle (EOM) morphology to determine the magnetic resonance imaging (MRI) measure best correlating with duction and thus contractility. Methods. Surface coil coronal MRI was obtained in target-controlled central gaze and multiple positions of adduction and abduction in 26 orbits of 15 normal volunteers. Duction angles were determined by position changes of the globe-optic nerve junction. Cross-sectional areas, partial volumes, and location of peak cross-sections of the horizontal rectus EOMs were computed in contiguous image planes 2-mm thick spanning the EOM origins to the globe equator. Results. All measures correlated significantly with duction angle (P < 0.0001). The best measures obtainable in single image planes were the maximum change in the cross-sectional area between equivalent image planes, with coefficients of determination R2 = 0.92 for medial rectus (MR) and 0.91 for lateral rectus (LR), and percentage change in maximum cross-section with R2 = 0.79 for MR and 0.78 for LR. The best partial volume measure of contractility was the change in partial volumes in four contiguous posterior planes (R2 = 0.86 MR and for 0.89 LR), particularly when combined with the corresponding change in partial volume for the antagonist EOM (R2 = 0.95 for MR and LR). Conclusions. EOM morphologic changes are highly correlated with degrees of duction and thus contractility. Both changes in single-plane maximum cross-sectional areas and posterior partial volumes provide accurate, quantitative measures of EOM contractility.

Clark, Robert A.; Demer, Joseph L.



Results of a combined adjustable recession and posterior fixation suture of the same vertical rectus muscle for incomitant vertical strabismus  

Microsoft Academic Search

Purpose: The posterior fixation suture (fadenoperation) is an effective treatment for complicated incomitant vertical strabismus. Traditional operative methods do not permit the simultaneous use of an adjustable recession of the same muscle. Methods: Seven patients with incomitant vertical strabismus and diplopia were treated with a combined adjustable recession and posterior fixation suture of the same vertical rectus muscle. Preoperative vertical

Darren L. Hoover



Thickness of Rectus Abdominis Muscle and Abdominal Subcutaneous Fat Tissue in Adult Women: Correlation with Age, Pregnancy, Laparotomy, and Body Mass Index  

PubMed Central

Background Rectus abdominis muscle and abdominal subcutaneous fat tissue are useful for reconstruction of the chest wall, and abdominal, vaginal, and perianal defects. Thus, preoperative evaluation of rectus abdominis muscle and abdominal subcutaneous fat tissue is important. This is a retrospective study that measured the thickness of rectus abdominis muscle and abdominal subcutaneous fat tissue using computed tomography (CT) and analyzed the correlation with the patients' age, gestational history, history of laparotomy, and body mass index (BMI). Methods A total of 545 adult women were studied. Rectus abdominis muscle and abdominal subcutaneous fat thicknesses were measured with abdominopelvic CT. The results were analyzed to determine if the thickness of the rectus abdominis muscle or subcutaneous fat tissue was significantly correlated with age, number of pregnancies, history of laparotomy, and BMI. Results Rectus abdominis muscle thicknesses were 9.58 mm (right) and 9.73 mm (left) at the xiphoid level and 10.26 mm (right) and 10.26 mm (left) at the umbilicus level. Subcutaneous fat thicknesses were 24.31 mm (right) and 23.39 mm (left). Rectus abdominismuscle thickness decreased with age and pregnancy. History of laparotomy had a significant negative correlation with rectus abdominis muscle thickness at the xiphoid level. Abdominal subcutaneous fat thickness had no correlation with age, number of pregnancies, or history of laparotomy. Conclusions Age, gestational history, and history of laparotomy influenced rectus abdominis muscle thickness but did not influence abdominal subcutaneous fat thickness. These results are clinically valuable for planning a rectus abdominis muscle flap and safe elevation of muscle flap.

Kim, Jungmin; Lim, Hyoseob; Lee, Se Il



Efficacy and mechanism of hypoxic postconditioning in salvage of ex vivo human rectus abdominis muscle from hypoxia/reoxygenation injury.  


In reconstructive surgery, skeletal muscle may endure protracted ischemia before reperfusion, which can lead to significant ischemia/reperfusion injury. Ischemic postconditioning induced by brief cycles of reperfusion/reocclusion at the end of ischemia has been shown to salvage skeletal muscle from ischemia/reperfusion injury in several animal models. However, ischemic postconditioning has not been confirmed in human skeletal muscle. Using an established in vitro human skeletal muscle hypoxic conditioning model, we tested our hypothesis that hypoxic postconditioning salvages ex vivo human skeletal muscle from hypoxia/reoxygenation injury and the mechanism involves inhibition of opening of the mitochondrial permeability transition pore (mPTP) and preservation of ATP synthesis. Muscle strips (~0.5×0.5×15mm) from human rectus abdominis muscle biopsies were cultured in Krebs-Henseleit-HEPES buffer, bubbled with 95%N(2)/5%CO(2) (hypoxia) or 95%O(2)/5%CO(2) (reoxygenation). Samples were subjected to 3h hypoxia/2h reoxygenation. Hypoxic postconditioning was induced by one or two cycles of 5min reoxygenation/5min hypoxia after 3h hypoxia. Muscle injury, viability and ATP synthesis after 2h of reoxygenation were assessed by measuring lactate dehydrogenase (LDH) release, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) reduction and ATP content, respectively. Hypoxic postconditioning or treatment with the mPTP-opening inhibitors Cyclosporine A (CsA, 5×10(-6)M) or N-Methyl-4-isoleucine Cyclosporine (NIM811, 5×10(-6)M) 10min before reoxygenation decreased LDH release, increased MTT reduction and increased muscle ATP content (n=7 patients; P<0.05). Conversely, treatment with the mPTP opener Atractyloside (5×10(-6)M) 10min before hypoxic postconditioning abolished its protective effect (n=7 patients; P<0.05). We conclude that hypoxic postconditioning effectively salvages human skeletal muscle from hypoxia/reoxygenation injury by inhibition of mPTP opening and preservation of ATP synthesis during reoxygenation. PMID:22575519

Naparus, Andreas; Ashrafpour, Homa; Hofer, Stefan O P; Zhong, Toni; Huang, Ning; Cahoon, Neil J; McAllister, Sandra E; Neligan, Peter C; Roy, Trisha; Lipa, Joan E; Pang, Cho Y



A study of the effect of pregnancy on muscle fibers of the rectus abdominis muscle of the rat.  


Samples of the rectus abdominis muscle were taken from Sprague-Dawley rats at 0, 3, 6, 6, 12, 15, 18, and 21 days of pregnancy, and at 1, 3, 6, 9, 12, and 15 days of postpartum. Sections were incubated for actomyosin adenosine triphosphatase activity following preincubation at a basic pH. Muscle fibers within a unit area of each sample were identified as to fiber type according to their enzyme activity, and the population of each type counted. The proportion of each fiber type was calculated and the diameter of 24 fibers of each type measured. No changes were noted in the muscle fiber proportions through the course of the experiment. Differential changes in muscle fiber diameters were noted in each of the three muscle fiber types. Slow oxidative fibers underwent an increase in diameter through the last half of pregnancy. The diameter was further increased as stretch of the muscle was released after birth, and did not decrease in the postpartum period. Fast glycolytic fibers decreased in diameter during the last half of pregnancy, but returned to the prepregnancy diameter in the first postpartum day. The diameter of the fast oxidative glycolytic fibers remained unchanged through the course of pregnacy and in the postpartum period. PMID:159648

Martin, W D



Fascicular Specialization in Human and Monkey Rectus Muscles: Evidence for Anatomic Independence of Global and Orbital Layers  

PubMed Central

Purpose Connective tissue pulleys inflect the extraocular muscles (EOMs) and receive insertions from some fibers. The authors investigated insertions and anatomic relationships of fiber fascicles within rectus EOMs to clarify the relationship to their pulleys. Methods Two human and two monkey orbits were removed intact, serially sectioned in the coronal plane, histologically stained, and digitally photographed. The authors traced representative fascicles in the human medial rectus (MR) and inferior rectus and monkey lateral rectus and superior rectus muscles. In the human MR, the authors computed average collagen fractions in the orbital layer (OL) and the global layer (GL). Results In human and monkey, OL fascicles remained distinct from each other and from the GL throughout. Most OL fascicles were inserted into the pulley through short tendons. Most GL fascicles bypassed the pulley without insertion. Collagen content in the human MR OL increased from 29% ± 5% (SD) in midorbit to 65% ± 9% in the anterior orbit but slightly decreased from 26% ± 6% to 23% ± 1% in the GL. Tracing of every fiber in a human MR OL fascicle demonstrated terminations on pulley tendons without myomyous junctions. Conclusions Fibers in the primate rectus OL lack myomyous or GL junctions, but nearly all insert on the pulley through a broad distribution of short tendons and dense intercalated collagen. Fibers in the GL generally do not insert on pulley tissues and are associated with less collagen. These features support the distinct role of the OL in anteroposterior positioning of connective tissues proposed in the active pulley hypothesis and substantial mechanical independence of the OL and GL.

Lim, Key Hwan; Poukens, Vadims; Demer, Joseph L.



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


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

Sinsel, N K; Guelinckx, P J


Short-term effects of botulinum toxin on the lateral rectus muscle of the cat  

Microsoft Academic Search

.   Botulinum toxin type A (BTX) is often used as an alternative to surgery for the treatment of strabismus and many other motor\\u000a or cosmetic problems. Although numerous studies established BTX as a powerful transmission-blocking agent at the neuromuscular\\u000a junction, no evaluation of extraocular muscle (EOM) contractile properties after administration of BTX exists. Some anatomical\\u000a studies on EOM fiber types

Diana M. Dimitrova; Mary S. Shall; Stephen J. Goldberg



Salvage of infected vascular graft via 'perivascular venous banding' technique coupled with rectus abdominis myocutaneous muscle flap transposition.  


This is the case of a severe Pseudomonas aeruginosa biological vascular graft infection, completely involving the perianastomotic tract of a femoro - femoral crossover bypass and resulting in repeated bleeding from the offended vessel wall. After the failure of a sartorious rotational muscle flap transposition into the infected groin wound, this 'high-grade' vascular graft infection was finally treated successfully by wrapping a great saphenous vein patch reinforcement circumferentially around the damaged biological vascular conduit and filling the infected wound with a rectus abdominis myocutaneous muscle flap transposition. The aim of this report is to illustrate this novel, to our knowledge, 'perivascular venous banding' technique and to evaluate the prospective of future testing of this surgical procedure. Starting from this singular case, we will also review the role of the rotational muscle flaps in the conservative management of major vascular graft infections. PMID:22375043

De Santis, F; Chaves Brait, C M; Caravelli, G; Pompei, S; Di Cintio, V



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

PubMed Central

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.

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



A Case of Extrusion of a Solid Silicone Tire Migrating through the Superior Rectus Muscle with Aeromonas hydrophila Infection following a Scleral Buckling Procedure.  


To our knowledge, there are no reports of Aeromonas hydrophila infection after a scleral buckling procedure. Also, migration of a silicone explant element through the rectus muscles is extremely rare. Herein, we describe a case experiencing extrusion of a solid silicone tire migrating through the superior rectus muscle with Aeromonas hydrophila infection following a scleral buckling procedure. A 42-year-old man was referred to our hospital complaining of ocular pain and purulent discharge in his left eye which has persisted for several months. He had a history of bilateral rhegmatogenous retinal detachment which had been treated with scleral buckling. The left eye showed extrusion of the solid silicone buckle which had migrated through the superior rectus muscle and an infection in the upper quadrant of the sclera. The buckle was removed, and the patient was treated with antibiotics. After the removal of the buckle, the symptoms showed rapid amelioration and there was no recurrence of retinal detachment. Aeromonas hydrophila was isolated from the discharge and the removed explant. He used well water in daily life. In this case, the Aeromonas hydrophila infection of the extruded buckle might have originated from contaminated well water. PMID:23213585

Makino, Shinji; Sato, Yukihiro



Three horizontal muscle surgery for large-angle infantile esotropia: validation of a table of amounts of surgery  

PubMed Central

Purpose To validate a table of amounts of three horizontal muscle surgery in patients with large-angle infantile esotropia (?60 prism dioptres, PD). Methods A prospective interventional case series reporting the postoperative alignment of 51 patients (27 male, 24 female) over a 15-year period was conducted. Surgery amounts were according to a published table developed on a previous patient cohort (n=49), using bilateral medial rectus recession with graded unilateral lateral rectus resection. Kaplan–Meier life-table survival curves were formulated for success to orthotropia (±10?PD) after one and subsequent horizontal muscle surgeries for up to 8 years follow-up. Results The median preoperative deviation was 65?PD (range 60–80?PD) and median age at surgery was 11.8 months (range 5.1 months–3.6 years). Surgical success to orthotropia (±10?PD) after one surgery was 100% at 2 months, 95.7% at 6 months, 91.3% at 12 months, 77.8% at 4 years, and 73.6% at 8 years. Postoperative failure requiring further horizontal surgery occurred in 17.6% (residual esotropia 4, consecutive exotropia 5). Conclusions Our second cohort has reproduced the success rate of the previous cohort (77.8% vs 77.1% at 4 years). If the published table of surgical amounts is used, three horizontal muscle surgery in large-angle infantile esotropia (?60?PD) appears to have a good long-term success rate, and does not lead to the high rates of either residual esotropia or consecutive exotropia reported by others in the literature.

Camuglia, J E; Walsh, M J; Gole, G A



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

PubMed Central

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 ?-pyridylmethyltrimethylammonium (and by nicotine) were measured. The equipotent molar ratios of all the agonists were measured relative to ?-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-releasing or withdrawing nature and other properties, such as their polar and lipophilic or lipophobic character. 5. There is no obvious correlation between the effects of a substituent on the affinity of the diethylamino or triethylammonium compounds and its effects on the activity of the trimethylammonium analogue. The most active compounds contain hydroxy- and amino-, phenyl or ?-pyridyl groups, m-hydroxyphenyl-propyltrimethylammonium being about 50 times as active as nicotine, but the corresponding diethylamino or triethylammonium compounds do not have high affinity. There does not seem necessarily to be an inverse relationship between activity and affinity, however, because some m-nitro and m-chloro trimethylammonium compounds have considerable activity and the analogous triethylammonium compounds have considerable affinity. 6. It is suggested that ability to activate these receptors is associated with the presence of substituents which can interact with water molecules which may be involved in the action of the drug at the receptor.

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



Transcatheter Arterial Embolization of Concurrent Spontaneous Hematomas of the Rectus Sheath and Psoas Muscle in Patients Undergoing Anticoagulation  

SciTech Connect

We report a case of concurrent rectus sheath and psoas hematomas in a patient undergoing anticoagulant therapy, treated by transcatheter arterial embolization (TAE) of inferior epigastric and lumbar arteries. Computed tomography (CT) demonstrated signs of active bleeding in two hematomas of the anterior and posterior abdominal walls. Transfemoral arteriogram confirmed the extravasation of contrast from the right inferior epigastric artery (RIEA). Indirect signs of bleeding were also found in a right lumbar artery (RLA). We successfully performed TAE of the feeding arteries. There have been few reports in the literature of such spontaneous hemorrhages in patients undergoing anticoagulation, successfully treated by TAE.

Basile, Antonio [Ospedale Barone I, Department of Radiology (Italy); Medina, Jose Garcia [Hospital Universitario Virgen de Arrixaca, Department of Radiology (Spain); Mundo, Elena [Ospedale Barone I, Department of Radiology (Italy); Medina, Vicente Garcia [Hospital General Universitario, Department of Radiology (Spain); Leal, Rafael [Hospital Universitario Virgen de Arrixaca, Department of Radiology (Spain)



SOD mRNA and MDA Expression in Rectus Femoris Muscle of Rats with Different Eccentric Exercise Programs and Time Points  

PubMed Central

Purpose Although superoxide dismutase (SOD) and malondialdehyde (MDA) affect Delayed Onset Muscle Soreness (DOMS), their effects are unclear in rectus femoris muscles (RFM) of rats with different eccentric exercise programs and time points. The purpose of this study is to investigate the effects of the various eccentric exercise programs at different time points on the SOD mRNA expression and MDA using rat as the animal model. Methods 248 male rats were randomly divided into 4 groups: control group (CTL, n?=?8), once-only exercise group (OEG, n?=?80), continuous exercise group (CEG, n?=?80), and intermittent exercise group (IEG, n?=?80). Each exercise group was divided into 10 subgroups that exercised 0.5 h, 6 h, 12 h, 24 h, 48 h, 72 h, 96 h, 120 h, 144 h, or 168 h. Rats were sacrificed and their SOD mRNA expression, and MDA concentrations of skeletal muscle tissue were measured. Results The specimen in all eccentric exercise programs showed increased RFM SOD1 mRNA expression levels at 0.5 h (P<0.05), and decreased RFM SOD3 mRNA expression at 0.5 h (P<0.05). The continuous eccentric exercise (CE) significantly enhanced muscle SOD2 mRNA level at 0.5 h (P<0.05). After once-only eccentric exercise (OE), SOD1, SOD2, and SOD3 mRNA expression significantly increased at 96 h, whereas MDA concentrations decreased at 96 h. After CE, the correlation coefficients of SOD1, SOD2, SOD3 mRNA expression levels and MDA concentrations were ?0.814, ?0.763, ?0.845 (all P<0.05) at 12 h. Conclusion Regular eccentric exercise, especially CE could enhance SOD1 and SOD2 mRNA expression in acute stage and the SOD2 mRNA expression correlates to MDA concentration in vivo, which may improve the oxidative adaption ability of skeletal muscles.

Zhao, Heng; Liu, Jiani; Pan, Shinong; Sun, Yingwei; Li, Qi; Li, Fei; Ma, Li; Guo, Qiyong



The Role of Thyroid Eye Disease and Other Factors in the Overcorrection of Hypotropia Following Unilateral Adjustable Suture Recession of the Inferior Rectus (An American Ophthalmological Society Thesis)  

PubMed Central

Purpose Overcorrection of hypotropia subsequent to adjustable suture surgery following inferior rectus recession is undesirable, often resulting in persistent diplopia and reoperation. I hypothesized that overcorrection shift after suture adjustment may be unique to thyroid eye disease, and the use of a nonabsorbable suture may reduce the occurrence of overcorrection. Methods A retrospective chart review of adult patients who had undergone eye muscle surgery with an adjustable suture technique was performed. Overcorrection shifts that occurred between the time of suture adjustment and 2 months postoperatively were examined. Descriptive statistics, linear regression, Anderson-Darling tests, generalized Pareto distributions, odds ratios, and Fisher tests were performed for two overcorrection shift thresholds (>2 and >5 prism diopters [PD]). Results Seventy-seven patients were found: 34 had thyroid eye disease and inferior rectus recession, 30 had no thyroid eye disease and inferior rectus recession, and 13 patients had thyroid eye disease and medial rectus recession. Eighteen cases exceeded the 2 PD threshold, and 12 exceeded the 5 PD threshold. Statistical analyses indicated that overcorrection was associated with thyroid eye disease (P=6.7E-06), inferior rectus surgery (P=6.7E-06), and absorbable sutures (>2 PD: OR=3.7, 95% CI=0.4–35.0, P=0.19; and >5 PD: OR=6.0, 95% CI=1.1–33.5, P=0.041). Conclusions After unilateral muscle recession for hypotropia, overcorrection shifts are associated with thyroid eye disease, surgery of the inferior rectus, and use of absorbable sutures. Surgeons performing unilateral inferior rectus recession on adjustable suture in the setting of thyroid eye disease should consider using a nonabsorbable suture to reduce the incidence of postoperative overcorrection.

Kerr, Natalie C.



Early detection of subclinical organ dysfunction by microdialysis of the rectus abdominis muscle in a porcine model of critical intra-abdominal hypertension.  


The aim of this study was to evaluate microdialysis of the rectus abdominis muscle (RAM) for early detection of subclinical organ dysfunction in a porcine model of critical intra-abdominal hypertension (IAH). Microdialysis catheters for analyses of lactate, pyruvate, and glycerol levels were placed in cervical muscles (control), gastric and jejunal wall, liver, kidney, and RAM of 30 anesthetized mechanically ventilated pigs. Catheters for venous lactate and interleukin 6 samples were placed in the jugular, portal, and femoral vein. Intra-abdominal pressure (IAP) was increased to 20 mmHg (IAH20 group, n = 10) and 30 mmHg (IAH30, n = 10) for 6 h by controlled CO2 insufflation, whereas sham animals (n = 10) exhibited a physiological IAP. In contrast to 20 mmHg, an IAH of 30 mmHg induced pathophysiological alterations consistent with an abdominal compartment syndrome. Microdialysis showed significant increase in the lactate/pyruvate ratio in the RAM of the IAH20 group after 6 h. In the IAH30 group, the strongest increase in lactate/pyruvate ratio was detected in the RAM and less pronounced in the liver and gastric wall. Glycerol increased in the RAM only. After 6 h, there was a significant increase in venous interleukin 6 of the IAH30 group compared with baseline. Venous lactate was increased compared with baseline and shams in the femoral vein of the IAH30 group only. Intra-abdominal pressure-induced ischemic metabolic changes are detected more rapidly and pronounced by microdialysis of the RAM when compared with intra-abdominal organs. Thus, the RAM represents an important and easily accessible site for the early detection of subclinical organ dysfunction during critical IAH. PMID:22683730

Benninger, Emanuel; Laschke, Matthias W; Cardell, Markus; Holstein, Joerg H; Lustenberger, Thomas; Keel, Marius; Trentz, Otmar; Menger, Michael D; Meier, Christoph



An Original Technique for Bladder Autoaugmentation with Protective Abdominal Rectus Muscle Flaps: An Experimental Study in Rats  

Microsoft Academic Search

Background. Bladder autoaugmentation uses partial detrusorectomy to create a diverticular bulge in the bladder mucosa. This technique has eliminated certain serious complications of cystoplasty with gastrointestinal tissues (e.g., fluid\\/electrolyte\\/acid-base imbalances, mucous hypersecretion), but the exposed mucosa is subject to fibrosis and, sometimes, to perforation, which can annul the benefits of surgery.Methods. We have developed an original technique based on traditional

C. Manzoni; A. Grottesi; C. D'Urzo; C. Pintus; G. Fadda; L. Perrelli



Rectus sheath haematoma or leaking aortic aneurysm - a diagnostic challenge: a case report  

Microsoft Academic Search

INTRODUCTION: A rectus sheath haematoma is a rare condition that arises from the accumulation of blood within the rectus sheath from either muscular tear or rupture of the epigastric vessels. It is a known complication of either blunt abdominal trauma, anticoagulation therapy or the repetitive contraction of the rectus muscle such as paroxysms of coughing. It remains an uncommon and

Aidan G Shaw; Simon Fleming; Polly Drew; Jonathan N Lund; Manjeet Riyat



Transient Increase of Higher-Order Aberrations after Lateral Rectus Recession in Children  

PubMed Central

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.

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



Why should surgery for early-onset strabismus be postponed?  

Microsoft Academic Search

The author presents a continued study of 82 cases of pseudoparalysis of the bilateral rectus muscles in early-onset convergent strabismus following early surgery. Up to 10 years after surgery motor results show that 72% of cases remain within +\\/- 10 prism dioptres after a single surgical procedure. Sensorial findings corroborate the results of other authors' studies in that binocular association

M. Deller



Nutritional status and muscle amino acids in children with end-stage renal failure  

Microsoft Academic Search

Nutritional status and muscle amino acids in children with end-stage renal failure. Nutritional status, assessed by anthropometric and biochemical methods, and muscle water, protein and amino acid composition, were evaluated in a control group of 10 children with normal renal function who were undergoing elective surgery, and in 15 children with end-stage chronic renal failure. Samples of the rectus abdominis

Alberto Canepa; José C Divino Filho; Ann-Marie Forsberg; Francesco Perfumo; Alba Carrea; Rosanna Gusmano; Jonas Bergström



[Rectus sheath block and transversus abdominis plane block for a patient with Lambert-Eaton myasthenic syndrome undergoing low anterior resection].  


A 55-year-old male with Lambert-Eaton myasthenic syndrome underwent low anterior resection. Before anesthetic induction, his arterial blood gas analysis showed chronic hypercapnia (pH 7.404, Paco2 59 mmHg, BE 9.1). Anesthesia was induced with propofol, remifentanil and ketamine. Uneventful tracheal intubation was achieved after superior laryngeal nerve block without using muscle relaxants. Then ultrasound-guided bilateral rectus sheath block and transversus abdominis plane block were performed using 60 ml of 0.375% ropivacaine. Anesthesia was maintained with propofol, remifentanil monitoring bispectral index. Good surgical condition was maintained even without using muscle relaxants. Although only a small amount of morphine was required during the early postoperative days, his postoperative course was smooth and uneventful. The present case shows that ultrasound-guided rectus sheath block and transversus abdominis plane block are safe and useful for abdominal surgery in patients with neuromuscular disease. PMID:23984583

Kimura, Futoshi; Oishi, Masafumi; Yakoshi, Chihiro; Ogasawara, Chihiro; Ishihara, Hironori; Hirota, Kazuyoshi



Differential Lateral Rectus Compartmental Contraction during Ocular Counter-Rolling  

PubMed Central

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.

Clark, Robert A.; Demer, Joseph L.



Effect of fibrin glue as an adjuvant to hang-back surgery  

PubMed Central

Background The hang-back surgery is a useful technique in the field of strabismus surgery. The aim of this study is to determine the stabilizing effects of fibrin glue as an adjuvant to hang-back surgery. Materials and methods Four (4)-mm hang-back recessions of the superior rectus muscle was performed in 32 eyes of 16 rabbits. Only in the left eye of the 16 rabbits, fibrin glue was applied between the recessed muscle bed and the sclera at the end of hang-back surgery (fibrin glue group). After 6?weeks, we compared the stability of the recessed rectus muscle between the fibrin glue group and the control group by evaluating the displacement of the muscle. Results The frequency of stable insertion of the recessed muscle at the intended site was greater in the fibrin glue group (9 eyes) compared to the control group (3 eyes) (p?=?0.028). In the control group, 5 eyes showed anterior displacement and 8 eyes showed posterior displacement and in the fibrin glue group, 1 eye showed anterior displacement, and 6 eyes showed posterior displacement. Anterior displacement was more common in the control group (6.3% Vs 31.3%). The control group and the fibrin glue group showed similar histological findings on microscopic examination. Conclusions Fibrin glue is effective in stabilizing the new rectus muscle insertion and decreasing the displacement in the hang-back surgery.



Fetal surgery for repair of myelomeningocele allows normal development of anal sphincter muscles in sheep.  


One major problem for patients with myelomeningocele (MMC) is fecal incontinence. To prevent this problem, fetal surgery for repair of MMC has been recently undertaken. The strategy behind this surgery is to allow normal development of anal sphincter muscles. The purpose of this study was to determine whether fetal surgery for repair of MMC allows normal development of anal sphincter muscles. Myelomeningocele was surgically created in fetal sheep at 75 days of gestation. At 100 days of gestation, fetal surgery for repair of the MMC lesion was performed. Three repair methods were used: standard neurosurgical repair (4 fetal sheep), covering the MMC lesion with Alloderm (2 fetal sheep), and covering the MMC lesion with Gore-Tex (2 fetal sheep). After the sheep were delivered (140 days of gestation), external and internal anal sphincter muscles were analyzed histopathologically. In control fetal sheep (not repaired) anal sphincter muscles did not develop normally. In contrast, in fetal sheep that underwent repair of the MMC, the external and internal anal sphincter muscles developed normally. Histopathologically, in the external sphincter muscles, muscle fibers were dense. In the internal sphincter muscles, endomysial spaces were small, myofibrils were numerous, and fascicular units were larger than those in unrepaired fetal sheep. There was no difference in muscle development for the repair methods. Fetal surgery for repair of MMC allows normal development of anal sphincter muscles. PMID:14689212

Yoshizawa, Jyoji; Sbragia, Lourenco; Paek, Bettina W; Sydorak, Roman M; Yamazaki, Yoji; Harrison, Michael R; Farmer, Diana L



Inferior Oblique Surgery for Restrictive Strabismus in Patients with Thyroid Orbitopathy  

PubMed Central

Introduction: Thyroid orbitopathy is the most common cause of restrictive strabismus. Patients often present with vertical or horizontal double vision, or both, due to restriction involving most commonly the inferior and medial rectus muscles. Traditional muscle surgery involves release of the tight muscles. Previous literature has described a frequent need for secondary operations and an overcorrection incidence of up to 50%. Recognizing that the tight muscles are also limited in their excursion, it was proposed that operating on the better-moving eye, particularly the inferior oblique, might produce an improvement in binocularity and decrease the incidence of overcorrection. Methods: A total of 37 patients with restrictive strabismus due to thyroid orbitopathy treated at the University of Virginia over 12 years with inferior oblique surgery were retrospectively reviewed. Results: Eight patients were treated with a combination of inferior oblique surgery and horizontal muscle surgery at the same time. One patient was treated with simultaneous inferior oblique and superior rectus surgery. Seven patients had vertical correction with inferior oblique surgery alone. Twenty-three patients required secondary procedures. Eight patients were overcorrected but only one following primary surgery. At the time of last follow-up, ranging from 6 months to 8 years, 33 patients had no diplopia, 2 had minimal diplopia, and 2 had persistent diplopia. All but two were completely functional. Conclusion: Inferior oblique surgery by balancing the overall excursion of extraocular muscles in thyroid patients may produce binocularity in primary position and down reading gaze. The amount of vertical correction from inferior oblique surgery alone is limited, often requiring ipsilateral superior or contralateral inferior rectus surgery. Inferior oblique surgery likely increases the area of binocular single vision and decreases the incidence of overcorrection. The use of Hess screen and binocular single vision fields is helpful in assessment and planning of surgery in these patients.

Newman, Steven A.



Muscle lengthening surgery causes differential acute mechanical effects in both targeted and non-targeted synergistic muscles.  


Epimuscular myofascial force transmission (EMFT) is a major determinant of muscle force exerted, as well as length range of force exertion. Therefore, EMFT is of importance in remedial surgery performed, e.g., in spastic paresis. We aimed to test the following hypotheses: (1) muscle lengthening surgery (involving preparatory dissection (PD) and subsequent proximal aponeurotomy (AT)) affects the target muscle force exerted at its distal and proximal tendons differentially, (2) forces of non-operated synergistic muscles are affected as well, (3) PD causes some of these effects. In three conditions (control, post-PD, and post-AT exclusively on m. extensor digitorum longus (EDL)), forces exerted by rat anterior crural muscles were measured simultaneously. Our results confirm hypotheses (1-2), and hypothesis (3) in part: Reduction of EDL maximal force differed by location (i.e. 26.3% when tested distally and 44.5% when tested proximally). EDL length range of active force exertion increased only distally. Force reductions were shown also for non-operated tibialis anterior (by 11.9%), as well as for extensor hallucis longus (by 8.4%) muscles. In tibialis anterior only, part of the force reduction (4.9%) is attributable to PD. Due to EMFT, remedial surgery should be considered to have differential effects for targeted and non-targeted synergistic muscles. PMID:23837929

Ate?, Filiz; Ozde?lik, Rana N; Huijing, Peter A; Yucesoy, Can A



Fat adherence syndrome after retinal surgery treated with amniotic membrane transplantation  

Microsoft Academic Search

PURPOSE: We present favorable results with amniotic membrane transplantation in a patient who developed fat adherence syndrome after retinal surgery.DESIGN: Interventional case report.METHODS: A 37-year-old man had diplopia resulting from hypotropia of the left eye after retinal detachment surgery. Removal of a previously implanted silicon sponge had little effect because of fibrous adhesion between the inferior rectus muscle and adjacent

Masakazu Yamada; Kei Shinoda; Akira Hatakeyama; Sachiko Nishina; Yukihiko Mashima



Ocular motility disorders secondary to sinus surgery.  


Sinus surgery has multiple potential ocular complications including visual loss, diplopia, infection, hemorrhage, and epiphora. We report six patients with ocular motility problems secondary to sinus surgery, review the literature on ocular motility disorders secondary to sinus surgery, and propose an approach for management of those ocular motility problems following sinus surgery. Intranasal sinus surgery was found to be the most common procedure resulting in injury to an extraocular muscle and the ethmoid sinus the most common structure being operated on when injury occurred. The medial rectus was the muscle most commonly injured and it had the poorest prognosis for recovery of functional vision free of diplopia. Optimal timing for repair depends on the structure injured, but early recognition and management appear to be a key to the best outcome for these injuries. PMID:8443115

Penne, R B; Flanagan, J C; Stefanyszyn, M A; Nowinski, T



Medial Rectus Recession Is as Effective as Lateral Rectus Resection in Divergence Paralysis Esotropia  

PubMed Central

Objective To propose medial rectus (MR) recession to be equally as effective as lateral rectus (LR) resection, which has heretofore been the preferred treatment for divergence paralysis esotropia (DPE). Methods We examined a 17-year surgical experience comparing LR resection with MR recession in adults with DPE, defined as symptomatic distance esotropia (ET) at least double the asymptomatic ET of 10 or less prism diopters (?) at near. Results Twenty-four patients with DPE underwent surgery. Six patients underwent bilateral LR resection and 2 underwent unilateral LR resection (group L), while 13 underwent bilateral MR recession and 3 underwent unilateral MR recession, with the target angle double the distance ET (group M). One of 8 patients in group L and 15 of 16 patients in group M underwent intraoperative adjustable surgery under topical anesthesia. Mean (SD) preoperative central gaze ET measured 15.0 (7.7) ? at distance and 4.1 (3.4) ? at near in group L, but 10.4 (6.8) ? at distance and 0.6 (1.7) ? at near in group M (P=.15; distance, 0.003, near). Postoperatively, no patient in either group had symptomatic diplopia or convergence insufficiency in follow-up from 8.5 to 40 months. Twice the usual surgical dose of MR recession per prism diopter was required to achieve correction of the distance deviation in DPE as compared with that recommended for ET generally and also for LR resection in the same condition. Conclusions Recession of the MR provides binocular single vision in DPE without convergence insufficiency at near, and it is convenient for intraoperative adjustment under topical anesthesia.

Chaudhuri, Zia; Demer, Joseph L.



Bilateral rectus femoris intramuscular haematoma following simultaneous quadriceps strain in an athlete: a case report  

Microsoft Academic Search

INTRODUCTION: Bilateral rectus femoris haematoma following a simultaneous strain of the quadriceps muscles is a very rare condition. CASE PRESENTATION: We report the case of a 21-year-old Greek Caucasian female rowing athlete who was injured on both thighs. She complained of pain and inability to walk. Physical examination revealed tenderness over the thighs and restriction of knee movement. The result

Konstantinos Natsis; Christos Lyrtzis; Georgios Noussios; Efthymia Papathanasiou; Nikolaos Anastasopoulos; Trifon Totlis



Atrophy of the Deltoid Muscle Following Rotator Cuff Surgery  

Microsoft Academic Search

Results: The thickness of the anterior deltoid fibers did not change significantly after surgery in the mini-open repair group, whereas it was significantly decreased in the open repair group at six months as well as at twelve months postoperatively (p < 0.05). At three months postoperatively, the mean University of California at Los Angeles score for active forward flexion in



Vitamin E and C supplementation does not ameliorate muscle dysfunction after anterior cruciate ligament surgery  

Microsoft Academic Search

Muscle atrophy and weakness are predominant impairments after anterior cruciate ligament (ACL) surgical repair. We tested the hypothesis that vitamin E and C supplementation will improve recovery from ACL injury. Men undergoing elective ACL surgery were randomly assigned to twice-daily supplements of either antioxidants (AO; vitamins E and C, n=10) or matching placebos (n=10) from 2 weeks before until 3

Tyler Barker; Scott W. Leonard; Janet Hansen; Roy H. Trawick; Ronda Ingram; Graham Burdett; Katherine M. Lebold; James A. Walker; Maret G. Traber




Microsoft Academic Search

Objective: To study associations between pain, trunk muscle strength, flexibility and disability in patients with lumbar disc herniation 2 months after surgery. Design: Clinical cross-sectional survey. Participants: 172 operated lumbar disc herniation patients. Methods: Back and leg pain on Visual Analogue Scale, Oswestry Disability Index and Brief Depression Scale were applied to assess the subjectively perceived outcome. Isometric and dynamic

Arja Häkkinen; Jari Ylinen; Hannu Kautiainen; Olavi Airaksinen; Arto Herno; Ulla Tarvainen; Ilkka Kiviranta



Double elevator weakening for unilateral congenital superior oblique palsy with ipsilateral superior rectus contracture and lax superior oblique tendon.  


In unilateral congenital superior oblique palsy, a large hypertropia is sometimes associated with ipsilateral contracture of the superior rectus muscle and apparent overaction of the contralateral superior oblique. Ipsilateral double elevator weakening is one surgical approach; however, this procedure could compromise supraduction. We report a series of three consecutive patients who underwent ipsilateral superior rectus and inferior oblique recessions for unilateral superior oblique palsy. Intraoperatively, all three patients were found to have a lax ipsilateral superior oblique tendon. Postoperatively, all three patients had satisfactory correction of the hypertropia and abnormal head position with minimal supraduction defect. This procedure seems to be an acceptable initial surgical option for treating congenital superior oblique muscle palsy with ipsilateral contracture of the superior rectus muscle, even when the ipsilateral superior oblique tendon is lax. PMID:22681951

Khan, Arif O



Anatomical and mechanical relationship between the proximal attachment of adductor longus and the distal rectus sheath.  


The objectives of this study were to investigate the anatomical relationship between the proximal adductor longus (AL) and rectus abdominis muscles and to determine whether unilateral loading of AL results in strain transmission across the anterior pubic symphysis to the contralateral distal rectus sheath. Bilateral dissections were conducted on 10 embalmed cadavers. Strain transfer across the pubic symphysis was examined on seven of these cadavers. An AL contraction was simulated by applying a controlled load in the direction of its proximal tendinous fibers, and the resultant strain in the contralateral distal rectus sheath was measured using a foil-type surface mounted microstrain gage. Adductor longus attached to the antero-inferior aspect of the pubis. In 18 of the 20 limbs, the proximal attachment of AL was tendinous on its superficial surface and muscular on its deep surface. The proximal AL tendon was found in most instances to have secondary communications with structures such as the contralateral distal rectus sheath, pubic symphysis anterior capsule, ilio-inguinal ligament, and contralateral proximal AL tendon. Despite these consistent anatomical observations, strain measured in the contralateral distal rectus sheath upon unilateral loading of the proximal AL varied considerably between cadavers. Measured strain had an average ± 1SD of 0.23 ± 0.43%. The proximal attachment of AL contributes to an anatomical pathway across the anterior pubic symphysis that is likely required to withstand the transmission of large forces during multidirectional athletic activities. This anatomical relationship may be a relevant factor in explaining the apparent vulnerability of the AL and rectus abdominis attachments to injury. PMID:23553712

Norton-Old, Kimberley J; Schache, Anthony G; Barker, Priscilla J; Clark, Ross A; Harrison, Simon M; Briggs, Christopher A



Effects of Inspiratory Muscle Training on Muscular and Pulmonary Function After Bariatric Surgery in Obese Patients  

Microsoft Academic Search

Background  This study seeks to assess the effect of inspiratory muscle training (IMT) on pulmonary function, respiratory muscle strength,\\u000a and endurance in morbidly obese patients submitted to bariatric surgery.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Thirty patients were randomly assigned to sham muscular training, or to IMT with a threshold device (40% of maximum inspiratory\\u000a pressure, MIP), for 30 min\\/day, from the 2nd until 30th postoperative (PO) day.

Carla Cristine Cunha Casali; Ana Paula Manfio Pereira; José Antônio Baddini Martinez; Hugo Celso Dutra de Souza; Ada Clarice Gastaldi


Frontalis suspension with fascia lata for severe congenital blepharoptosis using enhanced involuntary reflex contraction of the frontalis muscle.  


Increased stretching of the mechanoreceptors in Mueller's muscle induces involuntary reflex contraction of the ipsilateral frontalis muscle. We used this neurophysiological mechanism during surgery on 50 patients with severe unilateral or bilateral congenital blepharoptosis that does not have the levator muscle but has Mueller's muscle. To facilitate contraction of the superior rectus muscle to sufficiently stretch the mechanoreceptors in Mueller's muscle, transverse fibrous tissues that restrict the stretching are medially and laterally incised. Without fascial or muscular advancement, the fascia lata was grafted as far between the frontalis muscle and the tarsus as possible. After 15.5% postoperative shrinkage of the grafted fascia lata, all 50 patients involuntarily elevated their ptotic eyelids over the pupillary centre on primary gaze without severe lagophthalmos on eye closing. Forty-five patients could lift the upper eyelid over the pupillary centre even on upward gaze. Our procedure appeared to enhance the involuntary reflex contraction of the ipsilateral frontalis muscle, providing satisfactory dynamic retraction of the upper eyelid through fascia lata. We consider our procedure an alternative for reconstructing not only severe congenital blepharoptosis but also severe acquired blepharoptosis after orbital trauma or orbital tumour resection, in patients who do not have or lose the levator muscle while the Mueller's muscle, the superior rectus muscle and the trigeminal proprioceptive nerve function to induce involuntary reflex contraction of the frontalis muscle. PMID:18249045

Matsuo, Kiyoshi; Yuzuriha, Shunsuke



Isometric training of rats — Effects upon fast and slow muscle and modification by an anabolic hormone (Nandrolone Decanoate)  

Microsoft Academic Search

Some effects of isometric exercise were studied in fast rectus femoris muscle and slow soleus muscle of the male rat. Isometric twitch contraction time did not change in both muscles, however, maximum tetanic tension increased in the fast muscle. Changes in the enzyme activity pattern of energy supplying metabolism of the rectus femoris muscle consisted in an increase of creatine

Gerhard Ulrich Exner; Hans W. Staudte; Dirk Pette



Rectus sheath hematoma caused by non-contact strenuous exercise mimicking acute appendicitis.  


A healthy 26-year-old man visited the Emergency Department due to right lower quadrant pain of 2 days' duration that developed after wakeboarding. There was no history of direct trauma to the abdomen. Physical examination revealed tenderness and rebound tenderness on the right lower quadrant area. There was no palpable abdominal mass. Computed tomography (CT) of the abdomen was undertaken to discern the causes of acute abdomen, including acute appendicitis. CT revealed a small-size rectus sheath hematoma beneath the lower end of the right rectus muscle. The patient was admitted for supportive care including pain control and was discharged with improvement after 5 days. Rectus sheath hematoma can be caused by not only a direct blow but also non-contact strenuous exercise, for example, wakeboarding in this case. Although the majority of rectus sheath hematomas are self-limiting, some can cause peritoneal irritation signs, mimicking acute abdomen, and eventually lead to unnecessary laparotomy without clinical suspicion and ancillary tests including CT scan and ultrasonography. PMID:18722739

Oh, Je Hyeok; Kim, Tae Han; Cha, Sung Jae; Kim, Seung Ho



Unilateral Recession-Resection Surgery with Inferior Displacement Combined with Augmented Anterior Transposition of Inferior Oblique Muscle  

PubMed Central

We report the effects of unilateral recession-resection surgery of the horizontal recti muscles with inferior displacement and augmented anterior transposition of the inferior oblique muscle with a posterior intermuscular suture in a patient with large exotropia and considerable hypertropia.

