Purpose: To evaluate the minimally invasive strabismus surgery (MISS) technique in combined unilateral horizontal rectus muscle operations for esotropia. Methods: This study included 61 patients operated by one surgeon with MISS medial rectus muscle recession and lateral rectus muscle plication. Alignment, binocular vision, conjunctival injection and swelling as well as complications during the first 6 postoperative months were recorded prospectively.
Niccolò Pellanda; Daniel S. Mojon
Purpose To evaluate the effect of transposition procedures on the vertical rectus muscle (VRM) in the patients who underwent a medial rectus muscle (MR) transection after endoscopic sinus surgery (ESS). Methods In 4 patients with exotropia (XT) and a lack of adduction after ESS, orbital CT or MRI revealed a complete transection of the midportion of the MR. Full-tendon VRM transposition was performed within 3 months after injury (early surgery) in 2 patients with 40? XT. Two patients with 70? and 85? XT underwent an X-type augmented Hümmelsheim procedure, which involved pulling each half-tendon and crossing it through the undersurface of the severed MR to the other end of the MR insertion, concurrently with an ipsilateral lateral rectus (LR) recession 11 months and 36 months after ESS, respectively. The adduction deficits were divided into -1 through to -8. The patients were followed up for more than than 1.5 years. Results Postoperatively, 3 patients showed orthophoria and no diplopia in the primary position. The adduction deficits improved to -3.5 or -4. One patient who underwent an X-type augmented Hümmelsheim procedure showed a residual XT of 25?. Conclusions VRM transposition is effective in correcting a large XT secondary to a MR transection after ESS. When a longstanding large-angle XT with severe contracture of the ipsilateral LR and massive scarring of the adjacent tissues is present, the X-type augmented Hümmelsheim procedure coupled with an ipsilateral LR recession had an augmenting effect. PMID:18612228
Cho, Yoonae A.; Rah, Sang Hoon; Kim, Myung Mi
The possibility of heart surgery and vascular surgery and the increased number of dialyzed patients receiving dicourmarin and heparin treatment raises the question of the probable rupture of the abdominal muscles, in particular the rectus muscles, following the onset of lancing abdominal pain. The authors report a clinical case referred to them in emergency conditions. They examine the possible etiopathogenetic causes and underline the symptoms of acute abdomen in patients being treated with anti-coagulating drugs. PMID:8121595
Vadalà, G; Cardì, F; Fisicaro, E; De Luca, A; Mangiameli, A
Complete paralysis of the oculomotor nerve results in the lateral rectus and superior oblique muscles acting unopposed and the eye being fixed in an abducted, slightly depressed and intorted position. The goal of strabismus surgery in such cases is to achieve an acceptable alignment in primary position. Simple recession-resection procedures may not yield acceptable results, and numerous other procedures have been attempted, with limited success. We report the outcome of nasal transposition of two halves of the lateral rectus muscle combined with medial rectus surgery in 3 cases of total oculomotor nerve palsy. PMID:25173905
Sukhija, Jaspreet; Kaur, Savleen; Singh, Usha
Rectus femoris transfer is frequently performed to treat stiff-knee gait in subjects with cerebral palsy. In this surgery, the distal tendon is released from the patella and re-attached to one of several sites, such as the sartorius or the iliotibial band. Surgical outcomes vary, and the mechanisms by which the surgery improves knee motion are unclear. The purpose of this study was to clarify the mechanism by which the transferred muscle improves knee flexion by examining three types of transfers. Muscle-actuated dynamic simulations were created of ten children diagnosed with cerebral palsy and stiff-knee gait. These simulations were altered to represent surgical transfers of the rectus femoris to the sartorius and the iliotibial band. Rectus femoris transfers in which the muscle remained attached to the underlying vasti through scar tissue were also simulated by reducing but not eliminating the muscle’s knee extension moment. Simulated transfer to the sartorius, which converted the rectus femoris’ knee extension moment to a flexion moment, produced 32° ± 8° improvement in peak knee flexion on average. Simulated transfer to the iliotibial band, which completely eliminated the muscle’s knee extension moment, predicted only slightly less improvement in peak knee flexion (28° ± 8°). Scarred transfer simulations, which reduced the muscle’s knee extension moment, predicted significantly less (p < 0.001) improvement in peak knee flexion (14° ± 5°). Simulations revealed that improved knee flexion following rectus femoris transfer is achieved primarily by reduction of the muscle’s knee extension moment. Reduction of scarring of the rectus femoris to underlying muscles has the potential to enhance knee flexion. PMID:19217109
Fox, Melanie D.; Reinbolt, Jeffrey A.; Õunpuu, Sylvia; Delp, Scott L.
Resultados da cirurgia de transferência do músculo reto anterior da coxa em pacientes com paralisia cerebral Análise computadorizada da marcha pré e pós-operatória * Results from transfer surgery of rectus anterior muscle of the thigh in cerebral palsy patients
Objective: To assess results of distal thigh rectus anterior muscle transfer in patients with spastic cerebral palsy. The surgery was indicated for improvement of knee flexion motion during the swing phase of the gait. Methods: A total of 58 patients were included in the study, comprising 31 males (53.4%), and 27 females (46.5%). A total number of 104 limbs were
Melanda AG; Godoy W; Lopes Jr AG; ALESSANDRO GIURIZATTO MELANDA; GARCIA LOPES JR
Prophylactic treatment with low molecular weight heparins (LMWH) is currently widely used to prevent thromboembolic events. However, such treatment is not free of risk. Among the possible complications described is rectus sheath hematoma. We report the case of a patient undergoing surgery for a hypophysial adenoma approached by the transsphenoidal route. He received LMWH prophylaxis for thromboembolism and showed a tendency to hypotension during surgery. The patient's condition deteriorated to hypovolemic shock accompanied by episodes of atrial fibrillation with rapid ventricular response. With the transfusion of medications, blood products and plasma volume expanders, the patient was stabilized and surgery was completed. A computed tomography scan then revealed a hematoma occupying the greater part of the left anterior rectus muscle. With conservative wait-and-see treatment the abdominal symptoms disappeared and the hematoma gradually receded until fully resolved. Spontaneous rectus sheath hematoma is a rare condition. Presentation is quite nonspecific and computed tomography is needed for reaching a firm diagnosis. When a hematoma is large, the initial clinical picture may include hypovolemic shock, which may develop during surgery if the hematoma is not diagnosed early. Intraoperative management will be much more difficult than it would have been if diagnosis and treatment had taken place before the operation. PMID:16281745
Vidal, M A; López-Escobar, M; Medina, C; García, R; Torres, L M
Introduction: Connective tissue pulleys serve as the functional origins of the rectus extraocular muscles (EOMs) and constrain the sideslip of the posterior EOM bellies after transposition surgery. Anterior to the pulleys, EOM paths appreciably displace to reach their transposed insertions. The inflection points in the EOM paths from minimal posterior displacement to maximal anterior displacement should define the anteroposterior location
Robert A. Clark; Arthur L. Rosenbaum; Joseph L. Demer
Orbital floor fractures and associated injuries can cause strabismus. We present the case of a 34-year-old man with incomitant strabismus following orbital reconstruction after a high-impact baseball injury. Multipositional, high-resolution magnetic resonance imaging (MRI) revealed extensive longitudinal splitting of the inferior rectus muscle by an orbital floor implant that separated its orbital and global layers. PMID:21463958
Laursen, Jessica; Demer, Joseph L.
Purpose Structural abnormalities of extraocular muscles (EOMs) or their pulleys are associated with some forms of human strabismus. This experiment was conducted to investigate whether such abnormalities are associated with artificial or naturally occurring strabismus in monkeys. Methods Binocular alignment and grating visual acuities were determined in 10 monkeys representing various species using search coil recording and direct observations. Four animals were orthotropic, two had naturally occurring “A”-pattern esotropia, two had concomitant and one had “V”-pattern esotropia artificially induced by alternating or unilateral occlusion in infancy, and one had “A”-pattern exotropia artificially induced by prism wear. After euthanasia, 16 orbits were examined by high-resolution magnetic resonance imaging (MRI) in the quasicoronal plane. Paths and sizes of horizontal rectus EOMs were analyzed quantitatively in a standardized coordinate system. Whole orbits were then serially sectioned en bloc in the quasicoronal plane, stained for connective tissue, and compared with MRI. Nerve and EOM features were analyzed quantitatively. Results Quantitative analysis of MRI revealed no significant differences in horizontal rectus EOM sizes or paths among orthotropic or naturally or artificially strabismic monkeys. Histologic examination demonstrated no differences in EOM size, structure, or innervation among the three groups, and no differences in connective tissues in the pulley system. The accessory lateral rectus (ALR) EOM was present in all specimens, but was small, inconsistently located, and sparsely innervated. Characteristics of the ALR did not correlate with strabismus. Conclusions Major structural abnormalities of horizontal rectus EOMs and associated pulleys are unrelated to natural or artificial horizontal strabismus in the monkeys studied. The ALR is unlikely to contribute to horizontal strabismus in primates. However, these findings do not exclude a possible role of pulley abnormalities in disorders such as cyclovertical strabismus. PMID:17525187
Narasimhan, Anita; Tychsen, Lawrence; Poukens, Vadims; Demer, Joseph L.
We report a case of bilateral bifid insertion of superior rectus muscles, in a patient with oculocutaneous albinism as an incidental intraoperative finding during eye muscle surgery. The muscle was successfully operated on and the patient did well postoperatively. To our knowledge, this is the first report of this anomaly. PMID:23975092
Verma, Rashmi; Hertle, Richard W
The clinical use and outcome of the rectus abdominis muscle flap to repair prepubic hernias were evaluated retrospectively. Medical records (2002–2007) of 8 dogs that had a rectus abdominis muscle flap to repair traumatic prepubic tendon rupture were reviewed. Only minor donor site complications were noted, including self-limiting ventral and hind-limb swelling. No long-term complications including recurrence of hernia were noted. The results of this study indicate that the rectus abdominis muscle flap is a clinically useful option for repairing prepubic tendon rupture in dogs. PMID:22547842
Archipow, Wendy; Lanz, Otto I.
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
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
C. Bortolotto; D. R. Coscia; G. Ferrozzi
Aim: Bio-adhesives like cyanoacrylate offer an alternative to sutures to attach tissues, including in ophthalmology. This prospective trial evaluated the suitability and bio-tolerance of iso-amyl cyanoacrylate in rectus muscle recession surgery for strabismus. Materials and Methods: We randomized one eye in each of 10 cases of bilateral horizontal rectus recessions to 6/0 polyglactin and the other to iso-amyl-cyanoacrylate. We compared time to reattachment (from disinsertion), complications and inflammatory scores (0 to +3: nil, mild, moderate and severe) on Day One, at two and at four to six weeks post surgery. Results: There were no significant group differences in inflammatory scores (Wilcoxon, all values of P>0.05). All attachments held firm. Gluing took significantly longer by 5.24±1.91 min (95% CI for difference: 3.87-6.61). There were no complications. Conclusion: We feel that although it takes marginally longer, iso-amyl cyanoacrylate offers an effective and safe alternative to sutures for muscle recession in strabismus surgery. Since it is cheaper (vs. polyglactin) and offers multi-use possibility it may also prove to be cost-effective. PMID:20689194
Darakshan, Anjum; Amitava, Abadan K
For a physiologically realistic joint range of motion and therefore range of muscle fiber lengths, only part of the whole muscle force-length curve can be used in vivo; that is, only a section of the force-length curve is expressed. Previous work has determined that the expressed section of the force-length curve for individual muscles can vary between subjects; however, the degree of intersubject variability is different for different muscles. This study determined the expressed section of both the rectus femoris and gastrocnemius--muscles with very different ratios of tendon slack length to muscle fiber optimum length--for 28 nonspecifically trained subjects to test the hypothesis that the value of this ratio affects the amount of variability in the expressed section. The force-length curves of the two muscles were reconstructed from moment-angle data using the method of Herzog & ter Keurs (1988). There was no relationship between the expressed sections of the force-length curve for the two muscles. Less variability was found in the expressed section of the gastrocnemius compared with the rectus femoris, supporting the hypothesis. The lack of relationship between the expressed sections of the two muscles has implications for motor control and for training muscle for rehabilitation. PMID:20147757
Winter, Samantha L; Challis, John H
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
The desmoid tumour (DT) is a quite rare soft tissues neoplasm that lacks metastatic potential. Though it is characterized\\u000a by a local infiltrating growth that involves frequent relapses after surgical excision. The presented case report refers to\\u000a a young female in her childbearing age, who underwent the radical excision of a large DT infiltrating the left rectus muscle\\u000a of the
F. Galeotti; E. Facci; E. Bianchini
There is no doubt that appropriate use of thrombolytic drugs improves survival in patients with acute myocardial infarction. Streptokinase, one of the most commonly used thrombolytic drugs in large clinical trials, is not fibrin-specific and brings about a lytic state with potential for bleeding. We report a case of spontaneous rectus muscle hematoma following streptokinase therapy for acute myocardial infarction and review the relevant literature. To our knowledge, this is the first case reported in the literature. PMID:12104074
Yilmaz, Mehmet Birhan; Akin, Yesim; Güray, Umit; Kisacik, Halil; Korkmaz, Sule
Purpose To determine the volume and degree of asymmetry of the rectus abdominis muscle (RA) in professional soccer players. Methods The volume of the RA was determined using magnetic resonance imaging (MRI) in 15 professional male soccer players and 6 non-active male control subjects. Results Soccer players had 26% greater RA volume than controls (P<0.05), due to hypertrophy of both the dominant (28% greater volume, P<0.05) and non-dominant (25% greater volume, P<0.01) sides, after adjusting for age, length of the RA muscle and body mass index (BMI) as covariates. Total volume of the dominant side was similar to the contralateral in soccer players (P?=?0.42) and in controls (P?=?0.75) (Dominant/non-dominant?=?0.99, in both groups). Segmental analysis showed a progressive increase in the degree of side-to-side asymmetry from the first lumbar disc to the pubic symphysis in soccer players (r?=?0.80, P<0.05) and in controls (r?=?0.75, P<0.05). The slope of the relationship was lower in soccer players, although this trend was not statistically significant (P?=?0.14). Conclusions Professional soccer is associated with marked hypertrophy of the rectus abdominis muscle, which achieves a volume that is 26% greater than in non-active controls. Soccer induces the hypertrophy of the non-dominant side in proximal regions and the dominant side in regions closer to pubic symphysis, which attenuates the pattern of asymmetry of rectus abdominis observed in non-active population. It remains to be determined whether the hypertrophy of rectus abdominis in soccer players modifies the risk of injury. PMID:21541351
Idoate, Fernando; Calbet, Jose A. L.; Izquierdo, Mikel; Sanchis-Moysi, Joaquin
Background An important variability of contractile and metabolic properties between muscles has been highlighted. In the literature, the majority of studies on beef sensorial quality concerns M. longissimus thoracis. M. rectus abdominis (RA) is easy to sample without huge carcass depreciation and may appear as an alternative to M. longissimus thoracis for fast and routine physicochemical analysis. It was considered interesting to assess the muscle fibres of M. rectus abdominis in comparison with M. longissimus thoracis (LT) and M. triceps brachii (TB) on the basis of metabolic and contractile properties, area and myosin heavy chain isoforms (MyHC) proportions. Immuno-histochemical, histochemical, histological and enzymological techniques were used. This research concerned two populations of Charolais cattle: RA was compared to TB in a population of 19 steers while RA was compared to LT in a population of 153 heifers. Results RA muscle had higher mean fibre areas (3350 ?m2 vs 2142 to 2639 ?m2) than the two other muscles. In RA muscle, the slow-oxidative fibres were the largest (3957 ?m2) and the fast-glycolytic the smallest (2868 ?m2). The reverse was observed in TB muscle (1725 and 2436 ?m2 respectively). In RA muscle, the distinction between fast-oxidative-glycolytic and fast-glycolytic fibres appeared difficult or impossible to establish, unlike in the other muscles. Consequently the classification based on ATPase and SDH activities seemed inappropriate, since the FOG fibres presented rather low SDH activity in this muscle in comparison to the other muscles of the carcass. RA muscle had a higher proportion of I fibres than TB and LT muscles, balanced by a lower proportion either of IIX fibres (in comparison to TB muscle) or of IIA fibres (in comparison to LT muscle). However, both oxidative and glycolytic enzyme activities were lower in RA than in TB muscle, although the LDH/ICDH ratio was higher in RA muscle (522 vs 340). Oxidative enzyme activities were higher in RA than in LT muscle, whereas glycolytic enzyme activity was lower. In RA muscle, contractile and metabolic properties appeared to be less well-correlated than in the two other muscles. Conclusions RA muscle has some particularities in comparison to the LT and TB muscles, especially concerning the unusual large cross-section surface of SO fibres and the very low oxidative activity of intermediate IIA fibres. PMID:20205735
Proptosis and diplopia due to enlargement of extraocular muscles represent important presenting signs of many orbital disorders. Although dysthyroid ophthalmopathy is the most common cause of enlargement of extraocular muscles, the differential diagnosis is extensive. We report a patient with a 3-month history of diplopia and unilateral proptosis and a markedly enlarged inferior rectus muscle on imaging studies. A biopsy of the lesion followed by systemic evaluation established the diagnosis of metastatic renal cell carcinoma. There are few cases of metastatic tumors to the extraocular muscles reported in the literature and thus our objective is to report a new case, review the literature and reiterate the inclusion of this disorder in the differential diagnosis of enlargement of the extraocular muscles. PMID:16936974
Gonçalves, Allan Christian Pieroni; Costa, Patrícia Grativol; Monteiro, Mario Luiz Ribeiro
The effect of a 12-week high-intensity intermittent exercise program on fiber type composition and the oxidative capacity of rectus femoris skeletal muscle from 20 male Wistar rats (Trained, n = 10; Sedentary, n = 10) was histochemically determined. The training exercise program was developed in a motorized treadmill. It consisted of four running bouts of 2 min duration at 48 m/min, alternated with recovery intervals of 4 min. Training increased relative cross-sectional area of oxidative fibers (I, IIA, IIX) and decreased the same parameter in type IIB non-oxidative fibers (P < 0.001). Our results suggest that this type of strength exercise program is enough to induce changes in muscle fiber composition. This opens a possibility to use this kind of exercise in preventing and treating muscle atrophy. PMID:11347695
Diaz-Herrera, P; García-Castellano, J M; Torres, A; Morcuende, J A; Calbet, J A; Sarrat, R
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. PMID:23094250
Kim, Jungmin; Lim, Hyoseob; Lee, Se Il
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
Because primate studies provide data for the current experimental models of the human oculomotor system, we investigated 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 rectus whole-muscle or muscle unit contraction in response to abducens whole-nerve stimulation or stimulation of single abducens motoneurons or axons. Horizontal eye displacement was recorded using a magnetic search coil. (1) Motor units could be categorized based on contraction speed (fusion frequency) and fatigue. (2) The kt value (change in motoneuronal firing necessary to increase motor unit force by 1.0 mg) of the units correlated with maximum tetanic tension. (3) There was some tendency for maximum tetanic tension of this unit population to separate into three groups. (4) At a constant frequency of 100 Hz, 95% of the motor units demonstrated significantly different force levels dependent on immediately previous stimulation history (hysteresis). (5) A mean force change of 0.32 gm/ degrees and a mean frequency change of 4.7 Hz/ degrees of eye displacement were observed in response to whole-nerve stimulation. These quantitative data provide the first contractile measures of primate extraocular motor units. Models of eye movement dynamics may need to consider the nonlinear transformations observed between stimulation rate and muscle tension as well as the probability that as few as two to three motor units can deviate the eye 1 degrees. PMID:9852598
Goldberg, S J; Meredith, M A; Shall, M S
Introduction: Bladder histology and measures of maximal bladder pressure and maximal bladder volume during urinary loss in female rats submitted to bladder reconstruction with a myoperitoneal flap of rectus abdominis muscle were studied. Materials and Methods: Fifty female adult Wistar rats were studied, separated in 5 groups: Group 1 (immediate): submitted to laparotomy, cystostomy, and cystometry; Group 2 (sham): submit-
MAURÍCIO HACHUL; ANTÔNIO MACEDO JR.; MIGUEL SROUGI
Background Coactivation may be both desirable (injury prevention) or undesirable (strength measurement). In this context, different styles of muscle strength stimulus have being investigated. In this study we evaluated the effects of verbal and visual stimulation on rectus femoris and biceps femoris muscles contraction during isometric and concentric. Methods We investigated 13 men (age =23.1?±?3.8 years old; body mass =75.6?±?9.1 kg; height =1.8?±?0.07 m). We used the isokinetic dynamometer BIODEX device and an electromyographic (EMG) system. We evaluated the maximum isometric and isokinetic knee extension and flexion at 60°/s. The following conditions were evaluated: without visual nor verbal command (control); verbal command; visual command and; verbal and visual command. In relation to the concentric contraction, the volunteers performed five reciprocal and continuous contractions at 60°/s. With respect to isometric contractions it was made three contractions of five seconds for flexion and extension in a period of one minute. Results We found that the peak torque during isometric flexion was higher in the subjects in the VVC condition (p?>?0.05). In relation to muscle coactivation, the subjects presented higher values at the control condition (p?>?0.05). Conclusion We suggest that this type of stimulus is effective for the lower limbs. PMID:24099489
Background: Recurrent rectus diastasis is a troublesome complication because its correction requires an extensive procedure. Case Reports: Two patients with recurrent rectus diastasis secondary to abdominoplasty corrected by plication of the anterior rectus sheath are presented. These patients had lateral insertion of the rectus muscles. They were treated by the advancement of the rectus muscles after undermining of the posterior
Fabio Xerfan Nahas; Lydia Masako Ferreira; José de Arimatéia Mendes
. 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
The mechanical properties of two extraocular muscles (superior oblique and superior rectus muscles) of the frog were studied and compared with those of a frog's skeletal muscle (iliofibularis muscle) which contains the same types of muscle fibres as the oculorotatory muscles. The extraocular muscles are very fast twitching muscles. They exhibit a smaller contraction time, a smaller half-relaxation time, a higher fusion frequency, and a lower twitch-tetanus ratio than the skeletal muscles. The maximum isometric tetanic tension produced per unit cross-sectional area is lower in the extraocular muscles than in skeletal muscles. However, the extraocular muscles show a higher fatigue resistance than the skeletal muscles. With respect to the dynamic properties there are some differences between the various oculorotatory muscles of the frog. The superior rectus muscle exhibits a faster time-course of the contraction, a higher fusion frequency, and a higher fatigability than the superior oblique muscle. An increase of the extracellular K+-concentration evokes sustained contractures not only in the extraocular muscles but also in the iliofibularis muscle; between these muscles there are no striking differences in the mechanical threshold of the whole muscle preparation. The mechanical threshold depends on the Ca++-concentration of the bathing solution and it is found in a range between 12.5 and 17.5 mM K+ in a normal Ringer solution containing 1.8 mM Ca++. The static-mechanical properties of the extraocular muscles of the frog and the dependence of the active developed tension on the muscle extension are very similar to those which are known to exist in the extraocular muscles of other vertebrates. In tetanic activated frog's oculorotatory muscles a linear relationship exists between length and tension. A variation of the stimulation frequency does not change the slope of this curve but causes parallel shifts of the curve. The peculiar properties of the extraocular muscles of the frog are discussed with respect to the muscle fibre types in these muscles and to the diameter of the muscle fibres. PMID:309253
is one of the most common gait abnormalities in ambulatory children with cerebral palsy . Stiff knee with cerebral palsy following a variety of surgical treatments. Goldberg et al.  used statistical analysis Keywords: Predicting outcomes Rectus femoris transfer Stiff knee gait Cerebral palsy Gait analysis A B
Enthesitis of the direct tendon of the rectus femoris muscle is a rare pathology which mainly affects professional athletes, and it is caused by overuse and repetitive microtrauma. Athletic jumping and kicking exert a great stress on the direct tendon of the rectus femoris muscle, and volleyball and football players are therefore most frequently affected. Enthesitis may occur suddenly causing pain and functional impairment possibly associated with partial or complete tendon injuries, or it may be a chronic condition causing non-specific clinical symptoms. We present the case of a professional volleyball player who felt a sudden pain in the left side of the groin area during a training session although she had suffered no accidental injury. The pain was associated with impaired ipsilateral limb function. Tendon rupture was suspected, and magnetic resonance imaging (MRI) was performed. MRI showed a lesion at the myotendinous junction associated with marked inhomogeneity of the direct tendon. Ultrasound (US) examination confirmed the presence of both lesions and allowed a more detailed study of the pathology. This is a typical case of enthesitis which confirms that MRI should be considered the examination of choice in hip pain, particularly when the patient is a professional athlete, thanks to its panoramic visualization. However, also US is an ideal imaging technique for evaluating tendon injuries thanks to its high spatial resolution, and it can therefore be used effectively as a second line of investigation. PMID:23396666
Bortolotto, C.; Coscia, D.R.; Ferrozzi, G.
Enthesitis of the direct tendon of the rectus femoris muscle is a rare pathology which mainly affects professional athletes, and it is caused by overuse and repetitive microtrauma. Athletic jumping and kicking exert a great stress on the direct tendon of the rectus femoris muscle, and volleyball and football players are therefore most frequently affected. Enthesitis may occur suddenly causing pain and functional impairment possibly associated with partial or complete tendon injuries, or it may be a chronic condition causing non-specific clinical symptoms.We present the case of a professional volleyball player who felt a sudden pain in the left side of the groin area during a training session although she had suffered no accidental injury. The pain was associated with impaired ipsilateral limb function. Tendon rupture was suspected, and magnetic resonance imaging (MRI) was performed. MRI showed a lesion at the myotendinous junction associated with marked inhomogeneity of the direct tendon. Ultrasound (US) examination confirmed the presence of both lesions and allowed a more detailed study of the pathology.This is a typical case of enthesitis which confirms that MRI should be considered the examination of choice in hip pain, particularly when the patient is a professional athlete, thanks to its panoramic visualization. However, also US is an ideal imaging technique for evaluating tendon injuries thanks to its high spatial resolution, and it can therefore be used effectively as a second line of investigation. PMID:23396666
Bortolotto, C; Coscia, D R; Ferrozzi, G
Lamellar bone formation in an abnormal location is defined as heterotopic ossification. It commonly occurs around the hip joint and most often involves the abductor muscles. It is a benign condition; however, its etiology remains largely unknown. Most previously reported cases have been due to trauma or intramuscular hemorrhage. In this paper, we present a case of bilateral heterotopic ossification of the reflected head of rectus femoris muscle without antecedent trauma or any other known cause, as the first and unique case in the literature. She was treated by excision of the right symptomatic bony mass via a modified Smith-Petersen approach. Postoperatively, she received 75?mg indomethacin daily for six weeks. She was pain-free and obtained full range of motion 3 weeks after the first intervention. PMID:24804132
Tonbul, Murat; Ozen, Seyma; Tonbul, Ayse Tuba
A neuromuscular hamartoma is a rare benign tumour that is most frequently associated with peripheral nerves. The authors present a case of a 61 year-old man with bilateral exophthalmos and lid retraction who developed further proptosis and chemosis in the left eye over a five month period. An initial diagnosis of thyroid orbitopathy was made and he had a limited response to two courses of oral steroid administered in another centre. He was subsequently referred to our institution for further management when his condition worsened following withdrawal of treatment. Orbital CT scan showed a thickening of the recti muscles and particularly the left superior rectus and overlying soft tissue. Given this unusual pattern of muscle involvement in thyroid orbitopathy, a muscle biopsy was performed. This showed the presence of a neuromuscular hamartoma without malignant features. The orbital fat biopsy showed no pathological findings. A neuromuscular hamartoma not associated with a peripheral nerve is a rare entity, especially when coupled with an extraocular muscle. We wish to highlight the importance of a muscle biopsy when faced with a clinical picture and radiological pattern of extraocular muscle enlargement not typical of what we know to occur traditionally in thyroid eye disease. PMID:20497087
Cunniffe, Geraldine; Fernández, Javier; Alonso, Tirso; Balaguer, Oscar; Dinares, C; Huguet, Pere; Medel, Ramón
Two adult rhesus monkeys that had undergone 2 years of electrode penetrations into their abducens and vestibular nuclei, for chronic eye movement studies, were examined histologically. An analysis of their VIth nucleus neurons and lateral rectus muscles revealed the following. Twenty-two percent of the large neurons (?30 µm in diameter), on average, were missing and extensive neuropil disruption and gliosis was evident
J. R. McClung; K. E. Cullen; M. S. Shall; D. M. Dimitrova; S. J. Goldberg
as to different surgical procedures (CuÂ¨ppers' Fadenoperation, Y-split muscle recessions, botuli- num toxin: unilateral or bilateral muscle recessions, with or without muscle resec- tion1Â4 ; ``CuÂ¨ppers' Fadenoperation
COPYRIGHT Â© 2004 BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED 348 Three subjects after bilateral rectus femoris tendon transfer. A three-dimensional computer model adequate foot clearance. During the rectus femoris tendon transfer, the rectus femoris tendon is separated
The objective of this work was to study through in the electromyography the upper and lower umbilical rectus abdominis and the anterior and posterior parts of the external oblique muscles of children 8 to 10 years old. The children studied practice artistic and rhythmical gymnastic sports at the training and learning level and the study was made during abdominal exercise in the dorsal decubitus position on the ground and on a board. The children were divided into 2 groups: Group I - ten already trained children; Group II - nineteen learners. The participants in Group I practiced an average of 5 times a week and those in Group II practiced 2 times a week. The exercises analyzed were: on the ground, lifting the legs 30, 20 and 10 cm high with the knees flexed 90 degrees; flexing the trunk while maintaining the legs elevated and the knees flexed; flexing the trunk with homo and heterolateral rotation of the trunk while maintaining the legs elevated and the knees flexed. On the board, flexing the trunk with the knees flexed 90 degrees on top of the board inclined 30, 20 and 10 cm; flexing the trunk with rotation of the trunk homo and heterolateral with the knees flexed on the board inclined 30, 20 and 10 cm. The results showed that the superior umbilical part of the rectus abdominis muscle presented more intense action potential than the inferior-umbilical part; the more intense action potential occurred at the flexing of the trunk and at the flexing of the trunk with homo and heterolateral rotation. The anterior part of the external oblique muscle presented more intense action potential than the posterior part; the more intense action potential occurred at the flexing of the trunk and at the flexing of the trunk with heterolateral rotation. In both of the muscles the more intense action potential occurred between 45 and 60 degrees of flexing the trunk; the children in Group I presented more intense action potential than those in Group II; the exercise of lifting the flexed legs did not prove efficient for strengthening the analyzed abdominal muscle structure. PMID:8549433
Moraes, A C; Bankoff, A D; Pellegrinotti, L L; Moreira, Z W; Galdi, E H
Purpose L-glutamine is the most abundant amino acid found in human muscle and plays an important role in protein synthesis and can reduce the levels of inflammation biomarkers and creatine kinase (CK) after training sessions. Delayed onset muscle soreness (DOMS) develops after intense exercise and is associated with an inflammatory response. The purpose of this study was to investigate the effect of glutamine supplementation on surface electromyography activity of the vastus medialis muscle (VMM) and rectus femoris muscle (RFM) and levels of creatine kinase after an eccentric contraction. Methods Seventeen healthy men (age: 22.35±2.27yr; body mass: 69.91± 9.78kg; height: 177.08±4.32cm) were randomly assigned to experimental (n=9) and control groups (n=8) in a double-blind manner. In both groups, subjects were given L-glutamine supplementation (0.1g.kg-1) or placebo three times a week for 4 weeks. Median frequency (MDF) and mean power frequency (MPF) for VMM and RFM muscles and also CK measurements were performed before, 24h and 48 h after a resistance training session. The resistance training included 6 sets of eccentric leg extensions to exhaustion with 75% of 1RM. Results There was no significant difference between groups for MDF or MPF in VMM and RFM. The difference of CK level between the groups was also not significant. Conclusion The results of this study indicate that glutamine supplementation has no positive effect on muscle injury markers after a resistance training session. PMID:24868432
Rahmani-Nia, Farhad; Farzaneh, Esmail; Damirchi, Arsalan; Majlan, Ali Shamsi; Tadibi, Vahid
muscles, and provides an alternative to ``CuÂ¨ppers Fadenoperation,'' recession, and similar procedures. I for the treatment of variable angle strabismus is the so called ``Fadenoperation'' by CuÂ¨ppers, also referred strabismus. The CuÂ¨ppers technique leads to a reduction of muscle torque, and has been used clinically
Purpose To compare the organization of human and rat ocular medial recti muscles (MR).\\u000a \\u000a \\u000a \\u000a Methods The cryosections of human and rat MR were processed for myofibrillar ATPase (mATPase), succinate dehydrogenase and glycerol-3-phosphate\\u000a dehydrogenase. To reveal myosin heavy chain (MyHC) isoforms, specific monoclonal antibodies against MyHC-1\\/?- slow, ?-cardiac\\u000a (-?), -2a, -2x, -2b, -extraocular (eom), -embryonic (-emb) and -neonatal (-neo) were applied. The MyHC
Branka Stirn Kranjc; Vika Smerdu; Ida Eržen
Nylon and polydioxanone are two sutures commonly used to correct rectus diastasis. Polydioxanone, as an absorbable suture, has the advantage of not being palpable in thin patients. Because several forces act against the plication, an absorbable suture would not be efficient in these cases. In this study, two groups of 10 patients each were studied. These patients underwent abdominoplasty and correction of rectus diastasis. In the control group, 2-0 nylon was used to plicate the anterior aponeurosis and 0-polydioxanone was used in the experimental group. The tension of the abdominal wall was measured with a dynamometer in both groups. The width of rectus diastasis was measured 3 cm above and 2 cm below the umbilicus, using a computed tomography (CT) scan before the operation and 3 weeks and 6 months after surgery. The width of rectus diastasis was measured intraoperatively at the same levels. The data were analyzed by Student's t test. Both groups had similar abdominal wall tension on both levels. The diastasis recti was completely corrected at both levels, as confirmed by the 3-week postoperative CT scan and the 6-month CT scan. At the superior level, the width of the rectus diastasis on the preoperative CT scan (2.6 +/- 0.7 cm) was similar to the values obtained intraoperatively (2.7 +/- 0.6 cm), showing no significant statistical difference. At the inferior level, the largest difference between the preoperative CT scan and the intraoperative finding was 0.3 cm. In conclusion, the correction of rectus diastasis with 2-0 nylon and 0-polydioxanone was achieved and maintained after 6 months. CT scans are an accurate method for studying rectus diastasis and other muscles of the abdominal wall. PMID:11304594
Nahas, F X; Augusto, S M; Ghelfond, C
ELECTROMYOGRAPHIC STUDY OF THE Rectus femoris AND Biceps femoris (LONG HEAD) MUSCLES DURING BILATERAL ISOTONIC CONTRACTION IN A 45 o LEG PRESS APPARATUS ESTUDO ELETROMIOGRÁFICO DOS MÚSCULOS Rectus femoris E Biceps femoris (CABEÇA LONGA) DURANTE CONTRAÇÃO ISOTÔNICA NO APARELHO LEG PRESS 45º
The aim of this study was to compare the bilateral electric activity of the rectus femoris (RF) and biceps femoris long head (BF) muscles during flexion and extension isotonic movements of the thigh and leg. Six men and six women accomplished all movements in 45° Leg Press apparatus with 30% and 60% of the maximum voluntary load (MVL). Electromyographic signs
BERNARDINO JÚNIOR; Daniela Cristina de Oliveira; Eduardo Gaspareto; Alexandre GONÇALVES; Guilherme Gulart; Lázaro Antônio
The retroperitoneum is rich in vascular structures and can harbor large hematomas, traumatic or spontaneous. The management of retroperitoneal hematomas depends on the mechanism of injury and whether they are pulsatile/expanding. Rectus sheath hematomas are uncommon abdominal wall hematomas secondary to trauma to the epigastric arteries of the rectus muscle. The common risk factors include anticoagulation, strenuous exercise, coughing, coagulation disorders, and invasive procedures on/through the abdominal wall. The management is largely supportive, with the reversal of anticoagulation and transfusions; angioembolization may be necessary. PMID:24267499
Highly myopic strabismus, also known as 'heavy eye syndrome' or 'myopic strabismus fixus', is an acquired restrictive strabismus occurred in patients with pathologic myopia. Patients often manifest extreme esotropia, hypotropia and restrictive ocular motility.Recession of medial rectus and resection of lateral rectus, even dis-insertion of medial rectus surgery often have limited effect in the severe high myopia strabismus, and susceptible to recur postoperatively.In the European strabismus meeting of 2001, Yokoyama first proposed a new surgical idea, he suggested to union the lateral rectus and superior rectus together, and use it as a muscle pulley to push the herniated eyeball back into the muscle cone. After that, a series of studies focused on the specific surgical operation methods. The objective of this article is to review recent research progress of highly myopic strabismus surgery, in order to give some recommendations for the improvement of surgical treatment. PMID:25312465
Wei, Yan; Kang, Xiaoli
Introduction Rectus sheath hematoma is an uncommon cause of acute abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. It could occur spontaneously or after trauma. They are usually located infraumblically and often misdiagnosed as acute abdomen, inflammatory diseases or tumours of the abdomen. Case presentation We reported three cases of rectus sheath hematoma presenting with a mass in the abdomen and diagnosed by computerized tomography. The patients recovered uneventfully after bed rest, intravenous fluid replacement, blood transfusion and analgesic treatment. Conclusion Rectus sheath hematoma is a rarely seen pathology often misdiagnosed as acute abdomen that may lead to unnecessary laparotomies. Computerized tomography must be chosen for definitive diagnosis since ultrasonography is subject to error due to misinterpretation of the images. Main therapy is conservative management. PMID:18221529
Kapan, Selin; Turhan, Ahmet N; Alis, Halil; Kalayci, Mustafa U; Hatipoglu, Sinan; Yigitbas, Hakan; Aygun, Ersan
Seventeen patients were submitted to delayed unilateral breast reconstruction using pedicled, muscle-sparing turbocharged transverse rectus abdominis myocutaneous flap based on the contralateral perforator vessels. The lateral portion of the rectus abdominis muscle on the pedicled side was preserved in 12 patients. Zones II and IV were included in the flap in all cases. Mean duration of surgery was 7 hours and 15 minutes. Four complications developed in the abdominal donor site: contralateral abdominal bulging (n = 1), minor suture dehiscence (n = 2), and epidermolysis at the border of the abdominal flap and umbilical scar (n = 1). Three partial losses (10%-30%) occurred in the reconstructed breast (17.64% of cases), whereas 2 cases of fat necrosis were associated with partial losses. One patient developed deep vein thrombosis with pulmonary embolism; however, outcome was favorable. This proved a viable alternative for breast reconstruction, with satisfactory results in most patients and acceptable morbidity and surgical time. PMID:24625511
Sbalchiero, Juliano Carlos; de Albuquerque Leal, Paulo Roberto; Dos Santos, César Cabello
Microvascular free muscle transfer utilizing the rectus abdominis muscle, in combination with a mesh skin graft and transarticular external fixator, were used following the surgical excision of an elbow hygroma in a Newfoundland dog. Postoperatively, the dog did well with minimal complications and has yet to have a recurrence 10 months following surgery. This report describes the utility and successful use of the rectus abdominis free tissue transfer in the surgical correction of a difficult elbow hygroma in the dog. PMID:18593859
Green, Michael L; Miller, Jonathan M; Lanz, Otto I
Objective. The purpose of this study was to review the normal and sonographic (US) anatomy of the central aponeurosis of the rectus femoris muscle, describe the sonographic appearance of its tears and correlate it with the MR findings. Design and patients. The rectus femoris internal architecture was evaluated by cadaveric dissection. To correlate the sonographic normal findings with cadaveric data,
Stefano Bianchi; Carlo Martinoli; Nyali Peiris Waser; Maria Pia Bianchi-Zamorani; Egisto Federici; Jean Fasel
Summary Breast reconstruction with autogenous tissue is indicated after rejection of a silicone implant, large tissue defects and irradiation damage of the chest wall, and when the patient desires a long-term result free of problems. Two breast-reconstruction techniques are shown using abdominal skin and adipose tissue pedicled on a rectal muscle: (I) breast reconstruction with the vertical rectus abdominis flap
W. Mühlbauer; P. Ramatschi
Because of the lack of agreement on when rectus diastasis (RD) is pathologic, the aim was to investigate indications for surgical repair. This study presents classifications of RD, current knowledge on the relation to pregnancy, and conservative and surgical management. A systematic search in Pubmed, Embase, Cochrane, and Cinahl revealed 437 studies. Inclusion criteria were applied according to the above mentioned subjects of interest. In total 28 studies were included, representing 3725 patients, 11 of these by assessing reference lists of included studies. Only one RCT was found; most studies were case-series lacking statistical analysis. RD was common in post-partum women. Antepartum activity level may have a protective effect on RD and exercise may improve post-partum symptoms of RD. Repair was done during abdominoplasty or laparoscopically. The patient-satisfaction was high and long-term recurrence was reported by one study, while five reported no recurrence. Overall major complications were few, while minor complications were primarily seroma and wound complications. RD is by itself not a true hernia and, therefore, not associated with the risk of strangulation. Repair is mostly done due to cosmetic reasons. The condition does not necessarily require repair, and conservative management may be an alternative. If done, the protrusion of the abdomen, rather than the diastasis itself should influence the decision of repair. It is recommended that future studies use the established classifications (e.g. Beer, Rath, or Nahas) when reporting RD and long-term outcome of treatment. Comparison of surgical techniques and studies that address and compare conservative management with surgery are needed. PMID:24256310
Akram, Javed; Matzen, Steen Henrik
Cosmetic blepharoplasty is the most often performed procedure in plastic surgery and ophthalmic plastic surgery. Many complications have been reported including ectropion, exposure keratitis, hemorrhage, epiphora, infection, vision loss, and, very rarely, diplopia. Although uncommon, there have been several case reports and case series published evaluating possible causes of this problem, including aggressive excision of fat, wound-related inflammation, conjunctival edema, and temporary muscle disturbances. Although the inferior oblique muscle is most susceptible to injury, the inferior rectus and superior oblique muscles are also subject to trauma. When performing cosmetic blepharoplasties, surgeons should be cautious when dissecting fat pads and should do so under direct visualization. Meticulous cautery is also important to avoiding injury to the extraocular muscles. Fresnel prisms and Bangerter filters can be used to help alleviate diplopia in patients with small-angle strabismus. Surgical exploration and extraocular muscle surgery may be indicated in patients with diplopia that cannot be resolved with nonsurgical treatment. PMID:23002470
Iliopsoas bursitis is the classical manifestation of synovial cysts of the hip. We report the first observation of a new localization of these cysts: the sheath of rectus femoris muscle. The patient presented with a hip osteoarthritis and an important mass of the front of the thigh. Computed tomography was useful in establishing the diagnosis and hip arthrography confirmed the communication between the joint and the rectus femoris sheath. PMID:2625690
Fritz, P; Mariette, X; Clerc, D; Glon, Y; Bennet, P; Bisson, M
Background: Many multimodal analgesia techniques have been tried to provide adequate analgesia for midline incisions extending above and below the umbilicus aiming at limiting the perioperative use of morphine thus limiting side effects. Ultrasound (US) guidance made the anesthesiologist reconsider old techniques for wider clinical use. The rectus sheath block (RSB) is a useful technique under-utilized in the adult population. Objectives: Our study examined the efficacy of a preemptive single-injection rectus sheath block in providing better early postoperative pain scores compared to general anesthesia alone. Patients and Methods: Sixty patients were recruited in this randomized controlled trial. These patients were divided into two groups: RSB group had an RSB after induction of anesthesia and before surgical incision, and GA (general anesthesia) group had general anesthesia alone. Both groups were compared for verbal analogue scale (VAS) score, opioid consumption and hemodynamic variables in the post-anesthesia care unit (PACU). Analgesic requirements in surgical wards were recorded in postoperative days (POD) 0, 1 and 2. Results: The median VAS score was significantly lower in RSB group compared with GA group in all 5 time points in the PACU (P ? 0.05). Also PACU morphine consumption was lower in RSB group than GA group patients (95% confidence interval [CI] of the difference in means between groups, ?4.59 to ?2.23 mg). Morphine consumption was also less in the first 2 postoperative days (POD0 and POD1). Conclusions: Ultrasound-guided rectus sheath block is an easy technique to learn. This technique, when it is used with general anesthesia, will be more effective in reducing pain scores and opioid consumption compared with general anesthesia alone. PMID:25289373
Bashandy, Ghada Mohammad Nabih; Elkholy, Abeer Hassan Hamed
] Durfee, W. (1992). Muscle model identification in neural prosthesis systems. In Neural Prostheses, Paul Iaizzo2, Brett Burgstahler1 , Sukruti Ponkshe1 Departments of Mechanical Engineering1 and Surgery2.rad.washington.edu/academics/academic-sections/msk/muscle-atlas Rectus Femoris FOOT PLATE REACTION BAR SUPPORT YOKE LOAD CELL SHORT DAC MCP4821 SPI BATTERY 14.4 V NIMH
Durfee, William K.
