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Sample records for abdominis myocutaneous tram

  1. 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

  2. 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

  3. 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. PMID:26950289

  4. SPLIT rectus abdominis myocutaneous double free flap for extremity reconstruction.

    PubMed

    Nyame, Theodore T; Holzer, Paul W; Helm, Douglas L; Maman, Daniel Y; Winograd, Jonathan M; Cetrulo, Curtis L

    2014-01-01

    A Mathes and Nahai type III muscle, such as the rectus abdominis muscle, can be utilized to cover two separate wounds simultaneously utilizing its dual blood supply thereby minimizing donor site morbidity and operative time. We report a case for treatment of bilateral Gustillo type IIIB lower extremity injuries treated with a single rectus abdominis muscle split into two free flaps, with one based on the deep inferior epigastric vessels and one on the superior epigastric vessels to cover the contralateral wound. In our patient, both lower extremity wounds were covered with muscle flaps from the same donor site in a single operation, salvaging both limbs with progression to unassisted ambulatory status. We show in this case report that the utilization of the vascular anatomy of the rectus muscle allows for division of the flap into two flaps, permitting preservation of the contralateral abdominal wall integrity and coverage of two wounds with a single muscle.

  5. 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.

  6. Vertical rectus abdominis myocutaneous flap for vaginal reconstruction after radical pelvic surgery for Stage II vaginal carcinoma.

    PubMed

    Tapisiz, O L; Gungor, T; Demiralp, C O; Demirseren, M E; Yalcin, H; Mollamahmutoglu, L

    2011-01-01

    Primary carcinomas of the vagina are uncommon, occurring only 2-3% of all gynecological malignancies. In women with early stage of disease, primary surgery, consisting of radical vaginectomy (plus hysterectomy in patients with tumors involving the upper vagina) and systematic dissection of lymphatic drainage of tumor, is a valid option. In these patients, a rectus abdominis myocutaneous (RAM) flap may be favorably used for vaginal reconstruction during radical pelvic surgery. Here we describe a case of Stage II vaginal carcinoma treated with radical pelvic surgery and vertical-RAM (V-RAM) flap reconstruction.

  7. Surgical resection of invasive adenoid cystic carcinoma of the lacrimal gland and wound closure using a vertical rectus abdominis myocutaneous free flap.

    PubMed

    Andrade, João Paulo; Figueiredo, Sergio; Matias, Julio; Almeida, Ana Catarina

    2016-01-01

    A 64-year-old man presented with a 3-month history of recurrent conjunctivitis. He was evaluated by an ophthalmologist and submitted to a CT scan that revealed an intraconic mass with invasion of the lateral orbital wall. He was operated, the mass was completely removed (with preservation of the intraorbital structures) and the lateral orbital wall rebuilt. The histopathological analysis revealed an adenoid cystic carcinoma of the lacrimal gland. 4 months later a painful recurrence of the lesion was diagnosed with invasion of the orbital roof and eyelids. After a multidisciplinary discussion and request from the patient, an exenteration of the orbit and removal of the lateral and superior orbital wall and dura mater was performed with the objective of a total resection. The wound and orbit were closed with a vertical rectus abdominis myocutaneous free flap to ensure closure. PMID:27646316

  8. Technique for Minimizing Donor-site Morbidity after Pedicled TRAM-Flap Breast Reconstruction: Outcomes by a Single Surgeon’s Experience

    PubMed Central

    Rietjens, Mario; De Lorenzi, Francesca; Andrea, Manconi; Petit, Jean-Yves; Hamza, Alaa; Martella, Stefano; Barbieri, Benedetta; Gottardi, Alessandra; Giuseppe, Lomeo

    2015-01-01

    Background: Breast reconstruction with pedicled transverse rectus abdominis myocutaneous (TRAM) flap can result in significant abdominal wall donor-site morbidity. We present our technique of transversely dividing the anterior fascia and rectus abdominis combined with reinforcement above the arcuate line for closure of the anterior abdominal wall defect to prevent contour deformities performed by a single senior surgeon and compare these results with those of our prior series. Methods: We described our new technique of closure of the abdominal wall defect and retrospectively performed the comparison between the results of pedicled TRAM flaps using the new closure technique and those of 420 pedicled TRAM flaps from our 2003 publication in terms of abdominal bulging and hernia. Results: Sixty-seven pedicled TRAM flaps in 65 patients were compared with 420 pedicled TRAM flaps of the 2003 series. The new technique was associated with 5 partial TRAM flap necroses (8%). There was no total flap loss with the new technique. The median follow-up period was 13 months (range, 4–36 months). There were no instances of abdominal hernia and bulge during follow-up in the new series. Compared with the previous 2003 series, the new technique was superior in terms of occurrence of abdominal wall hernia or bulging. Conclusions: We are still performing pedicled TRAM flap for autologous breast reconstruction. Using the technique of transversely dividing the anterior fascia and rectus abdominis combined with reinforcement above the arcuate line can reduce the occurrence of abdominal bulging and hernia. PMID:26495189

  9. 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

  10. 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.

  11. Reconstruction of concomitant total loss of the upper and lower lips with a free vertical rectus abdominis flap.

    PubMed

    Jallali, Navid; Malata, Charles M

    2005-01-01

    Total loss of both lips is fortunately rare as reconstruction of such defects poses an enormous challenge. We present a case of concomitant loss of both lips as a result of fulminant pneumococcal septicemia, which was reconstructed with a free vertical rectus abdominis myocutaneous flap due to lack of traditional donor sites. PMID:15696515

  12. TRAM flap breast reconstruction after radiation treatment.

    PubMed Central

    Williams, J K; Bostwick, J; Bried, J T; Mackay, G; Landry, J; Benton, J

    1995-01-01

    OBJECTIVE: Patients with and without radiation treatment before their breast reconstruction were compared to study the relationship of radiation to flap-related complications. SUMMARY BACKGROUND DATA: The transverse rectus abdominis muscle (TRAM) flap for breast reconstruction involves a a vascular pedicle and recipient bed, both included in the radiated field of patients undergoing adjunctive therapy. Detailed reviews of flap-related complications in this subgroup of patients have been limited. METHODS: One hundred eight patients with radiation treatment who subsequently underwent a TRAM flap breast reconstruction were compared with 572 patients with no radiation treatment before similar reconstruction. Flap-related complications, radiation dosage, time, fields, relationships between risk factors, and complications were studied. RESULTS: Overall complication rates were comparable between the two groups. Only fat necrosis (> 10% of total reconstruction) was found to be statistically significant (17.6% vs. 10.1%, p = 0.03228). No difference was found for fat necrosis in unipedicled vs. bipedicled flaps controlled for radiation (17.7% vs. 17.4%). Obesity and radiation therapy were associated with fat necrosis and major infection in a logistic regression. Significant abdominal scarring was also associated with major infection (p = 0.0044). CONCLUSIONS: In this, the largest reported series, radiation therapy was associated with increased fat necrosis and major infection. The use of the TRAM flap was not found to be prohibitive in radiated patients and should still be the first choice in this subgroup of patients. Images Figure 1. Figure 2. PMID:7794079

  13. 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

  14. Obesity Should Not Prevent from TRAM Flap Breast Reconstruction in Developing Countries.

    PubMed

    Alipour, Sadaf; Omranipour, Ramesh; Akrami, Rahim

    2015-12-01

    Transverse rectus abdominis musculocutaneous (TRAM) flap is the most common procedure performed for breast reconstruction after mastectomy for breast cancer. Obesity is a relative contraindication, and complex modifications have been proposed in the pedicled technique for obese patients. We studied ischemic complications in our patients to investigate the effect of body weight on the outcome of TRAM flap breast reconstruction. Pertinent data from medical records of patients receiving a TRAM flap surgery from 1986 to 2011 were extracted. Patients were divided into three groups based on the body mass index (BMI): normal (<25 kg/m(2)), overweight (25-29.9 kg/m(2)), and obese (>30 kg/m(2)). Flap necrosis is defined as any visible nonviable tissue in the reconstructed breast. It was observed that 117 patients had received TRAM flap reconstruction. Fifty-eight patients were excluded. Of the remaining 59 cases, 24 had normal BMI, 21 were overweight, and 14 were obese. No patient was found to develop flap necrosis. Outcome of TRAM flap breast reconstruction in obese patients is similar to nonobese patients. No major necrosis in need of reoperation was identified in the studied obese patients. It was concluded that categorizing obesity as a relative contraindication to TRAM flap breast reconstruction should be revisited based on larger cohort studies. PMID:26730022

  15. 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

  16. OVERVIEW OF UPPER TRAM TERMINAL, TRAM TRESTLE, AND PRIMARY ORE ...

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

    OVERVIEW OF UPPER TRAM TERMINAL, TRAM TRESTLE, AND PRIMARY ORE BIN, LOOKING NORTHEAST. REMAINS OF A BLACKSMITH'S FORGE AND WORK CAN BE SEEN JUST BELOW THE ORE BIN (SEE CA-291-32 FOR DETAIL). ROCK FOUNDATIONS LOCATED JUST ABOVE THE ORE BIN AND ALONG THE FIRST RIDGELINE ARE TENT PADS. SEE CA-291-49 (CT) FOR IDENTICAL COLOR TRANSPARENCY. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  17. OVERVIEW OF UPPER TRAM TERMINAL, TRAM TRESTLE, AND PRIMARY ORE ...

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

    OVERVIEW OF UPPER TRAM TERMINAL, TRAM TRESTLE, AND PRIMARY ORE BIN, LOOKING NORTHEAST. REMAINS OF A BLACKSMITH'S FORGE AND WORK CAN BE SEEN JUST BELOW THE ORE BIN (SEE CA-291-32 FOR DETAIL). ROCK FOUNDATIONS LOCATED JUST ABOVE THE ORE BIN AND ALONG THE FIRST RIDGELINE ARE TENT PADS. SEE CA-291-24 FOR IDENTICAL B&W NEGATIVE. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  18. EAST ELEVATION OF LOWER TRAM TERMINAL, LOOKING NORTHWEST. TRAM CARS ...

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

    EAST ELEVATION OF LOWER TRAM TERMINAL, LOOKING NORTHWEST. TRAM CARS ENTERED AND EXITED FROM RIGHT,AND DUMPED INTO THE ORE BIN SEEN AT LOWER LEFT. BELOW THE ORE BIN IS A JAW CRUSHER FOUNDATION. THE WOODEN BOX AT CENTER IS FILLED WITH ROCKS, PROVIDING THE COUNTERWEIGHT TO THE TRAMWAY CABLE, WHICH KEEPS IT TAUGHT. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  19. Measurement of the volume of the pedicled TRAM flap in immediate breast reconstruction.

    PubMed

    Chang, K P; Lin, S D; Hou, M F; Lee, S S; Tsai, C C

    2001-12-01

    The transverse rectus abdominis musculocutaneous (TRAM) flap is now accepted as the standard for breast reconstruction, but achieving symmetrical breast reconstruction is still a challenge. A precise estimate of the volume of the flap is necessary to reconstruct a symmetrical and aesthetically pleasing breast. Many methods have been developed to overcome this problem, but they have not been suitable for the pedicled TRAM flap. By using a self-made device based on the Archimedes' principle, the authors can calculate accurately the volume of the pedicled TRAM flap and predict reliably the breast volume intraoperatively. The "procedure" is based on a self-made box into which the pedicled TRAM flap is placed. Warm saline is added to the box and the flap is then removed. Flap volume is calculated easily by determining the difference between the preestimated volume of the box and the volume of the residual water. From February to May 2000, this method was used on 28 patients to predict breast volume for breast reconstruction. This study revealed that the difference of the maximal chest circumferences (the index of the breast volume) demonstrates a positive correlation with the difference of the volumes and weights between the mastectomy specimen and the net TRAM flap. However, a more closely positive correlation exists between the differences of maximal chest circumference volume (r = 0.677) than maximal chest circumference weight (r = 0.618). These data reveal that the reconstructed breast's volume has a closer relationship with the volume of the net pedicled TRAM flap, rather than with its weight. PMID:11756827

  20. BEO Tram Spectral Data 2014

    SciTech Connect

    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.

  1. [Temperature determination of the skin surface for the estimation of blood supply disorders in myocutaneous island flaps of rats].

    PubMed

    Herrberger, U; Tilgner, A; Schumann, D

    1989-01-01

    In rectus abdominis myocutaneous island flaps (3.0 x 1.5 cm) of rats (Uje:WIST) skin surface temperature was measured by an infrared pyrometer for monitoring flap viability following experimentally induced blood flow insufficiency. The insufficiency was caused by ligation of the pedicle vessels (epigastric superior artery and vein) on the 3rd, 4th, 5th and 7th d after flap replantation, and by occlusion of these vessels with microclips for 2 h. Only the temperature differences between the intact and the operated skin surface were used to estimate blood flow efficiency not, the absolute values. These differences were statistically insignificant between the intact right and left abdominal skin areas and between the intact skin and the vital flap surfaces. In these cases the maximal temperature differences were 0.52 degree C. Only during the early postoperative period (3-days ligation group) a correlation between blood flow insufficiency and flap viability is expressed by temperature differences (2.14 degrees C). Later on (7-days ligation group) a temperature difference of 1.87 degrees C was no evidence of disturbed wound healing. Thus in advanced stages in myocutaneous flaps differences of blood flow and neovascularization respectively cannot be estimated reliably by measurements of skin surface temperature. However, temperature differences greater than 2 degrees C signal impaired flap viability. PMID:2711783

  2. 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

  3. Postmastectomy reconstruction: comparative analysis of the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous flap versus breast implant reconstruction.

    PubMed

    Cederna, P S; Yates, W R; Chang, P; Cram, A E; Ricciardelli, E J

    1995-11-01

    Over 40,000 postmastectomy breast reconstructions are performed annually. In this study, we investigated the psychosocial, functional, and cosmetic effects of transverse rectus abdominis musculocutaneous (TRAM) flap versus breast implant reconstruction. Thirty-three women who had undergone postmastectomy breast reconstruction were contacted by telephone and agreed to participate in the study. Twenty-two women completed the self-assessment questionnaires regarding their quality of life, psychological symptoms, functional status, body image, and global satisfaction. The TRAM and implant groups contained 8 and 14 patients, respectively. The groups were well matched for age, employment status, marital status, race, religion, and severity of medical and surgical illnesses. The average follow-up was 36 months. Statistical analysis of the responses revealed that women who had undergone TRAM flap reconstruction were more satisfied with how their reconstructed breast felt to the touch (p = .01), and there was a trend toward greater satisfaction with the appearance of their reconstructed breast (p = .08). However, these same patients identified more difficulties as far as functioning at work or school, performing vigorous physical activities, participating in community or religious activities, visiting with relatives, and interacting with male friends (p < .04). There were no statistically significant differences in body image or overall satisfaction. In this small cohort study, both the TRAM flap group and the implant group were satisfied with the results of their breast reconstruction, but the TRAM flap group was more satisfied with how their breast felt and tended to be more satisfied with the cosmetic result. The TRAM flap group reported greater psychological, social, and physical impairments as a result of their reconstruction. PMID:8579262

  4. An investigation of the application of laser-assisted indocyanine green fluorescent dye angiography in pedicle transverse rectus abdominus myocutaneous breast reconstruction

    PubMed Central

    Newman, Martin I; Samson, Michel C; Tamburrino, Joseph F; Swartz, Kimberly A; Brunworth, Louis

    2011-01-01

    BACKGROUND: Pedicle transverse rectus abdominus myocutaneous (pTRAM) flaps remain the most common method of autologous tissue breast reconstruction. Using pTRAM flaps, complications often arise postoperatively, secondary to inadequate circulation. Tissues from distant angiosomes are associated with poorer perfusion, but this differs among patients. Many modalities have been used to reduce the risk of complications, but none have achieved widespread application. The authors believe that laser-assisted indocyanine green fluorescent dye angiography (LA-ICGA) can potentially reduce the risk of complications. METHODS: In two routine, single-pedicle, ipsilateral pTRAM flaps, LA-ICGA imaging was performed following the division of the distal rectus muscle and deep inferior epigastric pedicle. The resulting images were used to guide design of the flap and debridement. RESULTS: In case 1, good perfusion was observed in zone 1 and part of zone 2. In case 2, good perfusion was observed in zone 1 and 50% of zone 3, with little perfusion in zone 2. In both cases, tissues with poor perfusion were debrided before transfer and inset. In both patients, there were no issues with wound healing, tissue necrosis or fat necrosis. CONCLUSIONS: The variability of perfusion of the pTRAM flap among individuals is well appreciated. LA-ICGA helped to determine the limits of good perfusion and, therefore, the limits of tissue to be preserved for transfer and inset. This helped to avoid harvesting poorly perfused tissue that would have almost certainly experienced necrosis and, ultimately, would have reduced the risk of postoperative complications. PMID:22379372

  5. Management of osteoradionecrosis of the mandible with myocutaneous flaps

    SciTech Connect

    Baker, S.R.

    1983-12-01

    Involvement of large areas of the mandible or the entire mandible with osteoradionecrosis may result in severe functional disability and cosmetic deformity. The use of a well-vascularized pectoralis major myocutaneous flap from outside the original field of irradiation has been successful in obtaining functional and cosmetic goals. Myocutaneous flaps provide bulk for contour and tissue support, and their rich vascular supply promotes healing of the heavily irradiated soft tissue and bone. Successful bone grafting for mandibular reconstruction may follow control of the osteoradionecrosis.

  6. 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

  7. 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

  8. 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

  9. 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

  10. DETAIL VIEW OF UPPER TRAM TERMINAL STRUCTURE, LOOKING NORTHEAST TOWARD ...

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

    DETAIL VIEW OF UPPER TRAM TERMINAL STRUCTURE, LOOKING NORTHEAST TOWARD THE REAR OF THE STRUCTURE. THE WHEELS AT THE TOP OF THE TRAM BUCKETS RODE OFF THE STATIONARY CABLES ONTO THE TRACK SUPPORTED BY THE "C" IRONS SUSPENDED FROM THE TOP TIMBERS, CLEARLY SEEN AT THE TOP OF THE FRAME. THE ANCHOR POINTS FOR THE TWO STATIONARY CABLES ARE AT BOTTOM CENTER, JUST BELOW THE CABLE WHEEL. THE MAIN CABLE WHEEL IS IN THE DISTANCE AT CENTER LEFT. THE ORE CHUTES COMING FROM THE ORE BIN ARE AT LEFT CENTER EDGE. TRAM BUCKETS WERE CHARGED HERE. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  11. OVERVIEW OF LOWER TRAM TERMINAL AND STAMP MILL SITE, LOOKING ...

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

    OVERVIEW OF LOWER TRAM TERMINAL AND STAMP MILL SITE, LOOKING NORTHWEST. THE AERIAL TRAMWAY BEGINS AT THE TERMINAL AND CONTINUES NORTH TO THE UPPER RIGHT. THE FIRST SUPPORT TOWER CAN BE SEEN. JUST BELOW THE WATER TANK IS A LOADING PLATFORM AND TRAM TRESTLE USED FOR THE TRANSPORT OF SUPPLIES THAT LEAD UP TO THE TRAM TERMINAL. ALL THREE LEVELS OF THE FORMER 20 STAMP MILL CAN BE SEEN AT CENTER. SEE CA-291-02 FOR IDENTICAL B&W NEGATIVE. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  12. OVERVIEW OF LOWER TRAM TERMINAL AND STAMP MILL SITE, LOOKING ...

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

    OVERVIEW OF LOWER TRAM TERMINAL AND STAMP MILL SITE, LOOKING NORTHWEST. THE AERIAL TRAMWAY BEGINS AT THE TERMINAL AND CONTINUES NORTH TO THE UPPER RIGHT. THE FIRST SUPPORT TOWER CAN BE SEEN. JUST BELOW THE WATER TANK IS A LOADING PLATFORM AND TRAM TRESTLE USED FOR THE TRANSPORT OF SUPPLIES THAT LEAD UP TO THE TRAM TERMINAL. ALL THREE LEVELS OF THE FORMER 20 STAMP MILL CAN BE SEEN AT CENTER. SEE CA-291-46( CT) FOR IDENTICAL COLOR TRANSPARENCY. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  13. Pectoralis myocutaneous flap for salvage of necrotic wounds

    SciTech Connect

    Price, J.C.; Davis, R.K.; Koltai, P.J.

    1985-02-01

    The authors have utilized six pectoralis major myocutaneous flaps in attempts to salvage extensive necrotic wounds of the pharynx and neck. The flap was employed in the following situations: massive necrosis of the entire neck skin with both carotid artery systems exposed, radiation necrosis of the neck skin with exposure of carotid artery, dehiscence of gastric pull-up from pharynx with resultant carotid exposure, failed trapezius flap in a radionecrotic oral cavity, and two cases of pharyngocutaneous fistula with extensive soft tissue necrosis. These flaps achieved healing in all cases. One death occurred 3 weeks following complete cutaneous healing secondary to a ruptured carotid pseudoaneurysm. One flap underwent total skin loss but the entirety of the muscle survived and the fistula was successfully closed with the back of the muscle being subsequently skin grafted. One case of dehiscence of the flap from oral mucosa resulted in a minor exposure of mandible with limited osteoradionecrosis controlled by topical means. This flap has performed extremely well in these precarious and difficult situations that previously may not have been salvageable. It has also been effective in abbreviating the required hospitalization and wound care. The authors conclude that the pectoralis myocutaneous flap should be the primary choice for the management of extensive postsurgical wound necrosis.

  14. GENERAL VIEW OF MILL, LOOKING WEST NORTHWEST, WITH TRAM HOUSE ...

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

    GENERAL VIEW OF MILL, LOOKING WEST NORTHWEST, WITH TRAM HOUSE AND OFFICE BUILDING IN CENTER. COAL BIN AND BOILER HOUSE ARE AT FAR LEFT. - Shenandoah-Dives Mill, 135 County Road 2, Silverton, San Juan County, CO

  15. DETAIL VIEW OF UPPER TRAM TERMINAL STRUCTURE, LOOKING SOUTH TOWARD ...

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

    DETAIL VIEW OF UPPER TRAM TERMINAL STRUCTURE, LOOKING SOUTH TOWARD THE FRONT OF THE STRUCTURE. THE WHEELS AT THE TOP OF THE TRAM BUCKETS RODE OFF THE STATIONARY CABLES ONTO THE TRACK SUPPORTED BY THE "C" IRONS SUSPENDED FROM THE TOP TIMBERS ON THE LEFT AND RIGHT. THE BUCKET OPENING MECHANISM IS ON THE LEFT, AND PART OF THE CLOSING MECHANISM ON THE RIGHT EDGE OF THE FRAME. THE TWO CABLES AT CENTER ARE THE STATIONARY TRAM CABLES THAT RUN ALONG THE TOP OF THE SUPPORT TOWERS ON WHICH THE WHEELS OF THE TRAM BUCKETS RODE. THEY ARE ANCHORED AT GROUND LEVEL JUST OFF FRAME TO THE LOWER LEFT. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  16. DETAIL VIEW OF AERIAL TRAM SUPPORT TOWER TWO, WITH TOWERS ...