Hong, Samin; Hong, Young Taek; Seong, Gong Je



Anatomical Analysis of Intraorbital Structures Regarding Sinus Surgery Using Multiplanar Reconstruction of Computed Tomography Scans  

PubMed Central

Objectives This study aimed to investigate the anatomy of the intraorbital structures regarding to endoscopic sinus surgery and external frontal sinus surgery analyzing computer tomography (CT) scans. Methods The CT scans of 100 patients were retrospectively evaluated. The anatomic relationships between the intraorbital structures and paranasal structures were measured using multiplanar reconstruction of the CT scan. Results The mean distances from the medial orbital floor (MOF) to the intraorbital structures were measured at the depth of the anterior ethmoid (AE), basal lamella (BL), and midportion of posterior ethmoid (PE) in the coronal planes respectively. The mean distances from the MOF to the medial rectus muscle and inferior rectus muscle at the depth of AE were approximately 8 mm and those distances in the BL and PE decreased rapidly. The mean distances from the MOF to the infraorbital nerve at the depth of the AE and BL were approximately more than 10 mm. The mean distances from the vertical axis, which passed through the MOF, to the superior oblique muscle and optic nerve at the depth of the PE were approximately 5 mm medially and 1 mm laterally. In addition, the mean distance from the midline to the trochlea of the superior oblique muscle was approximately 15 mm. Conclusions Those measurements provide spatial information on the placements of the extraocular muscles within the orbit. The measurements will contribute to the avoidance of orbital complications during sinus surgery.

Hwang, Se Hwan; Park, Chan Soon; Cho, Jin Hee; Kim, Soo Whan; Kim, Byung Guk



Rectus sheath tunnels for continent stomas  

Microsoft Academic Search

Continent stoma rectus sheath tunnel (CSRST) has been used in antegrade colonic enema (ACE) and urinary continent cutaneous\\u000a diversion (UCCD) stomas to reduce leakage and to support a straight track for the continent conduit. All patients that underwent\\u000a CSRST between 1995 and 2005 were identified and their case notes retrospectively reviewed. Patients were divided into two\\u000a groups: the ACE group

Alan P. Dickson; Basem A. Khalil; Raimondo M. Cervellione



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

PubMed Central

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.

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



Effects of ACL reconstruction surgery on muscle activity of the lower limb during a jump-cut maneuver in males and females.  


We compared muscle activity of the quadriceps, hamstring, and gastrocnemius muscles when ACL-intact (ACLINT ) and ACL-reconstructed (ACLREC ) male and female subjects performed a jump-cut task. Surface electromyography sensors were used to evaluate time to peak muscle activity and muscle activity ratios. Rectus femoris (RF) and vastus medialis (VM) peak timing was 71 and 78?ms earlier in ACLINT than in ACLREC subjects, respectively. Biceps femoris (BF) peak timing was 90?ms earlier in ACLINT than in ACLREC subjects and 75?ms earlier in females than in males. Medial gastrocnemius (MG) muscle peak timing was 77?ms earlier in ACLINT than in ACLREC subjects. Lateral gastrocnemius (LG) and MG muscle peak times were 106?ms and 87?ms earlier in females than in males, respectively. The RF, VM, BF, and MG peaked later in ACLREC than in ACLINT subjects. There was evidence suggesting that the loading phase quadriceps:hamstring (quad:ham) muscle activity ratio was greater in ACLREC than in ACLINT subjects. Finally, the injury risk phase quad:ham muscle activity ratio was 4.8 times greater in females than in males. In conclusion, differences exist in muscle activity related to ACL status and sex that could potentially help explain graft failure risk and the sex bias. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. Published by Wiley Periodicals, Inc. J Orthop Res 31:1890-1896, 2013. PMID:23966333

Coats-Thomas, Margaret S; Miranda, Daniel L; Badger, Gary J; Fleming, Braden C



Comparison of rectus femoris transposition with traditional transfer for treatment of stiff knee gait in patients with cerebral palsy  

Microsoft Academic Search

Purpose  To assess the outcome of children with cerebral palsy following reposition of the distal rectus femoris tendon for treatment\\u000a of stiff knee gait.\\u000a \\u000a \\u000a \\u000a Methods  Children with cerebral palsy with stiff knee gait who underwent rectus femoris transfer were studied retrospectively. Inclusion\\u000a criteria were cerebral palsy of diplegic or quadriplegic type, preoperative and 1 year postoperative three-dimensional motion\\u000a analysis, and no other surgery

Yoram Hemo; Michael D. Aiona; Rosemary A. Pierce; Robin Dorociak; Michael D. Sussman



Technical Changes in Paraspinous Muscle Flap Surgery Have Increased Salvage Rates of Infected Spinal Wounds  

PubMed Central

Objectives: The objective of this study is to introduce modifications in paraspinous muscle flap surgery and compare this new variation's ability to salvage infected hardware with the classic technique. Infected posterior spine wounds are a difficult problem for reconstructive surgeons. As per experience, hardware retention in infected wounds maintains spinal stability, decreases length of stay, and decreases the wound healing complication rate. Methods: An 11-year retrospective office and hospital chart review was conducted between July 1996 and August 2007. All patients who underwent paraspinous muscle flap reconstruction for postspine surgery wound infections during this time period were included. There were 51 patients in the study representing the largest reported series, to date, for this procedure. Twenty-two patients underwent treatment using the modified technique and 29 patients were treated using the classic technique. Results: There was no statistical difference between the 2 groups in demographics, medical history, or reason for initial spine surgery. The hardware salvage rate associated with the modified technique was greater than the rate associated with the classic technique (95.4% vs 75.8%; P = .03). There were fewer postreconstruction wound healing complications requiring hospital readmission in the modified technique group than the classic group (13.6% vs 44.8%; P = .04). Patients in the modified technique group demonstrated a shorter mean length of stay than the patients in the classic group (23.7 days vs 29.7; P = .25). Conclusions: The modified paraspinous muscle flap technique is an excellent option for spinal wound reconstruction, preservation of spinal hardware, and local infection control.

Mericli, Alexander F.; Moore, John H.; Copit, Steven E.; Fox, James W.; Tuma, Gary A.



Isokinetic rotator muscles fatigue in glenohumeral joint instability before and after Latarjet surgery: a pilot prospective study.  


We aimed to analyze the changes in isokinetic internal (IR) and external (ER) rotator muscles fatigue (a) in patients with non-operated recurrent anterior instability, and (b) before and after shoulder surgical stabilization with the Bristow-Latarjet procedure. Thirty-seven patients with non-operated unilateral recurrent anterior post-traumatic instability (NG) were compared with 12 healthy subjects [control group (CG)]. Twenty patients with operated recurrent anterior instability group (OG) underwent isokinetic evaluation before and 3, 6, and 21 months after Bristow-Latarjet surgery. IR and ER muscles strength was evaluated with Con-Trex® dynamometer, with subjects seated and at a 45° shoulder abduction angle in scapular plane. IR and ER muscle fatigue was determined after 10 concentric repetitions at 180° · s(-1) through the fatigue index, the percent decrease in performance (DP), and the slope of peak torque decrease. There were no differences in rotator muscles fatigue between NG and CG. In OG, 3 months post-surgery, IR DP of operated shoulder was significantly (P < 0.001) higher than presurgery and 6 and 21 months post-surgery. Rotator muscles fatigability was not associated with recurrent anterior instability. After surgical stabilization, there was a significantly higher IR fatigability in the operated shoulder 3 months post-surgery, followed by recovery evidenced 6 months post-surgery and long-term maintenance over 21 months. PMID:23116174

Edouard, P; Bankolé, C; Calmels, P; Beguin, L; Degache, F



Bilateral rectus femoris intramuscular haematoma following simultaneous quadriceps strain in an athlete: a case report  

PubMed Central

Introduction Bilateral rectus femoris haematoma following a simultaneous strain of the quadriceps muscles is a very rare condition. Case presentation We report the case of a 21-year-old Greek Caucasian female rowing athlete who was injured on both thighs. She complained of pain and inability to walk. Physical examination revealed tenderness over the thighs and restriction of knee movement. The result of a roentgenogram was normal, and there was no evidence of fracture or patella displacement. Magnetic resonance imaging revealed haematoma formation in both the rectus femoris muscles. The diameters of the left and right haematomas within the muscles were 6 cm and 5 cm, respectively. Therapeutic approaches included compression bandages, ice application, rest, elevation, and administration of muscle relaxant drugs. Active stretching and isometric exercises were performed after three days. The patient was able to walk using crutches two days after the initiation of treatment. On the seventh day, she had regained her full ability to walk without crutches. Non-steroidal anti-inflammatory drugs were administered on the fifth day and continued for one week. Six weeks later, she had pain-free function and the result of magnetic resonance imaging was normal. She was able to resume her training programme and two weeks later, she returned to her previous sport activities and competitions. Conclusion There are references in the literature regarding the occurrence of unilateral quadriceps haematomas following strain and bilateral quadriceps tendon rupture in athletes. Simultaneous bilateral rectus femoris haematomas after a muscle strain is a rare condition. It must be diagnosed early. The three phases of treatment are rest, knee mobilization, and restoration of quadriceps function.



Knee extensor muscle oxygen consumption in relation to muscle activation  

Microsoft Academic Search

Recently, fatigability and muscle oxygen consumption (mVO2) during sustained isometric contractions were found to be less at shorter (30° knee angle; 0° = full extension) compared to longer knee extensor muscle lengths (90°) and, at low torques, less in the rectus femoris (RF) muscle than in the vastus lateralis and medialis. In the present study we hypothesized that these findings could be

R. D. Kooistra; M. E. Blaauboer; J. R. Born; C. J. de Ruiter; A. de Haan



Biochemical and transcriptomic analyses of two bovine skeletal muscles in Charolais bulls divergently selected for muscle growth  

Microsoft Academic Search

This work aimed to investigate the consequences of muscle growth selection on muscle characteristics. An oxidative muscle (Rectus abdominis, RA) and a glycolytic one (Semitendinosus, ST) were studied in two groups of six extreme young Charolais bulls of high or low muscle growth. Mitochondrial activity was lower in muscles of bulls with high muscle growth. Transcriptomic studies allowed the identification

Karine Sudre; Isabelle Cassar-Malek; Anne Listrat; Yasuko Ueda; Christine Leroux; Catherine Jurie; Charles Auffray; Gilles Renand; Patrice Martin; Jean-François Hocquette



Electromyographic activity of the rectus abdominis during a traditional crunch and the basic jackknife exercise with the Ab Lounge™.  


The use of nontraditional exercise devices such as the Ab Lounge™ has been promoted as being as effective as the traditional abdominal crunch in strengthening the abdominal musculature. Evidence for this is lacking, however. The purpose of this study was to compare the degree of activation of the upper and lower rectus abdominis using electromyography (EMG) during a traditional crunch with the basic jackknife using the Ab Lounge™. Twenty-two subjects (6 men and 16 women) were randomly selected from the student population at the University of the West Indies (Mona Campus). The mean age of the participants was 20.5 ± 1.5 years, height 166.4 ± 6.2 cm, weight 64 ± 10.3 kg, and waist-hip ratio 0.7 ± 0.1. Surface EMG was used to assess the muscle activity from the upper and lower rectus abdominis while each exercise was performed. The EMG data were full-wave rectified and normalized using a mathematical model that was set up in Microsoft Excel for Windows XP. Statistical analysis was performed on the data using a univariate analysis of variance with gender as a covariate. Significance was determined by p < 0.05. The mean EMG data recorded for the upper rectus abdominis was significantly higher with the traditional crunch when compared with the basic jackknife performed on the Ab Lounge™ (F = 4.39, p = 0.04). The traditional crunch produced a higher level of activity in the lower rectus abdominis when compared with the basic jackknife, but this was not statistically significant (F = 0.249, p = 0.62). There was no significant interaction between gender and the effect of the type of exercise on upper and lower rectus abdominis activation. These results suggest that the traditional abdominal crunch is more effective than the basic jackknife is in activating the rectus abdominis musculature. PMID:21912295

Nelson, Gail A; Bent-Forsythe, Denise A; Roopchand-Martin, Sharmella C



Responses of Medial Rectus Motoneurons in Monkeys with Strabismus  

PubMed Central

Purpose. Monkeys reared under conditions of alternating monocular occlusion during their first few months of life show large horizontal strabismus, “A” patterns, and dissociated vertical deviation. “A” patterns manifest as an inappropriate horizontal component in the deviated eye during vertical eye movements (cross-axis movement). The objective of this study was to investigate response properties of medial rectus motoneurons (MRMNs) in relation to strabismus properties. Methods. Burst-tonic activity of 21 MRMNs in the oculomotor nucleus were recorded from two monkeys with exotropia as they performed horizontal and vertical smooth pursuit (0.2 Hz, ±10°) under monocular viewing conditions. Neuronal responses and horizontal component of eye movements were used to identify regression coefficients in a first-order model for each tracking condition. Results. Comparison of position, velocity, and constant parameter coefficients, estimated from horizontal tracking data with either eye viewing, showed no significant differences (P > 0.07), indicating that neuronal activity could account for the horizontal misalignment. Comparison of the position, velocity, and constant parameter coefficients estimated from horizontal tracking and the cross-axis condition showed no significant differences (P > 0.07), suggesting that motoneuron activity could account for most of the inappropriate horizontal cross-axis movement observed in the covered eye during vertical smooth pursuit. Conclusions. These data suggest that, in animals with sensory-induced strabismus, central innervation to extraocular muscles is responsible for setting the state of strabismus. Mechanical factors such as muscle length adaptation (for horizontal misalignment) and pulley heterotopy or static torsion (for “A” patterns) likely do not play a major role in determining properties in a sensory-induced strabismus.

Joshi, Anand C.



Significant Immediate and Long-Term Reduction of Astigmatism after Lateral Rectus Recession in Divergent Duane’s Syndrome  

Microsoft Academic Search

Duane’s syndrome is associated with anisometropia and amblyopia. We encountered 1 patient with right divergent Duane’s syndrome (type 2 according to Huber’s classification) with high astigmatism of the right eye and a head turn. In order to improve the head turn and thereby avoid eccentric gaze through the glasses, the right lateral rectus muscle was recessed by 7.75 mm. Postoperatively,

H. E. Killer; A. Bähler





Sections Bone, Joint, and Muscle Disorders Chapters Biology of the Musculoskeletal System Muscles There are three types of muscles: skeletal, smooth, and cardiac (heart). Two of these kinds—skeletal and smooth— ...



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Effects of short-term, high intensity ( Sprint ) training on some contractile and metabolic characteristics of fast and slow muscle of the rat  

Microsoft Academic Search

Effects of a three weeks lasting short-term, high intensity training (sprint training) upon contractile parameters and selected enzyme activities of energy-supplying metabolism in slow soleus and fast rectus femoris muscle were investigated in female rats. Isometric twitch contraction time decreased in the soleus muscle. Maximum tetanic tension was found increased in soleus and rectus femoris muscle. Increases in hexokinase and

Hans W. Staudte; Gerhard U. Exner; Dirk Pette



Respiratory Muscle Training in Patients Recovering Recent Open Cardiothoracic Surgery: A Randomized-Controlled Trial  

PubMed Central

Objectives. To evaluate the clinical efficacy and feasibility of an expiratory muscle training (EMT) device (Respilift) applied to patients recovering from recent open cardiothoracic surgery (CTS). Design. Prospective, double-blind, 14-day randomised-controlled trial. Participants and Setting. A total of 60 inpatients recovering from recent CTS and early admitted to a pulmonary rehabilitation program. Interventions. Chest physiotherapy plus EMT with a resistive load of 30?cm H2O for active group and chest physiotherapy plus EMT with a sham load for control group. Measures. Changes in maximal expiratory pressure (MEP) were considered as primary outcome, while maximal inspiratory pressures (MIP), dynamic and static lung volumes, oxygenation, perceived symptoms of dyspnoea, thoracic pain, and well being (evaluated by visual analogic scale—VAS) and general health status were considered secondary outcomes. Results. All outcomes recorded showed significant improvements in both groups; however, the change of MEP (+34.2?mmHg, P < 0.001 and +26.1%, P < 0.001 for absolute and % of predicted, resp.) was significantly higher in active group. Also VAS dyspnoea improved faster and more significantly (P < 0.05) at day 12, and 14 in active group when compared with control. The drop-out rate was 6%, without differences between groups. Conclusions. In patients recovering from recent CTS, specific EMT by Respilift is feasible and effective. This trial is registered with NCT01510275.

Venturelli, Elena; Siscaro, Gherardo; Florini, Fabio; Papetti, Alessandra; Lugli, Daniela; Cerulli, Massimo; Clini, Enrico



Relationship Between Motor Alignment at Postoperative Day 1 and at Year 1 After Symmetric and Asymmetric Surgery in Intermittent Exotropia  

Microsoft Academic Search

Purpose: To evaluate the relationship between the motor alignment at postoperative day 1 and at year 1 following bilateral lateral rectus recession (BLR, symmetric surgery) and unilateral lateral rectus recession-medial rectus resection (R&R, asymmetric surgery) for the treatment of intermittent exotropia, X(T).Methods: Forty-six patients with basic or pseudo-divergence excess type of X(T) underwent BLR and 57 patients underwent R&R. The

Se-Youp Lee; Young Chun Lee



Rhabdomyolysis of Gluteal Muscles Leading to Renal Failure: A Potentially Fatal Complication of Surgery in the Morbidly Obese  

Microsoft Academic Search

Background: Rhabdomyolysis is a well-known cause of renal failure and is most commonly caused by ischemia\\/reperfusion or crush\\u000a injury. We describe a new cause of this syndrome in a series of 6 patients who underwent necrosis of the gluteal muscles after\\u000a bariatric surgery, 3 of whom eventually died of renal failure. Methods: Potential etiologic factors were studied by comparing\\u000a these

David Bostanjian; Gary J. Anthone; Nahid Hamoui; Peter F. Crookes



Unusual presentation of orbital cysticercosis-ptosis, diminution of vision and medial rectus weakness: a case report  

PubMed Central

Cysticercosis is the most common parasitic disease of the nervous system. The disease occurs when humans become the intermediate host in the life cycle of Taenia solium by ingesting its eggs from contaminated food. The most common sites of involvement of cysticerci are soft tissue, eye and central nervous system. Unusual location of the cysts may result in uncommon manifestations. Ocular cysticercosis can involve both the intraocular and extra ocular muscle. Extra ocular muscle cysticercosis is rare. We are reporting the unusual manifestation of ptosis, proptosis, diminution of vision and medial rectus palsy due to cysticercosis. The patient was successfully treated with systemic steroids and albendazole.

Jajoo, Ulhas; Yelwatkar, Samir; Ashish, Jaikishan



Double deep inferior epigastric arteries encountered during vertical rectus abdominis flap harvest: a case report and literature review.  


The rectus abdominis flap offers a number of advantages over other flaps used in head and neck reconstruction. The flap can be harvested by a separate team and can be tailored to include skin, muscle, and fat. In addition, the available vascular pedicle is long and its large caliber provides an appropriate size match with recipient neck vessels. Central to reconstructive success is defining an arterial and venous pedicle that provides balanced perfusion to all components of the flap. Anomalous vascular anatomy presents principal challenges in reestablishing free flap perfusion. We present a case of double, right deep inferior epigastric arteries encountered during vertical rectus abdominis myocutaneous flap reconstruction of the tongue and floor of the mouth and discuss the clinical outcomes of this reconstruction. PMID:23780602

Chung, Thomas K; Wilson, Keith; Patil, Yash J




NSDL National Science Digital Library

Tendons are rope-like fibers that join muscles to bones. Muscles contract and lengthen and muscles get shorter when they contract. A ligament is a flexible band of fibrous tissue that connects the bones and binds the joints together. They connect bones to bones and they sometimes act as guides for tendons.

Olivia Worland (Purdue University;Biological Sciences)



The inferiorly based masseter muscle flap: anatomical basis for its use in head and neck reconstructive surgery.  


The aim of this study was to investigate and elucidate the anatomical basis for the use of the inferiorly based masseter muscle flap in the reconstruction of oropharyngeal defects after ablative surgery. The anatomy of the masseter muscle, with particular emphasis on its blood supply, was studied using plain and coloured resin injected dissections and a series of digital subtraction angiograms and external carotid arteriograms. Both techniques were demonstrated to be reliable and effective means of anatomical investigation of blood vessels. The vascular anatomy of the masseter muscle and the anatomical and angiological results as well as a case report are described. The masseter muscle, when used as an inferiorly based flap, provides the necessary bulk for reconstruction of moderate size defects in the lateral border of the tongue, posterior floor of the mouth, retromolar trigone, anterior tonsillar pillars and lateral pharyngeal wall. Although the masseter muscle has small dimensions, it offers a reliable method of reconstruction in selected defects without the disadvantages of cosmetic and functional loss. PMID:2051046

Marinho, L H; Shanahan, D A; Langdon, J D; Sinnatamby, C S





... After surgery there can be a risk of complications, including infection, too much bleeding, reaction to anesthesia, or accidental injury. There is almost always some pain with surgery. Agency for Healthcare Research and Quality




... how pain will be treated Preparing for the Day of Surgery Various preparations are made in the ... Then, this device can perform more accurately. The Day of Surgery Before most operations, a person removes ...


Recovery of calf muscle strength following acute achilles tendon rupture treatment: a comparison between minimally invasive surgery and conservative treatment.  


The aim of this study was to measure the effect of treatment of acute Achilles tendon ruptures on calf muscle strength recovery. Eighty-three patients with acute Achilles tendon rupture were randomly allocated to either minimally invasive surgery with functional after-treatment or conservative treatment by functional bracing. Calf muscle strength using isokinetic testing was evaluated at 3 months and after 6 or more months posttreatment. To exclusively investigate the effect of treatment on outcome, the authors excluded patients with major complications from the analysis. In 31 of 39 patients in the surgical treatment group and 25 of 34 patients in the conservative treatment group, isokinetic strength tests were performed. In the analysis of differences in mean peak torque, no statistically significant differences were found between surgery and conservative treatment, except for plantar flexion strength at 90 degrees per second at the second measurement, favoring conservative treatment. After 8 to 10 months follow- up, loss of plantar flexion strength was still present in the injured leg in both treatment groups. In conclusion, isokinetic muscle strength testing did not detect a statistically significant difference between minimally invasive surgical treatment with functional after-treatment and conservative treatment by functional bracing of acute Achilles tendon ruptures. PMID:19825777

Metz, Roderik; van der Heijden, Geert J M G; Verleisdonk, Egbert-Jan M M; Tamminga, Rob; van der Werken, Christiaan




Microsoft Academic Search

Muscles give us both stability and power for all body movements. However, muscle contractions do more than enable our activities\\u000a of daily living; they also allow us to exercise, which is associated with beneficial effects on longevity, general health,\\u000a self-esteem, and mood.1,2 With exercise, however, there is also the possibility of injury.\\u000a \\u000a Traumatic insults to muscle in athletes are commonplace.

Robert Downey Boutin; Sean T. Powell; Mark D. Bracker


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


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

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



Infrahyoid muscle flap for pharyngeal fistulae after cervical spine surgery: a novel approach--Report of six cases  

PubMed Central

A report of our experiences involving the treatment six male patients with a new method of closing perforations in the pharynx and upper esophagus, following surgery of the cervical spine region. Perforation of the pharynx and upper esophagus are rare complications following cervical spine surgery. The grave consequences of these complications necessitate in most cases immediate surgical therapy. In most cases, the first step involves the removal of the cervical plate and screws. The defect was then closed using a vascular pedicled musculofascia flap derived from the infrahyoid musculature. In all cases, the flap healed into place without complications. The patients began taking oral nutrients after an average of seven postoperative (5–12) days. In none of the cases did functional disorders or complications arise during the follow-up period (1–5 years). The infrahyoid muscle flap is well suited for reconstruction of the posterior pharyngeal wall and the upper esophagus.

Niedeggen, Andreas; Todt, Ingo; Westhofen, Martin; Ernst, Arne





... candidate for lung surgery. Lung Volume Reduction Surgery (LVRS) is a procedure to help people with severe COPD. LVRS is not a cure for COPD but can ... that the remaining healthier portion can perform better. LVRS can also allow the diaphragm to return to ...


Workhorse Flaps in Chest Wall Reconstruction: The Pectoralis Major, Latissimus Dorsi, and Rectus Abdominis Flaps  

PubMed Central

Large and life-threatening thoracic cage defects can result from the treatment of traumatic injuries, tumors, infection, congenital anomalies, and radiation injury and require prompt reconstruction to restore respiratory function and soft tissue closure. Important factors for consideration are coverage with healthy tissue to heal a wound, the potential alteration in respiratory mechanics created by large extirpations or nonhealing thoracic wounds, and the need for immediate coverage for vital structures. The choice of technique depends on the size and extent of the defect, its location, and donor site availability with consideration to previous thoracic or abdominal operations. The focus of this article is specifically to describe the use of the pectoralis major, latissimus dorsi, and rectus abdominis muscle flaps for reconstruction of thoracic defects, as these are the workhorse flaps commonly used for chest wall reconstruction.

Bakri, Karim; Mardini, Samir; Evans, Karen K.; Carlsen, Brian T.; Arnold, Phillip G.



Biological Mechanisms of Muscle Reattachment and Migration with or without Osseous Surgery.  

National Technical Information Service (NTIS)

Under this contract five studies were carried out to investigate the relationship of muscle function and skeletal growth and adaptation; (1) Studies of adaptations resulting from vertical repositioning of osseous elements in adults, in which a bite openin...

J. A. McNamara D. S. Carlson



Mechanical and histological characterization of the abdominal muscle. A previous step to modelling hernia surgery.  


The aims of this study are to experimentally characterize the passive elastic behaviour of the rabbit abdominal wall and to develop a mechanical constitutive law which accurately reproduces the obtained experimental results. For this purpose, tissue samples from New Zealand White rabbits 2150±50 (g) were mechanically tested in vitro. Mechanical tests, consisting of uniaxial loading on tissue samples oriented along the craneo-caudal and the perpendicular directions, respectively, revealed the anisotropic non-linear mechanical behaviour of the abdominal tissues. Experiments were performed considering the composite muscle (including external oblique-EO, internal oblique-IO and transverse abdominis-TA muscle layers), as well as separated muscle layers (i.e., external oblique, and the bilayer formed by internal oblique and transverse abdominis). Both the EO muscle layer and the IO-TA bilayer demonstrated a stiffer behaviour along the transversal direction to muscle fibres than along the longitudinal one. The fibre arrangement was measured by means of a histological study which confirmed that collagen fibres are mainly responsible for the passive mechanical strength and stiffness. Furthermore, the degree of anisotropy of the abdominal composite muscle turned out to be less pronounced than those obtained while studying the EO and IO-TA separately. Moreover, a phenomenological constitutive law was used to capture the measured experimental curves. A Levenberg-Marquardt optimization algorithm was used to fit the model constants to reproduce the experimental curves. PMID:21316627

Hernández, B; Peña, E; Pascual, G; Rodríguez, M; Calvo, B; Doblaré, M; Bellón, J M



Use of vascularized posterior rectus sheath allograft in pediatric multivisceral transplantation--report of two cases.  


Restoring abdominal wall cover and contour in children undergoing bowel and multivisceral transplantation is often challenging due to discrepancy in size between donor and recipient, poor musculature related to birth defects and loss of abdominal wall integrity from multiple surgeries. A recent innovation is the use of vascularized posterior rectus sheath to enable closure of abdomen. We describe the application of this technique in two pediatric multivisceral transplant recipients--one to buttress a lax abdominal wall in a 22-month-old child with megacystis microcolon intestinal hypoperistalsis syndrome and another to accommodate transplanted viscera in a 10-month child with short bowel secondary to gastoschisis and loss of domain. This is the first successful report of this procedure with long-term survival. The procedure has potential application to facilitate difficult abdominal closure in both adults and pediatric liver and multivisceral transplantation. PMID:22594310

Ravindra, K V; Martin, A E; Vikraman, D S; Brennan, T V; Collins, B H; Rege, A S; Hollenbeck, S T; Chinappa-Nagappa, L; Eager, K; Cousino, D; Sudan, D L





... be treated with radiation or chemotherapy. Enable direct access for chemotherapy, radiation implants, or genetic treatment of malignant tumors. Relieve seizures (due to a brain tumor) that are hard to control. Types The most common types of surgery for ...


Abdominal Muscle Strains in Professional Baseball: 1991-2010  

Microsoft Academic Search

Background: The abdominal core muscles (internal and external oblique, rectus and transversus abdominis) play an important role in the baseball activities of pitching and hitting. Proper abdominal muscle activation during throwing and swinging is crucial for generating optimal ball velocity and bat speed. Abdominal muscle strains can result in substantial loss of playing time, and their incidence has never been

Stan A. Conte; Matthew M. Thompson; Matthew A. Marks; Joshua S. Dines



Relative Activity of Abdominal Muscles during Commonly Prescribed Strengthening Exercises.  

ERIC Educational Resources Information Center

|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…

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



Postoperative outcomes following preoperative inspiratory muscle training in patients undergoing open cardiothoracic or upper abdominal surgery: protocol for a systematic review  

PubMed Central

Background In patients undergoing open cardiothoracic and upper abdominal surgery, postoperative pulmonary complications remain an important cause of postoperative morbidity and mortality, impacting upon hospital length of stay and health care resources. Adequate preoperative respiratory muscle strength may help protect against the development of postoperative pulmonary complications and therefore preoperative inspiratory muscle training has been suggested to be of potential value in improving postoperative outcomes. Methods/Design A systematic search of electronic databases will be undertaken to identify randomized trials of preoperative inspiratory muscle training in patients undergoing elective open cardiothoracic and upper abdominal surgery. From these trials, we will extract available data for a list of predefined outcomes, including postoperative pulmonary complications, hospital length of stay and respiratory muscle strength. We will meta-analyze comparable results where possible, and report a summary of the available pool of evidence. Discussion This review will provide the most comprehensive answer available to the question of whether preoperative inspiratory muscle training is clinically useful in improving postoperative outcomes in patients undergoing cardiothoracic and upper abdominal surgery. It will help inform clinicians working in the surgical arena of the likely effectiveness of instituting preoperative inspiratory muscle training programs to improve postoperative outcomes.



Hematoma of rectus sheath following subcutaneous enoxaparin injection.  


Anticoagulation drugs are frequently used to prevent deep vein thrombosis in high-risk patients. Subcutaneous low molecular weight heparin (LMWH) is increasingly used in both hospitalized patients and outpatient settings. This necessitates familiarity of both health care providers and patients with such treatment and vigilance on possible complications. Here we present a case of hematoma of rectus sheath that occurred following subcutaneous injection of enoxaparin and was successfully treated with conservative management. PMID:23737319

Firoozbakhsh, Shahram; Parsaei, Reza; Jafarshad, Reyhaneh



The penis rectus as a marker in human palaeontology?  

Microsoft Academic Search

Thepenis rectus, i.e. the human penis which maintains an almost horizontal position in its flaccid state, has so far only been observed amongst\\u000a the Bushmen in southern Africa. There, however, it is already displayed in prehistoric rock art in stark and obviously intended\\u000a contrast with differently positioned penes of other population groups. A similar juxtaposition can be found in European

H. Loofs-Wissowa



Work in progress report - Cardiac general Short-term transcutaneous electrical nerve stimulation after cardiac surgery: effect on pain, pulmonary function and electrical muscle activity  

Microsoft Academic Search

This study aimed to evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) for treatment of postoperative pain in patients who underwent cardiac surgery. In addition, we sought to determine whether TENS would be related to improved pulmonary function and muscle electrical activity in this patient population. Forty-five patients, 32 males and 13 females, aged 41-74 years were randomly allocated

Gerson Cipriano Jr; Antonio Carlos de Camargo; Graziella Franca Bernardelli; Paulo Alberto Tayar Peresb; Tayar Peres



Eye muscle repair - discharge  


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


Vertical rectus abdominis musculocutaneous flap for breast reconstruction after irradiation  

SciTech Connect

We have used a contralateral vertical rectus abdominis musculocutaneous flap based upon the superior epigastric vessels in six patients to provide coverage after resection of locally recurrent breast carcinoma in irradiated tissues. Primary healing of defects as large as 16 cm X 35 cm has been obtained using this technique. Although there is no evidence to suggest that such a procedure significantly lengthens survival, it was clearly beneficial to the quality of life in these patients. Our results suggest that older patients with relatively indolent disease receive the greatest benefit from this procedure.

Reed, W.P.; Spence, R.J.



Isometric training of rats — Effects upon fast and slow muscle and modification by an anabolic hormone (Nandrolone Decanoate)  

Microsoft Academic Search

Some effects of isometric exercise were studied in fast rectus femoris muscle and slow soleus muscle of the female rat. Isometric twitch contraction time shortened by 20% in fast and prolonged by 20% in slow muscle. Maximum tetanic tension increased by 20% in the fast muscle. Changes in the enzyme activity pattern of energy supplying metabolism differed in the two

Gerhard Ulrich Exner; Hans W. Staudte; Dirk Pette



Reinnervation of the Extraocular Muscles in Goldfish is Nonselective  

Microsoft Academic Search

The selectivity of axonal regeneration to the extraocular mus- cles in teleosts has been reinvestigated by mapping, with retro- gradely transported HRF', the motor pools of the muscles in- nervated by the oculomotor nerve. In normal goldfish, the motoneurons of the superior rectus, inferior recfus, and inferior oblique muscles formed discrete, nonoverlapping motor pools; the motor pool of the medial

Steven S. Scherer


Dried Human Amniotic Membrane Does Not Alleviate Inflammation and Fibrosis in Experimental Strabismus Surgery  

PubMed Central

Purpose. The purpose of this study was to evaluate the efficacy of dried human amniotic membrane (AM) in reducing the postoperative inflammatory response and scarring after strabismus surgery. Methods. The inflammatory response at the extraocular muscle reattachment site was analyzed after superior rectus (SR) resection in 12 rabbits. Dried human AM (Ambiodry2) was applied between the resected SR muscle plane and Tenon's capsule of the left eyes of rabbits. As a control, the right eyes of rabbits underwent SR resection only. The surgeon randomly ordered which eye gets operated first during the experiment. Two weeks later, enucleation was performed. Six sagittal sections were made for each eye at the insertion of the SR muscle. The grade of postoperative inflammation and the presence of fibrosis were evaluated in histological examinations. Results. There was no statistically significant difference in the intensity of inflammation and fibrous proliferation between the eyes treated with dried human AM after SR resection and those treated with SR resection only. Conclusions. The use of dried human AM was not effective in controlling the postoperative inflammation and scarring in rabbit eyes after extraocular muscle surgery. However, this may be due to the devitalized dry preparation of human AM (Ambiodry2), which may have lost the expected anti-inflammatory and anti-scarring properties, and further studies on humans may be necessary.

Kim, Hong Kyun; Shin, Jae Pil



Isometric training of young rats — Effects upon hind limb muscles  

Microsoft Academic Search

The soleus, reetus femoris, and gastrocnemius muscles of young rats trained isometrically for 4 weeks were studied by light and electron microscopy.—The percentage of fast-twitch oxidative muscle fibers decreased at the cost of the fast-twitch glycolytic fibers in the rectus femoris muscle. The percentages of the slow-twitch oxidative fibers did not change significantly in any of the muscles studied. The

Werner Mtiller; W. Vogell



The bone inducing capacity of syngeneic thyroid tissue in guinea-pig muscle.  


Syngeneic thyroid extract injected into the rectus femoris muscle of guinea-pigs resulted in the appearance within the muscle of osteoblasts and the formation of bone. Injection of irritant failed to do so. It is thought that thyroid extracts exert their effect by inducing osteoblast transporation in muscle fibroblasts. PMID:102746

Zarrin, K



Age-related muscle atrophy in the lower extremities and daily physical activity in elderly women  

Microsoft Academic Search

This study investigated the relationship between age-related declines in muscle thickness of the lower extremities and daily physical activity in elderly women. The subjects comprised 20 young women and 17 elderly women residing in a nursing home. Lower limb muscle thickness was measured by B-mode ultrasound with the following 10 muscles; gluteus maximus, gluteus medius, gluteus minimus, psoas major, rectus

Tome Ikezoe; Natsuko Mori; Masatoshi Nakamura; Noriaki Ichihashi



Development of an ergonomic musculoskeletal model to estimate muscle forces during vertical jumping  

Microsoft Academic Search

This study investigated a musculoskeletal model that includes the function of the antagonistic muscles and biarticular muscles and models muscles acting across the hip, knee and ankle joints, simultaneously. Furthermore, this study can be applied to dynamic motions. One vertical jump trials were conducted to validate the proposed model. Electromyograms (EMGs) of tibials anterior, gastrocnemius, soleus, rectus femoris, vastus lateralis,

Isamu Nishida; Masato Maeda; D. Gordon; E. Robertson; Keiichi Shirase



Assessment of the sensory quality and shelf stability of selected Horro beef muscles in Ethiopia  

Microsoft Academic Search

The objective of this work was to assess sensory quality and retail life of Horro beef muscles in Ethiopia. Six muscles: M. rhomboideus (RM), M. infraspinatus (IS), M. longissimus lumborum (LL), M. semimembranosus (SM), M. biceps femoris (BF) and M. rectus femoris (RF) were considered. Sensory quality of the muscles was rated by a 9-member trained panel for palatability, tenderness,

Melese Abdisa Yadata; Carsten Werner; Markos Tibbo; Clemens B. A. Wollny; Michael Wicke



Complications in Women Undergoing Burch Colposuspension Versus Autologous Rectus Fascia Sling for the Treatment of Stress Urinary Incontinence  

PubMed Central

Purpose To determine clinicodemographic factors associated with complications of continence procedures, the impact of concomitant surgeries on complication rates and the relationship between incidence of cystitis and method of post-operative bladder drainage. Materials and Methods Serious adverse events (SAEs) and adverse events (AEs) of the Stress Incontinence Surgical Efficacy Trial (SISTEr), a randomized trial comparing Burch colposuspension to autologous rectus fascial sling, were reviewed. Clinicodemographic variables were analyzed to determine those associated with the development of AEs using logistic regression analysis. Complications were stratified based on the presence or absence of concomitant surgery. Differences in complication rates (controlling for concomitant surgery) and cystitis rates (controlling for method of bladder emptying) were compared using Fisher’s exact test. Results Blood loss (p=0.0002) and operative time (p<0.0001) were significantly associated with development of an AE. Subjects undergoing concomitant surgeries had a significantly higher SAE rate (14.2% vs 7.3%, p=0.01) and AE rate (60.5% vs. 48%, p<0.01) compared to subjects undergoing continence surgery alone. Cystitis rates were higher (p<0.01) in the sling versus the Burch group up to 6 weeks postoperatively regardless of concomitant surgery status. Intermittent self catheterization (ISC) increased the rate of cystitis by 17% and 23% in the Burch and sling groups, respectively. Conclusions Concomitant surgeries at the time of continence surgery increased the risk for complications. Sling surgery was associated with a higher risk of cystitis within the first 6 weeks postoperatively. ISC increased risk of cystitis in both groups. The occurrence of complications was associated with surgical factors, not patient-related factors.

Chai, Toby C.; Albo, Michael E.; Richter, Holly E.; Norton, Peggy A.; Dandreo, Kimberly J.; Kenton, Kimberly; Lowder, Jerry L.; Stoddard, Anne M.



A mechanical leech for transverse rectus abdominis musculocutaneous flaps.  


Venous congestion in the intraoperative and postoperative period can be a problem with some transverse rectus abdominis musculocutaneous flaps. We evolved a technique to allow us the ability to bleed the congested flap in a controlled manner both intra- and postoperatively. Arteriotomy cannulae are placed within the lumens of the deep inferior epigastric artery (DIEA) and vein (DIEV) and they are brought out on the lateral aspect of the reconstructed breast. We believe that intermittent venous bleeding from the DIEV allows a congested flap time to improve venous outflow and adapt to the new reversed blood circulation. When laser Doppler flow meter is simultaneously used as a monitor, bleeding from the DIEV or DIEA can improve balance between arterial and venous pressure in the flap. PMID:8215123

Hartrampf, C R; Drazan, L; Noel, R T



Properties of Two Homologous Alkaline Proteases from Streptomyces rectus  

PubMed Central

Some physicochemical properties of two thermostable proteases from Streptomyces rectus are described. The enzymes were judged to be identical with respect to molecular weight, inactivation with serine protease inhibitors, and in primary structure by peptide analysis. Amino acid analysis indicated the enzymes had identical compositions except for their amide content. The molecular weights of the enzymes were judged to be 28,000 by sedimentation equilibrium, 26,200 by sedimentation diffusion, and 29,100 from amino acid analysis. Titration of the proteases with diisopropylfluorophosphate and phenylmethane sulfonylfuoride indicate equivalent weights of 28,500 and 32,800 g, respectively, for the proteins. The pentapeptide around the serine residue reacting with diisopropylfluorophosphate was isolated and had the composition: Asx1, Gly1, Thr1, Ser1, Met1.

Borgia, Peter; Campbell, L. Leon



Muscle activity in wedge, parallel, and giant slalom skiing.  


Muscle activity patterns of six alpine skiers were compared during nine runs each of wedge (W), short radius parallel (P), and giant slalom (GS) turns. Bipolar surface electrodes were placed over 12 muscles on the right side of the body: anterior tibialis, medial gastrocnemius, vastus medialis, vastus lateralis, rectus femoris, medial hamstrings, biceps femoris, gluteus maximus, adductors, rectus abdominis, external obliques, and erector spinae. Repeated measures ANOVA was used to test for differences in average and peak EMG amplitudes between W, P, and GS (P < 0.1). Average amplitude was significantly different between all turning styles (W < P < GS) for four muscles (vastus lateralis, medial hamstrings, biceps femoris, and external obliques) and significantly less for W versus P or GS for four muscles (anterior tibialis, vastus medialis, rectus femoris, and rectus abdominis). The gluteus maximus was the only muscle that had significantly greater activity in W than P. Average amplitude was greater than 50% MVC for the vastus medialis, vastus lateralis, biceps femoris, gluteus maximus, and adductors in all conditions; and for the anterior tibialis, medial hamstrings, and rectus femoris in GS and P; and for the medial gastrocnemius and erector spinae in GS. Peak amplitude was greater than 150% maximal voluntary contraction (MVC) for the vastus medialis, vastus lateralis, biceps femoris, gluteus maximus, and adductors in all conditions, and for the medial gastrocnemius, rectus femoris, and erector spinae in GS. This research indicates that with the exception of the gluteus maximus, greater muscle activity is required in GS followed by P and W turns. PMID:9107639

Hintermeister, R A; O'Connor, D D; Lange, G W; Dillman, C J; Steadman, J R



[Comparison of cross face nerve graft with masseteric nerve as donor nerves for free functional muscle transfers in facial reanimation surgery].  


Several surgical techniques have been proposed for the reconstruction of the smile in facial paralysis. The 2-stage approach utilising a cross-facial nerve graft (CFNG) and subsequent free functional muscle transfer represents the "gold standard". A single-stage alternative is the use of the masseteric nerve as donor nerve. Here we have retrospectively analysed the outcome of 8 patients who were treated with either of these procedures (4 per treatment group). We compared the oral commisure excursion between the 2 groups. Use of the masseteric nerve led to reinnervation of the muscle graft within 3 months. The 2-stage procedure required more than 12 months from the first procedure until first muscle contractions could be observed. A spontaneous smile could not be achieved in all patients when the masseteric nerve was used. The oral commisure excursion was symmetrical when compared to the healthy side in both groups, however the excursion was significantly higher in the masseteric nerve group compared to the CFNG group of patients. Most patients with the masseteric nerve as a donor nerve underwent a secondary procedure, which involved thinning of the muscle flap. In conclusion, the use of the masseteric nerve as a donor nerve for facial reanimation surgery is a single-stage alternative to the use of a CFNG as donor nerve. It delivers reliable results with strong muscle contractions with limitations in regard to achieving a spontaneous smile. PMID:23970401

Eisenhardt, S U; Thiele, J R; Stark, G B; Bannasch, H



A rare case of spontaneous rectus sheath haematoma in a patient with mechanical prosthetic aortic and mitral valves.  