A new series of acrylic adhesive mixtures was specifically designed for use in strabismus surgery, more precisely to join the rectus muscles to the sclera. These two-part adhesives consisted of a mixture of ethyl cyanoacrylate (CN) and ethyl carboxyacrylate (ECA). ECA acted as a plasticizer imparting flexibility to the CN, and also as a nonreactive diluent, serving to reduce the
Verónica Pascual-Sánchez; María del Mar Mahíques-Bujanda; José Miguel Martín-Martínez; Jorge L. Alió-Sanz; Emilia Mulet-Homs
Dengue fever, also known as breakbone fever, is an infectious tropical disease caused by the Dengue virus. It is associated with a number of complications, which are well documented. However, Dengue fever associated with rectus sheath hematoma (RSH) is a very rare complication. Only one case report has been published prior supporting the association of Dengue fever with RSH. We report a case of Dengue fever who presented with RSH and was successfully treated conservatively. RSH is also an uncommon cause of acute abdominal pain. It is accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. PMID:25161976
Sharma, Anurag; Bhatia, Sonia; Singh, Rajendra Pratap; Malik, Gaurav
During multilevel surgery, muscle-tendon lengthening (MTL) is commonly carried out in children with cerebral palsy. However, it is unclear if MTL also modifies increased muscle tone and if pathologic activation patterns are changed as an indirect effect of the biomechanical changes. Since investigations addressing this issue are limited, this study aimed at evaluating the effects of MTL on muscle tone and activation pattern. Forty-two children with spastic diplegia who were treated by MTL underwent standardized muscle tone testing (modified Ashworth and Tardieu test), dynamic EMG and three-dimensional gait analysis before, one and three years after MTL. For the evaluation of muscle activation patterns the norm-distance of dynamic EMG data was analyzed. Range of motion and joint alignment in clinical examination were found to be significantly improved one year after MTL. However, deterioration of these parameters was noted after three years. Muscle tone was significantly reduced one year postoperatively but showed an increase after three years. Joint kinematics were found significantly closer to reference data of age matched controls initially after surgery, but deteriorated until three years postoperatively. However, the EMG patterns of the muscles which were surgically addressed were found to be unchanged in either follow-up. These findings suggest that despite the influence of MTS on biomechanics and physiology (muscle tone reduction and improvements of joint mobility and gait pattern) MTS does not change abnormal patterns of muscle activation. Recurrence of increased muscle tone and deterioration of kinematic parameters three years after surgery may be attributed to these persistent pathologic activation patterns. PMID:23228624
Dreher, T; Brunner, R; Vegvari, D; Heitzmann, D; Gantz, S; Maier, M W; Braatz, F; Wolf, S I
Abstract A number of 77 large incisional hernias located on the midline of the abdomen were operated following Rives-Stoppa procedure, in a period of five years (2006-2011), in the Surgery Clinic I of the University Hospital Bucharest. The characteristics of the study group were mean age - 62 years, predominance of females - 63 cases (82%), the rate of obesity - 26 observations (34%). Immediate postoperative morbidity was represented by (no. cases): thrombophlebitis (3), prolonged postoperative ileus (6), seroma (12) extended hematic drainage (5), hematoma (4). There were no fatalities. Late postoperative morbidity (no. cases) registered granulomas (4) and recurrence (2). We obtained good and very good results in 71 cases (92%).
Gangur?, AG; Palade, R?
Muscle strength changes following multi-level surgery in cerebral palsy and the impact of rehabilitation on functional recovery are largely unknown. The aim of this study was to quantify lower limb muscle strength changes in children with spastic diplegia after multi-level orthopaedic surgery and to compare the efficacy of progressive resistance strengthening (RS) versus active exercise (AE).Twenty children with spastic diplegia
Maria Seniorou; Nicky Thompson; Marian Harrington; Tim Theologis
A number of 77 large incisional hernias located on the midline of the abdomen were operated following Rives-Stoppa procedure, in a period of five years (2006-2011), in the Surgery Clinic I of the University Hospital Bucharest. The characteristics of the study group were mean age - 62 years, predominance of females - 63 cases (82%), the rate of obesity - 26 observations (34%). Immediate postoperative morbidity was represented by (no. cases): thrombophlebitis (3), prolonged postoperative ileus (6), seroma (12) extended hematic drainage (5), hematoma (4). There were no fatalities. Late postoperative morbidity (no. cases) registered granulomas (4) and recurrence (2). We obtained good and very good results in 71 cases (92%). PMID:25408767
Gangur?, Ag; Palade, R?
Journal of Biomechanics 41 (2008) 2362Â2369 Importance of preswing rectus femoris activity in stiff-knee May 2008 Abstract Stiff-knee gait is characterized by diminished and delayed knee flexion during swing. Rectus femoris transfer surgery, a common treatment for stiff-knee gait, is often recommended when
PURPOSE: To assess functional and anatomical outcomes after foveal translocation with 360-degree retinotomy and simultaneous torsional muscle surgery in patients with myopic neovascular maculopathy.METHODS: Foveal translocation with 360-degree retinotomy was performed in 11 eyes of 11 patients with myopic neovascular maculopathy. Ten eyes had simultaneous torsional muscle surgery with recession of the superior oblique muscle and tucking of the inferior
Takashi Fujikado; Masahito Ohji; Shunji Kusaka; Atsushi Hayashi; Motohiro Kamei; Annabelle A Okada; Koichi Oda; Yasuo Tano
Purpose: To evaluate the fate of the hamstring muscles in general and the semitendinosus muscle in particular, after anterior cruciate ligament (ACL) reconstruction with an autologous semitendinosus tendon graft from the ipsilateral side. Type of Study: Prospective consecutive case series investigation. Methods: Included were 16 consecutive patients, 14 male and 2 female, with a mean age of 26 years. The
Karl Eriksson; Per Hamberg; Eva Jansson; Hans Larsson; Adel Shalabi; Torsten Wredmark
Aims: To compare the ultrastructural aspects of human extraocular muscles in two types of mitochondrial disease: chronic progressive external ophthalmoplegia (CPEO) and Leber’s hereditary optic neuropathy (LHON).Methods: Muscle samples of the medial rectus obtained from surgery in a sporadic case of CPEO associated with deleted mitochondrial DNA, and post mortem in a case of 3460\\/ND1 LHON were processed for electron
A Carta; V Carelli; T D’Adda; F N Ross-Cisneros; A A Sadun
Introduction Muscle injuries are very common in athletes. Depending on the type of sport, muscle injuries represent approximately 9–54%\\u000a of total injuries. The rectus femoris muscle is very important in specific sports, such as soccer and American football, because\\u000a it is the muscle involved in movements, such as sprinting and kicking the ball. Therefore, we believe that these disabling\\u000a injuries need
Víctor Vaquerizo García; Daniel Casas Duhrkop; Roberto Seijas; Oscar Ares; Ramón Cugat
Up to 30% of patients relapse after orthognathic operations, and one reason might be incomplete neuromuscular adaptation of the masticatory muscles. Displacement of the mandible in sagittal or vertical directions, or both, leads to stretching or compression of these muscles. The aim of this study was to analyse stretching factors in 35 patients with retrognathism or prognathism of the mandible (Classes II and III). Tissue samples were taken from both sides of the masseter muscle (anterior and posterior) both before and 6 months after operation. Developmental myosin heavy chains MYH3 and MYH8, the fast and slow MYH 1, 2, and 7, and cyclo-oxygenase (COX) 2, forkhead transcription factor (FOX)O3a, calcineurin, and nuclear factor of activated T cells (NFAT)1c (stretching and regeneration-specific), were analysed by real time polymerase chain reaction (PCR). Correlations of Class II and III with sagittal and vertical cephalometric measurements ANB and ML-NL-angle were examined, and the results showed significant differences in amounts of MYH8 (p<0.05), MYH1 (p<0.05), and FOXO3a (p<0.05) between the 2 groups. Regeneration factor COX2 is more dominant in Class II. Surgically, bite opening (ML/NL angle) correlated with stretching indicators FOXO3a, calcineurin, and NFAT1c only in Class II patients. This means that stretching of the masseter muscle caused by lengthening of the mandible and raising of the bite in Class II patients was more likely to lead to relapse (similar to that in patients with open bite) than in Class III patients. In conclusion, deep bite should be reduced more by incisor intrusion than by skeletal opening. The focus in these patients should be directed towards physiotherapeutic strengthening of the muscles of mastication, and more consideration should be given to change in the vertical dimension. PMID:23280152
Breuel, Wiebke; Krause, Micaela; Schneider, Matthias; Harzer, Winfried
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. PMID:22688183
Chaudhuri, Zia; Demer, Joseph L.
Inappropriate activity of M. rectus femoris (RF) during swing is believed to contribute to stiff knee gait in cerebral palsy. This study used musculoskeletal modeling techniques to analyze rectus femoris musculo-tendon (MT) length and lengthening velocity during stiff knee gait in 35 children with diplegic cerebral palsy (CP). Duncan Ely test scores were used to categorize the patients into four groups with increasing levels of rectus femoris spasticity. Knee kinematics confirmed a significant reduction and delay of maximal peak knee flexion during swing in the patient groups compared to reference values. Maximal musculo-tendon length of M. rectus femoris was reduced and occurred prematurely in swing. Musculo-tendon lengthening velocity was significantly reduced and the timing of the maximal lengthening velocity was shifted into stance phase. The present study demonstrates altered dynamic behavior of the M. rectus femoris in stiff knee gait and the results indicate that maximal knee flexion in swing was not a valid reference for the MT length of the M. rectus femoris. Furthermore, in the patient group maximal musculo-tendon lengthening velocity of the muscle related to the stance phase rather than the stance-swing transition. PMID:16399519
Jonkers, Ilse; Stewart, Caroline; Desloovere, Kaat; Molenaers, Guy; Spaepen, Arthur
The purpose of this study was to examine the morphological profiles of 4 constituents (vastus lateralis, vastus medialis, vastus intermedius and rectus femoris) of the quadriceps femoris in oarsmen through comparison with non-athletes. T1-weigheted magnetic resonance (MR) images of the thigh were obtained from 14 oarsmen and 19 non-athlete men. From the MR images, serial anatomical cross-sectional areas (ACSAs) and muscle volume of each muscle were determined. The muscle volume of the total quadriceps femoris, vastus lateralis, vastus medialis and vastus intermedius were significantly larger in the oarsmen than in the non-athlete men, whereas that of the rectus femoris was comparable for the 2 groups. The portion of the rectus femoris as a percentage of total quadriceps femoris volume was significantly higher in the non-athlete men than in the oarsmen, and vice versa for the vastus lateralis. The proximal-to-distal and middle-to-distal ACSA ratios in each muscle did not differ between the 2 groups. The present results indicate inferior muscular hypertrophy of the rectus femoris compared to the vasti in oarsmen, and that the vasti are equally hypertrophied along their lengths. This may be due to muscle-specific adaptation to the rowing exercise. PMID:24022573
Ema, R; Wakahara, T; Kanehisa, H; Kawakami, Y
There are many noninfectious disorders in the critical care unit (CCU) that mimic sepsis. Pseudosepsis is the term applied to noninfectious disorders that mimic sepsis. Fever/leukocytosis is not diagnostic of infection but frequently accompanies a wide variety of noninfectious disorders. When fever/leukocytosis and hypotension are present, sepsis is the presumptive diagnosis until proven otherwise. After empiric therapy for sepsis is initiated, the clinician should rule out the noninfectious causes of pseudosepsis. The most common causes of pseudosepsis in the CCU setting are pulmonary embolism, myocardial infarction, gastrointestinal hemorrhage, overzealous diuretic therapy, acute pancreatitis, relative adrenal insufficiency, and (rarely) rectus sheath hematoma. Rectus sheath hematoma may occur secondary to trauma/anticoagulation therapy and may present as an acute surgical abdomen mimicking sepsis. Rectus sheath hematoma should be considered when other causes of pseudosepsis or sepsis fail to explain persistent hypotension unresponsive to fluids/pressors. The diagnosis of rectus sheath hematoma is by abdominal ultrasound or computed tomography scan. If the abdominal computed tomography scan is negative for other intra-abdominal pathology and other causes of pseudosepsis are eliminated, then the diagnosis of pseudosepsis caused by rectus sheath hematoma is confirmed by demonstrating a hematoma in the rectus sheath. Treatment of rectus sheath hematoma is surgical drainage and ligation of any bleeding vessels. Evacuation of the rectus sheath hematoma rapidly reverses the patient's hypotension and is curative. We describe a case of pseudosepsis caused by rectus sheath hematoma in an elderly man with hypotension unresponsive to fluids/pressors and mimicking septic shock. Clinicians should be aware that rectus sheath hematoma is a rare but important cause of pseudosepsis in patients in the CCU. PMID:17137947
Hamid, Naveed S; Spadafora, Philip F; Khalife, Michael E; Cunha, Burke A
The purpose of this study was to determine the effectiveness of muscle-release surgery for children with cerebral palsy (CP) using longitudinal and stratified analysis. Twenty-five children with CP (15 females, 10 males; age range 4 to 16 years; mean age 8 years 2 months, SD 3 years 2 months) were selected from five treatment centres in Japan. Twenty-two children had spastic diplegia, two had spastic quadriplegia, and one had athetospastic quadriplegia. Motor function for each child was assessed using the Gross Motor Function Measure (GMFM). Assessment was conducted on eight separate occasions: 1 month and 1 week before surgery, and 1, 2, 4, 6, 9, and 12 months after surgery. Participants' motor function before surgery was classified using the Gross Motor Function Classification System (GMFCS). Six children were classified at level I, three at level II, six at level III, and 10 at level IV. A significant difference was found after surgery in the GMFCS levels III and IV groups (p<0.05). Improvement in GMFM scores between 1 week before surgery and 12 months after surgery were 1, 5, 8.5, and 8.5 for GMFCS levels I to IV respectively. Results indicate that this treatment is advantageous for improving motor function in children within GMFCS levels III and IV. PMID:15287245
Kondo, Izumi; Hosokawa, Kanoko; Iwata, Manabu; Oda, Atsushi; Nomura, Tadao; Ikeda, Keiichi; Asagai, Yoshimi; Kohzaki, Tomokazu; Nishimura, Hitoshi
Knee hyperextension (genu recurvatum, GR) is often seen in children with bilateral spastic cerebral palsy (CP). Primary GR appears essential without previous treatment. As equinus deformity is suspected to be one of the main factors evoking primary GR, the purpose of this study was to determine whether lengthening the calf muscles to decrease equinus would decrease coexisting GR in children with bilateral spastic CP. In a retrospective study, 19 CP patients with primary GR (mean age: 9.4 years, 13 male, 6 female, 26 involved limbs) in whom an aponeurotic calf muscle lengthening procedure was performed during single-event multilevel surgery were included and investigated using three-dimensional gait analysis before and at a mean follow-up of 14 months after the procedure according to a standardized protocol. After calf muscle lengthening, a significant improvement in ankle dorsiflexion (9.5°) and a significant reduction (10.5°) in knee hyperextension (p<0.001) were found during mid-stance of the gait cycle. Six limbs (23%) showed no improvement concerning knee hyperextension and were designated as nonresponders. In these patients no significant improvement in ankle dorsiflexion was found after surgery either. Improvement in ankle dorsiflexion and reduction in knee hyperextension in stance phase correlated significantly (r=0.46; p=0.019). These findings indicate that equinus deformity is a Major underlying factor in Primary GR and that calf muscle lengthening can effectively reduce GR in patients with CP. PMID:24029800
Klotz, M C M; Wolf, S I; Heitzmann, D; Krautwurst, B; Braatz, F; Dreher, T
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. PMID:19011678
Mericli, Alexander F.; Moore, John H.; Copit, Steven E.; Fox, James W.; Tuma, Gary A.
A study was performed to analyze whether local denervation of the medial branch of the dorsal ramus of the lumbar spinal nerve occurs in a patient with postoperative failed-back surgery syndrome/postdiscotomy syndrome (FBSS/PDS). We investigated the effect of the loss of innervation of the multifidus muscle on neuronal nitrite oxide synthetase (n-NOS) and endothelial nitrite oxide synthetase (e-NOS) applying realtime RT-PCR and immunohistochemistry. Our study demonstrates a substantial reduction of n-NOS expression, supporting the view that local denervation of the multifidus is involved in the pathology of FBSS. No regulation of e-NOS was detectable. Interestingly, this change is region-specific and does not occur throughout the entire multifidus segment. This result supports the hypothesis that local denervation of the multifidus muscle is involved in the pathology of FBSS/ PDS. PMID:12670053
Zoidl, G; Grifka, J; Boluki, D; Willburger, R E; Zoidl, C; Krämer, J; Dermietzel, R; Faustmann, P M
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
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
Study Design Cross sectional study. Purpose To evaluate characteristics of back muscle strength in patients scheduled for lumbar fusion surgery. Overview of Literature Little is known regarding muscle strength in patients with symptomatic lumbar degenerative diseases who require fusion surgery. Methods Consecutive 354 patients scheduled for posterior lumbar interbody fusion due to symptomatic degenerative diseases were approached for participation. 316 patients were enrolled. Before surgery, muscle strength was assessed by measuring maximal isometric extension strength at seven angular positions (0°, 12°, 24°, 36°, 48°, 60°, and 72°) and mean isometric strength was calculated. The Oswestry Disability Index (0-100) and visual analogue scale (0-100) for back pain were recorded. Muscle strength was compared according to gender, age (<60, 60-70, and ?70 years) and scheduled fusion level (short, <3; long, ?3). Results Isometric strength was significantly decreased compared with previously reported results of healthy individuals, particularly at extension positions (0°-48°, p<0.05). Mean isometric strength was significantly lower in females (p<0.001) and older patients (p<0.05). Differences of isometric strength between short and long level fusion were not significantly different (p>0.05). Isometric strengths showed significant, but weak, inverse correlations with age and Oswestry Disability Index (r<0.4, p<0.05). Conclusions In patients with symptomatic lumbar degenerative diseases, back muscle strength significantly decreased, particularly at lumbar extension positions, and in females and older patients. PMID:25346820
Park, Won Hah; Lee, Chong Suh; Kang, Kyung Chung
Sensitivity of slow fibers of mixed muscles of Testudo horsfieldi and Agama caucasica to cholinomimetic drugs were investigated by the cumulative concentration -- action curve method. These muscles, like the rectus abdominis muscle of frogs, are most sens...
N. Y. Lukomskaya, E. K. Rozhkova
Although was published many cases of ectopic osteogenesis of traumatic, neurogenic cause or hereditable form, the etiology of ectopic osteogenesis remaining unknown. We present ectopic osteogenesis in the rectus abdominal sheath. The study material was represented from fragments of ectopic bones discovered in rectus sheath of four patients suffering iterative surgical abdominal interventions. The pieces of ectopic bone were decalcified and then were made to the standard techniques (paraffin inclusion, general techniques dyeing). The process of ectopic osteogenesis was analyzed through microscopically study to seriated sections of discovered piece, finding the presence of the hematopoesis foci. We conclude that is important identifying and characterizing the osteoinductor agents because these allowed the study of osteogenesis to the cellular level and make an estimation of the abnormally bone developing mechanisms. A possible osteoinductor factor has been considerate the non-absorbable wound closure material. PMID:16838064
Me?in?, C; Me?in?-Botoran, Mihaela Iustina; Dr?goi, G S; Pa?alega, M; Vîlcea, D; Vasile, I
Objective To describe the MR imaging findings of acute and chronic rectus femoris origin (RFO) injuries.Materials and methods A retrospective review of pelvic and hip MR imaging procedures was performed over a 4-year period for detection of cases with injuries to the RFO. Subjects were classified as having either acute or chronic symptoms. MR imaging studies, radiographs, CT scans, radiology reports, medical
Hugue Ouellette; Bijoy J. Thomas; Erik Nelson; Martin Torriani
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. PMID:20167096
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
Background Groin dissections result in large wounds with exposed femoral vessels requiring soft tissue coverage, and the reconstructive options are diverse. In this study we reviewed our experience with the use of the pedicled anterolateral thigh and vertical rectus abdominis musculocutaneous flaps in the reconstruction of large groin wounds. Methods Groin reconstructions performed over a period of 10 years were evaluated, with a mean follow up of two years. We included all cases with large or complex (involving perineum) defects, which were reconstructed with the pedicled anterolateral thigh musculocutaneous or the vertical rectus abdominis musculocutaneous (VRAM) flaps. Smaller wounds which were covered with skin grafts, locally based flaps and pedicled muscle flaps were excluded. Results Twenty-three reconstructions were performed for large or complex groin defects, utilising the anterolateral thigh (n=10) and the vertical rectus abdominis (n=13) pedicled musculocutaneous flaps. Femoral vein reconstruction with a prosthetic graft was required in one patient, and a combination flap (VRAM and gracilis muscle flap) was performed in another. Satisfactory coverage was achieved in all cases without major complications. No free flaps were used in our series. Conclusions The anterolateral thigh and vertical rectus abdominis pedicled musculocutaneous flaps yielded consistent results with little morbidity in the reconstruction of large and complex groin defects. A combination of flaps can be used in cases requiring extensive cover. PMID:25276649
Aslim, Edwin Jonathan; Rasheed, Mohamed Zulfikar; Lin, Fangbo; Ong, Yee-Siang
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 to receive TENS (n=23) or sham treatment (n=22) during 4 h on the third postoperative day. A 0-10 visual analogic scale was used to assess pain; lung function was evaluated by spirometry and surface electromyography (n=10 in each group) was used to quantify electrically-induced muscle activity (trapezius and pectoralis major). TENS was associated with significant reductions on spontaneous and cough-induced postoperative pain as compared to sham (P<0.05). There was also improvement in chest wall-pulmonary mechanics after TENS with proportional increases in tidal volume and vital capacity (P<0.05). In addition, electrical activity of both muscle groups was enhanced after TENS, but not post sham (P<0.05). TENS is a valuable strategy to alleviate postoperative pain following cardiac surgery with positive effects on pulmonary ventilatory function and electrical activity of thoracic and girdle muscles. PMID:18417519
Cipriano, Gerson; de Camargo Carvalho, Antonio Carlosde; Bernardelli, Graziella França; Tayar Peres, Paulo Alberto
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
values for total collagen content as well as highest percentage of soluble collagen when compared to the M. rectus femoris, M. gluteobiceps, M. semitendinosus, and M. semimembranosus (Cross et al., 1973). However, Longissimus dorsi muscles were rated....05) and (P rectus femoris were assigned the highest panel ratings for tenderness while the M. semimembranosus was assigned the lowest. The M. semitendinosus also...
Tschirhart, Tara Elizabeth
Incisional hernia development is a significant complication after laparoscopic abdominal surgery. Intra-abdominal pressure (IAP) is known to initiate the extrusion of intestines through the abdominal wall, but there is limited data on the mechanics of IAP generation and the structural properties of rectus sheath. This paper presents an explanation of the mechanics of IAP development, a study of the uniaxial and biaxial tensile properties of porcine rectus sheath, and a simple computational investigation of the tissue. Analysis using Laplace?s law showed a circumferential stress in the abdominal wall of approx. 1.1MPa due to an IAP of 11kPa, commonly seen during coughing. Uniaxial and biaxial tensile tests were conducted on samples of porcine rectus sheath to characterise the stress-stretch responses of the tissue. Under uniaxial tension, fibre direction samples failed on average at a stress of 4.5MPa at a stretch of 1.07 while cross-fibre samples failed at a stress of 1.6MPa under a stretch of 1.29. Under equi-biaxial tension, failure occurred at 1.6MPa with the fibre direction stretching to only 1.02 while the cross-fibre direction stretched to 1.13. Uniaxial and biaxial stress-stretch plots are presented allowing detailed modelling of the tissue either in silico or in a surrogate material. An FeBio computational model of the tissue is presented using a combination of an Ogden and an exponential power law model to represent the matrix and fibres respectively. The structural properties of porcine rectus sheath have been characterised and add to the small set of human data in the literature with which it may be possible to develop methods to reduce the incidence of incisional hernia development. PMID:24725440
Lyons, Mathew; Winter, Des C; Simms, Ciaran K
Individuals who have suffered cerebral insults often exhibit stiff-knee gait, a condition characterized by reduced knee flexion during swing. We investigated the effect that an increment in normal rectus femoris (RF) activity can have on hip and knee joint angles during swing, as a first step to determining this muscle's involvement in stiff-knee gait. For this, we developed a protocol
Antonio Hernández; Amy L. Lenz; Darryl G. Thelen
The asynchronous development of structural and metabolic disorders of aponeurosis, leading to the development of defects in sheath of the rectus abdominis is the major factor of hernia of linea alba formation. Development of diastasis of m. rectus abdominis is caused by primary structural and metabolic changes of myocytes caused by the extreme overload. The important factor of the operation is restoration of anatomic and physiologic parameters of the abdominal wall by bringing mm. rectus abdominis together, shortening and enforsing of aponeurosis makes it possible to distribute regularly the load on the aponeurotic sheath of musculi recti. PMID:9379607
Gireev, G I; Zagirov, U Z; Shakhnazarov, A M
We present an anatomical mapping of the most important muscles influencing the nose, incorporating constant anatomical structures, and their spatial correlations. At our disposal were the midfaces of 18 bodies of both sexes, obtained by informed consent from body donors aged between 60 and 80 years. Macroscopically, we dissected the nasal regions of eight corpses, six midfaces were prepared according to plastination histology, four by creating plastinated slices. On their way from their periosteal origin to the edge of the skin, the muscles of the nose cross the subcutaneous adipose tissue, dividing it into superficial and deep layers. The individual muscle fibers insert into the skin directly at the reticular corium. Sometimes, they reach the border of the epidermis which represents a special arrangement of corial muscle attachments. The course of the anatomical fibers of individual nasal muscles presented macroscopically and microscopically in this study offers surgeons a detailed overview of the anatomically important muscular landmarks of the midface. PMID:24863980
Konschake, Marko; Fritsch, Helga
... a symptom of a problem or improve some body function. Some surgeries are done to find a problem. For example, ... that once needed large incisions (cuts in the body) can now be done using much smaller cuts. This is called laparoscopic surgery. Surgeons insert a thin tube with a camera ...
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
The effects of neuromuscular blocking agents and anticholinesterases on the twitch and tonic neuromuscular systems of the superior rectus muscle and the twitch system of the tibialis anterior muscle were studied in pentobarbital-anesthetized cats. The twitch system is character- ized by large-diameter nerve fibers, plaque-like nerve endings, and Fibrillenstruktur muscle fibers; the tonic system by small-diameter nerve fibers, grape-like nerve
Ronald L. Katz; Kenneth E. Eakins
The aims were to assess the technical feasibility of using a single electrode in the posterior arytenoid muscles (PAM) for\\u000a intraoperative monitoring of the recurrent laryngeal nerve (RLN) in thyroid surgery, to validate the new method against the\\u000a insertion of electrodes placed in the vocal cord muscle, and to report the results of the clinical application of the new\\u000a concept.
Stephan Haerle; D. Sidler; Th. Linder; W. Mueller
Recently, there has been an increasing focus on the rapid reduction of muscles that are required for the bending of the hip joint during walking (flexor muscles around the hip joint) with age. The flexor muscles around the hip joint include femoral rectus and abdominal muscles. These muscles have been implicated in falling in the elderly. In this study, we
Hiroki Takada; Tomoki Shiozawa; Masumi Takada; Satoshi Iwase; Masaru Miyao
An Investigation into Reliability of Knee Extension Muscle Strength Measurements, and into the Relationship between Muscle Strength and Means of Independent Mobility in the Ward: Examinations of Patients Who Underwent Femoral Neck Fracture Surgery
[Purpose] The purpose of the present study was to investigate the reliability of isometric knee extension muscle strength measurement of patients who underwent femoral neck fracture surgery, as well as the relationship between independent mobility in the ward and knee muscle strength. [Subjects] The subjects were 75 patients who underwent femoral neck fracture surgery. [Methods] We used a hand-held dynamometer and a belt to measure isometric knee extension muscle strength three times, and used intraclass correlation coefficients (ICCs) to investigate the reliability of the measurements. We used a receiver operating characteristic curve to investigate the cutoff values for independent walking with walking sticks and non-independent mobility. [Results] ICCs (1, 1) were 0.9 or higher. The cutoff value for independent walking with walking sticks was 0.289 kgf/kg on the non-fractured side, 0.193 kgf/kg on the fractured side, and the average of both limbs was 0.238 kgf/kg. [Conclusion] We consider that the test-retest reliability of isometric knee extension muscle strength measurement of patients who have undergone femoral neck fracture surgery is high. We also consider that isometric knee extension muscle strength is useful for investigating means of independent mobility in the ward. PMID:24567667
Katoh, Munenori; Kaneko, Yoshihiro
As the most recognizable part of the body, the face has always interested, not only artists, but doctors as well. Each has had their own perception of facial beauty. The task for plastic and aesthetic surgery regarding the face is to reconstruct, not only traumatic lesions, but also to prevent the effects of facial tissue aging. It is also important to preserve the aesthetic values of the face in different emotional conditions. Those conditions are partially represented by mimetic or facial muscles. One might suggest that the perception of human beings portrayed by the artists could be very helpful in the realm of plastic and aesthetic surgery. Take, for example, Hans Memling, a fifteenth century Flemish artist whose masterpiece "Last Judgment" is exhibited at Gda?sk National Museum in Poland. The fortunate individuals on the left side of the painting are queuing at heaven's gate to receive their reward. Their faces are smooth with smiles, displaying blessings and happiness. The right-hand side of the painting exemplifies the expression of fear and the drama of the situation. These sinners have been damned and sentenced to hell by evil creatures. The fear, pain, and tragedy of condemnation fill their faces. For plastic and cosmetic surgeons, studying the works of great artists has not been as valuable as using the emotionless and intangible figures of an anatomy book. Undoubtedly, the only useful paintings and sculptures are those that are full of expression with the face displaying a plethora of emotions. In all surgical approaches where mimetic muscles are concerned, one has to remember and be conscious of the fact that the face is a very significant part of our body. PMID:12016503
Jankau, Jerzy; Grzybiak, Marek
Penetration of teicoplanin into serum, heart valves, and subcutaneous and muscle tissues was determined in 22 patients undergoing open-heart surgery. Each patient received 12 mg of teicoplanin per kg of body weight as a 30-min intravenous infusion preoperatively. Within 10 h, serum concentrations of teicoplanin declined from 43.1 to 2.8 microg/ml. Teicoplanin concentrations in subcutaneous tissues reached their peak of 9.2 microg/g after 2 to 3 h and decreased slowly to 2.3 microg/g after 9 to 10 h. Concentrations in muscle decreased from 8.7 microg/g to nondetectable levels. Teicoplanin concentrations in cardiac valvular tissue reached their peak of 6.1 microg/g and decreased thereafter to 1.7 microg/g. Teicoplanin concentrations in heart valves were high enough to inhibit methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococci, which are known to cause postoperative wound infections and infective endocarditis. PMID:9371368
Frank, U K; Schmidt-Eisenlohr, E; Mlangeni, D; Schindler, M; Hoh, A; Beyersdorf, F; Daschner, F D
Herein, we report a case of a 39-year-old woman with an 18-month history of peripartum cardiomyopathy. Transthoracic echocardiography revealed severe functional mitral regurgitation and a left ventricular ejection fraction of 20%. Despite optimal medical therapy, she was in New York Heart Association heart failure class IV, with dyspnea on minimal exertion. The patient underwent minimally invasive mitral valve repair with placement of a papillary muscle sling, which improved her symptoms. PMID:23422810
Benjo, Alexandre M; Macedo, Franscisco Y B; Santana, Orlando; Lamelas, Joseph
The architectural feature of the rectus femoris (RF) has been scarcely investigated despite its substantial contribution to knee extension torque and large plasticity in the muscularity. This study aimed to examine the reproducibility and validity of ultrasound measurements of RF architecture and interrelationships among the architectural parameters. After confirming the measurement accuracy of an examiner (measurement errors <1%), in vivo and cadaveric measurements of fascicle lengths and pennation angles of RF were performed. Day-to-day reproducibility of measurements was investigated in vivo including muscle thickness measurement. Validity of measurements was investigated by comparing the values between direct and ultrasound measurements for the cadaver. The intraclass correlation coefficients were 0·984, 0·960 and 0·932, and root mean square difference between measured values on 2 days was 0·8 mm, 3·1 mm and 1·4° for muscle thickness, fascicle length and pennation angle, respectively. The validity of measurements was similar or better than those of previous reports on other muscles. We also confirmed a positive correlation between the muscle thickness and the pennation angle as has been shown in other muscles. The current results warrant the use of B-mode ultrasonography for examining the architectural characteristics of RF in vivo. PMID:23692615
Ema, Ryoichi; Wakahara, Taku; Mogi, Yasuyoshi; Miyamoto, Naokazu; Komatsu, Toshihiko; Kanehisa, Hiroaki; Kawakami, Yasuo
Rectus sheath hematoma usually occurs unilateral but rare cases of bilateral hematoma have been reported. Herein we report the first case of spontaneous bilateral Rectus Sheath Hematoma in the kidney transplanted patient. PMID:24350093
Feizzadeh Kerigh, Behzad; Maddah, Ghodratolah
Spontaneous rectus sheath hematoma (SRSH) is an uncommon medical emergency in the elderly. We present a case of SRSH with an atypical clinical presentation and discuss literature regarding diagnosis and proper management. A 75-year-old female patient was transferred to the emergency department due to acute dyspnoea and confusion. Her medical history revealed a viral infection of the upper respiratory tract, and no coughing or use of anticoagulants. The clinical examination showed tenderness of the left lower abdomen, although palpation was misleading due to patient's obesity. Laboratory investigations showed light anaemia. Ultrasonography and computed tomography revealed a large rectus sheath hematoma of the left abdominal wall. Despite further deterioration of the patient, conservative management including bed rest, fluid replacement, blood products transfusion, and proper analgesia was successful. No surgical intervention was needed. Prompt diagnosis and management of SRSH plays significant role in the prognosis, especially in elder patients. Independently of size and severity, conservative management remains the first therapeutic choice. Only by failure of supportive management, progressive and large hematoma or uncontrollable hemodynamic patients, interventional management including surgery or less invasive newer techniques is indicated. PMID:24839570
Galyfos, George; Karantzikos, Georgios; Palogos, Konstantinos; Sianou, Argiri; Filis, Konstantinos; Kavouras, Nikolaos
Several approaches for repair of diastasis recti during abdominoplasty and repair of rectus sheath defect during transverse rectus abdominis musculocutaneous flap harvest have been described. Although these have generally been effective, we feel our procedure to be advantageous. The method presented is quick, easy, and efficient. In addition, because a looped (double), monofilament suture is used, a stronger, more aesthetic repair is accomplished. This technique has been used in 39 patients over a 25-month period. No recurrences of diastasis recti and no hernias have been observed. Furthermore, all patients remain without complaint. PMID:8141528
Asaadi, M; Haramis, H T
, semitendinosus, biceps femoris, rectus femoris and adductor muscles were dissected from nine fresh hams. Each muscle was analyzed for lactate dehydrogenase (LDH) activity after receiving one of eighteen treatments: fresh, untreated held at 4 C for 4 d; aged...). The semimembranosus (SM), semitendinosus (ST), biceps femoris (BF) and rectus femoris (RF) muscles were dissected and closely trimmed of all connective tissue membranes and seam and intermuscular fat. The hams were treated as follows: Ham Pl-Fresh. The four...
