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1

Paralysis of the upper rectus abdominis muscle after video-assisted or open thoracic surgery: an underdiagnosed complication?  

PubMed

In open or video-assisted thoracic surgery, injury to one to four intercostal sensory nerves is a well-recognized complication. This nerve damage is a well-defined cause for chronic postoperative pain. In this discussion, the motor innervation of the rectus abdominis muscle with the T7 to T12 intercostal nerves has been neglected. Paralysis of rectus abdominis might pose significant burden on patients, delay recovery, and thus warrants exploration. PMID:19766836

Pätilä, Tommi; Sihvo, Eero I; Räsänen, Jari V; Ramstad, Raimo; Harjula, Ari; Salo, Jarmo A

2009-10-01

2

Rectus muscle resection in Graves' ophthalmopathy  

PubMed Central

BACKGROUND In the treatment of Graves’ ophthalmopathy, rectus muscle resections generally are avoided because of the concern of reaggravating inflammation and creating excessive extraocular muscle restriction. In patients with large-angle strabismus and in patients with residual strabismus after maximal recession surgery, however, rectus muscle resection may be considered. We report a series of 8 patients with Graves’ ophthalmopathy who underwent rectus muscle resections. METHODS The records of 270 patients with Graves’ ophthalmopathy who had undergone strabismus surgery were retrospectively reviewed. Data from subjects who had undergone rectus muscle resections were collected, including age at surgery, duration of disease, duration of diplopia, previous eye or strabismus surgeries, history of radioactive iodine or corticosteroid treatment, current thyroid medications, current use of corticosteroids, tobacco use, and signs and symptoms used to diagnose Graves’ ophthalmopathy. RESULTS Eight patients (5 females) were identified (mean age, 51.1 ± 17.6 years). Preoperatively, 4 patients had a horizontal deviation and 4 patients had both horizontal and vertical deviations in primary gaze. Mean preoperative horizontal deviation was 27.9? ± 15.2? and mean vertical deviation was 6.3? ± 5.4?. At final follow-up examination, 7 patients were orthotropic in primary gaze; 1 patient had a larger deviation from slippage as the result of a broken suture within the first postoperative week. None of the patients were overcorrected or developed atypical inflammation. CONCLUSIONS In this series, patients with Graves’ ophthalmology were successfully treated with the use of rectus muscle resections as part of the surgical plan. Careful ocular motility assessment and patient selection is critical if this option is contemplated.

Yoo, Sylvia H.; Pineles, Stacy L.; Goldberg, Robert A.; Velez, Federico G.

2013-01-01

3

Anatomical and Functional Recovery of Neurotized Remnant Rectus Abdominis Muscle in Muscle-Sparing Pedicled Transverse Rectus Abdominis Musculocutaneous Flap  

PubMed Central

Background Pedicled transverse rectus abdominis musculocutaneous flaps typically sacrifice the entire muscle. In our experience, the lateral strip of the rectus abdominis muscle can be spared in an attempt to maintain function and reduce morbidity. When the intercostal nerves are injured, muscle atrophy appears with time. The severed intercostal nerve was reinserted into the remnant lateral strip of the rectus abdominis muscle to reduce muscle atrophy. Methods The authors retrospectively reviewed 9 neurotized cases and 10 non-neurotized cases. Abdominal computed tomography was performed to determine the area of the rectus muscles. Electromyography (EMG) was performed to check contractile function of the remnant muscle. A single investigator measured the mean areas of randomly selected locations (second lumbar spine) using ImageJ software in a series of 10 cross-sectional slices. We compared the Hounsfield unit (HU) pre- and postoperatively to evaluate regeneration quality. Results In the neurotization group, 7 of 9 cases maintained the mass of remnant muscle. However, in the non-neurotization group, 8 of 10 lost their mass. The number of totally atrophied muscles in each of the two groups was significantly different (P=0.027). All of the remnant muscles showed contractile function on EMG. The 9 remaining remnant rectus abdominis muscles showed declined the HU value after surgery but also within a normal range of muscle. Conclusions Neurotization was found to be effective in maintaining the mass of remnant muscle. Neurotized remnant muscle had contractile function on EMG and no fatty degeneration by HU value.

Jeong, Woonhyeok; Yeo, Hyeonjung; Jeong, Hoijoon; Kim, Junhyung; Han, Kihwan; Lee, Soyoung

2013-01-01

4

Surgery for Complete Vertical Rectus Paralysis Combined with Horizontal Strabismus  

PubMed Central

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

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

2014-01-01

5

[Functional multislice spiral computed tomography of the rectus muscle of the eye in scar changes].  

PubMed

The study deals with the capacities of functional multislice spiral computed tomography (FMSCT) in choosing a treatment policy and planning the tactic and scope of surgery for posttraumatic scar changes in the rectus muscle of the eye. Orbital MSCT and FMSCT were conducted in 15 patients (30 orbits). The findings showed that it was necessary to perform orbital FMSCT in posttaumatic scar changes to evaluate the contractility of the rectus muscles and their involvement in the area where a fracture occurs. Improved diagnosis achieved by FNSCT could optimally choose the tactics and scope of surgical intervention. PMID:22288140

Chupova, N A; Bodrova, I V; Ternovo?, S K; Grusha, Ia O; Danilov, S S

2011-01-01

6

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

PubMed Central

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

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

2013-01-01

7

Aetiology and management of the 'detached' rectus muscle.  

PubMed Central

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

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

1992-01-01

8

Strabismus due to flap tear of a rectus muscle.  

PubMed Central

PURPOSE: To present a previously unreported avulsion-type injury of the rectus muscle, usually the inferior rectus, and detail its diagnosis and operative repair. METHODS: Thirty-five patients underwent repair of flap tears of 42 rectus muscles. The muscle abnormality was often subtle, with narrowing or thinning of the remaining attached global layer of muscle. The detached flap of external (orbital) muscle was found embedded in surrounding orbital fat and connective tissue. Retrieval and repair were performed in each case. RESULTS: Fourteen patients had orbital fractures, 7 had blunt trauma with no fracture, and 9 had suspected trauma but did not undergo computed tomographic scan. Five patients experienced this phenomenon following retinal detachment repair. Diagnostically, the predominant motility defect in 25 muscles was limitation toward the field of action of the muscle, presumably as a result of a tether created by the torn flap. These tethers simulated muscle palsy. Seventeen muscles were restricted away from their field of action, simulating entrapment. The direction taken by the flap during healing determined the resultant strabismus pattern. All patients presenting with gaze limitation toward an orbital fracture had flap tears. The worst results following flap tear repair were seen in patients who had undergone orbital fracture repair before presentation, patients who had undergone previous attempts at strabismus repair, and patients who experienced the longest intervals between the precipitating event and the repair. The best results were obtained in patients who underwent simultaneous fracture and strabismus repair or early strabismus repair alone. CONCLUSIONS: Avulsion-type flap tears of the extraocular muscles are a common cause of strabismus after trauma, and after repair for retinal detachment. Early repair produces the best results, but improvement is possible despite long delay.

Ludwig, I H; Brown, M S

2001-01-01

9

Long-term results of four horizontal rectus muscle recession in nystagmus treatment.  

PubMed

Abstract Purpose: To report the long-term results of four horizontal rectus muscle recessions that were performed for infantile nystagmus syndrome treatment. Methods: In this case series, patients with infantile nystagmus syndrome who had four horizontal muscle recessions previously were recruited and ophthalmological examination and electronystagmography recordings were performed. Objectively, amplitude and frequency of nystagmus were measured from the recordings and the intensity was calculated. Visual acuity, stereopsis, and alignment were evaluated and compared with the preoperative and postoperative values. Results: The records of the 12 patients who had four horizontal rectus muscle recession surgery were evaluated and six patients (5 male, 1 female) who had regular follow-ups were included in this study. Mean follow-up was 14.17?±?0.41 years (minimum 14 years, maximum 15 years) and mean age of patients at the last visit was 22 years (20-28 years). On subjective evaluation, two-thirds (4/6) of the patients were satisfied with the surgical results and had the impression that after surgery, nystagmus decreased in intensity and head posture improved. On objective evaluation, visual acuity was found to be the same, however, stereopsis improved (preoperatively and postoperatively median stereopsis was 600?sec arc vs 200?sec arc final). The decrease in nystagmus amplitude and frequency was still maintained. Conclusions: Nystagmus surgery on four horizontal rectus muscles has positive effects on binocular function and nystagmus parameters in the long-term follow-up. As we could not treat the primary pathology, the visual acuity was about the same but the decrease in nystagmus amplitude and frequency was still maintained with better stereopsis, and patient satisfaction. PMID:24798590

Atilla, Huban; Demir, Helin Deniz; I??kçelik, Yusuf

2014-06-01

10

Rectus abdominis muscle flap for repair of prepubic tendon rupture in 8 dogs.  

PubMed

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

2011-11-01

11

Optimizing pedicled transverse rectus abdominis muscle flap breast reconstruction.  

PubMed

With improved detection and genetic screening for breast cancer, increasing numbers of patients are choosing mastectomy and immediate breast reconstruction. Advances in breast reconstruction and mastectomy techniques over the last 25 years have increased expectations for breast reconstruction. The purpose of this review is to describe the role of the pedicled transverse rectus abdominis muscle (TRAM) flap in modern breast reconstruction.The pedicled TRAM flap is the most common method of autologous breast reconstruction. TRAM flap reconstruction involves the transfer of lower abdominal skin and subcutaneous fat based on the superior epigastric vessels. Common risk factors for complications from pedicled TRAM flap reconstruction include smoking, obesity, and postoperative radiotherapy. Patients with these risk factors are often candidates for a vascular delay procedure whose purpose is to enhance the blood flow within the TRAM flap.Despite advances in free flap breast reconstruction, pedicled TRAM flap breast reconstruction remains an excellent option for unilateral breast reconstructions. Unlike microsurgical breast reconstruction, the pedicled TRAM flap does not require sophisticated postoperative monitoring and can be performed efficiently in any hospital setting. Furthermore, with the addition of a vascular delay procedure, pedicled TRAM reconstructions can be safely performed even in traditionally "high risk" patients. PMID:18677131

Kanchwala, Suhail K; Bucky, Louis P

2008-01-01

12

Expanding Repertoire In The Oculomotor Periphery: Selective Compartmental Function In Rectus Extraocular Muscles  

PubMed Central

Since connective tissue pulleys implement Listing's law by systematically changing rectus extraocular muscle (EOM) pulling directions, non-Listing's law gaze-dependence of the vestibulo-ocular reflex is currently inexplicable. Differential activation of compartments within rectus EOMs may endow the ocular motor system with more behavioral diversity than previously supposed. Innervation to horizontal, but not vertical, rectus EOMs of mammals is segregated into superior and inferior compartments. Magnetic resonance imaging in normal subjects demonstrates contractile changes in the lateral rectus (LR) inferior, but not superior, compartment during ocular counter-rolling (OCR) induced by head tilt. In human orbits ipsilesional to unilateral superior oblique palsy, neither LR compartment exhibits contractile change during head tilt, although the inferior compartment contracts normally in contralesional orbits. This suggests that differential compartmental LR contraction assists normal OCR. Computational simulation suggests that differential compartmental action in horizontal rectus EOMs could achieve more force than required by vertical fusional vergence.

Demer, Joseph L.; Clark, Robert A.; da Silva Costa, Roberta M.; Kung, Jennifer; Yoo, Lawrence

2012-01-01

13

Rectus abdominalis muscle metastasis from uterine leiomyosarcoma: An unusual case and review of the literature  

PubMed Central

Uterine leiomyosarcoma is an aggressive malignancy. Spread to the lung, thyroid, liver, brain, pancreas, heart, duodenum, breast, vagina, submandibular gland, and bone has been reported. We describe a case of metastatic uterine leiomyosarcoma to the rectus abdominalis muscle as the first case in the literature. A 39-year-old nulligravid woman presented with a history of pelvic pain. Physical examination discovered about a 6-cm mass in the suprapubic region. She had previously undergone a hysterectomy for uterine leiomyosarcoma. Operative findings had revealed a mass measuring 4×5×6 cm located in the rectus abdominalis muscle. Abnormal mitotic figures and necrosis were evident, and uterine leiomyosarcoma was diagnosed. Uterine leiomyosarcomas are malignancies of the smooth muscle arising from the myometrium. Skeletal muscle is an uncommon site of metastasis by hematogenous spread. In conclusion, we have described a case of skeletal muscle metastasis (first case of rectus abdominalis muscle metastasis) secondary to uterine leiomyosarcoma.

Gungor, Tayfun; Akbay, Serap; Aksut, Hayri; Y?lmaz, Bulent

2014-01-01

14

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

Microsoft Academic Search

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

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

1998-01-01

15

Acute rectus muscle palsy in children as a result of orbital myositis  

Microsoft Academic Search

OBJECTIVE: Acute rectus muscle palsy caused by orbital myositis is often confused with infectious orbital cellulitis. The purpose of this article is to clarify the former condition by explaining how it is manifested and treated. METHODS: The seven children less than age 11 years in this study were examined after having an acute onset of ocular pain. Physical examination indicated

Zane F. Pollard

1996-01-01

16

Massive Hemoperitoneum Caused byComplete Transection of the Rectus AbdominisMuscle  

Microsoft Academic Search

The introduction of restraint devices in cars diminished tremendously the mortality caused by motor vehicle accidents. Hand-in-hand with the decline in mortality, a wide spectrum of injuries associated with the use of seat belts has been documented. In this case report we describe a patient who presented with massive hemoperitoneum caused by complete transection of the rectus abdominis muscle due

Gad Shaked; David Czeiger; Yancu Hartzanu; Isaac Levy

2003-01-01

17

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

PubMed Central

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

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

1994-01-01

18

Versatile use of rectus abdominis muscle and musculocutaneous flaps for soft-tissue reconstruction: our clinical experiences in 25 cases  

Microsoft Academic Search

The rectus abdominis muscle and musculocutaneous flaps have contributed to the efficient reconstruction of tissue defects\\u000a that require a large amount of cutaneous and muscular tissue. In this article, outcomes of soft-tissue defects after reconstruction\\u000a with the rectus abdominis muscle and musculocutaneous flaps were retrospectively analyzed. From August 2003 to June 2009,\\u000a 25 flaps were transferred to reconstruct a wide

Yalcin Kulahci; Celalettin Sever; Rahmi Evinc; Fatih Uygur; Cihan ?ahin; Sinan Öksüz; Nurettin Noyan; Haluk Duman; Fuat Yüksel

19

Dynamic Rectus Abdominis Muscle Sphincter for Stomal Continence  

Microsoft Academic Search

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

J. W. J. M. Bardoel

2002-01-01

20

Large Asymmetric Hypertrophy of Rectus Abdominis Muscle in Professional Tennis Players  

PubMed Central

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

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

2010-01-01

21

Functional Morphometry of Horizontal Rectus Extraocular Muscles during Horizontal Ocular Duction  

PubMed Central

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

Clark, Robert A.; Demer, Joseph L.

2012-01-01

22

[Intrafascial hematoma of the rectus abdominis muscle as a complication after laparoscopic operations].  

PubMed

We report on two patients with intrafascial hematoma of the musculus rectus abdominis following laparoscopic operations. One patient was operated on a stenosis of the common iliac artery for an aortofemoral bypass. The other patient was operated on an inguinal hernia. Only a CT scan of the abdomen led to the correct diagnosis, because the use of ultrasound was limited by pneumoperitoneum and bandages, and retroperitoneal bleeding could not be recognized. Computed tomography is a valid method for detecting this complication of laparoscopic surgery. PMID:9538930

Pennekamp, W; Barbera, L

1998-01-01

23

Pfannenstiel incision as an alternative approach for harvesting the rectus abdominis muscle for free-tissue transfer.  

PubMed

The rectus abdominis muscle has been one of the most commonly used donor tissues for free-flap reconstruction of defects in the extremities and in selected head and neck patients. The rectus abdominis has provided adequate soft-tissue mass with predictable anatomy and results for the majority of its applications in free-flap reconstruction. Harvesting of this muscle has typically been done through a paramedian or midline incision, which has left a lengthy notable scar on a patient's abdomen. To avoid the late aesthetic deformity associated with this typical approach for the rectus abdominis, we began harvesting the muscle through a Pfannenstiel incision. Patients were initially selected based on young age and limited soft-tissue requirements. With additional experience, this technique was extended to include all healthy patients regardless of age. Also, soft-tissue limitations no longer became an issue, as we learned the entire rectus abdominis muscle could be harvested from this approach. An extended Pfannenstiel incision was made from the ipsilateral anterior superior iliac spine to the lateral border of the contralateral rectus abdominis. A superiorly based flap was raised to expose the full length of the anterior rectus sheath from pubis to costal margin. In our earlier patients, a periumbilical incision was made for presumed easier access, but we discovered this was an unnecessary maneuver. With the anterior sheath fully exposed, the muscle was harvested and the sheath repaired in a routine manner. The elevated abdominal flap was returned to its anatomic position and closed over a suction drain. Since 1993, 10 patients have undergone a Pfannenstiel approach for harvesting of the rectus abdominis muscle. The mean age was 16. The areas requiring coverage included a traumatic elbow defect, seven traumatic lower extremity defects, one lower extremity sarcoma defect, and one lower extremity septic joint defect. Mean follow-up for these patients was 12 months. There were no flap failures. One patient developed an arterial thrombosis on postoperative day 5 and was treated with successful revision. There were no abdominal wall complications. Cosmesis was judged as good in all patients. We would recommend avoiding this approach in heavy or moderate smokers, diabetic patients, and patients with significant obesity. The Pfannenstiel approach to the rectus abdominis muscle has allowed for complete harvest of the muscle, improved aesthetic results compared with alternative techniques, and avoidance of donor-site morbidityin healthy patients. PMID:10744222

Salgado, C J; Orlando, G S; Herceg, S; Serletti, J M

2000-04-01

24

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

PubMed Central

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

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

2012-01-01

25

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

NASA Astrophysics Data System (ADS)

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

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

2014-05-01

26

The peripheral course of the axons innervating the medial rectus muscle within the subarachnoid portion of the oculomotor nerve.  

PubMed Central

There is clinical evidence of topographic localisation of fibres within the oculomotor nerve. It is generally accepted that the pupillomotor fibres have a localised course within the dorsomedial periphery of the subarachnoid portion. However, the precise course of the individual groups of axons innervating each muscle has not been examined in detail. In this study the course of the axons innervating the medial rectus muscle was investigated in the subarachnoid portion of the oculomotor nerve of the rat. The medial rectus muscle was injected with horseradish peroxidase until it was fully infiltrated. The subarachnoid portion of the oculomotor nerve was removed and sectioned longitudinally in the sagittal plane. Sections were reacted with tetramethylbenzidine as a chromogen. Labelled axons were found to be localised in the ventral part of the subarachnoid portion of the nerve. Images Fig. 1 Fig. 2 Fig. 3

Atasever, A; Durgun, B; Kansu, T; Cumhur, M

1992-01-01

27

Precision transverse rectus abdominis muscle flap breast reconstruction: a reliable technique for efficient preoperative planning.  

PubMed

The advent of the skin-sparing mastectomy has had a profound impact on autogenous breast reconstruction by making it a "filling" procedure rather than a "shaping" procedure. The reliability of the skin-sparing mastectomy has allowed plastic surgeons to improve the accuracy and efficiency of the transverse rectus abdominis muscle (TRAM) flap. The purpose of this study is to describe our experience with a novel technique for the preoperative planning of pedicled TRAM flap breast reconstructions. All patients are preoperatively marked in the upright position. Measurements of the key anatomic boundaries of the breast are carefully transferred to the abdomen to reliably recreate the size and shape of the reconstructed breast. The markings are tailored to each patient with specific design variations accounting for such patient characteristics as the need for postoperative radiation, breast ptosis, bilateral reconstruction, and previous biopsy scars. We performed a retrospective review of 472 patients who underwent pedicled TRAM flap breast reconstruction by a single surgeon utilizing the Precision TRAM marking technique between 1996 and 2007. The average of follow-up was 3.4 years. The average patient age was 48 years. The average surgical time was 2.8 hours for unilateral reconstructions. The overall incidence of complications was quite low. Importantly, the rate of mastectomy skin loss was 1.2%. Other TRAM-related complications were similar to those reported in the literature. The Precision TRAM technique for preoperative marking can improve the efficiency and accuracy of TRAM flap breast reconstruction. We have enjoyed overall excellent esthetic results with minimal complications utilizing this technique in a wide variety of patients. PMID:18434826

Kanchwala, Suhail K; Bucky, Louis P

2008-05-01

28

Effects of Recession versus Tenotomy Surgery without Recession in Adult Rabbit Extraocular Muscle  

PubMed Central

Purpose. Surgical recession of an extraocular muscle (EOM) posterior to its original insertion is a common form of strabismus surgery, weakening the rotational force exerted by the muscle on the globe and improving eye alignment. The purpose of this study was to assess myosin heavy chain (MyHC) isoform expression and satellite cell activity as defined by Pax7 expression in recessed EOMs of adult rabbits compared with that in muscles tenotomized but not recessed and with that in normal control muscles. Methods. The scleral insertion of the superior rectus muscle was detached and sutured either 7 mm posterior to its original insertion site (recession surgery) or at the same site (tenotomy). One day before euthanatization, the rabbits received bromodeoxyuridine (BrdU) injections. After 7 and 14 days, selected EOMs from both orbits were examined for changes in fast, slow, neonatal, and developmental MyHC isoform expression, Pax7 expression, and BrdU incorporation. Results. Recession and tenotomy surgery resulted in similar changes in the surgical EOMs. These included a decreased proportion of fast MyHC myofibers, an increased proportion of slow MyHC myofibers, and increased BrdU-positive satellite cells. Similar changes were seen in the non-operated contralateral superior rectus muscles. The ipsilateral inferior rectus showed reciprocal changes to the surgical superior rectus muscles. Conclusions. The EOMs are extremely adaptive to changes induced by recession and tenotomy surgery, responding with modulations in fiber remodeling and myosin expression. These adaptive responses could be manipulated to improve surgical success rates.

Christiansen, Stephen P.; Antunes-Foschini, Rosalia S.

2010-01-01

29

Inferior rectus recession--an effective procedure?  

PubMed Central

AIMS—To examine the postoperative stability of inferior rectus recession, with particular reference to the incidence of progressive overcorrection.?METHODS—The results of consecutive patients undergoing inferior rectus recession over a 3 year period were reviewed.?RESULTS—21 patients underwent inferior rectus recession, using an adjustable suture technique in all but three cases. In 16 patients additional vertical muscle surgery was performed at the time of the inferior rectus recession. All patients were followed for a minimum of 3 months postoperatively, with a mean follow up of 9.3 months. At the final postoperative visit 11 patients were well aligned, eight were undercorrected, and two were overcorrected. In five of the eight undercorrected cases, the residual deviation was the result of postoperative drift in the direction of the preoperative deviation, following an initially good alignment. Review of the results failed to reveal any factor predictive for this postoperative drift.?CONCLUSION—The risk of postoperative overcorrection following inferior rectus recession should be considered, but in this study, undercorrection occurred more frequently than overcorrection. The possible reasons for overcorrection and undercorrection are discussed.??

Scotcher, S.; O'Flynn, E.; Morris, R.

1997-01-01

30

Successful management of recalcitrant infection related to total hip replacement using pedicled rectus femoris or vastus lateralis muscle flaps.  

PubMed

Deep prosthetic joint infection remains an uncommon but serious complication of total hip replacement. We reviewed 24 patients with recalcitrant hip wounds following infected total hip replacement treated with either pedicled rectus femoris or vastus lateralis muscle flaps between 1998 and 2009. The mean age of the patients was 67.4 years (42 to 86) with ten men and 14 women. There had been a mean of four (1 to 8) previous attempts to close the wound. A total of 20 rectus femoris and five vastus lateralis flaps were used, with one of each type of flap failing and requiring further reconstruction. All patients had positive microbiology. At a mean follow-up of 47 months (9 to 128), 22 patients had a healed wound and two had a persistent sinus. The prosthesis had been retained in five patients. In the remainder it had been removed, and subsequently re-implanted in nine patients. Six patients continued to take antibiotics at final follow-up. This series demonstrates the effectiveness of pedicled muscle flaps in healing these infected wounds. The high number of previous debridements suggests that these flaps could have been used earlier. PMID:21586772

Choa, R; Gundle, R; Critchley, P; Giele, H

2011-06-01

31

Bilateral Simultaneous Heterotopic Ossification of the Reflected Head of Rectus Femoris Muscle: A Case Report and Review of the Literature  

PubMed Central

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.

Tonbul, Murat; Ozen, Seyma; Tonbul, Ayse Tuba

2014-01-01

32

Large Asymmetric Hypertrophy of Rectus Abdominis Muscle in Professional Tennis Players  

Microsoft Academic Search

PurposeTo determine the volume and degree of asymmetry of the musculus rectus abdominis (RA) in professional tennis players.MethodsThe volume of the RA was determined using magnetic resonance imaging (MRI) in 8 professional male tennis players and 6 non-active male control subjects.ResultsTennis players had 58% greater RA volume than controls (P = 0.01), due to hypertrophy of both the dominant (34%

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

2010-01-01

33

Surface Electromyography Assessments of the Vastus medialis and Rectus femoris Muscles and Creatine Kinase after Eccentric Contraction Following Glutamine Supplementation  

PubMed Central

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.

Rahmani-Nia, Farhad; Farzaneh, Esmail; Damirchi, Arsalan; Majlan, Ali Shamsi; Tadibi, Vahid

2013-01-01

34

Lateral rectus muscle paralysis induced by ribavirin and pegylated interferon-?2a in a patient with HIV/HCV co-infection.  

PubMed

We report a lateral rectus muscle paralysis occurring 2 weeks after initiation of an interferon-? and ribavirin treatment in a patient with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) virus co-infection. This patient presented with horizontal diplopia that appeared rapidly and without any other neurological symptoms. Symptoms fully resolved with treatment interruption without any ophthalmological sequelae. This side effect is rare and has never been reported in a HIV-HCV co-infected patient. PMID:22350324

Mellon, Guillaume; Stitou, Hind; Aoun, Olivier; Tubiana, Roland; Thibault, Vincent; Valantin, Marc Antoine; Bricaire, François

2012-12-01

35

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

PubMed Central

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

Makino, Shinji; Sato, Yukihiro

2012-01-01

36

Reconstruction of Abdominal Wall of a Chronically Infected Postoperative Wound with a Rectus Abdominis Myofascial Splitting Flap  

PubMed Central

Background If a chronically infected abdominal wound develops, complications such as peritonitis and an abdominal wall defect could occur. This could prolong the patient's hospital stay and increase the possibility of re-operation or another infection as well. For this reason, a solution for infection control is necessary. In this study, surgery using a rectus abdominis muscle myofascial splitting flap was performed on an abdominal wall defect. Methods From 2009 to 2012, 5 patients who underwent surgery due to ovarian rupture, cesarean section, or uterine myoma were chosen. In each case, during the first week after operation, the wound showed signs of infection. Surgery was chosen because the wounds did not resolve with dressing. Debridement was performed along the previous operation wound and dissection of the skin was performed to separate the skin and subcutaneous tissue from the attenuated rectus muscle and Scarpa's fascial layers. Once the anterior rectus sheath and muscle were adequately mobilized, the fascia and muscle flap were advanced medially so that the skin defect could be covered for reconstruction. Results Upon 3-week follow-up after a rectus abdominis myofascial splitting flap operation, no major complication occurred. In addition, all of the patients showed satisfaction in terms of function and esthetics at 3 to 6 months post-surgery. Conclusions Using a rectus abdominis myofascial splitting flap has many esthetic and functional benefits over previous methods of abdominal defect treatment, and notably, it enabled infection control by reconstruction using muscle.

Bae, Sung Kyu; Kang, Seok Joo; Kim, Jin Woo; Kim, Young Hwan

2013-01-01

37

Histochemical and immunohistochemical profile of human and rat ocular medial rectus muscles  

Microsoft Academic Search

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

2009-01-01

38

A muscle-clamping system with an absorbable jaw clip to reduce suturing in strabismus surgery.  

PubMed

Most of the ocular complications of strabismus surgery are related to needle trauma during the suturing of muscles. The authors have developed a muscle-clamping system with an absorbable jaw clip to facilitate exact techniques of eye muscle surgery and to reduce the risk of complications. The absorbable jaw clip is composed of a lower fixing body with three jaws and an upper supporting body. The clip is used to tie an extraocular muscle (which is moved and reattached with the membrane) with a single scleral bite. Using the absorbable jaw clip, the authors performed superior rectus recession on 16 eyes of eight rabbits. The authors examined the conjunctival injection, muscle adhesion power, and light microscopic findings at 1, 2, 4, and 8 weeks postoperatively. The conjunctival injection diminished with time. Bond strengths ranged from 380 to 620 gram gravity, which is sufficient to withstand the normal pull of human extraocular muscles. Some inflammatory cells were found microscopically, and fibrosis increased with time. The muscle-clamping method with the newly invented clip was technically easy, fast, and exact, and it may reduce suturing and complications during strabismus surgery. PMID:9507262

Min, B M; Kim, S Y; Yang, J M

1998-02-01

39

Ultrasound-guided rectus sheath block in children with umbilical hernia: Case series  

PubMed Central

Background: Umbilical hernia repair, a common day-case surgery procedure in children, is associated with a significant postoperative pain. The most popular peripheral nerve blocks used in umbilical hernia repair are rectus sheath infiltration and caudal block. The rectus sheath block may offer improved pain relief following umbilical hernia repair with no undesired effects such as lower limb motor weakness or urinary retention seen with caudal block which might delay discharge from the hospital. Ultrasound guidance of peripheral nerve blocks has reduced the number of complications and improved the quality of blocks. The aim of this case series is to assess the post rectus sheath block pain relief in pediatric patients coming for umbilical surgery. Methods: Twenty two (22) children (age range: 1.5-8 years) scheduled for umbilical hernia repair were included in the study. Following the induction of general anesthesia, the ultrasonographic anatomy of the umbilical region was studied with a 5-16 MHz 50 mm linear probe. An ultrasound-guided posterior rectus sheath block of both rectus abdominis muscles (RMs) was performed (total of 44 punctures). An in-plain technique using Stimuplex A insulated facet tip needle 22G 50mm. Surgical conditions, intraoperative hemodynamic parameters, and postoperative analgesia by means of the modified CHEOPS scale were evaluated. Results: ultrasonograghic visualization of the posterior sheath was possible in all patients. The ultrasound guided rectus sheath blockade provided sufficient analgesia in all children with no need for additional analgesia except for one patient who postoperatively required morphine 0.1 mg/kg intravenously. There were no complications. Conclusions: Ultrasound guidance enables performances of an effective rectus sheath block for umbilical hernia. Use of the Stimuplex A insulated facet tip needle 22G 50mm provides easy, less traumatic skin and rectus muscle penetration and satisfactory needle visualiza.

Alsaeed, Abdul Hamid; Thallaj, Ahmed; Khalil, Nancy; AlMutaq, Nada; Aljazaeri, Ayman

2013-01-01

40

Analysis of two different techniques in the treatment of knee stiffness in swing phase due to fibrous rectus femoris muscle in children.  

PubMed

The objective of this study was to analyze two surgical techniques in the treatment of fibrous rectus femoris muscle in children. Data from 152 patients (161 knees) from July 1991 to December 2004 were analyzed. Clinical signs were knee stiffness in swing phase, positive Ely and Ober tests, and abnormal flexion angles of the knee and hip. Patients were operated according to one of two variants: variant A, to release the proximal tendon and variant B, to release the middle shaft of the rectus femoris muscle. There were 96 women (63.2%) and 56 men (36.8%) in this study. Bilateral involvement was found in nine patients; only the left knee was affected in 34 patients (22.4%) and only the right knee in 109 patients (71.7%). All 152 patients (161 knees) developed fibrous rectus femoris muscle (RFM) after repeated intramuscular injection of antibiotic(s) into the RFM. A total of 145 knees (136 patients) were classified as severe and 16 knees (16 patients) were classified as moderate. Overall, we attained excellent results in 109 (67.7%), good results in 26 (16.1%), fair results in 14 (8.7%), and poor results in 12 knees (7.5%). There have been no complications so far. Generally, surgical treatment of knee stiffness in swing phase due to fibrous RFM according to variant B led to postoperative poor results in only 1.2% of patients, whereas variant A gave postoperative poor results in 14.5% of patients. The surgical procedure is simple and safe, and knee and hip functions, tendency for crouch gait, and anterior pelvic tilt were remarkably improved. PMID:21394041

Hung, Nguyen Ngoc

2011-05-01

41

Degree of swelling of the medial rectus muscle on CT images to differentiate old from new medial orbital wall fracture.  

PubMed

The aims of this study were to compare the degree of swelling of the medial rectus muscle (MR) in a recent fracture group, an old fracture group, and a normal group and to use this to differentiate old medial orbital wall fracture from recent fracture.We made measurements of the computed tomography images of 43 patients with a recent medial orbital wall fracture (the recent fracture group), 46 patients with depression of the medial wall and who were without a recent trauma history (the old fracture group), and 86 patients who were without any facial injury (the normal group). On the axial view, the width of the MR was measured bilaterally, and the width ratio to the contralateral side was calculated. On the coronal view, the height of the MR was measured bilaterally, and the height ratio to the contralateral side was calculated. The width-to-height ratio was also measured on the involved side.The width ratio of the recent fracture group was 1.42 ± 0.31, and it was significantly higher than that of the old fracture group (1.25 ± 0.15) or the normal group (1.00 ± 0.09). The width ratio of the old fracture group was also significantly higher than that of the normal group. The height ratio of the normal group (1.00 ± 0.04) was significantly higher than that of the recent fracture group (0.91 ± 0.15) or the old fracture group (0.86 ± 0.07). The height ratio of the recent fracture group was also significantly higher than that of the old fracture group (P = 0.043). The width-height ratio of the recent fracture group (0.63 ± 0.23) was significantly higher than that of the old fracture group (0.55 ± 0.09) or the normal group (0.37 ± 0.05). The height-to-width ratio of the old fracture group was also significantly higher than that of the normal group.We think the width ratio of the MR of the injured side to the MR of the contralateral side can be the better parameter to differentiate a recent fracture from an old fracture. PMID:22801118

Hwang, Kun; Hwang, Pil Joong; Huan, Fan; Kang, Young Hye

2012-07-01

42

Intramuscular degloving injuries to the rectus femoris: findings at MRI.  

