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Sample records for abdominis myocutaneous tram

  1. In situ Transverse Rectus Abdominis Myocutaneous Flap: A Rat Model of Myocutaneous Ischemia Reperfusion Injury

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  3. Abdominal Closure after TRAM Flap Breast Reconstruction with Transversus Abdominis Muscle Release and Mesh

    PubMed Central

    Avendano-Peza, Héctor; Novitsky, Yuri W.

    2016-01-01

    Summary: Breast reconstruction with a pedicled transverse rectus abdominis muscle (TRAM) flap can result in significant abdominal wall donor-site morbidity. Although the pedicled TRAM flap donor area reinforced with mesh results in decreased rates of postoperative abdominal bulging and hernias, the best technique to accomplish that is yet to be elucidated. We present our novel technique of posterior components separation with transversus abdominis muscle release and retromuscular mesh reinforcement for donor-area closure during pedicled TRAM flap breast reconstruction. PMID:27757337

  4. Etanercept protects myocutaneous flaps from ischaemia reperfusion injury: An experimental study in a rat tram flap model.

    PubMed

    Ersoy, Burak; Çevik, Özge; Çilingir, Özlem Tuğçe

    2016-08-01

    Background Being an inevitable component of free tissue transfer, ischemia-reperfusion injury tends to contribute to flap failure. TNF-α is an important proinflammatory cytokine and a prominent mediator of the ischemia-reperfusion injury. Etanercept, a soluble TNF-α binding protein, has shown anti-inflammatory and anti-apoptotic effects in animal models of renal and myocardial ischemia-reperfusion injury. We have designed an experimental study to investigate the effect of etanercept on myocutaneous ischemia-reperfusion injury on transverse rectus abdominis myocutaneous flap model in rats. Methods Twenty-four male Sprague-Dawley rats were divided into 3 groups: In group 1 (sham), the TRAM flap was raised and sutured back without further intervention. In group 2 (control), the flap was raised and the ischemia-reperfusion protocol was followed. In group 3, etanercept (10 mg/kg, i.v.) was administered 10 minutes before reperfusion. At the end of the reperfusion period, biochemical and histolopathological evaluations were performed on serum and tissue samples. Results In the etanercept group the IMA and 8-OHdG levels (p = 0.005 and p = 0.004, respectively) were found significantly lower, and the GSH and SOD levels (p = 0.01 and p < 0.001, respectively) significantly higher in comparison to the control group. The histopathological analysis has revealed a lower degree of hyalinization, degenerated muscle fibers and nuclear change in the etanercept group compared to the control group. Conclusion The results of our experimental study indicate that etanercept offers protection against ischemia-reperfusion injury in skeletal muscle tissue, enhancing the TRAM flap viability. The ability of etanercept to induce ischemic tolerance suggests that it may be applicable in free-flap surgery.

  5. A case report on a full-thickness chest wall reconstruction with polypropylene mesh and stainless steel mesh concurrently using a transverse rectus abdominis myocutaneous flap.

    PubMed

    Yoshino, Naoyuki; Yamauchi, Shigeo; Akimoto, Masataka; Hisayoshi, Takao; Koizumi, Kiyoshi; Shimizu, Kazuo

    2006-12-01

    A full-thickness chest wall resection requires subsequent chest wall reconstruction. A chest wall resection and reconstruction was performed using a transverse rectus abdominis myocutaneous (TRAM) flap, together with polypropylene mesh (Marlex mesh) and stainless steel mesh (SSM). A 71-year-old man was diagnosed as having recurrent lung cancer in the chest wall, and underwent surgical resection. Marlex mesh was sutured to the posterior wall of the surgical defect. A portion of the SSM was adjusted to the size of the defect and cut out. Its edges were folded to make the portion into a plate. This SSM plate was placed anteriorly to the Marlex mesh and sutured to the ribs. The Marlex mesh was folded back on the SSM plate by 2 cm and fixed. After the above procedures, a left-sided TRAM flap was raised through a subcutaneous tunnel up to the defect and sutured to the region. The patient was discharged from hospital 19 days postoperatively. The wound was fine and he had no flail chest or dyspnea, and carcinomatous pain resolved.

  6. Extensive Chest Wall Tissue Loss and its Management by Vertical Rectus Abdominis Myocutaneous Flap

    PubMed Central

    Basu, Sandip Kanti; Bain, Jayanta; Chattopadhyay, Debarati; Majumdar, Bijay Kumar

    2017-01-01

    Extensive electric burn around the chest in children is rare and this type of injury always poses a great challenge for its management. A 12-year-old male child with extensive electric burn of the chest wall was admitted to hospital. It was a neglected case of 9 days old burn; the young boy was in critical condition having systemic features of toxemia with widespread necrosis of the skin, subcutaneous tissues, and muscles along with exposed bones (ribs and sternum) with the risk of impending rupture of pleura through the exposed intercostal spaces. After initial resuscitation, a thorough debridement of all necrotic tissues was done. Thereafter, a superiorly based vertical rectus abdominis myocutaneous flap was harvested to cover the exposed bones and intercostal spaces. The remaining raw areas were skin grafted. The child made an excellent recovery with good outcome. PMID:28082777

  7. Initial experience with the use of porcine acellular dermal matrix (Strattice) for abdominal wall reinforcement after transverse rectus abdominis myocutaneous flap breast reconstruction.

    PubMed

    Cicilioni, Orlando; Araujo, Gerson; Mimbs, Nancy; Cox, Matthew D

    2012-03-01

    Reestablishing anterior rectus fascial integrity remains a clinical challenge after transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction. The main concerns include herniation and bulging due to abdominal weakness. Mesh-assisted closure of the fascial defect has improved bulging and herniation rates but infection, extrusion, and encapsulation are serious concerns with mesh use. Biologic tissue matrices may overcome some of these mesh-related complications. The initial experience of using Strattice for fascial closure after TRAM flap procedure is described in this article. Strattice was in-lain and sutured between the anterior and posterior layers of the rectus fascia, at the rectus muscle donor site. The abdominal wall was closed with progressive tension sutures. Postoperative complications at the donor site were assessed. A total of 16 unilateral and 9 bilateral reconstructions were performed in 25 patients. Length of hospital stay was 2 to 3 days which is shorter than with mesh repair (typically 4-5 days). During a mean follow-up period of 14.0 months, complications occurred in 7 patients (28%): seroma formation (2), minor skin separation (2), superficial skin infection (2), and superficial wound dehiscence (1). Complications were not directly related to Strattice and all, except one (superficial skin infection), were resolved without surgical intervention. In all patients, routine abdominal functions were restored 4 months postoperatively. Strattice is a safe, alternative option to synthetic mesh for fascial repair following TRAM flap breast reconstruction. When used in conjunction with progressive tension suture closure of the abdominal wall, dynamic reconstruction of the abdominal wall with resumption of abdominal function is possible with Strattice.

  8. Free transverse rectus abdominis myocutaneous and deep inferior epigastric perforator flaps for breast reconstruction: a systematic review of flap complication rates and donor-site morbidity.

    PubMed

    Sailon, Alexander M; Schachar, Jeffrey S; Levine, Jamie P

    2009-05-01

    Free transverse rectus abdominis myocutaneous and deep inferior epigastric perforator flaps represent increasingly popular options for breast reconstruction. Although several retrospective, small-scale studies comparing these flaps have been published, most have failed to find a significant difference in flap complication rates or donor-site morbidity. We systematically reviewed the current literature, and subsequently pooled and analyzed data from included studies. Included studies reported flap complications and/or donor site morbidities for both flap types. Eight studies met the inclusionary criteria. For flap complications, there was a statistically significant difference between deep inferior epigastric perforator and free transverse rectus abdominis myocutaneous flaps in fat necrosis rates (25.5 +/- 0.49 vs. 11.3% +/- 0.41%, P < 0.001) and total necrosis rates (4.15 +/- 0.08 vs. 1.59% +/- 0.08%, P = 0.044). Partial necrosis rates were not statistically significant (3.54 +/- 0.07 vs. 1.60% +/- 0.07%, P = 0.057). For donor-site morbidity, there was no statistically significant difference in abdominal bulge (8.07 +/- 0.23 vs. 11.25% +/- 0.29%, P = 0.28). Multicenter, prospective studies are needed to further investigate differences between these flap options.

  9. 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

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

    1998-10-01

    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.

  10. Breast reconstruction with single-pedicle TRAM flap in breast cancer patients with low midline abdominal scar

    PubMed Central

    Wu, Jun-Dong; Huang, Wen-He; Qiu, Si-Qi; He, Li-Fang; Guo, Cui-Ping; Zhang, Yong-Qu; Zhang, Fan; Zhang, Guo-Jun

    2016-01-01

    Breast reconstruction with transverse rectus abdominis myocutaneous (TRAM) flap is challenging in patients with low midline abdominal scar. In this study, we aimed to investigate the clinical feasibility of immediate breast reconstruction using single-pedicle TRAM (SP-TRAM) flaps in patients with low midline abdominal scar. There were 4 strict selection criteria: 1) presence at least 3 perforators on the pedicle side; 2) perforators with regional average flow velocity of >20 cm/s; 3) upper edge of the abdominal scar at least 4 cm from the umbilicus; and 4) scar age >1 year. Eight breast cancer patients with low midline abdominal scar (scar group) and 20 without (control group) underwent immediate breast reconstruction with SP-TRAM flaps consisting of zone I and III and zone II tissues. Flap complications, donor-site complications, and cosmetic results were compared between the two groups. All flaps survived and both groups presented similar flap and donor site complications, including fat necrosis, seroma, hematoma, infection, delayed wound healing, and abdominal hernia, and patients in both groups had similar aesthetic results (p > 0.05). Thus, the study demonstrated that breast reconstruction using SP-TRAM flap was a safe approach in carefully selected patients with low midline abdominal scar. PMID:27406872

  11. “Emergency” definitive reconstruction of a necrotising fasciitis thigh debridement defect with a pedicled TRAM flap

    PubMed Central

    Hughes, Tom; Yu, Jonathan T.S.; Wong, Kai Yuen; Malata, Charles M.

    2013-01-01

    INTRODUCTION Necrotising fasciitis (NF) is a rare, severe, rapidly progressing and life-threatening synergistic infection primarily affecting the superficial fascia. A novel method of definitive and aesthetic reconstruction of NF thigh defects by using a pedicled transverse rectus abdominis myocutaneous (TRAM) flap without recourse to temporising skin grafts is presented. PRESENTATION OF CASE A 30-year-old parous woman presented in extremis with fulminant NF of her left anteromedial thigh. Following emergency radical debridement and intensive care stabilisation she was reconstructed 48 h later in a single stage with a pedicled TRAM flap islanded on the ipsilateral deep inferior epigastric vessels. There was excellent contour restoration of her thigh and coverage of the exposed femoral vessels. DISCUSSION Pedicled flaps based on the rectus abdominis muscle provide a large, readily available reconstructive option for correction of substantial regional defects as herein illustrated. They are robust when based on dominant inferior vascular pedicle with a long reach and wide arc of rotation when designed transversely (as a TRAM flap). CONCLUSION This case also illustrates that definitive flap reconstruction of NF can be successfully undertaken in the emergent setting, thereby negating the need for large areas of skin grafting which can lead to contractures with consequent functional impairment and suboptimal aesthetic results. PMID:23548707

  12. Preoperative TRAM free flap volume estimation for breast reconstruction in lean patients.

    PubMed

    Minn, Kyung Won; Hong, Ki Yong; Lee, Sang Woo

    2010-04-01

    To obtain pleasing symmetry in breast reconstruction with transverse rectus abdominis myocutaneous (TRAM) free flap, a large amount of abdominal flap is elevated and remnant tissue is trimmed in most cases. However, elevation of abundant abdominal flap can cause excessive tension in donor site closure and increase the possibility of hypertrophic scarring especially in lean patients. The TRAM flap was divided into 4 zones in routine manner; the depth and dimension of the 4 zones were obtained using ultrasound and AutoCAD (Autodesk Inc., San Rafael, CA), respectively. The acquired numbers were then multiplied to obtain an estimate of volume of each zone and the each zone volume was added. To confirm the relation between the estimated volume and the actual volume, authors compared intraoperative actual TRAM flap volumes with preoperative estimated volumes in 30 consecutive TRAM free flap breast reconstructions. The estimated volumes and the actual elevated volumes of flap were found to be correlated by regression analysis (r = 0.9258, P < 0.01). According to this result, we could confirm the reliability of the preoperative volume estimation using our method. Afterward, the authors applied this method to 7 lean patients by estimation and revision of the design and obtained symmetric results with minimal donor site morbidity. Preoperative estimation of TRAM flap volume with ultrasound and AutoCAD (Autodesk Inc.) allow the authors to attain the precise volume desired for elevation. This method provides advantages in terms of minimal flap trimming, easier closure of donor sites, reduced scar widening and symmetry, especially in lean patients.

  13. The impact of Pfannenstiel scars on TRAM flap complications.

    PubMed

    Dayhim, Fariba; Wilkins, Edwin G

    2004-11-01

    For the past two decades, the transverse rectus abdominis musculocutaneous (TRAM) flap has been a mainstay of postmastectomy breast reconstruction. Because the flap depends on musculocutaneous perforating vessels from the rectus muscle for survival, some authors have raised concerns about increased risks of TRAM flap loss in patients with scars from previous abdominal surgeries, particularly those with Pfannenstiel scars. To assess the effects of Pfannenstiel scars on complication rates, we retrospectively evaluated the inpatient and outpatient records of 241 patients undergoing TRAM reconstruction in a single institution over an 11-year period. Of these patients, 51 had previous Pfannenstiel scars. while 190 did not. Controlling for potential confounding variables (body mass index and timing of reconstruction), logistic regressions found no significant differences between the Pfannenstiel and nonPfannenstiel cohorts in the rate of flap loss (15.7% and 20%, respectively; P = 0.376) or in the incidence of postoperative abdominal donor site laxity (17.6% and 12.1%, respectively; P= 0.361). Within the Pfannenstiel group, the type of TRAM reconstruction (ie, pedicle versus free flaps) did not have a significant effect on complication rates. We conclude that previous concerns over the impact of preexisting Pfannenstiel scars on TRAM flap complications are unfounded.

  14. Is there a Rationale for Autologous Breast Reconstruction in Older Patients? A Retrospective Single Center Analysis of Quality of life, Complications and Comorbidities after DIEP or ms-TRAM Flap Using the BREAST-Q.

    PubMed

    Ludolph, Ingo; Horch, Raymund E; Harlander, Marina; Arkudas, Andreas; Bach, Alexander D; Kneser, Ulrich; Schmitz, Marweh; Taeger, Christian D; Beier, Justus P

    2015-01-01

    Autologous breast reconstruction with the deep inferior epigastric perforator (DIEP) or muscle-sparing transverse rectus abdominis myocutaneous (ms-TRAM) flap is a common method in the majority of patients after mastectomy. Because of an increased perioperative risk profile the benefit in older patients is questionable. To assess the postoperative quality of life and peri- and post-operative complications of older compared to younger patients is the aim of this retrospective study. In a retrospective analysis 39 older (i.e. >60 years) and 140 younger patients (i.e. <60 years) with autologous breast reconstruction in the Department of Plastic Surgery at the University Hospital of Erlangen-Nuernberg were surveyed at least 6 month postoperative using the BREAST-Q questionnaire. Correlations were generated between comorbidities and complications. Significant differences were observed regarding hospitalization, pre-existing diseases and the choice of DIEP versus ms-TRAM flaps. Parameters such as major and minor complications, bulging or hernia and risk factors (e.g. smoking or obesity) showed no significant differences. The results of the questionnaire parameters showed no significant difference between both groups, revealing high satisfaction with the aesthetic result and an improvement in quality of life independent of age. Autologous breast reconstruction after mastectomy generates a gain in quality of life and shows a good to excellent overall satisfaction in older as well as younger patients. Despite a longer hospitalization and a different risk profile there were no significant differences regarding minor and major complications in the postoperative course. Hence autologous breast reconstruction for older patients is justified and should be taken into consideration.

  15. 31. LOOKING SOUTHEAST. AS THE TRAM ENTERED THE GRAVITY TRAM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    31. LOOKING SOUTHEAST. AS THE TRAM ENTERED THE GRAVITY TRAM LINE, IT CROSSED THIS CUT-STONE BRIDGE AND WAS CONTROLLED BY THE SWITCHING PLATFORM IN THE BACKGROUND - Independent Coal & Coke Company, Kenilworth, Carbon County, UT

  16. Salvage for pectoralis major myocutaneous flap failure in head and neck reconstruction by microvascular flap.

    PubMed

    Tang, Chen-Ling; Wu, Yi-Chia; Lai, Ching-Hung; Lai, Chung-Sheng; Lin, Chih-Lung; Lin, Sin-Daw; Chang, Kao-Ping

    2012-10-01

    The pectoralis major myocutaneous pedicled flap (PMMPF) - the "workhorse" for head and neck reconstruction - is associated with a high incidence of complications in certain cases. This study presents free tissue transfer as an alternative salvage technique after PMMPF failure in head and neck reconstruction. It includes seven consecutive patients who underwent free tissue salvage after PMMPF failure in head and neck reconstruction from January 2008 to September 2010 at Kaohsiung Medical University Hospital, Taiwan. Four vertical rectus abdominis myocutaneous (VRAM) flaps were applied for tongue and mouth floor defects, while three anterolateral thigh (ALT) flaps were used for mouth floor, buccal, and cheek defects. All flaps survived uneventfully, and normal oral feeding was achieved without major complications. Free tissue transfer has several advantages and can be successfully employed in head and neck reconstruction, and it is also a reliable salvage procedure after PMMPF failure in such cases.

  17. Paradoxical effects of heme arginate on survival of myocutaneous flaps

    PubMed Central

    Czopek, Alicja; Wigmore, Stephen J.; Kluth, David C.

    2013-01-01

    Ischemia reperfusion injury (IRI) contributes to partial flap and solid organ transplant failure. Heme-oxygenase 1 (HO-1) is an inducible, cytoprotective enzyme which protects against IRI in solid organ transplant models. Heme arginate (HA), a HO-1 inducer, is a promising, translatable, preconditioning agent. This study investigated the effects of preconditioning with HA on the clinical outcome of a myocutaneous IRI model. Forty male Lewis rats were randomized to intravenously receive 1) Control-NaCl, 2) HA, 3) HA and tin mesoporphyrin (SnMP), a HO-1 inhibitor; and 4) SnMP alone. Twenty-four hours later, an in situ transverse rectus abdominis myocutaneous flap was performed under isoflurane anesthesia. Viability of flaps was measured clinically and by laser-Doppler perfusion scanning. In vitro work on human epidermal keratinocytes (HEKa) assessed the effects of HA, SnMP, and the iron chelator desferrioxamine on 1) cytotoxicity, 2) intracellular reactive oxygen species (ROS) concentration, and 3) ROS-mediated DNA damage. In contrast to our hypothesis, HA preconditioning produced over 30% more flap necrosis at 48 h compared with controls (P = 0.02). HA-containing treatments produced significantly worse flap perfusion at all postoperative time points. In vitro work showed that HA is cytotoxic to keratinocytes. This cytotoxicity was independent of HO-1 and was mediated by the generation of ROS by free heme. In contrast to solid organ data, pharmacological preconditioning with HA significantly worsened clinical outcome, thus indicating that this is not a viable approach in free flap research. PMID:24089372

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

    PubMed

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

    2016-02-01

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

  19. [Radiotherpay and immediate breast reconstruction with myocutaneous flap in breast cancer of reserved prognosis].

    PubMed

    Missana, M C; Levy, C; Barreau-Pouhaer, L; Janin, N

    2000-04-01

    In France, immediate breast reconstruction (IBR) for infiltrating carcinoma remains controversial. Many teams advocate the possible event of a post mastectomy radiotherapy and its negative effect on IBR. In our Institute we do not exclude infiltrating breast cancer patient from IBR. In the poor prognostic patients who wish IBR, we recommend autologous IBR to obtain the best aesthetic result with minimum revision procedures and best tolerance to adjuvant radiotherapy. From January 1993 to December 1997, we performed 687 IBR with myocutaneous flap for infiltrating carcinomas. In this group only 68 patients needed postoperative chest wall radiotherapy (45 Gy): 27 TRAM flap, 41 latissimus flap. Only one of the TRAM but 39 of latissimus flaps were associated with a prosthesis. The mean follow-up was 24 months. Fourteen patients developed metastatic disease, and ten were dead at the time of the chart revue. The autogenous TRAM flap tolerate radiation quite well and remain soft and mobile. The latissimus flap associated with a prosthesis developed capsular contracture (BAKER II or III) in 71% of cases. In all cases the cosmetic impairment was not important and the result after capsulectomy remained soft. We concluded that IBR could be offered to motivated patients in all stages of the disease regardless of the subsequent chest wall radiotherapy, and we recommend its use for possible autologous reconstruction.

  20. Metabolism in pedicled and free TRAM flaps: a comparison using the microdialysis technique.

    PubMed

    Edsander-Nord, Asa; Röjdmark, Jonas; Wickman, Marie

    2002-02-01

    The most common complication in flap surgery is of a circulatory nature. Impeded blood flow leads to altered metabolism in the tissue. Possible metabolic differences between different zones of the transverse rectus abdominis muscle (TRAM) flap were studied and the metabolism of pedicled and free TRAM flaps was compared intraoperatively and postoperatively. The method used was microdialysis, which is a useful technique for following local metabolic changes continuously in various tissues.Twenty-two patients with a pedicled or free TRAM flap were monitored using the microdialysis technique. Two microdialysis catheters were placed subcutaneously in the flap (zone I and zone II), and a third one was placed subcutaneously in the flank to serve as a control. The flaps were monitored intraoperatively and postoperatively for 3 days with repeated analyses of extracellular glucose, lactate, and glycerol concentrations. An additional analysis of pyruvate was performed in some patients to calculate the lactate-to-pyruvate ratio. This study showed that glucose, lactate, and glycerol change in a characteristic way when complete ischemia (i.e., complete inhibition of the blood circulation) is present. A slower stabilization with prolonged metabolic signs of ischemia, such as lower glucose and higher lactate and glycerol concentrations, was seen in zone II compared with zone I, and more pronounced metabolic signs of ischemia, but with a faster recovery, were detected in the free TRAM flap group than in the pedicled TRAM flap group. The fact that the metabolites returned to normal earlier in free flaps than in pedicled flaps may indicate that free TRAM flaps sustain less ischemic damage because of better and more vigorous perfusion.

  1. BEO Tram Spectral Data 2014

    DOE Data Explorer

    Torn, Margaret; Serbin, Shawn

    2015-06-10

    Visible to near-infrared (350-1100nm) vegetation spectral reflectance data collected on the BEO automated tram measurement platform during the 2014 growing season. The spectra were collected using a PP Systems UniSpec-DC instrument and was processed to at-surface reflectance and interpolated to 1nm.

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

    PubMed

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

    2016-06-01

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

  3. Crossed pectoralis major myocutaneous flap for recurrent oral cavity cancers

    PubMed Central

    Pancholi, Mayank; Sharma, Sanjay; Desai, Sanjay M.; Agrawal, Deepak

    2016-01-01

    Background: Oral cavity cancers are fairly common and have propensity to recur locally. Since Pectoralis Major Myocutaneous (PMMC) flap is the most widely used first flap for reconstruction, it is exhausted at the earliest and recurrence poses a formidable challenge for reconstructive surgeon. Present study evaluated the feasibility of contralateral Pectoralis Major Myocutaneous Flap for reconstruction after resection of recurrent tumour. Methods: This was a study of the patients presenting with recurrent oral cavity cancer after exhausted ipsilateral Pectoralis Major Myocutaneous Flap (PMMC) in whom we used contralateral Pectoralis Major Myocutaneous Flap (Crossed PMMC Flap) for reconstruction between October 2013 to June 2016. Results: Five patients with recurrence underwent reconstruction with contralateral Pectoralis Major Myocutaneous Flap. In all the flap was successfully used to reconstruct defects involving the entire buccal mucosa and in one patient the flap could be used to reconstruct full thickness resection defect(crossed bipedal PMMC Flap) with ease. Conclusion: Crossed Pectoralis Major Myocutaneous Flap can be used safely and reliably for reconstruction of the buccal mucosal defect and in selected patients even for full thickness cheek defect as folded bipaddle Pectoralis Major Myocutaneous Flap.

  4. Rectus abdominis muscle strains in tennis players

    PubMed Central

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

    2007-01-01

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

  5. Rectus abdominis muscle strains in tennis players.

    PubMed

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

    2007-11-01

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

  6. OVERVIEW OF UPPER TRAM TERMINAL, TRAM TRESTLE, PRIMARY ORE BIN,OVERBURDEN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    OVERVIEW OF UPPER TRAM TERMINAL, TRAM TRESTLE, PRIMARY ORE BIN,OVERBURDEN PILE, AND DEBRIS SCATTER,LOOKING NORTH NORTHWEST. THE MAIN ACCESS TRAIL BETWEEN THE LOWER MILL AREA GOES ACROSS THE CENTER LEFT TO RIGHT. WINCHING ENGINE AND FOUNDATION IN UPPER RIGHT CORNER (SEE CA-291-37). - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  7. Quality of Life and Patient-Reported Outcomes in Breast Cancer Survivors

    PubMed Central

    Macadam, Sheina A.; Zhong, Toni; Weichman, Katie; Papsdorf, Michael; Lennox, Peter A.; Hazen, Alexes; Matros, Evan; Disa, Joseph; Mehrara, Babak; Pusic, Andrea L.; Van Laeken, Nancy; Cordeiro, Peter; Vidal, Dale; Klassen, Anne; Cano, Stefan

    2016-01-01

    Background Approximately 20% of women select autologous tissue for postmastectomy breast reconstruction, and most commonly choose the abdomen as the donor site. An increasing proportion of women are seeking muscle-sparing procedures but the benefit remains controversial. It is therefore important to determine whether better outcomes are associated with these techniques, thereby justifying longer operative times and increased costs. Methods Patients from five North American centers were eligible if they had reconstruction using the deep inferior epigastric artery perforator flap (DIEP), muscle sparing free transverse abdominis myocutaneous flap (msf-TRAM), free transverse abdominis myocutaneous flap (f-TRAM), or the pedicled transverse abdominis myocutaneous flap (p-TRAM) with minimum one-year follow-up. Patients were sent the BREAST-Q©. Demographics and complications were collected by chart review. Results We analyzed 1790 charts representing 670 DIEP, 293 msf-TRAM, 683 p-TRAM, and 144 f-TRAM patients with average follow up of 5.5 years. Flap loss did not differ by flap type. Partial flap loss was higher in p-TRAM compared to DIEP (p=0.002). Fat necrosis was higher in p-TRAM compared to DIEP and msf-TRAM (p<0.001). Hernia/bulge was highest in p-TRAM (p<0.001). Physical Well-Being (Abdomen) scores were higher in DIEP compared to p-TRAM controlling for age, follow-up, BMI, laterality, abdominal surgery, mesh, radiation, income, and education. Conclusions Complications and patient-reported outcomes differ when comparing abdominally-based breast reconstruction techniques. The results of this study show that the DIEP was associated with the highest abdominal well-being and the lowest abdominal morbidity when compared to the p-TRAM, but did not differ from msf-TRAM and f-TRAM. PMID:26910656

  8. Comparison of fat necrosis between zone II and zone III in pedicled transverse rectus abdominis musculocutaneous flaps: a prospective study of 400 consecutive cases.

    PubMed

    Kim, Eun Key; Lee, Taik Jong; Eom, Jin Sup

    2007-09-01

    Fat necrosis in transverse rectus abdominis musculocutaneous (TRAM) flap is considered to be mainly affected by blood supply. This prospective study compares the incidence of fat necrosis between zones II and III in 400 consecutive patients who had undergone unipedicled TRAM flap breast reconstruction. Fifty-eight patients (14.5%) suffered from fat necrosis, and 7 had 2 separate nodules. Fifty-four occurred in zone II, 10 in zone III, and 1 in zone I. The incidence of fat necrosis in zone II was significantly higher than in zone III (P < 0.001). The weight of the mastectomy specimen and the relative amount of zone II tissue included in the flap had positive correlation with the incidence of fat necrosis. This result implies relatively poor perfusion of zone II compared with zone III.

  9. TRAM HOUSE INTERIOR, LOOKING SOUTH. NOTE HORIZONTAL, IDLER, BULL WHEEL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    TRAM HOUSE INTERIOR, LOOKING SOUTH. NOTE HORIZONTAL, IDLER, BULL WHEEL TO REVERSE DIRECTION OF TRACTION CABLE. TRAM CABLE DRIVE MOTOR (NO LONGER EXTANT) WAS AT MINE END OF TRAM. - Shenandoah-Dives Mill, 135 County Road 2, Silverton, San Juan County, CO

  10. Rectus Abdominis Endometrioma after Caesarean Section

    PubMed Central

    Mishina, Anna; Zaharia, Sergiu; Zastavnitsky, Gheorghe

    2016-01-01

    Isolated rectus abdominis muscle endometriosis is very uncommon with less than 20 case reports being published to date since its first description in 1984 by Amato and Levitt. We report another case of isolated rectus abdominis endometriosis in a 37-year-old patient with a previous caesarian section. We also discuss the diagnostic and treatment particularities in these patients. In our case, the treatment was only surgical and currently the patient is disease-free during the 24-month follow-up. PMID:27999704

  11. 3. Elevation, tram deck, bonanza "A" frame and crushers level ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. Elevation, tram deck, bonanza "A" frame and crushers level 11. - Kennecott Copper Corporation, Concentration Mill, On Copper River & Northwestern Railroad, Kennicott, Valdez-Cordova Census Area, AK

  12. Hemipelvectomy for Buttock Tumors Utilizing an Anterior Myocutaneous Flap of Quadriceps Femoris Muscle

    PubMed Central

    Sugarbaker, Paul H.; Chretien, Paul A.

    1983-01-01

    Hemipelvectomy utilizing an anterior myocutaneous flap is indicated for aggressive tumors of the buttock and proximal portion of the posterior thigh. A large operative defect created posteriorly by amputation of the lower extremity, hemipelvis, and buttock is covered by a myocutaneous flap of quadriceps femoris muscle and overlying skin and subcutaneous tissue. The superficial femoral artery is preserved to sustain the myocutaneous flap. ImagesFig. 2A,B,C.Fig. 2A,B,C. PMID:6848048

  13. DETAIL VIEW OF TRAM BUCKET AUTOMATIC LOCKING MECHANISM ON LOWER ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF TRAM BUCKET AUTOMATIC LOCKING MECHANISM ON LOWER TRAM TERMINAL, LOOKING WEST. AS EMPTY BUCKETS PASSED THROUGH THIS MECHANISM, A LEVER ON THE BUCKET WAS ACTIVATED THAT LOCKED THE BUCKET TO THE MOVING CABLE, CARRYING IT ALONG BACK UP TO THE MINES. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  14. DETAIL VIEW OF AERIAL TRAM CABLE COUNTERWEIGHT SYSTEM, LOOKING DOWN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF AERIAL TRAM CABLE COUNTERWEIGHT SYSTEM, LOOKING DOWN THROUGH THE LOWER TERMINAL FLOOR. TWO SUSPENDED ROCK FILLED WOODEN BOXES CAN BE SEEN AT BOTTOM. THE METAL FRAMEWORK WAS INSTALLED BY THE PARK SERVICE DURING THE AERIAL TRAM'S STABILIZATION IN THE 1983. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  15. Latissimus Dorsi Myocutaneous Flap for Breast Reconstruction: Bad Rap or Good Flap?

    PubMed Central

    Perdikis, Galen; Koonce, Stephanie; Collis, George; Eck, Dustin

    2011-01-01

    Objective: This article serves to review latissimus dorsi myocutaneous flap as an option for breast reconstruction postmastectomy. Since the introduction of the latissimus dorsi myocutaneous flap in the late 1970s, its use has always been as a secondary technique, particularly after the development of the transverse rectus abdominus myocutaneous flap in the 1980s. Methods: A literature review of the history of latissimus dorsi myocutaneous flap utilized for breast reconstruction as well as a review of our institution's experience with latissimus dorsi myocutaneous flap and tissue expander placement was performed. Results: There remains a paucity of published studies investigating latissimus dorsi myocutaneous flap for breast reconstruction. Most studies have small numbers and do not utilize tissue expanders. More recently several small studies have been published that show acceptably low complication rates with aesthetically pleasing outcomes when latissimus dorsi myocutaneous flap is employed with a tissue expander. At our institution, we have employed latissimus dorsi myocutaneous flap with tissue expander placement for both delayed and immediate reconstruction with subsequent replacement with a permanent implant with a capsular contraction rate of 10.5%. Our data and others more recently published demonstrate very acceptable capsular contracture rates and aesthetic outcomes, particularly when an expander is utilized. Conclusion: The latissimus dorsi myocutaneous flap remains an excellent choice for breast reconstruction with a low risk of complications. PMID:22031843

  16. Monitoring of free TRAM flaps with microdialysis.

    PubMed

    Udesen, A; Løntoft, E; Kristensen, S R

    2000-02-01

    The aim of this investigation was to follow the metabolism of free TRAM flaps using microdialysis. Microdialysis is a new sampling technique that provide opportunities to follow the biochemistry in specific organs or tissues. A double-lumen microdialysis catheter or probe, with a dialysis membrane at the end, is introduced into the specific tissue. Perfusion fluid is slowly pumped through the catheter and equilibrates across the membrane with surrounding extracellular concentrations of low molecular weight substances. The dialysate is collected in microvials and analyzed by an instrument using very small volumes. Glucose, glycerol, and lactate concentrations were measured in the flaps and compared with those in a reference catheter that was placed subcutaneously in the femur. The investigation continued 72 hr postoperatively. The study group consisted of 14 women who underwent reconstruction with a free TRAM flap, and one woman with a double TRAM flap. During flap ischemia, the concentration of glucose was reduced, while the lactate and glycerol levels increased. The differences between the flaps and controls were statistically highly significant. After reperfusion of the flaps, the concentrations of glucose, lactate, and glycerol approached normal. One flap failed because of an arterial anastomosis thrombosis. This was clearly demonstrated by the samples from the microdialysis: the concentration of glucose fell to an unmeasurable level; the concentration of lactate increased for a period before it stopped due to lack of glucose; and the concentration of glycerol increased to a very high level, probably because ischemia caused damage to the cell membranes of which glycerol is an important part. The authors concluded that microdialysis can detect ischemia in free flaps at an early stage, making early surgical intervention possible.

  17. 12. VIEW, LOOKING NORTH, SHOWING CABLEWAY AND TRAM ABOVE AN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. VIEW, LOOKING NORTH, SHOWING CABLEWAY AND TRAM ABOVE AN ARCH UNDER CONSTRUCTION, WITH RAILROAD BRIDGE IN BACKGROUND - Cotter Bridge, Spanning White River at U.S. Highway 62, Cotter, Baxter County, AR

  18. Translation Microscopy (TRAM) for super-resolution imaging

    PubMed Central

    Qiu, Zhen; Wilson, Rhodri S; Liu, Yuewei; R Dun, Alison; Saleeb, Rebecca S; Liu, Dongsheng; Rickman, Colin; Frame, Margaret; Duncan, Rory R; Lu, Weiping

    2016-01-01

    Super-resolution microscopy is transforming our understanding of biology but accessibility is limited by its technical complexity, high costs and the requirement for bespoke sample preparation. We present a novel, simple and multi-color super-resolution microscopy technique, called translation microscopy (TRAM), in which a super-resolution image is restored from multiple diffraction-limited resolution observations using a conventional microscope whilst translating the sample in the image plane. TRAM can be implemented using any microscope, delivering up to 7-fold resolution improvement. We compare TRAM with other super-resolution imaging modalities, including gated stimulated emission deletion (gSTED) microscopy and atomic force microscopy (AFM). We further developed novel ‘ground-truth’ DNA origami nano-structures to characterize TRAM, as well as applying it to a multi-color dye-stained cellular sample to demonstrate its fidelity, ease of use and utility for cell biology. PMID:26822455

  19. TRAM HOUSE INTERIOR, LOOKING SOUTHEAST. NOTE TRACTION CABLE BULL WHEEL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    TRAM HOUSE INTERIOR, LOOKING SOUTHEAST. NOTE TRACTION CABLE BULL WHEEL AND DEPARTING BUCKET "12," STILL ON RAIL AND JUST PRIOR TO ENGAGING TRACTION CABLE. - Shenandoah-Dives Mill, 135 County Road 2, Silverton, San Juan County, CO

  20. TOP VIEW OF UPPER TRAM TERMINAL, PRIMARY ORE BIN, AND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    TOP VIEW OF UPPER TRAM TERMINAL, PRIMARY ORE BIN, AND ORE CHUTE,LOOKING SOUTHWEST. TRAM MACHINERY AND GEARS ARE AT LOWER CENTER. A SMALL ELECTRIC MOTOR AT THE REAR LEFT OF THE TERMINAL PROBABLY WAS ADDED AFTER THE ORIGINAL CONSTRUCTION. THE MOVING CABLE OF THE TRAM WAS DRIVEN BY THESE GEARS AND THE LARGE WHEEL UNDERNEATH (SEE CA-291-31 FOR DETAIL). EMPTY TRAM BUCKETS CAME IN FROM THE LEFT, SWINGING AROUND TO THE CHUTES FROM THE ORE BIN TO BE LOADED FOR THE TRIP DOWN TO THE MILL (SEE CA-291-35 FOR DETAIL). THE BREAK OVER TOWER CAN BE SEEN IN THE DISTANCE AT TOP LEFT. THE SUPPORT TOWER BETWEEN THE UPPER TERMINAL AND THE BREAK OVER TOWER IS COLLAPSED. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  1. Myocutaneous revascularization following graded ischemia in lean and obese mice

    PubMed Central

    Clark, Ross M; Coffman, Brittany; McGuire, Paul G; Howdieshell, Thomas R

    2016-01-01

    Background Murine models of diabetes and obesity have provided insight into the pathogenesis of impaired epithelialization of excisional skin wounds. However, knowledge of postischemic myocutaneous revascularization in these models is limited. Materials and methods A myocutaneous flap was created on the dorsum of wild type (C57BL/6), genetically obese and diabetic (ob/ob, db/db), complementary heterozygous (ob+/ob−, db+/db−), and diet-induced obese (DIO) mice (n=48 total; five operative mice per strain and three unoperated mice per strain as controls). Flap perfusion was documented by laser speckle contrast imaging. Local gene expression in control and postoperative flap tissue specimens was determined by quantitative reverse transcription polymerase chain reaction (RT-PCR). Image analysis of immunochemically stained histologic sections confirmed microvascular density and macrophage presence. Results Day 10 planimetric analysis revealed mean flap surface area necrosis values of 10.8%, 12.9%, 9.9%, 0.4%, 1.4%, and 23.0% for wild type, db+/db−, ob+/ob−, db/db, ob/ob, and DIO flaps, respectively. Over 10 days, laser speckle imaging documented increased perfusion at all time points with revascularization to supranormal perfusion in db/db and ob/ob flaps. In contrast, wild type, heterozygous, and DIO flaps displayed expected graded ischemia with failure of perfusion to return to baseline values. RT-PCR demonstrated statistically significant differences in angiogenic gene expression between lean and obese mice at baseline (unoperated) and at day 10. Conclusion Unexpected increased baseline skin perfusion and augmented myocutaneous revascularization accompanied by a control proangiogenic transcriptional signature in genetically obese mice compared to DIO and lean mice are reported. In future research, laser speckle imaging has been planned to be utilized in order to correlate spatiotemporal wound reperfusion with changes in cell recruitment and gene expression to

  2. Cornerstones in reconstructive plastic surgery: Argentinian development of muscular, myocutaneous, and fasciocutaneous flaps.

    PubMed

    Kostianovsky, A S; Sostaric, N M

    1992-01-01

    This article pays tribute to two Argentinian surgeons whose work has been published in their local journals but is unknown internationally. Goldtraj's pioneering work on the treatment of vascular ulcers of the leg using a muscular flap, presented in 1954, and Spadafora's work on the treatment of tissue defects with myocutaneous and fasciocutaneous flaps, presented in 1964, are discussed. Both papers deserve a place among the pioneering contributions on the subject of muscular as well as myocutaneous and fasciocutaneous flaps.

  3. DETAIL VIEW OF LOWER TRAM TERMINAL, SECONDARY ORE BIN, CRUSHER ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF LOWER TRAM TERMINAL, SECONDARY ORE BIN, CRUSHER FOUNDATION, AND BALL MILL FOUNDATIONS, LOOKING NORTH NORTHWEST. ORE FROM THE MINES WAS DUMPED FROM THE TRAM BUCKETS INTO THE PRIMARY ORE BIN UNDER THE TRAM TERMINAL. A SLIDING CONTROL DOOR INTRODUCED THE INTO THE JAW CRUSHER (FOUNDATIONS,CENTER). THE CRUSHED ORE WAS THEN CONVEYED INTO THE SECONDARY ORE BIN AT CENTER LEFT. A HOLE IN THE FLOOR OF THE ORE BIN PASSED ORE ONTO ANOTHER CONVEYOR THAT BROUGHT IT OUT TO THE BALL MILL(FOUNDATIONS,CENTER BOTTOM). THIS SYSTEM IS MOST LIKELY NOT THE ORIGINAL SET UP, PROBABLY INSTALLED IN THE MINE'S LAST OCCUPATION IN THE EARLY 1940s. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  4. Intractable pain due to rectus abdominis intramuscular haemangioma.

    PubMed

    Scozzari, G; Reddavid, R; Conti, L; Trombetta, F; Toppino, M; Sandrucci, S

    2014-08-01

    Haemangiomas are tumours of vascular origin accounting for approximately 7 % of all benign tumours. Three types of haemangioma have been described according to the vessel type involved: capillary, cavernous and mixed. Intramuscular haemangiomas (IMHs) are infrequent, accounting for less than 1 % of all haemangiomas and are mostly located in the extremities and the trunk. Intramuscular haemangiomas of the rectus abdominis muscle are extremely rare, with only one previous case reported in the literature to the best of our knowledge. In this report, we present the case of a patient with intractable pain related to IMHs of the rectus abdominis and we analyse diagnostic assessment and surgical management of the condition.

  5. EAST ELEVATION OF LOWER TRAM TERMINAL WITH SIX FOOT SCALE, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    EAST ELEVATION OF LOWER TRAM TERMINAL WITH SIX FOOT SCALE, LOOKING NORTHWEST. THE SCALE IS LOCATED AT CENTER RIGHT, AGAINST THE SECOND SUPPORT TIMBER FROM THE RIGHT. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  6. TRAM HOUSE INTERIOR, LOOKING SOUTHEAST. NOTE DEPARTING ORE BUCKET "12" ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    TRAM HOUSE INTERIOR, LOOKING SOUTHEAST. NOTE DEPARTING ORE BUCKET "12" AND SUSPENSION CABLE ANGLING DOWN THROUGH FLOOR AT LOWER LEFT. LARGE LEVER ON SIDE OF BUCKET ALLOWS IT TO BE ROTATED FOR DUMPING ORE. - Shenandoah-Dives Mill, 135 County Road 2, Silverton, San Juan County, CO

  7. OVERVIEW OF AERIAL TRAM SUPPORT TOWERS NINE, TEN, AND DEEP ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    OVERVIEW OF AERIAL TRAM SUPPORT TOWERS NINE, TEN, AND DEEP RAVINE,LOOKING SOUTH FROM BREAK OVER TOWER LOCATION. A SINGLE ORE BUCKET HANGS FROM THE CABLE AT CENTER. DEATH VALLEY'S FLOOR IS IN THE DISTANCE (TOP). - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  8. OBLIQUE DETAIL VIEW OF LOWER TRAM TERMINAL, LOOKING NORTHWEST. THE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    OBLIQUE DETAIL VIEW OF LOWER TRAM TERMINAL, LOOKING NORTHWEST. THE JAW CRUSHER FOUNDATION CAN BE CLEARLY SEEN AT CENTER LEFT WITH A CONVEYOR TO CARRY CRUSHED ORE UP TO THE SECONDARY ORE BIN,LEFT. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  9. DETAIL VIEW OF TRAM SUSPENSION CABLE OILING CAR. NOTE CIRCULAR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF TRAM SUSPENSION CABLE OILING CAR. NOTE CIRCULAR TRACTION CABLE CLAMP IN CENTER AND OIL FEED TO CABLE BETWEEN TWO RIGHT-HAND WHEELS. OIL REDUCED FRICTION AND RUST. - Shenandoah-Dives Mill, 135 County Road 2, Silverton, San Juan County, CO

  10. DETAIL VIEW OF AERIAL TRAM SUPPORT TOWERS THREE AND FOUR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF AERIAL TRAM SUPPORT TOWERS THREE AND FOUR WITH TOWERS FIVE AND SIX IN THE DISTANCE, LOOKING NORTHEAST. THE TWO INTACT CABLES RUNNING ALONG TOP OF THE TOWERS ARE FIXED. WHILE THE MOVING CABLE IS LYING SLACK ON THE GROUND. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  11. Three-dimensional derailment analysis of a crashed city tram

    NASA Astrophysics Data System (ADS)

    Zhou, Hechao; Wang, Wenbin; Hecht, Markus

    2013-08-01

    City tram collisions are simulated using multi-body dynamics. The aim of this paper is to investigate the collision-induced derailment. Simulation results demonstrate that the corner obstacle collision scenario defined in EN 15227 is mainly focused on the energy absorption process. Due to the large impact angle (45°), it is unlikely for a city tram to comply with this scenario without derailment. In order to avoid derailment, the maximum impact angle between city tram and oblique obstacle should be reduced to 25°. Moreover, some influence factors are analysed, such as mass of loaded passengers, friction coefficient, impact angle, etc. Derailment phenomenon is shown to be significantly dependent on these parameters. Two measures are proposed to prevent the collided city tram from derailment. One is using secondary lateral dampers to absorb collision energy. Another is increasing the lateral stiffness of secondary springs as well as the lateral clearance, so that more collision energy can be stored in the suspension. With these measures, the safety against derailment can be improved.

  12. Pedicled myocutaneous flap of latissimus dorsi muscle for reconstruction of anterior and middle skull defects: an alternative.

    PubMed

    Seckel, B R; Upton, J; Freidberg, S R; Gilbert, K P; Murray, J E

    1986-01-01

    Three cases are presented demonstrating the use of a pedicled myocutaneous flap of latissimus dorsi muscle to reconstruct large defects of the anterior and middle skull after ablative surgery for carcinoma. This method is proposed as an alternative to reconstruction with a free myocutaneous flap in selected patients.

  13. DETAIL VIEW OF WINCHING ENGINE LOCATED AT THE UPPER TRAM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF WINCHING ENGINE LOCATED AT THE UPPER TRAM TERMINAL, LOOKING NORTHEAST. THE CABLE FROM THIS ENGINE LEADS DOWN INTO THE DEEP RAVINE IN FRONT OF THE UPPER TRAM TERMINAL. IT WAS PROBABLY USED TO DRAG MATERIALS UP TOWARD THE TERMINAL WHEN THE TERMINAL WAS BEING CONSTRUCTED, OR IN TIMES OF TRAMWAY BREAKDOWN. THE DRIVE ENGINE IS IN THE BACKGROUND. TWO LONG OPERATING LEVERS FOR THE ENGINE ARE IN THE CENTER FOREGROUND. AN EXTRA SPOOL OF CABLE IS ON THE GROUND TO THE RIGHT OF THE ENGINE. A WATER PIPELINE STRETCHES ACROSS THE SLOPE IN THE BACKGROUND, CARRYING WATER TO THE UPPER MINES. SEE CA-291-37 FOR IDENTICAL B&W NEGATIVE. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  14. DETAIL VIEW OF WINCHING ENGINE LOCATED AT THE UPPER TRAM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF WINCHING ENGINE LOCATED AT THE UPPER TRAM TERMINAL LOOKING NORTHEAST. THE CABLE FROM THIS ENGINE LEADS DOWN INTO THE DEEP RAVINE IN FRONT OF THE UPPER TRAM TERMINAL. IT WAS PROBABLY USED TO DRAG MATERIALS UP TOWARD THE TERMINAL WHEN THE TERMINAL WAS BEING CONSTRUCTED, OR IN TIMES OF TRAMWAY BREAK DOWN. THE DRIVE ENGINE IS IN THE BACKGROUND. TWO LONG OPERATING LEVERS FOR THE ENGINE ARE IN THE CENTER FOREGROUND. AN EXTRA SPOOL OF CABLE IS ON THE GROUND TO THE RIGHT OF THE ENGINE. A WATER PIPELINE STRETCHES ACROSS THE SLOPE IN THE BACKGROUND, CARRYING WATER TO THE UPPER MINES. SEE CA-291-52 (CT) FOR IDENTICAL COLOR TRANSPARENCY. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  15. Fulminant course in a case of malignant phyllodes tumor

    PubMed Central

    Chang, Young Woo; Kim, Hwan Soo; Kim, Deok Woo

    2017-01-01

    We present the case of a 31-year-old woman with an inflammatory and ulcerative malignant phyllodes tumor in her right breast. A right modified radical mastectomy and transverse rectus abdominis myocutaneous (TRAM) flap were performed. A month after the initial operation, several masses recurred at the superior margin and deep margin of the TRAM flap. Wide excision was performed, but masses recurred at the inferior margin and in both lung fields 2 weeks after the second operation. Six weeks after the second operation, the patient died due to progression of dyspnea and respiratory failure. PMID:28203559

  16. 110. MILL APPROACH FROM EAST. THE TRAM LINE RANT TO ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    110. MILL APPROACH FROM EAST. THE TRAM LINE RANT TO THE RIGHT (NORTH) OF THE ROAD AND REACHED THE CRUDE ORE BINS AROUND THE FAR BEND. BUILDINGS FROM FRONT TO BACK ARE, ON RIGHT, OIL WAREHOUSE AND GASOLINE SHED, AND ON LEFT, GARAGE, CARPENTER'S SHOP, OIL SHED, AND MACHINE SHOP. - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

  17. DETAIL VIEW OF AERIAL TRAM SUPPORT TOWER SIX WITH TOWERS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF AERIAL TRAM SUPPORT TOWER SIX WITH TOWERS SEVEN,EIGHT, NINE, TEN, AND BREAK OVER TOWER IN DISTANCE, LOOKING NORTH. TOWER SIX IS THE LAST BEFORE A DEEP CHASM, AS IS SEEN BY THE DISTANCE BETWEEN TOWERS SIX AND SEVEN. SEE CA-291-48 (CT) FOR IDENTICAL COLOR TRANSPARENCY. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  18. DETAIL VIEW OF AERIAL TRAM SUPPORT TOWER SIX WITH TOWERS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF AERIAL TRAM SUPPORT TOWER SIX WITH TOWERS SEVEN, EIGHT, NINE, TEN, AND BREAK OVER TOWER IN DISTANCE, LOOKING NORTH. TOWER SIX IS THE LAST BEFORE A DEEP CHASM, AS IS SEEN BY THE DISTANCE BETWEEN TOWERS SIX AND SEVEN. SEE CA-291-21 FOR IDENTICAL B&W NEGATIVE. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  19. Ca2+ -activated K+ channel-3.1 blocker TRAM-34 alleviates murine allergic rhinitis.

    PubMed

    Lin, Hai; Zheng, Chunquan; Li, Jing; Yang, Chen; Hu, Li

    2014-12-01

    The precise pathogenesis of allergic rhinitis (AR) remains unclear and AR is less easily cured. Recent evidence has suggested that calcium-activated K+ channel-3.1(KCa3.1) is implicated in the immune response of allergic and inflammatory diseases and TRAM-34 is a selective KCa3.1 blocker. However, little is known about its role in AR. We aimed to investigate the effect of TRAM-34 in a mouse model of AR induced by ovalbumin (OVA). The BALB/c mice were divided into six groups: untreated AR group, 200 μg TRAM-34 treated AR group, 400 μg TRAM-34 treated AR group, 200 μg TRAM-34 treated normal group, 400 μg TRAM-34 treated normal group and untreated normal control group. Histopathological characteristics were assessed by HE staining. KCa3.1 protein expression was investigated by immunohistochemistry and western blotting method, and mRNA expression of KCa3.1, stromal interaction molecule1 (STIM1) and Orai1 in nasal tissues were assessed by real-time PCR. Furthermore, concentrations of OVA-specific IgE, ECP, IL-4, IL-5, IL-17 and IL-1β in nasal lavage fluid (NLF) were analyzed by enzyme-linked immunosorbent assay (ELISA). Results showed that TRAM-34 administration into the nostril attenuated sneezing, nasal rubbing, epithelial cell proliferation, eosinophil infiltration and inhibited nasal mucosa KCa3.1, STIM1 and Orai1 expression in TRAM-34 treated mice compared with untreated AR mice and suppressed inflammatory cytokines in the NLF of TRAM-34 treated groups compared with untreated AR mice. In conclusion, TRAM-34 could effectively alleviate murine allergic rhinitis by suppressing KCa3.1 and leads to reduction of K+ efflux and Ca2 + influx, leading to inflammation reduction and allergic responses attenuation.

  20. Architecture of the rectus abdominis, quadratus lumborum, and erector spinae.

    PubMed

    Delp, S L; Suryanarayanan, S; Murray, W M; Uhlir, J; Triolo, R J

    2001-03-01

    Quantitative descriptions of muscle architecture are needed to characterize the force-generating capabilities of muscles. This study reports the architecture of three major trunk muscles: the rectus abdominis, quadratus lumborum, and three columns of the erector spinae (spinalis thoracis, longissimus thoracis and iliocostalis lumborum). Musculotendon lengths, muscle lengths, fascicle lengths, sarcomere lengths, pennation angles, and muscle masses were measured in five cadavers. Optimal fascicle lengths (the fascicle length at which the muscle generates maximum force) and physiologic cross-sectional areas (the ratio of muscle volume to optimal fascicle length) were computed from these measurements. The rectus abdominis had the longest fascicles of the muscles studied, with a mean (S.D.) optimal fascicle length of 28.3 (4.2)cm. The three columns of the erector spinae had mean optimal fascicle lengths that ranged from 6.4 (0.6)cm in the spinalis thoracis to 14.2 (2.1)cm in the iliocostalis lumborum. The proximal portion of the quadratus lumborum had a mean optimal fascicle length of 8.5 (1.5)cm and the distal segment of this muscle had a mean optimal fascicle length of 5.6 (0.9)cm. The physiologic cross-sectional area of the rectus abdominis was 2.6 (0.9)cm(2), the combined physiologic cross-sectional area of the erector spinae was 11.6 (1.8)cm(2), and the physiologic cross-sectional area of the quadratus lumborum was 2.8 (0.5)cm(2). These data provide the basis for estimation of the force-generating potential of these muscles.

  1. DETAIL VIEW OF ORE CHARGING CHUTES OF THE UPPER TRAM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF ORE CHARGING CHUTES OF THE UPPER TRAM TERMINAL,LOOKING NORTHWEST TOWARD THE REAR OF THE STRUCTURE. THE ELECTRIC DRIVE MOTOR IS IN THE BACKGROUND AT UPPER RIGHT JUST BEHIND THE DRIVE GEAR. THE BELT FROM THIS MOTOR CONNECTED TO THE WHEEL AT TOP CENTER,WHICH DROVE THE SMALLER GEAR MESHED WITH THE LARGER ONE. THERE ARE NO CONTROL DOORS FOR THESE CHUTES OTHER THAN THE METAL ONES IN THE FOREGROUND. SEE CA-291-51 (CT) FOR IDENTICAL COLOR TRANSPARENCY. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  2. DETAIL VIEW OF ORE CHARGING CHUTES OF THE UPPER TRAM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF ORE CHARGING CHUTES OF THE UPPER TRAM TERMINAL, LOOKING NORTHWEST TOWARD THE REAR OF THE STRUCTURE. THE ELECTRIC DRIVE MOTOR IS IN THE BACKGROUND AT UPPER RIGHT JUST BEHIND THE DRIVE GEAR. THE BELT FROM THIS MOTOR CONNECTED TO THE WHEEL AT TOP CENTER, WHICH DROVE THE SMALLER GEAR MESHED WITH THE LARGER ONE. THERE ARE NO CONTROL DOORS FOR THESE CHUTES OTHER THAN THE METAL ONES IN THE FOREGROUND. SEE CA-291-35 FOR IDENTICAL B&W NEGATIVE. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  3. Experimental studies on annoyance caused by noises from trams and buses

    NASA Astrophysics Data System (ADS)

    Sandrock, Stephan; Griefahn, Barbara; Kaczmarek, Tomasz; Hafke, Honorata; Preis, Anna; Gjestland, Truls

    2008-06-01

    Acute annoyance due to noise from trams and buses was ascertained and compared in two experimental studies. First, 22 healthy young persons (19-22 years) using a standardised scale, rated their annoyance caused by noise from trams, buses and trucks, which were each presented at seven sound levels. The noise of a tram was judged to be equally annoying as the noise of a bus with a 3 dB lower level, which corresponds to the calculated loudness difference. The noises of a tram and of a bus were superimposed onto a 2-h realistic road traffic scenario in the second study. This study was conducted with 60 healthy young persons (18-31 years). Twenty participants were each exposed either to the scenario with the tram or the bus ( LAeqT=55 dBA) or to a control condition ( LAeqT=43.6 dBA) while working on different mental tasks. Performance data did not differentiate between the noise conditions, but the participants were again less annoyed by the scenario with the tram, suggesting a possible bonus for the tram. This assumption has to be verified in future studies. The fact that calculated loudness could predict annoyance in the psychoacoustic tests and this annoyance due to the same noises presented in complex scenarios might indicate the possibility of a more economical approach, at least to noises between which loudness differs greatly.

  4. UPTF-TRAM experiments for SBLOCA: Evaluation of condensation processes in TRAM tests A6 and A7

    SciTech Connect

    Sonneburg, H.G.; Tuunanen, J.; Palazov, V.V.

    1995-09-01

    The investigation of thermal-hydraulic phenomena related to reactor transients with accident management measures is the goal of the TRansient and accident Management (TRAM) experimental programme being carried out at the Upper Plenum Test Facility (UPTF) at Mannheim (Germany). These experimental investigations and test analyses are funded by the German Federal Minister for Research and Technology (BMFT). The UPTF simulates these phenomena in a 1:1 such relative to the dimension of a PWR. Condensation of steam during Emergency Core Cooling (ECC) water injection from accumulators into the primary system is one of the phenomena studied within the accumulators into the primary system is one of the phenomena studied within the TRAM programme. This phenomenon partly controls the efficiency of accumulator injection if the high pressure safety systems fail. Beside this, the condensation within the nitrogen inside the accumulator for a certain period controls the pressure development inside the accumulator. Thus, both condensation phenomena determine the ECC flow rate delivered to the primary system. Concerning the condensation inside the primary system, this is also of safety relevance in the case of Pressurized Thermal Shock (PTS) during cold leg injection.

  5. The supraclavicular artery island and trapezius myocutaneous flaps in head and neck reconstruction.

    PubMed

    Ramirez, Carlos A; Fernandes, Rui P

    2014-08-01

    The supraclavicular artery island flap can be readily used to reconstruct defects within the neck, parotid, lateral temporal region, and lower third of the face. Benefits of the supraclavicular flap include good color and texture match, an ease of harvest, and minimal donor site morbidity; there is also no significant post-operative monitoring required. The trapezius muscle serves as a source for multiple myocutaneous flaps of which most are considered to be salvage flaps among head and neck reconstructive surgeons.

  6. Reconstruction of large head and neck deformities: experience with free gracilis muscle and myocutaneous flaps.

    PubMed

    Del Frari, Barbara; Schoeller, Thomas; Wechselberger, Gottfried

    2010-01-01

    Microvascular free flaps continue to revolutionize coverage options in head and neck reconstruction. The authors describe their experience with the gracilis free flap and the myocutaneous gracilis free flap with reconstruction of head and neck defects. Eleven patients underwent 12 free tissue transfer to the head and neck region. The reconstruction was performed with the transverse myocutaneous gracilis (TMG) flap (n = 7) and the gracilis muscle flap with skin graft (n = 5). The average patient age was 63.4 years (range, 17-82 years). The indications for this procedure were tumor and haemangioma resections. The average patient follow-up was 20.7 months (range, 1 month-5.7 years). Total flap survival was 100%. There were no partial flap losses. Primary wound healing occurred in all cases. Recipient site morbidities included one hematoma. In our experience for reconstruction of moderate volume and surface area defects, muscle flaps with skin graft provide a better color match and skin texture relative to myocutaneous or fasciocutaneous flaps. The gracilis muscle free flap is not widely used for head and neck reconstruction but has the potential to give good results. As a filling substance for large cavities, the transverse myocutaneus gracilis flap has many advantages including reliable vascular anatomy, relatively great plasticity and a concealed donor area.

  7. Application of a random effects negative binomial model to examine tram-involved crash frequency on route sections in Melbourne, Australia.

    PubMed

    Naznin, Farhana; Currie, Graham; Logan, David; Sarvi, Majid

    2016-07-01

    Safety is a key concern in the design, operation and development of light rail systems including trams or streetcars as they impose crash risks on road users in terms of crash frequency and severity. The aim of this study is to identify key traffic, transit and route factors that influence tram-involved crash frequencies along tram route sections in Melbourne. A random effects negative binomial (RENB) regression model was developed to analyze crash frequency data obtained from Yarra Trams, the tram operator in Melbourne. The RENB modelling approach can account for spatial and temporal variations within observation groups in panel count data structures by assuming that group specific effects are randomly distributed across locations. The results identify many significant factors effecting tram-involved crash frequency including tram service frequency (2.71), tram stop spacing (-0.42), tram route section length (0.31), tram signal priority (-0.25), general traffic volume (0.18), tram lane priority (-0.15) and ratio of platform tram stops (-0.09). Findings provide useful insights on route section level tram-involved crashes in an urban tram or streetcar operating environment. The method described represents a useful planning tool for transit agencies hoping to improve safety performance.

  8. Injuries Due to Wedging of Bicycle Wheels in On-road Tram Tracks

    PubMed Central

    Deunk, Jaap; Harmsen, Annelieke M. K.; Schonhuth, Casper P.; Bloemers, Frank W.

    2014-01-01

    Background: In cities with trams as public transportation, tram tracks are often on public roads, creating a shared road situation with other road participants like cyclists. Beside the risk of direct collisions, this situation can also lead to bicycle wheels getting wedged in tram tracks, causing cyclists to fall. Objectives: The aim of this study was to gain more insight in the injury pattern of this trauma mechanism and to draw attention to the risks of the infrastructural situation with on-road tram tracks. Patients and Methods: A one-year, prospective, observational cohort study was conducted. All patients admitted after presentation to the emergency department of a level 1 trauma center, who got injured because their bicycle wheels got wedged in tram tracks, were included. Data were collected on patient demographics, type of injury and treatment. Results: Ten patients were included. Six were male. The mean age was 38 years. Six patients required surgery, mostly because of extremity injuries. Mean duration of admission was 4 days. Mean injury severity score was 13. One patient died as a result of the injuries sustained in the accident. Conclusions: Tram tracks on public roads are potentially dangerous and can lead to serious injuries and even mortality amongst cyclist. Operative intervention is frequently needed. PMID:25685751

  9. Rectus abdominis muscle free flap harvest by laparoscopic sheath-sparing technique.

    PubMed

    Greensmith, A; Januszkiewicz, J; Poole, G

    2000-04-01

    Previous reports of endoscopic rectus abdominis muscle harvest have described techniques that are hampered by the need for anterior rectus sheath division or mechanical devices to maintain the optical cavity. The authors report the first successful clinical case of a laparoscopic sheath-sparing rectus abdominis muscle harvest for free tissue transfer. It offers considerable advantages over the traditional open method and, with the help of an experienced laparoscopic surgeon, it should add little to operative time.

  10. A role for the adaptor proteins TRAM and TRIF in toll-like receptor 2 signaling.

    PubMed

    Nilsen, Nadra J; Vladimer, Gregory I; Stenvik, Jørgen; Orning, M Pontus A; Zeid-Kilani, Maria V; Bugge, Marit; Bergstroem, Bjarte; Conlon, Joseph; Husebye, Harald; Hise, Amy G; Fitzgerald, Katherine A; Espevik, Terje; Lien, Egil

    2015-02-06

    Toll-like receptors (TLRs) are involved in sensing invading microbes by host innate immunity. TLR2 recognizes bacterial lipoproteins/lipopeptides, and lipopolysaccharide activates TLR4. TLR2 and TLR4 signal via the Toll/interleukin-1 receptor adaptors MyD88 and MAL, leading to NF-κB activation. TLR4 also utilizes the adaptors TRAM and TRIF, resulting in activation of interferon regulatory factor (IRF) 3. Here, we report a new role for TRAM and TRIF in TLR2 regulation and signaling. Interestingly, we observed that TLR2-mediated induction of the chemokine Ccl5 was impaired in TRAM or TRIF deficient macrophages. Inhibition of endocytosis reduced Ccl5 release, and the data also suggested that TRAM and TLR2 co-localize in early endosomes, supporting the hypothesis that signaling may occur from an intracellular compartment. Ccl5 release following lipoprotein challenge additionally involved the kinase Tbk-1 and Irf3, as well as MyD88 and Irf1. Induction of Interferon-β and Ccl4 by lipoproteins was also partially impaired in cells lacking TRIF cells. Our results show a novel function of TRAM and TRIF in TLR2-mediated signal transduction, and the findings broaden our understanding of how Toll/interleukin-1 receptor adaptor proteins may participate in signaling downstream from TLR2.

  11. 30 CFR 75.829 - Tramming continuous mining machines in and out of the mine and from section to section.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Tramming continuous mining machines in and out... continuous mining machines in and out of the mine and from section to section. (a) Conditions of use. Tramming the continuous mining machine in and out of the mine and from section to section must be done...

  12. 30 CFR 75.829 - Tramming continuous mining machines in and out of the mine and from section to section.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Tramming continuous mining machines in and out... continuous mining machines in and out of the mine and from section to section. (a) Conditions of use. Tramming the continuous mining machine in and out of the mine and from section to section must be done...

  13. 30 CFR 75.829 - Tramming continuous mining machines in and out of the mine and from section to section.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Tramming continuous mining machines in and out... continuous mining machines in and out of the mine and from section to section. (a) Conditions of use. Tramming the continuous mining machine in and out of the mine and from section to section must be done...

  14. 30 CFR 75.829 - Tramming continuous mining machines in and out of the mine and from section to section.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Tramming continuous mining machines in and out... continuous mining machines in and out of the mine and from section to section. (a) Conditions of use. Tramming the continuous mining machine in and out of the mine and from section to section must be done...

  15. 30 CFR 75.829 - Tramming continuous mining machines in and out of the mine and from section to section.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Tramming continuous mining machines in and out... continuous mining machines in and out of the mine and from section to section. (a) Conditions of use. Tramming the continuous mining machine in and out of the mine and from section to section must be done...