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

    DETAIL VIEW OF AERIAL TRAM SUPPORT TOWER TWO, WITH TOWERS THREE,FOUR, FIVE AND SIX IN DISTANCE, LOOKING NORTHEAST. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  17. 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

  18. 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

  19. 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.

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. DETAIL OVERHEAD VIEW OF SECONDARY ORE BIN, CONVEYOR PLATFORM TRAM ...

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

    DETAIL OVERHEAD VIEW OF SECONDARY ORE BIN, CONVEYOR PLATFORM TRAM TRESTLE, AND LOADING PLATFORM, LOOKING SOUTHWEST. THE HOLE IN THE ORE BIN FLOOR CAN BE SEEN, AND BALL MILL FOUNDATION AT LOWER LEFT CORNER. SEE CA-291-13 FOR IDENTICAL B&W NEGATIVE. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  7. 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

  8. 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

  9. 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

  10. [Pedicled versus free TRAM flap for breast reconstruction].

    PubMed

    Galla, T J; Lukas, B; Feller, A M

    1999-03-01

    In breast reconstruction, the free TRAM-flap offers many advantages over the pedicled TRAM-flap. Due to its superior perfusion, the free flap rarely develops necrosis. Shaping of the flap is easier due to the lack of the thick muscle pedicle. Because the rectus muscle is spared, there is minimal donor site morbidity. However, the necessary microvascular anastomoses reduced the acceptance of the free TRAM-flap. During a 13-months period, 51 breast reconstructions were performed in 41 patients, 31 unilateral and ten bilateral. 45 flaps served for delayed reconstruction and six flaps for immediate reconstruction. The operations were performed by two teams working simultaneously. The average operating time was 3.9 hours for unilateral and 6.9 hours for bilateral delayed reconstruction. For immediate reconstruction, 6.2 and 6.3 hours were required for uni- and bilateral procedures, respectively. In 38 flaps, the thoracodorsal vessels served as recipient vessels; 13 flaps were anastomosed to the internal mammary artery and vein. Postoperative complications were observed in 13 patients. Three vessel anastomoses had to be revised. In one flap, a partial necrosis occurred; in two flaps hematoma evacuation was necessary. Two patients suffered from fat necroses at the abdomen and one umbilicus was lost. Skin irritations and seromas at the abdomen occurred in five patients. Pulmonary embolism was diagnosed in one patient three weeks postoperatively. Abdominal hernias or bulging in the epigastric area were not observed up to 15 months after reconstruction. These results reveal a low complication rate for breast reconstruction with the free TRAM-flap. The advantages of this technique as compared to the pedicled technique are discussed.

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. Xenogeneic acellular dermal matrix in combination with pectoralis major myocutaneous flap reconstructs hypopharynx and cervical esophagus.

    PubMed

    Yin, Danhui; Tang, Qinglai; Wang, Shuang; Li, Shisheng; He, Xiangbo; Liu, Jiajia; Liu, Bingbing; Yang, Mi; Yang, Xinming

    2015-11-01

    The aim of this study was to explore xenogeneic acellular dermal matrix (ADM) in combination with pectoralis major myocutaneous flap in hypopharynx and cervical esophagus reconstruction. A total of five patients were treated with this surgical method to reconstruct hypopharynx and cervical esophagus in Second Xiangya Hospital between January 2012 and April 2013. Four of them had hypopharyngeal carcinoma with laryngeal and cervical esophageal invasion, while the fifth patient with hypopharyngeal cancer had developed scars and atresia after postoperative radiotherapy. The defect length after hypopharyngeal and cervical esophageal resection was 6-8 cm, and was repaired by a combination of ADM and pectoralis major myocutaneous flap by our team. Interestingly, the four patients had primary healing and regained their eating function about 2-3 weeks after surgery, the fifth individual suffered from pharyngeal fistula, but recovered after dressing change about 2 months. Postoperative esophageal barium meals revealed that the pharynx and esophagus were unobstructed in all five patients. Xenogeneic ADM in combination with pectoralis major myocutaneous flap for hypopharynx and cervical esophagus reconstruction is a simple, safe and effective method with fewer complications. Nevertheless, according to the defect length of the cervical esophagus, the patients need to strictly follow the medical advice.

  17. Structural safety of trams in case of misguidance in a switch

    NASA Astrophysics Data System (ADS)

    Schindler, Christian; Schwickert, Martin; Simonis, Andreas

    2010-08-01

    Tram vehicles mainly operate on street tracks where sometimes misguidance in switches occurs due to unfavourable conditions. Generally, in this situation, the first running gear of the vehicle follows the bend track while the next running gears continue straight ahead. This leads to a constraint that can only be solved if the vehicle's articulation is damaged or the wheel derails. The last-mentioned situation is less critical in terms of safety and costs. Five different tram types, one of them high floor, the rest low floor, were examined analytically. Numerical simulation was used to determine which wheel would be the first to derail and what level of force is needed in the articulation area between two carbodies to make a tram derail. It was shown that with pure analytical simulation, only an idea of which tram type behaves better or worse in such a situation can be gained, while a three-dimensional computational simulation gives more realistic values for the forces that arise. Three of the four low-floor tram types need much higher articulation forces to make a wheel derail in a switch misguidance situation. One particular three-car type with two single-axle running gears underneath the centre car must be designed to withstand nearly three times higher articulation forces than a conventional high-floor articulated tram. Tram designers must be aware of that and should design the carbody accordingly.

  18. 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.

  19. 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.

  20. Creative Use of Contralateral Combined Myocutaneous Free Flap for Empyema Cavity.

    PubMed

    Tan, Hannah B; Mohan, Anita T; Coonar, Aman S; Malata, Charles M

    2016-01-01

    Treatment of chronic postpneumonectomy empyema is a reconstructive problem that is always complicated by previous thoracic surgical procedures. Free flaps may be used because they effectively obliterate remaining pleural cavity dead space. Combined muscle free flaps with common vascular pedicles are viable alternatives when single muscle flaps do not possess adequate bulk. This case describes a contralateral combined latissimus dorsi-serratus anterior myocutaneous free flap with anastomoses to thoracodorsal vessels used for correction of chronic empyema. We also describe successful correction of a posterolateral chest wall defect using the adjacent axillary system as a recipient vessel. An accompanying skin paddle also enabled reliable cutaneous coverage of the external defect. PMID:26694302

  1. 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

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

    PubMed

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

    2009-09-01

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

  3. Transversus Abdominis Plane Catheter Bolus Analgesia after Major Abdominal Surgery

    PubMed Central

    Bjerregaard, Nils; Nikolajsen, Lone; Bendtsen, Thomas Fichtner; Rasmussen, Bodil Steen

    2012-01-01

    Purpose. Transversus abdominis plane (TAP) blocks have been shown to reduce pain and opioid requirements after abdominal surgery. The aim of the present case series was to demonstrate the use of TAP catheter injections of bupivacaine after major abdominal surgery. Methods. Fifteen patients scheduled for open colonic resection surgery were included. After induction of anesthesia, bilateral TAP catheters were placed, and all patients received a bolus dose of 20 mL bupivacaine 2.5 mg/mL with epinephrine 5 μg/mL through each catheter. Additional bolus doses were injected bilaterally 12, 24, and 36 hrs after the first injections. Supplemental pain treatment consisted of paracetamol, ibuprofen, and gabapentin. Intravenous morphine was used as rescue analgesic. Postoperative pain was rated on a numeric rating scale (NRS, 0–10) at regular predefined intervals after surgery, and consumption of intravenous morphine was recorded. Results. The TAP catheters were placed without any technical difficulties. NRS scores were ≤3 at rest and ≤5 during cough at 4, 8, 12, 18, 24, and 36 hrs after surgery. Cumulative consumption of intravenous morphine was 28 (23–48) mg (median, IQR) within the first 48 postoperative hours. Conclusion. TAP catheter bolus injections can be used to prolong analgesia after major abdominal surgery. PMID:22666242

  4. Transversus abdominis block: clinical uses, side effects, and future perspectives.

    PubMed

    Taylor, Robert; Pergolizzi, Joseph V; Sinclair, Alexander; Raffa, Robert B; Aldington, Dominic; Plavin, Stanford; Apfel, Christian C

    2013-04-01

    Poorly controlled acute pain during the postoperative setting after abdominal surgery can be detrimental to the patient. Current pain management practices for the postoperative abdominal surgery patient rely heavily on opioids, which are associated with many unwanted side effects. Recently, interest surrounding regional anesthesia has been growing owing to its demonstrated efficacy and safety outcomes. More specifically, the transversus abdominis plane (TAP) block procedure has attracted attention owing to its ability to successfully block peripheral pain signaling in the abdomen, its ease of use, few complications, and its greater acceptability. A majority of the studies published has demonstrated the successful reduction in pain in many abdominal surgical procedures using local anesthetics during the TAP block. However, the short duration of the pain block causes the patient to still rely on other analgesics throughout the additional postoperative days. Preliminary studies using continuous infusion catheters placed in the TAP has been one of the ways to prolong the nerve block in the abdomen; however, technical and operational issues currently limit the widespread adoption of this method. In this review, current studies will be presented and summarized to update the field on the potential benefits of the TAP block procedure, in addition to providing insight into the future direction of the drugs that could be used for TAP block.

  5. Lateral gastrocnemius myocutaneous flap transposition to the midlateral femur: extending the arc of rotation.

    PubMed

    Agarwal, Rishi Raj; Broder, Kevin; Kulidjian, Anna; Bodor, Richard

    2014-05-01

    We report the successful use of an extended lateral gastrocnemius myocutaneous flap for coverage of the midlateral femur using successive delayed elevations. A 62-year-old man underwent wide resection of a liposarcoma of the right anterior thigh with free flap reconstruction and subsequent radiation therapy 10 years before. Four years later, the patient fractured his irradiated femur and was treated with a retrograde intramedullary nail, which subsequently became infected, causing osteomyelitis of the distal femur, septic arthritis of the knee joint, and nonunion of his pathologic fracture. Although advised by numerous surgeons to undergo above-knee amputation, we offered our motivated patient a multidisciplinary approach to clear his infection and pathology; implanted new orthopedic hardware; performed delayed flap reconstruction; and rehabilitated him back to painless, unassisted ambulation. The extended lateral gastrocnemius myocutaneous flap used provided perfused soft tissues and durable coverage for the patient's exposed orthopedic hardware of the midlateral femur, 14 cm above the joint line of the knee. By using this flap to cover a femur defect well above published heights, our patient avoided amputation after years of worsening incapacitation.

  6. Reliability of ultrasound imaging of the transversus abdominis muscle in asymptomatic subjects

    PubMed Central

    Chung, Sin Ho; You, Young Youl

    2015-01-01

    [Purpose] The purpose of this study was to assess intra-rater and inter-rater procedural reliability of ultrasound imaging measurements of transversus abdominis thickness. [Subjects] Thirty therapists who attended the B Hospital in Hwaseong participated in the study. [Methods] Two examiners assessed transverse abdominis thickness at rest and during contraction. Intra-class correlation coefficient with 95% confidence interval and, standard error of measurement were calculated. [Results] The intra-rater procedural reliability of ultrasound imaging measurements of transverse abdominis thickness, assessed using the intra-class correlation coefficient, was 0.65–0.86 (within-day, 0.65–0.86; between-day, 0.77–0.85). The inter-rater procedural reliability of ultrasound imaging measurements of transverse abdominis thickness, assessed using the intra-class correlation coefficient, was 0.72–0.86 (within-day, 0.72–0.86; between-day, 0.82–0.83). [Conclusion] Ultrasound imaging can be used as a reliable method for measurements of transverse abdominis thickness. PMID:26157222

  7. Ultrasonographic Measurement of Transverse Abdominis in Stroke Patients

    PubMed Central

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

    2014-01-01

    Objective To compare transverse abdominis (TrA) contractility in stroke patients with hemiparesis and healthy adults using musculoskeletal ultrasonography. Methods Forty-seven stroke patients with hemiparesis and 25 age-matched healthy control subjects participated in this study. Stroke patients were divided into three groups on the basis of their degree of ambulation. Group A consisted of 9 patients with wheelchair ambulation, group B of 23 patients with assisted ambulation, and group C of 15 patients with independent ambulation. Inter-rater reliability regarding ultrasonographic measurement of abdominal muscle thickness in the control group was assessed by two examiners. The TrA contraction ratio (TrA contracted thickness/TrA resting thickness) was measured during abdominal drawing-in maneuver and was compared between the patients and the control group and between the ambulation groups. Results The inter-rater reliability ranged from 0.900 to 0.947. The TrA contraction ratio was higher in the non-paretic side than in the paretic side (1.40±0.62 vs. 1.14±0.35, p<0.01). The TrA contraction ratio of the patient group was lower in the non-paretic side as well as in the paretic side than that of the control group (right 1.85±0.29, left 1.92±0.42; p<0.001). No difference was found between the ambulation regarding the TrA contraction ratio. Conclusion The TrA contractility in hemiparetic stroke patients is significantly decreased in the non-paretic side as well as in the paretic side compared with that of healthy adults. Ultrasonographic measurement can be clinically used in the evaluation of deep abdominal muscles in stroke patients. PMID:25024954

  8. A Role for the Adaptor Proteins TRAM and TRIF in Toll-like Receptor 2 Signaling*

    PubMed Central

    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

    2015-01-01

    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. PMID:25505250

  9. 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

  10. 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

  11. 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

  12. Tram-Track Suture Technique for Pupillary Capture of a Scleral Fixated Intraocular Lens

    PubMed Central

    Kim, Sung In; Kim, Kiseok

    2016-01-01

    Purpose To report a new technique using tram-track suture for pupillary capture of a scleral fixated posterior chamber intraocular lens (PC-IOL) to reposition the tilted IOL. Methods In this prospective interventional case series, we describe a tram-track suture for pupillary capture of a scleral fixated PC-IOL. A long straight needle with double-armed 10-0 polypropylene is passed behind the iris and just above the optic portion (tilted forward) of the IOL. The other straight needle with double-armed 10-0 polypropylene is passed just below the optic portion (tilted backward) of the IOL. After the IOL is repositioned properly, the polypropylene sutures are gently pulled and tied. Results Four eyes of 4 patients underwent tram-track suture for pupillary capture of a scleral fixated PC-IOL. No intra- or postoperative complications were noted, and no pupillary captures were detected during the follow-up period. Conclusions The tram-track suture technique provides good centration and stability of a PC-IOL. This technique is an easy and effective way to reposition pupillary capture of an IOL. Further, it is also minimally invasive as it maintains a closed system. PMID:27462257

  13. DETAIL OVERHEAD VIEW OF SECONDARY ORE BIN. CONVEYOR PLATFORM,TRAM TRESTLE, ...

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

    DETAIL OVERHEAD VIEW OF SECONDARY ORE BIN. CONVEYOR PLATFORM,TRAM TRESTLE, AND LOADING PLATFORM. LOOKING SOUTHWEST. THE HOLE IN THE ORE BIN FLOOR CAN BE SEEN, AND BALL MILL FOUNDATION AT LOWER LEFT CORNER. SEE CA-291-47(CT) FOR IDENTICAL COLOR TRANSPARENCY. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  14. Comparison of Long-Term Outcomes of Postmastectomy Radiotherapy between Breast Cancer Patients with and without Immediate Flap Reconstruction

    PubMed Central

    Lee, Hsin-Hua; Hou, Ming-Feng; Wei, Shu-Yi; Lin, Sin-Daw; Luo, Kuei-Hau; Huang, Ming-Yii; Ou-Yang, Fu; Huang, Chih-Jen

    2016-01-01

    Purpose To compare the long-term clinical outcomes of postmastectomy radiotherapy (PMRT) between breast cancer patients with and without immediate transverse rectus abdominis myocutaneous (TRAM) flap reconstruction. Methods The study included 492 patients with stage II or III breast cancer who underwent modified radical mastectomy (MRM) and chemotherapy followed by PMRT between 1997 and 2011. Cox regression model and Kaplan-Meier curves were calculated, and the log-rank test was used to evaluate the differences between overall and disease-free survival rates in the 2 groups. Results Among 492 patients, 213 patients had immediate TRAM flap reconstruction. The mean follow-up was 7.2 years (range, 11–191 months). The 5-year and 10-year disease free survival rates were 81% and 76% for the TRAM flap group and 78% and 73% for the non-flap group. The 5-year and 10-year overall survival rates were 89% and 73% for the TRAM flap group and 83% and 74% for the non-flap group. Conclusions There exists no statistically significant difference in the rates of local recurrence, distant metastasis, disease-free and overall survival when comparing immediate TRAM flap reconstruction with no reconstruction. Our results suggest that immediate TRAM flap reconstruction does not compromise long term clinical outcomes in breast cancer patients requiring PMRT. PMID:26863006

  15. 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.

  16. 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

  17. Gracilis myocutaneous flap: evaluation of potential risk factors and long-term donor-site morbidity.

    PubMed

    Papadopoulos, Othon; Konofaos, Petros; Georgiou, Panos; Chrisostomidis, Chrisostomos; Tsantoulas, Zacharias; Karypidis, Dimitrios; Kostakis, Alkiviadis

    2011-09-01

    This study reviewed our experience with the gracilis myocutaneous (GMC) flap, potential risk factors for flap necrosis, and long-term morbidity at the donor-site. From 1993 to 2002, 29 GMC flaps were harvested from 27 patients (pedicled n = 21 and free n = 8). The overall incidence of flap necrosis was 13.79% (partial (n = 2) and total (n = 2) necrosis). Flap necrosis was correlated with body mass index >25 (P = 0.022), with smoking (P = 0.04 9) and with radiation therapy at the recipient site (P = 0.020). The long-term morbidity at the donor-site was low, except for scar appearance (17.24%), thigh contour deformity (58.62%), and hypoesthesia (17.24%). Significant age and gender differences were seen for ranking of scar ugliness, with females (P = 0.0061) and younger patients (age ≤55) (P = 0.046) assigned higher values. Significant age differences were seen for ranking of thigh contour deformity, with younger patients assigned higher values (P = 0.0012). In conclusion, patient overweight, smoking, and previous radiation therapy at the recipient site may be the "potential risk factors" for flap necrosis. The long-term morbidity at the donor-site was low, which was in agreement with previous reported studies. A larger series would be the subject of a future study.

  18. 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. PMID:24209385

  19. 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

  20. Transneuronal tracing of neural pathways controlling an abdominal muscle, rectus abdominis, in the ferret.

    PubMed

    Billig, I; Foris, J M; Card, J P; Yates, B J

    1999-02-27

    Abdominal muscles participate in generating a large number of behaviors and reflex responses, including expiration, coughing, sneezing, vomiting, postural control, production of speech, straining, facilitation of venous return to the heart, and reaction to vestibular stimulation. However, the only premotor neurons that have been conclusively shown to influence abdominal motoneurons are located in nucleus retroambiguus, the expiratory region of the caudal ventral respiratory group. In the present study, the neural circuitry controlling the activity of one abdominal muscle, rectus abdominis, was mapped using the transneuronal tracer pseudorabies virus (PRV) in the ferret. Injections of PRV into rectus abdominis labeled large presumed motoneurons in the ventral horn of T12-L4, and smaller presumed interneurons that were scattered in laminae VII, VIII, IX, and X of T4-L4. In addition, neurons in several areas of the medulla and caudal pons, including the retroambigual nucleus, medial and ventromedial reticular formation, nucleus prepositus hypoglossi, vestibular nuclei, and raphe nuclei, were infected by transynaptic passage of PRV from rectus abdominis motoneurons. Thus, the multifunctional roles of abdominal muscles appear to be coordinated by premotor neurons located in both the spinal cord and several regions of the brainstem. PMID:10023028

  1. 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. PMID:26277386

  2. 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.

  3. Evolution of a "falx lunatica" in demarcation of critically ischemic myocutaneous tissue.

    PubMed

    Harder, Yves; Amon, Michaela; Georgi, Mirko; Banic, Andrej; Erni, Dominique; Menger, Michael D

    2005-03-01

    Using intravital microscopy in a chronic in vivo mouse model, we studied the demarcation of myocutaneous flaps and evaluated microvascular determinants for tissue survival and necrosis. Chronic ischemia resulted in a transition zone, characterized by a red fringe and a distally adjacent white falx, which defined the demarcation by dividing the proximally normal from the distally necrotic tissue. Tissue survival in the red zone was determined by hyperemia, as indicated by recovery of the transiently reduced functional capillary density, and capillary remodeling, including dilation, hyperperfusion, and increased tortuosity. Angiogenesis and neovascularization were not observed over the 10-day observation period. The white rim distal to the red zone, appearing as "falx lunatica," showed a progressive decrease of functional capillary density similar to that of the necrotic distal area but without desiccation, and thus transparency, of the tissue. Development of the distinct zones of the critically ischemic tissue could be predicted by partial tissue oxygen tension (Pt(O(2))) analysis by the time of flap elevation. The falx lunatica evolved at a Pt(O(2)) between 6.2 +/- 1.3 and 3.8 +/- 0.7 mmHg, whereas tissue necrosis developed at <3.8 +/- 0.7 mmHg. Histological analysis within the falx lunatica revealed interstitial edema formation and muscle fiber nuclear rarefaction but an absence of necrosis. We have thus demonstrated that ischemia-induced necrosis does not demarcate sharply from normal tissue but develops beside a fringe of tissue with capillary remodeling an adjacent falx lunatica that survives despite nutritive capillary perfusion failure, probably by direct oxygen diffusion.

  4. 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.

  5. 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.

  6. Reconstruction of transhumeral amputation stumps with ipsilateral pedicled latissimus dorsi myocutaneous flap in high voltage electrical burns.

    PubMed

    Kesiktas, Erol; Eser, Cengiz; Gencel, Eyuphan; Aslaner, Emrah Efe; Yavuz, Metin

    2015-03-01

    Injury due to high-voltage (>1000V) electricity is one of the most challenging problems in emergency medicine and plastic surgery. Extremity amputation because of electrical injury yields a stump that leaves vital structures, such as bone, muscle, blood vessels, and nerves, exposed; these structures should be covered with appropriate tissue. We designed a retrospective study that included twelve patients with a high-voltage electrical injury followed by trans-humeral amputation who were evaluated between 2004 and 2013. The ages of the patients ranged between 8 and 35 years (mean, 16.9 years). Following amputation, the defects were covered with an ipsilateral pedicled latissimus dorsi (LD) myocutaneous flap for stump protection and functional transfer. We concluded that the use of an ipsilateral LD myocutaneous flap is an adequate surgical operation in upper extremity amputations resulting from high-voltage electrical burn injuries and that this procedure permits stump length maintenance, contributes to arm functioning, avoids extended operation times, and prepares patients for prosthesis usage.