Every year nearly 300 000 patients have heart valve operations and mostly prosthetic valves are inserted. Coumadin is the mainstay of therapy in these individuals but it has many side effects, mostly related to its anticoagulant effect. Rectus sheath haematoma (RSH) is a rare complication of abdominal trauma, surgery and excessive strain, however, anticoagulant agents may predispose to this condition without any precipitating event. Reversal of anticoagulation and resuscitation with fluids and blood products are necessary but anticoagulation is crucial in patients with prosthetic valves, as they have acquired thrombotic diathesis. Herein we report on a case of spontaneous RSH in a patient with prosthetic mitral and aortic valves and a history of prosthetic valve thrombosis. He was successfully managed medically. PMID:22832479

Aykan, Ahmet; Oguz, Ali; Yildiz, Mustafa; Özkan, Mehmet



Changes in metabolism and blood flow in peripheral tissue (skeletal muscle) during cardiac surgery with cardiopulmonary bypass: the biochemical microdialysis study.  


The aim of this study was to monitor the metabolism and blood flow in the interstitium of the skeletal muscle during cardiac surgery with cardiopulmonary bypass (CPB) and in the early postoperative period by means of microdialysis and to compare metabolic changes during CPB at normothermia (NT) and hypothermia (HT). Surgical revascularization using CPB was performed in 50 patients, 25 patients (group HT) were operated using hypothermic CPB, 25 (group NT) using normothermic CPB. Interstitial microdialysis was performed by two CMA 60 probes (CMA Microdialysis AB, Solna, Sweden) inserted into the patient's deltoid muscle. Constituents analysed in the obtained dialysates, collected at intervals, were glucose, urea, glycerol and lactate. Tissue blood flow was monitored by dynamic microdialysis with gentamicin as a marker. In both groups, NT versus HT, similar dynamics of concentrations were found. Low initial concentrations were followed by gradual increases during CPB and in the following phase of the operation. Concentrations were higher in the NT group. Immediately after the operation, the decrease in values continued, with a gradual increase in the succeeding postoperative period in both groups. Similar dynamic changes in the lactate concentration were found in both groups. The gentamicin concentrations were lower in the NT group (versus the HT group). The results showed dynamic changes in the interstitial concentrations of glucose, urea, glycerol and lactate, which depend on the phase of the surgery in the CPB and early postoperative phase in the both groups of patients. Higher tissue perfusion of the skeletal muscle was noted in those patients operated on in normothermia. The dynamics of the concentration changes of these substances in the interstitium of the skeletal muscle has been proven to be caused by both the metabolic activity of the tissue and by the blood flow through the interstitium of the muscle. PMID:15072256

Mand'ák, J; Zivný, P; Lonský, V; Palicka, V; Kakrdová, D; Marsíková, M; Kunes, P; Kubícek, J



Decreasing strabismus surgery  

PubMed Central

Aim: To determine whether there has been a consistent change across countries and healthcare systems in the frequency of strabismus surgery in children over the past decade. Methods: Retrospective analysis of data on all strabismus surgery performed in NHS hospitals in England and Wales, on children aged 0–16 years between 1989 and 2000, and between 1994 and 2000 in Ontario (Canada) hospitals. These were compared with published data for Scotland, 1989–2000. Results: Between 1989 and 1999–2000 the number of strabismus procedures performed on children, 0–16 years, in England decreased by 41.2% from 15 083 to 8869. Combined medial rectus recession with lateral rectus resection decreased from 5538 to 3013 (45.6%) in the same period. Bimedial recessions increased from 489 to 762, oblique tenotomies from 43 to 121, and the use of adjustable sutures from 29 to 44, in 2000. In Ontario, operations for squint decreased from 2280 to 1685 (26.1%) among 0–16 year olds between 1994 and 2000. Conclusion: The clinical impression of decrease in the frequency of paediatric strabismus surgery is confirmed. In the authors’ opinion this cannot be fully explained by a decrease in births or by the method of healthcare funding. Two factors that might have contributed are better conservative strabismus management and increased subspecialisation that has improved the quality of surgery and the need for re-operation. This finding has a significant impact upon surgical services and also on the training of ophthalmologists.

Arora, A; Williams, B; Arora, A K; McNamara, R; Yates, J; Fielder, A



Effects of Synovex-S and recombinant bovine growth hormone (Somavubove) on growth responses of steers: II. Muscle morphology and proximate composition of muscles.  


Twenty crossbred beef steers (initial BW 182 +/- 1.8 kg) were used in a 2 x 2 factorial to determine the effects of implantation with Synovex-S (SYN; 20 mg 17-beta estradiol benzoate + 200 mg progesterone, ear implant) and administration of recombinant bovine growth hormone (Somavubove SbV, .1 mg.kgBW-1.d-1, i.m.) on the morphology of six muscles (longissimus, psoas major, supraspinatus, triceps brachii, semitendinosus, rectus femoris) of growing steers. Implantation with SYN decreased the percentage distribution of FOG fibers and increased FG fibers in the supraspinatus and rectus femoris muscles (P < .05). Steers treated with SYN had a larger area of SO and FG fibers in the psoas major muscle (P < .05). The administration of SbV decreased the percentage distribution of FOG fibers and increased FG fibers in the rectus femoris muscle (P < .05). Steers administered SbV had larger SO, FOG, and FG fibers in the psoas major muscle and SO fibers in the supraspinatus and semitendinosus muscles (P < .05). The combined administration of SYN and SbV had minimal, if any, effect on the percentage distribution of fiber types (P > .05) but increased (P < .05) the fiber areas of all muscles (18.5 to 54.8%) except the rectus femoris (P > .05). Proximate composition of the muscles was generally not affected (P > .05) by any of the treatments. The only observations were decreases in fat content for psoas major and rectus femoris muscles as a result of the combined administration of SYN and SbV. These results indicate that both growth-promoting agents, SYN and SbV, have potential to increase muscle fiber size, but muscles respond differently to the administrations of SYN and SbV. However, when SYN and SbV are administered in combination, the combined effects result in an additive increase in muscle fiber hypertrophic response. PMID:8994906

Ono, Y; Solomon, M B; Elsasser, T H; Rumsey, T S; Moseley, W M



Electromyographic muscle activity in curl-up exercises with different positions of upper and lower extremities.  


The purpose of the study was to evaluate the electromyographic (EMG) activity of muscles in curl-up exercises depending on the position of the upper and lower extremities. From the perspective of biomechanics, different positions of the extremities result in shifting the center of gravity and changing muscular loads in abdominal strength exercises. The subjects of the research were 3 healthy students (body mass 53-56 kg and height 163-165 cm) with no history of low back pain or abdominal surgery. Subjects completed 18 trials for each of the 9 exercises (static curl-up with 3 positions of the upper and 3 position of the lower extremities). The same experiment with the same subjects was conducted on the next day. The EMG activity of rectus abdominis (RA), erector spinae (ES), and quadriceps femoris-long head (rectus femoris [RF]) was examined during the exercises. The surface electrical activity was recorded for the right and left sides of each muscle. The raw data for each muscle were rectified and integrated. The statistical analysis showed that changing the position of upper extremities in the examined exercises affects the EMG activity of RA and ES but does not significantly affect the EMG activity of RF. Additionally, it was found that curl-up exercises with the upper extremities extended behind the head and the lower extremities flexed at 90° in the hip and knee joints involve RA with the greatest intensity, whereas curl-up exercises with the upper extremities extended along the trunk and the lower extremities flexed at 90° in the hip and knee joints involve RA with the lowest intensity. PMID:20940638

Rutkowska-Kucharska, Alicja; Szpala, Agnieszka



Trunk muscle activity in healthy subjects during bridging stabilization exercises  

PubMed Central

Background Trunk bridging exercises are often used as therapeutic exercises for lumbopelvic stabilization. These exercises focus on the retraining of muscle coordination patterns in which optimal ratios between local segmental stabilizing and global torque producing muscle activity are assumed to be essential. However, a description of such ratios is lacking. The purpose of this study was to investigate both relative (as a percentage of maximal voluntary isometric contraction) muscle activity levels and ratios of local to global muscle activity, during bridging stabilization exercises. Methods Thirty healthy university students (15 men, 15 women) with a mean age of 19.6 year volunteered to perform 3 bridging exercises (single bridging, ball bridge and unilateral bridging). The surface electromyographic activity of different trunk muscles was evaluated on both sides. Results During all bridging exercises, the ratio of the internal oblique to the rectus abdominis was very high due to minimal relative activity of the rectus abdominis. In general, the ratio of the internal/external abdominal oblique activity was about 1. However, during the unilateral bridging exercise, the ipsilateral internal/external abdominal oblique activity ratio was 2.79 as a consequence of the significant higher relative activity of the internal oblique compared to the external oblique. The relative muscle activity and the ratios of the back muscles demonstrated similar activity levels for all back muscles, resulting in ratios about 1. Conclusion Both the minimal relative activity of the rectus abdominis and the high internal oblique to the rectus abdominis activity ratio reported in the present study are in accordance with results of other trunk stabilization exercises. The relative muscle activity and the ratio of the abdominal obliques seem to alter depending on the task and the presumable need for stability. The findings concerning the relative muscle activity and the ratios of the back muscles support the assumption that during these bridging exercises, all back muscles contribute in a similar way to control spine positions and movements in a healthy population.

Stevens, Veerle K; Bouche, Katie G; Mahieu, Nele N; Coorevits, Pascal L; Vanderstraeten, Guy G; Danneels, Lieven A



Length-tension curves of human eye muscles during succinylcholine-induced contraction.  


We have made intraoperative, continuous-registration, length-tension diagrams of detached eye muscles in 80 strabismus patients under general anaesthesia. In 47 of these we repeated the measurements after contraction evoked by succinylcholine chloride. In contracting horizontal and vertical rectus muscles, we found a linear relation between length and tension. In contracting oblique muscles, however, the relation between length and tension was frequently nonlinear. In superior oblique palsies, the superior oblique was found to be stiff after elongation and before injection of succinylcholine, and it did not contract after injection of succinylcholine. The ipsilateral inferior oblique did contract after injection of succinylcholine, but with a higher spring constant than usual (ie, contracture of the ipsilateral antagonist). In three cases the superior oblique contracted vividly after administration of succinylcholine despite the presence of excyclotropia, stereopsis, torticollis (two cases) and a hypertropia that increased in adduction, in down-gaze, in adduction and down-gaze and on ipsilateral head-tilt. In a case of general fibrosis syndrom we found almost normally contracting vertical recti, which is compatible only with a supranuclear or misdirectional cause. These cases demonstrate the usefulness of the assessment of the length-tension diagram of an eye muscle during surgery, before and during contraction evoked by succinylcholine chloride. PMID:3417416

Simonsz, H J; Kolling, G H; van Dijk, B; Kaufmann, H



Major orbital complications of endoscopic sinus surgery  

PubMed Central

BACKGROUND—The paranasal sinuses are intimately related to the orbit and consequently sinus disease or surgery may cause severe orbital complications. Complications are rare but can result in serious morbidity, the most devastating of which is severe visual loss.?METHODS—A retrospective review was undertaken of four cases of severe orbital trauma during endoscopic sinus surgery.?RESULTS—All the cases suffered medial rectus damage, one had additional injury to the inferior rectus and oblique, and two patients were blinded as a result of direct damage to the optic nerve or its blood supply.?CONCLUSION—Some ophthalmic complications of endoscopic sinus surgery are highlighted, the mechanisms responsible are discussed, and recommendations for prevention, early recognition, and management are proposed. ??

Rene, C; Rose, G; Lenthall, R; Moseley, I



Spatial orientation of extraocular muscle EMG responses to tilt in the rabbit during postnatal development  

Microsoft Academic Search

Unanaesthetized pigmented rabbits 2–45 days of age were gradually tilted (15° steps) over 360° around three orthogonal body axes. The multiunit electromyogram activity of superior rectus (SR) and superior oblique (SO) extraocular muscles was recorded with chronically implanted pairs of fine wire electrodes after each tilt step. The integrated EMG activity of the extraocular muscles in response to static tilt

Helmut Tegetmeyer



TLR4 mediate intrauterine growth restriction after systemic C. rectus infection in mice  

PubMed Central

Summary Campylobacter rectus is associated with fetal exposure and low-birth weight in humans. C. rectus also invades placental tissues and induces fetal intrauterine growth-restriction (IUGR) in mice, along with Toll-like receptors (TLR4) overexpression, suggesting that TLR4 may mediate placental immunity and IUGR in mice. To test this hypothesis we examined the effect of in vitroTLR4 neutralization in trophoblastic proinflammatory activity and studied the IUGR phenotype in a congenic TLR4-mutant mouse strain after in vivo C. rectus infection. Human trophoblasts were pretreated with TLR4 neutralizing antibodies and infected with C. rectus; pro-inflammatory cytokine production was assessed by cytokine multiplexing assays. Neutralizing TLR4 antibodies significantly impaired the production of pro-inflammatory cytokines in trophoblastic cells after infection in a dose-dependent manner. We used a subcutaneous chamber model to provide a C. rectus challenge in BALB/cAnPt (TLR4Lps-d) and wild-type(WT) females. Females were mated with WT or TLR4Lps-dmales once/week; pregnant mice were infected at (E)7.5 and sacrificed at (E)16.5 to establish IUGR phenotypes. Maternal C. rectus infection significantly decreased fetal weight/length in infected WT when compared to sham WT controls(P<0.05, ANOVA). However, infected TLR4Lps-d?/? mice did not show statistically significant differences in fetal weight and length when compared to WT controls(P>0.05). Furthermore, heterozygous TLR4Lps-d ?/+fetuses showed IUGR phenotype rescue. We concluded that TLR4 is an important mediator of trophoblastic proinflammatory responses and TLR4-deficient fetuses do not develop IUGR phenotypes after C. rectus infection, suggesting that placental cytokine activation is likely to be mediated by TLR4 during low birth weight/preterm delivery pathogenesis.

Arce, R.M.; Caron, K.M.; Barros, S.P.; Offenbacher, S.



Preliminary results using a flexible endoscope for orbital surgery  

Microsoft Academic Search

A technique for visualizing the optic nerve, the short and long posterior ciliary arteries and nerves, the ophthalmic vein, and the rectus muscles using a flexible endoscope was developed in human cadavers. Previous reports of orbital endoscopy were limited to the use of a rigid endoscope. Potential applications for this new flexible endoscopic technique include the biopsy of orbital tumors,

Alexander M. Eaton; Richard E. Braunstein; Herman D. Schubert; Stephen L. Trokel; Jeffery G. Odel; Myles M. Behrens



Use of MMG Signals for the Control of Powered Orthotic Devices: Development of a Rectus Femoris Measurement Protocol  

Microsoft Academic Search

A test protocol is defined for the purpose of measuring rectus femoris mechanomyographic (MMG) signals. The protocol is specified in terms of the following: measurement equipment, signal processing requirements, human postural requirements, test rig, sensor placement, sensor dermal fixation, and test procedure. Preliminary tests of the statistical nature of rectus femoris MMG signals were performed, and Gaussianity was evaluated by

Michele Gabrio Antonelli; P. Beomonte Zobel; J. Giacomin



Arthroscopic excision of heterotopic calcification in a chronic rectus femoris origin injury: a case report  

PubMed Central

Rectus femoris origin injuries in adult athletes are uncommon. In the acute phase, conservative treatment seems to have a favourable outcome, with surgical repair reserved for unsuccessful cases only. However, a group of patients may develop chronic pain and disability after recovery from the acute phase due to heterotopic calcification occurring at the site of injury. Open and arthroscopic excision of such calcifications has been described in the literature although arthroscopic excision of large calcified lesions in the rectus femoris has not been reported previously. A relevant case is presented and discussed.

El-Husseiny, M; Sukeik, M; Haddad, FS



Dynamic reconstruction of full-thickness abdominal wall defects using free innervated vastus lateralis muscle flap combined with free anterolateral thigh flap.  


Reconstruction of full-thickness abdominal wall defects remains a difficult surgical challenge. Although various reconstructive methods, including artificial mesh, pedicled and free flaps, have been reported, most reported reconstruction of only the fascia layer, leaving the resected rectus abdominis muscle unreconstructed. However, recent studies suggested the importance of dynamic reconstruction with functional muscle in preventing abdominal hernia in the long-term. According to the principle of reconstructive surgery, "replace lost tissue with similar tissue," a functionally and aesthetically ideal reconstruction is to reconstruct all components of the abdominal wall structure, including skin, subcutaneous fat, fascia, and muscle. We present 2 cases with full-thickness abdominal wall defects in the upper abdominal region, which we reconstructed with a free innervated vastus lateralis muscle flap combined with a free anterolateral thigh flap. The motor nerve of the vastus lateralis muscle was sutured with the intercostal nerve, and reinnervation was confirmed by electromyography. This method allows reconstruction of all components of the abdominal wall with a single flap, and dynamic reconstruction is achieved which will reduce the risk of postoperative hernia. We believe this method can be a good option for reconstruction of full-thickness abdominal wall defects with long-term stability. PMID:22214798

Iida, Takuya; Mihara, Makoto; Narushima, Mitsunaga; Todokoro, Takeshi; Hara, Hisako; Yoshimatu, Hidehiko; Koshima, Isao; Kadono, Takafumi



A comparison of the effects of epidural and spinal anesthesia with ischemia-reperfusion injury on the rat transverse rectus abdominis musculocutaneous flap.  


The purpose of this study is to compare the effects of spinal and epidural anesthesia on a rat transverse rectus abdominus myocutaneous flap ischemia-reperfusion injury model.Forty Sprague-Dawley rats were divided into 4 experimental groups: group I (n = 10), sham group; group II (n = 10), control group; group III (n = 10), epidural group; and group IV (n = 10), spinal group. After the elevation of the transverse rectus abdominus myocutaneous flaps, all groups except for the sham group were subjected to normothermic no-flow ischemia for 4 hours, followed by a reperfusion period of 2 hours. At the end of the reperfusion period, biochemical and histopathological evaluations were performed on tissue samples.Although there was no significant difference concerning the malonyldialdehyde, nitric oxide, and paraoxonase levels in the spinal and epidural groups, the total antioxidant state levels were significantly increased, and the total oxidative stress levels were significantly decreased in the epidural group in comparison to the spinal group. The pathological evaluation showed that findings related to inflammation, nuclear change rates and hyalinization were significantly higher in the spinal group compared with the epidural group.Epidural anesthesia can be considered as a more suitable method that enables a decrease in ischemia-reperfusion injuries in the muscle flaps. PMID:23187711

Acar, Yusuf; Bozkurt, Mehmet; Firat, Ugur; Selcuk, Caferi Tayyar; Kapi, Emin; Isik, Fatma Birgul; Kuvat, Samet Vasfi; Celik, Feyzi; Bozarslan, Beri Hocaoglu



Preliminary results using a flexible endoscope for orbital surgery  

NASA Astrophysics Data System (ADS)

A technique for visualizing the optic nerve, the short and long posterior ciliary arteries and nerves, the ophthalmic vein, and the rectus muscles using a flexible endoscope was developed in human cadavers. Previous reports of orbital endoscopy were limited to the use of a rigid endoscope. Potential applications for this new flexible endoscopic technique include the biopsy of orbital tumors, fenestration of the optic nerve sheath with mid-infrared lasers, photocoagulation of orbital tumors, and retrieval of foreign bodies or slipped muscles.

Eaton, Alexander M.; Braunstein, Richard E.; Schubert, Herman D.; Trokel, Stephen L.; Odel, Jeffery G.; Behrens, Myles M.



Influence of the recipient vessel on fat necrosis after breast reconstruction with a free transverse rectus abdominis myocutaneous flap.  


The effect of the selection of recipient vessels on the rate of fat necrosis after microsurgical reconstruction of the breast remains largely unknown. Our aim was to evaluate the incidence of fat necrosis after unilateral breast reconstruction with a free transverse rectus abdominis myocutaneous (TRAM) flap after anastomosis with either the internal mammary vessels or the thoracodorsal artery and vein. Consecutive patients who had unilateral reconstruction with a free, muscle-sparing TRAM flap at two tertiary care centres over a 6-year period were identified. The incidence of fat necrosis, defined as postoperative firmness of 1 cm or more persisting for 3 months or more after anastomosis was calculated. To control for the effect of potentially confounding variables (body mass index (BMI), history of preoperative or postoperative radiation, previous abdominal operation, smoking, and hospital) we did a matched-cohort study. A total of 840 unilateral muscle-sparing TRAM flaps were done using either the internal mammary (n = 109) or the thoracodorsal (n = 731) vessels. Evaluation of the entire cohort showed that the incidence of fat necrosis after the two anastomoses was 13 (12%) compared with 130 (18%), respectively (p = 0.17). To control for the effect of confounding variables, 98 patients who had internal mammary anastomoses were matched 1:1 with 98 patients who had thoracodorsal anastomoses. Pair-wise comparisons showed that the incidence of fat necrosis was significantly higher when the thoracodorsal vessels were used (29; 30%) compared to when the internal mammary vessels were used (12; 12%; p = 0.002). Our results showed that a higher rate of fat necrosis may be seen after muscle-sparing TRAM flap reconstruction after anastomosis to the thoracodorsal vessels than with the internal mammary vessels. The exact mechanisms of this association are unknown and warrant additional investigation. PMID:20465509

Kropf, Nina; Macadam, Sheina A; McCarthy, Colleen; Disa, Joseph J; Pusic, Andrea L; Da Lio, Andrew; Crisera, Christopher; Mehrara, Babak J



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

Microsoft Academic Search

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

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



The use of transposed rectus femoris muscle in the treatment of infected abdominal wounds  

Microsoft Academic Search

Summary  A recent publication, where three experienced workers in the field of managing post-operative contaminated open wounds, especially\\u000a of the abdominal wall, underscores the considerable number of different methods that are in vogue. Infected abdominal wounds\\u000a are usually treated by debridement, the administration of appropriate antibiotics and wound closure on a delayed basis. In\\u000a the presence of a surgical implant, the

R. Ger; G. Angus



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

Microsoft Academic Search

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

Michael C. Anderson; Nicholas A. T. Brown; Kent N. Bachus; Bruce A. MacWilliams



Use of rectus fascia graft for corporeal reconstruction during placement of penile implant  

Microsoft Academic Search

ObjectivesTo report on the technique of using autologous rectus fascia graft for corporeal and tunica reconstruction during placement of an inflatable penile prosthesis. Reconstructing the corpora cavernosa and closing the tunica albuginea over an inflatable penile prosthesis can be challenging when severe fibrosis is encountered.

Apurba S. Pathak; Joseph H. Chang; Ashish R. Parekh; Sherif R. Aboseif



Antibiotic prophylaxis with teicoplanin in patients undergoing breast reconstruction with the transverse rectus abdominis myocutaneous flap  

Microsoft Academic Search

The authors report the results of a randomized clinical trial of antibiotic prophylaxis for post-operative infection following breast reconstruction with the transverse rectus abdominis myocutaneous (TRAM) flap. The aim was to evaluate the efficacy and tolerability of short-term parenteral prophylaxis with teicoplanin; the endpoint of the study was the reduction of wound contamination assessed by microbiologic culture of drain fluid.

S. Franchellil; M. S. Leone; M. L. Rainero; M. Gipponi; F. Cafiero; R. Capuzzo; M. Costantini; P. L. Santi



Effect of two loading rates on the elasticity of the human anterior rectus sheath.  


Tensile properties of connective tissues of the abdominal wall are necessary to better analyze the mechanical response of the human abdominal wall. Some tensile properties of these tissues have been reported in the past but data are still missing regarding the dependence of the elasticity on the loading rate, especially for the rectus sheath. Thus the aim of this study was to assess for the variation of human anterior rectus sheath elasticity using two loading rates. Seventeen samples of the rectus sheath were taken from three human post-mortem subjects and tested under tension at two different loading rates (0.01s(-1) and 50s(-1)). The mean value (standard deviation) of the quasi-static elasticity is 5.6 (3.2)MPa for the rectus sheath. The values at the high loading rate are 14 (8.3)MPa. The failure strength and the elasticity (at 50s(-1)) are significantly correlated (r²=0.79, p<0.01). Such a relationship opens the way to the estimation of the failure strength by a unique measurement of the elasticity. The loading rate influence was statistically significant with a linear elasticity 2.5 times greater at 50s(-1) than 0.01s(-1). Thus the loading rate influence on the mechanical properties would have to be taken into account in models considering transitory loading such as coughing and sneezing. PMID:23434793

Ben Abdelounis, H; Nicolle, S; Otténio, M; Beillas, P; Mitton, D



A new dose-response curve for bilateral medial rectus recessions for infantile esotropia  

Microsoft Academic Search

Purpose: In 1982, Mims et al1 generated the first rigorous dose-response curve for bilateral medial rectus recessions for infantile esotropia (ET). Curve fitting calculations were hampered by substantial variability of surgical effect for the larger angles of ET, and an exponential curve was chosen for angles below 30 ET and a straight line for angles above 30 ET. In a

Huy M. Tran; James L. Mims; Robert C. Wood



[Pelvic reconstruction after tubular rectumresection (extended abdominoperineal resection combined with extended transpelvic myocutaneous M. rectus abdominis flap (extended VRAM) in low rectum cancer - case series)].  


In advanced lower rectal cancer tubular abdomino-perineal resection (APR) in combination with simultaneous extended distally pedicled vertical rectus abdominis muscle flap (VRAM) facilitates a more radical tumor resection. Additionally a prolapse of small intestine into the pelvis can be blocked and a perineal defect coverage can be achieved. 4 patients have been treated with an interdisciplinary one stage combined tubular APR and extended VRAM. In all cases a R0 resection and a complete defect closure could be achieved.The extended VRAM is an appropriate technique to close the pelvic defect because it originates from a non irradiated area, has a monitor island, and the donor site does not handicap the patient as much as local flaps. This interdisciplinary approach facilitates a more radical tumor resection and thus reduces the risk of recurrence. PMID:22956283

Dahmann, S; Simunec, D; Caylak, T; Biermann, L; Frommhold, K; Meyer-Marcotty, M V



Day zero ambulation under modified femoral nerve block after minimally invasive surgery for total knee arthroplasty: preliminary report.  


Ambulation in the early postoperative period of total knee arthroplasty is crucial, in order to avoid complications and obtain preferable outcomes. Although a femoral nerve block can provide enough postoperative analgesia after total knee arthroplasty, falling, or other accidents due to motor paresis, are potentially adverse events in patients who have received a conventional femoral nerve block. We devised a modified femoral nerve block to spare voluntary knee extension ability, and clinically applied it to patients who received total knee arthroplasty under minimally invasive surgery. In our new-approach nerve blockade technique, the main targets of the sensory nerves are the saphenous nerves which branch out from the femoral nerve trunk. All the patients rated pain at bed rest between 0 and 3 on a numerical rating scale 3 h after the operation. In addition, the rectus femoris muscle was not affected at all, and the surgically invaded vastus medialis oblique muscle was completely anesthetized. Patients were able to not only actively raise their extremities with their knee in extension, but also to flex the knee in the air without pain or aggravation. On day 0, the patients were able to walk around, with the leg that had been operated upon not giving way. Our anesthetic approach can provide better pain relief than a conventional femoral nerve block, while the patients achieve ambulation on the day of the procedure, following minimally invasive knee surgery. PMID:22955443

Ishiguro, Shigeo; Asano, Naoki; Yoshida, Kakunoshin; Nishimura, Akinobu; Wakabayashi, Hiroki; Yokochi, Ayumu; Hasegawa, Masahiro; Sudo, Akihiro; Maruyama, Kazuo



Rectus abdominis myocutaneous flaps for perineal reconstruction: modifications to the technique based on a large single-centre experience  

PubMed Central

INTRODUCTION Perineal wound breakdown with delayed wound healing represents a significant cause of morbidity following surgery and radiotherapy to the perineum. The rectus abdominis myocutaneous (RAM) flap has been used increasingly to reconstruct the perineum with good effect. We describe our six-year experience of reconstruction of the perineum with the RAM flap and share some surgical adjuncts we believe are useful. METHODS We conducted a retrospective case note review of all patients who underwent a reconstruction of the perineum using the RAM flap between August 2003 and October 2009. Indications for the flap, complication rates and outcomes were all observed. RESULTS We conducted 16 RAM flap procedures, 15 of which (94%) were primary repairs and 1 (6%) a secondary repair. Three (19%) developed donor site hernias, two (12.5%) developed minor perineal wound infections, eight (50%) developed minor perineal wound breakdown and in one (6%) flap failure was observed. No perineal hernias were observed. There were no surgical mortalities. CONCLUSIONS The RAM flap has a high success rate and an acceptable morbidity rate and is a useful tool in the reconstruction of complex perineal wounds. Modifications to the standard surgical technique may reduce complications and improve the versatility of this flap.

McMenamin, DM; Clements, D; Edwards, TJ; Fitton, AR; Douie, WJP



A study of postural changes after abdominal rectus plication abdominoplasty.  


PURPOSE: Factors such as body masses and humour are known to influence human posture. Abdominoplasty, which causes a sudden change in body masses, significantly improves body image and self-esteem. The aim of this study was to assess postural changes after abdominoplasty by studding the position and orientation through space of the body and the centre of pressure. METHODS: Patients affected by excess abdominal skin and/or significant abdominal muscular anterior wall laxity due to undergo an abdominoplasty were enrolled. Posture was evaluated both before and for 1 year after surgery by quantifying the centres of mass, using the Fastrak™ system, and the centre of pressure, using stabilometry. The Wilcoxon signed-rank sum test was used to compare changes. RESULTS: Forty-six patients were enrolled. A retro-positioning of the pelvis with a compensatory advancement of the head and shoulders, confirmed by the baropodometric analysis, was evident in the early post-operative period. The biomechanical system subsequently stabilized, achieving a state of equilibrium 1 year after surgery. CONCLUSIONS: We believe that the change in posture following abdominoplasty is a consequence of both surgery (changes in body masses) and psychological factors that influence posture. Indeed, redundant abdominal skin and abdominal muscular anterior wall weakness are often associated with kyphosis since patients try to hide what they consider to be a source of embarrassment. The discovery of a new body image eliminates dissatisfaction, reduces anxiety and increases self-esteem, which provide psychological and physical benefits that improve the quality of life. PMID:23132640

Mazzocchi, M; Dessy, L A; Di Ronza, S; Iodice, P; Saggini, R; Scuderi, N



Influence of hip external rotation on hip adductor and rectus femoris myoelectric activity during a dynamic parallel squat.  


This study sought to compare the myoelectric activity of the hip adductors (HAs) and rectus femoris (RF) when the hip was in a neutral position or externally rotated by 30° or 50° (H0, H30, and H50, respectively) during a parallel squat. Ten healthy subjects performed 10 repetitions of squats in each of the 3 hip positions and the myoelectric activities of the HAs and RF were recorded. The signal was then divided into categories representing concentric (C) and eccentric (E) contractions in the following ranges of motion: 0-30° (C1 and E1), 30-60° (C2 and E2), and 60-90° (C3 and E3) of knee flexion. From those signals, an root mean square (RMS) value for each range of motion in each hip position was obtained. All values were normalized to those obtained during maximum voluntary isometric contraction. We found that HAs showed a significant increase in myoelectric activity during C3 and E3 in the H30 and H50 positions, as compared with H0. Meanwhile, RF activity did not significantly differ between hip positions. Both muscles showed higher activation during 60-90° (C3 and E3) of knee flexion, as compared with 0-30° (C1 and E1) and 30-60° (C2 and E2). The results suggest that if the aim is to increase HA activity despite the low percentage of muscle activation, squats should be performed with 30° of external rotation and at least 90° of knee flexion. PMID:20651607

Pereira, Glauber Ribeiro; Leporace, Gustavo; Chagas, Daniel das Virgens; Furtado, Luis F L; Praxedes, Jomilto; Batista, Luiz A



Clinico-radiologic findings of entrapped inferior oblique muscle in a fracture of the orbital floor.  


A 51-year old man presented with vertical and torsional diplopia after reduction of a blowout fracture at another hospital one year ago. He had no anormalies of head position and 14 prism diopters (PD) right hypertropia (RHT) in the primary position. In upgaze no vertical deviation was found, and hyperdeviation on downgaze was 35PD. Bielschowsky head tilt test showed a negative response. Distinct superior oblique (SO) and inferior rectus (IR) underaction of the right eye was noted but IO overaction was mild on the ocular version test. Double Maddox rod test (DMRT) revealed 10-degree extorsion, but fundus extorsion was minimal in the right eye.Thin-section coronal CT scan showed that there was no fracture line on the anterior orbital floor, but a fracture remained on the posterior orbital floor. Also, the anterior part of the right inferior oblique muscle was vertically reoriented and the medial portion of the inferior oblique muscle was not traced on the coronal CT scan. The patient underwent 14 mm right IO recession and 3 mm right IR resection. One month after the surgery, his vertical and torsional diplopia were eliminated in the primary position. PMID:19794954

Kim, Soo; Kim, Taik-Kun; Kim, Seung-Hyun



[Some properties of transport ATPases in functionally different muscles].  


The properties of Ca-transporting system in sarcoplasmic reticulum membranes in fast and slow frog muscles as well as some properties of sarcolemma Na, K-ATPase of the same object were investigated. The rate of Ca2+ uptake, Ca-ATPase activity and Ca/ATP ratio for the reticulum of fast muscle demonstrated higher values than those for the reticulum of slow muscle. The rate of Ca2+ accumulation by the fragments of the rectus reticulum and Ca/ATP ratio were found to decrease under the influence of acetylcholine (0.05-5 mM). The transport system of the sartorius reticulum was found to be less sensitive to acetylcholine. The peak activity of Na, K-ATPase in femoral muscles of the frog occurred at 80 mM NaCl and 60 mM KCl, whereas in the rectus abdominal muscle it equalled 100 mM NaCl and 40 mM KCl. Thus, Na, K-ATPase activity in the slow muscle was predominantly higher than that in the mixed (femoral) muscles. If the sarcolemma preparations of the muscles of both types the inhibitory effect of acetylcholine on Na; K-ATPase was registered. The enzyme of slow muscles exhibited higher sensibility to acetylcholine. PMID:139169

Esyrev, O V; Uspanova AhK; Omarova, R D; Sarsenova, Sh S; Kniazevskaia, I B



Spontaneous rectus sheath hematoma diagnosed by point-of-care ultrasonography.  


ABSTRACTSpontaneous rectus sheath hematoma is an uncommon condition that can mimic other conditions associated with an acute abdomen. We report the case of a patient with a spontaneous rectus sheath hematoma due to a ruptured inferior epigastric artery pseudoaneurysm who presented with hypotension and severe abdominal pain and was diagnosed using emergency department point-of-care ultrasonography. Point-of-care ultrasonography has been increasingly used in the evaluation of emergency department patients with acute abdomen and hypotension to expedite the diagnosis and management of aortic aneurysm and intraperitoneal bleeding. Resuscitation and urgent surgical and interventional radiology consultations resulted in the successful embolization of a branch of the inferior epigastric artery and a good outcome. PMID:23458146

Shokoohi, Hamid; Boniface, Keith; Reza Taheri, M; Pourmand, Ali



Rectus sheath haematoma: a rare presentation of non-contact strenuous exercises  

PubMed Central

Rectus sheath haematoma (RSH) is a well?documented but uncommon clinical condition. It is usually a self?limiting condition but can present as a life?threatening emergency. RSH after non?contact vigorous exercise is unknown. Two such cases secondary to yoga and laughter therapy sessions, respectively, are reported. One of them required surgical intervention, whereas the other was successfully treated conservatively.

Sharma, Hemant; Shekhawat, Narayan Singh; Bhandari, Sudhir; Memon, Breda; Memon, Muhammed Ashraf



High-density areas on muscle CT in childhood-onset Pompe disease are caused by excess calcium accumulation  

Microsoft Academic Search

We report two patients with childhood-onset Pompe disease showing striking changes with high-density areas on skeletal muscle\\u000a CT, not seen in adult- or infantile-onset forms of this disease. While the anterior compartment of the thigh muscles was less\\u000a affected in the adult-onset form, the rectus femoris and tibial muscles were preferentially involved from the early stage\\u000a in the childhood-onset form

Keiko Ishigaki; Satomi Mitsuhashi; Ryohei Kuwatsuru; Terumi Murakami; Keiko Shishikura; Haruko Suzuki; Yoshito Hirayama; Ikuya Nonaka; Makiko Osawa



A comparison of three induction regimens using succinylcholine, vecuronium, or no muscle relaxant: impact on the intraoperative monitoring of the lateral spread response in hemifacial spasm surgery: study protocol for a randomised controlled trial  

PubMed Central

Background Surgical microvascular decompression (MVD) is the curative treatment for hemifacial spasm (HFS). Monitoring MVD by recording the lateral spread response (LSR) intraoperatively can predict a successful clinical outcome. However, the rate of the LSR varies between trials, and the reason for this variation is unclear. The aim of our trial is to evaluate the rate of the LSR after intubation following treatment with succinylcholine, vecuronium, or no muscle relaxant. Methods and design This trial is a prospective randomised controlled trial of 96 patients with HFS (ASA status I or II) undergoing MVD under general anaesthesia. Patients are randomised to receive succinylcholine, vecuronium, or no muscle relaxant before intubation. Intraoperative LSR will be recorded until dural opening. The primary outcome of this study is the rate of the LSR, and the secondary outcomes are post-intubation pharyngolaryngeal symptoms, the rate of difficult intubations, the rate of adverse haemodynamic events and the relationship between the measurement of LSR or not, and clinical success rates at 30?days after surgery. Discussion This study aims to evaluate the impact of muscle relaxants on the rate of the LSR, and the study may provide evidence supporting the use of muscle relaxants before intubation in patients with HFS undergoing MVD surgery. Trials registration ChiCTR-TRC-11001504 Date of registration: 24 June, 2011. The date the first patient was randomised: 30 September, 2011.



Your Muscles  


... and skeletal (say: SKEL-uh-tul) muscle. Smooth Muscles Smooth muscles — sometimes also called involuntary muscles — are ... muscles keep the eyes focused. Continue A Hearty Muscle The muscle that makes up the heart is ...



PubMed Central

Background Antagonistic activation of abdominal muscles and raised intra-abdominal pressure are associated with both spinal unloading and spinal stabilization. Rehabilitation regimens have been proposed to improve spinal stability via selective recruitment of certain trunk muscle groups. This biomechanical study used an analytical model to address whether lumbar spinal stability is increased by selective activation of abdominal muscles. Methods The biomechanical model included anatomically realistic three-layers of curved abdominal musculature connected by fascia, rectus abdominis and 77 symmetrical pairs of dorsal muscles. The muscle activations were calculated with the model loaded with either flexion, extension, lateral bending or axial rotation moments up to 60 Nm, along with intra-abdominal pressure up to 5 or 10 kPa (37.5 or 75 mm Hg) and partial bodyweight. After solving for muscle forces, a buckling analysis quantified spinal stability. Subsequently, different patterns of muscle activation were studied by forcing activation of selected abdominal muscles to at least 10% or 20% of maximum. Findings The spinal stability increased by an average factor of 1.8 with doubling of intra-abdominal pressure. Forced activation of obliques or transversus abdominis muscles to at least 10% of maximum increased stability slightly for efforts other than flexion, but forcing at least 20% activation generally did not produce further increase in stability. Forced activation of rectus abdominis did not increase stability. Interpretation Based on predictions from an analytical spinal buckling model, the degree of stability was not substantially influenced by selective forcing of muscle activation. This casts doubt on the supposed mechanism of action of specific abdominal muscle exercise regimens that have been proposed for low back pain rehabilitation.

Stokes, Ian A.F.; Gardner-Morse, Mack G.; Henry, Sharon M.



Muscle activity during different styles of deep water running and comparison to treadmill running at matched stride frequency.  


The purpose of this study was to compare muscle activity during deep water running (DWR) and treadmill running on dry land (TMR) as well as to investigate effect of stride frequency (SF) on muscle activity while using different styles of DWR (high-knee and cross-country styles, DWR-HK and DWR-CC, respectively). Eight subjects participated in this study. The baseline condition consisted of TMR at the preferred stride frequency (PSF). The remaining conditions consisted of DWR-HK and DWR-CC at PSF, PSF-15%, and PSF+15%. Muscle activity was recorded from the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius. Rectus femoris and biceps femoris muscle activity during DWR-CC-PSF were significantly greater than that of TMR-PSF (P<0.05). However, rectus femoris muscle activity during DWR-HK-PSF was significantly lower than that of TMR-PSF (P<0.05). Gastrocnemius muscle activity during both DWR-HK-PSF and DWR-CC-PSF were significantly lower than that of TMR-PSF (P<0.05). Furthermore, muscle activity from all tested muscles during DWR-HK and DWR-CC increased with increasing SF (P<0.05). These observations indicated that muscle activity is influenced not only by running in the water but also by the style of DWR (DWR-HK, DWR-CC) used. PMID:23195856

Masumoto, Kenji; Applequist, Bryon C; Mercer, John A



Treatment for 'A' or 'V' pattern esotropia by slanting muscle insertion.  

PubMed Central

BACKGROUND--Patients with 'A' or 'V' pattern esotropia without vertical muscle overaction have traditionally been treated with medial rectus recession and vertical transposition of the muscle insertions. METHOD--Seven cases are presented treated by slanting muscle insertions, whereby the lower margin of the medial rectus is preferentially recessed more than the upper margin in esotropia, and the upper margin is recessed more than the lower margin in A esotropia. RESULTS--All seven patients had their A or V patterns eliminated, with six achieving good alignment in all positions of gaze. CONCLUSION--The slanting muscle insertion should be considered as an alternative technique in all cases of A or V pattern esotropia.

Biedner, B; Rothkoff, L



The Deep Inferior Epigastric Perforator and Pedicled Transverse Rectus Abdominis Myocutaneous Flap in Breast Reconstruction: A Comparative Study  

PubMed Central

Background Our objective was to compare the complication rates of two common breast reconstruction techniques performed at our hospital and the cost-effectiveness for each test group. Methods All patients who underwent deep inferior epigastric perforator (DIEP) flap and transverse rectus abdominis myocutaneous (TRAM) flap by the same surgeon were selected and matched according to age and mastectomy with or without axillary clearance. Patients from each resultant group were selected, with the patients matched chronologically. The remainder were matched for by co-morbidities. Sixteen patients who underwent immediate breast reconstruction with pedicled TRAM flaps and 16 patients with DIEP flaps from 1999 to 2006 were accrued. The average total hospitalisation cost, length of hospitalisation, and complications in the 2 year duration after surgery for each group were compared. Results Complications arising from both the pedicled TRAM flaps and DIEP flaps included fat necrosis (TRAM, 3/16; DIEP, 4/16) and other minor complications (TRAM, 3/16; DIEP, 1/16). The mean hospital stay was 7.13 days (range, 4 to 12 days) for the pedicled TRAM group and 7.56 (range, 5 to 10 days) for the DIEP group. Neither the difference in complication rates nor in hospital stay duration were statistically significant. The total hospitalisation cost for the DIEP group was significantly higher than that of the pedicled TRAM group (P<0.001). Conclusions Based on our study, the pedicled TRAM flap remains a cost-effective technique in breast reconstruction when compared to the newer, more expensive and tedious DIEP flap.

Tan, Shane; Yek, Jacklyn; Ong, Wei Chen; Hing, Chor Hoong; Lim, Thiam Chye



Sensory evaluation of beef-flavor-intensity, tenderness, and juiciness among major muscles  

Microsoft Academic Search

Twelve muscles from eight USDA Select\\/Choice grade steers were evaluated for beef-flavor intensity, tenderness, and juiciness. The biceps femoris, psoas major, gluteus medius, semimembranosus, and triceps brachii were similar in beef-flavor-intensity (P > 0·05) and were ranked as the most intensely flavored of all muscles. The rectus femoris, longissimus lumborum, serratus ventralis, infraspinatus, semitendinosus, pectoralis profundus, and supraspinatus generally were

C. F. Carmack; C. L. Kastner; M. E. Dikeman; J. R. Schwenke; C. M. García Zepeda



The effect of aqueous extract of orthosiphon thymiflorus on isolated skeletal muscles.  