  16. Studies on the spread of local anaesthetic solution in transversus abdominis plane blocks.

    PubMed

    Carney, J; Finnerty, O; Rauf, J; Bergin, D; Laffey, J G; Mc Donnell, J G

    2011-11-01

    The extent of analgesia provided by transversus abdominis plane blocks depends upon the site of injection and pattern of spread within the plane. There are currently a number of ultrasound-guided approaches in use, including an anterior oblique-subcostal approach, a mid-axillary approach and a more recently proposed posterior approach. We wished to determine whether the site of injection of local anaesthetic into the transversus abdominis plane affects the spread of the local anaesthetic within that plane, by studying the spread of a local anaesthetic and contrast solution in four groups of volunteers. The first group underwent the classical landmark-based transversus abdominis plane block whereby two different volumes of injectate were studied: 0.3 ml.kg(-1) vs 0.6 ml.kg(-1). The second group underwent transversus abdominis plane block using the anterior subcostal approach. The third group underwent transversus abdominis plane block using the mid-axillary approach. The fourth group underwent transversus abdominis plane block using the posterior approach, in which local anaesthetic was deposited close to the antero-lateral border of the quadratus lumborum. All volunteers subsequently underwent magnetic resonance imaging at 1, 2 and 4 h following each block to determine the spread of local anaesthetic over time. The studies demonstrated that the anterior subcostal and mid-axillary ultrasound approaches resulted in a predominantly anterior spread of the contrast solution within the transversus abdominis plane and relatively little posterior spread. There was no spread to the paravertebral space with the anterior subcostal approach. The mid-axillary transversus abdominis plane block gave faint contrast enhancement in the paravertebral space at T12-L2. In contrast, the posterior approaches, using both landmark and ultrasound identifications, resulted in predominantly posterior spread of contrast around the quadratus lumborum to the paravertebral space from T5 to L1

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

    PubMed Central

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

    2012-01-01

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

  18. OVERVIEW OF STAMP MILL SITE,LOOKING SOUTHWEST. THE LOWER TRAM TERMINAL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    OVERVIEW OF STAMP MILL SITE,LOOKING SOUTHWEST. THE LOWER TRAM TERMINAL IS OUT OF FRAME, JUST TO THE RIGHT. WATER TANK, LOADING PLATFORM, AND TRAM TRESTLE LEADING UP TO THE TRAM TERMINAL ARE AT RIGHT. THE STRUCTURE AT EXTREME RIGHT BELOW THE TRESTLE, ARE REMAINS OF A SECONDARY ORE BIN, WITH BALL MILL FOUNDATIONS AND WOOD DEBRIS JUST BELOW ON THE SECOND LEVEL. AT CENTER IS A BOILER AND THE FRAME WORK OF A FILTER PRESS. THE SMALL STRUCTURE AT CENTER LEFT IS AN INTERPRETIVE SIGN PLACED BY THE PARK SERVICE. AT LOWER LEFT, THIRD LEVEL OF THE MILL, ARE THE REMAINS OF A BLACKSMITH'S FORGE. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  19. Correlations between Transversus Abdominis Thickness, Lumbar Stability, and Balance of Female University Students

    PubMed Central

    Gong, Wontae

    2013-01-01

    [Purpose] The purpose of the present study was to analyze the correlations of the thicknesses of the transversus abdominis muscle (Tra) and the internal obliquus abdominis muscle (Io) with static lumbar stability (SLS), dynamic lumbar stability (DLS), and balance. [Subjects] The subjects of the present study were 40 female university students who had no physical defects or pain. [Methods] The thicknesses of Tra and Io muscles were measured using an ultrasonic imaging diagnostic unit. SLS and DLS were measured using a Pressure Biofeedback Unit (PBU), and Weight Distribution Indexes (WDI) and stability scores (SS) were measured using a balance measuring unit. [Results] As the thickness of the Tra increased, SLS, DLS, WDI, and SS improved. As SLS improved, DLS and WDI were also improved. [Conclusion] To improve lumbar stability and balance, training is needed in order to increase the muscle mass of the transversus abdominis muscle. PMID:24259828

  20. DETAIL VIEW OF TRAM BUCKET FRAME, SHOWING CLAMPING MECHANISM,WITHOUT ORE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF TRAM BUCKET FRAME, SHOWING CLAMPING MECHANISM,WITHOUT ORE BUCKET AND WHEELS. THE FRAME IS LYING ON ITS SIDE. THE ORE BUCKET WAS ATTACHED TO THE LEFT SIDE, AND TWO WHEELS WERE ATTACHED TO THE SPINDLE ON THE RIGHT. THE FRAME AND BUCKET ARE SUSPENDED FROM THE STATIONARY CABLE BY THE TWO WHEELS, WITH THE ORE BUCKET HANGING BELOW. THE WHEEL AND LEVER AT CENTER WERE ACTIVATED BY THE OPENING AND CLOSING MECHANISMS ON THE TRAM TERMINALS TO LOCK OR RELEASE THE BUCKET ONTO THE MOVING CABLE THAT RAN THROUGH THE SQUARE BLOCK AT CENTER. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  1. Tram Squealing Noise and Its Impact on Human Health

    PubMed Central

    Panulinová, Eva; Harabinová, Slávka; Argalášová, Lubica

    2016-01-01

    Introduction: Tramway has become a serious urban noise source in densely populated areas. The disturbance from squealing noise is significant. Curve squeal is the very loud, tonal noise emitted by tram operation in tight radius curves. Studies had reported a relationship between noise levels and health effects, such as annoyance, sleep disturbance, and elevated systolic and diastolic blood pressure. Materials and Methods: This study aimed to analyze the wheel squeal noise along the tramway line in Košice, Slovakia, review the effects on human health, and discuss its inclusion in the design method. To observe the influence of a track curve on noise emission, several measurement points were selected, and the noise emission was measured both in the curve and in the straight lines employing the same type of permanent way. Results: The results in the sections with the radius below 50 m were greatly affected by the presence of a squeal noise, while the resulting noise level in the sections with the radius above 50 m depended on their radius. The difference between the average values of LAeq with and without the squeal in the measurement points with the radius below 50 m was 9 dB. The difference between the measurements in the curve sections with the radius below 50 m and those in the straight line was 2.7 dB. Conclusion: The resulting noise level in general was influenced by the car velocity and the technical shape of the permanent way. These results can be used in noise prognoses and in the health effect predictions. PMID:27991464

  2. Activity of the Agrobacterium Ti plasmid conjugal transfer regulator TraR is inhibited by the product of the traM gene.

    PubMed Central

    Fuqua, C; Burbea, M; Winans, S C

    1995-01-01

    The Agrobacterium Ti plasmid tra regulon was previously found to be positively regulated by the TraR protein in the presence of a diffusible N-acyl homoserine lactone designated Agrobacterium autoinducer (AAI). TraR and AAI are similar to LuxR from Vibrio fischeri and the Vibrio autoinducer (VAI), which regulate target bioluminescence (lux) genes in a cell density-dependent manner. We now show that tra genes are also regulated by a second protein, designated TraM, which acts to antagonize TraR-dependent activation. The traM gene is closely linked to traR, and the two genes are transcribed convergently. The predicted TraM proteins of two different Ti plasmids are 77% identical but are not significantly similar to other protein sequences in the database, and thus TraM may represent a novel regulatory protein. Null mutations in traM cause strongly increased conjugation, tra gene transcription, and AAI production. A functional copy of traM introduced into traM mutants decreased conjugation, tra gene transcription, and AAI synthesis. TraM inhibits transcription of traA, traI, and traM. Although traM was first identified by its octopine-inducible promoter, we now show that induction by octopine requires traR, strongly suggesting that TraR is the direct traM activator. PMID:7868612

  3. Effect of pilates mat exercises and conventional exercise programmes on transversus abdominis and obliquus internus abdominis activity: pilot randomised trial.

    PubMed

    Critchley, Duncan J; Pierson, Zoe; Battersby, Gemma

    2011-04-01

    Pilates training is said to increase Transversus abdominis (TrA) and Obliquus internus (OI) activation during exercise and functional activities. 34 Pain-free health club members with no Pilates experience, mean (SD) age 30(7) years, were randomised to Pilates mat exercises or strength training. Participants exercised unsupervised twice-weekly for eight weeks. TrA and OI thickness (a proxy for muscle activity at the low-medium efforts of our exercises) were measured with ultrasound pre- and post-training during Pilates exercises 'Imprint' (an abdominal drawing-in manoeuvre) and 'Hundreds A' (lying supine, arms slightly raised, hips and knees flexed to 90°) and 'Hundreds B' (as A, with neck flexion) and functional postures sitting and standing. Pilates participants had increased TrA thickness in Hundreds A [all values mean (SD) mm]: 3.7(1.3) pre-intervention, 4.7(1.1) post-intervention (P = 0.007); and decreased OI muscle thickness during Imprint: 11.7(2.8) pre-intervention, 10.8(3.5) post-intervention (P = 0.008). Strength training participants had greater OI thickness during Imprint (P = 0.014), Hundreds A (P = 0.018) and Hundreds B (P = 0.004) than Pilates participants post-intervention. There were no changes in muscle thickness at rest or during functional postures. Pilates training appears to increase TrA activity but only when performing Pilates exercises. Further research is required into Pilates in clinical populations and how to increase deep abdominal activation during functional activities.

  4. Myocutaneous flap (V-Y design) from the nasal bridge for medial canthal reconstruction.

    PubMed

    Moretti, E A; Gomez Garcia, F

    1998-07-01

    Repair of soft tissue loss of the medial canthal area is usually accomplished by using skin grafts or frontal flaps based on the glabellar vessels. However, skin grafts can provoke scar tissue contracture, or skin color chromatic changes (hypopigmentation or hyperpigmentation). On the other hand, frontal flaps are sometimes thicker than normal skin and lead to unsatisfactory aesthetic results. To avoid these disadvantages, the authors designed an alternative method for reconstruction of defects of the medical canthal area. The authors suggest using a myocutaneous flap (V-Y design) from the nasal bridge to repair soft tissue defects no larger than 2 cm in diameter (surface < 4 cm2) in the medial canthal area. The pedicle of this flap is based on supratrochlear and dorsal nasal vessels. This technique has proved safe and reliable and has led to good functional and cosmetic results.

  5. Relationship between the phases of the menstrual cycle and the transversus abdominis muscle

    PubMed Central

    Ubukata, Hitomi; Matsumura, Ayana

    2015-01-01

    [Purpose] This study investigated changes in the thickness of the transversus abdominis muscle at various stages of the menstrual cycle. [Subjects] The subjects were 15 young healthy females with regular menstrual cycles. [Methods] A regular menstrual cycle was defined as a 28-day cycle comprising 3 phases: the menstrual phase, the follicular phase, and the luteal phase. For the purpose of the study, measurements were taken at day 3 (menstrual phase), day 12 (follicular phase), and day 21 (luteal phase) of the cycle. An ultrasonic imaging diagnostic device (MyLab 25) and a linear expression probe were used for measurement of the transversus abdominis muscle. [Results] There were no significant differences in the variation rate of the thickness of the muscle at any phase of the menstrual cycle. [Conclusion] The results suggested that the sex hormones associated with the menstrual cycle do not affect the contractility or changes in the thickness of the transversus abdominis muscle. For the reasons stated above, there is little need to consider the menstrual cycle when measuring muscle thickness in physical therapy scenarios because the transversus abdominis muscle does not depend on the menstrual cycle. PMID:25931681

  6. Children with spinal dysraphism: transversus abdominis plane (TAP) catheters to the rescue!

    PubMed

    Taylor, Lauren J; Birmingham, Patrick; Yerkes, Elizabeth; Suresh, Santhanam

    2010-10-01

    Transversus abdominis plane (TAP) block catheters may offer an alternative to a central neuraxial blockade for patients undergoing major abdominal surgery (Paediatr Anaesth 19: 2009; 296). This case series consists of two children with spinal dysraphism in whom bilateral TAP block catheters were placed for postoperative pain relief. Administration of low dose, low concentration local anesthetic provided both children with excellent postoperative analgesia.

  7. TRAM1 protect HepG2 cells from palmitate induced insulin resistance through ER stress-JNK pathway.

    PubMed

    Tang, Zhuqi; Zhang, Wanlu; Wan, Chunhua; Xu, Guangfei; Nie, Xiaoke; Zhu, Xiaohui; Xia, Nana; Zhao, Yun; Wang, Suxin; Cui, Shiwei; Wang, Cuifang

    2015-02-20

    Excess serum free fatty acids (FFAs) are fundamental to the pathogenesis of insulin resistance. Chronic endoplasmic reticulum (ER) stress is a major contributor to obesity-induced insulin resistance in the liver. With high-fat feeding (HFD), FFAs can activate chronic endoplasmic reticulum (ER) stress in target tissues, initiating negative crosstalk between FFAs and insulin signaling. However, the molecular link between insulin resistance and ER stress remains to be identified. We here reported that translocating chain-associated membrane protein 1 (TRAM1), an ER-resident membrane protein, was involved in the onset of insulin resistance in hepatocytes. TRAM1 was significantly up-regulated in insulin-resistant liver tissues and palmitate (PA)-treated HepG2 cells. In addition, we showed that depletion of TRAM1 led to hyperactivation of CHOP and GRP78, and the activation of downstream JNK pathway. Given the fact that the activation of ER stress played a facilitating role in insulin resistance, the phosphorylation of Akt and GSK-3β was also analyzed. We found that depletion of TRAM1 markedly attenuated the phosphorylation of Akt and GSK-3β in the cells. Moreover, application with JNK inhibitor SP600125 reversed the effect of TRAM1 interference on Akt phosphorylation. The accumulation of lipid droplets and expression of two key gluconeogenic enzymes, PEPCK and G6Pase, were also determined and found to display a similar tendency with the phosphorylation of Akt. Glucose uptake assay indicated that knocking down TRAM1 augmented PA-induced down-regulation of glucose uptake, and inhibition of JNK using SP600125 could block the effect of TRAM1 on glucose uptake. These data implicated that TRAM1 might protect HepG2 cells against PA-induced insulin resistance through alleviating ER stress.

  8. Rectus abdominis muscle resection and fascial reconstruction for the treatment of uterine leiomyosarcoma invading the abdominal wall: a case report.

    PubMed

    Yoon, B S; Seong, S J; Song, T; Kim, M L; Kim, M K

    2014-01-01

    The authors present a case of intra-abdominal recurrent leiomyosarcoma invading a large area of the abdominal wall. The patient underwent cytoreductive surgery, including resection of the rectus abdominis muscle, followed by reconstruction of the defect using synthetic mesh. The tumor was surgically removed by en bloc resection, including most of the rectus abdominis muscle and ileum. The abdominal wall defect was repaired using synthetic mesh. The patient underwent radiotherapy and chemotherapy after the surgery and was healthy one year later.

  9. Urban air quality comparison for bus, tram, subway and pedestrian commutes in Barcelona.

    PubMed

    Moreno, Teresa; Reche, Cristina; Rivas, Ioar; Cruz Minguillón, Maria; Martins, Vânia; Vargas, Concepción; Buonanno, Giorgio; Parga, Jesus; Pandolfi, Marco; Brines, Mariola; Ealo, Marina; Sofia Fonseca, Ana; Amato, Fulvio; Sosa, Garay; Capdevila, Marta; de Miguel, Eladio; Querol, Xavier; Gibbons, Wes

    2015-10-01

    Access to detailed comparisons in air quality variations encountered when commuting through a city offers the urban traveller more informed choice on how to minimise personal exposure to inhalable pollutants. In this study we report on an experiment designed to compare atmospheric contaminants inhaled during bus, subway train, tram and walking journeys through the city of Barcelona. Average number concentrations of particles 10-300 nm in size, N, are lowest in the commute using subway trains (N<2.5×10(4) part. cm(-3)), higher during tram travel and suburban walking (2.5×10(4) cm(-3)5.0×10(4) cm(-3)), with extreme transient peaks at busy traffic crossings commonly exceeding 1.0×10(5) cm(-3) and accompanied by peaks in Black Carbon and CO. Subway particles are coarser (mode 90 nm) than in buses, trams or outdoors (<70 nm), and concentrations of fine particulate matter (PM2.5) and Black Carbon are lower in the tram when compared to both bus and subway. CO2 levels in public transport reflect passenger numbers, more than tripling from outdoor levels to >1200 ppm in crowded buses and trains. There are also striking differences in inhalable particle chemistry depending on the route chosen, ranging from aluminosiliceous at roadsides and near pavement works, ferruginous with enhanced Mn, Co, Zn, Sr and Ba in the subway environment, and higher levels of Sb and Cu inside the bus. We graphically display such chemical variations using a ternary diagram to emphasise how "air quality" in the city involves a consideration of both physical and chemical parameters, and is not simply a question of measuring particle number or mass.

  10. Abdominal wall injuries: rectus abdominis strains, oblique strains, rectus sheath hematoma.

    PubMed

    Johnson, Rob

    2006-04-01

    Abdominal wall injuries are reported to be less common than actually perceived by sports medicine practitioners. National Collegiate Athletic Association injury statistics for 2004-2005 cite a high of 0.71 abdominal muscle injuries per 1000 player-hours in wrestling competition to a low of 0.01 injuries per 1000 player-hours in autumn football practices. British professional soccer clubs reported an incidence of "torso" injuries of up to 7% of all injuries over the course of several seasons. Injury definition is most likely the explanation for this discrepancy. The abdominal wall muscles (rectus abdominis, external and internal obliques, and transverse abdominis) are injured by direct blows to the abdomen or by sudden or repetitive trunk movement, either rotation or flexion/extension. With the exception of the rare rectus sheath hematoma that does not self-tamponade, the treatment for these problems is nonoperative with symptoms guiding rehabilitation and return to play decisions.

  11. The Troll in Toll: Mal and Tram as bridges for TLR2 and TLR4 signaling.

    PubMed

    Sheedy, Frederick J; O'Neill, Luke A J

    2007-08-01

    Signaling by two of the most important bacteria-sensing TLRs, TLR2 and TLR4, involves two adaptor proteins, MyD88 adaptor-like (Mal) and Toll/IL-1 receptor (TIR) domain-containing adaptor-inducing IFN-beta (Trif)-related adaptor molecule (TRAM). Recently, new insights into the functioning of these two adapters have emerged. Mal is required by both TLRs to act as a bridge to recruit the adaptor MyD88, leading ultimately to NF-kappaB activation. Similarly, TRAM acts as a bridge to recruit TRIF to the TLR4 complex, leading to activation of the transcription factor IFN regulatory factor 3. Consistent with Mal and TRAM being key points of control, recent evidence suggests that they are subject to regulation by phosphorylation. Further, a variant in Mal in humans has been found to protect against multiple infectious diseases. Finally, another TIR domain-containing adaptor, sterile alpha and HEAT/armadillo motif protein (SARM), has been shown to act as an inhibitor of TRIF-dependent signaling. These recent discoveries add to the complexity of TLR signaling and highlight specific control mechanisms for TLR2 and TLR4 signaling.

  12. Continuous postoperative analgesia via quadratus lumborum block - an alternative to transversus abdominis plane block.

    PubMed

    Visoiu, Mihaela; Yakovleva, Nataliya

    2013-10-01

    Different transversus abdominis plane blocks techniques cause variations in postoperative analgesia characteristics. We report the use of unilateral quadratus lumborum catheter for analgesia following colostomy closure. The catheter was placed under direct ultrasound visualization and had good outcomes: low pain scores and minimal use of rescue analgesic medication. No complications were reported in this pediatric patient. More studies are needed to evaluate the effectiveness and safety of this regional anesthesia technique.

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

    PubMed Central

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

    2010-01-01

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

  14. Subclavicular Pectoralis Major Myocutaneous Flap for Optimal Reconstruction of Large Orbitozygomatic Defects: A Case Report

    PubMed Central

    Pingarron, Lorena; Ruiz, Julian; Rey, Juan; Maniegas, Lourdes; Roson, Silvia; Martinez, Dolores

    2014-01-01

    Since the introduction of microvascular free flaps, the pectoralis major myocutaneous flap (PMMF) has been relegated to background for most reconstructive surgeons. The objective of this article is to show the advantages of cervicofacial defects reconstruction with PMMF using the subclavicular plane route in a challenging clinical case. An 83-year-old man presented with cutaneous temporomalar lesion with orbital spread. Tumor resection was performed, including 12 × 11 cm skin and subcutaneous tissue, overlying zygomatic and malar bone, and orbital exenteration. Radical parotidectomy and functional neck dissection were performed. PMMF was chosen as reconstructive option routing the pedicle to the subclavicular plane. The length of the pedicle was 31 cm. The subclavicular route for PMMF increases the flap's length and arc of rotation compared with the conventional supraclavicular one. This procedure decreases the bulk of the PMMF pedicle which makes it functionally and cosmetically favorable. By using this modification, we may widen the “safe” reconstructive possibilities. PMID:25136415

  15. Reconstruction of complex oro-facial defects using the myocutaneous sub-mental artery flap.

    PubMed

    Saleh, D B; Fourie, L; Mizen, K D

    2014-07-01

    Oro-facial defects require reconstruction that provides suitable colour match and texture. Moreover inner and outer cheek lining and bulk are key considerations. In cases of severe oro-facial infections concomitant mandibular abnormality, for example trismus, can mandate the need for tissue to obturate mandibular defects. We assessed the use of the myocutaneous sub-mental artery flap (MSA) in non-oncological patients with such defects. Twenty two consecutive patients were included in this case series. All patients were survivors of Cancrum Oris (NOMA). Demographic details, nutritional status and co-morbidities were recorded. Defects were classified according to the tissues destroyed; cheek, mandible, oral cavity, lip(s), nose and eye(s). Simultaneous procedures carried out were recorded. The surgical anatomy of the MSA is described. All patients had composite defects of the cheek and oral cavity plus another local anatomical structure. Adjunct procedures such as trismus release were carried out in 18/22 patients. Four patients required a return to theatre. There was no trismus recurrence observed. No flap losses were incurred. The MSA is a robust flap with minimal incidence of major complications. The MSA negates the need for microsurgical tissue transfer. Furthermore the MSA provides adequate bulk to obturate these defects. Future applications of the MSA may include complex oro-facial oncological defects.

  16. Pectoralis major myocutaneous flap for head and neck reconstruction: risk factors for fistula formation.

    PubMed

    Leite, A K N; de Matos, L L; Belli, M; Kulcsar, M A V; Cernea, C R; Garcia Brandão, L; Pinto, F R

    2014-12-01

    The pectoralis major myocutaneous flap (PMMF) is a safe and versatile flap used widely for head and neck cancer reconstructions, but one of the major and most feared complications is oro- or pharyngocutaneous fistula. Herein, we attempt to establish risk factors for fistula formation in reconstructions of mucosal defects in the head and neck using PMMF through retrospective analysis of PMMF performed during 3 years at a single institution, with a total of 84 procedures. There were 69 men and 15 women, with a mean age of 59.5 years. There were 15 cases of partial flap loss, two total flap losses and 31 fistulas. The independent risk factors for fistula formation were preoperative serum hemoglobin < 13 g/dl, preoperative serum albumin < 3.4 g/dl and hypopharynx reconstruction. The PMMF is still a very useful flap and this is the first multivariate analysis analysing risk factors for fistula formation. These findings are helpful in selecting patients with elevated risk of fistula formation, and therefore preventive measures can be undertaken to avoid potentially serious complications.

  17. Speech articulation after subtotal glossectomy and reconstruction with a myocutaneous flap.

    PubMed

    Knuuttila, H; Pukander, J; Määttä, T; Pakarinen, L; Vilkman, E

    1999-01-01

    Speech samples of 9 subjects (8 males, 1 female) were recorded before and 0.5-2 years after a partial glossectomy and reconstruction with a pectoralis major myocutaneous flap. A reading sample, a list of meaningful and nonsense words, and a list of sustained vowels were recorded. The speech samples were evaluated by pairs of naive listeners and using acoustic analysis of the vowel production. Each pair listened to the recordings of only one patient. Inter-rater agreement was satisfactory. The general impression of the speech outcome varied from normal to moderately impaired. The perceptually estimated impairments of speech articulation in the after/before comparisons were statistically significant. Only the first formant of the vowel /i/ (rise) and the second formant of the vowel /a/ (drop) changed significantly at the group level. There was a negative correlation (r = -0.79) between the extent of tongue resection and the drop of the second formant of the vowel /a/. The perceptual variables showed a relationship (r = 0.74-0.82) with the changes in the level of the second formant of the vowel /i/. The relationship that emerged between the perceptual estimates and the objective acoustic parameters suggests that it will be possible to develop clinically relevant test batteries for articulatory quality analysis.

  18. TRAM1 protects AR42J cells from caerulein-induced acute pancreatitis through ER stress-apoptosis pathway.

    PubMed

    Cai, Yongxia; Shen, Yanbo; Xu, Guangling; Tao, Ran; Yuan, Weiyan; Huang, Zhongwei; Zhang, Dongmei

    2016-05-01

    Chronic endoplasmic reticulum (ER) stress in pancreatic acinar cells has emerged as a major contributor to the recovery of acute pancreatitis (AP). However, the molecular mechanisms linking AP and ER stress remain not fully understood. In this study, we employed caerulein to induce AP-like inflammation in the AR42J rat pancreatic acinar cells to mimic the AP-like acinar cell injury. Caerulein can activate ER stress in AR42J cells, but the molecular link between AP and ER stress remains to be identified. We here reported that translocating chain-associated membrane protein 1 (TRAM1), an ER-resident multispanning membrane protein, was involved in the onset of AP-like injury on AR42J cells. TRAM1 was significantly elevated in caerulein-treated AR42J cells. Furthermore, we showed that knockdown of TRAM1 led to hyperactivation of 78 kDa glucose-regulated protein precursor (GRP78) and C/EBP homologous protein (CHOP) and the activation of downstream apoptosis pathway. Given the fact that the activation of ER stress played a protection role in AP, the pro-inflammatory mediators TNF-α and IL-6 and the marker of cell injury LDH were also analyzed. We found that depletion of TRAM1 markedly increased the secretion of TNF-α, IL-6, and LDH in the cells. Moreover, flow cytometry indicated that treatment with caerulein induced a significant decrease of apoptotic index and increase of necrosis index in TRAM1-siRNA cells, compared with control groups, as indicated by downregulated expression of cleaved caspase-3, caspase-8, and caspase-9 mRNA expression activity in TRAM1-siRNA cells. These data implicated that TRAM1 might protect AR42J cells against caerulein-induced AP in AR42J cells through alleviating ER stress.

  19. Mechanistic basis of plasmid-specific DNA binding of the F plasmid regulatory protein, TraM.

    PubMed

    Peng, Yun; Lu, Jun; Wong, Joyce J W; Edwards, Ross A; Frost, Laura S; Mark Glover, J N

    2014-11-11

    The conjugative transfer of bacterial F plasmids relies on TraM, a plasmid-encoded protein that recognizes multiple DNA sites to recruit the plasmid to the conjugative pore. In spite of the high degree of amino acid sequence conservation between TraM proteins, many of these proteins have markedly different DNA binding specificities that ensure the selective recruitment of a plasmid to its cognate pore. Here we present the structure of F TraM RHH (ribbon-helix-helix) domain bound to its sbmA site. The structure indicates that a pair of TraM tetramers cooperatively binds an underwound sbmA site containing 12 base pairs per turn. The sbmA is composed of 4 copies of a 5-base-pair motif, each of which is recognized by an RHH domain. The structure reveals that a single conservative amino acid difference in the RHH β-ribbon between F and pED208 TraM changes its specificity for its cognate 5-base-pair sequence motif. Specificity is also dictated by the positioning of 2-base-pair spacer elements within sbmA; in F sbmA, the spacers are positioned between motifs 1 and 2 and between motifs 3 and 4, whereas in pED208 sbmA, there is a single spacer between motifs 2 and 3. We also demonstrate that a pair of F TraM tetramers can cooperatively bind its sbmC site with an affinity similar to that of sbmA in spite of a lack of sequence similarity between these DNA elements. These results provide a basis for the prediction of the DNA binding properties of the family of TraM proteins.

  20. Inhibition of vascular calcification by block of intermediate conductance calcium-activated potassium channels with TRAM-34.

    PubMed

    Freise, Christian; Querfeld, Uwe

    2014-07-01

    Vascular calcifications are a hallmark of advanced cardiovascular disease in patients with chronic kidney disease. A key event is the transition of contractile vascular smooth muscle cells (VSMC) into an osteoblast-like phenotype, promoting a coordinated process of vascular remodeling resembling bone mineralization. Intermediate-conductance calcium-activated potassium channels (KCa3.1) are expressed in various tissues including VSMC. Aiming for novel therapeutic targets in vascular calcification, we here studied effects of KCa3.1-inhibition on VSMC calcification by the specific KCa3.1 inhibitor TRAM-34. Calcification in the murine VSMC cell line MOVAS-1 and primary rat VSMC was induced by calcification medium (CM) containing elevated levels of PO4(3-) and Ca(2+). Cell signaling, calcification markers, and release of nitric oxide and alkaline phosphatase were assessed by luciferase reporter plasmids, RT-PCR and specific enzymatic assays, respectively. KCa3.1 gene silencing was achieved by siRNA experiments. TRAM-34 at 10nmol/l, decreased CM-induced calcification and induced NO release of VSMC accompanied by decreased TGF-β signaling. The CM-induced mRNA expressions of osterix, osteocalcin, matrix-metalloproteinases (MMP)-2/-9 were reduced by TRAM-34 while osteopontin expression was increased. Further, TRAM-34 attenuated the CM- and TNF-α-induced activation of NF-κB and reduced the release of MMP-2/-9 by VSMC. Finally, TRAM-34 abrogated CM-induced apoptosis and KCa3.1 gene silencing protected VSMC from CM-induced onset of calcification. In summary, TRAM-34 interferes with calcification relevant signaling of NF-κB and TGF-β thereby blocking the phenotypic transition/calcification of VSMC. We conclude that the results provide a rationale for further studies regarding a possible therapeutic role of KCa3.1 inhibition by TRAM-34 or other inhibitors in vascular calcification.

  1. StarTram: An Ultra Low Cost Launch System to Enable Large Scale Exploration of the Solar System

    NASA Astrophysics Data System (ADS)

    Powell, James; Maise, George; Paniagua, John

    2006-01-01

    StarTram is a new approach for low launch to space using Maglev technology. Spacecraft are magnetically levitated and accelerated without propellants to orbital speeds in an evacuated tunnel at ground level using only electrical energy. The cost of the electric energy for acceleration to 8 kilometers per second is only 60 cents per kilogram of payload. After reaching orbital speed, the StarTram spacecraft coast upwards inside an evacuated levitated launch tube to an altitude, of 10 kilometers or more, where they enter the low-pressure ambient atmosphere. The launch tube is magnetically levitated by the repulsive force between a set of high current superconducting cables on it and oppositely directed currents in a set of superconducting cables on the ground beneath. High strength Kevlar tethers anchor the launch tube against crosswinds and prevent it from moving laterally or vertically. A Magneto Hydro Dynamic (MHD) pump at the exit of the evacuated launch tube prevents air from entering the tube. Two StarTram systems are described, a high G (30G) system for cargo only launch and a moderate G (2.5 G) system for passenger/cargo spacecraft. StarTram's projected unit cost is $30 per kilogram of payload launched, including operating and amortization costs. A single StarTram facility could launch more than 100,000 tons of cargo per year and many thousands of passengers. StarTram would use existing superconductors and materials, together with Maglev technology similar to that now operating. The StarTram cargo launch system could be implemented by 2020 AD and the passenger system by 2030 AD.

  2. Platysma myocutaneous flap for reconstruction of intraoral defects following excision of oral sub mucous fibrosis: A report of 10 cases

    PubMed Central

    Ramanujam, Sathyanarayanan; Venkatachalam, Suresh; Subramaniyan, Monica; Subramaniyan, Deepika

    2015-01-01

    Various surgical procedures are available for treating oral submucous fibrosis, but all of them have their inherent drawbacks. The superiorly based platysma myocutaneous flap is a common reconstruction option for intraoral defects followed after excision of fibrous bands in oral submucous fibrosis. The superiorly based flap has an excellent blood supply, but less efficient venous drainage when compared with posteriorly based flap. We present our results of using a superiorly based flap in the treatment of oral submucous fibrosis. Of 10 patients eight had no postoperative complications, one patient developed partial skin loss and other developed venous congestion which was managed conservatively. PMID:26538949

  3. Myocutaneous Mucormycosis in a Diabetic Burnt Patient Led to Upper Extremity Amputation; A Case Report

    PubMed Central

    Ayaz, Mehdi; Moein, Reza

    2017-01-01

    Mucormycosis is a rare opportunistic fungal infection that can implicate cranial sinuses, brain, lungs, gastrointestinal tract and skin. Although it can occur in patients with competent and incompetent immunity such as patients with diabetes mellitus, lymphoma, leukemia and burns, but it has an aggressive, malignant and lethal course in patients with incompetent immunity. To enforce the importance of burn in patients with underlaying diseases such as diabetes, we are going to report a rare case of diabetic burnt patient complicated by right upper extremity myocutaneous mucormycosis. We selected this case to emphasis the importance of underlying disease (diabetes mellitus) with cutaneous burn, aggressive treatment of fungal infection in these patients and referring such case to burn center to prevent catastrophic results. A 50-year-old woman was introduced to us after several days of medical and surgical care of right upper extremity and trunk split-thickness burn. Due to gross muscle necrosis of right upper extremity and poor general condition of the patient, she was taken to the operating room that led to right upper extremity amputation and several times of aggressive debridement to save her life. Pathologic report was indicative of mucormycosis. We can conclude from this case that: 1) Burn, even partially thickness and with little body surface area, should be referred to burn center for better care 2) No response to usual medical treatment should make us more sensitive to consider the unusual causes of infection such as fungi 3) Suspected dead tissues should be excised aggressively especially if suspiciousness to wound sepsis and fungal infection is present especially in an immunocompromised patient. PMID:28246626

  4. Tug 'O' war: challenges of transverse upper gracilis (TUG) myocutaneous free flap breast reconstruction.

    PubMed

    Locke, Michelle B; Zhong, Toni; Mureau, Marc A M; Hofer, Stefan O P

    2012-08-01

    Autologous tissue microsurgical breast reconstruction is increasingly requested by women following mastectomy. While the abdomen is the most frequently used donor site, not all women have enough abdominal tissue excess for a unilateral or bilateral breast reconstruction. A secondary choice in such women may be the transverse upper gracilis (TUG) myocutaneous flap. This study reviews our experience with TUG flap breast reconstruction looking specifically at reconstructive success rate and the requirement for secondary surgery. A total of 16 free TUG flaps were performed to reconstruct 15 breasts in eight patients over a period of five years. Data were collected retrospectively by chart review. Follow up ranged from 14 to 41 months. During the follow up period, there was one (6.3%) complete flap loss in an immediate breast reconstruction patient. Four further flaps (25%) failed in their primary aim of breast reconstruction, as they required additional significant reconstruction with either deep inferior epigastric perforator (DIEP) flaps (two flaps (12.5%), one patient) or augmentation with silicone breast implants (two flaps (12.5%), one patient), giving a successful breast reconstruction rate with the TUG flap of only 66.7%. In all of the remaining reconstructed breasts, deficient flap volume or breast contour was seen. Eight flaps were augmented by lipofilling. A total of 62.5% of the donor sites had complications, namely sensory disturbance of the medial thigh (25%) and poor scar (37.5%) requiring revision. This series demonstrates a high rate of reconstructive failure and unsatisfactory outcomes from TUG flap breast reconstruction. We feel this reinforces the necessity of adequate pre-operative patient assessment and counselling, including discussion regarding the likelihood of subsequent revisional surgery, before embarking on this form of autologous breast reconstruction.

  5. Radiation-Induced Leiomyosarcoma after Breast Cancer Treatment and TRAM Flap Reconstruction

    PubMed Central

    Olcina, M.; Merck, B.; Giménez-Climent, M. J.; Almenar, S.; Sancho-Merle, M. F.; Llopis, F.; Vázquez-Albadalejo, C.

    2008-01-01

    The development of a radiation-induced sarcoma (RIS) in the post mastectomy thoracic treatment volume is an infrequent, but recognized, event. Its frequency is rising in relation with increasing survival of breast cancer patients treated with adjuvant radiation therapy, and is associated with poor prognosis despite treatment. We present a case of leiomyosarcoma in a patient who underwent mastectomy followed by radiotherapy for invasive ductal carcinoma. A delayed TRAM flap reconstruction was performed 10 years after and a rapid growing mass under the reconstructed flap appeared, on routine follow-up, twenty years later. This report analyzes the diagnostic and therapeutic approach of patients with RIS. PMID:18464918

  6. [Significance of abdominal wall CT-angiography in planning DIEA perforator flaps, TRAM flaps and SIEA flaps].

    PubMed

    Fansa, H; Schirmer, S; Frerichs, O; Gehl, H B

    2011-04-01

    Muscle sparing TRAM flaps and DIEA perforator flaps are standard procedures for breast reconstruction. Recently CT-angiography has been established to evaluate perforator vessels pre-operatively. CT-angiography was introduced to our department in July 2009. In a retrospective analysis data of the last 20 patients (altogether 22 flaps) before CT-angiography introduction and the following 20 (also 22 flaps) patients after introduction of CT-angiography were analysed with regard to the ratio of TRAM to DIEP flaps, and the time required to raise the flaps. The same surgeon raised all flaps. As different surgeons performed dissection of the recipient site, anastomoses, and insertion of flaps, and patients received primary (with sentinel or complete lymphadenctomy) or secondary reconstructions, only the time required harvesting the flap was compared. Thus other influences on raising the flap were eliminated. DIEP flaps were harvested with one single perforator. If perfusion or was considered not to be safe via one single perforator a muscle sparing TRAM flap (ms2) was raised. Angiography was performed using a 64-slice multi-detector CT scanner. CT-angiography did not lead to an increased rate of DIEP flaps in relation to ms2-TRAM flaps. Harvesting time of all flap types with CT-angiography on average was 121 min, without CT-angiography 135 min. This was not significantly different. However, separate analysis of DIEP flaps and ms2-TRAM flaps revealed a significant advantage of CT-angiography based harvesting of DIEP flaps of 26 min: with CT-angiography 101 min vs. 127 min without CT-angiography (p<0.028). There were no significant differences for ms2-TRAM flaps. All scans showed course and branching, diameter and size of the inferior epigastric artery. If evident the superficial inferior epigastric artery (SIEA) was marked. Dosage was 292 mGy-606 mGy×cm dependent on body weight. CTDI was 6.8-14.7 mGy. CT-angiography is a reproducible and observer independent procedure

  7. A new technique of closing a gastroatmospheric fistula with a rectus abdominis muscle flap

    PubMed Central

    Singh, Harjeet; Talukder, Shibojit; Verma, Ganga Ram

    2015-01-01

    Proximal enteroatmospheric fistulae are difficult to manage and carry high mortality from sepsis and electrolyte imbalances. Conservative management with total parenteral nutrition, exclusion of fistula, resection and anastomosis are conventional methods of treatment with low success rate. Providing muscle cover to manage an enteroatmospheric fistula is a noble concept. A postoperative high-output gastroatmospheric fistula (GAF) was repaired by superior epigastric artery-based rectus abdominis muscle flap (RAMF). Postoperative recovery was uneventful. This technique may be useful for closure of proximal enteroatmospheric fistulae that fail to heal through medical and conventional surgical management. PMID:25819831

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

    PubMed

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

    2012-06-01

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

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

    SciTech Connect

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

    1986-02-01

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

  10. Tiltrotor Aeroacoustic Code (TRAC) Prediction Assessment and Initial Comparisons with Tram Test Data

    NASA Technical Reports Server (NTRS)

    Burley, Casey L.; Brooks, Thomas F.; Charles, Bruce D.; McCluer, Megan

    1999-01-01

    A prediction sensitivity assessment to inputs and blade modeling is presented for the TiltRotor Aeroacoustic Code (TRAC). For this study, the non-CFD prediction system option in TRAC is used. Here, the comprehensive rotorcraft code, CAMRAD.Mod1, coupled with the high-resolution sectional loads code HIRES, predicts unsteady blade loads to be used in the noise prediction code WOPWOP. The sensitivity of the predicted blade motions, blade airloads, wake geometry, and acoustics is examined with respect to rotor rpm, blade twist and chord, and to blade dynamic modeling. To accomplish this assessment, an interim input-deck for the TRAM test model and an input-deck for a reference test model are utilized in both rigid and elastic modes. Both of these test models are regarded as near scale models of the V-22 proprotor (tiltrotor). With basic TRAC sensitivities established, initial TRAC predictions are compared to results of an extensive test of an isolated model proprotor. The test was that of the TiltRotor Aeroacoustic Model (TRAM) conducted in the Duits-Nederlandse Windtunnel (DNW). Predictions are compared to measured noise for the proprotor operating over an extensive range of conditions. The variation of predictions demonstrates the great care that must be taken in defining the blade motion. However, even with this variability, the predictions using the different blade modeling successfully capture (bracket) the levels and trends of the noise for conditions ranging from descent to ascent.

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

    PubMed

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

    2011-01-01

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

  12. Evolution of the transversus abdominis plane block and its role in postoperative analgesia.

    PubMed

    Lissauer, Jonathan; Mancuso, Kenneth; Merritt, Christopher; Prabhakar, Amit; Kaye, Alan David; Urman, Richard D

    2014-06-01

    Since it was first described by Rafi in 2001, the transversus abdominis plane (TAP) block can be best described as a peripheral nerve block to the anterior abdominal wall (T6 to L1). The TAP block is specifically a local anesthetic injection into the fascial plane superficial to the transversus abdominis muscle and deep to the internal oblique muscle. The TAP block has been a subject of controversy with regard to utility, to indications, and more fundamentally, how best to place the block and its precise mechanism of action. The evolution of thinking with regard to this block, or more correctly family of interrelated blocks, includes knowledge of underlying anatomy, as well as an appreciation of its varied approaches. The TAP block affords excellent analgesia for abdominal procedures. In summary, the TAP block affords effective analgesia with opioid sparing effects, technical simplicity, and long duration of action. Some disadvantages include the need for bilateral block for midline incisions and absence of effectiveness for visceral pain.

  13. Relation between serum ischemia-modified albumin levels and rectus abdominis muscle flap viability.

    PubMed

    Livaoğlu, Murat; Arvas, Leyla; Karaçal, Naci; Menteşe, Ahmet; Karahan, S Caner; Sözen, Emrah

    2011-05-01

    Ischemia is a major cause of flap failure in reconstructive surgery. To detect circulatory compromise, many flap monitoring methods are used; however, there is no any optimal standard method. Ischemia-modified albumin (IMA) is an ischemia marker, which has recently been investigated in many studies and largely validated for early detection of ischemia. In this study, we investigated possible relationship between muscle flap viability and serum IMA levels in experimental flap model. The rectus abdominis muscle flap model was used in 18 New Zealand white rabbits. The study was planned using 3 groups. In group 1, the rectus abdominis muscle flap was harvested as a superior pedicle-based flap in which the inferior pedicle was sacrificed. In group 2, the flap was harvested by severing the superior pedicle. Both pedicles were harvested in group 3. Serum IMA levels were measured before the procedure and 1 hour, 6 hours, and 7 days postoperatively and then compared. In group 3, in which the ischemia was evident, and in group 1, IMA levels were significantly high 1 hour postoperatively (P < 0.05). There was no other significant difference in any of the other studied parameters between the groups. In conclusion, IMA can be used as a biochemical parameter for monitoring muscle flap viability.

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

    PubMed Central

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

    2011-01-01

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

  15. Detection of convective initiation using Meteosat SEVIRI: implementation in and verification with the tracking and nowcasting algorithm Cb-TRAM

    NASA Astrophysics Data System (ADS)

    Merk, D.; Zinner, T.

    2013-08-01

    In this paper a new detection scheme for convective initiation (CI) under day and night conditions is presented. The new algorithm combines the strengths of two existing methods for detecting CI with geostationary satellite data. It uses the channels of the Spinning Enhanced Visible and Infrared Imager (SEVIRI) onboard Meteosat Second Generation (MSG). For the new algorithm five infrared (IR) criteria from the Satellite Convection Analysis and Tracking algorithm (SATCAST) and one high-resolution visible channel (HRV) criteria from Cb-TRAM were adapted. This set of criteria aims to identify the typical development of quickly developing convective cells in an early stage. The different criteria include time trends of the 10.8 IR channel, and IR channel differences, as well as their time trends. To provide the trend fields an optical-flow-based method is used: the pyramidal matching algorithm, which is part of Cb-TRAM. The new detection scheme is implemented in Cb-TRAM, and is verified for seven days which comprise different weather situations in central Europe. Contrasted with the original early-stage detection scheme of Cb-TRAM, skill scores are provided. From the comparison against detections of later thunderstorm stages, which are also provided by Cb-TRAM, a decrease in false prior warnings (false alarm ratio) from 91 to 81% is presented, an increase of the critical success index from 7.4 to 12.7%, and a decrease of the BIAS from 320 to 146% for normal scan mode. Similar trends are found for rapid scan mode. Most obvious is the decline of false alarms found for the synoptic class "cold air" masses.

  16. Detection of convective initiation using Meteosat SEVIRI: implementation in and verification with the tracking and nowcasting algorithm Cb-TRAM

    NASA Astrophysics Data System (ADS)

    Merk, D.; Zinner, T.

    2013-02-01

    In this paper a new detection scheme for Convective Initation (CI) under day and night conditions is presented. The new algorithm combines the strengths of two existing methods for detecting Convective Initation with geostationary satellite data and uses the channels of the Spinning Enhanced Visible and Infrared Imager (SEVIRI) onboard Meteosat Second Generation (MSG). For the new algorithm five infrared criteria from the Satellite Convection Analysis and Tracking algorithm (SATCAST) and one High Resolution Visible channel (HRV) criteria from Cb-TRAM were adapted. This set of criteria aims for identifying the typical development of quickly developing convective cells in an early stage. The different criteria include timetrends of the 10.8 IR channel and IR channel differences as well as their timetrends. To provide the trend fields an optical flow based method is used, the Pyramidal Matching algorithm which is part of Cb-TRAM. The new detection scheme is implemented in Cb-TRAM and is verified for seven days which comprise different weather situations in Central Europe. Contrasted with the original early stage detection scheme of Cb-TRAM skill scores are provided. From the comparison against detections of later thunderstorm stages, which are also provided by Cb-TRAM, a decrease in false prior warnings (false alarm ratio) from 91 to 81% is presented, an increase of the critical success index from 7.4 to 12.7%, and a decrease of the BIAS from 320 to 146% for normal scan mode. Similar trends are found for rapid scan mode. Most obvious is the decline of false alarms found for synoptic conditions with upper cold air masses triggering convection.

  17. Validation of the METEOSAT storm detection and nowcasting system Cb-TRAM with lightning network data - Europe and South Africa

    NASA Astrophysics Data System (ADS)

    Zinner, T.; Forster, C.; de Coning, E.; Betz, H.-D.

    2013-02-01

    In this manuscript, recent changes to the DLR METEOSAT thunderstorm TRacking And Monitoring algorithm (Cb-TRAM) are presented as well as a validation of Cb-TRAM against the European ground-based LIghtning NETwork data (LINET) of Nowcast GmbH and Lightning Detection Network (LDN) data of the South African Weather Service (SAWS). The validation is conducted along the well known skill scores probability of detection (POD) and false alarm ratio (FAR) on the basis of METEOSAT/SEVIRI pixels as well as on the basis of thunderstorm objects. The values obtained demonstrate the limits of Cb-TRAM in specific as well as the limits of satellite methods in general which are based on thermal emission and solar reflectivity information from thunderstorm tops. Although the climatic conditions and the occurence of thunderstorms is quite different for Europe and South Africa, the quality score values are similar. Our conclusion is that Cb-TRAM provides robust results of well-defined quality for very different climatic regimes. The POD for a thunderstorm with intense lightning is about 80% during the day. The FAR for a Cb-TRAM detected thunderstorm which is not at least close to intense lightning activity is about 50%; if the proximity to any lightning activity is evaluated the FAR is even much lower at about 15%. Pixel-based analysis shows that the detected thunderstorm object size is not indiscriminately large, but well within the physical limitations of the method. Nighttime POD and FAR are somewhat worse as the detection scheme can not use high resolution visible information. Nowcasting scores show useful values up to approximatelly 30 min.

  18. Validation of the Meteosat storm detection and nowcasting system Cb-TRAM with lightning network data - Europe and South Africa

    NASA Astrophysics Data System (ADS)

    Zinner, T.; Forster, C.; de Coning, E.; Betz, H.-D.

    2013-06-01

    In this paper, recent changes to the Meteosat thunderstorm TRacking And Monitoring algorithm (Cb-TRAM) are presented as well as a validation of Cb-TRAM against data from the European ground-based LIghtning NETwork (LINET) of Nowcast GmbH and the South African Weather Service Lightning Detection Network (SAWS LDN). Validation is conducted along the well-known skill measures probability of detection (POD) and false alarm ratio (FAR) on the basis of Meteosat/SEVIRI pixels as well as on the basis of thunderstorm objects. The values obtained demonstrate specific limitations of Cb-TRAM, as well as limitations of satellite methods in general which are based on thermal emission and solar reflectivity information from thunderstorm cloud tops. Although the climatic conditions and the occurrence of thunderstorms are quite different for Europe and South Africa, quality score values are similar. Our conclusion is that Cb-TRAM provides robust results of well-defined quality for very different climatic regimes. The POD for a thunderstorm with intense lightning is about 80% during the day. The FAR for a Cb-TRAM detection which is not even close to intense lightning is about 50%. If only proximity to any lightning activity is required, FAR is much lower at about 15%. Pixel-based analysis shows that detected thunderstorm object size is not indiscriminately large, but well within physical limitations of the satellite method. Night-time POD and FAR are somewhat worse as the detection scheme does not use the high-resolution visible information during night-time hours. Nowcasting scores show useful values up to approximately 30 min in advance.

  19. Safety impacts of platform tram stops on pedestrians in mixed traffic operation: A comparison group before-after crash study.

    PubMed

    Naznin, Farhana; Currie, Graham; Logan, David; Sarvi, Majid

    2016-01-01

    Tram stops in mixed traffic environments present a variety of safety, accessibility and transport efficiency challenges. In Melbourne, Australia the hundred year-old electric tram system is progressively being modernized to improve passenger accessibility. Platform stops, incorporating raised platforms for level entry into low floor trams, are being retro-fitted system-wide to replace older design stops. The aim of this study was to investigate the safety impacts of platform stops over older design stops (i.e. Melbourne safety zone tram stops) on pedestrians in the context of mixed traffic tram operation in Melbourne, using an advanced before-after crash analysis approach, the comparison group (CG) method. The CG method evaluates safety impacts by taking into account the general trends in safety and the unobserved factors at treatment and comparison sites that can alter the outcomes of a simple before-after analysis. The results showed that pedestrian-involved all injury crashes reduced by 43% after platform stop installation. This paper also explores a concern that the conventional CG method might underestimate safety impacts as a result of large differences in passenger stop use between treatment and comparison sites, suggesting differences in crash risk exposure. To adjust for this, a modified analysis explored crash rates (crash counts per 10,000 stop passengers) for each site. The adjusted results suggested greater reductions in pedestrian-involved crashes after platform stop installation: an 81% reduction in pedestrian-involved all injury crashes and 86% reduction in pedestrian-involved FSI crashes, both are significant at the 95% level. Overall, the results suggest that platform stops have considerable safety benefits for pedestrians. Implications for policy and areas for future research are explored.

  20. Signal averaging and waveform analysis of laser Doppler flowmetry monitoring of porcine myocutaneous flaps: I. Acute assessment of flap viability.

    PubMed

    Stack, B C; Futran, N D; Ridley, M B; Schultz, S; Sillman, J S

    1995-11-01

    Postoperative monitoring of microvascular free-tissue transfer is essential to the early identification and correction of vascular compromise. Laser Doppler flowmetry is a noninvasive monitor of capillary bed perfusion. Its current clinical use requires continuous monitoring and trend analysis to detect changes in capillary perfusion. This study investigated the hypothesis that signal averaging of laser Doppler flowmetry output triggered by a fixed point in the cardiac cycle would provide accurate information about the microvascular flow patterns not dependent on trend analysis. These results indicate that averaged waveform analysis allowed for a rapid, objective, and statistically significant distinction between a viable myocutaneous flap and one with vascular compromise in a porcine model. Moreover, this technique allows for distinction between venous and arterial insufficiency.

  1. Measurement and analysis of electromagnetic fields from trams, trains and hybrid cars.

    PubMed

    Halgamuge, Malka N; Abeyrathne, Chathurika D; Mendis, Priyan

    2010-10-01

    Electricity is used substantially and sources of electric and magnetic fields are, unavoidably, everywhere. The transportation system is a source of these fields, to which a large proportion of the population is exposed. Hence, investigation of the effects of long-term exposure of the general public to low-frequency electromagnetic fields caused by the transportation system is critically important. In this study, measurements of electric and magnetic fields emitted from Australian trams, trains and hybrid cars were investigated. These measurements were carried out under different conditions, locations, and are summarised in this article. A few of the measured electric and magnetic field strengths were significantly lower than those found in prior studies. These results seem to be compatible with the evidence of the laboratory studies on the biological effects that are found in the literature, although they are far lower than international levels, such as those set up in the International Commission on Non-Ionising Radiation Protection guidelines.

  2. Calculation of the Aerodynamic Behavior of the Tilt Rotor Aeroacoustic Model (TRAM) in the DNW

    NASA Technical Reports Server (NTRS)

    Johnson, Wayne

    2001-01-01

    Comparisons of measured and calculated aerodynamic behavior of a tiltrotor model are presented. The test of the Tilt Rotor Aeroacoustic Model (TRAM) with a single, 1/4-scale V- 22 rotor in the German-Dutch Wind Tunnel (DNW) provides an extensive set of aeroacoustic, performance, and structural loads data. The calculations were performed using the rotorcraft comprehensive analysis CAMRAD II. Presented are comparisons of measured and calculated performance and airloads for helicopter mode operation, as well as calculated induced and profile power. An aerodynamic and wake model and calculation procedure that reflects the unique geometry and phenomena of tiltrotors has been developed. There are major differences between this model and the corresponding aerodynamic and wake model that has been established for helicopter rotors. In general, good correlation between measured and calculated performance and airloads behavior has been shown. Two aspects of the analysis that clearly need improvement are the stall delay model and the trailed vortex formation model.

  3. Expression of tak1 and tram induces synergistic pro-inflammatory signalling and adjuvants DNA vaccines.

    PubMed

    Larsen, Karen Colbjørn; Spencer, Alexandra J; Goodman, Anna L; Gilchrist, Ashley; Furze, Julie; Rollier, Christine S; Kiss-Toth, Endre; Gilbert, Sarah C; Bregu, Migena; Soilleux, Elizabeth J; Hill, Adrian V S; Wyllie, David H

    2009-09-18

    Improving vaccine immunogenicity remains a major challenge in the fight against developing country diseases like malaria and AIDS. We describe a novel strategy to identify new DNA vaccine adjuvants. We have screened components of the Toll-like receptor signalling pathways for their ability to activate pro-inflammatory target genes in transient transfection assays and assessed in vivo adjuvant activity by expressing the activators from the DNA backbone of vaccines. We find that a robust increase in the immune response necessitates co-expression of two activators. Accordingly, the combination of tak1 and tram elicits synergistic reporter activation in transient transfection assays. In a mouse model this combination, but not the individual molecules, induced approximately twofold increases in CD8+ T-cell immune responses. These results indicate that optimal immunogenicity may require activation of distinct innate immune signalling pathways. Thus this strategy offers a novel route to the discovery of a new generation of adjuvants.

  4. A Novel Tram Stent Method in the Treatment of Coronary Bifurcation Lesions – Finite Element Study

    PubMed Central

    Arokiaraj, Mark C.; De Santis, Gianluca; De Beule, Matthieu; Palacios, Igor F.

    2016-01-01

    A novel stent was designed for the treatment of coronary bifurcation lesion, and it was investigated for its performance by finite element analysis. This study was performed in search of a novel method of treatment of bifurcation lesion with provisional stenting. A bifurcation model was created with the proximal vessel of 3.2 mm diameter, and the distal vessel after the side branch (2.3 mm) was 2.7 mm. A novel stent was designed with connection links that had a profile of a tram. Laser cutting and shape setting of the stent was performed, and thereafter it was crimped and deployed over a balloon. The contact pressure, stresses on the arterial wall, stresses on the stent, the maximal principal log strain of the main artery and the side-branch were studied. The study was performed in Abaqus, Simulia. The stresses on the main branch and the distal branch were minimally increased after deployment of this novel stent. The side branch was preserved, and the stresses on the side branch were lesser; and at the confluence of bifurcation on either side of the side branch origin the von-Mises stress was marginally increased. The stresses and strain at the bifurcation were significantly lesser than the stresses and strain of the currently existing techniques used in the treatment of bifurcation lesions though the study was primarily focused only on the utility of the new technology. There is a potential for a novel Tram-stent method in the treatment of coronary bifurcation lesions. PMID:26937643

  5. A Novel Tram Stent Method in the Treatment of Coronary Bifurcation Lesions - Finite Element Study.

    PubMed

    Arokiaraj, Mark C; De Santis, Gianluca; De Beule, Matthieu; Palacios, Igor F

    2016-01-01

    A novel stent was designed for the treatment of coronary bifurcation lesion, and it was investigated for its performance by finite element analysis. This study was performed in search of a novel method of treatment of bifurcation lesion with provisional stenting. A bifurcation model was created with the proximal vessel of 3.2 mm diameter, and the distal vessel after the side branch (2.3 mm) was 2.7 mm. A novel stent was designed with connection links that had a profile of a tram. Laser cutting and shape setting of the stent was performed, and thereafter it was crimped and deployed over a balloon. The contact pressure, stresses on the arterial wall, stresses on the stent, the maximal principal log strain of the main artery and the side-branch were studied. The study was performed in Abaqus, Simulia. The stresses on the main branch and the distal branch were minimally increased after deployment of this novel stent. The side branch was preserved, and the stresses on the side branch were lesser; and at the confluence of bifurcation on either side of the side branch origin the von-Mises stress was marginally increased. The stresses and strain at the bifurcation were significantly lesser than the stresses and strain of the currently existing techniques used in the treatment of bifurcation lesions though the study was primarily focused only on the utility of the new technology. There is a potential for a novel Tram-stent method in the treatment of coronary bifurcation lesions.

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

    PubMed Central

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

    2011-01-01

    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. PMID:22294942

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  9. A novel method of minimally invasive rectus abdominis muscle flap harvest: Laparoscopic surgeons take note

    PubMed Central

    Aijaz, Tabish; Singhal, Dhruv; Tan, Sanda A.; Iqbal, Atif

    2017-01-01

    The rectus abdominis muscle (RAM) is a workhorse flap to fill or repair abdominal defects. A drawback of an open RAM harvest is donor site morbidity, and minimally invasive techniques for flap harvesting have been previously proposed but involve vertical division of the rectus fascia. We present a case of a 52-year-old woman with a recurrent rectovaginal fistula in a radiated field treated with a laparoscopic low anterior resection with simultaneous RAM flap harvest utilising a single Pfannenstiel incision. Our novel modified laparoscopic-assisted RAM harvest technique prevents longitudinal violation of the anterior and posterior rectus sheaths, thereby promoting a quick recovery, improved cosmesis and decreased post-operative morbidity. PMID:28281481

  10. Transversus abdominis plane block in renal allotransplant recipients: A retrospective chart review

    PubMed Central

    Gopwani, SR; Rosenblatt, MA

    2016-01-01

    Context: The efficacy of the transversus abdominis plane (TAP) block appears to vary considerably, depending on the surgical procedure and block technique. Aims: This study aims to add to the existing literature and provide a more clear understanding of the TAP blocks role as a postoperative analgesic technique, specifically in renal allotransplant recipients. Settings and Design: A retrospective chart review was conducted by querying the intraoperative electronic medical record system of a 1200-bed tertiary academic hospital over a 5 months period, and reviewing anesthetic techniques, as well as postoperative morphine equivalent consumption. Materials and Methods: Fifty renal allotransplant recipients were identified, 13 of whom received TAP blocks while 37 received no regional analgesic technique. All blocks were performed under ultrasound guidance, with 20 mL of 0.25% bupivacaine injected in the transversus abdominis fascial plane under direct visualization. The primary outcome was postoperative morphine equivalent consumption. Statistical Analysis Used: Morphine consumption was compared with the two-tailed Mann–Whitney U-test. Continuous variables of patient baseline characteristics were analyzed with unpaired t-test and categorical variables with Fischer Exact Test. A P < 0.05 was considered statistically significant. Results: A statistically significant decrease in cumulative morphine consumption was found in the group that received the TAP block at 6 h (2.46 mg vs. 7.27 mg, P = 0.0010), 12 h (3.88 mg vs. 10.20 mg, P = 0.0005), 24 h (6.96 mg vs. 14.75 mg, P = 0.0013), and 48 h (11 mg vs. 20.13 mg, P = 0.0092). Conclusions: The TAP block is a beneficial postoperative analgesic, opiate-sparing technique in renal allotransplant recipients. PMID:27833477

  11. Method of Breast Reconstruction Determines Venous Thromboembolism Risk Better Than Current Prediction Models

    PubMed Central

    Patel, Niyant V.; Wagner, Douglas S.

    2015-01-01

    Background: Venous thromboembolism (VTE) risk models including the Davison risk score and the 2005 Caprini risk assessment model have been validated in plastic surgery patients. However, their utility and predictive value in breast reconstruction has not been well described. We sought to determine the utility of current VTE risk models in this population and the VTE rate observed in various methods of breast reconstruction. Methods: A retrospective review of breast reconstructions by a single surgeon was performed. One hundred consecutive transverse rectus abdominis myocutaneous (TRAM) patients, 100 consecutive implant patients, and 100 consecutive latissimus dorsi patients were identified over a 10-year period. Patient demographics and presence of symptomatic VTE were collected. 2005 Caprini risk scores and Davison risk scores were calculated for each patient. Results: The TRAM reconstruction group was found to have a higher VTE rate (6%) than the implant (0%) and latissimus (0%) reconstruction groups (P < 0.01). Mean Davison risk scores and 2005 Caprini scores were similar across all reconstruction groups (P > 0.1). The vast majority of patients were stratified as high risk (87.3%) by the VTE risk models. However, only TRAM reconstruction patients demonstrated significant VTE risk. Conclusions: TRAM reconstruction appears to have a significantly higher risk of VTE than both implant and latissimus reconstruction. Current risk models do not effectively stratify breast reconstruction patients at risk for VTE. The method of breast reconstruction appears to have a significant role in patients’ VTE risk. PMID:26090287

  12. Detailed mineralogical characterization of the Bullfrog and Tram members USW-G1, with emphasis on clay mineralogy

    SciTech Connect

    Bish, D.L.

    1981-10-01

    The detailed mineralogy of the Bullfrog and Tram Members of the Crater Flat Tuff from drill hole USW-G1 has been examined, primarily to characterize fully the amounts and types of clay minerals in the tuffs and the possible effects clay minerals have on rock properties. Results of bulk sample x-ray diffraction analyses agree closely with previous determinations, although slightly higher clay mineral contents were found in this study. X-ray diffraction analysis of fine fractions revealed that the clay minerals in the tuffs are sodium-saturated montmorillonite-beidellites with typical layer charges and no high-charge layers. These smectites are found in virtually all samples of the Bullfrog and Tram, and there is no correlation between the amounts of smectites and the amounts of zeolite, quartz, and feldspar. Smectites are present in both welded and nonwelded horizons and are scarce in some zones with slight-to-absent welding.

  13. Comparison of the thicknesses of the transversus abdominis and internal abdominal obliques during plank exercises on different support surfaces.

    PubMed

    Do, Yong-Chan; Yoo, Won-Gyu

    2015-01-01

    [Purpose] This study applied variable plank exercises on a stable surface consisting of a mat, on an unstable surface consisting of a dynamic cushion placed under the upper extremities and lower extremities. [Subjects] Forty-three healthy male and female subjects in their 20s voluntarily consented to participate in this study. [Methods] The subjects performed the plank exercises on the three support surfaces. Ultrasound imaging was conducted while they carried out plank exercises. [Results] The changes in the thicknesses of both the transversus abdominis and internal abdominal obliques were statistically more significant for LEDCP than for MatP. In addition, the changes in the thickness of the transversus abdominis were statistically more significant for LEDCP than for UEDCP. [Conclusion] Therefore, applying an unstable condition to the lower limbs using a dynamic cushion is considered more effective during plank exercises.

  14. [Why and how to perform an ultrasound-guided transversus abdominis plane block: A step-by-step approach].

    PubMed

    Nohuz, E; El Drayi, B; Triki, A; Grossmannova, K; Boudier, B; Koffi, K; Albaut, M; Dualé, C

    2016-12-01

    Used in clinical practice as part of a multimodal analgesic regimen, the transversus abdominis plane block (TAP block) is a relative novel procedure in which local anaesthetic agents are injected into the anatomic neurofascial space between the internal oblique and the transversus abdominis muscle. It allows a significantly prolonged duration of analgesia during the early postoperative stage in abdominal surgery. This regional anesthesia technique provides analgesia to the skin, muscles of the anterior abdominal wall and parietal peritoneum in order to decrease the incision-related pain. Thus, it reduces postoperative opiate requirements and opioids-related side effects (nausea, vomiting, delayed resumption of intestinal transit, drowsiness, respiratory depression, urine retention). Additionally, the TAP block appears particularly interesting when neuraxial techniques or opioids are contraindicated. Moreover, the ultrasound-guided procedure provides a significant success rate of this block and additionally avoids major complications. We describe our technique of ultrasound-guided TAP block and discuss its indications, contraindication and potential complications.

  15. The Small GTPase Arf6 Is Essential for the Tram/Trif Pathway in TLR4 Signaling*

    PubMed Central

    Van Acker, Tim; Eyckerman, Sven; Vande Walle, Lieselotte; Gerlo, Sarah; Goethals, Marc; Lamkanfi, Mohamed; Bovijn, Celia; Tavernier, Jan; Peelman, Frank

    2014-01-01

    Recognition of lipopolysaccharides (LPS) by Toll-like receptor 4 (TLR4) at the plasma membrane triggers NF-κB activation through recruitment of the adaptor proteins Mal and MyD88. Endocytosis of the activated TLR4 allows recruitment of the adaptors Tram and Trif, leading to activation of the transcription factor IRF3 and interferon production. The small GTPase ADP-ribosylation factor 6 (Arf6) was shown to regulate the plasma membrane association of Mal. Here we demonstrate that inhibition of Arf6 also markedly reduced LPS-induced cytokine production in Mal−/− mouse macrophages. In this article, we focus on a novel role for Arf6 in the MyD88-independent TLR4 pathway. MyD88-independent IRF3 activation and IRF3-dependent gene transcription were strictly dependent on Arf6. Arf6 was involved in transport of Tram to the endocytic recycling compartment and internalization of LPS, possibly explaining its requirement for LPS-induced IRF3 activation. Together, these results show a critical role for Arf6 in regulating Tram/Trif-dependent TLR4 signaling. PMID:24297182

  16. TRAM-Derived Decoy Peptides inhibits the inflammatory response in mouse mammary epithelial cells and a mastitis model in mice.

    PubMed

    Hu, Xiaoyu; Tian, Yuan; Wang, Tiancheng; Zhang, Wenlong; Wang, Wei; Gao, Xuejiao; Qu, Shihui; Cao, Yongguo; Zhang, Naisheng

    2015-10-05

    It has been proved that TRAM-Derived Decoy peptides have anti-inflammatory properties. In this study, we synthesized a TRAM-Derived decoy peptide (TM6), belongs to TRAM TIR domain, of which sequence is "N"-RQIKIWFQNRRMKWK, KENFLRDTWCNFQFY-"C" and evaluated the effects of TM6 on lipopolysaccharide-induced mastitis in mice. In vivo, LPS-induced mice mastitis model was established by injection of LPS through the duct of mammary gland. TM6 was injected 1h before or after LPS treatment. In vitro, primary mouse mammary epithelial cells were used to investigate the effects of TM6 on LPS-induced inflammatory responses. The results showed that TM6 inhibited LPS-induced mammary gland histopathologic changes, MPO activity, and TNF-α, IL-1β and IL-6 production in mice. In vitro, TM6 significantly inhibited LPS-induced TNF-α and IL-6 production, as well as NF-κB and MAPKs activation. In conclusion, this study demonstrated that TM6 had protective effects on LPS-mastitis and may be a promising therapeutic reagent for mastitis treatment.

  17. Pectoralis Major Myocutaneous Flap for Head and Neck Defects in the Era of Free Flaps: Harvesting Technique and Indications

    PubMed Central

    Liu, Muyuan; Liu, Weiwei; Yang, Xihong; Guo, Haipeng; Peng, Hanwei

    2017-01-01

    The role of the pectoralis major myocutaneous flap (PMMF) in head and neck reconstruction is challenged recently due to its natural drawbacks and the popularity of free flaps. This study was designed to evaluate the indications and reliability of using a PMMF in the current free flap era based on a single center experience. The PMMF was harvested as a pedicle-skeletonized flap, with its skin paddle caudally and medially to the areola, including the third intercostal perforator, preserving the upper one third of the pectoralis major muscle. The harvested flap was passed via a submuscular tunnel over the clavicle. One hundred eighteen PMMFs were used in 114 patients, of which 76 were high-risk candidates for a free flap; 8 patients underwent total glossectomy, and 30 underwent salvage or emergency reconstruction. Major complications occurred in 4 patients and minor complications developed in 10. Tracheal extubation was possible in all cases, while oral intake was possible in all but 1 case. These techniques used in harvesting a PMMF significantly overcome its natural pitfalls. PMMFs can safely be used in head and neck cancer patients who need salvage reconstruction, who are high risk for free flaps, and who need large volume soft-tissue flaps. PMID:28387356

  18. Pectoralis Major Myocutaneous Flap for Head and Neck Defects in the Era of Free Flaps: Harvesting Technique and Indications.

    PubMed

    Liu, Muyuan; Liu, Weiwei; Yang, Xihong; Guo, Haipeng; Peng, Hanwei

    2017-04-07

    The role of the pectoralis major myocutaneous flap (PMMF) in head and neck reconstruction is challenged recently due to its natural drawbacks and the popularity of free flaps. This study was designed to evaluate the indications and reliability of using a PMMF in the current free flap era based on a single center experience. The PMMF was harvested as a pedicle-skeletonized flap, with its skin paddle caudally and medially to the areola, including the third intercostal perforator, preserving the upper one third of the pectoralis major muscle. The harvested flap was passed via a submuscular tunnel over the clavicle. One hundred eighteen PMMFs were used in 114 patients, of which 76 were high-risk candidates for a free flap; 8 patients underwent total glossectomy, and 30 underwent salvage or emergency reconstruction. Major complications occurred in 4 patients and minor complications developed in 10. Tracheal extubation was possible in all cases, while oral intake was possible in all but 1 case. These techniques used in harvesting a PMMF significantly overcome its natural pitfalls. PMMFs can safely be used in head and neck cancer patients who need salvage reconstruction, who are high risk for free flaps, and who need large volume soft-tissue flaps.