PubMed

OBJECTIVE. The purpose of this study was to describe the MRI characteristics of intramuscular degloving injuries to the rectus femoris whereby the inner bipennate component of the indirect head is dissociated from its superficial unipennate component. CONCLUSION. Injuries to the rectus femoris muscle are common in athletes, especially European football (soccer) players. The complex muscle-within-a-muscle anatomic configuration of the rectus femoris makes it susceptible to various types of injuries. PMID:24450607

Kassarjian, Ara; Rodrigo, Rosa Monica; Santisteban, Juan Maria

2014-05-01

43

Retroperitoneal and rectus sheath hematomas.  

PubMed

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

Kasotakis, George

2014-02-01

44

Outcome of unilateral lateral rectus recession and medial rectus resection in primary exotropia  

PubMed Central

Background The purpose of this study was to measure the success rate of unilateral lateral rectus recession and medial rectus resection in primary exotropia. Methods This is an interventional case series of 55 patients with primary exotropia (degree of deviation 15–85 PD), above the age of 5 years. Patients were treated in the Department of Ophthalmology, Jinnah Postgraduate Medical Center, Karachi, Pakistan, during the period of July 2009 to March 2010. All the patients underwent surgical procedure i.e., lateral rectus muscle recession (maximum up to 10 mm) and medial rectus muscle resection (up to 6 mm) of one eye, according to the Park’s method. Surgery was done based on prism cover test measurements obtained at 6 m with appropriate optical correction in place. Patients were re evaluated at one day, one month, two months and six months post operatively. Final outcome was considered at the end of six months at which achievement of ?10 PD of exotropia was the success. Data was analyzed on SPSS version 17.0. Results We obtained success (?10 PD) in 42 out of 55 patients (76.4%) and 13 out of 55 patients (23.6%) did not meet our criteria for surgical success (>10 PD). Analysis of success with the type of primary exotropia showed that success was achieved in 22 out of 24 cases of intermittent type (91.6%) and 20 out of 31 cases of constant type (64.5%)(P Value 0.019). The highest percentage of success was achieved in patients with the pre-operative deviation of ?70 PD i.e., 93.3% (42 out of 45 cases), while none of the patients with the pre-operative deviation of >70 PD (10 out of 10 cases) achieved the criteria for success. Conclusion We conclude that pre-operative deviation is one of the strongest predictor for favorable surgical outcome. Therefore, eliminating the factors causing error in the correct determination of pre-operative deviation should improve the success and predictability of the surgical outcome. Despite the obstacles in the surgical management of strabismus, our results are encouraging.

2013-01-01

45

Moderate Intra-Abdominal Hypertension Leads to Anaerobic Metabolism in the Rectus Abdominis Muscle Tissue of Critically Ill Patients: A Prospective Observational Study  

PubMed Central

Purpose. We hypothesize that intra-abdominal hypertension (IAH) is associated with the presence of anaerobic metabolism in the abdominal rectus muscle (RAM) tissue of critically ill patients. Methods. We included 10 adult, critically ill patients with intra-abdominal pressure (IAP) above 12?mmHg. Microdialysis catheters (CMA 60) were inserted into the RAM tissue. The samples were collected up to 72 hours after enrollment. Results. The patients' median (IQR) APACHE II at inclusion was 29 (21–37); 7 patients were in shock. IAP was 14.5 (12.5–17.8)?mmHg at baseline and decreased significantly over time, concomitantly with arterial lactate and vasopressors requirements. The tissue lactate-to-pyruvate (L/P) ratio was 49 (36–54) at the beginning of the study and decreased significantly throughout the study. Additionally, the tissue lactate, lactate-to-glucose (L/G) ratio, and glutamate concentrations changed significantly during the study. The correlation analysis showed that lower levels of pyruvate and glycerol were associated with higher MAP and abdominal perfusion pressures (APP) and that higher levels of glutamate were correlated to elevated IAP. Conclusions. Moderate IAH leads to RAM tissue anaerobic metabolism suggestive for hypoperfusion in critically ill patients. Correlation analysis supports the concept of using APP as the primary endpoint of resuscitation in addition to MAP and IAP.

Maddison, Liivi; Karjagin, Juri; Tenhunen, Jyrki; Kirsimagi, Ulle; Starkopf, Joel

2014-01-01

46

Diplopia and acute rectus muscle palsy as symptoms of an infected follicular cyst of a maxillary right third molar: a case report.  

PubMed

Severely impacted third molars have a high risk of developing a dentigerous cyst. Dental cysts in the maxilla can cause acute infection of the maxillary sinus that can involve the orbital cavity. Possible complications of infections of the orbital cavity are eyesight reduction, including blindness, and disseminated infections, including brain abscesses. This article reports on a 53-year-old male patient with diplopia caused by acute rectus inferior muscle palsy as symptoms of an empyema of the maxillary right sinus. An infected follicular cyst due to the impacted and displaced maxillary right third molar caused the empyema. An emergency trepanation with drainage of the right maxillary sinus was performed. Additionally, intravenous antibiotic therapy with penicillin G and metronidazole resulted in improvement. In a secondary surgical process 2 weeks later, the cyst and the third molar were removed. Complete recovery was noted. It is important to be familiar with clinical diagnostics in cases of undefined pain of the teeth and jaws. Radiographic imaging is indicated in such cases. Disseminated odontogenic infections must be considered as the primary origin of pain and diplopia. PMID:17694213

Metzger, Marc Christian; Wagner, Kai Wolfgang; Hohlweg-Majert, Bettina; Voss, Pit Jacob; Schoen, Ralf; Schmelzeisen, Rainer

2007-01-01

47

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

PubMed Central

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

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

2013-01-01

48

Progressive Muscle Relaxation and Pain Perception in Abdominal Surgery Patients.  

National Technical Information Service (NTIS)

This study was conducted to determine if use of progressive muscle relaxation could decrease pain perception, analgesic use, and anxiety in post-operative abdominal surgery patients. Review of demographic data showed the experimental and control group to ...

B. A. Mertely

1989-01-01

49

Rectus abdominis diastasis.  

PubMed

Abstract 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

2014-06-01

50

Isolated lateral rectus myositis.  

PubMed

Orbital myositis is a rare non-granulomatous inflammatory process within the orbit. Grave's disease and lymphoproliferative disorders are considered the most common cause of orbital myositis. The idiopathic form should be considered after exclusion of known causes or associations. Isolated orbital myositis is a very rare form of this disease. We report a case of an isolated lateral rectus myositis to draw the attention of physicians to this condition, as prompt treatment in our patient resulted in complete recovery. PMID:21063661

Obeid, Tahir H; Qanash, Sultan A; Abulaban, Ahmad A; Al-Shamy, Abdalrhman M

2010-11-01

51

Improvement of hip abductor muscle weakness after lumbar decompressive surgery  

PubMed Central

Introduction. Degenerative lumbar spinal disorder is common in Japan, and the L5 nerve root is commonly involved in this disorder. The symptoms of L5 radiculopathy are irradiating lateral leg pain, and numbness and weakness of tibialis anterior and the hip abductor muscle. There has been only one report on the results of surgery for hip abductor muscle weakness caused by degenerative lumbar spinal disorder. Patients and methods. In this study, we analyzed the strength of the hip abductor muscle before and after decompressive surgery in 26 cases and the relationship between the lumbar disc herniation (LDH) and lumbar spinal canal stenosis (LSCS) groups. Results. Of the total 26 cases, muscle strength improved in 23 cases (88%), with complete recovery in 17 cases (65%). In the LDH group, the improvement rate was 92%. In the LSCS group, the improvement rate was 68%. Although the improvement rate for the LDH group was higher than that for the LSCS group, the difference was not significant (P = 0.054). Discussion. Decompressive surgery may be an effective method to improve hip abductor muscle weakness in degenerative lumbar spinal disorder.

Horaguchi, Kiyoshi; Yamada, Noboru; Iwai, Kazuo

2012-01-01

52

Accessory lateral rectus in a patient with normal ocular motor control.  

PubMed

: Although supernumerary extraocular muscles are common in monkeys and other species, they are relatively rare in humans and typically are noted in the context of childhood strabismus. We present a case of an incidentally found unilateral accessory lateral rectus muscle in a 51-year-old woman with normal ocular motor control. In this patient, the accessory lateral rectus was approximately 10% the size of a normally sized lateral rectus muscle. It originated from the orbital apex, traveled between the optic nerve and the lateral rectus and attached to the superolateral aspect of the globe. This unique case demonstrates that accessory lateral rectus in humans may have no impact on eye movement and ocular alignment. PMID:24796602

Liao, Yaping Joyce; Hwang, Jaclyn J

2014-06-01

53

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

PubMed Central

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

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

2008-01-01

54

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

PubMed Central

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

2012-01-01

55

Preoperative hesitating urinary stream is associated with postoperative voiding dysfunction and surgical failure following Burch colposuspension or pubovaginal rectus fascial sling surgery  

PubMed Central

Introduction and hypothesis We hypothesized that certain preoperative voiding symptoms would be correlated with poorer post-continence surgery outcomes in women. Methods Preoperative voiding symptoms from 655 women were assessed with questionnaires. Outcomes (overall failures, stress-specific failures, and voiding dysfunction) after Burch or sling surgery were measured. Logistic regression models were used to associate preoperative voiding symptoms with postoperative outcomes. Results Hesitating urinary stream was associated with voiding dysfunction [OR 2.22, p=0.01], overall [OR 1.57, p=0.03], and stress-specific [OR 1.67, p=0.009] failures. A ten-point increase in preoperative Urogenital Distress Inventory-obstructive (UDI-O) subscore was associated with overall [OR 1.10, p=0.049] and stress-specific [OR 1.21, p<0.0001] failures. Even controlling for severity of POPQ stage, significant associations of hesitating urinary stream with voiding dysfunction, overall and stress-specific failures remained. Conclusions Preoperative hesitating urinary stream and obstructive voiding symptoms were associated with poorer surgical outcomes. Further studies in this area may be fruitful.

Sanses, Tatiana V.; Brubaker, Linda; Xu, Yan; Kraus, Stephen R.; Lowder, Jerry L.; Lemack, Gary E.; Norton, Peggy; Litman, Heather J.; Tennstedt, Sharon L.; Chai, Toby C.

2011-01-01

56

Differential Lateral Rectus Compartmental Contraction during Ocular Counter-Rolling  

PubMed Central

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

Clark, Robert A.; Demer, Joseph L.

2012-01-01

57

Posterior compartment of the lower leg reconstruction with free functional rectus femoris transfer after sarcoma resection.  

PubMed

A 72-year-old man with the third recurrence of a low-grade liposarcoma of the right lower leg came to our attention seeking limb-salvage surgery. The tumour was removed en bloc with all the superficial posterior compartment of the leg. Appropriate foot flexion was restored by means of a free-functional rectus femoris musculocutaneous flap harvested from the ipsilateral thigh. The patient was kept on a postoperative splint for 6 weeks. Three months after the operation, clinical and elecromyographic signs of reinnervation were observed. The patient was able to walk, run and climb stairs and no donor-site morbidity was observed. Thigh extension was rated M4, comparable to the contralateral thigh. Foot flexion, without any postoperative exercise, was rated M3 with a 30 degrees excursion. To the best of our knowledge, this is the first report of reconstruction of the posterior compartment of the leg r with a free functional rectus femoris flap. We believe this muscle could be the ideal option for such reconstruction. PMID:19589741

Moschella, F; D'Arpa, S; Pirrello, R; Cordova, A

2010-03-01

58

Rectus abdominis overuse injury in a tennis athlete treated with traumeel  

PubMed Central

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

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

2012-01-01

59

Spontaneous rectus sheath hematomas: clinical and radiological features  

Microsoft Academic Search

.   We reviewed the clinical and radiological features in eight patients with spontaneous rectus sheath hematoma (RSH). The diagnosis\\u000a was confirmed at surgery in four patients, and spontaneous resolution occurred in the other four. All patients were elderly\\u000a adults. Acute abdominal pain and a palpable mass after muscular strain, such as coughing or twisting, were features highly\\u000a suggestive of RSH.

T. Fukuda; I. Sakamoto; S. Kohzaki; M. Uetani; M. Mori; T. Fujimoto; K. Hayashi; S. Matsuo

1996-01-01

60

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

PubMed

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

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

2013-10-01

61

Recovery of muscle strength following multi-level orthopaedic surgery in diplegic cerebral palsy  

Microsoft Academic Search

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

2007-01-01

62

Silicone spacer repair of medial rectus after iatrogenic orbit fracture.  

PubMed

A 51-year-old woman underwent endoscopic nasal polypectomy and ethmoidectomy with accidental entry into the right orbit causing enophthalmos and transection of the medial rectus muscle (MR). The repair of a fracture and of a damaged MR is technically challenging, particularly when large portions of bone and muscle are missing. We report a rare case of repair of the bony defect with an implant and reattachment of the MR with a silicone retina band, through a combined transcaruncular and transconjunctival approach. Postoperatively, the patient had residual enophthalmos and strabismus; further surgical options are discussed. PMID:21697756

Krakauer, Mark; Aakalu, Vinay K; Davis, Patricia L; Ahmad, Amjad Z

2012-01-01

63

Total extrusion of a silicone encircling band through the muscle insertions presenting as orbital cellulitis.  

PubMed

Abstract Introduction: We present an unusual case of anterior migration of a solid silicone encircling band 9 years after scleral buckling surgery. Materials and Methods: An 83-year old woman presented with acute onset of pain and discharge in her left eye. She had undergone cataract surgery complicated by endophthalmitis and managed with pars plana vitrectomy nine years earlier. Results: The patient was treated with transection and removal of the extruding encircling band. Pain ceased within two days. Two weeks postoperatively, the conjunctiva was well adapted without any discharge, ocular motility was as preoperatively. Discussion: Anterior migration of an encircling band through all four rectus muscle insertions is a very uncommon late complication following scleral buckling surgery. The remarkably good preservation of ocular motility in our case can be attributed to the slow advancement of the encircling band over nine years, which allowed a gradual reattachment of the rectus muscle insertions to the sclera. PMID:24832589

Kotoulas, Andreas; Symeonidis, Chrysanthos; Kalantzis, George; Droutsas, Konstantinos; Koutsandrea, Chryssanthi; Georgalas, Ilias

2014-08-01

64

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

PubMed Central

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

Chaudhuri, Zia; Demer, Joseph L.

2013-01-01

65

Pseudosepsis: rectus sheath hematoma mimicking septic shock.  

PubMed

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

2006-01-01

66

Rectus sheath catheter infusions for post-operative pain management.  

PubMed

Managing pain following major abdominal surgery remains a challenge. Traditionally, patient-controlled analgesia (PCA) or epidural analgesia have been used, which have improved post-operative pain and the patient experience, but have presented some problems in recovery. PCA can cause adverse effects, including sedation, nausea, vomiting, and prolonged gastric ileus. While epidurals do have some advantages over PCA, there are risks involved related to catheter insertion and adverse effects, such as hypotension and motor blocks which limit mobility. This article examines rectus sheath catheter infusions, a relatively new and alternative technique to epidural analgesia, and presents some early audit data related to pain scores, analgesic use and mobility. PMID:24938982

Layzell, Mandy

2014-06-18

67

Genetic stretching factors in masseter muscle after orthognathic surgery.  

PubMed

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

2013-09-01

68

Dramatic Reversal of Derangements in Muscle Metabolism and Diastolic Left Ventricular Function after Bariatric Surgery  

PubMed Central

Objective To define muscle metabolic and cardiovascular changes following surgical intervention in clinically severe obese patients. Background Obesity is a state of metabolic dysregulation which may lead to maladaptive changes in heart and skeletal muscle, including insulin resistance and heart failure. In a prospective longitudinal study 43 consecutive patients were subjected to metabolic profiling, skeletal muscle biopsies and resting echocardiograms at baseline as well as three and nine months after bariatric surgery. Results Body mass index (BMI) decreased [mean changes (95% CI): 7.7 kg/m2 (6.70–8.89) at 3 months and 5.6 kg/m2 (4.45–6.80), p<0.0001 at 9 months after surgery], with restoration of insulin sensitivity and decreases in plasma leptin at the same time points. Concurrent with these changes were dramatic decreases in skeletal muscle transcript levels of stearoyl CoA desaturase (SCD) and pyruvate dehydrogenase kinase-4 (PDK4) at three and nine months (p<0.0001, for both), and a significant decrease in peroxisome proliferation activated receptor alpha (PPAR-?) regulated genes at nine months. Left ventricular relaxation impairment, assessed by tissue Doppler imaging, normalized nine months after surgery. Conclusions Weight loss results in the reversal of systemic and muscle metabolic derangements and is accompanied by a normalization of left ventricular diastolic function.

Leichman, Joshua G.; Wilson, Erik B.; Scarborough, Terry; Aguilar, David; Miller, Charles C.; Yu, Sherman; Algahim, Mohamed F.; Reyes, Manuel; Moody, Frank G.; Taegtmeyer, Heinrich

2008-01-01

69

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

PubMed Central

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

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

2014-01-01

70

Jaw muscle tension after succinychloline in children undergoing strabismus surgery  

Microsoft Academic Search

The increases in tension at the masseter and adductor pollicis muscles following succinylcholine, 1 mg · kg?1, during halothane anaesthesia were measured in eight children, 3–10 yr, with strabismus. The results were compared with those\\u000a obtained in a control group of general surgical patients. Supramaximal train-of-four (TOF) stimulation was applied to the\\u000a ulnar nerve and the nerve to the masseter

J. M. Saddler; J. C. Bevan; M. H. Plumley; R. C. Polomeno; F. Donati; D. R. Bevan

1990-01-01

71

Comparison of the effects of caffeine and a 2-alkyl-1,2,3-benzotriazinium iodide on frog rectus abdominis.  

PubMed Central

1 The mode of action of 2-n-propyl-4-p-tolylamino-1,2,3-benzotriazinium iodide (TnPBI), which induced contractures of frog rectus abdominis muscle, was investigated. 2 TnPBI caused contractures of frog rectus abdominis when the muscle had been depolarized with potassium chloride. 3 Experiments with TnPBI and caffeine in calcium-free Ringer suggested that both compounds produce contractures by releasing intracellular bound calcium. 4 It is suggested that at least two calcium stores are involved, one of which is sensitive to caffeine while both are sensitive to TnPBI.

Muir, C K; Scott, N C

1977-01-01

72

Lobectomy—video-assisted thoracic surgery versus muscle-sparing thoracotomy: A randomized trial  

Microsoft Academic Search

Video-assisted thoracic surgery has been adopted by some thoracic surgeons as the preferred approach over thoracotomy for many benign and malignant diseases of the chest. However, little concrete evidence exists to support this technique as the superior approach. This randomized study was carried out to define the advantages of video-assisted lobectomy over muscle-sparing thoracotomy and lobectomy. Sixty-one patients with presumed

Thomas J. Kirby; Michael J. Mack; Rodney J. Landreneau; Thomas W. Rice

1995-01-01

73

Bladder muscle biopsy and urethral sphincter EMG in patients with bladder dysfunction after pelvic surgery.  

PubMed Central

Eleven patients who suffered persistent bladder dysfunction after pelvic surgery have been investigated by needle urethral sphincter electromyography (EMG) and bladder muscle biopsy, and the results compared with those obtained in a series of controls. Individual motor units recorded from the urethral sphincter in patients who had undergone pelvic surgery were strikingly abnormal, suggesting the presence of reinnervation, and the density of detrusor innervation was significantly reduced. However, since reduction in the density of detrusor innervation may occur in circumstances other than peripheral nerve injury, we conclude that urethral sphincter EMG provides the most effective means of assessing damage to vesico-urethral innervation as a result of previous pelvic surgery. Images Figure 5.

Kirby, R S; Fowler, C J; Gilpin, S A; Gosling, J A; Milroy, E J; Turner-Warwick, R T

1986-01-01

74

The functional effect of a distal rectus femoris tenotomy in adults with cerebral palsy.  

PubMed

The purpose of this study was to determine the effect of a distal rectus femoris tenotomy on function and gait in adults with cerebral palsy who had diminished knee flexion during swing. A stiff knee gait pattern is commonly seen in individuals with cerebral palsy and frequently leads to tripping and falling. Five subjects, 25-51 years, (34.6±10.3 years) participated in the study; each individual had the surgery after the age of 18. Four of the five subjects underwent bilateral distal rectus femoris tenotomies for a total of nine limbs being studied. Four of the five subjects had a single procedure of a distal rectus femoris tenotomy and one subject also had bilateral adductor tenotomies. All individuals underwent a pre-operative and post-operative, (3.28±1.6 years) three-dimensional gait analysis. Pre-operative gait revealed diminished peak knee flexion and out of phase rectus femoris activity with a quiet vastus lateralis during swing in all subjects. Significant findings after a distal rectus femoris tenotomy included: improved peak swing knee flexion, improved peak stance hip extension, and increased total knee excursion without loss in knee extension strength. During swing, knee flexion angle improved on average 11° which correlated with subjective report of less shoe wear, tripping, and falling due to improved clearance. In conclusion, a distal rectus femoris tenotomy should be considered a surgical option for adults with cerebral palsy and a stiff knee gait pattern to improve mobility, function, and quality of life. PMID:24742707

Drefus, Lisa C; Buckland, Melanie A; Backus, Sherry I; Root, Leon

2014-05-01

75

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

Microsoft Academic Search

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

Gerhard Ulrich Exner; Hans W. Staudte; Dirk Pette

1973-01-01

76

Spontaneous rectus sheath hematoma during rivaroxaban therapy.  

PubMed

Rivaroxaban is an oral anticoagulant agent that directly inhibits Factor Xa and interrupts both the intrinsic and extrinsic pathway of the coagulation cascade and is currently indicated for use in patients for atrial fibrillation and prophylaxis of deep venous thrombosis. The present case reports of spontaneous rectus sheath hematoma during rivaroxaban therapy for atrial fibrillation in a 75-year-old woman. PMID:24987185

Kocayigit, Ibrahim; Can, Yusuf; Sahinkus, Salih; Ayd?n, Ercan; Vatan, Mehmet Bulent; K?l?c, Harun; Gunduz, Huseyin

2014-05-01

77

Spontaneous rectus sheath hematoma during rivaroxaban therapy  

PubMed Central

Rivaroxaban is an oral anticoagulant agent that directly inhibits Factor Xa and interrupts both the intrinsic and extrinsic pathway of the coagulation cascade and is currently indicated for use in patients for atrial fibrillation and prophylaxis of deep venous thrombosis. The present case reports of spontaneous rectus sheath hematoma during rivaroxaban therapy for atrial fibrillation in a 75-year-old woman.

Kocayigit, Ibrahim; Can, Yusuf; Sahinkus, Salih; Ayd?n, Ercan; Vatan, Mehmet Bulent; K?l?c, Harun; Gunduz, Huseyin

2014-01-01

78

Correction of ptosis or pseudoptosis in congenital double elevator palsy by either extraocular muscle or lid surgery  

Microsoft Academic Search

Fifteen of 19 patients diagnosed with double elevator palsy (DEP) assocaited with ptosis or pseudoptosis underwent surgical\\u000a intervention including muscle transposition operation, levator resection and\\/or frontal suspension surgery. Surgical intervention\\u000a for DEP not only achieved significant reduction in vertical deviation but also accomplished correction of pseudoptosis. In\\u000a subjects with true ptosis specific ptosis surgery is essential after strabismus surgery.

Ay?e G. Kocak-Altintas; Inci Koçak-Midillioglu; Atilla Argin; Sunay Duman

2003-01-01

79

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

PubMed Central

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

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

2013-01-01

80

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

PubMed Central

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

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

2011-01-01

81

Immediate breast reconstruction for stage III breast cancer using transverse rectus abdominis musculocutaneous (TRAM) flap  

Microsoft Academic Search

Background: The management of stage III breast cancer is challenging; it often includes multimodal treatment with systemic therapy and\\/or radiation therapy and surgery. Immediate breast reconstruction has not traditionally been performed in these patients. We review the results of immediate transverse rectus abdominis musculocutaneous (TRAM) flap in 21 patients treated for stage III breast cancer.\\u000aMethods: Data have been collected

Toncred M. Styblo; Melinda M. Lewis; Grant W. Carlson; Douglas R. Murray; William C. Wood; David Lawson; Jerome Landry; Lorie Hughes; Foad Nahai; John Bostwick

1996-01-01

82

Deep inferior epigastric artery perforated rectus abdominis free flap for head and neck reconstruction  

Microsoft Academic Search

The deep inferior epigastric artery perforated rectus abdominis (DIEAP-ra) free flap is a modification of the classic myocutaneous\\u000a DIEA free flap in which only fasciocutaneous tissue is harvested based on the paraumbilical perforators of the medial row.\\u000a The aim of this retrospective study is to describe our experience with this reconstructive technique in head and neck surgery.\\u000a Between 2004 and

Johnny Cappiello; Cesare Piazza; Valentina Taglietti; Piero Nicolai

83

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

PubMed

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

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

2013-12-01

84

Obstructive uropathy secondary to rectus sheath hematoma.  

PubMed

Rectus sheath hematoma (RSH) is uncommon and is often reported in the setting of anticoagulation or trauma. Typically RSH presents with localized or diffuse abdominal pain and a fixed abdominal wall mass, however, various presentations and complications have been reported depending on the setting and extent of the hematoma. We report a case of a rapidly expanding RSH causing obstructive anuria and hydronephrosis in addition to a review of literature on this rare presentation of RSH. PMID:23600103

Dangle, Pankaj P; Patel, Mitesh B; Terán, Marcos; Chehval, Micheal J

2013-01-01

85

Eye muscle surgery for infantile nystagmus syndrome in the first two years of life  

PubMed Central

Purpose: To report visual and elctrophysioloigcal effects of eye muscle surgery in young patients with infantile nystagmus syndrome (INS). Methods: Prospective, interventional case cohort of 19 patients aged under 24 months who were operated on for combinations of strabismus, an anomalous head posture, and nystagmus. All patients were followed at least nine months. Outcome measures, part of an institutionally approved study, included Teller acuity, head position, strabismic deviation, and eye movement recordings, from which waveform types and a nystagmus optimal foveation fraction (NOFF). Computerized parametric and nonparametric statistical analysis of data were perfomed using standard software on both individual and group data. Results: Age averaged 17.7 months (13.1-month follow-up). Thirteen (68%) patients had associated optic nerve or retinal disease. 42% had amblyopia, 68% had refractive errors. Group means in binocular Teller acuity (P < 0.05), strabismic deviation (P < 0.05), head posture (P < 0.001), and the NOFF measures (P < 0.01) from eye movement recordings improved in all patients. There was a change in null zone waveforms to more favorable jerk types. There were no reoperations or surgical complications. Conclusions: Surgery on the extraocular muscles in patients aged less than two years with INS results in improvements in multiple aspects of ocular motor and visual function.

Hertle, Richard W; Felius, Joost; Yang, Dongsheng; Kaufman, Matthew

2009-01-01

86

Cholinergic Reception in Slow Fibers of Mixed Muscles of 'Testudo Horsfieldi' and 'Agama Caucasica'.  

National Technical Information Service (NTIS)

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

1971-01-01

87

Motor evoked potential monitoring during spinal surgery: responses of distal limb muscles to transcranial cortical stimulation with pulse trains  

Microsoft Academic Search

During spinal surgery, motor evoked potentials (MEPs) were recorded from distal upper and lower limb muscles following multipulse transcranial electrical stimulation of the cortex. Twenty-two patients, 9 of them myelopathic, were anaesthetised with propofol ± nitrous oxide. Using trains of 3–6 pulses separated by 2 ms, consistent responses generally measuring more than 100 ?V were obtained from every patient except

S. J. Jones; R. Harrison; K. F. Koh; N. Mendoza; H. A. Crockard

1996-01-01

88

[Temporal muscle flap in cranio-facial reconstructive surgery. Apropos of 32 cases].  

PubMed

The temporalis muscle flap is used in craniofacial reconstructive surgery to repair defects, to restore facial contours and to cover bone grafts. These possibilities of reconstruction are analysed in the light of 32 cases. After reviewing the anatomy and the surgical technique, this series is presented as a function of the various types of defect: cranio-orbital (9 cases), defects of the malar area (6 cases), maxillary defects (7 cases), mandibular defects (7 cases), malar and parotid soft tissues defects (2 cases), mastoid defects (1 case). This study indicates that the temporalis flap possesses several advantages: great vascular reliability, associated with simplicity of flap raising and an easily available tissue volume. The arc of rotation constitutes the limiting factor. Romberg's syndrome does not constitute an ideal indication of choice, as the muscle may be atrophied. Similarly, when the defect requires thin cover, it would be wiser to use a thinner flap, such as fascia temporalis superficialis. Donor site sequelae are negligible. Limitation of mouth opening (3 cases) and frontal paralysis (2 cases) are usually transient. The field of application of this flap can be extended by continuing the flap as far as the pericranium or calvarium, allowing complex reconstructions. PMID:7574388

Cothier-Savey, I; Jousset, C; Raulo, Y

1995-04-01

89

The Extracellular Space on Voluntary Muscle Tissues.  

National Technical Information Service (NTIS)

The volume occupied by the extracellular space has been investigated in six types of voluntary muscles: sartorius (frog), semitendinosus (frog), tibialis anticus longus (frog), iliofibularis (frog), rectus abdominis (frog), and diaphragm (rat). With the a...

G. N. Ling M. H. Kromash

1966-01-01

90

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

PubMed

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

2014-06-01

91

Anatomically-Driven Soft-Tissue Simulation Strategy for Cranio-Maxillofacial Surgery Using Facial Muscle Template Model  

Microsoft Academic Search

\\u000a We propose a computationally efficient and bio-mechanically relevant soft-tissue simulation method for cranio-maxillofacial\\u000a (CMF) surgery. A template-based facial muscle reconstruction was introduced to minimize the efforts on preparing a patient-specific\\u000a model. A transversely isotropic mass-tensor model (MTM) was adopted to realize the effect of directional property of facial\\u000a muscles in reasonable computation time. Additionally, sliding contact around teeth and mucosa

Hyungmin Kim; Philipp Jürgens; Lutz-Peter Nolte; Mauricio Reyes

2010-01-01

92

New approach in strabismus surgery in high myopia  

PubMed Central

AIMS—To develop appropriate methods of eye muscle surgery in highly myopic patients with esotropia and hypotropia, with respect to the pathological findings in high resolution magnetic resonance imaging (MRI).?METHODS—35 patients with unilateral or bilateral high myopia and strabismus—that is, axial length of the globe averaged 29.4 mm. Multiple coronal, transverse, and parasagittal MRI image planes were obtained using a Siemens Magnetom 1.5 tesla MRI scanner. In 15 patients with a pathological plane of recti extraocular muscles found by MRI and confirmed intraoperatively, a new technique of eye muscle surgery was performed to re-establish the physiological muscle plane. This was checked postoperatively in addition to the measurement of alignment and motility by MRI.?RESULTS—The new MRI finding of a dislocation of the lateral rectus (LR) into the temporocaudal quadrant by 3.4 mm requires new surgical techniques. Only fixing the LR in the physiological meridian at the equator with a silicone loop (`guide pulley') or a non-absorbable suture is a causal therapy. This yields alignment and improves abduction and elevation.?CONCLUSIONS—If the described misalignment of the LR is detected by MRI, a common high dosage recess-resect procedure for esotropia may even aggravate the deviation. The most important aim of eye muscle surgery is to normalise the pathological path of the LR. The restoration of the physiological function of the dislocated LR is remarkable.??

Krzizok, T.; Kaufmann, H.; Traupe, H.

1997-01-01

93

Hydrolyse enzymatique de la propionylcholine, de l'acétylthiocholine et de la butyrylthiocholine par le rectus de grenouille  

Microsoft Academic Search

Summary The enzymatic hydrolysis of propionylcholine (PrCh), acetylthiocholine (AcThCh), and butyrylthiocholine (BuThCh), by extracts of the muscle rectus abdominis, was determined. Inhibition of this hydrolysis by D.F.P. and 3318 CT [bis(pipéridinométhylcoumaranyl- 5)cétone diméthiodide] — utilized over a range of concentrations covering both specific and non-specific concentrations—showed that PrCh is hydrolyzed by an acetylcholinesterase (70%) and an Xcholinesterase (30%), AcThCh by

J. Jacob; M. Pécot-Dechavassine

1958-01-01

94

Synostotic anterior plagiocephaly: a cause of familial congenital superior oblique muscle palsy.  

PubMed

Anterior plagiocephaly due to unicoronal craniosynostosis is commonly associated with an ipsilateral hypertropia and a contralateral head tilt. The ipsilateral superior oblique weakness has been attributed to the shortening of the orbital roof with retroplacement of the trochlea, and to heterotopic positioning of the vertical rectus muscles within the orbit. These anatomical aberrations may alter ocular rotations to mimic a true congenital superior oblique palsy. This paper describes two siblings with synostotic plagiocephaly and simulated superior oblique palsy with ocular torticollis successfully managed by strabismus surgery. Synostotic plagiocephaly should be included in the differential diagnosis of familial congenital superior oblique palsy. PMID:24141756

Matalia, Jyoti; Kasturi, Nirupama; Brodsky, Michael C

2013-01-01

95

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

Microsoft Academic Search

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

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

2003-01-01

96

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

Microsoft Academic Search

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

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

1973-01-01

97

Is skeletal muscle luxury perfusion the main hemodynamic effect of high-dose insulin in cardiac surgery?  