Effects of an aqueous extract of orthosiphon thymiflorus on acetyl choline induces contraction on isolated frog rectus abdominis muscle were studies. The aqueous extract of orthosiphon thymiflorus produced significant inhibitory effect on the dose response curve of acetyl choline. It is concluded that the aqueous extract of orthosiphon thymiflorus  may exert an inhibitory effect on the skeletal muscle contraction and may be due to inhibition of the effect of acetylcholine at the receptor site. PMID:22556868

Kavimani, S; Elango, R; Gupta, M; Majumdar, U K



Combination of hypoxic preconditioning and postconditioning does not induce additive protection of ex vivo human skeletal muscle from hypoxia/reoxygenation injury.  


We previously demonstrated that hypoxic preconditioning (HPreC) or postconditioning (HPostC) protected ex vivo human skeletal muscle from hypoxia/reoxygenation injury. Here, we investigated if combined HPreC and HPostC could convey additive protection. Human rectus abdominis muscle strips were cultured in normoxic Krebs buffer for 5 hours (control) or in 3 hours hypoxic/2 hours normoxic buffer (treatment groups). HPreC and HPostC were induced by 1 cycle of 5 minutes hypoxia/5 minutes reoxygenation immediately before or after 3 hours hypoxia, respectively. Muscle injury, viability, and adenosine triphosphate (ATP) synthesis were assessed by measuring lactate dehydrogenase release, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide reduction, and ATP content, respectively. Hypoxia/reoxygenation caused lactate dehydrogenase to increase and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide reduction and ATP content to decrease (P < 0.05; n = 7). HPreC, HPostC, and combination of both were equally effective in protection of muscle from hypoxia/reoxygenation injury. Atractyloside (5 × 10 M), a mitochondrial permeability transition pore opener, abolished the protective effect of HPreC or HPostC. We conclude that HPreC and HPostC protect ex vivo human skeletal muscle against hypoxia/reoxygenation injury by closing the mitochondrial permeability transition pore. For that reason, they are equally effective and do not demonstrate an additive effect. Moreover, the potent effect of HPostC indicates ischemic postconditioning as an effective clinical intervention against reperfusion injury in autogenous skeletal muscle transplantation and replantation surgery. PMID:22691884

Naparus, Andreas; Ashrafpour, Homa; Huang, Ning; Hofer, Stefan O P; Zhong, Toni; Forrest, Christopher R; Pang, Cho Y



The effect of an exercise ball on trunk muscle responses to rapid limb movement.  


The use of exercise balls as an aid to facilitate improvements in posture in patients with trunk weakness is widely advocated. However, mechanisms underlying any effect on postural mechanisms have received little attention. This study compared the increases in trunk EMG activity in response to limb movement when seated on an exercise ball or on a chair in 16 healthy, moderately active subjects. At the sound of an auditory cue, the subjects carried out either hip flexion or arm flexion (unilateral or bilateral), as fast as possible, whilst sitting on an exercise ball or a standard chair. The amplitude of EMG activity was recorded from selected trunk muscles (erector spinae, external obliques, internal obliques and rectus abdominis) and either an upper limb muscle (deltoid) or a lower limb muscle (rectus femoris). There were minimal differences in amplitudes of EMG activity in any of the trunk muscles between the conditions (ball or chair) following the upper limb movements. These results suggest that there is no benefit in simple arm flexion movements whilst seated on the exercise ball in comparison to a chair. The onset and amplitude of the rectus abdominis (RA) and external obliques (EO) were significantly different between conditions in the hip flexion protocol. However, they do suggest significant benefit in decreasing RA and EO muscle activity onsets and increasing amplitude in the hip flexion condition. These results may have implications for rehabilitation of those with trunk muscle deficits such as stroke. PMID:22050973

Weaver, H; Vichas, D; Strutton, P H; Sorinola, I



Synergists activation pattern of the quadriceps muscle differs when performing sustained isometric contractions with different EMG biofeedback  

Microsoft Academic Search

The aims of the present study were to examine (1) endurance time and (2) activation pattern of vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) muscles during fatiguing isometric knee extensions performed with different EMG biofeedbacks. Thirteen men (27  5 year) volunteered to participate in three experimental sessions. Each session involved a submaximal isometric contraction held until failure at an

Boris Matkowski; Alain Martin; Romuald Lepers



Variation in palatability and biochemical traits within and among eleven beef muscles1,2,3,4  

Microsoft Academic Search

The objective of this study was to deter- mine the extent of variation in, and relationships among, biochemical and palatability traits within and among 11 major beef muscles. Longissimus thoracis et lumborum (LD), psoas major (PM), gluteus medius (GM), semimembranosus (SM), adductor (AD), biceps femoris (BF), semitendinosus (ST), rectus femoris (RF), triceps brachii (TB), infraspinatus (IS), and supraspi- natus (SS)

M. S. Rhee; T. L. Wheeler; S. D. Shackelford; M. Koohmaraie; Roman L. Hruska



Assessment of human knee extensor muscles stress from in vivo physiological cross-sectional area and strength measurements  

Microsoft Academic Search

Summary  The physiological cross-sectional areas (CSAp) of the vastus lateralis (VL), vastus intermedius (VI), vastus medialis (VM) and rectus femoris (RF) were obtained, in vivo, from the reconstructed muscle volumes, angles of pennation and distance between tendons of six healthy male volunteers by nuclear magnetic resonance imaging (MRI). In all subjects, the isometric maximum voluntary contraction strength (MVC) was measured at

M. V. Narici; L. Landoni; A. E. Minetti



Delayed Soft Tissue Reconstruction with a Horizontal Rectus Abdominis Musculocutaneous Flap following Hip Exarticulation  

PubMed Central

Coverage of large soft tissue defects at the hip region constitutes a challenge for plastic surgeons. We report the case of a 43-year-old female with necrotizing fasciitis of the right thigh, necessitating hip exarticulation and substantial debridement of necrotic tissue. An ipsilateral horizontal rectus abdominis myocutaneous (HRAM) flap was used to cover the defect. The reconstruction was carried out after the attempt of local tissue rearrangement. In light of the successful outcome, we propose that this flap be considered in the future planning of soft tissue reconstruction at the hip region.

R?dgaard, Jes Christian; Tei, Troels Michael



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

PubMed Central

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”.

Gamlin, Paul D.; Miller, Joel M.



Extraocular muscle: cellular adaptations for a diverse functional repertoire.  


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

Porter, John D



In vitro senescence enhances IL-6 production in human gingival fibroblasts induced by lipopolysaccharide from Campylobacter rectus.  


The production of interleukin-6 (IL-6) in human gingival fibroblasts (Gin cells) is increased by lipopolysaccharide (LPS) from Campylobacter rectus (C. rectus), which is associated with adult periodontitis; however, the age-related changes in the susceptibility of Gin cells to C. rectus LPS remain unclear. We examined the influence of in vitro senescence on C. rectus LPS-stimulated IL-6 production in Gin cells. LPS was prepared from C. rectus ATCC 33238 using hot phenol-water. The Gin cells were established from healthy gingival tissue removed from three patients, aged 10-12 years. The cells were cultured until confluence then stimulated with LPS (0.01, 0.1, 1.0 and 10.0 micrograms/ml). Levels of IL-6 released in the medium were measured after incubation for 3, 6, 9, 12, and 24 h. In both young (5-6 population doublings) and senescent (17-20 population doublings) cells, LPS stimulated IL-6 production in a dose- and time-dependent manner. In response to 0.01-10.0 micrograms/ml of LPS, IL-6 production in the senescent cells was higher than that in the young cells. Using cells from each of the three donors, we found that this phenomenon of higher LPS-stimulated IL-6 production in senescent cells was reproducible. The greater capacity of the senescent cells to synthesize IL-6 in response to LPS was a higher production of mRNA for IL-6. This increase of IL-6 production induced by C. rectus LPS in senescent Gin cells could help to explain the increased susceptibility to periodontal diseases shown by aged individuals. PMID:8735906

Ogura, N; Matsuda, U; Tanaka, F; Shibata, Y; Takiguchi, H; Abiko, Y



Tension-Free Vaginal Tape and Autologous Rectus Fascia Pubovaginal Sling for the Treatment of Urinary Stress Incontinence: A Medium-Term Follow-Up  

Microsoft Academic Search

Objectives: To compare two different procedures, tension-free vaginal tape (TVT) and autologous rectus fascia sling, according to their medium-term subjective and objective outcomes and satisfaction rates in the treatment of urinary stress incontinence in women. Subjects and Methods: One hundred women with type II urinary stress incontinence were randomized to be treated with either TVT or autologous rectus fascia sling.

Farzaneh Sharifiaghdas; Nassrin Mortazavi



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

SciTech Connect

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.

Miyamoto, Y.; Hattori, T.; Niimoto, M.; Toge, T. (Hiroshima Univ. School of Medicine (Japan))



Extraocular muscle motor units characterized by spike-triggered averaging in alert monkey.  


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 0.5-5.25mg, initial twitch delays averaging 2.4 ms, and time to peak contraction averaging 9.3 ms. 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

Gamlin, Paul D; Miller, Joel M



Identification of motoneurons supplying multiply- or singly-innervated extraocular muscle fibers in the rat.  


In mammals, the extraocular muscle fibers can be categorized in singly-innervated and multiply-innervated muscle fibers. In the monkey oculomotor, trochlear and abducens nucleus the motoneurons of multiply-innervated muscle fibers lie separated from those innervating singly-innervated muscle fibers and show different histochemical properties. In order to discover, if this organization is a general feature of the oculomotor system, we investigated the location of singly-innervated muscle fiber and multiply-innervated muscle fiber motoneurons in the rat using combined tract-tracing and immunohistochemical techniques. The singly-innervated muscle fiber and multiply-innervated muscle fiber motoneurons of the medial and lateral rectus muscle were identified by retrograde tracer injections into the muscle belly or the distal myotendinous junction. The belly injections labeled the medial rectus muscle subgroup of the oculomotor nucleus or the greatest part of abducens nucleus, including some cells outside the medial border of abducens nucleus. In contrast, the distal injections labeled only a subset of the medial rectus muscle motoneurons and exclusively cells outside the medial border of abducens nucleus. The tracer detection was combined with immunolabeling using antibodies for perineuronal nets (chondroitin sulfate proteoglycan) and non-phosphorylated neurofilaments. In monkeys both antibodies permit a distinction between singly-innervated muscle fiber and multiply-innervated muscle fiber motoneurons. The experiments revealed that neurons labeled from a distal injection lack both markers and are assumed to represent multiply-innervated muscle fiber motoneurons, whereas those labeled from a belly injection are chondroitin sulfate proteoglycan- and non-phosphorylated neurofilament-immunopositive and assumed to represent singly-innervated muscle fiber motoneurons. The overall identification of multiply-innervated muscle fiber and singly-innervated muscle fiber motoneurons within the rat oculomotor nucleus, trochlear nucleus, and abducens nucleus revealed that the smaller multiply-innervated muscle fiber motoneurons tend to lie separate from the larger diameter singly-innervated muscle fiber motoneurons. Our data provide evidence that rat extraocular muscles are innervated by two sets of motoneurons that differ in their molecular, morphological, and anatomical properties. PMID:16330150

Eberhorn, A C; Büttner-Ennever, J A; Horn, A K E



Atlas of the muscle motor points for the lower limb: implications for electrical stimulation procedures and electrode positioning.  


The aim of the study was to investigate the uniformity of the muscle motor point location for lower limb muscles in healthy subjects. Fifty-three subjects of both genders (age range: 18-50 years) were recruited. The muscle motor points were identified for the following ten muscles of the lower limb (dominant side): vastus medialis, rectus femoris, and vastus lateralis of the quadriceps femoris, biceps femoris, semitendinosus, and semimembranosus of the hamstring muscles, tibialis anterior, peroneus longus, lateral and medial gastrocnemius. The muscle motor point was identified by scanning the skin surface with a stimulation pen electrode and corresponded to the location of the skin area above the muscle in which an electrical pulse evoked a muscle twitch with the least injected current. For each investigated muscle, 0.15 ms square pulses were delivered through the pen electrode at low current amplitude (<10 mA) and frequency (2 Hz). 16 motor points were identified in the 10 investigated muscles of almost all subjects: 3 motor points for the vastus lateralis, 2 motor points for rectus femoris, vastus medialis, biceps femoris, and tibialis anterior, 1 motor point for the remaining muscles. An important inter-individual variability was observed for the position of the following 4 out of 16 motor points: vastus lateralis (proximal), biceps femoris (short head), semimembranosus, and medial gastrocnemius. Possible implications for electrical stimulation procedures and electrode positioning different from those commonly applied for thigh and leg muscles are discussed. PMID:21796408

Botter, Alberto; Oprandi, Gianmosè; Lanfranco, Fabio; Allasia, Stefano; Maffiuletti, Nicola A; Minetto, Marco Alessandro



Simplified use of suture fixation associated with lateral rectus myectomy in management of complete third nerve palsy.  


Different techniques have been used with varying success in third nerve palsy. Globe tethering technique is one treatment option. The authors describe a novel surgical technique in which permanent suture is used as a tethering agent associated with lateral rectus myectomy. Three patients underwent this technique. Horizontal alignment was satisfactory postoperatively. PMID:21158373

Ameri, Ahmad; Jafari, AliReza K; Anvari, Faramarz; Rezvan, Jahangir; Fard, Masoud Aghsaei



Unstable gait due to spasticity of the rectus femoris: gait analysis and motor nerve block.  


We present the case of a 54 year-old man presenting with a right Brown-Séquard plus syndrome (BSPS) after a traumatic cervical spinal cord injury. After being operated on with selective tibial neurotomy and triceps surae lengthening because of a right spastic equinus foot, he developed a gait disorder at high speed. The patient complained about an instability of the right knee. Observational gait analysis exhibited an oscillating, flexion/extension motion of the right knee during stance, which was confirmed by gait analysis. Dynamic electromyographic recordings exhibited a clonus of the right rectus femoris (RF) during stance. The spastic activity of the RF and the abnormal knee motion totally reversed after a motor nerve block of the RF, as well as after botulinum toxin type A injection into the RF. We emphasize that complex, spastic gait disorders can benefit from a comprehensive assessment including gait analysis and nerve blocks. PMID:23043733

Gross, R; Leboeuf, F; Rémy-Néris, O; Perrouin-Verbe, B



Operative Treatment of a Complete Rupture of the Origination of the Rectus Femoris  

PubMed Central

A 23-year-old male athlete reported both feeling and hearing a pop in his anterior thigh while sprinting. This was followed by immediate pain and an inability to walk. He had swelling and tenderness in his inguinal region. Radiographs were normal. An magnetic resonance imaging revealed a complete avulsion of the rectus femoris from its origin on the anterior inferior iliac spine. Following discussions of his treatment options, the patient chose to undergo operative management of the injury. A surgical repair was performed of the tendon of the direct head to the anterior inferior iliac spine through bone tunnels. He had a full recovery over the next 6 months and subsequently returned to unrestricted active military duty.

Bottoni, Craig R.; D'Alleyrand, Jean-Claude G.



Orbital Magnetic Resonance Imaging of Extraocular Muscles in Chronic Progressive External Ophthalmoplegia: Specific Diagnostic Findings  

PubMed Central

INTRODUCTION Chronic progressive external ophthalmoplegia (CPEO) is characterized by slowly progressive bilateral ophthalmoplegia and blepharoptosis. Molecular diagnosis is problematic because sporadic mitochondrial DNA deletions can be causative. We sought findings using magnetic resonance imaging (MRI) that might support the diagnosis of CPEO. METHODS Two men (ages 31 and 47 years) and 3 women (ages 40–49 years) with CPEO and symptom durations of 8 months to 28 years underwent high-resolution (2-mm slice thickness, 312 micron pixels), surface coil, T1-weighted orbital MRI in coronal planes. Images were analyzed quantitatively to determine extraocular muscle (EOM) sizes and were compared with 10 age- and gender-matched normal volunteers, one subject with myasthenia gravis, and with 30 subjects having EOM paralysis caused by oculomotor, trochlear,0 and abducens neuropathies. RESULTS EOM function was clinically diminished in CPEO, most markedly for the superior rectus (SR) and levator muscles. All EOMs in CPEO exhibited unusual qualitative T1 MRI signal abnormalities. Unlike the profound EOM atrophy typical of neurogenic paralysis, anterior volumes of medial rectus, lateral rectus, and inferior rectus muscles in CPEO were not smaller than normal ( p > 0.003). Anterior volumes of the SR muscle-levator complex and superior oblique were significantly reduced ( p < 0.003). Denervated EOMs exhibited statistically significant volume reduction when compared with normal and CPEO groups. Volume of the SR muscle-levator complex was the same in subjects with CPEO and oculomotor palsies. CONCLUSIONS CPEO is associated with minimal EOM volume reduction despite clinically severe weakness. This combination of findings may be specific for CPEO and could resolve the diagnostic dilemma in difficult cases.

Ortube, Maria Carolina; Bhola, Rahul; Demer, Joseph L.



Age-related muscle atrophy in the lower extremities and daily physical activity in elderly women.  


This study investigated the relationship between age-related declines in muscle thickness of the lower extremities and daily physical activity in elderly women. The subjects comprised 20 young women and 17 elderly women residing in a nursing home. Lower limb muscle thickness was measured by B-mode ultrasound with the following 10 muscles; gluteus maximus, gluteus medius, gluteus minimus, psoas major, rectus femoris, vastus lateralis, vastus intermedius, biceps femoris, gastrocnemius and soleus. Daily physical activity was evaluated using life-space assessment (LSA) which assessed the life-space level, degree of independence, and frequency of attainment. Muscle thickness in the gluteus maximus, gluteus medius, gluteus minimus, psoas major, rectus femoris, vastus lateralis, vastus intermedius, biceps femoris and gastrocnemius, but not soleus, was significantly greater in the young group than the elderly group. The greatest rates of age-related loss of skeletal muscle mass in the lower limbs showed in the psoas major, while the smallest loss showed in soleus muscle. Only the gluteus medius was significantly associated with the LSA score (r = 0.528, p < 0.05) in elderly women. These results suggest that the reduction in skeletal mass with age is smaller in soleus muscle, and that the age-related decline in gluteus medius muscle is influenced by daily physical activity. PMID:20832875

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



Muscle Disorders  


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 ...


Muscle atrophy  


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 ...


Muscle Cramps  


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 ...


The administration of an oral carbohydrate-containing fluid prior to major elective upper-gastrointestinal surgery preserves skeletal muscle mass postoperatively—a randomised clinical trial  

Microsoft Academic Search

Aim: Recent evidence suggests that the provision of energy-containing fluids is safe and may impact positively on markers of recovery. The aims of this study were to assess the tolerance of preoperative carbohydrate fluid administration and to determine its effect on postoperative metabolic and clinical responses.Methods: Patients admitted to the Royal Infirmary of Edinburgh for major, elective abdominal surgery were

K. A. Yuill; R. A. Richardson; H. I. M. Davidson; O. J. Garden; R. W. Parks



Cervical radiculopathy: Pain, muscle weakness and sensory loss in patients with cervical radiculopathy treated with surgery, physiotherapy or cervical collar A prospective, controlled study  

Microsoft Academic Search

This prospective, randomised study compares the efficacy of surgery, physiotherapy and cervical collar with respect to pain, motor weakness and sensory loss in 81 patients with long-lasting cervical radiculopathy corresponding to a nerve root that was significantly compressed by spondylotic encroachment, with or without an additional bulging disk, as verified by MRI or CT-myelography. Pain intensity was registered on a

L. C. G. Persson; U. Moritz; L. Brandt; C.-A. Carlsson



Controversies in Bariatric surgery: Evidence-based discussions on laparoscopic adjustable gastric banding  

Microsoft Academic Search

Laparoscopic adjustable gastric banding (LAGB) is a surgical option that involves placing a silicone band circumferentially\\u000a around the uppermost aspect of the stomach. The band creates a small proximal pouch that empties slowly resulting in early\\u000a satiety and a decreased appetite. The band is attached to an access port that is secured to the rectus muscle and can be accessed

Christine J. Ren



Muscles, Muscles Everywhere  

NSDL National Science Digital Library

This activity helps students learn about the three different types of muscles and how outer space affects astronauts' muscles. They will discover how important it is for astronauts to get adequate exercise both on Earth and in outer space. Also, through the design of their own microgravity exercise machine, students learn about the exercise machines that engineers design specifically for astronaut use.

Integrated Teaching And Learning Program


The Influence of Allogeneic Red Blood Cell Transfusion Compared with 100% Oxygen Ventilation on Systemic Oxygen Transport and Skeletal Muscle Oxygen Tension After Cardiac Surgery  

Microsoft Academic Search

In this study we investigated the effects of allogeneic red blood cell (RBC) transfusion on tissue oxygenation compared with those of 100% oxygen ventilation by us- ing systemic oxygen transport variables and skeletal muscle oxygen tension (Ptio2). Fifty-one volume- resuscitated, mechanically ventilated patients with a nadir hemoglobin concentration in the range from 7.5 to 8.5 g\\/dL after elective coronary artery

Stefan Suttner; Swen N. Piper; Bernhard Kumle; Katrin Lang; Frank Isgro; Joachim Boldt



Functional and morphometric evaluation of end-to-side neurorrhaphy for muscle reinnervation.  


This study was undertaken to quantify the effect of motor collateral sprouting in an end-to-side repair model allowing end organ contact. Besides documentation of the functional outcome of muscle reinnervation by end-to-side neurorrhaphy, this experimental work was performed to determine possible downgrading effects to the donor nerve at end organ level. In 24 female New Zealand White rabbits, the motor nerve branch to the rectus femoris muscle of the right hindlimb was dissected, cut, and sutured end-to-side to the motor branch to the vastus medialis muscle after creating an epineural window. The 24 rabbits were divided into two groups of 12 each, with the second group receiving additional crush injury of the vastus branch. After a period of 8 months, maximum tetanic tension in the reinnervated rectus femoris and the vastus medialis muscles was determined. The contralateral healthy side served as control. The reinnervated rectus femoris muscle showed an average maximum tetanic force of 24.9 N (control 26.2 N, p = 0.7827), and the donor- vastus medialis muscle 11.0 N (control 7.3 N, p = 0.0223). There were no statistically significant differences between the two experimental groups (p = 0.9914). The average number of regenerated myelinated nerve fibers in the rectus femoris motor branch was 1,185 +/- 342 (control, 806 +/- 166), and the mean diameter was 4.6 +/- 0.6 microm (control, 9.4 +/- 1.0 microm). In the motor branch to the vastus medialis muscle, the mean fiber number proximal to the coaptation site was 1227 (+/-441), and decreased distal to the coaptation site to 795 (+/-270). The average difference of axon counts in the donor nerve proximal to distal regarding the repair site was 483.7 +/- 264.2. In the contralateral motor branch to the vastus medialis muscle, 540 (+/- 175) myelinated nerve fibers were counted. In nearly all cross-section specimens of the motor branch to the vastus medialis muscle, altered nerve fibers could be identified in one fascicle distal and proximal to the repair site. The results show a relevant functional reinnervation by end-to-side neurorrhaphy without functional impairment of the donor muscle. It seems to be evident that most axons in the attached segment were derived from collateral sprouts. Nonetheless, the present study confirms that end-to-side neurorrhaphy is a reliable method of reconstruction for damaged nerves, which should be applied clinically in a more extended manner. PMID:10946937

Giovanoli, P; Koller, R; Meuli-Simmen, C; Rab, M; Haslik, W; Mittlböck, M; Meyer, V E; Frey, M



Assessment of the sensory quality and shelf stability of selected Horro beef muscles in Ethiopia.  


The objective of this work was to assess sensory quality and retail life of Horro beef muscles in Ethiopia. Six muscles: M. rhomboideus (RM), M. infraspinatus (IS), M. longissimus lumborum (LL), M. semimembranosus (SM), M. biceps femoris (BF) and M. rectus femoris (RF) were considered. Sensory quality of the muscles was rated by a 9-member trained panel for palatability, tenderness, juiciness, amount of connective tissue (ACT), lean color and surface discoloration and measured by Warner-Bratzler Shear Force (WBSF). Retail life of the six muscles were evaluated for CIE 1976 L(?)a(?)b(?) color values across 6 days. Significant differences (p<0.05) between muscles for all sensory attributes and WBSF were found. Significant L(?)a(?)b(?) color values of muscles and USDA quality grades by retail life were found (p<0.05). Significant correlations (p<0.05 or p<0.01) of key parameters were also identified. PMID:20416784

Yadata, Melese Abdisa; Werner, Carsten; Tibbo, Markos; Wollny, Clemens B A; Wicke, Michael



Trunk muscle activities during abdominal bracing: comparison among muscles and exercises.  


Abdominal bracing is often adopted in fitness and sports conditioning programs. However, there is little information on how muscular activities during the task differ among the muscle groups located in the trunk and from those during other trunk exercises. The present study aimed to quantify muscular activity levels during abdominal bracing with respect to muscle- and exercise-related differences. Ten healthy young adult men performed five static (abdominal bracing, abdominal hollowing, prone, side, and supine plank) and five dynamic (V- sits, curl-ups, sit-ups, and back extensions on the floor and on a bench) exercises. Surface electromyogram (EMG) activities of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES) muscles were recorded in each of the exercises. The EMG data were normalized to those obtained during maximal voluntary contraction of each muscle (% EMGmax). The % EMGmax value during abdominal bracing was significantly higher in IO (60%) than in the other muscles (RA: 18%, EO: 27%, ES: 19%). The % EMGmax values for RA, EO, and ES were significantly lower in the abdominal bracing than in some of the other exercises such as V-sits and sit-ups for RA and EO and back extensions for ES muscle. However, the % EMGmax value for IO during the abdominal bracing was significantly higher than those in most of the other exercises including dynamic ones such as curl-ups and sit-ups. These results suggest that abdominal bracing is one of the most effective techniques for inducing a higher activation in deep abdominal muscles, such as IO muscle, even compared to dynamic exercises involving trunk flexion/extension movements. Key PointsTrunk muscle activities during abdominal bracing was examined with regard to muscle- and exercise-related differences.Abdominal bracing preferentially activates internal oblique muscles even compared to dynamic exercises involving trunk flexion/extension movements.Abdominal bracing should be included in exercise programs when the goal is to improve spine stability. PMID:24149153

Maeo, Sumiaki; Takahashi, Takumi; Takai, Yohei; Kanehisa, Hiroaki



Trunk Muscle Activities During Abdominal Bracing: Comparison Among Muscles and Exercises  

PubMed Central

Abstract Abdominal bracing is often adopted in fitness and sports conditioning programs. However, there is little information on how muscular activities during the task differ among the muscle groups located in the trunk and from those during other trunk exercises. The present study aimed to quantify muscular activity levels during abdominal bracing with respect to muscle- and exercise-related differences. Ten healthy young adult men performed five static (abdominal bracing, abdominal hollowing, prone, side, and supine plank) and five dynamic (V- sits, curl-ups, sit-ups, and back extensions on the floor and on a bench) exercises. Surface electromyogram (EMG) activities of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES) muscles were recorded in each of the exercises. The EMG data were normalized to those obtained during maximal voluntary contraction of each muscle (% EMGmax). The % EMGmax value during abdominal bracing was significantly higher in IO (60%) than in the other muscles (RA: 18%, EO: 27%, ES: 19%). The % EMGmax values for RA, EO, and ES were significantly lower in the abdominal bracing than in some of the other exercises such as V-sits and sit-ups for RA and EO and back extensions for ES muscle. However, the % EMGmax value for IO during the abdominal bracing was significantly higher than those in most of the other exercises including dynamic ones such as curl-ups and sit-ups. These results suggest that abdominal bracing is one of the most effective techniques for inducing a higher activation in deep abdominal muscles, such as IO muscle, even compared to dynamic exercises involving trunk flexion/extension movements. Key points Trunk muscle activities during abdominal bracing was examined with regard to muscle- and exercise-related differences. Abdominal bracing preferentially activates internal oblique muscles even compared to dynamic exercises involving trunk flexion/extension movements. Abdominal bracing should be included in exercise programs when the goal is to improve spine stability.

Maeo, Sumiaki; Takahashi, Takumi; Takai, Yohei; Kanehisa, Hiroaki



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...


Muscle Cramp  


... can usually treat muscle cramps at home with self-care measures. Symptoms Most muscle cramps develop in the ... muscle weakness Happen frequently Don't improve with self-care Aren't associated with an obvious cause, such ...


Leg muscles  

NSDL National Science Digital Library

Like many areas of the body, the legs contain bones, muscles, tendons, and ligaments. All of these are needed for movement. Muscles contract and lengthen as movement occurs. Muscles become shorter when they contract.

Uwe Gille (None;)



Ultrasonography-Guided Bilateral Rectus Sheath Block vs Local Anesthetic Infiltration After Pediatric Umbilical Hernia Repair: A Prospective Randomized Clinical Trial.  


IMPORTANCE Regional anesthetic techniques can be used to alleviate postoperative pain in children undergoing pediatric surgical procedures. Use of ultrasonographic guidance for bilateral rectus sheath block (BRSB) has been shown to improve immediate pain scores and reduce use of postoperative analgesia in the postanesthesia care unit (PACU). OBJECTIVE To compare efficacy of ultrasonography-guided BRSB and local anesthetic infiltration (LAI) in providing postoperative analgesia after pediatric umbilical hernia repair. DESIGN Prospective, observer-blinded, randomized clinical trial. SETTING Tertiary-referral urban children's hospital. PARTICIPANTS Eligible children 3 to 12 years of age undergoing elective umbilical hernia repair from November 16, 2009, through May 31, 2011. INTERVENTIONS Ropivacaine hydrochloride administered at the conclusion of surgery as LAI by the surgeon (n?=?25) or as ultrasonography-guided BRSB by the anesthesiologist (n?=?27). MAIN OUTCOMES AND MEASURES Scores on the FACES Pain Rating Scale measured at 10-minute intervals and all use of analgesic medications in the PACU. RESULTS Median FACES scores in the PACU were lower in the BRSB group compared with the LAI group at 10 minutes (0 vs 1; P?=?.04), 30 minutes (0 vs 1; P?=?.01), and 40 minutes or later (0 vs 1; P?=?.03). Fewer doses of opioid and nonopioid medications were given to the BRSB group compared with the LAI group (5 vs 11 doses for opioids; 5 vs 10 for nonopioids). CONCLUSIONS AND RELEVANCE In the PACU, ultrasonography-guided BRSB after umbilical hernia repair in children is associated with lower median FACES scores and decreased use of opioid and nonopioid medications compared with LAI. Future studies could examine the use of longer-acting anesthetic agents with ultrasonography-guided BRSB. TRIAL REGISTRATION Identifier: NCT01015053. PMID:23760519

Dingeman, R Scott; Barus, Lindsay M; Chung, Hyun Kee; Clendenin, David J; Lee, Christopher S; Tracy, Sarah; Johnson, Victor M; Dennett, Kate V; Zurakowski, David; Chen, Catherine



The effect of squat depth on multiarticular muscle activation in collegiate cross-country runners.  


The squat is a closed-chain lower body exercise commonly performed by many athletes. Muscle activity has been examined during partial and parallel squats in male weightlifters, but not in male and female runners. Therefore, this study measured muscle activity with surface electromyography (EMG) during partial and parallel squats in 20 Division I collegiate cross-country runners (10 males and 10 females) in a randomized crossover design. We hypothesized the parallel squat would increase extensor muscle activitation (i.e. hamstrings and erector spinae). Furthermore, we sought to determine if changes in muscle activity were different between males and females. Participants performed 6 repetitions using their 10 repetition maximum loads for each condition during EMG testing. EMG was performed on the right rectus femoris, biceps femoris, lumbar erector spinae, and lateral head of the gastrocnemius. Rectus femoris activity (0.18 ± 0.01 vs. 0.14 ± 0.01 mV) and erector spinae activity (0.16 ± 0.01 vs. 0.13 ± 0.01 mV) were significantly higher (p < 0.05) during the parallel squat than during the partial squat condition. This increase in muscle activity may be attributed to greater ranges of motion at the hip and knee joints. Biceps femoris and gastrocnemius activity were similar between conditions. No significant differences existed between males and females (squat condition × gender; p > 0.05). During preliminary isokinetic testing, both male and female runners demonstrated deficient hamstrings-to-quadriceps ratios, which would not likely improve by performing parallel squats based on our EMG findings. Despite the reduced load of the parallel squat, rectus femoris and erector spinae activity were elevated. Thus, parallel squats may help runners to train muscles vital for uphill running and correct posture, while preventing injury by using lighter weights through a larger range of motion. PMID:23254544

Gorsuch, Joshua; Long, Janey; Miller, Katie; Primeau, Kyle; Rutledge, Sarah; Sossong, Andrew; Durocher, John J



Changes in expiratory muscle function following spinal cord section.  


Following spinal cord injury, muscles below the level of injury develop variable degrees of disuse atrophy. The present study assessed the physiological changes of the expiratory muscles in a cat model of spinal cord injury. Muscle fiber typing, cross-sectional area, muscle weight, and changes in pressure-generating capacity were assessed in five cats spinalized at the T(6) level. Airway pressure (P)-generating capacity was monitored during lower thoracic spinal cord stimulation before and 6 mo after spinalization. These parameters were also assessed in five acute animals, which served as controls. In spinalized animals, P fell from 41 +/- l to 28 +/- 3 cm H2O (means +/- SE; P < 0.001). Muscle weight of the external oblique, internal oblique, transversus abdominis, and internal intercostal muscles decreased significantly (P < 0.05 for each). Muscle weight of the external oblique, internal oblique, transversus abdominis, and internal intercostal, but not rectus abdominis (RA), correlated linearly with P (r > 0.7 for each; P < 0.05 for each). Mean muscle fiber cross-sectional area of these muscles was significantly smaller (P < 0.05 for each; except RA) and also correlated linearly with P (r > 0.55 for each; P < 0.05 for each, except RA). In spinalized animals, the expiratory muscles demonstrated a significant increase in the population of fast muscle fibers. These results indicate that, following spinalization, 1) the expiratory muscles undergo significant atrophy and fiber-type transformation and 2) the P-generating capacity of the expiratory muscles falls significantly secondary to reductions in muscle mass. PMID:17158247

Kowalski, Krzysztof E; Romaniuk, Jaroslaw R; DiMarco, Anthony F



Muscle-tendon structure and dimensions in adults and children  

PubMed Central

Muscle performance is closely related to the architecture and dimensions of the muscle–tendon unit and the effect of maturation on these architectural characteristics in humans is currently unknown. This study determined whether there are differences in musculo-tendinous architecture between adults and children of both sexes. Fascicle length and pennation angle were measured from ultrasound images at three sites along the length of the vastus intermedius, vastus lateralis, vastis medialis and rectus femoris muscles. Muscle volume and muscle–tendon length were measured from magnetic resonance images. Muscle physiological cross-sectional area (PCSA) was calculated as the ratio of muscle volume to optimum fascicle length. Fascicle length was greater in the adult groups than in children (P < 0.05) but pennation angle did not differ between groups (P > 0.05). The ratios between fascicle and muscle length and between fascicle and tendon length were not different (P > 0.05) between adults and children for any quadriceps muscle. Quadriceps volume and PCSA of each muscle were greater in adults than children (P < 0.01) but the relative proportion of each head to the total quadriceps volume was similar in all groups. However, the difference in PCSA between adults and children (men ? 104% greater than boys, women ? 57% greater than girls) was greater (P < 0.05) than the difference in fascicle length (men ? 37% greater than boys, women ? 10% greater than girls). It is concluded that the fascicle, muscle and tendon lengthen proportionally during maturation, thus the muscle–tendon stiffness and excursion range are likely to be similar in children and adults but the relatively greater increase in PCSA than fascicle length indicates that adult muscles are better designed for force production than children’s muscles.

O'Brien, Thomas D; Reeves, Neil D; Baltzopoulos, Vasilios; Jones, David A; Maganaris, Constantinos N



Sensitivity of model predictions of muscle function to changes in moment arms and muscle-tendon properties: a Monte-Carlo analysis.  


Hill-type muscle models are commonly used in musculoskeletal models to estimate muscle forces during human movement. However, the sensitivity of model predictions of muscle function to changes in muscle moment arms and muscle-tendon properties is not well understood. In the present study, a three-dimensional muscle-actuated model of the body was used to evaluate the sensitivity of the function of the major lower limb muscles in accelerating the whole-body center of mass during gait. Monte-Carlo analyses were used to quantify the effects of entire distributions of perturbations in the moment arms and architectural properties of muscles. In most cases, varying the moment arm and architectural properties of a muscle affected the torque generated by that muscle about the joint(s) it spanned as well as the torques generated by adjacent muscles. Muscle function was most sensitive to changes in tendon slack length and least sensitive to changes in muscle moment arm. However, the sensitivity of muscle function to changes in moment arms and architectural properties was highly muscle-specific; muscle function was most sensitive in the cases of gastrocnemius and rectus femoris and insensitive in the cases of hamstrings and the medial sub-region of gluteus maximus. The sensitivity of a muscle's function was influenced by the magnitude of the muscle's force as well as the operating region of the muscle on its force-length curve. These findings have implications for the development of subject-specific models of the human musculoskeletal system. PMID:22507351

Ackland, David C; Lin, Yi-Chung; Pandy, Marcus G



Delayed synapse elimination in mouse levator palpebrae superioris muscle  

PubMed Central

At birth, synaptic sites in developing rodent muscles are innervated by numerous motor axons. During subsequent weeks, this multiple innervation disappears as one terminal strengthens and all the others are eliminated. Experimental perturbations that alter neuromuscular activity affect the rate of synaptic refinement with more activity accelerating the time to single innervation and neuromuscular blockade retarding it. But it remains unclear whether patterns of muscle use (driven by endogenous neuronal activity) contribute to the rate of synapse elimination. For this reason we examined the timing of supernumerary nerve terminal elimination at synapses in extraocular muscles (EOMs), a specialized set of muscles that control eye movements. On the basis of their exceptionally high patterns of activity, we hypothesized that synaptic refinement would be greatly accelerated at these synapses. We found, however, that rates of synaptic refinement were only modestly accelerated in rectus and oblique EOMs compared with synapses in somite-derived skeletal muscle. In contrast to these results, we observed a dramatic delay in the elimination of supernumerary nerve terminals from synapses in the levator palpebrae superioris (LPS) muscle, a specialized EOM that initiates and maintains eye-lid elevation. In mice, natural eye-opening occurs at the end of the second postnatal week of development. Thus, while synapse elimination is occurring in most EOMs and somite-derived skeletal muscles it appears dramatically delayed in a set of specialized eyelid muscles that remain immobile during early postnatal development.

Fox, Michael A.; Tapia, Juan Carlos; Kasthuri, Narayanan; Lichtman, Jeff W.



Mini-open anterior spine surgery for anterior lumbar diseases  

Microsoft Academic Search

Minimally invasive surgeries including endoscopic surgery and mini-open surgery are current trend of spine surgery, and its\\u000a main advantages are shorter recovery time and cosmetic benefits, etc. However, mini-open surgery is easier and less technique\\u000a demanding than endoscopic surgery. Besides, anterior spinal fusion is better than posterior spinal fusion while considering\\u000a the physiological loading, back muscle function, etc. Therefore, we

Ruey-Mo Lin; Kuo-Yuan Huang; Kuo-An Lai



Muscle fatigue  

Microsoft Academic Search

Muscle fatigue is a common symptom but there are no universally accepted methods for quantitating the function of voluntary muscle. This paper describes three main methods of assessment: simple clinical tests of muscle function; thermal probe measurements of metabolic heat production during muscular contraction; needle biopsy studies of muscle structure and chemistry. These methods, though at a relatively early stage

R. H. T. Edwards



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


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 + salamanders) or salamander larvae depending on whether or not a homologous muscle is present in frog tadpoles. PMID:21374703

Kleinteich, Thomas; Haas, Alexander



The gross morphology and histochemistry of respiratory muscles in bottlenose dolphins, Tursiops truncatus.  


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 0.3 s) (Ridgway et al. 1969 Science 166:1651-1654). The predominantly slow-twitch fiber profile of their diaphragm (Dearolf 2003 J Morphol 256:79-88) suggests that this muscle does not likely power their rapid ventilatory event. Based on Bramble's (1989 Amer Zool 29:171-186) 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 craniocervical (scalenus, sternocephalicus, sternohyoid), thoracic (intercostals, transverse thoracis), and lumbopelvic (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 craniocervical muscles act to draw the sternum and associated ribs craniodorsally, which flares the ribs laterally, and increases the thoracic cavity volume required for inspiration. The lumbopelvic 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 dolphins utilize muscles, similar to those used by galloping mammals, to power their explosive ventilation. PMID:18777569

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



Use of the SF-36 quality of life scale to assess the effect of pelvic floor muscle exercise on aging males who received transurethral prostate surgery  

PubMed Central

Purpose We used the Short Form (SF)-36® Health Survey scale to assess the effect of pelvic floor muscle exercise (PFE) on aging males who received transurethral resection of the prostate (TUR-P). Methods From April 2010 to December 2010, a total of 66 patients who underwent TUR-P were enrolled in this study. They were randomized into two groups (with 33 patients in each group) – an experimental group who performed postoperative PFE every day and a control group. Data, including the International Prostate Symptom Score (IPSS), uroflowmetry study, and the SF-36 quality of life measure, were collected before the operation, and at 1, 4, 8, and 12 weeks after the operation. We analyzed the differences between the two groups with respect to their IPSS scores, maximal urinary flow rate, residual urine amount, and life quality. Results A total of 61 patients (experimental group: 32 patients, and control group: 29 patients) completed this study. We found that at 12 weeks postop, patients who performed PFE every day had a better maximal urinary flow rate (16.41 ± 6.20 vs 12.41 ± 7.28 mL/min) (P = 0.026) compared with patients in the control group. The experimental group had a much greater decrease in IPSS score (P < 0.001). As for the SF-36 scale, the experimental group had higher scores than did the control group on both the physiological domain (54.86 vs 49.86) (P = 0.029) and the psychological domain (61.88 vs 52.69) (P = 0.005). However, there were no significant differences with respect to the postvoiding residual urine between the two groups (57.24 ± 52.95 vs 64.68 ± 50.63 mL) (P = 0.618). Conclusion Compared with the control group, patients who performed PFE for 12 weeks after TUR-P showed improvement in their maximal urinary flow rate and lower urinary tract symptoms, and had a better quality of life. The immediate initiation of PFE is suggested for patients who undergo TUR-P.

Hou, Chen-Pang; Chen, Tzu-Yu; Chang, Chia-Chi; Lin, Yu-Hsiang; Chang, Phei-Lang; Chen, Chien-Lun; Hsu, Yu-Chao; Tsui, Ke-Hung



Tibialis Anterior Tendon Transfer after Clubfoot Surgery  

Microsoft Academic Search

Recurrent dynamic and structural deformities following clubfoot surgery are commonly due to residual muscle imbalance from\\u000a a strong tibialis anterior muscle and weak antagonists. We asked whether subcutaneous tibialis anterior tendon transfer effectively\\u000a treated recurrent deformities following clubfoot surgery and whether the presence of structural deformities influenced the\\u000a outcome. The patients were divided into two groups: Group I, dynamic supination

George H. Thompson; Harry A. Hoyen; Tracey Barthel



Pressure-induced Rhabdomyolysis after Bariatric Surgery  

Microsoft Academic Search

Rhabdomyolisis most commonly occurs after muscle injury, alcohol ingestion, drug intake and exhaustive exercise. Prolonged\\u000a muscle compression at the time of surgery may produce this complication. Obesity has been reported as a risk factor for pressure-induced\\u000a rhabdomyolysis, but no reports associated with bariatric surgery could be found in the literature. We report 3 superobese\\u000a patients who developed rhabdomyolysis after bariatric

Gonzalo Torres-Villalobos; Eric Kimura; Juan Luis Mosqueda; Eduardo García-García; Miguel F. Herrera



Chiton myogenesis: perspectives for the development and evolution of larval and adult muscle systems in molluscs.  