  19. Influence of approaching tram on behaviour of pedestrians in signalised crosswalks in Poland.

    PubMed

    Kruszyna, Maciej; Rychlewski, Jeremi

    2013-06-01

    Research done in two Polish cities has uncovered an influence of an approaching tram on pedestrian behaviour. The measurements were done by counting pedestrians waiting for a green signal, crossing on red signal safely, or crossing on red signal taking a risk of being hit by a car, differentiating between pedestrians attempting to board a public transport vehicle and other pedestrians. It was expected, that pedestrian behaviour might be influenced by traffic control predictability, therefore two cities were chosen for the task: Wrocław with fixed time traffic control and Poznań with a majority of traffic responsive traffic signals. Data from the measurements was compared in order to find behaviour patterns - the comparison led to a conclusion, that an attempt to get on board of an incoming public transport vehicle can be a major cause for pedestrians to violate a red signal, including an increase of unsafe behaviour. These pedestrians may provoke other pedestrians to cross on a red signal. On the other hand if traffic control guarantees boarding the public transport vehicle, passengers-to-be may be even more obedient than other pedestrians.

  20. FeTRAM. An organic ferroelectric material based novel random access memory cell.

    PubMed

    Das, Saptarshi; Appenzeller, Joerg

    2011-09-14

    Science and technology in the electronics area have always been driven by the development of materials with unique properties and their integration into novel device concepts with the ultimate goal to enable new functionalities in innovative circuit architectures. In particular, a shift in paradigm requires a synergistic approach that combines materials, devices and circuit aspects simultaneously. Here we report the experimental implementation of a novel nonvolatile memory cell that combines silicon nanowires with an organic ferroelectric polymer-PVDF-TrFE-into a new ferroelectric transistor architecture. Our new cell, the ferroelectric transistor random access memory (FeTRAM) exhibits similarities with state-of-the-art ferroelectric random access memories (FeRAMs) in that it utilizes a ferroelectric material to store information in a nonvolatile (NV) fashion but with the added advantage of allowing for nondestructive readout. This nondestructive readout is a result of information being stored in our cell using a ferroelectric transistor instead of a capacitor-the scheme commonly employed in conventional FeRAMs.

  1. Evolution of transversus abdominis plane infiltration techniques for postsurgical analgesia following abdominal surgeries

    PubMed Central

    Gadsden, Jeffrey; Ayad, Sabry; Gonzales, Jeffrey J; Mehta, Jaideep; Boublik, Jan; Hutchins, Jacob

    2015-01-01

    Transversus abdominis plane (TAP) infiltration is a regional anesthesia technique that has been demonstrated to be effective for management of postsurgical pain after abdominal surgery. There are several different clinical variations in the approaches used for achieving analgesia via TAP infiltration, and methods for identification of the TAP have evolved considerably since the landmark-guided technique was first described in 2001. There are many factors that impact the analgesic outcomes following TAP infiltration, and the various nuances of this technique have led to debate regarding procedural classification of TAP infiltration. Based on our current understanding of fascial and neuronal anatomy of the anterior abdominal wall, as well as available evidence from studies assessing local anesthetic spread and cutaneous sensory block following TAP infiltration, it is clear that TAP infiltration techniques are appropriately classified as field blocks. While the objective of peripheral nerve block and TAP infiltration are similar in that both approaches block sensory response in order to achieve analgesia, the technical components of the two procedures are different. Unlike peripheral nerve block, which involves identification or stimulation of a specific nerve or nerve plexus, followed by administration of a local anesthetic in close proximity, TAP infiltration involves administration and spread of local anesthetic within an anatomical plane of the surgical site. PMID:26677342

  2. Efficacy of Transversus Abdominis Plane Block and Rectus Sheath Block in Laparoscopic Inguinal Hernia Surgery

    PubMed Central

    Takebayashi, Katsushi; Matsumura, Masakata; Kawai, Yasuhiro; Hoashi, Takahiko; Katsura, Nagato; Fukuda, Seijun; Shimizu, Kenji; Inada, Takuji; Sato, Masugi

    2015-01-01

    We aimed to assess the efficacy of transversus abdominis plane (TAP) block and rectus sheath (RS) block in patients undergoing laparoscopic inguinal hernia surgery. Few studies have addressed the efficacy and safety associated with TAP block and RS block for laparoscopic surgery. Thirty-two patients underwent laparoscopic inguinal hernia surgery, either with TAP and RS block (Block+ group, n = 18) or without peripheral nerve block (Block− group, n = 14). Preoperatively, TAP and RS block were performed through ultrasound guidance. We evaluated postoperative pain control and patient outcomes. The mean postoperative hospital stays were 1.56 days (Block+ group) and 2.07 days (Block− group; range, 1–3 days in both groups; P = 0.0038). A total of 11 patients and 1 patient underwent day surgery in the Block+ and Block− groups, respectively (P = 0.0012). Good postoperative pain control was more commonly observed in the Block+ group than in the Block− group (P = 0.011). TAP and RS block was effective in reducing postoperative pain and was associated with a fast recovery in patients undergoing laparoscopic inguinal hernia surgery. PMID:25875548

  3. Ultrasound-guided transversus abdominis plane block: What are the benefits of adding dexmedetomidine to ropivacaine?

    PubMed Central

    Mishra, Manjaree; Mishra, Shashi Prakash; Singh, Somendra Pal

    2017-01-01

    Background: Ultrasound-guided transversus abdominis plane (TAP) block has recently come up as a modality to take care of postoperative pain. It can somewhat avoid the use of intravenous opioid analgesics and hence to avoid its complications. We have performed a prospective, double-blinded, randomized study to assess the analgesic effect of adding dexmedetomidine to local ropivacaine on TAP block for patients undergoing lower abdominal surgeries. Aim: The aim is to assess whether addition of dexmedetomidine to ropivacaine may bring some improvements to the analgesic efficacy of TAP blocks in patients undergoing lower abdominal surgeries. Materials and Methods: The study was conducted on forty patients undergoing lower abdominal surgeries under general anesthesia. The patients were divided into two groups: one receiving plain ropivacaine (Group 1) and other receiving ropivacaine with dexmedetomidine (Group 2) during TAP block. The patients in the two groups were compared for age, sex, body mass index, incidence of postoperative nausea, and vomiting and pain as measured on visual analog scale (VAS). Results: There was significantly lower pain score on VAS at 1, 3, 6, 12, and 18 h in Group 2 than in Group 1. Conclusion: The addition of dexmedetomidine to ropivacaine during TAP block improves analgesic effect of TAP block and prolongs the duration of analgesia as well. PMID:28217055

  4. Myocutaneous sternocleidomastoid flap for reconstruction after the resection of a parapharyngeal heterotopic glioma in a child with cleft palate, and systematic review of parapharyngeal glial heterotopia.

    PubMed

    Prado-Calleros, Héctor M; Arrieta-Gómez, José R; Castillo-Ventura, Beatriz; Martínez, Sara Parraguirre; Jiménez-Gutiérrez, Carlos; Jiménez-Escobar, Irma

    2016-02-01

    We describe the surgery and reconstruction employed with a sternocleidomastoid myocutaneous flap for the treatment of a heterotopic glioma in a 2-year-old boy with incomplete palatal fissure who presented with dysphagia and snoring, in whom a lateral pharyngeal wall mass obstructing 60% of the airway was noted. Heterotopic gliomas are uncommonly reported in the parapharyngeal space and should be included in the differential diagnosis at this location in children. Parapharyngeal tumors present difficult diagnostic and management challenges; head and neck surgeons must be prepared not only for the resection but also for the reconstruction of these rare lesions.

  5. Analgesic efficacy of ultrasound-guided subcostal transversus abdominis plane block

    PubMed Central

    Ma, Jianfeng; Jiang, Yifei; Tang, Shiyi; Wang, Benfu; Lian, Qingquan; Xie, Zuokai; Li, Jun

    2017-01-01

    Abstract Background: To evaluate the analgesic efficacy on defined areas of the abdomen and back after ultrasound-guided subcostal transversus abdominis plane (TAP) block using 0.25% levobupivacaine 0.5 mL/kg. Methods: Twenty patients undergoing elective laparoscopic cholecystectomy, between 20 and 60 years of age with operative time <1 hour, received subcostal TAP block using 0.25% levobupivacaine 0.5 mL/kg on the left side. Surgery started after 1 hour of observation. Sensory assessment was undertaken using pinprick and 75% ethyl alcohol at 10, 20, 30 minutes, 1, 3, and 12 hours after TAP block at 19 testing zones that were divided by anatomic landmark lines on the abdomen and the back. Efficacy of zone was defined as loss of cold temperature sensation or loss of pinprick pain sensation in more than 50% patients in that testing zone. Duration was determined by analgesia and loss of temperature sensation beginning within 30 minutes of TAP block placement lasting until time points of 1, 3, and 12 hours. All of the testing zones were divided as Group I effective at 20 minutes in less than 50% patients (0%–50%), Group II 50% to 70% patients, Group III 70% to 90% patients, and Group IV 90% to 100% patients. Results: Twenty patients meeting the study requirements were included. At each time point, the efficacies among 4 groups were significantly different. Subcostal TAP had good efficacy and stable duration in zones 1, 2, 3, 5, and 6. Conclusion: Subcostal TAP block with 0.25% levobupivacaine 0.5 mL/kg dose provided effective analgesia in the anterior abdominal wall between medioventral line to anterior axillary line except the lateral upper abdominal region. PMID:28272260

  6. Transversus Abdominis Plane Versus Ilioinguinal and Iliohypogastric Nerve Blocks for Analgesia Following Open Inguinal Herniorrhaphy*

    PubMed Central

    Stav, Anatoli; Reytman, Leonid; Stav, Michael-Yohay; Troitsa, Anton; Kirshon, Mark; Alfici, Ricardo; Dudkiewicz, Mickey; Sternberg, Ahud

    2016-01-01

    Objectives We hypothesized that preoperative (pre-op) ultrasound (US)-guided posterior transversus abdominis plane block (TAP) and US-guided ilioinguinal and iliohypogastric nerve block (ILI+IHG) will produce a comparable analgesia after Lichtenstein patch tension-free method of open inguinal hernia repair in adult men. The genital branch of the genitofemoral nerve will be blocked separately. Methods This is a prospective, randomized, controlled, and observer-blinded clinical study. A total of 166 adult men were randomly assigned to one of three groups: a pre-op TAP group, a pre-op ILI+IHG group, and a control group. An intraoperative block of the genital branch of the genitofemoral nerve was performed in all patients in all three groups, followed by postoperative patient-controlled intravenous analgesia with morphine. The pain intensity and morphine consumption immediately after surgery and during the 24 hours after surgery were compared between the groups. Results A total of 149 patients completed the study protocol. The intensity of pain immediately after surgery and morphine consumption were similar in the two “block” groups; however, they were significantly decreased compared with the control group. During the 24 hours after surgery, morphine consumption in the ILI+IHG group decreased compared with the TAP group, as well as in each “block” group versus the control group. Twenty-four hours after surgery, all evaluated parameters were similar. Conclusion Ultrasound-guided ILI+IHG provided better pain control than US-guided posterior TAP following the Lichtenstein patch tension-free method of open inguinal hernia repair in men during 24 hours after surgery. (ClinicalTrials.gov number: NCT01429480.) PMID:27487311

  7. Swiss Ball Versus Mat Exercises For Core Activation of Transverse Abdominis in Recreational Athletes

    PubMed Central

    Nayak, Nirmala; Nair, Sudeep; Sherpa, Lobsang Bhuti; Dsouza, Diana

    2016-01-01

    Introduction Core stability is an essential component for improving athletic performance and injury prevention. Exercises on a Swiss ball and on the mat are two different ways of improving core stability. Comparison of these methods can help physiotherapists incorporate the better method for athletic training and rehabilitation. Aim To compare swiss ball and mat exercises for core stability of transverse abdominis in recreational athletes. Materials and Methods This pilot randomized control trial was performed on a total of 25 recreational athletes. Subjects were alternatively allocated into three different groups: group A performed swiss ball exercises; group B performed mat exercises; and group C was the control group. Statistical analysis Paired t-test for pre and post values within the group and one-way ANOVA for between the groups comparison was used. Results There was significant improvement in the core stability in Group A (Pre values: 3.6±2.06; Post values: 8.3±3.02; p-value: <0.05) and Group B (Pre values: 2.1±2.4; Post values: 4.3±2.5; p-value<0.05), however, improvement was more in group A compared to group B. Conclusion There was significant improvement seen in the recreational athletes performing exercises on Swiss ball as compared to athletes performing exercises on mat. Therefore, Swiss ball exercises can be included in the prehabilitation and rehabilitation stages of athletic training to prevent injury and enhanced recovery post injury, thereby, improving performance of the athletes. PMID:28208990

  8. Utility of ultrasound-guided transversus abdominis plane block for day-case inguinal hernia repair

    PubMed Central

    Pitoni, Sara; Gonnella, Gianluigi; Alfieri, Sergio; Catarci, Stefano; Draisci, Gaetano

    2017-01-01

    Background The transversus abdominis plane (TAP) block is a regional anesthesia technique that effectively reduces the pain intensity and use of analgesia in abdominal surgery. The aim of this study was to determine the utility of the ultrasound-guided TAP block in improving the efficacy of the ultrasound-guided ilioinguinal/iliohypogastric nerve (IIN/IHN) block for intraoperative anesthesia and postoperative pain control in day-case inguinal hernia repair (IHR). Methods We conducted a descriptive study of patients undergoing elective primary unilateral open IHR. Fifty-nine patients were divided into two groups according to the anesthetic technique used: ultrasound-guided TAP block plus ultrasound-guided IIN/IHN block (TAP group) vs. ultrasound-guided IIN/IHN block alone (IIN/IHN group). The outcome measures were the adequacy of anesthesia during surgery and postoperative analgesia. Results Four patients (12.5%) in the TAP group and 10 patients (37.0%) in the IIN/IHN group experienced inadequate anesthesia and needed systemic sedation (P < 0.05). No significant differences in additional local anesthetic volume were found between the two groups. Patients in the TAP group reported lower pain scores at the end of surgery (0.4 ± 0.8 vs. 2.1 ± 2.5, P < 0.01), at 2 hours after surgery (0.8 ± 1.3 vs. 3.0 ± 2.2, P < 0.01), at discharge (1.4 ± 1.2 vs. 4.3 ± 2.2, P < 0.01), and at 24 hours (1.5 ± 1.1 vs. 4.5 ± 2.3, P < 0.01). Conclusions The combination of the TAP and IIN/IHN blocks is associated with better intraoperative anesthesia and lower postoperative pain scores compared with the IIN/IHN block alone. PMID:28184266

  9. Addition of clonidine to bupivacaine in transversus abdominis plane block prolongs postoperative analgesia after cesarean section

    PubMed Central

    Singh, Ranju; Kumar, Nishant; Jain, Aruna; Joy, Sudipta

    2016-01-01

    Background and Aims: The aim was to compare duration of postoperative analgesia with addition of clonidine to bupivacaine in bilateral transversus abdominis plane (TAP) block after lower segment cesarean section (LSCS). Material and Methods: One hundred American Society of Anesthesiologists (ASA) grade I and II pregnant patients undergoing LSCS under spinal anesthesia were randomly divided to receive either 20 ml bupivacaine 0.25% (Group B; n = 50) or 20 ml bupivacaine+1ug/kg clonidine bilaterally (Group BC; n = 50) in TAP block in a double-blind fashion. The total duration of analgesia, patient satisfaction score, total requirement of analgesics in the first 24 h, and the side effects of clonidine such as sedation, dryness of mouth, hypotension, and bradycardia were observed. P < 0.05 was taken as significant. Results: In 99 patients analyzed, TAP block failed in five patients. Duration of analgesia was significantly longer in Group BC (17.8 ± 3.7 h) compared to Group B (7.3 ± 1.2 h; P < 0.01). Mean consumption of diclofenac was 150 mg and 65.4 mg in Groups B and BC (P < 0.01), respectively. All patients in Group BC were extremely satisfied (P < 0.01) while those in Group B were satisfied. Thirteen patients (28%) in Group BC were sedated but arousable (P = 0.01) compared to none in Group B. In Group BC, 19 patients complained of dry mouth compared to 13 in Group B (P = 0.121). None of the patients experienced hypotension or bradycardia. Conclusion: Addition of clonidine 1 μg/kg to 20 ml bupivacaine 0.25% in TAP block bilaterally for cesarean section significantly increases the duration of postoperative analgesia, decreases postoperative analgesic requirement, and increases maternal comfort compared to 20 ml of bupivacaine 0.25% alone. PMID:28096583

  10. Thoracic epidural catheter for postoperative pain control following an ineffective transversus abdominis plane block using liposome bupivacaine

    PubMed Central

    Terrien, Brian D; Espinoza, David; Stehman, Charles C; Rodriguez, Gabriel A; Connolly, Nicholas C

    2017-01-01

    A 24-year-old female with a history of ulcerative colitis underwent colectomy. The patient received an ineffective transversus abdominis plane (TAP) block with liposome bupivacaine (Exparel) intraoperatively and was started on a hydromorphone patient-controlled analgesia 5 hours after the TAP block, which did not relieve her pain. A continuous thoracic epidural (CTE) was then placed after blood levels of bupivacaine were drawn, and the patient immediately experienced significant pain relief. The combined use of liposome bupivacaine and bupivacaine CTE infusion in the postoperative management of this patient demonstrated no safety concerns, provided excellent analgesia and plasma concentrations of bupivacaine remained far below toxic levels. PMID:28144162

  11. Annexin A2 binds to endosomes and negatively regulates TLR4-triggered inflammatory responses via the TRAM-TRIF pathway

    PubMed Central

    Zhang, Shuang; Yu, Min; Guo, Qiang; Li, Rongpeng; Li, Guobo; Tan, Shirui; Li, Xuefeng; Wei, Yuquan; Wu, Min

    2015-01-01

    Lipopolysaccharide (LPS) derived from Gram-negative bacteria activates plasma membrane signaling via Toll-like receptor 4 (TLR4) on host cells and triggers innate inflammatory responses, but the underlying mechanisms remain to be fully elucidated. Here we reveal a role for annexin A2 (AnxA2) in host defense against infection as anxa2−/− mice were highly susceptible to Gram-negative bacteria-induced sepsis with enhanced inflammatory responses. Computing analysis and biochemical experiments identified that constitutive AnxA2 expression facilitated TLR4 internalization and its subsequent translocation into early endosomal membranes. It activated the TRAM-dependent endosomal signaling, leading to the release of anti-inflammatory cytokines. Importantly, AnxA2 deficiency prolonged TLR4-mediated signaling from the plasma membrane, which was attributable to pro-inflammatory cytokine production (IL-6, TNFα and IL-1β). Thus, AnxA2 directly exerted negative regulation of inflammatory responses through TLR4-initiated TRAM-TRIF pathway occurring on endosomes. This study reveals AnxA2 as a critical regulator in infection-initiated inflammation, which protects the host from excessive inflammatory damage. PMID:26527544

  12. Slow expiration reduces sternocleidomastoid activity and increases transversus abdominis and internal oblique muscle activity during abdominal curl-up.

    PubMed

    Yoon, Tae-Lim; Kim, Ki-Song; Cynn, Heon-Seock

    2014-04-01

    The aim of this study was to investigate the effects of quiet inspiration versus slow expiration on sternocleidomastoid (SCM) and abdominal muscle activity during abdominal curl-up in healthy subjects. Twelve healthy subjects participated in this study. Surface electromyography (EMG) was used to collect activity of bilateral SCM, rectus abdominis (RA), external oblique (EO), and transversus abdominis/internal oblique (TrA/IO) muscles. A paired t-test was used to determine significant differences in the bilateral SCM, RF, EO, and TrA/IO muscles between abdominal curl-up with quiet inspiration and slow expiration. There were significantly lower EMG activity of both SCMs and greater EMG activity of both IOs during abdominal curl-up with slow expiration, compared with the EMG activity of both SCMs and IOs during abdominal curl-up with quiet inspiration (p<.05). The results of this study suggest that slow expiration would be recommended during abdominal curl-up for reduced SCM activation and selective activation of TrA/IO in healthy subjects compared with those in abdominal curl up with quiet inspiration.

  13. Is unilateral transversus abdominis plane block an analgesic alternative for ureteric shock wave lithotripsy?

    PubMed Central

    Elnabtity, Ali Mohamed Ali; Tawfeek, Mohamed M.; Keera, Amr Ali; Badran, Yasser Ali

    2015-01-01

    Background: Various sedative and analgesic techniques have been used during shock wave lithotripsy (SWL). Aim: This study aimed at evaluating the efficacy of ultrasound-guided unilateral transversus abdominis plane (TAP) block as an analgesic technique alternative during ureteric SWL. Settings and Design: Prospective randomized comparative study. Materials and Methods: Fifty patients scheduled for ureteric SWL were randomly allocated into two equal groups: Group (F) received 1.5 mcg/kg fentanyl intravenous and group (T) received unilateral TAP block with injection of 25 ml of bupivacaine 0.25% (62.5 mg). Statistical Analysis: Statistical analysis was performed using SPSS program version 19 and EP16 program. Results: The visual analog scale was significantly less in group (T) than in group (F) both intra-operatively (at 10, 20, 30, and 40 min) and postoperatively (at 10 min intervals in the postanesthesia care unit [PACU]) (P < 0.001). Rescue analgesia with pethidine during the procedure and in the PACU was less (P < 0.001) in the group (T) than group (F) with a median of 20 mg versus 55 mg, respectively. The higher sedation scores observed in group (F) at 15, 25, and 35 min during the procedure, and at 20 min during the PACU time were statistically highly significant (P < 0.001), but only significant at 10 min (P = 0.03) and 30 min (P = 0.007) during the PACU time. There was also highly significant decrease (P < 0.001) in the time of PACU stay in group (T) (38.2 ± 6.6 min) compared with group (F) (89.2 ± 13.39 min). We recorded 6 patients in group (F) (24%) who have developed respiratory depression (respiratory rate < 10 breaths/min) compared to 0% in group (T) (P = 0.022). In addition, in group (F) nausea was noted in 8 patients (32%) and vomiting in 6 patients (24%), which was statistically significant when compared to group (T) (0%) (P = 0.01 and 0.022, respectively). Conclusion: Ultrasound-guided unilateral TAP block is an effective alternative analgesic

  14. Targeting of microglial KCa3.1 channels by TRAM-34 exacerbates hippocampal neurodegeneration and does not affect ictogenesis and epileptogenesis in chronic temporal lobe epilepsy models.

    PubMed

    Ongerth, Tanja; Russmann, Vera; Fischborn, Sarah; Boes, Katharina; Siegl, Claudia; Potschka, Heidrun

    2014-10-05

    Blockade of KCa3.1 channels has been suggested as a novel strategy to reduce microglia activation. The concept has been confirmed by neuroprotective effects in a rat brain ischemia-reperfusion model and reduced microglia activation surrounding glioblastomas. Cumulating evidence exists that microglia activation significantly contributes to epileptogenesis as well as intrinsic severity in the chronic epileptic brain. Taken together these data raised the question whether the KCa3.1 channel blocker triarylmethane-34 (TRAM-34) might also exert beneficial effects in chronic epilepsy models. In a rat post-status epilepticus model TRAM-34 treatment following the insult did not result in neuroprotective effects. Whereas status epilepticus-associated neurodegeneration remained unaffected in the piriform cortex, loss of pyramidal cells in the hippocampal CA1 and CA3a region and of neuropeptide Y-positive interneurons in the hilus proved to be exacerbated by pharmacological KCa3.1 blockade. The development of spontaneous seizures and of behavioral and cognitive alterations was comparable in animals receiving TRAM-34 treatment or the respective vehicle. The kindling model of temporal lobe epilepsy with a massive stimulation paradigm with frequent seizure elicitation in fully kindled rats was used to assess a putative disease-modifying effect. However, sub-chronic TRAM-34 treatment failed to exert relevant effects on seizure generation and thresholds. In conclusion, the data obtained in two different chronic epilepsy models argue against using KCa3.1 blockers as disease-modifying or antiepileptogenic agents. Exacerbation of neuronal cell loss in TRAM-34 pre-treated epileptic animals rather indicates that translational development of the compound needs to carefully consider the pathophysiological mechanisms associated with different brain insults.

  15. The Effects of Stabilization and Mckenzie Exercises on Transverse Abdominis and Multifidus Muscle Thickness, Pain, and Disability: A Randomized Controlled Trial in NonSpecific Chronic Low Back Pain.

    PubMed

    Hosseinifar, Mohammad; Akbari, Mohammad; Behtash, Hamid; Amiri, Mohsen; Sarrafzadeh, Javad

    2013-12-01

    [Purpose] This study compared the effectiveness of stabilization and McKenzie exercises on pain, disability, and thickness of the transverse abdominis and multifidus muscles in patients with nonspecific chronic low back pain. [Subjects] Thirty patients were randomly assigned into two groups: the McKenzie and stabilization exercise groups. [Methods] Before and after intervention, pain, disability, and thickness of the transverse abdominis and multifidus muscles were evaluated by visual analogue scale, functional rating index, and sonography, respectively. The training program was 18 scheduled sessions of individual training for both groups. [Results] After interventions, the pain score decreased in both groups. The disability score decreased only in the stabilization group. The thickness of the left multifidus was significantly increased during resting and contracting states in the stabilization group. The thickness of the right transverse abdominis during the abdominal draw-in maneuver, and thickness of the left transverse abdominis during the active straight leg raising maneuver were significantly increased in the stabilization group. The intensity of pain, disability score, thickness of the right transverse abdominis during the abdominal draw-in manouver, and thickness of the left transverse abdominis during active straight leg raising in the stabilization group were greater than those on the Mackenzie. [Conclusion] Stabilization exercises are more effective than McKenzie exercises in improving the intensity of pain and function score and in increasing the thickness of the transverse abdominis muscle.

  16. Monitoring ecosystem dynamics in an Arctic tundra ecosystem using hyperspectral reflectance and a robotic tram system

    NASA Astrophysics Data System (ADS)

    Goswami, Santonu

    ) Is NDVI a good predictor for aboveground biomass and leaf area index (LAI) for plant species that are common in an arctic landscape? (4) How can cyberinfrastructure tools be developed to optimize ground-based remote sensing data collection, management and processing associated with a large scale experimental infrastructure? The Biocomplexity project experimentally manipulated the water table (drained, flooded, and control treatments) of a vegetated thaw lake basin to investigate the effects of altered hydrology on land-atmosphere carbon balance. In each experimental treatment, hyperspectral reflectance data were collected in the visible and near IR range of the spectrum using a robotic tram system that operated along a 300m tramline during the snow free growing period between June and August 2005-09. Water table depths (WTD) and soil volumetric water content were also collected along these transects. During 2005-2007, measurements were made without experimental treatments. Experimental treatments were run in 2008 and 2009, which involved water table being raised (+10cm) and lowered (-10cm) in flooding and draining treatments respectively. A new spectral index, the normalized difference surface water index (NDSWI) was developed and tested at multiple spatial and temporal scales. NDSWI uses the 460nm (blue) and 1000nm (IR) bands and was to capture surface hydrological dynamics in the study area using the robotic tram system. When applied to high spatial resolution satellite imagery, NDSWI was also able to capture changes in surface hydrology at the landscape scale. Interannual patterns of land-surface phenology (measured with the normalized difference vegetation index - NDVI) unexpectedly lacked marked differences under experimental conditions. Measurement of NDVI was, however, compromised when WTD was above ground level. NDVI and NDSWI were negatively correlated when WTD was above ground level, which held when scaled to MODIS imagery collected from satellite

  17. Formation of independently revascularized bowel segments using the rectus abdominis muscle flap: a rat model for jejunal prefabrication.

    PubMed

    Tan, Bien-Keem; Chen, Hung-Chi; Wei, Fu-Chan; Ma, Shwu-Fan; Lan, Chyn-Tair; See, Lai-Chu; Wan, Yung-Liang

    2002-02-01

    Reconstruction of the pharyngoesophagus with free jejunal transfer is a major challenge when recipient neck vessels are absent because of previous surgery or irradiation. In such instances, jejunal transfer using a muscle flap as a "vascular carrier" may be a problem-solving alternative. Pretransfer vascularization of the jejunum is achieved by wrapping the muscle flap around the small bowel segment. After a short staging period, the mesenteric pedicle is divided and the bowel segment is transferred up to the neck based on its new blood supply. The objectives of this study were to develop an animal model for prefabricating independently revascularized jejunal segments using the rectus abdominis muscle flap and to determine the minimal time required for independent bowel survival. Twenty-four mature (500-g to 700-g) rats were divided into six experimental groups of four animals each. In each animal, a 1.5-cm segment of proximal jejunum was isolated on two jejunal arteries and wrapped with a superior pedicled rectus abdominis muscle flap. To determine the time of neovascular takeover, the mesenteric pedicles were ligated on postoperative day 2 (group I), day 3 (group II), day 4 (group III), day 5 (group IV), day 6 (group V), and day 7 (group VI). At the time of pedicle ligation, the composite flap was transposed to a new subcutaneous position. Viability of bowel was assessed according to gross appearance and histologic examination 48 hours after transfer. Complete survival of revascularized jejunum in 11 of 12 animals was obtained after pedicle ligation on postoperative day 5 and beyond (p < 0.0001, Fisher's exact test). These bowel segments demonstrated luminal patency, intact pink mucosa, mucus production, and visible peristalsis. Histologic examination showed healthy intestinal epithelium and tissue integration along the serosa-muscle interphase. In contrast, pedicle ligation on day 4 and earlier resulted in varying degrees of bowel necrosis characterized by

  18. Cocontraction of Ankle Dorsiflexors and Transversus Abdominis Function in Patients With Low Back Pain

    PubMed Central

    Chon, Seung-Chul; You, Joshua H.; Saliba, Susan A.

    2012-01-01

    Context The abdominal draw-in maneuver (ADIM) with cocontraction has been shown to be a more effective method of activating the transversus abdominis (TrA) in healthy adults than the ADIM alone. Whether such an augmented core stabilization exercise is effective in managing low back pain (LBP) remains uncertain. Objective To determine the effect of 2 weeks of ADIM and cocontraction training on abdominal muscle thickness and activation timing and to monitor pain and function in patients with LBP. Design Case-control study. Setting Local orthopaedic clinic and research laboratory. Patients or Other Participants Twenty patients with mechanical LBP (age = 27.20 ± 6.46 years, height = 166.25 ± 8.70 cm, mass = 58.10 ± 11.81 kg) and 20 healthy, age-matched people (age = 24.25 ± 1.59 years, height = 168.00 ± 8.89 cm, mass = 60.65 ± 11.99 kg) volunteered for the study. Intervention(s) Both the LBP and control groups received ten 30-minute sessions of ADIM and cocontraction training of the tibialis anterior (TA) and rectus femoris (RF) muscles over a 2-week period. Main Outcome Measure(s) A separate, mixed-model analysis of variance was computed for the thicknesses of the TrA, internal oblique (IO), and external oblique muscles. The differences in mean and peak electromyographic (EMG) amplitudes, onset time, and latency were compared between the groups. The visual analog pain scale, Pain Disability Index, and LBP rating scale were used to assess pain in the LBP group before and after the intervention. Results We found an interaction between the LBP and control groups and a main effect from pretest to posttest for only TrA muscle thickness change (F1,38 = 6.57, P = .01). Reductions in all pain measures were observed after training (P < .05). Group differences in peak and mean EMG amplitudes and onset time values for TrA/IO and TA were achieved (P < .05). The RF peak (t38 = −3.12, P = .003) and mean (t38 = −4.12, P = .001) EMG amplitudes were different, but no group

  19. The platysma myocutaneous flap (PMF) for head and neck reconstruction: a retrospective and multicentric analysis of 91 T1-T2 patients.

    PubMed

    Tosco, Paolo; Garzino-Demo, Paolo; Ramieri, Guglielmo; Tanteri, Giulia; Pecorari, Giancarlo; Caldarelli, Claudio; Garzaro, Massimiliano; Giordano, Carlo; Berrone, Sid

    2012-12-01

    The platysma myocutaneous flap (PMF) was first applied to intraoral reconstructions in 1978. PMF is not only an alternative to microvascular flaps but it also represents an excellent reconstructive choice especially in cases where free tissue transfer cannot be carried out. Failure and complications rate have been described as varying from 18 to 45% and this is why this flap should not be used in specific cases such as in the presence of cervical metastases and in cases of mandibulectomy and simultaneous reconstruction with alloplastic materials. The purpose of this study is to examine the experience and results obtained in three different and independent institutes where PMF has been adopted in 91 patients for head and neck cancer reconstructions. The authors report their departments' separate but simultaneous experiences with PMF for small and middle-size soft tissue defects in a 10-year period.

  20. Constriction of the levator hiatus during instruction of pelvic floor or transversus abdominis contraction: a 4D ultrasound study.

    PubMed

    Bø, Kari; Braekken, Ingeborg H; Majida, Memona; Engh, Marie E

    2009-01-01

    A new theory claims that the pelvic floor muscles (PFM) can be trained via the transversus abdominis (TrA). The aim of the present study was to compare the effect of instruction of PFM and TrA contraction on constriction of the levator hiatus, using 4D perineal ultrasonography. Thirteen women with pelvic organ prolapse participated in the study. Perineal ultrasound in standing position was used to assess constriction of the levator hiatus. Analyses were conducted off-line with measurements in the axial plane of minimal hiatal dimensions. The reduction of all the hiatal dimensions was significantly greater during PFM than TrA contraction. All patients had a reduction of the levator hiatus area during PFM contraction (mean reduction 24.0%; range 6.1-49.2%). In two patients, there was an increase of the levator hiatus area during TrA contraction. Instruction of PFM contraction is more effective than TrA contraction.

  1. Analgesic efficacy of transversus abdominis plane block in neonates and early infants for colostomy and reversal of colostomy.

    PubMed

    Chen, Chee Kean; Teo, Shu Ching; Phui, Vui Eng; Saman, Mat Ariffin

    2015-01-01

    The application of ultrasound-guided transversus abdominis plane (TAP) block in paediatric population is gaining popularity among anaesthetists. We present a case series of ultrasound-guided TAP block in ten neonate and infants undergoing colostomy and reversal of stoma. Classical TAP as described by Hebbard was carried out and a maximum dosage of 1ml/kg of 0.25% levobupivacaine was injected. Pain score was assessed using Neonatal Infant Pain Scale for 24 hours. In all patients, the block was successful with minimal hemodynamic changes intraoperatively and no additional systemic analgesia was needed intraoperative and immediate postoperatively. Ultrasound-guided TAP block has an important role in providing safe and effective analgesia for colostomy creation and reversal of stoma surgeries in paediatric population.

  2. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain

    PubMed Central

    Tennfjord, Merete Kolberg; Hilde, Gunvor; Ellström-Engh, Marie; Bø, Kari

    2016-01-01

    Background/aim Diastasis recti abdominis (DRA) is defined as a separation of the 2 muscle bellies of rectus abdominis. To date there is scant knowledge on prevalence, risk factors, and consequences of the condition. The present study aimed to investigate the prevalence of DRA during pregnancy and post partum, presence of possible risk factors, and the occurrence of lumbopelvic pain among women with and without DRA. Methods This prospective cohort study followed 300 first-time pregnant women from pregnancy till 12 months post partum. Data were collected by electronic questionnaire and clinical examinations. DRA was defined as a palpated separation of ≥2 fingerbreadths either 4.5 cm above, at or 4.5 cm below the umbilicus. Women with and without DRA were compared with independent samples Student's t-test and χ2/Fisher exact test, and OR with significance level >0.05. Results Prevalence of DRA was 33.1%, 60.0%, 45.4%, and 32.6% at gestation week 21, 6 weeks, 6 months and 12 months post partum, respectively. No difference in risk factors was found when comparing women with and without DRA. OR showed a greater likelihood for DRA among women reporting heavy lifting ≥20 times weekly (OR 2.18 95% CI 1.05 to 4.52). There was no difference in reported lumbopelvic pain (p=0.10) in women with and without DRA. Conclusions Prevalence of mild DRA was high both during pregnancy and after childbirth. Women with and without DRA reported the same amount of lumbopelvic pain 12 months post partum. PMID:27324871

  3. Analysis of Conservative Tracer Tests in the Bullfrog, Tram, and Prow Pass Tuffs, 1996 to 1998, Yucca Mountain, Nye County, Nevada

    USGS Publications Warehouse

    Umari, Amjad; Fahy, Michael F.; Earle, John D.; Tucci, Patrick

    2008-01-01

    To evaluate the potential for transport of radionuclides in ground water from the proposed high-level nuclear-waste repository at Yucca Mountain, Nevada, conservative (nonsorbing) tracer tests were conducted among three boreholes, known as the C-hole Complex, and values for transport (or flow) porosity, storage (or matrix) porosity, longitudinal dispersivity, and the extent of matrix diffusion were obtained. The C-holes are completed in a sequence of Miocene tuffaceous rock, consisting of nonwelded to densely welded ash-flow tuff with intervals of ash-fall tuff and volcaniclastic rocks, covered by Quaternary alluvium. The lower part of the tuffaceous-rock sequence includes the Prow Pass, Bullfrog, and Tram Tuffs of the Crater Flat Group. The rocks are pervaded by tectonic and cooling fractures. Paleozoic limestone and dolomite underlie the tuffaceous rocks. Four radially convergent and one partially recirculating conservative (nonsorbing) tracer tests were conducted at the C-hole Complex from 1996 to 1998 to establish values for flow porosity, storage porosity, longitudinal dispersivity, and extent of matrix diffusion in the Bullfrog and Tram Tuffs and the Prow Pass Tuff. Tracer tests included (1) injection of iodide into the combined Bullfrog-Tram interval; (2) injection of 2,6 difluorobenzoic acid into the Lower Bullfrog interval; (3) injection of 3-carbamoyl-2-pyridone into the Lower Bullfrog interval; and (4) injection of iodide and 2,4,5 trifluorobenzoic acid, followed by 2,3,4,5 tetrafluorobenzoic acid, into the Prow Pass Tuff. All tracer tests were analyzed by the Moench single- and dual-porosity analytical solutions to the advection-dispersion equation or by superposition of these solutions. Nonlinear regression techniques were used to corroborate tracer solution results, to obtain optimal parameter values from the solutions, and to quantify parameter uncertainty resulting from analyzing two of the three radially convergent conservative tracer tests

  4. Single step fibula-pro-tibia transfer and soft tissue coverage with free myocutaneous latissimus dorsi flap after extensive osteomyelitis and soft tissue necrosis--a 3 year follow up.

    PubMed

    Föhn, M; Bannasch, H; Stark, G B

    2009-11-01

    A 10-year-old girl from Ghana, Africa, developed chronic osteomyelitis of her right tibia and a large soft tissue defect on the ventral lower leg after a minor injury. She was treated more than 6 months after trauma without any improvement. We report a follow up of 3 years after reconstruction with a single-step pedicled fibula-pro-tibia transfer and wound coverage with a free myocutaneous latissimus dorsi flap.

  5. [Acute colonic pseudo-obstruction (Ogilvie's syndrome) - a rare complication after ablation mammae and direct reconstruction with a free TRAM flap].

    PubMed

    Rauer, T; Sproedt, J; Gelpke, H; Jandali, A R

    2014-08-01

    We report a case of a 62 year old woman who presented with Ogilvie's syndrome as a complication of mastectomy with free TRAM flap reconstruction due to angiosarcoma of the right breast. In the acute postoperative period, the patient expired as a result of Ogilvie's syndrome related complications. Several assumptions regarding the causes of Ogilvie's Syndrome as well as current theories about aetiology, diagnosis and therapy are discussed in this case presentation.

  6. EFFECTS OF 2-PAM AND EA 1814 ON NEUROMUSCULAR TRANSMISSION. I. EFFECTS OF 2-PAM AND EA 1814 ON THE FROG RECTUS ABDOMINIS MUSCLE PREPARATION

    DTIC Science & Technology

    Contracture of the isolated frog Rectus abdominis muscle was used to study pharmacological properties of 2-PAM (2-pyridine aldoxime methiodide) and...example, concentrations of 2-PAM in excess of 4 x 10 to the -5th power M potentiate contractures of the frog rectus muscle elicited by acetylcholine...2-PAM inhibits the response to the depolarizing agents, decamethonium and carbamylcholine, which are not susceptible to hydrolysis by the ChE of frog

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

    PubMed Central

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

    2015-01-01

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

  8. Do various baseline characteristics of transversus abdominis and lumbar multifidus predict clinical outcomes in nonspecific low back pain? A systematic review.

    PubMed

    Wong, Arnold Y L; Parent, Eric C; Funabashi, Martha; Stanton, Tasha R; Kawchuk, Gregory N

    2013-12-01

    Although individual reports suggest that baseline morphometry or activity of transversus abdominis or lumbar multifidus predict clinical outcome of low back pain (LBP), a related systematic review is unavailable. Therefore, this review summarized evidence regarding the predictive value of these muscular characteristics. Candidate publications were identified from 6 electronic medical databases. After review, 5 cohort studies were included. Although this review intended to encompass studies using different muscle assessment methods, all included studies coincidentally used ultrasound imaging. No research investigated the relation between static morphometry and clinical outcomes. Evidence synthesis showed limited evidence supporting poor baseline transversus abdominis contraction thickness ratio as a treatment effect modifier favoring motor control exercise. Limited evidence supported that high baseline transversus abdominis lateral slide was associated with higher pain intensity after various exercise interventions at 1-year follow-up. However, there was limited evidence for the absence of relation between the contraction thickness ratio of transversus abdominis or anticipatory onset of lateral abdominal muscles at baseline and the short- or long-term LBP intensity after exercise interventions. There was conflicting evidence for a relation between baseline percent thickness change of lumbar multifidus during contraction and the clinical outcomes of patients after various conservative treatments. Given study heterogeneity, the small number of included studies and the inability of conventional greyscale B-mode ultrasound imaging to measure muscle activity, our findings should be interpreted with caution. Further large-scale prospective studies that use appropriate technology (ie, electromyography to assess muscle activity) should be conducted to investigate the predictive value of morphometry or activity of these muscles with respect to LBP-related outcomes measures.

  9. Unilateral versus bilateral ultrasound-guided transversus abdominis plane blocks during ureteric shock wave lithotripsy: A prospective randomized trial

    PubMed Central

    Elnabtity, Ali Mohamed Ali; Shabana, Waleed Mansour

    2016-01-01

    Background: Ultrasound-guided transversus abdominis plane (TAP) block has been used for intra- and post-operative analgesia during abdominal operations and for ureteric shock wave lithotripsy (SWL) as well. Aim: This study aimed at comparing ultrasound-guided unilateral versus bilateral TAP blocks as analgesic techniques for unilateral ureteric SWL. Settings and Design: Prospective randomized comparative study. Patients and Methods: Sixty patients scheduled for unilateral ureteric SWL were randomly allocated into two groups: Group (U) received unilateral TAP block in the form of 25 ml of bupivacaine 0.25% (i.e., 62.5 mg), and Group (B) received bilateral TAP blocks in the form of 25 ml of bupivacaine 0.25% (i.e., 62.5 mg) on each side. Statistical Analysis: This was performed using SPSS program version 19 ((IBM Corp., Armonk, NY, USA) and EP 16 program. Results: The mean values of intra- and post-procedural visual analog scale at different time intervals were around (30), which was statistically insignificant between groups (P > 0.05). There were no significant differences between groups regarding cardiopulmonary stability, postanesthesia care unit time, the total amount of rescue fentanyl and patient satisfaction scores (P > 0.05). There were no significant side effects in both groups. Conclusion: Ultrasound-guided unilateral TAP block is as safe and effective analgesic technique as bilateral TAP blocks during unilateral ureteric SWL. It can be used as the sole analgesic technique during ureteric SWL. PMID:27453645

  10. A neuromuscular strategy to prevent spinal torsion: backward perturbation alters asymmetry of transversus abdominis muscle thickness into symmetry.

    PubMed

    Kim, Yushin; Shim, Jae Kun; Son, Jaebum; Pyeon, Hyo Young; Yoon, Bumchul

    2013-06-01

    Symmetric co-contraction of the transversus abdominis (TrA) muscle is beneficial in terms of increasing trunk stability. The aim of this study was to investigate the symmetry of lateral abdominal muscle thickness during static and dynamic conditions. Fifteen male subjects (27.13 ± 5.51 years old) were instructed to sit on a chair and maintain upright posture. Every individual subject wore a jacket harness that could be backwardly attached to a 9-kg weight through a pulley system. An unexpected drop of the weight induced the transition from static to dynamic condition. The thickness of external oblique, internal oblique, and TrA muscles was measured with ultrasonography. Our results revealed more symmetry of TrA thickness during the dynamic condition (21% vs. 13%, p = 0.019) compared with the static. The symmetric muscle thickness of TrA during the dynamic condition is considered a result of more contraction on the non-dominant side. This phenomenon could be a possible strategy of deep abdominal muscles to prevent spinal torsion during sudden trunk perturbation.

  11. No Difference in Transverse Abdominis Activation Ratio between Healthy and Asymptomatic Low Back Pain Patients during Therapeutic Exercise

    PubMed Central

    Gorbet, Nathaniel; Selkow, Noelle M.; Hart, Joseph M.; Saliba, Susan

    2010-01-01

    Dysfunction of the transverse abdominis (TrA) has been associated with LBP. Several therapeutic exercises are prescribed to help target the TrA. Rehabilitative ultrasound imaging (RUSI) is used to capture activation of the TrA during exercise. The purpose was to examine TrA activation during the ADIM and quadruped exercises between healthy and nonsymptomatic LBP patients. We instructed the subjects how to perform the exercises and measured muscle thickness of the TrA at rest and during the exercises using RUSI. This allowed us to calculate TrA activation ratio during these exercises. We found no significant differences between activation ratios of the two groups during either exercise; however TrA activation during the ADIM was higher than the quadruped exercise. These exercises were capable of activating the TrA, which may be in part due to the verbal instruction they received. These exercises could be used during prevention or rehabilitation programs, since the TrA is activated. PMID:22110965

  12. The analgesic efficacy of ultrasound-guided transversus abdominis plane block on postoperative pain and morphine consumption in varicocelectomy

    PubMed Central

    Ömür, Dilek; Oğuzalp, Hüseyin; Kiraz, Hasan A.; Ekin, Serpil; Alan, Cabir; Ersay, Ahmet R.; Hancı, Volkan

    2016-01-01

    Objectives: To evaluate the analgesic effect of transversus abdominis plane (TAP) block administered before varicocele surgery. Methods: This study was completed at the Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey, between January 2011 and April 2013. In a prospective, double blind, randomized, placebo controlled clinical study, 40 male patients scheduled for elective varicocele operations were randomized to group T (treatment group) or group C (controls). After receiving general anesthesia, group T received a TAP block using 20 mL 0.25% bupivacaine on the operation side, whereas group C received a control block using 20 mL 0.9% Sodium chloride. During the first 24 hours after surgery, the patient pain was evaluated using the visual analogue scale (VAS) at rest and while coughing. Postoperative patient controlled analgesia morphine consumption, VAS scores, and side effects were recorded. Results: Of 34 patients, Group T (n=18) had significantly lower VAS pain scores than Group C (n=16) both at rest and while coughing. The total morphine consumed was lower (7.7 ± 4.0) versus 21.6 ± 12.4 mg, p<0.001) in the 24 hours after surgery. Conclusion: As part of a multimodal analgesic regime after varicocelectomy surgery, morphine consumption and VAS pain scores were significantly lower among those receiving 20 mL 0.25% bupivacaine administered for a TAP block than among controls. PMID:27279511

  13. Population pharmacokinetic model of free and total ropivacaine after transversus abdominis plane nerve block in patients undergoing liver resection

    PubMed Central

    Ollier, Edouard; Heritier, Fabrice; Bonnet, Caroline; Hodin, Sophie; Beauchesne, Brigitte; Molliex, Serge; Delavenne, Xavier

    2015-01-01

    Aims The aim of this study was to develop a pharmacokinetic model in order to characterize the free and total ropivacaine concentrations after transversus abdominis plane block in a population of patients undergoing liver resection surgery. In particular, we evaluated the impact of the size of liver resection on ropivacaine pharmacokinetics. Methods This work is based on a single-centre, double-blinded, randomized, placebo-controlled study. Among the 39 patients included, 19 patients were randomized to the ropivacaine group. The free and total ropivacaine concentrations were measured in nine or 10 blood samples per patient. A pharmacokinetic model was built using a nonlinear mixed-effect modelling approach. Results The free ropivacaine concentrations remained under the previously published toxic threshold. A one-compartment model, including protein binding site with a first-order absorption, best described the data. The protein binding site concentration was considered as a latent variable. Bodyweight, the number of resected liver segments and postoperative fibrinogen evolution were, respectively, included in the calculation of the volume of distribution, clearance and binding site production rate. The resection of three or more liver segments was associated with a 53% decrease in the free ropivacaine clearance. Conclusions Although large liver resections were associated with lower free ropivacaine clearance, the ropivacaine pharmacokinetic profile remained within the safe range after this type of surgery. PMID:25557141

  14. Ultrasound-guided transversus abdominis plane block for post-operative analgesia in patients undergoing caesarean section

    PubMed Central

    Mankikar, Maitreyi Gajanan; Sardesai, Shalini Pravin; Ghodki, Poonam Sachin

    2016-01-01

    Background and Aims: Transversus abdominis plane (TAP) block is a fascial plane block providing post-operative analgesia in patients undergoing surgery with infra-umbilical incisions. We evaluated analgesic efficacy of TAP block with ropivacaine for 24 h after caesarean section through a Pfannenstiel incision. Methods: Sixty patients undergoing caesarean section under spinal anaesthesia were randomised to undergo TAP block with ropivacaine (n = 30) versus control group (n = 30) with normal saline, in addition to standard analgesia with intravenous paracetamol and tramadol. At the end of the surgery, ultrasound-guided TAP plane block was given bilaterally using ropivacaine or normal saline (15 ml on either side). Each patient was assessed post-operatively by a blinded investigator at regular intervals up to 24 h for visual analogue score (VAS) and requirement of analgesia. SPSS version 18.0 software was used. Demographic data were analysed using Student's t-test and the other parameters using paired t-test. Results: TAP block with ropivacaine compared with normal saline reduced post-operative VAS at 24 h (P = 0.004918). Time for rescue analgesia in the study group was prolonged from 4.1 to 9.53 h (P = 0.01631). Mean requirement of tramadol in the first 24 h was reduced in the study group. Conclusion: US guided TAP block after caesarean section reduces the analgesic requirement in the first 24 h. PMID:27141108

  15. Breast Reconstruction Options

    MedlinePlus

    ... surgery to allow for better healing. You need radiation therapy. Many doctors recommend that women not have immediate ... al. Ischemic complications in pedicle, free, and muscle sparing transverse rectus abdominis myocutaneous flaps for breast reconstruction. ...

  16. Recovery of sensation in immediate breast reconstruction with latissimus dorsi myocutaneous flaps after breast-conservative surgery and skin-sparing mastectomy.

    PubMed

    Tomita, Koichi; Yano, Kenji; Hosokawa, Ko

    2011-04-01

    In breast reconstruction, sensation in the reconstructed breasts affects the patients' quality of life along with its aesthetic outcome. Fortunately, less invasive procedures such as breast-conservative surgery (BCS) and skin-sparing mastectomy (SSM) have greatly contributed to the improved aesthetic outcome in immediate breast reconstruction. However, there are few reports on the recovery of breast sensation after BCS and SSM. We retrospectively reviewed 104 consecutive patients who underwent immediate breast reconstruction with the latissimus dorsi myocutaneous flap between 2001 and 2006 at our institution. The sensations of pain, temperature, touch, and vibration were examined at the nipple and skin envelope during the follow-up period (range: 12-61 months, mean: 31 months), and a stratified analysis was performed to determine the critical factors affecting the sensation recovery after BCS and SSM. We found that large breast size significantly impaired the recovery of sensation in the nipple and skin envelope after BCS as well as SSM. Older age and high body mass index value were the factors which negatively affected the sensation in the skin envelope after SSM. While all our BCS patients underwent postoperative radiation therapy, it did not negatively affect the recovery of sensation in SSM patients. On the basis of these findings, we could further improve the sensation of the reconstructed breasts after BCS and SSM. Especially after SSM, the use of innervated flaps is recommended in the patients with large breast, increased age, or obesity when the nipple-areola complex is resected.

  17. Conjugative type IV secretion in Gram-positive pathogens: TraG, a lytic transglycosylase and endopeptidase, interacts with translocation channel protein TraM.

    PubMed

    Kohler, Verena; Probst, Ines; Aufschnaiter, Andreas; Büttner, Sabrina; Schaden, Lisa; Rechberger, Gerald N; Koraimann, Günther; Grohmann, Elisabeth; Keller, Walter

    2017-02-17

    Conjugative transfer plays a major role in the transmission of antibiotic resistance in bacteria. pIP501 is a Gram-positive conjugative model plasmid with the broadest transfer host-range known so far and is frequently found in Enterococcus faecalis and Enterococcus faecium clinical isolates. The pIP501 type IV secretion system is encoded by 15 transfer genes. In this work, we focus on the VirB1-like protein TraG, a modular peptidoglycan metabolizing enzyme, and the VirB8-homolog TraM, a potential member of the translocation channel. By providing full-length traG in trans, but not with a truncated variant, we achieved full recovery of wild type transfer efficiency in the traG-knockout mutant E. faecalis pIP501ΔtraG. With peptidoglycan digestion experiments and tandem mass spectrometry we could assign lytic transglycosylase and endopeptidase activity to TraG, with the CHAP domain alone displaying endopeptidase activity. We identified a novel interaction between TraG and TraM in a bacterial-2-hybrid assay. In addition we found that both proteins localize in focal spots at the E. faecalis cell membrane using immunostaining and fluorescence microscopy. Extracellular protease digestion to evaluate protein cell surface exposure revealed that correct membrane localization of TraM requires the transmembrane helix of TraG. Thus, we suggest an essential role for TraG in the assembly of the pIP501 type IV secretion system.

  18. Ca(2+)-activated K(+) channel-3.1 blocker TRAM-34 attenuates airway remodeling and eosinophilia in a murine asthma model.

    PubMed

    Girodet, Pierre-Olivier; Ozier, Annaig; Carvalho, Gabrielle; Ilina, Olga; Ousova, Olga; Gadeau, Alain-Pierre; Begueret, Hugues; Wulff, Heike; Marthan, Roger; Bradding, Peter; Berger, Patrick

    2013-02-01

    Key features of asthma include bronchial hyperresponsiveness (BHR), eosinophilic airway inflammation, and bronchial remodeling, characterized by subepithelial collagen deposition, airway fibrosis, and increased bronchial smooth muscle (BSM) mass. The calcium-activated K(+) channel K(Ca)3.1 is expressed by many cells implicated in the pathogenesis of asthma, and is involved in both inflammatory and remodeling responses in a number of tissues. The specific K(Ca)3.1 blocker 5-[(2-chlorophenyl)(diphenyl)methyl]-1H-pyrazole (TRAM-34) attenuates BSM cell proliferation, and both mast cell and fibrocyte recruitment in vitro. We aimed to examine the effects of K(Ca)3.1 blockade on BSM remodeling, airway inflammation, and BHR in a murine model of chronic asthma. BALB/c mice were sensitized with intraperitoneal ovalbumin (OVA) on Days 0 and 14, and then challenged with intranasal OVA during Days 14-75. OVA-sensitized/challenged mice received TRAM-34 (120 mg/kg/day, subcutaneous) from Days -7 to 75 (combined treatment), Days -7 to 20 (preventive treatment), or Days 21 to 75 (curative treatment). Untreated mice received daily injections of vehicle (n = 8 per group). Bronchial remodeling was assessed by histological and immunohistochemical analyses. Inflammation was evaluated using bronchoalveolar lavage and flow cytometry. We also determined BHR in both conscious and anesthetized mice via plethysmography. We demonstrated that curative treatment with TRAM-34 abolishes BSM remodeling and subbasement collagen deposition, and attenuates airway eosinophilia. Although curative treatment alone did not significantly reduce BHR, the combined treatment attenuated nonspecific BHR to methacholine. This study indicates that K(Ca)3.1 blockade could provide a new therapeutic strategy in asthma.

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

    PubMed

    Lee, Diane; Hodges, Paul W

    2016-07-01

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

  20. Full-Span Tiltrotor Aeroacoustic Model (TRAM) Overview and 40- by 80-Foot Wind Tunnel Test. [conducted in the 40- by 80-Foot Wind Tunnel at Ames Research Center

    NASA Technical Reports Server (NTRS)

    McCluer, Megan S.; Johnson, Jeffrey L.; Rutkowski, Michael (Technical Monitor)

    2001-01-01

    Most helicopter data trends cannot be extrapolated to tiltrotors because blade geometry and aerodynamic behavior, as well as rotor and fuselage interactions, are significantly different for tiltrotors. A tiltrotor model has been developed to investigate the aeromechanics of tiltrotors, to develop a comprehensive database for validating tiltrotor analyses, and to provide a research platform for supporting future tiltrotor designs. The Full-Span Tiltrotor Aeroacoustic Model (FS TRAM) is a dual-rotor, powered aircraft model with extensive instrumentation for measurement of structural and aerodynamic loads. This paper will present the Full-Span TRAM test capabilities and the first set of data obtained during a 40- by 80-Foot Wind Tunnel test conducted in late 2000 at NASA Ames Research Center. The Full-Span TRAM is a quarter-scale representation of the V-22 Osprey aircraft, and a heavily instrumented NASA and U.S. Army wind tunnel test stand. Rotor structural loads are monitored and recorded for safety-of-flight and for information on blade loads and dynamics. Left and right rotor balance and fuselage balance loads are monitored for safety-of-flight and for measurement of vehicle and rotor aerodynamic performance. Static pressure taps on the left wing are used to determine rotor/wing interactional effects and rotor blade dynamic pressures measure blade airloads. All of these measurement capabilities make the FS TRAM test stand a unique and valuable asset for validation of computational codes and to aid in future tiltrotor designs. The Full-Span TRAM was tested in the NASA Ames Research Center 40- by 80-Foot Wind Tunnel from October through December 2000. Rotor and vehicle performance measurements were acquired in addition to wing pressures, rotor acoustics, and Laser Light Sheet (LLS) flow visualization data. Hover, forward flight, and airframe (rotors off) aerodynamic runs were performed. Helicopter-mode data were acquired during angle of attack and thrust sweeps for

  1. Pethidine efficacy in achieving the ultrasound-guided oblique subcostal transversus abdominis plane block in laparoscopic cholecystectomy: A prospective study

    PubMed Central

    Breazu, Caius Mihai; Ciobanu, Lidia; Bartos, Adrian; Bodea, Raluca; Mircea, Petru Adrian; Ionescu, Daniela

    2017-01-01

    Pethidine is a synthetic opioid with local anesthetic properties. Our goal was to evaluate the analgesic efficacy of pethidine for achieving the ultrasound-guided oblique subcostal transversus abdominis plane (OSTAP) block in laparoscopic cholecystectomy. This prospective, double-blind study included 79 patients of physical status I and II according to American Society of Anesthesiologists, scheduled for elective laparoscopic cholecystectomy. The patients were randomly allocated into three groups, depending on the drug used to achieve preoperative bilateral OSTAP block: 1) OSTAP-Placebo (treated with normal saline); 2) OSTAP-Bupivacaine (treated with 0.25% bupivacaine); and 3) OSTAP-Pethidine (treated with 1% pethidine). The efficacy of pethidine in achieving the OSTAP block was analyzed using visual analog scale (VAS), intraoperative opioid dose, opioid consumption in post anesthesia care unit, and opioid consumption in the first 24 postoperative hours. The pain scores assessed by VAS at 0, 2, 4, 6, 12, and 24 hours were significantly lower in OSTAP-Pethidine than in OSTAP-Placebo group (p < 0.001). The mean intraoperative opioid consumption was significantly lower in OSTAP-Pethidine compared to OSTAP-Placebo group (150 versus 400 mg, p < 0.001), as well as the mean opioid consumption in the first 24 hours (20.4 versus 78 mg, p < 0.001). Comparing VAS assessment between OSTAP-Bupivacaine and OSTAP-Pethidine groups, statistically significant differences were observed only for the immediate postoperative pain assessment (0 hours), where lower values were observed in OSTAP-Pethidine group (p = 0.004). There were no statistically significant differences in the incidence of postoperative nausea and vomiting (p = 0.131) between the groups. The use of 1% pethidine can be an alternative to 0.25% bupivacaine in achieving OSTAP block for laparoscopic cholecystectomy. PMID:28027453

  2. Individuals with chronic low back pain do not modulate the level of transversus abdominis muscle contraction across different postures.

    PubMed

    Miura, Takuya; Yamanaka, Masanori; Ukishiro, Kengo; Tohyama, Harukazu; Saito, Hiroshi; Samukawa, Mina; Kobayashi, Takumi; Ino, Takumi; Takeda, Naoki

    2014-12-01

    The aim of this study was to evaluate the thickness of the transversus abdominis (TrA) muscle in three basic postures in subjects with and without chronic low back pain. Subjects were classified into a chronic low back pain group (n = 27) and a healthy control group (n = 23). The thickness of the TrA muscle was measured at rest and during the abdominal drawing-in manoeuvre (ADIM) in supine, sitting and standing postures using B-mode ultrasound imaging. Contraction ratio (TrA thickness during the ADIM/TrA thickness at rest) was calculated for each posture. At rest, the TrA thickness in the sitting and standing postures was significantly greater than in the supine posture (p < 0.017) in the control group, but similar in all three postures in the low back pain group. TrA thickness was similar in the low back pain and control group in all three postures. During the ADIM, TrA thickness was significantly greater in the control group than in the chronic low back pain group in all three postures. The contraction ratio was also significantly higher in the control group than in the chronic low back pain group in all three postures. These results indicate that the automatic postural contraction of the TrA observed in the control subjects in the sitting and standing postures was not demonstrated in subjects with chronic low back pain. The present study revealed the one aspect of different response of the TrA muscle to changing posture between two groups.

  3. Double Back Cut in Post-mastectomy Breast Skin (Fish-Shaped Skin Paddle) in Delayed Pedicled TRAM Flap Breast Reconstruction.

    PubMed

    Berezovsky, Alexander Bogdanov; Pagkalos, Vasileios A; Shoham, Yaron; Krieger, Yuval; Silberstein, Eldad

    2015-08-01

    Breast reconstruction has become standard of care for female patients with breast cancer. The transverse rectus abdominis musculo-cutaneous flap (TRAMf) is the most common method of immediate or delayed autologous breast reconstruction following mastectomy. We share our experience with modified, double back cut of post-mastectomy skin in delayed pedicled TRAMf breast reconstruction, resulting in fish-shaped skin paddle. This sort of back cut is a simple, reliable way to obtain a natural, esthetically pleasant breast mound with inconspicuous hidden scars.

  4. Meta-Analysis of Parkinson's Disease Transcriptome Data Using TRAM Software: Whole Substantia Nigra Tissue and Single Dopamine Neuron Differential Gene Expression

    PubMed Central

    Mariani, Elisa; Frabetti, Flavia; Tarozzi, Andrea; Pelleri, Maria Chiara; Pizzetti, Fabrizio

    2016-01-01

    The understanding of the genetic basis of the Parkinson's disease (PD) and the correlation between genotype and phenotype has revolutionized our knowledge about the pathogenetic mechanisms of neurodegeneration, opening up exciting new therapeutic and neuroprotective perspectives. Genomic knowledge of PD is still in its early stages and can provide a good start for studies of the molecular mechanisms that underlie the gene expression variations and the epigenetic mechanisms that may contribute to the complex and characteristic phenotype of PD. In this study we used the software TRAM (Transcriptome Mapper) to analyse publicly available microarray data of a total of 151 PD patients and 130 healthy controls substantia nigra (SN) samples, to identify chromosomal segments and gene loci differential expression. In particular, we separately analyzed PD patients and controls data from post-mortem snap-frozen SN whole tissue and from laser microdissected midbrain dopamine (DA) neurons, to better characterize the specific DA neuronal expression profile associated with the late-stage Parkinson's condition. The default "Map" mode analysis resulted in 10 significantly over/under-expressed segments, mapping on 8 different chromosomes for SN whole tissue and in 4 segments mapping on 4 different chromosomes for DA neurons. In conclusion, TRAM software allowed us to confirm the deregulation of some genomic regions and loci involved in key molecular pathways related to neurodegeneration, as well as to provide new insights about genes and non-coding RNA transcripts not yet associated with the disease. PMID:27611585

  5. Rehabilitation and Return to Sport Following Surgical Repair of the Rectus Abdominis and Adductor Longus in a Professional Basketball Player: A Case Report.

    PubMed

    Short, Steven M; Anloague, Philip A; Strack, Donald S

    2016-08-01

    Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352.

  6. Infiltration of liposome bupivacaine into the transversus abdominis plane for postsurgical analgesia in robotic laparoscopic prostatectomy: a pilot study

    PubMed Central

    Sternlicht, Andrew; Shapiro, Max; Robelen, Gary; Vellayappan, Usha; Tuerk, Ingolf A

    2014-01-01

    Background Transversus abdominis plane (TAP) infiltration has been increasingly used for postsurgical analgesia in abdominal/pelvic procedures; however, duration/extent of analgesia with standard local anesthetics is limited. This pilot study assessed the preliminary efficacy and safety of two volumes of liposome bupivacaine administered via TAP infiltration in patients undergoing robotic laparoscopic prostatectomy. Methods In this single-center, open-label, prospective study, patients older than 18 years received TAP infiltration with liposome bupivacaine immediately after surgery. The first 12 patients received a total volume of 20 mL liposome bupivacaine (266 mg); the next 12 received 40 mL liposome bupivacaine (266 mg). The liposome bupivacaine was diluted with 0.9% normal saline. The primary efficacy measure was duration of analgesia, measured by time to first opioid administration. Secondary outcome measures included patient-assessed pain scores, opioid use, and opioid-related adverse events (AEs). Results Twenty-four patients received liposome bupivacaine (20 mL, n=12; 40 mL, n=12) and were included in the primary analysis. Three refused participation in a 10-day follow-up visit and did not complete the study. Median time to first opioid administration after surgery was 23 and 26 minutes for the 20 and 40 mL groups, respectively. Mean total amount of postsurgical opioids ranged from 25.4 to 27.3 mg; after hospital discharge to day 10, both groups required a mean of 0.7 oxycodone/acetaminophen tablets/day. Mean pain scores of 4.4 and 5.3 were reported at 1 hour and 3.1 and 3.9 at 2 hours postsurgery, with 20 and 40 mL doses, respectively. Neither group had mean scores higher than 3.0 at any further assessments. No opioid-related or treatment-related serious AEs were reported. Conclusion Median time to first opioid administration did not differ between the two groups. No differences in secondary outcomes were observed on the basis of volume administered. These

  7. Comparison of Transversus Abdominis Plane Infiltration with Liposomal Bupivacaine versus Continuous Epidural Analgesia versus Intravenous Opioid Analgesia

    PubMed Central

    Ayad, Sabry; Babazade, Rovnat; Elsharkawy, Hesham; Nadar, Vinayak; Lokhande, Chetan; Makarova, Natalya; Khanna, Rashi; Sessler, Daniel I.; Turan, Alparslan

    2016-01-01

    Epidural analgesia is considered the standard of care but cannot be provided to all patients Liposomal bupivacaine has been approved for field blocks such as transversus abdominis plane (TAP) blocks but has not been clinically compared against other modalities. In this retrospective propensity matched cohort study we thus tested the primary hypothesis that TAP infiltration are noninferior (not worse) to continuous epidural analgesia and superior (better) to intravenous opioid analgesia in patients recovering from major lower abdominal surgery. 318 patients were propensity matched on 18 potential factors among three groups (106 per group): 1) TAP infiltration with bupivacaine liposome; 2) continuous Epidural analgesia with plain bupivacaine; and; 3) intravenous patient-controlled analgesia (IV PCA). We claimed TAP noninferior (not worse) over Epidural if TAP was noninferior (not worse) on total morphine-equivalent opioid and time-weighted average pain score (10-point scale) within first 72 hours after surgery with noninferiority deltas of 1 (10-point scale) for pain and an increase less of 20% in the mean morphine equivalent opioid consumption. We claimed TAP or Epidural groups superior (better) over IV PCA if TAP or Epidural was superior on opioid consumption and at least noninferior on pain outcome. Multivariable linear regressions within the propensity-matched cohorts were used to model total morphine-equivalent opioid dose and time-weighted average pain score within first 72 hours after surgery; joint hypothesis framework was used for formal testing. TAP infiltration were noninferior to Epidural on both primary outcomes (p<0.001). TAP infiltration were noninferior to IV PCA on pain scores (p = 0.001) but we did not find superiority on opioid consumption (p = 0.37). We did not find noninferiority of Epidural over IV PCA on pain scores (P = 0.13) and nor did we find superiority on opioid consumption (P = 0.98). TAP infiltration with liposomal bupivacaine and

  8. Addition of fentanyl to the ultrasound-guided transversus abdominis plane block does not improve analgesia following cesarean delivery

    PubMed Central

    WANG, LI-ZHONG; LIU, XIA; ZHANG, YING-FA; HU, XIAO-XIA; ZHANG, XIAO-MING

    2016-01-01

    The present study aimed to investigate whether the addition of fentanyl to the transversus abdominis plane (TAP) block procedure may improve analgesic duration following cesarean delivery. A total of 147 nulliparous women with an American Society of Anesthesiologists physical status I–II, scheduled for elective cesarean delivery under spinal anesthesia, were enrolled in the present study. All patients underwent cesarean delivery under spinal anesthesia with 10 mg bupivacaine and 10 µg fentanyl, after which the patients underwent an ultrasound-guided bilateral TAP block with either 0.375% ropivacaine (group TR; n=48), 0.375% ropivacaine and 50 µg subcutaneous fentanyl (group TRSF; n=49), or a mixture of 0.375% ropivacaine and 50 µg fentanyl (2.5 µg/ml; group TRF; n=50) per side. The TAP block formed part of a multimodal analgesic regimen comprising patient-controlled analgesia (PCA) with intravenous fentanyl, and regular treatment with diclofenac and paracetamol. The TAP block was performed in the midaxillary line using an in-plane technique. The primary outcome was the time to the first PCA, whereas secondary outcomes were the cumulative and interval PCA consumptions, visual analogue scale (VAS) pain scores at rest and during movement, side effects assessed at 2, 6, 12, 24 and 48 h postoperatively, and patient satisfaction with postoperative analgesia. No significant differences were observed in the median time to the first PCA among the three groups (P=0.640), which were 150 min (70–720 min) in group TR, 165 min (90–670 min) in group TRSF, and 190 min (70–680 min) in group TRF. Fentanyl consumption, VAS pain scores, side effects and patient satisfaction were similar among the three groups; however, the demand for fentanyl was significantly decreased in the TRSF and TRF groups at 2 h postoperatively (P=0.001 and 0.002, respectively), as compared with group TR. No complications attributed to the TAP block were detected. In conclusion, the results of the

  9. Arctic Climate Forcing Observations to Improve Earth System Models: Measurements at High Frequency, Fine Spatial Resolution, and Climatically Relevant Spatial Scales with the use of the Recently Deployed NGEE-Arctic Tram

    NASA Astrophysics Data System (ADS)

    Curtis, J. B.; Serbin, S.; Dafflon, B.; Raz Yaseef, N.; Torn, M. S.; Cook, P. J.; Lewin, K. F.; Wullschleger, S. D.