PubMed

Insulin, in combination with glucose and potassium (GIK), can be used in heart surgery to improve hemodynamic performance. This study evaluates the role of skeletal muscle vasodilation in hemodynamic effects of high-dose GIK therapy early after coronary surgery. Thirty-three male patients undergoing coronary artery bypass grafting were included in a prospective, randomized and controlled study. Eleven patients received infusions of mixed amino acids (11.4 g) and insulin solution (225 IU insulin, glucose with the glucose clamp technique, and potassium), 11 patients received infusions of mixed amino acids (11.4 g) and 11 patients served as control subjects. During combined insulin and amino acid infusion, cardiac output increased by 13+/-3% (+0.6+/-0.2 L x min(-1)) and systemic vascular resistance decreased by 24+/-3% (-320+/-46 dyn x s x cm(-5)). The changes differed from those in the control group (CO: -0.2+/-0.1 L x min(-1), p < 0.05; SVR: +136+/-42 dyn x s x cm(-5), p < 0.05). Changes in skeletal muscle perfusion and leg vascular resistance did not differ significantly among the groups. At most, changes in leg blood flow could explain 40% of the changes in cardiac output. Skeletal muscle luxury perfusion is not the main hemodynamic effect of high-dose insulin in the early postoperative period after coronary surgery. PMID:10983674

Lindholm, L; Nilsson, B; Kirnö, K; Sellgren, J; Nilsson, F; Jeppsson, A

2000-08-01

98

Purification and Characterization ofCampylobacter rectus Surface Layer Proteins  

Microsoft Academic Search

Campylobacter rectus is a putative periodontopathogen which expresses a proteinaceous surface layer (S- layer) external to the outer membrane. S-layers are considered to play a protective role for the microorganism in hostile environments. The S-layer proteins from six different C. rectus strains (five human isolates and a nonhuman primate (NHP) isolate) were isolated, purified, and characterized. The S-layer proteins of

Hiroshi Nitta; Stanley C. Holt; Andjeffrey L. Ebersole

99

Septic cavernous sinus thrombosis due to Campylobacter rectus infection.  

PubMed

We report a case of cavernous sinus thrombosis in a 55-year-old Chinese man who presented with headache, ophthalmoplegia and ptosis. Campylobacter rectus was eventually isolated from the blood cultures. He was treated with broad-spectrum antibiotics, anticoagulation and steroids with improvement in his condition. To our knowledge, this is the first documented case of septic cavernous sinus thrombosis caused by C. rectus. PMID:24842357

Leo, Qi Jie Nicholas; Bolger, Dennis Thomas

2014-01-01

100

Electrical stimulation and biofeedback exercise of pelvic floor muscle for children with faecal incontinence after surgery for anorectal malformation.  

PubMed

We report our experience of electrical stimulation and biofeedback exercise of pelvic floor muscle for children with faecal incontinence after surgery for anorectal malformation (ARM). Electrical stimulation and biofeedback exercise of pelvic floor muscle were performed on children with post-operative faecal soiling following repair of intermediate or high type ARM. Children under the age of 5 years or with learning difficulties were excluded. They had 6 months supervised programme in the Department of Physiotherapy followed by 6 months home based programme. Bowel management including toilet training, dietary advice, medications and enemas were started before the pelvic floor muscle exercise and continued throughout the programme. Soiling frequency rank, Rintala continence score, sphincter muscle electromyography (EMG) and anorectal manometry were assessed before and after the programme. Wilcoxon signed rank test was performed for statistical analysis. From March 2001 to May 2006, 17 children were referred to the programme. Twelve patients (M:F = 10:2; age = 5-17 years) completed the programme. There was a trend of improvement in Rintala score at sixth month (p = 0.206) and at the end of programme (p = 0.061). Faecal soiling was significantly improved at sixth month (p = 0.01) and at the end of the programme (p = 0.004). Mean sphincter muscle EMG before treatment was 1.699 microV. Mean EMG at sixth month and after the programme was 3.308 microV (p = 0.034) and 3.309 microV (p = 0.002) respectively. After the programme, there was a mean increase in anal sphincter squeeze pressure of 29.9 mmHg (p = 0.007). Electrical stimulation and biofeedback exercise of pelvic floor muscle is an effective adjunct for the treatment of faecal incontinence in children following surgery for anorectal malformation. PMID:17001486

Leung, M W Y; Wong, B P Y; Leung, A K P; Cho, J S Y; Leung, E T Y; Chao, N S Y; Chung, K W; Kwok, W K; Liu, K K W

2006-12-01

101

Outcome study of bilateral lateral rectus recession for intermittent exotropia in children.  

PubMed Central

PURPOSE: This paper reports an outcome study of 52 consecutive children treated by bilateral lateral rectus recession for intermittent exotropia over a 9 year period (1981-90) with a minimum follow up of 6 months. METHODS: Successful alignment was defined as the absence of any postoperative intermittent or constant tropia in any position of gaze. The study examined the variables that might be predictive of successful alignment. The charts were abstracted for age at initial surgery, quantity of initial deviation, initial refraction, motor alignment at 1 week and 6 months, final alignment, secondary surgery results and the incidence of a monofixation syndrome result. RESULTS: Motor tests demonstrated that 32 (62%) of the patients were successfully aligned by the initial procedure performed for a mean of 25 prism diopters of preoperative deviation while viewing distant targets at a mean age of 4 years 8 months, followed for a mean of 4 years, 4 months. The incidence of undercorrections and overcorrections were approximately equal in quantity suggesting that the current surgical dosage was adequate, but the age at initial surgery, initial deviation, initial refraction and 1 week postoperative alignment results were not predictive of success. Alignment at 6 months, however, was highly correlated with successful alignment by the end of the study (p = 0.002). Secondary surgery was performed for 11 patients and 5 patients were found to have a monofixation syndrome result. CONCLUSION: Successful alignment was achieved in the majority of children treated for intermittent exotropia by an initial bilateral lateral rectus recession. However, 20% of the patients received secondary surgery for a residual deviation, and the study confirmed a previously reported 10% incidence of monofixation syndrome result in children surgically treated for this type of strabismus.

Ing, M R; Nishimura, J; Okino, L

1997-01-01

102

Dissociated vertical deviation: an asymmetric condition treated with large bilateral superior rectus recession.  

PubMed

Bilateral superior rectus recessions were performed on 25 patients for dissociated vertical deviation (DVD). Large recessions (at least 10 mm from the original insertion) have proved effective and safe, although all patients were slightly undercorrected. There were no complications of ptosis, upper lid retraction, alterations of palpebral fissure width, failure of upgaze, oblique dysfunction or overcorrection. The DVD was always asymmetric, with the greater deviation in the non-dominant eye. Forty percent of the patients had a decompensated asymmetry manifested by unilateral hypertropia of at least 10 prism diopters in addition to the DVD. These patients require an asymmetrical amount of surgery. Two such patients required reoperation, not because of residual DVD, but because of failure to correct this hypertropia. Currently we do bilateral superior rectus recessions of greater than 10 mm OU for DVD, reserving unilateral surgery for the patient with such deep amblyopia that he will never fix with the operated eye. An eye with manifest hypertropia in addition to DVD requires at least five more millimeters (greater than 15 mm) than the fixating eye. Maximum amounts of recession have not yet been determined. PMID:7050333

Magoon, E; Cruciger, M; Jampolsky, A

1982-01-01

103

Muscles  

MedlinePLUS Videos and Cool Tools

... Introduction Muscles are very important elements of the human body. They account for about half of a ... and the triceps allows us to extend it. Anatomy The skeletal muscles vary in shape and strength. ...

104

Gestational choriocarcinoma metastasis to the extraocular muscle: a case report.  

PubMed

This case report describes a biopsy-proven metastasis of gestational choriocarcinoma to the medial rectus muscle. Patient evaluation and follow up included comprehensive ophthalmologic history and examination, external and fundus photography, immunohistochemistry preparations of the medial rectus muscle specimen, MRI, ultrasound of the abdomen and pelvis, comprehensive blood tests, and CT scans of the chest, abdomen, and pelvis. The tissue specimen was obtained via a medial perilimbal conjunctival peritomy. MRI revealed a mass intrinsic to the right medial rectus muscle. Immunohistochemical staining confirmed gestational choriocarcinoma metastasis in medial rectus muscle biopsy. The patient showed general and orbital improvement following 7 subsequent cycles of chemotherapy. In conclusion, gestational choriocarcinoma may metastasize to the orbit in addition to the previously reported ocular site, the choroid. A chemotherapy regimen of etoposide, methotrexate, actinomycin-D, cyclophosphamide, and vincristine can effectively treat the intraorbital component of the disease. PMID:23924991

Dhrami-Gavazi, Elona; Lo, Christopher; Patel, Payal; Galic, Vijaya; Pareja, Fresia; Kazim, Michael

2014-01-01

105

Abdominal wall surgery  

MedlinePLUS

Abdominal wall surgery is surgery that improves the appearance of flabby, stretched-out abdominal (belly) muscles and skin. ... mini-tummy tuck" to more complicated, extensive surgery. Abdominal wall surgery is not the same as liposuction, which ...

106

Surgery for Breast Cancer  

MedlinePLUS

... muscles under the breast. Possible side effects of breast surgery Aside from pain after the surgery and the ... to one of these volunteers. Chronic pain after breast surgery After breast surgery, some women have pain that ...

107

Surgery  

MedlinePLUS

... a cure for COPD but can improve one's quality of life. The goal of the surgery is to reduce ... help improve breathing ability, lung capacity, and overall quality of life among those who are qualified for it. Lung ...

108

EMG Activity of Selected Trunk and Hip Muscles During a Squat Lift: Effect of Varying the Lumbar Posture.  

National Technical Information Service (NTIS)

The electromyographic (EMG) activity of selected hip and trunk muscles was recorded during a squat lift and the effects of two different lumbar spine postures were examined. Seven muscles were analyzed: rectus abdominis (RA), abdominal oblique (AO), erect...

J. Vakos

1990-01-01

109

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

PubMed Central

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.

Feizzadeh Kerigh, Behzad; Maddah, Ghodratolah

2013-01-01

110

Spontaneous rectus sheath hematoma in the elderly: an unusual case and update on proper management.  

PubMed

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

2014-01-01

111

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

PubMed Central

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.

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

2014-01-01

112

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

National Technical Information Service (NTIS)

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

J. A. McNamara D. S. Carlson

1984-01-01

113

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

PubMed Central

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.

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

2012-01-01

114

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

PubMed Central

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

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

2011-01-01

115

Asymptomatic blood cyst of the papillary muscle in an adult undergoing coronary bypass surgery  

PubMed Central

Blood-filled cysts of larger size attached to the heart valves represent a very rare finding in adults. We report here a case of a blood-filled cyst attached to the papillary muscle, demonstrating the importance of multimodal preoperative diagnostic imaging combining both echocardiography and magnetic resonance imaging.

Donndorf, Peter; Bermaoui, Benjamin; Westphal, Bernd; Steinhoff, Gustav

2013-01-01

116

Asymptomatic blood cyst of the papillary muscle in an adult undergoing coronary bypass surgery.  

PubMed

Blood-filled cysts of larger size attached to the heart valves represent a very rare finding in adults. We report here a case of a blood-filled cyst attached to the papillary muscle, demonstrating the importance of multimodal preoperative diagnostic imaging combining both echocardiography and magnetic resonance imaging. PMID:23223673

Donndorf, Peter; Bermaoui, Benjamin; Westphal, Bernd; Steinhoff, Gustav

2013-03-01

117

Teres major muscle activation relates to clinical outcome in tendon transfer surgery  

Microsoft Academic Search

BackgroundIn massive rotator cuff tears a teres major (TMj) tendon transfer to the insertion of the supraspinatus (SSp) reverses its adduction moment arm into abduction which is supposed to be an adequate salvage procedure. Analysis of muscle function to find biomechanical ground of such success is scarce.

Frans Steenbrink; Rob G. H. H. Nelissen; Carel G. M. Meskers; Michiel A. J. van de Sande; Piet M. Rozing; Jurriaan H. de Groot

2010-01-01

118

Extraocular muscle cysticercosis mimicking idiopathic orbital inflammation: case report  

Microsoft Academic Search

Presentation of one case of extraocular muscle enlargement caused by cysticercosis, its clinical, diagnostic and treatment aspects, and review of the literature on this theme. A female 38-year-old patient with extraocular muscle enlargement and a small cystic lesion at the superior rectus muscle insertion was treated with oral prednisone for almost one year, with a non- specific inflammation of right

Hélio Angotti-Neto; Allan Christian Pieroni Gonçalves; Frederico Castelo Moura; Mário Luiz Ribeiro Monteiro

2007-01-01

119

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

PubMed Central

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

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

1983-01-01

120

Ex vivo intraoperative angiography for rectus abdominis musculocutaneous free flaps.  

PubMed

In this study, the vascular architecture of rectus abdominis free flaps nourished by deep inferior epigastric vessels was investigated using an ex vivo intraoperative angiogram. Oblique rectus abdominis free flaps were elevated and isolated from the donor site. In 11 patients, the vascular architecture of these flaps was analyzed before the flap was thinned. Radiographic study identified an average of 2.1 large deep inferior epigastric arterial perforators in each flap. In nine of the 11 flaps, the axial artery was visible. In four flaps, the axial artery originated from the perforator of the lateral branch of the deep inferior epigastric artery; in five others, it originated from the medial branch. In each flap, the angle of the axial perforator from its anterior rectus sheath in the vertical plane was measured; its mean was 50.6 degrees. All flaps survived, although three showed partial necrosis in the distal portions. In two of these three flaps, the axial artery was not visible in the angiograms, and the third revealed a one-sided distribution of axial flap arteries. Using ex vivo intraoperative angiography, the architecture of the individual flap, its axial perforator, and its connecting axial flap vessel could be investigated. This information can help the surgeon safely thin and separate the flap. PMID:12045546

Ohjimi, Hiroyuki; Era, Kozo; Tanahashi, Shinji; Kawano, Katsuyuki; Manabe, Tsuyoshi; Naitoh, Masatoshi

2002-06-01

121

Deep inferior epigastric artery perforated rectus abdominis free flap for head and neck reconstruction.  

PubMed

The deep inferior epigastric artery perforated rectus abdominis (DIEAP-ra) free flap is a modification of the classic myocutaneous DIEA free flap in which only fasciocutaneous tissue is harvested based on the paraumbilical perforators of the medial row. The aim of this retrospective study is to describe our experience with this reconstructive technique in head and neck surgery. Between 2004 and 2009, 24 patients affected by oncologic maxillofacial, skull base, oral, and oropharyngeal defects were submitted to reconstruction with DIEAP-ra. After harvesting the DIEAP-ra, the longitudinally split muscular belly was sutured and the anterior rectus sheath closed with a nonabsorbable mattress suture without inlay mesh interposition. Surgical defects encompassed half of the hard palate in ten patients, orbit and part of the cranial vault in one, radical extended parotidectomy in four, subtotal glossectomy in seven, and total glossectomy in two cases. The only complete flap necrosis (4%) developed as a consequence of an orocutaneous fistula and required a second latissimus dorsi free flap. Another case (4%) developed a partial necrosis for oropharyngeal fistula after total glossectomy that healed after transposition of a pedicled myofascial pectoralis major. Two patients (8%) presented a minor salivary fistula that healed by medication alone. No major complication of the donor site was observed. DIEAP-ra is a valid alternative to the DIEA free flap when applied to complex maxillofacial or tongue major defects. Its greatest advantages are the reduced donor site morbidity and a more adjustable thickness of the skin paddle, particularly in females and obese patients. PMID:21866360

Cappiello, Johnny; Piazza, Cesare; Taglietti, Valentina; Nicolai, Piero

2012-04-01

122

Comparison of DXA and water measurements of body fat following gastric bypass surgery and a physiological model of body water, fat, and muscle composition  

PubMed Central

Measurement of body composition changes following bariatric surgery is complicated because of the difficulty of measuring body fat in highly obese individuals that have increased photon absorption and are too large for the standard dual-energy X-ray absorptiometry (DXA) table. We reproducibly measured body composition from half-body DXA scans and compared the values of total body fat estimated from total body water (TBW) and DXA measurements before and after Roux-en-Y gastric bypass surgery (RYGB). DXA, TBW (deuterium dilution), extracellular water (ECW; bromide dilution), and intracellular water (ICW) measurement (by subtraction) were made before surgery and at 2 wk, 6 wk, 6 mo, and 12 mo after surgery. Twenty individuals completed baseline and at least four follow-up visits. DXA appeared to underestimate the fat and bone mass in extreme obesity (before surgery), whereas at 6 and 12 mo after surgery, the DXA and TBW fat measurements were similar. The ECW-to-ICW ratio was increased in obese individuals and increased slightly more after surgery. We describe a new model that explains this abnormal water composition in terms of the normal physiological changes that occur in body composition in obesity and weight loss. This model is also used to predict the muscle mass loss following RYGB.

Levitt, David G.; Beckman, Lauren M.; Mager, Jennifer R.; Valentine, Bret; Sibley, Shalamar D.; Beckman, Tiffany R.; Kellogg, Todd A.; Ikramuddin, Sayeed

2010-01-01

123

The "sliding door" technique for closure of abdominal wall defects after rectus abdominis musculocutaneous flap transposition.  

PubMed

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

2013-11-01

124

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

PubMed Central

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

Kim, Hong Kyun; Shin, Jae Pil

2013-01-01

125

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

Microsoft Academic Search

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

Gerhard Ulrich Exner; Hans W. Staudte; Dirk Pette

1973-01-01

126

Reinnervation of the Extraocular Muscles in Goldfish is Nonselective  

Microsoft Academic Search

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

Steven S. Scherer

127

Influence of ski materials on muscle activity  

Microsoft Academic Search

The purpose of this study was to examine whether differences in construction between the compact ski, the racing ski and the soft ski influence the behavioural and electromuscular responses of the user. Eight qualified male ski instructors performed two ‘shuss’ trials and three different basic turns. Six muscles (M. biceps femoris, M. gastrocnemius lateralis and medialis, M. rectus femoris, M.

J. P. Clarys; L. van Puymbroeck; J. Publie; E. Bollens; J. Cabri; B. de Witte

1986-01-01

128

Functional anatomy of the levator palpebrae superioris muscle and its connective tissue system  

Microsoft Academic Search

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

A Ettl; S Priglinger; J Kramer; L Koornneef

1996-01-01

129

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

PubMed

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

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

2013-08-01

130

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

PubMed

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

2014-04-01

131

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

PubMed Central

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.

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

2014-01-01

132

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

PubMed

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

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

2013-03-01

133

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

PubMed

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

Rutkowska-Kucharska, Alicja; Szpala, Agnieszka

2010-11-01

134

Major orbital complications of endoscopic sinus surgery  

PubMed Central

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

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

2001-01-01

135

Eye muscle repair  

MedlinePLUS

... The condition is more commonly known as "crossed eyes." Surgery may be recommended when strabismus does not improve ... Eye muscle surgery does not fix the poor vision of a lazy (amblyopic) eye. The child may have to ...

136

Rectus Femoris Distal Tendon Resection Improves Knee Motion in Patients With Spastic Diplegia  

Microsoft Academic Search

Background  Children with spastic diplegia frequently show excessive knee extension (stiff-knee gait) throughout swing phase, which may\\u000a interfere with foot clearance. Abnormal rectus femoris activity is commonly associated with a stiff-knee gait. Rectus femoris\\u000a transfer has been recommended to enhance knee flexion during swing. However, recent studies suggest the transfer does not\\u000a generate a knee flexor moment but diminishes knee extension

Ana Presedo; Fabrice Megrot; Brice Ilharreborde; Keyvan Mazda; Georges-François Penneçot

137

Muscle ultrasound measurements and functional muscle parameters in non-dystrophic myotonias suggest structural muscle changes.  

PubMed

Patients with non-dystrophic myotonias, including chloride (myotonia congenita) and sodium channelopathies (paramyotonia congenita/potassium aggravated myotonias), may show muscular hypertrophy in combination with some histopathological abnormalities. However, the extent of muscle changes has never been assessed objectively in a large group genetically confirmed patients. This study quantitatively determines echo intensities, thicknesses, ranges-of-motion and force of four skeletal muscles in 63 genetically confirmed patients. The main findings revealed elevated echo intensities in all muscles except the rectus femoris (+1.3-2.2SD, p<0.0001), and hypertrophy in the arms (+0.5-0.9SD, p<0.01). Muscle echo intensities were inversely correlated to the corresponding ranges-of-motion (biceps brachii: r= -0.43; p<0.001, forearm flexors: r= -0.47; p<0.001, rectus femoris: r= -0.40; p=0.001, and tibial anterior: r= -0.27; p=0.04) and correlated positively to age (r=0.22; p=0.05). The echo intensity of the forearm flexors was inversely correlated to their muscles' force (r= -0.30; p=0.02). Together, these data suggest that non-dystrophic myotonias may lead to structural muscle changes. PMID:19540760

Trip, J; Pillen, S; Faber, C G; van Engelen, B G M; Zwarts, M J; Drost, G

2009-07-01

138

Comparative study of Y-split recession versus bilateral medial rectus recession for surgical management of infantile esotropia  

PubMed Central

Aim This prospective study compares the results of bilateral medial rectus recession versus (vs) Y-split recession of medial recti techniques for surgical management of essential infantile esotropia. Patients and methods Thirty patients were included in this study and had preoperative infantile esotropia with large angles (ie, >30 prism diopters [PD]). Patients were divided into Group A, which underwent bilateral medial rectus (BMR) recession and Group B, which underwent bilateral Y-split recession of medial recti muscles. All patients were subjected to complete ophthalmologic examination and met the criteria for inclusion in this study. The degrees of BMR recessions performed ranged from 6.0–7.5 mm. All operations were performed under general anesthesia. Follow-up visits were conducted at 1 and 2 weeks, and 1, 3, and 6 months postoperatively. Rates of reoperation for residual esotropia and consecutive exotropia were determined. Results The patients’ preoperative angles of deviation ranged from 30–80 PD. Group A consumed 57% less operative time than Group B. Immediately postoperatively, the Y-splitting technique showed satisfactory results (ie, orthotropic or residual angles ?15 PD) in 73% of patients vs 67% only for the BMR recession patients. By the end of six months of follow up; 13% of the BMR technique patients vs 27% of the Y-splitting technique patients showed negative change of PD but without reoperation. Conclusion Our results suggest that, although the Y-splitting technique is more difficult and time consuming, both procedures are effective and have shown comparable results for the correction of horizontal deviation ?70 PD.

Badawi, Nermeen; Hegazy, Khaled

2014-01-01

139

[Variability of interspike intervals of human motor neurons during voluntary muscle contraction and tonic vibration reflex].  

PubMed

Firing of motor units of human soleus, triceps brachii and rectus femoris muscles was studied. Standard deviations of interspike intervals against mean intervals were plotted during voluntary muscle contraction and tonic vibration reflex. There was no significant difference between the results obtained under these conditions. PMID:1598125

Kozhina, G V; Person, R S

1992-01-01

140

Cervical muscle strength after laminoplasty  

Microsoft Academic Search

.  ?To determine changes in cervical muscle strength after laminoplasty and to evaluate the relation between muscle strength\\u000a and neck pain, we measured maximum isometric muscle strength using a handheld dynamometer. We also investigated neck pain\\u000a before surgery and every month after surgery in 21 subjects who had undergone French-door laminoplasty. Muscle strength decreased\\u000a particularly 1 month after surgery, the extensor

Sueo Nakama; Kikuko Nitanai; Yoichi Oohashi; Teruaki Endo; Yuichi Hoshino

2003-01-01

141

Quadriceps EMG muscle activation during accurate soccer instep kicking  

Microsoft Academic Search

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

2011-01-01

142

Initial tension of the human extraocular muscles in the primary eye position.  

PubMed

This study proposes a mathematical model to estimate the initial tension forces of the extraocular muscles (EOMs). These forces are responsible for the mechanical equilibrium of the eye suspended in primary position. The passive contributions were obtained using the corresponding Cauchy stress-stretch relationships based on the previous clinical experimental data; whereas the active contributions were obtained using an optimum method with weakening the effect of innervation. The initial tension forces of the EOMs were estimated to be 48.8±14.2mN for the lateral rectus, 89.2±31.6mN for the medial rectus, 50.6±17.6mN for the superior rectus, 46.2±13.4mN for the inferior rectus, 15.6±8.3mN for the superior oblique, and 17.1±12.1mN for the inferior oblique. PMID:24657805

Gao, Zhipeng; Guo, Hongmei; Chen, Weiyi

2014-07-21

143

Mimetic Muscles and Emotions: Hans Memling's Fifteenth Century Masterpiece, ``Last Judgment,'' as a Study for Aesthetic Surgery  

Microsoft Academic Search

.   As the most recognizable part of the body, the face has always interested, not only artists, but doctors as well. Each has\\u000a had their own perception of facial beauty. The task for plastic and aesthetic surgery regarding the face is to reconstruct,\\u000a not only traumatic lesions, but also to prevent the effects of facial tissue aging. It is also

Jerzy Jankau; Marek Grzybiak

2002-01-01

144

A new linear muscle fiber model for neural control of saccades.  

PubMed

A comprehensive model for the control of horizontal saccades is presented using a new muscle fiber model for the lateral and medial rectus muscles. The importance of this model is that each muscle fiber has a separate neural input. This model is robust and accounts for the neural activity for both large and small saccades. The muscle fiber model consists of serial sequences of muscle fibers in parallel with other serial sequences of muscle fibers. Each muscle fiber is described by a parallel combination of a linear length tension element, viscous element and active state tension generator. PMID:23578053

Enderle, John D; Sierra, Daniel A

2013-04-01

145

Intramuscular innervations of muscle flaps that are commonly used in clinical settings  

Microsoft Academic Search

Purpose  Abductor hallucis, latissimus dorsi, gracilis, rectus abdominis, sartorius and pectoralis minor are muscle flaps that are\\u000a commonly used in clinic, but their intramuscular innervation has seldom been systematically investigated.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Five Chinese fresh human cadavers were included in the study and abductor hallucis, latissimus dorsi, gracilis, rectus abdominis,\\u000a sartorius and pectoralis muscles were dissected. After gross anatomy measurement, the specimens were

Da-zhi Yu; An-tang Liu; Rui-shan Dang; Chuan-sen Zhang; Jian-lin Zhang; Gang Chen; Jing Yi; Tong Han; Hua Jiang

2010-01-01

146

Spinal cord location of the motoneurons innervating the abdominal, cutaneous maximus, latissimus dorsi and longissimus dorsi muscles in the cat  

Microsoft Academic Search

Horseradish peroxidase (HRP) injections were made in the rectus abdominis, obliquus externus, obliquus internus, transversus abdominis, cutaneous maximus, latissimus dorsi and the longissimus dorsi muscles in the cat. The results showed that motoneurons innervating the obliquus externus, obliquus internus and transversus abdominis muscles were located in greatly overlapping areas of midthoracic, caudal thoracic and upper lumbar spinal segments. These motoneuronal

G. Holstege; J. van Neerven; F. Evertse

1987-01-01

147

A Case of Postsurgical Necrotizing Fasciitis Invading the Rectus Abdominis Muscle and Review of the Literature  

PubMed Central

Necrotizing fasciitis is a life-threatening, soft tissue infection and an early diagnosis is needed to permit a prompt surgical and medical intervention. Due to the high fatal potential of the disease complications, the radiologist should distinguish necrotizing fasciitis from the most common soft tissue infections, in order to permit a prompt surgical and medical treatment. We present a case of a wide necrotizing fasciitis who presented at our emergency department and we also provide the basic tools, through a review of the literature, for the general radiologist to distinguish, with computed tomography and magnetic resonance imaging, necrotizing fasciitis from the most common infections that could present during our routine practice.

Cremona, Antonio; Guidi, Marco; Carusi, Valentina

2014-01-01

148

Reconstruction of large soft tissue defects of the lower torso with rectus abdominis musculocutaneous flaps  

Microsoft Academic Search

Seven large defects of the lower torso were closed with rectus abdominis musculocutaneous flaps: two large roin defects, three abdominal wall defects, and two open lateral pelvic wounds. Five of the flaps were inferiorly based and two superiorly based. The donor site was closed primarily unless a large skin paddle was taken, in which case the donor site was skin

A. J. Franzo; R. L. Nesmith

1990-01-01

149

The rectus sling to prevent loop colostomy retraction: a case series  

PubMed Central

Diverting stomas are being used increasingly in the management of rectal cancer, particularly with low anterior resection following neoadjuvant therapy. We describe a simple anchorage method for loop colostomy using a rectus fascial sling. This has been used successfully in fifteen patients with no complications or evidence of significant spill over of faecal contents into the efferent loop.

Atkin, Gary; Scott, Mike A; Mathur, Pawan; Mitchell, Ian C

2005-01-01

150

Endurance training decreases the alkaline proteolytic activity in mouse skeletal muscles  

Microsoft Academic Search

Summary  Alkaline and myofibrillar protease activities of rectus femoris, soleus, and tibialis anterior muscles and the pooled sample of gastrocnemius and plantaris muscles were analyzed in male NMRI-mice during a running-training program of 3, 10, or 20 daily 1-h sessions. The activity of citrate synthase increased during the endurance training, reflecting the increased oxidative capacity of skeletal muscles. The activities of

A. Salminen; M. Kihlström; H. Kainulainen; T. Takala; V. Vihko

1984-01-01

151

Traumatic Rupture of the Superior Oblique Muscle Tendon  

PubMed Central

Traumatic rupture of the superior oblique muscle is rare. We report a case of a 54-year-old man injured by the metal hook of a hanger, resulting in a rupture of the superior oblique muscle tendon. He complained of torsional diplopia when in the primary position. The distal margin of the superior oblique muscle was reattached to sclera 5 and 9 mm apart from the medial insertion of the superior rectus muscle. One week after the operation, torsional diplopia disappeared. However, a 4-prism diopter ipsilateral hypertropia was observed. Three months later, hypertropia gradually increased to 20 prism dioptors and the second operation was done to correct vertical diplopia.

Chung, Hye Jin; Baek, Ji Won

2014-01-01

152

Traumatic rupture of the superior oblique muscle tendon.  

PubMed

Traumatic rupture of the superior oblique muscle is rare. We report a case of a 54-year-old man injured by the metal hook of a hanger, resulting in a rupture of the superior oblique muscle tendon. He complained of torsional diplopia when in the primary position. The distal margin of the superior oblique muscle was reattached to sclera 5 and 9 mm apart from the medial insertion of the superior rectus muscle. One week after the operation, torsional diplopia disappeared. However, a 4-prism diopter ipsilateral hypertropia was observed. Three months later, hypertropia gradually increased to 20 prism dioptors and the second operation was done to correct vertical diplopia. PMID:24882961

Chung, Hye Jin; Baek, Ji Won; Lee, Young Chun

2014-06-01

153

Surgery-Induced Changes and Early Recovery of Hip-Muscle Strength, Leg-Press Power, and Functional Performance after Fast-Track Total Hip Arthroplasty: A Prospective Cohort Study  

PubMed Central

Background By measuring very early changes in muscle strength and functional performance after fast-track total hip arthroplasty (THA), post-operative rehabilitation, introduced soon after surgery, can be designed to specifically target identified deficits. Objective(s) Firstly, to quantify changes (compared to pre-operative values) in hip muscle strength, leg-press power, and functional performance in the first week after THA, and secondly, to explore relationships between the muscle strength changes, and changes in hip pain, systemic inflammation, and thigh swelling. Design Prospective, cohort study. Setting Convenience sample of patients receiving a THA at Copenhagen University Hospital, Hvidovre, Denmark, between March and December 2011. Participants Thirty-five patients (65.9±7.2 years) undergoing THA. Main outcome measures Hip muscle strength, leg-press power, performance-based function, and self-reported disability were determined prior to, and 2 and 8 days after, THA (Day 2 and 8, respectively). Hip pain, thigh swelling, and C-Reactive Protein were also determined. Results Five patients were lost to follow-up. Hip muscle strength and leg press power were substantially reduced at Day 2 (range of reductions: 41–58%, P<0.001), but less pronounced at Day 8 (range of reductions: 23–31%, P<0.017). Self-reported symptoms and function (HOOS: Pain, Symptoms, and ADL) improved at Day 8 (P<0.014). Changes in hip pain, C-Reactive Protein, and thigh swelling were not related to the muscle strength and power losses. Conclusion(s) Hip muscle strength and leg-press power decreased substantially in the first week after THA – especially at Day 2 – with some recovery at Day 8. The muscle strength loss and power loss were not related to changes in hip pain, systemic inflammation, or thigh swelling. In contrast, self-reported symptoms and function improved. These data on surgery-induced changes in muscle strength may help design impairment-directed, post-operative rehabilitation to be introduced soon after surgery. Trial Registration ClinicalTrials.gov NCT01246674.

Holm, Bente; Thorborg, Kristian; Husted, Henrik; Kehlet, Henrik; Bandholm, Thomas

2013-01-01

154

Respiratory-related activation of human abdominal muscles during exercise  

PubMed Central

We tested the hypothesis that abdominal muscles are active during the expiratory phase of the respiratory cycle during exercise. Electromyographic (EMG) activities of external oblique and rectus abdominis muscles were recorded during incremental exercise to exhaustion and during 30 min of constant work rate exercise at an intensity of 85 % of the peak oxygen consumption rate (V?O2). High amplitude intramuscular EMG activities of both abdominal muscles could be evoked with postural manoeuvres in all subjects. During cycling, respiratory-related activity of the external obliques was evoked in four of seven subjects, whereas rectus abdominis activity was observed in six of the seven subjects. We measured only the activity that was confined exclusively to the expiratory phase of the respiratory cycle. Expiratory activity of both muscles increased with exercise intensity, although peak values averaged only 10-20 or 20-40 % of the peak activity (obtained during maximal, voluntary expiratory efforts) for the external oblique and rectus abdominis muscles, respectively. To estimate how much of the recorded abdominal muscle activity was supporting leg movements during exercise, we compared the activity at the very end of incremental exercise to that recorded during the first five respiratory cycles after the abrupt cessation of exercise, when ventilation was still very high. Although external oblique activity was reduced after exercise stopped, clear expiratory activity remained. Rectus abdominis activity remained high after exercise cessation, showing a gradual decline that approximated the decline in ventilation. During constant work rate exercise, EMG activities increased to 40-50 and 5-10 % of peak in rectus and external oblique muscles, respectively, and then plateaued for the remainder of the bout in spite of a continual upward drift in V?O2 and pulmonary ventilation. Linear regression analysis showed that the rise in respiratory-related expiratory muscle activity during progressive intensity exercise was significantly correlated with ventilation, although weakly. In constant work rate exercise, expiratory EMG activities increased, but the changes were highly variable and did not change as a function of exercise time, even though ventilation drifted significantly with time. These experiments suggest that abdominal muscles play a role in regulating the ventilatory response to progressive intensity bicycle exercise, although some of the observed activity may support postural adjustments or limb movements. The contribution of abdominal muscles to ventilation during constant work rate exercise is variable, and expiratory activity does not ‘drift’ significantly with time.