Collins, Sharen Sue
This study investigated the use of EMG biofeedback to simulate weakened rectus femorii and gastrocnemii muscles during the performance of a lifting task. Eight healthy women performed 15 kg free-style lifts from floor level. Three conditions were tested: unconstrained lifting, lifting with rectus femorii activity volitionally limited bilaterally through EMG biofeedback to less than 45% of maximal EMG activity, and
Trina A. Buhr; Don B. Chaffin; Bernard J. Martin
Summary Insertional tendinopathy of the adductors and rectus abdominis is common in male athletes, especially in soccer players. It may be worsened by physical activity and it usually limits sport performance. The management goal in the acute phase consists of analgesic and anti-inflammatory drugs and physical rehabilitation. In the early stages of rehabilitation, strengthening exercises of adductors and abdominal muscles, such as postural exercises, have been suggested. In the sub-acute phase, muscular strength is targeted by overload training in the gym or aquatherapy; core stability exercises seem to be useful in this phase. Finally, specific sport actions are introduced by increasingly complex exercises along with a preventive program to limit pain recurrences. PMID:23738289
Valent, Alessandro; Frizziero, Antonio; Bressan, Stefano; Zanella, Elena; Giannotti, Erika; Masiero, Stefano
of discoloration. M. longissimus lumborum, M. longissimus thoracis, M. semitendinosus, and M. tensor fasciae latae were grouped as "high" color stability muscles, M. semimembranosus, M. rectus femoris, and M. vastus lateralis were grouped as "moderate" color...
McKenna, David Richard
[Purpose] In the present study, we investigated femoral muscle activity during toe-gripping, and the role of the femoral muscles in toe-gripping strength. [Subjects] Fourteen healthy young women were selected. [Methods] We measured the maximum voluntary contraction of the rectus femoris and long head of the biceps femoris muscles. We then calculated the percent integrated EMG (%IEMG) during the toe-gripping action. [Results] We found that the %IEMG of the biceps femoris was significantly higher than that of the rectus femoris. Moreover, a significant positive correlation was found between the %IEMG of the rectus femoris and that of the biceps femoris. [Conclusion] These results suggest that femoral muscles co-contract during the toe-gripping action, and thus possibly contribute to knee joint stability. PMID:25364128
Soma, Masayuki; Murata, Shin; Kai, Yoshihiro; Nakae, Hideyuki; Satou, Yousuke
The lateral rectus (LR) muscle of the pigeon was directly stimulated in situ at 41°C. The length tension relationships for active and passive tension were investigated to determine the optimum muscle length (Lo). Isometric responses to single and twin pulses, tetani and sinusoidal stimulation were measured
John Stelling; Alistair Mc Vean
PURPOSE: Patients with overcorrected strabismus (and several patients with undercorrection after extraocular muscle resection) underwent exploration of previously operated muscles, with the intention of advancing their tendons to prevent the need for surgery on additional muscles. Unexpectedly, it was found that, in many cases, an elongated scar segment of variable length was interposed between the muscle and its insertion site on the sclera. Laboratory investigations were carried out to elucidate the underlying mechanism(s) and to create an animal model of the disorder. METHODS: Lengthened scars were repaired on 198 muscles during 134 procedures performed on 123 patients. The scars consisted of amorphous connective tissue interposed between the globe and normal tendon. Repair was accomplished by excision of the scar and reattachment of the muscle to sclera, using absorbable sutures in 64 cases and nonabsorbable sutures in 70 cases. Histopathologic examination was performed on 82 clinical specimens, and tissue culture studies were performed on 7 specimens. To develop an animal model, 10 New Zealand white rabbits underwent bilateral superior rectus resection. Half of the eyes received sub-Tenon's injections of collagenase over the operative site during weeks 2, 3, 5, and 6 postoperatively; the other half received saline solution injections on the same schedule. At 10 weeks, half the sites were studied histologically, and the other half underwent collagen creep analysis. In a second study, the use of absorbable versus nonabsorbable sutures was compared in the rabbit model. RESULTS: In the clinical cases, the mean length of the elongated scar segments was 4.2 mm. A total of 105 of the 134 repair procedures were judged successful. Thirty-one procedures resulted in recurrence of the original overcorrection; 7 of these had documented restretches. Factors that distinguished patients with stretched scars from patients with classic slipped muscles included minimal or no limitation of versions, less separation of the tendons from sclera, and thicker appearance of the scar segments. The use of nonabsorbable sutures in the repair procedure reduced the recurrence rate. Histologic examination of the clinical stretched scar specimens showed dense connective tissue that was less well organized compared with normal tendon. In the tissue culture studies, cells cultured from the stretched scar specimens grew rapidly and were irregularly shaped. A high-molecular-weight protein was identified in the culture medium. By contrast, cells cultured from normal tendon (controls) grew more slowly and regularly, stopped growing at 4 days, and produced less total protein than cultured stretched scar specimens. In the animal model studies, the collagenase-treated sites showed elongated scars with increased collagen between the muscle and the sclera, as well as increased collagen creep rates, compared with the saline-treated controls. The use of nonabsorbable sutures in collagenase-treated animal model surgery sites was associated with shorter, thicker scars compared with similar sites sutured with absorbable sutures. CONCLUSIONS: A lengthened or stretched, remodeled scar between an operated muscle tendon and sclera is a common occurrence and is a factor contributing to the variability of outcome after strabismus repair, even years later. This abnormality may be revealed by careful exploration of previously operated muscles. Definitive repair requires firm reattachment of tendon to sclera with nonabsorbable suture support. Images FIGURE 3 FIGURE 4 FIGURE 5 FIGURE 6 FIGURE 7 FIGURE 8 FIGURE 9 FIGURE 10 FIGURE 11 FIGURE 12 FIGURE 13 FIGURE 14 FIGURE 15 FIGURE 16 FIGURE 17 FIGURE 18 FIGURE 19 FIGURE 20 FIGURE 21 FIGURE 22 FIGURE 23 FIGURE 24 FIGURE 25 FIGURE 26 FIGURE 27 FIGURE 28 FIGURE 29 FIGURE 30 FIGURE 31 FIGURE 32 FIGURE 33 FIGURE 34 FIGURE 35 FIGURE 36 FIGURE 37 FIGURE 38 FIGURE 39 FIGURE 40 FIGURE 41 FIGURE 42 FIGURE 43 FIGURE 44 FIGURE 45 FIGURE 46 FIGURE 52 FIGURE 53 FIGURE 54 FIGURE 55 FIGURE 58 FIGURE 59 FIGURE 60 FIGURE 61 FIGURE 62 FIGURE 63
Ludwig, I H
The effect of topical lignocaine applied to the eye muscles, on the incidence of the oculocardiac reflex during squint surgery of the medial rectus was investigated in 56 healthy children aged between 3-14 years. Three groups were studied. One (n = 16): stimulation of the reflex without lignocaine; 2 (n = 10): stimulation of the reflex after topical administration of 1 mg kg-1 lignocaine 2% to the medial part of the eye after induction of anaesthesia; 3 (n = 30): stimulation of the oculocardiac reflex without, and after a 5 min interval under the influence of lignocaine. Topical administered lignocaine significantly attenuated the OCR (105 vs. 68 bpm group II vs. group 1:82 vs. 63 bpm in group III). Severe bradycardiac rhythm disturbances, in particular cardiac stand-still, were not observed after lignocaine had been applied. Systemic side effects of lignocaine were not seen. PMID:8829929
Ruta, U; Möllhoff, T; Markodimitrakis, H; Brodner, G
Radical surgery is often necessary in patients with local recurrence of rectal cancer or in those with carcinoma associated with an anal fistula. The surgery may include extended excision of the perineal area and can create a large dead space in the pelvis and a large skin defect, often necessitating reconstruction of the pelvic floor using rectus abdominis musculocutaneous (RAM) flap transposition. Wound dehiscence and incisional hernia are common complications of RAM flap transposition. We report herein our encounter with 3 patients in whom we used a "sliding door" technique for reconstruction of the abdominal wall after the creation of a RAM flap. One patient underwent abdominoperineal resection with sacrectomy and RAM flap transposition; he experienced a postoperative surgical site infection and wound dehiscence, which we urgently repaired by reconstructing the abdominal wall using the sliding door technique. Two other patients underwent posterior pelvic exenteration with sacrectomy and RAM flap transposition. These patients underwent simultaneous abdominal wall reconstruction using the sliding door technique. No patient experienced postoperative pelvic sepsis, wound dehiscence, or incisional hernia. The sliding door technique might be useful for preventing wound dehiscence and incisional hernia in patients undergoing RAM flap transposition. PMID:24394135
Nakamoto, Takayuki; Koyama, Fumikazu; Kobata, Yasunori; Nagao, Mitsuo; Nakagawa, Tadashi; Nakamura, Shinji; Ueda, Takeshi; Nishigori, Naoto; Inoue, Takashi; Kawasaki, Keijiro; Obara, Shinsaku; Fujii, Hisao; Kido, Akira; Koizumi, Munehisa; Tanaka, Yasuhito; Nakajima, Yoshiyuki
Introduction: Minimal access surgery is common in all fields of medicine. We compared a new minimally invasive strabismus surgery (MISS) approach with a standard paralimbal strabismus surgery (SPSS) approach in terms of post-operative course. Materials and Methods: This parallel design study was done on 28 eyes of 14 patients, in which one eye was randomized to MISS and the other to SPSS. MISS was performed by giving two conjunctival incisions parallel to the horizontal rectus muscles; performing recession or resection below the conjunctival strip so obtained. We compared post-operative redness, congestion, chemosis, foreign body sensation (FBS), and drop intolerance (DI) on a graded scale of 0 to 3 on post-operative day 1, at 2-3 weeks, and 6 weeks. In addition, all scores were added to obtain a total inflammatory score (TIS). Statistical Analysis: Inflammatory scores were analyzed using Wilcoxon's signed rank test. Results: On the first post-operative day, only FBS (P =0.01) and TIS (P =0.04) showed significant difference favoring MISS. At 2-3 weeks, redness (P =0.04), congestion (P =0.04), FBS (P =0.02), and TIS (P =0.04) were significantly less in MISS eye. At 6 weeks, only redness (P =0.04) and TIS (P =0.05) were significantly less. Conclusion: MISS is more comfortable in the immediate post-operative period and provides better cosmesis in the intermediate period. PMID:24088635
Sharma, Richa; Amitava, Abadan K; Bani, Sadat AO
\\u000a Recently, there has been an increasing focus on the rapid reduction of muscles that are required for the bending of the hip\\u000a joint during walking (flexor muscles around the hip joint) with age. The flexor muscles around the hip joint include femoral\\u000a rectus and abdominal muscles. These muscles have been implicated in falling in the elderly people. In this study,
Hiroki Takada; Tomoki Shiozawa; Masaru Miyao; Yasuyuki Matsuura; Masumi Takada
Introduction: Cavernous sinus thrombosis is a rare but serious disease associated with significant morbidity and mortality. Early recognition and prompt treatment is necessary to improve patient outcomes in this potentially fatal disease. Case Report: A 55-year-old man visiting from mainland China with no significant past medical history presented with eight days of headache. One day prior to admission, the patient developed diplopia and ptosis of his left eye. Physical examination revealed a fixed, dilated left pupil and left third, fourth, and sixth nerve palsies with loss of sensation in the left supraorbital region. Initial magnetic resonance imaging (MRI) of the brain showed fullness of the left cavernous sinus and dilated left superior ophthalmic vein consistent with cavernous sinus thrombosis. Treatment was initiated with broad spectrum antibiotics, high-dose corticosteroids, and anticoagulants. Hours after admission, he developed new proptosis, ophthalmoplegia, and marked chemosis of his right eye. Bilateral carotid artery angiogram ruled out indirect or direct carotid cavernous fistula. Computed tomography (CT) angiogram of the neck showed right internal jugular vein thrombosis extending into the right sigmoid sinus, while CT of the chest revealed solid and cavitary pulmonary nodules consistent with septic pulmonary emboli. Repeat MRI two days later showed progression of thrombosis to the contralateral cavernous sinus and superior ophthalmic vein. MRI venogram showed decreased, and in some portions, lack of flow in the right transverse, sigmoid sinuses and visualized internal jugular vein. Blood cultures eventually grew Campylobacter rectus identified by 16S rRNA sequencing. Additional history revealed that the patient had an uncomplicated tooth extraction of a decayed upper left molar 3 months ago. As Campylobacter rectus is a member of the human oral flora associated with human periodontal disease, we hypothesized that the patient's infection likely started from left upper molar removal causing bacteremia and resulting in left cavernous sinus and right internal jugular vein thromboses with septic pulmonary emboli. The patient's condition improved and he was discharged from hospital to continue medical care in China. Discussion: Despite the very few cases of invasive Campylobacter rectus infections reported in literature, this case illustrates that Campylobacter rectus can be pathogenic. Dental infections may result in serious complications and an odontogenic source of infection should always be considered in patients with cavernous sinus thrombosis.
(chuck shoulder) muscles have more intense beefy flavor than the Rectus femoris (round); however, the round was noted as having less off-flavors than the tenderloin and chuck steaks (Yancey et al., 2005; Stetzer, Tucker, McKeith, Brewer, 2007). Results... (chuck shoulder) muscles have more intense beefy flavor than the Rectus femoris (round); however, the round was noted as having less off-flavors than the tenderloin and chuck steaks (Yancey et al., 2005; Stetzer, Tucker, McKeith, Brewer, 2007). Results...
Philip, Chrisly Mary
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
Reconstructive options after vulvectomy is preferably performed using fasciocutaneous flaps. If the defect is very large, the use of vertical rectus abdominis myocutaneous (VRAM) flap is recommended. We report a case of a patient affected by multirecurrent anal carcinoma, treated by chemotherapy, radiotherapy and surgery several times, until an extended abdominoperineal resection of Miles was performed. Since other surgical options were no more available, a primary reverse VRAM flap reconstruction was harvested, together with an end-to-end nerve anastomosis between the cutaneous ramus of the 8th intercostal nerve and the superior branch of the pudendal nerve to achieve sensibility. Encouraging results, without actual recurrence of the disease, were obtained. PMID:19631598
Di Benedetto, Giovanni; Siquini, Walter; Bertani, Aldo; Grassetti, Luca
An increase in inter-recti distance (IRD) is common in the peripartum period, but is not well documented. This study evaluated the IRD from 36 weeks of gestation to 12 weeks postpartum using two single case studies. Measurements were taken with the rectus abdominis at rest and during contraction at three levels along the linea alba, using a pair of dial calipers. The maximum divarication in the antenatal period was 58mm (resting) and 55mm (active) at the level of the umbilicus. An increase of 200 to 400% was demonstrated at 12 weeks postpartum vis-à-vis the 36th week of gestation. In conclusion, despite individual variability, IRD persists in the postpartum period. Further study is required to establish generalisation. PMID:11676815
Hsia, Merry; Jones, Sue
This study was to quantitatively characterize the spatial, temporal, and neuromuscular activation patterns of Tai Chi gait (TCG). Ten healthy young subjects were tested. The kinematics of TCG and normal gait (NG) were measured using a marker-based motion analysis system and two biomechanical force plates. Surface electromyography (EMG) was recorded from six left-side muscles: tibialis anterior, soleus, peronaeus longus, rectus
Ge Wu; Wei Liu; Juvena Hitt; Debra Millon
Six competitive soccer players were recruited to examine EMG activation in three quadriceps muscles during a kicking accuracy task. Participants performed three maximum instep place kicks of a stationary ball, 11 m perpendicular from the centre of the goal line towards targets (0.75 m) in the four corners of the goal. Surface EMG of the vastus lateralis, vastus medialis, and rectus
Joanna C. Scurr; Victoria Abbott; Nick Ball
years after surgery. Keywords Muscle Â· Magnetic resonance imaging Â· Rectus femoris Â· Tendon transfer resonance imaging findings after rectus femoris transfer surgery Introduction Orthopedic surgery the magnetic resonance (MR) imaging appearance of the knee flexor and extensor ten- dons after bilateral rectus
Blemker, Silvia Salinas
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
Rectus femoris injuries are extremely common in athletes, particularly in soccer players, rugby player, and sprinters. Magnetic resonance imaging (MRI) plays a key role in diagnosis, prognosis, and rehabilitation of these injuries. The current article discusses current concepts in the diagnosis and treatment of rectus femoris injuries in elite athletes, including a discussion of the less well known myofascial injuries and key prognostic factors as seen at MR imaging. PMID:21514758
Kassarjian, A; Rodrigo, R M; Santisteban, J M
Purpose: To evaluate the outcome of strabismus surgery for congenital superior oblique palsy (SOP) in relation to correction of head tilt and hypertropia. The cohort of patients mainly involved very young children. This is the first study to use a standardized instrument to objectively measure torticollis before and after surgery. Materials and Methods: A non-comparative interventional case series of 13 cases of congenital superior oblique palsy with head tilt, who underwent simultaneous superior oblique tuck and inferior oblique recession between Jan 2000 and Dec 2008, were studied. Results: The mean duration of SOP until surgery was 36.8 months. Of the 12 unilateral cases, 8 were right-sided. Mean follow-up period was 17 months (range 7-36). The outcome was determined at the last follow-up. Mean pre-and post-operative hypertropia (p.d.) in forced primary position was 19 ± 7 and 2 ± 6, respectively (P < 0.0001). The head tilt reduced from mean of 17 ± 9 to 2 ± 2 degrees (P < 0.0001). Success, defined as hypertropia <5 PD and head tilt less than 5 degrees, was achieved in 69% (9/13. C.I. 42-88%) and 85% (11/13. C.I. 56-96%), respectively. The success rate for achieving both criteria was 61.5% (C.I. 35-88%). Five patients required additional surgery; usually a contralateral inferior rectus muscle recession, which was successful in all cases. One case developed asymptomatic Brown syndrome (7.69% - C.I. 6.7-22.2). Conclusions: Simultaneous superior oblique tuck and inferior oblique muscle recession can successfully treat selected cases of congenital superior oblique palsy. About one-third required an additional procedure, which led to total normalization of the head position. PMID:24008792
Kekunnaya, Ramesh; Isenberg, Sherwin J
Gene therapy for muscular diseases requires the efficient transfection of a large proportion of myofiber cells within a given muscle. In the present experiments, patterns of ?-galactosidase expression were examined in mouse rectus femoris muscles at various time-points after a single injection of lacZ encoded plasmid DNA. ?-Galactosidase expression was detected 3 h after injection and rose to peak levels
SG Doh; HL Vahlsing; J Hartikka; X Liang; M Manthorpe
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
. Muscle activity patterns were measured from the rectus femoris, biceps femoris, tibialis anterior and gastrocnemius medialis\\u000a muscles using electromyography (EMG). Recordings were made from six runners while they ran for 30 min around a track at a\\u000a constant, self-selected pace. They were made from three sites along each muscle belly, and for ten consecutive steps on each\\u000a 450 m lap completed.
James M. Wakeling; Silvia A. Pascual; Benno M. Nigg; Vinzenz Tscharner
Congential fibrosis of the extraocular muscles is characterized by the replacement of normal contractile muscle tissue by fibrous tissue or fibrous bands in varying degrees. The clinical entities which result from the fibrous replacement can be classified under the following headings: general fibrosis syndrome, congenital fibrosis of the inferior rectus muscle with blepharoptosis, strabismus fixus, vertical retraction syndrome and congential unilateral fibrosis, enophthalmos and blepharoptosis. Genetic factors may or may not be apparent. One pedigree with general fibrosis syndrome was traced through five generations. Light and electron microscopy demonstrated replacement of normal muscle by collagen and dense fibrous tissue with occasional areas of degenerated skeletal muscle. The surgical mangement attempts to achieve some functional readjustment of the ocular and lid position as well as the abnormal head posture. The surgical results were considered satisfactory when compared with the original position of the eyes and the backward head tilt. PMID:754372
Harley, R D; Rodrigues, M M; Crawford, J S
Background Correction of rectus diastasis (RD) is performed during most abdominoplasties. This study aimed to evaluate the long-term\\u000a result of RD correction when the plication of the anterior rectus sheath is performed with an absorbable suture.\\u000a \\u000a \\u000a \\u000a \\u000a Methods Abdominoplasty was performed for 12 women who presented with Nahas’ type A musculoaponeurotic deformity. The RD was measured\\u000a preoperatively with two computed tomography (CT) scan
Fabio Xerfan Nahas; Lydia Masako Ferreira; Pedro Bins Ely; Charles Ghelfond
Â· Appendix Â Attached to colon / large intestine Â No known function Â Inflamed Â· Surgery Â Removal #12;Elec 331 - Minimally Invasive Surgery 7 Hernia Â· Hernia Â Weakened abdominal wall (muscle) Â Intestine protrudes through abdomen Â Visible bulge Â· Surgery Â Retract intestine Â Sew abdominal wall Gallbladder Pre
Pulfrey, David L.
activity of the pedaling-leg hamstring muscles (biceps femoris and semimembranosus) during flexion-phase hamstrings activity and a con- tralateral feedback mechanism modulating rectus femoris and tibialis anterior capacity of individuals with spinal cord injury through the application of principles derived from pattern
The purpose of this investigation was to compare the thresholds of neuromuscular fatigue determined simultaneously from the vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) muscles using the electromyographic fatigue threshold (EMGFT) test, Eight adult volunteers [mean (SD) age, 33 (10) years] served as subjects for this investigation. The results of a one-way repeated measured ANOVA indicated that
Terry J. Housh; Herbert A. deVries; Glen O. Johnson; Dona J. Housh; Sharon A. Evans; Jeffrey R. Stout; Tammy K. Evetovich; Roxanna M. Bradway
E. Gold Scott L. Delp # ISS 2006 Dynamic magnetic resonance imaging of muscle function after surgery function in vivo before and after surgery. This commentary is on the use of cine phase contrast MRI to study the function of the rectus femoris muscle after surgical transfer. Rectus femoris transfer surgery
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. PMID:21943461
McMenamin, DM; Clements, D; Edwards, TJ; Fitton, AR; Douie, WJP
Background Perineal reconstruction following pelvic exenteration is a challenging area in plastic surgery. Its advantages include preventing complications by obliterating the pelvic dead space and minimizing the scar by using the previous abdominal incision and a vertical rectus abdominis musculocutaneous (VRAM) flap. However, only a few studies have compared the complications and the outcomes following pelvic exenteration between cases with and without a VRAM flap. In this study, we aimed to compare the complications and the outcomes following pelvic exenteration with or without VRAM flap coverage. Methods We retrospectively reviewed the cases of nine patients for whom transpelvic VRAM flaps were created following pelvic exenteration due to pelvic malignancy. The complications and outcomes in these patients were compared with those of another nine patients who did not undergo such reconstruction. Results Flap reconstruction was successful in eight cases, with minor complications such as wound infection and dehiscence. In all cases in the reconstructed group (n=9), structural integrity was maintained and major complications including bowel obstruction and infection were prevented by obliterating the pelvic dead space. In contrast, in the control group (n=9), peritonitis and bowel obstruction occurred in 1 case (11%). Conclusions Despite the possibility of flap failure and minor complications, a VRAM flap can result in adequate perineal reconstruction to prevent major complications of pelvic exenteration.
Jeon, Heechang; You, Hi-Jin; Kim, Hyon-Surk; Lee, Byung-Il; Park, Seung Ha
Astronauts assigned to long-duration missions experience bone and muscle atrophy in the lower limbs. The use of musculoskeletal simulation software has become a useful tool for modeling joint and muscle forces during human activity in reduced gravity as access to direct experimentation is limited. Knowledge of muscle and joint loads can better inform the design of exercise protocols and exercise countermeasure equipment. In this study, the LifeModeler(TM) (San Clemente, CA) biomechanics simulation software was used to model a squat exercise. The initial model using default parameters yielded physiologically reasonable hip-joint forces. However, no activation was predicted in some large muscles such as rectus femoris, which have been shown to be active in 1-g performance of the activity. Parametric testing was conducted using Monte Carlo methods and combinatorial reduction to find a muscle parameter set that more closely matched physiologically observed activation patterns during the squat exercise. Peak hip joint force using the default parameters was 2.96 times body weight (BW) and increased to 3.21 BW in an optimized, feature-selected test case. The rectus femoris was predicted to peak at 60.1% activation following muscle recruitment optimization, compared to 19.2% activation with default parameters. These results indicate the critical role that muscle parameters play in joint force estimation and the need for exploration of the solution space to achieve physiologically realistic muscle activation.
Hanson, Andrea; Reed, Erik; Cavanagh, Peter
[Purpose] This study verified the leg muscle activities of elderly subjects performing leg cycle ergometer exercise. [Subjects] Forty-one elderly persons were the subjects of this study. [Methods] For the three distances corresponding to knee flexion angles of 15, 45, and 70, the muscle activities of the rectus femoris, biceps femoris, tibialis anterior and lateral gastrocnemius were measured while the subjects exercised on a cycle ergometer. [Results] The rectus femoris and biceps femoris showed statistically significant increases as the distance between the cycle ergometer and the body increased, and the lateral gastrocnemius muscle activation showed a statistically significant increase as the distance from the body to the cycle ergometer decreased. [Conclusion] When the elderly have limb muscle weakness, leg cycle ergometer distances should be adjusted. PMID:25364121
Kim, Seon-Chill; Lee, Sang-Yeol; Lee, Young-Ik
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
Four bio-mechanical tests were used to study properties of the rectus sheath for laparoscopic abdominal access procedure and to provide surgical exposure by the ChulaLift gasless retractor. The profile of forces and displacement showed how some patients were good candidates for the gasless operation. The lifting weight should not excess 10 kg for minimal harm and optimal exposure. The rectus hooking could be an alternative choice for abdominal wall fixing during the first trocar entry. One-cm width hooking, the rectus sheath could withstand 18-20 kg lifting force. The exposure provided by the gasless technique was narrow between the lateral ports compared to the conventional technique. The rectus sheath could be hooked to provide effective fixing of the area to be penetrated by the first trocar, and this fascial layer could be lifted to produce exposure in the gasless technique. PMID:12188429
Tansatit, Tanvaa; Wisawasukmongchol, Wirach; Bunyavejchevin, Suvit; Rodanant, Oralux; Jongsakul, Teerachote; Chamsuwan, Supoj; Tansrisawad, Nat; Hoonwijit, Udomsak
This study investigated the effect of prolonged walking with load carriage on muscle activity and fatigue in children. Fifteen Chinese male children (age=6 years, height=120.0+/-5.4 cm, mass=22.9+/-2.6 kg) performed 20-min walking trials on treadmill (speed=1.1 ms(-1)) with different backpack loads (0%, 10%, 15% and 20% body weight). Electromyography (EMG) signals from upper trapezius (UT), lower trapezius (LT) and rectus abdominis (RA) were recorded at several time intervals (0, 5, 10, 15 and 20 min), and were normalized to the signals collected during maximum voluntary contraction. Integrated EMG signal (IEMG) was calculated to evaluate the muscle activity. Power spectral frequency analysis was applied to evaluate muscle fatigue by the shift of median power frequency (MPF). Results showed that a 15% body weight (BW) load significantly increased muscle activity at lower trapezius when the walking time reached 15 min. When a 20% BW load was being carried, increase in muscle activity was found from 5 min, and muscle fatigue was found from 15 min. In upper trapezius, increase of muscle activity was not found within the 20-min period, however, muscle fatigue was found from 10 min. No increased muscle activity or muscle fatigue was found in rectus abdominis. It is suggested that backpack loads for children should be restricted to no more than 15% body weight for walks of up to 20 min duration to avoid muscle fatigue. PMID:17720538
Hong, Youlian; Li, Jing-Xian; Fong, Daniel Tik-Pui
This study investigated the effects of age and inactivity due to being chronically bedridden on atrophy of trunk muscles. The subjects comprised 33 young women (young group) and 41 elderly women who resided in nursing homes or chronic care institutions. The elderly subjects were divided into two groups: independent elderly group who were able to perform activities of daily living involving walking independently (n = 28) and dependent elderly group who were chronically bedridden (n = 13). The thickness of the following six trunk muscles was measured by B-mode ultrasound: the rectus abdominis, external oblique, internal oblique, transversus abdominis, thoracic erector spinae (longissimus) and lumbar multifidus muscles. All muscles except for the transversus abdominis and lumbar multifidus muscles were significantly thinner in the independent elderly group compared with those in the young group. The thicknesses of all muscles in the dependent elderly group was significantly smaller than that in the young group, whereas there were no differences between the dependent elderly and independent elderly groups in the muscle thicknesses of the rectus abdominis and internal oblique muscles. In conclusion, our results suggest that: (1) age-related atrophy compared with young women was less in the deep antigravity trunk muscles than the superficial muscles in the independent elderly women; (2) atrophy associated with chronic bed rest was more marked in the antigravity muscles, such as the back and transversus abdominis. PMID:21472438
Ikezoe, Tome; Mori, Natsuko; Nakamura, Masatoshi; Ichihashi, Noriaki
AIMS/BACKGROUND: The connective tissue system of the levator palpebrae superioris muscle (LPS) consists of the septa surrounding its muscle sheath, the superior transverse ligament (STL) commonly referred to as 'Whitnall's ligament' and the common sheath which is the fascia between the LPS and the superior rectus muscle (SRM). The anterior band-like component of the common sheath is called transverse superior fascial expansion (TSFE) of the SRM and LPS. It mainly extends from the connective tissue of the trochlea to the fascia of the lacrimal gland. A detailed description of the relation between the LPS and its connective tissue is presented. Furthermore, the course of the LPS in the orbit is described. The study was conducted to provide a morphological basis for biomechanical and clinical considerations regarding ptosis surgery. METHODS: Postmortem dissections were performed in 16 orbits from eight cadavers. The microscopical anatomy was demonstrated in six formalin preserved orbits from six cadavers which had been sectioned in the frontal and sagittal plane and stained with haematoxylin and azophloxin. Surface coil magnetic resonance imaging in the sagittal and coronal plane was performed in five orbits from five normal volunteers using a T1 weighted spin echo sequence. RESULTS: The STL and the TSFE surround the LPS to form a fascial sleeve around the muscle which has attachments to the medial and lateral orbital wall. The TSFE, which is thicker than the STL, blends with Tenon's capsule. The STL and the fascial sheath of the LPS muscle are suspended from the orbital roof by a framework of radial connective tissue septa. MR images show that the TSFE is located between the anterior third of the superior rectus muscle and the segment of the LPS muscle where it changes its course from upwards to downwards. In this area, the LPS reaches its highest point in the orbit (culmination point). The culmination point is located a few millimetres posterior to the equator and superior to the globe. CONCLUSION: Whitnall's ligament can be considered to consist of two distinct parts--the TSFE inferior to the LPS and the STL superior to the LPS. Since the medial and lateral main attachments of Whitnall's ligament are situated inferior to the level of the culmination point of the LPS, the ligament itself is unlikely to suspend the levator muscle. However, a suspension of the LPS may be achieved by the radial connective tissue septa of the superior orbit. The TSFE in connection with the globe may have an additional supporting function. The elasticity of Whitnall's ligament and its connections with highly elastic structures including Tenon's capsule, may provide the morphological substrate for the previously proposed passive (that is, without orbicularis action) lowering of the lid during downward saccades. Images PMID:8949713
Ettl, A; Priglinger, S; Kramer, J; Koornneef, L
Background Relatively large calcific tendinitis with persistent symptoms after extended periods of conservative treatment is an indication for operative therapy. Arthroscopy, as a treatment for calcific tendinitis of the hip abductors and calcinosis circumscripta, has been described previously; however, to our knowledge, the clinical and radiological response to arthroscopic removal of calcific tendinitis of the rectus femoris tendon has not. Methods We present arthroscopic treatment of unusual calcific tendonitis of the origin of the rectus femoris and associated intra-articular lesions in 3 patients with chronic coxa pain. Results Our cases show that hip arthroscopy is an effective therapeutic modality for calcific tendinitis of the hip joint with satisfactory short-term outcomes. Conclusions Calcific tendinitis, although an uncommon clinical entity, should be a part of the differential diagnosis of acute or chronic hip pain. PMID:24266900
in a variety of human muscles: the- nar, 45Â90% of maximal voluntary contraction (MVC) (Gatev et al. 1986); biceps brachii, 11Â60% MVC (Ivan- ova 1990; Garland et al. 1994); deltoid, (DeLuca and Forrest 1973); rectus femoris, 17Â35% MVC (Person and Kudina 1972); and triceps brachii, 20% MVC (Garland et al. 1997
Background Not only is a radiation ulcer nonviable itself, but the surrounding irradiated tissue also shows poor healing. Therefore,\\u000a healing in an irradiated field cannot be expected if a flap used for reconstruction fails even partially. For repair of radiation\\u000a ulcers, a flap with a stable blood supply is required. A superiorly based vertical rectus abdominis myocutaneous (VRAM) flap\\u000a is commonly
Masao Fujiwara; Yoko Nakamura; Akira Sano; Ei Nakayama; Miyuki Nagasawa; Toru Shindo
This study aimed to examine whether changes in the activity of shoulder and neck muscles have consequences for the activation of primary breathing muscles. It further aimed to compare muscle loading levels of professional and student singers. Four professional opera singers participated in the study. Previous unpublished recordings of 4 to 16 student singers and one opera singer were included to allow comparison of EMG loading levels between student and professional singers. Electromyographic (EMG) recordings of trapezius (TR), sternocleidomastoideus (STM), intercostals (INT), rectus abdominis (RC) and the lateral abdominal muscles (OBL) were performed. EMG biofeedback (BF) was performed on TR and STM to lower the activity in these two muscles and the potential change in EMG activity of INT, RC and OBL were examined. Three singing tasks were performed: aria, sustained tones and extreme tones. Each task was performed three times with variation in volume or pitch. Following the first performance of the singing tasks, the BF session was carried out and muscle activity recorded in a repeat performance of the same tasks. The EMG activity levels of all muscles were compared before and after BF. We found no significant effect of reduced TR/STM activity on the activation of INT, RC and OBL. Professional opera singers activated the TR, INT, RC and OBL muscles to higher levels than the student singers did. Another finding was large inter-subject variation in muscle usage, showing an idiosyncratic composition of the muscle contribution to subglottal pressure. PMID:15260181
Pettersen, V; Westgaard, R H
[Purpose] The purpose of this study was to investigate the effects of trunk stabilization exercise on the muscle EMG activations related to core stability. [Subjects and Methods] Fifteen elderly people in a geriatric hospital performed trunk stabilization exercises with a Swiss ball for 20 minutes five times per week for 8 weeks. Trunk muscle activations were measured using electromyography before and after the intervention. [Results] After the intervention, the muscle activations of the rectus abdominis, erector spinae, lateral low-back (quadratus lumborum and external oblique), and gluteus medius muscles increased significantly. [Conclusion] The trunk stabilization exercise with a Swiss ball significantly increased the muscle activities of the elderly.