  7. 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.

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

    PubMed

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

    2015-03-27

    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.

  9. Ultrasound Guided Transversus Abdominis Plane Block for Anterior Cutaneous Nerve Entrapment Syndrome.

    PubMed

    Sahoo, Rajendra Kumar; Nair, Abhijit S

    2015-10-01

    Anterior cutaneous nerve entrapment syndrome (ACNES) is one the most common cause of chronic abdominal wall pain. The syndrome is mostly misdiagnosed, treated wrongly and inadequately. If diagnosed correctly by history, examination and a positive carnett test, the suffering of the patient can be relieved by addressing the cause i.e. local anaesthetic with steroid injection at the entrapment site. Conventionally, the injection is done by landmark technique. In this report, we have described 2 patients who were diagnosed with ACNES who were offered ultrasound guided transverses abdominis plane (TAP) injection who got significant pain relief for a long duration of time. PMID:26495084

  10. Three new species of Coccobius Ratzeburg (Hymenoptera, Aphelinidae) and redescription of C. abdominis Huang and C. furviflagellatus Huang from China.

    PubMed

    Wang, Zhu-Hong; Huang, Jian; Polaszek, Andrew

    2014-01-01

    Three new species of Coccobius Ratzeburg (Hymenoptera: Aphelinidae) are described from China, Coccobius bimaculatus Wang, Huang & Polaszek sp. nov., Coccobius jinshanensis Wang, Huang & Polaszek sp. nov. and Coccobius leptocerus Wang, Huang & Polaszek sp. nov. Coccobius abdominis Huang 1994 and Coccobius furviflagellatus Huang 1994, originally described in Chinese, are redescribed in English and illustrated by macrophotography based on newly collected material. All five species were reared from Diaspididae (Hemiptera) scale insects on bamboo. Both the male of C. furviflagellatus and the diaspidid host association of C. abdominis and C. furviflagellatus are recorded for the first time.

  11. 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.

  12. Pectoralis major myocutaneous flap in head and neck reconstruction: An experience in 100 consecutive cases

    PubMed Central

    Tripathi, Mayank; Parshad, Sanjeev; Karwasra, Rajender Kumar; Singh, Virender

    2015-01-01

    Background: The pectoralis major myocutaneous (PMMC) flap has been used as a versatile and reliable flap since its first description by Ariyan in 1979. In India head and neck cancer patients usually present in the advanced stage making PMMC flap a viable option for reconstruction. Although free flap using microvascular technique is the standard of care, its use is limited by the availability of expertise and resources in developing world. The aim of this study is to identify the outcomes associated with PMMC flap reconstruction. Patients and Methods: After ethical approval we retrospectively analyzed 100 PMMC flap at a tertiary care hospital from 2006 to 2013. A total of 137 PMMC flap reconstructions were performed out of which follow-up data of 100 cases were available in our record. Results: A total of 100 patients were reviewed of these 86% were of oral cavity and oropharyngeal lesions, 8% were of hypopharyngeal, 3% were of laryngeal malignancies and 3 cases were of salivary gland tumor. Most tumors (83%) were advanced (T3 or T4 lesion). 95 PMMC flap reconstruction were done as a primary procedure, and 5 were salvage procedure. PMMC flap was used to cover mucosal defect in 84 patients, skin defects in 10 patient and both in 6 patients. Overall flap related complications were 40% with a major complication in 10% and minor complications in 30%. No total flap loss occurred in any patient, major flap occurred in 6% and minor flap loss in 12%. In minor flap loss patients, necrotic changes were mostly limited to skin. Orocutaneous and pharyngocutaneous fistula developed in 12 patients. 10% patients required re-surgery after developing various flap related complications Pleural empyema developed in 3 patients. Other minor complications such as neck skin dehiscence and intra-oral flap dehiscence developed in 26 patients. Conclusion: PMMC flap is a versatile flap with an excellent reach to face oral cavity and neck region. With limited expertise and resources, it is

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

    PubMed

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

    2003-01-01

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

  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. StarTram: Ultra Low Cost Launch For Large Space Architectures

    NASA Astrophysics Data System (ADS)

    Powell, J.; Maise, G.; Paniagua, J.

    2004-02-01

    The StarTram Maglev system can launch hundreds of thousands of tons of cargo per year to orbit (~1000 times present capability) plus many thousands of passengers. The launch cost is only $30/kilogram of cargo, ~ 1/300 th of present cost. Magnetically levitated spacecraft accelerate to >=8 km/see in an evacuated ground tunnel using superconducting (SC) Maglev technology now operating in Japan for high speed trains. No propellant is used; energy from the electrical grid costs $0.50 per kg of launch weight. After reaching orbital speed, the levitated craft ascend in a curving evacuated launch tube that is magnetically levitated above Earth's surface by the repulsion force between SC cables attached to it and an opposing set of SC cables on the surface. The levitation force is 4 tons/meter of tube length at 20 km altitude, and exceeds the tube weight. High strength Kevlar tethers to the ground prevent vertical and lateral motion. Craft enter the atmosphere at 20 km through an open exit that prevents in-leakage of low density air by high speed gas ejectors and an MHD (Magnetic Hydro Dynamic) pump, and coast to apogee, where a small V burn (~500 m/s) establishes orbit. Deceleration as it enters the atmosphere at 20 km is modest, ~1 g. Peak heating is ~5 KW/cm2 for times of a few seconds before the craft reaches space. The technology for StarTram-C now exists, and no breakthroughs in materials are required. Two possible StarTram systems are compared, one for cargo only, and the second for both passengers and cargo.

  16. 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.

  17. 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

    ...) Meet all applicable requirements for medium-voltage circuits in 30 CFR 75. ER06AP10.002 (2) Step-up... supplying low or medium voltage to the step-up transformer must meet the applicable requirements of 30 CFR... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Tramming continuous mining machines in and...

  18. 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

    ...) Meet all applicable requirements for medium-voltage circuits in 30 CFR 75. ER06AP10.002 (2) Step-up... supplying low or medium voltage to the step-up transformer must meet the applicable requirements of 30 CFR... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Tramming continuous mining machines in and...

  19. 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

    ...) Meet all applicable requirements for medium-voltage circuits in 30 CFR 75. ER06AP10.002 (2) Step-up... supplying low or medium voltage to the step-up transformer must meet the applicable requirements of 30 CFR... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Tramming continuous mining machines in and...

  20. 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

    ...) Meet all applicable requirements for medium-voltage circuits in 30 CFR 75. ER06AP10.002 (2) Step-up... supplying low or medium voltage to the step-up transformer must meet the applicable requirements of 30 CFR... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Tramming continuous mining machines in and...

  1. 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

    ...) Meet all applicable requirements for medium-voltage circuits in 30 CFR 75. ER06AP10.002 (2) Step-up... supplying low or medium voltage to the step-up transformer must meet the applicable requirements of 30 CFR... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Tramming continuous mining machines in and...

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

    PubMed

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

    2012-04-01

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

  3. 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

  4. 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

  5. Pain relief after transversus abdominis plane block for abdominal surgery in children: a service evaluation

    PubMed Central

    Bergmans, Elonka; Jacobs, Alet; Desai, Rachel; Masters, Oliver W; Thies, Karl C

    2015-01-01

    We carried out a prospective service evaluation of the quality of pain control after preoperative transverse abdominis plane (TAP) block in 100 children undergoing abdominal surgery. Data were collected on type of procedure, age, weight, level of the block, local anesthetic used, additional analgesia, and hourly pain scores. Of the 100 patients, 87 were included in the evaluation, 77% of who were less than 1 year old. Adequate pain relief was achieved in 93% of all patients. Almost half (47%) of our patients did not require intravenous (IV) opioids in the postoperative period and 27% did not need any IV opioids at all. Our results confirm the good quality of perioperative analgesia achieved with a TAP block as part of a multimodal approach in children undergoing abdominal surgery. Depending on the patient’s age and the type of procedure, a TAP block may eliminate the need for IV opioids. PMID:25897261

  6. Useful Points of Geometry and Topography of the Lumbar Triangle for Transversus Abdominis Plane Block

    PubMed Central

    Ziętek, Zbigniew; Starczewski, Kamil; Sulikowski, Tadeusz; Iwan-Ziętek, Iza; Żukowski, Maciej; Kamiński, Marek; Ziętek-Czeszak, Angelika

    2015-01-01

    Background A new look at the topography of the lumbar triangle becomes a challenge for modern anesthesia. The aim of this study was to redefine the topography of the lumbar triangle for transverse abdominis plane block. Material/Methods We explored 74 lumbar regions in 37 preserved cadavers (17 F and 20 M). Results The lumbar triangle was identified in 66 (89%) out of all explored cadavers’ lumbar regions. The predominant triangle was the acute-angled shaped. It was identified in 39 (59%) out of all explored lumbar regions. The second type of dissected triangles had the obtuse-angled shaped. Most triangles of acute-angled shaped and obtuse-angled shaped (36) had medium surface (range from 3 cm2 to 6 cm2), which accounted for 55% of all dissected lumbar triangles. The mean surface of the lumbar triangle was 3.6±2.2 cm2. Based on other measurements, we demonstrated that the majority of the lumbar triangles (62 triangles) were beyond the posterior axillary line. Conclusions According to the obtained results, the randomized searching for lumbar triangle should be limited to the area situated beyond of the posterior axillary line. The region situated anteriorly to the midaxillary line was defined in the study as the critical area for finding the lumbar triangle. Outcomes from the study revealed that the size and the location of the lumbar triangle as the gate for the transverse abdominal plane block may be responsible for difficulties encountered by anesthetists. Thus, establishing the area with the highest probability of localization of the lumbar triangle can improve both safety and efficiency of transversus abdominis plane block. PMID:26714659

  7. 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. PMID:26476596

  8. 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.

  9. 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.

  10. TRAM (Transcriptome Mapper): database-driven creation and analysis of transcriptome maps from multiple sources

    PubMed Central

    2011-01-01

    Background Several tools have been developed to perform global gene expression profile data analysis, to search for specific chromosomal regions whose features meet defined criteria as well as to study neighbouring gene expression. However, most of these tools are tailored for a specific use in a particular context (e.g. they are species-specific, or limited to a particular data format) and they typically accept only gene lists as input. Results TRAM (Transcriptome Mapper) is a new general tool that allows the simple generation and analysis of quantitative transcriptome maps, starting from any source listing gene expression values for a given gene set (e.g. expression microarrays), implemented as a relational database. It includes a parser able to assign univocal and updated gene symbols to gene identifiers from different data sources. Moreover, TRAM is able to perform intra-sample and inter-sample data normalization, including an original variant of quantile normalization (scaled quantile), useful to normalize data from platforms with highly different numbers of investigated genes. When in 'Map' mode, the software generates a quantitative representation of the transcriptome of a sample (or of a pool of samples) and identifies if segments of defined lengths are over/under-expressed compared to the desired threshold. When in 'Cluster' mode, the software searches for a set of over/under-expressed consecutive genes. Statistical significance for all results is calculated with respect to genes localized on the same chromosome or to all genome genes. Transcriptome maps, showing differential expression between two sample groups, relative to two different biological conditions, may be easily generated. We present the results of a biological model test, based on a meta-analysis comparison between a sample pool of human CD34+ hematopoietic progenitor cells and a sample pool of megakaryocytic cells. Biologically relevant chromosomal segments and gene clusters with

  11. Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb.

    PubMed

    Hodges, P W; Richardson, C A

    1998-02-01

    The temporal parameters of the response of the trunk muscles associated with movement of the lower limb were investigated in people with and without low back pain (LBP). The weight shift component of the task was completed voluntarily prior to a stimulus to move to allow investigation of the movement component of the response. In the control subjects the onset of electromyographic (EMG) activity of all trunk muscles preceded that of the muscle responsible for limb movement, thus contributing to the feed-forward postural response. The EMG onset of transversus abdominis was delayed in the LBP subjects with movement in each direction, while the EMG onsets of rectus abdominis, erector spinae, and oblique abdominal muscles were delayed with specific movement directions. This result provides evidence of a change in the postural control of the trunk in people with LBP.

  12. 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.

  13. 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. PMID:20554578

  14. 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.

  15. 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

  16. 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. PMID:26937643

  17. 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.

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

    PubMed

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

    2016-06-01

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

  19. Specific fibre composition and metabolism of the rectus abdominis muscle of bovine Charolais cattle

    PubMed Central

    2010-01-01

    Background An important variability of contractile and metabolic properties between muscles has been highlighted. In the literature, the majority of studies on beef sensorial quality concerns M. longissimus thoracis. M. rectus abdominis (RA) is easy to sample without huge carcass depreciation and may appear as an alternative to M. longissimus thoracis for fast and routine physicochemical analysis. It was considered interesting to assess the muscle fibres of M. rectus abdominis in comparison with M. longissimus thoracis (LT) and M. triceps brachii (TB) on the basis of metabolic and contractile properties, area and myosin heavy chain isoforms (MyHC) proportions. Immuno-histochemical, histochemical, histological and enzymological techniques were used. This research concerned two populations of Charolais cattle: RA was compared to TB in a population of 19 steers while RA was compared to LT in a population of 153 heifers. Results RA muscle had higher mean fibre areas (3350 μm2 vs 2142 to 2639 μm2) than the two other muscles. In RA muscle, the slow-oxidative fibres were the largest (3957 μm2) and the fast-glycolytic the smallest (2868 μm2). The reverse was observed in TB muscle (1725 and 2436 μm2 respectively). In RA muscle, the distinction between fast-oxidative-glycolytic and fast-glycolytic fibres appeared difficult or impossible to establish, unlike in the other muscles. Consequently the classification based on ATPase and SDH activities seemed inappropriate, since the FOG fibres presented rather low SDH activity in this muscle in comparison to the other muscles of the carcass. RA muscle had a higher proportion of I fibres than TB and LT muscles, balanced by a lower proportion either of IIX fibres (in comparison to TB muscle) or of IIA fibres (in comparison to LT muscle). However, both oxidative and glycolytic enzyme activities were lower in RA than in TB muscle, although the LDH/ICDH ratio was higher in RA muscle (522 vs 340). Oxidative enzyme activities were

  20. 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.

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

    PubMed Central

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

    2016-01-01

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

  2. 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

  3. Efficacy of laparoscopic transversus abdominis plane block for elective laparoscopic cholecystectomy in elderly patients

    PubMed Central

    Tihan, Deniz; Totoz, Tolga; Tokocin, Merve; Ercan, Gulcin; Calikoglu, Tugba Koc; Vartanoglu, Talar; Celebi, Fatih; Dandin, Ozgur; Kafa, Ilker Mustafa

    2016-01-01

    Transversus abdominis plane (TAP) block technique seems to offer one of the most efficient methods for a local pain control. Our aim is to demonstrate the effectiveness and safety of TAP block for post-operative pain control under laparoscopic vision in elderly patients during laparoscopic cholecystectomy. The patients aged more than 65 years old, who had cholecystectomy due to symptomatic cholelithiasis, were retrospectively evaluated. The patients that were operated under general anesthesia + laparoscopic TAP block and those who were operated only under only general anesthesia were compared according to their’ age and gender, comorbidities, American Society of Anesthesiologists scores, visual analog scale (VAS) for pain and length of stay in the hospital. Median (±interquartile range) values of post-operative 24th-hour-VAS for pain was found consecutively 2 (±1-3) in TAP block + group and 3 (±2-5) in TAP block - group. The median post-operative 24th-hour-VAS value in overall patients was three. Patients’ VAS values were higher in the TAP block – group with a statistically significant difference (p = 0.001). Furthermore, no statistically significant difference was found for other parameters in two groups. The laparoscopic-guided TAP block can easily be performed and has potential for lower visceral injury risk and shorter operational time. Efficacy, safety and other advantages (analgesic requirements, etc.) make it an ideal abdominal field block in elderly patients. PMID:26773187

  4. 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

    2015-10-01

    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.

  5. Top-k similar graph matching using TraM in biological networks.

    PubMed

    Amin, Mohammad Shafkat; Finley, Russell L; Jamil, Hasan M

    2012-01-01

    Many emerging database applications entail sophisticated graph-based query manipulation, predominantly evident in large-scale scientific applications. To access the information embedded in graphs, efficient graph matching tools and algorithms have become of prime importance. Although the prohibitively expensive time complexity associated with exact subgraph isomorphism techniques has limited its efficacy in the application domain, approximate yet efficient graph matching techniques have received much attention due to their pragmatic applicability. Since public domain databases are noisy and incomplete in nature, inexact graph matching techniques have proven to be more promising in terms of inferring knowledge from numerous structural data repositories. In this paper, we propose a novel technique called TraM for approximate graph matching that off-loads a significant amount of its processing on to the database making the approach viable for large graphs. Moreover, the vector space embedding of the graphs and efficient filtration of the search space enables computation of approximate graph similarity at a throw-away cost. We annotate nodes of the query graphs by means of their global topological properties and compare them with neighborhood biased segments of the datagraph for proper matches. We have conducted experiments on several real data sets, and have demonstrated the effectiveness and efficiency of the proposed method

  6. Reliability of ultrasound elastography for the quantification of transversus abdominis elasticity

    PubMed Central

    Akagi, Ryota; Takahashi, Hideyuki

    2015-01-01

    Background The transversus abdominis (TrA), which is considered to be involved in controlling spinal stability, is covered by two muscles (i.e. the external and internal oblique muscles) as well as subcutaneous fat. Therefore, there were doubts about whether it was possible to perform highly reliable measurements of muscle elasticity. Purpose To investigate the reliability of ultrasound elastography for the quantification of elasticity of the TrA. Material and Methods A skilled and an unskilled operator of ultrasound elastography measured TrA elasticity in 10 healthy men (age, 24 ± 4 years; height, 172.0 ± 5.2 cm; weight, 72.3 ± 12.0 kg) in the supine position. The tests were repeated six times; of the six measured values, a group of four measurements showing the lowest coefficient of variation (CV) was adopted and the mean values were used for further analysis. This procedure was repeated twice on each participant on two different days. Results The intra-class correlation coefficients (ICCs) between days for skilled and unskilled operators were 0.86 (P < 0.00) and 0.59 (P = 0.02), respectively, and the CVs were 8.7% and 13.8%, respectively. The ICCs between operators and CVs were in the range of 0.56–0.57 (P = 0.02–0.03) and 13.5–15.5%, respectively. No systematic error was found for any comparison. Conclusion The reliabilities of the skilled and unskilled operators were high and moderate, respectively. PMID:26413315

  7. Ultrasound-guided continuous transverse abdominis plane block for abdominal surgery

    PubMed Central

    Kadam, Rao V; Field, J B

    2011-01-01

    Introduction: Transversus abdominis plane (TAP) block is a new regional analgesic technique for postoperative pain in abdominal surgery. Its efficacy is not clear, and thus it needs to be explored for its regular utilisation on prolonged period. The objective was to study the continuous local anaesthetic infusion effect on postoperative analgesia. Continuous use of TAP block as an analgesic technique has not been evaluated prospectively in clinical trials. This study evaluates the efficacy of ultrasound-guided TAP block in comparison with PCA fentanyl in major abdominal surgery. Materials and Methods: There were 20 patients in the study, allocated to TAP and control groups. The parameters measured were pain scores on a numerical rating scale (NRS) of 0-10 at various time intervals and the amount of fentanyl used as rescue analgesia. Patient satisfaction scores were recorded in the TAP block group and along with any complications related to the block. Results: The postoperative median pain scores on coughing on day one were 6.0 for control group and 2.0 for the TAP group (P = 0.02); on day two, the equivalent scores were 7.0 and 2.0 (P = 0.01). The fentanyl requirement at one hour was 203 μ for the control group and 78 μg for the TAP group (P = 0.03); at day one, the control and TAP requirements were 1237 μg and 664 μg respectively (P = 0.01). Three TAP patients rated their satisfaction as ‘excellent’, four as ‘satisfied, and two as ‘poor’. Conclusion: TAP block is a promising technique for postoperative analgesia in major abdominal surgeries. Our study demonstrated lower pain scores in the TAP group with reduced fentanyl requirement. Further, a large scale study is needed to establish the efficacy of TAP block in this setting. PMID:21897502

  8. 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

  9. Transversus abdominis plane infiltration for laparoscopic gastric banding: A pilot study

    PubMed Central

    Jr, Gildasio S De Oliveira; Fitzgerald, Paul; Ahmad, Shireen; Kim, John; Rahangdale, Rohit; McCarthy, Robert

    2014-01-01

    AIM: To estimate an effect size for the transversus abdominis plane (TAP) infiltration on quality of recovery in patients undergoing laparoscopic gastric band surgery. METHODS: The pilot study was a randomized, double blinded, placebo controlled trial. Patients undergoing laparoscopic gastric band surgery were randomized to receive a bilateral TAP infiltration with 20 mL of 0.5% ropivacaine or saline. The evaluated outcomes included quality of recovery-40 (QoR-40) at 24 h, postoperative opioid consumption and pain. Data was examined using the Mann-Whitney U test. RESULTS: Nineteen subjects were recruited. There was a positive trend favoring the TAP infiltration group in global QoR-40 scores at 24 h after surgery, median [interquartile range (IQR)] of 175.5 (170-189) compared to 170 (160-175) in the control group (P = 0.06). There also a positive trend toward a lower cumulative opioid consumption in the TAP infiltration group, median (IQR) of 7.5 (2.5-11.5) mg iv morphine equivalents compared to 13 (7-21.5) in the control group (P = 0.07). Correlation analysis (Spearman’s Rho) demonstrated an inverse relationship between 24 h cumulative opioid consumption and global QoR-40 scores, -0.49 (P = 0.03). CONCLUSION: The use of multimodal analgesic techniques to reduce opioid related side effects is particularly desirable in morbidly obese patients undergoing gastric reduction surgery. The TAP infiltration seems to have a clinically important effect in reducing postoperative opioid consumption and improve quality of recovery after laparoscopic gastric band surgery in morbid obese patients. Future studies to confirm the beneficial effects of the TAP infiltration in these patients are warranted. PMID:24600508

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

    PubMed

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

    1988-07-01

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

  11. Is transverse abdominis plane block effective following local anesthetic infiltration in laparoscopic totally extraperitoneal hernia repair?