Abraham, Kirk A; Feingold, Howard; Fuller, David D; Jenkins, Megan; Mateika, Jason H; Fregosi, Ralph F

2002-01-01

155

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

PubMed Central

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

2012-01-01

156

Rectus sheath haematoma: a serious complication of a commonly administered drug.  

PubMed

Ten days after an above knee amputation, this 62-year-old woman became acutely anaemic (haemoglobin drop of 10.4 to 6.2). Clinically, she had no obvious source of bleeding; however, on examination, her abdomen was slightly distended and she was tender over the suprapubic area. A CT scan of her abdomen and pelvis was arranged which showed a large haematoma (17 × 11 cm) arising from the anterior abdominal wall from the deep aspect of the left rectus abdominus, extending across the midline to the right rectus abdominus and deep into the pelvis. This may have been spontaneous or may have been due to direct injury when injecting subcutaneous heparin. PMID:23580671

Parkinson, Fran; Khalid, Usman; Woolgar, Justin

2013-01-01

157

Optimizing Muscle Parameters in Musculoskeletal Modeling Using Monte Carlo Simulations  

NASA Technical Reports Server (NTRS)

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

2011-01-01

158

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

PubMed Central

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

Biedner, B; Rothkoff, L

1995-01-01

159

Previous Multiple Abdominal Surgeries: A Valid Contraindication to Abdominal Free Flap Breast Reconstruction?  

PubMed Central

Presented in part at the following Academic Meetings: 57th Meeting of the Italian Society of Plastic, Reconstructive and Aesthetic Surgery, September 24-27, 2008, Naples, Italy.45th Congress of the European Society for Surgical Research (ESSR), June 9-12, 2010, Geneva, Switzerland.British Association of Plastic Reconstructive and Aesthetic Surgeons Summer Scientific Meeting, June 30-July 2, 2010, Sheffield Hallam University, Sheffield, UK. Background: Patients with previous multiple abdominal surgeries are often denied abdominal free flap breast reconstruction because of concerns about flap viability and abdominal wall integrity. We therefore studied their flap and donor site outcomes and compared them to patients with no previous abdominal surgery to find out whether this is a valid contraindication to the use of abdominal tissue. Patients and Methods: Twenty patients with multiple previous abdominal operations who underwent abdominal free flap breast reconstruction by a single surgeon (C.M.M., 2000-2009) were identified and retrospectively compared with a cohort of similar patients without previous abdominal surgery (sequential allocation control group, n = 20). Results: The index and control groups were comparable in age, body mass index, comorbidities, previous chemotherapy, and RT exposure. The index patients had a mean age of 54 years (r, 42-63) and an average body mass index of 27.5 kg/m2 (r, 22-38). The main previous surgeries were Caesarean sections (19), hysterectomies (8), and cholecystectomies (6). They underwent immediate (n = 9) or delayed (n = 11) reconstructions either unilaterally (n = 18) or bilaterally (n = 2) and comprising 9 muscle-sparing free transverse rectus abdominis muscle and 13 deep inferior epigastric perforator flaps. All flaps were successful, and there were no significant differences in flap and donor site outcomes between the 2 groups after an average follow up of 26 months (r, 10-36). Conclusion: Multiple previous abdominal surgeries did not predispose to increased flap or donor site morbidity. On the basis of our experience, we have proposed some recommendations for successful abdominal free flap breast reconstruction in patients with previous multiple scars. Careful preoperative planning and the use of some intraoperative adaptations can allow abdominal free flap breast reconstruction to be reliably undertaken in such patients.

Di Candia, Michele; Asfoor, Ahmed Al; Jessop, Zita M.; Kumiponjera, Devor; Hsieh, Frank; Malata, Charles M.

2012-01-01

160

Previous multiple abdominal surgeries: a valid contraindication to abdominal free flap breast reconstruction?  

PubMed

PRESENTED IN PART AT THE FOLLOWING ACADEMIC MEETINGS: 57th Meeting of the Italian Society of Plastic, Reconstructive and Aesthetic Surgery, September 24-27, 2008, Naples, Italy.45th Congress of the European Society for Surgical Research (ESSR), June 9-12, 2010, Geneva, Switzerland.British Association of Plastic Reconstructive and Aesthetic Surgeons Summer Scientific Meeting, June 30-July 2, 2010, Sheffield Hallam University, Sheffield, UK.Background: Patients with previous multiple abdominal surgeries are often denied abdominal free flap breast reconstruction because of concerns about flap viability and abdominal wall integrity. We therefore studied their flap and donor site outcomes and compared them to patients with no previous abdominal surgery to find out whether this is a valid contraindication to the use of abdominal tissue. Patients and Methods: Twenty patients with multiple previous abdominal operations who underwent abdominal free flap breast reconstruction by a single surgeon (C.M.M., 2000-2009) were identified and retrospectively compared with a cohort of similar patients without previous abdominal surgery (sequential allocation control group, n = 20). Results: The index and control groups were comparable in age, body mass index, comorbidities, previous chemotherapy, and RT exposure. The index patients had a mean age of 54 years (r, 42-63) and an average body mass index of 27.5 kg/m(2) (r, 22-38). The main previous surgeries were Caesarean sections (19), hysterectomies (8), and cholecystectomies (6). They underwent immediate (n = 9) or delayed (n = 11) reconstructions either unilaterally (n = 18) or bilaterally (n = 2) and comprising 9 muscle-sparing free transverse rectus abdominis muscle and 13 deep inferior epigastric perforator flaps. All flaps were successful, and there were no significant differences in flap and donor site outcomes between the 2 groups after an average follow up of 26 months (r, 10-36). Conclusion: Multiple previous abdominal surgeries did not predispose to increased flap or donor site morbidity. On the basis of our experience, we have proposed some recommendations for successful abdominal free flap breast reconstruction in patients with previous multiple scars. Careful preoperative planning and the use of some intraoperative adaptations can allow abdominal free flap breast reconstruction to be reliably undertaken in such patients. PMID:22848775

Di Candia, Michele; Asfoor, Ahmed Al; Jessop, Zita M; Kumiponjera, Devor; Hsieh, Frank; Malata, Charles M

2012-01-01

161

Abdominal and hip flexor muscle activation during various training exercises.  

PubMed

The purpose of this study was to provide objective information on the involvement of different abdominal and hip flexor muscles during various types of common training exercises used in rehabilitation and sport. Six healthy male subjects performed altogether 38 different static and dynamic training exercises trunk and hip flexion sit-ups, with various combinations of leg position and support, and bi- and unilateral leg lifts. Myoelectric activity was recorded with surface electrodes from the rectus abdominis, obliquus externus, obliquus internus, rectus femoris, and sartorius muscles and with indwelling fine-wire electrodes from the iliacus muscle. The mean electromyogram amplitude, normalised to the highest observed value, was compared between static and dynamic exercises separately. The hip flexors were highly activated only in exercises involving hip flexion, either lifting the whole upper body or the legs. In contrast, the abdominal muscles showed marked activation both during trunk and hip flexion sit-ups. In hip flexion sit-ups, flexed and supported legs increased hip flexor activation, whereas such modifications did not generally alter the activation level of the abdominals. Bilateral, but not unilateral, leg lifts required activation of abdominal muscles. In trunk flexion sit-ups an increased activation of the abdominal muscles was observed with increased flexion angle, whereas the opposite was true for hip flexion sit-ups. Bilateral leg lifts resulted in higher activity levels than hip flexion sit-ups for the iliacus and sartorius muscles, while the opposite was true for rectus femoris muscles. These data could serve as a basis for improving the design and specificity of test and training exercises. PMID:9118976

Andersson, E A; Nilsson, J; Ma, Z; Thorstensson, A

1997-01-01

162

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

PubMed Central

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

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

2013-01-01

163

Long-Term Outcome of Medial Rectus Recession and Pulley Posterior Fixation in Esotropia With High AC/A Ratio  

PubMed Central

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.

Wabulembo, Geoffrey; Demer, Joseph L.

2014-01-01

164

A case of central carcinoma of the mandible arising from a recurrent odontogenic keratocyst: delineation of surgical margins and reconstruction with bilateral rectus abdominis myocutaneous free flaps.  

PubMed

A case of central carcinoma of the mandible arising from a recurrent odontogenic keratocyst is reported. A 38-year-old man was admitted to the Tokai University Hospital due to postoperative infection of a recurrent odontogenic keratocyst of the left mandible. He had had a cystectomy for an odontogenic keratocyst 4 years ago. The lesion revealed bony destruction of the mandible with worm-eating shaped margins with extension to the facial skin. A biopsy specimen revealed squamous cell carcinoma. The mandible was resected with facial skin and the sublingual space was dissected to preserve the lingual nerve. The oral and the facial resections were reconstructed with a titanium plate and bilateral rectus abdominis myocutaneous free flaps. The plate was removed due to infection around the margins and readjustment of the flaps was conducted 5 months after the surgery. He has not had a local relapse, metastasis, or incisional hernia for 8 months following surgery. Good occlusion has been attained by the residual mandible, and he is able to eat without any problems. PMID:10359504

Ota, Y; Karakida, K; Watanabe, D; Miyasaka, M; Tsukinoki, K

1998-10-01

165

Dependence of human maximum vertical counter-movement jump height on activation sequence of the biarticular muscles  

Microsoft Academic Search

BackgroundWhen executing vertical jumps a noticeable problem transpires in the efficient transfer of rotational energies of the trunk and the lower body segments into the largest possible vertical velocity. In the transfer of energy, the biarticular muscles rectus femoris (RF) and gastrocnemius (GAS) play an important (Bobbert & Van Ingen Schenau, 19881; Gregoire et al., 19842).ObjectiveThe hypothesis of the study

M Bra?i?; M Supej; Z Matja?i?

2011-01-01

166

Duodenal-jejunal bypass surgery does not increase skeletal muscle insulin signal transduction or glucose disposal in Goto-Kakazaki type 2 diabetic rats  

PubMed Central

BACKGROUND Duodenal-jejunal bypass (DJB) has been shown to reverse type 2 diabetes (T2DM) in Goto-Kakazaki (GK) rats, a rodent model of non-obese T2DM. Skeletal muscle insulin resistance is a hallmark decrement in T2DM. The aim of the current work was to investigate the effects of DJB on skeletal muscle insulin signal transduction and glucose disposal. It was hypothesized that DJB would increase skeletal muscle insulin signal transduction and glucose disposal in GK rats. METHODS DJB was performed in GK rats. Sham operations were performed in GK and non-diabetic Wistar-Kyoto (WKY) rats. At two weeks post-DJB, oral glucose tolerance (OGTT) was measured. At three weeks post-DJB, insulin-induced signal transduction and glucose disposal were measured in skeletal muscle. RESULTS In GK rats and compared to Sham operation, DJB did not: 1) improve fasting glucose or insulin; 2) improve OGTT; or 3) increase skeletal muscle insulin signal transduction or glucose disposal. Interestingly, skeletal muscle glucose disposal was similar between WKY-Sham, GK-Sham, and GK-DJB. CONCLUSIONS Bypassing of the proximal small intestine does not increase skeletal muscle glucose disposal. The lack of skeletal muscle insulin resistance in GK rats questions whether this animal model is adequate to investigate the etiology and treatments for T2DM. Additionally, bypassing of the foregut may lead to different findings in other animal models of T2DM as well as in T2DM patients.

Gavin, Timothy P.; Sloan, Ruben C.; Lukosius, Eric Z.; Reed, Melissa A.; Pender, John R.; Boghossian, Van; Carter, Jacqueline J.; McKernie, Robert D.; Parikh, Kushal; Price, J. William; Tapscott, Edward B.; Pories, Walter J.; Dohm, G. Lynis

2013-01-01

167

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

PubMed Central

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

Gamlin, Paul D.; Miller, Joel M.

2011-01-01

168

Delayed immediate surgery for orbital floor fractures: Less can be more.  

PubMed

Orbital floor fractures can result in diplopia, enophthalmos, hypoglobus and infraorbital dysthesia. Currently, the most common treatment for orbital floor fractures is immediate surgical intervention. However, there are a number of well-documented cases of unoperated orbital floor fractures in the literature, culminating in diplopia or enophthalmos in few patients. Of these, none reported the diplopia or enophthalmos to be bothersome. As reported previously in the ophthalmology literature, most orbital floor fracture-induced diplopia resolves as the swelling settles, and the few patients with remaining diplopia can successfully be treated with surgery on the uninvolved eye. It has also been commented that most patients with enophthalmos are asymptomatic. The authors' institution has more than 50 surgeon-years experience with delaying immediate surgery for two weeks to allow time for the swelling-induced diplopia to resolve. In the authors' experience, true entrapment of the inferior rectus muscle is rare. The present article describes a study of late follow-up (average 945 days) of 11 nonoperated patients with orbital floor fractures. In the eight patients who initially presented with diplopia, there was resolution of functionally limiting double vision. Only one patient had asymptomatic, but measurably significant, enophthalmos at -3 mm. All patients had full restoration of extraocular movements and resolution of infraorbital dysthesia. None of the patients were exposed to the operative risks of ectropion, infection, implant extrusion, bleeding or blindness. The present study provides level IV evidence that delaying surgery up to two weeks after orbital floor fracture may avoid unnecessary surgical risks and inconveniences in many patients with orbital floor fracture. PMID:23204882

Tang, David T; Lalonde, Jan F; Lalonde, Donald H

2011-01-01

169

Spontaneous cecum perforation following rectus abdominis free flap transfer for isolated lower limb trauma.  

PubMed

A case of a 32-year-old motorcyclist, who sustained an open comminuted fracture of the left tibia and subsequently developed spontaneous cecal perforation following successful fixation of the fracture and reconstruction of the soft tissue defect with a rectus abdominis free flap, is reported. Although benign cecal perforation has been described in patients with thermal burns and blunt trauma of the abdomen or pelvis, our association has not been reported previously in the medical literature. It is important to recognize cecal perforation early as it is associated with a high mortality from peritonitis and septicaemia. PMID:19205059

Stevens, Roger J G; Moss, Anthony L H

2009-01-01

170

Inhibition sélective des «vraies» et «pseudo»-cholinestérases du rectus de grenouille  

Microsoft Academic Search

Summary The hydrolysis of acetylcholine chloride (0.01M) by frog's rectus extracts, is inhibited by low concentrations of 3318 CT (CI-50 3.2×10?7) and high concentrations of D.F.P. (CI-50 1.3×10?5). Inversely, the hydrolysis of butyrylcholine perchlorate is inhibited by low concentrations of D.F.P. (CI-50 3×10?9) and high concentrations of 3318 CT (CI-50 3×10?4). Both are inhibited by similar concentrations of neostigmine (CI-50

J. Jacob; M. Dechavassine

1956-01-01

171

Use of polyurethane with sustained release dexamethasone in delayed adjustable strabismus surgery  

PubMed Central

Aim: To determine the effect of polyurethane film with sustained release dexamethasone (SRD) in delayed adjustable strabismus surgery. Methods: A prospective, masked observer, controlled study was performed in rabbits. Thirty four rabbit eyes were divided into three groups. After recession of the superior rectus muscle (SRM), polyurethane film with or without SRD, or balanced salt solution was applied beneath and over SRM in the polyurethane-dexamethasone group (group P-D), polyurethane group (group P), and the control group (group C), respectively. Delayed adjustment was performed once on each SRM at 4 and 6 weeks postoperatively by a masked observer. The possible length to adjust and the necessary force required for the adjustment, as well as the degree of any adhesions, were also evaluated. Results: In the control group, adjustment was impossible in all of the eyes at 4 and 6 weeks postoperatively. In group P-D, adjustment was possible in 11 out of 11 eyes (11/11) 4 weeks postoperatively and in 10/11 eyes 6 weeks postoperatively. In group P, adjustment was possible in 9/11 eyes 4 weeks postoperatively and in 10/12 eyes 6 weeks postoperatively. Conclusions: Use of polyurethane film with and without SRD could delay adjustment in most eyes for up to 6 weeks postoperatively. Polyurethane is helpful for delaying adjustment in rabbit eyes until 6 weeks postoperatively without the need for frequent topical instillation of steroids.

Kim, J H; Jeong, S Y; Jung, M H; Hwang, J-M

2004-01-01

172

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

Microsoft Academic Search

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

Farzaneh Sharifiaghdas; Nassrin Mortazavi

2008-01-01

173

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

SciTech Connect

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

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

1986-02-01

174

Muscle activity in professional classical singing: a study on muscles in the shoulder, neck and trunk.  

PubMed

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

2004-01-01

175

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  

PubMed Central

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.

2014-01-01

176

Blinding orbital cellulitis: a complication of strabismus surgery.  

PubMed

A 56-year-old healthy man underwent left medial rectus recession and lateral rectus resection for esotropia. The next day he developed severe left periocular pain with decreased vision, an afferent pupillary defect, periorbital edema, limited ocular motility, and proptosis. Computed tomography showed fat stranding and less than 90 degrees of posterior globe tenting. Despite intravenous antibiotics to treat orbital cellulitis, and a lateral canthotomy and cantholysis to decompress the orbit, visual acuity worsened to no light perception. The patient underwent emergent orbital decompression including release of the superior and inferior septum and outfracturing of the orbital floor and medial wall; however, there was no recovery of vision. Blinding orbital cellulitis is a rare complication after strabismus surgery. Despite poor prognosis, prompt diagnosis and aggressive treatment may maximize visual potential. PMID:17117105

Hoyama, Erika; Limawararut, Vanessa; Leibovitch, Igal; Pater, John; Davis, Garry; Selva, Dinesh

2006-01-01

177

Congenital focal muscle dysplasia in the lower extremities from probable abnormal innervation: a case report.  

PubMed

A two-year-seven-month-old girl with pes equinovarus congenita, muscle hypotonia and weakness limited to the lower extremities is presented. Upon admission to our hospital, she could stand with support but could not walk alone. Serum creatine kinase level was normal and the electromyogram was nondiagnostic. The muscle CT disclosed an almost total absence of bilateral vastus lateralis and medialis, rectus femoris and gastrocnemius muscles. The biopsied vastus lateralis muscle was almost completely replaced by fat tissue, and a small amount of muscle tissue showed uniform type 1 fiber and an aggregate of atrophic fibers in one fascicle. Because of an absence of progressive muscle weakness and neurogenic EMG findings, the authors conclude that the muscle pathology was due to the congenital anomalous condition of probable abnormal innervation to developing muscles. PMID:1621926

Yamanouchi, H; Nonaka, I; Kaga, M; Hirayama, Y; Kurokawa, T

1992-03-01

178

The MRC1/CD68 Ratio Is Positively Associated with Adipose Tissue Lipogenesis and with Muscle Mitochondrial Gene Expression in Humans  

PubMed Central

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.

Moreno-Navarrete, Jose Maria; Ortega, Francisco; Gomez-Serrano, Maria; Garcia-Santos, Eva; Ricart, Wifredo; Tinahones, Francisco; Mingrone, Geltrude; Peral, Belen; Fernandez-Real, Jose Manuel

2013-01-01

179

Ultrasound guided rectus sheath blockade compared to peri-operative local anesthetic infiltration in infants undergoing supraumbilical pyloromyotomy  

PubMed Central

Background: Provision of appropriate analgesia for supraumbilical pyloromyotomy in infants is limited by concerns about sensitivity to opioids and other medication groups, due to immature metabolism. Local anesthetic infiltration and ultrasound guided rectus sheath blockade are two techniques commonly employed to provide perioperative analgesia. The aim of this review was to compare the quality of post-operative analgesia afforded by these two techniques. Materials and Methods: A retrospective chart analysis of hospital records of all patients who underwent supraumbilical pyloromyotomy at a tertiary pediatric hospital between March 2009 and February 2011. Analysis of the anesthetic technique employed and post-operative acetaminophen requirements were performed. Additional information as to time to first post-operative feed, any complications and time of discharge from the hospital were collected by reviewing the post-operative nursing notes. Results: A total of 30 patients underwent supraumbilical pyloromyotomy during this period. A total of 18 received local anesthetic infiltration at the end of the procedure and 12 patients underwent ultrasound guided pre-incisional rectus sheath block for post-operative analgesia. Patients who had post-operative local anesthetic infiltration had a median (range) of 2 (1-3) doses of acetaminophen in the first 24 h. In the group of patients who received a rectus sheath block, the median (range) number of doses of acetaminophen in the first 24 h was also 2 (1-3). There were no differences in time to first feed and time to hospital discharge between the groups. The volume of local anesthetic administered was significantly smaller in the group receiving analgesia via rectus sheath block. Conclusion: Local anesthetic infiltration and pre-incisional ultrasound guided rectus sheath block provide similar degrees of post-operative analgesia. There were no differences between the two groups in time for first post-operative feed and time to hospital discharge.

Kumar, Anoop; Wilson, Graham A. M.; Engelhardt, Thomas E.

2014-01-01

180

Inferior rectus palsy as an isolated ocular motor sign: acquired etiologies and outcome.  

PubMed

The aim of this work is to elucidate underlying etiologies, lesion locations, and outcomes of inferior rectus (IR) palsy of acquired origin. Retrospective search identified 44 patients with acquired IR palsy between April 2006 and May 2011 from four Neurology and two Ophthalmology Clinics in Korea. We analyzed clinical features, the results of radiological and laboratory evaluation, and prognosis. The most common causes were vascular (n = 16, 36 %) and trauma (n = 12, 27 %). Vascular disorders included microvascular ischemia (n = 10, 23 %), cerebral infarction (n = 5, 11 %), and dural arterio-venous fistula (n = 1, 2 %). Other causes were inflammation (n = 7, 16 %), myasthenia gravis (n = 5, 11 %), and thyroid ophthalmopathy (n = 1, 2 %). We were unable to determine the etiology in the remaining three patients (7 %). Most patients (95 %) showed a complete recovery with or without treatment. Acquired IR palsy mostly occurs with brainstem or orbital lesions, and has an excellent prognosis. PMID:22743791

Choi, Kwang-Dong; Choi, Jae-Hwan; Choi, Hee Young; Huh, Young-Eun; Kim, Hyo Jung; Oh, Sun-Young; Jeong, Seong-Hae; Hwang, Jeong-Min; Kim, Ji Soo

2013-01-01

181

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

PubMed

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

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

2012-12-01

182

Needle electromyography of the rectus abdominis in patients with amyotrophic lateral sclerosis.  

PubMed

We examined the role of needle electromyography (EMG) of the rectus abdominis (RA) in assessing thoracic involvement in amyotrophic lateral sclerosis (ALS). Needle EMG of the RA was performed in 67 patients with sporadic ALS and 110 healthy controls. The presence of abnormal spontaneous activity, configuration of motor unit action potentials (MUAPs), and recruitment pattern of motor unit potentials were examined. In ALS patients, MUAPs in the RA were of prolonged duration, large amplitude, and showed increased prevalence of polyphasic waveforms compared to controls. Significant differences in MUAP parameters, presence of abnormal spontaneous potentials, and interference patterns were noted between ALS patients and controls. Additionally, we found that active denervation was more frequent in the RA of ALS patients with dyspnea than those without dyspnea. Thus, conventional needle EMG of the RA is a valuable electrophysiological method to assess clinical and subclinical involvement of thoracic lower motor neurons in patients with suspected ALS. PMID:17034039

Xu, Yingsheng; Zheng, Juyang; Zhang, Shuo; Kang, Dexuan; Zhang, Jun; Fan, Dongsheng

2007-03-01

183

The Effects of Push-ups with the Trunk Flexed on the Shoulder and Trunk Muscles  

PubMed Central

[Purpose] The purpose of this study was to compare the activity of the shoulder and trunk muscles in two push-up positions: standard push-ups and push-ups with the trunk flexed. [Subjects] Fifteen young adult males participated in the study. [Methods] This study measured the clavicular and sternocostal portions of the pectoralis major, the serratus anterior, and the rectus abdominis during push-ups under the two conditions. [Results] The activity of the sternocostal portion of the pectoralis major and that of the rectus abdominis were significantly greater under Condition 1 than under Condition 2. The activity of the clavicular portion of the pectoralis major and that of the serratus anterior were significantly greater under Condition 2 compared with Condition 1. [Conclusion] These results indicate that exercises can selectively activate muscle parts under different clinical situations.

Kang, Dong-hyun; Jung, So-young; Nam, Dong-hun; Shin, Seung-je; Yoo, Won-gyu

2014-01-01

184

Preliminary observations of muscle fibre cross sectional area of flexor digitorum brevis in cadaver feet with and without claw toes  

PubMed Central

Background In order to facilitate normal gait, toes require to be in a rectus position during the propulsive phase. This requires a correct balance and sequence of activity of the intrinsic musculature of the feet. Alteration of this balance and sequence may lead to the development of claw toes. Atrophy of the lumbricals occurs in the development of claw toes, but it is not known if changes occur in any other intrinsic muscles, including flexor digitorum brevis. This study set out to investigate whether hypertrophic changes were evident in flexor digitorum brevis in feet with claw toes. Methods Four cadaver feet were investigated, two with rectus toes and two with claw toes. Flexor digitorum brevis was removed from each, and seven anatomically significant tissue sections from each muscle were routinely processed, cut and stained. One hundred and sixty muscle fibre cross sectional areas were measured from each section. Results The mean age of the donors was 81.5 years, and three of the four were female. Results showed that the cross sectional area of fibres from feet with claw toes was 417 ?g2 significantly greater (p < 0.01) than the cross sectional area of fibres from feet with rectus toes, which was 263 ?g2. Conclusions Although this study has several limitations, preliminary observations reveal that flexor digitorum brevis muscle fibre cross sectional area is significantly reduced in feet with claw toes. This would indicate a relationship between muscle fibre atrophy of flexor digitorum brevis and clawing of the lesser toes.

2010-01-01

185

Autologous, cadaveric, and synthetic materials used in sling surgery: comparative biomechanical analysis  

Microsoft Academic Search

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

2001-01-01

186

Muscle biopsy  

MedlinePLUS

... Muscular disorders such as muscular dystrophy or congenital myopathy Metabolic defects of the muscle A muscle biopsy ... done to tell the difference between nerve and muscle disorders. A muscle that has recently been injured, such ...

187

Functional and morphological variety in trunk muscles of urodela.  

PubMed

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

2014-03-01

188

Joint mobility and the oscillation characteristics of muscle.  

PubMed

The aim of this study was to investigate which muscle characteristics of oscillation of the lower extremities have influence on trunk forward flexion and knee extension. The frequency and the decrement of damped oscillation of the muscles m. rectus femoris, m. biceps femoris, m. semitendinosus and t. semimembranosus in relaxed, contracted or stretched states were recorded by the myometer among the 22 first-year male students of the department of physical education. The subjects were divided twice into two groups according to: 1) the values of the trunk forward flexion, and 2) the values of the knee extension range of motion. The oscillation frequency of m. rectus femoris of the groups with high trunk forward flexion and high knee extension range of motion was lower than in groups with less range of motion. The similarity was followed in the decrement of m. semitendinosus. The difference between the decrements of the relaxed and stretched state of m. semitendinosus and the decrement of the relaxed state of the same muscle tendon correlated with the knee extension range of motion (r=0.46 and r=0.48, P<0.05). The relationship between the decrement of the relaxed state of m. biceps femons and the range of motion was r=-0.51 (P<0.01). The results of this study showed that the characteristics of the damped oscillation as indirect parameters of viscoelastic properties of the muscles were related to the joint mobility. PMID:9502304

Hein, V; Vain, A

1998-02-01

189

Functional and Morphological Variety in Trunk Muscles of Urodela  

PubMed Central

ABSTRACT 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.

OMURA, Ayano; ANZAI, Wataru; ENDO, Hideki

2013-01-01

190

Abdominal muscle training in sport.  

PubMed Central

This paper evaluates several abdominal exercises, and highlights factors which are important for their safe prescription and effective use. The function of the abdominal muscles and hip flexors is considered, and the importance of the infra-umbilical portion of the rectus abdominis is emphasized. The effects of flexion on the lumbar spine are outlined. The trunk curl, sit-up, and straight leg raise are analysed, together with modifications of these exercises. The effect of foot fixation and hip flexion during the performance of the sit-up is discussed. The sit-up performed with foot fixation, and the bilateral straight leg raise can compound hip muscle imbalance, and both hyperextend and hyperflex the lumbar spine and are therefore not recommended. The importance of muscular control of pelvic tilt is considered with reference to muscle imbalance around the pelvis. It is recommended that a musculoskeletal assessment should be performed before prescribing abdominal exercises. Exercise therapy to re-educate control of pelvic tilt is described. Intra-abdominal pressure, and the effects of abdominal exercise on this mechanism, and lumbar stabilization are examined. The importance of training specificity is stressed.

Norris, C M

1993-01-01

191

Effect of prolonged walking with backpack loads on trunk muscle activity and fatigue in children  

Microsoft Academic Search

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±5.4cm, mass=22.9±2.6kg) performed 20-min walking trials on treadmill (speed=1.1ms?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

Youlian Hong; Jing-Xian Li; Daniel Tik-Pui Fong

2008-01-01

192

Preliminary Study: The Impact of Moderate Exercises on Biomechanical Response of the Humans Muscles  

Microsoft Academic Search

The electromyography (EMG) activity of the biceps femoris, rectus femoris, gastrocnemius, and fourth lumbar (L4) and fifth\\u000a lumbar (L5) muscles of 5 male subjects was measured during a series of maneuvers which include standing, bowing, prostration,\\u000a and sitting. Raw EMG was processed by root-mean-square (RMS) technique using a time constant of 50 ms. The results show that\\u000a the gastrocnemius is

Mohd Helmy Rizal Salahuddin; W. A. B. Wan Abas; N. A. Abu Osman; F. Ibrahim; R. B. A. Rahim

193

Muscles, Muscles Everywhere  

NSDL National Science Digital Library

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

Integrated Teaching And Learning Program

194

Robotic surgery  

MedlinePLUS

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

195

Dissociated effects of botulinum toxin chemodenervation on ocular deviation and saccade dynamics in chronic lateral rectus palsy  

PubMed Central

AIM—Changes in saccade velocity/amplitude characteristics (main sequence) and attenuation of distance esotropia in response to botulinum toxin (BTX-A) chemodenervation of the antagonist medial rectus were studied in a group of nine patients with chronic lateral rectus palsy.?METHODS—Serial measurements of ocular deviation and infrared oculograms of saccadic eye movements to targets at 5°-20° of lateral gaze were made before injection and at 2, 4, 8, 16, and 20 weeks after injection.?RESULTS—At 2 weeks after injection, the ocular deviation changed by a mean of 34.5 prism dioptres and the 5° and 10° adduction saccades were significantly slowed (p<0.02 Wilcoxon signed rank test). By the second examination, however, the adducting saccade peak velocity had returned to normal while the mean ocular deviation remained significantly changed (p=0.01 Wilcoxon matched pairs). By 20 weeks the mean ocular deviation was not significantly different from that before injection (p=0.14 matched pairs).?CONCLUSIONS—The ocular realignment caused by BTX-A may persist after saccadic function has been restored. This may be because toxin may have a more profound and long lasting effect on the orbital singly innervated fibres which are active tonically at rest to hold gaze whereas there is relative sparing of the additional motor units recruited during fast eye movements.?? Keywords: lateral rectus palsy; botulinum toxin; saccades

Acheson, J; Bentley, C; Shallo-Hoffmann, J; Gresty, M

1998-01-01

196

Return of sensibility and final outcome of breast reconstructions using free transverse rectus abdominis musculocutaneous flaps.  

PubMed

Thirty-nine patients who had had free transverse rectus abdominis musculocutaneous (TRAM) flaps were studied and interviewed 5 months to 2.3 years after the procedure. The main reason why the patients had wanted the reconstruction in the first place was difficulty with the external prosthesis. Thirty three of 39 would have had the operation again; three were hesitant, and three had regrets for reasons other than that the breast was not satisfactory. All patients considered that the symmetry of the breasts was good or satisfactory with bras; without bras, one patient thought that the symmetry was poor, and the physician thought that the symmetry was poor in nine patients. Two-point discrimination turned out to be too delicate for studying the sensitivity of the breast. When pressure sensitivity was studied with von Frey monofilaments, the threshold values were significantly lower on the lateral and medial side and under the reconstructed breast than on the opposite side. In 22 patients the lateral part, and in 23 the medial part, of the reconstructed breast was insensate. There was good or satisfactory pressure sensitivity on the lateral side in nine patients and on the medial side in eight. The return of sensitivity to the autogenous breast reconstruction was variable among the patients studied, but it did not affect their satisfaction with the reconstruction. PMID:7597387

Lapatto, O; Asko-Seljavaara, S; Tukiainen, E; Suominen, E

1995-03-01

197

Determination of passive viscoelastic response of the abdominal muscle and related constitutive modeling: stress-relaxation behavior.  

PubMed

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

2014-08-01

198

Analysis of skeletal muscle has potential value in the assessment of cocaine-related deaths.  

PubMed

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

2013-03-10

199

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

PubMed Central

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

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

2013-01-01

200

Congenital fibrosis of the extraocular muscles.  

PubMed Central

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

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

1978-01-01

201

Long-term outcomes of unilateral lateral rectus recession versus recess-resect for intermittent exotropia of 20-25 prism diopters  

PubMed Central

Background The purpose of this study was to compare surgical outcomes of unilateral lateral rectus recession (ULR) and unilateral recess-resect (RR) for intermittent exotropia of 20-25 prism diopters (PD). Methods In this retrospective study, ULR was performed on 82 patients and RR on 98 patients for the treatment of intermittent exotropia of 20-25 PD with a follow-up period of 24 months or more. The main outcome measures were postoperative exodeviation angles and final success rates. A surgical success was considered to be an alignment within 10 PD. Results The mean follow-up duration after the surgery was 53.8?±?26.4 months in the ULR group and 52.5?±?27.4 months in the RR group (p?=?0.482). The mean deviation angles at postoperative 1 day were -0.49 PD (esodeviation) in the ULR group and -1.98 PD in the RR group. Subsequently, at postoperative 1 week, 1 and 3 months, the deviations became more exotropic in the ULR group than in the RR group (p?

2014-01-01

202

Diagnostic injection of Xylocaine into extraocular muscles.  