Kim, Seong Gil; Yong, Min Sik; Na, Sang Su
The JACS prospective cohort study of newly diagnosed women with breast cancer investigating joint and muscle pain, aches, and stiffness: pain and quality of life after primary surgery and before adjuvant treatment
Background Breast cancer affects one in eight UK women during their lifetime: many of these women now receive adjuvant chemotherapy and hormone therapy. Joint and muscle pains, aches, and stiffness are common but the natural history, aetiology and impact of these symptoms are unknown. A cohort study of newly diagnosed women with primary breast cancer was established to explore this. In this paper we present study methods and sample characteristics, describe participants’ experience of musculoskeletal pain at baseline interview, and explore its impact on quality of life. Methods Women with non-metastatic breast cancer were recruited following primary surgery into a multi-centre cohort study. They received questionnaires by post five times (baseline, 3, 6 , 9 and 12 months) to investigate prevalence, severity, location and correlates of musculoskeletal pain, and impact on quality-of-life. Pain was measured by the Nordic musculoskeletal questionnaire, the Brief Pain Inventory, and MSK-specific questions, and quality of life by the SF-36 and FACIT scales. Results 543 women (mean age 57 years, range 28–87, 64% postmenopausal) were recruited following surgery for primary breast cancer from breast cancer clinics in eight hospitals. Fifteen per cent of the eligible cohort was missed; 28% declined to participate. Joint or muscle aches, pains or stiffness were reported by 69% women with 28% specifically reporting joint pain/aches/stiffness. Quality of life, as measured by the FACT-B and adjusted for age, depression, surgery and analgesic use, is significantly worse in all domains in those with musculoskeletal problems than those without. Conclusions Our findings highlights the importance of a better understanding of these symptoms and their impact on the lives of women with primary breast cancer so that healthcare professionals are better equipped to support patients and to provide accurate information to inform treatment decisions. Further papers from this study will address these issues. PMID:24964929
The use of musculoskeletal simulation software has become a useful tool for modelling joint and muscle forces during human activity, including in reduced gravity because direct experimentation is difficult. Knowledge of muscle and joint loads can better inform the design of exercise protocols and exercise countermeasure equipment. In this study, the LifeModeler™ (San Clemente, CA, USA) biomechanics simulation software was used to model a squat exercise. The initial model using default parameters yielded physiologically reasonable hip-joint forces but no activation was predicted in some large muscles such as rectus femoris, which have been shown to be active in 1-g performance of the activity. Parametric testing was conducted using Monte Carlo methods and combinatorial reduction to find a muscle parameter set that more closely matched physiologically observed activation patterns during the squat exercise. The rectus femoris was predicted to peak at 60.1% activation in the same test case compared to 19.2% activation using default parameters. These results indicate the critical role that muscle parameters play in joint force estimation and the need for exploration of the solution space to achieve physiologically realistic muscle activation. PMID:24050838
Reed, Erik B; Hanson, Andrea M; Cavanagh, Peter R
Purpose: Medial rectus (MR) recession with pulley posterior fixation (PF) can be used to treatesotropia (ET) with a high accommodative convergence to accommodation (AC/A) ratio as effectively in the short term as MR recession with scleral PF. This study provides a novel examination of the long-term results of MR recession with pulley PF (PPF). Methods: In 21 children we performed bilateral MR recession and pulley PF for ET greater at near than distance (high AC/A). Mean follow-up was 3.5 ± 2.5 (standard deviation [SD]) years. Results: Mean age at presentation was 2.7 ± 1.8 and at surgery 4.3 ± 1.6 years. Fourteen (67%) children had amblyopia. Distance and near pre-operative ET averaged 19.6? ± 10.5? and 36.9? ± 18.9?, respectively. Mean near-distance (N-D) disparity was 16.4? ± 12.3?. The MR recession averaged 4.4 ± 0.9 mm. Early mean postoperative ET was 1.3 ± 3.3? at distance and 2.8? ± 5.2? at near. Mean late postoperative ET was 0.1? ± 5.8? and 1.0? ± 6.2? at distance and near, respectively. At the final postoperative examination, mean N-D disparity was reduced to 0.9? ± 3.6?. Discussion: MR recession with PPF has a high long-term effectiveness, even in patients with amblyopia and autism. Since no posterior scleral suturing is required, it minimizes the perforation risk associated with scleral PF. Conclusion: MR recession with PPF is a safe and highly effective long-term treatment for ET with high AC/A ratio. Long-term results may surpass those of alternate procedures. PMID:22906381
Wabulembo, Geoffrey; Demer, Joseph L.
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
[Purpose] The purpose of this study was to determine whether forced expiration is correlated with abdominal muscle thickness. [Subjects] Twenty-three healthy male volunteers participated in this study. [Methods] The peak expiratory flow (PEF) was obtained using a peak flow meter with subjects in the sitting position. The thicknesses of the right rectus abdominis, external oblique, internal oblique, and transverse abdominis muscles were measured using B-mode ultrasonography at the end of a relaxed expiration in the supine position. [Results] Among the abdominal muscles, only the thickness of the external oblique muscle displayed a significant correlation with PEF. [Conclusion] It appears that the thickness of the external oblique muscle might be associated with PEF during forced expiration.
Ishida, Hiroshi; Kobara, Kenichi; Osaka, Hiroshi; Suehiro, Tadanobu; Ito, Tomotaka; Kurozumi, Chiharu; Watanabe, Susumu
Our purpose was to determine if endurance exercise training would increase the oxidative capacity of the abdominal expiratory muscles of the rat. Accordingly, 9 male rats were subjected to an endurance training protocol (1 h/day, 6 days/week, 9 weeks) and 9 litter-mates served as controls. Citrate synthase (CS) activity was used as an index of oxidative capacity, and was determined in the following muscles: soleus, plantaris, costal diaphragm, crural diaphragm, and in all four abdominal muscles: rectus abdominis, transversus abdominis, external oblique, and internal oblique. Compared to their non-trained litter-mates, the trained rats had higher peak whole body oxygen consumption rates (+ 16%) and CS activities in plantaris (+34%) and soleus (+36%) muscles. Thus, the training program caused substantial systemic and locomotor muscle adaptations. The CS activity of costal diaphragm was 20% greater in the trained animals, but no difference was observed in crural diaphragm. The CS activity in the abdominal muscles was less than one-half of that in locomotor and diaphragm muscles, and there were no significant changes with training except in the rectus abdominis where a 26% increase was observed. The increase in rectus abdominis CS activity may reflect its role in postural support and/or locomotion, as none of the primary expiratory pumping muscles adapted to the training protocol. The relatively low levels of CS activity in the abdominal muscles suggests that they are not recruited frequently at rest, and the lack of an increase with training indicates that these muscles do not contribute significantly to the increased ventilatory activity accompanying exercise in the rat.
Uribe, J. M.; Stump, C. S.; Tipton, C. M.; Fregosi, R. F.
The purpose of this study was to determine force-length relations of selected human skeletal muscles, based on the theoretical foundations of the cross-bridge model and to calculate a strength curve for knee extension from these relations. Force-length relations were determined for the rectus femoris, vastus lateralis, vastus medialis, vastus intermedius and gastrocnemius muscles, using sarcomere\\/ fiber length data form both
Walter Herzog; Sheila K. Abrahamse; Henk E. D. J. Keurs
Background Alternative macrophages (M2) express the cluster differentiation (CD) 206 (MCR1) at high levels. Decreased M2 in adipose tissue is known to be associated with obesity and inflammation-related metabolic disturbances. Here we aimed to investigate MCR1 relative to CD68 (total macrophages) gene expression in association with adipogenic and mitochondrial genes, which were measured in human visceral [VWAT, n?=?147] and subcutaneous adipose tissue [SWAT, n?=?76] and in rectus abdominis muscle (n?=?23). The effects of surgery-induced weight loss were also longitudinally evaluated (n?=?6). Results MCR1 and CD68 gene expression levels were similar in VWAT and SWAT. A higher proportion of CD206 relative to total CD68 was present in subjects with less body fat and lower fasting glucose concentrations. The ratio MCR1/CD68was positively associated with IRS1gene expression and with the expression of lipogenic genes such as ACACA, FASN and THRSP, even after adjusting for BMI. The ratio MCR1/CD68 in SWAT increased significantly after the surgery-induced weight loss (+44.7%; p?=?0.005) in parallel to the expression of adipogenic genes. In addition, SWAT MCR1/CD68ratio was significantly associated with muscle mitochondrial gene expression (PPARGC1A, TFAM and MT-CO3). AT CD206 was confirmed by immunohistochemistry to be specific of macrophages, especially abundant in crown-like structures. Conclusion A decreased ratio MCR1/CD68 is linked to adipose tissue and muscle mitochondrial dysfunction at least at the level of expression of adipogenic and mitochondrial genes. PMID:23951013
Moreno-Navarrete, Jose Maria; Ortega, Francisco; Gomez-Serrano, Maria; Garcia-Santos, Eva; Ricart, Wifredo; Tinahones, Francisco; Mingrone, Geltrude; Peral, Belen; Fernandez-Real, Jose Manuel
artery branches from the aorta are the coronary arteries that supply the heart muscle with blood. Disease pressure, obesity, lack of exercise and genetic traits inherited from your parents. Â· Heart valves can Heart 2 Prior to Admission 4 Home Preparation 5 Hospital Admission 7 The Day of Surgery 10 After Surgery
Mootha, Vamsi K.
[Purpose] The purpose of this study was to show the effect of different forefoot and heel support surfaces on the activities of the rectus femoris and medial hamstring muscles during the sit-to-stand task while wearing high-heel shoes. [Subjects] Fifteen female subjects were recruited. [Methods] The muscle activities of the rectus femoris and hamstring muscles were recorded using an MP150 system during the sit-to-stand task while wearing various high-heeled shoes. [Results] The activities of the rectus femoris and medial hamstring muscles significantly decreased when subjects wore condition 1 shoes compared with when they wore condition 2, 3 or 4 high-heeled shoes. The activities of the rectus femoris and medial hamstring muscles significantly decreased when subjects wore condition 2 high-heeled shoes compared with condition 3 or 4 high-heeled shoes. [Conclusion] The results can be interpreted as indicating that the size of the forefoot supporting surface can influence the lower extremity muscles of women wearing high-heeled shoes more than the size of the heel supporting surface. PMID:25364105
The motor neurons for the accessory muscles of respiration, pectoralis, trapezius, external oblique, and the rectus abdominis were studied in the spinal cord. The objective was to determine if the localization and morphology of the motor neurons for these muscles bear any distinct relationship to the specialized function of these muscles, serving both as supportive skeletal muscles and as accessory respiratory muscles. In addition, it was of interest to know if the inspiratory role of the pectoralis and trapezius muscles and the expiratory role of the external oblique and rectus abdominis are related to the spatial organization of the motor neurons; this knowledge may be important in the discrimination of influences from afferent connections. The motor neurons for these muscles were retrogradely labeled with true blue and were compared with the triceps motor neurons. All neurons occurred ipsilateral and most labeling occurred in C6-7. The motor neurons for the accessory muscles were mainly confined to the ventrolateral tip of the ventral gray matter. The triceps neurons were dorsolateral to the respiratory related neurons in C6-7. Within the confines of the ventrolateral area, the majority of neurons for the pectoralis were localized medial to ventromedial, those for the trapezius were ventrolateral, and those for the external oblique were in the extreme ventrolateral to ventral sections of C7. No neurons were observed in C2 to T2 for the rectus abdominis. A second neuronal column occurred medioventrally in the ventral gray of C4-6 for the trapezius, and is distinct and separated from the C6-7 cell column.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3212669
Charlton, C G; Crowell, B; Benson, R
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. PMID:17070475
Ortube, Maria Carolina; Bhola, Rahul; Demer, Joseph L.
The goal was to assess the effects of multiple aponeurotomy on mechanics of muscle with extramuscular myofascial connections. Using finite element modelling, effects of combinations of the intervention carried out at a proximal (P), an intermediate (I) and a distal (D) location were studied: (1) Case P, (2) Case P-I, (3) Case P-D and (4) Case P-I-D. Compared to Case
Can A. Yucesoy; Zeynep ?eref-Ferlengez; Peter A. Huijing
\\u000a The force–velocity relationship for a single muscle fibre is commonly described using a hyperbolic equation. In contrast,\\u000a in-vivo experiments on movements requiring coordination of multiple joints have found a linear relationship for leg press\\u000a and cycling.\\u000a \\u000a \\u000a To investigate this relationship, cycling was modelled using a forward dynamic model incorporating four muscles: rectus femoris,\\u000a a single vastus muscle, a single hamstring
P. J. Sinclair
The monitoring of a single muscle location does not reflect the heterogeneity of the muscle groups activation during exercise. In the past, measurements of oxygen consumption (VO2) at single muscle locations could be carried out non-invasively by near-infrared continuous wave spectroscopy (NIRCWS) at rest or during isometric contractions. In the present study, human regional quadriceps (vastus lateralis and rectus femoris) VO2 was investigated at rest and during maximal voluntary contractions using a 12- channel NIRCWS system with an acquisition time of 0.1 s.
Quaresima, Valentina; van der Sluijs, Marco C.; Menssen, Jan; Grillotti, Lucia; Ferrari, Marco; Colier, Willy N.
BACKGROUND/AIMS—In search of a way to prevent postoperative adhesion after strabismus surgery, an animal study was performed to assess the effect of a gel consisting of a polyglycan ester in a gelatin matrix (ADCON-L).?METHODS—Bilateral recessions of superior rectus muscle (SR) were performed on 16 rabbits. ADCON-L was applied beneath and over the SR in the right eyes of all rabbits, while the operative fields in the left eyes were irrigated with a balanced salt solution (BSS). The adjustment was performed on each SR at 4 and 7 days postoperatively on the same eye. The length and force of the adjustment and the degree of adhesion were recorded. At 3 weeks postoperatively, disinsertional force was measured in several of the eyes, and the other eyes were enucleated.?RESULTS—The length of the adjustment was longer and the force of the adjustment was less in the ADCON-L group than in the BSS treated group at 4 and 7 days postoperatively (p=0.00). A significant reduction (p=0.00) in the degree of adhesion was noted in eyes treated with ADCON-L. There was no significant difference in disinsertional force between the two groups. Histopathological evaluation of the muscle revealed decreased fibrosis of perimuscular connective tissue in eyes treated with ADCON-L at 3 weeks postoperatively.?CONCLUSION—This study suggests that ADCON-L helps to prevent postoperative adhesion in rabbits and enables adjustment twice within 7 days postoperatively without complications.?? PMID:11133717
Choi, M. Y.; Auh, S.; Choi, D. G.; Chang, B. L.
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
Byrne, JM, Bishop, NS, Caines, AM, Crane, KA, Feaver, AM, and Pearcey, GEP. Effect of using a suspension training system on muscle activation during the performance of a front plank exercise. J Strength Cond Res 28(11): 3049-3055, 2014-The objective of the study was to examine the effect of suspension training on muscle activation during performance of variations of the plank exercise. Twenty-one participants took part. All individuals completed 2 repetitions each of 4 different plank exercises that consisted of a floor based plank, or planks with arms suspended, feet suspended, or feet and arms suspended using a TRX Suspension System. During plank performance, muscle activation was recorded from rectus abdominis, external oblique, rectus femoris, and serratus anterior (SA) muscles using electromyography. All planks were performed for a total of 3 seconds. Resulting muscle activation data were amplitude normalized, and root mean square activation was then determined over the full 3 second duration of the exercise. A significant main effect of plank type was found for all muscles. Post hoc analysis and effect size examination indicated that abdominal muscle activation was higher in all suspended conditions compared to the floor based plank. The highest level of abdominal muscle activation occurred in the arms suspended and arms/feet suspended conditions, which did not differ from one another. Rectus femoris activation was greatest during the arms suspended condition, whereas SA activity peaked during normal and feet suspended planks. These results indicate that suspension training as performed in this study seems to be an effective means of increasing muscle activation during the plank exercise. Contrary to expectations, the additional instability created by suspending both the arms and feet did not result in any additional abdominal muscle activation. These findings have implications in prescription and progression of core muscle training programs. PMID:24796979
Byrne, Jeannette M; Bishop, Nicole S; Caines, Andrew M; Crane, Kalynn A; Feaver, Ashley M; Pearcey, Gregory E P
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))
The containment of the elevator muscle of the upper lip and wing of nose was used for the treatment of patients with gummy smile. This technique had corrected esthetic alterations of smile, reducing the upper lip elevation, which results in a smaller gingival display. An upper lip lengthening as well as a reduction in the upper lip shortening when the patient smiled could be observed. The high smile line was corrected without compromising the labial harmony. This study presents an innovative and effective therapeutic option to obtain a natural and harmonious smile. The patient expressed a high degree of satisfaction.
Storrer, Carmen Lucia Mueller; Valverde, Fabiane Kristine Bochenek; Santos, Felipe Rychuv; Deliberador, Tatiana Miranda
Trunk musculature in Urodela species varies by habitat. In this study, trunk musculature was examined in five species of adult salamanders representing three different habitats: aquatic species, Amphiuma tridactylum and Necturus maculosus; semi-aquatic species, Cynops pyrrhogaster; terrestrial species, Hynobius nigrescens and Ambystoma tigrinum. More terrestrial species have heavier dorsal and ventral trunk muscles than more aquatic forms. By contrast, the lateral hypaxial musculature was stronger in more aquatic species. The number of layers of lateral hypaxial musculature varied among Urodela species and did not clearly correlate with their habitats. The M. rectus abdominis was separated from the lateral hypaxial musculature in both terrestrial and semi-aquatic species. In aquatic species, M. rectus abdominis was not separated from lateral hypaxial musculature. Lateral hypaxial musculature differed in thickness among species and was relatively thinner in terrestrial species. In more terrestrial species, dorsal muscles may be used for stabilization and ventral flexing against gravity. Ventral muscle may be used in preventing dorsally concave curvature of the trunk by dorsal muscles and by weight. The lengthy trunk supported by limbs needs muscular forces along the ventral contour line in more terrestrial species. And, the locomotion on well-developed limbs seems to lead to a decrease of the lateral hypaxial musculature. PMID:24065082
Omura, Ayano; Anzai, Wataru; Endo, Hideki
METHODS. Superior rectus and superior oblique muscles of hatchling chicks were treated in vivo either to increase levels of trophic factors CT-1, IGF-I, glial cell line-derived neurotro- phic factor (GDNF), or brain-derived neurotrophic factor (BDNF), or to decrease their levels with neutralizing antibodies and binding proteins. Forty-eight hours after factors were in- jected into the orbit, the contractile force of
Jennifer Chen; Christopher S. von Bartheld
The purpose of this study was to investigate the effect of repeated maximal isometric contraction on electromechanical delay (EMD) of the quadriceps femoris muscle. Eleven college-aged subjects participated in an exercise protocol which consisted of 25 one-leg maximal knee extensions each lasting 8 s, followed by a 2-s relaxation. Surface electromyography (EMG) was recorded from the vastus lateralis and rectus
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
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
Yoshihiro Miyamoto; Takao Hattori; Minoru Niimoto; Tetsuya Toge
Objectives. To compare the biomechanical properties of allografts, autografts, and synthetic materials used in sling surgery using the Instron tensinometer.Methods. The sling grafts we studied consisted of autologous tissues (dermis, rectus fascia, and vaginal mucosa), cadaver tissues (decellularized dermis and freeze-dried, gamma-irradiated fascia lata), and synthetics (Gore-Tex and polypropylene mesh). The sling grafts were constructed into two types of slings:
Jong M Choe; Rupa Kothandapani; Laura James; Doug Bowling
The purpose of this study was to investigate the difference in the onset times of the abdominal muscle following a rapid arm task in lumbar spinal stenosis (LSS). In total, 32 patients with LSS were recruited from W oriental hospital. Muscle activity onset of the internal oblique (IO) and external oblique (EO) muscles was measured by electromyography (EMG) activity with a rapid arm movement and during the performance of a walking task. The LSS group demonstrated a significantly later onset of the IO, EO, and rectus abdominal (RA) muscles than the normal group. The deltoid reaction time of the normal group demonstrated significantly earlier activations of IO and EO, while the deltoid reaction time of the LSS group demonstrated significantly delayed activations of IO and RA. The EMG measurements of the IO, EO, and RA muscles while standing and walking were reliable and they offer empirical information about the trunk muscle activation of LSS patients.
Song, Hyun Seung; Park, Seong Doo
This study assesses the interpretive value of cocaine, benzoylecgonine (BZE) and cocaethylene (COET) in skeletal muscle (rectus femoris) in cocaine-using decedents. The distribution of these analytes in cardiac muscle (CM), vitreous humour (VH), femoral blood (FB) and cardiac blood (CB) is also reported. In rectus femoris muscle, the spatial distribution of the analytes was examined across the whole rectus femoris muscle collected from seven fatalities in which cocaine was detected. In six of these cases, death was attributed to trauma and in one case the cause of death was undetermined but suspected to be drug related. In two additional cases analytes were detected in the blood and/or VH but not in the muscle. The muscle was sectioned into 12-15 approximately equal segments, each of which was analysed after homogenisation. Tissue and bio-fluid samples were extracted by solid phase extraction with confirmation and quantification by GC-ion trap-MS/MS. No significant variation was observed in the concentration of any analyte throughout the muscle in the 7 cases analysed. The results reported here are in contrast to a previous study in which great variation in the concentration of some basic drugs (mainly tricyclic antidepressants and benzodiazepines) was observed throughout the thigh muscle bulk (Williams and Pounder, 1997). Analyte concentrations in skeletal muscle (SM) correlated well with those in FB (p<0.01). In general, the concentration of cocaine and COET followed the order VH > CM > SM > FB ? CB. Cocaine concentrations measured in VH were significantly higher than in blood and muscle. Inter-matrix variations in the concentrations of BZE and COET were less marked. The concentration of BZE exceeded that of cocaine in all matrices and in all cases except one where the time between death and drug intake was suspected to be short. In this case, the cocaine to BZE ratio measured in SM (2.66), CM (2.91) and VH (2.19) was higher than that measured in FB (0.97). Given that the concentrations of cocaine and its metabolites were uniformly distributed throughout the muscle and considering the good correlation observed between muscle and blood, muscle could be of interpretive value in cocaine related deaths. Further, since cocaine is known to have greater post-mortem stability in muscle than blood, concentrations measured in muscle may reflect more closely those at the time of death and might be of particular value in cases with an extended period between death and tissue sampling. PMID:23291147
Rees, Kelly A; Seulin, Saskia; Yonamine, Mauricio; Leyton, Vilma; Munoz, Daniel R; Gianvecchio, Victor A P; Pounder, Derrick J; Osselton, M David
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. PMID:23015909
Bottoni, Craig R.; D'Alleyrand, Jean-Claude G.
In this paper, the authors investigate the passive viscoelastic properties of rabbit abdominal wall. In vitro strain relaxation tests were performed in the oblique muscle (in two perpendicular directions), the rectus abdominis and the linea alba in the longitudinal direction. Based on experimental data, a model for the viscoelastic mechanical properties of this tissue is presented here. In particular, we used a 3D non-linear viscoelastic model to fit data sets obtained from tissue of the rabbit abdominal wall. Uniaxial relaxation tests were carried out for samples obtained from the abdominal wall. The experimental results clearly demonstrate the anisotropy and nonlinearity of the abdominal tissue. The stress relaxation was higher in the transverse direction (closer to muscle fibers) with an average value of the final stress ratio of 48%, than in the longitudinal direction with around 56% of this ratio for the oblique muscle. These tests, at several stretch levels, presented a different behavior depending on the region where the tissue sample was located. There was no dependence between the stress relaxation ratio and the stretch level for the oblique muscles in their longitudinal or transverse directions (p>0.01). In contrast, for rectus abdominis and linea alba a dependence between the stress relaxation ratio and stretch level was found. Our study revealed an increase in the stress relaxation ratio for the rectus abdominis (p<0.01) and a decrease for the linea alba with higher stretch levels (p<0.01). Overall good predictions ?<0.115 were obtained with the model proposed for the oblique muscle (no dependence on the stretch level) and to reproduce the non-linear viscoelastic response of rectus abdominis and linea alba. PMID:24793173
Calvo, B; Sierra, M; Grasa, J; Muñoz, M J; Peña, E
decrease in peak single-twitch tension might occur in the antagonist of the affected muscle under any, extraocular muscle, eye muscle surgery, length-tension, muscle plasticity References 1. Rosenbaum AL, Egbert growth of striated muscle fibers. JAnat. 1973; 116:45-55. 7. Scott AB. Change of eye muscle sarcomeres
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
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
Purpose To characterize how infants with myelomeningocele (MMC) activate lower limb muscles over the first year of life, without practice, while stepping on a motorized treadmill. Methods Twelve infants with MMC were tested longitudinally at 1, 6, 12 months. Electromyography (EMG) was used to collect data from the tibialis anterior (TA), lateral gastrocnemius (LG), rectus femoris (RF), biceps femoris (BF). Results Across the first year, infants showed no EMG activity for ~50% of the stride cycle w/poor rhythmicity and timing of muscles, when activated. Single muscle activation predominated; agonist-antagonist co-activation was low. Probability of individual muscle activity across the stride decreased w/age. Conclusions Infants with MMC show high variability in timing and duration of muscle activity, few complex combinations, and very little change over time. PMID:23685739
Sansom, Jennifer K.; Teulier, Caroline; Smith, Beth A.; Moerchen, Victoria; Muraszko, Karin; Ulrich, Beverly D.
In this paper, we present a semi-automated segmentation method for magnetic resonance images of the quadriceps muscles. Our\\u000a method uses an anatomically anchored, template-based initialization of the level set-based segmentation approach. The method\\u000a only requires the input of a single point from the user inside the rectus femoris. The templates are quantitatively selected\\u000a from a set of images based on
Jeffrey W. Prescott; Thomas M. Best; Mark S. Swanson; Furqan Haq; Rebecca D. Jackson; Metin N. Gurcan
Rectus Sheath Hematoma (RSH) represents an unusual entity which is characterized by acute abdominal pain and tender palpable abdominal mass usually, among elderly patients receiving anticoagulant therapy. We report the case of an 81-year-old woman admitted to our department due to acute abdominal pain and oligoanuria. The patient had recently been hospitalized due to acute myocardial infarction (AMI) and atrial fibrillation (AF) and received both anticoagulant and antiplatelet therapies. The radiological assessments revealed an extended Rectus Sheath Hematoma and bilateral hydronephrosis. Treatment of the hematoma required cessation of anticoagulants and antiplatelet agents, immobilization, blood and fresh frozen plasma transfusion, and administration of vasopressors. The patient recovered gradually and was discharged home fifteen (15) days later. PMID:25126429
Mourounoglou, Maria; Sabanis, Nikolaos
This study explored the trunk and lower limb muscle activity of 15 males during unilateral hockey bag carriage of 10%, 20%, and 30% of one's body weight (BW) compared with without a load during walking. The electromyography (EMG) activities of the left and right erector spinae, rectus abdominis, gluteus maximus, rectus femoris, vastus medialis, biceps femoris, semitendinosus, and the medial gastrocnemius were studied. A 2-way repeated measures analysis of variance (ANOVA) was used to examine the differences between the load weight and muscle side. Results showed significant increase in peak EMG and iEMG in the carrying side vastus medialis, rectus abdominis, semitendinosus, and gastrocnemii (p < 0.05) at the 30% BW load. The noncarrying side showed a greater peak EMG in the semitendinosus and rectus femoris at the 30% BW load when compared with the carrying side (p < 0.05). It was concluded that unilateral hockey bag carriage is similar to both backpack and side-pack carriage styles. PMID:24392769
Corrigan, Liam Patrick; Li, Jing Xian
This study examined the effects of unloading on skeletal muscle structure. Method: Eight subjects walked on crutches for six weeks with a 110 cm elevated sole on the right shoe. This removed weight bearing by the left lower limb. Magnetic resonance imaging of both lower limbs and biopsies of the left m. vastus laterallis (VL) were used to study muscle structure. Results: Unloading decreased (P less than 0.05) muscle cross-sectional areas (CSA) of the knee extensors 16 percent. The knee flexors showed about 1/2 of this response (-7 percent, P less than 0.05). The three vasti muscles each showed decreases (P less than 0.05) of about 15 percent. M. rectus femoris did not change. Mean fiber CSA in VL decreased (P less than 0.05) 14 percent with type 2 and type 1 fibers showing reductions of 15 and 11 percent respectively. The ankle extensors showed a 20 percent decrease (P less than 0.05) in CSA. The reduction for the 'fast' m. gastrocnemius was 27 percent compared to the 18 percent decrease for the 'slow' soleus. Summary: The results suggest that decreases in muscle CSA are determined by the relative change in impact loading history because atrophy was (1) greater in extensor than flexor muscles, (2) at least as great in fast as compared to slow muscles or fibers, and (3) not dependent on single or multi-joint function. They also suggest that the atrophic responses to unloading reported for lower mammals are quantitatively but not qualitatively similar to those of humans.
Dudley, G.; Tesch, P.; Hather, B.; Adams, G.; Buchanan, P.
: We devised a method to measure the Q-angle (the angle between the rectus femoris and the patellar ligament), using computed\\u000a tomography (CT), in 1993. In this study, I investigated the lateral shift at each point forming the angle as factors affecting\\u000a the Q-angle. The study group consisted of 83 patients with recurrent patellar dislocation (83 lower limbs) and a
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 study consisted of biomechanical modelling and in vitro experiments. The objective of the study was to find a mechanical cause of acute low back pain (LBP) in everyday situations. The precise mechanism producing LBP is still under discussion. Most biomechanical studies link the concepts of stooped postures and buckling instability of the spine under high compressive load. No biomechanical model addresses situations with small or neglectable compressive spinal load. The proposed conceptual model describes strain on the iliolumbar ligaments (ILs) when slouching from standing upright. Delayed or absent recruitment of back muscles that protect against hyperkyphosis of the lumbar spine is a conditional factor. Erector spinae and multifidus muscle forces are included, representing a bifurcation in back muscle force: one part acting on the iliac bones and one part acting on the sacrum. The multifidus muscle action on the sacrum may produce nutation which can be counteracted by pelvic floor muscles, which would link back problems and pelvic floor problems. The effect of simulated muscle tension on the ILs and the L5-S1 intervertebral disc angle was measured using embalmed specimens. Forces were applied to simulate erector spinae and sacral part of multifidus tension, bilateral up to 100 N each. Strain gauge sensors registered elongation of the ILs. Explorative biomechanical model calculations show that dynamic slouching, driven by upper body weight and (as an example) rectus abdominis muscle force may produce failure load of the spinal column and the ILs. The quasi-static test on embalmed specimens showed a significant increase of IL elongation with simulated rectus abdominis muscle force. Adding erector spinae or multifidus muscle tension eased the ILs. Sudden slouching of the upright trunk may create failure risk for the spine and ILs. This loading mode may be prevented by controlling loss of lumbar lordosis with erector spinae and multifidus muscle force. PMID:17553728
Snijders, Chris J; Hermans, Paul F G; Niesing, Ruud; Jan Kleinrensink, Gert; Pool-Goudzwaard, Annelies
The unipedicled TRAM flap is an useful alternative to breast reconstruction after mastectomy in patients who refuse mammary implants. There is however the risk of unpredictable partial skin necrosis even after rigorous surgical procedures. Certain authors have proposed color flow doppler assessment before reconstructive surgery better to identify the vascular network and optimise patient selection. We performed a prospective study
B. Meunier; E. Watier; J. Leveque; G. Roche; Y. Rolland; J. P. Pailheret
Summary The unipedicled TRAM flap is an useful alternative to breast reconstruction after mastectomy in patients who refuse mammary implants. There is however the risk of unpredictable partial skin necrosis even after rigorous surgical procedures. Certain authors have proposed color flow doppler assessment before reconstructive surgery better to identify the vascular network and optimise patient selection. We performed a prospective
B Meunier; E Watier; J Leveque; G Roche; Y Rolland; JP Pailheret
[Purpose] This study compared the effects of sling exercises with and without vibration on the muscular activity of the internal oblique (IO), rectus abdominis (RA), multifidus (MF), and erector spinae (ES) muscles of healthy adults. [Methods] Eleven healthy university students (11 men) with a mean age of 22.8?years were enrolled in this study. Subjects performed supine and prone bridge exercises with the knees flexed using a sling suspension system with and without vibration. The amplitudes of the EMG activities of selected trunk muscles (internal oblique, rectus abdominis, erector spinae, multifidus) were recorded. Two types of exercise conditions were executed in a random sequence for 5 seconds each. The signals detected from the middle 3 seconds (after discarding the signals of the first and the last one seconds) were used in the analysis. A 3-minute break was given after each exercise to minimize muscle fatigue. [Results] During the supine bridge exercise with vibration, the activities of the IO, RA, MF, and ES muscles were significantly higher than those of the supine bridge exercise without vibration. Additionally, during the prone bridge exercise with vibration, the activities of the IO, RA, MF, and ES were significantly higher than those of the prone bridge exercise without vibration. [Conclusion] Sling exercises with vibration improved the trunk muscle activities of healthy adults compared to the sling exercises without vibration. The information presented here is important for clinicians who use lumbar stabilization exercises as an evaluation tool or a rehabilitation exercise. PMID:24259778
Choi, Youngin; Kang, Hyungkyu
Previous research has described kinetic characteristics of treadmill steps in very stable steppers, in cross-sectional designs. In this study we examined, longitudinally, muscle activation patterns during treadmill stepping, without practice, in 12 healthy infants at 1, 6, and 12 mo of age. We assessed lateral gastrocnemius, tibialis anterior, rectus femoris, and biceps femoris as infants stepped on a treadmill during twelve 20-s trials. Infants showed clear changes in kinematics, such as increased step frequency, increased heel contact at touch down, and more flat-footed contact at midstance. Electromyographic data showed high variability in muscle states (combinations), with high prevalence of all muscles active initially, reducing with age. Agonist-antagonist muscle coactivation also decreased as age increased. Probability analyses showed that across step cycles, the likelihood a muscle was on at any point tended to be <50%; lateral gastrocnemius was the exception, showing an adultlike pattern of probability across ages. In summary, over time, healthy infants produce a wide variety of muscle activation combinations and timings when generating stepping patterns on a treadmill, even if some levels of muscle control arose with time. However, the kinematic stability improved much more clearly than the underlying kinetic strategies. We conclude that although innate control of limb movement improves as infants grow, explore, and acquire functional movement, stepping on a treadmill is a novel and unpracticed one. Hence, developing stable underlying neural activations will only arise as functional practice ensues, similarly to that observed for other functional movements in infancy. PMID:22490560
Teulier, Caroline; Sansom, Jennifer K.; Muraszko, Karin
Background: The aim of this study was to investigate the efficacy of the rectus abdominis myo-peritoneal flap (RAMP) technique for the closure and augmentation of small, non-elastic, non-compliant bladder exstrophies. Materials and Methods: The RAMP technique was used in three boys with bladder exstrophy who presented late with small, non-elastic, non-compliant bladder. The clinical outcome, imaging, cystoscopy, biochemical and microbiological studies were assessed during a follow-up of 36 months. Results: Bladder closure and augmentation was achieved in all patients without any complications. There were no urinary tract infections, metabolic problems or electrolyte disturbances and the kidney function remained normal in all patients. Radiography confirmed intact function and anatomy of the urinary tract and cystoscopy showed complete coverage of the inner peritoneal layer of RAMP with uroepithelium. No stone formation or mucous production was detected. Conclusions: The RAMP technique is a good alternative for closing bladder exstrophies and achieves an increase in bladder capacity and compliance. The technique is indicated in the closure of large bladder defects, bladder exstrophies with small, inelastic, non-compliant bladder remnants and failed primary closures. PMID:22279277
Hip joint surgeries are commonplace in our aging society. Robotic hip joint surgery is performed to cut bone precisely and is expected to be performed as minimally invasive treatment. Minimally invasive hip joint surgery needs operating space between muscle tissues and the bone around hip joint. In this paper a prototype of an articulated muscle-retracting robot for minimally invasive RAO
Masaru Yanagihara; Jun Okamoto; Norihiro Mitsui; Masakatsu G. Fujie
Background Impaired balance, loss of mobility and falls are major problems associated with changes in muscle in older adults. However, the extent to which muscle composition and related performance measures for different lower limb muscles are associated with falls in older individuals is unclear. This study evaluated lower limb muscle attenuation, intramuscular adipose tissue (IMAT) infiltration and muscle performance in older fallers and non-fallers. Methods For this cross-sectional study, fifty-eight community dwelling older individuals (>65 years) were classified into fallers (n?=?15) or non-fallers (n?=?43). Computed tomography (CT) was used to determine muscle attenuation and intramuscular adipose tissue (IMAT) of multiple thigh and hip muscles. Muscle performance was assessed with isokinetic dynamometry. Results For both groups, Rectus Femoris showed the highest muscle attenuation and lowest IMAT infiltration, and Gluteus Maximus and Gluteus Medius/Minimus muscles had the lowest muscle attenuation and highest IMAT infiltration. Fallers exhibited lower muscle attenuation and higher IMAT infiltration than non-faller participants in most muscles, where the gluteal muscles were the most affected (p?0.05). Fallers also showed a lower peak hip abduction torque (p?0.05). There were significant associations (r?=?0.31 to 0.53) between joint torques and muscle composition, with the strongest associations between Gluteus Medius/Minimus and hip abduction strength. Conclusions While fallers were generally differentiated from non-fallers by muscle composition, the most affected muscles were the proximal gluteal muscles of the hip joint accompanied by lower hip abduction strength, which may contribute to impaired balance function and increased risk for falls. PMID:24666603
The aim of this study was to locate the breakpoints of cerebral and muscle oxygenation and muscle electrical activity during a ramp exercise in reference to the first and second ventilatory thresholds. Twenty-five cyclists completed a maximal ramp test on an electromagnetically braked cycle-ergometer with a rate of increment of 25 W/min. Expired gazes (breath-by-breath), prefrontal cortex and vastus lateralis (VL) oxygenation [Near-infrared spectroscopy (NIRS)] together with electromyographic (EMG) Root Mean Square (RMS) activity for the VL, rectus femoris (RF), and biceps femoris (BF) muscles were continuously assessed. There was a non-linear increase in both cerebral deoxyhemoglobin (at 56 ± 13% of the exercise) and oxyhemoglobin (56 ± 8% of exercise) concomitantly to the first ventilatory threshold (57 ± 6% of exercise, p > 0.86, Cohen's d < 0.1). Cerebral deoxyhemoglobin further increased (87 ± 10% of exercise) while oxyhemoglobin reached a plateau/decreased (86 ± 8% of exercise) after the second ventilatory threshold (81 ± 6% of exercise, p < 0.05, d > 0.8). We identified one threshold only for muscle parameters with a non-linear decrease in muscle oxyhemoglobin (78 ± 9% of exercise), attenuation in muscle deoxyhemoglobin (80 ± 8% of exercise), and increase in EMG activity of VL (89 ± 5% of exercise), RF (82 ± 14% of exercise), and BF (85 ± 9% of exercise). The thresholds in BF and VL EMG activity occurred after the second ventilatory threshold (p < 0.05, d > 0.6). Our results suggest that the metabolic and ventilatory events characterizing this latter cardiopulmonary threshold may affect both cerebral and muscle oxygenation levels, and in turn, muscle recruitment responses. PMID:24782786
Racinais, Sebastien; Buchheit, Martin; Girard, Olivier
The pelvic floor muscles are vital to male genitourinary health. Pelvic floor muscle training may prove helpful in a variety of clinical circumstances: stress urinary incontinence that follows prostate surgery, overactive bladder, postvoid dribbling, erectile dysfunction, ejaculation issues including premature ejaculation, and pelvic pain due to levator muscle spasm. PMID:24821468
Siegel, Andrew L
Seventeen male patients with ischaemic heart disease (IHD) and effort angina performed OBLA exercise stress tests (set to 2.0 mmol × 1-1). They had muscle biopsies from the vastus lateralis muscle the day before coronary by-pass grafting, and from the internal and external intercostal, diaphragm and gastrocnemius muscles during surgery. They had a low WOBLA (83 ± 6 W, mean
Jan Karlsson; Sigurd Gunnes; Bjarne Semb
The definition of spasticity as a velocity-dependent activation of the tonic stretch reflex during a stretch to a passive muscle is the most widely accepted. However, other mechanisms are also thought to contribute to pathological muscle activity and, in patients post-stroke and spinal cord injury can result in different activation patterns. In the lower-limbs of children with spastic cerebral palsy (CP) these distinct activation patterns have not yet been thoroughly explored. The aim of the study was to apply an instrumented assessment to quantify different muscle activation patterns in four lower-limb muscles of children with CP. Fifty-four children with CP were included (males/females n?=?35/19; 10.8±3.8 yrs; bilateral/unilateral involvement n?=? 32/22; Gross Motor Functional Classification Score I–IV) of whom ten were retested to evaluate intra-rater reliability. With the subject relaxed, single-joint, sagittal-plane movements of the hip, knee, and ankle were performed to stretch the lower-limb muscles at three increasing velocities. Muscle activity and joint motion were synchronously recorded using inertial sensors and electromyography (EMG) from the adductors, medial hamstrings, rectus femoris, and gastrocnemius. Muscles were visually categorised into activation patterns using average, normalized root mean square EMG (RMS-EMG) compared across increasing position zones and velocities. Based on the visual categorisation, quantitative parameters were defined using stretch-reflex thresholds and normalized RMS-EMG. These parameters were compared between muscles with different activation patterns. All patterns were dominated by high velocity-dependent muscle activation, but in more than half, low velocity-dependent activation was also observed. Muscle activation patterns were found to be both muscle- and subject-specific (p<0.01). The intra-rater reliability of all quantitative parameters was moderate to good. Comparing RMS-EMG between incremental position zones during low velocity stretches was found to be the most sensitive in categorizing muscles into activation patterns (p<0.01). Future studies should investigate whether muscles with different patterns react differently to treatment. PMID:24651860
Bar-On, Lynn; Aertbelien, Erwin; Molenaers, Guy; Desloovere, Kaat
To establish an adequate model to study the proliferation and differentiation of adult caprine skeletal muscle in response to bioactive compounds, a pool of satellite cells (SC) was derived from the rectus abdominis muscle of adult goat. Skeletal muscle contains a population of adult stem cells, named as satellite cells that reside beneath the basal lamina of skeletal muscle fiber and other populations of cells. These SC are multipotent stem cells, since cells cultured in the presence of specific cell lineage inducing cocktails can differentiate into several types of mesenchymal lineage, such as osteocytes and adipocytes. In the present study, we have developed a modified protocol for isolating satellite cells (>90%) and examined their myogenic and contractile properties in vitro. PMID:20865326
Ramani, Umed V.; Ahir, Viral B.; Rank, Dharamshi N.; Joshi, Chaitanya G.