    2014-12-01

    In order to improve the representation of the land surface and subsurface properties and their associated feedbacks with climate forcings, climate change, and drivers in Earth System Models (ESMs), detailed observations need to be made at climatically relevant spatial and temporal scales. Pan-Arctic spatial heterogeneity and temporal variation present major challenges to the current generation of ESMs. To enable highly spatially resolved and high temporal frequency measurements for the independent validation of modeled energy and greenhouse gas surface fluxes at core to intermediate scales, we have developed, tested, and deployed an automated observational platform, the Next Generation Ecosystem Experiment (NGEE)-Arctic Tram. The NGEE-Arctic Tram, installed on the Barrow Environmental Observatory (BEO) near Barrow, AK in mid May 2014, consists of 65 meters of elevated track and a fully automated cart carrying a suite of radiation and remote sensing instrumentation. The tram transect is located within the NGEE eddy covariance tower footprint to help better understand the relative contribution of different landforms (e.g. low center vs high center polygonal tundra and associated vegetation) to the overall energy budget of the footprint. Electrical resistivity tomography (ERT), soil moisture, and soil temperature sensors are acquired autonomously and co-located with the tram to link subsurface properties with surface observations. To complement the high frequency and fine spatial resolution of the tram, during the summer field seasons of 2013 and 2014 a portable version of the NGEE-Arctic Tram (also know as the portable energy pole or PEP); was used to characterize surface albedo, NDVI, surface temperature, and photosynthetically active radiation (PAR) across two ~500 m BEO transects co-located with subsurface ERT and ground penetrating radar (GPR) measurements. In addition, a ~ 3 Km transect across three drained thaw-lake basins (DTLB) of different climate

  10. Acellular Dermal Matrix as a Core Strut for Projection in Nipple Reconstruction: Approaches for Three Different Methods of Breast Reconstruction

    PubMed Central

    Park, Gui-Yong; Cho, Hee-Eun; Lee, Byung-Il; Park, Seung-Ha

    2016-01-01

    Background The objective of this paper was to describe a novel technique for improving the maintenance of nipple projection in primary nipple reconstruction by using acellular dermal matrix as a strut in one of three different configurations, according to the method of prior breast reconstruction. The struts were designed to best fill the different types of dead spaces in nipple reconstruction depending on the breast reconstruction method. Methods A total of 50 primary nipple reconstructions were performed between May 2012 and May 2015. The prior breast reconstruction methods were latissimus dorsi (LD) flap (28 cases), transverse rectus abdominis myocutaneous (TRAM) flap (10 cases), or tissue expander/implant (12 cases). The nipple reconstruction technique involved the use of local flaps, including the C-V flap or star flap. A 1×2-cm acellular dermal matrix was placed into the core with O-, I-, and L-shaped struts for prior LD, TRAM, and expander/implant methods, respectively. The projection of the reconstructed nipple was measured at the time of surgery and at 3, 6, and 9 months postoperatively. Results The nine-month average maintenance of nipple projection was 73.0%±9.67% for the LD flap group using an O-strut, 72.0%±11.53% for the TRAM flap group using an I-strut, and 69.0%±10.82% for the tissue expander/implant group using an L-strut. There were no cases of infection, wound dehiscence, or flap necrosis. Conclusions The application of an acellular dermal matrix with a different kind of strut for each of 3 breast reconstruction methods is an effective addition to current techniques for improving the maintenance of long-term projection in primary nipple reconstruction. PMID:27689049

  11. A numerical analysis of the influence of tram characteristics and rail profile on railway traffic ground-borne noise and vibration in the Brussels Region.

    PubMed

    Kouroussis, G; Pauwels, N; Brux, P; Conti, C; Verlinden, O

    2014-06-01

    Nowadays, damage potentially caused by passing train in dense cities is of increasing concern and restricts improvement to the interconnection of various public transport offers. Although experimental studies are common to quantify the effects of noise and vibration on buildings and on people, their reach is limited since the causes of vibrations can rarely be deduced from data records. This paper presents the numerical calculations that allow evaluating the main contributions of railway-induced ground vibrations in the vicinity of buildings. The reference case is the Brussels Region and, more particularly, the T2000 tram circulating in Brussels city. Based on a pertinent selection of the vibration assessment indicators and a numerical prediction approach, various results are presented and show that the free-field analysis is often improperly used in this kind of analysis as the interaction of soil and structure is required. Calculated high ground vibrations stem from singular rail surface defects. The use of resilient wheels is recommended in order to reduce the ground-borne noise and vibration to permissible values.

  12. Spatial variability of particle number concentrations and NOx in the Karlsruhe (Germany) area obtained with the mobile laboratory ‘AERO-TRAM'

    NASA Astrophysics Data System (ADS)

    Hagemann, Rowell; Corsmeier, Ulrich; Kottmeier, Christoph; Rinke, Rayk; Wieser, Andreas; Vogel, Bernhard

    2014-09-01

    For the first time in Germany, we obtained high-resolution spatial distributions of particle numbers and nitrogen oxides in an urban agglomeration using a tram system. In comparison to particle numbers the NOx concentration decreased much faster with a significantly steeper gradient when going from the inner city to the surrounding area. In case of NOx the decrease was 70% while for particle number concentration it was only 50%. We found an area in the rural surrounding with a second increase of particle numbers without simultaneous enhanced NOx levels. The source of the high particle numbers could be ascribed to industry emissions about 5-10 km away. The mean spatial distribution of particle number concentration depended on wind direction, wind velocity and boundary layer stability. The dependency was particularly strong in the rural area affected by industrial emissions, where individual wind directions led to concentration differences of up to 25%. The particulate concentration was 40% higher during low wind velocities (1-5 m s-1) than during high wind velocities (>5 m s-1). We observed similar findings for the impact of boundary layer stability on particle numbers concentration. Particle pollution was 40% higher for stable stratification compared to neutral or unstable cases.

  13. Transforming growth factor-beta differentially inhibits MyD88-dependent, but not TRAM- and TRIF-dependent, lipopolysaccharide-induced TLR4 signaling.

    PubMed

    Naiki, Yoshikazu; Michelsen, Kathrin S; Zhang, Wenxuang; Chen, Shuang; Doherty, Terence M; Arditi, Moshe

    2005-02-18

    Transforming growth factor-beta1 (TGF-beta1) is a multifunctional, potent anti-inflammatory cytokine produced by many cell types that regulates cell proliferation, apoptosis, and immune responses. Toll-like receptors (TLRs) recognize various pathogen-associated molecular patterns and are therefore a pivotal component of the innate immune system. In this study we show that TGF-beta1 blocks the NF-kappaB activation and cytokine release that is stimulated by ligands for TLRs 2, 4, and 5. We further show that TGF-beta1 can specifically interfere with TLR2, -4, or -5 ligand-induced responses involving the adaptor molecule MyD88 (myeloid differentiation factor 88) but not the TRAM/TRIF signaling pathway by decreasing MyD88 protein levels in a dose- and time-dependent manner without altering its mRNA expression. The proteasome inhibitor epoxomicin abolished the MyD88 degradation induced by TGF-beta1. Furthermore, TGF-beta1 resulted in ubiquitination of MyD88 protein, suggesting that TGF-beta1 facilitates ubiquitination and proteasomal degradation of MyD88 and thereby attenuates MyD88-dependent signaling by decreasing cellular levels of MyD88 protein. These findings importantly contribute to our understanding of molecular mechanisms mediating anti-inflammatory modulation of immune responses by TGF-beta1.

  14. Predictive risk factors of free flap thrombosis in breast reconstruction surgery.

    PubMed

    Masoomi, Hossein; Clark, Emily G; Paydar, Keyianoosh Z; Evans, Gregory R D; Nguyen, Audrey; Kobayashi, Mark R; Wirth, Garrett A

    2014-11-01

    Vascular thrombosis is one of the major postoperative complications of free flap microvascular breast reconstruction operations. It is associated with higher morbidity, higher cost, increased length of hospital stay, and potentially flap loss. Our purpose is to evaluate the rate of this complication and whether patient characteristics play a role. Using the Nationwide Inpatient Sample (NIS) database, we examined the clinical data of patients who underwent free flap breast reconstruction between 2009 and 2010 in the United States. Multivariate and univariate regression analyses were performed to identify independent risk factors of flap thrombosis. A total of 15,211 patients underwent free flap breast reconstruction surgery (immediate reconstruction: 43%). The most common flap was the free deep inferior epigastric perforator (DIEP) flap (53.6%), followed by free transverse rectus abdominis myocutaneous (TRAM) flap (43.1%), free superficial inferior epigastric artery (SIEA) flap (2%), and free gluteal artery perforator (GAP) flap (1.3%). The overall rate of flap thrombosis was 2.4 %, with the highest rate seen in the SIEA group (11.4%) and the lowest in the TRAM group (1.7%). Peripheral vascular disease (adjusted odds ration [AOR] 10.61), SIEA flap (AOR, 4.76) and delayed reconstruction (AOR, 1.42) were found to be statistically significant risk factors for flap thrombosis. Other comorbidities were not linked. While the overall rate of flap thrombosis in free flap breast reconstruction was relatively low (2.4%), Plastic Surgeons should be aware that patients with peripheral vascular disease and those undergoing free SIEA flap are at higher risk of flap thrombosis and they should closely monitor flaps to increase the chance for early salvage.

  15. Cracking the perfusion code?: Laser-assisted Indocyanine Green angiography and combined laser Doppler spectrophotometry for intraoperative evaluation of tissue perfusion in autologous breast reconstruction with DIEP or ms-TRAM flaps.

    PubMed

    Ludolph, Ingo; Arkudas, Andreas; Schmitz, Marweh; Boos, Anja M; Taeger, Christian D; Rother, Ulrich; Horch, Raymund E; Beier, Justus P

    2016-10-01

    The aim of this prospective study was to assess the correlation of flap perfusion analysis based on laser-assisted Indocyanine Green (ICG) angiography with combined laser Doppler spectrophotometry in autologous breast reconstruction using free DIEP/ms-TRAM flaps. Between February 2014 and July 2015, 35 free DIEP/ms-TRAM flaps were included in this study. Besides the clinical evaluation of flaps, intraoperative perfusion dynamics were assessed by means of laser-assisted ICG angiography and post-capillary oxygen saturation and relative haemoglobin content (rHb) using combined laser Doppler spectrophotometry. Correlation of the aforementioned parameters was analysed, as well as the impact on flap design and postoperative complications. Flap survival rate was 100%. There were no partial flap losses. In three cases, flap design was based on the angiography, contrary to clinical evaluation and spectrophotometry. The final decision on the inclusion of flap areas was based on the angiographic perfusion pattern. Angiography and spectrophotometry showed a correlation in most of the cases regarding tissue perfusion, post-capillary oxygen saturation and relative haemoglobin content. Laser-assisted ICG angiography is a useful tool for intraoperative evaluation of flap perfusion in autologous breast reconstruction with DIEP/ms-TRAM flaps, especially in decision making in cases where flap perfusion is not clearly assessable by clinical signs and exact determination of well-perfused flap margins is difficult to obtain. It provides an objective real-time analysis of flap perfusion, with high sensitivity for the detection of poorly perfused flap areas. Concerning the topographical mapping of well-perfused flap areas, laser-assisted angiography is superior to combined laser Doppler spectrophotometry.

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

    PubMed Central

    Abdelsalam, Khaled; Mohamdin, OW

    2016-01-01

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

  17. Comparison of ultrasound-guided transversus abdominis plane block with bupivacaine and ropivacaine as adjuncts for postoperative analgesia in laparoscopic cholecystectomies

    PubMed Central

    Sinha, Shradha; Palta, Sanjeev; Saroa, Richa; Prasad, Abhishek

    2016-01-01

    Background and Aims: Transversus abdominis plane (TAP) block is a popular technique for post-operative analgesia in abdominal surgeries. The aim of the study was to evaluate the relative efficacy of bupivacaine versus ropivacaine for post-operative analgesia using ultrasound-guided TAP block in laparoscopic cholecystectomies. Methods: Sixty adults undergoing elective laparoscopic cholecystectomy were randomised to receive ultrasound-guided TAP block at the end of the surgical procedure with either 0.25% bupivacaine (Group I, n = 30) or 0.375% ropivacaine (Group II, n = 30). All patients were assessed for post-operative pain and rescue analgesic consumption at 10 min, 30 min, 1 h, 4 h, 8 h, 12 h and 24 h time points. Means for normally distributed data were compared using Student's t-test, and proportions were compared using Chi-square or Fisher's exact test whichever was applicable. Results: Patients receiving ultrasound-guided TAP block with ropivacaine (Group II) had significantly lower pain scores when compared to patients who received the block with bupivacaine (Group I) at 10 min, 30 min and 1 h. However, both the drugs were equivalent for post-operative analgesia and 24 h cumulative rescue analgesic requirement (median [interquartile range]) (75.00 [75.00–75.00] in Group I vs. 75.00 [75.00–93.75] in Group II, P = 0.366). Conclusion: Ultrasound-guided TAP block with ropivacaine provides effective analgesia in the immediate post-operative period up to 1 h as compared to bupivacaine. However, both the drugs are similar in terms of 24 h cumulative rescue analgesic requirement. PMID:27141110

  18. Tracer airflow measurement system (TRAMS)

    DOEpatents

    Wang, Duo

    2007-04-24

    A method and apparatus for measuring fluid flow in a duct is disclosed. The invention uses a novel high velocity tracer injector system, an optional insertable folding mixing fan for homogenizing the tracer within the duct bulk fluid flow, and a perforated hose sampling system. A preferred embodiment uses CO.sub.2 as a tracer gas for measuring air flow in commercial and/or residential ducts. In extant commercial buildings, ducts not readily accessible by hanging ceilings may be drilled with readily plugged small diameter holes to allow for injection, optional mixing where desired using a novel insertable foldable mixing fan, and sampling hose.

  19. A novel technique for managing open abdomen with the combined use of mesh-mediated traction and the bilateral anterior rectus abdominis sheath turnover flap method: how to do it.

    PubMed

    Arai, Masatoku; Kushimoto, Shigeki; Kim, Shiei; Masuno, Tomohiko; Hagiwara, Jun; Ishii, Hiromoto; Yokota, Hiroyuki

    2015-10-01

    Proper management of abdominal compartment syndrome and open abdomen is important for improving the survival of critically ill patients. However, in cases requiring a prolonged period of open abdomen, it is frequently difficult to perform definitive fascial closure due to lateralization of the abdominal musculature. We herein present a novel combined technique for managing open abdomen. A 74-year-old male with diffuse peritonitis was transferred to our department, after which a long period of open abdomen made it difficult to achieve fascial closure. Polypropylene mesh was sutured to the fascial edges to reduce the gap, which was then serially tightened under negative pressure wound therapy. However, since it was not possible to accomplish definitive fascial closure, abdominal closure was performed using the bilateral anterior rectus abdominis sheath turnover flap method after removing the mesh, without any complications. This combined technique may be an effective alternative in patients requiring open abdomen with subsequent difficulty in achieving definitive fascial closure.

  20. First case of penile metastasis following abdominoperineal resection with VRAM flap reconstruction

    PubMed Central

    Kozan, Andrei A.; Smith, Adrian M.; Ilsley, David W.; Rhodes, Nicholas

    2016-01-01

    Penile metastases are rare in colorectal cancer. We report the first case of such a recurrence in a patient who had undergone an extralevator abdominoperineal resection with vertical rectus abdominis myocutaneous flap perineal reconstruction. The patient was treated with curative intent by total penectomy. PMID:27887019

  1. The ability of intra-operative perfusion mapping with laser-assisted indocyanine green angiography to predict mastectomy flap necrosis in breast reconstruction: a prospective trial.

    PubMed

    Munabi, Naikhoba C O; Olorunnipa, Olushola B; Goltsman, David; Rohde, Christine H; Ascherman, Jeffrey A

    2014-04-01

    Mastectomy skin flap ischaemia leading to necrosis is a common occurrence. Laser-assisted indocyanine green (ICG) angiography can assist to locate these poorly perfused areas intra-operatively. Our study aims to identify specific perfusion values produced by ICG angiography that accurately predict mastectomy flap necrosis. A total of 42 patients undergoing autologous or implant-based breast reconstruction had mastectomy flaps imaged using laser-assisted ICG angiography at the completion of reconstruction. Intra-operative perfusion values were correlated with postoperative skin flap outcomes. Risk factors for abnormal perfusion were recorded and analysed. A total of 62 breast reconstructions were imaged, including 48 tissue expander reconstructions, six transverse rectus abdominis myocutaneous (TRAM) flaps, six deep inferior epigastric perforator (DIEP) flaps and two direct-to-implant reconstructions. Eight cases (13%) of full-thickness skin necrosis were identified postoperatively. A SPY Elite(®) value of ≤ 7 accurately predicted the development of flap necrosis at 88% sensitivity and 83% specificity. False-positive cases (those with perfusion values ≤ 7 which did not develop necrosis) were more likely to have a smoking history and/or to have had an epinephrine-containing tumescent solution used during mastectomy. Excluding patients with smoking or epinephrine use, a SPY value of ≤ 7 predicted flap necrosis with a sensitivity of 83% and specificity of 97%. Thus, these data suggest that laser-assisted ICG angiography predicts postoperative outcomes with high accuracy. In our series, a SPY value of ≤ 7 correlated well with mastectomy flap necrosis. Furthermore, smoking and intra-operative injections containing epinephrine should be considered when evaluating low perfusion values as they can lead to false-positive test results.

  2. Improved perioperative analgesia with ultrasound-guided ilioinguinal/iliohypogastric nerve or transversus abdominis plane block for open inguinal surgery: a systematic review and meta-analysis of randomized controlled trials

    PubMed Central

    Wang, Yuexiang; Wu, Tao; Terry, Marisa J.; Eldrige, Jason S.; Tong, Qiang; Erwin, Patricia J.; Wang, Zhen; Qu, Wenchun

    2016-01-01

    [Purpose] Ultrasound-guided ilioinguinal/iliohypogastric (II/IH) nerve and transversus abdominis plane (TAP) blocks have been increasingly utilized in patients for perioperative analgesia. We conducted this meta-analysis to evaluate the clinical efficacy of ultrasound-guided II/IH nerve or TAP blocks for perioperative analgesia in patients undergoing open inguinal surgery. [Subjects and Methods] A systematic search was conducted of 7 databases from the inception to March 5, 2015. Randomized controlled trials (RCTs) comparing the clinical efficacy of ultrasound-guided vs. landmark-based techniques to perform II/IH nerve and TAP blocks in patients with open inguinal surgery were included. We constructed random effects models to pool the standardized mean difference (SMD) for continuous outcomes and the odds ratio (OR) for dichotomized outcomes. [Results] Ultrasound-guided II/IH nerve or TAP blocks were associated with a reduced use of intraoperative additional analgesia and a significant reduction of pain scores during day-stay. The use of rescue drugs was also significantly lower in the ultrasound-guided group. [Conclusion] The use of ultrasound-guidance to perform an II/IH nerve or a TAP block was associated with improved perioperative analgesia in patients following open inguinal surgery compared to landmark-based methods. PMID:27134411

  3. 36 CFR 1192.179 - Trams, similar vehicles and systems.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... units, including but not limited to vehicles providing shuttle service to remote parking areas, between... addition, each such unit shall comply with § 1192.23 (b) or (c) and shall provide at least one space...

  4. 36 CFR 1192.179 - Trams, similar vehicles and systems.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... units, including but not limited to vehicles providing shuttle service to remote parking areas, between... addition, each such unit shall comply with § 1192.23 (b) or (c) and shall provide at least one space...

  5. 36 CFR 1192.179 - Trams, similar vehicles and systems.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... units, including but not limited to vehicles providing shuttle service to remote parking areas, between... addition, each such unit shall comply with § 1192.23 (b) or (c) and shall provide at least one space...

  6. 36 CFR 1192.179 - Trams, similar vehicles and systems.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... units, including but not limited to vehicles providing shuttle service to remote parking areas, between... addition, each such unit shall comply with § 1192.23 (b) or (c) and shall provide at least one space...

  7. 36 CFR 1192.179 - Trams, similar vehicles and systems.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... units, including but not limited to vehicles providing shuttle service to remote parking areas, between... addition, each such unit shall comply with § 1192.23 (b) or (c) and shall provide at least one space...

  8. Vaginal reconstruction with pedicled vertical deep inferior epigastric perforator flap (diep) after pelvic exenteration. A consecutive case series.

    PubMed

    Ferron, Gwénael; Gangloff, Dimitri; Querleu, Denis; Frigenza, Melanie; Torrent, Juan Jose; Picaud, Laetitia; Gladieff, Laurence; Delannes, Martine; Mery, Eliane; Boulet, Berenice; Balague, Gisele; Martinez, Alejandra

    2015-09-01

    Vaginal reconstruction after pelvic exenteration (PE) represents a challenge for the oncologic surgeon. Since the introduction of perforator flaps, using pedicled vertical DIEP (deep inferior epigastric perforator) flap allows to reduce the donor site complication rate. From November 2012 to December 2014, 27 PEs were performed in our institution. 13 patients who underwent PE with vaginal reconstruction and programmed DIEP procedure for gynecologic malignancies were registered. Nine patients underwent PE for recurrent disease and four for primary treatment. Six of the 13 patients have a preoperative fistula. Anterior PE was performed in 10 patients, and total PE in 3 patients. A vertical DIEP flap was performed in 10 patients using one or two medial perforators. The reasons for abortion of vertical DIEP flap procedure were: failure to localizing perforator vessels in two cases, and unavailability of plastic surgeon in one case. A vertical fascia-sparring rectus abdominis myocutaneous flap was then harvested. Median length of surgery was 335min, and 60min for DIEP harvesting and vaginal reconstruction. No flap necrosis occurred. One patient in the VRAM (vertical rectus abdominis myocutaneous) group experienced a late incisional hernia and one patient in the DIEP flap group required revision for vaginal stenosis. In our experience, DIEP flap represents our preferred choice of flap for circumferential vaginal reconstruction after PE. To achieve a high reproducibility, the technically demanding pedicled vertical DIEP flap has to be harvested by a trained surgeon, after strict evaluation of the preoperative imaging with identification and localization of perforator vessels.

  9. Extended abdominoperineal resection in women: the barbadian experience

    PubMed Central

    Zbar, Andrew P; Shenoy, Radhakanth K; Chiappa, Antonio

    2007-01-01

    Background and objectives We report our results of a selective approach to primary direct appositional vaginal repair versus transverse rectus abdominis flap repair (TRAM) in patients with extensive rectal/anal cancer or in cases with primary cancer of cervix, vagina or vulva involving the anal canal and anal sphincters. Methods Eighteen female patients (mean age: 62.9 years; range: 44–81 years) with a median follow-up of 14 months (range: 2–36 months) undergoing extended abdominoperineal reconstruction with total mesorectal excision between May 2002 and September 2005, were studied. Results Twelve patients underwent an extended abdominoperineal resection with hysterectomy and vaginectomy, with 6 patients undergoing primary TRAM flap reconstruction following pelvic exenteration. Exenterative procedures were performed in 2 cases of primary vaginal cancer, following Wertheim hysterectomy for carcinoma of the cervix with recurrence after radiation and in 2 further cases of anal cancer with extensive pelvic recurrence after primary chemoradiation. Fifteen cases are alive on follow-up with no evidence of disease; 2 patients who had recurrent carcinoma of the cervix and who underwent TRAM flap reconstruction, have recurrent disease after 5 and 6 months of follow-up, respectively. Discussion Our experience shows that careful primary closure of an extended abdominoperineal resection wound is effective and safe. Our one case of wound breakdown after primary repair underwent external beam and intracavitary irradiation primarily with wound breakdown of a primary repair followed by a delayed pedicled graciloplasty. TRAM flap reconstruction has been reserved in our unit for patients undergoing total pelvic extenteration. In general, we would recommend the use of TRAM flap reconstruction in younger sexually active patients where there has been external irradiation combined with brachytherapy. PMID:17214895

  10. The bipedicled latissimus dorsi myocutaneous free flap: clinical experience with 53 patients.

    PubMed

    Karaaltin, Mehmet Veli; Erdem, Adnan; Canter, Ibrahim; Cavdar, Günay; Baghaki, Semih

    2010-01-01

    The Latissimus dorsi musculocutaneous flap is a valuable workhorse of the microsurgeon, especially in closing large body defects. One of the pitfalls in harvesting the flap, is particularly in its inferior aspect which may be unreliable. Here we report a series of 53 patients who were undergone bipedicled free latissimus dorsi musculocutaneous free flaps for extensive tissue defects. The age of patients were between 5 and 64 and all of them were males. The wound sizes in these patients ranged between 31-35 x 10-12 cm and flap dimensions were between 38-48 x 6-8 cm. Perforator branches of the 10th intercostal vessels were dissected and supercharged to the flaps to reduce the risk of ischemia of the inferior cutaneous extensions. The secondary pedicles were anastomosed to recipient vessels other than the primary pedicles. Recipient areas were consisted of lower extremities. Four patients suffered of early arterial failure in the major pedicle and all revisions were successfully attempted. Neither sign of venous congestion nor arterial insufficiency were observed at the inferior cutaneous extensions of the flaps, and all defects were reconstructed successfully. All donor sites were primarily closed, only two patients suffered from a minor area of superficial epidermal loss at the donor site, without suffering any adjunct complications. In conclusion coverage of large defects can be safely performed with extending the skin paddle of latissimus dorsi flap as a bipedicled free flap.

  11. Postoperative seroma formation after abdominoplasty with placement of continuous infusion local anesthetic pain pump

    PubMed Central

    Smith, Melissa M; Lin, Michael P; Hovsepian, Raffi V; Wood, David; Nguyen, Trung; Evans, Gregory RD; Wirth, Garrett A

    2009-01-01

    The most common complication after abdominoplasty is seroma formation. The incidence of seroma formation in abdominal procedures as a whole, including abdominoplasty, panniculectomy and transverse rectus abdominis myocutaneous flap abdominal donor sites, ranges from 1% to 38%. A recent concern among surgeons is the possibility of a causal relationship between the use of continuous infusion devices such as local anesthetic pain pumps and the development of seromas. A case of postoperative, persistent, recurrent seroma formation after abdominoplasty with the use of continuous infusion local anesthetic pain pump is presented. After several attempts at aspiration and drain catheter placement, only open surgical excision of the seroma cavity was found to be definitively effective in treating the development of seroma. PMID:21119843

  12. Care of patients with deep inferior epigastric perforator reconstruction.

    PubMed

    Long, Laura; Israelian, Amy

    2013-01-01

    Recent trends reflect greater numbers of women opting for mastectomy for invasive breast cancer. Breast reconstruction, either at the time of mastectomy or later, is increasingly an option patients prefer. Although many women opt for implants, reconstruction using autologous tissue offers several advantages including tissue that feels more natural and will age naturally with the patient. The deep inferior epigastric perforator flap has emerged as an alternative to the transverse rectus abdominis myocutaneous flap and allows for preservation of the underlying abdominal muscle. As greater numbers of surgeons are able to offer this microvascular alternative, nurses will care for these postoperative patients in the intensive care unit and medical/surgical settings. This article reviews the evaluation of patients for deep inferior epigastric perforator reconstruction and the unique complexities of postoperative nursing care for these patients.

  13. B-1 Systems Approach to Training. Training Resources Analytic Model (TRAM). Programmer’s Manual

    DTIC Science & Technology

    1975-07-01

    TABLES BLK1N - INPUTS COURCES INTKES - INITIALIZES RESOURCE TAbLES INTSOR - INITIALIZES SOURCE TABLES UPDRES - UPDATES RESOURCE TABLES UPüSOR...INITIALIZE STORAGE FOR RESOURCE DATA * UPDSOR * UPDATE SOURCE DATA IN CORE * UPDRES UPDATE RESOURCE DATA IN CORE { RETURN

  14. 49 CFR 38.179 - Trams, and similar vehicles, and systems

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... vehicles providing shuttle service to remote parking areas, between hotels and other public accommodations...) or (c) and shall provide at least one space for wheelchair or mobility aid users complying with §...

  15. 49 CFR 38.179 - Trams, and similar vehicles, and systems

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... vehicles providing shuttle service to remote parking areas, between hotels and other public accommodations...) or (c) and shall provide at least one space for wheelchair or mobility aid users complying with §...

  16. 49 CFR 38.179 - Trams, and similar vehicles, and systems

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... vehicles providing shuttle service to remote parking areas, between hotels and other public accommodations...) or (c) and shall provide at least one space for wheelchair or mobility aid users complying with §...

  17. 49 CFR 38.179 - Trams, and similar vehicles, and systems

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... vehicles providing shuttle service to remote parking areas, between hotels and other public accommodations...) or (c) and shall provide at least one space for wheelchair or mobility aid users complying with §...

  18. 49 CFR 38.179 - Trams, and similar vehicles, and systems

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... vehicles providing shuttle service to remote parking areas, between hotels and other public accommodations...) or (c) and shall provide at least one space for wheelchair or mobility aid users complying with §...

  19. Desmoid tumor following abdominally-based free flap breast reconstruction

    PubMed Central

    Oh, Christine; Hammoudeh, Ziyad S.

    2017-01-01

    Desmoid tumors are fibroblastic connective tissue tumors that most commonly develop within the anterior abdominal wall. The etiology of desmoid tumors has not been well defined; however, hereditary, hormonal, traumatic, and surgery-related causes have been implicated. Desmoid tumors are believed to arise from musculoaponeurotic structures. Development in the breast is very rare. Several reports of desmoid tumors arising in the vicinity of the fibrous capsule of a breast implant have been described, but to date, the authors are not aware of any published cases following autologous breast reconstruction. This report describes a desmoid tumor developing after a muscle-sparing free transverse rectus abdominis musculocutaneous (TRAM) flap for breast reconstruction and subsequent surgical management. PMID:28210557

  20. Laser photobiomodulation (830 and 660 nm) in mast cells, VEGF, FGF, and CD34 of the musculocutaneous flap in rats submitted to nicotine.

    PubMed

    das Neves, Lais Mara Siqueira; Leite, Gabriella de Paula Marcondes Ferreira; Marcolino, Alexandre Marcio; Pinfildi, Carlos Eduardo; Garcia, Sérgio Britto; de Araújo, João Eduardo; Guirro, Elaine Caldeira de Oliveira

    2017-02-01

    The aim of this study was to investigate the effect of laser photobiomodulation (PBM) on the viability of the transverse rectus abdominis musculocutaneous (TRAM) flap in rats subjected to the action of nicotine. We evaluated 60 albino Wistar rats, divided into six groups of ten animals. Group 1 (saline) underwent the surgical technique to obtain a TRAM flap; group 2 (laser 830 nm) underwent the surgical technique and was irradiated with a laser 830 nm; group 3 (laser 660 nm) underwent the surgical technique and was irradiated with a laser 660 nm; group 4 was treated with nicotine subcutaneously (2 mg/kg/2×/day/4 weeks) and underwent surgery; group 5 (nicotine + laser 830 nm) was exposed to nicotine, underwent the surgical technique, and was irradiated with a laser 830 nm; group 6 (nicotine + laser 660 nm) was exposed to nicotine, underwent the surgical technique, and was irradiated with a laser 660 nm. The application of PBM occurred immediately after surgery and on the two following days. The percentage of necrosis was assessed using the AxioVision® software. The number of mast cells (toluidine blue staining) was evaluated, and immunohistochemistry was performed to detect vascular endothelial growth factor expression (anti-VEGF-A), fibroblasts (anti-basic FGF), and neoformed vessels (anti-CD34). PBM with a wavelength of 830 nm increased the viability of the TRAM flap, with a smaller area of necrosis, increased number of mast cells, and higher expression of VEGF and CD34. PBM increases the viability of musculocutaneous flaps treated with to nicotine.

  1. Effect of acetylsalicylic acid on microvascular thrombosis in autologous breast reconstruction.

    PubMed

    Enajat, Morteza; Aziz Mohammadi, Mujzgan; Debeij, Jan; van der Hulst, Rene R W J; Mureau, Marc A M

    2014-01-01

    Although advances in microsurgery have increased success rates of autologous breast reconstruction, microvascular thrombosis still remains a major concern as a cause of flap failure. At present, no evidence-based guidelines on pharmacological prevention of microvascular thrombosis exist. This study investigates the effect of acetylsalicylic acid on the incidence of microvascular complications in patients undergoing autologous breast reconstruction. Patients undergoing deep inferior epigastric artery perforator or free transverse rectus abdominis myocutaneous flap breast reconstruction at two academic centers in the Netherlands between 2005 and 2011 were included. Patients at one center received once daily 0.6 mL of nadroparine and 40 mg acetylsalicylic acid, while patients at the other center received 0.6 mL nadroparine only. A total of 430 consecutive patients underwent 592 breast reconstructions. No statistically significant differences were found between the two groups in the incidence of flap failure (2.8 and 2.5%), microvascular thromboembolic complications (2.6 and 3.8%), venous congestion (3.4 and 2.8%), or overall complications (28.0 and 32.3%). Hematoma tended to occur more often in the group receiving acetylsalicylic acid (9.2 and 4.7%).It was found that no protective effect of acetylsalicylic acid on microvascular complications was present. Given its known risks and the somewhat increased occurrence of hematoma in the present study, we stopped to routinely administer acetylsalicylic acid after autologous breast reconstruction.

  2. An Innovative Solution to Complex Inguinal Defect: Deepithelialized SIEA Flap With Mini Abdominoplasty

    PubMed Central

    Daggett, Justin; Harrington, Michael; Dayicioglu, Deniz

    2017-01-01

    Introduction: We describe a novel technique of contralateral pedicled deepithelialized superficial inferior epigastric artery flaps, followed by abdominal advancement coverage, as an alternative treatment of radiated complicated inguinal or lower abdominal defects, avoiding the donor-site defect typically seen with other methods of coverage. Methods: Two male patients with histories of liposarcoma after excision and radiation to one side of lower abdomen/inguinal area presented with complicated wounds that were reconstructed with this technique. Results: Successful obliteration of dead space and wound closure were achieved with the combination of a superficial inferior epigastric artery flap with an abdominal advancement flap. In each case, patients went on to heal uneventfully without need for any secondary procedures. Discussion: The use of a superficial inferior epigastric artery flap for lower abdomen/groin defect closure is an option as an alternative to rectus abdominis myocutaneous flap and anterolateral thigh flaps and should be considered in patients with vascular anatomy conducive for this muscle-sparing procedure. Conclusions: A second layer-overlay coverage with an abdominal advancement flap creates a more durable repair in the complicated radiated wound and a well-concealed abdominoplasty scar. PMID:28197296

  3. Breast sensation after breast reconstruction: a systematic review.

    PubMed

    Shridharani, Sachin M; Magarakis, Michael; Stapleton, Sahael M; Basdag, Basak; Seal, Stella M; Rosson, Gedge D

    2010-07-01

    Studies show some return of breast sensation after breast reconstruction; however, recovery is variable and unpredictable. Efforts are being made to restore innervation by reattaching nerves (neurotization). We sought to systematically review the literature addressing breast sensation after reconstruction. The following databases were searched: EMBASE, Cochrane, and PubMed. Additionally, the PLASTIC AND RECONSTRUCTIVE SURGERY journal was hand searched from 1960 to 2009. Inclusion criteria included breast reconstruction for cancer, return of sensation with objective results, and patients aged 18 to 90 years. Studies with purely cosmetic procedures, case reports, studies with less than 10 patients, and studies involving male patients were excluded. The initial search yielded 109 studies, which was refined to 20 studies with a total pool of 638 patients. Innervated flaps have a greater magnitude of recovery, which occurs at an earlier stage compared with the noninnervated flaps. Overall, sensation to deep inferior epigastric artery perforator flaps may recover better sensation than transverse rectus abdominis myocutaneous flaps, followed by latissimus dorsi flaps, and finally implants. Women's needs and expectations for sensation have led plastic surgeons to investigate ways to facilitate its return. Studies, however, depict conflicting data. Larger series are needed to define the role of neurotization as a modality for improving sensory restoration.

  4. Effects of Tissue Component Volumes on Vascular Resistance in Free Flaps.

    PubMed

    Ono, Masashi; Takanari, Keisuke; Toriyama, Kazuhiro; Yagi, Shunjiro; Ebisawa, Katsumi; Sawamura, Hisashi; Kambe, Miki; Murotani, Kenta; Kamei, Yuzuru

    2017-01-01

    Background A successful free flap transfer is achieved, in part, by having a thorough understanding of vascular anatomy and blood flow dynamics. We previously reported that vascular resistance differs by type of free flap. To test the hypothesis that the difference reflects the proportion of tissue components within free flaps, we calculated blood flow and vascular resistance for free flaps in which we determined the volume of each tissue component. Methods Measurements and calculations were made for 40 free flap transfers performed at our hospital: 7 radial forearm flaps, 14 anterolateral thigh flaps, and 19 rectus abdominis myocutaneous flaps. Results The vascular resistance of free flaps was inversely related to the volume of each tissue component. Univariate regression analysis revealed that muscle volume correlated most closely with resistance (r = 0.881), followed by skin (r = 0.622), and fat (r = 0.577). Multiple regression analysis confirmed the relationship between combined muscle and fat volume and resistance (R(2) = 0.865). Conclusions A strong inverse correlation exists between vascular resistance and combined muscle and fat tissue volume in flaps. It may be helpful to consider these relationships when making decisions regarding choice of free flap and recipient vessels.

  5. Use of Latissimus Dorsi Pedicled Myocutaneous Flap for Reconstruction in the Chest Area of an 8-Month-Old Female Infant with Ectopia Cordis

    PubMed Central

    Dastagir, Khaled; Breymann, Thomas; Heckmann, Andreas; Horke, Alexander; Vogt, Peter Maria

    2014-01-01

    Ectopia cordis (EC) is characterized by a complete or partial malposition of the heart outside the thorax. Despite the interdisciplinary treatment, the repair of EC is still very difficult and offers new surgical challenges because of its complexity and various combinations with other anomalies. We report the successful outcome after using a pedicled latissimus dorsi flap in reconstructive surgery in the setting of chronic wound dehiscence in an 8-month-old female infant born with a thoracic EC and omphalocele. PMID:25798359

  6. Use of latissimus dorsi pedicled myocutaneous flap for reconstruction in the chest area of an 8-month-old female infant with ectopia cordis.

    PubMed

    Dastagir, Khaled; Breymann, Thomas; Heckmann, Andreas; Horke, Alexander; Vogt, Peter Maria

    2014-12-01

    Ectopia cordis (EC) is characterized by a complete or partial malposition of the heart outside the thorax. Despite the interdisciplinary treatment, the repair of EC is still very difficult and offers new surgical challenges because of its complexity and various combinations with other anomalies. We report the successful outcome after using a pedicled latissimus dorsi flap in reconstructive surgery in the setting of chronic wound dehiscence in an 8-month-old female infant born with a thoracic EC and omphalocele.

  7. Ultrasound assessment of transversus abdominis muscle contraction ratio during abdominal hollowing: a useful tool to distinguish between patients with chronic low back pain and healthy controls?

    PubMed

    Pulkovski, N; Mannion, A F; Caporaso, F; Toma, V; Gubler, D; Helbling, D; Sprott, H

    2012-08-01

    Spine stabilisation exercises, in which patients are taught to preferentially activate the transversus abdominus (TrA) during "abdominal hollowing" (AH), are a popular treatment for chronic low back pain (cLBP). The present study investigated whether performance during AH differed between cLBP patients and controls to an extent that would render it useful diagnostic tool. 50 patients with cLBP (46.3 ± 12.5 years) and 50 healthy controls (43.6 ± 12.7 years) participated in this case-control study. They performed AH in hook-lying. Using M-mode ultrasound, thicknesses of TrA, and obliquus internus and externus were determined at rest and during 5 s AH (5 measures each body side). The TrA contraction-ratio (TrA-CR) (TrA contracted/rest) and the ability to sustain the contraction [standard deviation (SD) of TrA thickness during the stable phase of the hold] were investigated. There were no significant group differences for the absolute muscle thicknesses at rest or during AH, or for the SD of TrA thickness. There was a small but significant difference between the groups for TrA-CR: cLBP 1.35 ± 0.14, controls 1.44 ± 0.24 (p < 0.05). However, Receiver Operator Characteristics (ROC) analysis revealed a poor and non-significant ability of TrA-CR to discriminate between cLBP patients and controls on an individual basis (ROC area under the curve, 0.60 [95% CI 0.495; 0.695], p = 0.08). In the patient group, TrA-CR showed a low but significant correlation with Roland Morris score (Spearman Rho = 0.328; p = 0.02). In conclusion, the difference in group mean values for TrA-CR was small and of uncertain clinical relevance. Moreover, TrA-CR showed a poor ability to discriminate between control and cLBP subjects on an individual basis. We conclude that the TrA-CR during abdominal hollowing does not distinguish well between patients with chronic low back pain and healthy controls.

  8. Infections following the application of leeches: two case reports and review of the literature

    PubMed Central

    2012-01-01

    Introduction Since the 1980s, leeches have been ingeniously used in the management of venous flap congestion. The presence of anticoagulative substances in their saliva improves the blood drainage. Their digestive tract contains several bacterial species, the main ones being Aeromonas hydrophila and Aeromonas veronii biovar sobria, which contribute to the digestion of ingested blood. These bacteria can be the cause of infections. Case presentation We report two cases of septicemia related to Aeromonas veronii biovar sobria that presented after leeches had been applied to congested transverse rectus abdominis myocutaneous flaps for delayed mammary reconstructions. Patient number 1 was a 55-year-old Caucasian woman who underwent a delayed breast reconstruction procedure. On the sixth postoperative day she showed a clinical presentation of septicemia. Aeromonas veronii biovar sobria was identified in the patient’s skin and blood bacteriological samples. Her fever ceased after 4 days of antibiotic treatment. Patient number 2 was a 56-year-old Caucasian woman who underwent a delayed breast reconstruction procedure. On the seventh postoperative day we noticed that she showed a clinical presentation of septicemia. Aeromonas veronii biovar sobria was identified in the patient’s blood cultures and local bacteriological samples. An antibiogram showed resistance to amoxicillin/clavulanic acid. Her fever ceased on the eleventh postoperative day after 4 days of antibiotic treatment. Conclusion The rate of infection after application of leeches is not negligible. The concentration of Aeromonas inside the digestive tracts of leeches largely decreases when the patient is under antibiotic therapy. These germs are sensitive to third-generation cephalosporins and fluoroquinolones and resistant to amoxicillin/clavulanic acid. We recommend preventive treatment based on classical measures of asepsis and on oral antibioprophylaxy with a fluoroquinolone during the whole period of

  9. Plastic and Reconstructive Surgery in the Treatment of Oncological Perineal and Genital Defects

    PubMed Central

    Brodbeck, Rebekka; Horch, Raymund E.; Arkudas, Andreas; Beier, Justus P.

    2015-01-01

    Defects of the perineum may result from ablative procedures of different malignancies. The evolution of more radical excisional surgery techniques resulted in an increase in large defects of the perineum. The perineogenital region per se has many different functions for urination, bowel evacuation, sexuality, and reproduction. Up-to-date individual and interdisciplinary surgical treatment concepts are necessary to provide optimum oncological as well as quality of life outcome. Not only the reconstructive method but also the timing of the reconstruction is crucial. In cases of postresectional exposition of e.g., pelvic or femoral vessels or intrapelvic and intra-abdominal organs, simultaneous flap procedure is mandatory. In particular, the reconstructive armamentarium of the plastic surgeon should include not only pedicled flaps but also free microsurgical flaps so that no compromise in terms of the extent of the oncological resection has to be accepted. For intra-abdominally and/or pelvic tumors of the rectum, the anus, or the female reproductive system, which were resected through an abdominally and a sacrally surgical access, simultaneous vertical rectus abdominis myocutaneous (VRAM) flap reconstruction is recommendable. In terms of soft tissue sarcoma of the pelvic/caudal abdomen/proximal thigh region, two-stage reconstructions are possible. This review focuses on the treatment of perineum, genitals, and pelvic floor defects after resection of malignant tumors, giving a distinct overview of the different types of defects faced in this region and describing a number of reconstructive techniques, especially VRAM flap and pedicled flaps like antero-lateral thigh flap or free flaps. Finally, this review outlines some considerations concerning timing of the different operative steps. PMID:26500887

  10. Nipple Reconstruction Using the C-V Flap Technique: Long-Term Outcomes and Patient Satisfaction

    PubMed Central

    Jalini, Lona; Lund, Jonathan; Kurup, Vijay

    2017-01-01

    BACKGROUND Nipple creation using the C-V flap technique is often the final step in breast reconstruction. The aim of this study was to subjectively and objectively assess the cosmetic outcomes and satisfaction of patients undergoing C-V flap nipple reconstruction. METHODS Subjective assessments of patient satisfaction with the neo-nipple were recorded by visual analogue scoring (VAS; 0-10). Objective measurements were performed using a calliper to measure nipple projection relative to the native breast. Descriptive data analysis was performed with differences in projection assessed with the Mann-Whitney test and mean and median VAS scores (with inter-quartile ranges; IQR) calculated to describe satisfaction. RESULTS Thirty-three C-V flap nipple reconstructions were performed. 87.9% received latissimus dorsi (LD) reconstructions with implants and 12.1% had transverse rectus abdominis muscle (TRAM) reconstructions. The median projection of reconstructed nipples was 4.7 mm (range 4-10.2 mm) at 4.6 years mean follow-up, which was not significantly different from the contralateral nipple (p = 0.34). Patient satisfaction was 9 (IQR: 8-10) with shape, 9 (IQR: 7.5-10) with projection, 5 (IQR: 2-9.6) with sensation, and 8.5 (IQR: 6-9.5) with symmetry. Median overall satisfaction was 9 (IQR: 8-10). Three patients had complete nipple loss, of whom two had undergone nipple piercing post procedure and none had received radiotherapy. CONCLUSION C-V flap nipple reconstructions provide a simple and reliable method to reconstruct the nipple that enhances confidence and perception of body image. Satisfaction was high with long-term outcomes in terms of projection equivalent to the contralateral breast. PMID:28289616

  11. Is Unilateral Implant or Autologous Breast Reconstruction Better in Obtaining Breast Symmetry?

    PubMed

    Cohen, Oriana; Small, Kevin; Lee, Christina; Petruolo, Oriana; Karp, Nolan; Choi, Mihye

    2016-01-01

    Unilateral breast reconstruction poses a special set of challenges to the reconstructive breast surgeon compared to bilateral reconstructions. No studies to date provide an objective comparison between autologous and implant based reconstructions in matching the contralateral breast. This study compares the quantitative postoperative results between unilateral implant and autologous flap reconstructions in matching the native breast in shape, size, and projection using three-dimensional (3D) imaging. Sixty-four patients who underwent unilateral mastectomy with tissue expander (TE)-implant (n = 34) or autologous microvascular free transverse rectus abdominus myocutaneous (TRAM; n = 18) or deep inferior epigastric artery perforator (DIEP; n = 12) flap (n = 30) reconstruction from 2007 to 2010 were analyzed. Key patient demographics and risk factors were collected. Using 3D scans of patients obtained during pre and postoperative visits including over 1 year follow-ups for both groups, 3D models were constructed and analyzed for total breast volume, anterior-posterior projection from the chest wall, and 3D comparison. No significant differences in mean age, body mass index, or total number of reconstructive surgeries were observed between the two groups (TE-implant: 52.2 ± 10, 23.9 ± 3.7, 3 ± 0.9; autologous: 50.7 ± 9.4, 25.4 ± 3.9, 2.9 ± 1.3; p > 0.05). The total volume difference between the reconstructed and contralateral breasts in the TE-implant group was insignificant: 27.1 ± 22.2 cc, similar to the autologous group: 29.5 ± 24.7 cc, as was the variance of breast volume from the mean. In both groups, the reconstructed breast had a larger volume. A-P projections were similar between the contralateral and the reconstructed breasts in the TE-implant group: 72.5 ± 3.21 mm versus 71.7 ± 3.5 mm (p > 0.05). The autologous reconstructed breast had statistically insignificant but less A-P projection compared to the contralateral breast (81.9 ± 16.1 mm versus 61

  12. Total sacrectomy and Galveston L-rod reconstruction for malignant neoplasms. Technical note.

    PubMed

    Gokaslan, Z L; Romsdahl, M M; Kroll, S S; Walsh, G L; Gillis, T A; Wildrick, D M; Leavens, M E

    1997-11-01

    Although radical resection is the best treatment for malignant sacral tumors, total sacrectomy for such tumors has been performed in only a few instances. Total sacral resection requires reconstruction of the pelvic ring plus establishment of a bilateral union between the lumbar spine and iliac bone. This technique is illustrated in two patients harboring large, painful, sacral giant-cell tumors that were unresponsive to prior treatment. These patients were treated with complete en bloc resection of the sacrum and complex iliolumbar reconstruction/stabilization and fusion. Surgery was performed in two stages, the first consisting of a midline celiotomy, dissection of visceral/neural structures, and ligation of internal iliac vessels, followed by an anterior L5-S1 discectomy. The second stage consisted of mobilization of an inferiorly based myocutaneous rectus abdominis pedicle flap for wound closure, followed by an L-5 laminectomy, bilateral L-5 foraminotomy, ligation of the thecal sac, division of sacral nerve roots, and transection of the ilia lateral to the tumor and sacroiliac joints. Placement of the instrumentation required segmental fixation of the lumbar spine from L-3 down by means of pedicle screws and the establishment of a bilateral liaison between the lumbar spine and the ilia by using the Galveston L-rod technique. The pelvic ring was then reestablished by means of a threaded rod connecting left and right ilia. Both autologous (posterior iliac crest) and allograft bone were used for fusion, and a tibial allograft strut was placed between the remaining ilia. The patients were immobilized for 8 weeks postoperatively and underwent progressive rehabilitation. At the 1-year follow-up review, one patient could walk unassisted, and the other ambulated independently using a cane. Both patients controlled bowel function satisfactorily with laxatives and diet and could maintain continence but required self-catheterization for bladder emptying. The authors

  13. Morphological and histomorphometric evaluation of the ventral rectus sheath of the rectus abdominis muscle, fascia lata and pectoral fascia. The beginning of a morphological information bank of human fascias.

    PubMed

    Morales-Avalos, Rodolfo; Soto-Domínguez, Adolfo; García-Juárez, Jaime; Cardenas-Serna, Marcela; Esparza-Hernández, Claudia N; Carreño-Salcedo, Sofía Alejandra; Montes-de-Oca-Luna, Roberto; Loera-Arias, María de Jesús; Saucedo-Cárdenas, Odila; Elizondo-Omaña, Rodrigo E; Guzmán-López, Santos

    2017-03-01

    The aim of this study was to characterize and compare the morphological and histomorphometric characteristics of the pectoral fascia, fascia lata and ventral rectus sheath. Twenty cadaveric samples of these fascias were analyzed and stained with hematoxylin and eosin, orcein, Van Gieson, Masson's trichrome and Verhoeff¨s stain (1200 slides in total). Morphological evaluation, semiquantitative, morphometric and microdensitometric analysis of elastic fibers present in each of the tissues and a morphometrical analysis of tissue thickness were performed. The mean value of the pectoral fascia thickness was 612±68.13 μm; 84±246 μm for the fascia lata and 584±92 μm for the ventral rectus sheath. The area occupied by the elastic fibers in the pectoral fascia was 12.24±5.84%; 6,54±3.85% for the fascia lata and 11.11±5.26% for the ventral rectus sheath. There were no statistically significant differences when comparing the mean values between the pectoral fascia and the ventral rectus sheath (p=0.07). There were statistically significant differences when comparing the fascia lata to the pectoral fascia and the ventral rectus sheath (p≤0.001). This study reports other morphological characteristics not described in previous histological studies of the analyzed tissues. The results of the morphometric and densitometric analysis in this study reveal that the fascia lata has the fewest elastic fibers of all the tissues analyzed, and the pectoral fascia has the most. These results will be useful for the beginning of a morphological information bank of human fascias.

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

    PubMed Central

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

    2015-01-01

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

  15. 78 FR 66380 - Final Environmental Impact Statement for the Restoration of the Mariposa Grove of Giant Sequoias...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    ... visitor services, and the availability of shuttle service and commercial tram service to the Grove... infrastructure within the Mariposa Grove, including a commercial tram operation, would remain. The shuttle... the South Entrance of Yosemite. A park shuttle would transport visitors two miles from the...

  16. A reevaluation of the unusual abdominal musculature of squamate reptiles (Reptilia: Squamata).

    PubMed

    Bhullar, Bhart-Anjan S

    2009-08-01

    The abdominal muscles of lizards and snakes (Squamata) have been the subject of periodic attention from anatomists, embryologists, and systematists. Until now, the presence of a superficial portion of the m. rectus abdominis, named the m. rectus abdominis lateralis, has been considered a key synapomorphy of the clade Autarchoglossa, which includes all extant squamates save Gekkota and Iguania. However, the precise anatomical relations of the m. rectus abdominis lateralis have never been fully investigated. Here, I show that the m. rectus abdominis lateralis is present in Iguania. Its absence in Gekkota represents rare gross anatomical support for recent molecular-structure-based hypotheses of squamate relationships placing geckoes as sister to the remaining squamates. Where present, it is the most superficial trunk muscle, exterior to the m. obliquus externus. The separation of the m. rectus abdominis lateralis from the m. rectus abdominis occurs as the m. obliquus externus aponeurosis and part of the m. obliquus internus aponeurosis emerge superficially to form the outer portion of the rectus sheath. In Autarchoglossa, the contralateral mm. recti abdomines laterales meet at the midline and are attached to the imbricae of the transverse scale rows characteristic of the clade, suggesting developmental, functional, and evolutionary association. Because the m. rectus abdominis lateralis is sometimes continuous with the pectoralis, its exclusive association with the m. rectus abdominis is questionable. It may be a neomorphic layer that is part of the abaxial developmental system, comprising those muscles whose connective tissue is largely derived from lateral plate as opposed to somatic mesoderm.

  17. Electromyographic analysis of four popular abdominal exercises.

    PubMed

    Piering, A W; Janowski, A P; Wehrenberg, W B; Moore, M T; Snyder, A C

    1993-01-01

    This study was designed to evaluate the effects of four specific sit-up exercises on muscular activity of the rectus abdominis. Pairs of surface electrodes were placed unilaterally on four quadrants of the rectus abdominis, delimited by tendinous inscriptions, in four male subjects. Electromyographic (EMG) recordings were taken while the subjects performed four different abdominal exercises. Each abdominal exercise was hypothesized to have a specific effect on one of the four quadrants of the rectus abdominis. The four exercises analyzed were: 1) long lying crunch, 2) bent knee crunch, 3) leg raise, and 4) vertical leg crunch. Analysis of the standardized EMG recordings demonstrated no significant differences in the mean muscle activity between the four different quadrants, in the mean muscle activity between the four different exercises, and in interactions between the exercises and the quadrants of the rectus abdominis. We conclude that none of the four abdominal exercises studied are specific for strengthening individual muscle quadrants of the rectus abdominis.

  18. Statistically optimal analysis of state-discretized trajectory data from multiple thermodynamic states.

    PubMed

    Wu, Hao; Mey, Antonia S J S; Rosta, Edina; Noé, Frank

    2014-12-07

    We propose a discrete transition-based reweighting analysis method (dTRAM) for analyzing configuration-space-discretized simulation trajectories produced at different thermodynamic states (temperatures, Hamiltonians, etc.) dTRAM provides maximum-likelihood estimates of stationary quantities (probabilities, free energies, expectation values) at any thermodynamic state. In contrast to the weighted histogram analysis method (WHAM), dTRAM does not require data to be sampled from global equilibrium, and can thus produce superior estimates for enhanced sampling data such as parallel/simulated tempering, replica exchange, umbrella sampling, or metadynamics. In addition, dTRAM provides optimal estimates of Markov state models (MSMs) from the discretized state-space trajectories at all thermodynamic states. Under suitable conditions, these MSMs can be used to calculate kinetic quantities (e.g., rates, timescales). In the limit of a single thermodynamic state, dTRAM estimates a maximum likelihood reversible MSM, while in the limit of uncorrelated sampling data, dTRAM is identical to WHAM. dTRAM is thus a generalization to both estimators.

  19. GENERAL VIEW OF DEHYDRATER (STRUCTURE 12), SHED (STRUCTURE 18), FRUIT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    GENERAL VIEW OF DEHYDRATER (STRUCTURE 12), SHED (STRUCTURE 18), FRUIT TRAY STORAGE ROOM (STRUCTURE 11), WITH FRUIT DRYING AREA AND TRAM TRACKS IN FOREGROUND, FROM NORTHWEST - Stevens Ranch Complex, State Route 101, Coyote, Santa Clara County, CA

  20. 21. ROUTE OF THE SHELF LINE, LOOKING NORTHWEST. IN AREAS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    21. ROUTE OF THE SHELF LINE, LOOKING NORTHWEST. IN AREAS WHERE THE ROUTE CROSSED PARTICULARLY STEEP TERRAIN, THE COMPANY USED EXTENSIVE ROCK RIPRAP TO SUPPORT THE TRAM GRADE. - Independent Coal & Coke Company, Kenilworth, Carbon County, UT

  1. DETAIL VIEW OF BLACKSMITH'S FORGE AND WORK AREA ON WEST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF BLACKSMITH'S FORGE AND WORK AREA ON WEST SIDE OF UPPER TRAM TERMINAL, LOOKING EAST. FORGE IS IN FOREGROUND, WITH THE ANVIL BLOCK JUST TO THE RIGHT AND BEHIND IT. A TRAM CAR IS UPSIDE DOWN TO THE LEFT OF THE FORGE. THE PIPE GOING INTO THE FORGE ON THE RIGHT CARRIED COMPRESSED AIR TO BLOW THE COALS. AT CENTER RIGHT ON THE TRAM TERMINAL ARE THE OPENING AND CLOSING MECHANISMS FOR THE ORE BUCKETS. AT CENTER LEFT IS A BRAKE WHEEL. THE ANCHOR POINTS FOR THE STATIONARY TRAM CABLES ARE JUST BELOW THIS WHEEL. THE FRONT END OF THE TERMINAL IS JUST OFF FRAME ON THE RIGHT. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  2. Cystic Fibrosis Chest X-Ray Findings: A Teaching Analog

    DTIC Science & Technology

    2008-07-01

    tram-track sign” has been used as a descriptive radiographic term. For example, there is “tram- tracking” of the optic nerve meninges that can...congenital, or secondary to severe infection, or secondary to an obstructive process. The most common infectious causes in adults are tuberculosis ...Mycobacterium (i.e. Tuberculosis ) MRSA TORCHES Fungal Infection Obstructive Foreign Body Aspiration Bronchial Stricture Airway Mass/Tumor

  3. Multiensemble Markov models of molecular thermodynamics and kinetics.

    PubMed

    Wu, Hao; Paul, Fabian; Wehmeyer, Christoph; Noé, Frank

    2016-06-07

    We introduce the general transition-based reweighting analysis method (TRAM), a statistically optimal approach to integrate both unbiased and biased molecular dynamics simulations, such as umbrella sampling or replica exchange. TRAM estimates a multiensemble Markov model (MEMM) with full thermodynamic and kinetic information at all ensembles. The approach combines the benefits of Markov state models-clustering of high-dimensional spaces and modeling of complex many-state systems-with those of the multistate Bennett acceptance ratio of exploiting biased or high-temperature ensembles to accelerate rare-event sampling. TRAM does not depend on any rate model in addition to the widely used Markov state model approximation, but uses only fundamental relations such as detailed balance and binless reweighting of configurations between ensembles. Previous methods, including the multistate Bennett acceptance ratio, discrete TRAM, and Markov state models are special cases and can be derived from the TRAM equations. TRAM is demonstrated by efficiently computing MEMMs in cases where other estimators break down, including the full thermodynamics and rare-event kinetics from high-dimensional simulation data of an all-atom protein-ligand binding model.

  4. Multiensemble Markov models of molecular thermodynamics and kinetics

    PubMed Central

    Wu, Hao; Paul, Fabian; Noé, Frank

    2016-01-01

    We introduce the general transition-based reweighting analysis method (TRAM), a statistically optimal approach to integrate both unbiased and biased molecular dynamics simulations, such as umbrella sampling or replica exchange. TRAM estimates a multiensemble Markov model (MEMM) with full thermodynamic and kinetic information at all ensembles. The approach combines the benefits of Markov state models—clustering of high-dimensional spaces and modeling of complex many-state systems—with those of the multistate Bennett acceptance ratio of exploiting biased or high-temperature ensembles to accelerate rare-event sampling. TRAM does not depend on any rate model in addition to the widely used Markov state model approximation, but uses only fundamental relations such as detailed balance and binless reweighting of configurations between ensembles. Previous methods, including the multistate Bennett acceptance ratio, discrete TRAM, and Markov state models are special cases and can be derived from the TRAM equations. TRAM is demonstrated by efficiently computing MEMMs in cases where other estimators break down, including the full thermodynamics and rare-event kinetics from high-dimensional simulation data of an all-atom protein–ligand binding model. PMID:27226302

  5. Effect of craniocervical posture on abdominal muscle activities

    PubMed Central

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

    2016-01-01

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

  6. The quorum sensing transcriptional regulator TraR has separate binding sites for DNA and the anti-activator

    SciTech Connect

    Zheng, Zhida; Fuqua, Clay; Chen, Lingling

    2012-02-10

    Highlights: Black-Right-Pointing-Pointer Quorum sensing transcription factor TraR is inhibited by forming TraR-TraM complex. Black-Right-Pointing-Pointer K213 is a key DNA binding residue, but not involved in interaction with TraM. Black-Right-Pointing-Pointer Mutations of TraM-interacting TraR residues did not affect DNA-binding of TraR. Black-Right-Pointing-Pointer Mutations of TraR residues reduced the TraR-TraM interaction more than those of TraM. Black-Right-Pointing-Pointer TraM inhibition on DNA-binding of TraR is driven by thermodynamics. -- Abstract: Quorum sensing represents a mechanism by which bacteria control their genetic behaviors via diffusible signals that reflect their population density. TraR, a quorum sensing transcriptional activator in the Rhizobiaceae family, is regulated negatively by the anti-activator TraM via formation of a TraR-TraM heterocomplex. Prior structural analysis suggests that TraM and DNA bind to TraR in distinct sites. Here we combined isothermal titration calorimetry (ITC) and electrophoretic mobility shift assays (EMSA) to investigate roles of TraR residues from Rhizobium sp. NGR234 in binding of both TraM and DNA. We found that K213A mutation of TraR{sub NGR} abolished DNA binding, however, did not alter TraM binding. Mutations of TraM-interfacing TraR{sub NGR} residues decreased the TraR-TraM interaction, but did not affect the DNA-binding activity of TraR{sub NGR}. Thus, our biochemical studies support the independent binding sites on TraR for TraM and DNA. We also found that point mutations in TraR{sub NGR} appeared to decrease the TraR-TraM interaction more effectively than those in TraM{sub NGR}, consistent with structural observations that individual TraR{sub NGR} residues contact with more TraM{sub NGR} residues than each TraM{sub NGR} residues with TraR{sub NGR} residues. Finally, we showed that TraM inhibition on DNA-binding of TraR was driven thermodynamically. We discussed subtle mechanistic differences in TraM

  7. [Large abdominal wall reconstruction by free flap after recurrence of a dermatofibrosarcoma protuberans].

    PubMed

    Le Fourn, B; Lejeune, F; Sartre, J Y; Loirat, Y; Pannier, M

    1996-12-01

    Based on a case of recurrence of a dermatofibrosarcoma protuberans of the abdominal wall, the authors discuss the need for initial wide resection of this type of skin tumour and the possibilities of repair of extensive full thickness defects of the abdominal wall by means of a latissimus dorsi myocutaneous free flap.

  8. Effects of opioids on local anesthesia in the rat: a codeine and tramadol study.

    PubMed

    Carnaval, Talita Girio; Sampaio, Roberta Moura; Lanfredi, Camila Bernadeli; Borsatti, Maria Aparecida; Adde, Carlos Alberto

    2013-01-01

    Opioids are central analgesics that act on the CNS (central nervous system) and PNS (peripheral nervous system). We investigated the effects of codeine (COD) and tramadol (TRAM) on local anesthesia of the sciatic nerve. Eighty Wistar male rats received the following SC injections in the popliteal fossa: local anesthetic with epinephrine (LA); local anesthetic without vasoconstrictor (LA WV); COD; TRAM; LA + COD; LA + TRAM; COD 20 minutes prior to LA (COD 20' + LA) or TRAM 20 minutes prior to LA (TRAM 20' + LA). As a nociceptive function, the blockade was considered the absence of a paw withdraw reflex. As a motor function, it was the absence of claudication. As a proprioceptive function, it was the absence of hopping and tactile responses. All data were compared using repeated-measures analysis of variance (ANOVA). Opioids showed a significant increase in the level of anesthesia, and the blockade duration of LA + COD was greater than that of the remaining groups (p < 0.05). The associated use of opioids improved anesthesia efficacy. This could lead to a new perspective in controlling dental pain.

  9. Translational Integrity and Continuity: Personalized Biomedical Data Integration

    PubMed Central

    Wang, Xiaoming; Liu, Lili; Fackenthal, James; Cummings, Shelly; Cook, Maggie; Hope, Kisha; Silverstein, Jonathan C.; Olopade, Olufunmilayo I

    2009-01-01

    Translational research data are generated in multiple research domains from the bedside to experimental laboratories. These data are typically stored in heterogeneous databases, held by segregated research domains, and described with inconsistent terminologies. Such inconsistency and fragmentation of data significantly impedes the efficiency of tracking and analyzing human-centered records. To address this problem, we have developed a data repository and management system named TraM (http://tram.uchicago.edu), based on a domain ontology integrated entity relationship model. The TraM system has the flexibility to recruit dynamically evolving domain concepts and the ability to support data integration for a broad range of translational research. The web-based application interfaces of TraM allow curators to improve data quality and provide robust and user-friendly cross-domain query functions. In its current stage, TraM relies on a semi-automated mechanism to standardize and restructure source data for data integration and thus does not support real-time data application. PMID:18760382

  10. Luminescence techniques and characterization of the morphology of polymer latices. 3. An investigation of the microenvironments within stabilized aqueous latex dispersions of poly(n-butyl methacrylate) and polyurethane.