PubMed

In situations where it is unclear which extraocular muscle is causing anomalous eye movement or to what extent one of two muscles is responsible, temporary paralysis of the muscle with Xylocaine may provide the answer. The procedure is to inject 0.2 to 0.5 cc 2% Xylocaine directly into the muscle using electromyography (EMG) for precise localization, a technique similar to that of therapeutic injections of botulinum toxin (Oculinum). The procedure is especially useful for Duane's syndrome, superior oblique palsy, and other situations where abnormal muscle insertions or innervations make diagnosis of the muscle responsible for an eye movement anomaly difficult and surgery unpredictable. PMID:7099568

Magoon, E; Cruciger, M; Scott, A B; Jampolsky, A

1982-05-01

203

Muscle Deoxygenation Causes Muscle Fatigue  

NASA Technical Reports Server (NTRS)

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

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

1999-01-01

204

Muscle-tendon structure and dimensions in adults and children.  

PubMed

Muscle performance is closely related to the architecture and dimensions of the muscle-tendon unit and the effect of maturation on these architectural characteristics in humans is currently unknown. This study determined whether there are differences in musculo-tendinous architecture between adults and children of both sexes. Fascicle length and pennation angle were measured from ultrasound images at three sites along the length of the vastus intermedius, vastus lateralis, vastis medialis and rectus femoris muscles. Muscle volume and muscle-tendon length were measured from magnetic resonance images. Muscle physiological cross-sectional area (PCSA) was calculated as the ratio of muscle volume to optimum fascicle length. Fascicle length was greater in the adult groups than in children (P < 0.05) but pennation angle did not differ between groups (P > 0.05). The ratios between fascicle and muscle length and between fascicle and tendon length were not different (P > 0.05) between adults and children for any quadriceps muscle. Quadriceps volume and PCSA of each muscle were greater in adults than children (P < 0.01) but the relative proportion of each head to the total quadriceps volume was similar in all groups. However, the difference in PCSA between adults and children (men approximately 104% greater than boys, women approximately 57% greater than girls) was greater (P < 0.05) than the difference in fascicle length (men approximately 37% greater than boys, women approximately 10% greater than girls). It is concluded that the fascicle, muscle and tendon lengthen proportionally during maturation, thus the muscle-tendon stiffness and excursion range are likely to be similar in children and adults but the relatively greater increase in PCSA than fascicle length indicates that adult muscles are better designed for force production than children's muscles. PMID:20345856

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

2010-05-01

205

Long-term evaluation of postmastectomy breast reconstruction with the pedicled transverse rectus abdominis musculocutaneous flap.  

PubMed

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

2013-10-01

206

Muscle imaging findings in GNE myopathy.  

PubMed

GNE myopathy (MIM 600737) is an autosomal recessive muscle disease caused by mutations in the UDP-N-acetylglucosamine 2-epimerase/N-acetylmannosamine kinase (GNE) gene. Besides the typical phenotype, characterized by the initial involvement of the distal leg muscles that eventually spreads proximally with sparing of the quadriceps, uncommon presentations with a non-canonical clinical phenotype, unusual muscle biopsy findings or both are increasingly recognized. The aim of our study was to characterize the imaging pattern of pelvic and lower limb muscles in GNE myopathy, thus providing additional diagnostic clues useful in the identification of patients with atypical features. We retrospectively evaluated muscle MRI and CT scans of a cohort of 13 patients heterogeneous for GNE mutations and degree of clinical severity. We found that severe involvement of the biceps femoris short head and, to a lesser extent, of the gluteus minimus, tibialis anterior, extensor hallucis and digitorum longus, soleus and gastrocnemius medialis was consistently present even in patients with early or atypical disease. The vastus lateralis, not the entire quadriceps, was the only muscle spared in advanced stages, while the rectus femoris, vastus intermedius and medialis showed variable signs of fatty replacement. Younger patients showed hyperintensities on T2-weighted sequences in muscles with a normal or, more often, abnormal T1-weighted signal. Our results define a pattern of muscle involvement that appears peculiar to GNE myopathy. Although these findings need to be further validated in a larger cohort, we believe that the recognition of this pattern may be instrumental in the initial clinical assessment of patients with possible GNE myopathy. PMID:22231866

Tasca, Giorgio; Ricci, Enzo; Monforte, Mauro; Laschena, Francesco; Ottaviani, Pierfrancesco; Rodolico, Carmelo; Barca, Emanuele; Silvestri, Gabriella; Iannaccone, Elisabetta; Mirabella, Massimiliano; Broccolini, Aldobrando

2012-07-01

207

Evidence of an Asymmetrical Endophenotype in Congenital Fibrosis of Extraocular Muscles Type 3 Resulting from TUBB3 Mutations  

PubMed Central

Purpose. Orbital magnetic resonance imaging (MRI) was used to investigate the structural basis of motility abnormalities in congenital fibrosis of the extraocular muscles type 3 (CFEOM3), a disorder resulting from missense mutations in TUBB3, which encodes neuron-specific ?-tubulin isotype III. Methods. Ophthalmic examinations in 13 volunteers from four CFEOM3 pedigrees and normal control subjects, were correlated with TUBB3 mutation and MRI findings that demonstrated extraocular muscle (EOM) size, location, contractility, and innervation. Results. Volunteers included clinically affected and clinically unaffected carriers of R262C and D417N TUBB3 amino acid substitutions and one unaffected, mutation-negative family member. Subjects with CFEOM3 frequently had asymmetrical blepharoptosis, limited vertical duction, variable ophthalmoplegia, exotropia, and paradoxical abduction in infraduction. MRI demonstrated variable, asymmetrical levator palpebrae superioris and superior rectus EOM atrophy that correlated with blepharoptosis, deficient supraduction, and small orbital motor nerves. Additional EOMs exhibited variable hypoplasia that correlated with duction deficit, but the superior oblique muscle was spared. Ophthalmoplegia occurred only when the subarachnoid width of CN3 was <1.9 mm. A-pattern exotropia was frequent, correlating with apparent lateral rectus (LR) muscle misinnervation by CN3. Optic nerve (ON) cross sections were subnormal, but rectus pulley locations were normal. Conclusions. CFEOM3 caused by TUBB3 R262C and D417N amino acid substitutions features abnormalities of EOM innervation and function that correlate with subarachnoid CN3 hypoplasia, occasional abducens nerve hypoplasia, and subclinical ON hypoplasia that can resemble CFEOM1. Clinical and MRI findings in CFEOM3 are more variable than those in CFEOM1 and are often asymmetrical. Apparent LR innervation by the inferior rectus motor nerve is an overlapping feature of Duane retraction syndrome and CFEOM1. These findings suggest that CFEOM3 is an asymmetrical, variably penetrant, congenital cranial dysinnervation disorder leading to secondary EOM atrophy.

Clark, Robert A.; Tischfield, Max A.; Engle, Elizabeth C.

2010-01-01

208

Proximal skeletal muscle alterations in streptozotocin-diabetic rats: a histochemical and morphometric analysis.  

PubMed

The response of rat quadriceps muscle fibers to chronic streptozotocin (STZ) diabetes was studied. Transverse sections of rectus femoris muscle from diabetic and weight-matched control rats were assayed for myofibrilar adenosine triphosphatase (ATPase) and nicotinamide adenine dinucleotide-tetrazolium reductase (NADH-TR). A quantitative analysis was carried out by an automatic interactive analysis system focused on the fiber type size and distribution. STZ-induced diabetes caused important effects in this muscle, with changes in the distribution of oxidative enzyme reactions, type I fiber hypertrophy, and type II fiber atrophy, which was greater in type IIB than in type IIA. It is concluded that hypoinsulinism produces morphological alterations in proximal skeletal muscle fibers that are similar to those of neurogenic myopathy. Thus the pathological changes in these mammalian muscle fibers could explain the clinical syndrome seen in diabetic patients called "diabetic symmetrical proximal motor neuropathy," perhaps the least understood of the major neuropathic complications of diabetes. PMID:1829578

Medina-Sanchez, M; Rodriguez-Sanchez, C; Vega-Alvarez, J A; Menedez-Pelaez, A; Perez-Casas, A

1991-05-01

209

Plastic Surgery  

MedlinePLUS

... aftermath of disease treatments like rebuilding a woman's breast after surgery for breast cancer. Cosmetic (also called aesthetic ) procedures ... plan will and won't cover. For example, breast enlargement surgery is considered a purely cosmetic procedure and is ...

210

Heart Surgery  

MedlinePLUS

... common type of heart surgery for adults is coronary artery bypass grafting (CABG). During CABG, a healthy artery ... body is connected, or grafted, to a blocked coronary (heart) artery. Doctors also use heart surgery to Repair or ...

211

After Surgery  

MedlinePLUS

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

212

Cataract Surgery  

MedlinePLUS Videos and Cool Tools

... truck driver from Chandler, Arizona, is having cataract surgery today on his left eye. A month ago ... anesthesia to numb the eye area. With microscopic surgery the surgeon can make a very small incision, ...

213

The double deep gluteal muscles.  

PubMed

During routine dissections on a 65-year-old male cadaver, we encountered double piriformis, double gemelli superior and inferior, double quadratus femoris muscles in the left gluteal region. The sciatic nerve passed between the lower piriformis and the upper superior gemelli muscles infrapiriform foramen as usual. No other variation was found in the region. This rare variation may be of importance in the radiology and surgery of this region. PMID:16532103

Tanyeli, Ercan; Pestemalci, Turan; Uzel, Mehmet; Yildirim, Mehmet

2006-03-01

214

The Effects of Sling Exercise Using Vibration on Trunk Muscle Activities of Healthy Adults  

PubMed Central

[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.

Choi, Youngin; Kang, Hyungkyu

2013-01-01

215

Influence of ski materials on muscle activity.  

PubMed

The purpose of this study was to examine whether differences in construction between the compact ski, the racing ski and the soft ski influence the behavioural and electromuscular responses of the user. Eight qualified male ski instructors performed two 'shuss' trials and three different basic turns. Six muscles (M. biceps femoris, M. gastrocnemius lateralis and medialis, M. rectus femoris, M. vastus lateralis and M. tibialis anterior) were studied, using a conventional but portable electromyographic (EMG) registration with telemetric synchronization, active electrodes and a six-channel portable data recorder. Muscle contractions were continuously registered and visualized in raw EMG form and linear envelopes. The differences between the mean rectified EMG data of dynamic contractions while skiing and the mean rectified EMG data of the maximal voluntary contraction were used in the primary analysis of data, from which the participation levels of the muscles investigated could be calculated for each type of ski. Based on this comparison, differences between the effects on muscle activity of the three types of skis were unimportant. In a second phase, the normalized linear envelopes of all subjects were graphically superimposed and averaged. This was performed for each muscle, for each movement, for each leg and for each ski tested. The EMG data were considered in combination with anthropometric values, with snow characteristics and with the velocity of skiing. This study showed systematic differences between the use of the racing, soft and compact ski. On average the soft ski showed the lowest muscle activity patterns and thus the most economical muscular efforts for all muscles investigated and within all movements. PMID:3586106

Clarys, J P; Van Puymbroeck, L; Publie, J; Bollens, E; Cabri, J; De Witte, B

1986-01-01

216

Microanatomy of Adult Zebrafish Extraocular Muscles  

PubMed Central

Binocular vision requires intricate control of eye movement to align overlapping visual fields for fusion in the visual cortex, and each eye is controlled by 6 extraocular muscles (EOMs). Disorders of EOMs are an important cause of symptomatic vision loss. Importantly, EOMs represent specialized skeletal muscles with distinct gene expression profile and susceptibility to neuromuscular disorders. We aim to investigate and describe the anatomy of adult zebrafish extraocular muscles (EOMs) to enable comparison with human EOM anatomy and facilitate the use of zebrafish as a model for EOM research. Using differential interference contrast (DIC), epifluorescence microscopy, and precise sectioning techniques, we evaluate the anatomy of zebrafish EOM origin, muscle course, and insertion on the eye. Immunofluorescence is used to identify components of tendons, basement membrane and neuromuscular junctions (NMJs), and to analyze myofiber characteristics. We find that adult zebrafish EOM insertions on the globe parallel the organization of human EOMs, including the close proximity of specific EOM insertions to one another. However, analysis of EOM origins reveals important differences between human and zebrafish, such as the common rostral origin of both oblique muscles and the caudal origin of the lateral rectus muscles. Thrombospondin 4 marks the EOM tendons in regions that are highly innervated, and laminin marks the basement membrane, enabling evaluation of myofiber size and distribution. The NMJs appear to include both en plaque and en grappe synapses, while NMJ density is much higher in EOMs than in somatic muscles. In conclusion, zebrafish and human EOM anatomy are generally homologous, supporting the use of zebrafish for studying EOM biology. However, anatomic differences exist, revealing divergent evolutionary pressures.

Kasprick, Daniel S.; Kish, Phillip E.; Junttila, Tyler L.; Ward, Lindsay A.; Bohnsack, Brenda L.; Kahana, Alon

2011-01-01

217

Skeletal muscle responses to unloading in humans  

NASA Technical Reports Server (NTRS)

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.

1992-01-01

218

Longitudinal changes in muscle activity during infants' treadmill stepping.  

PubMed

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; Ulrich, Beverly D

2012-08-01

219

Longitudinal changes in muscle activity during infants' treadmill stepping  

PubMed Central

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.

Teulier, Caroline; Sansom, Jennifer K.; Muraszko, Karin

2012-01-01

220

Functional Reconstruction of a Combined Tendocutaneous Defect of the Achilles Using a Segmental Rectus Femoris Myofascial Construct: A Viable Alternative  

PubMed Central

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.

DeFazio, Michael Vincent; Han, Kevin Dong

2014-01-01

221

Muscle Shape as a Predictor of Traumatic Enophthalmos  

PubMed Central

The literature on enophthalmos is reviewed to understand its etiology and its prevention following orbital fractures. Specifically, the importance of muscle shape changes in predicting enophthalmos is discussed. The indications for surgical repair of orbital blowout fractures are well established. However, 7 to 10% of patients still develop enophthalmos despite these criteria. Because late repair of enophthalmos is associated with poor esthetic and functional results, the sensitivity and specificity of the current indications need to be further improved. Increased orbital volumes after fracture together with soft tissue displacement and herniation are the two most important factors causing enophthalmos. The loss of both bone and periorbita as supporting structures is seen on coronal computed tomography scan as changes in shape of the extraocular muscles. In floor fractures, the inferior rectus changes from an ellipse to a more rounded shape. The same is true for the medial rectus in medial wall fractures. It is the degree of rounding measured as a ratio of height to width that has been shown to be predictive of enophthalmos. Therefore, because rounding signifies loss of bone and soft tissue support, it may be a more important indication for surgical intervention than fracture size alone.

Chiasson, Genevieve; Matic, Damir B.

2010-01-01

222

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

PubMed Central

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

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

2013-01-01

223

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

PubMed

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

2014-01-01

224

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

PubMed Central

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.

Racinais, Sebastien; Buchheit, Martin; Girard, Olivier

2014-01-01

225

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

PubMed Central

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

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

2012-01-01

226

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

PubMed Central

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

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

2012-01-01

227

Getting Muscles  

MedlinePLUS

... using your muscles when you do it. Eat Strong What should you eat if you want strong muscles? You might think you need a lot ... Your muscles — and your entire body — will be strong and healthy if you eat a variety of ...

228

Elastic modulus of muscle and tendon with shear wave ultrasound elastography: variations with different technical settings.  

PubMed

Standardization on Shear wave ultrasound elastography (SWUE) technical settings will not only ensure that the results are accurate, but also detect any differences over time that may be attributed to true physiological changes. The present study evaluated the variations of elastic modulus of muscle and tendon using SWUE when different technical aspects were altered. The results of this study indicated that variations of elastic modulus of muscle and tendon were found when different transducer's pressure and region of interest (ROI)'s size were applied. No significant differences in elastic modulus of the rectus femoris muscle and patellar tendon were found with different acquisition times of the SWUE sonogram. The SWUE on the muscle and tendon should be performed with the lightest transducer's pressure, a shorter acquisition time for the SWUE sonogram, while measuring the mean elastic modulus regardless the ROI's size. PMID:22952961

Kot, Brian Chin Wing; Zhang, Zhi Jie; Lee, Arthur Wai Chun; Leung, Vivian Yee Fong; Fu, Siu Ngor

2012-01-01

229

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

PubMed Central

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

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

2013-01-01

230

[Cosmetic eyelid surgery].  

PubMed

Cosmetic eyelid surgery is becoming increasingly popular. It can rejuvenate the patient's appearance with relatively minor side effects. Its risk/benefit ratio is one of the best in facial cosmetic surgery. However, the patient does not always accurately assess the aesthetic appearance of his or her eyelids. This underscores the importance of clinical examination in order to determine the patient's wishes, and then make an accurate diagnosis and potential surgical plan. We currently oppose, in general, surgical techniques involving tissue removal (skin-muscle and/or fat) in favor of those involving tissue repositioning and grafting (autologous fat pearl transposition, obtained by liposuction, and lipostructure). Furthermore, the place of adjuvant therapies to blepharoplasty is steadily increasing. They mainly include surface treatments (peels and lasers), dermal fillers and anti-wrinkle botulinum toxin injections. They are also increasingly used in isolation in novel ways. In all cases, a perfect knowledge of anatomy and relevant skills and experience remain necessary. PMID:24275517

Ruban, J-M; Barbier, J; Malet, T; Baggio, E

2014-01-01

231

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

PubMed Central

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.

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

2014-01-01

232

Integration core exercises elicit greater muscle activation than isolation exercises.  

PubMed

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

2013-03-01

233

Quadriceps EMG muscle activation during accurate soccer instep kicking.  

PubMed

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

2011-02-01

234

Changes in muscle coordination and power output during sprint cycling.  

PubMed

This study investigated the changes in muscle coordination associated to power output decrease during a 30-s isokinetic (120rpm) cycling sprint. Modifications in EMG amplitude and onset/offset were investigated from eight muscles [gluteus maximus (EMGGMAX), vastus lateralis and medialis obliquus (EMGVAS), medial and lateral gastrocnemius (EMGGAS), rectus femoris (EMGRF), biceps femoris and semitendinosus (EMGHAM)]. Changes in co-activation of four muscle pairs (CAIGMAX/GAS, CAIVAS/GAS, CAIVAS/HAM and CAIGMAX/RF) were also calculated. Substantial power reduction (60±6%) was accompanied by a decrease in EMG amplitude for all muscles other than HAM, with the greatest deficit identified for EMGRF (31±16%) and EMGGAS (20±14%). GASonset, HAMonset and GMAXonset shifted later in the pedalling cycle and the EMG offsets of all muscles (except GASoffset) shifted earlier as the sprint progressed (P<0.05). At the end of the sprint, CAIVAS/GAS and CAIGMAX/GAS were reduced by 48±10% and 43±12%, respectively. Our results show that substantial power reduction during fatiguing sprint cycling is accompanied by marked reductions in the EMG activity of bi-articular GAS and RF and co-activation level between GAS and main power producer muscles (GMAX and VAS). The observed changes in RF and GAS EMG activity are likely to result in a redistribution of the joint powers and alterations in the orientation of the pedal forces. PMID:24861507

O'Bryan, Steven J; Brown, Nicholas A T; Billaut, François; Rouffet, David M

2014-07-25

235

Trunk muscle endurance tests: effect of trunk posture on test outcome.  

PubMed

The objective of this study was to investigate the effect of different trunk postures during the abdominal flexor test on isometric endurance holding times and surface electromyographic (EMG) activity of contributing trunk flexor and extensor muscles in 16 healthy college-age male rowers (age, 22.0 ± 1.55 years; height, 179.1 ± 5.47 cm; weight, 68.0 ± 4.18 kg) with a minimum of 12 months rowing experience. Subjects performed 2 maximal effort abdominal flexor tests, 1 held with correct posture and the other with a slightly flexed incorrect trunk posture. Maximum holding time was assessed for each posture while EMG muscle activity was recorded for the external oblique, rectus abdominis, internal oblique, rectus femoris, and lumbar erector spinae muscles. Mean maximal holding time for the incorrectly positioned abdominal flexor test was significantly longer than for the correct position (p < 0.05). EMG activity during the first and last 20% of a time normalized comparison showed significantly lower muscle activity during the incorrect trunk posture in all muscles investigated (p < 0.05). There were no significant differences (p > 0.05) in muscle activity when comparing an equivalent time period at the actual termination of each of the 2 abdominal flexor tests. Although minor variations in trunk posture seem to be acceptable in practice of this isometric abdominal flexor test, the present data indicate that minor lumbar kyphosis deviating away from the correct abdominal flexor test posture can significantly skew test reliability, resulting in longer endurance holding times and relatively lower muscle activity of the trunk muscles. PMID:19996789

Tse, Michael A; McManus, Alison M; Masters, Richard S

2010-12-01

236

Bone remodelling in the natural acetabulum is influenced by muscle force-induced bone stress.  

PubMed

A modelling framework using the international Physiome Project is presented for evaluating the role of muscles on acetabular stress patterns in the natural hip. The novel developments include the following: (i) an efficient method for model generation with validation; (ii) the inclusion of electromyography-estimated muscle forces from gait; and (iii) the role that muscles play in the hip stress pattern. The 3D finite element hip model includes anatomically based muscle area attachments, material properties derived from Hounsfield units and validation against an Instron compression test. The primary outcome from this study is that hip loading applied as anatomically accurate muscle forces redistributes the stress pattern and reduces peak stress throughout the pelvis and within the acetabulum compared with applying the same net hip force without muscles through the femur. Muscle forces also increased stress where large muscles have small insertion sites. This has implications for the hip where bone stress and strain are key excitation variables used to initiate bone remodelling based on the strain-based bone remodelling theory. Inclusion of muscle forces reduces the predicted sites and degree of remodelling. The secondary outcome is that the key muscles that influenced remodelling in the acetabulum were the rectus femoris, adductor magnus and iliacus. PMID:23982908

Fernandez, Justin; Sartori, Massimo; Lloyd, David; Munro, Jacob; Shim, Vickie

2014-01-01

237

A Micromechanical Model of Skeletal Muscle to Explore the Effects of Fiber and Fascicle Geometry  

PubMed Central

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

Sharafi, Bahar; Blemker, Silvia S.

2010-01-01

238

Superior oblique surgery: when and how?  

PubMed Central

Background The purpose of this paper is to review different types of superior oblique muscle surgeries, to describe the main areas in clinical practice where superior oblique surgery is required or preferred, and to discuss the preferred types of superior oblique surgery with respect to their clinical outcomes. Methods A consecutive nonrandomized retrospective series of patients who had undergone superior oblique muscle surgery as a single procedure were enrolled in the study. The diagnosis, clinical features, preoperative and postoperative vertical deviations in primary position, type of surgery, complications, and clinical outcomes were reviewed. The primary outcome measures were the type of strabismus and the type of superior oblique muscle surgery. The secondary outcome measure was the results of the surgeries. Results The review identified 40 (20 male, 20 female) patients with a median age of 6 (2–45) years. Nineteen patients (47.5%) had Brown syndrome, eleven (27.5%) had fourth nerve palsy, and ten (25.0%) had horizontal deviations with A pattern. The most commonly performed surgery was superior oblique tenotomy in 29 (72.5%) patients followed by superior oblique tuck in eleven (27.5%) patients. The amount of vertical deviation in the fourth nerve palsy and Brown syndrome groups (P = 0.01 for both) and the amount of A pattern in the A pattern group were significantly reduced postoperatively (P = 0.02). Conclusion Surgery for the superior oblique muscle requires experience and appropriate preoperative evaluation in view of its challenging nature. The main indications are Brown syndrome, fourth nerve palsy, and A pattern deviations. Superior oblique surgery may be effective in terms of pattern collapse and correction of vertical deviations in primary position.

Sekeroglu, Hande Taylan; Sanac, Ali Sefik; Arslan, Umut; Sener, Emin Cumhur

2013-01-01

239

Refractive Surgery  

PubMed Central

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

Kellum, Keith

2000-01-01

240

Refractive surgery.  

PubMed

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

Kellum, K

2000-07-01

241

Antagonist muscle coactivation during isokinetic knee extension.  

PubMed

The aim of the present study was to quantify the amount of antagonist coactivation and the resultant moment of force generated by the hamstring muscles during maximal quadriceps contraction in slow isokinetic knee extension. The net joint moment at the knee joint and electromyographic (EMG) signals of the vastus medialis, vastus lateralis, rectus femoris muscles (quadriceps) and the biceps femoris caput longum and semitendinosus muscles (hamstrings) were obtained in 16 male subjects during maximal isokinetic knee joint extension (KinCom, ROM 90-10 degrees, 30 degrees x s(-1)). Two types of extension were performed: [1] maximal concentric quadriceps contractions and [2] maximal eccentric hamstring contractions Hamstring antagonist EMG in [1] were converted into antagonist moment based on the EMG-moment relationships determined in [2] and vice versa. Since antagonist muscle coactivation was present in both [1] and [2] a set of related equations was constructed to yield the moment/EMG relationships for the hamstring and quadriceps muscles, respectively. The equations were solved separately for every 0.05 degrees knee joint angle in the 90-10 degrees range of excursion (0 degrees = full extension) ensuring that the specificity of muscle length and internal muscle lever arms were incorporated into the moment/EMG relationships established. Substantial hamstring coactivation was observed during quadriceps agonist contraction. This resulted in a constant level of antagonist hamstring moment of about 30 Nm throughout the range of motion. In the range of 30-10 degrees from full knee extension this antagonist hamstring moment corresponded to 30-75% of the measured knee extensor moment. The level of antagonist coactivation was 3-fold higher for the lateral (Bfcl) compared to medial (ST) hamstring muscles The amount of EMG crosstalk between agonist-antagonist muscle pairs was negligible (Rxy2<0.02-0.06). The present data show that substantial antagonist coactivation of the hamstring muscles may be present during slow isokinetic knee extension. In consequence substantial antagonist flexor moments are generated. The antagonist hamstring moments potentially counteract the anterior tibial shear and excessive internal tibial rotation induced by the contractile forces of the quadriceps near full knee extension. In doing so the hamstring coactivation is suggested to assist the mechanical and neurosensory functions of the anterior cruciate ligament (ACL). PMID:10755275

Aagaard, P; Simonsen, E B; Andersen, J L; Magnusson, S P; Bojsen-Møller, F; Dyhre-Poulsen, P

2000-04-01

242

[Reconstruction of quadriceps femoris muscle function with muscle transfer].  

PubMed

Femoral nerve palsy, mostly of iatrogen cause, leads to paresis of quadriceps muscle with complete loss of knee extension. Therapeutical options include neurolysis, nerve reconstruction or functional muscle transplantations. Another concept is the transfer of hamstring muscles as described in post polio surgery. We describe our experience of biceps femoris and semitendinosus muscle transfer for reconstruction of knee extension. From 2003 to 2007 seven patients (mean age 43) with complete loss of knee extension after femoral nerve lesion were treated. Nerve palsy was caused by direct lesion, traction, hematoma after collapse, lesion of lumbosacral plexus and an unclear muscle dystrophy. Indication for muscle transfer was due to long standing muscle paresis. All patients received a transfer of biceps femoris and semitendinosus muscle/tendon into the quadriceps tendon. Patients were immobilised in a cast for 6 weeks in extended knee position. Weight bearing started after 8 weeks. Operations went uneventfully. All patients were able to extend the knee postoperatively against gravity and were able to climb stairs without help. 4 Patients had complete knee extension, 2 had a lack of 20 degrees , one of 30 degrees. Daily routine was possible in all cases. No instability of knee joints occurred postoperatively. In a nerve lesion close to the muscle a nerve reconstruction should be aimed. If not performed or with unsuccessful outcome, muscle transfer is a good option to restore function. All recent studies describe good to excellent results with stable knees, allowing the patient to manage daily routine without assistance and to climb stairs up and down. Long term complications such as dislocation of patella or genu recurvatum were not observed in our patients. The latter results as typical complication in polio from weakening knee flexion through biceps femoris transfer, if the gastrocnemius muscle is not forceful enough. However in an isolated femoral nerve lesion this will rarely occur. PMID:20235008

Fansa, H; Meric, C

2010-08-01

243

The Effect of Backpack Load on Muscle Activities of the Trunk and Lower Extremities and Plantar Foot Pressure in Flatfoot  

PubMed Central

[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.

Son, Hohee

2013-01-01

244

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

PubMed Central

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

Olsen, Olav; Sj?haug, Mona; van Beekvelt, Mireille; Mork, Paul Jarle

2012-01-01

245

Effects of spaceflight and cage design on abdominal muscles of male rodents.  

PubMed

We examined the effects of a 16-day spaceflight mission on the size of muscle fibers in the rectus abdominis, external oblique and transversus abdominis muscles of adult male Fisher rats. The rats were individually housed in orbit, in contrast to the one previous spaceflight investigation of the same muscles, where the rats were group-housed pregnant females. The cross-sectional area of the muscle fibers was used as a measure of muscle atrophy or hypertrophy. The transversus, which is presumed to be the primary expiratory muscle and consequently works against internal hydrostatic pressures that are not likely to change much between 1 G and weightlessness, did not change in size. However, both the rectus abdominis (a spinal flexor) and the external oblique (a rotator of the torso), which resist gravity in the 1 G environment, showed significant signs of atrophy after extended exposure to microgravity. The atrophy of the external oblique was diametrically opposite to hypertrophy of the same muscle observed in group-housed rodents previously exposed to spaceflight. Although the two missions differed in several factors, such as the gender of the rats and mission duration, we believe that housing of the animals was the key factor that accounted for the different responses of the external oblique. Previous research has shown that group-housed rats in spaceflight exhibited seven times more rotations of their torsos than matched ground controls. Thus unloading of the musculoskeletal system may not be achieved in weightlessness when animals have the freedom to interact with each other. PMID:11241404

Fejtek, M; Wassersug, R

2001-04-15

246

Muscle fatigue  

PubMed Central

Muscle fatigue is a common symptom but there are no universally accepted methods for quantitating the function of voluntary muscle. This paper describes three main methods of assessment: simple clinical tests of muscle function; thermal probe measurements of metabolic heat production during muscular contraction; needle biopsy studies of muscle structure and chemistry. These methods, though at a relatively early stage of development, have given promising results which suggest that they could be useful in assessing possible new forms of treatment in patients with neuromuscular disorders. ImagesFig. 7

Edwards, R. H. T.

1975-01-01

247

Brain surgery  

MedlinePLUS

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

248

Foot Surgery  

MedlinePLUS

... function of your foot. Types of Foot Surgery Fusions: Fusions are usually performed to treat arthritic conditions of the foot and ankle. A fusion involves removing all cartilage from a joint and ...

249

Mechanical power and muscle action during forward and backward running.  

PubMed

Recently, there has been increasing interest in using backward running (BR) as an exercise and rehabilitation tool. To date, no study has been performed that combined electromyography (EMG) and joint kinetics to study BR. The purpose of this study was to compare selected EMG and kinetic parameters in the stance phase of forward running (FR) and backward running (BR). The sagittal plane of the right knee was analyzed during three trials of FR and BR in six male subjects. Four 60-Hz video cameras collected motion data, and a link segment model of the right lower extremity was established. Force plate and EMG data were collected at 1000 Hz and synchronized with the video data. The knee muscle peak (+) and peak (-) mechanical power and total (+) and total (-) mechanical work were calculated. Electromyography signals were captured from the right lower extremity on the rectus femoris, vastus lateralis, vastus medialis, biceps femoris, gastrocnemius, and tibialis anterior muscles. Statistical analysis indicated that significantly less (p < 0.05) peak (+) and (-) power and total (+) work occurred at the knee during BR than during FR. Significant differences (p < .05) in muscle firing patterns between conditions were observed. Muscle action of the vastus lateralis (VL) and vastus medialis oblique (VMO) was largely eccentric and concentric during FR and isometric and concentric during BR. Backward running appears to be a good method for achieving isometric and concentric muscle action of the VMO and VL and may be useful in clinical conditions that require an increase in knee extensor strength. PMID:8467337

Flynn, T W; Soutas-Little, R W

1993-02-01

250

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

PubMed Central

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

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

2013-01-01

251

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

PubMed Central

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

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

2011-01-01

252

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

PubMed Central

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

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

2012-01-01

253

Coexistence of a pectoralis quartus muscle and an unusual axillary arch: case report and review.  

PubMed

A pectoralis quartus muscle and an unusual axillary arch were found on the left side of a female cadaver. The axillary arch was a musculoaponeurotic complex continuous with the iliacal fibers of the latissimus dorsi. The muscular part, together with the tendon of pectoralis major, inserted into the lateral lip of the bicipital groove of the humerus, whereas the aponeurotic part was formed by a fibrous band that extended deep to the pectoralis major to insert into the coracoid process between the attachments of the coracobrachialis and pectoralis minor. The pectoralis quartus originated from the rectus sheath, and joined the inferior medial border of the fibrous band of the axillary arch, at the lateral edge of the pectoralis major. The axillary arch muscle crossed anteriorly the axillary vessels and the brachial plexus. The clinical importance of these muscles is reviewed. PMID:12203382

Bonastre, Victoria; Rodríguez-Niedenführ, Marc; Choi, David; Sañudo, José R

2002-08-01

254

Effect of Muscle Vibration on Spatiotemporal Gait Parameters in Patients with Parkinson's Disease  

PubMed Central

[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.

Han, Jintae; Kim, Eunjung; Jung, Jaemin; Lee, Junghoon; Sung, Hyeryun; Kim, Jaewoo

2014-01-01

255

Torque-related changes in mechanomyographic intensity patterns for the superficial quadriceps femoris muscles.  

PubMed

The purpose of this study was to investigate changes in mechanomyographic (MMG) intensity patterns for the vastus lateralis (VL), rectus femoris (RF) and vastus medialis (VM) during submaximal to maximal concentric isokinetic, eccentric isokinetic and isometric muscle actions of the leg extensors. Eleven men (mean ± SD age = 20.1 ± 1.1 years) performed concentric, eccentric and isometric muscle actions of the dominant leg extensors on 3 separate days. Surface MMG signals were detected from the VL, RF and VM, processed with a wavelet analysis and examined with a trend plot. The results indicated that the trend plot was capable of tracking systematic changes in MMG amplitude and frequency with an increase in torque. However, these changes were statistically significant in only 26% of the cases. There were also no consistent differences between muscles or contraction types for the significance of the trend plots. PMID:22920285

Beck, Travis W; Stock, Matt S; Defreitas, Jason M

2014-05-01

256

Acyltryptophols reversibly inhibit muscle contractions caused by the actions of acetylcholine and raised potassium ion concentrations.  