We investigated muscle development in two chiton species, Mopalia muscosa and Chiton olivaceus, from embryo hatching until 10 days after metamorphosis. The anlagen of the dorsal longitudinal rectus muscle and a larval prototroch muscle ring are the first detectable muscle structures in the early trochophore-like larva. Slightly later, a ventrolaterally situated pair of longitudinal muscles appears, which persists through metamorphosis. In addition, the anlagen of the putative dorsoventral shell musculature and the first fibers of a muscular grid, which is restricted to the pretrochal region and consists of outer ring and inner diagonal muscle fibers, are generated. Subsequently, transversal muscle fibers form underneath each future shell plate and the ventrolateral enrolling muscle is established. At metamorphic competence, the dorsoventral shell musculature consists of numerous serially repeated, intercrossing muscle fibers. Their concentration into seven (and later eight) functional shell plate muscle bundles starts after the completion of metamorphosis. The larval prototroch ring and the pretrochal muscle grid are lost at metamorphosis. The structure of the apical grid and its atrophy during metamorphosis suggests ontogenetic repetition of (parts of) the original body-wall musculature of a proposed worm-shaped molluscan ancestor. Moreover, our data show that the "segmented" character of the polyplacophoran shell musculature is a secondary condition, thus contradicting earlier theories that regarded the Polyplacophora (and thus the entire phylum Mollusca) as primarily eumetameric (annelid-like). Instead, we propose an unsegmented trochozoan ancestor at the base of molluscan evolution. PMID:11748697

Wanninger, Andreas; Haszprunar, Gerhard



Effects of the Sustained Release of IGF-1 on Extraocular Muscle of the Infant Non-Human Primate: Adaptations at the Effector Organ Level  

PubMed Central

Purpose. The authors have demonstrated that prolonged exposure of adult rabbit extraocular muscle (EOM) to insulin-like growth factor-1 (IGF-1) results in significantly increased cross-sectional area and muscle force generation lasting over 3 months. Here the authors assess the effects on EOM of sustained IGF-1 treatment on normal binocular infant Macaca mulatta. Methods. Sustained-release IGF-1 pellets were implanted bilaterally in each medial rectus (MR) muscle of two normal infant non-human primates. Eye position was examined using corneal light reflex testing. After 3 months, morphometric analyses of myofiber cross-sectional area and innervation density in treated MR muscles were compared with an age-matched control and with antagonist lateral rectus (LR) muscles. Results. After 3 months, the slow-release pellets remained at the implantation site in all four MR muscles treated. The treated MR showed pronounced increases in cross-sectional area and nerve density, mirrored in the untreated antagonist LR. Conclusions. Three months of bilateral sustained IGF-1 release in infant non-human primate MR resulted in increased muscle size and innervation density, mirrored in the untreated antagonist LR. It appears that bilateral MR treatment resulted in slow adaptation of both treated MR and contralateral LR muscles over time such that functional homeostasis and near-normal alignment were maintained. Further work is needed to determine what signaling mechanisms maintain proportional innervation when EOMs are forced to adapt to an externally applied perturbation.

Willoughby, Christy L.; Christiansen, Stephen P.; Mustari, Michael J.



Modeling Muscles  

ERIC Educational Resources Information Center

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…

Goodwyn, Lauren; Salm, Sarah



Modeling Muscles  

ERIC Educational Resources Information Center

|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…

Goodwyn, Lauren; Salm, Sarah



Involutional Entropion Surgery: A Modified Technique  

Microsoft Academic Search

Purpose: A study to evaluate the effectiveness of a modified procedure to correct involutional entropion. Methods: Seventeen cases of involutional entropion underwent surgery and had a postoperative follow-up of 18 months. The authors describe a technique of vertically shortening the anterior lamella (skin and orbicularis muscle), using a blepharoplasty incision and reflection of a skin muscle flap. Results: In 16

Andrea Marabotti; Andrea Bedei; Gustavo Lanza; Anna Cariello; Iacopo Giannecchini



Diplopia and strabismus following ocular surgeries.  


Postoperative diplopia and strabismus may result from a variety of ocular surgical procedures. Common underlying mechanisms include sensory disturbance, scarring, direct extraocular muscle injury, myotoxicity from injections of local anesthesia or antibiotics, and malpositioning of extraocular muscles by implant materials. The most common patterns are vertical and horizontal motility disturbance. Treatment options include prisms, botulinum, occlusion, or surgery. PMID:20452637

Guo, Suqin; Wagner, Rudolph; Gewirtz, Matthew; Maxwell, Dawn; Pokorny, Kathryn; Tutela, Arthur; Caputo, Anthony; Zarbin, Marco



Increasing exercise intensity reduces heterogeneity of glucose uptake in human skeletal muscles.  


Proper muscle activation is a key feature of survival in different tasks in daily life as well as sports performance, but can be impaired in elderly and in diseases. Therefore it is also clinically important to better understand the phenomenon that can be elucidated in humans non-invasively by positron emission tomography (PET) with measurements of spatial heterogeneity of glucose uptake within and among muscles during exercise. We studied six healthy young men during 35 minutes of cycling at relative intensities of 30% (low), 55% (moderate), and 75% (high) of maximal oxygen consumption on three separate days. Glucose uptake in the quadriceps femoris muscle group (QF), the main force producing muscle group in recreational cycling, and its four individual muscles, was directly measured using PET and 18F-fluoro-deoxy-glucose. Within-muscle heterogeneity was determined by calculating the coefficient of variance (CV) of glucose uptake in PET image voxels within the muscle of interest, and among-muscles heterogeneity of glucose uptake in QF was expressed as CV of the mean glucose uptake values of its separate muscles. With increasing intensity, within-muscle heterogeneity decreased in the entire QF as well as within its all four individual parts. Among-muscles glucose uptake heterogeneity also decreased with increasing intensity. However, mean glucose uptake was consistently lower and heterogeneity higher in rectus femoris muscle that is known to consist of the highest percentage of fast twitch type II fibers, compared to the other three QF muscles. In conclusion, these results show that in addition to increased contribution of distinct muscle parts, with increases in exercise intensity there is also an enhanced recruitment of muscle fibers within all of the four heads of QF, despite established differences in muscle-part specific fiber type distributions. Glucose uptake heterogeneity may serve as a useful non-invasive tool to elucidate muscle activation in aging and diseased populations. PMID:23284929

Heinonen, Ilkka; Nesterov, Sergey V; Kemppainen, Jukka; Fujimoto, Toshihiko; Knuuti, Juhani; Kalliokoski, Kari K



Increasing Exercise Intensity Reduces Heterogeneity of Glucose Uptake in Human Skeletal Muscles  

PubMed Central

Proper muscle activation is a key feature of survival in different tasks in daily life as well as sports performance, but can be impaired in elderly and in diseases. Therefore it is also clinically important to better understand the phenomenon that can be elucidated in humans non-invasively by positron emission tomography (PET) with measurements of spatial heterogeneity of glucose uptake within and among muscles during exercise. We studied six healthy young men during 35 minutes of cycling at relative intensities of 30% (low), 55% (moderate), and 75% (high) of maximal oxygen consumption on three separate days. Glucose uptake in the quadriceps femoris muscle group (QF), the main force producing muscle group in recreational cycling, and its four individual muscles, was directly measured using PET and 18F-fluoro-deoxy-glucose. Within-muscle heterogeneity was determined by calculating the coefficient of variance (CV) of glucose uptake in PET image voxels within the muscle of interest, and among-muscles heterogeneity of glucose uptake in QF was expressed as CV of the mean glucose uptake values of its separate muscles. With increasing intensity, within-muscle heterogeneity decreased in the entire QF as well as within its all four individual parts. Among-muscles glucose uptake heterogeneity also decreased with increasing intensity. However, mean glucose uptake was consistently lower and heterogeneity higher in rectus femoris muscle that is known to consist of the highest percentage of fast twitch type II fibers, compared to the other three QF muscles. In conclusion, these results show that in addition to increased contribution of distinct muscle parts, with increases in exercise intensity there is also an enhanced recruitment of muscle fibers within all of the four heads of QF, despite established differences in muscle-part specific fiber type distributions. Glucose uptake heterogeneity may serve as a useful non-invasive tool to elucidate muscle activation in aging and diseased populations.

Kemppainen, Jukka; Fujimoto, Toshihiko; Knuuti, Juhani; Kalliokoski, Kari K.



[Effect of various metabolic poisons on the nature of contraction of the straight muscle of the abdomen of frog].  


A slow decline of responses was obtained after acetylcholine and KCl-stimulation of musculus rectus abdominis of the lake frog in the presence of antymicin A (0.27 mcg/ml). Dinitrophenol (up to 6.7.10(-4) M) as well as antymicin A inhibited the muscle contractility, with the effect being reversible. Muscle contraction ensued the application of dinitrophenol in concentration more than 6.7.10(-4)M. Decurarization ability of dinitrophenol was established. Mechanisms of disruption of the excitation--contraction coupling due to metabolic inhibitors are discussed. PMID:142325

Esyrev, O V; Murzakhmetova, M K; Omarova, R D



Pathological changes in levator palpebrae superioris muscle treated with botulinum toxin in a case of carotico-cavernous fistula.  

PubMed Central

We describe the case of a patient with carotico-cavernous fistula who had botulinum toxin A to induce a protective ptosis 4.5 days before death. The levator palpebrae superioris muscle from both sides and the superior rectus muscle from the injected side were obtained for examination. The preserved samples were stained with haematoxylin and eosin, Martius scarlet blue, Glees, S100, dehydrogenase, ATPase, and toluidine blue as well as being examined by electron microscopy. Inflammation and oedema were found that were probably due to the carotico-cavernous fistula. Axonal and some myelin sheath damage were also seen. Images

Adams, G G; Dilly, P N



Whole Body Muscle Activity during the FIFA 11+ Program Evaluated by Positron Emission Tomography  

PubMed Central

Purpose This study investigated the effect of the FIFA 11+ warm-up program on whole body muscle activity using positron emission tomography. Methods Ten healthy male volunteers were divided into a control group and a group that performed injury prevention exercises (The 11+). The subjects of the control group were placed in a sitting position for 20 min and 37 MBq of 18F-fluorodeoxyglucose (FDG) was injected intravenously. The subjects then remained seated for 45 min. The subjects of the exercise group performed part 2 of the 11+for 20 min, after which FDG was injected. They then performed part 2 of the 11+for 20 min, and rested for 25 min in a sitting position. Positron emission tomography-computed tomography images were obtained 50 min after FDG injection in each group. Regions of interest were defined within 30 muscles. The standardized uptake value was calculated to examine the FDG uptake of muscle tissue per unit volume. Results FDG accumulation within the abdominal rectus, gluteus medius and minimus were significantly higher in the exercise group than in the control group (P<0.05). Conclusion The hip abductor muscles and abdominal rectus were active during part 2 of the FIFA 11+ program.

Nakase, Junsuke; Inaki, Anri; Mochizuki, Takafumi; Toratani, Tatsuhiro; Kosaka, Masahiro; Ohashi, Yoshinori; Taki, Junichi; Yahata, Tetsutaro; Kinuya, Seigo; Tsuchiya, Hiroyuki



Effect of days on concentrate feed on sensory off-flavor score, off-flavor descriptor and fatty acid profiles for selected muscles from cull beef cows  

Microsoft Academic Search

The effects of short-term realimentation (0, 42 or 84 days) of cull beef cows (n=24) and post-mortem aging (10 or 20 days) of selected muscles on sensory off-flavor score, off-flavor descriptors of m. Gluteus medius (GLM), m. Longissimus lumborum (LOL), m. Triceps brachii-long head (LON) and m. Rectus femoris (REF) and fatty acid profiles (GLM, LOL and LON) were researched.

A. M. Stelzleni; D. D. Johnson



Influence of exercise training and exhaustion on ⁴⁵Ca\\/sup + +\\/ content of skeletal muscle mitochondria and fragmented sarcoplasmic reticulum  

Microsoft Academic Search

Following a 25\\/kg i\\/p injection, ⁴⁵Ca\\/sup + +\\/ activity from the mitochondria and fragmented sarcoplasmic reticulum (FSR) of the superficial rectus femoris (FG-fibers) and combined soleus muscle (SO-fibers) of trained (T, N = 9) and untrained (UT, N = 8) male Wistar rats was determined. The FG mitochondrial ⁴⁵Ca\\/sup + +\\/ activity from rested animals was 3.9 (T) and

H. W. Bonner; C. K. Buffington; S. W. Leslie



Behavioral preparation for surgery: Benefit or harm?  

Microsoft Academic Search

Elective surgery patients were prepared for surgery with training in muscle relaxation or with information about sensations they would experience. Relaxation reduced hospital stay, pain, and medication for pain and increased strength, energy, and postoperative epinephrine levels. Information reduced hospital stay. Personality variables (denial, fear, aggressiveness) were associated with recovery and influenced patients' responses to preparation. Less frightened patients benefited

John F. Wilson



Stretching Skeletal Muscle: Chronic Muscle Lengthening through Sarcomerogenesis  

PubMed Central

Skeletal muscle responds to passive overstretch through sarcomerogenesis, the creation and serial deposition of new sarcomere units. Sarcomerogenesis is critical to muscle function: It gradually re-positions the muscle back into its optimal operating regime. Animal models of immobilization, limb lengthening, and tendon transfer have provided significant insight into muscle adaptation in vivo. Yet, to date, there is no mathematical model that allows us to predict how skeletal muscle adapts to mechanical stretch in silico. Here we propose a novel mechanistic model for chronic longitudinal muscle growth in response to passive mechanical stretch. We characterize growth through a single scalar-valued internal variable, the serial sarcomere number. Sarcomerogenesis, the evolution of this variable, is driven by the elastic mechanical stretch. To analyze realistic three-dimensional muscle geometries, we embed our model into a nonlinear finite element framework. In a chronic limb lengthening study with a muscle stretch of 1.14, the model predicts an acute sarcomere lengthening from 3.09m to 3.51m, and a chronic gradual return to the initial sarcomere length within two weeks. Compared to the experiment, the acute model error was 0.00% by design of the model; the chronic model error was 2.13%, which lies within the rage of the experimental standard deviation. Our model explains, from a mechanistic point of view, why gradual multi-step muscle lengthening is less invasive than single-step lengthening. It also explains regional variations in sarcomere length, shorter close to and longer away from the muscle-tendon interface. Once calibrated with a richer data set, our model may help surgeons to prevent muscle overstretch and make informed decisions about optimal stretch increments, stretch timing, and stretch amplitudes. We anticipate our study to open new avenues in orthopedic and reconstructive surgery and enhance treatment for patients with ill proportioned limbs, tendon lengthening, tendon transfer, tendon tear, and chronically retracted muscles.

Zollner, Alexander M.; Abilez, Oscar J.; Bol, Markus; Kuhl, Ellen



Stretching skeletal muscle: chronic muscle lengthening through sarcomerogenesis.  


Skeletal muscle responds to passive overstretch through sarcomerogenesis, the creation and serial deposition of new sarcomere units. Sarcomerogenesis is critical to muscle function: It gradually re-positions the muscle back into its optimal operating regime. Animal models of immobilization, limb lengthening, and tendon transfer have provided significant insight into muscle adaptation in vivo. Yet, to date, there is no mathematical model that allows us to predict how skeletal muscle adapts to mechanical stretch in silico. Here we propose a novel mechanistic model for chronic longitudinal muscle growth in response to passive mechanical stretch. We characterize growth through a single scalar-valued internal variable, the serial sarcomere number. Sarcomerogenesis, the evolution of this variable, is driven by the elastic mechanical stretch. To analyze realistic three-dimensional muscle geometries, we embed our model into a nonlinear finite element framework. In a chronic limb lengthening study with a muscle stretch of 1.14, the model predicts an acute sarcomere lengthening from 3.09[Formula: see text]m to 3.51[Formula: see text]m, and a chronic gradual return to the initial sarcomere length within two weeks. Compared to the experiment, the acute model error was 0.00% by design of the model; the chronic model error was 2.13%, which lies within the rage of the experimental standard deviation. Our model explains, from a mechanistic point of view, why gradual multi-step muscle lengthening is less invasive than single-step lengthening. It also explains regional variations in sarcomere length, shorter close to and longer away from the muscle-tendon interface. Once calibrated with a richer data set, our model may help surgeons to prevent muscle overstretch and make informed decisions about optimal stretch increments, stretch timing, and stretch amplitudes. We anticipate our study to open new avenues in orthopedic and reconstructive surgery and enhance treatment for patients with ill proportioned limbs, tendon lengthening, tendon transfer, tendon tear, and chronically retracted muscles. PMID:23049683

Zöllner, Alexander M; Abilez, Oscar J; Böl, Markus; Kuhl, Ellen



Integration core exercises elicit greater muscle activation than isolation exercises.  


The American College of Sports Medicine and the United States Department of Health and Human Services advocate core training as a means to improve stability, reduce injury, and maintain mobility. There are countless exercises that target the primary core trunk muscles (abdominal and lumbar) with the aim of providing these benefits. However, it is unknown as to which exercises elicit the greatest activation thereby maximizing functional gains and peak performance. Thus, our purpose was to determine whether integration core exercises that require activation of the distal trunk muscles (deltoid and gluteal) elicit greater activation of primary trunk muscles in comparison with isolation core exercises that only require activation of the proximal trunk muscles. Twenty participants, 10 men and 10 women, completed 16 randomly assigned exercises (e.g., crunch, upper body extension, and hover variations). We measured muscle activity with surface electromyography of the anterior deltoid, rectus abdominus, external abdominal oblique, lumbar erector spinae, thoracic erector spinae, and gluteus maximus. Our results indicate that the activation of the abdominal and lumbar muscles was the greatest during the exercises that required deltoid and gluteal recruitment. In conclusion, when completing the core strength guidelines, an integrated routine that incorporates the activation of distal trunk musculature would be optimal in terms of maximizing strength, improving endurance, enhancing stability, reducing injury, and maintaining mobility. PMID:22580983

Gottschall, Jinger S; Mills, Jackie; Hastings, Bryce



In situ transverse rectus abdominis myocutaneous flap: a rat model of myocutaneous ischemia reperfusion injury.  


Free tissue transfer is the gold standard of reconstructive surgery to repair complex defects not amenable to local options or those requiring composite tissue. Ischemia reperfusion injury (IRI) is a known cause of partial free flap failure and has no effective treatment. Establishing a laboratory model of this injury can prove costly both financially as larger mammals are conventionally used and in the expertise required by the technical difficulty of these procedures typically requires employing an experienced microsurgeon. This publication and video demonstrate the effective use of a model of IRI in rats which does not require microsurgical expertise. This procedure is an in situ model of a transverse abdominis myocutaneous (TRAM) flap where atraumatic clamps are utilized to reproduce the ischemia-reperfusion injury associated with this surgery. A laser Doppler Imaging (LDI) scanner is employed to assess flap perfusion and the image processing software, Image J to assess percentage area skin survival as a primary outcome measure of injury. PMID:23770929

Edmunds, Marie-Claire; Wigmore, Stephen; Kluth, David



Contribution of IL-1 beta to the enhancement of Campylobacter rectus lipopolysaccharide-stimulated PGE2 production in old gingival fibroblasts in vitro.  


Campylobacter rectus is associated with adult periodontitis. We previously reported that C. rectus lipopolysaccharide (LPS)-stimulated prostaglandin E2 (PGE2) production in old cells of human gingival fibroblasts (HGFs) is higher than that in young cells. The present study examined whether an enhancement of C. rectus LPS-stimulated interleukin (IL)-1 beta production in old HGFs contributed to the increased production of PGE2. LPS was prepared from C. rectus ATCC33238. HGFs were established from healthy gingiva in three patients, aged 10-12 years. Cellular aging in culture was determined with increasing doubling. The cultured cells were treated with LPS (0.01-10 micrograms/ml), and the amount of IL-1 beta in the medium was measured after a 24 h incubation. The LPS-stimulated IL-1 beta production in each old cell (corresponding to 57-67% of complete life-span) was increased (1.6-2.6 times) compared to that in the young cells (corresponding to 17-20% of the life-span). The IL-1 beta mRNA synthesis in the presence of LPS in the old cells was higher than that in the young cells. The enhancement of LPS-stimulated PGE2 production was inhibited by anti-IL-1 beta antibody and by IL-1 receptor antagonist. These findings suggest that the greater ability of old cells to produce PGE2 in response to C. rectus LPS is due to their greater level of IL-1 beta. PMID:9255759

Takiguchi, H; Yamaguchi, M; Okamura, H; Abiko, Y



Breast Surgery  


... Friday, 9 AM to 10 PM EST. FACTS FOR LIFE Breast Cancer Surgery The goal of breast cancer surgery is to ... Choose a surgeon who does a lot of breast cancer surgeries. • Ask your surgeon which options are best for you and why. You may want to get ...


A micromechanical model of skeletal muscle to explore the effects of fiber and fascicle geometry.  


Computational models of muscle generally lump the material properties of connective tissue, muscle fibers, and muscle fascicles together into one constitutive relationship that assumes a transversely isotropic microstructure. These models do not take into account how variations in the microstructure of muscle affect its macroscopic material properties. The goal of this work was to develop micromechanical models of muscle to determine the effects of variations in muscle microstructure on the macroscopic constitutive behavior. We created micromechanical models at the fiber and fascicle levels based on histological cross-sections of two rabbit muscles, the rectus femoris (RF) and the soleus, to determine the effects of microstructure geometry (fiber and fascicle shapes) on the along-fiber shear modulus of muscle. The two fiber-level models predicted similar macroscopic shear moduli (within 13.5% difference); however, the two fascicle-level models predicted very different macroscopic shear moduli (up to 161% difference). We also used the micromechanical models to test the assumption that the macroscopic properties of muscle are transversely isotropic about the fiber (or fascicle) direction. The fiber-level models exhibited behavior consistent with the transverse isotropy assumption; however, the fascicle-level models exhibited transversely anisotropic behavior. Micromechanical models, combined with fiber and fiber bundle mechanical experiments, are needed to understand how normal or pathological variations in microstructure give rise to the observed macroscopic behavior of muscle. PMID:20846654

Sharafi, Bahar; Blemker, Silvia S



The Effects of Grade and Speed on Leg Muscle Activations during Walking  

PubMed Central

Compared to level walking, additional muscle actions are required to raise and lower the center of mass during uphill and downhill walking, respectively. However, it remains unclear which muscle recruitment strategies are employed at typical grades when walking over a range of speeds. Based on previous reports, we hypothesized that, across a range of walking speeds, hip, knee, and ankle extensor muscle activations increase with steeper uphill grade, but only knee extensor muscle activations increase with steeper downhill grade. We also hypothesized that these changes in muscle activations with grade become more pronounced with faster walking speed. To test these hypotheses, ten young adult subjects (5M/5F) walked on a standard treadmill at seven grades (0, ±3, ±6, and ±9°) and three speeds (0.75, 1.25, and 1.75 m·s?1). We quantified the stance phase electromyographic activities of the gluteus maximus (GMAX), biceps femoris (BF), rectus femoris (RF), vastus medialis (VM), medial gastrocnemius (MG), and soleus (SOL) muscles. On average, compared to level walking, hip (BF: 635%, GMAX: 345%), knee (RF: 165%, VM: 366%), and ankle (MG: 175%, SOL: 136%) extensor muscle activities increased to walk up 9°, but only knee (RF: 310%, VM: 246%) extensor muscle activities increased to walk down 9°. Further, these changes in muscle activations with grade became greater with faster walking speed. We conclude that people employ distinct uphill (hip, knee, and ankle extensors) and downhill (knee extensors) muscle recruitment strategies generally across walking speeds and progressively with steeper grade.

Franz, Jason R.; Kram, Rodger



The relationship between muscle deoxygenation and activation in different muscles of the quadriceps during cycle ramp exercise  

PubMed Central

The relationship between muscle deoxygenation and activation was examined in three different muscles of the quadriceps during cycling ramp exercise. Seven young male adults (24 ± 3 yr; mean ± SD) pedaled at 60 rpm to exhaustion, with a work rate (WR) increase of 20 W/min. Pulmonary oxygen uptake was measured breath-by-breath, while muscle deoxygenation (HHb) and activity were measured by time-resolved near-infrared spectroscopy (NIRS) and surface electromyography (EMG), respectively, at the vastus lateralis (VL), rectus femoris (RF), and vastus medialis (VM). Muscle deoxygenation was corrected for adipose tissue thickness and normalized to the amplitude of the HHb response, while EMG signals were integrated (iEMG) and normalized to the maximum iEMG determined from maximal voluntary contractions. Muscle deoxygenation and activation were then plotted as a percentage of maximal work rate (%WRmax). The HHb response for all three muscle groups was fitted by a sigmoid function, which was determined as the best fitting model. The c/d parameter for the sigmoid fit (representing the %WRmax at 50% of the total amplitude of the HHb response) was similar between VL (47 ± 12% WRmax) and VM (43 ± 11% WRmax), yet greater (P < 0.05) for RF (65 ± 13% WRmax), demonstrating a “right shift” of the HHb response compared with VL and VM. The iEMG also showed that muscle activation of the RF muscle was lower (P < 0.05) compared with VL and VM throughout the majority of the ramp exercise, which may explain the different HHb response in RF. Therefore, these data suggest that the sigmoid function can be used to model the HHb response in different muscles of the quadriceps; however, simultaneous measures of muscle activation are also needed for the HHb response to be properly interpreted during cycle ramp exercise.

Chin, Lisa M. K.; Kowalchuk, John M.; Barstow, Thomas J.; Kondo, Narihiko; Amano, Tatsuro; Shiojiri, Tomoyuki



Adaptations intheTemporalis Muscles ofRabbits after Masseter Muscle Removal  

Microsoft Academic Search

Masseter muscles weresurgically removed insixyoungfemale rabbits sothatwecould study adaptations ofthesuperficial temporalis mus- cles (ST)toincreasedfunctional requirements. Eight weeks following surgery, weusedmorphological measurements, histochemistry, con- tractile properties insitu, andocclusal force invivotocompare the muscles intheexperimental animals andsixcontrol rabbits. Analysis oftheresults demonstrated adecrease infatigability ofSTafter mas- seter myectomy. Incisal occlusal force decreased by65%during the first twoweeks, andnorecovery wasobserved during thefollowing sixweeks. Ateight weeks post-surgery,



Abnormal muscle activation during gait in diabetes patients with and without neuropathy.  


The World Health Organization warns that, in 2000, as many as 33 million Europeans suffered from diabetes, approximately 15% will likely develop foot ulcers, and approximately 15-20% of these patients will face lower-extremity amputation. Changes in some gait parameters that appear to be specific in diabetes have been identified in the literature: shorter stride length, reduced walking speed, and altered lower limb and trunk mobility. The present study aimed at evaluating the role of altered muscle activity in gait alterations of diabetic subjects with and without neuropathy. This study involved 50 subjects: 10 controls (BMI 24.4 ± 2.8, age 61.2 ± 5.07), 20 diabetics (BMI 26.4 ± 2.5, age 56.53 ± 13.29) and 20 neuropathics (BMI 26.8 ± 3.4, age 61.2 ± 7.7). The electrical activity of six muscles was collected bilaterally on the lower limb during gait: gluteus medius, rectus femoris, tibialis anterior, peroneous longus, gastrocnemius lateralis, and extensor digitorum communis. Electromyographic activity was represented through linear envelopes. Time and space parameters were also evaluated by means of two Bertec force plates and a six cameras motion capture system (BTS, 60-120 Hz). At initial contact and loading response, an early peak of rectus femoris activity occurred in diabetic subjects with and without neuropathy. During midstance a delay of gastrocnemius activity was observed in diabetic non-neuropathic subjects. During terminal swing a delay of rectus femoris and gluteus medius activity was seen in diabetic non-neuropathic subjects'. The results suggest that important muscle activity deviations are present in diabetic subjects although these are not directly related to neuropathy. PMID:22098824

Sawacha, Zimi; Spolaor, Fabiola; Guarneri, Gabriella; Contessa, Paola; Carraro, Elena; Venturin, Andrea; Avogaro, Angelo; Cobelli, Claudio



Muscle moment arms of the gibbon hind limb: implications for hylobatid locomotion  

PubMed Central

Muscles facilitate skeletal movement via the production of a torque or moment about a joint. The magnitude of the moment produced depends on both the force of muscular contraction and the size of the moment arm used to rotate the joint. Hence, larger muscle moment arms generate larger joint torques and forces at the point of application. The moment arms of a number of gibbon hind limb muscles were measured on four cadaveric specimens (one Hylobates lar, one H. moloch and two H. syndactylus). The tendon travel technique was used, utilizing an electro-goniometer and a linear voltage displacement transducer. The data were analysed using a technique based on a differentiated cubic spline and normalized to remove the effect of body size. The data demonstrated a functional differentiation between voluminous muscles with short fascicles having small muscle moment arms and muscles with longer fascicles and comparatively smaller physiological cross-sectional area having longer muscle moment arms. The functional implications of these particular configurations were simulated using a simple geometric fascicle strain model that predicts that the rectus femoris and gastrocnemius muscles are more likely to act primarily at their distal joints (knee and ankle, respectively) because they have short fascicles. The data also show that the main hip and knee extensors maintain a very small moment arm throughout the range of joint angles seen in the locomotion of gibbons, which (coupled to voluminous, short-fascicled muscles) might help facilitate rapid joint rotation during powerful movements.

Channon, Anthony J; Crompton, Robin H; Gunther, Michael M; Vereecke, Evie E



Human soleus muscle: A comparison of fiber composition and enzyme activities with other leg muscles  

Microsoft Academic Search

The relationship between fiber composition and enzyme profiles as estimated from in vitro enzyme activities has been studied in human skeletal muscle. Samples from the soleus, gastrocnemius, and vastus lateralis muscles were obtained both by biopsying normal subjects and from patients during nonmuscular related general surgery. The samples were analyzed for fiber composition, phosphorylase (a+b), phosphofructokinase, and creatine phosphokinase activities.

Philip D. Gollnick; Bertil Sjödin; Jan Karlsson; Eva Jansson; Bengt Saltin



Differential Glucose Uptake in Quadriceps and Other Leg Muscles During One-Legged Dynamic Submaximal Knee-Extension Exercise  

PubMed Central

One-legged dynamic knee-extension exercise (DKE) is a widely used model to study the local cardiovascular and metabolic responses to exercise of the quadriceps muscles. In this study, we explored the extent to which different muscles of the quadriceps are activated during exercise using positron emission tomography (PET) determined uptake of [18F]-fluoro-deoxy-glucose (GU) during DKE. Five healthy male subjects performed DKE at 25?W for 35?min and both the contracting and contralateral resting leg were scanned with PET from mid-thigh and distally. On average, exercise GU was the highest in the vastus intermedius (VI) and lowest in the vastus lateralis (VL; VI vs VL, p?muscles in the exercising leg was 35?±?9%. Compared to mean GU in QF (=100%), GU was on average 73% in VL, 84% in rectus femoris, 115% in vastus medialis, and 142% in VI. Variable activation of hamstring muscles and muscles of the lower leg was also observed. These results show that GU of different muscles of quadriceps muscle group as well as between individuals vary greatly during DKE, and suggests that muscle activity is not equal between quadriceps muscles in this exercise model. Furthermore, posterior thigh muscles and lower leg muscles are more active than hitherto thought even during this moderate exercise intensity.

Kalliokoski, Kari K.; Boushel, Robert; Langberg, Henning; Scheede-Bergdahl, Celena; Ryberg, Ann Kathrine; D?ssing, Simon; Kjaer, Andreas; Kjaer, Michael



Differential glucose uptake in quadriceps and other leg muscles during one-legged dynamic submaximal knee-extension exercise.  


One-legged dynamic knee-extension exercise (DKE) is a widely used model to study the local cardiovascular and metabolic responses to exercise of the quadriceps muscles. In this study, we explored the extent to which different muscles of the quadriceps are activated during exercise using positron emission tomography (PET) determined uptake of [(18)F]-fluoro-deoxy-glucose (GU) during DKE. Five healthy male subjects performed DKE at 25?W for 35?min and both the contracting and contralateral resting leg were scanned with PET from mid-thigh and distally. On average, exercise GU was the highest in the vastus intermedius (VI) and lowest in the vastus lateralis (VL; VI vs VL, p?muscles in the exercising leg was 35?±?9%. Compared to mean GU in QF (=100%), GU was on average 73% in VL, 84% in rectus femoris, 115% in vastus medialis, and 142% in VI. Variable activation of hamstring muscles and muscles of the lower leg was also observed. These results show that GU of different muscles of quadriceps muscle group as well as between individuals vary greatly during DKE, and suggests that muscle activity is not equal between quadriceps muscles in this exercise model. Furthermore, posterior thigh muscles and lower leg muscles are more active than hitherto thought even during this moderate exercise intensity. PMID:22046164

Kalliokoski, Kari K; Boushel, Robert; Langberg, Henning; Scheede-Bergdahl, Celena; Ryberg, Ann Kathrine; Døssing, Simon; Kjær, Andreas; Kjær, Michael



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


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

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



The GroEL-like protein from Campylobacter rectus: immunological characterization and interleukin-6 and -8 induction in human gingival fibroblast.  


The native GroEL-like protein was purified from Campylobacter rectus, a putative periodontal pathogen, by affinity chromatography on ATP-agarose followed by high performance liquid chromatography on Superose 6. The purified 64-kDa protein (denatured form of GroEL-like protein) was immunoreactive by SDS-PAGE and Western immunoblotting with the monoclonal antibody directed against heat shock protein 60 of human origin. The native GroEL-like protein stimulated both interleukin-6 (IL-6) and IL-8 secretion by a confluent monolayer of human gingival fibroblast in their culture supernatant. During the 22-h incubation, the amounts of IL-6 and IL-8 were increased by 5.4- and 3.5-fold, respectively. These data suggested that the GroEL-like protein might be considered to be a virulence factor of C. rectus in periodontal disease. PMID:9785445

Hinode, D; Yoshioka, M; Tanabe, S; Miki, O; Masuda, K; Nakamura, R



Myogenic Growth Factors Can Decrease Extraocular Muscle Force Generation: A Potential Biological Approach to the Treatment of Strabismus  

PubMed Central

PURPOSE Future pharmacologic treatment of strabismus may be optimized if drugs that are less potentially toxic to patients can be developed. Prior studies have shown that direct injection of extraocular muscles (EOMs) with insulin growth factor or fibroblast growth factor results in significant increases in the generation of EOM force. The purpose of this study was to examine the morphometric and physiological effects of direct EOM injection with the growth factors BMP4, TGF?1, Shh, and Wnt3A. METHODS One superior rectus muscle of normal adult rabbits was injected with BMP4, TGF?1, Shh, or Wnt3A. The contralateral muscle was injected with an equal volume of saline to serve as a control. After 1 week, the animals were euthanatized, and both superior rectus muscles were removed and assayed physiologically. The muscles were stimulated at increasing frequencies to determine force generation. A separate group of treated and control superior rectus muscles were examined histologically for alterations in total muscle cross-sectional area and myosin heavy chain isoform (MyHC) composition. RESULTS One week after a single injection of BMP4, TGF?1, Shh, or Wnt3A, all treated muscles showed significant decreases in generation of force compared with control muscles. BMP4, TGF?1, Shh, and Wnt3A significantly decreased the mean myofiber cross-sectional area of fast MyHC-positive myofibers. BMP4 resulted in a conversion of fast-to-slow myofibers and a significant decrease in the percentage of developmental and neonatal MyHC-positive myofibers. Alterations in mean cross-sectional area and proportion of MyHCs were seen after injection with TGF?1, Shh, and Wnt3A. TGF?1 and BMP4 injections resulted in increased Pax7-positive satellite cells, whereas BMP4, TGF?1, and Wnt3A resulted in a decrease in MyoD-positive satellite cells. CONCLUSIONS These results suggest that, rather than using toxins or immunotoxins, a more biological approach to decrease muscle strength is possible and demonstrate the potential utility of myogenic signaling factors for decreasing EOM strength. Ongoing drug-delivery studies will elucidate means of extending treatment effect to make such agents clinically useful.

Anderson, Brian C.; Christiansen, Stephen P.; McLoon, Linda K.



Osseous Surgery  


... their teeth. Osseous surgery reshapes the bone to get rid of the defects. This procedure is often used ... surgery. You can reduce swelling by applying an ice pack to the outside of your face in the treated area. In some situations, you may get a prescription for antibiotics to prevent an infection. ...


Masseter muscle thickness three years after surgical correction of class III dentofacial deformity  

Microsoft Academic Search

ObjectiveTo analyse the effect of integrated orthodontic treatment, orthognathic surgery and orofacial myofunctional therapy on masseter muscle thickness in patients with class III dentofacial deformity three years after orthognathic surgery.

Luciana V. V. Trawitzki; Roberto O. Dantas; J. Elias-Júnior; Francisco V. Mello-Filho



Tennis elbow surgery - discharge  


... surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... had surgery to repair a tendon in your elbow. The surgeon made a cut (incision) over the ...


Two-stage reconstruction of infected deep median sternotomy wound with an intercostal pedicled oblique rectus abdominis musculocutaneous flap after coronary artery bypass grafting.  


Median sternotomy wounds infected after coronary artery bypass grafting with bilateral internal mammary arteries are generally poor in condition, cannot be debrided adequately, and are limited in flap selection for reconstruction. The authors treated 2 patients with two-stage reconstruction using a modified superior-based rectus abdominis musculocutaneous flap. First, simple debridement was performed with the goal of preserving the internal mammary artery grafts. Then, delayed reconstruction with the oblique rectus abdominis musculocutaneous flap supplied by the superior epigastric and seventh intercostal vessels was performed. Despite ligature of the bilateral internal mammary arteries at their full length, the large oblique skin paddle designed along the angiosome as far as the midaxillary line survived almost completely in both patients, resulting in cessation of pus discharge. The circulation to the superior epigastric and intercostal vessels might be reinforced because of the delay phenomenon. Two-stage reconstruction with a superior pedicled oblique rectus abdominis musculocutaneous flap presents a successful resolution of infected median sternotomy wounds after coronary artery bypass grafting with sacrifice of bilateral internal mammary arteries. PMID:14520073

Mochizuki, Yasushi; Okazaki, Mutsumi; Kurashina, Reiko; Kano, Mayuko



Histological analysis of fibres in myotomes of antarctic fish. II. Morphometry of muscle fibres and capillaries.  


In a survey of nine species of antarctic Teleosts belonging to the families Chaenichthyidae (two species) and Nototheniidae (seven species) the surface density (Sv), volume density (Vv), number of muscle fibres and capillaries in 0.1 mm2 area and the diameters of capillaries were estimated. Muscle fibre to capillary ratio (C:F) and streamlinedness (1/h) of the fish were also calculated. It was found that the Sv values of the muscle fibres are inversely correlated with streamlinedness of the fish. However, this relation is disturbed in these fish which have low metabolic activity. In the genera Notothenia and Dissostichus only the Sv of the muscle fibres is greater in the caudal myotomes in comparison with those in the trunk. The capillarization of the muscle tissue in white-and red-blooded fish does not differ significantly, it differs however, in the case of musculus lateralis magnus (MLM) and musculus rectus lateralis (MRL). Capillary to fibre ratio (C:F) significantly differs between red and white portion of muscle in all species investigated. The diameters of white-blooded fish capillaries are importantly greater in comparison with those of red-blooded fish. It is concluded that muscles of white-blooded fish are morphologically adapted to the lack of hemoglobin and myoglobin by: relatively large diameters of their capillaries, but not by their density, and by the low Sv values of their muscle fibres. PMID:7168239

Kilarski, W; Smia?owska, E; Friedhuber, A



Total and regional blood flows in vascularized skeletal muscle grafts in rabbits  

SciTech Connect

The transplantation of whole skeletal muscles is a common clinical procedure. Although atypical blood flows have been reported in small free muscle grafts, the blood flow of large neurovascular-intact (NVI) and neurovascular-anastomosed (NVA) grafts have not been measured. Because the maximum specific force (N/cm{sup 2}) of NVI and NVA grafts is 65% that of control muscles, we hypothesized that total and regional blood flows of NVI and NVA grafts at rest and during twitch contractions are significantly lower than lower flows of control muscles. In rabbits, blood flows of control rectus femoris (RFM) muscles and NVI and NVA grafts of RFM muscles were measured by the radioactive-microsphere technique. Total blood flows in grafts were not different from the control RFM muscle values, except for a higher resting flow in NVA grafts and a lower flow at 3 Hz in NVI grafts. Minor variations in regional flows were observed. We conclude that the operative procedures of grating and repair of blood vessels affect the vascular bed of muscles minimally, and the deficits observed in grafts do not arise from inadequate perfusion.

Burton, H.W.; Stevenson, T.R.; Dysko, R.C.; Gallagher, K.P.; Faulkner, J.A. (Univ. of Michigan Medical School, Ann Arbor (USA))



Muscle aches  


... Other blood tests to look at muscle enzymes (creatine kinase) and possibly a test for Lyme disease ... Jr, Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009: ...


Muscle Physiology  

NSDL National Science Digital Library

The Muscle Physiology Lab at the University of California-San Diego provides this comprehensive source of information on the neuromuscular system. The Web site appears as a extensive menu of subtopics, each leading to pages of detailed text and diagrams. Students studying muscle structure and function should find this well-organized and authoritative resource extremely useful. The Web site also includes a search tool for quickly finding pages of interest, and a list of related links for additional information.



Acinic Cell Carcinoma of Minor Salivary Gland of the Base of Tongue That Required Reconstructive Surgery  

PubMed Central

Acinic cell carcinoma of minor salivary gland of the base of tongue is very rare. Squamous cell carcinoma is the most common tumor in the base of tongue. We present a patient with gigantic acinic cell carcinoma of the base of tongue. This patient required emergency tracheotomy before surgery, because he had dyspnea when he came to our hospital. We removed this tumor by pull-through method and performed reconstructive surgery using a rectus abdominis myocutaneous flap. It was a case that to preserved movement of the tongue and swallowing function by keeping lingual arteries and hypoglossal nerves. This case was an extremely rare case of ACC of the base of tongue that required reconstructive surgery.

Wada, Kota; Watanabe, Subaru; Ando, Yuji; Seino, Yoichi; Moriyama, Hiroshi



Muscle trigger point therapy in tension-type headache.  


Recent evidence suggests that active trigger points (TrPs) in neck and shoulder muscles contribute to tension-type headache. Active TrPs within the suboccipital, upper trapezius, sternocleidomastoid, temporalis, superior oblique and lateral rectus muscles have been associated with chronic and episodic tension-type headache forms. It seems that the pain profile of this headache may be provoked by referred pain from active TrPs in the posterior cervical, head and shoulder muscles. In fact, the presence of active TrPs has been related to a higher degree of sensitization in tension-type headache. Different therapeutic approaches are proposed for proper TrP management. Preliminary evidence indicates that inactivation of TrPs may be effective for the management of tension-type headache, particularly in a subgroup of patients who may respond positively to this approach. Different treatment approaches targeted to TrP inactivation are discussed in the current paper, focusing on tension-type headache. New studies are needed to further delineate the relationship between muscle TrP inactivation and tension-type headache. PMID:22364330

Alonso-Blanco, Cristina; de-la-Llave-Rincón, Ana Isabel; Fernández-de-las-Peñas, César



FGFR1 inhibits skeletal muscle atrophy associated with hindlimb suspension  

PubMed Central

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.

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



Cataract Surgery  


... have had previous LASIK or other laser vision correction , you can still have cataract surgery. In planning ... provide your Eye M.D. with the vision correction prescription you had before LASIK, if possible. This ...