    PubMed

    Soutar, I; Swanson, L; Annable, T; Padget, J C; Satgurunathan, R

    2006-06-20

    Fluorescence techniques (including time-resolved anisotropy measurements, TRAMS) have been used to probe differences in morphology between two stabilized aqueous latex dispersions (poly(n-butyl methacrylate), PBMA, and polyurethane, PU). Use of the emission characteristics of probes such as pyrene and phenanthrene dispersed within particles reveals that the PU latices are more heterogeneous in nature: evidence exists, particularly from quenching measurements and TRAMS, that voids and channels of water permeate the PU structure, resulting in a relatively soft, open particle, swollen by ingress of the bulk aqueous phase. Fluorescence measurements indicate that PBMA colloids, however, are composed of relatively hard, hydrophobic particles. In addition, TRAMS are considered to be a valuable tool both for probing the morphological characteristics of such dispersions and in estimating the average particle size.

  11. The core musculature in male prepubescent tennis players and untrained counterparts: a volumetric MRI study.

    PubMed

    Sanchis-Moysi, Joaquin; Idoate, Fernando; Álamo-Arce, David; Calbet, José A L; Dorado, Cecilia

    2017-04-01

    The effects of exercise on the core musculature have not been investigated in prepubescents. The main purpose of the present study was to determine the volume and degree of asymmetry of rectus abdominis, obliques and transversus abdominis, quadratus lumborum, iliopsoas, gluteus and paravertebralis muscles in prepubescent tennis players and in untrained boys. The muscle volume was determined using magnetic resonance imaging (MRI) in 7 male prepubescent tennis players and 10 untrained controls (mean age 11.0 ± 0.8 years, Tanner 1-2). After accounting for height and body weight as covariates, the tennis players had 14-34% greater volume than the controls in all the muscles analysed (P < 0.05) except in paravertebralis, dominant quadratus lumborum and non-dominant gluteus, which had similar volumes in both groups (P = NS). Compared to controls, the tennis players displayed a greater degree of asymmetry in quadratus lumborum and rectus abdominis (3% vs. 15%, P < 0.01 and 8% vs. 17%, P = 0.06, respectively). The level of asymmetry of obliques and transversus abdominis, iliopsoas, gluteus and paravertebralis muscles was similar in both groups (P = NS). In conclusion, tennis playing at prepubertal ages induces a selective hypertrophy of the core musculature and exaggerates the degree of asymmetry of quadratus lumborum and rectus abdominis compared to untrained boys.

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

    PubMed

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

    2012-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  14. Exercises for Women with Persistent Pelvic and Low Back Pain after Pregnancy

    PubMed Central

    Unsgaard-Tøndel, Monica; Vasseljen, Ottar; Woodhouse, Astrid; Mørkved, Siv

    2016-01-01

    Background: Specific stabilizing exercises activating deep local muscles in coordination with global muscles are recommended in the treatment of pregnancy-related lumbopelvic pain. Some studies have suggested that recruitment of the deepest abdominal muscle, transversus abdominis, is crucial in the development and improvement of lumbopelvic pain. Objective: This exploratory study aimed to describe the development of pain, disability and transversus abdominis recruitment before, during and after an individually designed intervention including an exercise program for women with persisting lumbopelvic pain after delivery. Design: A multiple-baseline, single-subject experimental design was applied. Methods: Sixteen women with lumbopelvic pain after delivery were included and received tailored exercise therapy, including ultrasound-guided activation of deep muscles, strengthening and stretching exercises and advice. Pain, disability and ultrasound-recorded activation of transversus abdominis was registered weekly. Treatment and testing was performed in a primary care setting in Trondheim, Norway. Results: All sixteen included women reported reduced pain and decreased disability over the intervention period. The magnitude of transversus abdominis activation varied substantially between individuals and tests. While there was a statistically significant correlation between change in pain and change in disability, no correlation was observed between change in transversus abdominis activation and change in symptoms. Limitations: This is an exploratory study and results cannot be generalized without replication in controlled studies. Conclusions: Pain and disability due to persistent low back and pelvic pain after delivery were reduced after specific, individual adapted exercise including deep and superficial lumbopelvic muscles. Changes in pain and disability were not associated with changes in transversus abdominis activation. PMID:27157173

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

    NASA Technical Reports Server (NTRS)

    Miller, Alan D.

    1987-01-01

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

  16. Reconstruction of Abdominal Wall Defects Using a Pedicled Anterolateral Thigh Flap including the Vastus Lateralis Muscle: A Report of Two Cases

    PubMed Central

    Fujioka, Masaki; Ishiyama, Satoko

    2016-01-01

    The purpose of abdominal wall reconstruction is to prevent hernias and protect the abdominal viscera. In cases involving full-thickness defects of the rectus abdominis muscle, the muscle layer should be repaired. We present 2 cases in which full-thickness lower rectus abdominis muscle defects were reconstructed using vastus lateralis-anterolateral thigh flaps. The pedicled vastus lateralis-anterolateral thigh flap provides skin, fascia, and muscle tissue. Furthermore, it has a long neurovascular pedicle and can reach up to the periumbilical area and cover large defects. We consider that this muscle flap is a good option for repairing full-thickness lower abdominal defects. PMID:28074168

  17. Hydrogen Sulfide Mitigates Reperfusion Injury in a Porcine Model of Vascularized Composite Autotransplantation

    DTIC Science & Technology

    2014-05-01

    Hydrogen Sulfide Mitigates Reperfusion Injury in a Porcine Model of Vascularized Composite Autotransplantation Carole Y. Villamaria, MD,*Þ C. Anton...interim perfusion of hydrogen sulfide (H2S) mitigates the effects of reperfusion injury in the setting of delayed resto- ration of blood flow. Methods: A...for reconstructing previ- ously unreconstructable injuries. Key Words: hydrogen sulfide , gracilis myocutaneous flap, vascularized composite tissue

  18. Salvage mastectomy after failed breast-conserving therapy for carcinoma of the breast.

    PubMed Central

    Barr, L. C.; Brunt, A. M.; Phillips, R. H.; Ellis, H.

    1991-01-01

    The indications, technique and complications of salvage mastectomy in 25 patients with local recurrence after breast-conserving therapy for carcinoma of the breast have been reviewed. Two patients required myocutaneous flaps to repair the defect, and six patients (24%) suffered wound infection or breakdown. Subsequent local relapse occurred in a total of five patients, two of whom died with uncontrolled chest wall skin nodules. PMID:2018316

  19. 1. VIEW SHOWING FOUNDATIONS OF HOISTING WORKS, ROYAL MINE, 1988, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. VIEW SHOWING FOUNDATIONS OF HOISTING WORKS, ROYAL MINE, 1988, LOOKING SOUTHEAST. GLORY HOLE DROPS OFF TO LEFT, AND EXCAVATED TRENCH FOR THE 1920s SURFACE TRAM IN RIGHT FOREGROUND - Royal Consolidated Gold Mine & Mills, Hoisting Work, 4.0 Air Miles Northwest of Copperopolis, Copperopolis, Calaveras County, CA

  20. 113. VIEW OF MACHINE SHOP FROM WEST. AREA IN FOREGROUND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    113. VIEW OF MACHINE SHOP FROM WEST. AREA IN FOREGROUND WAS ONCE ENCLOSED AS PART OF THE SHOP. THE TRAM LINE AND SNOWSHED RAN TO THE RIGHT (SOUTH) TO EAGLE MINE PORTAL. - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

  1. 3. EAGLE MILL, DETAIL OF CRUDE ORE BIN FROM NORTH, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. EAGLE MILL, DETAIL OF CRUDE ORE BIN FROM NORTH, c. 1908-10. SHOWS EXPOSED CRUSHER HOUSE IN FRONT OF (SOUTH) CRUDE ORE BIN AND SNOW SHED ADDED OVER TRAM TRACKS. NOTE LACK OF EAST OR WEST CRUDE ORE BINS. CREDIT JW. - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

  2. DETAIL VIEW OF FILTER PRESS REMAINS, BOILER, SECONDARY ORE BIN, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    DETAIL VIEW OF FILTER PRESS REMAINS, BOILER, SECONDARY ORE BIN, TRAM TRESTLE AND WATER TANK, LOOKING NORTHWEST. HIS VIEW IS TAKEN FROM THE THIRD LEVEL OF THE MILL, NEARBY THE BLACKSMITH'S FORGE. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  3. Be Here Now: Young Women's War Diaries and the Practice of Intentionality

    ERIC Educational Resources Information Center

    Wahlstrom, Ralph L.

    2012-01-01

    Here, the author looks at four diaries, more specifically three conventional diaries and a blog: "The Diary of a Young Girl," by Anne Frank; "Zlata's Diary," by Zlata Filipovic; and "Last Night I Dreamed of Peace" by Dang Thuy Tram. "Baghdad Burning" is the transcript of a web log, a blog, by a young Iraqi woman who went by the pseudonym…

  4. View of the Radiator Mount (Feature 13), looking eastnortheast. The ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    View of the Radiator Mount (Feature 13), looking east-northeast. The Tram Support remains (Feature 21) are in background - Orphan Lode Mine, North of West Rim Road between Powell Point and Maricopa Point, South Rim, Grand Canyon Village, Coconino County, AZ

  5. 49. VIEW FROM WEST OF DUST COLLECTOR BLOWER LOCATED AT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    49. VIEW FROM WEST OF DUST COLLECTOR BLOWER LOCATED AT CRUSHED OXIDIZED ORE BIN FEED LEVEL. THE ROASTER IS BEYOND AND THE MACHINE SHOP IS ON THE TRAM TERRACE, UPPER RIGHT. - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

  6. 18. VIEW OF CRUDE ORE BINS FROM WEST. WEST CRUDE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. VIEW OF CRUDE ORE BINS FROM WEST. WEST CRUDE ORE BIN AND TRESTLE FROM TWO JOHNS TRAMLINE TO SOUTH, CRUDE ORE BIN IN FOREGROUND. MACHINE SHOP IN BACKGROUND. THE TRAM TO PORTLAND PASSED TO NORTH OF MACHINE SHOP. - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

  7. 10. TROJAN MILL, EXTERIOR FROM EAST, c. 191928. ADDITION TO ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. TROJAN MILL, EXTERIOR FROM EAST, c. 1919-28. ADDITION TO THE EAST END OF MILLING FLOOR VISIBLE WITH TRAM ENTRY DOOR. ALSO SEEN ARE THE ADDITIONS FOR MILL SOLUTION TANKS AND THE EAST SIDE OF SAMPLING ROOMS. CREDIT JW. - Bald Mountain Gold Mill, Nevada Gulch at head of False Bottom Creek, Lead, Lawrence County, SD

  8. 36 CFR Appendix - Figures to Part 1192

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Figures to Part 1192 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY GUIDELINES FOR TRANSPORTATION VEHICLES Other Vehicles and Systems Trams, similar vehicles and systems. Pt....

  9. 30 CFR 75.523-2 - Deenergization of self-propelled electric face equipment; performance requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Deenergization of self-propelled electric face... Electrical Equipment-General § 75.523-2 Deenergization of self-propelled electric face equipment; performance requirements. (a) Deenergization of the tramming motors of self-propelled electric face equipment, required...

  10. 30 CFR 75.523-2 - Deenergization of self-propelled electric face equipment; performance requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Deenergization of self-propelled electric face... Electrical Equipment-General § 75.523-2 Deenergization of self-propelled electric face equipment; performance requirements. (a) Deenergization of the tramming motors of self-propelled electric face equipment, required...

  11. 30 CFR 75.523-2 - Deenergization of self-propelled electric face equipment; performance requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Deenergization of self-propelled electric face... Electrical Equipment-General § 75.523-2 Deenergization of self-propelled electric face equipment; performance requirements. (a) Deenergization of the tramming motors of self-propelled electric face equipment, required...

  12. 30 CFR 75.523-2 - Deenergization of self-propelled electric face equipment; performance requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Deenergization of self-propelled electric face... Electrical Equipment-General § 75.523-2 Deenergization of self-propelled electric face equipment; performance requirements. (a) Deenergization of the tramming motors of self-propelled electric face equipment, required...

  13. 30 CFR 77.1607 - Loading and haulage equipment; operation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... out of the cabs and in safe locations, unless the trucks are designed specifically to protect the... and all trucks shall be trimmed properly when they have been loaded higher than the confines of their... tram conveyor buckets shall not be overloaded, and feed shall be regulated to prevent spillage....

  14. 36 CFR Appendix - Figures to Part 1192

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Figures to Part 1192 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY GUIDELINES FOR TRANSPORTATION VEHICLES Other Vehicles and Systems Trams, similar vehicles and systems. Pt....

  15. 35. DETAIL OF TRAMWAY/WALKWAY OVER CYANIDE TANKS, LOOKING EAST. CLASSIFIED ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    35. DETAIL OF TRAMWAY/WALKWAY OVER CYANIDE TANKS, LOOKING EAST. CLASSIFIED SANDS WERE LOADED INTO SMALL TRAM CARS FROM THE SPOUT OF THE CLASSIFIER IN THE DISTANCE AT CENTER AND CONVEYED BY HAND TO BE DUMPED INTO THE TANKS BELOW. - Skidoo Mine, Park Route 38 (Skidoo Road), Death Valley Junction, Inyo County, CA

  16. Development of a Ballistic Specification for Magnesium Alloy AZ31B

    DTIC Science & Technology

    2008-12-01

    GERMANY 4 FRANHOFER INSTITUT FUR KURZZEITDYNAMIK ERNST MACH INSTITUT V HOHLER E STRASSBURGER R TRAM K THOMA ECKERSTRASSE4 D...FORSCHUNGSINSTITUT ST LOUIS H ERNST H LERR CEDEX 5 RUE DU GENERAL CASSAGNOU F 68301 SAINT LOUIS FRANCE 1 DIEHL GMBH AND CO M

  17. An Analysis of Magnesium Alloy AZ31B-H24 for Ballistic Applications

    DTIC Science & Technology

    2007-12-01

    4 FRANHOFER INSTITUT FUR KURZZEITDYNAMIK ERNST MACH INSTITUT V HOHLER E STRASSBURGER R TRAM K THOMA ECKERSTRASSE4 D 79 104...FRANZOSISCHES FORSCHUNGSINSTITUT ST LOUIS H ERNST H LERR CEDEX 5 RUE DU GENERAL CASSAGNOU F 68301 SAINT LOUIS FRANCE 1 DIEHL GMBH

  18. KCa3.1 channel inhibition sensitizes malignant gliomas to temozolomide treatment

    PubMed Central

    D'Alessandro, Giuseppina; Grimaldi, Alfonso; Chece, Giuseppina; Porzia, Alessandra; Esposito, Vincenzo; Santoro, Antonio; Salvati, Maurizio; Mainiero, Fabrizio; Ragozzino, Davide; Angelantonio, Silvia Di; Wulff, Heike; Catalano, Myriam; Limatola, Cristina

    2016-01-01

    Malignant gliomas are among the most frequent and aggressive cerebral tumors, characterized by high proliferative and invasive indexes. Standard therapy for patients, after surgery and radiotherapy, consists of temozolomide (TMZ), a methylating agent that blocks tumor cell proliferation. Currently, there are no therapies aimed at reducing tumor cell invasion. Ion channels are candidate molecular targets involved in glioma cell migration and infiltration into the brain parenchyma. In this paper we demonstrate that: i) blockade of the calcium-activated potassium channel KCa3.1 with TRAM-34 has co-adjuvant effects with TMZ, reducing GL261 glioma cell migration, invasion and colony forming activity, increasing apoptosis, and forcing cells to pass the G2/M cell cycle phase, likely through cdc2 de-phosphorylation; ii) KCa3.1 silencing potentiates the inhibitory effect of TMZ on glioma cell viability; iii) the combination of TMZ/TRAM-34 attenuates the toxic effects of glioma conditioned medium on neuronal cultures, through a microglia dependent mechanism since the effect is abolished by clodronate-induced microglia killing; iv) TMZ/TRAM-34 co-treatment increases the number of apoptotic tumor cells, and the mean survival time in a syngeneic mouse glioma model (C57BL6 mice implanted with GL261 cells); v) TMZ/TRAM-34 co-treatment reduces cell viability of GBM cells and cancer stem cells (CSC) freshly isolated from patients. Taken together, these data suggest a new therapeutic approach for malignant glioma, targeting both glioma cell proliferating and migration, and demonstrate that TMZ/TRAM-34 co-treatment affects both glioma cells and infiltrating microglia, resulting in an overall reduction of tumor cell progression. PMID:27096953

  19. Mobilization of Chimeric oriT Plasmids by F and R100-1: Role of Relaxosome Formation in Defining Plasmid Specificity

    PubMed Central

    Fekete, Richard A.; Frost, Laura S.

    2000-01-01

    Cleavage at the F plasmid nic site within the origin of transfer (oriT) requires the F-encoded proteins TraY and TraI and the host-encoded protein integration host factor in vitro. We confirm that F TraY, but not F TraM, is required for cleavage at nic in vivo. Chimeric plasmids were constructed which contained either the entire F or R100-1 oriT regions or various combinations of nic, TraY, and TraM binding sites, in addition to the traM gene. The efficiency of cleavage at nic and the frequency of mobilization were assayed in the presence of F or R100-1 plasmids. The ability of these chimeric plasmids to complement an F traM mutant or affect F transfer via negative dominance was also measured using transfer efficiency assays. In cases where cleavage at nic was detected, R100-1 TraI was not sensitive to the two-base difference in sequence immediately downstream of nic, while F TraI was specific for the F sequence. Plasmid transfer was detected only when TraM was able to bind to its cognate sites within oriT. High-affinity binding of TraY in cis to oriT allowed detection of cleavage at nic but was not required for efficient mobilization. Taken together, our results suggest that stable relaxosomes, consisting of TraI, -M, and -Y bound to oriT are preferentially targeted to the transfer apparatus (transferosome). PMID:10869081

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

    PubMed Central

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

    2012-01-01

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

  1. Continuous bilateral TAP block in patient with prior abdominal surgery.

    PubMed

    Lima, Isabel Flor de; Linda, Filipe; dos Santos, Ângela; Lages, Neusa; Correia, Carlos

    2013-01-01

    We present as an option for epidural analgesia and intravenous opioid infusion a clinical case of transversus abdominis plane (TAP) block, with bilateral placement of catheter for postoperative analgesia after exploratory laparotomy performed in a patient with previous abdominal surgery and heart, kidney and liver failure.

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

    PubMed Central

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

    2016-01-01

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

  3. The effects of aquatic trunk exercise on gait and muscle activity in stroke patients: a randomized controlled pilot study.

    PubMed

    Park, Byoung-Sun; Noh, Ji-Woong; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Park, Jaehong; Kim, Junghwan

    2015-11-01

    [Purpose] The purpose of this study was to investigate the relationship between muscle activity and gait function following aquatic trunk exercise in hemiplegic stroke patients. [Subjects and Methods] This study's participants included thirteen hemiplegic patients (ten males and three females). The aquatic therapy consisted of administering concentrative aquatic therapy for four weeks in a therapeutic pool. Gait parameters were measured using a gait analysis system adjusted to each subject's comfortable walking speed. Electromyographic signals were measured for the rectus abdominis, external abdominal oblique, transversus abdominis/internal-abdominal oblique, and erector spine of each patients. [Results] The pre- and post-training performances of the transversus abdominis/internal-abdominal oblique were compared statistically. There was no statistical difference between the patients' pre- and post-training values of maximal voluntary isometric contraction of the rectus abdominis, but the external abdominal oblique values tended to improve. Furthermore, gait factors improved significantly in terms of walking speeds, walking cycles, affected-side stance phases, affected-stride lengths, and stance-phase symmetry indices, respectively. [Conclusion] These results suggest that the trunk exercise during aquatic therapy may in part contribute to clinically relevant improvements in muscle activities and gait parameters.

  4. [Imaging features of pubalgia].

    PubMed

    Sans, N; Lhoste-Trouilloud, A; Sethom, S; Camara, P-Y; Jirari, M; Ponsot, A; Railhac, J-J

    2011-06-01

    Pubalgia is a generic term used to describe groin pain due to a multitude of different etiologies such as skeletal (microtraumatic pubic symphysis arthropathy), muscular (adductor or rectus abdominis disorders), or abdominal wall (inguinal hernia) disorders. Diagnosis relies mainly on MRI for musculoskeletal disorders and ultrasound for abdominal wall disorders.

  5. Intestinal obstruction following harvest of VRAM-flap for reconstruction of a large perineal defect

    PubMed Central

    Elawa, Sherif; Hallböök, Olof; Myrelid, Pär; Zdolsek, Johann

    2015-01-01

    A patient with locally advanced adenocarcinoma of the rectum was operated with abdominoperineal resection and perineal reconstruction with a vertical rectus abdominis musculocutaneous flap. Six days postoperatively, there was herniation of the small bowel, between the anterior and posterior rectus sheaths, to a subcutaneous location. PMID:27252980

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

    ERIC Educational Resources Information Center

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

    2001-01-01

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

  7. In vivo ultrasound assessment of respiratory function of abdominal muscles in normal subjects.

    PubMed

    Misuri, G; Colagrande, S; Gorini, M; Iandelli, I; Mancini, M; Duranti, R; Scano, G

    1997-12-01

    Ultrasonography has recently been proposed for assessing changes in thickness and motion of the diaphragm during contraction in humans. Data on ultrasound assessment of abdominal muscles in humans are scarce. We therefore investigated the changes in thickness and the relevant mechanical effects of abdominal muscles using this technique during respiratory manoeuvres in normal subjects. We evaluated the thickness of the abdominal muscle layers in six normal male subjects (aged 26-36 yrs) using a 7.5 MHz B-mode ultrasound transducer. Gastric (Pg) and mouth pressures, muscle thickness of external oblique (EO), internal oblique (IO), transversus abdominis (TA) and rectus abdominis (RA) were assessed at functional residual capacity (FRC), residual volume (RV), total lung capacity (TLC), during progressive (PEEs) and maximal expiratory efforts (MEEs) against a closed airway and during homolateral (HTR) and contralateral (CTR) trunk rotation. Abdominal muscle thickness was found to be reproducible (coefficient of variation and two-way analysis of variance). Compared to FRC, the thickness of IO, TA and RA significantly increased at RV and during MEEs, whereas EO remained unchanged; at TLC, the thickness of IO and TA significantly decreased. During PEEs, a significant relationship between increase in Pg and TA thickness was observed in all subjects, the thickness of the other abdominal muscles being inconsistently related to Pg. Finally, a significant increase in the thickness of IO and EO was found during HTR and CTR, respectively. We conclude that during maximal expiratory manoeuvres, transversus abdominis, internal oblique and rectus abdominis thickened similarly. Transversus abdominis seems to be the major contributor in generating abdominal expiratory pressure during progressive expiratory efforts. External oblique seems to be preferentially involved during trunk rotation. These results suggest the possible value of studying the abdominal muscles by ultrasonography in

  8. Exposure to volatile organic compounds: Comparison among different transportation modes

    NASA Astrophysics Data System (ADS)

    Do, Duc Hoai; Van Langenhove, Herman; Chigbo, Stephen Izuchukwu; Amare, Abebech Nuguse; Demeestere, Kristof; Walgraeve, Christophe

    2014-09-01

    The increasing trend of promoting public transportation (bus tram, metro, train) and more environmental friendly and sustainable non fossil-fuel alternatives (walking, cycling etc) as substitutes for auto vehicles brings forward new questions with regard to pollutant levels to which commuters are exposed. In this study, three transportation modes (tram, auto vehicle and bicycle) are studied and concentration levels of 84 volatile organic compounds (VOCs) (hydrocarbons, aromatic hydrocarbons, oxygen containing hydrocarbons, terpenes and halogenated compounds) are measured along a route in the city of Ghent, Belgium. The concentration levels are obtained by active sampling on Tenax TA sorbent tubes followed by thermal desorption gas chromatography mass spectrometry (TD-GC-MS) using deuterated toluene as an internal standard. The median total VOC concentrations for the tram mode (33 μg/m³) is 1.7 times higher than that of the bicycle mode (20 μg/m³) and 1.5 times higher than for the car mode (22 μg/m³). It is found that aromatic hydrocarbons account for a significant proportion in the total VOCs concentration (TVOCs) being as high as 41-57%, 59-72% and 58-72% for the tram, car and bicycle respectively. In all transportation modes, there was a high (r > 0.6) degree of correlation between BTEX compounds, isopropylbenzene, n-propylbenzene, 1,3,5-trimethylbenzene and 1,2,4-trimethylbenzene. When comparing time weighed average concentrations along a fixed route in Ghent, it is found that commuters using the tram mode experience the highest TVOCs concentration levels. However, next to the concentration level to which commuters are exposed, the physical activity level involving the mode of transportation is important to assess the exposure to toxic VOCs. It is proven that the commuter using a bicycle (4.3 ± 1.5 μg) inhales seven and nine times more benzene compared to the commuter using the car and tram respectively, when the same route is followed.

  9. Effects of Intermediate-Conductance Ca(2+)-Activated K(+) Channels on Human Endometrial Carcinoma Cells.

    PubMed

    Zhang, Yingli; Feng, Youji; Chen, Lu; Zhu, Jianqing

    2015-06-01

    The objective of this study was to investigate the effect of intermediate-conductance Ca(2+)-activated K(+) (KCa3.1) channels on the cell proliferation, cell cycle, apoptosis, migration, and invasion in endometrial cancer (EC) cells. Human EC cell lines HEC-1-A and Ishikawa were cultured in vitro and transfected with recombinant plasmid containing KCa3.1-targeting shRNA. RT-qPCR and Western blot were used to examine the mRNA and protein expression levels of KCa3.1 channels in transfected cells. In addition, the specific inhibitor of KCa3.1, TRAM-34, was used to examine the effect of KCa3.1 blockage on migration capacity and invasiveness of EC cells using transwell assay. Proliferation and apoptotic rates of EC cells transfected with KCa3.1 shRNA or treated with TRAM-34 were analyzed using MTT, BrdU incorporation assay, and flow cytometry. Expression of cell cycle proteins and metalloproteinase-2 (MMP-2) was evaluated by RT-qPCR and Western blotting. TRAM-34 treatment and KCa3.1 silencing using shRNA dramatically suppressed both the mRNA and protein expression of KCa3.1 channels (P < 0.01) compared with control groups. Blockage of KCa3.1 by TRAM-34 treatment and KCa3.1 shRNA transfection exerted inhibitory effect on cell growth of both EC cell lines, as demonstrated by increased cell population at G0-G1 phase and decreased cell population at S phase. However, both the treatments did not result in significant changes in the apoptotic rate (P > 0.05) compared to controls. Protein expressions of cyclin D1, cyclin E, and survivin were significantly decreased in the experimental groups comparing to control. We showed that TRAM-34 treatment led to significantly inhibited migration, invasion, and MMP-2 expression in HEC-1-A and Ishikawa cells, compared with the control group (P < 0.01). Blockage of KCa3.1 channel activity or expression inhibits cell proliferation and cell cycle progression without inducing apoptosis in EC cells. Moreover, TRAM-34 could reduce the

  10. Comparison of aesthetic breast reconstruction after skin-sparing or conventional mastectomy in patients receiving preoperative radiation therapy.

    PubMed

    Chang, Eric I; Ly, Daphne P; Wey, Philip D

    2007-07-01

    Many options exist for the surgical treatment of breast cancer in terms of tumor extirpation and reconstruction. Skin-sparing mastectomy (SSM) with immediate reconstruction offers patients a superior result, but this can be jeopardized by preoperative radiotherapy. We compared the outcomes of reconstruction after SSM or conventional mastectomy (CM) in the previously irradiated breast. We evaluated 41 patients over an 8-year period, who were divided into 3 categories: preoperative radiotherapy prior to SSM (n = 8), CM after preoperative radiation therapy (n = 9), and no chest wall irradiation prior to SSM (n = 20). The first group demonstrated significantly higher frequency of native flap compromise and capsular contracture formation than the other 2 groups.SSM with TRAM or latissimus with implant reconstruction is an esthetically optimal option for the treatment of patients without previous radiotherapy. However, for patients with preoperative chest wall radiation, TRAM flap reconstruction was superior to latissimus flap with implant after SSM.

  11. Control techniques for an automated mixed traffic vehicle

    NASA Technical Reports Server (NTRS)

    Meisenholder, G. W.; Johnston, A. R.

    1977-01-01

    The paper describes an automated mixed traffic vehicle (AMTV), a driverless low-speed tram designed to operate in mixed pedestrian and vehicular traffic. The vehicle is a six-passenger electric tram equipped with sensing and control which permit it to function on existing streets in an automatic mode. The design includes established wire-following techniques for steering and near-IR headway sensors. A 7-mph cruise speed is reduced to 2 mph or a complete stop in response to sensor (or passenger) inputs. The AMTV performance is evaluated by operation on a loop route and by simulation. Some necessary improvements involving sensors, sensor pattern, use of an audible signal, and control lag are discussed. It is suggested that appropriate modifications will eliminate collision incidents.

  12. Influence of Wake Models on Calculated Tiltrotor Aerodynamics

    NASA Technical Reports Server (NTRS)

    Johnson, Wayne

    2001-01-01

    The tiltrotor aircraft configuration has the potential to revolutionize air transportation by providing an economical combination of vertical take-off and landing capability with efficient, high-speed cruise flight. To achieve this potential it is necessary to have validated analytical tools that will support future tiltrotor aircraft development. These analytical tools must calculate tiltrotor aeromechanical behavior, including performance, structural loads, vibration, and aeroelastic stability, with an accuracy established by correlation with measured tiltrotor data. The recent test of the Tilt Rotor Aeroacoustic Model (TRAM) with a single,l/4-scale V-22 rotor in the German-Dutch Wind Tunnel (DNW) provides an extensive set of aeroacoustic, performance, and structural loads data. This paper will examine the influence of wake models on calculated tiltrotor aerodynamics, comparing calculations of performance and airloads with TRAM DNW measurements. The calculations will be performed using the comprehensive analysis CAMRAD II.

  13. Tool for Rapid Analysis of Monte Carlo Simulations

    NASA Technical Reports Server (NTRS)

    Restrepo, Carolina; McCall, Kurt E.; Hurtado, John E.

    2011-01-01

    Designing a spacecraft, or any other complex engineering system, requires extensive simulation and analysis work. Oftentimes, the large amounts of simulation data generated are very di cult and time consuming to analyze, with the added risk of overlooking potentially critical problems in the design. The authors have developed a generic data analysis tool that can quickly sort through large data sets and point an analyst to the areas in the data set that cause specific types of failures. The Tool for Rapid Analysis of Monte Carlo simulations (TRAM) has been used in recent design and analysis work for the Orion vehicle, greatly decreasing the time it takes to evaluate performance requirements. A previous version of this tool was developed to automatically identify driving design variables in Monte Carlo data sets. This paper describes a new, parallel version, of TRAM implemented on a graphical processing unit, and presents analysis results for NASA's Orion Monte Carlo data to demonstrate its capabilities.

  14. OVERVIEW OF CYANIDE PLANT FOUNDATIONS, ZINC BOXES, TANKS, AND TAILINGS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    OVERVIEW OF CYANIDE PLANT FOUNDATIONS, ZINC BOXES, TANKS, AND TAILINGS PILES, LOOKING NORTHEAST. THE LOWER TRAM TERMINAL AND MILL SITE IS AT TOP CENTER IN THE DISTANCE. THE DARK SPOT JUST BELOW THE TRAM TERMINAL ARE REMAINS OF THE DEWATERING BUILDING. THE MAIN ACCESS ROAD IS AT UPPER LEFT. THE FOUNDATIONS AT CENTER SUPPORTED SIX 25 FT. OR GREATER DIAMETER SETTLING TANKS WHERE TAILINGS FROM THE MILL SETTLED IN A CYANIDE SOLUTION IN ORDER TO RECLAIM ANY GOLD CONTENT. THE PREGNANT SOLUTION WAS THEN RUN THROUGH THE ZINC BOXES ON THE GROUND AT CENTER RIGHT, WHERE ZINC SHAVINGS WERE INTRODUCED, CAUSING THE GOLD TO PRECIPITATE OUT OF THE CYANIDE SOLUTION, WHICH COULD BE USED AGAIN. THE FLAT AREA IN THE FOREGROUND WITH THE TANK AND TANK HOOPS IS THE FOOTPRINT OF A LARGE BUILDING WHERE THE PRECIPITATION AND FURTHER FILTERING AND FINAL CASTING TOOK PLACE. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  15. Assessing the role of IKCa channels in generating the sAHP of CA1 hippocampal pyramidal cells

    PubMed Central

    Turner, Ray W.; Asmara, Hadhimulya; Engbers, Jordan D. T.; Miclat, Jason; Rizwan, Arsalan P.; Sahu, Giriraj; Zamponi, Gerald W.

    2016-01-01

    ABSTRACT Our previous work reported that KCa3.1 (IKCa) channels are expressed in CA1 hippocampal pyramidal cells and contribute to the slow afterhyperpolarization that regulates spike accommodation in these cells. The current report presents data from single cell RT-PCR that further reveals mRNA in CA1 cells that corresponds to the sequence of an IKCa channel from transmembrane segments 5 through 6 including the pore region, revealing the established binding sites for 4 different IKCa channel blockers. A comparison of methods to internally apply the IKCa channel blocker TRAM-34 shows that including the drug in an electrode from the onset of an experiment is unviable given the speed of drug action upon gaining access for whole-cell recordings. Together the data firmly establish IKCa channel expression in CA1 neurons and clarify methodological requirements to obtain a block of IKCa channel activity through internal application of TRAM-34. PMID:26950800

  16. [Anatomic changes after radical surgery and reconstruction with pedunculated or revascularized flaps in advanced head and neck tumors: computerized tomography and magnetic resonance findings].

    PubMed

    Osti, M F; Scattoni Padovan, F; Ricciardi, D; De Angelis D'Ossat, M; Sbarbati, S; Pirolli, C; Maurizi Enrici, R; Anaveri, G

    1997-04-01

    January, 1992, to October, 1995, sixty-four patients with advanced head and neck cancer underwent head and neck reconstructive surgery using myocutaneous or revascularized flaps; in the same period, all patients were consecutively examined with CT and MRI. Myocutaneous flaps wer used in 26 patients: 12 flaps were tubular and 14 linear. Revascularized flaps were used in 38 patients: to repair a large defect in 26 patients (14 latissimus dorsi flaps and 12 temporal muscle flaps) and to repair an oral damage in 12 patients (5 revascularized radial and 7 jejunal flaps). CT and MR images of myocutaneous flaps showed the flaps as fatty areas, repairing large surgical defects, hypodense at CT and hyperintense at MRI, with no post-contrast enhancement. The postoperative scar around the flap exhibited soft-tissue density with slight post-contrast enhancement at CT and slightly hypodense on T2-weighted MR images. Post-contrast CT and MRI showed slight scar enhancement with no signal changes in the fatty component. The appearance of revascularized flaps at CT and MRI depends on the characteristics of the structure used to repair the surgical defect: jejunal and radial flaps appeared as mostly fatty thickened layers with both imaging methods. Temporal and latissimus dorsi flaps are made basically of muscular tissue, fatty tissue and occasionally skin (used to repair a mucosal defect): consequently, CT showed a structure with mostly parenchymal density in all cases and MRI depicted intermediate signal intensity. MRI was useful to detect 12 revascularized jejunal or radial flaps thanks to its higher contrast resolution and multiplanar capabilities showing even such thin structures as these flaps. Moreover, MRI permitted to study skull base reconstruction with revascularized (latissimus dorsi) flaps in 5 of our patients.

  17. Lovell, Alfred Charles Bernard [Sir Bernard] (1913-)

    NASA Astrophysics Data System (ADS)

    Murdin, P.

    2000-11-01

    Physicist and astronomer, born in Oldland Common, Gloucestershire, England. Worked on cosmic rays at Manchester, researched radar in the Second World War, and afterwards with J S HEY procured an ex-army mobile radar unit used to detect V-2 rockets and attempted to detect cosmic ray showers with it. Interference from the electric trams at Manchester displaced the work to the university's botanical...

  18. New York City Fire Department Chief Officer’s Evaluation of the Citywide Incident Management System as It Pertains to Interagency Emergency Response

    DTIC Science & Technology

    2011-09-01

    Bronx Zoo tram incident 9. African drummer/dancer who returned from Africa with Anthrax contaminated animal skins. Said person was hospitalized with...command, it kept the FDNY “back and out of their perimeter,” thus, ensuring that “FD resources are excluded from the scene” (survey response #52, 1...approximately 30 minutes. Your responses will be kept confidential. Your name and unit will not be mentioned or associated with the findings. This project

  19. Soviet Material on Internal Wave Effects, Number 6, November 1975 - April 1976

    DTIC Science & Technology

    1976-08-06

    any scalar characteristic at three points lying in a given horizontal plane. Dotsenko , S. V. , M. G. Poplavskaya, and G. A ...16, 1976 Contract Expiration Date: September 17, 1976 Amount of Contract: $109, 724 Contract NOIMD/Q03- 76C-02S4 I) A ^ PA C Principal...Boulevard Arlington, VA 22209 14 MONITORING AGENCY NAME ft A DDR ESSfi/d///creri( tram Controlling Otlic ) Defense Supply Service - Washington

  20. Pregnancy in the early stages following DIEP flap breast reconstruction--a review and case report.

    PubMed

    Bhat, W; Akhtar, S; Akali, A

    2010-11-01

    We report a case of a 30-year-old lady who became pregnant 3 months after undergoing a DIEP breast reconstruction. There are reports of pregnancy following TRAM, DIEP flap breast reconstruction and abdominoplasty performed after breast reconstruction, however this is the only case in the literature of a pregnancy within 3 months of DIEP breast reconstruction. The literature on breast reconstruction and pregnancy is reviewed.

  1. Railway track component condition monitoring using optical fibre Bragg grating sensors

    NASA Astrophysics Data System (ADS)

    Buggy, S. J.; James, S. W.; Staines, S.; Carroll, R.; Kitson, P.; Farrington, D.; Drewett, L.; Jaiswal, J.; Tatam, R. P.

    2016-05-01

    The use of optical fibre Bragg grating (FBG) strain sensors to monitor the condition of safety critical rail components is investigated. Fishplates, switchblades and stretcher bars on the Stagecoach Supertram tramway in Sheffield in the UK have been instrumented with arrays of FBG sensors. The dynamic strain signatures induced by the passage of a tram over the instrumented components have been analysed to identify features indicative of changes in the condition of the components.

  2. Overview of the Helios Version 2.0 Computational Platform for Rotorcraft Simulations

    DTIC Science & Technology

    2011-01-01

    Field, CA This article summarizes the capabilities and development of the Helios version 2.0, or Shasta, software for rotary wing simulations. Specific...the fuselage, rotors, flaps and stores. In addition, a new run-mode to handle maneuvering flight has been added. Fundamental changes of the Helios...for the NACA0015 wing , TRAM rotor in hover and the UH-60A in forward flight. I. Introduction Rotorcraft computations are challenging because they are

  3. Movement of Satellite-Tracked Buoys in the Beaufort Sea (1979-1981).

    DTIC Science & Technology

    1983-06-01

    34Of 4,mtMO- D.L. Murphy, I.M. Lissauer , and J.C. Myers CGR&DC 4/83 9. a’im 0 N w.. Wi..ss |. fie 14. (TRAM United States Coast Guard Research and...Eastern Mid-Latitude North Pacific. Journal of Geophysical Research, Vol. 86(C9): 8022-8030. Murphy, D.L., P.A. Tebeau, and I.M. Lissauer , 1981. Long

  4. Science, Technology, and Warfare. Proceedings of the Military History Symposium (3rd) Held at the United States Air Force Academy (Colorado Springs, Colorado) on 8-9 May 1969

    DTIC Science & Technology

    1970-09-01

    practice (unless we call the tram-road and truck, as in Agricola , a conveyor) . I believe we will not go far wrong in supposing that pick, shovel, and...it up-+not of course the really dangerous and dirty business but the definable and fascinating problem of the flight of bodies through the air. It...civilians that the military had no business to be dabbling with technological experiments. Writing for the theatergoers of Puritan London, Ben Jonson

  5. Jack Human Modelling Tool: A Review

    DTIC Science & Technology

    2010-01-01

    particular, entry into the driver workstation and the design of the workstation itself were identified as potential ergonomic issues. Initially, a...driver to rotate their seat (so they faced the rear of the tram) and sell tickets to the boarding passengers . Using a range of mannequin sizes (from...changing the seat design to allow fore/aft adjustment of the seat as well as vertical adjustment. 7 DSTO-TR-2364 Figure 6 A clothed and

  6. Defense Small Business Innovation Research Program (SBIR). Volume 2. Navy Projects, Abstracts of Phase 1 Awards from FY 1989 SBIR Solicitation

    DTIC Science & Technology

    1990-04-01

    STUDY IS BASED ON A TWO-STAGE PROCESSOR: A " FRONT - END " PROCESSOR WHICH TRANSFORMS THE INCOMING STREAM OF ANGLE-ONLY MEASUREMENTS INTO AN EVOLVING TIME...SYSTEMS AND TRAIN ESM OPERATORS WOULD HAVE MANY ADVANTAGES. THE EQUIPMENT WOULD HAVE TO PRODUCE MULTIPE RF SIGNALS TO TEST RECEIVER FRONT ENDS AS WELL... FRONT ENDS . A TRANSPORTABLE RF SIMULATOR IS PROPOSED TO COMPLIMENT TRAMS AND RESULT IN A COMPLETE RF TEST/TRAINING SYSTEM. THIS TRANSLATABLE RF

  7. 14. VIEW LOOKING SOUTHWEST AT THE NORTHEAST CORNER OF THE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. VIEW LOOKING SOUTHWEST AT THE NORTHEAST CORNER OF THE MILL. THE INCLINED TRESTLE WHICH IS CONSIDERABLE DECAYED IN THIS PHOTOGRAPH, WAS PART OF A TRAMWAY THAT LEAD FROM A MINE ADIT LOCATED NEAR WHERE THE CYANIDE PLANT WAS LOCATED , UP INTO THE DELIVERY LEVEL OF THE MILL ORE WAS CONVEYED ALONG THIS TRAM IN 125 TON ORE CARS. - Standard Gold Mill, East of Bodie Creek, Northeast of Bodie, Bodie, Mono County, CA

  8. Ballistic Performance Testing of Aluminum Alloy 5059-H131 and 5059-H136 for Armor Applications

    DTIC Science & Technology

    2008-05-01

    CANADA 2 DEUTSCH FRANZOSISCHES FORSCHUNGSINSTITUT ST LOUIS H ERNST H LERR CEDEX 5 RUE DU GENERAL CASSAGNOU F 68301 SAINT LOUIS...DEFENCE DIR OF EQPT & TECH LAND RUV 2 D HAUG POSTFACH 1328 53003 BONN GERMANY 4 FRANHOFER INSTITUT FUR KURZZEITDYNAMIK ERNST ... MACH INSTITUT V HOHLER E STRASSBURGER R TRAM K THOMA ECKERSTRASSE4 D 79 104 FREIBURG GERMANY 1 MINISTRY OF DEFENCE DGA

  9. Optimization of Peripheral Vision.

    DTIC Science & Technology

    1986-11-01

    or corporation ; or as conveying any rights or permission to manufacture, use, or sell any patented invention that may in any way be related thereto...peripheral field than were nonathletes. Reardon of Trams~orld Airliaes (TWA) (personal commnication ) reports that senior pilots have siglificantly...the writer that he should reexamine the data that were available in the three reports by his and Crannelll. Briggs (personal commnication ) pointed out

  10. Complex posterior thoracic wall reconstruction using a crossover combined latissimus dorsi and serratus anterior free flap.

    PubMed

    Bodin, Frédéric; Dissaux, Caroline; Steib, Jean-Paul; Massard, Gilbert

    2016-03-01

    Radical resection of an extended malignant sarcoma of the chest wall requires full-thickness thoracic chest wall reconstruction. Reconstruction is tedious in the case of posteriorly located tumours, because the ipsilateral pedicled myocutaneous latissimus dorsi flap is involved and hence not usable for soft tissue coverage. We report an original case of a left giant dorsal chondrosarcoma originating from the 11th costovertebral joint. After extended resection and skeletal reconstruction, soft tissue coverage was achieved with an original contralateral free flap encompassing both latissimus dorsi and serratus anterior muscles. The flap pedicle was anastomosed to the ipsilateral thoracodorsal vessels.

  11. Reconstruction of the chin using an expanded deltopectoral flap following multiple recurrences of oral cancer

    PubMed Central

    Balakrishnan, Chenicheri; Hackenson, David; Balakrishnan, Anila; Elliott, David; Careaga, Daniel

    2012-01-01

    An important alternative to free tissue transfer in patients requiring correction of soft tissue chin defects are local and regional flaps, such as the pectoralis major myocutaneous flap and deltopectoral flap. With predictable vascular supply, potential for large size, and good aesthetic match for facial and cervical skin, the deltopectoral flap can offer the reconstructive surgeon additional options in patients who lack vessels suitable for free tissue transfer. The use of an expanded deltopectoral flap for a staged reconstruction of the chin in a patient with cancer recurrences, concomitant resections, radiation and multiple reconstructions is reported. PMID:23997595

  12. The perils of public transport.

    PubMed

    Atenstaedt, R L

    2007-01-01

    Section 33 of The Public Health (Control of Disease) Act 1984 makes it an offence for a person in England and Wales who is suffering from a notifiable disease, e.g. cholera, to use any bus, tram or train; or use a taxi without notifying the driver or owner of the vehicle, or their carer to allow them to do so. Section 34 of the same act prohibits the owner, driver or conductor of a bus, train or tram from carrying a person who he knows is suffering from one of these diseases However, a taxi can carry an affected person, provided this individual pays a sum in addition to the fare to cover the costs of disinfection. Assuming that the owner or driver did not know that a passenger was suffering from one of these diseases, he must inform the local authority, which is required to disinfect the taxi for free. A literature review using PubMed did not reveal any evidence that buses, trains, trams or taxis provide a significant vehicle for transmission of notifiable diseases. Is it therefore about time that a non-evidence-based and little-used law is removed from the British statute books?

  13. Transformational Technologies to Expedite Space Access and Development

    NASA Astrophysics Data System (ADS)

    Rather, John D. G.

    2010-01-01

    Throughout history the emergence of new technologies has enabled unforeseen breakthrough capabilities that rapidly transformed the world. Some global examples from the twentieth century include AC electric power, nuclear energy, and turbojet engines. At the systems level, success of both Apollo and the Space Shuttle programs depended upon taming hydrogen propulsion and developing high-temperature atmospheric reentry materials. Human space development now is stymied because of a great need for breakthrough technologies and strategies. It is believed that new capabilities exist within the present states-of-the-art of superconducting technology that can be implemented to transform the future of human space development. This paper is an overview of three other papers presented within this forum, which summarizes the principles and consequences of StarTram, showing how the resulting breakthrough advantages can lead directly to safe space tourism and massive development of the moon, Mars and the outer solar system. StarTram can implement cost-effective solar power from space, simple utilization of asteroid material to protect humans from ionizing radiation, and effective defense of the Earth from devastating cosmic impacts. Synergistically, StarTram technologies will revolutionize ground transportation on the Earth, leading to enormous reduction in energy consumption and creation of millions of jobs. High energy lasers will also be discussed because of their importance to power beaming applications.

  14. A triceps musculocutaneous flap for chest-wall defects

    SciTech Connect

    Hartrampf, C.R. Jr.; Elliott, L.F.; Feldman, S. )

    1990-09-01

    A posterior upper arm flap based on the profunda brachii vessels has been described to cover soft-tissue defects in the upper anterolateral chest. In our series, the posterior upper arm skin is elevated with the long head of the triceps muscle to cover seven chest-wall defects resulting from indolent postradiation open wounds following partial TRAM flap failure (n = 2), soft-tissue deficiencies following partial TRAM flap loss (n = 3), and primarily as an ancillary flap in TRAM flap breast reconstruction (n = 2). This flap also may be used to supply well-vascularized tissue in the regions of the shoulder, axilla, and posterolateral back. A prerequisite for this operation is redundant tissue of the upper arm often present in middle-aged women and in patients with lymphedema following mastectomy. In our series of seven patients, all donor sites were closed primarily, and there was no subjective functional deficit following transfer of the long head of the triceps muscle.

  15. Transformational Technologies to Expedite Space Access and Development

    SciTech Connect

    Rather, John D. G.

    2010-01-28

    Throughout history the emergence of new technologies has enabled unforeseen breakthrough capabilities that rapidly transformed the world. Some global examples from the twentieth century include AC electric power, nuclear energy, and turbojet engines. At the systems level, success of both Apollo and the Space Shuttle programs depended upon taming hydrogen propulsion and developing high-temperature atmospheric reentry materials. Human space development now is stymied because of a great need for breakthrough technologies and strategies. It is believed that new capabilities exist within the present states-of-the-art of superconducting technology that can be implemented to transform the future of human space development. This paper is an overview of three other papers presented within this forum, which summarizes the principles and consequences of StarTram, showing how the resulting breakthrough advantages can lead directly to safe space tourism and massive development of the moon, Mars and the outer solar system. StarTram can implement cost-effective solar power from space, simple utilization of asteroid material to protect humans from ionizing radiation, and effective defense of the Earth from devastating cosmic impacts. Synergistically, StarTram technologies will revolutionize ground transportation on the Earth, leading to enormous reduction in energy consumption and creation of millions of jobs. High energy lasers will also be discussed because of their importance to power beaming applications.

  16. Ontogenetic changes of trunk muscle structure in the Japanese black salamander (Hynobius nigrescens).

    PubMed

    Omura, Ayano; Anzai, Wataru; Koyabu, Daisuke; Endo, Hideki

    2015-08-01

    We investigated ontogenetic changes in the trunk muscles of the Japanese black salamander (Hynobius nigrescens) before, during and after metamorphosis. Given that amphibians change their locomotive patterns with metamorphosis, we hypothesized that they may also change the structure of their trunk muscles. The trunk muscles were macroscopically observed, and the weight ratios of each trunk muscle group were quantified at six different developmental stages. Immediately after hatching, we found that the lateral hypaxial muscle was composed of one thick M. ventralis, from ventral edge of which M. transversus abdominis arose later, followed by M. obliquus externus and M. rectus abdominis. The weight ratios of the dorsal and abdominal muscles to the trunk muscles increased with growth. We suggest that a single thick and large lateral hypaxial muscle facilitates swimming during early developmental stages. The increase in the weight ratios of the dorsal and abdominal muscles with growth possibly assists with gravity resistance necessary for terrestrial life.

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

    PubMed Central

    Park, Hankyu; Hwang, Byoungha; Kim, Yeoungsung

    2015-01-01

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

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

    PubMed

    Kang, Dong-Hyun; Jung, So-Young; Nam, Dong-Hun; Shin, Seung-Je; Yoo, Won-Gyu

    2014-06-01

    [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.

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

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

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

  20. Ultrasound-guided continuous quadratus lumborum block for postoperative analgesia in a pediatric patient.

    PubMed

    Chakraborty, Arunangshu; Goswami, Jyotsna; Patro, Viplab

    2015-02-01

    Quadratus lumborum block is a recently introduced variation of transversus abdominis plane block. In this report, we describe the use of ultrasound-guided continuous quadratus lumborum block for postoperative analgesia in a 7-year-old child scheduled to undergo radical nephrectomy (left-sided) for Wilms tumor. The result was excellent postoperative analgesia and minimal requirement for rescue analgesics. The modification described may allow easier placement of a catheter for continuous infusion of local anesthetic.

  1. Celiac axis compression syndrome: laparoscopic approach in a strange case of chronic abdominal pain in 71 years old man

    PubMed Central

    Eretta, Costantino; Olcese, Sonja; Imperatore, Mikaela; Francone, Elisa; Bianchi, Claudio; Bruno, Maria Santina; Sagnelli, Carlo; Di Martino, Maria; Ranghetti, Savina; Martino, Valter; Falco, Emilio; Berti, Stefano

    2016-01-01

    Abstract Celiac Axis Compression Syndrome by the Median Arcuate Ligament is a very rare condition characterized by chronic postprandial abdominal pain (angina abdominis), nausea, vomiting, which occurs mostly in young patients. The main treatment is a surgical procedure that consists of the division of the arcuate ligament combined with the section of the close diaphragmatic crus and the excision of the celiac plexus. Actually laparoscopic management is feasible and safe.

  2. Anesthetic management of a child with Apert syndrome

    PubMed Central

    Metodiev, Yavor; Gavrilova, Nadezhda; Katzarov, Atanas

    2011-01-01

    In this paper, the authors describe an anesthetic technique for a child with Apert syndrome, presenting to the operating room for a syndactyly separation. The anesthetic approach is innovative for the clinic and is a combination of intravenous anesthesia and two regional techniques (axillary block and transversus abdominis plane block, respectively). They were performed under ultrasound guidance and provided analgesia in the two body regions, which were to be operated. PMID:21655026

  3. Soft-tissue hemorrhage in hemophiliac patients

    SciTech Connect

    Shirkhoda, A; Mauro, M.A.; Staab, E.V.; Blatt, P.M.

    1983-06-01

    Fifty-four hemophiliac patients underwent a total of 94 studies using computed tomography (CT), ultrasound, or both. Not only common bleeding sites such as the iliopsoas muscles but also several unusual sites were encountered: these included th iliac bone, bowel wall, mesentery, rectus abdominis muscle, retroperitoneum, bladder wall, and scrotum. Both modalities gave comparable results, and each was helpful in (a) establishing the diagnosis, (b) evaluating the extent of bleeding and its effect on adjacent organs, and (c) demonstrating regression after treatment.

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

    PubMed

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

    2016-05-01

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

  5. Quorum Sensing in Rhizobium sp. Strain NGR234 Regulates Conjugal Transfer (tra) Gene Expression and Influences Growth Rate

    PubMed Central

    He, Xuesong; Chang, William; Pierce, Deanne L.; Seib, Laura Ort; Wagner, Jennifer; Fuqua, Clay

    2003-01-01

    Rhizobium sp. strain NGR234 forms symbiotic, nitrogen-fixing nodules on a wide range of legumes via functions largely encoded by the plasmid pNGR234a. The pNGR234a sequence revealed a region encoding plasmid replication (rep) and conjugal transfer (tra) functions similar to those encoded by the rep and tra genes from the tumor-inducing (Ti) plasmids of Agrobacterium tumefaciens, including homologues of the Ti plasmid quorum-sensing regulators TraI, TraR, and TraM. In A. tumefaciens, TraI, a LuxI-type protein, catalyzes synthesis of the acylated homoserine lactone (acyl-HSL) N-3-oxo-octanoyl-l-homoserine lactone (3-oxo-C8-HSL). TraR binds 3-oxo-C8-HSL and activates expression of Ti plasmid tra and rep genes, increasing conjugation and copy number at high population densities. TraM prevents this activation under noninducing conditions. Although the pNGR234a TraR, TraI, and TraM appear to function similarly to their A. tumefaciens counterparts, the TraR and TraM orthologues are not cross-functional, and the quorum-sensing systems have differences. NGR234 TraI synthesizes an acyl-HSL likely to be 3-oxo-C8-HSL, but traI mutants and a pNGR234a-cured derivative produce low levels of a similar acyl-HSL and another, more hydrophobic signal molecule. TraR activates expression of several pNGR234a tra operons in response to 3-oxo-C8-HSL and is inhibited by TraM. However, one of the pNGR234a tra operons is not activated by TraR, and conjugal efficiency is not affected by TraR and 3-oxo-C8-HSL. The growth rate of NGR234 is significantly decreased by TraR and 3-oxo-C8-HSL through functions encoded elsewhere in the NGR234 genome. PMID:12533456

  6. Blockade of the intermediate-conductance Ca(2+)-activated K+ channel inhibits the angiogenesis induced by epidermal growth factor in the treatment of corneal alkali burn.

    PubMed

    Yang, Huike; Li, Xiaodong; Ma, Jing; Lv, Xiaohong; Zhao, Shu; Lang, Wen; Zhang, Yafang

    2013-05-01

    Epidermal growth factor (EGF) is used to treat alkali-burned corneas. However, EGF-induced corneal angiogenesis, which is currently untreatable, is a side effect of this therapy. We therefore explored the role of the intermediate-conductance Ca(2+)-activated K(+) channel (KCa3.1) in EGF-induced angiogenesis and tested whether KCa3.1 blockade can suppress EGF-induced corneal angiogenesis. The proliferation, migration and tube formation of HUVECs (human umbilical vein endothelial cells) in response to EGF, the MEK inhibitor PD98059 and the KCa3.1 inhibitor TRAM-34 were analyzed in vitro via MTT, cell counting, scratch and tube formation assays. The protein and mRNA levels of KCa3.1, phosphorylated-ERK (P-ERK), total-ERK (T-ERK), cyclin-dependent kinase 4 (CDK4), vimentin and MMP-2 were assessed via western blotting and RT-PCR. KCa3.1 and vimentin expression were also detected through immunofluorescence staining. Flow cytometry was performed to examine the cell cycle. Further, an in vivo murine alkali-burned cornea model was developed and treated with EGF and TRAM-34 eye drops to analyze the effect of these treatments on corneal healing and angiogenesis. The corneas were also analyzed by histological staining. The in vitro results showed that EGF induces the upregulation of KCa3.1 and P-ERK in HUVECs and that this upregulation is suppressed by PD98059. EGF stimulates proliferation, migration and tube formation in HUVECs, and this effect can be suppressed by TRAM-34. TRAM-34 also arrests HUVECs in the G1 phase of the cell cycle and downregulates CDK4, vimentin and MMP-2 in these cells. The in vivo results indicated that TRAM-34 suppresses EGF-induced corneal angiogenesis without affecting EGF-induced corneal wound healing. In summary, the upregulation of KCa3.1 may be crucial for EGF-induced angiogenesis through the MAPK/ERK signaling pathway. Thus, KCa3.1 may be a potential target for the treatment of EGF-induced corneal angiogenesis.

  7. Change in trunk muscle activities with prone bridge exercise in patients with chronic low back pain

    PubMed Central

    Kong, Yong-soo; Park, Seol; Kweon, Mi-Gyong; Park, Ji-won

    2016-01-01

    [Purpose] The aim of this study was to determine the effect of three different bridge exercises on internal oblique, external oblique, transverse abdominis, and erector spinae activities. [Subjects and Methods] Forty-five subjects with chronic low back pain participated in this study. The training outcome was evaluated with three different testing methods: supine bridge exercise, supine bridge on Swiss ball exercise, and prone bridge exercise. The activities of the transverse abdominis, internal oblique, external oblique, and erector spinae were measured using surface electromyography. [Results] There were significant differences in the internal oblique, external oblique, and erector spinae according to the three kinds of bridging exercises. The internal oblique, external oblique and transverse abdominis activities were highest in the prone bridge exercise, followed by those in the supine bridge on Swiss ball exercise, and supine bridge exercises. The activity of erector spine was highest in the supine bridge on Swiss ball exercise followed by the supine bridge exercise and prone bridge exercise. [Conclusion] These results suggest that prone bridge exercise is more effective than conventional supine bridge exercise and supine bridge on Swiss ball in increasing trunk muscle activity of chronic low back pain patients. PMID:26957771

  8. The Influence of Dual Pressure Biofeedback Units on Pelvic Rotation and Abdominal Muscle Activity during the Active Straight Leg Raise in Women with Chronic Lower Back Pain.

    PubMed

    Noh, Kyung-Hee; Kim, Ji-Won; Kim, Gyoung-Mo; Ha, Sung-Min; Oh, Jae-Seop

    2014-05-01

    [Purpose] This study was performed to assess the influence of applying dual pressure biofeedback units (DPBUs) on the angle of pelvic rotation and abdominal muscle activity during the active straight leg raise (ASLR). [Subjects] Seventeen patients with low-back pain (LBP) participated in this study. [Methods] The subjects were asked to perform an active straight leg raise (ASLR) without a PBU, with a single PBU, and with DPBUs. The angles of pelvic rotation were measured using a three-dimensional motion-analysis system, and the muscle activity of the bilateral internal oblique abdominis (IO), external oblique abdominis (EO), and rectus abdominis (RA) was recorded using surface electromyography (EMG). One-way repeated-measures ANOVA was performed to determine the rotation angles and muscle activity under the three conditions. [Results] The EMG activity of the ipsilateral IO, contralateral EO, and bilateral RA was greater and pelvic rotation was lower with the DPBUs than with no PBU or a single PBU. [Conclusion] The results of this study suggest that applying DPBUs during ASLR is effective in decreasing unwanted pelvic rotation and increasing abdominal muscle activity in women with chronic low back pain.

  9. Myosin heavy chain expression in respiratory muscles of the rat.

    PubMed

    LaFramboise, W A; Watchko, J F; Brozanski, B S; Daood, M J; Guthrie, R D

    1992-03-01

    Myosin heavy chain (MHC) isoforms of hind limb adult rat muscles and muscles with a range of respiratory activities were analyzed by a sodium dodecyl sulfate polyacrylamide gel electrophoresis technique that allowed electrophoretic separation of the three fast and one slow MHC isoform found in typical rat muscle. Costal and crural diaphragm muscle samples expressed a mixture of MHC beta/slow, MHC2A, and MHC2X but little MHC2B. In contrast, MHC2B was the dominant MHC isoform in the genioglossus, intercostal, and three abdominal muscles, all of which exhibited minimal expression of MHC beta/slow. The amount of MHC2X (relative to total MHC composition) was similar in the diaphragm, genioglossus, and transversus abdominis muscles, while considerably less was detected in the rectus abdominis and external oblique muscles. These results indicate that MHC2X is broadly and variably distributed among respiratory muscles. Furthermore, these data suggest that a large portion of 2X fibers (containing MHC2X), which cannot be detected by standard histochemical analysis, may be present in the genioglossus and transversus abdominis muscles as has been demonstrated for the diaphragm muscle. We speculate that an association exists between the level of MHC2X expression and frequency of respiratory recruitment.

  10. Radial free forearm flap versus pectoralis major pedicled flap for reconstruction in patients with tongue cancer: Assessment of quality of life

    PubMed Central

    Zhang, Peipei; Li, Rui; Liu, Yiming; Kan, Quancheng

    2016-01-01

    Background This study investigated the quality of life of Chinese patients with tongue cancer who had undergone immediate flap reconstruction surgery. In addition, we compared 2 groups of patients: those who had received radial forearm free flap (RFFF) surgery and others who had received pectoralis major myocutaneous flap (PMMF) surgery. Material and Methods Patients who received RFFF or PMMF reconstruction after primary tongue cancer treated with total and subtotal tongue resection were eligible for the current study. The patients’ demographic data, medical history, and quality of life scores (14-item Oral Health Impact Profile (OHIP-14) and the University of Washington Quality of Life (UW-QOL) questionnaires) were collected. Results A total of 41 of 63 questionnaires were returned (65.08%). There were significant differences between the 2 groups in the gender (p< .05). Patients reconstructed with RFFF performed better in the shoulder domains, in addition to worse appearance domains. Conclusions Using either RFFF or PMMF for reconstruction of defects after tongue cancer resection significantly influences a patient’s quality of life. Data from this study provide useful information for physicians and patients during their discussion of reconstruction modalities for tongue cancers. Key words:Quality of life, radial forearm free flaps, pectoralis major myocutaneous flap, tongue cancer, oral function. PMID:27694786

  11. A Pre-Clinical Canine Model for Composite Tissue Transplantation

    PubMed Central

    Mathes, David W.; Noland, Marie; Graves, Scott; Schlenker, Robert; Miwongtum, Tiffany; Storb, Rainer

    2010-01-01

    The feasibility of composite tissue allografts (CTA) has been demonstrated by the successful transplantation of the hand, abdomen and face. However, the survival of these transplants is dependent on immunosupression. Our laboratory is interested in achieving tolerance in order to decrease the risks associated with the use of chronic immunosuppression. The purpose of this experiment was to develop a large animal model for CTA. Four canine flaps were auto-transplanted to examine the use of a myocutaneous rectus flap based on the deep inferior epigastric vessels. Five CTA transplants were performed between Dog Leukocyte Antigen (DLA) identical littermates without any therapy. The allografts were followed clinically and underwent routine biopsies. The anatomic dissections and auto-transplants were all successful and revealed that the flap could be divided into two separate components. Skin is routinely perfused by the superficial epigastric artery. Rectus muscle is perfused by the deep inferior epigastrc system. This allows the allografts to be transplanted as muscle, skin or with both components based on the external iliac artery and veins. The DLA-identical littermates rejected the allografts in 15 to 30 days. This study demonstrates the versatility of the myocutaneous rectus flap for use in canines as composite tissue allograft models. PMID:20108180

  12. Reconstruction of the form and function of lateral malleolus and ankle joint.

    PubMed

    Kiyokawa, Kensuke; Tanaka, Shinsuke; Kiduka, Yuichiro; Inoue, Yojiro; Yamauchi, Toshihiko; Tai, Yoshiaki

    2005-08-01

    Soft-tissue reconstruction alone cannot obtain normal ankle function in patients with large defects in the area of the lateral malleolus. The authors report a functional reconstructive method for the lateral malleolus, utilized in a male patient whose osteosarcoma in the fibula was resected with surrounding soft tissue. In order to reconstruct the lateral malleolus, the remaining half of the fibula at the knee was removed, and the fibular head was fixed with the tibia at the ankle joint. Ligaments were reconstructed with tendon grafts. Skin and soft-tissue defects were reconstructed with a combined composite flap comprised of a latissimus dorsi myocutaneous flap and a serratus anterior muscle flap. Dead space around the bone graft was filled with the serratus anterior muscle flap that was divided into two portions. The surface was covered with the latissimus dorsi myocutaneous flap. The patient regained almost normal function of the ankle joint. This technique would be a useful functional reconstructive method for patients with large defects in the area of the lateral malleolus.

  13. Reconstruction of through-and-through osteocutaneous defects of the mouth and face with subscapular system flaps.

    PubMed Central

    Kalavrezos, Nicholas; Hardee, Peter S. G. F.; Hutchison, Iain L.

    2005-01-01

    BACKGROUND: Major ablative surgery in the head and neck region may create composite defects involving the oral mucosa, bone and the overlying facial skin. The large surface area and the three-dimensional nature of these defects pose a difficult reconstructive challenge requiring adequate bone and large, positionally versatile skin flaps. PATIENTS AND METHODS: From September 1993 to May 2000, 19 patients with through-and-through osteocutaneous defects of the mouth and face were reconstructed with composite subscapular artery system flaps. The evaluated parameters included: (i) site and dimensions of the tissue defect; (ii) specific flap properties; and (iii) review of the recipient and donor site morbidity. RESULTS: 10 variants of scapular osteocutaneous flaps, eight latissimus dorsi with serratus anterior and rib osteo-myocutaneous flaps, and one combination of an osteocutaneous scapular and myocutaneous latissimus dorsi flap were used to reconstruct composite facial defects with mean dimensions of: skin 54.4 cm(2), mucosa 56.2 cm(2) and bone of 8.2 cm. Ischaemic complications occurred in three patients including one total flap failure and one failure of the bony component in previously irradiated patients. The third flap was successfully salvaged. No significant long-term donor site morbidity was noted. CONCLUSION: Composite flaps based on the subscapular artery system are a versatile reconstructive modality for large through-and-through defects of the mouth and face. PMID:15720908

  14. Refinement of Nasal Reconstruction with a V/Y-alar-perforator Flap

    PubMed Central

    Langer, Martin F.; Roldán, J. Camilo

    2017-01-01

    Background: The ala of the nose is vascularized by a dense net of perforators originating from the lateral nasal artery or the angular artery. These vessels reach the ala in a cascade fashion from the alar groove/lateral nasal wall. Based on these vessels, a V/Y flap can be dissected with a wide range of mobility. Materials and Methods: Nineteen patients underwent reconstruction of the nose by means of a V/Y-alar-perforator flap alone or in combination with a myocutaneous rotation flap from the lateral nasal wall and/or from the nasal dorsum for reconstruction of defects at the nasal tip, ala of the nose, and/or lateral nasal wall. All patients were followed up 8 months after surgery in average. Results: There was no prolonged congestion or any tissue loss. All patients presented postoperatively with excellent aesthetic results, and no nasal distortion was observed. Conclusion: The V/Y-alar-perforator flap alone or in combination with a myocutaneous rotation flap proved to be a reliable tool in the armamentarium for reconstruction of nasal tip and alar defects providing good aesthetic results. PMID:28203497

  15. [Arterial vascularization of the triceps sural muscle].