PubMed

1. Acetylmethoxytryptophol, originally isolated from the pineal gland, inhibits both the nicotinic and muscarinic receptor stimulatory activities of acetylcholine on frog rectus muscle and guinea pig ileum. 2. Synthetic homologues and analogues, including the acetyl-, propionyl-, butyryl-, and valeryl-methoxytryptophols, tryptophols and alpha-methyl-tryptophols have been prepared and shown to possess similar activity on the frog muscle, with butyryl compounds being the most active. Methoxytryptophol, tryptophol, alpha-methyltryptophol and acetylhydroxytryptophol possess little or no activity. 3. All acyltryptophols tested inhibit the effect of increased potassium concentrations on frog muscle. 4. It is concluded that the acyltryptophols act not at the transmitter receptor level but either at the potassium ion channel or elsewhere in the cell membrane. PMID:6854308

Fernando, I N; Francis, P L; Smith, I

1983-01-01

257

Muscle Excursion Does Not Correlate with Increased Serial Sarcomere Number after Muscle Adaptation to Stretched Tendon Transfer  

PubMed Central

SUMMARY Chronic skeletal muscle stretch typically increases serial muscle fiber sarcomere number. Since serial sarcomere number correlates with functional excursion in normal muscle, observed changes in sarcomere number are often extrapolated to their new assumed function. However, this has not been well demonstrated experimentally. Thus, we measured the functional properties of muscles stretched due to tendon transfer surgery. Muscle active and passive length-tension curves were measured 1 week and 4 weeks after surgery, and then each muscle was further examined to determine structural adaptation as well as single fiber and fiber bundle passive mechanical properties. We found a disconnect between the functional and structural muscle properties. Specifically, muscle excursion was significantly lower in the transferred muscle compared to controls, even though serial sarcomere number had increased. Furthermore, maximum tetanic tension was significantly reduced, though the two groups had similar physiological cross sectional areas. Passive tension increased in the transferred muscle, which was deemed to be due to proliferation of extracellular matrix. These data are the first to report that muscle morphological adaptation after chronic stretch does not accurately predict the muscle’s functional properties. These data have significant implications for examining muscle physiological properties under surgical interventions.

Takahashi, Mitsuhiko; Ward, Samuel R.; Friden, Jan; Lieber, Richard L.

2012-01-01

258

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

PubMed Central

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

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

2011-01-01

259

Effects of weight loss and exercise on trunk muscle composition in older women  

PubMed Central

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.

Ryan, Alice S; Harduarsingh-Permaul, Aruna Selina

2014-01-01

260

Solar surgery  

NASA Astrophysics Data System (ADS)

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

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

2003-04-01

261

Nail surgery.  

PubMed

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

Haneke, Eckart

2013-01-01

262

Lower Extremity Muscle Thickness During 30-Day 6 degrees Head-Down Bed Rest with Isotonic and Isokinetic Exercise Training  

NASA Technical Reports Server (NTRS)

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.

1993-01-01

263

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

SciTech Connect

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

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

1988-11-01

264

Dual encoding of muscle tension and eye position by abducens motoneurons  

PubMed Central

Extraocular muscle tension associated with spontaneous eye movements has a pulse-slide-step profile similar to that of motoneuron firing rate. Existing models only relate motoneuron firing to eye position, velocity and acceleration. We measured and quantitatively compared lateral rectus muscle force and eye position with the firing of abducens motoneurons in the cat to determine fundamental encoding correlations. During fixations (step), muscle force increased exponentially with eccentric eye position, consistent with a model of estimate ensemble motor innervation based on neuronal sensitivities and recruitment order. Moreover, firing rate in all motoneurons tested was better related to eye position than to muscle tension during fixations. In contrast, during the postsaccadic slide phase, the time constant of firing rate decay was closely related to that of muscle force decay, suggesting that all motoneurons encode muscle tension as well. Discharge characteristics of abducens motoneurons formed overlapping clusters of phasic and tonic motoneurons, thus, tonic units recruited earlier and had a larger slide signal. We conclude that the slide signal is a discharge characteristic of the motoneuron that controls muscle tension during the post-saccadic phase and that motoneurons are specialized for both tension and position-related properties. The organization of signal content in the pool of abducens motoneurons from the very phasic to the very tonic units is possibly a result of the differential trophic background received from distinct types of muscle fibers.

Davis-Lopez de Carrizosa, Maria A.; Morado-Diaz, Camilo J.; Miller, Joel M.; de la Cruz, Rosa R.; Pastor, Angel M.

2011-01-01

265

Medieval surgery.  

PubMed

How many readers of this journal have tried to imagine what surgery was like before the sophisticated technical developments described in its pages? Not just before such important advances as blood transfusion, anaesthesia and asepsis, but long before the evolution of teaching hospitals, with their steeply-raked operating theatres, crowded with students and other curious onlookers. Today's medical experts tend to dismiss early practitioners of surgery as "primitive" and "unscientific" because their ideas about human physiology (which appeared perfectly rational at the time) now seem tinged with superstition. Surgery in medieval England was certainly very different from anything we are likely to encounter in the sanitized environment of the modern hospital, yet it was well organised, carefully regulated and made great demands upon the skill and dedication of the men and women who plied a difficult trade, in which the rewards could be considerable but the risks even greater. PMID:9146134

Rawcliffe, C

1997-03-01

266

On the time course of surgically induced compensatory muscle hypertrophication of the rat plantaris muscle.  

PubMed

1. The time course of the hypertrophy and hyperplasia of the rat plantaris muscle was determined from measurements of total muscle mass and cross-section analysis of fixed muscle. 2. Muscle enlargement was induced by the surgical removal of the plantaris synergist muscles, the gastrocnemius and the soleus. 3. From the date of surgery through the third post-operative week, muscle enlargement is due to fiber hypertrophication (approximately 100% increase in diameter). After post-operative week three, muscle enlargement is due to a combination of hyperplasia and hypertrophy. At week four the cross-sectional areas return to control values. 4. The neuromuscular junction area was determined by measuring Karnovsky stained post-synaptic membrane. Only a modest 10-30% increase was noted at weeks 2 and 3 with a return to control levels at week 4. The differences were not statistically different. PMID:1673378

Banks, F; Miriti, M; Brodwick, M S

1991-01-01

267

Tubal surgery.  

PubMed

Today, reproductive surgery has a limited place. In selected cases such as young women with a history of pelvic inflammatory disease, pelvic adhesions, and endometriosis, surgery could be considered. Most operations can be performed by laparoscopy; these include tubal anastomosis that yields a high pregnancy rate. On the other hand, women over the age of 37 with a long history of infertility or those who require a laparotomy are better treated with in-vitro fertilization. For women with hydrosalpinx undergoing IVF, salpingectomy is the best treatment option. It increases the chance of pregnancy and live birth rates and decreases the miscarriage rate. PMID:19661750

Zarei, Afsoon; Al-Ghafri, Wadha; Tulandi, Togas

2009-09-01

268

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

NASA Technical Reports Server (NTRS)

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.

1995-01-01

269

Muscle weights and succinic dehydrogenase distribution in the hind limb musculature of two rodents (Thryonomys gregorianus and Pedetes capensis) with different locomotory habits.  

PubMed

The hind limb muscles of the spring hare (Pedetes capensis) were found to be relatively heavier than the hind limb muscles of the cane rat (Thryonomys gregorianus). The distribution of succine dehydrogenase activity was investigated in four of these muscles (m. gluteus superficialis, m.semimembranosus, m. biceps femoris and m.rectus femoris) from both animals. It was found that the spring hare had a higher proportion of low-activity fibres in all four muscles than the cane rat. All muscle fibre types were also smaller in diameter in the spring hare than the cane rat. These results are discussed in relation to the different locomotry habits of the two animals. PMID:685649

Stickland, N C

1978-01-01

270

Muscle excursion does not correlate with increased serial sarcomere number after muscle adaptation to stretched tendon transfer.  

PubMed

Chronic skeletal muscle stretch typically increases serial muscle fiber sarcomere number. Since serial sarcomere number correlates with functional excursion in normal muscle, observed changes in sarcomere number are often extrapolated to their new assumed function. However, this has not been well demonstrated experimentally. Thus, we measured the functional properties of muscles stretched due to tendon transfer surgery. Muscle active and passive length-tension curves were measured 1 week and 4 weeks after surgery, and then each muscle was further examined to determine structural adaptation as well as single fiber and fiber bundle passive mechanical properties. We found a disconnect between the functional and structural muscle properties. Specifically, muscle excursion was significantly lower in the transferred muscle compared to controls, even though serial sarcomere number had increased. Furthermore, maximum tetanic tension was significantly reduced, though the two groups had similar physiological cross sectional areas. Passive tension increased in the transferred muscle, which was deemed to be due to proliferation of extracellular matrix. These data are the first to report that muscle morphological adaptation after chronic stretch does not accurately predict the muscle's functional properties. These data have significant implications for examining muscle physiological properties under surgical interventions. PMID:22532301

Takahashi, Mitsuhiko; Ward, Samuel R; Fridén, Jan; Lieber, Richard L

2012-11-01

271

Your Muscles  

MedlinePLUS

... skin. This allows you to contract your facial muscles just a tiny bit and make dozens of different kinds of faces. Even the smallest movement can turn a smile into a frown. You can raise your eyebrow ...

272

Fetal Surgery  

PubMed Central

Fetal surgery has come of age. For decades experimental fetal surgery proved essential in studying normal fetal physiology and development, and pathophysiology of congenital defects. Clinical fetal surgery started in the 1960s with intrauterine transfusions. In the 1970s, the advent of ultrasonography revolutionized fetal diagnosis and created a therapeutic vacuum. Fetal treatment, medical and surgical, is slowly trying to fill the gap. Most defects detected are best treated after birth, some requiring a modification in the time, mode and place of delivery for optimal obstetrical and neonatal care. Surgical intervention in utero should be considered for malformations that cause progressive damage to the fetus, leading to death or severe morbidity; that can be corrected or palliated in utero with a reasonable expectation of normal postnatal development; that cannot wait to be corrected after birth, even considering pre-term delivery; that are not accompanied by chromosomal or other major anomalies. At present, congenital hydronephrosis is the most common indication for fetal surgery, followed by obstructive hydrocephalus. Congenital diaphragmatic hernia also fulfills the criteria, but its correction poses more problems, and no clinical attempts have been reported so far. In the future many other malformations or diseases may become best treated in utero. The ethical and moral issues are complex and need to be discussed as clinical and experimental progress is made.

Laberge, Jean-Martin

1986-01-01

273

[Andrologic surgery].  

PubMed

The need of an economic and social low costs drive more and more surgeons towards the day surgery. The always growing diffusion of local anesthetic supports this trend. The drugs used as local anaesthetics are: carbocaine, procaine, lidocaine and bipivacaine. The Day Surgery can be largely employed in the therapy of andrological pathologies. In fact the anatomical placement of male genital apparatus allows easy possibilities of anaesthetical and surgical approach. It is so possible perform the following operations: meatotomy, section and plasty of fraenum, extirpation of Papovavirus lesions, circumcision, paraphymosis setting, corpora cavernosa drainage in priapism, section and ligation of deep dorsal vein, corporopexi, glandulopexi, cavernous crural plication, endocavernous penile prosthesis' implant, congenital or acquired penile recurvatum correction, blandulectomy, hepidydimis' cyst excision, testicle's biopsy, subcapsular orchiectomy sec. Higgins, testicular prosthesis' implant, resection and eversion of vaginal tunic of testicle in hydrocele's therapy, vasotomy and section and ligation of internal spermatic vein in varicocele's surgery. The Authors describe the anaesthetical and surgical techniques for bring forward these operations in Day Surgery. PMID:9707776

Austoni, E; Tonazzi, G L; Cazzaniga, A; Ardizzone, M V; Macola, G G; Gatti, G; Fenice, O; Goumas, Y K; Dell'Aglio, F

1998-06-01

274

The acute muscle swelling effects of blood flow restriction.  

PubMed

The purpose of this study was to investigate the potential mechanisms behind the blood flow restriction (BFR) stimulus in the absence of exercise. Nine participants completed a 10 minute time control and then a BFR protocol. The protocol was five, 5-minute bouts of inflation with 3-minutes of deflation between each bout. The pressure was set relative to each individual's thigh circumference. Significant increases in muscle thickness were observed for both the vastus lateralis (VL) [6%, p = 0.027] and rectus femoris (RF) [22%, p = 0.001] along with a significant decrease in plasma volume [15%, p = 0.001]. Ratings of discomfort during the BFR protocol peaked at 2.7 (light discomfort). There were no significant changes with whole blood lactate, electromyography (EMG), or heart rate (HR), however, there was a trend for a significant increase in HR during the 5th inflation (p = 0.057). In conclusion, this is the first study to demonstrate that the attenuation of both muscle atrophy and declines in strength previously observed with brief applications of BFR may have been mediated through an acute fluid shift induced increase in muscle size. This is supported by our finding that the changes in muscle thickness are maintained even after the cuffs have been removed. PMID:23238542

Loenneke, Jeremy Paul; Fahs, C A; Thiebaud, R S; Rossow, L M; Abe, T; Ye, Xin; Kim, D; Bemben, M G

2012-12-01

275

Variation of the Infrahyoid Muscle: Duplicated Omohyoid and Appearance of the Levator Glandulae Thyroideae Muscles  

PubMed Central

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.

Kim, Deog-Im; Kim, Ho-Jeong; Park, Jae-Young

2010-01-01

276

[Ultrasonography of muscle disease].  

PubMed

Muscle ultrasound is a useful tool of the neuromuscular disease. On muscle ultrasound, we can detect the affected muscle as increase of muscle echo intensity because of the fibrosis and fatty infiltration. Muscle atrophy and thickened muscle fascia are also visualized with muscle ultrasound. Another advantage of muscle ultrasound compared to other imaging technique is to visualize muscle movement, such as fasciculation. In this paper we review the findings of muscle ultrasound in normal muscle and affected muscle and discuss the possibilities and limitations of muscle ultrasound. PMID:24291933

Terasawa, Yuka; Takamatsu, Naoko; Kaji, Ryuji

2013-01-01

277

Piriformis syndrome surgery causing severe sciatic nerve injury.  

PubMed

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

2012-09-01

278

Scoliosis surgery - child  

MedlinePLUS

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

279

Modeling length-tension properties of RCPm muscles during voluntary retraction of the head.  

PubMed

Head retraction exercises are one of several commonly used clinical tools that are used to assess and treat patients with head and neck pain and to aid in restoration of a normal neutral head posture. Retraction of the head results in flexion of the occipitoatlantal (OA) joint and stretching of rectus capitis posterior minor (RCPm) muscles. The role that retraction of the head might have in treating head and neck pain patients is currently unknown. RCPm muscles arise from the posterior tubercle of the posterior arch of C1 and insert into the occipital bone inferior to the inferior nuchal line and lateral to the midline. RCPm muscles are the only muscles that attach to the posterior arch of C1. The functional role of RCPm muscles has not been clearly defined. The goal of this project was to develop a three-dimensional, computer-based biomechanical model of the posterior aspect of the OA joint. This model should help clarify why voluntary head retraction exercises seem to contribute to the resolution of head and neck pain and restoration of a normal head posture in some patients. The model documents that length-tension properties of RCPm muscles are significantly affected by variations in the physical properties of the musculotendonous unit. The model suggests that variations in the cross sectional area of RCPm muscles due to pathologies that weaken the muscle, such as muscle atrophy, may reduce the ability of these muscles to generate levels of force that are necessary for the performance of normal, daily activities. The model suggests that the main benefit of the initial phase of head retraction exercises may be to strengthen RCPm muscles through eccentric contractions, and that the main benefit of the final phase of retraction may be to stretch the muscles as the final position is held. PMID:24742529

Hallgren, Richard C

2014-08-01

280

Heterogeneous atrophy occurs within individual lower limb muscles during 60 days of bed rest.  

PubMed

To better understand disuse muscle atrophy, via magnetic resonance imaging, we sequentially measured muscle cross-sectional area along the entire length of all individual muscles from the hip to ankle in nine male subjects participating in 60-day head-down tilt bed rest (2nd Berlin BedRest Study; BBR2-2). We hypothesized that individual muscles would not atrophy uniformly along their length such that different regions of an individual muscle would atrophy to different extents. This hypothesis was confirmed for the adductor magnus, vasti, lateral hamstrings, medial hamstrings, rectus femoris, medial gastrocnemius, lateral gastrocnemius, tibialis posterior, flexor hallucis longus, flexor digitorum longus, peroneals, and tibialis anterior muscles (P ? 0.004). In contrast, the hypothesis was not confirmed in the soleus, adductor brevis, gracilis, pectineus, and extensor digitorum longus muscles (P ? 0.20). The extent of atrophy only weakly correlated (r = -0.30, P < 0.001) with the location of greatest cross-sectional area. The rate of atrophy during bed rest also differed between muscles (P < 0.0001) and between some synergists. Most muscles recovered to their baseline size between 14 and 90 days after bed rest, but flexor hallucis longus, flexor digitorum longus, and lateral gastrocnemius required longer than 90 days before recovery occurred. On the basis of findings of differential atrophy between muscles and evidence in the literature, we interpret our findings of intramuscular atrophy to reflect differential disuse of functionally different muscle regions. The current work represents the first lower-limb wide survey of intramuscular differences in disuse atrophy. We conclude that intramuscular differential atrophy occurs in most, but not all, of the muscles of the lower limb during prolonged bed rest. PMID:22984243

Miokovic, Tanja; Armbrecht, Gabriele; Felsenberg, Dieter; Belavý, Daniel L

2012-11-01

281

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

PubMed Central

For a given eye position, firing rates of abducens neurons (ABNs) generally (Mays et al. 1984), and lateral rectus (LR) motoneurons (MNs) in particular (Gamlin et al. 1989a), are higher in converged gaze than when convergence is relaxed, whereas LR and medial rectus (MR) muscle forces are slightly lower (Miller et al. 2002). Here, we confirm this finding for ABNs, report a similarly paradoxical finding for neurons in the MR subdivision of the oculomotor nucleus (MRNs), and, for the first time, simultaneously confirm the opposing sides of these paradoxes by recording physiological LR and MR forces. Four trained rhesus monkeys with binocular eye coils and custom muscle force transducers on the horizontal recti of one eye fixated near and far targets, making conjugate saccades and symmetric and asymmetric vergence movements of 16–27°. Consistent with earlier findings, we found in 44 ABNs that the slope of the rate-position relationship for symmetric vergence (kV) was lower than that for conjugate movement (kC) at distance, i.e., mean kV/kC = 0.50, which implies stronger LR innervation in convergence. We also found in 39 MRNs that mean kV/kC = 1.53, implying stronger MR innervation in convergence as well. Despite there being stronger innervation in convergence at a given eye position, we found both LR and MR muscle forces to be slightly lower in convergence, ?0.40 and ?0.20 g, respectively. We conclude that the relationship of ensemble MN activity to total oculorotary muscle force is different in converged gaze than when convergence is relaxed. We conjecture that LRMNs with kV < kC and MRMNs with kV > kC innervate muscle fibers that are weak, have mechanical coupling that attenuates their effective oculorotary force, or serve some nonoculorotary, regulatory function.

Davison, Ryan C.; Gamlin, Paul D.

2011-01-01

282

Assessment of muscle fatigue after an ultra-endurance triathlon using tensiomyography (TMG).  

PubMed

In this study, we used tensiomyography (TMG) to assess muscle status immediately after an ultra-endurance triathlon. Maximal radial displacement or deformation of the muscle belly, contraction time, delay time, sustain time, and relaxation time were measured for both legs, and dependent t-tests were used to compare means between the beginning and end of the race. The 19 men assessed (age 37.9 ± 7.1 years; height 177.5 ± 4.6 cm; weight: 73.6 ± 6.5 kg) participated in the 2009 edition of the Lanzarote Ironman. Deterioration in the neural response was observed for contraction time (P = 0.008) and relaxation time (P = 0.011), with a moderate decrease in the response time (sustain time) and a loss in muscle stiffness (deformation of the muscle belly). The effect of muscle fatigue on the rectus femoris and biceps femoris was different. Barely any changes in contraction time, relaxation time, sustain time, and deformation of the muscle belly were observed, while only the contraction response time decreased to a significant extent (reduction in delay time; P = 0.003). The considerable loss in contractile capacity induced by a long-distance race was reflected in changes in the neuromuscular response and fluctuations in the contractile capacity of the muscle. These modifications, derived from a prolonged, exhausting effort, can be assessed in a simple, non-aggressive, non-invasive way using tensiomyography. PMID:21391085

García-Manso, Juan Manuel; Rodríguez-Ruiz, David; Rodríguez-Matoso, Dario; de Saa, Yves; Sarmiento, Samuel; Quiroga, Miriam

2011-03-01

283

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

PubMed

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

Munro, B J; Steele, J R

2000-02-01

284

Abdominal and hip flexor muscle activity during 2 minutes of sit-ups and curl-ups.  

PubMed

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

2013-08-01

285

Passive mechanical properties of rat abdominal wall muscles suggest an important role of the extracellular connective tissue matrix.  

PubMed

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

2012-08-01

286

A Comparison of Flexi-bar and General Lumbar Stabilizing Exercise Effects on Muscle Activity and Fatigue.  

PubMed

[Purpose] The objective of this study was to compare the effects of flexi-bar training and general lumbar stabilization training on muscle activity and fatigue. [Methods] Twenty normal persons participated in this study. After warm up and a Maximum Voluntary Isomeric Contraction (MVIC) test, participants performed bridging exercise, quadruped lumbar stabilization exercise on quadruped and curl-up, with and without the flexi-bar training, each exercise lasting for 30 seconds. Electromyography was used for the assessment of the muscle activity and fatigue of the rectus abdominis, erector spinae, external oblique and internal oblique muscles. [Results] The bridging and quadruped exercises with the flexi-bar elicited significant increases in the muscle activates of the muscle groups. The curl-up exercise with the flexi-bar showed significant differences in external oblique and internal oblique muscle activities compared to the exercise without the flexi-bar. Muscle fatigue showed different results depending on the exercise. [Conclusion] Generally, flexi-bar exercise induced greater muscle activation and fatigue. However, because there were differences of effect dependent on the posture, we should prescribe the appropriate exercise for the target muscles. PMID:24648637

Kim, Jung-Hee; So, Ki-Hyun; Bae, Yu-Ri; Lee, Byoung-Hee

2014-02-01

287

Ambulatory Surgery in Oregon.  

National Technical Information Service (NTIS)

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

1982-01-01

288

Recurrence after skin-sparing mastectomy and immediate transverse rectus abdominis musculocutaneous flap reconstruction for invasive breast cancer  

PubMed Central

Background The aim of this study was to evaluate the recurrence pattern after skin-sparing mastectomy (SSM) and immediate breast reconstruction (IBR) using transverse rectus abdominis musculocutaneous (TRAM) flap in patients with invasive breast cancer. Methods From 1995 to 2010, patients with invasive breast cancer who underwent SSM followed by IBR using TRAM flap were retrospectively reviewed. The pattern of the first recurrence event was recorded. Results We identified 249 consecutive patients with invasive breast cancer, two-thirds of whom (67.1%) were diagnosed with stage II or stage III disease. During a median follow-up period of 53 months, three (1.2%) local, 13 (5.2%) regional, 34 (13.7%) distant, and five (2.0%) concurrent locoregional and distant recurrences were observed. The median time to recurrences was 26 months (range, 2 to 70 months) for all recurrences, 23 months (range, 2 to 64 months) for locoregional recurrences, and 26 months (range, 8 to 70 months) for distant recurrences. All local recurrent lesions were detectable by careful physical examination, and detection of local recurrence suggested the presence of distant metastasis (60.0%). In contrast to distant metastasis, the risk of locoregional recurrence did not increase significantly with an increase in disease stage. The 5-year overall, locoregional relapse-free, and distant relapse-free survival rates were 89.7%, 90.8%, and 81.6%, respectively. Conclusions SSM followed by immediate reconstruction using TRAM flap is an oncologically safe procedure even in patients with advanced-stage disease. Detection of local recurrence is crucial and can be aided by a thorough physical examination.

2013-01-01

289

Back extensor muscle fatigue in patients with lumbar disc herniation  

Microsoft Academic Search

We investigated back muscle fatigue and endurance in patients with lumbar disc herniation before and after surgery, and established the degree of association between perceived fatigue and objectively measured fatigue. Additionally, the relationships between muscle fatigue and endurance time on the one hand, and activity, participation, self-efficacy and health on the other, were investigated to clarify the grades of association

Åsa Dedering; Karin Harms-Ringdahl; Gunnar Nèmeth

2006-01-01

290

Muscle activation strategies in multiple muscle systems.  

PubMed

Multiple neural and mechanical factors need to be taken into account to understand muscle activation strategies during human movement. These factors include lateral force transmission via connective tissue, summation of forces across a joint, tendon compliance that influences muscle shortening/lengthening, and the activity of biarticular muscles that influences activation strategies in monoarticular muscles. The relevance of these factors to muscle activation strategy in multiple muscle systems is introduced. PMID:19106783

Shinohara, Minoru

2009-01-01

291

Changes in Quadriceps Muscle Activity During Sustained Recreational Alpine Skiing  

PubMed Central

During a day of skiing thousands of repeated contractions take place. Previous research on prolonged recreational alpine skiing show that physiological changes occur and hence some level of fatigue is inevitable. In the present paper the effect of prolonged skiing on the recruitment and coordination of the muscle activity was investigated. Six subjects performed 24 standardized runs. Muscle activity during the first two (PREskiing) and the last two (POSTskiing) runs was measured from the vastus lateralis (VL) and rectus femoris (RF) using EMG and quantified using wavelet and principal component analysis. The frequency content of the EMG signal shifted in seven out of eight cases significantly towards lower frequencies with highest effects observed for RF on outside leg. A significant pronounced outside leg loading occurred during POSTskiing and the timing of muscle activity peaks occurred more towards turn completion. Specific EMG frequency changes were observed at certain time points throughout the time windows and not over the whole double turn. It is suggested that general muscular fatigue, where additional specific muscle fibers have to be recruited due to the reduced power output of other fibers did not occur. The EMG frequency decrease and intensity changes for RF and VL are caused by altered timing (coordination) within the turn towards a most likely more uncontrolled skiing technique. Hence, these data provide evidence to suggest recreational skiers alter their skiing technique before a potential change in muscle fiber recruitment occurs. Key points The frequency content of the EMG signal shifted in seven out of eight cases significantly towards lower frequencies with highest effects observed for RF. General muscular fatigue, where additional specific fibers have to be recruited due to the reduced power output of other fibers, did not occur. A modified skiing style towards a less functional and hence more uncontrolled skiing technique seems to be a key issue with respect to the influence on muscle recruitment for applied prolonged skiing session.

Kroll, Josef; Muller, Erich; Seifert, John G.; Wakeling, James M.

2011-01-01

292

Activation of two types of fibres in rat extraocular muscles.  

PubMed Central

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

Chiarandini, D J

1976-01-01

293

Fetal surgery.  

PubMed Central

While most prenatally diagnosed malformations are best managed by appropriate medical and surgical therapy after birth, a few may require or benefit from correction before birth. Extensive experimental work in animals and innovative technologic developments have made fetal surgery a viable approach to perinatal care. Managing preterm labor continues to be a vexing problem. At present, only a few life-threatening malformations have been successfully corrected. Additional research into the abnormal function of some malformations, the development of less interventional techniques, and fetal stem cell transplantation should lead to successful treatment of more fetal disorders. Images

Harrison, M R

1993-01-01

294

Hemorrhoid Surgery  

NSDL National Science Digital Library

This patient education program explains what hemorrhoids are, symptoms, alternative treatments, as well as the benefits and risks of surgery. This is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: The tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

Institute, Patient E.

2008-10-09

295

[Robotic surgery].  

PubMed

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

2013-10-01

296

Trunk muscle activation during golf swing: Baseline and threshold.  

PubMed

There is a lack of studies regarding EMG temporal analysis during dynamic and complex motor tasks, such as golf swing. The aim of this study is to analyze the EMG onset during the golf swing, by comparing two different threshold methods. Method A threshold was determined using the baseline activity recorded between two maximum voluntary contraction (MVC). Method B threshold was calculated using the mean EMG activity for 1000ms before the 500ms prior to the start of the Backswing. Two different clubs were also studied. Three-way repeated measures ANOVA was used to compare methods, muscles and clubs. Two-way mixed Intraclass Correlation Coefficient (ICC) with absolute agreement was used to determine the methods reliability. Club type usage showed no influence in onset detection. Rectus abdominis (RA) showed the higher agreement between methods. Erector spinae (ES), on the other hand, showed a very low agreement, that might be related to postural activity before the swing. External oblique (EO) is the first being activated, at 1295ms prior impact. There is a similar activation time between right and left muscles sides, although the right EO showed better agreement between methods than left side. Therefore, the algorithms usage is task- and muscle-dependent. PMID:23816264

Silva, Luís; Marta, Sérgio; Vaz, João; Fernandes, Orlando; Castro, Maria António; Pezarat-Correia, Pedro

2013-10-01

297

Atrophy of suboccipital muscles in patients with chronic pain: a pilot study.  

PubMed

Magnetic resonance imaging studies were performed in six patients with chronic head and neck pain and in five control subjects to determine whether irreversible atrophic changes resulting in destruction of muscle fibers have a role in patients with chronic pain specific to the cervical spine. Both groups of subjects had medical history obtained and underwent physical examination and proton density-weighted (PD-weighted) magnetic resonance imaging. Subjects with chronic pain had substantial restriction of motion. Axial proton density-weighted images of the rectus capitis major and minor muscles were examined. In the subjects with chronic pain, the muscles had high signal intensity, indicating replacement of dead suboccipital skeletal muscle with fatty tissue. This infiltration was not observed in the control subjects who were free of significant motion restrictions and had no history of recurring neck and head pain. Analysis of pixel intensity values confirmed this finding. The reduction in proprioceptive afferent activity in affected muscles may cause increased facilitation of neural activity that is perceived as pain. At least mean squares algorithm was used to define a linear estimating equation for each subject. Linear regression analysis, using an alpha level < .005, was used to determine how well each subject's data fit the estimating equation. This preliminary work indicates substantial infiltration of fatty tissue into suboccipital muscles of some subjects being treated for chronic head and neck pain. PMID:7852102

Hallgren, R C; Greenman, P E; Rechtien, J J

1994-12-01

298

Electromyographic amplitude vs. concentric and eccentric squat force relationships for monoarticular and biarticular thigh muscles.  

PubMed

This study examined the linearity of the electromyographic (EMG) amplitude vs. concentric and eccentric squat force relationships for monoarticular and biarticular thigh muscles. Fourteen resistance-trained men (mean age ± SD: 22 ± 2 years; estimated thigh muscle cross-sectional area: 221.9 ± 22.7 cm) performed concentric and eccentric squats using a novel testing device from 10 to 90% of their maximum average force. Surface EMG signals were detected from the right vastus lateralis, rectus femoris, and biceps femoris. Linear regression was used to examine the relationships between EMG amplitude and force, and repeated measures analyses of variance were used to assess differences among the muscles. Moderate-to-high coefficients of determination were found for the vastus lateralis for both concentric and eccentric testings (r = 0.587-0.992). For the biceps femoris, the mean linear slope coefficient was significantly greater for concentric vs. eccentric testing (0.044 vs. 0.013 ?V RMS·N; p = 0.002; effect size = 1.44). Although EMG amplitude for the vastus lateralis and rectus femoris increased with changes in eccentric force output, the electrical activity of the biceps femoris remained stable. These results demonstrated that the EMG amplitude vs. force relationships for the vastus lateralis were linear, despite the fact that force production during the squat is related to the activation of muscles that must simultaneously function as agonists and antagonists. Our findings for eccentric force testing are in agreement with investigations showing reduced hip extensor activity during concurrent extension at the hip and knee joints. PMID:23897014

Luera, Micheal J; Stock, Matt S; Chappell, Andrew D W

2014-02-01

299

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

PubMed Central

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

Demer, Joseph L.

2007-01-01

300

ELECTROMYOGRAPHIC ASSESSMENT OF MUSCLE ACTIVITY BETWEEN GENDERS DURING UNILATERAL WEIGHT-BEARING TASKS USING ADJUSTED DISTANCES  

PubMed Central

Purpose/Background: Researchers have observed differences in muscle activity patterns between males and females during functional exercises. The research methods employed have used various step heights and lunge distances to assess functional exercise making gender comparisons difficult. The purpose of this study was to examine core and lower extremity muscle activity between genders during single?limb exercises using adjusted distances and step heights based on a percentage of the participant's height. Methods: Twenty men and 20 women who were recreationally active and healthy participated in the study. Two?dimensional video and surface electromyography (SEMG) were used to assess performance during three exercise maneuvers (step down, forward lunge, and side?step lunge). Eight muscles were assessed using SEMG (rectus abdominus, external oblique, erector spinae, rectus femoris, tensor fascia latae, gluteus medius, gluteus maximus, biceps femoris). Maximal voluntary isometric contractions (MVIC) were used for each muscle and expressed as %MVIC to normalize SEMG to account for body mass differences. Exercises were randomized and distances were normalized to the participant's lower limb length. Descriptive statistics, mixed?model ANOVA, and ICCs with 95% confidence intervals were calculated. Results: Males were taller, heavier, and had longer leg length when compared to the females. No differences in %MVIC activity were found between genders by task across the eight muscles. For both males and females, the step down task resulted in higher %MVIC for gluteus maximus compared to lunge, (p=0.002). Step down exercise produced higher %MVIC for gluteus medius than lunge (p=0.002) and side step (p=0.006). ICC3,3 ranged from moderate to high (0.74 to 0.97) for the three tasks. Conclusions: Muscle activation among the eight muscles was similar between females and males during the lunge, side?step, and step down tasks, with distances adjusted to leg length. Both males and females elicited higher muscle activity for gluteus maximus and gluteus medius as compared to the trunk, hip flexors, or hamstring muscles. However these values were well below the recruitment levels necessary for strengthening in both genders. Level of evidence: 4

Wilhelm, Jacqueline; Eisel, Patricia; Wiesner, Jessica; Rachow, Megan; Hatteberg, Lindsay

2012-01-01

301

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

PubMed Central

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

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

2011-01-01

302

Robotic Surgery  

NASA Technical Reports Server (NTRS)

The Automated Endoscopic System for Optimal Positioning, or AESOP, was developed by Computer Motion, Inc. under a SBIR contract from the Jet Propulsion Lab. AESOP is a robotic endoscopic positioning system used to control the motion of a camera during endoscopic surgery. The camera, which is mounted at the end of a robotic arm, previously had to be held in place by the surgical staff. With AESOP the robotic arm can make more precise and consistent movements. AESOP is also voice controlled by the surgeon. It is hoped that this technology can be used in space repair missions which require precision beyond human dexterity. A new generation of the same technology entitled the ZEUS Robotic Surgical System can make endoscopic procedures even more successful. ZEUS allows the surgeon control various instruments in its robotic arms, allowing for the precision the procedure requires.