Effects of sequential injections of hepatocyte growth factor and insulin-like growth factor-I on adult rabbit extraocular muscle  

PubMed Central

Purpose To determine whether hepatocyte growth factor (HGF) and insulin-like growth factor-I (IGF-I) have synergistic effects in promoting extraocular muscle fiber growth and force generation. Methods A superior rectus muscle of adult rabbits was treated with either a single injection of HGF or sequential injections of HGF followed 1 week later by IGF-I. One week after HGF alone and 1 week after the IGF-I injection, the superior rectus muscles from treated and control orbits were examined for alterations in force generation as well as changes in myofiber size. Results Injection of HGF alone did not result in changes to muscle force, specific tension, or myofiber cross-sectional area; however, it did result in a significant increase in numbers of satellite cells. Sequential injection of HGF and IGF-I resulted in significantly increased force, specific tension, and myofiber cross-sectional areas as well as increased numbers of satellite cells. Conclusions Preinjection with HGF augments the treatment effect of IGF-I. This is likely a result of HGF-induced activation of satellite cells. This synergistic effect should allow a reduction in IGF-I dosing required to produce a given increase in extraocular muscle force generation.

Willoughby, Christy L.; Ralles, Steven; Christiansen, Stephen P.; McLoon, Linda K.



Oculoplastic surgery.  


Esthetic and functional surgery in the periocular region falls into the domain of oculoplastic surgeons, as well as plastic surgeons and otorhinolaryngologists with training in facial plastic surgery. This article provides a description of 8 common eyelid procedures that are routinely performed under local anesthesia, with or without mild intravenous sedation. Serious complications are rare. The rate of postoperative infection in the highly vascularized eyelid tissues is less than 1% in our experience. PMID:24093658

Mehta, Sonul; Belliveau, Michel J; Oestreicher, James H



Plastic Surgery  

Microsoft Academic Search

\\u000a Comprehensive cancer centers in the United States interweave subspecialty care from multiple disciplines. These centers’ very\\u000a existence is testimony to the broad interdisciplinary approach to cancer care today. Plastic surgery, with its ability to\\u000a restore form and function, represents a small but critical component of the comprehensive care of patients with cancer. Plastic\\u000a surgical reconstruction extends the capabilities of surgery

Neil A. Fine; Charles E. Butler


Advances in Plastic Surgery  

PubMed Central

Recent progress in plastic surgery has been rapid and many new techniques have been developed. Reconstructive procedures have been advanced by a better understanding of the anatomy of the blood supply to skin and muscle, with the subsequent development of the use of axial flaps, musculocutaneous flaps and neurosensory flaps. Burn treatment has advanced greatly, making it possible to successfully treat larger and more complicated burns. The development of microsurgery has made possible free-flap transfer and replantation of amputated parts. Advances in surgical procedures on the hands include a realization that primary repair of lacerated tendons and nerves will give good results. Replacement joints have been developed that can be used in hands for joints destroyed by arthritis or trauma. Craniofacial surgery is a new field of endeavor in plastic surgery, involving new techniques that can be used to treat exophthalmos of Graves' disease and the facial deformities resulting from gigantism and acromegaly. Head and neck procedures have advanced, with the emphasis on immediate reconstruction using new flaps. Techniques for treating cleft lip and palate have been refined. Encouraging results have been reported in the treatment of nevus flammeus with argon lasers. In aesthetic surgical procedures, the aim is for safety and consistent long-lasting results. Improved understanding of the physiology and treatment of radionecrosis has evolved.

McDonald, Harold D.; Vasconez, Luis O.



Surgery for Ewing Tumors  


... tumors Next Topic Radiation therapy for Ewing tumors Surgery for Ewing tumors Several types of surgery can ... be reconstructed after surgery. Possible side effects of surgery The short-term side effects of surgery can ...


Motor nucleus activity fails to predict extraocular muscle forces in ocular convergence  

PubMed Central

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 (kV) was lower than that for conjugate movement (kC) at distance, i.e., mean kV/kC = 0.50, which implies stronger LR innervation in convergence. We also found in 39 MRNs that mean kV/kC = 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 kV < kC and MRMNs with kV > kC innervate muscle fibers that are weak, have mechanical coupling that attenuates their effective oculorotary force, or serve some nonoculorotary, regulatory function.

Davison, Ryan C.; Gamlin, Paul D.



Does using an ejector chair affect muscle activation patterns in rheumatoid arthritic patients? A preliminary investigation.  


The present study examined knee and arm extensor muscle activation patterns displayed by 12 elderly female rheumatoid arthritic patients (mean age = 65.5 +/- 8.6 yr) rising from an instrumented Eser ejector chair under four conditions: high seat (540 mm), low seat (450 mm), with and without ejector assistance. Electromyographic (EMG) signals were sampled (1000 Hz) for vastus lateralis (VL), vastus medialis (VM), rectus femoris (RF) and triceps brachii (TB) using a Noraxon Telemyo System (bandwidth 0-340 Hz). Muscle onset, offset and peak activity relative to loss of seat contact (SS), and integrated EMG, were calculated for each muscle burst before SS. A high seat significantly (p < or = 005) decreased VL and TB intensity but did not change muscle activation patterns compared with rising from a low seat. Ejector assistance significantly increased VM and RF burst duration and RF intensity but had no effect on vastii muscle intensity. It was concluded that concerns pertaining to muscle disuse when rising with ejector assistance were unfounded in the present study. However, further research is required to investigate the effects of habitual use of a mechanical ejector device on muscle activation patterns. PMID:10659447

Munro, B J; Steele, J R



Motor Evoked Potentials of Trunk Muscles in Traumatic Brain Injury Patients  

PubMed Central

Objective To evaluate the motor innervation of trunk muscles in traumatic brain injury patients. Method Twenty patients (12 men and 8 women) with traumatic brain injury were enrolled in this study. Their mean age was 41 years. Motor evoked potentials (MEPs) were performed on the motor cortex. Electromyographic activities were recorded from the bilateral rectus abdominis muscles, the external oblique abdominal muscles, and the 4th and 9th thoracic erector spinae muscles. The onset latency and amplitude of contralateral and ipsilateral MEPs were measured. All patients were assessed by the Korean version of the Berg Balance Scale (K-BBS) to investigate the relationship between the frequency of MEPs in trunk muscles and gait ability. Results The mean frequency of ipsilateral MEPs was 23.8% with more damaged hemisphere stimulation, while the contralateral MEPs showed a mean frequency of 47.5% with more damaged hemisphere stimulation in traumatic brain injury patients. The latencies and amplitudes of MEPs obtained from the more damaged hemisphere were not significantly different from those of the less damaged hemisphere. There was no correlation between the manifestation of MEPs in trunk muscles and gait ability. Conclusion The ipsilateral and contralateral corticospinal pathways to trunk muscles are less likely to be activated in traumatic brain injury patients because of direct injury of the descending corticospinal motor tract or decreased excitability of the corticospinal tract from prefrontal contusion.

Seo, Min-Ho; Ko, Myoung-Hwan; Seo, Jeong-Hwan



Electromyographic activity of selected trunk muscles in subjects with and without hemiparesis during therapeutic exercise.  


The purpose of this study was to evaluate the trunk muscles activity of hemiparetic and control subjects during selected therapeutic exercises with surface electromyography (sEMG). The sEMG evaluation included 12 subjects presenting hemiparesis after having suffered a unilateral stroke and 12 apparently healthy subjects. A 16-channel sEMG system was used; data were band pass filtered from 20 to 450Hz. The signal was normalized through reference voluntary contraction (RVC) and presented in percentage. The exercises used in the evaluations were trunk flexion and trunk extension. Rectus abdominis presented greater activation on the paretic side of the experimental group than on the corresponding side of the control group (P=0.035) (Cohen's d¯=0.94). During leg elevation, the non-paretic obliquus externus abdominis showed greater activation than in other exercises (P=0.019) (Cohen's d¯=0.75). No inter-group differences were found for either erectus spinae activity or contraction onset. Experimental group subjects showed muscle activity alterations, principally in the rectus abdominis, indicating the occurrence of compensatory strategies. PMID:21071243

Pereira, Ligia Maxwell; Marcucci, Fernando Cesar Iwamoto; de Oliveira Menacho, Maryela; Garanhani, Márcia Regina; Lavado, Edson Lopes; Cardoso, Jefferson Rosa



Effect of position and alteration in synergist muscle force contribution on hip forces when performing hip strengthening exercises  

PubMed Central

Background Understanding the magnitude and direction of joint forces generated by hip strengthening exercises is essential for appropriate prescription and modification of these exercises. The purpose of this study was to evaluate hip joint forces created across a range of hip flexion and extension angles during two hip strengthening exercises: prone hip extension and supine hip flexion. Methods A musculoskeletal model was used to estimate hip joint forces during simulated prone hip extension and supine hip flexion under a control condition and two altered synergist muscle force conditions. Decreased strength or activation of specific muscle groups was simulated by decreasing the modeled maximum force values by 50%. For prone hip extension, the gluteal muscle strength was decreased in one condition and the hamstring muscle strength in the second condition. For supine hip flexion, the strength of the iliacus and psoas muscles was decreased in one condition, and the rectus femoris, tensor fascia lata, and sartorius muscles in the second condition. Findings The hip joint forces were affected by hip joint position and partially by alterations in muscle force contribution. For prone hip extension, the highest net resultant force occurred with the hip in extension and the gluteal muscles weakened. For supine hip flexion, the highest resultant forces occurred with the hip in extension and the iliacus and psoas muscles weakened. Interpretation Clinicians can use this information to select exercises to provide appropriate prescription and pathology-specific modification of exercise.

Lewis, Cara L.; Sahrmann, Shirley A.; Moran, Daniel W.



Altered trunk muscle coordination during rapid trunk flexion in people in remission of recurrent low back pain.  


People with a history of low back pain (LBP) are at high risk to encounter additional LBP episodes. During LBP remission, altered trunk muscle control has been suggested to negatively impact spinal health. As sudden LBP onset is commonly reported during trunk flexion, the aim of the current study is to investigate whether dynamic trunk muscle recruitment is altered in LBP remission. Eleven people in remission of recurrent LBP and 14 pain free controls performed cued trunk flexion during a loaded and unloaded condition. Electromyographic activity was recorded from paraspinal (lumbar and thoracic erector spinae, latissimus dorsi, deep and superficial multifidus) and abdominal muscles (obliquus internus, externus and rectus abdominis) with surface and fine-wire electrodes. LBP participants exhibited higher levels of co-contraction of flexor/extensor muscles, lower agonistic abdominal and higher antagonistic paraspinal muscle activity than controls, both when data were analyzed in grouped and individual muscle behavior. A sub-analysis in people with unilateral LBP (n = 6) pointed to opposing changes in deep and superficial multifidus in relation to the pain side. These results suggest that dynamic trunk muscle control is modified during LBP remission, and might possibly increase spinal load and result in earlier muscle fatigue due to intensified muscle usage. These negative consequences for spinal health could possibly contribute to recurrence of LBP. PMID:23079004

D'hooge, Roseline; Hodges, Paul; Tsao, Henry; Hall, Leanne; Macdonald, David; Danneels, Lieven



Muscle madness.  


The Bio-electrical Impedance Analysis (BIA) test is being used to follow wasting syndrome in patients with HIV infection because of its ability to determine how much muscle and fat a person has in their body. Because muscle mass is essential to supporting the immune system, suppressing viral replication, and avoiding opportunistic infections, it is important to track any changes. The test is painless and involves an electrode attached to one foot and a hand whereby an electrical current is passed through the body and its speed is measured. The faster the passage, the more muscle is present. Results of the test include a fluid assessment, body cell mass, fat mass, and a cellular health measure. PMID:11365542

Beesley, S; Maurice, J



Robotic Surgery  

PubMed Central

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.

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



Solar surgery  

NASA Astrophysics Data System (ADS)

Experimental results are presented to substantiate that highly concentrated sunlight can pragmatically produce the same extent, rate, and type of photothermal tissue damage ordinarily generated with laser fiber-optic surgery. Typically, it is intense flux, rather than coherence, that renders laser light unique in generating rapid, highly localized tissue coagulation and ablation. The spectral properties of both biological tissue and available optical fibers render visible and near-infrared lasers as best suited for penetrative (as opposed to superficial) surgery. Solar photons are also viable candidates for such radiative surgery, provided they can be concentrated to the flux levels of surgical lasers, coupled into an optical fiber, and efficiently delivered to a remote operating theater. The simplicity and potentially low cost of a solar surgery unit counterbalance its feasibility being restricted to mid-day hours in sunny regions. After a brief review of our solar fiber-optic concentrator, we report on the rates and dimensions of tissue death produced in fresh ex vivo chicken livers for a range of values of delivered power and exposure time. An approximate analytic model can account for some of the principal experimental findings. Our experimental results demonstrate that solar surgery can produce lesions up to several cm3 in volume, with a surgical efficacy as good as that of lasers for corresponding procedures.

Gordon, Jeffrey M.; Feuermann, Daniel; Huleihil, Mahmoud; Mizrahi, Solly; Shaco-Levy, Ruthy



Nail surgery.  


Nail surgery is a special branch of hand and dermatologic surgery. It is not widely performed, and many physicians do not feel at ease to perform it. The objective of this contribution is to give a short overview of the most important surgical procedures in clinical practice. References from the literature and the author's own experiences are condensed to describe what a dermatologic practitioner with knowledge of the nail and some surgical skills can perform. Nail surgery is a precise technique that requires careful administration and attention to details. Proper patient preparation starts with a patient history to identify potential contraindications and to prevent unnecessary complications. The author recommends isopropyl alcohol scrub and chlorhexidine for disinfection and ropivacaine 1% for anesthesia. The technique used for anesthesia depends on the type of surgery. Surgical procedures are described for diagnostic biopsies, nail avulsion in general, onychogryposis, paronychia treatment, hematomas and bone fracture due to trauma, removal of subungual foreign bodies, ingrowing nails, pincer nails, warts, ungual fibrokeratomas, digital myxoid pseudocyst, subungual exostoses, and various tumors. If performed correctly with adequate skills, nail surgery will lead to functionally and aesthetically satisfying results in the majority of instances. PMID:24079580

Haneke, Eckart


[Presbyopia surgery].  


Presbyopia surgery is a compensation option which aims at creating an increased depth of field. Monovision preserves a good close-vision quality for myopes. Multifocality is well tolerated by hyperopes if it is compatible with good far-vision quality. Conductive keratoplasty and Lasik multifocal ablation patterns are newly emerging methods. Monovision and multifocality can be applied to surgery by using corneal or intraocular implantation techniques. Multifocal intraocular lenses (IOLs) are growing in popularity among patients and surgeons, and opened the way to refractive lens exchange. Still they are not used routinely in cataract surgery, for reasons probably connected to the frequently observed reduction in contrast sensitivity. Accommodative IOL provides new method to compensate accommodation of presbyopes. Indications depend on preoperative ametropia, patient age and visual needs. PMID:18652400

Gatinel, Damien



Does size matter? Technical considerations of a regenerative tissue matrix for use in reconstructive surgery  

PubMed Central

INTRODUCTION: Acellular dermal matrices have been used with increasing frequency in both reconstructive and cosmetic surgery. While many studies have described the safety and morbidity profiles of these materials, little is known about the relative mechanical properties of individual sheets of allograft harvested from distinct donors. METHODS: Sixty-two individual sheets of an acellular dermal matrix from distinct lot numbers (signifying different donors of the dermis) were prospectively analyzed before use. Distribution of thickness according to manufacturer specifications in the dry state were as follows: 0.009 inches to 0.013 inches (1 [1.6%]); 0.79 mm to 1.78 mm (3 [4.8%]); 0.79 mm to 2.03 mm (5 [8%]); 0.8 mm to 3.3 mm (1 [1.6%]); 1.8 mm to 3.3 mm (10 [16.1%]) and 28 mm (6 [9.7%]). The size of the matrix was recorded while dry, after hydration and following stretch. The percentage change in surface area was recorded for each lot. RESULTS: The 62 reconstructive cases included breast implant reconstruction (2 [3.2%]); ventral hernia repair (11 [17.7%]); abdominal closure following autologous tissue harvest (6 [9.6%]); autologous breast reconstruction (37 [59.6%]); extremity wound closures (3 [4.8%]) and reinforcement of vertical rectus abdominis muscle closure (3 [4.8%]). The mean percentage change in the size of the acellular dermal matrix to the hydrated state was 58% (36 of 62; thickness 0.06 mm to 3.30 mm); the mean percentage change in size from dry state was 7.14% (range 0% to 18.7%). The mean percentage change in the size of the hydrated matrix to the stretched state was 25.7% (range 0.25% to 70.6%). The variability in elasticity among the individual sheets was significant (P<0.0005). CONCLUSION: The acellular dermal matrix displayed highly variable elastic properties among distinct donors. This may be significant in procedures in which symmetry is critical.

Craft, Randall O; Rebecca, Alanna M; Flahive, Colleen; Casey, William J; Dueck, Amylou; Harold, Kristi L



Muscle strain (image)  


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 ...


[Geriatric surgery].  


Modern medicine, which is evidence-based and overly scientific, has forgotten its artistic component, which is very important for surgery in general and for geriatric surgery in particular. The surgeon treating an old patient must be a politician more than a technician, more an artist than a scientist. Like Leonardo da Vinci, he or she must use scientific knowledge with intelligence and sensitivity, transforming the elderly patient's last days of life into a beautiful and harmonious painting and not into something like an atomic power station which, while no doubt useful, is deprived of beauty and sometimes very dangerous. PMID:16669139

Paulino-Netto, Augusto



Sport-specific characteristics of trunk muscles in collegiate wrestlers and judokas.  


This study evaluated the sport-specific characteristics of the cross-sectional areas (CSAs) of trunk muscles and trunk muscle strength in wrestlers and judokas. We also examined whether their trunk muscles and muscle strength depended on athletic performance levels in each sport. The subjects comprised 14 male collegiate wrestlers and 14 judokas. Magnetic resonance imaging was used to assess the trunk muscle CSAs at the L3-4 level parallel to the lumbar disc space. A Biodex System3 was used to measure isokinetic trunk flexor and extensor muscle strength of peak torque, work, average torque, and average power. The absolute and relative CSAs of the trunk muscles in the wrestlers and judokas were significantly different (rectus abdominis: wrestling > judo, P < 0.05; obliques: wrestling < judo, P < 0.05; quadratus lumborum: wrestling < judo, P < 0.01). We confirmed that the absolute and relative trunk extensor and flexor strength of peak torque, work, and average torque were significantly higher in the collegiate wrestlers than in judokas. On athletic performance, the tendency of the CSAs and muscular strength of trunk muscles was not consistent with athletic performance levels in each sport. Our findings indicated that the sport-specific characteristics of the CSAs of the trunk muscles and trunk muscle strength obviously differed between the 2 similar sports. Athletes should practice the sport-specific training of trunk muscles and develop sport specificity in their sports. Particularly, wrestlers have to train in trunk flexion and extension motions, and judokas need to strengthen trunk rotation and lateral flexion motions. This information will be available for athletes as well as strength and technical training coaches in wrestling, judo, and the other sports. PMID:18550947

Iwai, Kazunori; Okada, Takashi; Nakazato, Koichi; Fujimoto, Hideo; Yamamoto, Yosuke; Nakajima, Hiroyuki



Electron-microscopic study of the restoration of irradiated muscle under the influence of regenerating muscle tissue  

SciTech Connect

The authors determine whether the development of satellite cells and their transformation into myoblasts under the influence of regenerating muscle tissue occurs in irradiated muscle. In the control series seven days after surgery, degenerative changes occurred over a considerable extent in the muscle fibers of the proximal stump: a loosening, fragmentation, and disappearance of myofibrils, the vesiculation of the sarcoplasmic reticulum, and mitochondrial swelling and breakdown. The stimulation of the processes of postradiational repair occurs under the influence of transplanted regenerating muscle tissue into irradiated traumatized muscle. This results in the restoration of its capacity for regeneration by both myosymplastic and myoblastic means.

Elyakova, G.V.; Azarova, V.S.; Popova, M.F.



Effects of chronic electrical stimulation on paralyzed expiratory muscles.  


Following spinal cord injury, the expiratory muscles develop significant disuse atrophy characterized by reductions in their weight, fiber cross-sectional area, and force-generating capacity. We determined the extent to which these physiological alterations can be prevented with electrical stimulation. Because a critical function of the expiratory muscles is cough generation, an important goal was the maintenance of maximal force production. In a cat model of spinal cord injury, short periods of high-frequency lower thoracic electrical spinal cord stimulation (SCS) at the T(10) level (50 Hz, 15 min, twice/day, 5 days/wk) were initiated 2 wk following spinalization and continued for a 6-mo period. Airway pressure (P)-generating capacity was determined by SCS. Five acute, spinalized animals served as controls. Compared with controls, initial P fell from 43.9 +/- 1.0 to 41.8 +/- 0.7 cmH(2)O (not significant) in the chronic animals. There were small reductions in the weight of the external oblique, internal oblique, transverses abdominis, internal intercostal, and rectus abdominis muscles (not significant for each). There were no significant changes in the population of fast muscle fibers. Because prior studies (Kowalski KE, Romaniuk JR, DiMarco AF. J Appl Physiol 102: 1422-1428, 2007) have demonstrated significant atrophy following spinalization in this model, these results indicate that expiratory muscle atrophy can be prevented by the application of short periods of daily high-frequency stimulation. Because the frequency of stimulation is similar to the expected pattern of clinical use for cough generation, the daily application of electrical stimulation could potentially serve the dual purpose of maintenance of expiratory muscle function and airway clearance. PMID:18403449

DiMarco, Anthony F; Kowalski, Krzysztof E



Activation of two types of fibres in rat extraocular muscles.  

PubMed Central

1. The contractile responses of the inferior rectus, one of the extraocular muscles of the rat, to a depolarization induced by an elevation of the potassium concentration in the external medium ([K]O) have been studied 'in vitro'. 2. The elevation of [K]O to 20 and 30 mM-K produced contractures that consisted of a sustained or tonic tension. When [K]O was increased to 50 mM or more a well-defined transient or phasic tension appeared before the tonic response. The increment of [K]O above 50 mM enhanced the phasic component and depressed the tonic tension. The maximal tonic tension, usually evoked by 50 mM-K, is about 50% of the tetanic tension, shows a gradual decline with time and lasts for hours. Control experiments performed in diaphragm showed that this muscle only responds with phasic tensions. 3. The difference in the repriming of the phasic and tonic responses when tensions were induced with salines containing low or normal [Cl] suggests that the muscle fibres responsible for the tonic tension are poorly permeable to Cl-. 4. The amplitude of the tonic tension was reduced by Ca deprivation and by an elevation of [Ca] in the saline to 10 mM. 5. It is concluded that in rat extraocular muscles, an increase in [K]O activates two types of muscle fibres: singly and multiply innervated. These appear to be functionally equivalent to the twitch and slow fibres of amphibian and avian muscle and would give rise to the phasic and tonic components of the contracture, respectively.

Chiarandini, D J



Maximizing the Use of Abdominoplasty Incision in Oncoplastic and Aesthetic Breast Surgery: Four Transabdominal (Transumbilical-Like) Augmentations  

Microsoft Academic Search

Background  The transabdominal (transumbilical [TUBA]) procedure for breast implant insertion is known for aesthetic aims, but cosmetic\\u000a and psychosocial improvements reported in aesthetic surgery should be transferred to breast reconstruction patients.\\u000a \\u000a \\u000a \\u000a Methods  Surgical and psychological aspects were analyzed in four cases through clinical evaluation and psychosocial assessment. Three\\u000a patients were candidates for postmastectomy reconstruction by transverse rectus abdominis myocutaneous (TRAM) flap, and

Egidio Riggio; Andrea Spano; Joseph Ottolenghi; Maurizio B. Nava



FGFR1 inhibits skeletal muscle atrophy associated with hindlimb suspension  

Microsoft Academic Search

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

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



Muscle-Invasive Urothelial Carcinoma of the Bladder  

Microsoft Academic Search

Muscle-invasive urothelial (transitional cell) carcinoma is a potentially lethal condition for which an attempt at curative surgery is required. Clinical staging does not allow for accurate determination of eventual pathologic status. Muscle-invasive urothelial carcinoma is a highly progressive disease, and initiation of definitive therapy within 3 months of diagnosis is worthwhile. Age is not a contraindication for aggressive surgical care,

S. Bruce Malkowicz; Hendrik van Poppel; Gerald Mickisch; Vito Pansadoro; Joachim Thüroff; Mark S. Soloway; Sam Chang; Mitchell Benson; Iwao Fukui



Identification of Ahasverus advena (Waltl) (foreign grain beetle) and Ahasverus rectus (LeConte) (Coleoptera: Cucujidae) by micromorphology of adult fragments including genitalia.  


Morphological characteristics of dissected fragments from male and female adult beetles of Ahasverus advena (Waltl) and A. rectus (LeConte) are described and illustrated, including original descriptions of the male genitalia of both species. Diagnostic differences are noted among the morphology of the head, antennae, mandibles, labium, tibial leg segments, prothorax, metasternum, and abdominal sternite I, and between the shape and/or setation of the paired lateral lobes, the apical margin of the aedeagus, the internal sac, and the paired 8th and 9th abdominal sternites for the male genitalia. PMID:3610962

Zimmerman, M L


Acute effects of proprioceptive neuromuscular facilitation and static stretching on maximal voluntary contraction and muscle electromyographical activity in indoor soccer players.  


The aim was to investigate and compare the effects of proprioceptive neuromuscular facilitation (PNF) and static stretching (SS) on maximal voluntary contraction (MVC) and muscle activation in indoor soccer players. Thirty-three young adult men were divided into two groups: (i) sedentary and (ii) trained. Each group completed three different experimental trials: SS, PNF and no stretching (NS). The MVC of knee extension was evaluated before and immediately after each condition along with electromyography from the vastus lateralis (VL) and rectus femoris (RF) muscles of the dominant leg. PNF or SS techniques induced no decrease on MVC and muscle electromyographical activity in indoor soccer players (P>0·05). The electromyography of the RF and VL was lower after SS only in the sedentary group (P?0·05). Short-duration PNF or SS has no effect on isometric MVC and muscle activity in indoor soccer players. PMID:23701400

Reis, Erika da Fonseca Silva; Pereira, Guilherme Borges; de Sousa, Nuno Manuel Frade; Tibana, Ramires Alsamir; Silva, Mauro Fernando; Araujo, Marcia; Gomes, Italo; Prestes, Jonato



Considering Surgery?  


... when you go home. Arrange for an adult to drive you home and stay with you for the first 24-hours after surgery. Get written instructions about your care, a phone number to call if you have a problem, and prescription ...


Robotic surgery  

Microsoft Academic Search

The application of an active surgical robot, the Surgical Assistant Robot for Prostatectomy (SARP), to transurethral resection of the prostate is discussed. SARP performs surgery under the supervision of a surgeon. The mechanical construction computing system, software, motion controller and image system of SARP are discussed

W. S. Ng; B. L. Davies; R. D. Hibberd; A. G. Timoney



Telepresence surgery  

Microsoft Academic Search

The authors' institute has established that precise surgical procedures can be carried out with Telepresence. Within this decade, Telepresence surgery may become an established component of a new, technologically enhanced mode of cost-effective health care delivery. Because of the substantial medical and financial benefit that Telepresence will bring to laparoscopic and other minimally invasive procedures, its first routine use is

P. S. Green; J. W. Hill; J. F. Jensen; A. Shah



Rehabilitative Surgery  

Microsoft Academic Search

Graves’ orbitopathy (GO) is a debilitating disease which adversely interferes with the quality of life of affected patients [1]. It is characterised by different degrees of disfigurement and alterations in vision, both of which contribute to loss of self-confidence, psychosocial stability and ability to function. In GO, surgery, which may be necessary to protect visual function in the active phase

L. Baldeschi



Arthroscopic Surgery.  

ERIC Educational Resources Information Center

|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.…

Connors, G. Patrick


Cardiac Surgery  

PubMed Central

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.

Weisse, Allen B.



Piriformis syndrome surgery causing severe sciatic nerve injury.  


Piriformis syndrome is a controversial entrapment neuropathy in which the sciatic nerve is thought to be compressed by the piriformis muscle. Two patients developed severe left sciatic neuropathy after piriformis muscle release. One had a total sciatic nerve lesion, whereas the second had a predominantly high common peroneal nerve lesion. Follow-up studies showed reinnervation of the hamstrings only. We conclude that piriformis muscle surgery may be hazardous and result in devastating sciatic nerve injury. PMID:22922582

Justice, Phillip E; Katirji, Bashar; Preston, David C; Grossman, Gerald E



The influence in airforce soldiers through wearing certain types of army-issue footwear on muscle activity in the lower extremities.  


The objective of the study was to analyse the influence of the shape and material of the military footwear worn by soldiers on muscle activity in the lower extremities, and whether such footwear could explain specific strain complaints and traumatic lesions in the region of the lower extremities.37 soldiers (one woman, 36 men) aged between 20 and 53 years underwent a dynamic electromyography (EMG) analysis. Wearing - one pair at a time - five different types of shoes, the subjects were asked to walk on a treadmill, where an EMG of the following muscles was taken: M. tibialis anterior, M. gastrocnemius mediales, M. gastrocnemius laterales, M. peroneus longus and M. rectus femoris.When the subjects wore old-fashioned outdoor jogging shoes increased muscle activity was observed in the region of the M. peroneus longus. This can be interpreted as a sign of the upper ankle joint requiring increased support and thus explain the higher susceptibility to sprains experienced in connection with these shoes. When the subjects wore combat boots, increased activity was observed in the region of the Mm. tibialis anterior and rectus femoris. The specific activity differences that were observed in particular muscles may have influence in the occurrence of certain disorders, especially in untrained recruits. This can be linked to various strain-related disorders such as shin splints and patellofemoral pain. The data obtained using EMG can provide information about the likelihood of a clustering of the complaints experienced by soldiers during training or active service. PMID:21886685

Schulze, Christoph; Lindner, Tobias; Schulz, Katharina; Finze, Susanne; Kundt, Guenther; Mittelmeier, Wolfram; Bader, Rainer



Lactic acid restores skeletal muscle force in an in vitro fatigue model: are voltage-gated chloride channels involved?  

PubMed Central

High interstitial K+ concentration ([K+]) has been reported to impede normal propagation of electrical impulses along the muscle cell membrane (sarcolemma) and then also into the transverse tubule system; this is one considered underlying mechanism associated with the development of muscle fatigue. Interestingly, the extracellular buildup of lactic acid, once considered an additional cause for muscle fatigue, was recently shown to have force-restoring effects in such conditions. Specifically, it was proposed that elevated lactic acid (and intracellular acidosis) may lead to inhibition of voltage-gated chloride channels, thereby reestablishing better excitability of the muscle cell sarcolemma. In the present study, using an in vitro muscle contractile experimental setup to study functionally viable rectus abdominis muscle preparations obtained from normal swine, we examined the effects of 20 mM lactic acid and 512 ?M 9-anthracenecarboxylic acid (9-AC; a voltage-gated chloride channel blocker) on the force recovery of K+-depressed (10 mM K+) twitch forces. We observed a similar muscle contractile restoration after both treatments. Interestingly, at elevated [K+], myotonia (i.e., hyperexcitability or afterdepolarizations), usually present in skeletal muscle with inherent or induced chloride channel dysfunctions, was not observed in the presence of either lactic acid or 9-AC. In part, these data confirm previous studies showing a force-restoring effect of lactic acid in high-[K+] conditions. In addition, we observed similar restorative effects of lactic acid and 9-AC, implicating a beneficial mechanism via voltage-gated chloride channel modulation.

Bandschapp, Oliver; Soule, Charles L.



Microsurgical repair and secondary surgery in obstetrical brachial plexus palsy  

Microsoft Academic Search

We present a personal experience with 750 children suffering from obstetrical brachial plexus palsy. The related surgery is described, including early microsurgical nerve reconstruction and secondary procedures including tendon and muscle transfers. The clinical examination, indications and timing for surgery, technical details of primary and secondary operations and the possible outcome are discussed. Both clinical and research work need an

Jörg Bahm; Hassan Noaman; Claudia Ocampo-Pavez



A new approach to assess the spasticity in hamstrings muscles using mechanomyography antagonist muscular group.  


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

Krueger, Eddy; Scheeren, Eduardo M; Nogueira-Neto, Guilherme N; Button, Vera Lúcia da S N; Nohama, Percy



Refuting The Polemic Against the Extraocular Muscle Pulleys: Jampel and Shi's Platygean View of Extraocular Muscle Mechanics  

PubMed Central

Background Late in the 20th Century, it was recognized that connective tissue structures in the orbit influence the paths of the extraocular muscles, and constitute their functional origins. Targeted investigations of these connective tissue “pulleys” led to the formulation of the active pulley hypothesis, which proposes that pulling directions of the rectus extraocular muscles are actively controlled via connective tissues. Purpose This review rebuts a series of criticisms of the active pulley hypothesis published by Jampel, and Jampel and Shi, in which these authors have disputed the existence and function of the pulleys. Methods The current paper reviews published evidence for the existence of orbital pulleys, the active pulley hypothesis, and physiologic tests of the active pulley hypothesis. Magnetic resonance imaging in a living subject, and histological examination of a human cadaver directly illustrate the relationship of pulleys to extraocular muscles. Results Strong scientific evidence is cited that supports the existence of orbital pulleys, and their role in ocular motility. The criticisms of have ignored mathematical truisms and strong scientific evidence. Conclusions Actively controlled orbital pulleys play a fundamental role in ocular motility. Pulleys profoundly influence the neural commands required to control eye movements and binocular alignment. Familiarity with the anatomy and physiology of the pulleys is requisite for a rational approach to diagnosing and treating strabismus using emerging methods. Conversely, approaches that deny or ignore the pulleys risk the sorts of errors that arise in geography and navigation from incorrect assumptions such as those of a flat (“platygean”) earth.

Demer, Joseph L.



Development of a precise control method for a medical robot working with stiff tissues during hip-joint surgery  

Microsoft Academic Search

Many medical robots are used in orthopedic surgery. Treatment via a small incision is known as minimally invasive surgery. The restricted applicability of current robots in minimally invasive surgery led us to explore the development of a robotic assisting tool. In orthopedic surgery, the operating space is full of muscle tissues, ligaments, and tendons. These stiff tissues must be scraped

Masaru Yanagihara; Jun Okamoto; Masakatsu G. Fujie; Norihiro Mitsui



Sustained Release of Bone Morphogenetic Protein-4 in Adult Rabbit Extraocular Muscle Results in Decreased Force and Muscle Size: Potential for Strabismus Treatment  

PubMed Central

Purpose. To assess the effect of a sustained-release preparation of bone morphogenetic protein-4 (BMP-4) on EOM force generation and muscle size. Methods. Sustained-release pellets, releasing 500 nanograms/day of BMP-4 for a maximum of 3 months, were implanted beneath the superior rectus muscle (SR) belly in anesthetized adult rabbits. The contralateral side received a placebo pellet as a control. After 1, 3, and 6 months, SRs were removed, and force generation at twitch and tetanic frequencies as well as fatigue resistance were determined in vitro. Myofiber size, myosin heavy chain isoform expression, and satellite cell density were assessed histologically. Results. SR force generation was significantly decreased by BMP-4 compared with the contralateral controls. Force generation was decreased by 25–30% by 1 month, 31–50% by 3 months, and at 6 months, after 3 BMP-4–free months, force was still decreased by 20–31%. No change in fatigue was seen. Significant decreases in muscle size were seen, greatest at 3 months. At all time points Pax7- and MyoD-positive satellite cell densities were significantly decreased. Conclusions. The decreased force generation and muscle size caused by sustained release of BMP-4 suggests that myogenic signaling factors may provide a more biological method of decreasing muscle strength in vivo than exogenously administered toxins. Treating antagonist-agonist pairs of EOM with titratable, naturally occurring myogenic signaling and growth factors may provide safe, efficacious, nonsurgical treatment options for patients with strabismus.

Anderson, Brian C.; Daniel, Mark L.; Kendall, Jeffrey D.; Christiansen, Stephen P.



Muscle Fibers  

NSDL National Science Digital Library

In this activity about human anatomy (page 20 of PDF), learners investigate the structure of muscles by comparing yarn and cooked meat. Learners will record their observations in a data table and draw conclusions based on their findings. Beef brisket or stew meat should be cooked in advance so learners can observe at least one, 1-inch cube of cooked meat. This guide includes background information, extensions, and a data table.

Chang, Kimberly; Moreno, Nancy P.; Tharp, Barbara Z.; Institute, National S.



Ultrasonic surgery.  

PubMed Central

Animal and clinical studies of a new approach in general surgery using an ultrasonic aspiration device have been encouraging. On 31 patients 11 liver procedures, 12 extensive head and neck dissections, 5 ultrasonic fulgurations for rectal cancer, and excision of 2 local oral lesions, 1 para-aortic mass, 1 pancreatic cancer, 1 giant subfascial lipoma, and 1 rectal villous adenoma have been carried out. Images FIg. 1 FIG. 2

Hodgson, W. J.



Ultrasonic surgery.  


Animal and clinical studies of a new approach in general surgery using an ultrasonic aspiration device have been encouraging. On 31 patients 11 liver procedures, 12 extensive head and neck dissections, 5 ultrasonic fulgurations for rectal cancer, and excision of 2 local oral lesions, 1 para-aortic mass, 1 pancreatic cancer, 1 giant subfascial lipoma, and 1 rectal villous adenoma have been carried out. PMID:7436305

Hodgson, W J



Ambulatory Surgery in Oregon.  

National Technical Information Service (NTIS)

'Ambulatory surgery' refers to surgery for which an overnight stay in a hospital is not anticipated as being medically necessary. Other commonly used terms are short-stay surgery, in-and-out surgery, and same day surgery. Ambulatory surgery can be perform...



Trunk muscle activity during stability ball and free weight exercises.  


The purpose of this investigation was to compare trunk muscle activity during stability ball and free weight exercises. Nine resistance-trained men participated in one testing session in which squats (SQ) and deadlifts (DL) were completed with loads of approximately 50, 70, 90, and 100% of one-repetition maximum (1RM). Isometric contractions during 3 stability ball exercises (quadruped (QP), pelvic thrust (PT), ball back extension (BE)) were also completed. During all exercises, average integrated electromyography (IEMG) from the rectus abdominus (RA), external oblique (EO), longissimus (L1) and multifidus (L5) was collected and analyzed. Results demonstrate that when expressed relative to 100% DL 1RM, muscle activity was 19.5 +/- 14.8% for L1 and 30.2 +/- 19.3% for L5 during QP, 31.4 +/- 13.4% for L1 and 37.6 +/- 12.4% for L5 during PT, and 44.2 +/- 22.8% for L1 and 45.5 +/- 21.6% for L5 during BE. IEMG of L1 during SQ and DL at 90 and 100% 1RM, and relative muscle activity of L5 during SQ and DL at 100% 1RM was significantly greater (P < or = 0.05) than in the stability ball exercises. Furthermore, relative muscle activity of L1 during DL at 50 and 70% 1RM was significantly greater than in QP and PT. No significant differences were observed in RA and EO during any of the exercises. In conclusion, activity of the trunk muscles during SQs and DLs is greater or equal to that which is produced during the stability ball exercises. It appears that stability ball exercises may not provide a sufficient stimulus for increasing muscular strength or hypertrophy; consequently, the role of stability ball exercises in strength and conditioning programs is questioned. SQs and DLs are recommended for increasing strength and hypertrophy of the back extensors. PMID:18296961

Nuzzo, James L; McCaulley, Grant O; Cormie, Prue; Cavill, Michael J; McBride, Jeffrey M



Is coordination of two-joint leg muscles during load lifting consistent with the strategy of minimum fatigue?  


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

Prilutsky, B I; Isaka, T; Albrecht, A M; Gregor, R J



Postoperative respiratory muscle dysfunction: pathophysiology and preventive strategies.  


Postoperative pulmonary complications are responsible for significant increases in hospital cost as well as patient morbidity and mortality; respiratory muscle dysfunction represents a contributing factor. Upper airway dilator muscles functionally resist the upper airway collapsing forces created by the respiratory pump muscles. Standard perioperative medications (anesthetics, sedatives, opioids, and neuromuscular blocking agents), interventions (patient positioning, mechanical ventilation, and surgical trauma), and diseases (lung hyperinflation, obesity, and obstructive sleep apnea) have differential effects on the respiratory muscle subgroups. These effects on the upper airway dilators and respiratory pump muscles impair their coordination and function and can result in respiratory failure. Perioperative management strategies can help decrease the incidence of postoperative respiratory muscle dysfunction. Such strategies include minimally invasive procedures rather than open surgery, early and optimal mobilizing of respiratory muscles while on mechanical ventilation, judicious use of respiratory depressant anesthetics and neuromuscular blocking agents, and noninvasive ventilation when possible. PMID:23429163

Sasaki, Nobuo; Meyer, Matthew J; Eikermann, Matthias



[Robotic surgery].  


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 possibility for minimally invasive access with its all 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 the patient through the more precise preparative activity thanks to the regained 3D vision. The gradual decrease of robotic surgical system costs and development of new generation minimally invasive devices may lead to a substantial change in the daily surgical activity. PMID:24144815

Sándor, József; Haidegger, Tamás; Kormos, Katalin; Ferencz, Andrea; Csukás, Domokos; Bráth, Endre; Szabó, Györgyi; Wéber, György



Comparison of the electromyographic variables at different muscle lengths and contraction intensities.  


Thirty-three (33) healthy volunteers (2.29 +/- 2.4 years) participated. Two active surface electrodes were placed on the rectus femoris muscle: one on the motor point (M) and the other on the thickest distal portion of the muscle (V). The volunteer was positioned on a Bonet table, with his/her trunk fixed, thigh at 90 degrees and leg with 105 degrees and 45 degrees flexion. The signal was collected simultaneously in the 2 electrodes and in the load cell, during the extension of the leg at 50% or 100% of the maximum voluntary isometric contraction (MVIC) for 5 seconds, repeated 3 times, with an interval of 1 minute. The EMG signal was obtained through a data acquisition module (EMG1000 - Lynx) of 16 bits (LYNX), with band- pass filter of 20-1.000 Hz and sampling frequency of 2.000 Hz. RMS and mean frequency (MF) were assessed with Matlab software. Statistical analysis consisted of the Wilcoxon test and Student t test (p < 0.05). At 50% of the MVIC, the RMS was greater in the shortened muscle than the lengthened one. Whereas at 100% there was an inversion, with the lengthened muscle presenting greater amplitude. The FM both at 50% and 100% MVIC was greater for the muscle in the shortened position. It was possible to conclude that changes in muscular length and in contraction intensity alter the electromyographic variables. PMID:18338529

Forti, Fabiana; Guirro, Rinaldo R J


Use of optical flow to estimate continuous changes in muscle thickness from ultrasound image sequences.  