    PubMed

    Mairesse, J L; Mestdagh, H; Procyk, S; Depreux, R

    1984-01-01

    The triceps surae muscle, the dorsal and medial leg skin constitute a very important reserve of muscular and myocutaneous flaps. The material on which the study was carried out consisted of 20 legs from standard cadavers. The superficialis femoral artery was injected with terebenthene and minimum mixture. The medial head of gastrocnemius is 23.3 em long, 6.9 cm wide, 1.25 mm thick at distal third. Its dominant blood supply is carried by the medialis gastrocnemius artery. It rises from popliteal artery 1.2 cm above the femoral tibial articulation with 1.9 mm diameter. It runs 3 cm down before entering muscle where it provides 2 or 3 mean branches. These branches give musculocutaneous arteries to the skin of the dorsal leg. The same study was performed for the lateral head of gastrocnemius and soleus. We studied also arteries of dorsomedial leg skin. The characteristics of long saphenous and short saphenous arteries were described. These muscles and dorsomedial leg skin can be used as muscular or myocutaneous flap for covering defects between the lower leg and the lower thigh.

  16. Functional restoration after subtotal glossectomy and laryngectomy.

    PubMed

    Mitrani, M; Krespi, Y P

    1988-01-01

    Extensive resection of carcinoma that involves the tongue base and supraglottic larynx is accompanied by significant potential morbidity and mortality. This is often indicated by poor rates of cure and the limited palliation afforded by radiotherapy alone. Removal of a significant portion of the posterior tongue frequently results in intractable aspiration. Techniques in reconstruction of the oropharyngeal defect and tongue base have included primary closure, random flaps, and myocutaneous flaps. Each of these techniques has been successful, to some degree, in resurfacing pharyngeal defects. However, the functional results in regard to deglutition are less than satisfactory as a result of aspiration. Frequently, simultaneous or delayed total laryngectomy is performed to deal with the pulmonary complications. Various types of laryngoplasty do not uniformly correct the problems of aspiration and deglutition associated with subtotal glossectomy. Our experience includes eight patients who had advanced squamous cell carcinoma of the tongue base, vallecula, and the supraglottic larynx. All patients underwent partial or subtotal glossectomy and laryngectomy. The mucosal defect was reconstructed with pectoralis myocutaneous flap. In order to reestablish voice, a primary tracheopharyngeal shunt was created with the use of a portion of cricoid and upper trachea. The majority of these patients have had successful rehabilitation of deglutition, mastication, and speech.

  17. [The lower trapezius muscle island flap. Anatomic principles and clinical relevance].

    PubMed

    Haas, F; Pierer, G; Weiglein, A; Moshammer, H; Schwarzl, F; Scharnagl, E

    1999-01-01

    Up to now, there is no uniform anatomic description neither of the branches of the subclavian artery nor of the pedicle of the lower myocutaneous trapezius flap. A dissection study was carried out on 140 necks in 70 cadavers. Variations of the subclavian artery and its branches, vessel diameter at different levels, the course of the pedicle under the levator scapulae muscle, the arc of rotation of the island flap, and the variations of the segmental intercostal branches to the lower part of the trapezius muscle were examined. Results of this study enable us to suggest a new nomenclature for the branches of the subclavian artery, a proper pedicle definition, and a technique for safe flap elevation. The lower trapezius island flap is a thin and pliable myocutaneous flap with a constant pedicle which ensures safe flap elevation. This flap has the potential for a wider acceptance due to minor donor site morbidity, large arc of rotation, and an ample range of clinical applications in the head and neck area as an island flap as well as a free flap.

  18. The Archveyor{trademark} mining system: Automated high wall mining, a precursor to improved safety, productivity, and cost underground

    SciTech Connect

    Sawarynski, T.J.

    1996-12-31

    Arch Mineral Corporation has an automated high wall miner called the Archveyor {trademark}. In production since 1992, it uses just two employees to operate the system. They consistently produce 91 metric tons per eight-hour employer-shift with peaks nearing 226 metric tons. The system uses a modified Joy 12CM miner cutting 3.7 meters. That loads into a 219 meter long continuous haulage Archveyor{trademark}. It discharges into a loadout vehicle that elevates the coal to load haul trucks. This technology can be adapted to mine over 305 meters into the high wall. Any continuous miner can be used to suit conditions. It is programmed to sump, shear down, sump, and shear up in a continuous cycle. It advances a set distance before the Archveyor{trademark} moves up behind it. The Archveyor{trademark} has a flight conveyor 838 mm wide used to tram and convey. Lift cylinders raise it off the ground to convey. To tram, the cylinders retract, dropping the Archveyor{trademark} to the ground. That places the full length of the return side or bottom of the flight conveyor in contract with the floor to tram in either direction. Programmable logic controllers are used with a gyroscope, gamma detectors, and inclinometers to keep on-heading and in-seam. Critical system functions are monitored and displayed for the operator. Safety, lower costs, and higher productivity drive the effort to use the Archveyor{trademark} technology underground. Arch Technology is assembling and preparing to install an underground system in the third quarter of 1996.

  19. Triarylmethanes, a New Class of Cx50 Inhibitors

    PubMed Central

    Bodendiek, Silke B.; Rubinos, Clio; Trelles, Maria Pilar; Coleman, Nichole; Jenkins, David Paul; Wulff, Heike; Srinivas, Miduturu

    2012-01-01

    The paucity of specific pharmacological agents has been a major impediment for delineating the roles of gap junction (GJ) channels formed by connexin proteins in physiology and pathophysiology. Here, we used the selective optimization of side activities (SOSA) approach, which has led to the design of high affinity inhibitors of other ion channels, to identify a specific inhibitor for channels formed by Cx50, a connexin subtype that is primarily expressed in the lens. We initially screened a library of common ion channel modulating pharmacophores for their inhibitory effects on Cx50 GJ channels, and identified four new classes of compounds. The triarlymethane (TRAM) clotrimazole was the most potent Cx50 inhibitor and we therefore used it as a template to explore the structure activity relationship (SAR) of the TRAMs for Cx50 inhibition. We describe the design of T122 (N-[(2-methoxyphenyl)diphenylmethyl]-1,3-thiazol-2-amine) and T136 (N-[(2-iodophenyl)diphenylmethyl]-1,3-thiazol-2-amine), which inhibit Cx50 with IC50s of 1.2 and 2.4 μM. Both compounds exhibit at least 10-fold selectivity over other connexins as well as major neuronal and cardiac voltage-gated K+ and Na+ channels. The SAR studies also indicated that the TRAM pharmacophore required for connexin inhibition is significantly different from the pharmacophore required for blocking the calcium-activated KCa3.1 channel. Both T122 and T136 selectively inhibited Cx50 GJ channels in lens epithelial cells, suggesting that they could be used to further explore the role of Cx50 in the lens. In addition, our results indicate that a similar approach may be used to find specific inhibitors of other connexin subtypes. PMID:22685432

  20. Stratigraphic and volcano-tectonic relations of Crater Flat Tuff and some older volcanic units, Nye County, Nevada

    SciTech Connect

    Carr, W.J.; Byers, F.M. Jr.; Orkild, P.P.

    1986-12-31

    The Crater Flat Tuff is herein revised to include a newly recognized lowest unit, the Tram Member, exposed at scattered localities in the southwest Nevada Test Site region, and in several drill holes in the Yucca Mountain area. The overlying Bullfrog and Prow Pass Members are well exposed at the type locality of the formation near the southeast edge of Crater Flat, just north of US Highway 95. In previous work, the Tram Member was thought to be the Bullfrog Member, and therefore was shown as Bullfrog or as undifferentiated Crater Flat Tuff on published maps. The revised Crater Flat Tuff is statigraphically below the Topopah Spring Member of the Paintbrush Tuff and above the Grouse Canyon Member of the Belted Range Tuff and is approximately 13.6 m.y. old. Drill holes on Yucca Mountain and near Fortymile Wash penetrate all three members of the Crater Flat as well as an underlying quartz-poor unit. Although the rocks are poorly exposed, geophysical and geologic evidence to date suggests that (1) the source of the Crater Flat Tuff is a caldera complex in the Crater Flat area between Yucca Mountain and Bare Mountain, and (2) there are at least two cauldrons within this complex - one probably associated with eruption of the Tram, the other with the Bullfrog and Prow Pass Members. The complex is named the Crater Flat-Prospector Pass caldera complex. The northern part of the Yucca Mountain area is suggested as the general location of the source of pre-Crater Flat tuffs, but a caldera related to the Lithic Ridge Tuff has not been specifically identified. 23 refs., 18 figs., 1 tab.

  1. Stratigraphic and volcano-tectonic relations of Crater Flat Tuff and some older volcanic units, Nye County, Nevada

    SciTech Connect

    Carr, W.J.; Byers, F.M. Jr.; Orkild, P.P.

    1984-12-31

    The Crater Flat Tuff is herein revised to include a newly recognized lowest unit, the Tram Member, exposed at scattered localities in the southwest Nevada Test Site region, and in several drill holes in the Yucca Mountain area. In previous work, the Tram Member was thought to be the Bullfrog Member, and therefore was shown as Bullfrog or as undifferentiated Crater Flat Tuff on published maps. The revised Crater Flat Tuff is stratigraphically below the Topopah Spring Member of the Paintbrush Tuff and above the Grouse Canyon Member of the Belted Range Tuff, and is approximately 13.6 m.y. old. Drill holes on Yucca Mountain and near Fortymile Wash penetrate all three members of the Crater Flat as well as an underlying quartz-poor unit, which is herein defined as the Lithic Ridge Tuff from exposures on Lithic Ridge near the head of Topopah Wash. In outcrops between Calico Hills and Yucca Flat, the Lithic Ridge Tuff overlies a Bullfrog-like unit of reverse magnetic polarity that probably correlates with a widespread unit around and under Yucca Flat, referred to previously as Crater Flat Tuff. This unit is here informally designated as the tuff of Yucca Flat. Although older, it may be genetically related to the Crater Flat Tuff. Although the rocks are poorly exposed, geophysical and geologic evidence to date suggests that (1) the source of the Crater Flat Tuff is a caldera complex in the Crater Flat area between Yucca Mountain and Bare Mountain, and (2) there are at least two cauldrons within this complex - one probably associated with eruption of the Tram, the other with the Bullfrog and Prow Pass Members. The complex is named the Crater Flat-Prospector Pass caldera complex. 24 references, 18 figures, 1 table.

  2. Voltage dependence of the Ca(2+)-activated K(+) channel K(Ca)3.1 in human erythroleukemia cells.

    PubMed

    Stoneking, Colin J; Shivakumar, Oshini; Thomas, David Nicholson; Colledge, William H; Mason, Michael J

    2013-05-01

    We have isolated a K(+)-selective, Ca(2+)-dependent whole cell current and single-channel correlate in the human erythroleukemia (HEL) cell line. The whole cell current was inhibited by the intermediate-conductance KCa3.1 inhibitors clotrimazole, TRAM-34, and charybdotoxin, unaffected by the small-conductance KCa2 family inhibitor apamin and the large-conductance KCa1.1 inhibitors paxilline and iberiotoxin, and augmented by NS309. The single-channel correlate of the whole cell current was blocked by TRAM-34 and clotrimazole, insensitive to paxilline, and augmented by NS309 and had a single-channel conductance in physiological K(+) gradients of ~9 pS. RT-PCR revealed that the KCa3.1 gene, but not the KCa1.1 gene, was expressed in HEL cells. The KCa3.1 current, isolated in HEL cells under whole cell patch-clamp conditions, displayed an activated current component during depolarizing voltage steps from hyperpolarized holding potentials and tail currents upon repolarization, consistent with voltage-dependent modulation. This activated current increased with increasing voltage steps above -40 mV and was sensitive to inhibition by clotrimazole, TRAM-34, and charybdotoxin and insensitive to apamin, paxilline, and iberiotoxin. In single-channel experiments, depolarization resulted in an increase in open channel probability (Po) of KCa3.1, with no increase in channel number. The voltage modulation of Po was an increasing monotonic function of voltage. In the absence of elevated Ca(2+), voltage was ineffective at inducing channel activity in whole cell and single-channel experiments. These data indicate that KCa3.1 in HEL cells displays a unique form of voltage dependence modulating Po.

  3. Side mounted V-type 4-cycle engine

    SciTech Connect

    Asano, A.; Kato, K.

    1987-06-09

    This patent describes a V-type four-cycle engine having overhead camshafts and a crankshaft, comprising: idle gear trains, the idle gear tram extending between the crankshaft and a camshaft and including idle gears; a gear retainer having first and second axles for rotatably mounting the idle gears; the first axle including a journal portion having a cylindrical surface about a first axial centerline and mounting portions having a cylindrical surface about a second axial centerline displaced from the first axial centerline; the mounting portions being supported by the gear retainer; and means for retaining the journal portion in selectable angular orientation with respect to the gear retainer.

  4. Estimating Blade Section Airloads from Blade Leading-Edge Pressure Measurements

    NASA Technical Reports Server (NTRS)

    vanAken, Johannes M.

    2003-01-01

    The Tilt-Rotor Aeroacoustic Model (TRAM) test in the Duitse-Nederlandse Wind (DNW) Tunnel acquired blade pressure data for forward flight test conditions of a tiltrotor in helicopter mode. Chordwise pressure data at seven radial locations were integrated to obtain the blade section normal force. The present investigation evaluates the use of linear regression analysis and of neural networks in estimating the blade section normal force coefficient from a limited number of blade leading-edge pressure measurements and representative operating conditions. These network models are subsequently used to estimate the airloads at intermediate radial locations where only blade pressure measurements at the 3.5% chordwise stations are available.

  5. Coupled Directional Stability of Multiple Ship Formations

    DTIC Science & Technology

    2013-06-01

    Criteria tn Hull Design using Linear Theory, • Tram;. RINA, : 993 Lyster. C. • ana l0l.1ghts. ll. L. , "Preatction Bquat1ons tor Ships• TUrning...Manoeuvring Criteria tn Hull Design using LlJlear Theory, • Trana. RINA, : 993 Lyster. C. • ana l0l.1ghts. ll. L. , "Prealction Bquatlans tor Ships• TUrning...Ship maneuvering and seakeeping,” Lecture Notes, Shanghai Jiao Tong University, 2006. [8] C. Daskam, “ DDG -2025: Combating the FIAC threat,” Project

  6. Microgram-scale protein structure determination by NMR.

    PubMed

    Aramini, James M; Rossi, Paolo; Anklin, Clemens; Xiao, Rong; Montelione, Gaetano T

    2007-06-01

    Using conventional triple-resonance nuclear magnetic resonance (NMR) experiments with a 1 mm triple-resonance microcoil NMR probe, we determined near complete resonance assignments and three-dimensional (3D) structure of the 68-residue Methanosarcina mazei TRAM protein using only 72 mug (6 microl, 1.4 mM) of protein. This first example of a complete solution NMR structure determined using microgram quantities of protein demonstrates the utility of microcoil-probe NMR technologies for protein samples that can be produced in only limited quantities.

  7. Heuristic Optimization Approach to Selecting a Transport Connection in City Public Transport

    NASA Astrophysics Data System (ADS)

    Kul'ka, Jozef; Mantič, Martin; Kopas, Melichar; Faltinová, Eva; Kachman, Daniel

    2017-02-01

    The article presents a heuristic optimization approach to select a suitable transport connection in the framework of a city public transport. This methodology was applied on a part of the public transport in Košice, because it is the second largest city in the Slovak Republic and its network of the public transport creates a complex transport system, which consists of three different transport modes, namely from the bus transport, tram transport and trolley-bus transport. This solution focused on examining the individual transport services and their interconnection in relevant interchange points.

  8. Experimental and Numerical Assessment of Vibro-Acoustic Behavior of Rubber-Damped Railway Wheels

    NASA Astrophysics Data System (ADS)

    Pešek, Luděk; Půst, Ladislav

    The reduction of noise and vibrations is very important task in many industrial and transport applications. The sources of intensive noise and vibrations are also tram and railway wheels at high speeds. Therefore the modern types of steel railway wheels contain the visco-elastic paddings. The first problem treated in this contribution is concerned with the theoretical and experimental investigation of the thermo-mechanical properties of rubber-like damping elements loaded with prestress by harmonic force. The dynamic modal and spectral properties of the whole railway wheel with damping elements will be investigated by the 3-D FEM model as the second problem.

  9. The Development of a Hydroperm (Trademark) Microfiltration System for the Treatment of ’MUST’ Hospital Wastewater Effluents.

    DTIC Science & Technology

    1977-10-01

    AD-A055 855 HYDRONAUTICS INC LAUREL MO F/G 13/2 THE DEVELOPMENT OF A HYDROPERM (TRADEMARK) MICROFILTRATION SYST—ETC(U) OCT...i.i mm T»-—— .inwni ii.i •np^ii tu 00 f OR FURTHER TRAM 7M* THE DEVELOPMENT OF A HYDROPERM• MICROFILTRATION SYSTEM FOR THE TREATMENT OF...Development of a Hydroperm7\\ Microfiltration System for the Treatment of *M\\jST’Tiospital Wastewater Effluents, READ INSTRUCTIONS BEFORE COMPLETING FORM

  10. ABDOMINAL MUSCLE ACTIVATION INCREASES LUMBAR SPINAL STABILITY: ANALYSIS OF CONTRIBUTIONS OF DIFFERENT MUSCLE GROUPS

    PubMed Central

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

    2011-01-01

    Background Antagonistic activation of abdominal muscles and raised intra-abdominal pressure are associated with both spinal unloading and spinal stabilization. Rehabilitation regimens have been proposed to improve spinal stability via selective recruitment of certain trunk muscle groups. This biomechanical study used an analytical model to address whether lumbar spinal stability is increased by selective activation of abdominal muscles. Methods The biomechanical model included anatomically realistic three-layers of curved abdominal musculature connected by fascia, rectus abdominis and 77 symmetrical pairs of dorsal muscles. The muscle activations were calculated with the model loaded with either flexion, extension, lateral bending or axial rotation moments up to 60 Nm, along with intra-abdominal pressure up to 5 or 10 kPa (37.5 or 75 mm Hg) and partial bodyweight. After solving for muscle forces, a buckling analysis quantified spinal stability. Subsequently, different patterns of muscle activation were studied by forcing activation of selected abdominal muscles to at least 10% or 20% of maximum. Findings The spinal stability increased by an average factor of 1.8 with doubling of intra-abdominal pressure. Forced activation of obliques or transversus abdominis muscles to at least 10% of maximum increased stability slightly for efforts other than flexion, but forcing at least 20% activation generally did not produce further increase in stability. Forced activation of rectus abdominis did not increase stability. Interpretation Based on predictions from an analytical spinal buckling model, the degree of stability was not substantially influenced by selective forcing of muscle activation. This casts doubt on the supposed mechanism of action of specific abdominal muscle exercise regimens that have been proposed for low back pain rehabilitation. PMID:21571410

  11. Advanced Clinical and Radiological Features of Ankylosing Spondylitis: Relation to Gender, Onset of First Symptoms and Disease Duration.

    PubMed

    Grubisić, Frane; Jajić, Zrinka; Alegić-Karin, Anita; Borić, Igor; Jajić, Ivo

    2015-12-01

    To determine the frequency of advanced clinical and radiological features of AS with reference to gender, onset of symptoms and disease duration. Fifty-seven patients diagnosed with AS were included in this study. Functional evaluation of the musculoskeletal system detected advanced clinical features: rubber-ball phenomenon, flattening of the chest anterior wall, diastasis of rectus abdominis muscle, steel back phenomenon, umbilical extrusion, skiing posture. Conventional radiographs of sacroiliac joints, pelvis and axial skeleton were obtained in order to analyze signs of sacroiliitis, syndesmophytes, vertebral squaring and ligamentous ossification. Statistical significance is found in the distribution of particular advanced clinical and radiological features of AS between men and women: rubber-ball phenomenon (p = 0.002), flat chest (p = 0.002), diastasis of rectus abdominis muscle (p = 0.002), skiing position (p = 0.000), syndesmophytes (p = 0.009) and ligamentous ossification (p = 0.030) in thoracic and lumbar spine. Onset of first disease symptoms (> 20 years of age) is significantly associated with radiological changes in thoracic spine (ligamentous ossification, p = 0.015) and cervical spine (vertebral squaring, p = 0.032). Longer disease duration (> 10 years) is significantly associated with the appearance of particular clinical features: rubber-ball phenomenon, p < 0.01; rectus abdominis diastasis, p=0.042) and radiological changes of sacroiliac joints (grade IV sacroileitis, p = 0.012), thoracic and lumbar spine (syndesmophytes, p = 0.015; ligamentous ossification, p = 0.027). Our study shows that the occurrence of clinical and some radiological features of AS appears to be gender dependent. Furthermore, onset of first disease symptoms (> 20 years of age) and longer disease duration (> 10 years) are associated with the higher risk of developing particular clinical signs and radiological features in sacroiliac joints and axial skeleton.

  12. Specific neuromuscular responses of high skilled laser sailors during a multi-joint posture sustained until exhaustion.

    PubMed

    Maïsetti, O; Boyas, S; Guével, A

    2006-12-01

    The aim of this study was to examine the myoelectric manifestations of neuromuscular fatigue induced by a sustained bout of hiking with regard to training status, laterality and muscle. Nineteen subjects, separated into three different groups according to their training status in hiking, volunteered to take part in this study. Subjects performed a sustained hiking test until exhaustion at 50 % of the maximal hiking torque on a specially developed hiking ergometer. The electrical activity of two bilateral (left and right sides) muscular chains involved in hiking including the rectus abdominis (RA), rectus femoris (RF), vastus lateralis (VL), and tibialis anterior (TA) muscles was explored using surface electromyography. Results indicated a higher endurance time (Tlim) for the highly trained group in hiking (45 %, p < 0.05). The mean electrical activity of the muscles studied reached a medium level at the end of the sustained hiking period (51 % of maximal values, p < 0.001), regardless of the training status. However, the increase in activation level was delayed in hikers (50 % Tlim) compared to non-hikers (25 % Tlim), especially for rectus abdominis and rectus femoris muscles. Furthermore, activation patterns of synergistic muscles differed among the groups so that electrical activity of knee extensors was higher than that of trunk flexors of hikers at the end of hiking task (e.g., left RA: 32 % vs. left VL: 54 % of maximal values, p < 0.001). Shifts in mean power frequency were more pronounced in rectus abdominis muscles (- 24 %, p < 0.001) than in rectus femoris (- 7 %, p < 0.001) and vastus lateralis (unchanged), regardless of the group. Hikers exhibited a lower and more delayed spectral compression (left side: - 1.3 %, right side: - 9.8 %) compared to non-hikers (left and right sides: - 15.1 %). These findings suggest that hikers prolonged endurance time by adjusting neural distribution of activity among synergists, thereby minimizing the contribution of the

  13. Chest wall reconstruction after extended resection

    PubMed Central

    Seder, Christopher W.

    2016-01-01

    Extensive chest wall resection and reconstruction is a challenging procedure that requires a multidisciplinary approach, including input from thoracic surgeons, plastic surgeons, neurosurgeons, and radiation oncologists. The primary goals of any chest wall reconstruction is to obliterate dead space, restore chest wall rigidity, preserve pulmonary mechanics, protect intrathoracic organs, provide soft tissue coverage, minimize deformity, and allow patients to receive adjuvant radiotherapy. Successful chest wall reconstruction requires the re-establishment of skeletal stability to prevent chest wall hernias, avoids thoracoplasty-like contraction of the operated side, protects underlying viscera, and maintain a cosmetically-acceptable appearance. After skeletal stability is established, full tissue coverage can be achieved using direct closure, skin grafts, local advancement flaps, pedicled myocutaneous flaps, or free flaps. This review examines the indications for chest wall reconstruction and describes techniques for establishment of chest wall rigidity and soft tissue coverage. PMID:27942408

  14. [Interdiscplinarity in thorax operations-from the viewpoint of the surgeon].

    PubMed

    Sunder-Plassmann, L; Liewald, F; Orend, K H

    2004-04-01

    Occasionally, thoracic interventions may require interdisciplinary teamwork with plastic surgery, heart and vascular surgery, or neurosurgery. Thoracic wall defects following excision of primary wall tumors or recurrent, ulcerating tumors of the breast may require full-thickness myocutaneous flaps, which can best be done with the help of plastic surgeons. In case of infiltration of the heart or thoracic aorta, the en bloc principle of T4 lung tumors occasionally requires the help of heart surgeons, for open atrial resection using the heart-lung machine, or vascular surgeons for aortic graft interposition. Paravertebral dumbbell tumors occasionally may infiltrate to the intraspinal space and therefore need removal by neurosurgeons. When and why other specialists are required for an interdisciplinary approach to diseases of the chest has not been clearly defined. Therefore it is wise to gain informed consent from the patient about the roles of different specialists in interdisciplinary treatment for his disease.

  15. Video-atlas on minimally invasive mitral valve surgery-The David Adams technique.

    PubMed

    Castillo, Javier G; Milla, Federico; Anyanwu, Anelechi C; Adams, David H

    2013-11-01

    Median sternotomy has unquestionably evolved over recent decades. Modern sternotomy involves a 7-8 cm lower midline skin incision, tunneling of the subcutaneous tissues with subsequent creation of myocutaneous flaps, full sternotomy, and standard cardiopulmonary bypass techniques with central cannulation. In experienced centers, modern sternotomy may achieve all the goals of minimally invasive surgery, including excellent cosmesis, excellent postoperative pain control, low rates of bleeding and transfusion (our re-exploration rate for bleeding is <1%), and the ability to perform any reconstructive technique that would be used in a standard sternotomy, with very high repair rates (our most recent series documented a repair rate exceeding 99% in an all-comers population of degenerative disease regardless of complexity).

  16. Niche reconstructive techniques for complex abdominal wall reconstruction: a review.

    PubMed

    Sue, Gloria R; Narayan, Deepak

    2014-04-01

    Abdominal wall defects resulting from recurrent hernias, trauma, and radiation necrosis are difficult and challenging to repair given the high rates of recurrence and surgical morbidity. Complex abdominal wall defects often require the transposition of autologous material to bridge the fascial gap. We present a review of niche reconstructive techniques that have been used in complex abdominal wall repair. The specific techniques reviewed include use of delayed and tunneled pedicled tensor fascia lata myofascial flap, de-epithelialized flap closure, free latissimus dorsi myocutaneous flap with or without innervation, and abdominal wall transplant. These niche surgical techniques have great potential to reduce recurrence rates when used in the proper setting for complex abdominal wall reconstruction. More studies are needed to evaluate the relative use of these techniques with the more widely established surgical methods of reconstruction.

  17. Trans-vastus Intermedius Transfer of the Pedicled Anterolateral Thigh Flap for Posterior Thigh Reconstruction

    PubMed Central

    Batdorf, Niles J.; Lettieri, Salvatore C.

    2013-01-01

    Summary: Proximal, posterior thigh wounds from oncologic or traumatic defects can be difficult wounds to reconstruct if local flap options have been sacrificed during the trauma or oncologic resection. Free flap options to cover these defects are also difficult because of the lack of convenient recipient vessels in the region. The authors present 2 cases (oncologic and traumatic) wherein a myocutaneous anterolateral thigh (ALT) flap was harvested and tunneled from the anterior muscle compartment to the posterior muscle compartment of the thigh through a medially based transmuscular tunnel, decreasing the required pedicle distance to the wound. This technique of transmuscular tunneling of the ALT flap expands the indications and utility of the ALT flap to cover posterior thigh wounds. PMID:25289275

  18. Osteoradionecrosis of sphenoid and temporal bones in a patient with maxillary sinus carcinoma: A case report

    SciTech Connect

    Inokuchi, T.; Sano, K.; Kaminogo, M. )

    1990-09-01

    A case of radionecrosis of sphenoid and temporal bones is reported. The patient received a combination of surgery, radiotherapy, and chemotherapy for his left maxillary sinus carcinoma. After the combined therapy, necrosis accompanying inflammation developed in the maxillary and temporal regions. Excision of the necrotic tissues was done, and the left ascending ramus of the mandible was resected because of persistent tumor mass at the left infratemporal fossa. Although the excision wound of the maxilla healed by epithelialization, an area of nonvital bone remained exposed in the temporal region, where progressive osteonecrosis with infection led to breakdown of the skin. The necrotic bones of the zygomatic arch and the sphenotemporal sutural region became visible through the skin defect, and computerized tomography scan revealed bone necrosis involving the inferolateral area and the base of the skull. Excision of the necrotic bone and reconstruction with sternocleidomastoid myocutaneous flap were performed.

  19. [Transdisciplinary Approach for Sarcopenia. Sarcopenia and physical disability in older adults].

    PubMed

    Ikezoe, Tome

    2014-10-01

    We investigated the effects of age on muscle atrophy and the relationship of locomotor ability with the sarcopenia in trunk and lower-limb muscle using ultrasound. Age-related muscle atrophy in elderly women was greatest for the psoas major and internal oblique muscles among the trunk and lower limb muscles. The age-related decline in gluteus medius muscle was closely associated with daily physical activity. Physical disability influenced muscle atrophy in the trunk and lower limbs, especially in the quadriceps femoris, soleus, transversus abdominis and lumbar multifidus muscles among elderly women. These findings may be a useful guideline for muscle strength training to prevent physical disability in the elderly people.

  20. Dengue Fever with rectus sheath hematoma: a case report.

    PubMed

    Sharma, Anurag; Bhatia, Sonia; Singh, Rajendra Pratap; Malik, Gaurav

    2014-04-01

    Dengue fever, also known as breakbone fever, is an infectious tropical disease caused by the Dengue virus. It is associated with a number of complications, which are well documented. However, Dengue fever associated with rectus sheath hematoma (RSH) is a very rare complication. Only one case report has been published prior supporting the association of Dengue fever with RSH. We report a case of Dengue fever who presented with RSH and was successfully treated conservatively. RSH is also an uncommon cause of acute abdominal pain. It is accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear.

  1. Large abdominal incisional hernias: repair by fascial approximation reinforced with a stainless steel mesh.

    PubMed

    Validire, J; Imbaud, P; Dutet, D; Duron, J J

    1986-01-01

    One hundred and fifty large abdominal incisional hernias were treated following a standardized operating technique using metallic mesh (Toilinox) and approximation of the anterior sheath of the rectus abdominis. The average follow-up was four years. Good clinical results without pain were found in more than 95 per cent of the patients. Recurrence occurred in 9.5 per cent of the patients. The complications, wound infection or parietal necrosis, never necessitated removal of the prosthesis. These results justify the use of this technique even when intra-abdominal septic procedure is associated.

  2. [THE CHOICE OF THE ANESTHESY OPTIMAL METHOD, USING DETERMINATION OF THE TOLL-LIKE RECEPTORS LEVEL IN THE PLASM AS A MARKER OF HYPERALGESIA IN EARLY POSTOPERATIVE PERIOD].

    PubMed

    Dmytriyev, D V

    2016-01-01

    There were examined 47 children, operated on for tumors of abdominal cavity and retroperitoneal space. The opioid-induced hyperalgesia may occur in early postoperative period. The anesthesia conduction of m. transverses abdominis (TAP-block), using 0.375% bupivacaine solution and combined spinal epidural analgesia (CSEA) for postoperative anesthesia have promoted the hyperalgesia severity reduction. Hyperalgesia in early postoperative period was demonstrated by upgrading of the toll-like receptors (TLR-4) level in the blood. The TLR-4 expression increased in the blood was noted while application of a TAP-block and CSEA.

  3. Ultrasound-guided truncal blocks: A new frontier in regional anaesthesia

    PubMed Central

    Chakraborty, Arunangshu; Khemka, Rakhi; Datta, Taniya

    2016-01-01

    The practice of regional anaesthesia is rapidly changing with the introduction of ultrasound into the working domain of the anaesthesiologist. New techniques are being pioneered. Among the recent techniques, notable are the truncal blocks, for example, the transversus abdominis plane block, rectus sheath block, hernia block and quadratus lumborum block in the abdomen and the pectoral nerves (Pecs) block 1 and 2, serratus anterior plane block and intercostal nerve block. This narrative review covers the brief anatomical discourse along with technical description of the ultrasound-guided truncal blocks. PMID:27761032

  4. Management of a Complicated Ruptured Infected Pseudoaneurysm of the Femoral Artery in a Drug Addict

    PubMed Central

    Psathas, Emmanouil; Lioudaki, Stella; Karantonis, Fotios-Filippos; Charalampoudis, Petros; Papadopoulos, Othon; Klonaris, Chris

    2012-01-01

    Infected pseudoaneurysm of the femoral artery represents a devastating complication of intravenous drug abuse, especially in the event of rupture. Operative strategy depends upon the extent of arterial injury and the coexistence of infection or sepsis. Options range from simple common femoral artery (CFA) ligation to complex arterial reconstruction with autologous grafts (arterial, venous, or homografts). We report herein the management of a 29-year-old male patient who was urgently admitted with a ruptured pseudoaneurysm of the right CFA, extending well above the inguinal ligament. Multidisciplinary approach with multiple arterial reconstructions and subsequent coverage of the tissue defect with a rectus abdominis musculocutaneous flap transposition was performed. PMID:23227421

  5. Warner-Bratzler shear evaluations of 40 bovine muscles.

    PubMed

    Belew, J B; Brooks, J C; McKenna, D R; Savell, J W

    2003-08-01

    Forty muscles from each of 20 beef carcass sides were used to perform Warner-Bratzler shear (WBS) force determinations for within and among muscle effects. The M. triceps brachii differed (P <0.05) in WBS values between the caput longum and caput laterale, and the M. gluteobiceps differed (P <0.05) in WBS values between the vertebral, cranial, and caudal portions. The M. trapezius did not differ between the pars cervicalis and pars thoracica. Larger muscles were evaluated for location effects within muscles. The M. pectoralis profundus, M. infraspinatus, M. triceps brachii (caput longum), psoas major, and M. semimembranosus all had significant location effects. Muscles were allocated into "very tender," "tender," "intermediate" or "tough" categories. Those muscles considered "very tender" (WBS <3.2 kg) were the diaphragm (outside skirt or wing of diaphragm), M. spinalis, M. infraspinatus, M. iliacus, M. psoas major, M. serratus ventralis, M. biceps brachii, M. obliquus internus abdominis, and M. vastus medius. Muscles considered "tender" (3.2 kg abdominis, M. rhomboideus, and M. triceps brachii. Muscles classified as "intermediate" (3.9 kg abdominis, M. semitendinosus, M. adductor, M. vastus lateralis, M. deltoideus, M. latissimus dorsi, M. transversus abdominis, and M. semimembranosus. Muscles classed as "tough" (WBS > 4.6 kg) were the M. extensor carpi radialis, M. trapezius, M. brachialis, M. pectoralis profundus, and M. flexor digitorum superficialis (hind limb). The diaphragm muscle was the most tender (WBS=2.03 kg), and the M. flexor digitorum superficialis was the toughest (WBS=7.74 kg

  6. Magnetic resonance imaging of athletic pubalgia and the sports hernia: current understanding and practice.

    PubMed

    Khan, Waseem; Zoga, Adam C; Meyers, William C

    2013-02-01

    Magnetic resonance imaging (MRI) has become the standard imaging modality for activity-related groin pain. Lesions, including rectus abdominis/adductor aponeurosis injury and osteitis pubis, can be accurately identified and delineated in patients with clinical conditions termed athletic pubalgia, core injury, and sports hernia. A dedicated noncontrast athletic pubalgia MRI protocol is easy to implement and should be available at musculoskeletal MR imaging centers. This article will review pubic anatomy, imaging considerations, specific lesions, and common MRI findings encountered in the setting of musculoskeletal groin pain.

  7. Magnetic resonance imaging for pain after surgical treatment for athletic pubalgia and the "sports hernia".

    PubMed

    Zoga, Adam C; Meyers, William C

    2011-09-01

    Magnetic resonance (MR) imaging technique and findings in the setting of athletic pubalgia, including injury at the rectus abdominis/adductor aponeurosis, are becoming widely recognized. A subset of these patients is treated with various pelvic floor repairs, mesh reinforcements, and tendon releases. Most of these patients do well after intervention, but some have persistent or refractory groin pain, and others eventually develop new injuries in the pubic region or elsewhere about the pelvic girdle. This review describes the expected and some unexpected MRI findings in patients with recurrent or persistent groin pain after a "sports hernia" repair.

  8. Successful treatment of athletic pubalgia in a lacrosse player with ultrasound-guided needle tenotomy and platelet-rich plasma injection: a case report.

    PubMed

    Scholten, Paul M; Massimi, Stephen; Dahmen, Nick; Diamond, Joanne; Wyss, James

    2015-01-01

    Athletic pubalgia is a syndrome of persistent groin pain due to chronic repetitive trauma or stress involving the pelvic joints and many musculotendinous structures that cross the anterior pelvis. As a result, the differential diagnosis can be complex, but insertional tendinopathies are the most common. This case report describes a novel approach to the treatment of distal rectus abdominis tendinopathies with ultrasound-guided needle tenotomy and platelet-rich plasma (PRP) injection. After injection, the patient returned to pain-free play at his previous level of intensity. This suggests that PRP may be a useful treatment for this diagnosis.

  9. Myofascial origins of low back pain. 2. Torso muscles.

    PubMed

    Simons, D G; Travell, J G

    1983-02-01

    Trigger points (TPs) in muscles of the lower torso associated with the spine are an important cause of low back pain. The quadratus lumborum is the muscle most commonly involved, but TPs located there are often overlooked because of inadequate physical examination techniques. TPs in the lower rectus abdominis refer pain horizontally across the low back, and those in the iliopsoas refer pain in a vertical pattern, parallel to the lumbosacral spine. The pain pattern of TPs in the serratus posterior inferior is noted in the region of the muscle itself.

  10. Respiratory muscle blood flow during exercise: effects of sex and ovarian cycle.

    PubMed

    Smith, Joshua R; Hageman, K Sue; Harms, Craig A; Poole, David C; Musch, Timothy I

    2017-01-26

    Sex and ovarian cycle have been speculated to modify respiratory muscle(s) blood flow control during exercise, but the findings are inconclusive. We tested the hypotheses that females would have higher respiratory muscle blood flow and vascular conductance (VC) compared to males during exercise and that this difference would be accentuated in proestrus versus ovariectomized (OVA) females. Mean arterial pressure (carotid artery catheter) and respiratory muscle blood flow (radiolabeled microspheres) were measured during moderate-intensity (24m/min, 10% grade) exercise in male (n=9), female (n=9), and OVA female (n=7) rats and near-maximal (60m/min, 5% grade) exercise in male (n=5) and female (n=7) rats. At rest, diaphragm, intercostal, and transversus abdominis blood flow were not different (p=0.33) among groups. During moderate-intensity exercise, diaphragm (M: 124±16; F: 140±14; OVA: 140±20mL/min/100g), intercostal (M: 33±5; F: 34±5; OVA: 30±5mL/min/100g), and transversus abdominis blood flow (M: 24±4; F: 35±7; OVA: 35±9mL/min/100g) significantly increased in all groups compared to rest, but were not different (p=0.12) among groups. From rest to moderate-intensity exercise, diaphragm (p<0.03) and transversus abdominis (p<0.04) VC increased in all groups, while intercostal VC increased only for males and females (p=0.01). No differences (p>0.13) existed in VC among groups. During near-maximal exercise, diaphragm (M: 304±62; F: 283±17mL/min/100g), intercostal (M: 29±8; F: 40±6mL/min/100g), and transversus abdominis (M: 85±14; F: 86±9mL/min/100g) blood flow and VC were not different (p>0.27) between males and females. These data demonstrate that respiratory muscle blood flow and vascular conductance at rest and during exercise are not affected by sex or ovarian cycle in rats.

  11. Cholinergic antagonists in a solitary wasp venom.

    PubMed

    Piek, T; Mantel, P

    1986-01-01

    The venom of the solitary wasp Philanthus triangulum contains a cholinergic antagonist of the nicotinic receptor of the rectus abdominis muscle of the frog, Xenopus laevis. The venom of African P. triangulum contains two different cholinergic factors, a competitive and a non-competitive antagonist. The venom of the European P. triangulum may not contain a competitive antagonist of the nicotinic receptor of X. laevis, but only a very strong non-competitive antagonist. The possible non-synonymity of both groups of P. triangulum is discussed.

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

    PubMed

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

    2000-03-01

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

  13. Donor-site Morbidity of Medial and Lateral Thigh-based Flaps: A Comparative Study

    PubMed Central

    Purnell, Chad A.; Lewis, Kevin C.; Mioton, Lauren M.; Hanwright, Philip J.; Galiano, Robert D.; Dumanian, Gregory A.; Alghoul, Mohammed S.

    2016-01-01

    Background: Free and pedicled medial and lateral thigh-based flaps are common reconstructive procedures. However, there have been no comparative studies of morbidity between medial and lateral donor sites. Methods: We conducted an Enterprise Data Warehouse-based review of all the senior authors’ (R.D.G., G.A.D., and M.S.A.) thigh-based free and pedicled flaps. Patient demographic data, donor-site complications, drain duration, and number of postoperative visits were collected and compared. Complications were also compared between fasciocutaneous flaps and muscle or myocutaneous flaps, and skin grafted donor sites. Results: We analyzed 352 flap donor sites, with 155 medial and 197 lateral. Two hundred seventeen (217) flaps were pedicled. Flap types included 127 gracilis, 27 rectus femoris, 134 anterolateral thigh, and 36 vastus lateralis-only flaps. There were no significant differences in complications between medial (17.4%) and lateral thigh (21.3%) donor sites, although lateral thigh flaps had a mean of 1 additional postoperative visit. Rates of wound dehiscence/healing issues were significantly higher in both gracilis myocutaneous flaps (25.9%) and flaps requiring a skin grafted donor site (31.2%). Postoperative therapeutic anticoagulation was the only significant risk factor for a donor-site complication. Flap complications resulted in increased drain duration and postoperative office visits. Conclusions: Donor-site morbidity is similar in both lateral and medial thigh-based flaps. The inclusion of muscle in the flap from either donor site does not seem to increase complications, but the inclusion of a skin paddle with gracilis muscle, or a skin grafted lateral thigh donor site, results in increased wound healing complications. PMID:27975004

  14. IK1 channels do not contribute to the slow afterhyperpolarization in pyramidal neurons

    PubMed Central

    Wang, Kang; Mateos-Aparicio, Pedro; Hönigsperger, Christoph; Raghuram, Vijeta; Wu, Wendy W; Ridder, Margreet C; Sah, Pankaj; Maylie, Jim; Storm, Johan F; Adelman, John P

    2016-01-01

    In pyramidal neurons such as hippocampal area CA1 and basolateral amygdala, a slow afterhyperpolarization (sAHP) follows a burst of action potentials, which is a powerful regulator of neuronal excitability. The sAHP amplitude increases with aging and may underlie age related memory decline. The sAHP is due to a Ca2+-dependent, voltage-independent K+ conductance, the molecular identity of which has remained elusive until a recent report suggested the Ca2+-activated K+ channel, IK1 (KCNN4) as the sAHP channel in CA1 pyramidal neurons. The signature pharmacology of IK1, blockade by TRAM-34, was reported for the sAHP and underlying current. We have examined the sAHP and find no evidence that TRAM-34 affects either the current underling the sAHP or excitability of CA1 or basolateral amygdala pyramidal neurons. In addition, CA1 pyramidal neurons from IK1 null mice exhibit a characteristic sAHP current. Our results indicate that IK1 channels do not mediate the sAHP in pyramidal neurons. DOI: http://dx.doi.org/10.7554/eLife.11206.001 PMID:26765773

  15. Fibre optic portable rail vehicle detector

    NASA Astrophysics Data System (ADS)

    Kepak, Stanislav; Cubik, Jakub; Zavodny, Petr; Hejduk, Stanislav; Nedoma, Jan; Davidson, Alan; Vasinek, Vladimir

    2016-12-01

    During track maintenance operations, the early detection of oncoming rail vehicles is critical for the safety of maintenance personnel. In addition, the detection system should be simple to install at the trackside by minimally qualified personnel. Fibre optic based sensor systems have the inherent advantages of being passive, unaffected by radio frequency interference (RFI) and suffering very low signal attenuation. Such a system therefore represents a good alternative to conventional approaches such as ultrasonic based sensor systems. The proposed system consists of one or more passive fibre trackside sensors and an x86 processing unit located at the work site. The solid fibre connection between sensors and processing unit eliminates the risk of RFI. In addition, the detection system sensors are easy to install with no requirement for electrical power at the sensor site. The system was tested on a tram line in Ostrava with the results obtained indicating the successful detection of all the trams in the monitoring windows using a single sensor. However, the platform allows flexibility in configuring multiple sensors where required by system users.

  16. Immature human dendritic cells enhance their migration through KCa3.1 channel activation.

    PubMed

    Crottès, David; Félix, Romain; Meley, Daniel; Chadet, Stéphanie; Herr, Florence; Audiger, Cindy; Soriani, Olivier; Vandier, Christophe; Roger, Sébastien; Angoulvant, Denis; Velge-Roussel, Florence

    2016-04-01

    Migration capacity is essential for dendritic cells (DCs) to present antigen to T cells for the induction of immune response. The DC migration is supposed to be a calcium-dependent process, while not fully understood. Here, we report a role of the KCa3.1/IK1/SK4 channels in the migration capacity of both immature (iDC) and mature (mDC) human CD14(+)-derived DCs. KCa3.1 channels were shown to control the membrane potential of human DC and the Ca(2+) entry, which is directly related to migration capacities. The expression of migration marker such as CCR5 and CCR7 was modified in both types of DCs by TRAM-34 (100nM). But, only the migration of iDC was decreased by use of both TRAM-34 and KCa3.1 siRNA. Confocal analyses showed a close localization of CCR5 with KCa3.1 in the steady state of iDC. Finally, the implication of KCa3.1 seems to be limited to the migration capacities as T cell activation of DCs appeared unchanged. Altogether, these results demonstrated that KCa3.1 channels have a pro-migratory effect on iDC migration. Our findings suggest that KCa3.1 in human iDC play a major role in their migration and constitute an attractive target for the cell therapy optimization.

  17. SK4 K(+) channels are therapeutic targets for the treatment of cardiac arrhythmias.

    PubMed

    Haron-Khun, Shiraz; Weisbrod, David; Bueno, Hanna; Yadin, Dor; Behar, Joachim; Peretz, Asher; Binah, Ofer; Hochhauser, Edith; Eldar, Michael; Yaniv, Yael; Arad, Michael; Attali, Bernard

    2017-02-20

    Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a stress-provoked ventricular arrhythmia, which also manifests sinoatrial node (SAN) dysfunction. We recently showed that SK4 calcium-activated potassium channels are important for automaticity of cardiomyocytes derived from human embryonic stem cells. Here SK4 channels were identified in human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) from healthy and CPVT2 patients bearing a mutation in calsequestrin 2 (CASQ2-D307H) and in SAN cells from WT and CASQ2-D307H knock-in (KI) mice. TRAM-34, a selective blocker of SK4 channels, prominently reduced delayed afterdepolarizations and arrhythmic Ca(2+) transients observed following application of the β-adrenergic agonist isoproterenol in CPVT2-derived hiPSC-CMs and in SAN cells from KI mice. Strikingly, in vivo ECG recording showed that intraperitoneal injection of the SK4 channel blockers, TRAM-34 or clotrimazole, greatly reduced the arrhythmic features of CASQ2-D307H KI and CASQ2 knockout mice at rest and following exercise. This work demonstrates the critical role of SK4 Ca(2+)-activated K(+) channels in adult pacemaker function, making them promising therapeutic targets for the treatment of cardiac ventricular arrhythmias such as CPVT.

  18. Stratigraphic and volcano-tectonic relations of Crater Flat Tuff and some older volcanic units, Nye County, Nevada

    NASA Astrophysics Data System (ADS)

    Carr, W. J.; Byers, F. M., Jr.; Orkild, P. P.

    The Crater Flat Tuff is herein revised to include a newly recognized lowest unit, the Tram member. The revised Crater Flat Tuff is stratigraphically below the Topopah Spring Member of the Paintbrush Tuff and above the Grouse Canyon Member of the Belted Range Tuff, and is approximately 13.6 m.y. old. In outcrops between Calico Hills and Yucca Flat, the Lithic Ridge Tuff overlies a Bullfrog-like unit of reverse magnetic polarity that probably correlates with a widespread unit around and under Yucca Flat, referred to previously as Crater Flat Tuff. This unit is here informally designated as the tuff of Yucca Flat. Geophysical and geologic evidence to date suggests that (1) the source of the Crater Flat Tuff is a caldera complex in the Crater Flat area between Yucca Mountain and Bare Mountain; and (2) there are at last two cauldrons within this complex - one probably associated with eruption of the Tram, the other with the Bullfrog and Prow Pass Members. The complex is named the Crater Flate Prospector Pass caldera complex.

  19. PRL-3 promotes the proliferation of LoVo cells via the upregulation of KCNN4 channels.

    PubMed

    Lai, Wei; Chen, Shuang; Wu, Heng; Guan, Yufeng; Liu, Lu; Zeng, Yujie; Zhao, Haiyan; Jiang, Jianmin; Chu, Zhonghua

    2011-10-01

    Previous studies have shown that phosphatase of regenerating liver-3 (PRL-3) plays an important role in the metastasis and proliferation of tumor cells. However, the mechanism by which PRL-3 controls the cell cycle of tumor cells remains unknown. In the present study, considering that the K+ channels strictly control cell proliferation, we examined whether K+ channels participate in the proliferation of tumor cells induced by PRL-3. Interestingly, the expression of intermediate-conductance Ca2+-activated K+ channels (KCNN4) was upregulated in an NF-κB-dependent manner when PRL-3 was transfected into LoVo cells. Also, we identified two NF-κB binding sites in the promoter region of KCNN4. Use of the specific inhibitor 1-[(2-chlorophenyl) diphenylmethyl]-1H-pyrazole (TRAM-34) significantly inhibited the proliferation induced by PRL-3 and blocked the cell cycle at the G2/M phase. Meanwhile, the level of phosphorylation of Cdc2 was increased in a dose-dependent manner. Furthermore, TRAM-34 also inhibited tumor formation of PRL-3 cell xenografts implanted by injection in nude mice. In conclusion, PRL-3 promoted the proliferation of LoVo cells through upregulation of KCNN4 channels which facilitated the G2/M transition.

  20. [Effect of Kv1.3 and KCa3.1 potassium ion channels on the proliferation and migration of monocytes/macrophages].

    PubMed

    Zhang, Shuang-Xia; Wang, Xian-Pei; Gao, Chuan-Yu; Ju, Chen-Hui; Zhu, Li-Jie; DU, Yi-Mei

    2015-10-25

    This study was aimed to investigate the effects of blockade of Ca(2+) activated channel KCa3.1 and voltage-gated potassium channel Kv1.3 of the monocytes/macrophages on inflammatory monocyte chemotaxis. Chemotaxis assay was used to test the inflammatory Ly-6C(hi) monocyte chemotaxis caused by the monocytes/macrophages. The proliferation of monocytes/macrophages was detected by cell counting kit-8 (CCK8). Enzyme-linked immunosorbent assay (ELISA) was applied to detect the C-C motif ligand 7 (CCL7) in cultured media. The results showed that the recruitment of Ly-6C(hi) monocyte induced by monocytes/macrophages was suppressed by the potent Kv1.3 blocker Stichodactyla helianthus neurotoxin (ShK) or the specific KCa3.1 inhibitor TRAM-34. Meanwhile, the proliferation of monocytes/macrophages was significantly inhibited by ShK. The response of Ly-6C(hi) monocyte pretreated with ShK or TRAM-34 to CCL2 was declined. These results suggest that KCa3.1 and Kv1.3 may play an important role in monocytes/macrophages' proliferation and migration.

  1. Rail roughness and rolling noise in tramways

    NASA Astrophysics Data System (ADS)

    Chiacchiari, L.; Thompson, DJ; Squicciarini, G.; Ntotsios, E.; Loprencipe, G.

    2016-09-01

    Companies which manage railway networks have to cope continually with the problem of operating safety and maintenance intervention issues related to rail surface irregularities. A lot of experience has been gained in recent years in railway applications but the case of tramways is quite different; in this field there are no specific criteria to define any intervention on rail surface restoration. This paper shows measurements carried out on some stretches of a tram network with the CAT equipment (Corrugation Analysis Trolley) for the principal purpose of detecting different states of degradation of the rails and identifying a level of deterioration to be associated with the need for maintenance through rail grinding. The measured roughness is used as an input parameter into prediction models for both rolling noise and ground vibration to show the potential effect that high levels of roughness can have in urban environment. Rolling noise predictions are also compared with noise measurements to illustrate the applicability of the modelling approach. Particular attention is given to the way the contact filter needs to be modelled in the specific case of trams that generally operate at low speed. Finally an empirical approach to assess vibration levels in buildings is presented.

  2. A vision-based approach for tramway rail extraction

    NASA Astrophysics Data System (ADS)

    Zwemer, Matthijs H.; van de Wouw, Dennis W. J. M.; Jaspers, Egbert; Zinger, Sveta; de With, Peter H. N.

    2015-03-01

    The growing traffic density in cities fuels the desire for collision assessment systems on public transportation. For this application, video analysis is broadly accepted as a cornerstone. For trams, the localization of tramway tracks is an essential ingredient of such a system, in order to estimate a safety margin for crossing traffic participants. Tramway-track detection is a challenging task due to the urban environment with clutter, sharp curves and occlusions of the track. In this paper, we present a novel and generic system to detect the tramway track in advance of the tram position. The system incorporates an inverse perspective mapping and a-priori geometry knowledge of the rails to find possible track segments. The contribution of this paper involves the creation of a new track reconstruction algorithm which is based on graph theory. To this end, we define track segments as vertices in a graph, in which edges represent feasible connections. This graph is then converted to a max-cost arborescence graph, and the best path is selected according to its location and additional temporal information based on a maximum a-posteriori estimate. The proposed system clearly outperforms a railway-track detector. Furthermore, the system performance is validated on 3,600 manually annotated frames. The obtained results are promising, where straight tracks are found in more than 90% of the images and complete curves are still detected in 35% of the cases.

  3. Activation of K(+) channel by 1-EBIO rescues the head and neck squamous cell carcinoma cells from Ca(2+) ionophore-induced cell death.

    PubMed

    Yin, Ming Zhe; Park, Seok-Woo; Kang, Tae Wook; Kim, Kyung Soo; Yoo, Hae Young; Lee, Junho; Hah, J Hun; Sung, Myung Hun; Kim, Sung Joon

    2016-01-01

    Ion channels in carcinoma and their roles in cell proliferation are drawing attention. Intracellular Ca(2+) ([Ca(2+)]i)-dependent signaling affects the fate of cancer cells. Here we investigate the role of Ca(2+)-activated K(+) channel (SK4) in head and neck squamous cell carcinoma cells (HNSCCs) of different cell lines; SNU-1076, OSC-19 and HN5. Treatment with 1 µM ionomycin induced cell death in all the three cell lines. Whole-cell patch clamp study suggested common expressions of Ca(2+)-activated Cl(-) channels (Ano-1) and Ca(2+)-activated nonselective cation channels (CAN). 1-EBIO, an activator of SK4, induced outward K(+) current (ISK4) in SNU-1076 and OSC-19. In HN5, ISK4 was not observed or negligible. The 1-EBIO-induced current was abolished by TRAM-34, a selective SK4 blocker. Interestingly, the ionomycin-induced cell death was effectively prevented by 1-EBIO in SNU-1076 and OSC-19, and the rescue effect was annihilated by combined TRAM-34. Consistent with the lower level of ISK4, the rescue by 1-EBIO was least effective in HN5. The results newly demonstrate the role of SK4 in the fate of HNSCCs under the Ca(2+) overloaded condition. Pharmacological modulation of SK4 might provide an intriguing novel tool for the anti-cancer strategy in HNSCC.

  4. Analysis of Advanced Rotorcraft Configurations

    NASA Technical Reports Server (NTRS)

    Johnson, Wayne

    2000-01-01

    Advanced rotorcraft configurations are being investigated with the objectives of identifying vehicles that are larger, quieter, and faster than current-generation rotorcraft. A large rotorcraft, carrying perhaps 150 passengers, could do much to alleviate airport capacity limitations, and a quiet rotorcraft is essential for community acceptance of the benefits of VTOL operations. A fast, long-range, long-endurance rotorcraft, notably the tilt-rotor configuration, will improve rotorcraft economics through productivity increases. A major part of the investigation of advanced rotorcraft configurations consists of conducting comprehensive analyses of vehicle behavior for the purpose of assessing vehicle potential and feasibility, as well as to establish the analytical models required to support the vehicle development. The analytical work of FY99 included applications to tilt-rotor aircraft. Tilt Rotor Aeroacoustic Model (TRAM) wind tunnel measurements are being compared with calculations performed by using the comprehensive analysis tool (Comprehensive Analytical Model of Rotorcraft Aerodynamics and Dynamics (CAMRAD 11)). The objective is to establish the wing and wake aerodynamic models that are required for tilt-rotor analysis and design. The TRAM test in the German-Dutch Wind Tunnel (DNW) produced extensive measurements. This is the first test to encompass air loads, performance, and structural load measurements on tilt rotors, as well as acoustic and flow visualization data. The correlation of measurements and calculations includes helicopter-mode operation (performance, air loads, and blade structural loads), hover (performance and air loads), and airplane-mode operation (performance).

  5. Multi-scale symbolic time reverse analysis of gas-liquid two-phase flow structures

    NASA Astrophysics Data System (ADS)

    Wang, Hongmei; Zhai, Lusheng; Jin, Ningde; Wang, Youchen

    Gas-liquid two-phase flows are widely encountered in production processes of petroleum and chemical industry. Understanding the dynamic characteristics of multi-scale gas-liquid two-phase flow structures is of great significance for the optimization of production process and the measurement of flow parameters. In this paper, we propose a method of multi-scale symbolic time reverse (MSTR) analysis for gas-liquid two-phase flows. First, through extracting four time reverse asymmetry measures (TRAMs), i.e. Euclidean distance, difference entropy, percentage of constant words and percentage of reversible words, the time reverse asymmetry (TRA) behaviors of typical nonlinear systems are investigated from the perspective of multi-scale analysis, and the results show that the TRAMs are sensitive to the changing of dynamic characteristics underlying the complex nonlinear systems. Then, the MSTR analysis is used to study the conductance signals from gas-liquid two-phase flows. It is found that the multi-scale TRA analysis can effectively reveal the multi-scale structure characteristics and nonlinear evolution properties of the flow structures.

  6. The effect of flexi-bar exercise with vibration on trunk muscle thickness and balance in university students in their twenties

    PubMed Central

    Lee, Seong-Jin; Kim, Yong-Nam; Lee, Dong-Kyu

    2016-01-01

    [Purpose] The purpose of this research was to determine the effect of Flexi-Bar exercise with vibration on trunk muscle thickness and balance in university students in their twenties. [Subjects and Methods] This research evaluated 26 university students in their twenties, equally and randomly divided into two groups. Both the experimental and control groups used an ordinary pole for exercise. In addition, the experimental group exercised by using a Flexi-Bar. Ultrasonic imaging was used to measure the changes in trunk muscle thickness. A balance measuring equipment was used to measure balance ability. [Results] The thickness of the transversus abdominis and the multifidus muscles in the experimental group increased, and the experimental group showed increased thickness in the transversus abdominis muscle compared to the control group. After 6 months of exercise, there was an improvement in the blind Romberg test and center of pressure moving distance with one-leg standing. [Conclusion] These results indicate that the Flexi-Bar exercise is effective in increasing trunk muscle thickness and improving balance. PMID:27190471

  7. Treatment of a chronic vesicocutaneous fistula and abdominal wall defect after resection of a soft tissue sarcoma using a bipedicled latissimus dorsi and serratus anterior free flap.

    PubMed

    Ludolph, Ingo; Apel, Hendrik; Horch, Raymund E; Beier, Justus P

    2014-11-01

    We present a surgical treatment for bladder reconstruction in a case of chronic vesicocutaneous radiation-induced fistula and reconstruction of the abdominal wall after resection of a liposarcoma in the rectus abdominis muscle. Fistulas are sequelae after radiotherapy. To regain bladder function and reconstitute abdominal wall stability, a microsurgical flap approach should be considered. A male patient underwent resection of a liposarcoma in the rectus abdominis muscle with adjuvant radiotherapy, suffering from a chronic vesicocutaneous fistula. A bipedicled combined latissimus dorsi and serratus anterior flap was carried out after resection of the fistula for reconstruction of the urine bladder and the abdominal wall. Ascending urethrography 4 weeks postoperatively showed no leakage. In the 4-month follow-up period, no signs of recurrence of the fistula or herniation occurred. A bipedicled flap allowed reconstruction of the urine bladder and the abdominal wall. Using non-irradiated, well-perfused intra-abdominal muscle tissue over the urine bladder prevented recurrence of the fistula.

  8. Effect of spinal decompression on the lumbar muscle activity and disk height in patients with herniated intervertebral disk

    PubMed Central

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

    2016-01-01

    [Purpose] This study was conducted to clarify the difference in therapeutic effects between traction and decompression therapies, and their clinical therapeutic significance. [Subjects and Methods] The subjects were 31 patients aged 35 to 50 years who had unilateral or bilateral lumbar and radicular leg pain. An intervention program was implemented in 31 patients with lumbar herniated intervertebral disks. For the experimental group, 15 subjects were randomly selected to receive decompression therapy and trunk stabilization exercise. For the control group, 16 subjects were randomly selected to receive traction therapy and trunk stabilization exercise. [Results] Activities of the rectus abdominis, transverse abdominis, and external oblique muscles increased significantly in both groups. However, the activity of the erector spine muscle decreased, which was the only significant change in muscle activity among those of the other muscles in both groups. The disk herniation index in the experimental group decreased significantly in comparison with that in the control group, and the difference in the change in disk herniation index between the groups was significant. [Conclusion] Decompression therapy was demonstrated to be more effective clinically than conventional traction therapy as an intervention method for disk disease. PMID:27942133

  9. Core Muscle Activity during TRX Suspension Exercises with and without Kinesiology Taping in Adults with Chronic Low Back Pain: Implications for Rehabilitation

    PubMed Central

    Fong, Shirley S. M.; Tam, Y. T.; Macfarlane, Duncan J.; Ng, Shamay S. M.; Bae, Young-Hyeon; Chan, Eleanor W. Y.; Guo, X.

    2015-01-01

    This study aimed to examine the effects of kinesiology taping (KT) and different TRX suspension workouts on the amplitude of electromyographic (EMG) activity in the core muscles among people with chronic low back pain (LBP). Each participant (total n = 21) was exposed to two KT conditions: no taping and taping, while performing four TRX suspension exercises: (1) hamstring curl, (2) hip abduction in plank, (3) chest press, and (4) 45-degree row. Right transversus abdominis/internal oblique (TrAIO), rectus abdominis (RA), external oblique (EO), and superficial lumbar multifidus (LMF) activity was recorded with surface EMG and expressed as a percentage of the EMG amplitude recorded during a maximal voluntary isometric contraction of the respective muscles. Hip abduction in plank increased TrAIO, RA, and LMF EMG amplitude compared with other TRX positions (P < 0.008). Only the hamstring curl was effective in inducing a high EMG amplitude of LMF (P < 0.001). No significant difference in EMG magnitude was found between the taping and no taping conditions overall (P > 0.05). Hip abduction in plank most effectively activated abdominal muscles, whereas the hamstring curl most effectively activated the paraspinal muscles. Applying KT conferred no immediate benefits in improving the core muscle activation during TRX training in adults with chronic LBP. PMID:26185520

  10. Effect of core muscle thickness and static or dynamic balance on prone bridge exercise with sling by shoulder joint angle in healthy adults

    PubMed Central

    Park, Mi Hwa; Yu, Jae Ho; Hong, Ji Heon; Kim, Jin Seop; Jung, Sang Woo; Lee, Dong Yeop

    2016-01-01

    [Purpose] To date, core muscle activity detected using ultrasonography during prone bridge exercises has not been reported. Here we investigated the effects of core muscle thickness and balance on sling exercise efficacy by shoulder joint angle in healthy individuals. [Subjects and Methods] Forty-three healthy university students were enrolled in this study. Ultrasonography thickness of external oblique, internal oblique, and transversus abdominis during sling workouts was investigated. Muscle thickness was measured on ultrasonography imaging before and after the experiment. Dynamic balance was tested using a functional reaching test. Static balance was tested using a Tetrax Interactive Balance System. [Results] Different muscle thicknesses were observed during the prone bridge exercise with the shoulder flexed at 60°, 90° or 120°. Shoulder flexion at 60° and 90° in the prone bridge exercise with a sling generated the greatest thickness of most transversus abdominis muscles. Shoulder flexion at 120° in the prone bridge exercise with a sling generated the greatest thickness of most external oblique muscles. [Conclusion] The results suggest that the prone bridge exercise with shoulder joint angle is an effective method of increasing global and local muscle strength. PMID:27134390

  11. Low-Grade Myxofibrosarcoma of the Rectus Abdominus Muscle Infiltrating into Abdominal Cavity: A Case Report

    PubMed Central

    Sakakibara, Shunsuke; Moriwaki, Aya; Kawamoto, Teruya; Suzuki, Satoshi; Ishimura, Takeshi; Hashikawa, Kazunobu; Terashi, Hiroto

    2017-01-01

    Objective: Myxofibrosarcoma (MFS) is a relatively rare tumor that is histologically characterized by myxoid stroma and spindle cell proliferation. This tumor most commonly arises as a slow growing, enlarging painless mass in the extremities of elderly patients. Methods: We report a case of a primary, low-grade MFS in the rectus abdominis muscle infiltrating the abdominal cavity of a 75-year-old man. Results: The patient underwent a wide excision of the right abdominal wall mass with a 3-cm surgical margin from the scar due to a biopsy. The tumor infiltrated the urinary bladder, peritoneum, and external iliac vessels. Twenty-six months after the initial operation, he had recurrences in his abdominal wall, urinary bladder, and right iliac vessels. Conclusions: To our knowledge, primary MFS of the muscle in the abdomen has not been documented previously. Although this case was histopathologically classified as a low-grade tumor, it infiltrated the abdominal cavity. The tumor is suspected to have penetrated the abdominal cavity below the linea arcuata, which lacks the posterior sheath of the rectus abdominis muscle; from there, it could easily spread without being blocked by any biological barriers. PMID:28293331

  12. Low-Grade Myxofibrosarcoma of the Rectus Abdominus Muscle Infiltrating into Abdominal Cavity: A Case Report.

    PubMed

    Nomura, Tadashi; Sakakibara, Shunsuke; Moriwaki, Aya; Kawamoto, Teruya; Suzuki, Satoshi; Ishimura, Takeshi; Hashikawa, Kazunobu; Terashi, Hiroto

    2017-01-01

    Objective: Myxofibrosarcoma (MFS) is a relatively rare tumor that is histologically characterized by myxoid stroma and spindle cell proliferation. This tumor most commonly arises as a slow growing, enlarging painless mass in the extremities of elderly patients. Methods: We report a case of a primary, low-grade MFS in the rectus abdominis muscle infiltrating the abdominal cavity of a 75-year-old man. Results: The patient underwent a wide excision of the right abdominal wall mass with a 3-cm surgical margin from the scar due to a biopsy. The tumor infiltrated the urinary bladder, peritoneum, and external iliac vessels. Twenty-six months after the initial operation, he had recurrences in his abdominal wall, urinary bladder, and right iliac vessels. Conclusions: To our knowledge, primary MFS of the muscle in the abdomen has not been documented previously. Although this case was histopathologically classified as a low-grade tumor, it infiltrated the abdominal cavity. The tumor is suspected to have penetrated the abdominal cavity below the linea arcuata, which lacks the posterior sheath of the rectus abdominis muscle; from there, it could easily spread without being blocked by any biological barriers.

  13. Systematic review of core muscle activity during physical fitness exercises.

    PubMed

    Martuscello, Jason M; Nuzzo, James L; Ashley, Candi D; Campbell, Bill I; Orriola, John J; Mayer, John M

    2013-06-01

    A consensus has not been reached among strength and conditioning specialists regarding what physical fitness exercises are most effective to stimulate activity of the core muscles. Thus, the purpose of this article was to systematically review the literature on the electromyographic (EMG) activity of 3 core muscles (lumbar multifidus, transverse abdominis, quadratus lumborum) during physical fitness exercises in healthy adults. CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, PubMed, SPORTdiscus, and Web of Science databases were searched for relevant articles using a search strategy designed by the investigators. Seventeen studies enrolling 252 participants met the review's inclusion/exclusion criteria. Physical fitness exercises were partitioned into 5 major types: traditional core, core stability, ball/device, free weight, and noncore free weight. Strength of evidence was assessed and summarized for comparisons among exercise types. The major findings of this review with moderate levels of evidence indicate that lumbar multifidus EMG activity is greater during free weight exercises compared with ball/device exercises and is similar during core stability and ball/device exercises. Transverse abdominis EMG activity is similar during core stability and ball/device exercises. No studies were uncovered for quadratus lumborum EMG activity during physical fitness exercises. The available evidence suggests that strength and conditioning specialists should focus on implementing multijoint free weight exercises, rather than core-specific exercises, to adequately train the core muscles in their athletes and clients.

  14. Biomechanical and Electromyographic Comparisons of Isometric Trunk Flexor Endurance Test Postures: Prone Plank Versus V-Sit.