The transverse rectus abdominis musculocutaneus (TRAM) flap is ideal for unilateral breast reconstruction. It can produce a breast with a lasting natural look, soft feeling, and good resemblance to the opposite breast. The aim was to evaluate long-term results of the TRAM flap reconstruction in an homogenous study population and to examine the impact on abdominal competence, appearance, and function relative to patient satisfaction. The study included 123 women from the cohort of patients undergoing a postmastectomy breast reconstruction in the period from 1992-2005. Data was collected from patient charts, a study-specific questionnaire, and a clinical follow-up visit. The response to the questionnaire was 81% (100/123), and 78 of them participated in a clinical follow-up visit. Eighty-four per cent were satisfied with the overall results of their breast reconstruction, and the majority of the women were pleased with the overall appearance of their abdomen. A significant correlation existed between satisfaction with the abdominal appearance and donor site complications (p = 0.01). No association was determined between complications in the breast area and smoking. A BMI above 25 increased the risk of complications. Radiation therapy (RT) significantly increased the risk of severe complications (p = 0.04) and of an inferior aesthetic result (p = 0.03). In conclusion, after a median of 6 years, women reconstructed with a TRAM flap were pleased with the overall result, with the appearance and strength of their abdomen including the umbilicus. Breast reconstruction with the pedicled TRAM flap results in lasting good results and pleased patients. PMID:23710788
Christensen, Bekka O; Overgaard, Jens; Kettner, Laura O; Damsgaard, Tine E
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
Six competitive soccer players were recruited to examine EMG activation in three quadriceps muscles during a kicking accuracy task. Participants performed three maximum instep place kicks of a stationary ball, 11 m perpendicular from the centre of the goal line towards targets (0.75 m(2)) in the four corners of the goal. Surface EMG of the vastus lateralis, vastus medialis, and rectus femoris of the kicking leg was normalized and averaged across all participants to compare between muscles, targets, and the phase of the kick. Although no significant difference were observed between muscles or kick phases, kicks to the right targets produced significantly greater muscle activity than those towards the left targets (P < 0.01). In addition, kicks towards the top right target demonstrated significantly greater muscle activity than towards the top and bottom left (P < 0.01). Under accurate soccer shooting conditions, kicks aimed to the top right corner of the goal demonstrated a higher level of quadriceps muscle activation than those towards the other corners. PMID:21170796
Scurr, Joanna C; Abbott, Victoria; Ball, Nick
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
Muscle fatigue is the decline in ability of a muscle to create force. Electromyography (EMG) is a medical technique for measuring muscle response to nervous stimulation. During a sustained muscle contraction, the power spectrum of the EMG shifts towards lower frequencies. These effects are due to muscle fatigue. Muscle fatigue is often a result of unhealthy work practice. In this research, the effectiveness of the wavelet transform applied to the surface EMG (SEMG) signal as a means of understanding muscle fatigue during walk is presented. Power spectrum and bispectrum analysis on the EMG signal getting from right rectus femoris muscle is executed utilizing various wavelet functions (WFs). It is possible to recognize muscle fatigue appreciably with the proper choice of the WF. The outcome proves that the most momentous changes in the EMG power spectrum are symbolized by WF Daubechies45. Moreover, this research has compared bispectrum properties to the other WFs. To determine muscle fatigue during gait, Daubechies45 is used in this research to analyze the SEMG signal.
Hussain, M. S.; Mamun, Md.
Research during the 1950's indicated that exercise played a role in the reduction of tumor growth. In the 1960's our studies confirmed that tumor-bearing rats, exercised to fatigue, demonstrated tumor inhibition. Our further studies isolated an extract (Fatigue Substance, or F-Substance) from rectus femoris muscles of rats which had been electrically stimulated to fatigue. This extract significantly inhibited growth of transplanted rat tumors. Research continued until 1978 when it became apparent the methodology at that time was not able to further identify the substance's active components. Using current technology, we now report on the further isolation and characterization of F-Substance. In cell proliferation assays, extracts from electrically stimulated rat rectus femoris muscles had more significant inhibitory effect on the breast cancer cell line MCF-7 than those isolated from unstimulated muscles. To identify the molecule(s) responsible for the antitumor activity, a rat cytokine antibody array was used to profile the cytokines in the substances. Among the 29 different cytokines contained on the array, 3 showed greater than 3-fold difference between the substances isolated from the stimulated and unstimulated muscles. LIX (also known as CXCL5) is 6-fold higher in the substances isolated from stimulated muscles than those from the unstimulated muscles. TIMP-1 is 4.6 fold higher and sICAM is 3.6 fold higher in the substances from the stimulated muscles. Our results indicated that cytokines released from contracting muscles might be responsible for the antitumor effect of F-Substance. PMID:23678371
Munoz, Ruben M.; Han, Haiyong; Tegeler, Tony; Petritis, Konstantinos; Von Hoff, Daniel D.; Hoffman, Stanley A.
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. PMID:21799133
Chin, Lisa M. K.; Kowalchuk, John M.; Barstow, Thomas J.; Kondo, Narihiko; Amano, Tatsuro; Shiojiri, Tomoyuki
The transformation of liver and biliary tract surgery into a full speciality began with the application of functional anatomy to segmental surgery in the 1950's, reinforced by ultrasound and new imaging techniques. The spectrum of gall-stone disease encountered by the hepatobiliary surgeon has changed with the laparoscopic approach to cholecystectomy. There is increased need for conservation techniques to repair the
Henri Bismuth; Pietro E. Majno
[Purpose] The purpose of this study was to investigate the changes in muscle activation of the trunk and lower extremities and plantar foot pressure due to backpack loads of 0, 10, 15, and 20% of body weight during level walking in individuals with flatfoot. [Methods] Fourteen young flatfoot subjects and 12 normal foot subjects participated in this study. In each session, the subjects were assigned to carry a backpack load, and there were four level walking modes: (1) unloaded walking (0%), (2) 10% body weight (BW) load, (3) 15% BW load, and (4) 20% BW load. Trunk and lower extremity muscle activities were recorded by surface EMG, and contact area and plantar foot pressure were determined using a RS scan system. [Results] The erector spinae, vastus medialis, tibialis anterior and gastrocnemius muscle activities, but not the rectus femoris and rectus abdominis muscle activities of flatfoot subjects significantly and progressively increased as load increased in flatfoot subjects. Contact area and pressure of the lateral and medial heel zones were significantly increased too. [Conclusion] Based on this data, the weight of a backpack could influence muscle activation and plantar foot pressure in flatfoot. PMID:24396193
The extent of unnecessary surgery has been the object of considerable speculation and occasional wild accusation in recent years. Most evidence of the existence of unnecessary surgery, such as information from studies of geographic variations and the results of second surgical opinion programs, is circumstantial. However, results from the few studies that have measured unnecessary surgery directly indicate that for some highly controversial operations the fraction that are unwarranted could be as high as 30 percent. Most unnecessary surgery results from physician uncertainty about the effectiveness of an operation. Elimination of this uncertainty requires more efficient production and dissemination of scientific information about clinical effectiveness. In the absence of adequate data from scientific studies, the use of a consensus of expert opinion, disseminated by means of comprehensive practice guidelines, offers the best opportunity to identify and eliminate unnecessary surgery. PMID:2668237
Leape, L L
[Purpose] The purpose of this study was to examine the activities of the abdominal muscles of women who had experienced vaginal delivery in comparison with those who had experienced Cesarean childbirth. [Subjects and Methods] A total of 14 subjects (7 vaginal delivery, 7 Cesarean section) performed an active straight leg raise to 20?cm above the ground, and we measured the activities of the internal oblique abdominal muscle, the external oblique abdominal muscle, and the rectus abdominal muscle on both sides using electromyography. The effort required to raise the leg was scored on a Likert scale. Then, the subjects conducted maximum isometric contraction for hip joint flexion with the leg raised at 20?cm, and maximum torque and abdominal muscle activities were measured using electromyography. [Results] During the active straight leg raise, abdominal muscle activities were higher in the Cesarean section subjects. The Likert scale did not show a significant difference. The activities of the abdominal muscles and the maximum torque of the hip joint flexion at maximum isometric contraction were higher in the vaginal delivery subjects. [Conclusion] The abdominal muscles of Cesarean section subjects showed greater recruitment for maintaining pelvic stability during the active straight leg raising, but were relatively weaker when powerful force was required. Therefore, we consider that more abdominal muscle training is necessary for maintaining pelvic stability of Cesarean section subjects. PMID:25202194
Kwon, Yu-Jeong; Hyung, Eun-Ju; Yang, Kyung-Hye; Lee, Hyun-Ok
The composite anterolateral thigh flap with vascularized fascia lata has emerged as a workhorse at our institution for complex Achilles defects requiring both tendon and soft tissue reconstruction. Safe elevation of this flap, however, is occasionally challenged by absent or inadequate perforators supplying the anterolateral thigh. When discovered intraoperatively, alternative options derived from the same vascular network can be pursued. We present the case of a 74-year-old male who underwent composite Achilles defect reconstruction using a segmental rectus femoris myofascial free flap. Following graduated rehabilitation, postoperatively, the patient resumed full activity and was able to ambulate on his tip-toes. At 1-year follow-up, active total range of motion of the reconstructed ankle exceeded 85% of the unaffected side, and donor site morbidity was negligible. American Orthopaedic Foot and Ankle Society and Short Form-36 scores improved by 78.8% and 28.8%, respectively, compared to preoperative baseline assessments. Based on our findings, we advocate for use of the combined rectus femoris myofascial free flap as a rescue option for reconstructing composite Achilles tendon/posterior leg defects in the setting of inadequate anterolateral thigh perforators. To our knowledge, this is the first report to describe use of this flap for such an indication. PMID:24883281
DeFazio, Michael Vincent; Han, Kevin Dong
In hand reconstructive surgery the palmaris longus muscle is one of the most utilized donor site for tendon reconstruction procedures. However, its anatomic position is variable and anatomic variations may be responsible for median nerve compression. We report the case of a 40-year-old, right-handed woman, who presented with numbness and paresthesias in the palm and in the flexor aspect of the first, second, and third fingers of her right hand for the preceding 5 months, coinciding with increase of office work (typing). The clinical examination and radiological investigations (ultrasound and magnetic resonance) revealed a subcutaneous mass (15 mm x 2.3 mm x 6 cm), with a lenticular shape and definite edges at the level of the volar aspect of the distal third of the forearm. The fine-needle aspiration biopsy revealed the presence of striated muscle fibers. During surgery, a muscle belly was found in the epifascial plane. This muscle originated from subcutaneous septa in the middle forearm and inserted on to the superficial palmar aponeurosis with fine short tendon fibers. Exposure of the antebrachial fascia did not reveal any area of weakness or muscle herniation. The palmaris longus tendon, flexor digitorum superficialis tendons, and flexor carpi radialis tendon showed usual topography under the antebrachial fascia. The accessory muscle was excised and histology revealed unremarkable striated muscle fibers, limited by a thin connective sheath. The presence of an accessory palmaris longus (APL) located in the epifascial plane could be ascribed to an unusual migration of myoblasts during the morphogenesis. Although extremely rare, APL is worth bearing in mind as a possible cause of median nerve compression and etiology of a volar mass in the distal forearm. PMID:16917822
Tiengo, Cesare; Macchi, Veronica; Stecco, Carla; Bassetto, Franco; De Caro, Raffaele
This study aimed to determine whether muscle stress (force per unit area) can be redistributed between individual heads of the quadriceps muscle when pain is induced into one of these heads. Elastography was used to measure muscle shear elastic modulus (an index of muscle stress). Electromyography (EMG) was recorded from vastus lateralis (VL), vastus medialis (VM), and rectus femoris (RF). In experiment I (n = 20), participants matched a knee extension force, and thus any reduction of stress within the painful muscle would require compensation by other muscles. In experiment II (n = 13), participants matched VL EMG amplitude and were free to vary external force such that intermuscle compensation would be unnecessary to maintain the experimental task. In experiments I and II, pain was induced by injection of hypertonic saline into VM or RF. Experiment III aimed to establish whether voluntary drive to the individual muscles could be controlled independently. Participants (n = 13) were asked to voluntarily reduce activation of VM or RF while maintaining knee extension force. During VM pain, there was no change in shear elastic modulus (experiments I and II) or EMG amplitude of VM (experiment II). In contrast, RF pain was associated with a reduction in RF elastic modulus (experiments I and II: -8 to -17%) and EMG amplitude (experiment II). Participants could voluntarily reduce EMG amplitude of RF (-26%; P = 0.003) but not VM (experiment III). These results highlight between-muscle differences in adaptation to pain that might be explained by their function (monoarticular vs. biarticular) and/or the neurophysiological constraints associated to their activation. PMID:25213640
Hug, François; Hodges, Paul W; Hoorn, Wolbert van den; Tucker, Kylie
\\u000a Surgery of the veins was dominant in the early days of the modern era of vascular surgery up to about 1980. Now it has languished\\u000a in performance and in progress. One of the many reasons for this is that arterial reconstruction is so spectacular and appealing\\u000a to both patient and surgeon that performance of its procedures has crowded out teaching
John J. Bergan; Nisha Bunke
\\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
Semicircular lipoatrophy is characterized by one or more partial, horizontal, band-like depressions, usually on the anterolateral thigh or thighs. We report the case of a 47-year-old woman who presented with a 1-month history of bilateral, parallel, symmetrical depressions on the anterolateral aspects of her thighs. She had been wearing a tight girdle, and the girdle's folds matched the cutaneous bands. Ultrasound examination of the affected areas showed that the muscle tensor fasciae latae became its tendon at this level, and the muscle rectus femoris originated at the same level in the deeper layer. Although semicircular lipoatrophy has a predisposition for the anterolateral aspect of the thigh, and has often been considered to be caused by repetitive mild trauma to the site, we speculate that it is also attributed to the vulnerability of the site, as explained by the muscle structure. PMID:25039249
Hinogami, Haruna; Sakai, Hiroshi; Shirabe, Hirotsugu
[Purpose] This study aimed to identify changes in muscle activation by comparing muscle activities of the affected side (AS) and non-affected side (NAS) during eccentric and concentric exercises in runners with unilateral Achilles tendinopathy. [Subjects] The study included 18 participants consisting of men and women with chronic Achilles tendinopathy in a single leg who had more than 1?year of running experience. [Methods] All subjects performed concentric and eccentric exercise with the Achilles tendon moving from full plantar flexion to full dorsiflexion for 8 seconds, and electromyography data was obtained. [Results] All muscles examined showed a significant increase in %maximal voluntary contraction (MVC) with concentric exercise compared with eccentric exercise. Compared with the NAS, the AS showed significant increases in %MVC of the rectus femoris, tibialis anterior, and lateral gastrocnemius. All interaction effects of exercise methods and injuries showed statistically significant changes. [Conclusion] Runners with Achilles tendinopathy show increases in medial gastrocnemius activity when performing eccentric exercise. PMID:25276014
The purpose of this investigation was to compare the thresholds of neuromuscular fatigue determined simultaneously from the vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) muscles using the electromyographic fatigue threshold (EMGFT) test. Eight adult volunteers [mean (SD) age, 33 (10) years] served as subjects for this investigation. The results of a one-way repeated measured ANOVA indicated that there was a significant (P < 0.05) difference among the mean EMGFT values for the VL [248(31)W], VM [223(43)W] and RF [220(30)W] muscles. Tukey post-hoc comparisons indicated that the EMGFT for the RF was significantly (P < 0.05) lower than that of the VL. These findings suggested that during cycle ergometry there is a dissociation in neuromuscular fatigue characteristics of the superficial muscles of the quadriceps femoris group. PMID:7588679
Housh, T J; deVries, H A; Johnson, G O; Housh, D J; Evans, S A; Stout, J R; Evetovich, T K; Bradway, R M
[Purpose] The purpose of this study was to investigate the effect of muscle vibration in the lower extremities in patients with Parkinson’s disease (PD) during walking. [Subjects] Nine patients with PD participated in this study and were tested with and without vibration (vibration at 60?Hz). [Methods] Eight oscillators of vibration were attached to the muscle bellies (tibialis anterior, gastrocnemius, biceps femoris, and rectus femoris) on both sides of the lower extremities with adhesive tape in this study. Spatiotemporal gait parameters were measured using a motion analysis system. [Results] Stride length and walking speed with vibration were significantly increased compared with those without vibration in PD patients. [Conclusion] These results suggest that the application of vibration to lower extremity muscles in patients with PD may improve the parkinsonian gait pattern. PMID:24926129
Han, Jintae; Kim, Eunjung; Jung, Jaemin; Lee, Junghoon; Sung, Hyeryun; Kim, Jaewoo
It has been well documented that the 15- to 35-Hz oscillatory activity of the sensorimotor cortex shows coherence with the muscle activity during weak to moderate steady contraction. To investigate the muscle dependency of the corticomuscular coherence and its training-related alterations, we quantified the coherence between electroencephalogram (EEG) from the sensorimotor cortex and rectified electromyogram (EMG) from five upper limb (first dorsal interosseous, flexor carpi radialis, extensor carpi radialis, biceps brachii, triceps brachii) and four lower limb muscles (soleus, tibialis anterior, biceps femoris, rectus femoris), while maintaining a constant force level at 30% of maximal voluntary contraction of each muscle, in 24 untrained, 12 skill-trained (ballet dancers), and 10 strength-trained (weightlifters) individuals. Data from untrained subjects demonstrated the muscle dependency of corticomuscular coherence. The magnitude of the EEG-EMG coherence was significantly greater in the distally located lower limb muscles, such as the soleus and tibialis anterior, than in the upper or other lower limb muscles in untrained subjects (P < 0.05). These results imply that oscillatory coupling between the sensorimotor cortex and spinal motoneurons during steady contraction differs among muscles, according to the functional role of each muscle. In addition, the ballet dancers and weightlifters showed smaller EEG-EMG coherences than the untrained subjects, especially in the lower limb muscles (P < 0.05). These results indicate that oscillatory interaction between the sensorimotor cortex and spinal motoneurons can be changed by long-term specialized use of the muscles and that this neural adaptation may lead to finer control of muscle force during steady contraction. PMID:20689093
Ushiyama, Junichi; Takahashi, Yuji; Ushiba, Junichi
The embryologic origin of the omohyoid muscle is different from that of the other neck muscles. A number of variations such as the absence of muscle, variable sites of origin and insertion, and multiple bellies have been reported. However, variations in the inferior belly of the omohyoid muscle are rare. There have been no reports of the combined occurrence of the omohyoid muscle variation with the appearance of the levator glandulase thyroideae muscle. Routine dissection of a 51-year-old female cadaver revealed a duplicated omohyoid muscle and the appearance of the levator glandulae thyroideae muscle. In this case, the two inferior bellies of the omohyoid muscle were found to originate inferiorly from the superior border of the scapula. One of the inferior bellies generally continued to the superior belly with the tendinous intersection. The other inferior belly continued into the sternohyoid muscle without the tendinous intersection. In this case, the levator glandulae thyroideae muscle appeared on the left side, which attached from the upper border of the thyroid gland to the inferior border of the thyroid cartilage. These variations are significant for clinicians during endoscopic diagnosis and surgery because of the arterial and nervous damage due to iatrogenic injuries. The embryologic origins of the omohyoid and levator glandulae thyroideae muscles may be similar based on the descriptions in the relevant literature. PMID:20879073
Kim, Deog-Im; Kim, Ho-Jeong; Park, Jae-Young
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. PMID:7072237
McDonald, Harold D.; Vasconez, Luis O.
Surgery of the spastic hand in cerebral palsy: report of thespastic muscles were defined in children with cerebral palsySpastic wrist flexors are more severely affected than wrist extensors in children with cerebral palsy.
Background Aging and obesity increase the risk for mobility limitations in women. Although trunk muscle composition is important to physical function, the implication of ectopic fat in the trunk muscles with respect to physical fitness and its potential for modification by lifestyle changes is unknown. Methods The effects of a 6-month period of either weight loss (WL) alone or of aerobic exercise (AEX) plus WL (AEX+WL), on trunk body composition, as measured by dual-energy X-ray absorptiometry (DXA) (to measure trunk fat and lean mass) and computed tomography (CT) (to measure the erector spinae, psoas, lateral abdominal, rectus abdominis muscle, and intramuscular fat, and the intramuscular adipose tissue [IMAT] areas) was determined in 65 overweight and obese postmenopausal women (aged 50–76 years). Results The area of the erector spinae, psoas, and rectus abdominis muscles declined with age in the women (P<0.05). Both the spinal and abdominal muscle areas were related to the maximal oxygen uptake (VO2max) (P<0.05). Body weight decreased by 8% after both AEX+WL and WL (P<0.001). The VO2max increased by 11% after AEX+WL (P<0.001) but did not change with WL alone (group effect, P<0.001). The DXA-measured trunk fat mass decreased by 16% after AEX+WL (P<0.001) and by 12% after WL (P<0.001). When both groups were combined, the IMAT decreased in all four muscle groups ? by 6% in the erector spinae (P<0.01), by 9% in the psoas (P<0.01), by 11% in the lateral abdominals (P<0.001), and by 6% in the rectus abdominis (P<0.05). The loss of fat mass was related to the loss of IMAT of the erector spinae and the lateral abdominals. Conclusions A lifestyle modification of diet-induced WL alone, or with AEX training, results in a significant reduction of the fat infiltration in the abdominal and spinal muscles of the trunk region. Our finding that losses of total body fat predict a reduction in the IMAT of the trunk supports the idea that WL reduces fat depots throughout the body. PMID:24623974
Ryan, Alice S; Harduarsingh-Permaul, Aruna Selina
The purpose of this study was to test the hypothesis that the reduction in plasma volume (PV) induced by resistance exercise reflects fluid loss to the extravascular space and subsequently selective increase in cross-sectional area (CSA) of active but not inactive skeletal muscle. We compared changes in active and inactive muscle CSA and PV after barbell squat exercise. Magnetic resonance imaging (MRI) was used to quantify muscle involvement in exercise and to determine CSA of muscle groups or individual muscles [vasti (VS), adductor (Add), hamstring (Ham), and rectus femoris (RF)]. Muscle involvement in exercise was determined using exercise-induced contrast shift in spin-spin relaxation time (T2)-weighted MR images immediately postexercise. Alterations in muscle size were based on the mean CSA of individual slices. Hematocrit, hemoglobin, and Evans blue dye were used to estimate changes in PV. Muscle CSA and PV data were obtained preexercise and immediately postexercise and 15 and 45 min thereafter. A hierarchy of muscle involvement in exercise was found such that VS > Add > Ham > RF, with the Ham and RF showing essentially no involvement. CSA of the VS and Add muscle groups were increased 10 and 5%, respectively, immediately after exercise in each thigh with no changes in Ham and RF CSA. PV was decreased 22% immediately following exercise. The absolute loss of PV was correlated (r2 = 0.75) with absolute increase in muscle CSA immediately postexercise, supporting the notion that increased muscle size after resistance exercise reflects primarily fluid movement from the vascular space into active but not inactive muscle.
Ploutz-Snyder, L. L.; Convertino, V. A.; Dudley, G. A.
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. PMID:23304595
Wada, Kota; Watanabe, Subaru; Ando, Yuji; Seino, Yoichi; Moriyama, Hiroshi
Muscle thickness was measured in 19 Bed-Rested (BR) men (32-42 year) subjected to IsoTonic (ITE, cycle orgometer) and IsoKi- netic (IKE, torque orgometer) lower extremity exercise training, and NO Exercise (NOE) training. Thickness was measured with ultrasonography in anterior thigh-Rectus Femoris (RF) and Vastus Intermadius (VI), and combined posterior log-soleus, flexor ballucis longus, and tibialis posterior (S + FHL +TP) - muscles. Compared with ambulatory control values, thickness of the (S + FHL + TP) decreased by 90%-12% (p less than 0.05) In all three test groups. The (RF) thickness was unchanged in the two exercise groups, but decreased by 10% (p less than 0.05) in the NOE. The (VI) thickness was unchanged In the ITE group, but decreased by 12%-l6% (p less than 0.05) in the IKE and NOE groups. Thus, intensive, alternating, isotonic cycle ergometer exercise training is as effective as intensive, intermittent, isokinetic exercise training for maintaining thicknesses of rectus femoris and vastus lntermedius anterior thigh muscles, but not posterior log muscles, during prolonged BR deconditioning.
Ellis, S.; Kirby, L. C.; Greenleaf, J. E.
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
Total hip arthroplasty via muscle-sparing approaches is advocated and performed with increasing frequency. However, performing total hip arthroplasty through muscle-sparing approaches may require a more forceful retraction, which in turn may damage the muscles which the less invasive approach intended to preserve. We report on the rupture of the piriformis muscle during primary total hip replacement performed through a posterior approach intended to preserve this muscle. The prevalence and effects of such iatrogenic injuries are currently unknown, although unrecognised muscle damage may be a potential reason why early postoperative gait analyses could not demonstrate the expected benefits of less invasive surgery. Surgeons should be aware of this potential complication when performing total hip arthroplasty through a less invasive posterior approach. PMID:24563964
Solomon, Lucian B; Naal, Florian D; Howie, Donald W
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
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
Gluteal muscle contracture is common after repeated intramuscular injections and sometimes is sufficiently debilitating to\\u000a require open surgery. We asked whether arthroscopic release of gluteal muscle contracture using radiofrequency energy would\\u000a decrease complications with clinically acceptable results. We retrospectively reviewed 108 patients with bilateral gluteal\\u000a muscle contractures (57 males, 51 females; mean age, 23.7 years). We used inferior, anterosuperior, and posterosuperior
Yu-Jie Liu; Yan Wang; Jing Xue; Pauline Po-Yee Lui; Kai-Ming Chan
In Asia, many activities of daily living (ADL) are performed while sitting cross-legged on the floor. This sitting posture rotates the pelvis in a more dorsal direction and lumbar lordosis is more flattened than while sitting on a chair. Sitting cross-legged induces a greater load on the intervertebral discs and spine, especially when in a slumped position that is known to increase disc pressure even more and to aggravate chronic low back pain (CLBP). Therefore, it is very important to instruct Asian people about the correct sitting posture. In addition, it is known that co-contraction of the deep spine-stabilizing muscles enhances lumbar segmental stability and the sacroiliac joint. However, little is known about the influence of co-contraction of the trunk deep muscles on spinal curvature while sitting cross-legged on the floor. The purpose of this study was to compare EMG (electromyographic) activity of the trunk muscles while slump cross-legged sitting with that during co-contraction of the trunk muscles and to investigate how this co-contraction influences spinal curvature. Ten healthy male volunteers (21.7 +/- 2.5 years old) without CLBP participated in the study. Bipolar surface electrodes were attached to the rectus abdominis, the obliquus externus abdominis, the obliquus internus abdominis, the lower back extensor muscles (L3) and the multifidus on the right side. EMG signals were continuously recorded while slump sitting cross-legged and during co-contraction of the trunk muscles. They were amplified, band-pass filtered, digitized and stored by a data acquisition system. The average muscle activity values over the five-second sample for each sitting posture were normalized to maximal voluntary contractions (%MVC). While the subjects performed both sitting postures, the curvature of the spine was measured using a skin-surface and hand-held device, the "Spinal Mouse". More significant activities of the trunk muscles, with the exception of the rectus abdominis, were observed during co-contraction of the trunk muscles than while slump sitting cross-legged. The co-contraction of the trunk muscles resulted in significantly less thoracic and lumbar curvature and more sacral angle than while slump sitting cross-legged. The results of this study indicated that co-contraction of the trunk muscles while sitting cross-legged could bring about the correct thoracic and lumbar curvature, and effectively stabilize the lumbopelvic region, and decrease focal stress on passive structures. PMID:20552952
Watanabe, S; Kobara, K; Ishida, H; Eguchi, A
The psychotherapeutic nature of cosmetic surgery is emphasised by outlining the range of symptoms from which patients suffer and by explaining the sequence of psychological reactions which cause them. The principles which govern the selection of patients are defined. A brief account of each of the main cosmetic operations is given together with notes on their limitations and risks. PMID:2589786
Harris, D. L.
Graves’ orbitopathy (GO) is a debilitating disease which adversely interferes with the quality of life of affected patients . 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
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
Well into the first decades of the 20th century, medical opinion held that any surgical attempts to treat heart disease were not only misguided, but unethical. Despite such reservations, innovative surgeons showed that heart wounds could be successfully repaired. Then, extracardiac procedures were performed to correct patent ductus arteriosus, coarctation of the aorta, and tetralogy of Fallot. Direct surgery on the heart was accomplished with closed commissurotomy for mitral stenosis. The introduction of the heart-lung machine and cardiopulmonary bypass enabled the surgical treatment of other congenital and acquired heart diseases. Advances in aortic surgery paralleled these successes. The development of coronary artery bypass grafting greatly aided the treatment of coronary heart disease. Cardiac transplantation, attempts to use the total artificial heart, and the application of ventricular assist devices have brought us to the present day. Although progress in the field of cardiovascular surgery appears to have slowed when compared with the halcyon times of the past, substantial challenges still face cardiac surgeons. It can only be hoped that sufficient resources and incentive can carry the triumphs of the 20th century into the 21st. This review covers past developments and future opportunities in cardiac surgery. PMID:22163121
Weisse, Allen B.
The aim of this study was to evaluate electromyographic (EMG) responses of erector spinae (ES) and lower limbs' muscles to dynamic forward postural perturbation (FPP) and backward postural perturbation (BPP) in patients with adolescent idiopathic scoliosis (AIS) and in a healthy control group. Ten right thoracic AIS patients (Cobb=21.6±4.4°) and 10 control adolescents were studied. Using bipolar surface electrodes, EMG activities of ES muscle at T10 (EST10) and L3 (ESL3) levels, biceps femoris (BF), gastrocnemius lateralis (G) and rectus femoris (RF) muscles in the right and the left sides during FPP and BPP were evaluated. Muscle responses were measured over a 1s time window after the onset of perturbation. In FPP test, the EMG responses of right EST10, ESL3 and BF muscles in the scoliosis group were respectively about 1.40 (p=0.035), 1.43 (p=0.07) and 1.45 (p=0.01) times greater than those in control group. Also, in BPP test, at right ESL3 muscle of the scoliosis group the EMG activity was 1.64 times higher than that in the control group (p=0.01). The scoliosis group during FPP displayed asymmetrical muscle responses in EST10 and BF muscles. This asymmetrical muscle activity in response to FPP is hypothesized to be a possible compensatory strategy rather than an inherent characteristic of scoliosis. PMID:25008019
Farahpour, Nader; Ghasemi, Safoura; Allard, Paul; Saba, Mohammad Sadegh
Abdominal wall muscles have a unique morphology suggesting a complex role in generating and transferring force to the spinal column. Studying passive mechanical properties of these muscles may provide insights into their ability to transfer force among structures. Biopsies from rectus abdominis (RA), external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) were harvested from male Sprague-Dawley rats, and single muscle fibers and fiber bundles (4-8 fibers ensheathed in their connective tissue matrix) were isolated and mechanically stretched in a passive state. Slack sarcomere lengths were measured and elastic moduli were calculated from stress-strain data. Titin molecular mass was also measured from single muscle fibers. No significant differences were found among the four abdominal wall muscles in terms of slack sarcomere length or elastic modulus. Interestingly, across all four muscles, slack sarcomere lengths were quite long in individual muscle fibers (>2.4 µm), and demonstrated a significantly longer slack length in comparison to fiber bundles (p < 0.0001). Also, the extracellular connective tissue matrix provided a stiffening effect and enhanced the resistance to lengthening at long muscle lengths. Titin molecular mass was significantly less in TrA compared to each of the other three muscles (p < 0.0009), but this difference did not correspond to hypothesized differences in stiffness. PMID:22267257
Brown, Stephen H M; Carr, John Austin; Ward, Samuel R; Lieber, Richard L
The authors present their 4-year experience with the pectoral muscle implant for aesthetic purposes in 16 male patients. The significant enhancement of the chest contour achieved and the satisfying results obtained with no major complications makes this procedure an interesting advancement in male body contour surgery. PMID:16855891
Pereira, Luiz Haroldo; Sabatovich, Oleg; Santana, Kátia Perim; Picanço, Ricardo
Previous studies have compared muscle activity between different types of sit-ups and curl-ups. However, few have examined the exercises used by the armed forces or investigated the influence of exercise duration on muscle activation. The aim of this study was to compare abdominal and hip flexor muscle activity between the style of sit-up used by the British Army and 4 variations of a curl-up, at the start, middle, and end of a 2-minute exercise period. Surface electromyograms (EMGs) were recorded from the upper and lower rectus abdominis, external oblique, transversus abdominis and internal oblique, and the rectus femoris (RF) of 23 British Army personnel. Isometric maximal voluntary contractions were used to normalize integrated EMGs to allow them to be compared between exercises. Curl-ups with arms crossed and feet restrained produced the highest integrated EMG in all the abdominal muscles (p < 0.05). Feet-restrained sit-ups and curl-ups also resulted in significantly higher activity in the RF than in nonrestrained versions of the curl-up (p < 0.001). The significant increase observed in muscle activity between the start and the end of the exercises (p < 0.001) was deemed to be in response to a reduction in force producing capacity of existing motor units. The RF experienced the greatest increase during exercises that activated the muscle the most, that is, sit-ups and curl-ups with feet restrained (p < 0.001). Previous research has indicated that such exercises produce high shear and compressive forces in the lower back, which can be injurious. Thus, if an organization wishes to assess the endurance of abdominal muscles, rather than hip flexors, then curl-ups without restraint of the feet should be performed instead of exercises in which the feet are restrained. PMID:23207881
Burden, Adrian M; Redmond, Colin G
... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving ...
... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving ...
... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving ...
Spinal curvature surgery - child; Kyphoscoliosis surgery - child; Video-assisted thoracoscopic surgery - child; VATS - child ... Before surgery, your child will receive general anesthesia. This will make ... and unable to feel pain during the operation. During ...
Hemangiomas are frequent benign hereditary vascular tumors. Intramuscular hemangiomas, a distinctive type of hemangioma occurring within the skeletal muscle, account for less than 1% of all hemangiomas. They occur more often in the trunk and extremity muscles, whereas the involvement of the temporal muscle is extremely rare. A 34-year-old man with a mass in his left temporal fossa was admitted. Computed tomographic scan showed no erosion of the bone, and magnetic resonance imaging revealed an ovoid mass within the temporal muscle. The lesion was surgically excised, and histopathologic examination confirmed the diagnosis of cavernous hemangioma. The patient was not able to lift his left eyebrow right after the surgery. Two months after the surgery, the patient recovered from paralysis, and there was no recurrence of tumor 12 months after the surgery. We report the 27th cavernous hemangioma case of the temporalis muscle. Care must be taken to avoid possible stretch injury to facial nerve branches while resecting these tumors. PMID:24905945
Eryilmaz, Mehmet Akif; Varsak, Yasin Kür?ad; Gül, Zuhal; U?ur, Ay?enur
This paper addresses the prediction of face soft tissue deformations resulting from bone repositioning in maxillofacial surgery. A generic 3D Finite Element model of the face soft tissues was developed. Face muscles are defined in the mesh as embedded structures, with different mechanical properties (transverse isotropy, stiffness depending on muscle contraction). Simulations of face deformations under muscle actions can thus
Matthieu Chabanas; Vincent Luboz; Yohan Payan
In bloodless surgery a series of measures has to be implemented to reduce the perioperative need for transfusion of whole blood or its components. Jehovah's Witness are the most representative group of patients opting for bloodless surgery as their faith follows strict believes that prohibits receiving blood. Geriatric patients requiring bloodless surgery are even more delicate and represent a challenge for surgeons. The physiological response of the over 65 year population to decreased hemoglobin level is slower and less effective than in young and adult patients. Herby we describe the perioperative protocol implemented in our surgical Department offered to geriatric Jehovah's Witness patients. Preoperative optimization of the patients is the key step in the preparation period. Intraoperative anesthetic and surgical measures are also required along with a strict postoperative follow-up. From our experience, bloodless surgery is feasible in the geriatric population as long as it is performed in specialized centers where a multidisciplinary team is prepared to specifically manage this scenario. Rigorous patients selection and preparation are mandatory. PMID:25183638
Guarino, Salvatore; Di Matteo, Filippo; Sorrenti, Salvatore; Greco, Roberto; Nardi, Matteo; Favoriti, Pasqualino; De Antoni, Enrico; Filippini, Angelo; Catania, Antonio
Orthopaedic Surgery Sports Medicine How Does Arthroscopic Shoulder Instability Surgery Work? Rev. 2/13 1 Table of Contents Â· Introduction to Shoulder Instability Surgery (Page 1) Â· Shoulder Instability Surgery Illustrations (Page 2) Â· Preparing for Shoulder Surgery (Pages 3-4) Â· General Post Surgery (Pages
Kim, Duck O.