    PubMed Central

    Kim, Mun Gyu; Ok, Si Young; Kim, Sang Ho; Lee, Se-Jin; Park, Sun Young; Yoo, Jae-Hwa; Cho, Ana; Hur, Kyung Yul; Kim, Myung Jin

    2014-01-01

    Background Transverse abdominis plane (TAP) block can be recommended as a multimodal method to reduce postoperative pain in laparoscopic abdominal surgery. However, it is unclear whether TAP block following local anesthetic infiltration is effective. We planned this study to evaluate the effectiveness of the latter technique in laparoscopic totally extraperitoneal hernia repair (TEP). Methods We randomly divided patients into two groups: the control group (n = 37) and TAP group (n = 37). Following the induction of general anesthesia, as a preemptive method, all of the patients were subjected to local anesthetic infiltration at the trocar sites, and the TAP group was subjected to ultrasound-guided bilateral TAP block with 30 ml of 0.375% ropivacaine in addition before TEP. Pain was assessed in the recovery room and post-surgery at 4, 8, and 24 h. Additionally, during the postoperative 24 h, the total injected dose of analgesics and incidence of nausea were recorded. Results: On arrival in the recovery room, the pain score of the TAP group (4.33 ± 1.83) was found to be significantly lower than that of the control group (5.73 ± 2.04). However, the pain score was not significantly different between the TAP group and control group at 4, 8, and 24 h post-surgery. The total amounts of analgesics used in the TAP group were significantly less than in the control group. No significant difference was found in the incidence of nausea between the two groups. Conclusions TAP block following local infiltration had a clinical advantage only in the recovery room. PMID:25558340

  12. 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

  13. 1-J operation of monolithic composite ceramics with Yb:YAG thin layers: multi-TRAM at 10-Hz repetition rate and prospects for 100-Hz operation.

    PubMed

    Divoky, Martin; Tokita, Shigeki; Hwang, Sungin; Kawashima, Toshiyuki; Kan, Hirofumi; Lucianetti, Antonio; Mocek, Tomas; Kawanaka, Junji

    2015-03-15

    Experimental amplification of 10-ns pulses to energy of 1 J at repetition rate of 10-100 Hz in cryogenic multipass total-reflection active-mirror (TRAM) amplifier is reported for the first time. By using a monolithic multi-TRAM, which is a YAG ceramic composite with three thin Yb:YAG active layers, efficient energy extraction was achieved without parasitic lasing. A detailed measurement of output characteristics of the laser amplifier is presented; results are discussed and compared with numerical calculations.

  14. Breast reconstruction following conservative mastectomies: predictors of complications and outcomes

    PubMed Central

    Voineskos, Sophocles H.; Frank, Simon G.

    2015-01-01

    Breast reconstruction can be performed using a variety of techniques, most commonly categorized into an alloplastic approach or an autologous tissue method. Both strategies have certain risk factors that influence reconstructive outcomes and complication rates. In alloplastic breast reconstruction, surgical outcomes and complication rates are negatively impacted by radiation, smoking, increased body mass index (BMI), hypertension, and prior breast conserving therapy. Surgical factors such as the type of implant material, undergoing immediate breast reconstruction, and the use of fat grafting can improve patient satisfaction and aesthetic outcomes. In autologous breast reconstruction, radiation, increased BMI, certain previous abdominal surgery, smoking, and delayed reconstruction are associated with higher complication rates. Though a pedicled transverse rectus abdominis myocutaneous (TRAM) flap is the most common type of flap used for autologous breast reconstruction, pedicled TRAMs are more likely to be associated with fat necrosis than a free TRAM or deep inferior epigastric perforator (DIEP) flap. Fat grafting can also be used to improve aesthetic outcomes in autologous reconstruction. This article focuses on factors, both patient and surgical, that are predictors of complications and outcomes in breast reconstruction. PMID:26645003

  15. Effects of selective exercise for the deep abdominal muscles and lumbar stabilization exercise on the thickness of the transversus abdominis and postural maintenance

    PubMed Central

    Lee, Jung-seok; Kim, Tae-ho; Kim, Da-yeon; Shim, Jae-ho; Lim, Jin-yong

    2015-01-01

    [Purpose] The purpose of this study was to examine the effects of selective exercise for the deep abdominal muscles (SEDA) and lumbar stabilization exercise (LSE) on the thickness of the transversus abdominis and postural maintenance on an unstable base of support. [Subjects and Methods] The subjects of this study were 20 male and 10 female adults in their 20s without lumbar pain. They were equally and randomly assigned to a SEDA group and a LSE group. The thickness of the transversus abdominis was measured using ultrasound imaging during rest and drawing-in. The thickness of the transversus abdominis was measured when subjects raised their right and left legs while lying on a Swiss ball. [Results] Initially, there were no differences between the two groups. After the intervention, significant differences were observed in all parameters. A significant interaction between group and period was not found for any parameters. [Conclusion] In conclusion, both SEDA and LSE thickened the transversus abdominis, which is a deep abdominal muscle, thereby adjusting posture, and stabilizing the trunk. These exercises increased the thickness of the deep abdominal muscles. They are important exercises for improving the stability of athletes or patients who need postural adjustment. PMID:25729169

  16. Effects of selective exercise for the deep abdominal muscles and lumbar stabilization exercise on the thickness of the transversus abdominis and postural maintenance.

    PubMed

    Lee, Jung-Seok; Kim, Tae-Ho; Kim, Da-Yeon; Shim, Jae-Ho; Lim, Jin-Yong

    2015-02-01

    [Purpose] The purpose of this study was to examine the effects of selective exercise for the deep abdominal muscles (SEDA) and lumbar stabilization exercise (LSE) on the thickness of the transversus abdominis and postural maintenance on an unstable base of support. [Subjects and Methods] The subjects of this study were 20 male and 10 female adults in their 20s without lumbar pain. They were equally and randomly assigned to a SEDA group and a LSE group. The thickness of the transversus abdominis was measured using ultrasound imaging during rest and drawing-in. The thickness of the transversus abdominis was measured when subjects raised their right and left legs while lying on a Swiss ball. [Results] Initially, there were no differences between the two groups. After the intervention, significant differences were observed in all parameters. A significant interaction between group and period was not found for any parameters. [Conclusion] In conclusion, both SEDA and LSE thickened the transversus abdominis, which is a deep abdominal muscle, thereby adjusting posture, and stabilizing the trunk. These exercises increased the thickness of the deep abdominal muscles. They are important exercises for improving the stability of athletes or patients who need postural adjustment.

  17. Monitoring Ecosystem Dynamics Ecosystem Using Hyperspectral Reflectance and a Robotic Tram System in Barrow Alaska

    NASA Astrophysics Data System (ADS)

    Goswami, S.; Gamon, J. A.; Tweedie, C. E.

    2012-12-01

    Understanding the future state of the earth system requires improved knowledge of ecosystem dynamics and long term observations of how ecosystem structures and functions are being impacted by global change. Improving remote sensing methods is essential for such advancement because satellite remote sensing is the only means by which landscape to continental-scale change can be observed. The Arctic appears to be impacted by climate change more than any other region on Earth. Arctic terrestrial ecosystems comprise only 6% of the land surface area on Earth yet contain an estimated 25% of global soil organic carbon, most of which is stored in permafrost. If projected increases in plant productivity do not offset forecast losses of soil carbon to the atmosphere as greenhouse gases, regional to global greenhouse warming could be enhanced. Soil moisture is an important control of land-atmosphere carbon exchange in arctic terrestrial ecosystems. However, few studies to date have examined using remote sensing, or developed remote sensing methods for observing the complex interplay between soil moisture and plant phenology and productivity in arctic landscapes. This study was motivated by this knowledge gap and addressed the following questions as a contribution to a large scale, multi investigator flooding and draining experiment funded by the National Science Foundation near Barrow, Alaska from 2005 - 2009. 1. How can optical remote sensing be used to monitor the surface hydrology of arctic landscapes? 2. What are the spatio-temporal dynamics of land-surface phenology (NDVI) in the study area and do hydrological treatment has any effect on inter-annual patterns? 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 developed to capture surface hydrological dynamics in the study area using the robotic tram system. When applied to

  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. 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

  20. 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

  1. 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.

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

    PubMed

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

    1995-11-01

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

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

    PubMed

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

    2013-11-01

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

  5. Successful return to high-level sports following early surgical repair of combined adductor complex and rectus abdominis avulsion.

    PubMed

    Tansey, R J; Benjamin-Laing, H; Jassim, S; Liekens, K; Shankar, A; Haddad, F S

    2015-11-01

    Hip and groin injuries are common in athletes who take part in high level sports. Adductor muscle tendon injuries represent a small but important number of these injuries. Avulsion of the tendons attached to the symphysis pubis has previously been described: these can be managed both operatively and non-operatively. We describe an uncommon variant of this injury, namely complete avulsion of the adductor sleeve complex: this includes adductor longus, pectineus and rectus abdominis. We go on to describe a surgical technique which promotes a full return to the pre-injury level of sporting activity. Over a period of ten years, 15 high-level athletes with an MRI-confirmed acute adductor complex avulsion injury (six to 34 days old) underwent surgical repair. The operative procedure consisted of anatomical re-attachment of the avulsed tissues in each case and mesh reinforcement of the posterior inguinal wall in seven patients. All underwent a standardised rehabilitation programme, which was then individualised to be sport-specific. One patient developed a superficial wound infection, which was successfully treated with antibiotics. Of the 15 patients, four complained of transient local numbness which resolved in all cases. All patients (including seven elite athletes) returned to their previous level of participation in sport.

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

    PubMed

    Martin, W D

    1979-11-01

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

  7. 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

  8. 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

  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. Efficacy of ultrasound-guided transversus abdominis plane block for postoperative analgesia in patients undergoing inguinal hernia repair

    PubMed Central

    Venkatraman, Rajagopalan; Abhinaya, Ranganathan Jothi; Sakthivel, Ayyanar; Sivarajan, Govindarajan

    2016-01-01

    Background and aim Transversus abdominis plane block (TAP block) is a novel procedure to provide postoperative analgesia following inguinal hernia surgery. The utilization of ultrasound has greatly augmented the success rate of this block and additionally avoiding complications. The aim of our study was to gauge the analgesic efficacy of ultrasound-guided TAP block in patients undergoing unilateral inguinal hernia repair. Materials and methods Sixty patients scheduled for elective inguinal hernia repair were selected for the study. At the end of the surgical procedure, they were randomly divided into two groups. Ultrasound-guided TAP block was performed with 20 mL of ropivacaine 0.2% (group A) or normal saline (group B). Visual analog scale (VAS) scores were used to assess pain. Paracetamol was given if VAS > 3 and tramadol was used when VAS > 6. Patients were monitored for VAS scores and total analgesic consumption for the 24-hour period. Results The TAP block with ropivacaine (group A) reduced VAS scores at 4, 6, and 12 hours. There was no distinction in VAS scores at 0, 2, and 24 hours between the two groups. The duration of analgesia for TAP block with ropivacaine lasted for 390 minutes. Total analgesics consumption was also significantly reduced in group A than group B. No complication was reported to TAP block in both the groups. Conclusion The ultrasound-guided TAP block provides good postoperative analgesia, reduces analgesic requirements, and provides good VAS scores with fewer complications following inguinal hernia surgery. PMID:26848274

  11. Oncoplastic breast surgery with latissimus dorsi myocutaneous flap for large defect in patients with ptotic breasts: is it feasible when combined with local flaps?

    PubMed Central

    2014-01-01

    Background The latissimus dorsi myocutaneous flap (LDMCF) is frequently applied to breast cancer patients for breast reconstruction. However, the LDMCF is considered inappropriate for patients with ptotic breast. The authors investigated combining LDMCF and two local flaps for large defects of the breast after partial mastectomy in patients with ptosis. Methods Nineteen patients with breast cancer underwent a partial mastectomy with immediate reconstruction. Reconstruction methods consisted of LDMCF, thoraco-epigastric flap, and inferior pedicled rotational local flap, referred to as a combined pedicle flap. The cosmetic results were self-assessed after chemotherapy and radiotherapy by a four-point scoring system. Results Ptosis was graded as follows: two patients with grade 1, 10 patients with grade 2, and seven patients with grade 3. The mean tumor size was 2.7 cm and multifocality was identified in 11 patients (57.9%). The mean excised volume was 468.5 cm3 and the percentage of excised volume was 46.2%. The cosmetic results were excellent in five patients, good in seven patients, fair in six patients, and poor in one patient. Conclusion The combined pedicle flap, consisting of LDMCF, thoraco-epigastric flap, and inferior pedicled rotational local flap, allows good cosmesis in breast cancer patients with large breasts or ptosis despite a wide excision. PMID:24669908

  12. Delineation of the clotrimazole/TRAM-34 binding site on the intermediate conductance calcium-activated potassium channel, IKCa1.

    PubMed

    Wulff, H; Gutman, G A; Cahalan, M D; Chandy, K G

    2001-08-24

    Selective and potent triarylmethane blockers of the intermediate conductance calcium-activated potassium channel, IKCa1, have therapeutic use in sickle cell disease and secretory diarrhea and as immunosuppressants. Clotrimazole, a membrane-permeant triarylmethane, blocked IKCa1 with equal affinity when applied externally or internally, whereas a membrane-impermeant derivative TRAM-30 blocked the channel only when applied to the cytoplasmic side, indicating an internal drug-binding site. Introduction of the S5-P-S6 region of the triarylmethane-insensitive small conductance calcium-activated potassium channel SKCa3 into IKCa1 rendered the channel resistant to triarylmethanes. Replacement of Thr(250) or Val(275) in IKCa1 with the corresponding SKCa3 residues selectively abolished triarylmethane sensitivity without affecting the affinity of the channel for tetraethylammonium, charybdotoxin, and nifedipine. Introduction of these two residues into SKCa3 rendered the channel sensitive to triarylmethanes. In a molecular model of IKCa1, Thr(250) and Val(275) line a water-filled cavity just below the selectivity filter. Structure-activity studies suggest that the side chain methyl groups of Thr(250) and Val(275) may lock the triarylmethanes in place via hydrophobic interactions with the pi-electron clouds of the phenyl rings. The heterocyclic moiety may project into the selectivity filter and obstruct the ion-conducting pathway from the inside.

  13. Using Visualized Matrix Effects to Develop and Improve LC-MS/MS Bioanalytical Methods, Taking TRAM-34 as an Example

    PubMed Central

    Ye, Jia-Hung; Pao, Li-Heng

    2015-01-01

    Matrix effects (MEs) continue to be an obstacle in the development of the LC-MS/MS method, with phospholipids being the major cause of MEs. Changing the mobile phase has been a common strategy to reduce MEs; however, the underlying mechanism is unclear. "In-source multiple-reaction monitoring" (IS-MRM) for glycerophosphocholines (PCs) has been commonly applied in many bioanalytical methods. "Visualized MEs" is a suitable term to describe the application of IS-MRM to visualize the elution pattern of phospholipids. We selected a real case to discuss the relationship of MEs and phospholipids in different mobile phases by quantitative, qualitative, and visualized MEs in LC-MS/MS bioanalysis. The application of visualized MEs not only predicts the ion-suppression zone but also helps in selecting an appropriate (1) mobile phase, (2) column, (3) needle wash solvent for the residue of analyte and phospholipids, and (4) evaluates the clean-up efficiency of sample preparation. The TRAM-34 LC-MS/MS method, improved by using visualized MEs, was shown to be a precise and accurate analytical method. All data indicated that the use of visualized MEs indeed provided useful information about the LC-MS/MS method development and improvement. In this study, an integrative approach for the qualitative, quantitative, and visualized MEs was used to decipher the complexity of MEs. PMID:25909956

  14. 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

  15. 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

  16. 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.

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

    PubMed

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

    2009-10-01

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

  18. Effect of adding dexamethasone to bupivacaine on transversus abdominis plane block for abdominal hysterectomy: A prospective randomized controlled trial

    PubMed Central

    Ammar, Amany S.; Mahmoud, Khaled M.

    2012-01-01

    Purpose: Different adjuvants have been used to improve the quality and increase the duration of local anesthetics during various nerve block techniques. The current study was aimed to evaluate the effect of adding dexamethasone to bupivacaine on the quality and duration of transversus abdominis plane (TAP) block. Methods: Sixty adult patients undergoing elective open abdominal hysterectomy were randomly allocated to receive TAP block using 20 mL of bupivacaine hydrochloride 0.25% + 2 mL saline 0.9% (control group, n=30) or 20 mL of bupivacaine hydrochloride 0.25% + 2 mL dexamethasone “8 mg” (dexamethasone group, n=30). The primary outcome was postoperative pain, as evaluated by visual analog scale (VAS) for pain scoring at 1, 2, 4, 12, 24 and 48 h postoperatively, whereas the secondary outcomes were time to first analgesia (TFA), morphine consumption and the occurrence of nausea, vomiting or somnolence. Results: The pain VAS score was significantly lower at the postoperative 2 h (4.9 vs. 28.1, P=0.01), 4 h (12.2 vs. 31.1, P=0.01) and 12 h (15.7 vs. 25.4, P=0.02). Furthermore, TFA was significantly longer in the dexamethasone group (459.8 vs. 325.4 min, P=0.002), with lesser morphine requirements in the postoperative 48 h (4.9 vs. 21.2 mg, P=0.003) and lower incidence of nausea and vomiting (6 vs. 14, P=0.03). No complications attributed to the block were recorded. Conclusion: Addition of dexamethasone to bupivacaine in TAP block prolonged the duration of the block and decreased the incidence of nausea and vomiting. PMID:23162395

  19. 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.

  20. Effects of closed chain exercises for the lumbar region performed with local vibration applied to an unstable support surface on the thickness and length of the transverse abdominis

    PubMed Central

    Yun, Kihyun; Lee, Sangyong; Park, Jinsik

    2015-01-01

    [Purpose] This study examined the effects of closed chain exercises performed with local vibration applied to an unstable support surface on the thickness and length of the transverse abdominis. [Subjects] The subjects were 64 healthy university students who were randomly assigned to a bridge exercise with sling and vibration group (BESVG, n=30) and a bridge exercise with sling group (BESG, n=34). [Methods] The bridge exercise was repeated four times per set and a total of 18 sets were performed: 9 sets in a supine position and 9 sets in a prone position. In both the BESVG and the BESG groups, the thickness and length of the transverse abdominis (TrA) were measured using ultrasonography with the abdomen “drawn-in” and the pressure of a biofeedback unit maintained at 40 mmHg, both before and after the intervention. [Results] In intra-group comparisons, the BESVG showed significant increases in the thickness of the TrA and significant decreases in the length of the TrA. The BESG showed significant increases in the thickness of the TrA. The BESVG showed significant increases in the thickness of the TrA and significant decreases in the length of the TrA compared to BESG. [Conclusion] Closed chain exercises for the lumbar region performed with local vibration applied to slings, which are unstable support surfaces, are an effective intervention for altering the thickness and length of the TrA. PMID:25642048

  1. Effects of closed chain exercises for the lumbar region performed with local vibration applied to an unstable support surface on the thickness and length of the transverse abdominis.

    PubMed

    Yun, Kihyun; Lee, Sangyong; Park, Jinsik

    2015-01-01

    [Purpose] This study examined the effects of closed chain exercises performed with local vibration applied to an unstable support surface on the thickness and length of the transverse abdominis. [Subjects] The subjects were 64 healthy university students who were randomly assigned to a bridge exercise with sling and vibration group (BESVG, n=30) and a bridge exercise with sling group (BESG, n=34). [Methods] The bridge exercise was repeated four times per set and a total of 18 sets were performed: 9 sets in a supine position and 9 sets in a prone position. In both the BESVG and the BESG groups, the thickness and length of the transverse abdominis (TrA) were measured using ultrasonography with the abdomen "drawn-in" and the pressure of a biofeedback unit maintained at 40 mmHg, both before and after the intervention. [Results] In intra-group comparisons, the BESVG showed significant increases in the thickness of the TrA and significant decreases in the length of the TrA. The BESG showed significant increases in the thickness of the TrA. The BESVG showed significant increases in the thickness of the TrA and significant decreases in the length of the TrA compared to BESG. [Conclusion] Closed chain exercises for the lumbar region performed with local vibration applied to slings, which are unstable support surfaces, are an effective intervention for altering the thickness and length of the TrA. PMID:25642048

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

    PubMed

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

    2016-08-01

    Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352. PMID:27374014

  3. The Effects of Bridge Exercise on an Unstable Base of Support on Lumbar Stability and the Thickness of the Transversus Abdominis

    PubMed Central

    Cho, Misuk; Jeon, Hyewon

    2013-01-01

    [Purpose] We examined the effects of an abdominal drawing-in bridge exercise using a pressure biofeedback unit on different bases on the thickness of trunk and abdominal muscles, and lumbar stability. [Subjects] Thirty healthy young adults (2 males, 28 females) took part in this study. The subjects were randomly and equally assigned to a stable bridge exercise group and an unstable bridge exercise group. [Methods] The subjects performed bridge exercises using an abdominal drawing-in method on a stable base and on an unstable base, and changes in their abdominal muscle thickness and on the stable and on unstable bases lumbar stability were evaluated. [Results] After the intervention, the stable bridge exercise group showed a statistically significantly increased muscle thickness in the transversus abdominis, and the unstable bridge exercise group showed significantly increased muscle thicknesses of the transversus abdominis and internal obliques in static and dynamic lumbar stability. The unstable bridge exercise group showed significant increase after performing the exercise. [Conclusion] Lumbar stability exercise, with the compensation of the lumbar spine minimized, using an abdominal drawing-in method on an unstable support of base is effective and efforts to prevent the compensation may induce a greater exercise effect. PMID:24259841

  4. Effects of closed chain exercises for the lumbar region performed with local vibration applied to an unstable support surface on the thickness and length of the transverse abdominis.

    PubMed

    Yun, Kihyun; Lee, Sangyong; Park, Jinsik

    2015-01-01

    [Purpose] This study examined the effects of closed chain exercises performed with local vibration applied to an unstable support surface on the thickness and length of the transverse abdominis. [Subjects] The subjects were 64 healthy university students who were randomly assigned to a bridge exercise with sling and vibration group (BESVG, n=30) and a bridge exercise with sling group (BESG, n=34). [Methods] The bridge exercise was repeated four times per set and a total of 18 sets were performed: 9 sets in a supine position and 9 sets in a prone position. In both the BESVG and the BESG groups, the thickness and length of the transverse abdominis (TrA) were measured using ultrasonography with the abdomen "drawn-in" and the pressure of a biofeedback unit maintained at 40 mmHg, both before and after the intervention. [Results] In intra-group comparisons, the BESVG showed significant increases in the thickness of the TrA and significant decreases in the length of the TrA. The BESG showed significant increases in the thickness of the TrA. The BESVG showed significant increases in the thickness of the TrA and significant decreases in the length of the TrA compared to BESG. [Conclusion] Closed chain exercises for the lumbar region performed with local vibration applied to slings, which are unstable support surfaces, are an effective intervention for altering the thickness and length of the TrA.