Muscle thickness is one of the most widely used parameters for quantifying muscle function. Ultrasonography is frequently used to estimate changes in muscle thickness in both static and dynamic contractions. Conventionally, most such measurements are conducted by manual analysis of ultrasound images. This manual approach is time consuming, subjective, susceptible to error and not suitable for measuring dynamic change. In this study, we developed an automated tracking method based on an optical flow algorithm using an affine motion model. The goal of the study was to evaluate the performance of the proposed method by comparing it with the manual approach and by determining its repeatability. Real-time B-mode ultrasound was used to examine the rectus femoris during voluntary contraction. The coefficient of multiple correlation (CMC) was used to quantify the level of agreement between the two methods and the repeatability of the proposed method. The two methods were also compared by linear regression and Bland-Altman analysis. The findings indicated that the results obtained using the proposed method were in good agreement with those obtained using the manual approach (CMC = 0.97 ± 0.02, difference = -0.06 ± 0.22 mm) and were highly repeatable (CMC = 0.91 ± 0.07). In conclusion, the automated method proposed here provides an accurate, highly repeatable and efficient approach to the estimation of muscle thickness during muscle contraction. PMID:23969163

Li, Qiaoliang; Ni, Dong; Yi, Wanguan; Chen, Siping; Wang, Tianfu; Chen, Xin



An oblique muscle hematoma as a rare cause of severe abdominal pain: a case report  

PubMed Central

Background Abdominal wall hematomas are an uncommon cause of acute abdominal pain and are often misdiagnosed. They are more common in elderly individuals, particularly in those under anticoagulant therapy. Most abdominal wall hematomas occur in the rectus sheath, and hematomas within the oblique muscle are very rare and are poorly described in the literature. Here we report the case of an oblique muscle hematoma in a middle-aged patient who was not under anticoagulant therapy. Case presentation A 42-year-old Japanese man presented with a painful, enlarging, lateral abdominal wall mass, which appeared after playing baseball. Abdominal computed tomography and ultrasonography showed a large soft tissue mass located in the patient’s left internal oblique muscle. A diagnosis of a lateral oblique muscle hematoma was made and the patient was treated conservatively. Conclusion Physicians should consider an oblique muscle hematoma during the initial differential diagnosis of pain in the lateral abdominal wall even in the absence of anticoagulant therapy or trauma.



Interface Stability Influences Torso Muscle Recruitment and Spinal Load During Pushing Tasks  

PubMed Central

Handle or interface design can influence torso muscle recruitment and spinal load during pushing tasks. The objective of the study was to provide insight into the role of interface stability with regard to torso muscle recruitment and biomechanical loads on the spine. Fourteen subjects generated voluntary isometric trunk flexion force against a rigid interface and similar flexion exertions against an unstable interface, which simulated handle design in a cart pushing task. Normalized electromyographic (EMG) activity in the rectus abdominus, external oblique and internal oblique muscles increased with exertion effort. When using the unstable interface, EMG activity in the internal and external oblique muscle groups was greater than when using the rigid interface. Results agreed with trends from a biomechanical model implemented to predict the muscle activation necessary to generate isometric pushing forces and maintain spinal stability when using the two different interface designs. The co-contraction contributed to increased spinal load when using the unstable interface. It was concluded that handle or interface design and stability may influence spinal load and associated risk of musculoskeletal injury during manual materials tasks that involve pushing exertions.




Do Palisade Endings in Extraocular Muscles Arise from Neurons in the Motor Nuclei?  

PubMed Central

Purpose. The purpose of this study was to localize the cell bodies of palisade endings that are associated with the myotendinous junctions of the extraocular muscles. Methods. Rhesus monkeys received tract-tracer injections (tetramethylrhodamine dextran [TMR-DA] or choleratoxin subunit B [CTB]) into the oculomotor and trochlear nuclei, which contain the motoneurons of extraocular muscles. All extraocular muscles were processed for the combined immunocytochemical detection of the tracer and SNAP-25 or synaptophysin for the visualization of the complete muscle innervation. Results. In all muscles—except the lateral rectus—en plaque and en grappe motor endings, but also palisade endings, were anterogradely labeled. In addition a few tracer-labeled tendon organs were found. One group of tracer-negative nerve fibers was identified as thin tyrosine hydroxylase-positive sympathetic fibers, and a second less numerous group of tracer-negative fibers may originate from the trigeminal ganglia. No cellular or terminal tracer labeling was present within the mesencephalic trigeminal nucleus or the trigeminal ganglia. Conclusions. These results confirm those of earlier studies and furthermore suggest that the somata of palisade endings are located close to the extraocular motor nuclei—in this case, probably within the C and S groups around the periphery of the oculomotor nucleus. The multiple en grappe endings have also been shown to arise from these cells groups, but it is not possible to distinguish different populations in these experiments.

Lienbacher, Karoline; Mustari, Michael; Ying, Howard S.; Buttner-Ennever, Jean A.



Duplicated axillary arch muscles arising from the latissimus dorsi  

PubMed Central

Many origins and insertions of an axillary muscular slip (also known as Langer's or axillary arch muscles) have been documented previously. In this report, we found duplicated axillary arch muscles (two variant muscular slips) originating from the inferolateral border of the right side latissimus dorsi muscle. Obviously, these axillary arch muscles can be distinguished as short and long muscular strips. While the origin was the same, the short muscular slip inserts into the fascia covering on the pectoralis minor, whereas the longer one inserts on/into the aponeurosis of pectoralis major. For the surgery in the axillary region, this rare variation should be considered a cause of surgical interventions.

Uabundit, Nongnut; Khamanarong, Kimaporn; Sripanidkulchai, Kittisak; Chaiciwamongkol, Kowit; Namking, Malivalaya; Ratanasuwan, Somsiri; Boonruangsri, Porntip; Hipkaeo, Wiphawi



Videothoracoscopic surgery.  


Although thoracoscopy has been used for diagnostic and minor therapeutic procedures for many years, there have been few reports of its use in performing major intrathoracic procedures which have traditionally required formal thoracotomy. We report our initial experience in this field. Fifty patients (M:F = 1.63:1, mean +/- SD age = 41.8 +/- 20.4 years, range = 14-80) underwent 54 endoscopic intrathoracic operations. The procedures carried out included wedge excision of solid pulmonary mass (10), pleurectomy (25), lung biopsy (14), and miscellaneous procedures (5). Under general anaesthesia a laparoscope attached to a video monitor was introduced into the chest. One or two additional stab incisions were made as needed for the introduction of standard surgical or endoscopic instruments and staplers. There were no deaths. One patient developed a second pneumothorax 7 days after endoscopic pleurectomy, necessitating open pleurodesis. All patients were discharged home between 2 and 11 days after surgery (mean +/- SD = 3.8 +/- 2.0 days). Endoscopic thoracic surgery is a safe and useful technique for certain cases. It merits further investigation and assessment. PMID:8347353

Donnelly, R J; Page, R D; Berrisford, R G; Dedeilias, P G



Identity of "orbitozygomatic muscle".  


Our exploration disclosed 17 (40%) stranded muscles of 42 hemifacial specimens of Korean cadavers. We name this distinct muscle "Orbitozygomatic Muscle (OZM)" that is either an aberrant orbicularis oculi muscle or a separate muscle. A triangular space bounded superiorly by the lowest edge of the orbicularis oculi muscle (OOM), laterally by Zygomaticus Minor, and inferiorly by OMZ gives way to neurovascular bundle and suborbicularis oculi fat pad (SOOF). PMID:12000873

Hwang, Kun; Lee, Daw Kwang; Chung, In Hyuk; Chung, Robert S; Lee, Se Il



The Effect of Neuromuscular Electrical Stimulation of the Infraspinatus on Shoulder External Rotation Force Production After Rotator Cuff Repair Surgery  

Microsoft Academic Search

Background: Muscle weakness, particularly of shoulder external rotation, is common after rotator cuff repair surgery. Neuromuscular electrical stimulation has been shown to be an effective adjunct in the enhancement of muscle recruitment. Hypothesis: Shoulder external rotation peak force can be enhanced by neuromuscular electrical stimulation after rotator cuff repair surgery. Study Design: Controlled laboratory study. Methods: Thirty-nine patients (20 men,

Michael M. Reinold; Leonard C. Macrina; Kevin E. Wilk; Jeffrey R. Dugas; E. Lyle Cain; James R. Andrews


Noninvasive stimulation of human corticospinal axons innervating leg muscles.  


These studies investigated whether a single electrical stimulus over the thoracic spine activates corticospinal axons projecting to human leg muscles. Transcranial magnetic stimulation of the motor cortex and electrical stimulation over the thoracic spine were paired at seven interstimulus intervals, and surface electromyographic responses were recorded from rectus femoris, tibialis anterior, and soleus. The interstimulus intervals (ISIs) were set so that the first descending volley evoked by cortical stimulation had not arrived at (positive ISIs), was at the same level as (0 ISI) or had passed (negative ISIs) the site of activation of descending axons by the thoracic stimulation at the moment of its delivery. Compared with the responses to motor cortical stimulation alone, responses to paired stimuli were larger at negative ISIs but reduced at positive ISIs in all three leg muscles. This depression of responses at positive ISIs is consistent with an occlusive interaction in which an antidromic volley evoked by the thoracic stimulation collides with descending volleys evoked by cortical stimulation. The cortical and spinal stimuli activate some of the same corticospinal axons. Thus it is possible to examine the excitability of lower limb motoneuron pools to corticospinal inputs without the confounding effects of changes occurring within the motor cortex. PMID:18509069

Martin, P G; Butler, J E; Gandevia, S C; Taylor, J L



Physically-based Modeling and Simulation of Extraocular Muscles  

PubMed Central

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 non-uniformity. 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.

Wei, Qi; Sueda, Shinjiro; Pai, Dinesh K.



Effects of the Compact Mutant Myostatin Allele Mstn Cmpt-dl1Abc Introgressed into a High Growth Mouse Line on Skeletal Muscle Cellularity  

Microsoft Academic Search

The murine myostatin mutation Mstn\\u000a \\u0009\\u0009\\u0009\\u0009\\u0009\\u0009\\u0009\\u0009\\u0009Cmpt-dl1Abc\\u000a \\u0009\\u0009\\u0009\\u0009\\u0009\\u0009\\u0009\\u0009 (Compact; C) was introduced into an inbred mouse line with extreme growth (DUHi) by marker-assisted introgression. To study the allelic\\u000a effects on muscle fibre hyperplasia and hypertrophy, myonuclear proliferation, protein accretion, capillary density, and muscle\\u000a fibre metabolism, samples from M. rectus femoris (RF) and M. longissimus dorsi (LD) muscles of animals wild-type (+\\/+), heterozygous

Charlotte Rehfeldt; Gerhard Ott; David E. Gerrard; László Varga; Werner Schlote; John L. Williams; Ulla Renne; Lutz Bünger



Carnitine supplementation to obese Zucker rats prevents obesity-induced type II to type I muscle fiber transition and favors an oxidative phenotype of skeletal muscle  

PubMed Central

Background In the present study, we tested the hypothesis that carnitine supplementation counteracts obesity-induced muscle fiber transition from type I to type II. Methods 24 obese Zucker rats were randomly divided into two groups of 12 rats each (obese control, obese carnitine) and 12 lean Zucker rats were selected for lean control group. A control diet was given to both control groups and a carnitine supplemented diet (3 g/kg diet) was given to obese carnitine group for 4 wk. Components of the muscle fiber transformation in skeletal muscle were examined. Results The plasma level of carnitine were lower in the obese control group compared to the lean control group and higher in the obese carnitine group than in the other groups (P?muscle fibers and higher mRNA levels of type I fiber-specific myosin heavy chain, regulators of muscle fiber transition and of genes involved in carnitine uptake, fatty acid transport, ?-oxidation, angiogenesis, tricarboxylic acid cycle and thermo genesis in M. rectus femoris compared to the other groups (P?muscle fiber transition and restores the muscle oxidative metabolic phenotype. Carnitine supplementation is supposed to be beneficial for the treatment of elevated levels of plasma lipids during obesity or diabetes.



The control of mono-articular muscles in multijoint leg extensions in man.  

PubMed Central

1. Movements often require control of direction and a magnitude of force exerted externally on the environment. Bi-articular upper leg muscles appear to play a unique role in the regulation of the net torques about the hip and knee joints, necessary for the control of this external force. 2. The aim of this study was to test the hypothesis that the mono-articular muscles act as work generators in powerful dynamic leg extensions, which means that they should be activated primarily in the phases during which they can contribute to work, irrespective of the net joint torques required to control the external force. 3. Cycling movements of six trained subjects were analysed by means of inverse dynamics, yielding net joint torques as well as activity patterns and shortening velocities of four mono- and four bi-articular leg muscles. 4. The results show that the mono-articular muscles exert force only in the phase in which these muscles shorten, whereas this appears not to be the case for the bi-articular muscles. 5. Reciprocal patterns of activation of the rectus femoris and hamstring muscles appear to tune the distribution of net joint torques about the hip and knee joints, necessary to control the (changing) direction of the force on the pedal. 6. An analysis of running in man and additional related literature based on animal studies appears to provide further support for the hypothesis that mono- and bi-articular muscles have essentially different roles in these powerful multijoint leg extension tasks.

van Ingen Schenau, G J; Dorssers, W M; Welter, T G; Beelen, A; de Groot, G; Jacobs, R



Cellular adaptation contributes to calorie restriction-induced preservation of skeletal muscle in aged rhesus monkeys.  


We have previously shown that a 30% reduced calorie intake diet delayed the onset of muscle mass loss in adult monkeys between ~16 and ~22 years of age and prevented multiple cellular phenotypes of aging. In the present study we show the impact of long term (~17 years) calorie restriction (CR) on muscle aging in very old monkeys (27-33 yrs) compared to age-matched Control monkeys fed ad libitum, and describe these data in the context of the whole longitudinal study. Muscle mass was preserved in very old calorie restricted (CR) monkeys compared to age-matched Controls. Immunohistochemical analysis revealed an age-associated increase in the proportion of Type I fibers in the VL from Control animals that was prevented with CR. The cross sectional area (CSA) of Type II fibers was reduced in old CR animals compared to earlier time points (16-22 years of age); however, the total loss in CSA was only 15% in CR animals compared to 36% in old Controls at ~27 years of age. Atrophy was not detected in Type I fibers from either group. Notably, Type I fiber CSA was ~1.6 fold greater in VL from CR animals compared to Control animals at ~27 years of age. The frequency of VL muscle fibers with defects in mitochondrial electron transport system enzymes (ETS(ab)), the absence of cytochrome c oxidase and hyper-reactive succinate dehydrogenase, were identical between Control and CR. We describe changes in ETS(ab) fiber CSA and determined that CR fibers respond differently to the challenge of mitochondrial deficiency. Fiber counts of intact rectus femoris muscles revealed that muscle fiber density was preserved in old CR animals. We suggest that muscle fibers from CR animals are better poised to endure and adapt to changes in muscle mass than those of Control animals. PMID:22226624

McKiernan, Susan H; Colman, Ricki J; Aiken, Erik; Evans, Trent D; Beasley, T Mark; Aiken, Judd M; Weindruch, Richard; Anderson, Rozalyn M



Architectural Analysis of Human Abdominal Wall Muscles: Implications for Mechanical Function  

PubMed Central

Study Design Cadaveric analysis of human abdominal muscle architecture. Objective To quantify the architectural properties of rectus abdominis (RA), external oblique (EO), internal oblique (IO) and transverse abdominis (TrA), and model mechanical function in light of these new data. Summary of Background Data Knowledge of muscle architecture provides the structural basis for predicting muscle function. Abdominal muscles greatly affect spine loading, stability, injury prevention and rehabilitation; however, their architectural properties are unknown. Methods Abdominal muscles from eleven elderly human cadavers were removed intact, separated into regions and micro-dissected for quantification of physiological cross-sectional area (PCSA), fascicle length and sarcomere length. From these data, sarcomere operating length ranges were calculated. Results IO had the largest PCSA and RA the smallest, and would thus generate the largest and smallest isometric forces, respectively. RA had the longest fascicle length, followed by EO, and would thus be capable of generating force over the widest range of lengths. Measured sarcomere lengths, in the post-mortem neutral spine posture, were significantly longer in RA and EO (3.29±0.07 and 3.18±0.11 ?m) compared to IO and TrA (2.61±0.06 and 2.58±0.05 ?m) (p < 0.0001). Biomechanical modeling predicted that RA, EO and TrA act at optimal force-generating length in the mid-range of lumbar spine flexion, where IO can generate approximately 90% of its maximum force. Conclusions These data provide clinically relevant insights into the ability of the abdominal wall muscles to generate force and change length throughout the lumbar spine range of motion. This will impact the understanding of potential postures in which the force-generating and spine stabilizing ability of these muscles become compromised, which can guide exercise/rehabilitation development and prescription. Future work should explore the mechanical interactions among these muscles and their relationship to spine health and function.

Brown, Stephen H. M.; Ward, Samuel R.; Cook, Mark S.; Lieber, Richard L.



Heart rate at the onset of muscle contraction and during passive muscle stretch in humans: a role for mechanoreceptors  

PubMed Central

Previous evidence suggests that the heart rate (HR) increase observed with isometric exercise is dependent on different afferent mechanisms to those eliciting the increase in blood pressure (BP). Central command and muscle metaboreceptors have been shown to contribute to this differential effect. However, in experimental animals passive stretch of the hindlimb increases HR suggesting that small fibre mechanoreceptors could also have a role. This has not been previously shown in humans and was investigated in this study. Healthy human volunteers were instrumented to record BP, ECG, respiration, EMG of rectus femoris and gastrocnemius and contraction force of triceps surae. Voluntary isometric contraction of triceps surae elicited a significant HR change in the first three respiratory cycles at 40 % of maximum voluntary contraction whereas BP did not change significantly until after 30 s. This suggests that different mechanisms are involved in the initiation of the cardiovascular changes. Sustained passive stretch of triceps surae for 1 min, by dorsiflexion of the foot, caused a significant (P < 0.05) increase in HR (5 ± 2.6 beats min?1) with no significant change in BP. A time domain measure of cardiac vagal activity was reduced significantly during passive stretch from 69.7 ± 12.9 to 49.6 ± 8.9 ms. Rapid rhythmic passive stretch (0.5 Hz for 1 min) was without significant effect suggesting that large muscle proprioreceptors are not involved. We conclude that in man small fibre muscle mechanoreceptors responding to stretch, inhibit cardiac vagal activity and thus increase HR. These afferents could contribute to the initial cardiac acceleration in response to muscle contraction.

Gladwell, V F; Coote, J H



Altering prosthetic foot stiffness influences foot and muscle function during below-knee amputee walking: a modeling and simulation analysis.  


Most prosthetic feet are designed to improve amputee gait by storing and releasing elastic energy during stance. However, how prosthetic foot stiffness influences muscle and foot function is unclear. Identifying these relationships would provide quantitative rationale for prosthetic foot prescription that may lead to improved amputee gait. The purpose of this study was to identify the influence of altered prosthetic foot stiffness on muscle and foot function using forward dynamics simulations of amputee walking. Three 2D muscle-actuated forward dynamics simulations of unilateral below-knee amputee walking with a range of foot stiffness levels were generated, and muscle and prosthetic foot contributions to body support and propulsion and residual leg swing were quantified. As stiffness decreased, the prosthetic keel provided increased support and braking (negative propulsion) during the first half of stance while the heel contribution to support decreased. During the second half of stance, the keel provided decreased propulsion and increased support. In addition, the keel absorbed less power from the leg, contributing more to swing initiation. Thus, several muscle compensations were necessary. During the first half of stance, the residual leg hamstrings provided decreased support and increased propulsion. During the second half of stance, the intact leg vasti provided increased support and the residual leg rectus femoris transferred increased energy from the leg to the trunk for propulsion. These results highlight the influence prosthetic foot stiffness has on muscle and foot function throughout the gait cycle and may aid in prescribing feet of appropriate stiffness. PMID:23312827

Fey, Nicholas P; Klute, Glenn K; Neptune, Richard R



A continuum of myofibers in adult rabbit extraocular muscle: force, shortening velocity, and patterns of myosin heavy chain colocalization  

PubMed Central

Extraocular muscle (EOM) myofibers do not fit the traditional fiber typing classifications normally used in noncranial skeletal muscle, in part, due to the complexity of their individual myofibers. With single skinned myofibers isolated from rectus muscles of normal adult rabbits, force and shortening velocity were determined for 220 fibers. Each fiber was examined for myosin heavy chain (MyHC) isoform composition by densitometric analysis of electrophoresis gels. Rectus muscle serial sections were examined for coexpression of eight MyHC isoforms. A continuum was seen in single myofiber shortening velocities as well as force generation, both in absolute force (g) and specific tension (kN/m2). Shortening velocity correlated with MyHCIIB, IIA, and I content, the more abundant MyHC isoforms expressed within individual myofibers. Importantly, single fibers with similar or identical shortening velocities expressed significantly different ratios of MyHC isoforms. The vast majority of myofibers in both the orbital and global layers expressed more than one MyHC isoform, with up to six isoforms in single fiber segments. MyHC expression varied significantly and unpredictably along the length of single myofibers. Thus EOM myofibers represent a continuum in their histological and physiological characteristics. This continuum would facilitate fine motor control of eye position, speed, and direction of movement in all positions of gaze and with all types of eye movements—from slow vergence movements to fast saccades. To fully understand how the brain controls eye position and movements, it is critical that this significant EOM myofiber heterogeneity be integrated into hypotheses of oculomotor control.

Park, Han na; Kim, Jong-Hee; Pedrosa-Domellof, Fatima; Thompson, LaDora V.



Lung surgery - discharge  


... discharge; Thoracoscopy - discharge; Video-assisted thoracoscopic surgery - discharge; VATS - discharge ... had open surgery or video-assisted thoracoscopic surgery (VATS). You may have had one of these common ...


Cosmetic breast surgery  


Cosmetic breast surgery may be done at an outpatient surgery clinic or in a hospital. Most women ... with a plastic surgeon if you are considering cosmetic breast surgery. Discuss how you expect to look ...


Muscle growth and exercise  

Microsoft Academic Search

This paper first reviews muscle growth and then considers the influence of exercise in growth. Knowledge about how muscle cells grow and some factors that may influence the growth pattern are discussed first since these effects must be considered before the influence of exercise becomes clear. Growth of muscle can occur in three ways: (1) by an increase in muscle

A. M. Pearson



Ischemia causes muscle fatigue  

Microsoft Academic Search

The purpose of this investigation was to determine whether ischemia, which reduces oxygenation in the extensor carpi radialis (ECR) muscle, causes a reduction in muscle force production. In eight subjects, muscle oxygenation (TO2) of the right ECR was measured noninvasively and continuously using near infrared spectroscopy (NIRS) while muscle twitch force was elicited by transcutaneous electrical stimulation (1 Hz, 0.1

Gita Murthy; Alan R. Hargens; Steve Lehman; David M. Rempel



Move Your Muscles!  

NSDL National Science Digital Library

This lesson covers the topic of muscles. Students learn about the three different types of muscles in the human body and the effects of microgravity on muscles. Students also learn how astronauts need to exercise in order to lessen muscle atrophy in space. Students discover what types of equipment engineers design to help the astronauts exercise while in space.

Integrated Teaching And Learning Program


Vestibular schwannoma surgery and headache.  


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

Levo, H; Blomstedt, G; Pyykkö, I



Development of software for human muscle force estimation.  


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

Tang, Gang; Qian, Li-wei; Wei, Gao-feng; Wang, Hong-sheng; Wang, Cheng-tao



Transoral Surgery  

PubMed Central

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

Rock, Jack P.; Tomecek, Frank J.; Ross, Lawrence



Bariatric Surgery  

PubMed Central

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 height and under-report their weight. The actual number of Ontario adults who are overweight or obese may be higher. Diet, exercise, and behavioural therapy are used to help people lose weight. The goals of behavioural therapy are to identify, monitor, and alter behaviour that does not help weight loss. Techniques include self-monitoring of eating habits and physical activity, stress management, stimulus control, problem solving, cognitive restructuring, contingency management, and identifying and using social support. Relapse, when people resume old, unhealthy behaviour and then regain the weight, can be problematic. Drugs (including gastrointestinal lipase inhibitors, serotonin norepinephrine reuptake inhibitors, and appetite suppressants) may be used if behavioural interventions fail. However, estimates of efficacy may be confounded by high rates of noncompliance, in part owing to the side effects of the drugs. In addition, the drugs have not been approved for indefinite use, despite the chronic nature of obesity. The Technology Morbidly obese people may be eligible for bariatric surgery. Bariatric surgery for morbid obesity is considered an intervention of last resort for patients who have attempted first-line forms of medical management, such as diet, increased physical activity, behavioural modification, and drugs. There are various bariatric surgical procedures and several different variations for each of these procedures. The surgical interventions can be divided into 2 general types: malabsorptive (bypassing parts of the gastrointestinal tract to limit the absorption of food), and restrictive (decreasing the size of the stomach so that the patient is satiated with less food). All of these may be performed as either open surgery or laparoscopically. An example of a malabsorptive technique is Roux-en-Y gastric bypass (RYGB). Examples of restrictive techniques are vertical banded gastroplasty (VBG) and adjustable gastric banding (AGB). The Ontario Health Insurance Plan (OHIP) Schedule of Benefits for Physician Services includ



Sensory and preference testing of selected beef muscles infused with a phosphate and lactate blend.  


Consumers expect beef products to be juicy and tender. In the present investigation four beef muscles, i.e. Biceps femoris (BF), Longissimus lumborum (LL), Rectus femoris (RF) and Semitendinosus (ST), were infused with a blend consisting of sodium and potassium salts, di- and triphosphates and lactates. The muscles were stored at 4°C for 24h, followed by storage at -18°C until the descriptive sensory analysis could be performed on all four muscles. BF and LL were also subjected to consumer sensory analysis to determine the overall degree of liking. The infused and non-infused samples did not differ significantly with regard to aroma and flavour. The infused samples were significantly more juicy and tender than the untreated samples. Although the infused samples were rated significantly higher in salty taste than the untreated samples, both treatments illustrated a relatively low mean value for saltiness. Both the infused LL and BF samples illustrated a high degree of liking. Therefore, the infusion of beef muscles with a blend containing phosphates and lactates could be applied successfully to enhance the sensory attributes of beef. PMID:22063836

Hoffman, L C; Muller, M; Vermaak, A



The influence of sudden perturbations on trunk muscle activity and intra-abdominal pressure while standing.  


Unexpected ventral and dorsal perturbations and expected, self-induced ventral perturbations were delivered to the trunk by suddenly loading a vest strapped to the torso. Six male subjects were measured for intra-abdominal pressure (IAP) and intra-muscular electromyography of the transversus abdominis (TrA), obliquus internus abdominis (OI), obliquus externus abdominis (OE) and rectus abdominis (RA) muscles. Erector spinae (ES) activity was recorded using surface electromyography. Displacements of the trunk and head were registered using a video-based system. Unexpected ventral loading produced activity in TrA, OI, OE and RA, and an IAP increase well in advance of activity from ES. Expected ventral loading produced pre-activation of all muscles and an increased IAP prior to the perturbation. The TrA was always the first muscle active in both the unexpected and self-loading conditions. Of the two ventral loading conditions, forward displacement of the trunk was significantly reduced during the self-loading. Unexpected dorsal loading produced coincident activation of TrA, OI, OE, RA and ES. These results indicate a response of the trunk muscles to sudden expected and unexpected ventral loadings other than the anticipated immediate extensor torque production through ES activation. It is suggested that the increase in IAP is a mechanism designed to improve the stability of the trunk through a stiffening of the whole segment. PMID:8050518

Cresswell, A G; Oddsson, L; Thorstensson, A



The Effect of the Weight of Equipment on Muscle Activity of the Lower Extremity in Soldiers  

PubMed Central

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.

Lindner, Tobias; Schulze, Christoph; Woitge, Sandra; Finze, Susanne; Mittelmeier, Wolfram; Bader, Rainer



Differences in adaptation rates after virtual surgeries provide direct evidence for modularity.  


Whether the nervous system relies on modularity to simplify acquisition and control of complex motor skills remains controversial. To date, evidence for modularity has been indirect, based on statistical regularities in the motor commands captured by muscle synergies. Here we provide direct evidence by testing the prediction that in a truly modular controller it must be harder to adapt to perturbations that are incompatible with the modules. We investigated a reaching task in which human subjects used myoelectric control to move a mass in a virtual environment. In this environment we could perturb the normal muscle-to-force mapping, as in a complex surgical rearrangement of the tendons, by altering the mapping between recorded muscle activity and simulated force applied on the mass. After identifying muscle synergies, we performed two types of virtual surgeries. After compatible virtual surgeries, a full range of movements could still be achieved recombining the synergies, whereas after incompatible virtual surgeries, new or modified synergies would be required. Adaptation rates after the two types of surgery were compared. If synergies were only a parsimonious description of the regularities in the muscle patterns generated by a nonmodular controller, we would expect adaptation rates to be similar, as both types of surgeries could be compensated with similar changes in the muscle patterns. In contrast, as predicted by modularity, we found strikingly faster adaptation after compatible surgeries than after incompatible ones. These results indicate that muscle synergies are key elements of a modular architecture underlying motor control and adaptation. PMID:23884944

Berger, Denise J; Gentner, Reinhard; Edmunds, Timothy; Pai, Dinesh K; d'Avella, Andrea



Impact of radiotherapy on laryngeal intrinsic muscles.  


Ionizing radiation as a cancer therapy is associated with a variety of undesirable side effects. Consequently, radiotherapy can negatively affect neuromuscular function. Clinical observations have identified problems with swallowing and voice function. Our study aims to evaluate the impact of radiotherapy on laryngeal soft tissues using image analysis to quantify its effect on the structure of the vocalis and thyroarytenoid muscles. Case control study, retrospective analysis. We collected total laryngectomy specimens from six patients with persistent or recurrent cancer who had received preoperative radiotherapy (60-66 Gy). The control group consisted of total laryngectomy specimens from six patients who underwent surgery as primary treatment. Sampling of the specimens only included non-cancerous laryngeal tissue. Laryngeal histological slices were evaluated using digital morphometric analysis system. Percentage of fibrosis and density of muscle fibers within the thyroarytenoid muscle were evaluated in both groups. We found no significant quantitative differences in muscle fibrosis (7.92% vs. 7.52%, P > 0.1). Changes were rather qualitative and included changes in the organization of the muscular fibers. A significant reduction in muscle fibers, however, was observed in the samples from irradiated larynges (66.45% vs. 42.03%, P < 0.01). Our analysis suggests that radiotherapy is responsible for a significant reduction in muscle fibers in the thyroarytenoid muscle and that these changes occur during treatment or relatively early after its completion. Loss of muscle mass after irradiation correlates with clinical observations of muscle weakness and decreased function in patients who undergo radiotherapy. PMID:21739096

Tedla, Miroslav; Valach, Matúš; Carrau, Ricardo L; Varga, Ivan; Profant, Milan; Mráz, Peter; Weismann, Peter



The use of biomaterials for chest wall reconstruction 30 years after radical surgery and radiation.  


The combination of titanium plates and acellular collagen matrix was used to restore anterior chest wall integrity in a 68-year-old woman more than 30 years after a Halsted mastectomy and radiation treatment. A vertical rectus abdominis muscle flap was used for myocutaneous coverage of the reconstructed chest wall. Partial necrosis of the flap caused prolonged exposure of the collagen matrix and the titanium plates, which were then covered with a free skin graft. Long-term results were satisfactory despite continued infection treated with vacuum-assisted closure and surgical debridement. Recently introduced materials for chest wall reconstruction may offer resilience to infection, tolerability, and stability, and their use may be contemplated when the potential for local morbidity is high. PMID:23006719

Rocco, Gaetano; Mori, Stefano; Fazioli, Flavio; La Rocca, Antonello; Martucci, Nicola; Setola, Sergio



The Patient Deficit Model Overturned: a qualitative study of patients' perceptions of invitation to participate in a randomized controlled trial comparing selective bladder preservation against surgery in muscle invasive bladder cancer (SPARE, CRUK/07/011)  

PubMed Central

Background Evidence suggests that poor recruitment into clinical trials rests on a patient ‘deficit’ model – an inability to comprehend trial processes. Poor communication has also been cited as a possible barrier to recruitment. A qualitative patient interview study was included within the feasibility stage of a phase III non-inferiority Randomized Controlled Trial (RCT) (SPARE, CRUK/07/011) in muscle invasive bladder cancer. The aim was to illuminate problems in the context of randomization. Methods The qualitative study used a ‘Framework Analysis’ that included ‘constant comparison’ in which semi-structured interviews are transcribed, analyzed, compared and contrasted both between and within transcripts. Three researchers coded and interpreted data. Results Twenty-four patients agreed to enter the interview study; 10 decliners of randomization and 14 accepters, of whom 2 subsequently declined their allocated treatment. The main theme applying to the majority of the sample was confusion and ambiguity. There was little indication that confusion directly impacted on decisions to enter the SPARE trial. However, confusion did appear to impact on ethical considerations surrounding ‘informed consent’, as well as cause a sense of alienation between patients and health personnel. Sub-optimal communication in many guises accounted for the confusion, together with the logistical elements of a trial that involved treatment options delivered in a number of geographical locations. Conclusions These data highlight the difficulty of providing balanced and clear trial information within the UK health system, despite best intentions. Involvement of multiple professionals can impact on communication processes with patients who are considering participation in RCTs. Our results led us to question the ‘deficit’ model of patient behavior. It is suggested that health professionals might consider facilitating a context in which patients feel fully included in the trial enterprise and potentially consider alternatives to randomization where complex interventions are being tested. Trial Registration ISRCTN61126465



An enhanced and validated generic thoraco-lumbar spine model for prediction of muscle forces.  


A direct measurement of the complete loads in the spine continues to remain elusive. Analytical musculoskeletal models to predict the internal loading conditions generally neglect or strongly simplify passive soft tissue structures. However, during large intervertebral motions, passive structures such as ligaments and the stiffness of the intervertebral discs are thought to play a critical role on the muscle forces required for equilibrium. The objective of the present study was to add the short segmental muscles, lumbar ligaments and disc stiffnesses to an existing base musculoskeletal model of the spine in order to establish what role passive soft tissue structures play in spinal loading, but also validate these results against experimentally determined load data. The long trunk muscles not included in previous models, short segmental muscles, lumbar ligaments and disc stiffnesses were implemented into a commercially available musculoskeletal spine model construct. For several activities of daily living, the loads acting on the vertebral bodies were then calculated relative to the value for standing, and then compared to the corresponding values measured in vivo. Good agreement between calculated and measured results could be achieved in all cases, with a maximum difference of 9%. The highest muscle forces were predicted in the m. longissimus (146N) for flexion, in the m. rectus abdominis (363N) for extension, and in the m. psoas major (144N and 81N) for lateral bending and axial rotation. This study has demonstrated that the inclusion of the complete set of muscle and ligament structures into musculoskeletal models of the spine is essential before accurate spinal forces can be determined. For the first time, trend validation of spinal loading has been achieved, thus allowing confidence in the precise prediction of muscle forces for a range of activities of daily living. PMID:21978915

Han, Kap-Soo; Zander, Thomas; Taylor, William R; Rohlmann, Antonius



Percutaneous Selective Myoablation in Plastic Surgery  

Microsoft Academic Search

A new technique in aesthetic plastic surgery termed “myoablation” is described. Thermal energy is applied via the percutaneous\\u000a route for ablation of selected facial muscles to modify the facial dynamics. Myoablation was found to be useful in ameliorating\\u000a noticeable frown wrinkles caused by muscular hyperactivity. A series of 30 patients underwent myoablation as the sole procedure\\u000a with encouraging results. In

Gregorio Hernandez Zendejas; Jose Guerrerosantos



Robotic mitral valve surgery  

Microsoft Academic Search

Traditionally mitral valve surgery has been performed via median sternotomy. However, a renaissance in cardiac surgery is occurring. Cardiac operations are being performed through smaller and alternative incisions with enhanced technological assistance. Specifically, minimally invasive mitral valve surgery has become standard for many surgeons. At our institution, we have developed a robotic mitral surgery program with the da VinciTM telemanipulation

Alan P. Kypson; L. Wiley Nifong; W. Randolph Chitwood



Challenges of Laparoscopic Surgery  

NSDL National Science Digital Library

Students teams use a laparoscopic surgical trainer to perform simple laparoscopic surgery tasks (dissections, sutures) using laparoscopic tools. Just like in the operating room, where the purpose is to perform surgery carefully and quickly to minimize patient trauma, students' surgery time and mistakes are observed and recorded to quantify their performances. They learn about the engineering component of surgery.

Integrated Teaching And Learning Program


Hypophosphatemia after cardiothoracic surgery  

Microsoft Academic Search

The incidence of hypophosphatemia during the first 48 h following cardiothoracic surgery was prospectively studied in 74 patients. Hypophosphatemia, defined by a serum phosphate below 2.50 mg\\/dl, was observed in 19 of 34 (56%) patients after thoracic surgery and in 20 of 40 (50%) patients after cardiac surgery. As a whole, hypophosphatemia occurred earlier after thoracic than after cardiac surgery.

J. Goldstein; J.-L. Vincent; J.-L. Leclerc; P. Vanderhoeft; R. J. Kahn



Motoneuronal and muscle synergies involved in cat hindlimb control during fictive and real locomotion: a comparison study  

PubMed Central

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.

Markin, Sergey N.; Lemay, Michel A.; Prilutsky, Boris I.



Masseter muscle hypertrophy. Aetiology and therapy.  


Masseter muscle hypertrophy (MMH) is most probably a congenital, genetically determined anomaly. Thus we should refer to it as hyperplasia rather than hypertrophy of the masseteric muscle. Excision of the internal layer of the masseter muscle and reduction of the thickened bone in the region of the mandibular angle, via an intraoral approach, is the treatment of choice. Immediately after surgery it is necessary to apply a fixed compression bandage to the masseteric region in order to obliterate dead space which would otherwise be filled by a haematoma which in turn leads to prolonged postoperative trismus. After removal of the bandage it is necessary to institute mouth opening exercises. Very good esthetic and functional results were achieved. PMID:3467004

Roncevi?, R



Full Tendon Transposition Augmented with Posterior Intermuscular Suture and Recession - Resection Surgery  

PubMed Central

Purpose To report an effect of the full tendon transposition augmented with posterior intermuscular suture and recession-resection surgery, for the patient with monocular elevation deficiency (MED) and large exotropia. Methods Interventional case report. Full tendon transposition augmented with posterior intermuscular suture and recession-resection surgery was performed for a 26-year-old male patient had monocular elevation deficiency (MED) and large exotropia. Results Preoperative angle of deviation was 56 prism diopters (PD) hypotropia and 45 PD right exotropia, compared with 18 PD left hypertropia and 10 PD right esotropia postoperatively. Essotropia persisted after 2.5 years, however, and so the right medial rectus was recessed after removal of the previous posterior intermuscular suture. At a three-year follow-up after the second surgery, alignment was straight in the primary position at near and far distances. Conclusions Full tendon transposition augmented with posterior intermuscular suture and recession-resection surgery was effective for a patient with MED associated with significant horizontal deviation, and a second operation was easily performed when overcorrection occurred.

Hong, Samin; Chang, Yoon-Hee



Effects of vascular occlusion on maximal force, exercise-induced T2 changes, and EMG activities of quadriceps femoris muscles.  


The purpose of our study was to determine the effect of vascular occlusion on neuromuscular activation and/or the energy metabolic characteristics of the quadriceps femoris (QF) muscles during muscle contractions. Seven men participated in the study. An occlusion cuff was attached to the proximal end of the right thigh, so that blood flow in the anterior medial malleolar artery was reduced to approximately 88 % of the non-occluded flow. Muscle functional magnetic resonance imaging and maximal voluntary contraction (MVC) were carried out before and immediately after 5 sets of 10 repetitions of knee extension exercises at 50 % of the 10 repetitions maximum, from which transverse relaxation times (T2) and maximal force were measured, respectively. Integrated electromyography (iEMG) activity was recorded from the belly of the rectus femoris, vastus lateralis, and vastus medialis muscles during MVC and repetitive exercises. The percentage change in T2 was significantly increased for individual QF muscles, and there was a significant increase in iEMG activity over the 5 sets of repetitive exercises under conditions of vascular occlusion, but there was no significant effect on isometric force and iEMG activity during MVC. These results are consistent with the idea that there is greater osmolite accumulation during exercise with occlusion, although increased neural activation cannot be ruled out. PMID:16802245

Kinugasa, R; Watanabe, T; Ijima, H; Kobayashi, Y; Park, H G; Kuchiki, K; Horii, A



High-Resolution Magnetic Resonance Imaging Demonstrates Abnormalities of Motor Nerves and Extraocular Muscles in Patients With Neuropathic Strabismus  

PubMed Central

Introduction Although the ocular motility examination has been used traditionally in the diagnosis of strabismus that is a result of cranial nerve (CN) abnormalities, magnetic resonance imaging (MRI) now permits the direct imaging of lesions in CN palsies. Methods Prospectively, nerves to extraocular muscles (EOMs) were imaged with T1 weighting in orbits of 83 orthotropic volunteers and 96 strabismic patients in quasicoronal planes using surface coils. Intraorbital resolution was 234–312 microns within 1.5- to 2.0-mm thick planes. CNs were imaged at the brainstem using head coils and T2 weighting, yielding 195 micron resolution in planes 1.0-mm thick in 6 normal volunteers and 22 patients who had oculomotor (CN3), trochlear (CN4), or abducens (CN6) palsies and Duane syndrome. Results Oculomotor (CN3) and abducens (CN6) but not trochlear (CN4) nerves were demonstrable in the orbit and skull base in all normal subjects. Patients with congenital CN3 palsies had hypoplastic CN3s both in orbit and skull base, with hypoplasia of involved EOMs. Patients with chronic CN6 and CN4 palsies exhibited atrophy of involved EOMs. Patients with Duane syndrome exhibited absence or hypoplasia of CN6 in both orbit and brainstem regions, often with mild hypoplasia and apparent misdirection of CN3 to the lateral rectus muscle. Unlike CN6 palsy, patients with Duane syndrome exhibited no EOM hypoplasia. Patients with congenital fibrosis exhibited severe hypoplasia of CN3, moderate hypoplasia of CN6, and EOM hypoplasia, particularly severe for the superior rectus and levator muscles. Conclusion High-resolution MRI can directly demonstrate pathology of CN3 and CN6 and affected EOM atrophy in strabismus caused by CN palsies. Direct imaging of CNs and EOMs by MRI is feasible and useful in differential diagnosis of complex strabismus.

Demer, Joseph L.; Ortube, Maria Carolina; Engle, Elizabeth C.; Thacker, Neepa



Frontalis Suspension Surgery in Upper Eyelid Blepharoptosis  

PubMed Central

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.

Takahashi, Yasuhiro; Leibovitch, Igal; Kakizaki, Hirohiko



Oral surgery: part 2. Endodontic surgery.  


In the past, the interaction between dentoalveolar surgery and restorative dentistry has been limited to the removal of teeth with pulp and/or periradicular disease or those that were unrestorable. However, with the increasing dental awareness of the population and the retention of teeth into later life, the interaction between dentoalveolar surgery and restorative dentistry is becoming a fundamental aspect of clinical practice. Indeed, endodontic and implant surgery are core activities that facilitate the retention of a functional dentition. PMID:24072296

Pop, I



Muscle Contusion (Bruise)  


... Resources Copyright 2007 American Academy of Orthopaedic Surgeons Muscle Contusion (Bruise) Athletes in all contact sports have many opportunities to get a muscle contusion (bruise). Contusions are second only to strains ...


Literacy Measure - MUSCLE  

Center for Drug Evaluation (CDER)

... Literacy Measure - MUSCLE. MUSCLE. Frequency. Percent. Valid Percent. Cumulative Percent. Valid, Correct, 1187, 98.8, 98.8, 98.8. ... More results from


Muscle strain treatment  


Treatment - muscle strain ... Question: How do you treat a muscle strain ? Answer: Rest and ice for the first few days after the injury. Anti-inflammatory medications or acetaminophen (Tylenol) also can be ...


Engineering skeletal muscle repair.  