Background Muscle architecture is known to be predictive of muscle function. However, it is unknown whether this relationship is similar in children and adolescents with and without cerebral palsy (CP). Objective The objective of this study was to determine whether the architecture of the rectus femoris (RF) and vastus lateralis (VL) muscles was predictive of maximum voluntary knee extensor torque in children and adolescents with and without CP and whether these measures were related to activity and participation levels. Design A case-control design was used. Methods Eighteen participants with CP (mean age=12.0 years, SD=3.2) at Gross Motor Function Classification System (GMFCS) levels I through IV and 12 age-matched peers with typical development (mean age=12.3 years, SD=3.9) were evaluated. Muscle thickness, fascicle length, and fascicle angle of the RF and VL muscles were measured with 2-dimensional, B-mode ultrasound imaging. The activity and participation measures used for participants with CP were the Pediatric Outcomes Data Collection Instrument (PODCI) and the Activities Scale for Kids, Performance Version (ASKp). Results When age and GMFCS level were controlled for, VL muscle thickness was the best predictor of knee extensor isometric torque in the group with CP (R2=.85). This prediction was similar to the prediction from VL muscle thickness and age in participants with typical development (R2=.91). Rectus femoris muscle fascicle length was significantly correlated with the Sports and Physical Functioning Scale of the PODCI (?=.49), and VL muscle fascicle angle was correlated with the Transfers and Basic Mobility Scale of the PODCI (r=.47) and with ASKp Locomotion subdomain (r=.50). Limitations A limitation of this study was the small sample size. Conclusions Ultrasound measures of VL muscle thickness, adjusted for age and GMFCS level, were highly predictive of maximum torque and have the potential to serve as surrogate measures of voluntary strength (force-generating capacity) in children and adolescents with and without CP. PMID:20847035
Simpson, Kit N.; Teefey, Sharlene A.; Damiano, Diane L.
Objective: We evaluated the ability of neuromonitoring to predict postoperative outcome in patients undergoing thyroid surgery for different indications. Summary Background Data: Neuromonitoring has been advocated to reduce the risk of vocal cord palsy and to predict postoperative vocal cord function. Methods: Three hundred twenty-eight patients (502 nerves at risk) were studied prospectively at a single center. Neuromonitoring was performed with the Neurosign 100® device by transligamental placement of the recording electrode into the vocalis muscles. Cumulative distribution of stimulation thresholds was determined by stepwise decreases in current (1 mA to 0.05 mA) for both the vagus and the recurrent nerve. Patients were grouped according to surgical risk (benign and malignant disease, reoperation for benign and for malignant disease). Results: If the electrophysiological response was correlated to postoperative vocal cord function, the sensitivity of neuromonitoring was modest (86% in surgery for benign disease) to low (25% in reoperation for malignant disease); the positive predictive value was modest (overall rate 62%) but acceptable (87%) if corrected for technical problems. Specificity and negative predictive values were high (ie, overall >95%). Stimulation thresholds were not augmented in 11 patients, in whom postoperative palsy developed despite normal intraoperative recordings. Similarly, an electrical field response was elicited in 14 of 21 patients with preoperative vocal cord palsy. Electromyographic recordings did not reveal an abnormal amplitude or a decline in nerve conduction velocity. Conclusions: Neuromonitoring is useful for identifying the recurrent laryngeal nerve, in particular if the anatomic situation is complicated by prior surgery, large tissue masses, aberrant nerve course. However, neuromonitoring does not reliably predict postoperative outcome. PMID:15213612
Hermann, Michael; Hellebart, Christa; Freissmuth, Michael
A full-thickness chest wall resection requires subsequent chest wall reconstruction. A chest wall resection and reconstruction was performed using a transverse rectus abdominis myocutaneous (TRAM) flap, together with polypropylene mesh (Marlex mesh) and stainless steel mesh (SSM). A 71-year-old man was diagnosed as having recurrent lung cancer in the chest wall, and under- went surgical resection. Marlex mesh was sutured
Naoyuki Yoshino; Shigeo Yamauchi; Masataka Akimoto; Takao Hisayoshi; Kiyoshi Koizumi; Kazuo Shimizu
This article reports a case of re-elevating a prior vertical rectus abdominis musculocutaneous flap as a deep inferior epigastric artery perforator-based propeller flap to cover a recurrent chest wall defect. This case demonstrates that a conventional musculocutaneous flap tissue with a preserved perforator can be recycled as a perforator flap. Furthermore, this technique can be a promising new surgical option for recurring abdominal and chest defects. PMID:21354884
Go, Ju Young; Lim, So Young; Mun, Goo Hyun; Bang, Sa Ik; Oh, Kap Sung; Pyon, Jai Kyong
The quadriceps muscles of neurologically intact and spinal cord injured (SCI) human subjects were stimulated with constant current pulses. Up to three, separately adjustable stimulating electrodes over the motor points for vastus medialis (VM), vastus lateralis (VL) and rectus femoris (RF) muscles were used to maximize torque generation while minimizing discomfort. The torque generated by stimulation increased as the knee was slowly flexed to about 1 rad (50-60 degrees) and decreased beyond that point (a 'negative slope' on a torque-angle curve). Despite this region of negative slope the force generated by small oscillations remained positively correlated to the angle changes. When the knee was slowly extended again from a flexed position, the torque continued to decline and therefore showed a large degree of 'hysteresis'. Of the three heads studied, only stimulation of RF muscle generally produced this behavior. VL and VM had torques that increased monotonically with knee flexion over the range studied. The torques generated with electrical stimulation of normal subjects represented up to about 30% of maximum voluntary contraction. When subjects generated similar torques voluntarily, the negative slope region and substantial hysteresis were not observed. Thus, SCI subjects may be adversely affected by hysteresis during electrically-induced transitions from sitting to standing and vice versa, while normal subjects are not. PMID:10213025
Stein, R B; Momose, K; Bobet, J
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
38 Surgical Sciences Cardiovascular Surgery, Thoracic Surgery ------------------------------------------------------ http://ctstokyo.umin.ne.jp/ We are leading in Japan by annual surgery case volume of 700. New knowledge. Â·Clinical research Â· Brain and spinal cord protection in thoracic aortic surgery Â· Minimally invasive
In this study, we showed that exercise type- and intensity-dependent regional differences in muscle oxygenation and oxygen consumption rate (Vo II) of the knee extensor muscles could be imaged in real time with a multi-channel spatially resolved near-infrared spectroscopy (SR-NIRS) imaging device. Healthy subjects performed isometric knee extension exercise for 30 s (without- or with-leg-press action) at different exercise intensities [10%, 40% and 70% of maximum voluntary contraction (MVC)]. "Separation-type" probes were attached to the skin over the major knee extensor muscles: vastus lateralis (VL), rectus femoris (RF) and vastus medialis (VM). Placement of the probes enabled simultaneously measurement of 12 sites over a skin area of about 30 cm2 (temporal resolution = 0.25 s). Local Vo II of each muscle, resting Vo II (Vo II, rest) and recovery Vo II (Vo II, rec ), were determined with arterial occlusion before the start and after the end of contraction, respectively. There was no significant difference between the values of Vo II rest, in the muscles. However, during knee extension exercise without-leg-press action, Vo II rec, value of the RF was significantly greater than the values of the VL and VM at all exercise intensities. In contrast, during exercise with-leg-press action, Vo II rec, values of the RF and VM were greater than those of the VL, especially during exercise at 40% and 70% MVC. In summary, the regional differences in muscle oxygenation and Vo II of the knee extensor muscles, probably due to the differences in relative contributions of muscles to exercise and in muscle architecture, were imaged using SR-NIRS.
Kek, Khai Jun; Miyakawa, Takahiro; Kudo, Nobuki; Yamamoto, Katsuyuki
Purpose To identify the causative mutation with its possible origin in a Chinese family with congenital fibrosis of extraocular muscles type 1 (CFEOM1) and to characterize the ocular phenotypes and lesions in the corresponding intracranial nerves. Methods Three affected siblings and their asymptomatic parents underwent comprehensive ophthalmic examinations and neuropathologic analysis involving magnetic resonance imaging (MRI). KIF21A, PHOX2A, and TUBB3 genes were sequenced on the leukocyte-derived DNA to detect variants. The disease-linked haplotype was analyzed using four microsatellite markers across the KIF21A locus. Results All three affected individuals displayed typical CFEOM1. MRI revealed complicated but consistent neuromuscular abnormalities in the two patients examined, including hypoplastic oculomotor nerves, complete absence of bilateral superior rectus muscles, and unilateral absence of the abducens nerve with marked atrophy of the corresponding lateral rectus muscle. A heterozygous hotspot mutation KIF21A c.2860C>T was identified in all patients, but it was absent in both parents. Haplotype analysis of the disease locus showed the likely maternal inheritance of the disease-associated haplotype to all three affected offspring, strongly suggesting maternal germline mosaicism of the mutation. Conclusions Germline mosaicism of KIF21A c.2860C>T is likely to cause the high occurrence of this mutation in the population. This information may be useful for genetic counseling. KIF21A mutations can affect the abducens nerve and cause complete absence of the bilateral superior rectus muscles. MRI characterization of new CFEOM1 phenotypes would assist clinical management. PMID:24426772
Liu, Gang; Chen, Xue; Sun, Xiantao; Liu, Hu; Zhao, Kanxing; Chang, Qinglin; Pan, Xinyuan; Wang, Xiuying; Yuan, Songtao; Liu, Qinghuai
Background In individuals with cerebral palsy (CP), adaptation and plasticity in the neuromuscular system can lead to detrimental changes affecting gait. Cycling may be an effective method to improve mobility. The biomechanics of cycling in adolescents with CP have been studied, but further analysis of the frequency and amplitude characteristics of the electromyographic (EMG) signals can assist with interpretation of the cycling kinematics. Methods Data were analyzed from ten adolescents with typical development (TD) (mean = 14.9 SD = 1.4 years) and ten adolescents with CP (mean = 15.6 SD = 1.8 years) as they cycled at two different cadences. Analyses of the lower extremity EMG signals involved frequency and amplitude analysis across the cycling revolution. Findings Examination of cycling cadence revealed that adolescents with CP had altered EMG characteristics in comparison to adolescents with typical development across the entire crank revolution for all muscles. Analyses of individual muscles indicated both inappropriate muscle activation and weakness. Interpretation A more comprehensive analysis of EMG activity has the potential to provide insight into how a task is accomplished. In this study, the control of the several muscles, especially the rectus femoris, was significantly different in adolescents with cerebral palsy. This, combined with muscle weakness, may have contributed to the observed deviations in joint kinematics. Interventions that increase muscle strength with feedback to the nervous system about appropriate activation timing may be beneficial to allow individuals with CP to cycle more efficiently. PMID:18082920
Lauer, Richard T.; Johnston, Therese E.; Smith, Brian T.; Lee, Samuel C.K.
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. PMID:17022164
Demer, Joseph L.
Saeterbakken, AH, Andersen, V, Kolnes, MK, and Fimland, MS. Effects of replacing free weights with elastic band resistance in squats on trunk muscle activation. J Strength Cond Res 28(11): 3056-3062, 2014-The purpose of this study was to assess the effects of adding elastic bands to free-weight squats on the neuromuscular activation of core muscles. Twenty-five resistance trained women with 4.6 ± 2.1 years of resistance training experience participated in the study. In randomized order, the participants performed 6 repetition maximum in free-weight squats, with and without elastic bands (i.e., matched relative intensity between exercises). During free-weight squats with elastic bands, some of the free weights were replaced with 2 elastic bands attached to the lowest part of the squat rack. Surface electromyography (EMG) activity was measured from the erector spinae, external oblique, and rectus abdominis, whereas a linear encoder measured the vertical displacement. The EMG activities were compared between the 2 lifting modalities for the whole repetition and separately for the eccentric, concentric, and upper and lower eccentric and concentric phases. In the upper (greatest stretch of the elastic band), middle, and lower positions in squats with elastic bands, the resistance values were approximately 117, 105, and 93% of the free weight-only trial. Similar EMG activities were observed for the 2 lifting modalities for the erector spinae (p = 0.112-0.782), external oblique (p = 0.225-0.977), and rectus abdominis (p = 0.315-0.729) in all analyzed phases. In conclusion, there were no effects on the muscle activity of trunk muscles of substituting some resistance from free weights with elastic bands in the free-weight squat. PMID:24832981
Saeterbakken, Atle H; Andersen, Vidar; Kolnes, Maria K; Fimland, Marius S
Due to the fast spread of laparoscopic cholecystectomy, surgical procedures have been changed essentially. The new techniques applied for both abdominal and thoracic procedures provided the possibility for minimally invasive access with all its advantages. Robots - originally developed for industrial applications - were retrofitted for laparoscopic procedures. The currently prevailing robot-assisted surgery is ergonomically more advantageous for the surgeon, as well as for the patient through the more precise preparative activity thanks to the regained 3D vision. The gradual decrease of costs of robotic surgical systems and development of new generations of minimally invasive devices may lead to substantial changes in routine surgical procedures. PMID:24144815
Sándor, József; Haidegger, Tamás; Kormos, Katalin; Ferencz, Andrea; Csukás, Domokos; Bráth, Endre; Szabó, Györgyi; Wéber, György
Electrophysiological evidence is presented that suggests that the innervation of the human puborectalis muscle differs from that of the external anal sphincter muscle. The latter is innervated by branches of the pudendal nerves, and the former by direct branches of the sacral plexus that enter the muscle from its pelvic surface. The striated urinary sphincter musculature also receives a dual innervation. The periurethral component is innervated by perineal branches of the pudendal nerves and the intramural portion by a different pathway, probably consisting of supralevator branches derived from the pelvic nerves. These findings are relevant to understanding the embryological derivation of these muscles and have practical importance in the surgery of this region of the body, particularly in the treatment of incontinence. PMID:3947015
Snooks, S. J.; Swash, M.
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
The purpose of this study was to describe lower extremity muscle activity during the lacrosse shot. Participants (n=5 females, age 22±2 years, body height 162.6±15.2 cm, body mass 63.7±23.6 kg) were free from injury and had at least one year of lacrosse experience. The lead leg was instrumented with electromyography (EMG) leads to measure muscle activity of the rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), and medial gastrocnemius (GA). Participants completed five trials of a warm-up speed shot (Slow) and a game speed shot (Fast). Video analysis was used to identify the discrete events defining specific movement phases. Full-wave rectified data were averaged per muscle per phase (Crank Back Minor, Crank Back Major, Stick Acceleration, Stick Deceleration). Average EMG per muscle was analyzed using a 4 (Phase) × 2 (Speed) ANOVA. BF was greater during Fast vs. Slow for all phases (p<0.05), while TA was not influenced by either Phase or Speed (p>0.05). RF and GA were each influenced by the interaction of Phase and Speed (p<0.05) with GA being greater during Fast vs. Slow shots during all phases and RF greater during Crank Back Minor and Major as well as Stick Deceleration (p<0.05) but only tended to be greater during Stick Acceleration (p=0.076) for Fast vs. Slow. The greater muscle activity (BF, RF, GA) during Fast vs. Slow shots may have been related to a faster approach speed and/or need to create a stiff lower extremity to allow for faster upper extremity movements. PMID:25114727
Millard, Brianna M; Mercer, John A
The purpose of this study was to describe lower extremity muscle activity during the lacrosse shot. Participants (n=5 females, age 22±2 years, body height 162.6±15.2 cm, body mass 63.7±23.6 kg) were free from injury and had at least one year of lacrosse experience. The lead leg was instrumented with electromyography (EMG) leads to measure muscle activity of the rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), and medial gastrocnemius (GA). Participants completed five trials of a warm-up speed shot (Slow) and a game speed shot (Fast). Video analysis was used to identify the discrete events defining specific movement phases. Full-wave rectified data were averaged per muscle per phase (Crank Back Minor, Crank Back Major, Stick Acceleration, Stick Deceleration). Average EMG per muscle was analyzed using a 4 (Phase) × 2 (Speed) ANOVA. BF was greater during Fast vs. Slow for all phases (p<0.05), while TA was not influenced by either Phase or Speed (p>0.05). RF and GA were each influenced by the interaction of Phase and Speed (p<0.05) with GA being greater during Fast vs. Slow shots during all phases and RF greater during Crank Back Minor and Major as well as Stick Deceleration (p<0.05) but only tended to be greater during Stick Acceleration (p=0.076) for Fast vs. Slow. The greater muscle activity (BF, RF, GA) during Fast vs. Slow shots may have been related to a faster approach speed and/or need to create a stiff lower extremity to allow for faster upper extremity movements. PMID:25114727
Millard, Brianna M.; Mercer, John A.
DEHN SURGERY SIDDHARTHA GADGIL Contents 1. Introduction 1 2. Co-ordinates for surgery 1 3. Some algebraic topology 2 4. The theorem of Lickorish and Wallace 3 5. Surgeries and Cobordisms 4 6. The Kirby Calculus 5 7. Constructing knots using surgery 5 8. Surgeries about knots 5 References 6 1. Introduction
Orthopaedic Surgery Sports Medicine How Does Arthroscopic Rotator Cuff Repair Surgery Work? Rev. 2 Surgical Illustrations (Pages 2-4) Â· Preparing for Rotator Cuff Surgery (Pages 5-6) Â· General Post Surgery to embark on the arthroscopic rotator cuff repair journey. The goal of rotator cuff repair surgery is create
Kim, Duck O.
Endoscopic surgery is often considered to be ‘minimally invasive surgery’ in the light of recent technical developments. Endoscopic neck surgery, including thyroid and parathyroid surgery, has developed rapidly over the past 2 years. The various techniques of thyroid surgery, including sites of incision and procedures for creating adequate working space, are described here. The cosmetic benefits of endoscopic versus conventional
OBJECTIVE: The purpose of the study was to assess the results and morbidity associated with simultaneous bilateral TRAM free flap breast reconstruction and describe refinements in its surgical technique. SUMMARY BACKGROUND DATA: Bilateral prophylactic total mastectomies might be an agreeable option for those patients at highest risk for breast cancer if autogenous tissue breast reconstruction could be performed with reasonable technical ease and acceptable morbidity. However, some surgeons harbor reservations regarding the extensiveness of the surgery, the associated morbidity, and the aesthetic quality of the resulting outcome. METHODS: A multicenter retrospective review of clinical experience with 120 consecutive patients who underwent 240 simultaneous bilateral TRAM free flap breast reconstructions was developed. RESULTS: The average operating time, including the time required for the breast ablative portion of the procedures, was 8.6 hours. The average length of hospitalization was 7.6 days. However, for the last 40 patients, these figures were reduced to 7.1 hours and 6.1 days, respectively. Nonautologous blood transfusions were needed in 33 cases (28%), but only 1 was required in the last 40 patients. Thromboses developed in six of 240 flaps (2.5%): 4 were arterial and 2 were venous. Re-exploration allowed us to restore circulation in five flaps, whereas one flap was unsalvageable and was replaced successfully with an alternate flap. An uncomplicated deep vein thromboses developed in one patient with a history of recurrent deep vein thromboses that had no adverse effect on her outcome. Minor complications developed in 18 patients (15%) (e.g., hematoma, partial wound necrosis, wound infection, or prolonged postoperative ileus) that did not affect the long-term outcome. Fourteen patients (11.6%) had abdominal wall weakness or hernias. Follow-up time averaged 37.2 months (range, 14-62 months). On last follow-up, patients' self-reported overall satisfaction with the procedure was 56% excellent, 40% good, and 4% fair.CONCLUSIONS: Simultaneous bilateral free flap reconstruction is technically feasible with a high rate of success and an acceptable morbidity. When performed by experienced surgeons, bilateral prophylactic total mastectomies combined with simultaneous bilateral TRAM free flap reconstruction may provide an adequate surgical option with aesthetically acceptable results for patients at high risk for breast cancer. Images Figure 1. Figure 4. Figure 5. Figure 6. PMID:9242334
Khouri, R K; Ahn, C Y; Salzhauer, M A; Scherff, D; Shaw, W W
1. This study used three techniques (bilateral phrenic nerve stimulation, motor cortex stimulation and quantitative electromyography) to assess the degree of activation of the diaphragm, intercostal-accessory muscles and abdominal muscles during postural tasks and respiratory manoeuvres. They included maximal inspiratory and expulsive efforts. 2. Bilateral phrenic nerve stimuli at supramaximal levels produced an average change in transdiaphragmatic pressure (Pdi) of 28 cmH2O during relaxation. During maximal inspiratory or expulsive efforts, all subjects were able to activate the diaphragm fully at functional residual capacity as judged by the failure of stimuli delivered during the voluntary efforts to increase Pdi. Peak voluntary Pdi was about 30% less for inspiratory than expulsive manoeuvres. 3. By contrast, transcranial activation of motor cortical output to the diaphragm and abdominal muscles produced an increment in abdominal pressure of 25 +/- 7 cmH2O during maximal voluntary expulsive efforts. Given the lack of response to phrenic nerve stimulation at similar voluntary pressures, this suggests that abdominal muscles, and not the diaphragm, fail to generate their full contractile force during maximal voluntary expulsive manoeuvres. 4. Motor cortical stimulation during weak inspiratory efforts produced a small reduction in oesophageal pressure (i.e. increase in net inspiratory force) of 7-14 cmH2O. This response could not be extinguished during maximal voluntary inspiratory efforts in two of three subjects. This occurred despite the cortical co-activation of 'antagonist' muscles in the chest wall and abdomen, and passive transmission of pressure from the abdominal to thoracic compartments. 5. Integrated electromyographic activity (EMG) recorded from abdominal muscles (rectus abdominis, external oblique) was greater during trunk flexion than during maximal expulsive efforts. Similarly, integrated EMG of the intercostal-accessory muscles (sternomastoid, scalenes, parasternal intercostals) was greater during tasks requiring head and/or neck flexion than during the maximal inspiratory efforts. 6. These data show that the diaphragm can be fully activated by the central nervous system during voluntary respiratory tasks but that other agonist 'respiratory' muscles need not be activated fully. Given the complex actions of 'inseries' respiratory muscles revealed here, it is argued that differences in the transdiaphragmatic pressure during various postural and respiratory tasks do not necessarily imply variation in the level of diaphragmatic neural drive. Images Fig. 5 Fig. 6 PMID:2231418
Gandevia, S C; McKenzie, D K; Plassman, B L
Purpose. Intramuscular innervation of horizontal rectus extraocular muscles (EOMs) is segregated into superior and inferior (transverse) compartments, while all EOMs are also divided into global (GL) and orbital (OL) layers with scleral and pulley insertions, respectively. We sought evidence of potential independent action by examining passive mechanical coupling between EOM compartments. Methods. Putative compartments of each of the six whole bovine anatomical EOMs were separately clamped to a physiologically controlled, dual channel microtensile load cell (5-mN force resolution) driven by independent, high-speed, linear motors having 20-nm position resolution. One channel at a time was extended or retracted by 3 to 5 mm, with the other channel stationary. Fiducials distributed on the EOM global surface enabled optical tracking of local deformation. Loading rates of 5 to 100 mm/sec were applied to explore speeds from slow vergence to saccades. Control loadings employed transversely loaded EOM and isotropic latex. Results. All EOM bellies and tendons exhibited substantial compartmental independence when loaded in the physiologic direction, both between OL and GL, and for arbitrary transverse parsings of EOM width ranging from 60%:40% to 80%:20%. Intercompartmental force coupling in the physiologic direction was less than or equal to 10% in all six EOMS even for saccadic loading rates. Coupling was much higher for nonphysiologic transverse EOM loading and isotropic latex. Optical tracking demonstrated independent strain distribution between EOM compartments. Conclusions. Substantial mechanical independence exists among physiologically loaded fiber bundles in bovine EOMs and tendons, providing biomechanical support for the proposal that differential compartmental function in horizontal rectus EOMs contributes to novel torsional and vertical actions. PMID:23188730
Shin, Andrew; Yoo, Lawrence; Chaudhuri, Zia; Demer, Joseph L.
Today, many office workers frequently adopt a relaxed or slumped sitting posture for many hours, and often people tend to spend their leisure time reclining against the backrest of a chair while sitting for a long time, as when watching television. While sitting, the pelvis rotates backwardly, and lumbar lordosis is flattened. Simultaneously, the load on the intervertebral discs and spine increases. Sitting in a slumped position is known to increase disc pressure even more, and to aggravate chronic low back pain (CLBP). Therefore, it is very important to teach workers and often people about the correct sitting posture. In addition, it has been recognized that co-contraction of the deep spine-stabilizing muscles enhances lumbar segmental stability and the sacro-iliac joint. However, little is known about the influence of co-contraction of the trunk deep muscles on spinal curvature during sitting reclining against the backrest of a chair. The purpose of this study was to compare the EMG (electromyographic) activity of the trunk muscles during slump sitting with that during co-contraction and to investigate how this cocontraction influences spinal curvature. Ten healthy male volunteers (20.8 +/- 0.8 years old) without CLBP participated in the study. Bipolar surface electrodes were attached to the rectus abdominis, the obliquus externus abdominis, the obliquus internus abdominis, the lower back extensor muscles (L3) and the multifidus on the right side. The EMG signals were continuously recorded during slump sitting and co-contraction of the trunk muscles, reclining against the backrest of chair. They were amplified, band-pass filtered, digitized and stored by a data acquisition system. The average muscle activity values over the five-second sample for each sitting posture were normalized to maximal voluntary contractions (%MVC). While the subjects performed both sitting postures, the curvature of the spine was measured using a new skin-surface and hand-held device, the "Spinal Mouse". More significant activities of the trunk muscles, with the exception of the rectus abdominis and the lower back extensor muscles (L3), were observed during co-contraction of the trunk muscles than during slump sitting. The co-contraction of the trunk muscles resulted in significantly less lumbar curvature and more sacral angle than during slump sitting. The thoracic curvature showed no significant change during either sitting posture. The results of this study indicated that co-contraction of the trunk muscles during sitting reclining against the backrest of a chair could bring about the correct lumbar curvature, effectively stabilize the lumbopelvic region, and decrease focal stress on passive structures. PMID:19097476
Watanabe, S; Eguchi, A; Kobara, K; Ishida, H
Ephedrine/caffeine combination (EC) has been shown to induce a small-to-moderate weight loss in obese patients. Several mechanisms have been proposed, among which an increased thermogenic capacity of skeletal muscle consequent to the EC-induced up-regulation of uncoupling protein 3 (UCP3) gene expression. We did a parallel group double-blind, placebo-controlled, 4-week trial to investigate this hypothesis. Thirteen morbidly obese women (25-52 years of age, body-mass index 48.0±4.0 kg/m2, range 41.1-57.6) were randomly assigned to EC (200/20 mg, n?=?6) or to placebo (n?=?7) administered three times a day orally, before undergoing bariatric surgery. All individuals had an energy-deficit diet equal to about 70% of resting metabolic rate (RMR) diet (mean 5769±1105 kJ/day). The RMR analysed by intention to treat and the UCP3 (long and short isoform) mRNA levels in rectus abdominis were the primary outcomes. Body weight, plasma levels of adrenaline, noradrenaline, triglycerides, free fatty acids, glycerol, TSH, fT4, and fT3 were assessed, as well as fasting glucose, insulin and HOMA index, at baseline and at the end of treatments. Body weight loss was evident in both groups when compared to baseline values (overall -5.2±3.2%, p<0.0001) without significant differences between the treated groups. EC treatment increased the RMR (+9.2±6.8%, p?=?0.020), differently from placebo which was linked to a reduction of RMR (-7.6±6.5%, p?=?0.029). No significant differences were seen in other metabolic parameters. Notably, no changes of either UCP3 short or UCP3 long isoform mRNA levels were evident between EC and placebo group. Our study provides evidence that 4-week EC administration resulted in a pronounced thermogenic effect not related to muscle UCP3 gene expression and weight loss in morbidly obese females under controlled conditions. Trial registration: ClinicalTrials.gov NCT02048215. PMID:24905629
Bracale, Renata; Petroni, Maria Letizia; Davinelli, Sergio; Bracale, Umberto; Scapagnini, Giovanni; Carruba, Michele O; Nisoli, Enzo
Ephedrine/caffeine combination (EC) has been shown to induce a small-to-moderate weight loss in obese patients. Several mechanisms have been proposed, among which an increased thermogenic capacity of skeletal muscle consequent to the EC-induced up-regulation of uncoupling protein 3 (UCP3) gene expression. We did a parallel group double-blind, placebo-controlled, 4-week trial to investigate this hypothesis. Thirteen morbidly obese women (25–52 years of age, body-mass index 48.0±4.0 kg/m2, range 41.1–57.6) were randomly assigned to EC (200/20 mg, n?=?6) or to placebo (n?=?7) administered three times a day orally, before undergoing bariatric surgery. All individuals had an energy-deficit diet equal to about 70% of resting metabolic rate (RMR) diet (mean 5769±1105 kJ/day). The RMR analysed by intention to treat and the UCP3 (long and short isoform) mRNA levels in rectus abdominis were the primary outcomes. Body weight, plasma levels of adrenaline, noradrenaline, triglycerides, free fatty acids, glycerol, TSH, fT4, and fT3 were assessed, as well as fasting glucose, insulin and HOMA index, at baseline and at the end of treatments. Body weight loss was evident in both groups when compared to baseline values (overall ?5.2±3.2%, p<0.0001) without significant differences between the treated groups. EC treatment increased the RMR (+9.2±6.8%, p?=?0.020), differently from placebo which was linked to a reduction of RMR (?7.6±6.5%, p?=?0.029). No significant differences were seen in other metabolic parameters. Notably, no changes of either UCP3 short or UCP3 long isoform mRNA levels were evident between EC and placebo group. Our study provides evidence that 4-week EC administration resulted in a pronounced thermogenic effect not related to muscle UCP3 gene expression and weight loss in morbidly obese females under controlled conditions. Trial Registration ClinicalTrials.gov NCT02048215 PMID:24905629
Bracale, Renata; Petroni, Maria Letizia; Davinelli, Sergio; Bracale, Umberto; Scapagnini, Giovanni; Carruba, Michele O.; Nisoli, Enzo
[Purpose] The purpose of this study was to examine the effects of the flexion angle of the knee joint and the abduction angle of the hip joint on the activation of the cervical region and abdominal muscles. [Subjects] A total of 42 subjects were enrolled 9 males and 33 females. [Methods] The bridging exercise in this study was one form of exercise with a knee joint flexion angle of 90°. Based on this, a bridging exercise was conducted at the postures of abduction of the lower extremities at 0, 5, 10, and 15°. [Result] The changes in the knee joint angle and the hip abduction angle exhibited statistically significant effects on the cervical erector spinae, adductor magnus, and gluteus medius muscles. The abduction angles did not result in statistically significant effects on the upper trapezium, erector spinae, external oblique, and rectus abdominis muscles. However, in relation to the knee joint angles, during the bridging exercise, statistically significant results were exhibited. [Conclusion] When patients with both cervical and back pain do a bridging exercise, widening the knee joint angle would reduce cervical and shoulder muscle activity through minimal levels of abduction, permitting trunk muscle strengthening with reduced cervical muscle activity. This method would be helpful for strengthening trunk muscles in a selective manner. PMID:24259870
Lee, Su-Kyoung; Park, Du-Jin
Orthopaedic Surgery Sports Medicine Hip Arthroscopy for Labral Tear Postoperative Rehabilitation;Orthopaedic Surgery Sports Medicine Hip Arthroscopy for Labral Tear Postoperative Rehabilitation Protocol Conditioning: Stationary bike Treadmill #12;Orthopaedic Surgery Sports Medicine Hip Arthroscopy for Labral Tear
Oliver, Douglas L.
This article reviews current thoughts regarding pediatric refractive surgery. This encompasses current trends in adult refractive surgery, differences between adult and pediatric refractive surgery, and future possibilities for refractive technology for the pediatric population. PMID:24852149
Stahl, Erin D
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. PMID:23327472
based prevention of hamstring injuries in sport. Br J Sportsthe hamstrings have the highest rate of re-injury 77,78 .hamstrings, with the exception of rectus femoris. A previous study showed RF strain injuries
Lin, Evie Ya Hui
With light and electron microscopy a comparison has been made of the morphology of ventricular (V) and Purkinje (P) fibers of the hearts of guinea pig, rabbit, cat, dog, goat, and sheep. The criteria, previously established for the rabbit heart, that V fibers are distinguished from P fibers by the respective presence and absence of transverse tubules is shown to be true for all animals studied. No evidence was found of a permanent connection between the sarcoplasmic reticulum and the extracellular space. The sarcoplasmic reticulum (SR) of V fibers formed couplings with the sarcolemma of a transverse tubule (interior coupling) and with the peripheral sarcolemma (peripheral coupling), whereas in P fibers the SR formed only peripheral couplings. The forms of the couplings were identical. The significance, with respect to excitation-contraction coupling, of the difference in the form of the couplings in cardiac versus skeletal muscle is discussed together with the electrophysiological implications of the differing geometries of bundles of P fibers from different animals. PMID:5645545
Sommer, Joachim R.; Johnson, Edward A.