  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. A waveguide finite element and boundary element approach to calculating the sound radiated by railway and tram rails

    NASA Astrophysics Data System (ADS)

    Nilsson, C.-M.; Jones, C. J. C.; Thompson, D. J.; Ryue, J.

    2009-04-01

    Engineering methods for modelling the generation of railway rolling noise are well established. However, these necessarily involve some simplifying assumptions to calculate the sound powers radiated by the wheel and the track. For the rail, this involves using an average vibration together with a radiation efficiency determined for a two-dimensional (2D) problem. In this paper, the sound radiation from a rail is calculated using a method based on a combination of waveguide finite elements and wavenumber boundary elements. This new method allows a number of the simplifying assumptions in the established methods to be avoided. It takes advantage of the 2D geometry of a rail to provide an efficient numerical approach but nevertheless takes into account the three-dimensional nature of the vibration and sound field and the infinite extent of the rail. The approach is used to study a conventional 'open' rail as well as an embedded tram rail of the type used for street running. In the former case it is shown that the conventional approach gives correct results and the complexity of the new method is mostly not necessary. However, for the embedded rail it is found that it is important to take into account the radiation from several wave types in the rail and embedding material. The damping effect of the embedding material on the rail vibration is directly taken into account and, for the example shown, causes the embedded rail to radiate less sound than the open rail above about 600 Hz. The free surface of the embedding material amplifies the sound radiation at some frequencies, while at other frequencies it moves out of phase with the rail and reduces the radiation efficiency. At low frequencies the radiation from the embedded rail resembles a line monopole source which produces greater power than the 'open' rail which forms a line dipole.

  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. 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

  9. Ultrasound-Guided Transversus Abdominis Plane Block versus Continuous Wound Infusion for Post-Caesarean Analgesia: A Randomized Trial

    PubMed Central

    Chandon, Michel; Bonnet, Agnès; Burg, Yannick; Barnichon, Carole; DesMesnards-Smaja, Véronique; Sitbon, Brigitte; Foiret, Christine; Dreyfus, Jean-François; Rahmani, Jamil; Laloë, Pierre-Antoine; Fischler, Marc; Le Guen, Morgan

    2014-01-01

    Objective To compare the analgesic effect of ultrasound-guided Transversus Abdominis Plane (TAP) block versus Continuous Wound Infusion (CWI) with levobupivacaine after caesarean delivery. Methods We recruited parturients undergoing elective caesareans for this multicenter study. Following written informed consent, they received a spinal anaesthetic without intrathecal morphine for their caesarean section. The postoperative analgesia was randomized to either a bilateral ultrasound guided TAP block (levobupivicaine = 150 mg) or a CWI through an elastomeric pump for 48 hours (levobupivacaine = 150 mg the first day and 12.5 mg/h thereafter). Every woman received regular analgesics along with oral morphine if required. The primary outcome was comparison of the 48-hour area under the curve (AUC) pain scores. Secondary outcomes included morphine consumption, adverse events, and persistent pain one month postoperatively. Results Recruitment of 120 women was planned but the study was prematurely terminated due to the occurrence of generalized seizures in one patient of the TAP group. By then, 36 patients with TAP and 29 with CWI had completed the study. AUC of pain at rest and during mobilization were not significantly different: 50 [22.5–80] in TAP versus 50 [27.5–130] in CWI (P = 0.4) and 190 [130–240] versus 160 [112.5–247.5] (P = 0.5), respectively. Morphine consumption (0 [0–20] mg in the TAP group and 10 [0–32.5] mg in the CWI group (P = 0.09)) and persistent pain at one month were similar in both groups (respectively 29.6% and 26.6% (P = 0.73)). Conclusion In cases of morphine-free spinal anesthesia for cesarean delivery, no difference between TAP block and CWI for postoperative analgesia was suggested. TAP block may induce seizures in this specific context. Consequently, such a technique after a caesarean section cannot be recommended. Trial Registration ClinicalTrials.gov NCT01151943 PMID:25093663

  10. 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

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

    PubMed

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

    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

  12. 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

  13. 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.

  14. Quorum Sensing but Not Autoinduction of Ti Plasmid Conjugal Transfer Requires Control by the Opine Regulon and the Antiactivator TraM

    PubMed Central

    Piper, Kevin R.; Farrand, Stephen K.

    2000-01-01

    Conjugal transfer of the Ti plasmids from Agrobacterium tumefaciens is controlled by autoinduction via the transcriptional activator TraR and the acyl-homoserine lactone ligand, Agrobacterium autoinducer (AAI). This control process is itself regulated by opines, which are small carbon compounds produced by the crown gall tumors that are induced by the bacteria. Opines control autoinduction by regulating the expression of traR. Transfer of pTiC58 from donors grown with agrocinopines A and B, the conjugal opines for this Ti plasmid, was detected only after the donors had reached a population level of 107 cells per cm2. Donors incubated with the opines and AAI transferred their Ti plasmids at population levels about 10-fold lower than those incubated with opines only. Transcription of the tra regulon, as assessed by monitoring a traA::lacZ reporter, showed a similar dependence on the density of the donor population. However, even in cultures at low population densities that were induced with opines and AAI, there was a temporal lag of between 15 and 20 h in the development of conjugal competence. Moreover, even after this latent period, maximal transfer frequencies required several hours to develop. This lag period was independent of the population density of the donors but could be reduced somewhat by addition of exogenous AAI. Quorum-dependent development of conjugal competence required control by the opine regulon; donors harboring a mutant of pTiC58 deleted for the master opine responsive repressor accR transferred the Ti plasmid at maximum frequencies at very low population densities. Similarly, an otherwise wild-type derivative of pTiC58 lacking traM, which codes for an antiactivator that inhibits TraR activity, transferred at high frequency in a population-independent manner in the absence of the conjugal opines. Thus, while quorum sensing is dependent upon autoinduction, the two phenomena are not synonymous. We conclude that conjugal transfer of pTiC58 is

  15. Quorum sensing but not autoinduction of Ti plasmid conjugal transfer requires control by the opine regulon and the antiactivator TraM.

    PubMed

    Piper, K R; Farrand, S K

    2000-02-01

    Conjugal transfer of the Ti plasmids from Agrobacterium tumefaciens is controlled by autoinduction via the transcriptional activator TraR and the acyl-homoserine lactone ligand, Agrobacterium autoinducer (AAI). This control process is itself regulated by opines, which are small carbon compounds produced by the crown gall tumors that are induced by the bacteria. Opines control autoinduction by regulating the expression of traR. Transfer of pTiC58 from donors grown with agrocinopines A and B, the conjugal opines for this Ti plasmid, was detected only after the donors had reached a population level of 10(7) cells per cm(2). Donors incubated with the opines and AAI transferred their Ti plasmids at population levels about 10-fold lower than those incubated with opines only. Transcription of the tra regulon, as assessed by monitoring a traA::lacZ reporter, showed a similar dependence on the density of the donor population. However, even in cultures at low population densities that were induced with opines and AAI, there was a temporal lag of between 15 and 20 h in the development of conjugal competence. Moreover, even after this latent period, maximal transfer frequencies required several hours to develop. This lag period was independent of the population density of the donors but could be reduced somewhat by addition of exogenous AAI. Quorum-dependent development of conjugal competence required control by the opine regulon; donors harboring a mutant of pTiC58 deleted for the master opine responsive repressor accR transferred the Ti plasmid at maximum frequencies at very low population densities. Similarly, an otherwise wild-type derivative of pTiC58 lacking traM, which codes for an antiactivator that inhibits TraR activity, transferred at high frequency in a population-independent manner in the absence of the conjugal opines. Thus, while quorum sensing is dependent upon autoinduction, the two phenomena are not synonymous. We conclude that conjugal transfer of pTiC58 is

  16. Ultrasound guided subcostal transversus abdominis plane (TAP) infiltration with liposomal bupivacaine for patients undergoing robotic assisted hysterectomy: A prospective randomized controlled study

    PubMed Central

    Hutchins, Jacob; Delaney, Daniel; Vogel, Rachel Isaksson; Ghebre, Rahel G.; Downs, Levi S.; Carson, Linda; Mullany, Sally; Teoh, Deanna; Geller, Melissa A.

    2015-01-01

    Introduction Optimal pain control after major surgery contributes to a patient’s recovery and satisfaction. The use of liposomal bupivacaine in subcostal transversus abdominis plane (TAP) blocks for postoperative pain control after robot assisted abdominal surgery has yet to be studied. Methods We conducted a prospective randomized controlled observer-blinded study comparing bilateral subcostal TAP blocks with bupivacaine to bilateral subcostal TAP blocks with liposomal bupivacaine. These were performed prior to the patient undergoing robot assisted hysterectomy. The patients’ pain scores, opioid use, side effects, and satisfaction were followed for 72 h after injection. Results Total opioid use in the first 72 h after injection was significantly decreased in the group that received liposomal bupivacaine compared to bupivacaine. Patients in the liposomal bupivacaine group had significantly lower maximal pain scores at all time periods studied as well as decreased incidence of nausea/vomiting. There was a trend toward decreased length of stay in the liposomal bupivacaine group. Conclusion Subcostal TAP blocks with liposomal bupivacaine decreased the total opioid requirement for the first 72 h after robot assisted hysterectomy when compared to subcostal TAP blocks with bupivacaine. PMID:26056753

  17. Ultrasound evaluation of muscle thickness changes in the external oblique, internal oblique, and transversus abdominis muscles considering the influence of posture and muscle contraction.

    PubMed

    Sugaya, Tomoaki; Abe, Yota; Sakamoto, Masaaki

    2014-09-01

    [Purpose] The aim of this study was to investigate muscle thickness changes in the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) muscles between the neutral position and trunk rotation, under a state of rest without voluntary contractions, and isometric contractions to both sides with resistance of 50% of the maximum trunk rotation strength. [Subjects] The subjects of this study were 21 healthy young men. [Methods] Muscle thickness changes in the EO, IO, and TrA in each position and state were evaluated by ultrasound. The range of motion at maximum trunk rotation and the maximum strength of trunk rotation were measured using a hand-held dynamometer. [Results] In the neutral position and at 50% trunk rotation to the right side, the thicknesses of the IO and TrA significantly increased with resistance. In both states, the thicknesses of the IO and TrA significantly increased at 50% trunk rotation to the right side. [Conclusion] The muscular contractions of the IO and TrA were stronger during ipsilateral rotation than in the neutral position and with resistance than at rest. Moreover, the muscular contraction was strongest in the resistive state during ipsilateral rotation.

  18. Addition of transversus abdominis plane block to patient controlled analgesia for laparoscopic high anterior resection improves analgesia, reduces opioid requirement and expedites recovery of bowel function

    PubMed Central

    Ris, F; Findlay, JM; Hompes, R; Rashid, A; Warwick, J; Cunningham, C; Jones, O; Crabtree, N

    2014-01-01

    Introduction Opioid sparing in postoperative pain management appears key in colorectal enhanced recovery. Transversus abdominis plane (TAP) blocks offer such an effect. This study aimed to quantify this effect on pain, opioid use and recovery of bowel function after laparoscopic high anterior resection. Methods This was a retrospective analysis of prospective data on 68 patients. Patients received an epidural (n=24), intravenous morphine patient controlled analgesia (PCA, n=22) or TAP blocks plus PCA (n=22) determined by anaesthetist preference. Outcome measures were numerical pain scores (0–3), cumulative intravenous morphine dose and time to recovery of bowel function (passage of flatus or stool). Results There were no differences in patient characteristics, complications or extraction site. The TAP block group had lower pain scores (0.7 vs 1.36, p<0.001) and morphine requirements (8mg vs 15mg, p=0.01) than the group receiving PCA alone at 12 hours and 24 hours. Earlier passage of flatus (2.0 vs 2.7 vs 3.4 days, p=0.002), stool (3.1 vs 4.1 vs 5.5 days, p=0.04) and earlier discharge (4 vs 5 vs 6 days, p=0.02) were also seen. Conclusions Use of TAP blocks was found to reduce pain and morphine use compared with PCA, expedite recovery of bowel function compared with PCA and epidural, and expedite hospital discharge compared with epidural. PMID:25350178

  19. Crystallization and preliminary structure determination of the transfer protein TraM from the Gram-positive conjugative plasmid pIP501.

    PubMed

    Goessweiner-Mohr, Nikolaus; Grumet, Lukas; Pavkov-Keller, Tea; Birner-Gruenberger, Ruth; Grohmann, Elisabeth; Keller, Walter

    2013-02-01

    The major means of horizontal gene spread (e.g. of antibiotic resistance) is conjugative plasmid transfer. It presents a serious threat especially for hospitalized and immuno-suppressed patients, as it can lead to the accelerated spread of bacteria with multiple antibiotic resistances. Detailed information about the process is available only for bacteria of Gram-negative (G-) origin and little is known about the corresponding mechanisms in Gram-positive (G+) bacteria. Here we present the purification, biophysical characterization, crystallization and preliminary structure determination of the TraM C-terminal domain (TraMΔ, comprising residues 190-322 of the full-length protein), a putative transfer protein from the G+ conjugative model plasmid pIP501. The crystals diffracted to 2.5 Å resolution and belonged to space group P1, with unit-cell parameters a = 39.21, b = 54.98, c = 93.47 Å, α = 89.91, β = 86.44, γ = 78.63° and six molecules per asymmetric unit. The preliminary structure was solved by selenomethionine single-wavelength anomalous diffraction.

  20. A comparison between the pectoralis major myocutaneous flap and the free anterolateral thigh perforator flap for reconstruction in head and neck cancer patients: assessment of the quality of life.

    PubMed

    Zhang, Xu; Li, Meng-Jie; Fang, Qi-Gen; Sun, Chang-Fu

    2014-05-01

    Our study investigated the quality of life (QoL) of Chinese patients after immediate reconstruction surgery on individuals with head and neck cancer. In addition, we compared the differences between pectoralis major myocutaneous flap (PMMF) and anterolateral thigh free flap (ALTFF). The University of Washington Quality of Life questionnaire, version 4, was used to assess the QoL. Assessments were performed at least 24 months postoperatively. A total of 110 patients' records were obtained. Among them, 86 patients completed a QoL questionnaire (78.2%). No significant differences could be found in age, primary site, T stage, N stage, and postoperative radiotherapy between PMMF and ALTFF groups. However, there were significant differences between both groups in sex, operation time, and complication. A matched analysis was performed to compare the differences in QoL between patients with head and neck cancers reconstructed with PMMF or ALTFF. Patients reconstructed with ALTFF had better shoulder but worse speech functions. There was a significant effect on the QoL of head and neck cancer patients who had undergone either PMMF or ALTFF reconstruction. The result of this study provide useful information for physicians and patients during their discussion of treatment modalities for head and neck cancers.

  1. 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

  2. Immunohistochemical analysis of bFGF, TGF-beta1 and catalase in rectus abdominis muscle from cattle foetuses at 180 and 260 days post-conception.

    PubMed

    Orzechowski, A; Gajkowska, B; Wojewódzka, U; Cassar-Malek, I; Picard, B; Hocquette, J F

    2002-12-01

    The potential for muscle growth depends on myoblast proliferation, which occurs essentially during the first two thirds of the foetal period in cattle. Thereafter, myofibres acquire their contractile and metabolic properties. Proliferation is regulated by molecular growth factors and by the tissue oxidative activity. The aim of this study was the quantification by immunochemistry of basic fibroblast growth factor (bFGF) and transforming growth factor beta 1 (TGF-beta1) and also of enzyme catalase (CAT) activity in rectus abdominis muscle. Samples were collected from cattle foetuses of different growth potential at 180 and 260 days post-conception (dpc). One major conclusion from this work is that protein contents of the muscle tissue bFGF and, to a lower extent, CAT activity decreased with increasing age during the foetal life. No differences were found between the different genotypes of cattle. However, the CAT to bFGF ratio tended to be lower in fast-growing cattle and increased with foetal age. TGF-beta1 did not change with age and was localised mostly at the vascular bed. CAT was detected in smooth and rough reticulum in striated muscles at 180dpc, and additionally in mitochondria at 260dpc. In conclusion, the balance between intracellular growth factors (bFGF and TGF-beta1) and the activity of antioxidant enzyme CAT may participate in the regulation of the transition from myoblast proliferation to differentiation. Thus, increased ratio of CAT to bFGF might be a good index indicating initiation of muscle maturation in cattle foetus prior to birth.

  3. A comparison of analgesic efficacy between oblique subcostal transversus abdominis plane block and intravenous morphine for laparascopic cholecystectomy. A prospective randomized controlled trial

    PubMed Central

    Tan, Peter Chee Seong; Phui, Vui Eng; Teo, Shu Ching

    2013-01-01

    Background The ultrasound-guided oblique subcostal transversus abdominis plane (OSTAP) block provides a wider area of sensory block to the anterior abdominal wall than the classical posterior approach. We compared the intra-operative analgesic efficacy of OSTAP block with conventional intravenous (IV) morphine during laparoscopic cholecystectomy. Methods Forty adult patients undergoing laparoscopic cholecystectomy under standard general anesthesia, were randomly assigned for either bilateral OSTAP block using 1.5 mg/kg ropivacaine on each side (n = 20) or IV morphine 0.1 mg/kg (n = 20). The intra-operative pulse rate, systolic and diastolic blood pressure and mean arterial blood pressure were monitored every five minutes. Repetitive boluses of IV fentanyl 0.5 µg/kg were given as rescue analgesia when any of the above-mentioned parameters rose more than 15% from the baseline values. Time to extubation was documented. Additional boluses of IV morphine 0.05 mg/kg were administered in the recovery room if the recorded visual analogue score (VAS) was more than 4. Nausea and vomiting score, as well as sedation score were recorded. Results The morphine group required more rescue fentanyl as compared to the OSTAP block group but the difference was not significant statistically. Time to extubation was significantly shorter in the OSTAP block group (mean [SD] 10.4 [2.60] vs 12.4 [2.54] min; P = 0.021). Both methods provided excellent analgesia and did not differ in postoperative morphine requirements. No between-group differences in sedation score and incidence of nausea and vomiting were demonstrated. Conclusions Ultrasound-guided OSTAP block has an important role as part of balanced anesthesia. It is as efficacious as IV morphine in providing effective analgesia during laparoscopic cholecystectomy. PMID:23814651

  4. Liposomal bupivacaine infiltration into the transversus abdominis plane for postsurgical analgesia in open abdominal umbilical hernia repair: results from a cohort of 13 patients

    PubMed Central

    Feierman, Dennis E; Kronenfeld, Mark; Gupta, Piyush M; Younger, Natalie; Logvinskiy, Eduard

    2014-01-01

    Background Achieving adequate control of postsurgical pain remains a challenge in patients undergoing abdominal surgery. Transversus abdominis plane (TAP) infiltration has been shown to provide postsurgical analgesia following lower abdominal surgery. We assessed the safety and efficacy of a prolonged-release liposomal formulation of the local anesthetic bupivacaine administered via infiltration into the TAP in a cohort of patients undergoing open abdominal umbilical hernia repair. Methods Patients included in the study were 18–75 years of age, had American Society of Anesthesiologists physical classification status 1–3, and underwent open abdominal umbilical hernia repair with ultrasound-guided TAP infiltration immediately after surgery using an equal-volume bilateral infusion of liposomal bupivacaine 266 mg (diluted to 30 mL in normal saline). Outcome measures included patient-reported pain intensity (11-point numeric rating scale), satisfaction with postsurgical analgesia (5-point Likert scale), incidence of opioid-related adverse events, and time to first use of supplemental rescue analgesia. Results Thirteen patients underwent surgery and received bilateral TAP infiltration with liposomal bupivacaine; TAP infiltration failed in the first patient. Mean numeric rating scale pain scores were 0.6 immediately before TAP infiltration and remained ≤2.3 through 120 hours after infiltration; mean scores at 120 hours and 10 days were 0.9 and 0.4, respectively. Ten patients (77%) required supplemental analgesia; median time to first use was 11 hours. At discharge and day 10, 54% and 62% of patients, respectively, were “extremely satisfied” with postsurgical analgesia (Likert score 5). There were no opioid-related or other adverse events. Conclusion Although the current study was limited by both its lack of a control group and its small size, to our knowledge, it is the first published report on use of liposomal bupivacaine for TAP infiltration. In this cohort

  5. Analgesic efficacy of ultrasound guided transversus abdominis plane block versus local anesthetic infiltration in adult patients undergoing single incision laparoscopic cholecystectomy: A randomized controlled trial

    PubMed Central

    Bava, Ejas P.; Ramachandran, Rashmi; Rewari, Vimi; Chandralekha; Bansal, Virinder Kumar; Trikha, Anjan

    2016-01-01

    Background: Transversus abdominis plane (TAP) block has been used to provide intra- and post-operative analgesia with single incision laparoscopic (SIL) bariatric and gynecological surgery with mixed results. Its efficacy in providing analgesia for SIL cholecystectomy (SILC) via the same approach remains unexplored. Aims: The primary objective of our study was to compare the efficacy of bilateral TAP block with local anesthetic infiltration for perioperative analgesia in patients undergoing SILC. Settings and Design: This was a prospective, randomized, controlled, double-blinded trial performed in a tertiary care hospital. Materials and Methods: Forty-two patients undergoing SILC were randomized to receive either ultrasound-guided (USG) bilateral mid-axillary TAP blocks with 0.375% ropivacaine or local anesthetic infiltration of the port site. The primary outcome measure was the requirement of morphine in the first 24 h postoperatively. Statistical Analysis: The data were analyzed using t-test, Mann–Whitney test or Chi-square test. Results: The 24 h morphine requirement (mean ± standard deviation) was 34.57 ± 14.64 mg in TAP group and 32.76 ± 14.34 mg in local infiltration group (P = 0.688). The number of patients requiring intraoperative supplemental fentanyl in TAP group was 8 and in local infiltration group was 16 (P = 0.028). The visual analog scale scores at rest and on coughing were significantly higher in the local infiltration group in the immediate postoperative period (P = 0.034 and P = 0.007, respectively). Conclusion: USG bilateral TAP blocks were not effective in decreasing 24 h morphine requirement as compared to local anesthetic infiltration in patients undergoing SILC although it provided some analgesic benefit intraoperatively and in the initial 4 h postoperatively. Hence, the benefits of TAP blocks are not worth the effort and time spent for administering them for this surgery. PMID:27746552

  6. 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.