    PubMed

    Musalem, Lindsay L; Stankovic, Tatjana; Glisic, Drazen; Cook, Gillian E; Beach, Tyson A

    2015-12-01

    The objective of this study was to investigate why holding times on 2 different tests of isometric trunk flexor endurance capacity (prone plank and v-sit) are weakly correlated. Body position and ground reaction force data from 10 men and 10 women were used to conduct static biomechanical analyses of both test postures, and bilateral activations of the rectus abdominis, internal and external obliques, latissimus dorsi, and lumbar and thoracic erector spinae were measured in a second sample of 15 men and 15 women while holding the test postures. No between-posture differences in net low back flexor moments were found (P = .111), but the lumbar spine was 28° more flexed in the v-sit than in the plank (P < .001). No between-posture differences were detected in the rectus abdominis (P = .397), external obliques (P = .204), internal obliques (P = .226), or lumbar erector spinae (P = .116) activation levels, but those of the thoracic erector spinae (P = .0253) and latissimus dorsi (P < .001) were greater in the plank than in the v-sit. Altogether, the findings suggest that differences between plank and v-sit holding times are most likely related to between-test differences in lumbar spine postures and shoulder demands.

  15. Effects of Vojta method on trunk stability in healthy individuals.

    PubMed

    Ha, Sun-Young; Sung, Yun-Hee

    2016-12-01

    Vojta reflex locomotion is important to main upright posture through stimulation of breast zone to patient with cerebral palsy. However, application in other diseases is no investigated. So, we determined the effects of stimulation of the breast zone on trunk stability in healthy individuals. Fourteen young healthy adults (7 males and 7 females) voluntarily participated in this study. The subjects were randomly divided into an experimental group (breast zone) and control group (arbitrary point). All groups were stimulated for 5 min on the left and right sides, respectively, for a total 10 times. We used the thickness of the external oblique abdominal muscle (EO), the internal oblique abdominal muscle, the transversus abdominis muscle (TrA), and the rectus abdominis muscles, as well as the area of the diaphragm by using ultrasonography. In the experimental group, the thickness of the TrA significantly increased during stimulation (P<0.05) while the thickness of the EO significantly decreased (P<0.05). Also, the area of diaphragm in inspiration was significantly different (P<0.05). Therefore, stimulation of the breast zone may be effective to improve trunk stability through activation of the TrA muscle and the diaphragm.

  16. Neutral spine control exercises in rehabilitation after lumbar spine fusion.

    PubMed

    Tarnanen, Sami P; Neva, Marko H; Häkkinen, Keijo; Kankaanpää, Markku; Ylinen, Jari; Kraemer, William J; Newton, Robert U; Häkkinen, Arja

    2014-07-01

    Lumbar spine fusion (LSF) has been reported to change the biomechanics of the spine and therefore the rehabilitation after LSF is important. In this study, the effect of selected neutral spine control exercises on activation of trunk muscles after LSF was evaluated. Muscle activity was measured by surface electromyography of the rectus abdominis, external oblique, longissimus, and multifidus muscles during 6 exercises in 22 LSF patients (mean age = 59 years; age range = 25-84 years; 50% women). Muscle activity concurrent with trunk flexion and extension during maximal voluntary isometric contraction (MVIC) was used as a reference value. Pain during the effort was assessed with a visual analog scale (VAS). The highest activity in the rectus abdominis muscles was measured during bilateral shoulder extension (51% of MVIC), and in the external oblique, it occurred during unilateral shoulder horizontal adduction (48% of MVIC) and unilateral hip extension (46% of MVIC) exercises. The highest activation of the multifidus and longissimus muscles (60-104%) was measured during bilateral shoulder flexion and modified Roman chair exercises. The mean (SD) self-reported back pain VAS scores during exercises varied from 3 (7) to 16 (26). Neutral spine control exercises activate trunk muscles and cause minimal pain and are therefore feasible exercises for home-based training to improve muscle endurance and postural control after LSF. In addition, the level of muscle activity during bilateral shoulder flexion and modified Roman chair exercises was over 60% of MVIC, justifying their use in training for strength of the trunk extensor muscles.

  17. Influence of alfalfa grazing-based feeding systems on carcass fat colour and meat quality of light lambs.

    PubMed

    Ripoll, G; Albertí, P; Joy, M

    2012-02-01

    One hundred and twenty-seven lambs were fed as follows: lambs and dams grazing alfalfa (Gr); the same as Gr but lambs had access to concentrate (Gr + S); ewes grazed and lambs received milk and concentrate until weaning and thereafter concentrate and straw (Rat-Gr); ewes and lambs were stall-fed (Ind). Lambs were slaughtered at 22-24 kg live weight and fat and M. rectus abdominis colour was measured instrumentally and subjectively. The evolution of the instrumental colour and texture of M. longissimus lumborum was also recorded. There were significant differences in the instrumental colour of subcutaneous fat amongst feeding systems, but no differences were observed upon visual appraisal. On average, M. rectus abdominis colour in the four feeding systems was classed as pink. Differences in longissimus thoracis colour at 0 h disappeared at 24h of air exposure and there were no differences in pH or cooking losses. At no time were any differences in instrumental texture found.

  18. An electromyographic comparison of a modified version of the plank with a long lever and posterior tilt versus the traditional plank exercise.

    PubMed

    Schoenfeld, Brad J; Contreras, Bret; Tiryaki-Sonmez, Gul; Willardson, Jeffrey M; Fontana, Fabio

    2014-09-01

    The purpose of the study was to compare core muscle activation of the tradition prone plank with a modified version performed with a long-lever and posterior-tilt using surface electromyography. To further determine if a specific component of this modified plank was more effective than the other in enhancing muscle activity, the plank with a long lever and the plank with a posterior pelvic tilt were studied individually. Nineteen participants performed all four variations of the plank for 30 seconds in a randomized order with 5-minute rest between exercise bouts. Compared to the traditional prone plank, the long-lever posterior-tilt plank displayed a significantly increased activation of the upper rectus abdominis (p < 0.001), lower abdominal stabilizers (p < 0.001), and external oblique (p < 0.001). The long-lever plank showed significantly greater activity compared to the traditional plank in the upper rectus abdominis (p = 0.015) and lower abdominal stabilizers (p < 0.001), while the posterior tilt plank elicited greater activity in the external oblique (p = 0.028). In conclusion, the long-lever posterior-tilt plank significantly increases muscle activation compared to the traditional prone plank. The long-lever component tends to contribute more to these differences than the posterior-tilt component.

  19. EMG activation of trunk and upper limb muscles following experimentally-induced overpronation and oversupination of the feet in quiet standing.

    PubMed

    Ntousis, Theodoros; Mandalidis, Dimitris; Chronopoulos, Efstathios; Athanasopoulos, Spyros

    2013-02-01

    Kinematic studies have shown that experimentally-induced overpronation or oversupination of the subtalar joint may alter the position of the legs, hips and pelvis and consequently the trunk and upper limb. The purpose of the present study was to examine whether such foot deformity affects the activity of muscles that act on the trunk and upper limb. Twenty-eight healthy individuals (11 males and 17 females) 21.4±1.9 years of age without skeletal deformity, leg length discrepancy (LLD), overpronated or oversupinated feet or excessive lateral pelvic inclination volunteered for the study. Bilateral EMG recordings of the latissimus dorsi, pectoralis major and rectus abdominis were undertaken for 30-s with each subject in the relaxed standing position and at 5° and 10° bilateral or unilateral overpronation or oversupination of the foot on the dominant side using wooden wedge-shape blocks. The recorded EMG activity was normalised based on the EMG activity produced by the muscles under investigation during maximum isometric voluntary contraction. The findings of the present study revealed that neither bilateral nor unilateral overpronation/oversupination of the feet induced a significant alteration of the EMG activity of the latissimus dorsi, pectoralis major and rectus abdominis on either the dominant or non-dominant side. These findings suggest that in the absence of other major structural deformity bilateral or unilateral foot overpronation or oversupination does not affect the EMG activity of muscles that act on the trunk and upper limb in quiet standing.

  20. The effect of food consumption on the thickness of abdominal muscles, employing ultrasound measurements.

    PubMed

    Kordi, Ramin; Rostami, Mohsen; Noormohammadpour, Pardis; Mansournia, Mohammad Ali

    2011-08-01

    Recently, the roles of transabdominal muscles particularly TrA (transverse abdominis) muscle in spinal stability leading to treatment of low back pain have been suggested. Both in clinical setting and follow up studies, abdominal muscle thickness measurements need to be repeated at a later point in time to demonstrate efficacy of a therapeutic intervention. Different issues have been suggested as source of error in the repeated measurements of abdominal muscle thickness in different days such as patient position and stability of probe location. The level of stomach fullness has not been investigated as a source of error in ultrasonic measurements of transabdominal muscles thickness. This study was performed to evaluate the effect of food consumption on thickness of lateral abdominal muscles. Lateral abdominal muscles thicknesses of 63 healthy volunteer men were measured before and after food consumption. All the measurements were performed in two transducer positions and both sides. Waist circumference and body weight of participants were also measured before and post-food consumption. The thickness measures of all three muscles layers of lateral abdominal muscles (external oblique, internal oblique and transversus abdominis) in both sides and measured positions were significantly reduced after food consumption. We found no correlation between the increase of waist circumference and reduction of muscle layer thicknesses after food consumption. In case of comparison between the values of transabdominal muscle thicknesses over the time, the effect of food consumption on muscle thickness might be assumed as a potential source of error.

  1. Impact of different body positions on bioelectrical activity of the pelvic floor muscles in nulliparous continent women.

    PubMed

    Chmielewska, Daria; Stania, Magdalena; Sobota, Grzegorz; Kwaśna, Krystyna; Błaszczak, Edward; Taradaj, Jakub; Juras, Grzegorz

    2015-01-01

    We examined pelvic floor muscles (PFM) activity (%MVC) in twenty nulliparous women by body position during exercise as well as the activation of abdominal muscles and the gluteus maximus during voluntary contractions of the PFMs. Pelvic floor muscle activity was recorded using a vaginal probe during five experimental trials. Activation of transversus abdominis, rectus abdominis, and gluteus maximus during voluntary PFM contractions was also assessed. Significant differences in mean normalized amplitudes of baseline PFM activity were revealed between standing and lying (P < 0.00024) and lying and ball-sitting positions (P < 0.0053). Average peak, average time before peak, and average time after peak did not differ significantly during the voluntary contractions of the PFMs. Baseline PFM activity seemed to depend on the body position and was the highest in standing. Pelvic floor muscles activity during voluntary contractions did not differ by position in continent women. Statistically significant differences between the supine lying and sitting positions were only observed during a sustained 60-second contraction of the PFMs.

  2. Value-based Clinical Quality Improvement (CQI) for Patients Undergoing Abdominal Wall Reconstruction.

    PubMed

    Stephan, Bradley; Ramshaw, Bruce; Forman, Brandie

    2015-05-01

    Patients with complex ventral/incisional hernias often undergo an abdominal wall reconstruction (AWR). These operations have a high cost of care and often result in a long hospital stay and high complication rates. Using the principles of clinical quality improvement (CQI), several attempts at process improvement were implemented in one hernia program over a 3-year period. For consecutive cases of patients undergoing abdominal wall reconstruction, process improvement attempts included the use of a long-term resorbable synthetic mesh (TIGR® Resorbable Matrix, Novus Scientific, Uppsala, Sweden) in place of a biologic mesh, the use of the transversus abdominis release approach in place of an open or endoscopic component separation (external oblique release) technique, and the use of a preoperative transversus abdominis plane (TAP) block using a long-acting local anesthetic (Exparel®, Pacira Pharmaceutical, Parsippany, NJ) as a part of perioperative multi-modal pain management and an enhanced recovery program. After over 60 cases, improvement in materials costs and postoperative outcomes were documented. No mesh-related complications occurred and no mesh removal was required. In this real-world, value-based application of CQI, several attempts at process improvement led to decreased costs and improved outcomes for patients who underwent abdominal wall reconstruction for complex ventral/incisional hernias. Value-based CQI could be a tool for improved health care value globally.

  3. Preoperative gluteus medius muscle atrophy as a predictor of walking ability after total hip arthroplasty

    PubMed Central

    NANKAKU, Manabu; TSUBOYAMA, Tadao; AOYAMA, Tomoki; KURODA, Yutaka; IKEGUCHI, Ryosuke; MATSUDA, Shuichi

    2016-01-01

    Purpose: To elucidate the relation between certain preoperative physical parameters and walking with a limp after total hip arthroplasty (THA) and determine whether it is possible to predict the walking ability of patients 6 months after THA. Methods: The subjects of this study comprised 74 female patients who had undergone unilateral THA. Before surgery, the hip abductor and knee extensor strengths were measured, the cross-sectional areas (CSAs) of the gluteus medius and rectus abdominis muscles were measured, and the Timed Up and Go test was conducted. The patients were then divided into two groups according to gait observation results 6 months postoperatively: walking without a limp (n=37) and walking with a limp (n=37). Results: The discriminating criteria between the two groups were age (61 years), CSA of the gluteus medius muscle (2000 mm2), and CSA of the rectus abdominis muscle (340 mm2). In the multiple logistic regression analysis, the gluteus medius muscle was the only significant predictor of limping after THA (β=1.64, R2=0.19, p<0.01). Conclusions: The results of the present study suggest that preoperative atrophy of the gluteus medius is an useful indicator for predicting walking with a limp 6 months postoperatively. PMID:28289576

  4. Functional and morphological variety in trunk muscles of Urodela.

    PubMed

    Omura, Ayano; Anzai, Wataru; Endo, Hideki

    2014-03-01

    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.

  5. Contributions of trunk muscles to anticipatory postural control in children with and without developmental coordination disorder.

    PubMed

    Kane, Kyra; Barden, John

    2012-06-01

    Current evidence suggests that movement quality is impacted by postural adjustments made in advance of planned movement. The trunk inevitably plays a key role in these adjustments, by creating a stable foundation for limb movement. The purpose of this study was to examine anticipatory trunk muscle activity during functional tasks in children with and without developmental coordination disorder (DCD). Eleven children with DCD (age 7 to 14 years) and 11 age-matched, typically-developing children performed three tasks: kicking a ball, climbing stairs, and single leg balance. Surface electromyography (EMG) was used to examine the neuromuscular activity of bilateral transversus abdominis/internal oblique, external oblique and L3/4 erector spinae, as well as the right tibialis anterior and rectus femoris muscles. Onset latencies for each muscle were calculated relative to the onset of rectus femoris activity. In comparison to the children with DCD, the typically-developing children demonstrated earlier onsets for right tibialis anterior, bilateral external oblique, and right transversus abdominis/internal oblique muscles. These results suggest that anticipatory postural adjustments may be associated with movement problems in children with DCD, and that timing of both proximal and distal muscles should be considered when designing intervention programs for children with DCD.

  6. Reorganised motor control strategies of trunk muscles due to acute low back pain.

    PubMed

    Hirata, R P; Salomoni, S E; Christensen, S W; Graven-Nielsen, T

    2015-06-01

    This study assessed how the low back motor control strategies were affected by experimental pain. In twelve volunteers the right m. longissimus was injected by hypertonic and isotonic (control) saline. The pain intensity was assessed on a visual analog scale (VAS). Subjects were seated on a custom-designed chair including a 3-dimensional force sensor adjusted to the segmental height of T1. Electromyography (EMG) was recorded bilaterally from longissimus, multifidus, rectus abdominis, and external oblique muscles. Isometric trunk extensions were performed before, during, and after the saline injections at 5%, 10%, and 20% of maximum voluntary contraction force. Visual feedback of the extension force was provided whereas the tangential force components were recorded. Compared with isotonic saline, VAS scores were higher following hypertonic saline injections (P<.01). Experimental low back pain reduced the EMG activity bilaterally of the rectus abdominis muscles during contractions at 10% and 20% MVC (P<.01) although force accuracy and tangential force variability was not affected. Increased variability in the tangential force composition was found during pain compared with the non-painful condition (P<.05). The immediate adaptation to pain was sufficient to maintain the quality of the task performance; however the long-term consequence of such adaptation is unknown and may overload other structures.

  7. Effects of Vojta method on trunk stability in healthy individuals

    PubMed Central

    Ha, Sun-Young; Sung, Yun-Hee

    2016-01-01

    Vojta reflex locomotion is important to main upright posture through stimulation of breast zone to patient with cerebral palsy. However, application in other diseases is no investigated. So, we determined the effects of stimulation of the breast zone on trunk stability in healthy individuals. Fourteen young healthy adults (7 males and 7 females) voluntarily participated in this study. The subjects were randomly divided into an experimental group (breast zone) and control group (arbitrary point). All groups were stimulated for 5 min on the left and right sides, respectively, for a total 10 times. We used the thickness of the external oblique abdominal muscle (EO), the internal oblique abdominal muscle, the transversus abdominis muscle (TrA), and the rectus abdominis muscles, as well as the area of the diaphragm by using ultrasonography. In the experimental group, the thickness of the TrA significantly increased during stimulation (P<0.05) while the thickness of the EO significantly decreased (P<0.05). Also, the area of diaphragm in inspiration was significantly different (P<0.05). Therefore, stimulation of the breast zone may be effective to improve trunk stability through activation of the TrA muscle and the diaphragm. PMID:28119875

  8. Post-translational Modification of Ribosomal Proteins: Structural and Functional Characterization of RimO from Thermotoga maritima, a Radical S-adenosylmethionine methylthiotransferase

    SciTech Connect

    Arragain, S.; Latour, J; Forouhar, F; Neely, H; Montelione, G; Hunt, J; Mulliez, E; Fontecave, M; Atta, M; et al.

    2010-01-01

    Post-translational modifications of ribosomal proteins are important for the accuracy of the decoding machinery. A recent in vivo study has shown that the rimO gene is involved in generation of the 3-methylthio derivative of residue Asp-89 in ribosomal protein S12 (Anton, B. P., Saleh, L., Benner, J. S., Raleigh, E. A., Kasif, S., and Roberts, R. J. (2008) Proc. Natl. Acad. Sci. U. S. A. 105, 1826-1831). This reaction is formally identical to that catalyzed by MiaB on the C2 of adenosine 37 near the anticodon of several tRNAs. We present spectroscopic evidence that Thermotoga maritima RimO, like MiaB, contains two [4Fe-4S] centers, one presumably bound to three invariant cysteines in the central radical S-adenosylmethionine (AdoMet) domain and the other to three invariant cysteines in the N-terminal UPF0004 domain. We demonstrate that holo-RimO can specifically methylthiolate the aspartate residue of a 20-mer peptide derived from S12, yielding a mixture of mono- and bismethylthio derivatives. Finally, we present the 2.0 {angstrom} crystal structure of the central radical AdoMet and the C-terminal TRAM (tRNA methyltransferase 2 and MiaB) domains in apo-RimO. Although the core of the open triose-phosphate isomerase (TIM) barrel of the radical AdoMet domain was conserved, RimO showed differences in domain organization compared with other radical AdoMet enzymes. The unusually acidic TRAM domain, likely to bind the basic S12 protein, is located at the distal edge of the radical AdoMet domain. The basic S12 protein substrate is likely to bind RimO through interactions with both the TRAM domain and the concave surface of the incomplete TIM barrel. These biophysical results provide a foundation for understanding the mechanism of methylthioation by radical AdoMet enzymes in the MiaB/RimO family.

  9. Post-translational Modification of Ribosomal Proteins - Structural and Functional Characterization of RimO from Thermotoga Maritima, A Radiacal S-Adenosylmethionine Methylthiotransferase

    SciTech Connect

    Arragain, S.; Garcia-Serres, R; Blondin, G; Douki, T; Clemancey, M; Latour, J; Forouhar, F; Neely, H; Montelione, G; et. al.

    2010-01-01

    Post-translational modifications of ribosomal proteins are important for the accuracy of the decoding machinery. A recent in vivo study has shown that the rimO gene is involved in generation of the 3-methylthio derivative of residue Asp-89 in ribosomal protein S12 (Anton, B. P., Saleh, L., Benner, J. S., Raleigh, E. A., Kasif, S., and Roberts, R. J. (2008) Proc. Natl. Acad. Sci. U. S. A. 105, 1826-1831). This reaction is formally identical to that catalyzed by MiaB on the C2 of adenosine 37 near the anticodon of several tRNAs. We present spectroscopic evidence that Thermotoga maritima RimO, like MiaB, contains two [4Fe-4S] centers, one presumably bound to three invariant cysteines in the central radical S-adenosylmethionine (AdoMet) domain and the other to three invariant cysteines in the N-terminal UPF0004 domain. We demonstrate that holo-RimO can specifically methylthiolate the aspartate residue of a 20-mer peptide derived from S12, yielding a mixture of mono- and bismethylthio derivatives. Finally, we present the 2.0 {angstrom} crystal structure of the central radical AdoMet and the C-terminal TRAM (tRNA methyltransferase 2 and MiaB) domains in apo-RimO. Although the core of the open triose-phosphate isomerase (TIM) barrel of the radical AdoMet domain was conserved, RimO showed differences in domain organization compared with other radical AdoMet enzymes. The unusually acidic TRAM domain, likely to bind the basic S12 protein, is located at the distal edge of the radical AdoMet domain. The basic S12 protein substrate is likely to bind RimO through interactions with both the TRAM domain and the concave surface of the incomplete TIM barrel. These biophysical results provide a foundation for understanding the mechanism of methylthioation by radical AdoMet enzymes in the MiaB/RimO family.

  10. Electromyographic investigation of abdominal exercises and the effects of fatigue.

    PubMed

    Robinson, Mark; Lees, Adrian; Barton, Gabor

    Abdominal exercises are widely used to develop the anterior muscles of the trunk. These exercises can be undertaken without the aid of equipment, but increasingly manufacturers are developing equipment which purportedly enhances the training effect for abdominal muscles. As there are many different products and exercises used for abdominal muscle development, it is likely that some are more effective than others. This study aimed to investigate the effectiveness of five commonly performed abdominal exercises. A second aim was to investigate the effects of fatigue on these exercises. Five different types of abdominal exercise [standard crunch (sit-up) with bent knees, gym ball crunch, crunch with 5 kg weight held behind the head, legs raised crunch and a commercially manufactured roller crunch] were examined using integrated surface electromyography (IEMG). The lower rectus abdominis (LRA), upper rectus abdominis (URA) and obliquus externus abdominis (EO) of 15 healthy male participants [age (mean +/- SD) 22.2 +/- 6.8 years; height 1.77 +/- 0.06 m; mass 79.3 +/- 10.7 kg] were monitored using a four-channel special purpose EMG data logger. Three trials of each exercise were performed in random order and normalized to enable comparisons between muscles and exercises. At a later date, ten participants were then re-tested when fresh and after a 30 min whole-body fatigue protocol that specifically targeted the abdominal muscles. Two exercises were evaluated, the abdominal roller crunch and legs raised crunch, which were judged to be the least and most effective, respectively, of the five exercises previously used. The normalized IEMG showed significant (p < 0.001) differences between exercises (gym ball crunch = 86.0 +/- 7.5%; legs raised crunch = 79.9 +/- 5.1%; 5 kg weight crunch = 65.1 +/- 13.4%; standard crunch = 56.2 +/- 3.2%; and roller crunch = 45.0 +/- 11.4%). Post-fatigue, the normalized mean IEMG for both exercises increased significantly (p < 0.05) for LRA and

  11. Redefining the induction of periodontal tissue regeneration in primates by the osteogenic proteins of the transforming growth factor-β supergene family.

    PubMed

    Ripamonti, U

    2016-12-01

    The molecular bases of periodontal tissue induction and regeneration are the osteogenic proteins of the transforming growth factor-β (TGF-β) supergene family. These morphogens act as soluble mediators for the induction of tissues morphogenesis sculpting the multicellular mineralized structures of the periodontal tissues with functionally oriented ligament fibers into newly formed cementum. Human TGF-β3 (hTGF-β3 ) in growth factor-reduced Matrigel(®) matrix induces cementogenesis when implanted in class II mandibular furcation defects surgically prepared in the non-human primate Chacma baboon, Papio ursinus. The newly formed periodontal ligament space is characterized by running fibers tightly attached to the cementoid surface penetrating as mineralized constructs within the newly formed cementum assembling and initiating within the mineralized dentine. Angiogenesis heralds the newly formed periodontal ligament space, and newly sprouting capillaries are lined by cellular elements with condensed chromatin interpreted as angioblasts responsible for the rapid and sustained induction of angiogenesis. The inductive activity of hTGF-β3 in Matrigel(®) matrix is enhanced by the addition of autogenous morcellated fragments of the rectus abdominis muscle potentially providing myoblastic, pericytic/perivascular stem cells for continuous tissue induction and morphogenesis. The striated rectus abdominis muscle is endowed with stem cell niches in para/perivascular location, which can be dominant, thus imposing stem cell features or stemness to the surrounding cells. This capacity to impose stemness is morphologically shown by greater alveolar bone induction and cementogenesis when hTGF-β3 in Matrigel(®) matrix is combined with morcellated fragments of autogenous rectus abdominis muscle. The induction of periodontal tissue morphogenesis develops as a mosaic structure in which the osteogenic proteins of the TGF-β supergene family singly, synergistically and synchronously

  12. [Morphological and physiological characterization of fiber types in the iliofibular muscle of Rana esculenta].

    PubMed

    Dauber, W

    1977-01-01

    In both longitudinal and cross sections of the M. iliofibularis of Rana esculenta three types of muscle fibres are identified by means of light and electron microscopy. These fibretypes called A-, B- and C-fibres are according to the fibres of m. rectus abdominis of the frog. They can be compared with the fibres of the m. rectus abdominis of rat and mouse. But there is another distribution of the fibretypes A, B and C in the m. iliofibularis and in the m. rectus abdominis. The m. iliofibularis is divided into two parts called "Tonusbündel" and "nichttonischer Teil" by means of their reaction to acetylcholine. The surface of the "Tonusbündel" consists of A-, B- and C-fibres while its inside is onlyformed by A- and B-fibres. They continue the "Tonusbündel" in the "nichttonischer Teil". This part chiefly consists of A-fibres. In cross sections their myofibrils are larger in their extent than the A-fibres known before. Therefore the A-fibretype has to be distinguished into two A-fibres: A1 and A2. The new one is called A2-fibre. A1-fibre is described in the "Tonusbündel" and in further investigations. The difference between the two fibres can be understood as a greater manifestation of power of the A1-fibre. The surface of the "nichttonischer Teil" of the m. iliofibularis consists of A2-fibres which easily could be found opposite the "Tonusbündel". At this point in contrary to the "Tonusbündel" could be found a defined morphological substrate for physiological investigations. The different reactions of "Tonusbündel" and "nichttonischer Teil" to acetylcholine could only be explained by the sum of reactions of all fibretypes in each bundle in correspondence with the reaction of the fibres in the neighbour bundle. But their different behaviour by summer- and winterfrogs is unknown. Therefore it is to discuss whether it is allowed to refer generally the results to "muscle" or "musclefibre" got from frogs living in cooled rooms. It is known in literature that not all

  13. Cannabinoid CB1 Receptors Are Localized in Striated Muscle Mitochondria and Regulate Mitochondrial Respiration

    PubMed Central

    Mendizabal-Zubiaga, Juan; Melser, Su; Bénard, Giovanni; Ramos, Almudena; Reguero, Leire; Arrabal, Sergio; Elezgarai, Izaskun; Gerrikagoitia, Inmaculada; Suarez, Juan; Rodríguez De Fonseca, Fernando; Puente, Nagore; Marsicano, Giovanni; Grandes, Pedro

    2016-01-01

    The cannabinoid type 1 (CB1) receptor is widely distributed in the brain and peripheral organs where it regulates cellular functions and metabolism. In the brain, CB1 is mainly localized on presynaptic axon terminals but is also found on mitochondria (mtCB1), where it regulates cellular respiration and energy production. Likewise, CB1 is localized on muscle mitochondria, but very little is known about it. The aim of this study was to further investigate in detail the distribution and functional role of mtCB1 in three different striated muscles. Immunoelectron microscopy for CB1 was used in skeletal muscles (gastrocnemius and rectus abdominis) and myocardium from wild-type and CB1-KO mice. Functional assessments were performed in mitochondria purified from the heart of the mice and the mitochondrial oxygen consumption upon application of different acute delta-9-tetrahydrocannabinol (Δ9-THC) concentrations (100 nM or 200 nM) was monitored. About 26% of the mitochondrial profiles in gastrocnemius, 22% in the rectus abdominis and 17% in the myocardium expressed CB1. Furthermore, the proportion of mtCB1 versus total CB1 immunoparticles was about 60% in the gastrocnemius, 55% in the rectus abdominis and 78% in the myocardium. Importantly, the CB1 immunolabeling pattern disappeared in muscles of CB1-KO mice. Functionally, acute 100 nM or 200 nM THC treatment specifically decreased mitochondria coupled respiration between 12 and 15% in wild-type isolated mitochondria of myocardial muscles but no significant difference was noticed between THC treated and vehicle in mitochondria isolated from CB1-KO heart. Furthermore, gene expression of key enzymes involved in pyruvate synthesis, tricarboxylic acid (TCA) cycle and mitochondrial respiratory chain was evaluated in the striated muscle of CB1-WT and CB1-KO. CB1-KO showed an increase in the gene expression of Eno3, Pkm2, and Pdha1, suggesting an increased production of pyruvate. In contrast, no significant difference was

  14. Survey and assessment of electric and magnetic field (EMF) public exposure in the transportation environment

    SciTech Connect

    Dietrich, F.M.; Jacobs, W.L.

    1999-03-01

    This research, conducted under the support of the Federal Electric and Magnetic Field Research and Public Information Dissemination (EMF RAPID) Engineering Program, characterized the extreme-low-frequency (ELF) electric and magnetic fields (EMF) which a traveler might encounter while using various forms of transportation. Extensive measurement of field level, frequency, temporal variability and spatial variability are reported for: conventional internal-combustion cars, trucks and buses; electric cars, trucks and buses; commuter trains; ferry boats; jetliners; airport shuttle trams; and escalators and moving sidewalks. Static magnetic field levels are also reported. Where possible, the source of the fields is identified. This effort extends extensive past work which investigated field in electrified trains, subways, light rail vehicles, and a magnetically levitated train by using similar protocols to characterize the complex ELF (3 Hz to 3000 Hz) electric and magnetic fields found in virtually all transportation systems.

  15. Detached Eddy Simulation of the UH-60 Rotor Wake Using Adaptive Mesh Refinement

    NASA Technical Reports Server (NTRS)

    Chaderjian, Neal M.; Ahmad, Jasim U.

    2012-01-01

    Time-dependent Navier-Stokes flow simulations have been carried out for a UH-60 rotor with simplified hub in forward flight and hover flight conditions. Flexible rotor blades and flight trim conditions are modeled and established by loosely coupling the OVERFLOW Computational Fluid Dynamics (CFD) code with the CAMRAD II helicopter comprehensive code. High order spatial differences, Adaptive Mesh Refinement (AMR), and Detached Eddy Simulation (DES) are used to obtain highly resolved vortex wakes, where the largest turbulent structures are captured. Special attention is directed towards ensuring the dual time accuracy is within the asymptotic range, and verifying the loose coupling convergence process using AMR. The AMR/DES simulation produced vortical worms for forward flight and hover conditions, similar to previous results obtained for the TRAM rotor in hover. AMR proved to be an efficient means to capture a rotor wake without a priori knowledge of the wake shape.

  16. Overview of the Helios Version 2.0 Computational Platform for Rotorcraft Simulations

    NASA Technical Reports Server (NTRS)

    Sankaran, Venkateswaran; Wissink, Andrew; Datta, Anubhav; Sitaraman, Jayanarayanan; Jayaraman, Buvna; Potsdam, Mark; Katz, Aaron; Kamkar, Sean; Roget, Beatrice; Mavriplis, Dimitri; Saberi, Hossein; Chen, Wei-Bin; Johnson, Wayne; Strawn, Roger

    2011-01-01

    This article summarizes the capabilities and development of the Helios version 2.0, or Shasta, software for rotary wing simulations. Specific capabilities enabled by Shasta include off-body adaptive mesh refinement and the ability to handle multiple interacting rotorcraft components such as the fuselage, rotors, flaps and stores. In addition, a new run-mode to handle maneuvering flight has been added. Fundamental changes of the Helios interfaces have been introduced to streamline the integration of these capabilities. Various modifications have also been carried out in the underlying modules for near-body solution, off-body solution, domain connectivity, rotor fluid structure interface and comprehensive analysis to accommodate these interfaces and to enhance operational robustness and efficiency. Results are presented to demonstrate the mesh adaptation features of the software for the NACA0015 wing, TRAM rotor in hover and the UH-60A in forward flight.

  17. Fastener Hole Quality. Volume 2

    DTIC Science & Technology

    1978-12-01

    i TEST TRAM: 1. 2T 4 5 O Z7W AVER~ AGE VIMRT: 3.07 060 0191o z AVERAGE Tcxs-.,Si 2 860 n i4.*k- 2760 (nI2 o _______ AREA:_____ 2660_______ BASELINE...LOAD: 19777 goAn (n ag ,•’ 71 gn 4o ( 7 3 , - CYCLES AT TERMINATION/ IZ: 3Ives/_ ___n l’ A D 2,7.7 l’ 1so: I I _Z. 1680 -066s 6 at?- .. ign 0!𔃿t7...TEST DATE: _-32 12800 2-6 _. , 31 1240030 12000 6 1d RAG WIDTH: S.oo( -29 11600 6 % OtO c5 n 1l AGE 28 11200 1 % I do t4-S,7/78,... -2ś 10so00

  18. Automated mixed traffic vehicle design AMTV 2

    NASA Technical Reports Server (NTRS)

    Johnston, A. R.; Marks, R. A.; Cassell, P. L.

    1982-01-01

    The design of an improved and enclosed Automated Mixed Traffic Transit (AMTT) vehicle is described. AMTT is an innovative concept for low-speed tram-type transit in which suitable vehicles are equipped with sensors and controls to permit them to operate in an automated mode on existing road or walkway surfaces. The vehicle chassis and body design are presented in terms of sketches and photographs. The functional design of the sensing and control system is presented, and modifications which could be made to the baseline design for improved performance, in particular to incorporate a 20-mph capability, are also discussed. The vehicle system is described at the block-diagram-level of detail. Specifications and parameter values are given where available.

  19. The human adaptor SARM negatively regulates adaptor protein TRIF-dependent Toll-like receptor signaling.

    PubMed

    Carty, Michael; Goodbody, Rory; Schröder, Martina; Stack, Julianne; Moynagh, Paul N; Bowie, Andrew G

    2006-10-01

    Toll-like receptors discriminate between different pathogen-associated molecules and activate signaling cascades that lead to immune responses. The specificity of Toll-like receptor signaling occurs by means of adaptor proteins containing Toll-interleukin 1 receptor (TIR) domains. Activating functions have been assigned to four TIR adaptors: MyD88, Mal, TRIF and TRAM. Here we characterize a fifth TIR adaptor, SARM, as a negative regulator of TRIF-dependent Toll-like receptor signaling. Expression of SARM blocked gene induction 'downstream' of TRIF but not of MyD88. SARM associated with TRIF, and 'knockdown' of endogenous SARM expression by interfering RNA led to enhanced TRIF-dependent cytokine and chemokine induction. Thus, the fifth mammalian TIR adaptor SARM is a negative regulator of Toll-like receptor signaling.

  20. A comment on power-law inflation with a dark radiation component

    NASA Astrophysics Data System (ADS)

    Di Valentino, Eleonora; Bouchet, François R.

    2016-10-01

    Tram et al. 2016 recently pointed out in [1] that power-law inflation in presence of a dark radiation component may relieve the 3.3 σ tension which exists within standard ΛCDM between the determination of the local value of the Hubble constant by Riess et al. (2016) [2] and the value derived from CMB anisotropy data [3] by the Planck collaboration. In this comment, we simply point out that this interesting proposal does not help in solving the σ8 tension between the Planck data and, e.g., the weak lensing measurements. Moreover, when the latest constraints on the reionization optical depth obtained from Planck HFI data [4] are included in the analysis, the H0 tension reappears and this scenario looses appeal.

  1. Mineralogy, petrology and whole-rock chemistry data compilation for selected samples of Yucca Mountain tuffs; Yucca Mountain Site Characterization Project

    SciTech Connect

    Connolly, J.R.

    1991-12-01

    Petrologic, bulk chemical, and mineralogic data are presented for 49 samples of tuffaceous rocks from core holes USW G-1 and UE-25a{number_sign}1 at Yucca Mountain, Nevada. Included, in descending stratigraphic order, are 11 samples from the Topopah Spring Member of the Paintbrush Tuff, 12 samples from the Tuffaceous Beds of Calico Hills, 3 samples from the Prow Pass Member of the Crater Flat Tuff, 20 samples from the Bullfrog Member of the Crater Flat Tuff and 3 samples from the Tram Member of the Crater Flat Tuff. The suite of samples contains a wide variety of petrologic types, including zeolitized, glassy, and devitrified tuffs. Data vary considerably between groups of samples, and include thin section descriptions (some with modal analyses for which uncertainties are estimated), electron microprobe analyses of mineral phases and matrix, mineral identifications by X-ray diffraction, and major element analyses with uncertainty estimates.

  2. Atypical Presentation of Idiopathic Bilateral Optic Perineuritis in a Young Patient

    PubMed Central

    Tevaraj, Jessica Mani Penny; Mohd-Noor, Raja-Azmi; Thavaratnam, Lakana Kumar; Salmah, Win Mar

    2016-01-01

    A previously healthy 27-year-old Malay male presented with acute onset of painless, severe blurring of vision in his right eye. It was associated with headache and vomiting for the past week. Relative afferent pupillary defect was present in the right eye, with reduced optic nerve function. Patient also had bilateral generalised optic disc swelling, splinter haemorrhages, and tortuous vessels. Initial examination was suggestive of either optic neuritis or raised intracranial pressure. Typical features of bilateral optic perineuritis (OPN) such as tram track and doughnut sign were observed on magnetic resonance imaging. Connective tissue and infective screening were negative. He was diagnosed with bilateral optic perineuritis and treated with high dose intravenous corticosteroids followed by a three-month course of oral steroids. His vision and optic nerve function recovered to baseline levels. PMID:28078151

  3. [Bus drivers' biomechanical risk assessment in two different contexts].

    PubMed

    Baracco, A; Coggiola, M; Perrelli, F; Banchio, M; Martignone, S; Gullino, A; Romano, C

    2012-01-01

    The application of standardize methods for the biomechanical risk assessment in non-industrial cycled activity is not always possible. A typical case is the public transport sector, where workers complain of suffering for shoulder more than elbow and wrist pains. The Authors present the results of two studies involving two public transport companies and the risk of biomechanical overload of upper limbs for bus and tram drivers. The analysis has been made using three different approaches: focus groups; static analysis by using anthropometric manikins; work sampling technique by monitoring worker's activity and posture at each minute, for two hours and for each binomial vehicle-route, considering P5F e P95M drivers and assessing the perceived efforts thorough the Borg's CR10 Scale. The conclusive results show that the ergonomic analysis managed by multiple non-standardized techniques may reach consistent and repeatable results according to the epidemiological evidences.

  4. [Medical visits before return to work, after a long lasting absence, above 60 days, for injuries or common diseases in a public transport company. Analysis and discussions of utility and consequences in term of evaluation of fitness to specific job].

    PubMed

    Verga, A; Bordini, L; Ricci, M G; Di Lucca, P; Todaro, A

    2012-01-01

    The aim of this study is to evaluate the opportunity to do medical visits before return to work, after a long continuous absence, above 60 days, for injuries (occupational and non-occupational) or common diseases. We have examined medical records of 403 workers, in 2010 and 2011, occupied in a public transport company, in order to control the following variables: job, age, clinical conditions related to the absences, classification of the absence as injuries or common disease and conclusions about medical fitness to specific job. Our findings have shown an equal percentage of causes of absences in term of injuries or common diseases. The main cause of absence and of non fit to specific job, after medical evaluation, is depending on orthopaedic post-traumatic diseases. This evidence support the importance to do medical visits after long-lasting absence from work, particularly in case of jobs (bus, tram, subway drivers) at risk for other people.

  5. Recurrent pure mucinous carcinoma of the breast with mediastinal great vessel invasion: HER-2/neu confers aggressiveness.

    PubMed

    Adair, Jamie D; Harvey, Kyle P; Mahmood, Ali; Caralis, James; Gordon, William; Yanish, Gregory

    2008-02-01

    Mucinous carcinoma of the breast, also known as colloid carcinoma, is a less common variant of breast cancer constituting less than five per cent of breast cancers. We report the case of a 42-year-old premenopausal female who presented with a palpable chest wall recurrence 4 years after simple mastectomy, axillary node dissection, and TRAM flap reconstruction for pure mucinous carcinoma. The recurrent neoplasm was a pure mucinous carcinoma and was found to be invading the mediastinum into the great vessels. The tumor was estrogen receptor positive, progesterone receptor negative, and HER-2/neu positive, which is an unusual finding for mucinous carcinoma. The fact that this tumor demonstrated HER-2/neu positivity may explain the uncharacteristic aggressive nature of this normally indolent type of breast tumor. To our knowledge, this is the first reported case of any mucinous breast cancer invading the mediastinal great vessels and its subsequent en-bloc resection.

  6. Reconstruction of late Holocene glacier retreat and relevant climatic and topographic patterns in southeastern Tibet by glacier mapping and equilibrium line altitude calculation

    NASA Astrophysics Data System (ADS)

    Loibl, David; Lehmkuhl, Frank

    2014-05-01

    Temperate glaciers in the eastern Nyainqêntanglha range, southeastern Tibet, are highly sensitive to climate change and are therefore of particular high interest for research on late Holocene changes of the monsoonal climate in High Asia. However, due to the remoteness of the area, the scarcity of empirical data, and the challenges to remote sensing work posed by cloud and snow cover, knowledge about the glacier dynamics and changes is still very limited. We applied a remote sensing approach that allowed a comprehensive regional glacier survey despite the few available data. Geomorphologic characteristics, distribution and late Holocene changes of 1964 glaciers were mapped from one of the few appropriate late summer satellite images: a Landsat ETM+ scene from September 23, 1999. The glacier dataset was subsequently parameterized by DEM supported measurements. Complex climate-relief-glacier interactions were studied in detail for three large glaciers in neighboring valleys. Despite their spatial proximity, these display strong heterogeneity in terms of catchment morphology, debris cover, and glacier characteristics. The results of this case study then provided the conceptual basis to use geomorphological evidence, i.e. trimlines and latero-frontal moraines, to obtain quantitative data on the changes since the Little Ice Age (LIA) maximum glacier advance. Statistical analysis of glacier length change revealed an average retreat of ~ 40 % and a trend towards stronger retreat for smaller glaciers. An evaluation of different methods to calculate equilibrium line altitudes (ELAs) indicates that an optimized toe-to-ridge altitude method (TRAM) outperforms other methods in settings with complex topography and a lack of mass-balance measurements. However, a large number of glacier measurements is crucial for high quality TRAM results and special attention has to be paid to different morphological glacier characteristics: debris-cover, reconstitution, valley floor

  7. Energy and wear optimisation of train longitudinal dynamics and of traction and braking systems

    NASA Astrophysics Data System (ADS)

    Conti, R.; Galardi, E.; Meli, E.; Nocciolini, D.; Pugi, L.; Rindi, A.

    2015-05-01

    Traction and braking systems deeply affect longitudinal train dynamics, especially when an extensive blending phase among different pneumatic, electric and magnetic devices is required. The energy and wear optimisation of longitudinal vehicle dynamics has a crucial economic impact and involves several engineering problems such as wear of braking friction components, energy efficiency, thermal load on components, level of safety under degraded or adhesion conditions (often constrained by the current regulation in force on signalling or other safety-related subsystem). In fact, the application of energy storage systems can lead to an efficiency improvement of at least 10% while, as regards the wear reduction, the improvement due to distributed traction systems and to optimised traction devices can be quantified in about 50%. In this work, an innovative integrated procedure is proposed by the authors to optimise longitudinal train dynamics and traction and braking manoeuvres in terms of both energy and wear. The new approach has been applied to existing test cases and validated with experimental data provided by Breda and, for some components and their homologation process, the results of experimental activities derive from cooperation performed with relevant industrial partners such as Trenitalia and Italcertifer. In particular, simulation results are referred to the simulation tests performed on a high-speed train (Ansaldo Breda Emu V250) and on a tram (Ansaldo Breda Sirio Tram). The proposed approach is based on a modular simulation platform in which the sub-models corresponding to different subsystems can be easily customised, depending on the considered application, on the availability of technical data and on the homologation process of different components.

  8. A quantitative transcriptome reference map of the normal human hippocampus.

    PubMed

    Caracausi, Maria; Rigon, Vania; Piovesan, Allison; Strippoli, Pierluigi; Vitale, Lorenza; Pelleri, Maria Chiara

    2016-01-01

    We performed an innovative systematic meta-analysis of 41 gene expression profiles of normal human hippocampus to provide a quantitative transcriptome reference map of it, i.e. a reference typical value of expression for each of the 30,739 known mapped and the 16,258 uncharacterized (unmapped) transcripts. For this aim, we used the software called TRAM (Transcriptome Mapper), which is able to generate transcriptome maps based on gene expression data from multiple sources. We also analyzed differential expression by comparing the hippocampus with the whole brain transcriptome map to identify a typical expression pattern of this subregion compared with the whole organ. Finally, due to the fact that the hippocampus is one of the main brain region to be severely affected in trisomy 21 (the best known genetic cause of intellectual disability), a particular attention was paid to the expression of chromosome 21 (chr21) genes. Data were downloaded from microarray databases, processed, and analyzed using TRAM software. Among the main findings, the most over-expressed loci in the hippocampus are the expressed sequence tag cluster Hs.732685 and the member of the calmodulin gene family CALM2. The tubulin folding cofactor B (TBCB) gene is the best gene at behaving like a housekeeping gene. The hippocampus vs. the whole brain differential transcriptome map shows the over-expression of LINC00114, a long non-coding RNA mapped on chr21. The hippocampus transcriptome map was validated in vitro by assaying gene expression through several magnitude orders by "Real-Time" reverse transcription polymerase chain reaction (RT-PCR). The highly significant agreement between in silico and experimental data suggested that our transcriptome map may be a useful quantitative reference benchmark for gene expression studies related to human hippocampus. Furthermore, our analysis yielded biological insights about those genes that have an intrinsic over-/under-expression in the hippocampus.

  9. Reduced nitric oxide-mediated relaxation and endothelial nitric oxide synthase expression in the tail arteries of streptozotocin-induced diabetic rats.

    PubMed

    Mokhtar, Siti Safiah; Vanhoutte, Paul M; Leung, Susan Wai Sum; Suppian, Rapeah; Yusof, Mohd Imran; Rasool, Aida Hanum Ghulam

    2016-02-15

    Diabetes is associated with endothelial dysfunction, which is characterized by impaired endothelium-dependent relaxations. The present study aimed to examine the role of nitric oxide (NO), prostacyclin and endothelium-dependent hyperpolarization (EDH), in the relaxation of ventral tail arteries of rats under diabetic conditions. Relaxations of tail arteries of control and diabetic rats were studied in wire myograph. Western blotting and immunostaining were used to determine the presence of proteins. Acetylcholine-induced relaxations were significantly smaller in arteries of diabetic compared to control rats (Rmax; 70.81 ± 2.48% versus 85.05 ± 3.15%). Incubation with the combination of non-selective cyclooxygenase (COX) inhibitor, indomethacin and potassium channel blockers, TRAM 34 and UCL 1684, demonstrated that NO-mediated relaxation was attenuated significantly in diabetic compared to control rats (Rmax; 48.47 ± 5.84% versus 68.39 ± 6.34%). EDH-type (in the presence of indomethacin and NO synthase inhibitor, LNAME) and prostacyclin-mediated (in the presence of LNAME plus TRAM 34 and UCL 1684) relaxations were not significantly reduced in arteries of diabetic compared to control rats [Rmax: (EDH; 17.81 ± 6.74% versus 34.16 ± 4.59%) (prostacyclin; 15.85 ± 3.27% versus 17.23 ± 3.75%)]. Endothelium-independent relaxations to sodium nitroprusside, salbutamol and prostacyclin were comparable in the two types of preparations. Western blotting and immunostaining indicated that diabetes diminished the expression of endothelial NO synthase (eNOS), while increasing those of COX-1 and COX-2. Thus, since acetylcholine-induced NO-mediated relaxation was impaired in diabetes because of reduced eNOS protein expression, pharmacological intervention improving NO bioavailability could be useful in the management of diabetic endothelial dysfunction.

  10. KCa3.1 inhibition switches the phenotype of glioma-infiltrating microglia/macrophages

    PubMed Central

    Grimaldi, A; D'Alessandro, G; Golia, M T; Grössinger, E M; Di Angelantonio, S; Ragozzino, D; Santoro, A; Esposito, V; Wulff, H; Catalano, M; Limatola, C

    2016-01-01

    Among the strategies adopted by glioma to successfully invade the brain parenchyma is turning the infiltrating microglia/macrophages (M/MΦ) into allies, by shifting them toward an anti-inflammatory, pro-tumor phenotype. Both glioma and infiltrating M/MΦ cells express the Ca2+-activated K+ channel (KCa3.1), and the inhibition of KCa3.1 activity on glioma cells reduces tumor infiltration in the healthy brain parenchyma. We wondered whether KCa3.1 inhibition could prevent the acquisition of a pro-tumor phenotype by M/MΦ cells, thus contributing to reduce glioma development. With this aim, we studied microglia cultured in glioma-conditioned medium or treated with IL-4, as well as M/MΦ cells acutely isolated from glioma-bearing mice and from human glioma biopsies. Under these different conditions, M/MΦ were always polarized toward an anti-inflammatory state, and preventing KCa3.1 activation by 1-[(2-Chlorophenyl)diphenylmethyl]-1H-pyrazole (TRAM-34), we observed a switch toward a pro-inflammatory, antitumor phenotype. We identified FAK and PI3K/AKT as the molecular mechanisms involved in this phenotype switch, activated in sequence after KCa3.1. Anti-inflammatory M/MΦ have higher expression levels of KCa3.1 mRNA (kcnn4) that are reduced by KCa3.1 inhibition. In line with these findings, TRAM-34 treatment, in vivo, significantly reduced the size of tumors in glioma-bearing mice. Our data indicate that KCa3.1 channels are involved in the inhibitory effects exerted by the glioma microenvironment on infiltrating M/MΦ, suggesting a possible role as therapeutic targets in glioma. PMID:27054329

  11. Intermediate-conductance Ca2+-activated K+ channel, KCa3.1, as a novel therapeutic target for benign prostatic hyperplasia.

    PubMed

    Ohya, Susumu; Niwa, Satomi; Kojima, Yoshiyuki; Sasaki, Shoichi; Sakuragi, Motomu; Kohri, Kenjiro; Imaizumi, Yuji

    2011-08-01

    Recently, a new experimental stromal hyperplasia animal model corresponding to clinical benign prostatic hyperplasia (BPH) was established. The main objective of this study was to elucidate the roles of the intermediate-conductance Ca(2+)-activated K(+) channel (K(Ca)3.1) in the implanted urogenital sinus (UGS) of stromal hyperplasia BPH model rats. Using DNA microarray, real-time polymerase chain reaction, Western blot, and/or immunohistochemical analyses, we identified the expression of K(Ca)3.1 and its transcriptional regulators in implanted UGS of BPH model rats and prostate needle-biopsy samples and surgical prostate specimens of BPH patients. We also examined the in vivo effects of a K(Ca)3.1 blocker, 1-[(2-chlorophenyl)diphenylmethyl]-1H-pyrazole (TRAM-34), on the proliferation index of implanted UGS by measurement of UGS weights and proliferating cell nuclear antigen immunostaining. K(Ca)3.1 genes and proteins were highly expressed in implanted UGS rather than in the normal host prostate. In the implanted UGS, the gene expressions of two transcriptional regulators of K(Ca)3.1, repressor element 1-silencing transcription factor and c-Jun, were significantly down- and up-regulated, and the regulations were correlated negatively or positively with K(Ca)3.1 expression, respectively. Positive signals of K(Ca)3.1 proteins were detected exclusively in stromal cells, whereas they were scarcely immunolocalized to basal cells of the epithelium in implanted UGS. In vivo treatment with TRAM-34 significantly suppressed the increase in implanted UGS weights compared with the decrease in stromal cell components. Moreover, significant levels of K(Ca)3.1 expression were observed in human BPH samples. K(Ca)3.1 blockers may be a novel treatment option for patients suffering from BPH.

  12. The Inhibition by Oxaliplatin, a Platinum-Based Anti-Neoplastic Agent, of the Activity of Intermediate-Conductance Ca²⁺-Activated K⁺ Channels in Human Glioma Cells.

    PubMed

    Huang, Mei-Han; Huang, Yan-Ming; Wu, Sheng-Nan

    2015-01-01

    Oxaliplatin (OXAL) is a third-generation organoplatinum which is effective against advanced cancer cells including glioma cells. How this agent and other related compounds interacts with ion channels in glioma cells is poorly understood. OXAL (100 µM) suppressed the amplitude of whole-cell K+ currents (I(K)); and, either DCEBIO or ionomycin significantly reversed OXAL-mediated inhibition of I(K) in human 13-06-MG glioma cells. In OXAL-treated cells, TRAM-34 did not suppress I(K) amplitude in these cells. The intermediate-conductance Ca(2+)-activated K+ (IK(Ca)) channels subject to activation by DCEBIO and to inhibition by TRAM-34 or clotrimazole were functionally expressed in these cells. Unlike cisplatin, OXAL decreased the probability of IK(Ca)-channel openings in a concentration-dependent manner with an IC50 value of 67 µM. No significant change in single-channel conductance of IK(Ca) channels in the presence of OXAL was demonstrated. Neither large-conductance Ca(2+)-activated K+ channels nor inwardly rectifying K+ currents in these cells were affected in the presence of OXAL. OXAL also suppressed the proliferation and migration of 13-06-MG cells in a concentration- and time-dependent manner. OXAL reduced IK(Ca)-channel activity in LoVo colorectal cancer cells. Taken together, the inhibition by OXAL of IK(Ca) channels would conceivably be an important mechanism through which it acts on the functional activities of glioma cells occurring in vivo.

  13. A quantitative transcriptome reference map of the normal human brain.

    PubMed

    Caracausi, Maria; Vitale, Lorenza; Pelleri, Maria Chiara; Piovesan, Allison; Bruno, Samantha; Strippoli, Pierluigi

    2014-10-01

    We performed an innovative systematic meta-analysis of 60 gene expression profiles of whole normal human brain, to provide a quantitative transcriptome reference map of it, i.e. a reference typical value of expression for each of the 39,250 known, mapped and 26,026 uncharacterized (unmapped) transcripts. To this aim, we used the software named Transcriptome Mapper (TRAM), which is able to generate transcriptome maps based on gene expression data from multiple sources. We also analyzed differential expression by comparing the brain transcriptome with those derived from human foetal brain gene expression, from a pool of human tissues (except the brain) and from the two normal human brain regions cerebellum and cerebral cortex, which are two of the main regions severely affected when cognitive impairment occurs, as happens in the case of trisomy 21. Data were downloaded from microarray databases, processed and analyzed using TRAM software and validated in vitro by assaying gene expression through several magnitude orders by 'real-time' reverse transcription polymerase chain reaction (RT-PCR). The excellent agreement between in silico and experimental data suggested that our transcriptome maps may be a useful quantitative reference benchmark for gene expression studies related to the human brain. Furthermore, our analysis yielded biological insights about those genes which have an intrinsic over-/under-expression in the brain, in addition offering a basis for the regional analysis of gene expression. This could be useful for the study of chromosomal alterations associated to cognitive impairment, such as trisomy 21, the most common genetic cause of intellectual disability.

  14. Aromatase Inhibitor-Associated Bone Fractures: A Case-Cohort GWAS and Functional Genomics

    PubMed Central

    Liu, Mohan; Goss, Paul E.; Ingle, James N.; Kubo, Michiaki; Furukawa, Yoichi; Batzler, Anthony; Jenkins, Gregory D.; Carlson, Erin E.; Nakamura, Yusuke; Schaid, Daniel J.; Chapman, Judy-Anne W.; Shepherd, Lois E.; Ellis, Matthew J.; Khosla, Sundeep; Wang, Liewei

    2014-01-01

    Bone fractures are a major consequence of osteoporosis. There is a direct relationship between serum estrogen concentrations and osteoporosis risk. Aromatase inhibitors (AIs) greatly decrease serum estrogen levels in postmenopausal women, and increased incidence of fractures is a side effect of AI therapy. We performed a discovery case-cohort genome-wide association study (GWAS) using samples from 1071 patients, 231 cases and 840 controls, enrolled in the MA.27 breast cancer AI trial to identify genetic factors involved in AI-related fractures, followed by functional genomic validation. Association analyses identified 20 GWAS single nucleotide polymorphism (SNP) signals with P < 5E-06. After removal of signals in gene deserts and those composed entirely of imputed SNPs, we applied a functional validation “decision cascade” that resulted in validation of the CTSZ-SLMO2-ATP5E, TRAM2-TMEM14A, and MAP4K4 genes. These genes all displayed estradiol (E2)-dependent induction in human fetal osteoblasts transfected with estrogen receptor-α, and their knockdown altered the expression of known osteoporosis-related genes. These same genes also displayed SNP-dependent variation in E2 induction that paralleled the SNP-dependent induction of known osteoporosis genes, such as osteoprotegerin. In summary, our case-cohort GWAS identified SNPs in or near CTSZ-SLMO2-ATP5E, TRAM2-TMEM14A, and MAP4K4 that were associated with risk for bone fracture in estrogen receptor-positive breast cancer patients treated with AIs. These genes displayed E2-dependent induction, their knockdown altered the expression of genes related to osteoporosis, and they displayed SNP genotype-dependent variation in E2 induction. These observations may lead to the identification of novel mechanisms associated with fracture risk in postmenopausal women treated with AIs. PMID:25148458

  15. Blockade of KCa3.1 potassium channels protects against cisplatin-induced acute kidney injury.

    PubMed

    Chen, Cheng-Lung; Liao, Jiunn-Wang; Hu, Oliver Yoa-Pu; Pao, Li-Heng

    2016-09-01

    Tubular cell apoptosis significantly contributes to cisplatin-induced acute kidney injury (AKI) pathogenesis. Although KCa3.1, a calcium-activated potassium channel, participates in apoptosis, its involvement in cisplatin-induced AKI is unknown. Here, we found that cisplatin treatment triggered an early induction of KCa3.1 expression associated with HK-2 cell apoptosis, the development of renal tubular damage, and apoptosis in mice. Treatment with the highly selective KCa3.1 blocker TRAM-34 suppressed cisplatin-induced HK-2 cell apoptosis. We further assessed whether KCa3.1 mediated cisplatin-induced AKI in genetic knockout and pharmacological blockade mouse models. KCa3.1 deficiency reduced renal function loss, renal tubular damage, and the induction of the apoptotic marker caspase-3 in the kidneys of cisplatin-treated KCa3.1 (-/-) mice. Pharmacological blockade of KCa3.1 by TRAM-34 similarly attenuated cisplatin-induced AKI in mice. Furthermore, we dissected the mechanisms underlying cisplatin-induced apoptosis reduction via KCa3.1 blockade. We found that KCa3.1 blockade attenuated cytochrome c release and the increase in the intrinsic apoptotic mediators Bax, Bak, and caspase-9 after cisplatin treatment. KCa3.1 blocking inhibited the cisplatin-induced activation of the endoplasmic reticulum (ER) stress mediator caspase-12, which is independent of calcium-dependent protease m-calpain activation. Taken together, KCa3.1 blockade protects against cisplatin-induced AKI through the attenuation of apoptosis by interference with intrinsic apoptotic and ER stress-related mediators, providing a potential target for the prevention of cisplatin-induced AKI.

  16. Antecedent hydrogen sulfide elicits an anti-inflammatory phenotype in postischemic murine small intestine: role of BK channels.

    PubMed

    Zuidema, Mozow Y; Yang, Yan; Wang, Meifang; Kalogeris, Theodore; Liu, Yajun; Meininger, Cynthia J; Hill, Michael A; Davis, Michael J; Korthuis, Ronald J

    2010-11-01

    The objectives of this study were to determine the role of calcium-activated, small (SK), intermediate (IK), and large (BK) conductance potassium channels in initiating the development of an anti-inflammatory phenotype elicited by preconditioning with an exogenous hydrogen sulfide (H(2)S) donor, sodium hydrosulfide (NaHS). Intravital microscopy was used to visualize rolling and firmly adherent leukocytes in vessels of the small intestine of mice preconditioned with NaHS (in the absence and presence of SK, IK, and BK channel inhibitors, apamin, TRAM-34, and paxilline, respectively) or SK/IK (NS-309) or BK channel activators (NS-1619) 24 h before ischemia-reperfusion (I/R). I/R induced marked increases in leukocyte rolling and adhesion, effects that were largely abolished by preconditioning with NaHS, NS-309, or NS-1619. The postischemic anti-inflammatory effects of NaHS-induced preconditioning were mitigated by BKB channel inhibitor treatment coincident with NaHS, but not by apamin or TRAM-34, 24 h before I/R. Confocal imaging and immunohistochemistry were used to demonstrate the presence of BKα subunit staining in both endothelial and vascular smooth muscle cells of isolated, pressurized mesenteric venules. Using patch-clamp techniques, we found that BK channels in cultured endothelial cells were activated after exposure to NaHS. Bath application of the same concentration of NaHS used in preconditioning protocols led to a rapid increase in a whole cell K(+) current; specifically, the component of K(+) current blocked by the selective BK channel antagonist iberiotoxin. The activation of BK current by NaHS could also be demonstrated in single channel recording mode where it was independent of a change in intracellular Ca(+) concentration. Our data are consistent with the concept that H(2)S induces the development of an anti-adhesive state in I/R in part mediated by a BK channel-dependent mechanism.

  17. FLASH interacts with p160 coactivator subtypes and differentially suppresses transcriptional activity of steroid hormone receptors.

    PubMed

    Kino, Tomoshige; Ichijo, Takamasa; Chrousos, George P

    2004-12-01

    We previously reported that tumor necrosis factor alpha receptor- and Fas-associated FLASH interacts with one of the p160 nuclear receptor coactivators, glucocorticoid receptor-interacting protein (GRIP) 1, at its nuclear receptor-binding (NRB) domain, and that inhibits the transcriptional activity of the glucocorticoid receptor (GR) by interfering with association of GR and GRIP1. Here, we further examined the specificity of FLASH suppressive effect and the physical/functional interactions between this protein and two other p160 family subtypes. The suppressive effect of FLASH on GR transactivation was observed in several cell lines and on the chromatin-integrated mouse mammary tumor virus (MMTV) promoter. FLASH strongly interacted with the NRB domain of the thyroid hormone receptor activator molecule (TRAM) 1, a member of the steroid hormone receptor coactivator (SRC) 3/nuclear receptor coactivator (N-CoA) 3 subtypes, as well as with SRC2/N-CoA2 p160 coactivator GRIP1, while its interaction with SRC1a, one of the SRC1/N-CoA1 proteins, was faint in yeast two-hybrid assays. Accordingly, FLASH strongly suppressed TRAM1- and GRIP1-induced enhancement of GR-stimulated transactivation of the MMTV promoter in HCT116 cells, while it did not affect SRC1a-induced potentiation of transcription. Furthermore, FLASH suppressed androgen- and progesterone receptor-induced transcriptional activity, but did not influence estrogen receptor-induced transactivation, possibly due to their preferential use of p160 coactivators in HCT116 and HeLa cells. Thus, FLASH differentially suppresses steroid hormone receptor-induced transcriptional activity by interfering with their association with SRC2/N-CoA2 and SRC3/N-CoA3 but not with SRC1/N-CoA1.

  18. [Reconstructive strategies in head and neck cancer: case history review from 1992 to 1997 (154 cases)].

    PubMed

    Succo, G; Merlino, G; Pecorari, G C; Liguori, G C; Bergamin, F; Riva, F; Di Lisi, D; Bramardi, F; Magliacani, G; Sartoris, A

    1998-08-01

    Technological progress in reconstructive surgery, in particular the use of pedunculated or free flaps, has given new impetus to head and neck dissection. This stems from the fact that such techniques provide greater oncological radicality, reduce the number of severe post-operative complications and give better quality of life. The present study examines 154 patients suffering from upper aero-digestive tract neoplasms (131 males and 23 females; age range 23-82 years) who had undergone radical surgery. Reconstruction was performed with flaps in 154 cases: 119 pedunculated flaps (102 large myocutaneous pectoral and 17 temporal muscle flaps) and 35 free flaps (18 radial osteofasciocutaneous, 13 radial fasciocutaneous and 4 omentum flaps). Analysis of the individual districts showed that the flap of choice was the temporal muscle flap when surgery involved the soft parts of the orbital-maxilly-zigomatic area and the rhinopharynx. This is because it is highly moldable and reliable. In surgery of the oral cavity and oropharynx the grand pectoral flap is most frequently used as it provides enough tissue for the reconstruction, adequately protects the vascular-nerve axis in the neck and it is quick and easy. However, the functional results are not the best and there is some alteration in the initial phases of deglutition. To reduce these problems, the authors encourage the use of free flaps which provide good results from both the functional and esthetic points of view. They are, however, more difficult to perform and this leads the authors to conclude that they should only be selected for certain patients (long life expectancy, female, young, etc.). In the center where the authors work the flap of choice is the radial fasciocutaneous or osteofasciocutaneous flap. In surgery of the hypopharynx and larynx reconstruction is normally performed with a grand pectoral myocutaneous flap, sculpted as needed for the individual case. In this region, reconstruction proves

  19. Rectus sheath hematoma: three case reports

    PubMed Central

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

    2008-01-01

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

  20. Spectrum of MRI findings in clinical athletic pubalgia.

    PubMed

    Zajick, Donald C; Zoga, Adam C; Omar, Imran M; Meyers, William C

    2008-03-01

    Athletic pubalgia is a frequently encountered syndrome for clinicians who treat active patients participating in a wide variety of athletic endeavors worldwide. Pathologies associated with this clinical scenario span anatomically from the pubic symphysis to the hip and include a myriad of poorly understood and incompletely described musculoskeletal entities, many of which are centered about the pubic symphysis and its tendinous attachments. In this article, we discuss the relevant anatomy and pathophysiology for the most frequently encountered of these disorders, using magnetic resonance (MR) images as a guide. We describe an MR imaging protocol tailored to clinical athletic pubalgia. We then review reproducible MRI patterns of pathology about the pubic symphysis, the rectus abdominis/adductor aponeurosis and the inguinal ring, as well as a group of clinically confounding entities remote from the symphysis but visible by MRI.

  1. Assessing viability of extracorporeal preserved muscle transplants using external field stimulation: a novel tool to improve methods prolonging bridge-to-transplantation time

    NASA Astrophysics Data System (ADS)

    Taeger, Christian D.; Friedrich, Oliver; Dragu, Adrian; Weigand, Annika; Hobe, Frieder; Drechsler, Caroline; Geppert, Carol I.; Arkudas, Andreas; Münch, Frank; Buchholz, Rainer; Pollmann, Charlotte; Schramm, Axel; Birkholz, Torsten; Horch, Raymund E.; Präbst, Konstantin

    2015-07-01

    Preventing ischemia-related cell damage is a priority when preserving tissue for transplantation. Perfusion protocols have been established for a variety of applications and proven to be superior to procedures used in clinical routine. Extracorporeal perfusion of muscle tissue though cumbersome is highly desirable since it is highly susceptible to ischemia-related damage. To show the efficacy of different perfusion protocols external field stimulation can be used to immediately visualize improvement or deterioration of the tissue during active and running perfusion protocols. This method has been used to show the superiority of extracorporeal perfusion using porcine rectus abdominis muscles perfused with heparinized saline solution. Perfused muscles showed statistically significant higher ability to exert force compared to nonperfused ones. These findings can be confirmed using Annexin V as marker for cell damage, perfusion of muscle tissue limits damage significantly compared to nonperfused tissue. The combination of extracorporeal perfusion and external field stimulation may improve organ conservation research.

  2. Lower extremity soft tissue defect reconstruction with the serratus anterior flap.

    PubMed

    Mastroianni, Melissa; Leto Barone, Angelo A; Shanmugarajah, Kumaran; Leonard, David A; Di Rosa, Luigi; Feingold, Randall S; Israeli, Ron; Cetrulo, Curtis L

    2014-03-01

    Reconstruction of limb-threatening lower extremity defects presents unique challenges. The selected method must provide adequate coverage of exposed bone, joints, and tendons while maximizing function of the limb. The traditional workhorse flaps, the free latissimus dorsi and rectus abdominis flaps, have been associated with donor site morbidity and bulkiness that can impair rehabilitation. We report a case series (n = 18) in which the free serratus anterior muscle flap and split thickness skin graft (STSG) was used for lower limb soft tissue coverage. Injuries were due to diabetes (9/18), trauma (7/18), and chronic venous stasis (2/18). A 94% flap survival rate was observed and all but one patient was ambulatory. No donor site morbidity was reported. Our series demonstrates that serratus anterior is an advantageous, reliable free flap with minimal donor site morbidity.