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
This study examined the reliability and validity of using customized templates to acquire panoramic ultrasound (US) images for determining cross-sectional area (CSA) and volume in the vastus lateralis (VL), rectus femoris (RF), medial gastrocnemius (MG) and lateral gastrocnemius (LG). Panoramic US and magnetic resonance imaging (MRI) images were analyzed by two trained investigators. The inter-experimenter reliability (coefficient of variation [CV]) of panoramic US ranged from 2.4% to 4.1% and the intraclass correlation (ICC) ranged from 0.963 to 0.991, whereas the inter-experimenter CV of MRI ranged from 2.8% to 3.8% and the ICC from 0.946 to 0.986. Bland-Altman plots demonstrated high agreement between US and MRI; however, values obtained from MRI were systematically larger than those obtained from US. The present results indicate that using a customized US template provides reliable measures of leg muscle CSA and, thus, could be used to characterize muscle CSA and volume. PMID:22749820
Scott, Jessica M; Martin, David S; Ploutz-Snyder, Robert; Caine, Timothy; Matz, Timothy; Arzeno, Natalia M; Buxton, Roxanne; Ploutz-Snyder, Lori
Cerebral palsy (CP), caused by an injury to the developing brain, can lead to alterations in muscle function. Subsequently, increased muscle stiffness and decreased joint range of motion are often seen in patients with CP. We examined mechanical and biochemical properties of the gastrocnemius and soleus muscles, which are involved in equinus muscle contracture. Passive mechanical testing of single muscle fibers from gastrocnemius and soleus muscle of patients with CP undergoing surgery for equinus deformity showed a significant increase in fiber stiffness (p?0.01). Bundles of fibers that included their surrounding connective tissues showed no stiffness difference (p?=?0.28).). When in vivo sarcomere lengths were measured and fiber and bundle stiffness compared at these lengths, both fibers and bundles of patients with CP were predicted to be much stiffer in vivo compared to typically developing (TD) individuals. Interestingly, differences in fiber and bundle stiffness were not explained by typical biochemical measures such as titin molecular weight (a giant protein thought to impact fiber stiffness) or collagen content (a proxy for extracellular matrix amount). We suggest that the passive mechanical properties of fibers and bundles are thus poorly understood. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:1667-1674, 2014. PMID:25138654
Mathewson, Margie A; Chambers, Henry G; Girard, Paul J; Tenenhaus, Mayer; Schwartz, Alexandra K; Lieber, Richard L
Background Although the utility of flaps for the treatment of sternal wound infections following median sternotomy has been reported for 30 years, there have been few reports on the risk factors for complications after reconstruction. The objective of this investigation was to identify factors related to complications after the reconstruction of sternal wound infections. Methods A retrospective analysis of 74 patients with reconstructive surgery after sternal wound infection over a 5-year period was performed. Clinical data including age, sex, body mass index (BMI), comorbidities, bacterial culture, previous cardiac surgery, wound depth, mortality rate, type of reconstructive procedure, and complication rate were collected. Results The patients' BMI ranged from 15.2 to 33.6 kg/m2 (mean, 23.1±3.74 kg/m2). Wound closure complications after reconstructive surgery were observed in 36.5% of the cases. The mortality rate was 2.7%. Diabetes mellitus significantly affected the rate of wound closure complications (P=0.041). A significant difference in the number of complications was seen between Staphylococcus aureus (S. aureus) and coagulase-negative Staphylococci (P=0.011). There was a correlation between harvesting of the internal thoracic artery and postoperative complications (P=0.048). The complication rates of the pectoralis major flap, rectus abdominis flap, omentum flap, a combination of pectoralis major flap and rectus abdominis flap, and direct closure were 23.3%, 33.3%, 100%, 37.5%, and 35.7%, respectively. Conclusions Diabetes mellitus, S. aureus, harvesting of the internal thoracic artery, and omentum flap were significant factors for complications after reconstruction. The omentum flap volume may be related to the complications associated with the omentum flap transfer in the present study. PMID:24883276
Takaku, Mitsuru; Matsuo, Shinji; Abe, Yoshiro; Harada, Hiroshi; Nagae, Hiroaki; Fujioka, Yusuke; Anraku, Kuniaki; Inagawa, Kiichi; Nakanishi, Hideki
It is now well recognized that muscle activity can be induced even in the paralyzed lower limb muscles of persons with spinal cord injury (SCI) by imposing locomotion-like movements on both of their legs. Although the significant role of the afferent input related to hip joint movement and body load has been emphasized considerably in previous studies, the contribution of the "alternate" leg movement pattern has not been fully investigated. This study was designed to investigate to what extent the alternate leg movement influenced this "locomotor-like" muscle activity. The knee-locked leg swing movement was imposed on 10 complete SCI subjects using a gait training apparatus. The following three different experimental conditions were adopted: 1) bilateral alternate leg movement, 2) unilateral leg movement, and 3) bilateral synchronous (in-phase) leg movement. In all experimental conditions, the passive leg movement induced EMG activity in the soleus and medial head of the gastrocnemius muscles in all SCI subjects and in the biceps femoris muscle in 8 of 10 SCI subjects. On the other hand, the EMG activity was not observed in the tibialis anterior and rectus femoris muscles. The EMG level of these activated muscles, as quantified by integrating the rectified EMG activity recorded from the right leg, was significantly larger for bilateral alternate leg movement than for unilateral and bilateral synchronous movements, although the right hip and ankle joint movements were identical in all experimental conditions. In addition, the difference in the pattern of the load applied to the leg among conditions was unable to explain the enhancement of EMG activity in the bilateral alternate leg movement condition. These results suggest that the sensory information generated by alternate leg movements plays a substantial role in amplifying the induced locomotor-like muscle activity in the lower limbs. PMID:15385590
Kawashima, Noritaka; Nozaki, Daichi; Abe, Masaki O; Akai, Masami; Nakazawa, Kimitaka
Transurethral surgery and twice-daily radiation plus paclitaxel-cisplatin or fluorouracil-cisplatin with selective bladder preservation and adjuvant chemotherapy for patients with muscle invasive bladder cancer (RTOG 0233): a randomised multicentre phase 2 trial
Summary Background We assessed effectiveness, safety, and tolerability of paclitaxel or fluorouracil when added to radiation plus cisplatin followed by adjuvant chemotherapy in a programme of selected bladder preservation for patients with muscle invasive bladder cancer. Methods In our randomised phase 2 trial, we enrolled patients with T2–4a transitional cell carcinoma of the bladder at 24 medical centres in the USA. We randomly allocated patients to receive paclitaxel plus cisplatin (paclitaxel group) or fluorouracil plus cisplatin (fluorouracil group) with twice-daily radiation in random block sizes per site on the basis of clinical T-stage (T2 vs T3–4). Patients and physicians were aware of treatment assignment. All patients had transurethral resection of bladder tumour and twice-daily radiotherapy to 40·3 Gy, along with allocated chemotherapy, followed by cystoscopic and biopsy assessment of response. Patients who had a tumour response with downstaging to T0, Tcis, or Ta received consolidation chemoradiotherapy to 64·3 Gy, with the same chemotherapy regimen as in the induction phase. Patients received adjuvant cisplatin-gemcitabine-paclitaxel after the end of chemoradiotherapy. If, after induction, persistent disease was graded as T1 or worse, we recommended patients undergo cystectomy and adjuvant chemotherapy. We assessed the primary endpoints of rates of treatment completion and toxic effects in all randomly allocated patients. This study is registered with ClinicalTrials.gov, number NCT00055601. Findings Between Dec 13, 2002, and Jan 11, 2008, we enrolled 97 patients, of whom 93 were eligible for analysis. Median follow-up was 5·0 years (IQR 5·0–6·2). Of 46 patients in the paclitaxel group, 45 (98%) completed induction (16 [35%] with grade 3–4 toxicity), 39 (85%) completed induction and consolidation (11 [24%] with grade 3–4 toxicity due to consolidation), and 31 (67%) completed the entire protocol with adjuvant chemotherapy. 34 (85%) of 40 assessable patients in the paclitaxel group had grade 3–4 toxicity during adjuvant chemotherapy. Of 47 patients in the fluorouracil group, 45 (96%) completed induction (nine [19%] with grade 3–4 toxicity), 39 (83%) completed induction and consolidation (12 [26%] had grade 3–4 toxicity due to consolidation), and 25 (53%) completed the entire protocol with adjuvant chemotherapy. 31 (76%) of 41 assessable patients in the fluorouracil group had grade 3–4 toxicity during adjuvant chemotherapy. Five (11%) patients treated with the paclitaxel regimen and three (6%) patients treated with the fluorouracil regimen developed late grade 3–4 radiotherapy toxicities. 11 (24%) patients treated with the paclitaxel regimen and 16 (34%) patients treated with the fluorouracil regimen developed late grade 3–4 toxicities unrelated to radiotherapy. One patient (in the fluorouracil group) died during follow-up. Six (13%) patients in the paclitaxel group and in three (6%) patients in the fluorouracil group discontinued due to treatment-related toxicity. Interpretation In the absence of phase 3 data, our findings could inform selection of a bladder-sparing trimodality chemotherapy regimen for patients with muscle invasive bladder cancer. Funding US National Cancer Institute. PMID:23823157
Mitin, Timur; Hunt, Daniel; Shipley, William U; Kaufman, Donald S; Uzzo, Robert; Wu, Chin-Lee; Buyyounouski, Mark K; Sandler, Howard; Zietman, Anthony L
The nasal mucosa is very vascular, receiving more blood flow per cubic centimeter of tissue than does muscle, brain or liver (Drettner and Aust, 1974; ). This vascularity can present a major problem during sinus surgery. Surgeons routinely use topical vasoconstrictors in endoscopic sinus surgery however, the optimal regimen is not clear. Imidazoline nasal sprays are often used up to 1hour before sinonasal surgery to aid in intraoperative vasoconstriction. After the induction of anaesthesia, epinephrine-based topical and submucosal preparations are subsequently administered to further enhance vasoconstriction. Imidazolines are non-selective, partial alpha adrenoceptor agonists with a higher affinity, yet lower potency, for alpha adrenoceptors when compared to epinephrine. It is hypothesized that imidazolines block the action of epinephrine on the alpha adrenoceptors of the nasal mucosa resulting in less vasoconstriction, and a poorer intra-operative field, when compared to the use of epinephrine alone. This paper hypothesizes that preoperative imidazoline administration may adversely affect optimal intra-operative vasoconstriction. PMID:24690300
Campbell, R G; Nair, S; Sacks, R; Douglas, R G
[Purpose] This study examined the correlation between the muscle activities and joint angle of the hip and knee according to the changes in stance width during a lifting task. [Subjects and Methods] The subjects of this study were 15 healthy students. A three-dimensional motion analyzer (SMART-E, BTS, Italy) was used to measure the joint angles of hip and knee during lifting. An 8-channel electromyograph (8-EMG) (Pocket EMG, BTS, Italy) was used to measure muscle activities of the erector spinae, gluteus maximus, rectus femoris, and tibialis anterior during lifting. The collected data were analyzed using the Pearson-test and SPSS 18.0. [Result] The muscle activity of the tibialis anterior was significantly decreased by increasing the stance width (r= ?0.285). Muscle activity of the erector spinae was significantly decreased by increasing the knee angle (r= ?0.444). The muscle activity of the gluteus maximus was significantly increased by increasing the muscle activity of the tibialis anterior (r= 0.295). [Conclusion] Efficient lifting is possible when stance width and knee flexion are increased, which results in reduced muscle activity of the tibialis anterior and the erector spinae. Lifting is facilitated when the muscle activities of the gluteus maximus and tibialis anterior are correlated. PMID:24259908
Objective To examine using surface electromyography whether stair climbing with abdominal hollowing (AH) is better at facilitating local trunk muscle activity than stair climbing without AH. Methods Twenty healthy men with no history of low back pain participated in the study. Surface electrodes were attached to the multifidus (MF), lumbar erector spinae, thoracic erector spinae, transverse abdominus - internal oblique abdominals (TrA-IO), external oblique abdominals (EO), and the rectus abdominis. Amplitudes of electromyographic signals were measured during stair climbing. Study participants performed maximal voluntary contractions (MVC) for each muscle in various positions to normalize the surface electromyography data. Results AH during stair climbing resulted in significant increases in normalized MVCs in both MFs and TrA-IOs (p<0.05). Local trunk muscle/global trunk muscle ratios were higher during stair climbing with AH as compared with stair climbing without AH. Especially, right TrA-IO/EO and left TrA-IO/EO were significantly increased (p<0.05). Conclusion Stair climbing with AH activates local trunk stabilizing muscles better than stair climbing without AH. The findings suggest that AH during stair climbing contributes to trunk muscle activation and trunk stabilization. PMID:24466515
Lee, Ah Young; Kim, Eun Hyuk; Cho, Yun Woo; Kwon, Sun Oh; Son, Su Min
of the optic nerve and bradycardia due to the manipulation of the extra- ocular muscles. If the procedure is properly performed it may be useful in canine cataract surgery. Berens et al discuss the relationship of ciliary ganglion block to pupillary... of the optic nerve and bradycardia due to the manipulation of the extra- ocular muscles. If the procedure is properly performed it may be useful in canine cataract surgery. Berens et al discuss the relationship of ciliary ganglion block to pupillary...
Silvera, Carlos Enrique
Muscle fibers have been classified into two major forms of red (slow twitch) and white (fast twitch) muscles. The red muscle utilizes lipid as energy source through mitochondrial metabolism and function to sustain the position against gravity (sometimes called as antigravity muscle). Under microgravity the red muscle is selectively involved. In our unloading study by hindlimb suspension experiment on rats, the one of the representative red muscle of soleus muscle underwent rapid atrophy; they reduced their weights about 50% after 2 week-unloading. In addition, myofibrils were occasionally markedly disorganized with selective thin filament loss. Mitochondria in the degenerated area were decreased in number. The white muscle fibers in the soleus muscle had mostly transformed to the red ones. It took about 1 month to recover morphologically. The satellite cell playing a major role in muscle regeneration was not activated. There still remained unsolved what are the mechanosensors to keep muscle function under normal gravity. Dr Nikawa's group proposed that one of ubiquitin ligases, Cbl-b is activated under microgravity and induces muscle fiber degeneration. There might be many factors to induce muscle atrophy and degeneration under microgravity. Further study is necessary to explore the pathomechanism of muscle atrophy in disused and under immobility conditions. PMID:23196603
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. PMID:21778415
Park, Han na; Kim, Jong-Hee; Pedrosa-Domellöf, Fatima; Thompson, LaDora V.
Aging process involves several structural changes in muscle tissue which lead to decrease in musculoskeletal function. One of the most common physiological modifications is the increase in fatigability in elderly people, which leads to inability to maintain strength and motor control. In this context, low-level laser therapy (LLLT) has demonstrated positive results in reducing fatigue during physical exercise. Thus, this study aimed to investigate the effects of LLLT on skeletal muscle fatigue in elderly women. Twenty-four subjects divided in two groups entered a crossover randomized triple-blinded placebo-controlled trial. Active LLLT (808 nm wavelength, 100 mW, energy 7 J) or an identical placebo LLLT was delivered on the rectus femoris muscle immediately before a fatigue protocol. Subjects performed a fatigue protocol which consisted of voluntary isotonic contractions of knee flexion-extension performed with a load corresponding to 75 % of 1-MR (Maximum Repetition) during 60 s. Surface electromyography (SEMG) signals were recorded from rectus femoris muscle of dominant lower limb to evaluate peripheral fatigability using median frequency analysis of SEMG signal. The number of repetitions of flexion-extension during fatigue protocol was also compared between groups. The values of median frequency were used to calculate the slope coefficient. The results showed no difference in the slope comparing placebo LLLT and active LLLT groups (p?=?0.293). However, a significant difference was observed in the number of repetitions between groups, after active LLLT, subjects demonstrated significantly higher number of repetitions (p?=?0.047). In this study, LLLT was efficient in increasing the mean number of repetitions during knee flexion-extension exercise, although results have not shown delay electromyographic fatigue. PMID:23296713
Toma, Renata Luri; Tucci, Helga Tatiana; Antunes, Hanna Karen Moreira; Pedroni, Cristiane Rodrigues; de Oliveira, Anamaria Siriani; Buck, Isabela; Ferreira, Pryscilla Dieguez; Vassão, Patricia Gabrielle; Renno, Ana Claudia Muniz
The purpose of this randomized, cross-over design study was to examine the effect of three different muscle potentiation protocols on acute changes in muscle architecture and vertical jump performance. Eleven experienced, resistance trained men (25.2±3.6y) completed three potentiation squat protocols using moderate intensity (MI; 75%, 3 sets x 10 repetitions), high intensity (HI; 90%, 3 sets x 3 repetitions) and 100% (1RM; 1 set x 1repetition) of their 1RM. In addition, all participants completed a control session (CTL) in which no protocol was performed. During each testing session, muscle architecture and vertical jump testing were assessed at baseline (BL), 8min post (8P) and 20min post (20P) workout. Ultrasound measures included cross sectional area (CSA) and pennation angle (PANG) of both the rectus femoris (RF) and vastus lateralis (VL). Following each ultrasound measure, peak vertical jump power (PVJP) and mean (MVJP) power was assessed using an accelerometer. Magnitude based inferences were used to make comparisons between trials. The MI trial resulted in a likely greater increase from BL to 8P and 20P in RF-CSA and VL-CSA, while the HI trial resulted in a likely greater change from BL to 20P in both RF-CSA and VL-CSA. Meanwhile, changes in PVJP and MVJP for the MI trial was likely decreased at BL-8P and BL–20P, while the HI trial was shown to result in a likely or possible decrease compared to CTL at BL-8P and BL–20P, respectively. A likely negative relationship was observed between changes in VL-PANG and MVJP (r = -0.35; p , 0.018) at BL-8P, and between changes in PVJP and RF-CSA (r = -0.37; p , 0.014) at BL–20P. Results of this study were unable to demonstrate any potentiation response from the trials employed, however these protocols did result in acute muscle architectural changes. Key points Three squat protocols using moderate intensity (75% 1-RM; 3 sets x 10 repetitions), high intensity (90% 1-RM, 3 sets x 3 repetitions) and maximal intensity (100% 1RM; 1 set x 1repetition) were unable to potentiate jump height or jump power in experienced, resistance trained men. Experienced, resistance trained athletes who are not competitive may be limited in regards to potentiation due to a poor level of conditioning. Both the moderate and high intensity potentiation protocols stimulated acute changes in muscle architecture. Greater increases in the CSA of both the RF and VL muscles were noted. A different potentiation protocol may have elicited greater changes in muscle architecture. PMID:25178394
Reardon, Danielle; Hoffman, Jay R.; Mangine, Gerald T.; Wells, Adam J.; Gonzalez, Adam M.; Jajtner, Adam R.; Townsend, Jeremy R.; McCormack, William P.; Stout, Jeffrey R.; Fragala, Maren S.; Fukuda, David H.
Background Within the structure of the skeletal muscle, there are fascicles of muscular fibers that are made up of serially distributed contractile elements. These elements are controlled by the nervous system, control which results in obtaining the muscular strength required for movement and its control. This study presents the neuromuscular assessment using tensiomyography method (TMG). Methods We studied two groups of soccer junior players, group 1 (experimental group) and group 2 (control group), each containing 15 soccer players; we have considered two situations of muscle training: the combination between the isometric-concentric contraction for group 1 and the concentric contraction for group 2. TMG is the electrical stimulation of the muscle group and the recording of the muscle parameters resulting after the isometric contraction: time contraction (Tc) and displacement (Dm) at rectus femoris muscle (RF), pointing out two moments T1 and T2. Results Tc decreasing and the Dm increasing involve a good response following the muscle training. For group 1, the Tc evolution is 22.54 ms/22.45 ms (T1/T2) for the right RF and 22.65 ms/22.26 ms for the left RF, while for group 2 results in a Tc evolution of 24.33 ms/28.57 ms (T1/T2) for the right RF and 25.74 ms/28.61 ms for the left RF. Dm for group 1, results in a 6.57 mm/6.85 mm (T1/T2) for the right RF and 6.92 mm/7.06 mm for the left RF, while for group 2, the Dm evolution shows 7.45 mm/5.83 mm (T1/T) for the right RF and 7.41 mm/6.26 mm for the left RF. Also, the evaluation on motor test indicated better results on T2 for the experimental group. Summarizing the results of Student t-test, we found significant differences between the averages of the two groups in all parameters (p?0.001), the experimental group registering better results than the control one. Conclusions It is possible to develop muscle training which can be monitored through TMG. PMID:23822158
Due to their profession and the tasks it entails, soldiers are exposed to high levels of physical activity and strain. This can result in overexertion and pain in the locomotor system, partly caused by carrying items of equipment. The aim of this study was to analyse the extent of muscle activity in the lower extremities caused by carrying specific items of equipment. For this purpose, the activity of selected groups of muscles caused by different items of equipment (helmet, carrying strap, backpack, and rifle) in the upper and lower leg was measured by recording dynamic surface electromyograms. Electrogoniometers were also used to measure the angle of the knee over the entire gait cycle. In addition to measuring muscle activity, the study also aimed to determine out what influence increasing weight load has on the range of motion (ROM) of the knee joint during walking. The activity of recorded muscles of the lower extremity, that is, the tibialis anterior, peroneus longus, gastrocnemius lateralis, gastrocnemius medialis, rectus femoris, and biceps femoris, was found to depend on the weight of the items of equipment. There was no evidence, however, that items of equipment weighing a maximum of 34% of their carrier's body weight had an effect on the ROM of the knee joint. PMID:22973179
Lindner, Tobias; Schulze, Christoph; Woitge, Sandra; Finze, Susanne; Mittelmeier, Wolfram; Bader, Rainer
The purpose of this work was to investigate the electromyographic (EMG) fatigue representations in muscles of male runners during run at different level of intensity. In this study, the EMG signals for the rectus femoris and biceps femoris (long head) were collected by bipolar electrodes from the left and right lower extremities. EMG measurements were recorded during the run on tartan athletic track. Four professional athletes had to run a 400 m distance with a different intensity. The first distance of 400 m took 90 s; the second, 70 s; the third, 60 s; and the last one was covered with a maximal velocity until exhaustion. Power spectral analysis of EMG signals was carried out to calculate MPF. The results of our study revealed the efforts of different intensity for each muscle individually. The effect of fatigue was observed only in the case of running with the highest velocity. The biggest changes in MPF were observed for BF (23.6%) and RF (19.5%) muscles of the left leg and then for BF (17.5%) and RF (12.5%) ones of the right leg. We supposed that those differences between the right and left legs were mainly due to the curve of the track where those muscles are differently loaded. PMID:22794153
Mastalerz, Andrzej; Gwarek, Lucyna; Sadowski, Jerzy; Szczepa?ski, Tadeusz
The aim of this study was to analyze trunk muscle activity during bridge style stabilization exercises, when combined with single and double leg support strategies. Twenty-nine healthy volunteers performed bridge exercises in 3 different positions (back, front and side bridges), with and without an elevated leg, and a quadruped exercise with contralateral arm and leg raise ("bird-dog"). Surface EMG was bilaterally recorded from rectus abdominis (RA), external and internal oblique (EO, IO), and erector spinae (ES). Back, front and side bridges primarily activated the ES (approximately 17% MVC), RA (approximately 30% MVC) and muscles required to support the lateral moment (mostly obliques), respectively. Compared with conventional bridge exercises, single leg support produced higher levels of trunk activation, predominantly in the oblique muscles. The bird-dog exercise produced greatest activity in IO on the side of the elevated arm and in the contralateral ES. In conclusion, during a common bridge with double leg support, the antigravity muscles were the most active. When performed with an elevated leg, however, rotation torques increased the activation of the trunk rotators, especially IO. This information may be useful for clinicians and rehabilitation specialists in determining appropriate exercise progression for the trunk stabilizers. PMID:22436839
García-Vaquero, María Pilar; Moreside, Janice M; Brontons-Gil, Evaristo; Peco-González, Noelia; Vera-Garcia, Francisco J
Quantification of muscle volume can be used as a means for the estimation of muscle strength. Its measuring process does not need the subject's muscular contractions so it is completely safe and particularly suited for elderly people. Therefore, we have developed a flexible measuring system for muscle volume using ultrasonography. In this system, an ultrasound probe is installed on a link mechanism which continuously scans fragmental images along the human body surface. These images are then measured and composed into a wide area cross-sectional image based on the spatial compounding method. The flexibility of the link mechanism enables the operator to measure the images under any body postures and body site. The spatial compounding method significantly reduces speckle and artifact noises from the composed cross-sectional image so that the operator can observe the individual muscles, such as Rectus femoris, Vastus intermedius, and so on, in detail. We conducted the experiments in order to examine the advantages of this system we have developed. The experimental results showed a high accuracy of the measuring position which was calculated using the link mechanism and presented the noise reduction effect based on the spatial compounding method. Finally, we confirmed high correlations between the MRI images and the ones of the developed system to verify the validity of the system.
Fukumoto, Kiyotaka; Fukuda, Osamu; Tsubai, Masayoshi; Muraki, Satoshi
The stimulus of gravity affects RNA production, which helps maintain the strength of human muscles on Earth (top), as seen in this section of muscle fiber taken from an astronaut before spaceflight. Astronauts in orbit and patients on Earth fighting muscle-wasting diseases need countermeasures to prevent muscle atrophy, indicated here with white lipid droplets (bottom) in the muscle sample taken from the same astronaut after spaceflight. Kerneth Baldwin of the University of California, Irvine, is conducting research on how reducing the stimulus of gravity affects production of the RNA that the body uses as a blueprint for making muscle proteins. Muscle proteins are what give muscles their strength, so when the RNA blueprints aren't available for producing new proteins to replace old ones -- a situation that occurs in microgravity -- the muscles atrophy. When the skeletal muscle system is exposed to microgravity during spaceflight, the muscles undergo a reduced mass that translates to a reduction in strength. When this happens, muscle endurance decreases and the muscles are more prone to injury, so individuals could have problems in performing extravehicular activity [space walks] or emergency egress because their bodies are functionally compromised.
A 42-year-old woman had vertical diplopia secondary to a palpable mass located in the left inferior orbit. At surgery, the mass was adherent to the globe, encapsulated, and seemed to arise from the inferior rectus muscle. Frozen section diagnosis was granular cell tumor. The tumor was removed in toto. No recurrence was apparent six years after surgery. PMID:6318639
Singleton, E M; Nettleship, M B
to do. Exercising, getting enough rest, and eating a balanced diet will help to keep your muscles your body strong. They help you to enjoy playing sports, dancing, walking the dog, swimming, and other strong! What can go wrong? Injuries Almost everyone has had sore muscles after exercising or working too
Baker, Chris I.
Complex program "Surgery without blood" was developed and introduced into a broad clinical practice. The main elements of this program are stimulation of erythropoesis, preparing in autoserum and autoblood before surgery with acute normovolemic hemodilution method, precise surgical technique, reinfusion of blood from wound and drainages, adequate anesthesia and correction of hemostasis system. This program permits one to minimize infusion of donor's blood components (DBC) in elective surgery (cardiosurgery, orthopedic surgery, neurosurgery, oncology, general surgery) and reduce significantly transfusion of DBC in urgent surgery. Rejection of DBC transfusion decreases number of postoperative complications and hospital stay, improves results of treatment and is cost-effective. PMID:15477831
Tarichko, Iu V; Ermolov, A S; Nemytin, Iu V; Domrachev, S A; Kurbanov, F S; Khvatov, B V; Ragimov, A A
a different muscle measurement. Repeatability of Diffusion Tensor Imaging and Water-Fat MRI in Lower Extremity Orthopaedic Surgery, Children's Hospital Los Angeles, Los Angeles, California, United States Target Audience tensor imaging. It is also of relevant to researchers interested in studies of muscle diseases
Southern California, University of
A young woman presented with a painful soft tissue swelling of the anterior aspect of the distal forearm. MRI revealed a hypertrophied reversed palmaris longus muscle confirmed by surgery, which also showed a second insertion to the flexor carpi radialis tendon. Variants of the palmaris longus muscle are discussed.
P. Bencteux; J. Simonet; L. El Ayoubi; M. Renard; I. Attignon; J. N. Dacher; J. Thiebot
percent of muscle mass every single year after the age of 75, a trend that is irreversible," cites Gilbert that are still functional to begin dividing and self-renewing." "An important thing to stress here, is the challenge of repairing skeletal muscles around the hip joint injured during surgery. The study points
Simmons, Craig A.
Artificial Muscles 3 primary types:3 primary types: Pneumatic Artificial Muscles (PAMs)Pneumatic Artificial Muscles Nanotube Muscles (CNMsCNMs)) http://en.wikipedia.org/wiki/Artificial_Muscle. http://en.wikipedia.org/wiki/Pneumatic_artificial_muscles. AlievAliev,, et alet al. Science 323, 1575 (2009). Science 323, 1575 (2009) #12;Pneumatic Artificial
Fygenson, Deborah Kuchnir
Pelvic floor muscle training exercises are a series of exercises designed to strengthen the muscles of the pelvic floor. ... Pelvic floor muscle training exercises are recommended for: Women ... have fecal incontinence Pelvic floor muscle training exercises ...
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
M. Ferrari; T. Binzoni; V. Quaresima
Although skeletal muscle is the single largest tissue in the body, there is little written about it in the radiologic literature.\\u000a Indirect muscle injuries, also called strains or tears, are common in athletics, and knowing the morphology and physiology\\u000a of the muscle-tendon unit is the key to the understanding of these injuries. Eccentric muscle activation produces more tension\\u000a within the
G. Y. El-Khoury; E. A. Brandser; M. H. Kathol; D. S. Tearse; J. J. Callaghan
Twelve patients undergoing total hip replacement were given 600 mg of linezolid as a 20 min iv infusion along with conventional prophylaxis of 1 g of cefamandole immediately before surgery. Routine total hip arthroplasty was carried out, and at timed intervals during surgery samples of bone, fat, muscle and blood were collected for assay by high-performance liquid chromato- graphy analysis.
A. M. Lovering; J. Zhang; G. C. Bannister; B. J. A. Lankester; J. H. M. Brown; G. Narendra; A. P. MacGowan
OBJECTIVE: To determine whether differences exist in the morphology of upper airway muscles between apneic and non-apneic snorersDESIGN: Muscle characteristic analysis in patients undergoing upper airway surgery in a tertiary sleep center.SUBJECTS: 10 non-apneic snorers and 10 sleep apnea hypopnea syndrome (SAHS).MEASUREMENTS: Frequency distribution of musculus uvulae (MU) muscle fiber area determined from 475±207 (mean±s.d.) and 697±165 type IIA fibers
J-A Simoneau; S St Pierre
Pedaling with independent cranks ensures each leg cycles independently of the other, and thus eliminates the contribution of the contralateral leg during the upstroke phase. Consequently the subject is required to actively pull-up the pedal to complete the cycle. The present study aimed to determine the acute effect of the use of independent cranks on muscle coordination during a submaximal pedaling exercise. Ten healthy males were asked to perform submaximal pedaling exercises at 100 Watts with normal fixed cranks (control condition) or independent cranks. Both 2-D pedal forces and electromyographic (EMG) SIGNALS of 10 lower limb muscles were recorded. When the mean EMG activity across the cycle was considered, the use of independent cranks significantly increased the activity level compared to control for Tibialis anterior (TA) (P = 0.0017; +336 ± 302%), Gastrocnemius medialis (GM) (P = 0.0005; +47 ± 25%), Rectus femoris (RF) (P = 0.005; +123 ± 153%), Biceps femoris (BF)-long head (P = 0.0001; +162 ± 97%), Semimembranosus (SM) (P = 0.0001; +304 ± 192%), and Tensor fascia latae (P = 0.0001; +586 ± 262%). The analysis of the four pedaling sectors revealed that the increased activity of hip and knee flexors mainly occurred during the top dead center and the upstroke phase. In addition, a high inter-individual variability was found in the way the participants adapted to pedaling with independent cranks. The present results showed that the enforced pull-up action required when using independent cranks was achieved by increasing the activation of hip and knee flexors. Further studies are needed to determine whether training with independent cranks has the potential to induce long-term changes in muscle coordination, and, if so, whether these changes are beneficial for cycling performance. PMID:24009587
Hug, François; Boumier, Florian; Dorel, Sylvain
Pedaling with independent cranks ensures each leg cycles independently of the other, and thus eliminates the contribution of the contralateral leg during the upstroke phase. Consequently the subject is required to actively pull-up the pedal to complete the cycle. The present study aimed to determine the acute effect of the use of independent cranks on muscle coordination during a submaximal pedaling exercise. Ten healthy males were asked to perform submaximal pedaling exercises at 100 Watts with normal fixed cranks (control condition) or independent cranks. Both 2-D pedal forces and electromyographic (EMG) SIGNALS of 10 lower limb muscles were recorded. When the mean EMG activity across the cycle was considered, the use of independent cranks significantly increased the activity level compared to control for Tibialis anterior (TA) (P = 0.0017; +336 ± 302%), Gastrocnemius medialis (GM) (P = 0.0005; +47 ± 25%), Rectus femoris (RF) (P = 0.005; +123 ± 153%), Biceps femoris (BF)—long head (P = 0.0001; +162 ± 97%), Semimembranosus (SM) (P = 0.0001; +304 ± 192%), and Tensor fascia latae (P = 0.0001; +586 ± 262%). The analysis of the four pedaling sectors revealed that the increased activity of hip and knee flexors mainly occurred during the top dead center and the upstroke phase. In addition, a high inter-individual variability was found in the way the participants adapted to pedaling with independent cranks. The present results showed that the enforced pull-up action required when using independent cranks was achieved by increasing the activation of hip and knee flexors. Further studies are needed to determine whether training with independent cranks has the potential to induce long-term changes in muscle coordination, and, if so, whether these changes are beneficial for cycling performance. PMID:24009587
Hug, Francois; Boumier, Florian; Dorel, Sylvain
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
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)
We studied the effect of resistance running on left cardiac ventricle size and rectus femoris muscle fiber composition. Ten male Wistar rats were trained on a treadmill 6 days per week for 12 weeks. Ten rats remained sedentary and served as controls. A higher endurance time (40%) and cardiac hypertrophy in the trained animals were indicators of training efficiency. Morphometric analysis of the left ventricle cross-sectional area, left ventricular wall, and left ventricular cavity were evaluated. The endurance-running group demonstrated a hypertrophy of the ventricular wall (22%) and an increase in the ventricular cavity (25%); (p<0.0001). Semi-quantitative analysis of rectus femoris fiber-type composition and of the oxidative and glycolytic capacity was histochemically performed. Endurance running demonstrated a significant (p<0.01) increase in the relative frequency of Type I (24%), Type IIA (8%) and Type IIX (16%) oxidative fibers, and a decrease in Type IIB (20%) glycolytic fibers. There was a hypertrophy of both oxidative and glycolytic fiber types. The relative cross-sectional area analysis demonstrated an increase in oxidative fibers and a decrease in glycolytic fibers (p<0.0001). Changes were especially evident for Type IIX oxidative-glycolytic fibers. The results of this study indicate that the left ventricle adapts to endurance running by increasing wall thickness and enlargement of the ventricular cavity. Skeletal muscle adapts to training by increasing oxidative fiber Type. This increase may be related to fiber transformation from Type IIB glycolytic to Type IIX oxidative fibers. These results open the possibility for the use of this type of exercise to prevent muscular atrophy associated with age or post-immobilization. PMID:11193205
Díaz-Herrera, P; Torres, A; Morcuende, J A; García-Castellano, J M; Calbet, J A; Sarrat, R
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. PMID:23634268
Moon, Kyung Yun; Lee, Soo-Eon; Kim, Ki-Jeong; Hyun, Seung-Jae; Kim, Hyun-Jib
Blepharoplasty is the most commonly performed procedure in aesthetic facial surgery. The upper eyelid is part of the same aesthetic subunit as the eyebrow and the lower eyelid is part of the same aesthetic subunit as the cheek. In upper eyelid blepharoplasty the excess skin and possibly also a portion of the sphincter is removed. A low-hanging eyebrow is preferably corrected by lifting the brow instead of over excising the redundant eyelid skin. Blepharoplasty of the lower eyelid is generally carried out by a very limited excision of the skin and the orbicularis oculi muscle in order to prevent lower lid retraction (ectropion). Rejuvenation in the lower lid region is also achieved by fat resection or redistribution, by means of which the double convex contour deformity is reduced. Blepharoplasty is generally performed under local anaesthesia and complications are rare. Patient satisfaction is generally high. PMID:25174189
Jansma, J; Schepers, R H; Schouten, H J; Vissink, A
... is a really good idea Third Quarter 2011 Cosmetic surgery to ease bullying? Second Quarter 2011 Facial Plastic ... 2014 | AMERICAN ACADEMY OF FACIAL PLASTIC AND RECONSTRUCTIVE SURGERY (AAFPRS) | ALL RIGHTS RESERVED | SITEMAP | CONTACT | PRIVACY Follow us on
Anesthesia for Ambulatory Surgery Share PRINT Print Home > Types Of Anesthesia > Detail Page Anesthesia for Ambulatory Surgery Today the majority of patients ... or supervised by an anesthesiologist. What is ambulatory anesthesia? Ambulatory anesthesia is designed so you can go ...
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. PMID:19639642
Melvin, Alan; Litsky, Alan; Mayerson, Joel; Witte, David; Melvin, David; Juncosa-Melvin, Natalia
Reinnervation, muscle regeneration, density of microvessels, and muscle-type specific atrophy were studied 3-4 years after surgery in surgically nonreinnervated free microvascular muscle flaps to 13 patients transplanted to the upper or lower extremities. Routine histology and immunohistochemistry for PGP 9.5 and S-100 (neuronal markers), Ki-67 (cell proliferation), myosin (muscle fiber types), and CD-31 (endothelium) were carried out, and results were analyzed morphometrically. Three to 4 years after surgery, severe atrophy of predominantly slow-type fibers was seen in 9 cases. In 4 cases, muscle-fiber diameter and fiber-type distribution were close to normal. Long intraoperative muscle ischemia and postoperative immobilization were associated with poor muscle bulk in flaps. The density of microvessels in flaps did not differ from control muscles. PGP 9.5 and S-100 immunopositive nerve fibers were detected in 7 patients. Reinnervation was associated with good muscle bulk. In 4 patients, activation of satellite cells was evident. The results suggest that in some cases, spontaneous reinnervation may occur in free muscle flaps, and that several years after microvascular free flap transfer, the muscle still attempts to regenerate. PMID:14748022
Kauhanen, M Susanna C; Lorenzetti, Fulvio; Leivo, Ilmo V V; Tukiainen, Erkki; Asko-Seljavaara, Sirpa L
Rationale: Patients with chronic obstructive pulmonary disease have shorter inspiratory muscles and higher motor unit firing rates dur- ing quiet breathing than do age-matched healthy subjects. Lung volume reduction surgery (LVRS) in patients with chronic obstruc- tive pulmonary disease improves lung function, exercise capacity, and quality of life. Objectives: We studied the effect of LVRS on length and motor unit
Robert B. Gorman; David K. McKenzie; Jane E. Butler; Jane F. Tolman; Simon C. Gandevia
Cardioplegia has become the gold standard of myocardial protection for practically every type of heart surgery during which the ascending aorta must be clamped. Although there is little doubt about the efficacy of cardioplegia in the adult heart, there are few studies on the pediatric heart and their results are contradictory. The physiology of pediatric heart muscle differs considerably from
Torsten Doenst; Christian Schlensak; Friedhelm Beyersdorf
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
Robotic surgery is an evolving technology that has been successfully applied to a number of surgical specialties, but its use in liver surgery has so far been limited. In this review article we discuss the challenges of minimally invasive liver surgery, the pros and cons of robotics, the evolution of medical robots, and the potentials in applying this technology to liver surgery. The current data in the literature are also presented. PMID:25392840
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.
Reaction time and muscle activation deficits might limit the individual's autonomy in activities of daily living and in participating in recreational activities. The aim of the present study was to assess the effects of a 14-week hippotherapy exercise program on movement reaction time and muscle activation in adolescents with intellectual disability (ID). Nineteen adolescents with moderate ID were assigned either to an experimental group (n=10) or a control group (n=9). The experimental group attended a hippotherapy exercise program, consisting of two 30-min sessions per week for 14 weeks. Reaction time, time of maximum muscle activity and electromyographic activity (EMG) of rectus femoris and biceps femoris when standing up from a chair under three conditions: in response to audio, visual and audio with closed eyes stimuli were measured. Analysis of variance designs showed that hippotherapy intervention program resulted in significant improvements in reaction time and a reduction in time to maximum muscle activity of the intervention group comparing to the control group in all 3 three conditions that were examined (p<0.05). The present findings suggest that the muscle reaction function of individuals with ID can be improved through hippotherapy training. Hippotherapy probably creates a changing environment with a variety of stimuli that enhance deep proprioception as well as other sensory inputs. In conclusion, this study provides evidence that hippotherapy can improve functional task performance by enhancing reaction time. PMID:23747935
Giagazoglou, Paraskevi; Arabatzi, Fotini; Kellis, Eleftherios; Liga, Maria; Karra, Chrisanthi; Amiridis, Ioannis
The aim of this study was to investigate the influence of an exercise device, designed to improve the function of lumbopelvic muscles via low-impact weight-bearing exercise, on electromyographic (EMG) activity of lumbopelvic, including abdominal muscles. Surface EMG activity was collected from lumbar multifidus (LM), erector spinae (ES), internal oblique (IO), external oblique (EO) and rectus abdominis (RA) during overground walking (OW) and exercise device (EX) conditions. During walking, most muscles showed peaks in activity which were not seen during EX. Spinal extensors (LM, ES) were more active in EX. Internal oblique and RA were less active in EX. In EX, LM and ES were active for longer than during OW. Conversely, EO and RA were active for a shorter duration in EX than OW. The exercise device showed a phasic-to-tonic shift in activation of both local and global lumbopelvic muscles and promoted increased activation of spinal extensors in relation to walking. These features could make the exercise device a useful rehabilitative tool for populations with lumbopelvic muscle atrophy and dysfunction, including those recovering from deconditioning due to long-term bed rest and microgravity in astronauts.
Caplan, Nick; Gibbon, Karl; Hibbs, Angela; Evetts, Simon; Debuse, Dorothée
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. PMID:9232855
Ferrari, M; Binzoni, T; Quaresima, V
1 Pediatric Surgery Gallengangatresie: eine seltene Erkrankung fÃ¤llt durch die Maschen eines Versorgungsnetzes C. Petersen, B. M. Ure Pediatric Surgery Warum machen wir so viel Wirbel um eine seltene Surgery Die Gallengangatresie ist ein Problem! Seltene Erkrankung: ca. 1: 18.000 In Deutschland ca. 40
Manstein, Dietmar J.
Simulation of Endoscopic Surgery Nicholas AYACHE 1 - StÃ©phane COTIN 1 - HervÃ© DELINGETTE 1 Jean of therapy. This is particularly true for video-surgery, where the use of video-images during, in order to rehearse a difficult surgical procedure. In the future, we believe that surgery simulators
/Head & Neck Surgery Facial Plastic and Reconstructive Surgery 7. If eyelid surgery is performed there mayPostoperative Instructions Following Facial Surgery 1. Your surgery will be performed in the Surgery Center on the 4th floor of the Center for Health and Healing (CHH) at Oregon Health & Sciences
Chapman, Michael S.