Healthy skeletal muscle has a remarkable capacity for regeneration. Even at a mature age, muscle tissue can undergo a robust rebuilding process that involves the formation of new muscle cells and extracellular matrix and the re-establishment of vascular and neural networks. Understanding and reverse-engineering components of this process is essential for our ability to restore loss of muscle mass and function in cases where the natural ability of muscle for self-repair is exhausted or impaired. In this article, we will describe current approaches to restore the function of diseased or injured muscle through combined use of myogenic stem cells, biomaterials, and functional tissue-engineered muscle. Furthermore, we will discuss possibilities for expanding the future use of human cell sources toward the development of cell-based clinical therapies and in vitro models of human muscle disease. PMID:23711735

Juhas, Mark; Bursac, Nenad



Treating Strabismus by Injecting the Agonist Muscle with Bupivacaine and the Antagonist with Botulinum Toxin  

PubMed Central

Purpose: We report the results of injection of bupivacaine (BUP) and botulinum toxin (BT) into agonist and antagonist muscles, respectively, to treat horizontal strabismus. Methods: We treated both horizontal muscles of 7 patients with comitant horizontal strabismus, 2 patients with partial lateral rectus (LR) paralysis, and one elderly myopic patient with acquired esotropia, injecting the agonist muscle with BUP in concentrations of 0.75% to 3.0% and volumes of 3.0 to 5.0 mL, and the antagonist with BT in about half the usual therapeutic dose to prevent it from stretching the BUP-treated muscle during its regeneration following BUP myotoxicity. We reinjected BT in one patient who had an inadequate response from the initial BT dose. Results: The 7 comitant patients were corrected (on average) 19.7 prism diopters (?), from 28.3? to 8.6?, at 193 days after injection. Muscle volume increase after BUP injection was 5.8% at 158 days. One LR palsy patient without LR atrophy was changed 55?; the other, with LR atrophy, was corrected 4?. Two patients had transient vertical deviations from the BT injection. The myopic patient with esotropia was unchanged. Conclusions: Injections of BUP and BT corrected 7 patients with comitant horizontal strabismus an average of 19.7?, about double the correction reported from BUP injection alone. BUP-injected muscles increased size by 5.8%. Of 2 patients with LR weakness, one without LR atrophy was changed by 55?, but another with LR atrophy was corrected only 4?.

Scott, Alan B.; Miller, Joel M.; Shieh, Kevin R.



Skeletal muscle stem cells  

Microsoft Academic Search

Satellite cells are myogenic stem cells responsible for the post-natal growth, repair and maintenance of skeletal muscle. This review focuses on the basic biology of the satellite cell with emphasis on its role in muscle repair and parallels between embryonic myogenesis and muscle regeneration. Recent advances have altered the long-standing view of the satellite cell as a committed myogenic stem

Jennifer CJ Chen; David J Goldhamer



Neurogenic muscle hypertrophy  

Microsoft Academic Search

Muscle hypertrophy is rare in denervating diseases. A patient with calf enlargement associated with L5–S1 radiculopathy and another with thenar, hypothenar, forearm and calf muscle hypertrophy in the course of chronic relapsing inflammatory demyelinating polyneuropathy are described. Gastrocnemius muscle biopsy revealed both type I and type II fibre hypertrophy in the former case and predominant type I fibre hypertrophy in

D. Pareyson; L. Morandi; V. Scaioli; R. Marazzi; A. Boiardi; A. Sghirlanzoni



Muscle-splitting thoracotomy.  


Muscle-splitting thoracotomy avoids transection of the latissimus dorsi and the serratus anterior muscles, thereby decreasing post thoracotomy pain and preserving the function and viability of these two muscles. The exposure provided for most intrathoracic procedures is excellent. PMID:9544153

Sadighi, P J; Woodworth, C S



Muscle Tissue Overview  

NSDL National Science Digital Library

This is a short overview of the three types of muscle tissue. Each type of muscle tissue is briefly described with a histology view of the tissue. This presentation also incorporates information regarding each muscle tissue and its role in attaining VO2 max.

Ms. Wendy M Rappazzo (Harford Community College Science, Technology, Engineering & Math)



Risk factors and blood flow in the free transverse rectus abdominis (TRAM) flap: smoking and high flap weight impair the free TRAM flap microcirculation.  


Mastectomy patients may have significant psychologic-related problems. Breast reconstruction provides in these cases substantial benefits in restoring body image and health-related quality of live. Autologous free tissue transfer is the treatment of choice due to excellent outcome. The purpose of this study was to elucidate the effect of the risk factors on the microcirculation and clinical outcome. In this prospective study, 21 patients with a free transverse rectus abdominis (TRAM) flap breast reconstruction were included. Patient demographics and flap characteristics were recorded. Blood flow was recorded in the central part (zone I) and the distal part (zone IV) of the flap with the laser Doppler flowmetry (LDF; Perimed). In this study, increased flap complications were seen in smokers when compared with nonsmokers (P < 0.000). LDF was higher in the older patient population (P = 0.008) in zone IV. Smoking, especially in combination with a high flap weight (HFW), revealed lower blood-flow values (P = 0.020) in zone IV. Other possible influencing risk factors such as a HFW and history of radio- and chemotherapy did not alter the microcirculation. Patients with smoking and a HFW did also show decreased blood flow but also more severe flap complications.Smoking, especially in patients with a HFW, impairs the free TRAM flap microcirculation in zone IV. In our opinion, these patients can still be included for reconstruction. However, extra care has to be taken during flap design to minimize disturbed wound healing. PMID:17901724

Booi, Darren I; Debats, Iris B J G; Boeckx, Willy D; van der Hulst, Rene R W J



Differential expression of neural cell adhesion molecule (NCAM) after tenotomy in rabbit skeletal muscle  

Microsoft Academic Search

Tenotomy is a commonly encountered event in orthopaedic surgery. In 23 rabbit extensor digitorum longus (EDL) muscles, within 24 h after tenotomy, a marked drop in maximum force production occurred. This was not explainable based on architectural changes and histological examination using standard markers for muscle injury, i.e., haematoxylin and eosin morphology, developmental myosin heavy chain (MHC) immunolabeling, and quantitation

Amir A. Jamali; Pouya Afshar; Reid A. Abrams; Richard L. Lieber



Correlation of muscle fiber type measurements with clinical and molecular genetic data in Duchenne muscular dystrophy  

Microsoft Academic Search

Clinical improvement following surgery in patients with Duchenne muscular dystrophy (DMD) may be influenced by the severity of muscle fiber damage. This study correlates morphometric alterations of muscle fiber types, severity of fat tissue proliferation and fibrosis with Western blots, multiplex polymerase chain reaction (PCR), and postoperative state in DMD. The main results of this study show that the mean

Jian-Feng Wang; Jürgen Forst; Sebastian Schröder; J. Michael Schröder



Axonal regeneration through muscle autografts submitted to local anaesthetic pretreatment.  


Freeze-thawed muscle grafts (FTMG) have been used as an alternative to nerve grafts for the reconstruction of peripheral nerve defects, although their use has some disadvantages. For instance, FTMG may fragment easily after freeze-thawing, a fact impairing their use for surgery. In this study we describe a method to obtain muscle autografts based on the myotoxic properties of local anaesthetics. Fifteen adult rats had their left tibialis anterior muscles injected transcutaneously with 0.3 ml of 2% lidocaine hydrochloride. Twenty-four hours later the injected muscle was removed and a lidocaine muscle graft (LMG) was obtained by trimming the muscle to a rectangular block of approximately 1.0 cm in length. The left sciatic nerve was exposed in the mid-thigh region and a segment removed so that a final 1.0 cm-long gap was produced. The LMG was coaxially autografted to the epineurium between the proximal and distal nerve stumps. In another 15 rats, the sciatic nerve gap was repaired with FTMG obtained from the tibialis anterior muscle. Surgical procedures were similar in both groups. Axonal regeneration and muscle reinnervation were studied quantitatively and ultrastructurally 60 days after the insertion of LMG and FTMG. The results showed that axonal regeneration with the LMG was qualitatively similar to that observed with the FTMG, with no significant differences between groups. We conclude that LMG was a successful muscle graft and a suitable alternative to other denaturing methods, without the disadvantages of FTMG. PMID:9924412

Santo Neto, H; Teodori, R M; Somazz, M C; Marques, M J



Modification of surgery equipment for ovine surgery.  


Surgery equipment was modified for ovine surgery. Pre- and postoperative holding pens were designed to meet the specific requirements of sheep. A hydraulic trolley lift was constructed and operating tables fitted with spilltrays. A gag was made to protect Magill tubing and the indifferent electrode was altered for electrosurgery. For fluoroscopy a flexible table was constructed to accommodate sheep. PMID:8049178

Herrmann, W D


Olympic weightlifting training causes different knee muscle-coactivation adaptations compared with traditional weight training.  


The purpose of this study was to compare the effects of an Olympic weightlifting (OL) and traditional weight (TW) training program on muscle coactivation around the knee joint during vertical jump tests. Twenty-six men were assigned randomly to 3 groups: the OL (n = 9), the TW (n = 9), and Control (C) groups (n = 8). The experimental groups trained 3 d · wk(-1) for 8 weeks. Electromyographic (EMG) activity from the rectus femoris and biceps femoris, sagittal kinematics, vertical stiffness, maximum height, and power were collected during the squat jump, countermovement jump (CMJ), and drop jump (DJ), before and after training. Knee muscle coactivation index (CI) was calculated for different phases of each jump by dividing the antagonist EMG activity by the agonist. Analysis of variance showed that the CI recorded during the preactivation and eccentric phases of all the jumps increased in both training groups. The OL group showed a higher stiffness and jump height adaptation than the TW group did (p < 0.05). Further, the OL showed a decrease or maintenance of the CI recorded during the propulsion phase of the CMJ and DJs, which is in contrast to the increase in the CI observed after TW training (p < 0.05). The results indicated that the altered muscle activation patterns about the knee, coupled with changes of leg stiffness, differ between the 2 programs. The OL program improves jump performance via a constant CI, whereas the TW training caused an increased CI, probably to enhance joint stability. PMID:21997458

Arabatzi, Fotini; Kellis, Eleftherios



Elevated gastrin secretion by in vivo gene electroporation in skeletal muscle.  


Whether or not in vivo gene transfer of gastrin gene into skeletal muscle by electroporation could modify gastrin secretion was examined. The expression plasmid vector, either pMEPrGaspA encoding the rat gastrin gene or pEGFP-N1 encoding the GFP reporter gene was injected into M. rectus abdominis of rats or M. biceps formis of mice. Subsequently, square electric pulses of direct current were applied six times at 25 V with a loading period of 100 msec per pulse. Clear foreign gene expression in the skeletal muscle was demonstrated by both GFP fluorescence and immunostaining of rat gastrin. Time course changes in plasma gastrin levels after transfection revealed that in rats, gastrin gene transfer significantly increased the plasma gastrin level for 4 weeks post-transfection (P<0.05), but the difference diminished at the end of the 10-week period. In mice, plasma gastrin level elevated similarly for 3 weeks, and pH of gastric contents decreased in the gastrin gene transfected group compared with the control counterpart (P<0.05). These findings suggest that localized in vivo gene transfer by electroporation allows skeletal muscle to become an artificial endocrine tissue for hormonal manipulation of animals. PMID:11605015

Yasui, A; Oda, K; Usunomiya, H; Kakudo, K; Suzuki, T; Yoshida, T; Park, H M; Fukazawa, K; Muramatsu, T



Back Muscle Changes after Pedicle Based Dynamic Stabilization  

PubMed Central

Objective Many studies have investigated paraspinal muscle changes after posterior lumbar surgery, including lumbar fusion. However, no study has been performed to investigate back muscle changes after pedicle based dynamic stabilization in patients with degenerative lumbar spinal diseases. In this study, the authors compared back muscle cross sectional area (MCSA) changes after non-fusion pedicle based dynamic stabilization. Methods Thirty-two consecutive patients who underwent non-fusion pedicle based dynamic stabilization (PDS) at the L4-L5 level between February 2005 and January 2008 were included in this retrospective study. In addition, 11 patients who underwent traditional lumbar fusion (LF) during the same period were enrolled for comparative purposes. Preoperative and postoperative MCSAs of the paraspinal (multifidus+longissimus), psoas, and multifidus muscles were measured using computed tomographic axial sections taken at the L4 lower vertebral body level, which best visualize the paraspinal and psoas muscles. Measurements were made preoperatively and at more than 6 months after surgery. Results Overall, back muscles showed decreases in MCSAs in the PDS and LF groups, and the multifidus was most affected in both groups, but more so in the LF group. The PDS group showed better back muscle preservation than the LF group for all measured muscles. The multifidus MCSA was significantly more preserved when the PDS-paraspinal-Wiltse approach was used. Conclusion Pedicle based dynamic stabilization shows better preservation of paraspinal muscles than posterior lumbar fusion. Furthermore, the minimally invasive paraspinal Wiltse approach was found to preserve multifidus muscles better than the conventional posterior midline approach in PDS group.

Moon, Kyung Yun; Lee, Soo-Eon; Kim, Ki-Jeong; Hyun, Seung-Jae; Kim, Hyun-Jib



Asynchronous Muscle and Tendon Adaptation After Surgical Tensioning Procedures  

PubMed Central

Background: Donor muscles are often highly stretched in tendon transfer surgery. Despite literature reports that showed adaptation of the serial sarcomere number to moderate stretch, little is known regarding adaptation to stretch outside of the physiological range (commonly seen in clinical tendon transfer). This study was performed to evaluate muscle-tendon-unit adaptation to tendon transfer surgery in an animal model. Methods: Thirty-seven male New Zealand White rabbits were used for muscle analysis, and twenty-five of those rabbits were also used for biological analysis of the tendons after the experiment. The extensor digitorum muscle of the second toe was transferred at a specific sarcomere length of 3.7 ?m, chosen to be near the end of the descending limb of the rabbit sarcomere length-tension curve. Animals were killed at five time points, at which complete muscle architectural analysis as well as measurements of tendon dimension, tendon water content, and tendon cytokine transcript levels were performed. Results: As expected, a rapid increase in the serial sarcomere number (mean and standard error of the mean, 4658 ± 154 in the transferred muscle compared with 3609 ± 80 in the control muscle) was found one week after the surgery. From this time point until eight weeks, this increased serial sarcomere number paradoxically decreased, while the sarcomere length remained constant. Eventually, at eight weeks, it reached the same value (3749 ± 83) as that in the control muscle (3767 ± 61). Tendon adaptation was delayed relative to muscle adaptation, but it was no less dramatic. Tendon length increased by 1.43 ± 0.74 mm over the eight-week time period, corresponding to a strain of 15.55% ± 4.08%. Conclusions: To our knowledge, this is the first report of biphasic adaptation of the serial sarcomere number followed by tendon adaptation, and it indicates that muscle adapts more quickly than tendon does. Taken together, these results illustrate a complex and unique interaction between muscles and tendons that occurs during adaptation to stretching during tendon transfer. Clinical Relevance: Understanding the time course of muscle-tendon-unit adaptation can provide surgeons with information to guide postoperative care following tendon transfers as well as guidelines for tensioning muscles during tendon transfer.

Takahashi, Mitsuhiko; Ward, Samuel R.; Marchuk, Linda L.; Frank, Cyril B.; Lieber, Richard L.



An Artificial Tendon with Durable Muscle Interface  

PubMed Central

A coupling mechanism that can permanently fix a forcefully contracting muscle to a bone anchor or any totally inert prosthesis would meet a serious need in orthopaedics. Our group developed the OrthoCoupler™ device to satisfy these demands. The objective of this study was to test OrthoCoupler’s performance in vitro and in vivo in the goat semitendinosus tendon model. For in vitro evaluation, 40 samples were fatigue-tested, cycling at 10 load levels, n=4 each. For in vivo evaluation, the semitendinosus tendon was removed bilaterally in 8 goats. Left sides were reattached with an OrthoCoupler, and right sides were reattached using the Krackow stitch with #5 braided polyester sutures. Specimens were harvested 60 days post-surgery and assigned for biomechanics and histology. Fatigue strength of the devices in vitro was several times the contractile force of the semitendinosus muscle. The in vivo devices were built equivalent to two of the in vitro devices, providing an additional safety factor. In strength testing at necropsy, suture controls pulled out at 120.5 ± 68.3 N, whereas each OrthoCoupler was still holding after the muscle tore, remotely, at 298±111.3N (mean ± SD)(p<0.0003). Muscle tear strength was reached with the fiber-muscle composite produced in healing still soundly intact. This technology may be of value for orthopaedic challenges in oncology, revision arthroplasty, tendon transfer, and sports-injury reconstruction.

Melvin, Alan; Litsky, Alan; Mayerson, Joel; Witte, David; Melvin, David; Juncosa-Melvin, Natalia



Oxidative Metabolism in Muscle  

NASA Astrophysics Data System (ADS)

Oxidative metabolism is the dominant source of energy for skeletal muscle. Near-infrared spectroscopy allows the non-invasive measurement of local oxygenation, blood flow and oxygen consumption. Although several muscle studies have been made using various near-infrared optical techniques, it is still difficult to interpret the local muscle metabolism properly. The main findings of near-infrared spectroscopy muscle studies in human physiology and clinical medicine are summarized. The advantages and problems of near-infrared spectroscopy measurements, in resting and exercising skeletal muscles studies, are discussed through some representative examples.

Ferrari, M.; Binzoni, T.; Quaresima, V.



Microcirculation in skeletal muscle  

PubMed Central

Summary The role of microcirculation in skeletal muscle is to provide the supply of oxygen and various nutrients and to remove waste products of muscle metabolism. As skeletal muscles are composed of different fibre types, this review tries to elucidate the question of capillary supply and flow with respect to these. It reviews the current knowledge of structure of microcirculation and its nervous, hormonal, and local (myogenic, metabolic and endothelial) control. It also discuss factors involved in the increase in blood flow and changes in microcirculation occurring during muscle contractions, exercise training, muscle hypertrophy and atrophy, hypoxia, ageing, hypertension, diabetes and limited blood supply.

Hudlicka, Olga



Effects of Lung Volume Reduction Surgery for Emphysema on Diaphragm Dimensions and Configuration  

Microsoft Academic Search

Part of the functional benefit provided by lung volume reduction surgery (LVRS) may be related to improvement in respiratory mus- cle function resulting from changes in diaphragm dimension and configuration. To study these changes, we obtained 3D recon- structions of the muscle using spiral computed tomography in 11 patients with severe emphysema before and 3 mo after surgery, and in




Smoking and surgery  


... concentration, and producing a sense of well-being. Quitting smoking and other tobacco products before surgery can make ... for a long time. Stretching the time between quitting smoking and your surgery out to 10 weeks or ...


Cataract surgery - series (image)  


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.


Otoplasty (Cosmetic Ear Surgery)  


... CLICK TO ENLARGE Otoplasty Otoplasty — also known as cosmetic ear surgery — is a procedure to change the ... Society of Plastic Surgeons. Accessed June 22, 2012. ...


Dental Implant Surgery  


Dental implant surgery Basics Multimedia Expert Answers Resources Reprints A single copy of this article may be reprinted for personal, noncommercial use only. Dental implant surgery By Mayo Clinic staff Original Article: http:// ...


Plastic and Cosmetic Surgery  


... through cosmetic surgery. Some of the most common body parts people want to improve through surgery include Breasts: Increase or reduce the size of breasts or reshape sagging breasts Ears: Reduce ...


Optical characterization of muscle  

NASA Astrophysics Data System (ADS)

Optical characterization and internal structure of biological tissues is highly important for biomedical optics. In particular for optical clearing processes, such information is of vital importance to understand the mechanisms involved through the variation of the refractive indices of tissue components. The skeletal muscle presents a fibrous structure with an internal arrangement of muscle fiber cords surrounded by interstitial fluid that is responsible for strong light scattering. To determine the refractive index of muscle components we have used a simple method of measuring tissue mass and refractive index during dehydration. After performing measurements for natural and ten dehydration states of the muscle samples, we have determined the dependence between the refractive index of the muscle and its water content. Also, we have joined our measurements with some values reported in literature to perform some calculations that have permitted to determine the refractive index of the dried muscle fibers and their corresponding volume percentage inside the natural muscle.

Oliveira, Luís; Lage, Armindo; Pais Clemente, Manuel; Tuchin, Valery V.



Muscle force redistributes segmental power for body progression during walking.  


The ankle plantar flexors were previously shown to support the body in single-leg stance to ensure its forward progression [J. Biomech. 34 (2001) 1387]. The uni- (SOL) and biarticular (GAS) plantar flexors accelerated the trunk and leg forward, respectively, with each opposing the effect of the other. Around mid-stance their net effect on the trunk and the leg was negligible, consistent with the body acting as an inverted pendulum. In late stance, their net effect was to accelerate the leg and trunk forward, consistent with an active push-off. Because other muscles are active in the beginning and end of stance, we hypothesized that their active concentric and eccentric force generation also supports the body and redistributes segmental power to enable body forward progression. Muscle-actuated forward dynamical simulations that emulated observed walking kinematics and kinetics of young adult subjects were analyzed to quantify muscle contributions to the vertical and horizontal ground reaction force, and to the acceleration and mechanical power of the leg and trunk. The eccentric uniarticular knee extensors (vasti, VAS) and concentric uniarticular hip extensors (gluteus maximus, GMAX) were found to provide critical support to the body in the beginning of stance, before the plantar flexors became active. VAS also decelerated the forward motion of both the trunk and the leg. Afterwards when VAS shortens in mid-stance, it delivered the power produced to accelerate the trunk and also redistributed segmental power to the trunk by continuing to decelerate the leg. When present, rectus femoris (RF) activity in the beginning of stance had a minimal effect. But in late stance the lengthening RF accelerated the knee and hip into extension, which opposed swing initiation. Though RF was lengthening, it still accelerated the trunk forward by decelerating the leg and redistributing the leg segmental power to the trunk, as SOL does though it is shortening instead of lengthening. Force developed from highly stretched passive hip structures and active force produced by the uniarticular hip flexors assisted GAS in swing initiation. Hamstrings (HAM) decelerated the leg in late swing while lengthening and accelerated the leg in the beginning of stance while shortening. We conclude that the uniarticular knee and hip extensor muscles are critical to body support in the beginning of stance and redistribution of segmental power by muscles throughout the gait cycle is critical to forward progression of the trunk and legs. PMID:15013508

Neptune, R R; Zajac, F E; Kautz, S A



Bariatric surgery: an overview.  


The rise of obesity in the UK has led to greater numbers of patients requiring bariatric surgery. This article provides an overview of the two main types of surgery available: laparoscopic adjustable gastric band and Roux-en-Y gastric bypass surgery. The nurse's role in pre-operative assessment and post-operative care are discussed. Strategies to maintain weight loss are suggested to ensure optimum outcomes of surgery and to improve patients' quality of life. PMID:22808602

Green, Nicky


Microendoscopic lumbar discectomy versus open surgery: an intraoperative EMG study  

Microsoft Academic Search

This study investigated electromyographic (EMG) activity as a marker of nerve root irritation during two different surgical procedures for lumbar disc herniation. Mechanically elicited EMG activity was recorded during the dynamic stages of surgery in muscle groups innervated by lumbar nerve roots. Confirmation of surgical activity was correlated with the activity of the electromyogram. Fifteen patients with lumbar disc herniations

U. Schick; J. Döhnert; A. Richter; A. König; H. Vitzthum



Complications with homologous fat grafts in breast augmentation surgery  

Microsoft Academic Search

The most common complications in breast augmentation surgery with homologous fat grafts obtained from fresh cadavers are presented, showing subsequent surgical procedures to reconstruct the breasts of such patients through use of silicone prostheses and muscle flaps from the latissimus dorsi.

Peter Pohl; Carlos Oscar Uebel



Mitochondrial crowding in smooth muscle cells after arterial ligation  

Microsoft Academic Search

Although the ultrastructural appearance of mitochondrial crowding after ischemic injury has been reported in myocardial and skeletal muscles, the mechanism for this is not clear. Thirty-five branches of the mesenteric arteries removed from eight patients during surgery were examined by electron microscopy: 22 had ligatures applied 30 minutes to 4 hours before resection, 13 had no ligatures. The number of

Ming K. Heng; Suni G. Allen; Moon K. Song; Madalene C. Y. Heng



Quantitative PCR Analysis of Laryngeal Muscle Fiber Types  

ERIC Educational Resources Information Center

|Voice and swallowing dysfunction as a result of recurrent laryngeal nerve paralysis can be improved with vocal fold injections or laryngeal framework surgery. However, denervation atrophy can cause late-term clinical failure. A major determinant of skeletal muscle physiology is myosin heavy chain (MyHC) expression, and previous protein analyses…

Van Daele, Douglas J.



Engineered Smooth Muscle Tissues: Regulating Cell Phenotype with the Scaffold  

Microsoft Academic Search

Culturing cells on three-dimensional, biodegradable scaffolds may create tissues suitable either for reconstructive surgery applications or as novel in vitro model systems. In this study, we have tested the hypothesis that the phenotype of smooth muscle cells (SMCs) in three-dimensional, engineered tissues is regulated by the chemistry of the scaffold material. Specifically, we have directly compared cell growth and patterns

Byung-Soo Kim; Janeta Nikolovski; Jeffrey Bonadio; Elizabeth Smiley; David J. Mooney



Surgery for Ventricular Arrhythmias  

Microsoft Academic Search

Surgery for ventricular arrhythmia has declined dra- matically in the recent years. Two recent surgical pa- pers were eulogies in praise of direct surgery for ven- tricular tachycardias associated with coronary artery disease (1-2), mourning the disappearance of referrals. Two comments can be made: #1 surgery for ventricular tachycardia never developed. The number of patients operated on in the eighties

Gerard M. Guiraudon



Training for laparoscopic surgery  

Microsoft Academic Search

Laparoscopic cholecystectomy has rapidly become the procedure of choice for most patients with symptomatic gallbladder disease. Laparoscopic surgery, however, has not been a required component of most general surgery training programs. The demonstrated efficacy of laparoscopic surgery dictates that this discipline be rapidly incorporated into residency programs. Laparoscopic cholecystectomy and other surgical endoscopic procedures have been an integral part of

Karl A. Zucker; Robert W. Bailey; Scott M. Graham; William Scovil; Anthony L. Imbembo



Surgery for Diabetic Retinopathy  

Microsoft Academic Search

Surgery for diabetic retinopathy addresses late secondary complications of a primary microvascular disease. Since surgery is not a causative therapy, the functional outcome of surgery depends on the degree of retinal ischemia and may be disappointing even in technically and anatomically successfully operated eyes. Typical indications for vitrectomy are vitreous hemorrhage, tractional retinal detachment, combined tractional rhegmatogenous retinal detachment and

Horst Helbig



Homologous muscle contraction during unilateral movement does not show a dominant effect on leg representation of the ipsilateral primary motor cortex.  


Co-activation of homo- and heterotopic representations in the primary motor cortex (M1) ipsilateral to a unilateral motor task has been observed in neuroimaging studies. Further analysis showed that the ipsilateral M1 is involved in motor execution along with the contralateral M1 in humans. Additionally, transcranial magnetic stimulation (TMS) studies have revealed that the size of the co-activation in the ipsilateral M1 has a muscle-dominant effect in the upper limbs, with a prominent decline of inhibition within the ipsilateral M1 occurring when a homologous muscle contracts. However, the homologous muscle-dominant effect in the ipsilateral M1 is less clear in the lower limbs. The present study investigates the response of corticospinal output and intracortical inhibition in the leg representation of the ipsilateral M1 during a unilateral motor task, with homo- or heterogeneous muscles. We assessed functional changes within the ipsilateral M1 and in corticospinal outputs associated with different contracting muscles in 15 right-handed healthy subjects. Motor tasks were performed with the right-side limb, including movements of the upper and lower limbs. TMS paradigms were measured, consisting of short-interval intracortical inhibition (SICI) and recruitment curves (RCs) of motor evoked potentials (MEPs) in the right M1, and responses were recorded from the left rectus femoris (RF) and left tibialis anterior (TA) muscles. TMS results showed that significant declines in SICI and prominent increases in MEPs of the left TA and left RF during unilateral movements. Cortical activations were associated with the muscles contracting during the movements. The present data demonstrate that activation of the ipsilateral M1 on leg representation could be increased during unilateral movement. However, no homologous muscle-dominant effect was evident in the leg muscles. The results may reflect that functional coupling of bilateral leg muscles is a reciprocal movement. PMID:23991067

Chiou, Shin-Yi; Wang, Ray-Yau; Liao, Kwong-Kum; Yang, Yea-Ru



Homologous Muscle Contraction during Unilateral Movement Does Not Show a Dominant Effect on Leg Representation of the Ipsilateral Primary Motor Cortex  

PubMed Central

Co-activation of homo- and heterotopic representations in the primary motor cortex (M1) ipsilateral to a unilateral motor task has been observed in neuroimaging studies. Further analysis showed that the ipsilateral M1 is involved in motor execution along with the contralateral M1 in humans. Additionally, transcranial magnetic stimulation (TMS) studies have revealed that the size of the co-activation in the ipsilateral M1 has a muscle-dominant effect in the upper limbs, with a prominent decline of inhibition within the ipsilateral M1 occurring when a homologous muscle contracts. However, the homologous muscle-dominant effect in the ipsilateral M1 is less clear in the lower limbs. The present study investigates the response of corticospinal output and intracortical inhibition in the leg representation of the ipsilateral M1 during a unilateral motor task, with homo- or heterogeneous muscles. We assessed functional changes within the ipsilateral M1 and in corticospinal outputs associated with different contracting muscles in 15 right-handed healthy subjects. Motor tasks were performed with the right-side limb, including movements of the upper and lower limbs. TMS paradigms were measured, consisting of short-interval intracortical inhibition (SICI) and recruitment curves (RCs) of motor evoked potentials (MEPs) in the right M1, and responses were recorded from the left rectus femoris (RF) and left tibialis anterior (TA) muscles. TMS results showed that significant declines in SICI and prominent increases in MEPs of the left TA and left RF during unilateral movements. Cortical activations were associated with the muscles contracting during the movements. The present data demonstrate that activation of the ipsilateral M1 on leg representation could be increased during unilateral movement. However, no homologous muscle-dominant effect was evident in the leg muscles. The results may reflect that functional coupling of bilateral leg muscles is a reciprocal movement.

Chiou, Shin-Yi; Wang, Ray-Yau; Liao, Kwong-Kum; Yang, Yea-Ru



Tensor tympani muscle: strange chewing muscle  

Microsoft Academic Search

ABSTRACT This work,seeks to alert medical and odontological,staff to understanding,and using interdisciplinary handling,for detecting different pathologies’ common,otic symptoms. It offers better tools for this shared symptomatology,during therapy’s conservative phase. Tensor tympani muscle physiology and function in the middle ear have been veiled, even when,their dysfunction and anatomical relationships may explain a group,of confused,otic symptoms,during conventional clinical evaluation. Middle ear muscles

Luis Miguel Ramírez; Luis Ernestos Ballesteros; German Pablo Sandoval


Optical fiber distributed temperature sensor in cardiological surgeries  

NASA Astrophysics Data System (ADS)

In those days a lot of cardiological surgeries is made every day. It is a matter of very significant importance keeping the temperature of the hearth low during the surgery because it decides whether the cells of the muscle will die or not. The hearth is cooled by the ice placed around the hearth muscle during the surgery and cooling liquid is injected into the hearth also. In these days the temperature is measured only in some points of the hearth using sensors based on the pH measurements. This article describes new method for measurement of temperature of the hearth muscle during the cardiological surgery. We use a multimode optical fiber and distributed temperature sensor (DTS) based on the stimulated Raman scattering in temperature measurements. This principle allows us to measure the temperature and to determine where the temperature changes during the surgery. Resolution in the temperature is about 0.1 degrees of Celsius. Resolution in length is about 1 meter. The resolution in length implies that the fiber must be wound to ensure the spatial resolution about 5 by 5 centimeters.

Skapa, Jan; Látal, Jan; Penhaker, Marek; Koudelka, Petr; Hancek, František; Vasinek, Vladimír



Changes in excitability of corticomotor inputs to the trunk muscles during experimentally-induced acute low back pain.  


Acute low back pain (LBP) is associated with differential changes in motor coordination of deep and superficial trunk muscles. Whether this is related to differential changes in excitability of descending corticomotor inputs remains unclear and was investigated in nine healthy individuals. Fine-wire i.m. electrodes were inserted bilaterally into deep (transversus abdominis (TrA)) and superficial abdominal muscles (obliquus externus abdominis (OE)), and surface electrodes were placed bilaterally over obliquus internus abdominis (OI), rectus abdominis (RA) and lumbar erector spinae (LES) muscles. Corticomotor excitability was assessed as amplitude of motor evoked potentials (MEPs) to transcranial magnetic stimulation (TMS) at a range of stimulator intensities, at rest and during voluntary abdominal contractions. Pain was induced by injection of hypertonic saline into interspinous ligaments of the lumbar spine. Corticomotor excitability was examined before, during and after the induction of LBP. During pain, amplitude of TrA MEPs to contralateral cortical stimulation was reduced, whereas amplitudes of OE and LES MEPs contralateral and ipsilateral to the stimulated cortex were increased. The findings highlight differential changes in excitability of corticomotor inputs to trunk muscles during acute LBP. Further work is required to reveal whether such changes involve spinal and/or supraspinal centres and their consequence for spine control. PMID:21333720

Tsao, H; Tucker, K J; Hodges, P W



Ocular neuromyotonia: differential diagnosis and treatment.  


Ocular neuromyotonia (ONM) is a rare but distinctive clinical entity characterized by involuntary episodic contraction of one or more muscles supplied by the ocular motor nerves. A retrospective review was conducted on all patients with ONM seen by the neuroophthalmology service in the past 20 years. Ten patients were identified with ONM; six affecting vertical muscles (superior oblique; inferior rectus; superior rectus) and four affecting lateral rectus muscles. Case 1 has been reported previously. Most episodes occurred every 10-40?min, lasted a few seconds to several minutes, and were repeated throughout the day. Only two patients had previously undergone cranial radiation. Two had thyroid eye disease. One patient presented with superior oblique myokymia and subsequently developed ONM. Membrane stabilizing medications were prescribed in 7 of the 10 patients with varied success. ONM episodes ceased after extraocular muscle surgery in one patient with thyroid eye disease. PMID:23713937

Roper-Hall, Gill; Chung, Sophia M; Cruz, Oscar A



Precision in liver surgery.  


Continuous theoretical and technological progress in the face of increasing expectations for quality health care has transformed the surgical paradigm. The authors systematically review these historical trends and propose the novel paradigm of "precision surgery," featuring certainty-based practice to ensure the best result for each patient with multiobjective optimization of therapeutic effectiveness, surgical safety, and minimal invasiveness. The main characteristics of precision surgery may be summarized as determinacy, predictability, controllability, integration, standardization, and individualization. The strategy of precision in liver surgery is to seek a balance of maximizing the removal of the target lesion, while maximizing the functional liver remnant and minimizing surgical invasiveness. In this article, the authors demonstrate the application of precision approaches in specific settings in complex liver surgery. They propose that the concept of precision surgery should be considered for wider application in liver surgery and other fields as a step toward the ultimate goal of perfect surgery. PMID:23943100

Dong, Jiahong; Yang, Shizhong; Zeng, Jianping; Cai, Shouwang; Ji, Wenbin; Duan, Weidong; Zhang, Aiqun; Ren, Weizheng; Xu, Yinzhe; Tan, Jingwang; Bu, Xiangyang; Zhang, Ning; Wang, Xuedong; Wang, Xianqiang; Meng, Xiangfei; Jiang, Kai; Gu, Wanqing; Huang, Zhiqiang



Change of muscle activation patterns in uphill cycling of varying slope.  


In the present study, we quantitatively described and compared lower extremity neuromuscular patterns during level cycling (LC), 10 and 20% uphill cycling (UC). We hypothesized that both the timing and intensity of activity of selected lower extremity muscles will differ between steep (but not moderate slope) UC condition and LC. Twelve trained mountain bikers performed an experimental test with three different cycling conditions (level, 10% slope and 20% slope) with EMG monitoring of eight lower extremity muscles. Significant changes (p < 0.05) in muscle activation timing during 20% UC compared to LC (15° later onset and 39° earlier offset) were observed in m. rectus femoris (RF). Range of activity during 20% UC compared to LC was also significantly (p < 0.05) modified in m. vastus medialis, m. vastus lateralis (8° and 5° shorter) and m. biceps femoris (BF; 17° longer). Furthermore, a reduction of EMG activity level was observed for RF and m. tibialis anterior (TA) during 20% UC compared to LC (25 and 19%; p < 0.05), while the opposite effect was observed for m. gluteus maximus (GM; 12%; p < 0.05). Peak cross-correlation coefficients in all cycling conditions for all muscles were high (all coefficients ? 0.83). We have shown that altered body orientation during steep, but not moderate, slope UC significantly modified the timing and intensity of several lower extremity muscles, the most affected being those that cross the hip joint and TA. The observed modifications in neuromuscular patterns during 20% UC could have a significant effect on lower extremity joint kinetics and cycling efficiency. PMID:22081125

Sarabon, Nejc; Fonda, Borut; Markovic, Goran



Adjusted saddle position counteracts the modified muscle activation patterns during uphill cycling.  


The main aim of this project was to study muscle activity patterns during steep uphill cycling (UC) (i.e., with a gradient of 20%) with (1) normal saddle geometry and (2) with adjusted saddle position ASP (i.e., moving the saddle forward and changing the tilt of the saddle by 20%). Based on our preliminary case study, we hypothesized that: (1) during 20% UC muscle activity patterns would be different from those of level cycling (LC) and (2) during 20% UC with ASP muscle activity patterns would resemble those of LC. Twelve trained male cyclists were tested on an electromagnetically braked cycle ergometer under three conditions with the same work rate (80% of maximal power output) and cadence (90 rpm): level (LC), 20% UC and 20% UC with ASP. Electromyographic signals were acquired from m. tibialis anterior (TA), m. soleus (SO), m. gastrocnemius (GC), m. vastus lateralis (VL), m. vastus medialis (VM), m. rectus femoris (RF), m. biceps femoris (BF) and m. gluteus maximus (GM). Compared to LC, 20% UC significantly modified both the timing and the intensity of activity of the selected muscles, while muscles that cross the hip joint were the most affected (RF later onset, earlier offset, shorter range of activity and decrease in peak amplitude of 34%; BF longer range of activity; GM increase in peak amplitude of 44%). These changes in EMG patterns during 20% UC were successfully counteracted by the use of ASP and it was interesting to observe that the use of ASP during 20% UC was perceived positively by all cyclists regarding both comfort and performance. These results could have a practical relevance in terms of improving performance during UC, together with reducing discomfort. PMID:21684759

Fonda, Borut; Panjan, Andrej; Markovic, Goran; Sarabon, Nejc



Congenital fibrosis of the extraocular muscles: magnetic resonance imaging findings and surgical treatment.  


Abstract Purpose: We analyzed findings of orbital and cranial magnetic resonance imaging (MRI) in patients with congenital fibrosis of the extraocular muscles (CFEOM). We described surgery and its outcome. Material and method: Nine out of 10 patients with clinical findings of CFEOM underwent orbital and cranial MRI to perform a study of the extraocular muscles and cranial nerves. A multimodality workstation platform developed by the imaging laboratory of our hospital for PC computer allowed us to visualize and measure the cross sections of the extraocular muscles in a coronal section. Surgery was indicated to resolve strabismus. Outcome was considered favorable if the final deviation was <10?pd in the primary position without head turn. Results: In 8 cases (6 males, 5 unilateral [3 left eye]), MRI revealed atrophy of at least 1 of the extraocular muscles supplied by the third nerve. Five patients had third nerve aplasia or hypoplasia. Clinical findings were compatible with a probable diagnosis of CFEOM in all 10 patients. Four patients underwent ptosis surgery before being diagnosed with CFEOM. Four patients underwent surgery to correct strabismus and, of these, 2 required multiple interventions (1 needed 4 interventions). Outcome was successful in only 2 cases. Conclusion: Orbital and cranial MRI provided useful information about extraocular muscles and cranial nerves in CFEOM. Surgery must be performed on an individual basis; the number of reoperations is high. The outcome of surgery was favorable in half of the cases. PMID:23978146

Merino, Pilar; Gómez de Liaño, Pilar; Fukumitsu, Hideki; Franco, Gema; Ruiz, Yolanda



Hyperinnervation of Skeletal Muscle Fibers: Dependence on Muscle Activity  

Microsoft Academic Search

After the motor nerve to the rat soleus muscle was blocked reversibly by local anesthesia, individual muscle fibers became innervated by a transplanted motor nerve without losing their original innervation. Such cross-innervation of the denervated soleus muscle by the same foreign nerve was largely reduced by direct electrical stimulation of the muscle. The results demonstrate the importance of muscle activity

Jan K. S. Jansen; Terje Lmo; Kare Nicolaysen; Rolf H. Westgaard



Postmastectomy reconstruction: comparative analysis of the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous flap versus breast implant reconstruction.  


Over 40,000 postmastectomy breast reconstructions are performed annually. In this study, we investigated the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous (TRAM) flap versus breast implant reconstruction. Thirty-three women who had undergone postmastectomy breast reconstruction were contacted by telephone and agreed to participate in the study. Twenty-two women completed the self-assessment questionnaires regarding their quality of life, psychological symptoms, functional status, body image, and global satisfaction. The TRAM and implant groups contained 8 and 14 patients, respectively. The groups were well matched for age, employment status, marital status, race, religion, and severity of medical and surgical illnesses. The average follow-up was 36 months. Statistical analysis of the responses revealed that women who had undergone TRAM flap reconstruction were more satisfied with how their reconstructed breast felt to the touch (p = .01), and there was a trend toward greater satisfaction with the appearance of their reconstructed breast (p = .08). However, these same patients identified more difficulties as far as functioning at work or school, performing vigorous physical activities, participating in community or religious activities, visiting with relatives, and interacting with male friends (p < .04). There were no statistically significant differences in body image or overall satisfaction. In this small cohort study, both the TRAM flap group and the implant group were satisfied with the results of their breast reconstruction, but the TRAM flap group was more satisfied with how their breast felt and tended to be more satisfied with the cosmetic result. The TRAM flap group reported greater psychological, social, and physical impairments as a result of their reconstruction. PMID:8579262

Cederna, P S; Yates, W R; Chang, P; Cram, A E; Ricciardelli, E J



Endoscopic Surgery: Ideal for Endocrine Surgery?  

Microsoft Academic Search

.   The laparoscopic approach of endocrine tumors is recent, the first reported resection of an adrenal gland in 1992. It represents\\u000a a revolution in endocrine surgery equivalent to that observed in general surgery after the first cholecystectomy was performed\\u000a in 1987. This new approach needs evaluation in terms of feasibility, indications, safety, and surgical procedure to define\\u000a its potential advantages.

Jacques Marescaux; Didier Mutter; Michel Vix; Joel Leroy



Muscle pain prophylaxis  

Microsoft Academic Search

Most individuals experience muscle soreness one or two days following novel physical activity such as the first down-hill,\\u000a snow skiing trip of the season. This arises from forced lengthening of skeletal muscles fibers while they are active, for\\u000a example, as the skier absorbs the shock of each mogul she\\/he encounters. Some muscle fibers are injured, force is reduced\\u000a and an

Gary A. Dudley



Skeletal muscle stem cells  

PubMed Central

Satellite cells are myogenic stem cells responsible for the post-natal growth, repair and maintenance of skeletal muscle. This review focuses on the basic biology of the satellite cell with emphasis on its role in muscle repair and parallels between embryonic myogenesis and muscle regeneration. Recent advances have altered the long-standing view of the satellite cell as a committed myogenic stem cell derived directly from the fetal myoblast. The experimental basis for this evolving perspective will be highlighted as will the relationship between the satellite cell and other newly discovered muscle stem cell populations. Finally, advances and prospects for cell-based therapies for muscular dystrophies will be addressed.

Chen, Jennifer CJ; Goldhamer, David J



Muscles And Motion  

NSDL National Science Digital Library

The following resource is fromLessonopoly, which has created student activities and lesson plans to support the video series, Science of the Olympic Winter Games, created by NBC Learn and the National Science Foundation. Featuring exclusive footage from NBC Sports and contributions from Olympic athletes and NSF scientists, the series will help teach your students valuable scientific concepts. In this particular lesson, students will learn several important characteristics about muscles and how muscles and bones work together to produce motion. Students will learn about the role of practice in strengthening muscles and muscle memory.