  3. Revision of loop colostomy under regional anaesthesia and sedation.

    PubMed

    Ng, Oriana; Thong, Sze Ying; Chia, Claramae Shulyn; Teo, Melissa Ching Ching

    2015-05-01

    Patients presenting for emergency abdominal procedures often have medical issues that cause both general anaesthesia and central neuraxial blockade to pose significant risks. Regional anaesthetic techniques are often used adjunctively for abdominal procedures under general anaesthesia, but there is limited published data on procedures done under peripheral nerve or plexus blocks. We herein report the case of a patient with recent pulmonary embolism and supraventricular tachycardia who required colostomy refashioning. Ultrasonography-guided regional anaesthesia was administered using a combination of ilioinguinal-iliohypogastric, rectus sheath and transversus abdominis plane blocks. This was supplemented with propofol and dexmedetomidine sedation as well as intermittent fentanyl and ketamine boluses to cover for visceral stimulation. We discuss the anatomical rationale for the choice of blocks and compare the anaesthetic conduct with similar cases that were previously reported.

  4. [Perioperative pain management for abdominal and thoracic surgery].

    PubMed

    Englbrecht, J S; Pogatzki-Zahn, E M

    2014-06-01

    Abdominal and thoracic surgical procedures can result in significant acute postoperative pain. Present evidence shows that postoperative pain management remains inadequate especially after "minor" surgical procedures. Various therapeutic options including regional anesthesia techniques and systemic pharmacotherapy are available for effective treatment of postoperative pain. This work summarizes the pathophysiological background of postoperative pain after abdominal and thoracic surgery and discusses the indication, effectiveness, risks, and benefits of the different therapeutic options. Special focus is given to the controversial debate about the indication for epidural analgesia, as well as various alternative therapeutic options, including transversus abdominis plane (TAP) block, paravertebral block (PVB), wound infiltration with local anesthetics, and intravenous lidocaine. In additional, indications and contraindications of nonopioid analgesics after abdominal and thoracic surgery are discussed and recommendations based on scientific evidence and individual risk and benefit analysis are made. All therapeutic options discussed are eligible for clinical use and may contribute to improve postoperative pain outcome after abdominal and thoracic surgical procedures.

  5. Profiling bone morphogenetic proteins and transforming growth factor-βs by hTGF-β3 pre-treated coral-derived macroporous bioreactors: the power of one.

    PubMed

    Ripamonti, Ugo; Dix-Peek, Thérèse; Parak, Ruqayya; Milner, Brenda; Duarte, Raquel

    2015-05-01

    To study the expression profile of bone morphogenetic proteins and transforming growth factor-βs (BMPs and TGFβs), coral-derived calcium carbonate-based macroporous bioreactors with limited conversion to hydroxyapatite (7% HA/CC) were pre-loaded with and without 250 μg hTGF-β3 and implanted in the rectus abdominis of 3 non-human primates Papio ursinus euthanized on day 60. To investigate the required dose of hNoggin, a BMPs antagonist that controls the induction of bone formation, 7% HA/CC were pre-loaded with 150 μg hNoggin, with 125 μg hTGF-β3/150 μg hNoggin, with or without 125 μg hTGF-β3 and implanted in the r. abdominis of 3 additional animals euthanized on day 90. Quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR) evaluated the expression' profile of BMP-2, BMP-3, BMP-4, BMP-6, BMP-7 and TGF-β1, -β2, and -β3 in tissue generating bioreactors as well as in the adjacent r. abdominis muscle. On day 60, 250 μg hTGF-β3 induced bone formation at the periphery of the implanted bioreactors only. On day 90, 125 μg hTGF-β3/treated bioreactors showed the induction of bone formation throughout the macroporous spaces. Untreated bioreactors induced bone, 4.11% vs. 2.00% on days 60 and 90, respectively. In hTGF-β3/treated bioreactors, BMP-2 and BMP-3 were up-regulated at both time periods, both in the homogenized constructs and in the adjacent r. abdominis muscle whilst BMP-4 in the homogenized construct only. In untreated 7% HA/CC constructs, BMP-2 was up-regulated in the macroporous construct only. On day 60, 250 μg hTGF-β3/treated and untreated macroporous constructs showed up-regulation of TGF-β1 with a six fold increase vs. TGF-β1 expression in adjacent muscle of untreated constructs. TGF-β2 was down regulated in both untreated and 250 μg hTGF-β3/treated bioreactors. On day 60, 250 μg hTGF-β3/treated bioreactors showed TGF-β3 expression in untreated, treated and adjacent muscle tissues. On day 90, BMP-2 was up

  6. A radiologic and anatomic assessment of injectate spread following transmuscular quadratus lumborum block in cadavers.

    PubMed

    Adhikary, S D; El-Boghdadly, K; Nasralah, Z; Sarwani, N; Nixon, A M; Chin, K J

    2017-01-01

    We performed bilateral transmuscular quadratus lumborum blocks in six cadavers using iodinated contrast and methylene blue. Computed tomography imaging was performed in four cadavers and anatomical dissection was completed in five. This demonstrated spread to the lumbar paravertebral space in 63% of specimens, laterally to the transversus abdominis muscle in 50% and caudally to the anterior superior iliac spine in 63% of specimens. There was no radiographic evidence of spread to the thoracic paravertebral space. Anatomical dissection revealed dye staining of the upper branches of the lumbar plexus and the psoas major muscle in 70% of specimens. Further clinical studies are required to confirm if the quadratus lumborum block might be a suitable alternative to lumbar plexus block.

  7. Frequency of anticipatory trunk muscle onsets in children with and without developmental coordination disorder.

    PubMed

    Kane, Kyra; Barden, John

    2014-02-01

    This study used electromyography to compare the frequency of anticipatory postural adjustments for three bilateral trunk muscles and unilateral tibialis anterior muscle between children with and without developmental coordination disorder (DCD; n = 22, ages 7 to 14 years) during three tasks (kicking a ball, stepping onto a step, standing on one foot). Between-group comparisons demonstrated significantly less frequent anticipatory activation of ipsilateral tibialis anterior, ipsilateral transversus abdominis/internal oblique, and bilateral external oblique muscles in children with DCD. Odds ratios indicated that children with DCD utilized anticipatory contractions of these muscles one half to one quarter as often as the typically developing children did, while performing the same tasks. These results suggest that the movement difficulties experienced by children with DCD may be associated with less frequent anticipatory adjustments. For these children, inconsistent preparatory activation may contribute to postural control difficulties, excessive movement variability and poor movement quality.

  8. Abdominal strengthening using the AbVice machine as measured by surface electromyographic activation levels.

    PubMed

    Avedisian, Lori; Kowalsky, Don S; Albro, Richard C; Goldner, Daniel; Gill, Robert C

    2005-08-01

    Twenty-four college students served as subjects in a study that examined the effect of a prototypical abdominal muscle strengthening device (AbVice) compared with other devices currently on the market. The purpose of the present study was to investigate a prototypical device (AbVice) that incorporates contraction of the hamstring and gluteal musculature in conjunction with the abdominals, which may assist in decreasing activation of the hip flexors by allowing greater activity levels of the abdominal musculature via the theory of reflex inhibition, compared with other devices currently available on the market (AbRoller and AbRocker). The repeated-measures study included 17 women and 7 men who ranged in age from 20-23 years (mean +/- SD age, 21.3 +/- 1.5 years). Each subject underwent a single session of data collection during which they completed 10 repetitions of abdominal crunches per device. Subjects completed 4 different crunch sets (AbRocker, AbRoller, standard crunch, AbVice). Counterbalancing of the device was used to negate the effect of fatigue. Speed of repetitions was ensured via use of a metronome set at 40 b.min(-1) to permit similar contraction times and rest periods between repetitions. Rest between conditions was 3 minutes. Mean activation levels of surface electromyography (EMG) were recorded for each condition at the following locations on the right side of the body: rectus abdominis 2.5 cm superior to the umbilicus, rectus abdominis 2.5 cm inferior to the umbilicus, external oblique abdominis 1.0 cm medial to the anterior superior iliac spine, and external oblique abdominis less than 1.0 cm superior to the inguinal ligament. Mean (SD) activation was 1,165.21 mV (634.60 mV) with the AbVice, 242.92 mV (263.03 mV) with the AbRocker, 753.29 mV (514.80 mV) with the standard crunch, and 757.67 mV (542.85 mV) with the AbRoller. Broken down by sex, women had the following mean (SD) EMG values: 1,079.76 mV (705.02 mV) with the AbVice, 680.35 mV (535.35 m

  9. Laughing: a demanding exercise for trunk muscles.

    PubMed

    Wagner, Heiko; Rehmes, Ulrich; Kohle, Daniel; Puta, Christian

    2014-01-01

    Social, psychological, and physiological studies have provided evidence indicating that laughter imposes an increased demand on trunk muscles. It was the aim of this study to quantify the activation of trunk muscles during laughter yoga in comparison with crunch and back lifting exercises regarding the mean trunk muscle activity. Muscular activity during laughter yoga exercises was measured by surface electromyography of 5 trunk muscles. The activation level of internal oblique muscle during laughter yoga is higher compared to the traditional exercises. The multifidus, erector spinae, and rectus abdominis muscles were nearly half activated during laughter yoga, while the activation of the external oblique muscle was comparable with the crunch and back lifting exercises. Our results indicate that laughter yoga has a positive effect on trunk muscle activation. Thus, laughter seems to be a good activator of trunk muscles, but further research is required whether laughter yoga is a good exercise to improve neuromuscular recruitment patterns for spine stability.

  10. Classification and characterization of beef muscles using front-face fluorescence spectroscopy.

    PubMed

    Sahar, Amna; Dufour, Eric

    2015-02-01

    The objective of this study was to evaluate the potential of fluorescence spectroscopy to identify different muscles and to predict some physicochemical and rheological parameters. Samples were taken from three muscles (Semitendinosus, Rectus abdominis and Infraspinatus) of Charolais breed. Dry matter content, fat content, protein content, texture and collagen content were determined. Moreover emission spectra were recorded in the range of 305-400nm, 340-540nm and 410-700nm by fixing the excitation wavelength at 290, 322 and 382nm, respectively. The results obtained were evaluated by partial least square discriminant analysis and partial least square regression. Results of our research work show that front-face fluorescence spectroscopy and chemometrics offer significant potential for the development of rapid and non-destructive methods for the identification and characterization of muscles.

  11. Reconstruction techniques after extralevator abdominoperineal rectal excision or pelvic exenteration: meshes, plasties and flaps.

    PubMed

    Frasson, Matteo; Flor-Lorente, Blas; Carreño, Omar

    2014-03-01

    Perineal wound complications after abdomino-perineal rectal resection are frequent and clinically relevant for their impact on the length of hospitalization, costs, patients' quality of life and oncologic results. With the diffusion of the preoperative radiotherapy and the gradual shift to the extra-elevator technique, the perineal morbidity rate has increased. Many series describing different techniques of primary closure of the perineal defect have been published, but high-quality clinical studies, indicating which is the best option, are missing. A biologic mesh, associated if possible to an omentoplasty, seems to be sufficient to close the perineal defect after extra-elevator abdomino-perineal rectal resection. However, when the proctectomy is associated to the resection of other organs, as for example vagina or sacrum, resulting in an ample perineal defect, the vertical rectus abdominis flap seems to be the best option. If the perineal defect is smaller, the gracilis or gluteus flaps could be other valid alternatives.

  12. Abdominal Wall Endometriosis: Myofibroblasts as a Possible Evidence of Metaplasia: A Case Report.

    PubMed

    Ibrahim, Mohamed Gamal; Delarue, Eleonore; Abesadze, Elene; Haas, Matthias; Sehouli, Jalid; Chiantera, Vito; Mechsner, Sylvia

    2017-01-01

    In this study, we report about a patient with extra-uterine endometriosis (EM) in the abdominal wall muscle with evident metaplasia based on the abundant alpha smooth muscle actin (ASMA)-expressing myofibroblasts. Laparotomy excision of the abdominal wall EM was done following ultrasonographic evidence of a hypodense swelling in the right rectus abdominis, which was confirmed by MRI. Immunohistochemistry staining for ASMA and collagen I was done, with the results confirming that endometriotic stromal cells expressed both. Anterior abdominal wall endometriosis was suspected because of the patient's history of recurrent EM combined with the cyclic nature of symptoms. MRI is useful in determining the extent of the disease. In case of persisting symptoms even under hormonal treatment, surgical excision is mandatory. The expression of both ASMA and collagen I in and around EM lesions supports the notion of the metaplastic process in the course of disease development.

  13. [Reconstruction of an abdominal wall defect with a superior epigastric perforator propeller flap: case report].

    PubMed

    Lepivert, J-C; Alet, J-M; Michot, A; Pélissier, P; Pinsolle, V

    2014-10-01

    Perforators flaps take a special place in reconstructive surgery. These flaps can be dissected and turned as a propeller blade on its pedicule axis. We report the case of a 54-year-old man presenting a recurrence of a dermatofibrosarcoma in the right hypochondrium. Tumor resection caused a large abdominal wall defect taking the anterior aponeurosis of the rectus abdominis. An angioscanner was realized in preoperative to locate the perforators of the deep superior epigastric artery. We realized a propeller flap based on a perforator of the left superior epigastric artery who allowed to cover the wall defect. We set up a patch of Vicryl® to reconstruct the aponeurosis plan at the same operative time. We didn't note any necrosis and complete healing occurred in 2 weeks. The margins were healthy. The cosmetic result and the low morbidity make this flap a good therapeutic option. This flap seems reliable, arteries perforators are constant with good diameter.

  14. The inguinal ligament and its lateral attachments: correcting an anatomical error.

    PubMed

    Acland, Robert D

    2008-01-01

    The inguinal portions of the internal oblique and transversus abdominis muscles are generally described as arising from the inguinal ligament. Previous authors have shown that this description is incorrect. A new dissection study in 15 lightly embalmed cadavers confirms that in reality the inguinal portions of these muscles arise from a thickened strip of ilipsoas fascia that forms the superolateral part of the ilio-pectineal arch. Details are given of a new dissection technique that fully exposes the deep aspect of the inguinal ligament, without disrupting its continuity. The historical background of the persistent textbook error is explored. It originated at a time when there was widespread descriptive and semantic confusion regarding the structure now known as the inguinal ligament.

  15. The effects of Pilates breathing trainings on trunk muscle activation in healthy female subjects: a prospective study

    PubMed Central

    Kim, Sung-Tae; Lee, Joon-Hee

    2017-01-01

    [Purpose] To investigate the effects of Pilates breathing on trunk muscle activation. [Subjects and Methods] Twenty-eight healthy female adults were selected for this study. Participants’ trunk muscle activations were measured while they performed curl-ups, chest-head lifts, and lifting tasks. Pilates breathing trainings were performed for 60 minutes per each session, 3 times per week for 2 weeks. Post-training muscle activations were measured by the same methods used for the pre-training muscle activations. [Results] All trunk muscles measured in this study had increased activities after Pilates breathing trainings. All activities of the transversus abdominis/internal abdominal oblique, and multifidus significantly increased. [Conclusion] Pilates breathing increased activities of the trunk stabilizer muscles. Activation of the trunk muscle indicates that practicing Pilates breathing while performing lifting tasks will reduce the risk of trunk injuries. PMID:28265138

  16. The synergistic induction of bone formation by the osteogenic proteins of the TGF-β supergene family.

    PubMed

    Ripamonti, Ugo; Parak, Ruqayya; Klar, Roland M; Dickens, Caroline; Dix-Peek, Thérèse; Duarte, Raquel

    2016-10-01

    The momentum to compose this Leading Opinion on the synergistic induction of bone formation suddenly arose when a simple question was formulated during a discussion session on how to boost the often limited induction of bone formation seen in clinical contexts. Re-examination of morphological and molecular data available on the rapid induction of bone formation by the recombinant human transforming growth factor-β3 (hTGF-β3) shows that hTGF-β3 replicates the synergistic induction of bone formation as invocated by binary applications of hOP-1:hTGF-β1 at 20:1 by weight when implanted in heterotopic sites of the rectus abdominis muscle of the Chacma baboon, Papio ursinus. The rapid induction of bone formation in primates by hTGF-β3 may stem from bursts of cladistic evolution, now redundant in lower animal species but still activated in primates by relatively high doses of hTGF-β3. Contrary to rodents, lagomorphs and canines, the three mammalian TGF-β isoforms induce rapid and substantial bone formation when implanted in heterotopic rectus abdominis muscle sites of P. ursinus, with unprecedented regeneration of full thickness mandibular defects with rapid mineralization and corticalization. Provocatively, thus providing potential molecular and biological rationales for the apparent redundancy of osteogenic molecular signals in primates, binary applications of recombinant human osteogenic protein-1 (hOP-1) with low doses of hTGF-β1 and -β3, synergize to induce massive ossicles in heterotopic rectus abdominis, orthotopic calvarial and mandibular sites of P. ursinus. The synergistic binary application of homologous but molecularly different soluble molecular signals has indicated that per force several secreted molecular signals are required singly, synchronously and synergistically to induce optimal osteogenesis. The morphological hallmark of the synergistic induction of bone formation is the rapid differentiation of large osteoid seams enveloping

  17. Microsurgical reconstruction during the early puerperium.

    PubMed

    Iglesias, M; Butrón, P; Granados, R

    1996-05-01

    A transverse rectus abdominis musculocutaneous free flap was electively performed for reconstructing the cutaneous cover in a patient during the early puerperium (12 hr after delivery). This flap was chosen because of the natural expansion achieved by pregnancy, and because it would cover the entire area to be reconstructed. During surgery, considerable vasodilation and continuous bleeding were encountered, as well as severe spasm of the arteries and veins both in the flap pedicle and at the recipient site. This spasm eased when local papaverine was used, and blood flow was interrupted but recurred as soon as the artery or vein had contact with the patient's blood. The administration of systemic papaverine caused dilation of flap and recipient vessels, but also of uterine vessels, with severe hemorrhage. Under such circumstances, the systemic use of papaverine was interrupted and systemic oxytocin was administered, with subsequent decrease in tissue perfusion and necrosis of the transplanted flap.

  18. The Role of Magnetic Resonance Imaging in Athletic Pubalgia and Core Muscle Injury.

    PubMed

    Coker, Dana J; Zoga, Adam C

    2015-08-01

    Magnetic resonance imaging (MRI) has become the standard of care imaging modality for a difficult, often misunderstood spectrum of musculoskeletal injury termed athletic pubalgia or core muscle injury. Armed with a dedicated noncontrast athletic pubalgia protocol and a late model phased array receiver coil, the musculoskeletal imager can play a great role in effective diagnosis and treatment planning for lesions, including osteitis pubis, midline pubic plate lesions, and rectus abdominis/adductor aponeurosis injury. Beyond these established patterns of MRI findings, there are many confounders and contributing pathologies about the pelvis in patients with activity related groin pain, including internal and periarticular derangements of the hip. The MRI is ideally suited to delineate the extent of expected injury and to identify the unexpected visceral and musculoskeletal lesions.

  19. The effects of Pilates breathing trainings on trunk muscle activation in healthy female subjects: a prospective study.

    PubMed

    Kim, Sung-Tae; Lee, Joon-Hee

    2017-02-01

    [Purpose] To investigate the effects of Pilates breathing on trunk muscle activation. [Subjects and Methods] Twenty-eight healthy female adults were selected for this study. Participants' trunk muscle activations were measured while they performed curl-ups, chest-head lifts, and lifting tasks. Pilates breathing trainings were performed for 60 minutes per each session, 3 times per week for 2 weeks. Post-training muscle activations were measured by the same methods used for the pre-training muscle activations. [Results] All trunk muscles measured in this study had increased activities after Pilates breathing trainings. All activities of the transversus abdominis/internal abdominal oblique, and multifidus significantly increased. [Conclusion] Pilates breathing increased activities of the trunk stabilizer muscles. Activation of the trunk muscle indicates that practicing Pilates breathing while performing lifting tasks will reduce the risk of trunk injuries.

  20. Revision of loop colostomy under regional anaesthesia and sedation

    PubMed Central

    Ng, Oriana; Thong, Sze Ying; Chia, Claramae Shulyn; Teo, Melissa Ching Ching

    2015-01-01

    Patients presenting for emergency abdominal procedures often have medical issues that cause both general anaesthesia and central neuraxial blockade to pose significant risks. Regional anaesthetic techniques are often used adjunctively for abdominal procedures under general anaesthesia, but there is limited published data on procedures done under peripheral nerve or plexus blocks. We herein report the case of a patient with recent pulmonary embolism and supraventricular tachycardia who required colostomy refashioning. Ultrasonography-guided regional anaesthesia was administered using a combination of ilioinguinal-iliohypogastric, rectus sheath and transversus abdominis plane blocks. This was supplemented with propofol and dexmedetomidine sedation as well as intermittent fentanyl and ketamine boluses to cover for visceral stimulation. We discuss the anatomical rationale for the choice of blocks and compare the anaesthetic conduct with similar cases that were previously reported. PMID:26034327

  1. The anal reflex elicited by cough and sniff: validation of a neglected clinical sign

    PubMed Central

    Chan, C; Ponsford, S; Swash, M

    2004-01-01

    Background: It is unclear whether contraction of the external anal sphincter (EAS) following a voluntary cough is an integral component of the cough response itself, or a reflex response to the abdominal and pelvic floor dynamics induced by the cough. Clinical experience suggests a reflex origin for this response. Objective: To compare motor latencies for intercostal, abdominal, and EAS muscle contraction after transcranial magnetic stimulation with those following voluntary coughing and sniffing. Methods: A needle electrode inserted into the EAS measured responses, which were confirmed by tonic electromyographic recording. Direct motor latencies from the cerebral cortex to the intercostal, rectus abdominis and EAS muscles were obtained using transcranial magnetic stimulation. Sniff and cough induced responses were also recorded in these muscles. Results: The results suggest that EAS responses following a voluntary cough or sniff represent a polysynaptic reflex. Conclusions: As the cough induced anal reflex response is consistent and easily elicited, its use in clinical neurological examination is appropriate. PMID:15377694

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

    PubMed

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

    2004-01-01

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

  3. Laparoscopic management of Spigelian hernia.

    PubMed

    Novell, F; Sanchez, G; Sentis, J; Visa, J; Novell, J; Novell Costa, F

    2000-12-01

    Spigelian hernia (SH) is an uncommon abdominal wall hernia. Its clinical symptoms are not characteristic, and the preoperative diagnosis is often difficult because SH can simulate the symptoms of more classical lower quadrant abdominal diseases. We report a case of SH in an 80-year-old woman that was complicated by incarceration and diagnosed by physical examination and ultrasound. At the time of presentation, she had an abdominal mass that was soft and occasionally painful, and aggravated by movements that increase intraabdominal pressure. Laparoscopic examination of the abdominal cavity identified the incarcerate jejunum ansae. The defect was a large opening in the peritoneum along the lateral margin of the rectus abdominis muscle. After dissection of the intestinal adhesions, a prosthetic polypropylene mesh was introduced and fixed with staples into the lateral abdominal wall. There were no postoperative complications. We conclude that the laparoscopic approach is a feasible alternative to the conventional open technique that is easy, safe, and allows excellent operative visualization.

  4. Athletic injuries of the lateral abdominal wall: review of anatomy and MR imaging appearance.

    PubMed

    Stensby, J Derek; Baker, Jonathan C; Fox, Michael G

    2016-02-01

    The lateral abdominal wall is comprised of three muscles, each with a different function and orientation. The transversus abdominus, internal oblique, and external oblique muscles span the abdominal cavity between the iliocostalis lumborum and quadratus lumborum posteriorly and the rectus abdominis anteriorly. The lateral abdominal wall is bound superiorly by the lower ribs and costal cartilages and inferiorly by the iliac crest and inguinal ligament. The lateral abdominal wall may be acutely or chronically injured in a variety of athletic endeavors, with occasional acute injuries in the setting of high-energy trauma such as motor vehicle collisions. Injuries to the lateral abdominal wall may result in lumbar hernia formation, unique for its high incarceration rate, and also Spigelian hernias. This article will review the anatomy, the magnetic resonance (MR) imaging approach, and the features and complications of lateral abdominal wall injuries.

  5. Effects of individual strengthening exercises for the stabilization muscles on the nutation torque of the sacroiliac joint in a sedentary worker with nonspecific sacroiliac joint pain.

    PubMed

    Yoo, Won-Gyu

    2015-01-01

    [Purpose] We investigated the effects of individual strengthening exercises for the stabilization muscles on the nutation torque of the sacroiliac joint in a sedentary worker with nonspecific sacroiliac joint pain. [Subject] A 36-year-old female complained of pain in the sacroiliac joints. [Methods] The subject performed individual strengthening exercises for the stabilization muscles for nutation torque of the sacroiliac joint for 3 weeks. Pain-provocation tests and visual analog scale (VAS) scores were evaluated before and after the exercises. [Results] After performing the individual strengthening exercises for the erector spinae, rectus abdominis, and biceps femoris muscles for 3 weeks, the subject displayed no pain in the pain provocation tests, and the VAS score was 2/10. [Conclusion] The individual strengthening exercises for the stabilization muscles of the sacroiliac joint performed in the present study appear to be effective for sedentary workers with sacroiliac joint pain.

  6. Microvascular free flaps in skull base reconstruction.

    PubMed

    Herr, Marc W; Lin, Derrick T

    2013-01-01

    The anatomical challenges of skull base surgery are well known. Furthermore, ablative and traumatic defects in this region produce complex reconstructive problems with a high risk of significant postoperative morbidity and mortality. Over the past two decades, microvascular free tissue reconstruction following open resection has been shown to improve outcomes and reduce complication rates when compared to the traditional use of pedicled flaps. The increasing use of free tissue transfer has been further strengthened by improved technical expertise and high flap success rates. Since the size and type of free tissue to be utilized must be individualized to each defect, the accomplished reconstructive surgeon should be extremely versatile and, by extension, facile with a several types of free flaps. Thus, four of the most commonly used flaps--the rectus abdominis, radial forearm, latissimus dorsi and anterolateral thigh flaps--are discussed.

  7. Assessing viability of extracorporeal preserved muscle transplants using external field stimulation: a novel tool to improve methods prolonging bridge-to-transplantation time

    PubMed Central

    Taeger, Christian D.; Friedrich, Oliver; Dragu, Adrian; Weigand, Annika; Hobe, Frieder; Drechsler, Caroline; Geppert, Carol I.; Arkudas, Andreas; Münch, Frank; Buchholz, Rainer; Pollmann, Charlotte; Schramm, Axel; Birkholz, Torsten; Horch, Raymund E.; Präbst, Konstantin

    2015-01-01

    Preventing ischemia-related cell damage is a priority when preserving tissue for transplantation. Perfusion protocols have been established for a variety of applications and proven to be superior to procedures used in clinical routine. Extracorporeal perfusion of muscle tissue though cumbersome is highly desirable since it is highly susceptible to ischemia-related damage. To show the efficacy of different perfusion protocols external field stimulation can be used to immediately visualize improvement or deterioration of the tissue during active and running perfusion protocols. This method has been used to show the superiority of extracorporeal perfusion using porcine rectus abdominis muscles perfused with heparinized saline solution. Perfused muscles showed statistically significant higher ability to exert force compared to nonperfused ones. These findings can be confirmed using Annexin V as marker for cell damage, perfusion of muscle tissue limits damage significantly compared to nonperfused tissue. The combination of extracorporeal perfusion and external field stimulation may improve organ conservation research. PMID:26145230

  8. Effects of chronic electrical stimulation on paralyzed expiratory muscles

    PubMed Central

    DiMarco, Anthony F.; Kowalski, Krzysztof E.

    2013-01-01

    Following spinal cord injury, the expiratory muscles develop significant disuse atrophy characterized by reductions in their weight, fiber cross-sectional area, and force-generating capacity. We determined the extent to which these physiological alterations can be prevented with electrical stimulation. Because a critical function of the expiratory muscles is cough generation, an important goal was the maintenance of maximal force production. In a cat model of spinal cord injury, short periods of high-frequency lower thoracic electrical spinal cord stimulation (SCS) at the T10 level (50 Hz, 15 min, twice/day, 5 days/wk) were initiated 2 wk following spinalization and continued for a 6-mo period. Airway pressure (P)-generating capacity was determined by SCS. Five acute, spinalized animals served as controls. Compared with controls, initial P fell from 43.9 ± 1.0 to 41.8 ± 0.7 cmH2O (not significant) in the chronic animals. There were small reductions in the weight of the external oblique, internal oblique, transverses abdominis, internal intercostal, and rectus abdominis muscles (not significant for each). There were no significant changes in the population of fast muscle fibers. Because prior studies (Kowalski KE, Romaniuk JR, DiMarco AF. J Appl Physiol 102: 1422-1428, 2007) have demonstrated significant atrophy following spinalization in this model, these results indicate that expiratory muscle atrophy can be prevented by the application of short periods of daily high-frequency stimulation. Because the frequency of stimulation is similar to the expected pattern of clinical use for cough generation, the daily application of electrical stimulation could potentially serve the dual purpose of maintenance of expiratory muscle function and airway clearance. PMID:18403449

  9. Selective Activation of Shoulder, Trunk, and Arm Muscles: A Comparative Analysis of Different Push-Up Variants

    PubMed Central

    Marcolin, Giuseppe; Petrone, Nicola; Moro, Tatiana; Battaglia, Giuseppe; Bianco, Antonino; Paoli, Antonio

    2015-01-01

    Context The push-up is a widely used exercise for upper limb strengthening that can be performed with many variants. A comprehensive analysis of muscle activation during the ascendant phase (AP) and descendant phase (DP) in different variants could be useful for trainers and rehabilitators. Objective To obtain information on the effect of different push-up variants on the electromyography (EMG) of a large sample of upper limb muscles and to investigate the role of the trunk and abdomen muscles during the AP and DP. Design Cross-sectional study. Setting University laboratory. Patients or Other Participants Eight healthy, young volunteers without a history of upper extremity or spine injury. Intervention(s) Participants performed a set of 10 repetitions for each push-up variant: standard, wide, narrow, forward (FP), and backward (BP). Surface EMG of 12 selected muscles and kinematics data were synchronously recorded to describe the AP and DP. Main Outcome Measure(s) Mean EMG activity of the following muscles was analyzed: serratus anterior, deltoideus anterior, erector spinae, latissimus dorsi, rectus abdominis, triceps brachii caput longus, triceps brachii caput lateralis, obliquus externus abdominis, pectoralis major sternal head, pectoralis major clavicular head, trapezius transversalis, and biceps brachii. Results The triceps brachii and pectoralis major exhibited greater activation during the narrow-base variant. The highest activation of abdomen and back muscles was recorded for the FP and BP variants. The DP demonstrated the least electrical activity across all muscles, with less marked differences for the abdominal and erector spinae muscles because of their role as stabilizers. Conclusions Based on these findings, we suggest the narrow-base variant to emphasize triceps and pectoralis activity and the BP variant for total upper body strength conditioning. The FP and BP variants should be implemented carefully in participants with low back pain because of the

  10. THE EFFICACY OF AN EIGHT-WEEK CORE STABILIZATION PROGRAM ON CORE MUSCLE FUNCTION AND ENDURANCE: A RANDOMIZED TRIAL

    PubMed Central

    Sperier, Aubrey D.; Hopkins, Colleen F.; Griffiths, Bridgette D.; Principe, Molly F.; Schnall, Barri L.; Bell, Johanna C.; Koppenhaver, Shane L.

    2016-01-01

    ABSTRACT Background Body armor is credited with increased survival rates in soldiers but the additional axial load may negatively impact the biomechanics of the spine resulting in low back pain. Multiple studies have found that lumbar stabilization programs are superior to generalized programs for patients with chronic low back pain. It is not known if such programs produce objective changes in trunk muscle function with wear of body armor. Hypothesis/Purpose An eight-week core stability exercise program would result in a larger improvement in physical endurance and abdominal muscle thickness than a control intervention. The purpose of this study was to assess the effectiveness of an eight-week core stability exercise program on physical endurance and abdominal muscle thickness with and without wear of body armor. Study Design Randomized controlled trial Methods Participants (N = 33) were randomized into either the core strengthening exercise group or the control group. Testing included ultrasound imaging of abdominal muscle thickness in hook-lying and standing with and without body armor and timed measures of endurance. Results There were statistically significant group by time interactions for transversus abdominis muscle contraction thickness during standing, both with (p = 0.018) and without body armor (p = 0.038). The main effect for hold-time during the horizontal side-support (p = 0.016) indicated improvement over time regardless of group. There was a significant group by time interaction (p = 0.014) for horizontal side-support hold-time when compliance with the exercise protocol was set at 85%, indicating more improvement in the core stabilization group than in the control group. Conclusion Performing an eight-week core stabilization exercise program significantly improves transversus abdominis muscle activation in standing and standing with body armor. When compliant with the exercises, such a program may increase trunk strength and

  11. Balance recovery is compromised and trunk muscle activity is increased in chronic obstructive pulmonary disease.

    PubMed

    Smith, Michelle D; Chang, Angela T; Hodges, Paul W

    2016-01-01

    Increased respiration in chronic obstructive pulmonary disease (COPD) requires greater abdominal muscle activation, which may impact on contribution of the trunk to postural control. This study aimed to determine whether recovery of balance from postural perturbations and trunk muscle activity differs in people with and without COPD before and/or after exercise. Electromyography (EMG) of the obliquus internus (OI) and externus (OE) abdominis, rectus abdominis (RA), erector spinae (ES) and deltoid muscles was recorded with surface electrodes during rapid shoulder flexion and extension. Time taken to regain baseline centre of pressure velocity (vCOP) and the number of postural adjustments following arm movement was calculated from force plate data. Time to recover balance in the direction of postural disturbance (anteroposterior vCOP) was longer in COPD, particularly more severe COPD, than controls. Mediolateral vCOP (perpendicular to the perturbation) and the number of postural adjustments did not differ between groups, but people with more severe COPD were less successful at returning their mediolateral vCOP to baseline. Abdominal muscle EMG was similar between groups, but controls had greater ES EMG during arm movements. Individuals with more severe COPD had greater OE and RA EMG both before and during arm movement compared to those with less severe COPD and controls. Following exercise, OE and ES EMG increased in people with less severe COPD. This study shows that severe COPD is associated with impaired ability to recover balance and greater trunk muscle activity during postural challenges. Augmented trunk muscle activity may limit the contribution of trunk movements to balance recovery and could contribute to increased falls risk.

  12. Trunk Muscle Activation at the Initiation and Braking of Bilateral Shoulder Flexion Movements of Different Amplitudes.

    PubMed

    Eriksson Crommert, M; Halvorsen, K; Ekblom, M M

    2015-01-01

    The aim of this study was to investigate if trunk muscle activation patterns during rapid bilateral shoulder flexions are affected by movement amplitude. Eleven healthy males performed shoulder flexion movements starting from a position with arms along sides (0°) to either 45°, 90° or 180°. EMG was measured bilaterally from transversus abdominis (TrA), obliquus internus (OI) with intra-muscular electrodes, and from rectus abdominis (RA), erector spinae (ES) and deltoideus with surface electrodes. 3D kinematics was recorded and inverse dynamics was used to calculate the reactive linear forces and torque about the shoulders and the linear and angular impulses. The sequencing of trunk muscle onsets at the initiation of arm movements was the same across movement amplitudes with ES as the first muscle activated, followed by TrA, RA and OI. All arm movements induced a flexion angular impulse about the shoulders during acceleration that was reversed during deceleration. Increased movement amplitude led to shortened onset latencies of the abdominal muscles and increased level of activation in TrA and ES. The activation magnitude of TrA was similar in acceleration and deceleration where the other muscles were specific to acceleration or deceleration. The findings show that arm movements need to be standardized when used as a method to evaluate trunk muscle activation patterns and that inclusion of the deceleration of the arms in the analysis allow the study of the relationship between trunk muscle activation and direction of perturbing torque during one and the same arm movement.

  13. Appropriately placed surface EMG electrodes reflect deep muscle activity (psoas, quadratus lumborum, abdominal wall) in the lumbar spine.

    PubMed

    McGill, S; Juker, D; Kropf, P

    1996-11-01

    This study tested the possibility of obtaining the activity of deeper muscles in the torso-specifically psoas, quadratus lumborum, external oblique, internal oblique and transverse abdominis, using surface myoelectric electrodes. It was hypothesized that: (1) surface electrodes adequately represent the amplitude of deep muscles (specifically psoas, quadratus lumborum, external oblique, internal oblique, transverse abdominis); (2) a single surface electrode location would best represent the activation profiles of each deep muscle over a broad variety of tasks. We assumed that prediction of activation within 10% of maximum voluntary contraction (RMS difference between the surface and intramuscular channels), over the time history of the signal, was reasonable and acceptable to assist clinical interpretation of muscle activation amplitude, and ultimately for modeled estimates of muscle force. Surface electrodes were applied and intramuscular electrodes were inserted on the left side of the body in five men and three women who then performed a wide variety of flexor tasks (bent knee and straight leg situps and leg raises, curl ups), extensor tasks (including lifting barbells up to 70 kg), lateral bending tasks (standing lateral bend and horizontal lying side support), twisting tasks (standing and sitting), and internal/external hip rotation. Using the criteria of RMS difference and the coefficient of determination (R2) to compare surface with intramuscular myoelectric signals, the results indicated that selected surface electrodes adequately represent the amplitude of deep muscles-always within 15% RMS difference, or less with the exception of psoas where differences up to 20% were observed but only in certain maximum voluntary contraction efforts. It appears reasonable for spine modelers, and particularly clinicians, to assume well selected surface electrode locations provide a representation of these deeper muscles-as long as they recognize the magnitude of error for

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

    PubMed Central

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

    2014-01-01

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

  15. Lumbopelvic motor control and low back pain in elite soccer players: a cross-sectional study.

    PubMed

    Grosdent, Stéphanie; Demoulin, Christophe; Rodriguez de La Cruz, Carlos; Giop, Romain; Tomasella, Marco; Crielaard, Jean-Michel; Vanderthommen, Marc

    2016-01-01

    This study aimed to investigate the relationship between the history of low back pain and quality of lumbopelvic motor control in soccer players. Forty-three male elite soccer players (mean age, 18.2 ± 1.4 years) filled in questionnaires related to low back pain and attended a session to assess lumbopelvic motor control by means of five tests (the bent knee fall out test, the knee lift abdominal test, the sitting knee extension test, the waiter's bow and the transversus abdominis test). A physiotherapist, blinded to the medical history of the participants, scored (0 = failed, 1 = correct) the performance of the players for each of the tests resulting in a lumbopelvic motor control score ranging from 0 to 5. Forty-seven per cent of the soccer players reported a disabling low back pain episode lasting at least two consecutive days in the previous year. These players scored worse lumbopelvic motor control than players without a history of low back pain (lumbopelvic motor control score of 1.8 vs. 3.3, P < 0.01). The between-groups difference was particularly marked for the bent knee fall out test, the knee lift abdominal test and the transversus abdominis test (P < 0.01). In conclusion, most soccer players with a history of low back pain had an altered lumbopelvic motor control. Further research should examine whether lumbopelvic motor control is etiologically involved in low back pain episodes in soccer players.

  16. Reliability of ultrasound in combination with surface electromyogram for evaluating the activity of abdominal muscles in individuals with and without low back pain.

    PubMed

    Yang, Kyung-Hye; Park, Du-Jin

    2014-08-01

    This study investigated the reliability of ultrasound in combination with surface electromyogram (EMG) for evaluating the activity of the abdominal muscles in individuals with and without low back pain during the abdominal drawing-in maneuver (ADIM). The study recruited ten individuals with or without low back pain, respectively. While the participants were performing the ADIM, the activities of the transversus abdominis (TrA) and the internal oblique (IO) were measured using ultra-sound, while the activities of the external oblique (EO) and the rectus abdominis (RA) were measured using surface EMG. Intra-class correlation coefficients (ICC) were used to verify the inter-rater reliability of ultrasound in combination with surface EMG at rest and during the ADIM, and Bland-Altman plots were used to verify intra-rater reliability. The inter-rater reliability for the two groups at rest and during the ADIM was excellent (ICC2,1 = 0.77-0.95). In the Bland-Altman plots, the mean differences and 95% limits of agreement in the abdominal muscles of the two groups at rest were -0.03∼0.03 mm (-0.66 to 0.60 mm) and -0.12∼ -0.05 (-0.58 to 0.48% MVIC), respectively. The mean differences and 95% limits of agreement in the abdominal muscles of the two groups during the ADIM were -0.04∼0.02 mm (-0.73 to 0.65 mm) and -0.19∼0.05% MVIC (-1.24 to 1.34% MVIC), respectively. The ultrasound in combination with surface EMG showed excellent inter-rater and intra-rater reliability at rest and during the ADIM.

  17. Abdominal muscle and epipubic bone function during locomotion in Australian possums: insights to basal mammalian conditions and Eutherian-like tendencies in Trichosurus.

    PubMed

    Reilly, Stephen M; McElroy, Eric J; White, Thomas D; Biknevicius, Audrone R; Bennett, Michael B

    2010-04-01

    Mammals have four hypaxial muscle layers that wrap around the abdomen between the pelvis, ribcage, and spine. However, the marsupials have epipubic bones extending anteriorly into the ventral hypaxial layers with two additional muscles extending to the ventral midline and femur. Comparisons of South American marsupials to basal eutherians have shown that all of the abdominal hypaxials are active bilaterally in resting ventilation. However, during locomotion marsupials employ an asymmetrical pattern of activity as the hypaxial muscles form a crosscouplet linkage that uses the epipubic bone as a lever to provide long-axis support of the body between diagonal limb couplets during each step. In basal eutherians, this system shifts off the femur and epipubic bones (which are lost) resulting in a shoulder to pelvis linkage associated with shifts in both the positions and activity patterns of the pectineus and rectus abdominis muscles during locomotion. In this study, we present data on hypaxial function in two species (Pseudocheirus peregrinus and Trichosurus vulpecula) representing the two major radiations of possums in Australia: the Pseudocheiridae (within the Petauroidea) and the Phalangeridae. Patterns of gait, motor activity, and morphology in these two Australian species were compared with previous work to examine the generality of 1) the crosscouplet lever system as the basal condition for the Marsupialia and 2) several traits hypothesized to be common to all mammals (hypaxial tonus during resting ventilation, ventilation to step synchrony during locomotion, and bilateral transversus abdominis activity during locomotor expiration). Our results validate the presence of the crosscouplet pattern and basic epipubic bone lever system in Australian possums and confirm the generality of basal mammalian patterns. However, several novelties discovered in Trichosurus, reveal that it exhibits an evolutionary transition to intermediate eutherian-like morphological and motor

  18. Mathematical modelling of the growth of human fetus anatomical structures.

    PubMed

    Dudek, Krzysztof; Kędzia, Wojciech; Kędzia, Emilia; Kędzia, Alicja; Derkowski, Wojciech

    2016-07-08

    The goal of this study was to present a procedure that would enable mathematical analysis of the increase of linear sizes of human anatomical structures, estimate mathematical model parameters and evaluate their adequacy. Section material consisted of 67 foetuses-rectus abdominis muscle and 75 foetuses- biceps femoris muscle. The following methods were incorporated to the study: preparation and anthropologic methods, image digital acquisition, Image J computer system measurements and statistical analysis method. We used an anthropologic method based on age determination with the use of crown-rump length-CRL (V-TUB) by Scammon and Calkins. The choice of mathematical function should be based on a real course of the curve presenting growth of anatomical structure linear size Ύ in subsequent weeks t of pregnancy. Size changes can be described with a segmental-linear model or one-function model with accuracy adequate enough for clinical purposes. The interdependence of size-age is described with many functions. However, the following functions are most often considered: linear, polynomial, spline, logarithmic, power, exponential, power-exponential, log-logistic I and II, Gompertz's I and II and von Bertalanffy's function. With the use of the procedures described above, mathematical models parameters were assessed for V-PL (the total length of body) and CRL body length increases, rectus abdominis total length h, its segments hI, hII, hIII, hIV, as well as biceps femoris length and width of long head (LHL and LHW) and of short head (SHL and SHW). The best adjustments to measurement results were observed in the exponential and Gompertz's models.

  19. Analysis of muscle activity during active pelvic tilting in sagittal plane

    PubMed Central

    TAKAKI, Sho; KANEOKA, Koji; OKUBO, Yu; OTSUKA, Satoru; TATSUMURA, Masaki; SHIINA, Itsuo; MIYAKAWA, Shumpei

    2016-01-01

    Background: Pelvic tilting is performed to improve lumbopelvic flexibility or retrain the motor control of local muscles. However, few studies investigated the activity of local muscles during pelvic tilting. Purpose: The purpose of this study was to investigate muscle activity during anterior and posterior pelvic tilting. Method: Twelve healthy males (age, 22.6 ± 1.4 years) participated. Fine-wire electrodes were inserted into the bilateral lumbar multifidus (MF) and transversus abdominis (TrA). Surface electrodes were used to record activity of the bilateral rectus abdominis, external oblique, and erector spinae (ES), and the unilateral right latissimus dorsi, gluteus maximus, semitendinosus, and rectus femoris muscles. The electromyographic activities during anterior and posterior pelvic tilting in a standing position were recorded and expressed as a percentage of the maximum voluntary contraction (%MVC) for each muscle. Results: The activities of the bilateral MF (right: 23.9 ± 15.9 %MVC, left: 23.9 ± 15.1 %MVC) and right ES (19.0 ± 13.3 %MVC) were significantly greater than those of the other muscles during anterior pelvic tilting. The activity of the left TrA (14.8 ± 16.4 %MVC) was significantly greater than that of the other muscles during posterior pelvic tilting. Conclusions: The results suggested that the MF and ES are related to anterior pelvic tilting. The activity of the TrA, which was classified as a local muscle, was greater during posterior pelvic tilting. This study indicated that local muscles such as the MF and TrA may be related to pelvic tilting. PMID:28289581

  20. Trunk Muscle Activation at the Initiation and Braking of Bilateral Shoulder Flexion Movements of Different Amplitudes

    PubMed Central

    Eriksson Crommert, M.; Halvorsen, K.; Ekblom, M. M.

    2015-01-01

    The aim of this study was to investigate if trunk muscle activation patterns during rapid bilateral shoulder flexions are affected by movement amplitude. Eleven healthy males performed shoulder flexion movements starting from a position with arms along sides (0°) to either 45°, 90° or 180°. EMG was measured bilaterally from transversus abdominis (TrA), obliquus internus (OI) with intra-muscular electrodes, and from rectus abdominis (RA), erector spinae (ES) and deltoideus with surface electrodes. 3D kinematics was recorded and inverse dynamics was used to calculate the reactive linear forces and torque about the shoulders and the linear and angular impulses. The sequencing of trunk muscle onsets at the initiation of arm movements was the same across movement amplitudes with ES as the first muscle activated, followed by TrA, RA and OI. All arm movements induced a flexion angular impulse about the shoulders during acceleration that was reversed during deceleration. Increased movement amplitude led to shortened onset latencies of the abdominal muscles and increased level of activation in TrA and ES. The activation magnitude of TrA was similar in acceleration and deceleration where the other muscles were specific to acceleration or deceleration. The findings show that arm movements need to be standardized when used as a method to evaluate trunk muscle activation patterns and that inclusion of the deceleration of the arms in the analysis allow the study of the relationship between trunk muscle activation and direction of perturbing torque during one and the same arm movement. PMID:26562017

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed

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

    2014-09-01

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

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

    PubMed Central

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

    2016-01-01

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

  4. Sublingual-plunging ranula as a complication of supraomohyoid neck dissection.

    PubMed

    Dietrich, Eva-Maria; Vasilios, Banikas; Maria, Lazaridou; Styliani, Papaemmanouil; Konstantinos, Antoniades

    2011-01-01

    Ranulas are rare cystic lesions resulting from damage or rupture of one or more of the ducts of the sublingual gland, that lead to mucus extravasation or dilatation of the gland's duct. Extravasation cysts are more common than retention cysts. We present a case of a 45-year-old male with a squamous cell carcinoma of the ventral surface of the tongue that was treated with excision of the oral lesion and bilateral supraomohyoid neck dissection without supplementary radiotherapy. A left myocutaneous platysma flap was raised for defect closure. Ten months postoperatively he presented complaining of swelling of the right submandibular region. The diagnosis, based on his medical anamnesis and the CT imaging, was a sublingual-plunging ranula. It is postulated that the ranula resulted from damage to the ducts of the sublingual gland during selective neck dissection. One year postoperatively there are no signs of recurrence either of the ranula or of the cancer. We suggest that sublingual gland excision and intraoral cyst marsupialization is a logical treatment for sublingual-plunging ranulas.

  5. Thrombospondin-1 limits ischemic tissue survival by inhibiting nitric oxide–mediated vascular smooth muscle relaxation

    PubMed Central

    Isenberg, Jeff S.; Hyodo, Fuminori; Matsumoto, Ken-Ichiro; Romeo, Martin J.; Abu-Asab, Mones; Tsokos, Maria; Kuppusamy, Periannan; Wink, David A.; Krishna, Murali C.

    2007-01-01

    The nitric oxide (NO)/cGMP pathway, by relaxing vascular smooth muscle cells, is a major physiologic regulator of tissue perfusion. We now identify thrombospondin-1 as a potent antagonist of NO for regulating F-actin assembly and myosin light chain phosphorylation in vascular smooth muscle cells. Thrombospondin-1 prevents NO-mediated relaxation of precontracted vascular smooth muscle cells in a collagen matrix. Functional magnetic resonance imaging demonstrated that an NO-mediated increase in skeletal muscle perfusion was enhanced in thrombospondin-1–null relative to wild-type mice, implicating endogenous thrombospondin-1 as a physiologic antagonist of NO-mediated vasodilation. Using a random myocutaneous flap model for ischemic injury, tissue survival was significantly enhanced in thrombospondin-1–null mice. Improved flap survival correlated with increased recovery of oxygen levels in the ischemic tissue of thrombospondin-1–null mice as measured by electron paramagnetic resonance oximetry. These findings demonstrate an important antag-onistic relation between NO/cGMP signaling and thrombospondin-1 in vascular smooth muscle cells to regulate vascular tone and tissue perfusion. PMID:17082319

  6. Serratus anterior venous tributary as a second outflow vein in latissimus dorsi free flaps.

    PubMed

    Goh, Terence; Tan, Bien-Keem; Ong, Yee-Siang; Chew, Winston

    2011-10-01

    The latissimus dorsi (LD) flap is a large and reliable myocutaneous flap with a consistently long vascular pedicle. However, the limitation of the thoracodorsal pedicle is that it has only one draining vein for anastomosis. We describe a simple technique of recruiting the tributary vein to the serratus anterior and using it as a second draining vein to alleviate congestion in lower limb reconstruction. The serratus anterior venous tributary segment is cut back to an avalvular segment which averages 5 mm in length. Provision of an additional venous outflow to the flap enabled a second venous anastomosis to the short saphenous vein (N = 1), the long saphenous vein (N = 2), a deep vein (N= 1), and to a deep vein via a vein graft (N = 1), respectively. Five patients with degloving injury of the lower extremity of sizes 150 cm(2) (10 × 15 cm) to 260 cm(2) (10 × 26 cm) underwent successful reconstruction using the LD muscle flap with the serratus anterior tributary vein as a second outflow vein. This serratus anterior venous tributary serves as a useful second outflow channel for alleviating venous congestion during lower limb reconstructive surgery and should be routinely preserved as a lifeboat.

  7. Coverage of Amputation Stumps Using a Latissimus Dorsi Flap With a Serratus Anterior Muscle Flap: A Comparative Study.

    PubMed

    Kim, Sang Wha; Jeon, Seung Bae; Hwang, Kyu Tae; Kim, Youn Hwan

    2016-01-01

    Amputation of the extremities is a definitive reconstructive option, and surgeons should aim to preserve maximum overall function. If the exposed bone cannot be adequately covered using local tissues, the stump can be reconstructed using a number of well-described free flap transfer techniques. Between January 2002 and December 2011, 31 patients with severe injuries to the lower extremities underwent above-the-knee, below-the-knee, and Chopart and Ray amputations. Bony stumps were covered using latissimus dorsi myocutaneous flaps alone (group 1), or together with serratus anterior muscle flaps (group 2). The groups were compared with respect to age, flap survival, skin flap size, immediate complications, wound sloughing, deep ulceration, need for bone amputation, limb visual analog scale score, time to prosthesis, and follow-up duration. The mean area of the latissimus dorsi skin flap was 255.9 cm, and immediate complications occurred in 8 (25.8%) patients. In the double-padding group, there were fewer cases of deep ulceration than in the single-flap group, and prostheses could be worn sooner. There were no statistically significant differences in other parameters. Successful reconstruction of amputation stumps requires an adequate, durable, weight-bearing, and well-contoured soft tissue cover. A latissimus dorsi musculocutaneous flap together with a serratus anterior muscle flap provides well-vascularized muscle tissue and a durable skin paddle, leading to less ulceration than conventional flap techniques.

  8. The fleur-de-lis upper gracilis flap for breast reconstruction: flap design and outcome.

    PubMed

    McKane, Brice W; Korn, Peter T

    2012-10-01

    We evaluated a fleur-de-lis design for the gracilis myocutaneous flap to improve flap volume for breast reconstruction. Thirty-one flaps were used in 17 consecutive patients undergoing the procedure for either thin body habitus (23 flaps) or prior abdominal surgery (8 flaps). The flap success rate was 100%. The fleur-de-lis flap provided proportionate breast reconstructions in all patients. Complications included 6 (19.3%) donor-site dehiscence and 4 (12.9%) episodes of cellulitis. Applying a negative pressure dressing to the donor site (n=26) significantly reduced the initially high dehiscence rate to 7.7% (P<0.01). There was no incidence of lower extremity edema or sensory loss. The fleur-de-lis gracilis flap can be performed with a low flap related complication rate and acceptable donor-site morbidity. Because of its standardized flap design, improved volume, and favorable breast shaping, it may allow autologous breast reconstruction to be offered to a greater number of patients.

  9. Reconstruction of chest wall defects.

    PubMed

    Hasse, J

    1991-12-01

    A series of 61 consecutive procedures of chest wall resection and reconstruction in 58 patients during the period between August, 1986 and December, 1990 is reported. The ages ranged between 6-77 years. The chest wall resection was indicated for malignant affections in 54 cases. Among these, there were 24 patients with bronchial carcinoma invading the chest wall, 17 patients with primary or metastatic sarcoma, 11 patients with recurrent breast cancer and 3 with cancer metastases of varying origin. Pulmonary resection included pneumonectomy in 8 cases, lobectomy in 19, segmental and wedge resections in 26. In the majority of resections, the reconstruction was accomplished without implants. In cases with full thickness removal of the chest wall, the plane of the rib cage and/or the sternum was reconstructed using Vicryl mesh (n = 7), PTFE soft tissue patch (n = 11), marlex-mesh (n = 1), or methyl-methacrylate (n = 3). There was one case of hospital mortality, 6 weeks postoperatively, due to neurological failure from an independent preoperatively undiagnosed brain tumor. There were 4 reoperations: one early and one late (4 months) infection, one case of limited superficial necrosis of a flap and one with chronic lymphous drainage from a large myocutaneous flap. In no instance was primary postoperative ventilation therapy necessary. Mechanical ventilation was instituted only on day 8 in the patient who accounts for the mortality in this series. In the presence of primary infection, the greater omentum was used for the restoration of the integument.

  10. PubMed Central

    DE MATOS, L.L.; BELLI, M.; KULCSAR, M.A.V.; CERNEA, C.R.; GARCIA BRANDÃO, L.; PINTO, F.R.

    2014-01-01

    SUMMARY The pectoralis major myocutaneous flap (PMMF) is a safe and versatile flap used widely for head and neck cancer reconstructions, but one of the major and most feared complications is oro- or pharyngocutaneous fistula. Herein, we attempt to establish risk factors for fistula formation in reconstructions of mucosal defects in the head and neck using PMMF through retrospective analysis of PMMF performed during 3 years at a single institution, with a total of 84 procedures. There were 69 men and 15 women, with a mean age of 59.5 years. There were 15 cases of partial flap loss, two total flap losses and 31 fistulas. The independent risk factors for fistula formation were preoperative serum hemoglobin < 13 g/dl, preoperative serum albumin < 3.4 g/dl and hypopharynx reconstruction. The PMMF is still a very useful flap and this is the first multivariate analysis analysing risk factors for fistula formation. These findings are helpful in selecting patients with elevated risk of fistula formation, and therefore preventive measures can be undertaken to avoid potentially serious complications. PMID:25762830

  11. Pharyngoesophageal reconstruction after resection of hypopharyngeal carcinoma: a new algorithm after analysis of 142 cases

    PubMed Central

    2014-01-01

    Background The aim of this study is to define an algorithm for the choice of reconstructive method for defects after laryngo-pharyngo-esophagectomy for hypopharyngeal carcinoma. Methods One hundred and forty two cases of hypopharyngeal carcinoma were included and operated on by either partial pharyngectomy, total pharyngectomy or esophagectomy. The reconstructive method was tailored according to the resected segment. Results Pectoralis flap was used in 48 cases, free jejunal flap in 28 cases, augmented colon bypass in 4 cases, gastric pull up in 32 cases and gastric tube in 30 cases. Mean hospital stay was 12 days. Mortality rate was 10.6% and morbidity rate was 31.7%. Total flap failure occurred in 3 cases of free flap and one case of pectoralis flap. There were 23 cases of early fistula. Late stricture occurred in 19 cases, being highest with myocutaneous flap (early fistula 12/50 and late stricture 13/50). Conclusion Free jejunal flap was the flap of choice for reconstruction when the safety margin is still above the clavicle. In cases with added esophagectomy, we recommend gastric tube as a method of choice for reconstruction. PMID:24912532

  12. The use of free flaps in skull base reconstruction.

    PubMed

    Macía, G; Picón, M; Nuñez, J; Almeida, F; Alvarez, I; Acero, J

    2016-02-01

    Skull base tumours are rare, comprising less than 1% of all tumours of the head and neck. Surgical treatment of these tumours involves the approach, the resection, and the reconstruction of the defect, which present a challenge due to the technical difficulty and anatomical complexity. A retrospective study of 17 patients with tumours involving the skull base, treated by resection and immediate reconstruction using microsurgical free flaps, is presented; 11 were men and six were women. The following types of flap were used: osteocutaneous fibula flaps, fasciocutaneous anterolateral thigh flaps, and myocutaneous latissimus dorsi flaps. The most common histology of the tumours was squamous cell carcinoma. The most frequent point of origin was the paranasal sinuses (58.8%). All of the free flaps used for reconstruction were viable. A cerebrospinal fluid fistula occurred in two patients, and in one of these cases, meningoencephalitis led to death. In conclusion, the reconstruction of large defects of the skull base after ablation requires a viable tissue that in many cases can be obtained only through the use of microvascular free flaps. The type of flap to be selected depends on the anatomical structures and size of the defect to be restored.

  13. Management of different kinds of head and neck defects with the submental flap for reconstruction.

    PubMed

    Tsai, Wan-Chun; Yang, Jinn-Moon; Liu, Shao-Cheng; Chu, Yueng-Hsiang; Lai, Wen-Sen; Lin, Yaoh-Shiang; Lee, Jih-Chin

    2015-12-01

    Head and neck surgeries often accompany with moderate-sized defects that require time-consuming reconstructions by free flaps. The submental flap is a versatile and time-effective option for reconstruction of orofacial defects providing acceptable cosmetic and functional results without requiring microsurgical techniques. A retrospective case series study of patients who underwent reconstruction with the submental flap between 2009 and 2013 was conducted. There were 36 patients (33 men and 3 women), with a mean age of 56.4 years, enrolled in this study. The primary lesion sites included oral cavity (24 patients), pharynx (8 patients), larynx (2 patients), neck (1 patient) as well as maxillary sinus (1 patient). All flaps were harvested as the myocutaneous flaps. All donor sites were closed primarily without the need of additional surgery. No complete loss of the flap was encountered and two cases developed marginal necrosis of the flap. The submental flap had a reliable pedicle and had minimal donor-site morbidity. It is an excellent flap option for patients with small- to medium-sized defects in head and neck region.

  14. Utility of the omentum in sacral reconstruction following total sacrectomy due to recurrent and irradiated giant cell tumour of the spine

    PubMed Central

    Unal, Cigdem; Eren, Guler Gamze; Isil, Eda; Alponat, Ahmet; Sarlak, Ahmet

    2012-01-01

    Reconstruction of the lumbosacral region after surgical excision of irradiated and recurrent spinal giant cell tumours remains a challenging problem. In this case report, we describe the use of the pedicled omentum flap in reconstruction of an irradiated and infected wide sacral defect of a 19-year-old male patient. The patient had radiotherapy and subsequent wide surgical resection after recurrence of the tumour. A myocutaneous flap from the gluteal area had failed previously. Local flap options could not be used because of the recent radiotherapy to the gluteal area. Since the patient had a laparotomy for tumour resection and a colostomy, abdominal muscles were not considered reliable for reconstructive procedures. A pedicled omentum flap was chosen as a reconstructive option because of its rich blood supply, large surface area, and angiogenic capacity. This report aims to describe the use of the pedicled omentum flap for reconstruction of the lumbosacral area following surgical resection of a spinal tumour, when gluteal and abdominal flap options for reconstruction are jeopardised. PMID:22754172

  15. De novo cataract development following a standard course of hyperbaric oxygen therapy.

    PubMed

    Gesell, L B; Trott, A

    2007-01-01

    A 49 y/o female under went 48 hyperbaric oxygen (HBO2) treatments at 2.5 ATA (atmospheres absolute) (253 kPa) for 90 minutes for chronic refractory osteomyelitis of the sacrum and recurrent failure of a sacral myocutaneous flap. Prior to HBO2 therapy, formal ophthalmic exams revealed myopia but no evidence of cataract formation. Eight weeks following the completion of HBO2 therapy, on repeat ophthalmic exam, the patient was discovered to have worsening myopia. Changes of the crystalline lens, consistent with nuclear cataract development, were identified in each eye. Other common causes of cataract formation including diabetes, corticosteroid use, and excessive exposure to ultraviolet light, were excluded. While transient visual changes are known to occur during HBO2 therapy, cataract formation has only rarely been reported and only after prolonged courses of treatment (150 or more treatments). This case identifies the need to further investigate the ocular effects of HBO2 therapy, especially with regard to cataract development and progression.

  16. Rotation flaps for coverage after total knee arthroplasty

    PubMed Central

    Pozzobon, Leonardo Rafael; Helito, Camilo Partezani; Guimarães, Tales Mollica; Gobbi, Riccardo Gomes; Pécora, José Ricardo; Camanho, Gilberto Luis

    2013-01-01

    OBJECTIVE: To evaluate the results obtained using local myocutaneous rotation flaps in cases of wound dehiscence after total knee arthroplasty. METHODS: Patients undergoing these surgical procedures were selected in the 2000-2012 period. The nine selected cases during this period were subjected to flap coverage due to skin dehiscence associated with infection. In eight cases we used rotation flaps of the medial gastrocnemius, and in one case we used advancing skin. RESULTS: Eighty nine percent of the cases were successful in the coverage of the prosthesis and the viability of the flaps. In four cases it was possible to maintain or review the prosthesis. Four other cases progressed to amputation due to failure on treatment of infections, and one case remained without the prosthesis. The functional evaluation showed an unsatisfactory outcome in 89% of cases. CONCLUSION: Coverage flaps are a good option for the treatment of cases of dehiscence with exposure of the prosthesis and the functional failure was associated with the inability to control the infection and the damage it caused. Level of Evidence IV, Case Series. PMID:24453672

  17. Three-Directional Reconstruction of a Massive Perineal Defect after Wide Local Excision of Extramammary Paget's Disease

    PubMed Central

    Cho, Seung Woo; Kwon, Sung Tack

    2016-01-01

    Extramammary Paget's disease (EMPD) is a rare, slow-growing intraepithelial malignancy that mainly involves the genital region, including the vulva, penis, scrotum, perianal, and periurethral areas. Although several treatment options exist, wide local excision with a safe margin is considered the treatment of choice. After resection of the lesion, it is often challenging to reconstruct the defect because defects in the perineal region require adequate volume for protection and are susceptible to infections, which is a particularly significant risk for large defects. We report a case of perivulvar EMPD that was reconstructed with three-directional local flaps after wide excision of the tumor. We covered the defect sequentially using the following 3 flaps: a gracilis myocutaneous flap from the left thigh, a bipedicled V-Y advancement flap from the lower abdomen, and an internal pudendal artery perforator-based island flap from the right buttock. To the best of our knowledge, this report is the first to describe a three-directional approach to extensive perivulvar reconstruction. PMID:27689055

  18. Cervical chyloma after neck dissection: a case report

    PubMed Central

    Kimura, Masashi; Ohto, Hiroyuki; Shibata, Akio; Yamada, Hiroki; Nishiwaki, Shusuke; Umemura, Masahiro

    2017-01-01

    ABSTRACT Cervical chylomas are rare pseudocystic collections that lack an epithelial lining and arise from the thoracic duct or its tributaries; although they typically develop after neck surgery or trauma, they can arise from unknown causes. Treatment options include not only conservative therapy, such as dietary modification, repeated aspirations, and sclerotherapy, but also include surgical excision. We describe a case of a chyloma in a 64-year-old Japanese woman with squamous cell carcinoma of the gingiva. The chyloma developed following left segmental mandibulectomy with radical neck dissection and reconstruction, using a titanium plate and a pectoralis major myocutaneous flap. One month after surgery, a left supraclavicular swelling was noted, so ultrasound-guided fine-needle aspiration and cytology were performed to exclude a recurrence of neck metastasis. The aspiration yielded a milky fluid without atypical or malignant cells on cytology, confirming the diagnosis of chyloma. Although we performed continuous compressive dressing and started the patient on a low-fat diet, the mass persisted. When the patient died of bone, lung, and liver metastases five months after the second surgery, the mass had not changed in size. Awareness of this complication is important to ensure timely diagnosis and appropriate treatment. PMID:28303066

  19. Comparison between anterolateral thigh perforator free flaps and pectoralis major pedicled flap for reconstruction in oral cancer patients-A quality of life analysis

    PubMed Central

    Xiao, Yan; Cai, Xiangping; Wang, Jing; Liu, Fei; Wang, Haibin

    2013-01-01

    The aim of this study was to compare the differences between anterolateral thigh perforator free flaps (ALTFF) and pectoralis major myocutaneous flap (PMMF) for reconstruction in oral cancer patients. Method and Patients: who received free flap or PMMF reconstruction after ablation surgeries were eligible for the current study. The patients’ demographic data, medical history, and quality of life scores(Medical Outcomes Study-Short Form-36 (MOS SF-36) and the University of Washington Quality of Life (UW-QOL) questionnaires were collected. Results: 81 of 118 questionnaires were returned (68.64%). There was significant differences between two groups in the gender (P<0.005). Patients reconstructed with ALTFF had better appearance domains and better shoulders domains, in addition to better role emotion domains. Conclusions: Using either PMMF or ALTFF for reconstruction of oral defects after cancer resection significantly influences a patient’s quality of life. Data from this study provide useful information for physicians and patients during their discussion of reconstruction modalities for oral cancers. Key words:Quality of life, ALTFF,PMMF, oral cancer. PMID:24121914

  20. Microsurgical free flaps: Controversies in maxillofacial reconstruction

    PubMed Central

    George, Rinku K.; Krishnamurthy, Arvind

    2013-01-01

    Reconstructive microsurgery for oral and maxillofacial (OMF) defects is considered as a niche specialty and is performed regularly only in a handful of centers. Till recently the pectoralis major myocutaneous flap (PMMC) was considered to be the benchmark for OMF reconstruction. This philosophy is changing fast with rapid advancement in reconstructive microsurgery. Due to improvement in instrumentation and the development of finer techniques of flap harvesting we can positively state that microsurgery has come of age. Better techniques, microscopes and micro instruments enable us to do things previously unimaginable. Supramicrosurgery and ultrathin flaps are a testimony to this. Years of innovation in reconstructive microsurgery have given us a reasonably good number of very excellent flaps. Tremendous work has been put into producing some exceptionally brilliant research articles, sometimes contradicting each other. This has led to the need for clarity in some areas in this field. This article will review some controversies in reconstructive microsurgery and analyze some of the most common microvascular free flaps (MFF) used in OMF reconstruction. It aims to buttress the fact that three flaps-the radial forearm free flap (RFFF), anterolateral thigh flap (ALT) and fibula are the ones most expedient in the surgeon's arsenal, since they can cater to almost all sizeable defects we come across after ablative surgery in the OMF region. They can thus aptly be titled as the workhorses of OMF reconstruction with regard to free flaps. PMID:23662264