  7. 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.

  8. VRAM-pedicled island flap for the coverage of an exposed prosthetic vascular graft in the suprapubic area.

    PubMed

    Rubino, C; Faenza, M; Campitiello, N; Fornino, G; Santanelli di Pompeo, F; Accarino, G C

    2016-01-01

    The exposure of prosthetic vascular graft is a dangerous complication in revascularization procedures. In this case report, we describe a successful coverage of an exposed prosthetic femorofemoral vascular graft in the suprapubic area, with a vertical rectus abdominis myocutaneous (VRAM) island flap. PMID:27583274

  9. VRAM-pedicled island flap for the coverage of an exposed prosthetic vascular graft in the suprapubic area

    PubMed Central

    Rubino, C.; Faenza, M.; Campitiello, N.; Fornino, G.; Santanelli di Pompeo, F.; Accarino, G. C.

    2016-01-01

    Abstract The exposure of prosthetic vascular graft is a dangerous complication in revascularization procedures. In this case report, we describe a successful coverage of an exposed prosthetic femorofemoral vascular graft in the suprapubic area, with a vertical rectus abdominis myocutaneous (VRAM) island flap. PMID:27583274

  10. 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

  11. 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..., shall comply with this section. For purposes of determining applicability of 49 CFR 37.101, 37.103, or... addition, each such unit shall comply with § 1192.23 (b) or (c) and shall provide at least one space...

  12. 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..., shall comply with this section. For purposes of determining applicability of 49 CFR 37.101, 37.103, or... addition, each such unit shall comply with § 1192.23 (b) or (c) and shall provide at least one space...

  13. 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..., shall comply with this section. For purposes of determining applicability of 49 CFR 37.101, 37.103, or... addition, each such unit shall comply with § 1192.23 (b) or (c) and shall provide at least one space...

  14. 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..., shall comply with this section. For purposes of determining applicability of 49 CFR 37.101, 37.103, or... addition, each such unit shall comply with § 1192.23 (b) or (c) and shall provide at least one space...

  15. 36 CFR 1192.179 - Trams, similar vehicles and systems.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., shall comply with this section. For purposes of determining applicability of 49 CFR 37.101, 37.103, or... wheelchair or mobility aid users complying with § 1192.23(d) unless the complete operating unit consisting of tractor and one or more trailers can already accommodate at least two wheelchair or mobility aid users....

  16. Unilateral Ultrasound-Guided Transversus Abdominis Plane Block After Nephrectomy; Postoperative Pain and Use of Opioids

    PubMed Central

    Azawi, Nessn H.; Mosholt, Karina Sif Sondergaard; Fode, Mikkel

    2016-01-01

    Background Pain has a wide spectrum of effects on the body and inadequately controlled postoperative pain may have harmful physiologic and psychological consequences and increase morbidity. In addition, opioid anesthetic agents in high doses can blunt endocrine and metabolic responses following surgery and are associated with side effects including dizziness, nausea, vomiting, constipation, and respiratory depression. Objectives The current study aimed to investigate if unilateral ultrasound-guided transverse abdominal plane block (TAP-block) could reduce pain and postoperative use of patient requested analgesics following nephrectomy compared to local injection of the same ropivacaine dose in the surgical wound. Patients and Methods Retrospective chart reviews were performed in 42 consecutive patients who received TAP-block in conjunction with nephrectomy from November 2013 to August 2014 (group A). For comparison, data were used from 40 other nephrectomy patients registered as part of a previous study (group B). In this group the patients had received local ropivacaine injection in the surgical wound. On univariate analyses, the groups were compared by t-test and the Fisher exact test. Multivariate analyses were conducted by multiple linear regression. Results Mean surgical time was 162 minutes in group A and 92 minutes in group B (P < 0.0001). The means of visual analogue scale (VAS) were 3.05 and 1.55 in A and B groups, respectively (P = 0.001). The means of morphine consumption were 5.2 mg and 5.9 mg in groups A and B, respectively (P = 0.58); while the means of sufentanil use were 9.8 μg and 6.0 μg in groups A and B, respectively (P = 0.06). When controlling for age, tumor size and American society of anesthesiologists classification (ASA) score on multivariate analysis, TAP-block was associated with a significant increase in VAS (+1.4 [95% CI, 0.6 - 2.3], P = 0.001) and sufentanil use (+6.2 μg [95% CI, 2.3 - 10.2], P = 0.003). There was no difference in morphine use on multivariate analysis (P = 0.99). Conclusions TAP-block in conjunction with laparoscopic nephrectomy did not reduce pain or opioid consumption. On the contrary, it seemed to prolong surgical time. PMID:27247931

  17. Closure of a contained open abdomen using a bipedicled myofascial oblique rectus abdominis flap technique.

    PubMed

    Gutarra, Fabian; Asensio, Javier Rodriguez; Kohan, Gustavo; Quarin, Carlos; Petrelli, Laura; Quesada, Bernabe Matias

    2009-11-01

    A contained open abdomen is commonly used during damage control laparotomy and consists of the temporary coverage of the abdomen for protection of the viscera and reduction of intra-abdominal pressure. Definitive closure of a contained open abdomen is technically difficult due to the inability to obtain primary fascial suture. The insertion of a prosthetic mesh can be complicated with enterocutaneous fistula, and other definitive closure techniques need several surgical procedures. We describe a low cost technique that allows definitive closure of large abdominal wall defects avoiding the risk of intestinal fistula.

  18. 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... purposes of determining applicability of 49 CFR 37.101, 37.103, or 37.105 the capacity of such a vehicle or...) or (c) and shall provide at least one space for wheelchair or mobility aid users complying with §...

  19. 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... purposes of determining applicability of 49 CFR 37.101, 37.103, or 37.105 the capacity of such a vehicle or...) or (c) and shall provide at least one space for wheelchair or mobility aid users complying with §...

  20. 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... purposes of determining applicability of 49 CFR 37.101, 37.103, or 37.105 the capacity of such a vehicle or...) or (c) and shall provide at least one space for wheelchair or mobility aid users complying with §...

  1. 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... purposes of determining applicability of 49 CFR 37.101, 37.103, or 37.105 the capacity of such a vehicle or...) or (c) and shall provide at least one space for wheelchair or mobility aid users complying with §...

  2. 7 CFR 500.21 - Fee schedule for tram and tours.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... OF AGRICULTURE NATIONAL ARBORETUM Fee Schedule for Certain Uses of National Arboretum Facilities and... citizen or Friend of the National Arboretum, and $2.00 per child under the age 17. Children under...

  3. 7 CFR 500.21 - Fee schedule for tram and tours.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... OF AGRICULTURE NATIONAL ARBORETUM Fee Schedule for Certain Uses of National Arboretum Facilities and... citizen or Friend of the National Arboretum, and $2.00 per child under the age 17. Children under...

  4. 49 CFR 38.179 - Trams, and similar vehicles, and systems

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... purposes of determining applicability of 49 CFR 37.101, 37.103, or 37.105 the capacity of such a vehicle or...) or (c) and shall provide at least one space for wheelchair or mobility aid users complying with § 38... can already accommodate at least two wheelchair or mobility aid users. Pt. 38, Figures Figures to...

  5. Comprehensive Evaluation of Risk Factors and Management of Impending Flap Loss in 2138 Breast Free Flaps.

    PubMed

    Chang, Edward I; Chang, Eric I; Soto-Miranda, Miguel A; Zhang, Hong; Nosrati, Naveed; Crosby, Melissa A; Reece, Gregory P; Robb, Geoffrey L; Chang, David W

    2016-01-01

    Loss of a breast free flap is a relatively rare but catastrophic occurrence. Our study aims to identify risk factors for flap loss and to assess whether different salvage techniques affect flap salvage. We performed a retrospective review of all breast free flaps performed at a single institution from 2000 to 2010. Overall, 2138 flaps were performed in 1608 patients (unilateral, 1120 and bilateral, 488) with 44 flap losses (2.1%). Age, body mass index, smoking, radiation, chemotherapy, and surgeon experience did not affect flap loss. Abdominal flaps based on a single perforator were at significantly higher risk for flap loss compared with flaps based on multiple perforators (P = 0.0007). Subgroup analysis of the subset of 166 compromised free flaps (flaps requiring a return to the operating room, an intraoperative anastomotic revision, or loss/partial loss of a free flap) demonstrated deep inferior epigastric perforator, and other flaps (superficial inferior epigastric artery and superior gluteal artery perforator) were significantly associated with flap loss [odds ratio (OR) 5.20; P = 0.03 and OR 6.91; P = 0.0004, respectively] compared with transverse rectus abdominis myocutaneous and muscle-sparing transverse rectus abdominis myocutaneous flaps. Although an intraoperative complication was not associated with a flap loss, the need for a reoperation was strongly predictive (P < 0.0001). Flap salvage was the highest within the first 24 hours (83.7%) and significantly less between days 1 and 3 (38.6%; P < 0.0001) and beyond 4 days (29.4%; P < 0.0001). Longer ischemia time was significantly associated with flap loss (P = 0.04). Salvage techniques (aspirin, heparinzation, thrombectomy, and thrombolytic) had no impact on flap salvage rates. Heparinization and thrombolytics were associated with higher loss rates (OR 3.40; P = 0.003 and OR 10.36; P < 0.0001, respectively). Free flap loss following breast reconstruction is multifactorial with higher losses in superficial

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

    PubMed Central

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

    1969-01-01

    1. Series of pyridylalkyl- and substituted phenylalkyl-trimethylammonium salts, triethylammonium salts, diethylamines and di-n-propylamines have been made. The substituents in the benzene ring were nitro, chloro, bromo, methoxy, hydroxy and amino groups and the alkyl residues had one, two, or three methylene groups separating the aromatic nucleus from the cationic head. 2. Most of the trimethylammonium compounds caused a contracture of the frog rectus muscle, but some were partial agonists and a few were antagonists. The di-n-propylamines were all antagonists, as were most of the diethylamines and triethylammonium compounds, though some of these were partial agonists and a few triethylammonium compounds were agonists. The affinities of the antagonists and partial agonists for the receptors stimulated by β-pyridylmethyltrimethylammonium (and by nicotine) were measured. The equipotent molar ratios of all the agonists were measured relative to β-pyridylmethyltrimethylammonium. 3. The dissociation constants of the pyridylmethyldiethylamines and substituted benzyldiethylamines were measured. The effects of substituents on the pKa of benzyldiethylamine were similar to their effects on the pKa of aniline, though there were differences with some of the o-substituted compounds, which could be attributed to internal hydrogen-bond formation. 4. There is no obvious correlation between the effects of a substituent on the pKa of benzyldiethylamine and its effects on affinity. Although increasing the size of the cationic group usually increased affinity, it did not always do so. The compounds with the highest affinity, p-hydroxybenzyldiethylamine (log K, 5·90) had about half the affinity of (+)-tubocurarine (log K, 6·11), but the triethylammonium analogue (log K, 4·17) had only about one-fiftieth of the affinity of the tertiary base. The binding of the drug to the receptor appears to involve many factors which include the size of the groups as well as their electron-releasing or withdrawing nature and other properties, such as their polar and lipophilic or lipophobic character. 5. There is no obvious correlation between the effects of a substituent on the affinity of the diethylamino or triethylammonium compounds and its effects on the activity of the trimethylammonium analogue. The most active compounds contain hydroxy- and amino-, phenyl or β-pyridyl groups, m-hydroxyphenyl-propyltrimethylammonium being about 50 times as active as nicotine, but the corresponding diethylamino or triethylammonium compounds do not have high affinity. There does not seem necessarily to be an inverse relationship between activity and affinity, however, because some m-nitro and m-chloro trimethylammonium compounds have considerable activity and the analogous triethylammonium compounds have considerable affinity. 6. It is suggested that ability to activate these receptors is associated with the presence of substituents which can interact with water molecules which may be involved in the action of the drug at the receptor. PMID:5348464

  7. Ultrasound Guided Subcostal Transversus Abdominis Plane (TAP) Infiltration with Liposomal Bupivacaine for Patients Undergoing Robotic Assisted Hysterectomy: A Retrospective Study

    PubMed Central

    Hutchins, Jacob; Vogel, Rachel Isaksson; Ghebre, Rahel; McNally, Amy; Downs, Levi S.; Gryzmala, Elizabeth; Geller, Melissa A

    2015-01-01

    Objective We sought to determine the effect of a subcostal TAP block with liposomal bupivacaine on post-operative maximal pain score and length of hospital stay among women undergoing robotic assisted hysterectomy. Methods This was a retrospective study comparing patients before and after consistent implementation of TAP blocks with liposomal bupivacaine during robotic assisted hysterectomies at a single academic institution. Analysis compared patient demographic and operative characteristics by TAP block use, along with outcomes of interest, including post-operative pain and length of hospital stay. Results There was a statistically significant decrease in maximal numerical rating score (NRS) pain scores, presence of nausea and vomiting, and length of hospital stay in those who had a TAP block with liposomal bupivacaine compared to those who did not receive a TAP block. These differences remained even after adjustment for potential confounders. Conclusions In this retrospective study, liposomal bupivacaine used in a TAP block was a useful method to provide postoperative pain control in patients undergoing robotic assisted hysterectomy and was associated with lower post-operative maximal pain scores and length of hospital stay. PMID:25790044

  8. Detailed structure of heat island phenomena from moving observations from electric tram-cars in Metropolitan Tokyo

    NASA Astrophysics Data System (ADS)

    Yamashita, Shuji

    In this study, the detailed horizontal structure, i.e. cliffs and plateaux of the heat island of the Metropolitan Tokyo area is investigated. According to Oke (1977), cliff is steep temperature gradient at the rural/urban boundary and plateau is a steady but weaker horizontal gradient of increasing temperature towards the city center. However, these features are not always evident, e.g. large city like Tokyo. To elucidate such aspects, moving observations of the horizontal distribution of air temperature from electric trains of the transportation network of Metropolitan Tokyo during late evening or early morning were thus conducted. In total, 16 railroad lines were used for the moving observations. The observations were done in two phases for sectional and horizontal distributions. Results show that three cliffs exist in the heat island of Metropolitan Tokyo, although the location of these cliffs should be taken into consideration for urban planning or urban redevelopment.

  9. A Runtime Data Verification Cyberinfrastructure for an Automated Robotic Tram System Measuring Surface Reflectance in the Arctic

    NASA Astrophysics Data System (ADS)

    Gallegos, I.; Goswami, S.; Tweedie, C. E.; Gamon, J.; Gates, A.

    2008-12-01

    Global change is amongst the greatest challenges facing humanity. Understanding the future state of the Earth System and how humans will need to adapt will require improved environmental observation capacity, more thorough understanding of environmental connectivity and integration of such data in to predictive models. Increasingly, environmental science is becoming data driven as the need for answering bigger picture questions increases - more than ever, researchers are collecting larger data streams through automated means, relying on data from other researchers or agencies, and integrating data from different disciplines. Associated with this advancement in the environmental sciences is the need for improved mechanisms and procedures to verify the integrity of data streams and improve trust in and optimization of data and work flows. A collaborative research effort between the Systems Ecology Lab at the University of Texas at El Paso and the University of Alberta performs ground-based hyperspectral remote sensing studies to investigate the effect of soil moisture on arctic ecosystem structure and function using a robotic cart and tramline infrastructure. This system generates about 60,000 data files during a normal field season and because of this high volume of data, it has become nearly impossible to quality check all spectral data collected using traditional data quality checking approaches. This presentation introduces a prototype run-time Data Quality Specification and Monitoring System (DQSMS) that has been developed in a collaborative effort with the NSF-funded Cyber-ShARE Center of Excellence at the University of Texas at El Paso. Using this software, users can customize data quality requirements and flag problematic data for post collection filtering and correction. The software also supports remote real time verification through wireless connectivity. We welcome input from other researchers and the opportunity to adapt this tool to other remote field instrumentation collecting environmental observations using automated means.

  10. Breast reconstruction at the MD Anderson Cancer Center

    PubMed Central

    2016-01-01

    The introduction of the transverse rectus abdominis myocutaneous flap in the 1970s marks the beginning of modern breast reconstruction although implants were available even earlier mainly for breast augmentation. Mastectomy techniques have evolved from the early Halsted radical mastectomy to the modern skin sparing mastectomy. The latter made possible using implants for breast reconstruction. Although prosthetic reconstruction provides a simpler procedure with quick recovery, autologous reconstruction offers more natural and long-lasting results especially in the setting of radiotherapy. Both forms have been extensively used at the MD Anderson Cancer Center (MDACC) while microsurgical breast reconstruction has been the hallmark of the MDACC experience. One of the most challenging areas of breast reconstruction is how to achieve good results without compromising adjuvant therapy when post-mastectomy radiotherapy is required. Managing upper extremity lymphedema following breast cancer treatment is another difficult issue which has gained great attention in recent years. This article highlights the important work in various aspects of breast reconstruction that has been done at the MDACC. PMID:27563563

  11. Breast reconstruction at the MD Anderson Cancer Center.

    PubMed

    Yu, Peirong

    2016-08-01

    The introduction of the transverse rectus abdominis myocutaneous flap in the 1970s marks the beginning of modern breast reconstruction although implants were available even earlier mainly for breast augmentation. Mastectomy techniques have evolved from the early Halsted radical mastectomy to the modern skin sparing mastectomy. The latter made possible using implants for breast reconstruction. Although prosthetic reconstruction provides a simpler procedure with quick recovery, autologous reconstruction offers more natural and long-lasting results especially in the setting of radiotherapy. Both forms have been extensively used at the MD Anderson Cancer Center (MDACC) while microsurgical breast reconstruction has been the hallmark of the MDACC experience. One of the most challenging areas of breast reconstruction is how to achieve good results without compromising adjuvant therapy when post-mastectomy radiotherapy is required. Managing upper extremity lymphedema following breast cancer treatment is another difficult issue which has gained great attention in recent years. This article highlights the important work in various aspects of breast reconstruction that has been done at the MDACC. PMID:27563563

  12. VEGF transfer based on gene-modified fibroblasts using a hypoxia-induced vector to modulate neoangiogenesis in ischaemic regions of myocutaneous transplants.

    PubMed

    Eggers, C; Müller, J; Schultze-Mosgau, S

    2015-02-01

    The effect of a hypoxia-inducible VEGF-expressing on wound healing in an ischaemic hind leg rat model was evaluated in this study. 180 Wistar rats were assigned randomly to three groups. After ligation of the femoral artery, group 1 received pRTP801-VEGF165, group 2 untransfected fibroblasts, group 3 saline; injection was into the subcutaneous tissue, proximal and distal to the artery ligation. Biopsy specimens were obtained on days 3, 5, 7, 14 after implementation. VEGF transgene expression, vessel architecture, the amount and total area of vessel formation were investigated. Results showed a significantly higher level of VEGF protein expression in group 1 compared to group 2 (P≤0.001) throughout the investigational period. Group 1 exhibited a significant growth of CD31-positive blood vessels in the subcutaneous tissue on day 14 compared to groups 2 and 3 (P≤0.001) (group 1, 62.20±1.92; group 2, 20.60±1.67; group 3, 12.40±1.14). Alpha-SMA-positive staining also showed significant vessel growth in group 1 on day 5 (group 1, 27.00±1.87; group 2, 7.20±1.48; group 3, 10.00±1.73). These results were confirmed in the distal muscle tissue. No significant results were obtained for the proximal muscle tissue. The subcutaneous application of pRTP801-VEGF165 showed a long-lasting effect, with an increased expression of VEGF over the entire observation period. It appears that the use of fibroblasts transfected with VEGF is a promising way to increase early angiogenesis in ischaemic tissue.

  13. Alternative venous outflow vessels in microvascular breast reconstruction.

    PubMed

    Mehrara, Babak J; Santoro, Timothy; Smith, Andrew; Arcilla, Eric A; Watson, James P; Shaw, William W; Da Lio, Andrew L

    2003-08-01

    The lack of adequate recipient vessels often complicates microvascular breast reconstruction in patients who have previously undergone mastectomy and irradiation. In addition, significant size mismatch, particularly in the outflow veins, is an important contributor to vessel thrombosis and flap failure. The purpose of this study was to review the authors' experience with alternative venous outflow vessels for microvascular breast reconstruction. In a retrospective analysis of 1278 microvascular breast reconstructions performed over a 10-year period, the authors identified all patients in whom the external jugular or cephalic veins were used as the outflow vessels. Patient demographics, flap choice, the reasons for the use of alternative venous drainage vessels, and the incidence of microsurgical complications were analyzed. The external jugular was used in 23 flaps performed in procedures with 22 patients. The superior gluteal and transverse rectus abdominis musculocutaneous (TRAM) flaps were used in the majority of the cases in which the external jugular vein was used (72 percent gluteal, 20 percent TRAM flap). The need for alternative venous outflow vessels was usually due to a significant vessel size mismatch between the superior gluteal and internal mammary veins (74 percent). For three of the external jugular vein flaps (13 percent), the vein was used for salvage after the primary draining vein thrombosed, and two of three flaps in these cases were eventually salvaged. In three patients, the external jugular vein thrombosed, resulting in two flap losses, while the third was salvaged using the cephalic vein. A total of two flaps were lost in the external jugular vein group. The cephalic vein was used in 11 flaps (TRAM, 64.3 percent; superior gluteal, 35.7 percent) performed in 11 patients. In five patients (54.5 percent), the cephalic vein was used to salvage a flap after the primary draining vein thrombosed; the procedure was successful in four cases. In three

  14. 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

  15. Soft-tissue reconstruction after total en bloc sacrectomy.

    PubMed

    Kim, Jennifer E; Pang, John; Christensen, Joani M; Coon, Devin; Zadnik, Patricia L; Wolinsky, Jean-Paul; Gokaslan, Ziya L; Bydon, Ali; Sciubba, Daniel M; Witham, Timothy; Redett, Richard J; Sacks, Justin M

    2015-06-01

    OBJECT Total en bloc sacrectomy is a dramatic procedure that results in extensive sacral defects. The authors present a series of patients who underwent flap reconstruction after total sacrectomy, report clinical outcomes, and provide a treatment algorithm to guide surgical care of this unique patient population. METHODS After institutional review board approval, data were collected for all patients who underwent total sacrectomy between 2002 and 2012 at The Johns Hopkins Hospital. Variables included demographic data, medical history, tumor characteristics, surgical details, postoperative complications, and clinical outcomes. All subtotal sacrectomies were excluded. RESULTS Between 2002 and 2012, 9 patients underwent total sacrectomy with flap reconstruction. Diagnoses included chordoma (n = 5), osteoblastoma (n = 1), sarcoma (n = 2), and metastatic colon cancer (n = 1). Six patients received gluteus maximus (GM) flaps with a prosthetic rectal sling following a single-stage, posterior sacrectomy. Four required additional paraspinous muscle (PSM) or pedicled latissimus dorsi (LD) fasciocutaneous flaps. Three patients underwent multistage sacrectomy with an anterior-posterior approach, 2 of whom received pedicled vertical rectus abdominis myocutaneous (VRAM) flaps, and 1 of whom received local GM, LD, and PSM flaps. Flap complications included dehiscence (n = 4) and infection (n = 1). During the 1st year of follow-up, 2 of 9 patients (22%) were able to ambulate with an assistive device by the 1st postoperative month, and 6 of 9 (67%) were ambulatory with a walker by the 3rd postoperative month. By postoperative Month 12, 5 of 9 patients (56%)-or 5 of 5 patients not lost to follow-up (100%)-were able to able to ambulate independently. CONCLUSIONS The authors' experience suggests that the GM and pedicled VRAM flaps are reliable options for softtissue reconstruction of total sacrectomy defects. For posterior-only operations, GM flaps with or without a prosthetic rectal

  16. Three-step orbitofacial reconstruction after extended total maxillectomy using free RAM flap and expanded cervicofacial flap with cartilage grafts.