2000-01-01

303

Muscle Fibers  

NSDL National Science Digital Library

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

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

2000-01-01

304

The distribution of blood flow between individual muscles and non-muscular tissues in the hind limb of the young ox (Bos taurus): values at thermoneurality and during exposuer to cold.  

PubMed Central

1. The radioactive microspheres method was used to measure the distribution of blood flow in the hind leg in conscious young steers exposed to thermoneutral and moderately cold environments. Simultaneous measurement of total leg blood flow allowed calculation of blood flow (ml. 100 g tissue-1 min-1) to individual muscles and the major non-muscular tissues in the leg. 2. In the thermoneutral environment, leg blood flow was distributed approximately according to tissue weight, so that about 65% went to muscle and the remainder to bone, skin, connective tissue and fat; 1-7-11-5% of the injected dose of microspheres was found in the lungs, indicating the presence of functioning arteriovenous anastomoses in the leg. 3. During cold exposure leg blood flow increased two-and-a-half fold and 91% of this increase was due to increased blood flow in muscle. This was accompanied by substantial decreases in both total and capillary blood flow in leg skin in three of the four animals. 4. Values for resting tissue blood flow to the six largest individual leg muscles were compared, as well as that for tissue blood flow to the remaining leg muscle. Blood flow in the three large upper thigh muscles (biceps femoris, semimembranosus and semitendinosus) was about half that in muscles in the rest of the leg. 5. Cold exposure caused a threefold increase in total leg muscle blood flow, but the only individual muscles to respond substantially in all four animals were the vastus lateralis and the rectus femoris. Comparison of results from individual animals suggested a relation between total leg blood flow and the number of muscles (apart from vastus lateralis and rectus femoris) involved in shivering. Leg adipose tissue blood flow also increased significantly in the cold.

Bell, A W; Hilditch, T E; Horton, P W; Thompson, G E

1976-01-01

305

Mohs Micrographic Surgery  

MedlinePLUS

newsletter | contact Share | Mohs Micrographic Surgery A A A AFTER: Skin cancer has been removed from the forehead. This image was taken immediately after Mohs micrographic surgery. Procedure Overview Mohs surgery is a technique ...

306

Pediatric refractive surgery.  

PubMed

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

2014-06-01

307

Cosmetic breast surgery  

MedlinePLUS

Cosmetic breast surgery is done at an outpatient surgery clinic or in a hospital. Most women receive general anesthesia for ... a plastic surgeon if you are considering cosmetic breast surgery. Discuss how you expect to look and feel ...

308

Coronary Artery Bypass Surgery  

MedlinePLUS

... t help, you may need coronary artery bypass surgery. The surgery creates a new path for blood to flow ... more than one bypass. The results of the surgery usually are excellent. Many people remain symptom-free ...

309

Muscle Uncoupling Protein 3 Expression Is Unchanged by Chronic Ephedrine/Caffeine Treatment: Results of a Double Blind, Randomised Clinical Trial in Morbidly Obese Females  

PubMed Central

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

Bracale, Renata; Petroni, Maria Letizia; Davinelli, Sergio; Bracale, Umberto; Scapagnini, Giovanni; Carruba, Michele O.; Nisoli, Enzo

2014-01-01

310

The Effects of Knee Joint and Hip Abduction Angles on the Activation of Cervical and Abdominal Muscles during Bridging Exercises  

PubMed Central

[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.

Lee, Su-Kyoung; Park, Du-Jin

2013-01-01

311

Risk Factors for Complications after Reconstructive Surgery for Sternal Wound Infection  

PubMed Central

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.

Takaku, Mitsuru; Matsuo, Shinji; Abe, Yoshiro; Harada, Hiroshi; Nagae, Hiroaki; Fujioka, Yusuke; Anraku, Kuniaki; Inagawa, Kiichi; Nakanishi, Hideki

2014-01-01

312

Atypical course of the rare accessory extensor carpi radialis muscle.  

PubMed Central

The description of a bilaterally well developed, bicipital and bipennate accessory extensor carpi radialis muscle is reported. The muscle arose between the origins of the long and short radial carpal extensor muscles and inserted by 2 tendons into the 1st 2 metacarpal bones. The ulnar tendinous insertion was simultaneously the origin of abductor pollicis brevis. Both heads of the accessory extensor carpi radialis muscle were innervated by a branch of the deep branch of the radial nerve. The present observation supplements our knowledge on variations in the antebrachial and carpal regions, which are important in hand surgery. Images Fig. 1

Khaledpour, C; Schindelmeiser, J

1994-01-01

313

Adynamic and dynamic muscle transposition techniques for anal incontinence  

PubMed Central

Gracilis muscle transposition is well established in general surgery and has been the main muscle transposition technique for anal incontinence. Dynamization, through a schedule of continuous electrical stimulation, converts the fatigue-prone muscle fibres to a tonic fatigue-resistant morphology with acceptable results in those cases where there is limited sphincter muscle mass. The differences between gluteoplasty and graciloplasty, as well as the techniques and complications of both procedures, are outlined in this review. Overall, these techniques are rarely carried out in specialized units with experience, as there is a high revision and explantation rate.

Barisic, Goran; Krivokapic, Zoran

2014-01-01

314

Architectural and morphological assessment of rat abdominal wall muscles: comparison for use as a human model  

PubMed Central

The abdominal wall is a composite of muscles that are important for the mechanical stability of the spine and pelvis. Tremendous clinical attention is given to these muscles, yet little is known about how they function in isolation or how they interact with one another. Given the morphological, vascular, and innervation complexities associated with these muscles and their proximity to the internal organs, an appropriate animal model is important for understanding their physiological and mechanical significance during function. To determine the extent to which the rat abdominal wall resembles that of human, 10 adult male Sprague-Dawley rats were killed and formalin-fixed for architectural and morphological analyses of the four abdominal wall muscles (rectus abdominis, external oblique, internal oblique, and transversus abdominis). Physiological cross-sectional areas and optimal fascicle lengths demonstrated a pattern that was similar to human abdominal wall muscles. In addition, sarcomere lengths measured in the neutral spine posture were similar to human in their relation to optimal sarcomere length. These data indicate that the force-generating and length change capabilities of these muscles, relative to one another, are similar in rat and human. Finally, the fiber lines of action of each abdominal muscle were similar to human over most of the abdominal wall. The main exception was in the lower abdominal region (inferior to the pelvic crest), where the external oblique becomes aponeurotic in human but continues as muscle fibers into its pelvic insertion in the rat. We conclude that, based on the morphology and architecture of the abdominal wall muscles, the adult male Sprague-Dawley rat is a good candidate for a model representation of human, particularly in the middle and upper abdominal wall regions.

Brown, Stephen H M; Banuelos, Karina; Ward, Samuel R; Lieber, Richard L

2010-01-01

315

Exercises to activate the deeper abdominal wall muscles: the Lewit: a preliminary study.  

PubMed

The abdominal wall is a prime target for therapeutic exercises aimed to prevent and rehabilitate low back pain and to enhance performance training. This study examined the "Lewit," a corrective exercise prescribed for several purposes, which is performed lying supine in a crook-lying position and involves forceful breathing. Muscle activation and lumbar posture were compared with bracing the abdominal wall (stiffening) with robust effort and "hollowing" (attempting to draw in the wall toward the naval) with robust effort. Eight healthy male volunteers with 6 channels of electromyography were collected by means of surface electrode pairs of the rectus abdominis, external oblique, and internal oblique (IO) together with lumbar motion. The Lewit exercise caused higher muscle activity in the deeper abdominal wall muscles, in particular the IO and by default the transverse abdominis were activated at 54% maximum voluntary contractions (MVCs) on average and 84% MVC peak with no change in spine posture to maintain the elastic equilibrium of the lumbar spine. The Lewit is a deep oblique muscle activation exercise, and the activation levels are of a sufficient magnitude for training muscle engrams. This information will assist strength and conditioning coaches with program design decisions where this corrective abdominal exercise may be considered for clients who elevate the ribcage during strength exertions, or for clients targeting the deep obliques. PMID:24345966

Badiuk, Boyd W N; Andersen, Jordan T; McGill, Stuart M

2014-03-01

316

Minimally invasive surgery.  

PubMed

Minimally invasive surgery (MIS), or laparoscopic surgery, plays a vital role in residency training in a number of surgical disciplines including general surgery, surgical oncology, colorectal surgery, pediatric surgery, and thoracic surgery. The tremendous patient demand for MIS over the past 2 decades has resulted in surgeons rapidly embracing this technique. Many general surgery residencies cover basic laparoscopy within their residency program; however, the experience with more advanced cases is more variable. This career resource guides the interested medical student and physician to opportunities for fellowship training in MIS. It includes a discussion of the specialty, training requirements, grant funding, research fellowships, and pertinent societies. PMID:20113703

Hamad, Giselle G; Curet, Myriam

2010-02-01

317

Imidazoline use in sinonasal surgery.  

PubMed

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; [1]). 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

2014-06-01

318

Reliability and validity of panoramic ultrasound for muscle quantification.  

PubMed

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

2012-09-01

319

Physically-based modeling and simulation of extraocular muscles.  

PubMed

Dynamic simulation of human eye movements, with realistic physical models of extraocular muscles (EOMs), may greatly advance our understanding of the complexities of the oculomotor system and aid in treatment of visuomotor disorders. In this paper we describe the first three dimensional (3D) biomechanical model which can simulate the dynamics of ocular motility at interactive rates. We represent EOMs using "strands", which are physical primitives that can model an EOM's complex nonlinear anatomical and physiological properties. Contact between the EOMs, the globe, and orbital structures can be explicitly modeled. Several studies were performed to assess the validity and utility of the model. EOM deformation during smooth pursuit was simulated and compared with published experimental data; the model reproduces qualitative features of the observed nonuniformity. The model is able to reproduce realistic saccadic trajectories when the lateral rectus muscle was driven by published measurements of abducens neuron discharge. Finally, acute superior oblique palsy, a pathological condition, was simulated to further evaluate the system behavior; the predicted deviation patterns agree qualitatively with experimental observations. This example also demonstrates potential clinical applications of such a model. PMID:20868704

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

2010-12-01

320

Physically-based Modeling and Simulation of Extraocular Muscles  

PubMed Central

Dynamic simulation of human eye movements, with realistic physical models of extraocular muscles (EOMs), may greatly advance our understanding of the complexities of the oculomotor system and aid in treatment of visuomotor disorders. In this paper we describe the first three dimensional (3D) biomechanical model which can simulate the dynamics of ocular motility at interactive rates. We represent EOMs using “strands”, which are physical primitives that can model an EOM's complex nonlinear anatomical and physiological properties. Contact between the EOMs, the globe, and orbital structures can be explicitly modeled. Several studies were performed to assess the validity and utility of the model. EOM deformation during smooth pursuit was simulated and compared with published experimental data; the model reproduces qualitative features of the observed non-uniformity. The model is able to reproduce realistic saccadic trajectories when the lateral rectus muscle was driven by published measurements of abducens neuron discharge. Finally, acute superior oblique palsy, a pathological condition, was simulated to further evaluate the system behavior; the predicted deviation patterns agree qualitatively with experimental observations. This example also demonstrates potential clinical applications of such a model.

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

2010-01-01

321

The role of orthopaedic surgery in sports medicine.  

PubMed Central

Orthopaedic surgery must play a significant role in the development of sports medicine as a viable academic discipline. Potential areas in which orthopaedic surgery can specifically contribute to such an evolution are discussed. Particular areas include skeletal development, the role of athletics on skeletal growth and trauma response, the mechanics of specific sports and the predisposition of specific sports to certain injury patterns, the role of muscle physiology and muscle stimulation in rehabilitation, and differing responses of the male and female skeletal system. Each of these areas is discussed in detail.

Ogden, J. A.

1980-01-01

322

Strength recovery and muscle activation of the knee extensor and flexor muscles after arthroscopic meniscectomy. A pilot study.  

PubMed

Maximal isokinetic strength and electromyographic activity of the operated leg were measured preoperatively and one, two, three, and eight weeks postoperatively after a partial medial meniscectomy by arthroscopy in a group of ten patients. Strength deficits, measured with a Kin-Com dynamometer using a static preloading protocol, were found in comparison with a group of matched healthy subjects preoperatively and three and eight weeks postoperatively in the knee extensors. These deficits were related to previously unreported modifications in the shape of the moment-angle curves and a tendency to lower activation levels of the vastus medialis (VM) but not the vastus lateralis or rectus femoris muscles. No deficits were found in the knee flexors preoperatively or three and eight weeks postoperatively, but the medial hamstrings activation level was lower for movements at 30 degrees per second. During flexion movements, the percentage of coactivation of the antagonist VM was significantly greater than healthy values at 30 degrees and 180 degrees per second. These results clearly indicate that neuromuscular recovery is not complete when return to work is advocated three to four weeks postoperatively. Such findings suggest the need for a rehabilitation program to promote recovery of the knee muscles in workers with a physically demanding occupation. PMID:1984919

Durand, A; Richards, C L; Malouin, F

1991-01-01

323

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

PubMed Central

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

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

2010-01-01

324

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

PubMed Central

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

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

2012-01-01

325

The Correlation between the Muscle Activity and Joint Angle of the Lower Extremity According to the Changes in Stance Width during a Lifting Task  

PubMed Central

[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.

Yoon, Jung-Gyu

2013-01-01

326

Neurotization improves contractile forces of tissue-engineered skeletal muscle.  

PubMed

Engineered functional skeletal muscle would be beneficial in reconstructive surgery. Our previous work successfully generated 3-dimensional vascularized skeletal muscle in vivo. Because neural signals direct muscle maturation, we hypothesized that neurotization of these constructs would increase their contractile force. Additionally, should neuromuscular junctions (NMJs) develop, indirect stimulation (via the nerve) would be possible, allowing for directed control. Rat myoblasts were cultured, suspended in fibrin gel, and implanted within silicone chambers around the femoral vessels and transected femoral nerve of syngeneic rats for 4 weeks. Neurotized constructs generated contractile forces 5 times as high as the non-neurotized controls. Indirect stimulation via the nerve elicited contractions of neurotized constructs. Curare administration ceased contraction in these constructs, providing physiologic evidence of NMJ formation. Histology demonstrated intact muscle fibers, and immunostaining positively identified NMJs. These results indicate that neurotization of engineered skeletal muscle significantly increases force generation and causes NMJs to develop, allowing indirect muscle stimulation. PMID:17822360

Dhawan, Vikas; Lytle, Ian F; Dow, Douglas E; Huang, Yen-Chih; Brown, David L

2007-11-01

327

Muscle Strains in the Thigh  

MedlinePLUS

Muscle Strains in the Thigh Print Article Text Size: + | - A muscle strain (muscle pull or tear) is a common injury, particularly ... sports. The thigh has three sets of strong muscles: the hamstring muscles in the back of the ...

328

Effect of exercise intervention on thigh muscle volume and anatomical cross-sectional areas--quantitative assessment using MRI.  

PubMed

The objective of this study was to evaluate the location-specific magnitudes of an exercise intervention on thigh muscle volume and anatomical cross-sectional area, using MRI. Forty one untrained women participated in strength, endurance, or autogenic training for 12 weeks. Axial MR images of the thigh were acquired before and after the intervention, using a T1-weighted turbo-spin-echo sequence (10 mm sections, 0.78 mm in-plane resolution). The extensor, flexor, adductor, and sartorius muscles were segmented between the femoral neck and the rectus femoris tendon. Muscle volumes were determined, and anatomical cross-sectional areas were derived from 3D reconstructions at 10% (proximal-to-distal) intervals. With strength training, the volume of the extensors (+3.1%), flexors (+3.5%), and adductors (+3.9%) increased significantly (P < 0.05) between baseline and follow-up, and with endurance training, the volume of the extensor (+3.7%) and sartorius (+5.1%) increased significantly (P < 0.05). No relevant or statistically significant change was observed with autogenic training. The greatest standardized response means were observed for the anatomical cross-sectional area in the proximal aspect (10-30%) of the thigh and generally exceeded those for muscle volumes. The study shows that MRI can be used to monitor location-specific effects of exercise intervention on muscle cross-sectional areas, with the proximal aspect of the thigh muscles being most responsive. PMID:20665894

Hudelmaier, Martin; Wirth, Wolfgang; Himmer, Maria; Ring-Dimitriou, Susanne; Sänger, Alexandra; Eckstein, Felix

2010-12-01

329

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

PubMed Central

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

2012-01-01

330

Muscle growth and exercise  

Microsoft Academic Search

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

A. M. Pearson

1990-01-01

331

Healthy Muscles Matter  

MedlinePLUS

... muscles in your body? These muscles help you move, lift things, pump blood through your body, and even help ... things, play sports, and do all the other things you love to do. Exercising, ... muscles let you move freely and keep your body strong. Healthy muscles ...

332

Move Your Muscles!  

NSDL National Science Digital Library

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

Integrated Teaching And Learning Program

333

Moments of force, power, and muscle coordination in speed-skating.  

PubMed

Two well-trained speed-skaters were subjected to a biomechanical analysis incorporating push-off forces, cinematographic data, and link segment modeling. To gain knowledge on the backgrounds on technique and performance in speed-skating, the muscle coordination was studied by EMG and muscle contraction velocities. In speed-skating during the push-off, the body center of gravity (cg) is accelerated with respect to the point of application of the push-off force, with a forward gliding skate. The velocity of cg is a result of rotation of segments. Due to the absence of plantar flexion of the foot, the knee extension range is limited. The short and explosive push-off can be considered as a catapult-like action. The knee extensor muscles vastus medialis and rectus femoris are prestretched in the gliding phase by the antagonistic action of gastrocnemius and biceps femoris. In this phase the skater rotates his cg from the lateral to the medial side of the skate to reach an optimal push-off angle. The power output in the push-off phase is mainly generated by the monoarticular extensor muscles gluteus maximus and vastus medialis. PMID:3429080

de Boer, R W; Cabri, J; Vaes, W; Clarijs, J P; Hollander, A P; de Groot, G; van Ingen Schenau, G J

1987-12-01

334

Effect of armor and carrying load on body balance and leg muscle function.  

PubMed

This study investigated the impact of weight and weight distribution of body armor and load carriage on static body balance and leg muscle function. A series of human performance tests were conducted with seven male, healthy, right-handed military students in seven garment conditions with varying weight and weight distributions. Static body balance was assessed by analyzing the trajectory of center of plantar pressure and symmetry of weight bearing in the feet. Leg muscle functions were assessed by analyzing the peak electromyography amplitude of four selected leg muscles during walking. Results of this study showed that uneven weight distribution of garment and load beyond an additional 9 kg impaired static body balance as evidenced by increased sway of center of plantar pressure and asymmetry of weight bearing in the feet. Added weight on non-dominant side of the body created greater impediment to static balance. Increased garment weight also elevated peak EMG amplitude in the rectus femoris to maintain body balance and in the medial gastrocnemius to increase propulsive force. Negative impacts on balance and leg muscle function with increased carrying loads, particularly with an uneven weight distribution, should be stressed to soldiers, designers, and sports enthusiasts. PMID:24021525

Park, Huiju; Branson, Donna; Kim, Seonyoung; Warren, Aric; Jacobson, Bert; Petrova, Adriana; Peksoz, Semra; Kamenidis, Panagiotis

2014-01-01

335

The effect of the weight of equipment on muscle activity of the lower extremity in soldiers.  

PubMed

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

2012-01-01

336

Trunk kinematics and trunk muscle activity during a rapidly applied load.  

PubMed

This study investigated the trunk kinematics and electromyographic (EMG) activity of eight trunk muscles when "expected" and "unexpected" loads were applied directly to the torso. Twenty individuals (mean age: 25.1 yr; range 20-33 yr) participated in this mixed model study in which gender was the between-subjects factor, and expectancy and symmetry of the applied load were within-subject factors. The sudden load was delivered to the subject via a cable attached to a thoracic harness and motion was restricted to the lumbar spine by strapping the pelvis to a rigid fixation apparatus. Surface EMG was recorded bilaterally from the longissimus thoracis (LGT), erector spinae (ERS), rectus abdominis (RAB) and the external obliques (EXO). Trunk kinematics were measured with a Lumbar Motion Monitor. During expected loading conditions, the peak muscle activity was reduced for the RAB and EXO bilaterally, and for the ERS(R) (p < 0.01) relative to the unexpected conditions. Conversely, the normalized area of EMG activity prior to the onset of load was increased for the ERS and EXO bilaterally, and for the RAB(R) (p < 0.05) during an expected loading event. Trunk motion in the sagittal and frontal planes was reduced during expected loading. Activation of the trunk muscles just prior to a rapid loading event increases trunk stiffness, decreasing trunk displacement and peak muscle activity. PMID:9779395

Thomas, J S; Lavender, S A; Corcos, D M; Andersson, G B

1998-08-01

337

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

PubMed Central

Due to their profession and the tasks it entails, soldiers are exposed to high levels of physical activity and strain. This can result in overexertion and pain in the locomotor system, partly caused by carrying items of equipment. The aim of this study was to analyse the extent of muscle activity in the lower extremities caused by carrying specific items of equipment. For this purpose, the activity of selected groups of muscles caused by different items of equipment (helmet, carrying strap, backpack, and rifle) in the upper and lower leg was measured by recording dynamic surface electromyograms. Electrogoniometers were also used to measure the angle of the knee over the entire gait cycle. In addition to measuring muscle activity, the study also aimed to determine out what influence increasing weight load has on the range of motion (ROM) of the knee joint during walking. The activity of recorded muscles of the lower extremity, that is, the tibialis anterior, peroneus longus, gastrocnemius lateralis, gastrocnemius medialis, rectus femoris, and biceps femoris, was found to depend on the weight of the items of equipment. There was no evidence, however, that items of equipment weighing a maximum of 34% of their carrier's body weight had an effect on the ROM of the knee joint.

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

2012-01-01

338

Long-term results of pectoralis major muscle transposition for infected sternotomy wounds.  

PubMed Central

During an 11.5-year period, 100 consecutive patients (79 male, 21 female) underwent repair of an infected sternotomy wound. Sixty-five patients had failed attempts at wound closure by other physicians. Median age was 61.5 years (range, 5 to 85 years). Reconstruction included muscle in 79 patients, omentum in 4, and both in 15. A total of 175 muscles were transposed, including 169 pectoralis major, 3 rectus abdominis, 2 external oblique, and 1 latissimus dorsi. Median number of operations was four (range, 1 to 11). Mechanical ventilation was required in 30 patients. Two perioperative deaths occurred, one related to sepsis. Median follow-up was 4.2 years (range, 1.3 to 13.5 years). Twenty-six patients had recurrent infection. Median time from our closure to recurrence was 5.5 months (range, 0.3 to 27.6 months). Cause of recurrence was inadequate removal of cartilage in 16 patients, bone in 6, and retained foreign body in 4. Eighteen patients had the wound reopened with further resection; 10 had another muscle or omentum transposition. There were 30 late deaths, only one related to recurrent infection. At the time of death or last follow-up, 92 patients had a healed chest wall. Transposition of the pectoralis major muscle remains an excellent method of management for infected sternotomy wounds. Failure is directly related to persistent infection of cartilage, bone, or retained foreign bodies.

Pairolero, P C; Arnold, P G; Harris, J B

1991-01-01

339

Lower extremity muscle activity during deep-water running on self-determined pace.  

PubMed

Although deep-water running (DWR) is often used to obtain the benefits of aerobic fitness and to reduce vertical component stress, its attendant muscle stress remains unclear. The present study investigated lower extremity muscle activity and during DWR compared to that during land walking (LW) and water walking (WW). Surface electromyography was used to evaluate muscle activity in nine healthy adults during each exercise at self-determined slow, moderate, and fast paces. The duration of swing phase, ankle, knee and hip joint angle, and each joint range of motion (ROM) also investigated. Results show that the percentages of maximal voluntary contraction (%MVC) of the soleus and medial gastrocnemius were lower during DWR than during LW or WW in the backward swing phase. The %MVC of the rectus femoris was higher during WW and DWR than during LW; that of the vastus lateralis was lower during WW and DWR than during LW in the forward swing phase. In the biceps femoris, the %MVC was higher during DWR than during LW or WW in the forward and backward swing phase. Every pace showed a similar trend. These results suggest that DWR can stimulate the hip joint flexor or extensor muscles. PMID:17572106

Kaneda, Koichi; Wakabayashi, Hitoshi; Sato, Daisuke; Uekusa, Tamotsu; Nomura, Takeo

2008-12-01

340

CARDIAC MUSCLE  

PubMed Central

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.

Sommer, Joachim R.; Johnson, Edward A.

1968-01-01

341

Tensiomyography method used for neuromuscular assessment of muscle training  

PubMed Central

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?muscle training which can be monitored through TMG.

2013-01-01

342

[The oculoauricular phenomenon: a new reflex, a new muscle -- m. retroauricularis (polygraphic EMG study) (author's transl)].  

PubMed

On forced lateral gaze the outer and upper part of both ears is turned backward (oculoauricular phenomenon). A new, as far as we know, skin muscle of the external ear is described and called "m. retroauricularis". The oculoauricular phenomenon is a reflex mechanism between the abducens (m. rectus externus) and facial (m. retroauricularis) nerves. The verification of the automatic and tonic coinnervation is made polygraphically (EMG, stimulodetection) and clinically (unilateral abolition in case of homolateral facial paralysis). The oculoauricular reflex is a physiological and bilateral phenomenon, often rudimentary in man. It serves in looking, hearing and miming. The bilateral mechanism of innervation in the brainstem via the medial longitudinal fasciculus corresponds to Bell's phenomenon as to the "anti Bell". PMID:57221

Heuser, M

1976-03-23

343

Minimally Invasive Surgery  

MedlinePLUS

... of the American Society for Reproductive Medicine Minimally invasive surgery This fact sheet was developed in collaboration ... as one procedure. Some common types of minimally invasive surgery are listed below: • Laparoscopy involves placing a ...

344

Bariatric Surgery Misconceptions  

MedlinePLUS

... related issues. Misconception: Surgery increases the risk for suicide. Truth: Individuals affected by severe obesity who are ... still others with overwhelming life stressors who commit suicide after bariatric surgery. Two large studies have found ...

345

Heart valve surgery  

MedlinePLUS

... Methods include: Endoscopy Percutaneous surgery (through the skin) Robot-assisted surgery The surgeon may be able to ... to your doctor before having any type of medical procedure. The clicking of mechanical heart valves may ...

346

Expectations of Sinus Surgery  

MedlinePLUS

... your doctor at a clinic appointment after surgery. Irrigations – The most important thing you can do to ... regularly irrigate your nose and sinuses with saline irrigations after surgery. Your doctor will show you how ...

347

Complications of Sinus Surgery  

MedlinePLUS

... It is normal to have some bleeding after septal and turbinate surgery and fortunately it rarely requires ... relieve the obstruction and pain. While sinus and septal surgery has risks, often not intervening does as ...

348

Weight Loss Surgery  

MedlinePLUS

Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you cannot lose weight ... obesity. There are different types of weight loss surgery. They often limit the amount of food you ...

349

[Progression toward bimaxillary surgery].  

PubMed

The authors explain the different reflexions which drive maxillo-facial surgery to a bimaxillary surgery. They describe this surgery relatively to Class II and Class III malocclusions with facial diseases in the vertical dimension. Surgical procedures seem to be directed by aesthetic (better facial balance) and functional problems, in spite of the ideal is not yet reached on this last point. PMID:2490254

Bourriau, G; Hadjean, E

1989-01-01

350

Training for laparoscopic surgery  

Microsoft Academic Search

Laparoscopic cholecystectomy has rapidly become the procedure of choice for most patients with symptomatic gallbladder disease. Laparoscopic surgery, however, has not been a required component of most general surgery training programs. The demonstrated efficacy of laparoscopic surgery dictates that this discipline be rapidly incorporated into residency programs. Laparoscopic cholecystectomy and other surgical endoscopic procedures have been an integral part of

Karl A. Zucker; Robert W. Bailey; Scott M. Graham; William Scovil; Anthony L. Imbembo

1993-01-01

351

Breast Cancer Surgery  

MedlinePLUS

... AM to 10 PM EST. FACTS FOR LIFE Breast Cancer Surgery The goal of breast cancer surgery is to remove the tumor from the breast. ... therapy. This helps to increase survival. Types of breast cancer surgery There are two main types of breast cancer ...

352

Does primary brachial plexus surgery alter palliative tendon transfer surgery outcomes in children with obstetric paralysis?  

Microsoft Academic Search

Background  The surgical management of obstetrical brachial plexus palsy can generally be divided into two groups; early reconstructions\\u000a in which the plexus or affected nerves are addressed and late or palliative reconstructions in which the residual deformities\\u000a are addressed. Tendon transfers are the mainstay of palliative surgery. Occasionally, surgeons are required to utilise already\\u000a denervated and subsequently reinnervated muscles as motors.

Atakan Ayd?n; Ahmet Biçer; Türker Özkan; Berkan Mersa; Safiye Özkan; Zeynep Ho?bay Y?ld?r?m

2011-01-01

353

Corneal & refractive surgery.  

PubMed

Excimer lasers and high technology instrumentation have ushered in a new era of vision improvement surgery in Hawaii, replacing the more traditional forms of refractive surgery: cataract surgery, corneal transplant surgery, and radial keratotomy. Corneal surgery has been enhanced by new techniques of microsurgery and a more effective tissue procurement system for donor corneal tissue. Several laser centers provide the latest in FDA-approved excimer laser procedures including PRK and PTK. Mild to moderate myopia and astigmatism may now be corrected. Off-label use of LASIK, too, may soon be realized. PMID:9339056

Yamamoto, G K

1997-09-01

354

Muscle reaction function of individuals with intellectual disabilities may be improved through therapeutic use of a horse.  

PubMed

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

2013-09-01

355

Using Electromyography to Detect the Weightings of the Local Muscle Factors to the Increase of Perceived Exertion During Stepping Exercise  

PubMed Central

Rate of perceived exertion (RPE) is a clinically convenient indicator for monitoring exercise intensity in cardiopulmonary rehabilitation. It might not be sensitive enough for clinicians to determine the patients' physiological status because its association with the cardiovascular system and local muscle factors is unknown. This study used the electromyographic sensor to detect the local muscle fatigue and stabilization of patella, and analyzed the relationship between various local muscle and cardiovascular factors and the increase of RPE during stepping exercise, a common exercise program provided in cardiopulmonary rehabilitation. Ten healthy adults (4 males and 6 females) participated in this study. Each subject used their right bare foot to step up onto a 23-cm-high step at a constant speed until the RPE score reached 20. The RPE, heart rate (HR), and surface EMG of the rectus femoris (RF), vastus medialis, and vastus lateralis were recorded at 1-minute intervals during the stepping exercise. The generalized estimating equations (GEE) analysis indicated that the increase in RPE significantly correlated with the increase in HR, and decrease in median frequency (MF) of the EMG power spectrum of the RF. Experimental results suggest that the increase in RPE during stepping exercise was influenced by the cardiovascular status, localized muscle fatigue in the lower extremities. The weighting of the local muscle factors was more than half of the weighting of the cardiovascular factor.

Chang, Ya-Ju; Liu, Chin-Chih; Lin, Cheng-Hsiang; Tsaih, Peih-Ling; Hsu, Miao-Ju

2008-01-01

356

Muscle Flaps and Their Role in Limb Salvage  

PubMed Central

Muscle flaps have proved to be a valuable and versatile tool in the surgical treatment of the severely compromised lower extremity. Utilized as both local pedicle flaps and free tissue transfers, muscles have been successfully employed to cover complex wounds, manage osteomyelitis, salvage infected vascular grafts, treat recalcitrant venous stasis ulcers, preserve amputation levels, and restore motion following compartment syndrome. Free flap pedicles have also been used in a flow-through fashion to create a distal arterial bypass. This article explores the multipurpose role of muscle flaps in limb salvage surgery and their beneficial physiologic characteristics in hostile wound environments.

Klebuc, Michael; Menn, Zachary

2013-01-01

357

Optical fiber distributed temperature sensor in cardiological surgeries  

NASA Astrophysics Data System (ADS)

In those days a lot of cardiological surgeries is made every day. It is a matter of very significant importance keeping the temperature of the hearth low during the surgery because it decides whether the cells of the muscle will die or not. The hearth is cooled by the ice placed around the hearth muscle during the surgery and cooling liquid is injected into the hearth also. In these days the temperature is measured only in some points of the hearth using sensors based on the pH measurements. This article describes new method for measurement of temperature of the hearth muscle during the cardiological surgery. We use a multimode optical fiber and distributed temperature sensor (DTS) based on the stimulated Raman scattering in temperature measurements. This principle allows us to measure the temperature and to determine where the temperature changes during the surgery. Resolution in the temperature is about 0.1 degrees of Celsius. Resolution in length is about 1 meter. The resolution in length implies that the fiber must be wound to ensure the spatial resolution about 5 by 5 centimeters.

Skapa, Jan; Látal, Jan; Penhaker, Marek; Koudelka, Petr; Hancek, František; Vasinek, Vladimír

2010-04-01

358

Laparoscopically Assisted Spinal Surgery  

PubMed Central

Background: Spinal surgery is one of the newest frontiers of videolaparoscopic surgery, but requires the cooperative efforts of both the spinal surgeon and the laparoscopic general surgeon. Data Base: We report our experience with 76 cases of laparoscopic spinal surgery, using both a transperitoneal and a retroperitoneal approach. Technical details and complications are described in detail. Conclusions: Fifty-one patients had a transperitoneal approach with an average operating time of 117 minutes. Uncomplicated cases stayed 4.4 days. Five patients required conversion. All but one patient had L5-S1 level surgery. Twenty-five patients had a retroperitoneal approach with 150 minutes operating time and a 5.7 day stay. Conversions were minimized with a two-balloon technique. The retroperitoneal approach allows for multiple level surgery with virtually unlimited fusion devices. Laparoscopically assisted spine surgery affords all the benefits of minimally invasive surgery, without limitations for the spinal surgeon.