Purpose Dynamic stability of the knee joint is a research topic of increasing focus after ACL injury, stroke, and incomplete spinal cord injury. Since rehabilitation programs use functional weight-bearing tasks to improve neuromuscular control of the knee, it is important to understand the adaptability of muscle control strategies during weight-bearing exercise. The purpose of this study was to compare muscle activation patterns during a single leg squat (SLS) exercise performed before and after feedback-controlled training. Methods This was a cross-sectional comparative study. Fifteen young, healthy individuals performed the SLS exercise while tracking a sinusoidal target with flexion and extension of the knee. The SLS instrument provided bidirectional resistance that was normalized to body weight. Six trials of 10 repetitions of the SLSs were performed to quantify improved performance (learning). Electromyographic activity from five muscles that cross the knee was analyzed. Accuracy of performance was measured by calculating the error between the target and actual knee displacement. Results Reduction in error measurements verified that individuals increased the accuracy of performance in each trial and retained this improvement across trials (p < 0.05). Modulation in muscle activity as a result of learning was reflected mainly in the biceps femoris, rectus femoris, and vastus lateralis muscles. Conclusion Increased accuracy with the SLS exercise was accompanied by a decrease in coactivation of selected musculature around the knee. This study presents a novel approach to quantify the effect of performance on muscle synergistic activation patterns during weight-bearing exercise. Controlled strengthening, as defined in this study, emphasizes accuracy of performance in conjunction with principles of strength training and has implications to knee control. PMID:17419885
Madhavan, Sangeetha; Shields, Richard K.
In this paper, we present a semi-automated segmentation method for magnetic resonance images of the quadriceps muscles. Our method uses an anatomically anchored, template-based initialization of the level set-based segmentation approach. The method only requires the input of a single point from the user inside the rectus femoris. The templates are quantitatively selected from a set of images based on modes in the patient population, namely, sex and body type. For a given image to be segmented, a template is selected based on the smallest Kullback-Leibler divergence between the histograms of that image and the set of templates. The chosen template is then employed as an initialization for a level set segmentation, which captures individual anatomical variations in the image to be segmented. Images from 103 subjects were analyzed using the developed method. The algorithm was trained on a randomly selected subset of 50 subjects (25 men and 25 women) and tested on the remaining 53 subjects. The performance of the algorithm on the test set was compared against the ground truth using the Zijdenbos similarity index (ZSI). The average ZSI means and standard deviations against two different manual readers were as follows: rectus femoris, 0.78?±?0.12; vastus intermedius, 0.79?±?0.10; vastus lateralis, 0.82?±?0.08; and vastus medialis, 0.69?±?0.16. PMID:20049623
Prescott, Jeffrey W; Best, Thomas M; Swanson, Mark S; Haq, Furqan; Jackson, Rebecca D; Gurcan, Metin N
, Rectus abdominous (flank muscle), and lymph glands and associated fat were removed from the rough ham. The ham was faced by removing a well rounded skin collar 6. 35 cm inward from the stifle joint. Collar fat exceeding 1. 27 cm was removed. The rough.... The loin was separated from the belly along a line that was perpendicular to the outside skin surface, extending in a straight line from a point on the most anterior rib which was 3. 81 cm from the junction of the rib and the thoracic vertebra to a point...
Harris, Shawn Dale
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
This research compared off-flavor notes and the relationship of pH and heme-iron content to off-flavor for different beef muscles. After grading, knuckles and shoulder clods were removed from 16 USDA Choice and 14 USDA Select beef carcasses, vacuum-packaged, and aged for 7 d. The rectus femoris (REC), vastus medalis (VAM), vastus lateralis (VAL), teres major (TER), infraspinatus (INF), and triceps brachii-long head (TRI) were separated, cut into steaks, and frozen (-16 degrees C). Sensory analysis was conducted using a trained taste panel, with steaks grilled to an internal temperature of 65 degrees C. Heme-iron concentration and pH were determined. The INF had lower (P < 0.05) off-flavor intensity ratings and less frequent sour flavor than the other muscles, and the VAL had the most intense (P < 0.05) off-flavor ratings and among the greatest frequency of sour, charred, and oxidized flavors. The frequencies of liver-like, bloody, and rancid flavors were not affected by muscle type. Heme-iron concentration did not differ among muscles. Three USDA Select carcasses had intense off-flavor in the muscles. Liver-like flavor was highly negatively correlated with off-flavor intensity for each of the muscles tested. Muscles rated a 5 or below (on an 8-point rating scale, where 1 = extremely intense off-flavor and 8 = no off-flavor) in off-flavor intensity and identified as liver-like by 30% or more of the panelists were grouped together and compared to normal muscles. Those in the liver-flavored group were less frequently identified as charred, probably because the liver-like flavor was so intense. There were no differences between the 2 groups for sour, metallic, bloody, oxidized, or fatty off-flavor notes. Regression equations containing the linear and quadratic functions of heme-iron concentration, muscle pH, and their interaction were established for the frequency of off-flavor notes within each muscle. The REC, TER, VAL, and VAM showed a relationship between pH, heme iron, and off-flavor intensity (P < 0.05). Liver-like flavor was explained partially by pH and heme iron in the REC, VAM, and VAL (R2 = 0.45 to 0.55; P < 0.05). Few other significant relationships were found. Heme iron and pH were unrelated to metallic, oxidized, or rancid flavors for any of the muscles tested. These data suggest that liver-like off-flavors are specific to individual animals, and that pH and heme iron are not strongly related to off-flavor notes. PMID:16971585
Meisinger, J L; James, J M; Calkins, C R
A sartorius muscle is the longest muscle of the human system. It runs over 2 joints- hip and knee joints. In the study 10 sartorius muscles were examined. They were dissected free of lower human limbs. Dimensions of limbs which these muscles come from and dimensions of the muscles and their component parts were examined. The attention was paid mainly to parts of tendon located inside the muscle belly. The results show that they are either of a comparable length (distal tendon) or several times longer (proximal tendon) than visible parts located outside of the muscle. Moreover, a complex structure of the distal tendon which includes 2 tracts of different places of insertion was stated. Inferior tract inserted in the same place as muscle tendons: semitendinosus and gracilis. The superior tract inserted transversely against the former one. The tendon of the sartorius muscle forms additionally an aponeurosis whose fibres enter into the deep fascia of crus. The muscle belly is characterised with various width on different levels of its length. In half of casess word-like distal segment of belly is formed. PMID:25242250
Dziedzic, D; Bogacka, U; Ciszek, B
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. PMID:22237405
Bandschapp, Oliver; Soule, Charles L.
Little research has been reported on the effects of using different devices with resistance exercises in a water environment. This study compared muscular activation of lower extremity and core muscles during leg adduction performed at maximum velocity with drag and floating devices of different sizes. A total of 24 young men (mean age 23.20 ± 1.18 years) performed 3 repetitions of leg adduction at maximum velocity using 4 different devices (ie, large/small and drag/floating). The maximum amplitude of the electromyographic root mean square of the adductor longus, rectus abdominis, external oblique on the dominant side, external oblique on the nondominant side, and erector lumbar spinae were recorded. Electromyographic signals were normalized to the maximum voluntary isometric contraction (MVIC). Unexpectedly, no significant (P > 0.05) differences were found in the neuromuscular responses among the different devices used; the average activation of agonist muscle adequate for neuromuscular conditioning was 40.95% of MVIC. In addition, external oblique activation is greater on the contralateral side to stabilize the body (average, 151.74%; P < 0.05). Therefore, if maximum muscle activation is required, the kind of device is not relevant. Thus, the choice should be based on economic factors. PMID:24875975
Borreani, Sebastien; Colado, Juan Carlos; Furio, Josep; Martin, Fernando; Tella, Víctor
The aim of this study was to determine the effect of prior cycling on EMG activity of selected lower leg muscles during running. Ten elite level triathletes underwent two testing sessions at race pace: a 40 km cycle followed by a 2 km run (CR) and a 10 km run followed by a 2 km run (RR). EMG data from selected lower limb muscles were collected at three sections of each run (0 km, 1 km and 2 km) for six strides using a portable data logger. Significant differences (p < 0.05) between condition were found for the level of activation (Lact) for biceps femoris (BF) during stance and vastus lateralis (VL) during flight and stance. Vastus medialis (VM) changed in Lact, during flight, between sections in the 2 km run. Furthermore, significant differences (p < 0.05) between condition were found for BF during stance and for rectus femoris (RF) and VM during flight. There was a significant difference (p < 0.05) in the duration of VL activation (Dact) across sections of the 2 km run. Findings from this investigation highlight changes in muscle function when changing from cycling to running and indicate a need to train specifically for the cycle to run transition. Such training may improve performance and reduce the risk of injury. PMID:14658244
Heiden, Tamika; Burnett, Angus
The current study examined the effects of using an unstable surface during whole-body vibration (WBV) exercise on leg and trunk muscle activity during a static semi-squat. Twenty-eight recreationally active university students completed 4 different test conditions: 1) stable surface with no WBV; 2) unstable surface with no WBV; 3) unstable surface with 30 Hz WBV low amplitude; and 4) unstable surface with 50 Hz WBV low amplitude. Surface electromyography (sEMG) was measured for the gastrocnemius medialis (GM), vastus medialis oblique (VMO), vastus lateralis (VL), rectus abdominis (RA), and multifidus (MF) muscles. Normalized to the stable condition, WBV at 30 Hz and an unstable surface increased EMG in the GM vs the unstable and stable surfaces (~35%; p<0.05). VMO EMG decreased in the unstable vs stable condition (~20%), WBV at 30 Hz and an unstable surface increased EMG vs all other conditions (~20-40%; p<0.05). MF EMG increased with WBV at 30 Hz (25%; p<0.05) vs the stable condition but not vs all other conditions. Using an unstable surface during WBV exposure increases EMG of muscles in the lower extremities and trunk suggesting the combination of an unstable surface combined with WBV may be an effective modality to further increase EMG. PMID:24879025
Marín, P J; Hazell, T J
The plication of the anterior rectus sheath is a procedure that is performed by most surgeons during abdominoplasty. A main concern is whether the correction of recti diastasis is really effective and if it is stable. In order to verify the position of the rectus muscle, a CT-scan was used in 14 patients who underwent abdominoplasty with rectus plication to compare the preoperative situation of these muscles with their position 3 weeks and 6 months postoperatively. None of these patients had had previous abdominal surgery. The recti diastasis was corrected with a two-layer 2-0 Nylon suture. A dynamometer was used to measure the resistance force of the anterior aponeurosis of the rectus. In all cases the CT data shows that correction of the diastasis was achieved completely after 6 months. PMID:9263554
Nahas, F X; Augusto, S M; Ghelfond, C
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, 19 women) who
Michael M. Reinold; Leonard C. Macrina; Kevin E. Wilk; Jeffrey R. Dugas; E. Lyle Cain; James R. Andrews
In this activity students measure the change in the area of calf muscle from transverse MRI images collected from an astronaut before and after a prolonged journey in space. They measure and compare the total area of calf muscle from before and after flight to determine if muscle loss has occurred. The lesson introduces some reasons for the muscle loss, measures to reduce the loss, and other effects of space flight. Students perform the image analysis with WebImage, a customized version of ImageJ running in a browser.
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
Background Side bridge endurance protocols have been suggested to evaluate lateral trunk flexor and/or spine stabilizer muscles. To date, no study has investigated muscle recruitment and fatigability during these protocols. Therefore the purpose of our study was to quantify fatigue parameters in various trunk muscles during a modified side bridge endurance task (i.e. a lateral isometric hold test on a 45° roman chair apparatus) and determine which primary trunk muscles get fatigued during this task. It was hypothesized that the ipsilateral external oblique and lumbar erector spinae muscles will exhibit the highest fatigue indices. Methods Twenty-two healthy subjects participated in this study. The experimental session included left and right lateral isometric hold tasks preceded and followed by 3 maximal voluntary contractions in the same position. Surface electromyography (EMG) recordings were obtained bilaterally from the external oblique, rectus abdominis, and L2 and L5 erector spinae. Statistical analysis were conducted to compare the right and left maximal voluntary contractions (MVC), surface EMG activities, right vs. left holding times and decay rate of the median frequency as the percent change from the initial value (NMFslope). Results No significant left and right lateral isometric hold tests differences were observed neither for holding times (97.2?±?21.5?sec and 96.7?±?24.9?sec respectively) nor for pre and post fatigue root mean square during MVCs. However, participants showed significant decreases of MVCs between pre and post fatigue measurements for both the left and right lateral isometric hold tests. Statistical analysis showed that a significantly NMFslope of the ipsilateral external oblique during both conditions, and a NMFslope of the contralateral L5 erector spinae during the left lateral isometric hold test were steeper than those of the other side’s respective muscles. Although some participants presented positive NMFslope for some muscles, each muscle presented a mean negative NMFslope significantly different from 0. Conclusions Although the fatigue indices suggest that the ipsilateral external oblique and contralateral L5 erector spinae show signs of muscle fatigue, this task seems to recruit a large group of trunk muscles. Clinicians should not view this task as evaluating specifically lateral trunk flexors, but rather as providing an indication of the general endurance and stabilisation capacity of the trunk. PMID:22515489
Abstract Context: Closed kinetic chain exercises are an integral part of rehabilitation programs after lower extremity injury. Sex differences in lower extremity kinematics have been reported during landing and cutting; however, less is known about sex differences in movement patterns and activation of the hip musculature during common lower extremity rehabilitation exercises. Objective: To determine whether lower extremity kinematics and muscle activation levels differ between sexes during closed kinetic chain rehabilitation exercises. Design: Cross-sectional with 1 between-subjects factor (sex) and 1 within-subjects factor (exercise). Setting: Research laboratory. Patients or Other Participants: Participants included 21 women (age ?=? 23 ± 5.8 years, height ?=? 167.6 ± 5.1 cm, mass ?=? 63.7 ± 5.9 kg) and 21 men (age ?=? 23 ± 4.0 years, height ?=? 181.4 ± 7.4 cm, mass ?=? 85.6 ± 16.5 kg). Intervention(s): In 1 testing session, participants performed 3 trials each of single-leg squat, lunge, and step-up-and-over exercises. Main Outcome Measure(s): We recorded the peak joint angles (degrees) of knee flexion and valgus and hip flexion, extension, adduction, and external rotation for each exercise. We also recorded the electromyographic activity of the gluteus maximus, rectus femoris, adductor longus, and bilateral gluteus medius muscles for the concentric and eccentric phases of each exercise. Results: Peak knee flexion angles were smaller and peak hip extension angles were larger for women than for men across all tasks. Peak hip flexion angles during the single-leg squat were smaller for women than for men. Mean root-mean-square amplitudes for the gluteus maximus and rectus femoris muscles in both the concentric and eccentric phases of the 3 exercises were greater for women than for men. Conclusions: Sex differences were observed in sagittal-plane movement patterns during the rehabilitation exercises. Because of the sex differences observed in our study, future researchers need to compare the findings for injured participants by sex to garner a better representation of altered kinematic angles and muscle activation levels due to injury. PMID:20210622
Dwyer, Maureen K.; Boudreau, Samantha N.; Mattacola, Carl G.; Uhl, Timothy L.; Lattermann, Christian
Currently, robot-assisted surgery is the most common type of robotic surgery used. In robot-assisted surgery, the operator is a surgeon, not a robotic system. Robotic systems assist the surgeons, but do not operate automatically. In this section, we focus on the master-slave type, which is the predominant type of robotic surgery used in cancer treatment, and discuss the role, present status, and the future of surgical robotic system in cancer treatment. In addition, the advantages and disadvantages of a robotic system are discussed, but further development of technologies and equipment is necessary to allow the safe, widespread introduction of a robotic system in more advanced surgery for malignant tumors. Such advances in the surgical robotic system will hopefully overcome the remaining problems and provide the ultimate minimally invasive surgery for cancer treatment. PMID:23528720
Ohuchida, Kenoki; Hashizume, Makoto
[Purpose] Lumbar fusion has been used for spinal disorders when conservative treatment fails. The minimally invasive approach causes minimal damage to the back muscles and shortens the postoperative recovery time. However, evidence regarding functional recovery in patients after minimally invasive lumbar spinal fusion is limited. The purpose of this study was to investigate how trunk control ability is affected after minimally invasive lumbar fusion surgery during the early postoperative phase. [Subjects and Methods] Sixteen patients and 16 age- and sex-matched healthy participants were recruited. Participants were asked to perform a maximum forward reaching task and were evaluated 1 day before and again 1 month after the lumbar fusion surgery. Center of pressure (COP) displacement, back muscle strength, and scores for the Visual Analog Scale, and Chinese version of the modified Oswestry Disability Index (ODI) were recorded. [Results] The healthy control group exhibited more favorable outcomes than the patient group both before and after surgery in back strength, reaching distance, reaching velocity, and COP displacement. The patient group improved significantly after surgery in all clinical outcome measurements. However, reaching distance decreased, and the reaching velocity as well as COP displacement did not differ before and after surgery. [Conclusion] The LBP patients with lumbar fusion surgery showed improvement in pain intensity 1 month after surgery but no improvement in trunk control during forward reaching. The results provide evidence that the back muscle strength was not fully recovered in patients 1 month after surgery and limited their ability to move their trunk forward. PMID:25202174
Pao, Jwo-Luen; Yang, Rong-Sen; Hsiao, Chen-Hsi; Hsu, Wei-Li
In the family of ophthalmology subspecialties, ophthalmic plastic surgery is the adopted child. There are probably more differences\\u000a than there are similarities with the other subspecialties. The diseases that oculoplastic surgeons treat are unique, and the\\u000a surgeries they perform are quite different from those of ophthalmology colleagues. These unique attributes of ophthalmic plastic\\u000a surgery warrant special consideration in the study
Tanuj Nakra; Norman Shorr
Surgery of Crohns disease is an important part of the general treatment algorithm. The role of surgery is changing with the development of conservative procedures. The recent years have seen the return to early treatment of patients with Crohns disease. Given the character of the disease and its intestinal symptoms, a specific approach to these patients is necessary, especially regarding the correct choice of surgery. The paper focuses on the luminal damage of the small and large intestine including complications of the disease. We describe the individual indications for a surgical solution, including the choice of anastomosis or multiple / repeated surgeries. PMID:25130639
Kala, Zden?k; Marek, Filip; Válek, Vlastimil A; Bartušek, Daniel
Bariatric surgery as a means to treat obesity is becoming increasingly common in the United States. An early form of bariatric surgery, the jejunoileal bypass, had to be abandoned in 1980 due to numerous complications, including hyperoxaluria and kidney stones. Current bariatric procedures have not been systematically evaluated to determine if they cause hyperoxaluria. Presented here are data showing that hyperoxaluria is the major metabolic abnormality in patients with bariatric surgery who form kidney stones. Further studies are needed to assess the prevalence of hyperoxaluria in all patients with bariatric surgery.
Asplin, John R.
Infants with myelomeningocele (MMC) increase step frequency in response to modifications to the treadmill surface. The aim was to investigate how these modifications impacted the electromyographic (EMG) patterns. We analyzed EMG from 19 infants aged 2–10 months, with MMC at the lumbosacral level. We supported infants upright on the treadmill for 12 trials, each 30 seconds long. Modifications included visual flow, unloading, weights, Velcro and lcriction. Surface electrodes recorded EMG from tibialis anterior, lateral gastrocnemius, rectus femoris and biceps femoris. We determined muscle bursts for each stride cycle and from these calculated various parameters. Results indicated that each of the five sensory conditions generated different motor patterns. Visual flow and friction which we previously reported increased step frequency impacted lateral gastrocnemius most. Weights, which significantly decreased step frequency increased burst duration and co-activity of the proximal muscles. We also observed an age effect, with all conditions increasing muscle activity in younger infants whereas in older infants visual flow and unloading stimulated most activity. In conclusion, we have demonstrated that infants with myelomeningocele at levels which impact the myotomes of major locomotor muscles find ways to respond and adapt their motor output to changes in sensory input. PMID:23158017
Pantall, Annette; Teulier, Caroline; Ulrich, Beverly D.
Muscle atrophy in patients receiving hemodialysis: Effects on muscle strength, muscle quality, and physical function.BackgroundDialysis patients are less active and have reduced functional capacity compared to individuals with normal renal function. Muscle atrophy and weakness may contribute to these problems. This investigation was undertaken to quantify the extent of atrophy in the lower extremity muscles, to determine whether defects in
Kirsten L Johansen; Tiffany Shubert; Julie Doyle; Brian Soher; Giorgos K Sakkas; Jane A Kent-Braun
Quality attributes of the longissimus lumborum (LL) were compared to the attributes of the muscles semimembranosus (SM), rectus femoris (RF), biceps femoris (BF), gluteus medius (GM) and the lateral portion of the semitendinosus (ST) in the ham, the psoas major (PM) in the loin and the supraspinatus (SS), infraspinatus (IS) and triceps brachii (TB) in the shoulder. Carcasses were allocated to quality groups based on measurements of muscle exudate and lightness (CIE-L(?)) in the LL. The SM, BF, GM and ST in the ham were similar to the LL (P > 0·05) in meat ultimate pH (pHu) and exudate and the GM, ST and LL were similar (P > 0·05) to the LL in lightness. The TB, RF, SS, PM and IS were similar (P > 0·05) in exudate, lightness and pHu and compared to the LL, were less exudative (P < 0·05) and darker (P < 0·05). When the LL was classed pale, and exudative, the GM, BF, SM and ST were also pale and exudative but the other muscles were darker and non-exudative. When the LL was classed dark and non-exudative, all other muscles were dark, non-exudative and the pHu was high. Therefore, the LL could serve as a reliable indicator of colour and exudate for all porcine musculature when the condition was dark and non-exudative (i.e. DFD). However, when the condition was pale and exudative (i.e. PSE), then the LL would serve as a reliable indicator only for the four major ham muscles, excluding the RF. PMID:22060153
Warner, R D; Kauffman, R G; Russel, R L
A trophy of skeletal muscle; muscle a trophy associated with manned space flight; the nature, causes, and mechanisms of muscle atrophy associated with space flight, selected physiological factors, biochemical aspects, and countermeasures are addressed.
Herbison, G. J.; Talbot, J. M.
Introduction: This anatomical study of the pectoral nerves and their innervation is to provide detail informations on the pectoral nerves and their variations in their course, to guide the cosmetic and plastic surgeons for their easy intra operative localization and to improve the understanding of the pectoral muscle innervation, which is very much required during breast reconstruction after modified radical mastectomy (MRM) in breast cancer; axillary dissection; removal of the pectoralis minor muscle, and in harvesting the pectoralis major for myocutaneous head and neck island flap surgeries. Materials and Methods: A total of 50 pectoral region specimens (both right and left sided) from 25 embalmed adult human cadavers (20 female & 05 male) were studied by dissection method. Statistical Analysis: The data were tabulated in Microsoft excel and analysed by using Statistical Package for Social Science (SPSS 17th version). Mean, Proportion, Standard deviation and Unpaired t-test were applied for analysing the data obtained. Result and Conclusion: In all the specimens, the medial pectoral nerve pierces the pectoralis minor muscle; but as a single trunk in 76%, and as dividing branches in 34% specimens. The extent of costal attachment of the pectoralis minor muscle found to be less than 6.0 cm in cases of the medial pectoral nerve piercing the pectoralis minor muscle as a single trunk. The medial pectoral nerve after piercing the pectoralis minor, ramify within the muscle supplying it, finally runs along the lateral aspect (lower border) of the pectoralis minor muscle to supply the lower portion or distal segment of the pectoralis major muscle. Similarly, the lateral pectoral nerve runs along the upper border (medial aspect) of the pectoralis minor muscle (98%) and then runs under surface of the pectoralis major muscle along with the pectoral branch of thoracoacromial artery, supplying the upper portion or most of the proximal 2/3rd of the pectoralis major muscle. Therefore, when the pectoralis minor muscle is removed in a modified radical mastectomy or during dissection between the two muscles, there is partial denervation of the pectoralis major muscle with partial atrophy and decrease in muscle mass. If the lateral pectoral nerve also injured along with the medial pectoral nerve, it can result in total denervation of the pectoralis major muscle with severe atrophy and fibrosis. In breast augmentation implants placing behind the pectoralis major muscle, it is found to be more advantageous if the pectoralis major muscle is partially denervated for the better projection and contour. The distance of the branches of the medial pectoral nerve and the lateral pectoral nerve in the pectoral muscles from the lateral margin of the sternum being 8.8-10.8 cm and 5.8-10.2 cm respectively. The proximal segment or upper portion of the pectoralis major muscle has got separate independent vascular and nerve supply; therefore, it can be safely used as a myocutaneous flap in surgeries of head and neck or anterior chest wall. PMID:25177552
Background Persons with post-stroke hemiparesis usually walk slowly and asymmetrically. Stroke severity and functional walking status are commonly predicted by post-stroke walking speed. The mechanisms that limit walking speed, and by extension functional walking status, need to be understood to improve post-stroke rehabilitation methods. Methods Three-dimensional forward dynamics walking simulations of hemiparetic subjects (and speed-matched controls) with different levels of functional walking status were developed to investigate the relationships between muscle contributions to walking subtasks and functional walking status. Muscle contributions to forward propulsion, swing initiation and power generation were analyzed during the pre-swing phase of the gait cycle and compared between groups. Findings Contributions from the paretic leg muscles (i.e., soleus, gastrocnemius and gluteus medius) to forward propulsion increased with improved functional walking status, with the non-paretic leg muscles (i.e., rectus femoris and vastii) compensating for reduced paretic leg propulsion in the limited community walker. Contributions to swing initiation from both paretic (i.e., gastrocnemius, iliacus and psoas) and non-paretic leg muscles (i.e., hamstrings) also increased as functional walking status improved. Power generation was also an important indicator of functional walking status, with reduced paretic leg power generation limiting the paretic leg contribution to forward propulsion and leg swing initiation. Interpretation These results suggest that deficits in muscle contributions to the walking subtasks of forward propulsion, swing initiation and power generation are directly related to functional walking status and that improving output in these muscle groups may be an effective rehabilitation strategy for improving post-stroke hemiparetic walking. PMID:21251738
Hall, A.L.; Peterson, C.L.; Kautz, S.A.; Neptune, R.R.
Adult Reconstructive Surgery Foot and Ankle Surgery Hand, Upper Extremity and Microvascular Surgery Oncology Orthopaedic Research Pediatric Surgery Spine Surgery Sports Medicine Trauma and Post______________________________: This letter is to welcome you to the University of California, Davis Department of Orthopaedic Surgery
Leistikow, Bruce N.
Adult Reconstructive Surgery Foot and Ankle Surgery Hand, Upper Extremity and Microvascular Surgery Oncology Orthopaedic Research Pediatric Surgery Spine Surgery Sports Medicine Trauma and Post Department of Orthopaedic Surgery 4860 Y Street, 1700 Sacramento, CA 95817 P: 916.734.2700 F: 916
Leistikow, Bruce N.
Adult Reconstructive Surgery Foot and Ankle Surgery Hand, Upper Extremity and Microvascular Surgery Oncology Orthopaedic Research Pediatric Surgery Spine Surgery Sports Medicine Trauma and Post OF CALIFORNIA, DAVIS Department of Orthopaedic Surgery 4860 Y Street, Suite 3800 Sacramento, CA 95817 P: 916
Leistikow, Bruce N.
[Purpose] This study examined the relationship between core stability and exercise intensity during a pulley-based shoulder exercise (PBSE) on an unstable support surface. [Subjects] Twenty healthy college students enrolled in this study. [Methods] Surface EMG was carried out in twenty healthy adult men. The electromyographic activities of the rectus abdominis (RA), erector spinae (ES), exercises with 14?kg or 26?kg of resistance and external oblique (EO) muscles during pulley-based shoulder on an unstable support surface (USS) were compared. [Results] The EMG signals of the RA, ES, and EO did not increase with increasing exercise resistance. [Conclusion] Increasing the exercise intensity to increase the core stability during PBSE on a USS may be ineffective. PMID:24926144
Cha, Jae Yun; Shin, Doo Chul; Shin, Seung Ho; Lee, Myung Mo; Lee, Kyoung Jin; Song, Chang Ho
The aim of this study was to obtain a better understanding of the cause of the medial rotation contracture of the shoulder after obstetric brachial plexus lesions by studying the morphology of the shortened subscapularis muscle. Muscle biopsy specimens were harvested from 13 children with obstetric brachial plexus palsy who underwent corrective surgery for the rotation contracture. The majority of
T. Hultgren; F. Einarsson; E. Runesson; C. Hemlin; J. Fridén; B.-O. Ljung
NOS is a key enzyme in the production of NO, a molecule that directly regulates vasorelaxation and blood supply. Diverse forms of muscle disease have been clinically associated with unusual fatigue after exercise. The localization of neuronal NOS (nNOS) at the plasma membrane of muscle has recently been shown to prevent muscle fatigue after exercise. In this issue of the JCI, Lai et al. show that dystrophin — the structural protein missing in individuals with Duchenne muscular dystrophy — anchors nNOS to the sarcolemma through a direct interaction with dystrophin spectrin-like repeats 16 and 17 (see the related article beginning on page 624). Furthermore, in another recently reported study of mouse models of muscular dystrophy, phosphodiesterase 5A inhibitors were used to treat the downstream ischemia that is associated with nNOS mislocalization. Collectively, these findings significantly advance our understanding of exercise-induced muscle fatigue and its role in muscle disease. PMID:19306501
Heydemann, Ahlke; McNally, Elizabeth
Q&A: Stop Smoking Share PRINT Print Home > Anesthesia Topics > Detail Page Q: Why should I quit smoking before I have surgery? A: By quitting smoking, ... especially important to the anesthesiologist that I quit smoking before my surgery? A: Anesthesiologists are the heart ...
Cosmetic vulvovaginal surgery arouses considerable media interest. There are significant ethical and technical challenges posed by such procedures, which may not be justified on medical grounds. Many such operations are performed without adequate evidence of either safety or psychosocial benefit. The best established female genital cosmetic procedure is reduction labioplasty. Women request reduction surgery for their labia for two distinct
Rufus Cartwright; Linda Cardozo
... steeper cornea to increase the eye's focusing power. Images that are focused beyond the retina, due to a short eye or flat cornea, will be pulled closer to or directly onto the retina after surgery. Astigmatism can be corrected with refractive surgery techniques ...
In February 2001, a questionnaire on the practice of refractive surgery was sent worldwide to all 8196 members of the American Society of Cataract and Refractive Surgery; 1511 responses (18.4%) were received. Although laser in situ keratomileusis (LASIK) was the most common refractive procedure reported, phakic intraocular lenses, clear lens extraction, and photorefractive keratectomy were also widespread. Nineteen percent of
Kerry D Solomon; Mike P Holzer; Helga P Sandoval; Luis G Vargas; Liliana Werner; David T Vroman; Terrance J Kasper; David J Apple
Cosmetic breast surgery is a surgical procedure to alter or revise the size or shape of the breasts. It is one of the most frequently performed surgical procedures in plastic surgery today. New surgical techniques and devices are continuously created making possible for surgeons to shape a breast in many different ways. For each case the patient have often many
Remis Balaniuk; Ivan Costa; Jairo Melo
Minimally invasive strategies can be expanded by combining standard surgical and interventional techniques. We performed a longitudinal prospective study of all pediatric patients who have undergone hybrid cardiac surgery at the University of Chicago Children's Hospital. Hybrid cardiac surgery was defined as combined catheter-based and surgical interventions in either one setting or in a planned sequential fashion within 24 hours.
E. A. Bacha; Z. M. Hijazi; Q. L. Cao; R. Abdulla; J. P. Starr; J. Quinones; P. Koenig; B. Agarwala
Objective: Surgical decision-making is a complex process. First, a medical decision is made to determine if surgery is necessary. Second, another medical decision is made to determine the type of surgery. Third, a corporate decision is made if such a surgery is financially feasible. Finally, a legal decision is made to proceed or refuse the chosen surgery. This paper examines these issues in the case of surgery for medically intractable epilepsy and proposes a method of decision analysis to guide epilepsy surgery. Materials and Methods: A stochastic game of imperfect information using techniques of game theory and decision analysis is introduced as an analytical tool for surgical decision-making. Results: Surgery for appropriately chosen patients suffering from medically intractable epilepsy may not only be feasible, but may be the best medical option and the best financial option for the patient, families, society and the healthcare system. Such a situation would then make it legally or ethically difficult to reject or postpone surgery for these patients. Conclusions: A process to collect data to quantify the parameters used in the decision analysis is hereby proposed. PMID:24791079
Bariatric surgery - gastric bypass - discharge; Roux-en-Y gastric bypass - discharge; Gastric bypass- Roux-en-Y - discharge ... Leslie D, Kellogg TA, Ikramuddin S. Bariatric surgery primer for the ... Med Clin North Am . 2007;91:353-381. Mechanick JI, Kushner RF, ...
Cataract remains a major cause of blindness in sub-Sahara and a major public health problem. Blindness prevalence in Togo is equal to 1%, more than half of it is due to cataract, while the number of cataract surgeries is low because of the lack of resources. We assessed the eye healthcare in Togo by cataract surgery. The aim was to estimate the number of cataract surgeries and the Cataract Surgery Rate (CSR) in the administrative regions. The demographic data (denominator) was collected from the Demography and Health Survey (1998) while the number of cataract surgeries (numerator) was obtained from medical registers. The Cataract Surgery Rate (CSR, operated cataracts per million) was assessed from 1995 to 2001. From 1995 to 2001, 3,885 cataract surgeries were performed. Public services predominated with 53.03% (n=2061) of the cataracts operated followed by confessional hospitals with 37.1% (n=1443) and private clinics 3.4% (n=143). Decentralised eye healthcares provided 241 cataract extractions. The University hospital centre of Lome Tokoin was the leader, with 32.5% (n=1,262) of operated cataracts followed by the confessional hospital of Glei, 27.2% (n=1,058). The average per centre per year was 43 cataract surgeries. The mean CSR was 126 and varied from 52 to 163 cataract surgeries per million people per year. There was an important concentration of cataract services in Lome where 41% (n=1,586) of cataracts were operated and the CSR was 334. The unequal distribution of cataract services (41% in Lome) leaves many regions without any resources. Since 1999, the CSR increased by 37% in 2000 and 14% in 2001. The Togolese eye healthcare system is poor and substantial further efforts are necessary to make it accessible and affordable to all those in need. This may be the way to reduce cataract surgery barriers and the unacceptable high prevalence of operable cataract blindness. PMID:12925316
Mensah, A; Balo, K P; Kondi, G; Banla, M; Koffigue, K B; Resnikoff, S; Astagneau, P; Brücker, G
Diplopia is an infrequent but distressing adverse outcome after uncomplicated cataract surgery. Many factors may contribute to the occurrence of this problem, including prolonged sensory deprivation resulting in disruption of sensory fusion, paresis of one or more extraocular muscles, myotoxic effects of local anaesthesia, optical aberrations (for example, aniseikonia) and pre-existing disorders (for example, thyroid orbitopathy). The purpose of this review is to present the aetiology and clinical features of diplopia after cataract surgery and to discuss the possible modalities for the prevention and treatment of this frustrating complication. PMID:25138745
Kalantzis, George; Papaconstantinou, Dimitris; Karagiannis, Dimitris; Koutsandrea, Chryssanthi; Stavropoulou, Dora; Georgalas, Ilias
This study used surface electromyography (sEMG) to examine whether there were differences in hip and trunk muscle activation during the rowing cycle on two of the most widely used air braked ergometers: the Concept 2C and the Rowperfect. sEMG methods were used to record the muscle activity patterns from the right: m. Erector spinae (ES), m. Rectus Abdominus (RA), m. Rectus Femoris (RF) and m. Biceps Femoris (BF) for their contributions as agonist-antagonist pairs underlying hip and trunk extension/flexion. The sEMG activity patterns of these muscles were examined in six young male elite rowers completing a 2 minute set at a moderate training intensity (23 stroke·min-1 and 1:47.500 m-1 split time, 300W). The rowers closely maintained the required target pace through visual inspection of the standard LCD display of each ergometer. The measurements of duration of each rowing cycle and onset of each stroke during the test were recorded simultaneously with the sEMG activity through the additional instrumentation of a foot-pressure switch and handle accelerometry. There were no significant differences between the two ergometer designs in group means for: work rate (i.e., rowing speed and stroke rate), metabolic load as measured by mean heart rate, rowing cycle duration, or timing of the stroke in the cycle. 2-D motion analysis of hip and knee motion for the rowing cycle from the video footage taken during the test also revealed no significant differences in the joint range of motion between the ergometers. Ensemble average sEMG activity profiles based on 30+ strokes were obtained for each participant and normalised per 10% intervals of the cycle duration as well as for peak mean sEMG amplitude for each muscle. A repeated measures ANOVA on the sEMG activity per 10% interval for the four muscles contributing to hip and trunk motion during the rowing cycle revealed no significant differences between the Concept 2C and Rowperfect (F = 0.070, df = 1,5, p = 0.802). The outcome of this study suggests that the two different ergometer designs are equally useful for dry land training. Key Points The effects of endurance training on HR recovery after exercise and cardiac ANS modulation were investigated in female marathon runners by comparing with untrained controls. Time and frequency domain analysis of HRV was used to investigate cardiac ANS modulation. As compared with untrained controls, the female marathon runners showed faster HR recovery after exercise, which should result from their higher levels of HRV, higher aerobic capacity and exaggerated blood pressure response to exercise. PMID:24431957
Nowicky, Alex V.; Horne, Sara; Burdett, Richard
The present study tests the hypothesis that local bioavailability of IGF-I is capable of regulating muscle protein balance and that muscle-directed IGF-I can selectively maintain muscle mass during bacterial infection. Initial studies in C57BL/6 mice demonstrated that increasing or decreasing bioavailable IGF-I within muscle by local administration of either Leu24 Ala31 IGF-I or IGF binding protein (IGFBP)-1, respectively, produced proportional changes in surrogate markers (e.g., phosphorylation of 4E–BP1 and S6K1) of protein synthesis. We next examined the ability of a sustained local administration of IGF-I to prevent sepsis-induced muscle atrophy over a 5-day period. At the time of cecal ligation and puncture or sham surgery, mice had a time-release pellet containing IGF-I implanted next to the gastrocnemius and a placebo pellet placed in the contralateral limb. Data indicated IGF-I released locally only affected the adjacent muscle and was not released into the circulation. Gastrocnemius from septic mice containing the placebo pellet was atrophied and had a reduced IGF-I protein content. In contrast, locally-directed IGF-I increased IGF-I protein within adjacent muscle to basal control levels. This change was associated with a proportional increase in muscle weight and protein, as well as increased phosphorylation of 4E–BP1 and the redistribution of eIF4E from the inactive eIF4E· 4EBP1 complex to the active eIF4E· eIF4G complex. Local IGF-I also prevented the sepsis-induced increase in atrogin-1 mRNA in the exposed muscle. Finally, local IGF-I prevented the sepsis-induced increase in muscle IL-6 mRNA. Thus, muscle-directed IGF-I attenuates the sepsis-induced atrophic response apparently by increasing muscle protein synthesis and potentially decreasing proteolysis. Collectively, our data suggest agents which increase the bioavailability of IGF-I within muscle per se might be effective in ameliorating the sepsis-induced loss of muscle mass without having undesirable effects on metabolic processes in distant organs. PMID:19375133
Nystrom, Gerald; Pruznak, Anne; Huber, Danuta; Frost, Robert A.; Lang, Charles H.