    PubMed

    Kajikawa, Akiyoshi; Ueda, Kazuki; Katsuragi, Yoko; Hirose, Taro; Asai, Emiko

    2010-10-01

    Facial defect after an extended total maxillectomy is one of the most difficult deformities to reconstruct aesthetically, because the defect is not only large but also three-dimensional. Although free-flap reconstruction is useful, the patchwork-like scar, bad colour match and poor texture match are major problems. The contracture and displacement of the reconstructed eyelids and eye socket are also serious matters. To resolve these problems, we have performed a three-step reconstruction using a free rectus abdominis myocutaneous (RAM) flap and an expanded cervicofacial flap with cartilage grafts. In the first step, a free RAM flap was transplanted to the defect after extended total maxillectomy. In the second step, tissue expanders were placed under the skin of the cheek and neck a year after the RAM flap transplantation. After expansion of the cheek and neck skin, the third step was performed. The inferior part of the external skin island of the RAM flap was raised and sutured to the superior margin of the skin island to create a pouch for the eye socket. Costal cartilage was grafted to reconstruct the orbital floor and malar prominence, and auricular cartilage was grafted to reconstruct the tarsal plates. Finally, the expanded cervicofacial flap was rotated to cover this construct. Two weeks after reconstruction, the neo-eyelids were divided to form the lid fissure. We performed the three-step reconstruction on six cases after extended total maxillectomy. In all cases, a deep and stable eye socket was reconstructed. The reconstructed eyelids and cheek were natural in appearance with good colour and texture match without conspicuous scars. To obtain symmetry and natural appearance in the orbitomaxillary reconstruction, there are five points that should be formed; the eye socket, the groundwork of the eye socket, the orbital floor and malar prominence, the tarsal plates and the surface of the eyelids and cheek. We do not reconstruct the palate to set prosthetic

  17. 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

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

    PubMed Central

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

    2016-01-01

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

  19. Dual Control of Quorum Sensing by Two TraM-Type Antiactivators in Agrobacterium tumefaciens Octopine Strain A6

    PubMed Central

    Wang, Chao; Zhang, Hai-Bao; Chen, Guozhou; Chen, Lingling; Zhang, Lian-Hui

    2006-01-01

    Agrobacterium tumefaciens wild-type strains have a unique quorum-sensing (QS)-dependent Ti plasmid conjugative transfer phenotype in which QS signaling is activated by corresponding conjugative opine inducers. Strain K588, with a nopaline-type chromosomal background harboring an octopine-type Ti plasmid, however, is a spontaneous mutant displaying a constitutive phenotype in QS. In this study, we show that a single amino acid mutation (L54P) in the QS antiactivator TraM encoded by the traM gene of Ti plasmid is responsible for the constitutive phenotype of strain K588. Introduction of the L54P point mutation to the TraM of wild-type strain A6 by allelic replacement, however, failed to generate the expected constitutive phenotype in this octopine-type strain. Intriguingly, the QS-constitutive phenotype appeared when the pTiA6 carrying the mutated traM was placed in the chromosomal background of the nopaline-type strain C58C1RS, suggesting an unknown inhibitory factor(s) encoded by the chromosomal background of strain A6 but not by C58C1RS. Low-stringency Southern blotting analysis showed that strain A6, but not strain C58 and its derivatives, contains a second traM homologue. The homologue, designated traM2, has 64% and 65% identities with traM at the DNA and peptide levels, respectively. Similar to TraM, TraM2 is a potent antiactivator that functions by blocking TraR, the QS activator, from specific binding to the tra gene promoters. Deletion of traM2 in strain A6 harboring the mutated traM confers a constitutive QS phenotype. The results demonstrate that the QS system in strain A6 is subjected to the dual control of TraM and TraM2. PMID:16547030

  20. 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

  1. Effects of bridge exercise on trunk core muscle activity with respect to sling height and hip joint abduction and adduction.

    PubMed

    Lee, Daehee; Park, Jungseo; Lee, Sangyong

    2015-06-01

    [Purpose] This study evaluated the effects of bridge exercise on trunk core muscle activity with respect to sling height and hip joint abduction and adduction. [Subjects] Fifteen healthy adult males participated. [Methods] In the bridge exercise, the height of the sling was set low or high during hip joint abduction and adduction. Electromyography was used to compare the differences between the muscle activities of the transverse abdominis, rectus abdominis, and erector spinae muscles. [Results] The muscle activities of the transverse abdominis, rectus abdominis, and erector spinae were significantly higher in the high sling position. Furthermore, the activities of the transverse abdominis and erector spinae were significantly higher during hip joint adduction than abduction regardless of sling height. [Conclusion] A high sling height is the most effective intervention for increasing the muscle activities of the transverse abdominis and erector spinae muscles during hip joint adduction in a bridge exercise. PMID:26180366

  2. Complications of surgery for radiotherapy skin damage

    SciTech Connect

    Rudolph, R.

    1982-08-01

    Complications of modern surgery for radiotherapy skin damage reviewed in 28 patients who had 42 operations. Thin split-thickness skin grafts for ulcer treatment had a 100 percent complication rate, defined as the need for further surgery. Local flaps, whether delayed or not, also had a high rate of complications. Myocutaneous flaps for ulcers had a 43 percent complication rate, with viable flaps lifting off radiated wound beds. Only myocutaneous flaps for breast reconstruction and omental flaps with skin grafts and Marlex mesh had no complications. The deeper tissue penetration of modern radiotherapy techniques may make skin grafts and flaps less useful. In reconstruction of radiation ulcers, omental flaps and myocutaneous flaps are especially useful, particularly if the radiation damage can be fully excised. The pull of gravity appears detrimental to myocutaneous flap healing and, if possible, should be avoided by flap design.

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

    PubMed

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

    2014-12-01

    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.

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

    SciTech Connect

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

    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.

  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. 30 CFR 75.1403-10 - Criteria-Haulage; general.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... control of the equipment. (j) Operators of self-propelled equipment should face in the direction of travel... maintained brakes, lights, and a warning device. (m) On and after March 30, 1971, all tram control...

  7. Mastectomy and breast reconstruction - what to ask your doctor

    MedlinePlus

    Mastectomy - what to ask your doctor; Breast reconstruction - what to ask your doctor; TRAM flap - what to ... your doctor; What to ask your doctor about mastectomy and breast reconstruction; Breast cancer - mastectomy - what to ...

  8. 40 CFR 261.35 - Deletion of certain hazardous waste codes following equipment cleaning and replacement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... required to be cleaned or replaced under 40 CFR 261.35 was cleaned or replaced as represented in the... limited to, treatment cylinders, sumps, tanks, piping systems, drip pads, fork lifts, and trams, in...

  9. Breast Reconstruction After Mastectomy

    MedlinePlus

    ... Women who have autologous tissue reconstruction may need physical therapy to help them make up for weakness experienced ... 127(1):15–22. [PubMed Abstract] Monteiro M. Physical therapy implications following the TRAM procedure. Physical Therapy. 1997; ...

  10. 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

  11. 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

  12. 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

  13. Necrotizing sialometaplasia in the mouth floor secondary to reconstructive surgery for tongue carcinoma.

    PubMed

    Matsumoto, T; Kuwabara, N; Shiotsu, H; Fukuda, Y; Yanai, A; Ichikawa, G

    1991-09-01

    Necrotizing sialometaplasia is a benign inflammatory process, which histologically can mimic squamous cell carcinoma. A 63-year-old man underwent left hemiglossectomy involving transplantation of a myocutaneous flap for squamous cell carcinoma of the tongue. One month after the operation, necrotizing sialometaplasia occurred in the minor salivary gland tissue of the mouth floor, compressed by the necrotic flap. This case is very unusual because of the occurrence of necrotizing sialometaplasia in the floor of the mouth. The etiology of the lesion was considered to be ischemia secondary to compression by the necrotic myocutaneous flap.

  14. Reliability of Abdominal Muscle Stiffness Measured Using Elastography during Trunk Rehabilitation Exercises.

    PubMed

    MacDonald, David; Wan, Alan; McPhee, Megan; Tucker, Kylie; Hug, François

    2016-04-01

    The aim of this study was to assess the intra-session and inter-rater reliability of shear modulus measured in abdominal muscles during two commonly used trunk stability exercises. Thirty healthy volunteers performed a series of abdominal hollow and abdominal brace tasks. Supersonic shear imaging was used to measure the shear modulus (considered an index of muscle tension) of the four anterior trunk muscles: obliquus externus abdominis, obliquus internus abdominis, transversus abdominis and rectus abdominis. Because of measurement artifacts, internus abdominis and transversus abdominis data were not analyzed for 36.7% and 26.7% of the participants, respectively. These participants exhibited thicker superficial fat layers than the others. For the remaining participants, fair to excellent intra-session and inter-rater reliability was observed with moderate to high intra-class coefficients (0.45-0.97) and low to moderate standard error of measurement values (0.38-3.53 kPa). Reliability values were consistently greater for superficial than for deeper muscles.

  15. Abdominal muscle activity during breathing with and without inspiratory and expiratory loads in healthy subjects.

    PubMed

    Mesquita Montes, António; Baptista, João; Crasto, Carlos; de Melo, Cristina Argel; Santos, Rita; Vilas-Boas, João Paulo

    2016-10-01

    Central Nervous System modulates the motor activities of all trunk muscles to concurrently regulate the intra-abdominal and intra-thoracic pressures. The study aims to evaluate the effect of inspiratory and expiratory loads on abdominal muscle activity during breathing in healthy subjects. Twenty-three higher education students (21.09±1.56years; 8males) breathed at a same rhythm (inspiration: two seconds; expiration: four seconds) without load and with 10% of the maximal inspiratory or expiratory pressures, in standing. Surface electromyography was performed to assess the activation intensity of rectus abdominis, external oblique and transversus abdominis/internal oblique muscles, during inspiration and expiration. During inspiration, transversus abdominis/internal oblique activation intensity was significantly lower with inspiratory load when compared to without load (p=0.009) and expiratory load (p=0.002). During expiration, the activation intensity of all abdominal muscles was significantly higher with expiratory load when compared to without load (p<0.05). The activation intensity of external oblique (p=0.036) and transversus abdominis/internal oblique (p=0.022) was significantly higher with inspiratory load when compared to without load. Transversus abdominis/internal oblique activation intensity was significantly higher with expiratory load when compared to inspiratory load (p<0.001). Transversus abdominis/internal oblique seems to be the most relevant muscle to modulate the intra-abdominal pressure for the breathing mechanics. PMID:27434376

  16. Reliability of Abdominal Muscle Stiffness Measured Using Elastography during Trunk Rehabilitation Exercises.

    PubMed

    MacDonald, David; Wan, Alan; McPhee, Megan; Tucker, Kylie; Hug, François

    2016-04-01

    The aim of this study was to assess the intra-session and inter-rater reliability of shear modulus measured in abdominal muscles during two commonly used trunk stability exercises. Thirty healthy volunteers performed a series of abdominal hollow and abdominal brace tasks. Supersonic shear imaging was used to measure the shear modulus (considered an index of muscle tension) of the four anterior trunk muscles: obliquus externus abdominis, obliquus internus abdominis, transversus abdominis and rectus abdominis. Because of measurement artifacts, internus abdominis and transversus abdominis data were not analyzed for 36.7% and 26.7% of the participants, respectively. These participants exhibited thicker superficial fat layers than the others. For the remaining participants, fair to excellent intra-session and inter-rater reliability was observed with moderate to high intra-class coefficients (0.45-0.97) and low to moderate standard error of measurement values (0.38-3.53 kPa). Reliability values were consistently greater for superficial than for deeper muscles. PMID:26746381

  17. 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

  18. 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

  19. An uncommon case of sarcomatoid urothelial carcinoma in covered bladder exstrophy.

    PubMed

    Pavone, Carlo; Vella, Marco; Fontana, Dario; Scalici Gesolfo, Cristina; Oieni, Sebastiano; Toia, Francesca; Cordova, Adriana

    2016-01-01

    We report a case of a woman affected by covered exstrophy, uterus didelphys and external genital malformation presenting with advanced bladder cancer. After neoadjuvant therapy and anterior pelvic exenteration, the abdominal wall was reconstructed with a pedicled myocutaneous muscle-sparing vastus lateralis flap. PMID:27583267

  20. [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.

  1. Free anterolateral thigh flap harvesting from paralytic limbs in post-polio syndrome

    PubMed Central

    Changchien, Chih-Hsuan; Chen, Wei-Chen; Su, Yu-Min

    2016-01-01

    Abstract We report two cases of poliomyelitis in which an anterolateral thigh myocutaneous free flap was harvested from the paralytic limb for oral reconstruction. We observed a decrease in the pedicle diameter of the anterolateral thigh flap, but the blood supply to the skin paddle was adequate. PMID:27583272

  2. Immunosuppressive nano-therapeutic micelles downregulate endothelial cell inflammation and immunogenicity

    PubMed Central

    Levey, Natalie; Esckilsen, Scott; Miller, Kayla; Dennis, William; Atkinson, Carl; Broome, Ann-Marie

    2015-01-01

    In this study, we developed a stable, nontoxic novel micelle nanoparticle to attenuate responses of endothelial cell (EC) inflammation when subjected to oxidative stress, such as observed in organ transplantation. Targeted Rapamycin Micelles (TRaM) were synthesized using PEG-PE-amine and N-palmitoyl homocysteine (PHC) with further tailoring of the micelle using targeting peptides (cRGD) and labeling with far-red fluorescent dye for tracking during cellular uptake studies. Our results revealed that the TRaM was approximately 10 nm in diameter and underwent successful internalization in Human Umbilical Vein EC (HUVEC) lines. Uptake efficiency of TRaM nanoparticles was improved with the addition of a targeting moiety. In addition, our TRaM therapy was able to downregulate both mouse cardiac endothelial cell (MCEC) and HUVEC production and release of the pro-inflammatory cytokines, IL-6 and IL-8 in normal oxygen tension and hypoxic conditions. We were also able to demonstrate a dose-dependent uptake of TRaM therapy into biologic tissues ex vivo. Taken together, these data demonstrate the feasibility of targeted drug delivery in transplantation, which has the potential for conferring local immunosuppressive effects without systemic consequences while also dampening endothelial cell injury responses. PMID:26167278

  3. ORE CONVEYANCE SYSTEM AND ADIT. LOOKING WEST. ORE FROM THE ...

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

    ORE CONVEYANCE SYSTEM AND ADIT. LOOKING WEST. ORE FROM THE MINES ABOVE AT THE RIDGELINE AND TO THE RIGHT WAS CONVEYED TO THIS AREA AND DUMPED INTO THE SHAFT AT CENTER. THIS SHAFT OPENS INTO THE ADIT AT BOTTOM CENTER. THERE IS ANOTHER SHAFT OPENING INTO THE ADIT JUST ABOVE THE ADIT BEHIND THE STONE WALL. THE ORE WAS LOADED INTO TRAM CARS INSIDE THE ADIT AND CONVEYED ON TRACKS TO THE TRESTLE LEADING TO THE PRIMARY ORE BIN AT THE TRAM TERMINAL. TRACKS CAN BE SEEN LEADING FROM THE ADIT AND TO THE LEFT. THE ORE WAS THEN DUMPED INTO A CHUTE AT THE END OF THE TRESTLE CARRYING IT INTO THE ORE BIN AT THE TRAM TERMINAL(SEE CHUTE ON CA-291-30). - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  4. 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.

  5. 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.

  6. A new regulatory element modulates homoserine lactone-mediated autoinduction of Ti plasmid conjugal transfer.

    PubMed Central

    Hwang, I; Cook, D M; Farrand, S K

    1995-01-01

    Conjugal transfer of the Agrobacterium tumefaciens nopaline-type Ti plasmid pTiC58 is induced by agrocinopines A and B, opines secreted by crown gall tumors induced by the bacterium. This regulation functions through the transcriptional repressor, AccR. However, actual transcription of the tra genes is regulated by autoinduction through the activator TraR and the substituted homoserine lactone second messenger, Agrobacterium autoinducer (AAI). We have identified a new regulatory element that modulates the response of TraR to AAI. The gene, called traM, suppresses TraR-AAI activation of transcription of tra genes carried on recombinant clones. The suppression could be relieved by increasing the expression of TraR but not by increasing AAI levels. traM is located between traR and traAF on pTiC58 and is transcribed in the clockwise direction. The 306-bp gene encodes an 11.2-kDa protein showing no significant relatedness to other proteins in the databases. Mutations in traM in pTiC58 conferred a transfer-constitutive phenotype, and strains harboring the Ti plasmid produced easily detectable amounts of AAI. These same mutations engineered into the transfer-constitutive Ti plasmid pTiC58 delta accR conferred a hyperconjugal phenotype and very high levels of AAI production. Expression of traM required TraR, indicating that transcription of the gene is regulated by the autoinduction system. TraM had no effect on the expression of traR, demonstrating that the suppressive effect is not due to repression of the gene encoding the activator. These results suggest that TraM is not a direct transcriptional regulator. Since the suppressive effect is demonstrable only when traM is overexpressed with respect to traR, we suggest that TraM functions to sequester TraR from the very small amounts of AAI produced under conditions when the agrocinopines are not present. PMID:7814335

  7. Insights into Airframe Aerodynamics and Rotor-on-Wing Interactions from a 0.25-Scale Tiltrotor Wind Tunnel Model

    NASA Technical Reports Server (NTRS)

    Young, L. A.; Lillie, D.; McCluer, M.; Yamauchi, G. K.; Derby, M. R.

    2001-01-01

    A recent experimental investigation into tiltrotor aerodynamics and acoustics has resulted in the acquisition of a set of data related to tiltrotor airframe aerodynamics and rotor and wing interactional aerodynamics. This work was conducted in the National Full-scale Aerodynamics Complex's (NFAC) 40-by-80 Foot Wind Tunnel, at NASA Ames Research Center, on the Full-Span Tilt Rotor Aeroacoustic Model (TRAM). The full-span TRAM wind tunnel test stand is nominally based on a quarter-scale representation of the V-22 aircraft. The data acquired will enable the refinement of analytical tools for the prediction of tiltrotor aeromechanics and aeroacoustics.

  8. Free rib graft reconstruction of the mandible: a forgotten option?

    PubMed Central

    Banerjee, A. R.; Westmore, G. A.

    1995-01-01

    Eleven patients underwent primary mandibular reconstruction following resection of a head and neck squamous cell carcinoma. Reconstruction consisted of a free rib graft and a pectoralis major myocutaneous flap. One rib graft failed and one graft, although successful, required removal during a wider resection for tumour recurrence. A further three patients have died since operation, two from tumour recurrence and one from unrelated medical causes. Six patients have undergone long-term follow-up of between 22 and 78 months with a mean of 51 months. They have oral continence, take a normal or semisolid diet, and have satisfactory cosmesis. We present the first long-term follow-up of a series of patients undergoing mandibular reconstruction with a free rib graft and pectoralis major myocutaneous flap. Images Figure 1 Figure 2 PMID:7574320

  9. Anterolateral thigh fasciocutaneous flap in the difficult perineogenital reconstruction.

    PubMed

    Luo, S; Raffoul, W; Piaget, F; Egloff, D V

    2000-01-01

    A pedicled anterolateral thigh fasciocutaneous flap that was used to cover a complicated perineogenital defect after bilateral gracilis myocutaneous flap for perineal reconstruction is presented. The indications and advantages of this approach are outlined. This technique offers to the plastic surgeon and gynecologic oncologist a new option in the armamentarium for reconstruction of the perineum, and it offers the patient reduced donor-site morbidity. PMID:10626987

  10. Irradiation autogenous mandibular grafts in primary reconstructions

    SciTech Connect

    Hamaker, R.C.

    1981-07-01

    The procedure, irradiated mandibular autografts, for primary reconstruction, is presented with an immediate success rate of 88%. Eight cases have undergone primary mandibular reconstruction with the tumorous mandible irradiated to 10,000 rads in a single dose. The longest follow-up is 2 3/4 years. The autograft has proven to be an ideal implant. Major resections of the mandible in conjunction with large myocutaneous flaps have been reconstructed utilizing this implant.

  11. Deep abdominal muscle thickness measured under sitting conditions during different stability tasks

    PubMed Central

    Nagai, Hideyuki; Akasaka, Kiyokazu; Otsudo, Takahiro; Sawada, Yutaka; Okubo, Yu

    2016-01-01

    [Purpose] This study was conducted to investigate ultrasonically determined changes in the thickness of the transversus abdominis and internal oblique muscles during different sitting conditions. [Subjects and Methods] Twenty healthy men volunteered to participate in this study. Four different sitting conditions including (A) sitting, (B) sitting with left hip flexion, (C) sitting with an abdominal hollowing maneuver (AHM), and (D) sitting with an AHM and left hip flexion, were used. Subjective exercise difficulty was evaluated. [Results] Transversus abdominis and internal oblique muscle thicknesses significantly differed between conditions, with significantly greater thickness between positions from (A) to (D). Stability of the surface when sitting had no effect on the muscle thickness of the transversus abdominis. By contrast, sitting on an unstable surface caused an increase in muscle thickness of the internal oblique in each condition. The subjects reported progressively increasing difficulty in performing each exercise in a stable position from (A) to (D), while the difficulty in an unstable position was significantly different between (A) and (B), and between (C) and (D). [Conclusion] Our findings suggest that task (B) on a stable surface should be chosen for maximal activation of transversus abdominis without inducing overactivation of the internal oblique muscle. PMID:27134381

  12. 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

  13. 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.