Cattey, Richard P.; Stoll, James E.; Robbins, Stephen

1997-01-01

359

Human Muscle Fiber  

NASA Technical Reports Server (NTRS)

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.

2003-01-01

360

Increased Collagen Synthesis Rate during Wound Healing in Muscle  

PubMed Central

Wound healing in muscle involves the deposition of collagen, but it is not known whether this is achieved by changes in the synthesis or the degradation of collagen. We have used a reliable flooding dose method to measure collagen synthesis rate in vivo in rat abdominal muscle following a surgical incision. Collagen synthesis rate was increased by 480% and 860% on days 2 and 7 respectively after surgery in the wounded muscle compared with an undamaged area of the same muscle. Collagen content was increased by approximately 100% at both day 2 and day 7. These results demonstrate that collagen deposition during wound healing in muscle is achieved entirely by an increase in the rate of collagen synthesis.

Zhou, Shaobo; Salisbury, Jonathan; Preedy, Victor R.; Emery, Peter W.

2013-01-01

361

No effect of sex steroids on compensatory muscle hypertrophy  

NASA Technical Reports Server (NTRS)

The effects of orchiectomy and/or subcutaneously implanted testosterone propionate (TP) on the hypertrophic response of rat plantaris muscles to functional overload (induced by bilateral removal of gastrocnemius and soleus muscles) are investigated experimentally. Muscle wet weight, metabolic substrate oxidation, and cytosolic androgen-receptor binding are measured, and the results are presented in tables. Eight weeks after surgery, the plantaris muscle weight as a percentage of body weight is found to be about twice that in rats without muscle overload, regardless of the sex-hormone status. Overloading causes decreased ability to oxidize glucose and pyruvate, decreased succinate dehydrogenase specific activity, and no change in the ability to oxidize beta-hydroxybutyrate or in androgen-receptor binding. The oxidative response is unaffected by orchiectomy or TP or both. It is argued that the actions of sex hormones and functional overload are not synergistic.

Max, S. R.; Rance, N. E.

1984-01-01

362

Penetration of linezolid into bone, fat, muscle and haematoma of patients undergoing routine hip replacement  

Microsoft Academic Search

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

2002-01-01

363

Actions de la néostigmine, du D.F.P. et du 3318 CT sur la sensibilité du rectus de grenouille aux esters acétique, propionique et butyrique de la choline  

Microsoft Academic Search

Summary The potentiating effects of Neostigmine, D.F.P. and 3318 CT (a selective “true” cholinesterase inhibitor) on acetylcholine (ACh), propionylcholine (PrCh), butyrylcholine (BuCh) and amyltrimethylammonium (AmT), have been studied using the frog's rectus abdominis. Neostigmine increases the actions of the three esters much more than that of AmT. Low concentrations of D.F.P. potentiate maximally BuCh but have practically no effect on

J. Jacob; M. Dechavassine

1955-01-01

364

Muscle Contusion (Bruise)  

MedlinePLUS

... contact sports have many opportunities to get a muscle contusion (bruise). Contusions are second only to strains ... object strike part of the body, crushing underlying muscle fibers and connective tissue without breaking the skin. ...

365

Muscle function loss  

MedlinePLUS

... caused by: A disease of the muscle itself (myopathy) A disease of the nervous system: nerve damage ( ... that cause muscle-function loss include: Alcohol-associated myopathy Congenital myopathies (usually due to a genetic disorder) ...

366

Initial inflammatory response of skeletal muscle to commonly used suture materials: An animal model study to evaluate muscle healing after surgical repair - histopathological perspective  

PubMed Central

Objectives: To evaluate initial inflammatory response of skeletal muscle to a few commonly used suture materials for muscle repair namely nylon, polydiaxonone (PDS II), plain catgut and polygalactin 910 which in turn determines the scarring of muscle and loss of function. Material and Methods: Inflammation and healing of muscle post repair was evaluated in the lateral thigh muscle (biceps femoris) of 8 adult healthy male Rattus norvegicus. The inflammatory reaction & healing of the skeletal muscle was evaluated histologically at the end of 48 hours, 1 week and 3 weeks. Results: At 48 hours post-surgery, Nylon samples showed severe inflammation followed by Catgut and Polygalactin. At 1 week post-surgery, the catgut group demonstrated increased macrophages infiltration while Nylon demonstrated persistant lymphocytic pro-inflammatory component. PDS sutures elicited minimal inflammatory response all through. Conclusion: In the present study the most desirable suture material was determined to be PDS due to its minimal tissue response and superior handling qualities. However the fact that the presence of macrophages in healing muscle enhances the repair process would be a pointer to create an environment which contains the sustained presence of macrophages to enhance optimal healing of skeletal muscle in the presence of an ideal suture material. Key words:Muscle healing, muscle repair, inflammatory response to sutures, sutures, healing.

Anantanarayanan, P.; Prakash, Geetha; Dare, B. J.; Deshpande, Ashwini

2013-01-01

367

An evaluation of upper-body muscle activation during coupled and uncoupled instability resistance training.  

PubMed

Campbell, BM, Kutz, MR, Morgan, AL, Fullenkamp, AM, and Ballenger, R. An evaluation of upper-body muscle activation during coupled and uncoupled instability resistance training. J Strength Cond Res 28(7): 1833-1838, 2014-Recently, there has been a growth in the popularity of resistance exercises performed on unstable surfaces. However, the relationship between unstable surface training and load coupling on muscle activation is unclear. The purpose of this study was to evaluate changes in muscle activation during a barbell (BB) (coupled) and dumbbell (DB) (uncoupled) chest press exercise performed on an unstable surface. The 3 specific chest press conditions included 50% 1 repetition maximum (RM) with BB (50% BB), 50% 1RM with DBs (50% DB), and 25% 1RM with DBs (25% DB). Ten male subjects participated in the study (age, 23.9 ± 2.6 years; body weight, 82.8 ± 10.2 kg). During testing, mean electromyographic activity was assessed for pectoralis major (PM), triceps brachii, anterior deltoid (AD), and rectus abdominis (RA) and was presented as a percent change across the lifting conditions. It was observed that muscle activation increased by 15% in both the PM and RA from the 50% BB condition to the 50% DB condition. Also, the greatest percent difference in muscle activation between the 50 and 25% DB conditions occurred for PM and AD (+54% during 50% DB). These results suggest that demands on the core musculature to provide stability are increased with the use of DBs (uncoupled) as opposed to a BB (coupled). Where instability training provides a sufficient hypertrophy stimulus in prime mover muscle groups, there may be the added benefit of core stability training. Specifically, this type of training may benefit both untrained persons and those engaged in active rehabilitation. PMID:24950226

Campbell, Brian M; Kutz, Matt R; Morgan, Amy L; Fullenkamp, Adam M; Ballenger, Ryan

2014-07-01

368

Central and peripheral fatigue of the knee extensor muscles induced by electromyostimulation.  

PubMed

The main purpose of this study was to characterise neuromuscular fatigue induced by 30 contractions of the knee extensor muscles evoked by electromyostimulation (EMS). Twelve healthy subjects were tested before and after a typical EMS session (frequency: 75 Hz, on-off ratio: 6.25 s on-20 s off) used for quadriceps femoris muscle strengthening. Surface electromyographic (EMG) activity and torque obtained during maximal voluntary and electrically evoked contractions were analysed to distinguish peripheral from central fatigue. Maximal voluntary torque of the knee extensor muscles decreased approximately 20 % (p < 0.001) following EMS. In the same way, peak torque associated to single (p < 0.05) and paired (p < 0.001) stimuli as well as M-wave amplitude (p < 0.05) significantly decreased as a result of EMS. The raw EMG activity of both vastus lateralis and rectus femoris muscle recorded during maximal voluntary isometric contraction significantly decreased after the session (-17.3 and -14.5 %, respectively) whereas no changes were observed when EMG signals were normalised to respective M-wave amplitudes. Similarly, voluntary activation estimated by using the twitch interpolation technique was unchanged following EMS. In conclusion, a typical session of EMS of the knee extensor muscles mainly induced neuromuscular propagation failure while excitation-contraction coupling and neural mechanisms were not significantly affected. It is recommended to interpret surface EMG data together with the corresponding M wave, at least for the knee extensor muscles, in order to distinguish peripheral from central causes of fatigue. PMID:16320169

Zory, R; Boërio, D; Jubeau, M; Maffiuletti, N A

2005-12-01

369

Physiological and electromyographic responses during 40-km cycling time trial: relationship to muscle coordination and performance.  

PubMed

The purpose of this study was to compare the oxygen uptake (VO(2)), respiratory exchange ratio (RER), cadence and muscle activity during cycling a 40-km time trial (TT), and to analyse the relationship between muscle activity and power output (PO). Eight triathletes cycled a 40-km TT on their own bicycles, which were mounted on a stationary cycle simulator. The VO(2), RER and muscle activity (electromyography, EMG) from tibialis anterior (TA), gastrocnemius medialis (GA), biceps femoris (BF), rectus femoris (RF) and vastus lateralis (VL) of the lower limb were collected. The PO was recorded from the cycle simulator. The data were collected at the 3rd, 10th, 20th, 30th and 38th km. The root mean square envelope (RMS) of EMG was calculated. The VO(2) and PO presented a significant increase at the 38th km (45.23+/-8.35 ml kg min(-1) and 107+/-7.11% of mean PO of 40-km, respectively) compared to the 3rd km (38.12+/-5.98 ml kg min(-1) and 92+/-8.30% of mean PO of 40-km, respectively). There were no significant changes in cadence and RER throughout the TT. The VL was the only muscle that presented significant increases in the RMS at the 10th km (22.56+/-3.05% max), 20th km (23.64+/-2.52% max), 30th km (25.27+/-3.00% max), and 38th km (26.28+/-3.57%max) when compared to the 3rd km (21.03+/-1.88%max). The RMS of VL and RF presented a strong relationship to PO (r=0.89 and 0.86, respectively, p<0.05). The muscular steady state reported for cycling a 30-min TT seems to occur in the 40-km TT, for almost all assessed muscles, probably in attempt to avoid premature muscle fatigue. PMID:17703997

Bini, Rodrigo R; Carpes, Felipe P; Diefenthaeler, Fernando; Mota, Carlos B; Guimarães, Antônio Carlos S

2008-07-01

370

Muscle Session Summary  

NASA Technical Reports Server (NTRS)

Presentations from the assembled group of investigators involved in specific research projeects related to skeletal muscle in space flight can categorized in thematic subtopics: regulation of contractile protein phenotypes, muscle growth and atrophy, muscle structure: injury, recovery,and regeneration, metabolism and fatigue, and motor control and loading factors.

Baldwin, Kenneth; Feeback, Daniel

1999-01-01

371

Muscle Tissue Overview  

NSDL National Science Digital Library

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

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

2007-08-15

372

An Artificial Tendon with Durable Muscle Interface  

PubMed Central

A coupling mechanism that can permanently fix a forcefully contracting muscle to a bone anchor or any totally inert prosthesis would meet a serious need in orthopaedics. Our group developed the OrthoCoupler™ device to satisfy these demands. The objective of this study was to test OrthoCoupler’s performance in vitro and in vivo in the goat semitendinosus tendon model. For in vitro evaluation, 40 samples were fatigue-tested, cycling at 10 load levels, n=4 each. For in vivo evaluation, the semitendinosus tendon was removed bilaterally in 8 goats. Left sides were reattached with an OrthoCoupler, and right sides were reattached using the Krackow stitch with #5 braided polyester sutures. Specimens were harvested 60 days post-surgery and assigned for biomechanics and histology. Fatigue strength of the devices in vitro was several times the contractile force of the semitendinosus muscle. The in vivo devices were built equivalent to two of the in vitro devices, providing an additional safety factor. In strength testing at necropsy, suture controls pulled out at 120.5 ± 68.3 N, whereas each OrthoCoupler was still holding after the muscle tore, remotely, at 298±111.3N (mean ± SD)(p<0.0003). Muscle tear strength was reached with the fiber-muscle composite produced in healing still soundly intact. This technology may be of value for orthopaedic challenges in oncology, revision arthroplasty, tendon transfer, and sports-injury reconstruction.

Melvin, Alan; Litsky, Alan; Mayerson, Joel; Witte, David; Melvin, David; Juncosa-Melvin, Natalia

2010-01-01

373

Dynamic simulation of the mastication muscles  

NASA Astrophysics Data System (ADS)

The purpose of a simulated operation system in craniofacial surgery is to evaluate and visualize the results of operations on the overall facial shape of the patient and on the functionality of his jaw. This paper presents the analyzation of muscle movements in the mastication system by applying real jaw movements to the simulation. With this method an accurate modeling of the mastication muscles can be performed which is a prerequisite for a realistic simulation and precise intra- operative registration. According to this results a large- scale musculoskeletal model of the mastication system is generated including kinematic and dynamic parameters. By integrating distance sensors in the simulation of a segmented CT (computer tomograph) image of the maxilla and mandible the motions of the masticatory muscles during different kinds of jaw movements have been analyzed. The data for this motions have been recorded by a commercial system (CONDYLOCOMP LR3) on a test person and transformed to the graphical simulation system. This method for the first time allows to observe the dynamics of the mastication muscles and their different parameters like muscle length ratio and velocity. The integration of a kinematic model for the jaw movement makes it possible to analyze non traced movements.

Weingaertner, Tim; Albrecht, Jochen

1998-05-01

374

Intramuscular myxoma of the cervical paraspinal muscle.  

PubMed

Myxoma is a neoplasm of mesenchymal origin composed of undifferentiated stellate cells in a myxoid stroma. This tumor can develop in a variety of locations. Myxomas that arise from skeletal muscles are called intramuscular myxomas. They usually occur in large skeletal muscles. Only ten cases of these benign tumors involving the neck muscles were reported in literature. Of them, only three were located at the paraspinal muscles. A 64-year-old woman presented with occipital and neck pain over 5 years noted an expansive painful lesion located at posterior cervical region with progressive volume increase in the last 12 months. Image exams revealed a large mass located in the left posterior region of the neck in contact with the C2, C3 and C4 laminae with no invasion of the vertebrae. Tumor total removal was performed through normal muscle margins and the vertebral periosteum was scraped. The tumor was encapsulated, lobulated with a gray-white appearance. The histological examination yielded the diagnosis of intramuscular myxoma. Follow-up at 1 year showed complete resolution of preoperative symptoms and no evidence of local recurrence. In conclusion, although rare, intramuscular myxoma should be included in differential diagnosis of cervical paraspinal tumors. We reported the fourth case of intramuscular myxoma in the paraspinal musculature of the neck. Despite its benign characteristics, local recurrence was reported after subtotal resection. Tumor total removal should be the goal of surgery. PMID:19301043

Falavigna, Asdrubal; Righesso, Orlando; Volquind, Daniel; Teles, Alisson Roberto

2009-07-01

375

Fine-needle aspiration cytodiagnosis of endometriosis in cesarean section scar and rectus sheath mass lesions -- a study of seven cases.  

PubMed

The diagnosis of endometriosis is usually established by a biopsy. Since endometriotic lesions can present as a mass lesion, it seems feasible to investigate them by the noninvasive method of fine-needle aspiration cytology (FNAC). In this study, seven cases (5 from a cesarean scar and 2 from rectus sheath) are presented in which FNAC was indicative of endometriosis. The aspirate was obtained using a disposable 10 ml syringe and 22 gauge needle. The material was collected as syringe and needle washings in a cytology container in which 30% ethyl alcohol was present. From half of this material, filter preparations were made on size 3 mum filters and stained by Papanicolaou method, while the remaining aspirate was spun and a cell block was made from the sediment and sections cut and stained with hematoxylin-eosin stain. In all cases the cytologic preparations showed tubular structures indicative of endometrial tissue and stromal cells indicative of endometriosis. This was further confirmed on examination of cell blocks, which showed histologic features of endometriosis characterized by endometrial glands separated by endometrial stroma and rare siderophages. The seven cases described are interesting, since the cytohistological finding in FNAC sample and cell block not only were indicative of the diagnosis of endometriosis, but also obviated the need for an invasive surgical procedure. PMID:18335552

Gupta, Raj K

2008-04-01

376

Muscle function after endoprosthetic replacement of the proximal tibia. Different techniques for extensor reconstruction in 17 tumor patients.  

PubMed

We analyzed in 17 patients the outcome of various surgical techniques for reconstruction of the extension apparatus after resection of the proximal tibia and tumor prosthesis implantation. The mean follow-up period was 5 (1.5-11) years. Knee extension and flexion strength were measured isokinetically by dynamometer and muscle activities of the vastus medialis, the vastus lateralis and the rectus femoris muscles determined by means of EMG. Muscle function of the operated leg was compared to that of the contralateral extremity by using various surgical techniques: fibula transposition, transposition of the gastrocnemius muscle, and combination technique. The results concerning the operated leg were compared within the 3 groups and the activity and strength of both legs were compared to those of a control group of healthy subjects matched for age and weight. The strength of extensor muscles of the healthy leg was greater than that of the control group in flexion position (60 degrees-90 degrees); the hamstring strength values were within the normal range. The strength of extensor muscles of the operated leg differed between groups II and III at 90 degrees in favor of group II (p < 0.01) and at 60 degrees to 20 degrees (p < 0.001) in favor of group III. Expressed in percentage ranges (nonoperated leg set at 100 percent) the flexor muscles averaged 30 percent, the extensor muscles represented on average 12 percent (9-17 percent) in group I, 9 percent (5-18 percent) in group II and 16 percent (6-26 percent) in group III, depending on the knee angle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7604712

Petschnig, R; Baron, R; Kotz, R; Ritschl, P; Engel, A

1995-06-01

377

Electromyographic normalization procedures for determining exercise intensity of closed chain exercises for strengthening the quadriceps femoris muscles.  

PubMed

The purpose of this study was to compare the electromyographic (EMG) amplitudes of the quadriceps femoris (QF) muscles during a maximum voluntary isometric contraction (MVIC) to submaximal and maximal dynamic concentric contractions during active exercises. A secondary purpose was to provide information about the type of contraction that may be most appropriate for normalization of EMG data if one wants to determine if a lower extremity closed chain exercise is of sufficient intensity to produce a strengthening response for the QF muscles. Sixty-eight young healthy volunteers (39 female, 29 male) with no lower extremity pain or injury participated in the study. Surface electrodes recorded EMG amplitudes from the vastus medialis obliquus (VMO), rectus femoris (RF), and vastus lateralis (VL) muscles during 5 different isometric and dynamic concentric exercises. The last 27 subjects performed an additional 4 exercises from which a second data set could be analyzed. Maximum isokinetic knee extension and moderate to maximum closed chain exercises activated the QF significantly more than a MVIC. A 40-cm. lateral step-up exercise produced EMG amplitudes of the QF muscles of similar magnitude as the maximum isokinetic knee extension exercises and would be an exercise that could be considered for strengthening the QF muscles. Most published EMG studies of exercises for the QF have been performed by comparing EMG amplitudes during dynamic exercises to a MVIC. This procedure can lead one to overestimate the value of a dynamic exercise for strengthening the QF muscles. We suggest that when studying the efficacy of a dynamic closed chain exercise for strengthening the QF muscles, the exercise be normalized to a dynamic maximum muscle contraction such as that obtained with knee extension during isokinetic testing. PMID:22310511

Ekstrom, Richard A; Osborn, Roy W; Goehner, Heather M; Moen, Adam C; Ommen, Brian M; Mefferd, Michael J; Bergman, Thomas R; Molencamp, Timothy B; Kelsey, Steven A

2012-03-01

378

Effects of hormone therapy on insulin signaling proteins in skeletal muscle of cynomolgus monkeys.  

PubMed

We have previously shown that hormone therapy (HT) with medroxyprogesterone acetate (MPA) alone or in combination with conjugated equine estrogens (CEE) impairs insulin sensitivity. In the current study, we sought to determine if the effect of MPA on whole body insulin sensitivity is associated with alterations in insulin signaling proteins in skeletal muscle. Ovariectomized cynomolgus monkeys were treated for 2 years with either no hormones (n = 10), CEE (0.625 mg/day human equivalent, n = 11) or CEE + MPA (2.5 mg/day human equivalent, n = 12). At the end of the study, biopsies of rectus femoris muscle were flash frozen in the basal and insulin-stimulated (10 min post-intravenous insulin injection) state. Immunoblotting revealed that CEE + MPA monkeys had significantly less glucose transporter 4 (GLUT4) expression (ANOVA P = 0.001), but there was no significant treatment effect on expression of insulin receptor, insulin receptor substrate (IRS)-1, IRS-2, or the p85 subunit of phosphatidylinositol 3-kinase (PI 3-K). There was a tendency for decreased insulin receptor tyrosine phosphorylation with CEE + MPA treatment (ANOVA P = 0.14). These deficiencies in skeletal muscle insulin signaling likely contribute to the unfavorable changes in whole body insulin sensitivity associated with CEE + MPA treatment. PMID:15219409

Shadoan, Melanie K; Zhang, Li; Wagner, Janice D

2004-05-01

379

Effects of whole-body vibration with an unstable surface on muscle activation.  

PubMed

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

Marin, P J; Hazell, T J

2014-06-01

380

Muscle activation in young men during a lower limb aquatic resistance exercise with different devices.  

PubMed

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

2014-05-01

381

Surgery for diabetic retinopathy.  

PubMed

Surgery for diabetic retinopathy addresses late secondary complications of a primary microvascular disease. Since surgery is not a causative therapy, the functional outcome of surgery depends on the degree of retinal ischemia and may be disappointing even in technically and anatomically successfully operated eyes. Typical indications for vitrectomy are vitreous hemorrhage, tractional retinal detachment, combined tractional rhegmatogenous retinal detachment and tractive macular edema. More recently diffuse diabetic macular edema has been shown to improve after removal of an attached vitreous in several cases. Neovascular glaucoma requires aggressive surgical intervention to salvage the eye. Cataract surgery is commonly performed in eyes with diabetic retinopathy. It may however deteriorate diabetic eye disease. Vitreous surgery also has a potential for severe complications in diabetic eyes which can be ameliorated but not eliminated by proper surgical strategies and techniques. The decision for an intervention in diabetic eyes always requires a careful weighing of risks and benefits of surgery. PMID:17380064

Helbig, Horst

2007-01-01

382

Does primary brachial plexus surgery alter palliative tendon transfer surgery outcomes in children with obstetric paralysis?  

PubMed Central

Background The surgical management of obstetrical brachial plexus palsy can generally be divided into two groups; early reconstructions in which the plexus or affected nerves are addressed and late or palliative reconstructions in which the residual deformities are addressed. Tendon transfers are the mainstay of palliative surgery. Occasionally, surgeons are required to utilise already denervated and subsequently reinnervated muscles as motors. This study aimed to compare the outcomes of tendon transfers for residual shoulder dysfunction in patients who had undergone early nerve surgery to the outcomes in patients who had not. Methods A total of 91 patients with obstetric paralysis-related shoulder abduction and external rotation deficits who underwent a modified Hoffer transfer of the latissimus dorsi/teres major to the greater tubercle of the humerus tendon between 2002 and 2009 were retrospectively analysed. The patients who had undergone neural surgery during infancy were compared to those who had not in terms of their preoperative and postoperative shoulder abduction and external rotation active ranges of motion. Results In the early surgery groups, only the postoperative external rotation angles showed statistically significant differences (25 degrees and 75 degrees for total and upper type palsies, respectively). Within the palliative surgery-only groups, there were no significant differences between the preoperative and postoperative abduction and external rotation angles. The significant differences between the early surgery groups and the palliative surgery groups with total palsy during the preoperative period diminished postoperatively (p < 0.05 and p > 0.05, respectively) for abduction but not for external rotation. Within the upper type palsy groups, there were no significant differences between the preoperative and postoperative abduction and external rotation angles. Conclusions In this study, it was found that in patients with total paralysis, satisfactory shoulder abduction values can be achieved with tendon transfers regardless of a previous history of neural surgery even if the preoperative values differ.

2011-01-01

383

Flavor relationships among muscles from the beef chuck and round.  

PubMed

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

2006-10-01

384

CV Surgery Online  

NSDL National Science Digital Library

Stanford University's HighWire Press has announced the online publication of several journals. CV Surgery Online offers "a fully searchable online compilation of articles pertinent to the cardiothoracic and vascular surgeon from the 5 American Heart Association Journals: Circulation, Circulation Research, Hypertension, Stroke, and Arteriosclerosis, Thrombosis, and Vascular Surgery." Published by the American Heart Association in conjunction with HighWire Press, the free trial period for CV Surgery Online ended December 31, 2000.

1999-01-01

385

Anaesthesia for urological surgery  

Microsoft Academic Search

A wide variety of patients present for urological surgery, from young fit patients to the elderly with multiple co-morbidities. Urological surgery ranges from minor, minimally invasive procedures to major surgery with significant physiological disturbance. It presents several specific challenges to anaesthetists. In day-case urology, a rapid turnover of patients, many of whom are elderly with significant co-morbidity, is required. General

Jane Duffty; Graeme Hilditch

2009-01-01

386

Herbal medications and plastic surgery: a hidden danger.  

PubMed

Herbal medicine is a multibillion-pound industry, and surveys suggest that ~10% of the UK population uses herbal supplements concurrently with prescription medications. Patients and health care practitioners are often unaware of the adverse side effects of herbal medicines. In addition, because many of these herbal supplements are available over the counter, many patients do not disclose these when listing medications to health care providers. A 39-year-old nurse underwent an abdominoplasty with rectus sheath plication after weight loss surgery. Postoperatively, she experienced persistent drain output, and after discharge, a seroma developed requiring repeated drainage in the clinic. After scar revision 10 months later, the woman bled postoperatively, requiring suturing. Again, a seroma developed, requiring repeated drainage. It was discovered that the patient had been taking a herbal menopause supplement containing ingredients known to have anticoagulant effects. Complementary medicine is rarely taught in UK medical schools and generally not practiced in UK hospitals. Many supplements are known to have anticoagulant, cardiovascular, and sedative effects. Worryingly, questions about herbal medicines are not routinely asked in clinics, and patients do not often volunteer such information. With the number and awareness of complementary medications increasing, their usage among the population is likely to increase. The authors recommend specific questioning about the use of complementary medications and consideration of ceasing such medications before surgery. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . PMID:24488003

Mohan, Arvind; Lahiri, Anindya

2014-04-01

387

Monomelic muscle atrophy.  

PubMed

Two patients with slowly progressive muscle atrophy limited to only one leg are reported. They had pes equinovarus deformity and muscle weakness in the affected leg but no symptom in the other limbs. Muscle biopsies from the affected leg showed dystrophic changes consisting of variation in muscle fiber size, endomysial fibrosis, and necrotic and regenerating fibers. Dystrophin was normally expressed at the surface membrane of the muscle fibers. These two patients possibly had a variant of distal muscular dystrophy, though a neural influence could not be completely excluded. PMID:8268728

Takemitsu, M; Murayama, K; Saga, T; Michihiro, N; Shiihara, H; Kimizuka, M; Nonaka, I

1993-07-01

388

Hyperoxaluria and Bariatric Surgery  

NASA Astrophysics Data System (ADS)

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.

2007-04-01

389

Pediatric heart surgery - discharge  

MedlinePLUS

Congenital heart surgery - discharge; Patent ductus arteriosus ligation - discharge; Hypoplastic left heart repair - discharge; Tetralogy of Fallot repair - discharge; Coarctation of the aorta repair - discharge; ...

390

Evaluation of malnutrition in orthopaedic surgery.  

PubMed

Malnutrition can increase the risk of surgical site infection in both elective spine surgery and total joint arthroplasty. Obesity and diabetes are common comorbid conditions in patients who are malnourished. Despite the relatively high incidence of nutritional disorders among patients undergoing elective orthopaedic surgery, the evaluation and management of malnutrition is not generally well understood by practicing orthopaedic surgeons. Serologic parameters such as total lymphocyte count, albumin level, prealbumin level, and transferrin level have all been used as markers for nutrition status. In addition, anthropometric measurements, such as calf and arm muscle circumference or triceps skinfold, and standardized scoring systems, such as the Rainey-MacDonald nutritional index, the Mini Nutritional Assessment, and institution-specific nutritional scoring tools, are useful to define malnutrition. Preoperative nutrition assessment and optimization of nutritional parameters, including tight glucose control, normalization of serum albumin, and safe weight loss, may reduce the risk of perioperative complications, including infection. PMID:24603829

Cross, Michael Brian; Yi, Paul Hyunsoo; Thomas, Charlotte F; Garcia, Jane; Della Valle, Craig J

2014-03-01

391

Optical characterization of muscle  

NASA Astrophysics Data System (ADS)

Optical characterization and internal structure of biological tissues is highly important for biomedical optics. In particular for optical clearing processes, such information is of vital importance to understand the mechanisms involved through the variation of the refractive indices of tissue components. The skeletal muscle presents a fibrous structure with an internal arrangement of muscle fiber cords surrounded by interstitial fluid that is responsible for strong light scattering. To determine the refractive index of muscle components we have used a simple method of measuring tissue mass and refractive index during dehydration. After performing measurements for natural and ten dehydration states of the muscle samples, we have determined the dependence between the refractive index of the muscle and its water content. Also, we have joined our measurements with some values reported in literature to perform some calculations that have permitted to determine the refractive index of the dried muscle fibers and their corresponding volume percentage inside the natural muscle.

Oliveira, Luís; Lage, Armindo; Pais Clemente, Manuel; Tuchin, Valery V.

2011-10-01

392

Changes in muscle activation patterns in response to enhanced sensory input during treadmill stepping in infants born with myelomeningocele.  

PubMed

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

2012-12-01

393

Glycopyrrolate induced bilateral angle closure glaucoma after cervical spine surgery.  

PubMed

To report a case of bilateral acute angle closure glaucoma (AACG) that occurred after cervical spine surgery with the use of glycopyrolate. A 59-year-old male who presented with severe bilateral bifrontal headache and eye pain that started 12 h postextubation from a cervical spine surgery. Neostigmine 0.05 mg/kg (4.5 mg) and glycopyrrolate 0.01 mg/kg (0.9 mg) were used as muscle relaxant reversals at the end of the surgery. Ophthalmic examination revealed he had bilateral AACG with plateau iris syndrome that was treated medically along with laser iridotomies. Thorough examination of anterior chamber should be performed preoperatively on all patients undergoing surgeries in the prone position and receiving mydriatic agents under general anesthesia. PMID:23741140

Jaroudi, Mahmoud; Fadi, Maalouf; Farah, Fadi; El Mollayess, Georges M

2013-01-01

394

Penile enlargement surgery.  

PubMed

Aesthetic surgery to improve the appearance of the penis, scrotum, and pubic region has successfully evolved. Penile lengthening is performed by releasing the suspensory ligament of the penis followed by use of penile weights. Girth is increased by wrapping a dermal-fat graft around the penile circumference. The choice of surgery is determined by the patient's anatomy and desires. PMID:9623619

Alter, G J

1998-06-01

395

Economics of epilepsy surgery  

PubMed Central

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.

Sadanand, Venkatraman

2014-01-01

396

Virtual Knee Surgery  

NSDL National Science Digital Library

In this online activity, learners assist in performing a virtual total knee replacement surgery. There is a great deal of information about this procedure specifically as well as general surgical information, along with questions the learner must answer (using information given onscreen) before the surgery can proceed.

Edheads; Cosi

2007-01-01

397

Lasik eye surgery - discharge  

MedlinePLUS

LASIK is eye surgery that permanently changes the shape of the cornea (the clear covering on the front of the eye) in ... improves. At the first doctor visit after the surgery, the eye shield will be removed and the doctor will ...

398

Electromyographic Activities of Trunk Muscles Due to Different Exercise Intensities during Pulley-based Shoulder Exercises on an Unstable Surface  

PubMed Central

[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.

Cha, Jae Yun; Shin, Doo Chul; Shin, Seung Ho; Lee, Myung Mo; Lee, Kyoung Jin; Song, Chang Ho

2014-01-01

399

Orbital endoscopic surgery  

PubMed Central

Minimally invasive ?keyhole? surgery performed using endoscopic visualization is increasing in popularity and is being used by almost all surgical subspecialties. Within ophthalmology, however, endoscopic surgery is not commonly performed and there is little literature on the use of the endoscope in orbital surgery. Transorbital use of the endoscope can greatly aid in visualizing orbital roof lesions and minimizing the need for bone removal. The endoscope is also useful during decompression procedures and as a teaching aid to train orbital surgeons. In this article, we review the history of endoscopic orbital surgery and provide an overview of the technique and describe situations where the endoscope can act as a useful adjunct to orbital surgery.

Selva, Dinesh

2008-01-01

400

Thigh and calf girth following knee injury and surgery.  

PubMed

Girth measures are commonly used to assess muscle atrophy or joint effusion. Little is known, however, regarding girth measurement changes following knee injury and subsequent surgery. Therefore, the purpose of this study was to compare the thigh and calf girth measurements of involved and noninvolved extremities prior to and following knee surgery for subjects with acute and chronic knee injuries. Of the 40 subjects that were studied, 22 subjects were placed in the acute group (less than 6 months from time of injury to presurgery measurement) and 18 subjects were placed in the chronic group (greater than 6 months from time of injury to presurgery measurement). Thigh and calf girth measurements were taken prior to surgery and then prior to the initiation of outpatient rehabilitation following surgery. For the acute and chronic groups, a three-way analysis of variance (ANOVA) with repeated measures on the extremity, muscle, and time factors was used to analyze the data. For each group, the three-way ANOVA revealed a significant two-way interaction between the extremity and time factors. Post hoc analysis revealed significant differences between involved and noninvolved extremities at both the pre- and post-surgery time periods for the acute and chronic groups. While thigh and calf girth measurement differences existed between the involved and noninvolved extremities prior to and after surgery, the bulk of the girth measurement differences existed prior to surgery for both groups. Based upon the results of this study, the assessment and rehabilitation of the thigh and calf following knee injury and surgery are recommended. PMID:9440035

Ross, M; Worrell, T W

1998-01-01