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

    PubMed

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

    2016-06-01

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

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

    PubMed

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

    2015-11-01

    [Purpose] The purpose of this study was to investigate the relationship between muscle activity and gait function following aquatic trunk exercise in hemiplegic stroke patients. [Subjects and Methods] This study's participants included thirteen hemiplegic patients (ten males and three females). The aquatic therapy consisted of administering concentrative aquatic therapy for four weeks in a therapeutic pool. Gait parameters were measured using a gait analysis system adjusted to each subject's comfortable walking speed. Electromyographic signals were measured for the rectus abdominis, external abdominal oblique, transversus abdominis/internal-abdominal oblique, and erector spine of each patients. [Results] The pre- and post-training performances of the transversus abdominis/internal-abdominal oblique were compared statistically. There was no statistical difference between the patients' pre- and post-training values of maximal voluntary isometric contraction of the rectus abdominis, but the external abdominal oblique values tended to improve. Furthermore, gait factors improved significantly in terms of walking speeds, walking cycles, affected-side stance phases, affected-stride lengths, and stance-phase symmetry indices, respectively. [Conclusion] These results suggest that the trunk exercise during aquatic therapy may in part contribute to clinically relevant improvements in muscle activities and gait parameters. PMID:26696736

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

    PubMed Central

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

    2015-01-01

    [Purpose] The purpose of this study was to investigate the relationship between muscle activity and gait function following aquatic trunk exercise in hemiplegic stroke patients. [Subjects and Methods] This study’s participants included thirteen hemiplegic patients (ten males and three females). The aquatic therapy consisted of administering concentrative aquatic therapy for four weeks in a therapeutic pool. Gait parameters were measured using a gait analysis system adjusted to each subject’s comfortable walking speed. Electromyographic signals were measured for the rectus abdominis, external abdominal oblique, transversus abdominis/internal-abdominal oblique, and erector spine of each patients. [Results] The pre- and post-training performances of the transversus abdominis/internal-abdominal oblique were compared statistically. There was no statistical difference between the patients’ pre- and post-training values of maximal voluntary isometric contraction of the rectus abdominis, but the external abdominal oblique values tended to improve. Furthermore, gait factors improved significantly in terms of walking speeds, walking cycles, affected-side stance phases, affected-stride lengths, and stance-phase symmetry indices, respectively. [Conclusion] These results suggest that the trunk exercise during aquatic therapy may in part contribute to clinically relevant improvements in muscle activities and gait parameters. PMID:26696736

  17. 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…

  18. Comparison of abdominal muscle thickness according to feedback method used during abdominal hollowing exercise

    PubMed Central

    Lee, Sangyong; Han, Seulki; Lee, Daehee

    2016-01-01

    [Purpose] This study was intended to examine the most effective feedback method for contracting the musculus transversus abdominis muscle by using basic training, a pressure biofeedback unit, and real-time ultrasonographic imaging during abdominal hollowing exercise training. [Subjects and Methods] The subjects in this study were 30 healthy young students in their twenties. Thirty subjects were divided randomly and equally into the basic training, the pressure biofeedback unit, and real-time ultrasonographic imaging groups. All of the subjects received abdominal hollowing exercise training for 15 minutes. The subjects in the pressure biofeedback unit group were trained by using a pressure biofeedback unit. Those in the real-time ultrasonographic imaging group received training with monitoring of possible contraction of their musculus transversus abdominis muscles on ultrasonography. [Results] In all the three groups, the musculus transversus abdominis became significantly thicker, but more significantly in the real-time ultrasonographic imaging group than in the basic training group. [Conclusion] The feedback method using real-time ultrasonographic imaging may be more effective in thickening the musculus transversus abdominis muscle during exercise than the traditional feedback method with manual contact only. However, it is insufficient in terms of overall qualitative improvement of exercise outcome. PMID:27799683

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

    PubMed

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

    2016-06-01

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

  20. [Thoracic wall defect reconstruction and dead space obliteration with an intra-/extrathoracic free flap].

    PubMed

    Harenberg, P S; Viol, A W; D'Amico, T A; Levin, L S; Erdmann, D

    2009-07-01

    Presented is the case of a 61-year-old male patient with a chronic thoracic wall defect, including a bronchopleural fistula, after multiple resections of a desmoid tumor. After partial lung resection to remove the bronchopleural fistula, dead space was partially obliterated and the thoracic wall reconstructed with a free combined intra- and extrathoracic rectus abdominis muscle flap. PMID:19280081

  1. 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

  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. 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

  4. 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…

  5. 36 CFR Appendix - Figures to Part 1192

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 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....

  6. 36 CFR Appendix - Figures to Part 1192

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true 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....

  7. 49 CFR Appendix - Figures to Part 38

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 1 2013-10-01 2013-10-01 false Figures to Part 38 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES Other Vehicles and Systems Trams, and similar vehicles, and systems Pt. 38, Figures Figures to Part 38 ER28SE98.000...

  8. 49 CFR Appendix - Figures to Part 38

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 1 2012-10-01 2012-10-01 false Figures to Part 38 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES Other Vehicles and Systems Trams, and similar vehicles, and systems Pt. 38, Figures Figures to Part 38 ER28SE98.000...

  9. 36 CFR Appendix - Figures to Part 1192

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 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....

  10. 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

  11. AERIAL VIEW LOOKING SOUTH SOUTHEAST, OF SHENANDOAHDIVES (MAYFLOWER) MINE UPPER ...

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

    AERIAL VIEW LOOKING SOUTH SOUTHEAST, OF SHENANDOAH-DIVES (MAYFLOWER) MINE UPPER TRAM STATION IN FOREGROUND AND PORTAL ABOVE (IN SHADOW). NOTE PACK TRAIL BETWEEN MINE HEAD AND NORTHERN END OF SILVER LAKE, JUST VISIBLE AT UPPER RIGHT. - Shenandoah-Dives Mill, 135 County Road 2, Silverton, San Juan County, CO

  12. 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....

  13. 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....

  14. 49 CFR Appendix - Figures to Part 38

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false Figures to Part 38 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES Other Vehicles and Systems Trams, and similar vehicles, and systems Pt. 38, Figures Figures to Part 38 ER28SE98.000...

  15. 49 CFR Appendix - Figures to Part 38

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Figures to Part 38 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES Other Vehicles and Systems Trams, and similar vehicles, and systems Pt. 38, Figures Figures to Part 38 ER28SE98.000...

  16. 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

  17. 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

  18. 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

  19. 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

  20. 30 CFR 75.523-2 - Deenergization of self-propelled electric face equipment; performance requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 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...

  1. 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

  2. 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

  3. Breast reconstruction - natural tissue

    MedlinePlus

    ... muscle flap; TRAM; Latissimus muscle flap with a breast implant; DIEP flap; DIEAP flap; Gluteal free flap; ... If you are having breast reconstruction at the same time as mastectomy, the surgeon may do either of the following: Skin-sparing mastectomy. This means ...

  4. Investigations of the F conjugation gene traI:traI mutants and lambdatraI transducing phages.

    PubMed

    Willetts, N; Maule, J

    1979-02-01

    A series of traI point and deletion mutants of Flac, and a traM mutant, were characterised. Complementation tests with an amber Flac traI mutant confirmed their genotypes, and in addition all the traI mutants, but not the traM mutant, were complemented by pRS31 (PSC101 traDI) and EDlambda109 (lambdatraI). Judging from the efficiencies of plating of F-specific phages, none of the mutations affected pilus formation. The traI products of F and of the F-like plasmid R1 were interchangeable with each other but not with that of R100, while the traM product of F could not be replaced by those of R1 or of R100. Neither traI nor traM were needed for conjugal transfer of ColE1. Three lambda transducing phages carrying traI were isolated by in vivo or in vitro techniques, and characterised by genetic complementation tests, by analysis of the fragments produced by restriction endonucleases, and by measurement of heteroduplex molecules. The genetic structures together with the sizes and F coordinates, of the transfer regions carried by the phages were thereby determined. Comparison of the proteins synthesised in UV-irradiated cells by one of the lambdatraI phages with those made by a derivative carrying an amber traI mutation, allowed the traI product to be identified as a protein of molecular weight 174,000. In addition, the molecular weights of the traD (84,000), traS (18,000), and traT (25,000) products made by the lambdatraSTD1 phage EDlambda107 were measured. The possible roles of the traI and traM products in conjugation are discussed. PMID:372754

  5. Statistical modelling of particle number concentration in Zurich at high spatio-temporal resolution utilizing data from a mobile sensor network

    NASA Astrophysics Data System (ADS)

    Mueller, M. D.; Hasenfratz, David; Saukh, Olga; Fierz, Martin; Hueglin, Christoph

    2016-02-01

    Highly resolved pollution maps are a valuable resource for many issues related to air quality including exposure modelling and urban planning. We present an approach for their generation based on data from a mobile sensor network and statistical modelling. An extensive record of particle number concentrations (PNCs) spanning more than 1.5 years was compiled by the tram-based OpenSense mobile sensor network in the City of Zurich. The sensor network consists of 10 sensor nodes installed on the roof of trams operating on different services according to their regular operation schedules. We developed a statistical modelling approach based on Generalized Additive models (GAMs) utilizing the PNC data obtained along the tram tracks as well as georeferenced information as predictor variables. Our approach includes a variable selection algorithm to ensure that individual models rely on the optimal set of predictor variables. Our models have high temporal and spatial resolutions of 30 min and 10 m by 10 m, respectively, and allow the spatial prediction of PNC in the municipal area of Zurich. We applied our approach to PNC data from two dedicated time periods: July-Sept. 2013 and Dec. 2013-Feb. 2014. The models strongly rely on traffic related predictor variables (vehicle counts) and, due to the hilly topography of Zurich, on elevation. We assessed the model performance by leave-one-out cross-validation and by comparing PNC predictions to measurements at fixed reference sites and to PNC measurements obtained by pedestrians. Model predictions reproduce well the main features of the PNC field in environment types similar to those passed by individual trams. Model performance is worse at elevated background locations probably due to the weak coverage of similar spots by the tram network. We end the paper by outlining a route finding algorithm which utilizes the highly resolved PNC maps providing the exposure minimal route for cyclists.

  6. 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

  7. Management of the Sequelae of Severe Congenital Abdominal Wall Defects

    PubMed Central

    Marti, Eunate; Delgado, Maria-Dolores; Gomez, Andres

    2016-01-01

    Background The survival rate of newborns with severe congenital abdominal wall defects has increased. After successfully addressing life-threatening complications, it is necessary to focus on the cosmetic and functional outcomes of the abdominal wall. Methods We performed a chart review of five cases treated in our institution. Results Five patients, ranging from seven to 18 years of age, underwent the following surgical approaches: simple approximation of the rectus abdominis fascia, the rectus abdominis sheath turnover flap, the placement of submuscular tissue expanders, mesh repair, or a combination of these techniques depending on the characteristics of each individual case. Conclusions Patients with severe congenital abdominal wall defects require individualized surgical treatment to address both the aesthetic and functional issues related to the sequelae of their defects. PMID:27218024

  8. Identifying muscle and processing combinations suitable for use as beef for fajitas.

    PubMed

    Huerta-Montauti, D; Miller, R K; Pfeiffer, C E Schuehle; Pfeiffer, K D; Nicholson, K L; Osburn, W N; Savell, J W

    2008-10-01

    Four different treatments-control, papain, blade tenderization, and papain+blade tenderization-were applied to sixty USDA Choice M. diaphragma pars costalis, M. transversus abdominis, M. obliquus abdominis internus, M. rhomboideus, M. trapezius, M. latissimus, and M. serratus ventralis. Trained (n=6) and consumer (n=81) panelists scored papain samples higher for most sensory traits. Treatment tended not to affect the palatability scores of the M. diaphragma pars costalis and M. serratus ventralis, which tended to receive higher scores in comparison to the other muscles. Consumers were willing to purchase the M. latissimus and M. serratus ventralis treated with papain+blade tenderization and papain, respectively, and these muscles performed well enough to be considered as alternatives in the beef fajita market. PMID:22063330

  9. 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.

  10. Differences in abdominal muscle activation during coughing between smokers and nonsmokers.

    PubMed

    Rhee, Min-Hyung; Lee, Dong-Rour; Kim, Laurentius Jongsoon

    2016-04-01

    [Purpose] The purpose of this study was to compare the activity of the abdominal muscles during coughing between smokers and nonsmokers. [Subjects] A total of 30 healthy adults (15 smokers, 15 nonsmokers) participated. [Methods] The percentage maximal voluntary isometric contraction values (%MVIC) of the rectus abdominis (RA), external abdominal oblique (EO), and internal abdominal oblique (IO) and transversus abdominis (TrA) were measured using surface electromyography. [Results] The %MVIC of the IO and TrA statistically significantly differed and the %MVIC of IO and TrA was found to be higher during coughing in nonsmokers compared with during coughing in smokers. [Conclusion] The activity of the deep abdominal muscles in nonsmokers was also higher than that of smokers during coughing. PMID:27190443

  11. Ontogenetic changes of trunk muscle structure in the Japanese black salamander (Hynobius nigrescens)

    PubMed Central

    OMURA, Ayano; ANZAI, Wataru; KOYABU, Daisuke; ENDO, Hideki

    2015-01-01

    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. PMID:25816856

  12. Dynamic EMG analysis of torque transfer in professional baseball pitchers.

    PubMed

    Watkins, R G; Dennis, S; Dillin, W H; Schnebel, B; Schneiderman, G; Jobe, F; Farfan, H; Perry, J; Pink, M

    1989-04-01

    Fifteen professional baseball pitchers underwent active pitching motion analysis of the abdominal oblique, rectus abdominis, lumbar paraspinous and gluteus maximus muscles bilaterally via surface electrode evaluation. Baseline resting and isometric maximum values were obtained and active data referenced against these for comparison. The muscle activity then was measured during the pitching sequence and analyzed in each of the five pitching phases. The abdominal oblique, lumbar paraspinous and rectus abdominis contralateral to the pitching arm and the ipsilateral gluteus maximus all had increases in activity level of 75 to 100% during the active pitching motion. Using these data indicating specific muscle group patterns with clinical and performance data, we hope to minimize injuries and maximize pitching performance.

  13. Abdominal Wall Endometriosis on the Right Port Site After Laparoscopy: Case Report and Literature Review

    PubMed Central

    Cozzolino, Mauro; Magnolfi, Stefania; Corioni, Serena; Moncini, Daniela; Mattei, Alberto

    2015-01-01

    Background Endometriosis can be intrapelvic or, rarely, extrapelvic. Endometriosis involving the rectus abdominis muscle on the trocar port site is a rare event; until now, only 16 cases have been reported in the literature. The majority of cases were associated with previous abdominal surgery such as diagnostic laparoscopy, cyst excision, appendectomy, myomectomy, or cholecystectomy. We review all the reported cases of this unusual form of extrapelvic endometriosis. Case Report We report a new case of abdominal wall endometriosis at the trocar port site in the rectus abdominis muscle in a woman who had undergone 2 laparoscopies for endometriosis in the 3 years before coming to our attention. The diagnosis was made by sonography. We performed a surgical resection of the lesion with a free macroscopic margin of 5-10 mm. Conclusion Endometriosis should be considered in the differential diagnosis of any abdominal swelling. In our experience, surgery is the treatment of choice. PMID:26412997

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

    PubMed

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

    2016-07-01

    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

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. [FUNCTIONAL PLASTIC OF ANTERIOR ABDOMINAL WALL HERNIAS].

    PubMed

    Grubnik, V V; Parfentyeva, N D; Parfentyev, R S

    2015-07-01

    In order to improve the treatment efficacy of postoperative anterior abdominal wall hernias the method of plastic with restoration of anatomical and physiological properties of the muscles of the anterior abdominal wall was used. After the intervention by the improved method, regardless of the location of the hernia defect yielded promising results for the conservation of anterior abdominal wall muscle function in 75% of cases completely restored functional ability of muscles recti abdomini. PMID:26591212

  20. 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.

  1. Reconstruction of the chin using an expanded deltopectoral flap following multiple recurrences of oral cancer.

    PubMed

    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.

  2. Reconstruction of the chin using an expanded deltopectoral flap following multiple recurrences of oral cancer.

    PubMed

    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

  3. Lateral mandibulectomy and partial glossectomy with plate application.

    PubMed

    Ghali, G E; Sikes, J W

    1997-09-01

    The goals of composite resection with reconstruction plate application include removal of the primary tumor, any compromised portions of the mandible, and any involved lymph-bearing tissue. Recent advances in surgical technique and reconstruction have made this treatment a more appealing choice for patients. Although microvascular free flaps may be the treatment of choice in the younger patient with an excellent prognosis, the use of reconstruction plates with a myocutaneous flap remains a viable alternative for many patients with oral cancer. Regardless of the reconstructive technique utilized, both functional and aesthetic parameters must be addressed in treatment planning for patients with head and neck cancer.

  4. Prevention and Management of Nonhealing Perineal Wounds

    PubMed Central

    Kamrava, Allen; Mahmoud, Najjia N.

    2013-01-01

    Complex perineal wounds are at risk for nonhealing. High-risk procedures include proctectomy for Crohn disease, anal cancer and radiated distal rectal cancers. A basic understanding of both patient and procedural risk factors is helpful in planning and executing operative procedures for these conditions and to minimize associated wound complications. Diabetes, obesity, and malnutrition may contribute to wound breakdown and failure to heal. Delaying operative intervention, adding nutritional supplementation, and employing intestinal diversion as well as myocutaneous flaps may help optimize conditions for wound healing. PMID:24436658

  5. 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...

  6. 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.

  7. Identification and Characterization of a Second Quorum-Sensing System in Agrobacterium tumefaciens A6

    PubMed Central

    Wang, Chao; Yan, Chunlan; Fuqua, Clay

    2014-01-01

    Quorum sensing (QS) is a widespread mechanism of bacterial communication in which individual cells produce and respond to small chemical signals. In Agrobacterium tumefaciens, an acylhomoserine lactone-dependent QS mechanism is known to regulate the replication and conjugation of the tumor-inducing (Ti) plasmid. Most of the QS regulatory proteins are encoded within the Ti plasmid. Among them, TraI is the LuxI-type enzyme synthesizing the QS signal N-3-oxooctanoyl-l-homoserine lactone (3OC8HSL), TraR is the LuxR-type transcriptional factor that recognizes 3OC8HSL, and TraM is an antiactivator that antagonizes TraR. Recently, we identified a TraM homolog encoded by the traM2 gene in the chromosomal background of A. tumefaciens A6. In this study, we further identified additional homologs (TraI2 and TraR2) of TraI and TraR in this strain. We showed that similar to TraI, TraI2 could predominantly synthesize the QS signal 3OC8HSL. We also showed that TraR2 could recognize 3OC8HSL and activate the tra box-containing promoters as efficiently as TraR. Further analysis showed that traM2, traI2, and traR2 are physically linked on a mobile genetic element that is not related to the Ti plasmid. These findings indicate that A. tumefaciens A6 carries a second QS system that may play a redundant role in the regulation of the replication and conjugation of the Ti plasmid. PMID:24464459

  8. Design, fabrication and test of last cut Follower

    NASA Technical Reports Server (NTRS)

    Ashley, P. R.; Poulsen, P. D.

    1981-01-01

    An optical device for following the cut in mining operations is described, and the results of acceptance testing reported. A measuring accuracy of + or - 1/16 inch was demonstrated. Preliminary results on longwall testing with the device mounted on a shearer are presented. Roof profiles measured during tramming and during cutting are presented. Comparison of acoustic measurements with optical measurement of the roof profiles indicates close agreement.

  9. Algorithm for Public Electric Transport Schedule Control for Intelligent Embedded Devices

    NASA Astrophysics Data System (ADS)

    Alps, Ivars; Potapov, Andrey; Gorobetz, Mikhail; Levchenkov, Anatoly

    2010-01-01

    In this paper authors present heuristics algorithm for precise schedule fulfilment in city traffic conditions taking in account traffic lights. The algorithm is proposed for programmable controller. PLC is proposed to be installed in electric vehicle to control its motion speed and signals of traffic lights. Algorithm is tested using real controller connected to virtual devices and real functional models of real tram devices. Results of experiments show high precision of public transport schedule fulfilment using proposed algorithm.

  10. Induction and Loss of Ti Plasmid Conjugative Competence in Response to the Acyl-Homoserine Lactone Quorum-Sensing Signal▿

    PubMed Central

    Su, Shengchang; Khan, Sharik R.; Farrand, Stephen K.

    2008-01-01

    Conjugative transfer of the Ti plasmids of Agrobacterium tumefaciens is controlled by a quorum-sensing system composed of TraR and its signal N-(3-oxo-octanoyl)-l-homoserine lactone. This system is, in turn, controlled by the conjugative opines produced by crown gall tumors induced on plants by the bacteria. Using nonpolar traI mutants, we examined the kinetics of induction of conjugative transfer in response to exogenous acyl-homoserine lactone. In the absence of the antiactivator TraM, onset of induction of transfer requires about 30 min, 15 to 20 min of which is needed for expression and construction of the conjugative apparatus. TraM delays the onset of conjugation by 30 min. While the rate of development of conjugative competence was not significantly affected by levels of TraR, maximum efficiencies of transfer were correlated with amounts of the activator in the donors. Donors harboring Ti plasmids lacking TraM were fully induced by the quormone at concentrations as low as 100 pM. TraM raised the concentration of signal required for maximum activity to 1 nM. Donors grown in batch culture retained conjugative competence following signal removal, even when in stationary phase. However, donors kept in balanced growth rapidly lost transfer ability following signal removal. Loss of transfer was mirrored by a decrease in levels of active TraR. Decreases in TraR activity and conjugative competence could be accounted for by dilution associated with cell division, suggesting that while induction of Ti plasmid conjugation is an active process, the cells lack a mechanism for disassembling the conjugative apparatus when signals become limiting. PMID:18203831

  11. 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

  12. Effects of different types of contraction in abdominal bracing on the asymmetry of left and right abdominal muscles.

    PubMed

    Park, Sung-Hyun; Song, Min-Young; Park, Hyeon-Ji; Park, Ji-Hyun; Bae, Hyun-Young; Lim, Da-Som

    2014-12-01

    [Purpose] The purpose of this study was to investigate the effective strength levels of abdominal muscle contraction using the bracing contraction method. [Subjects] The experiment was conducted with 31 healthy male (M=15) and female (F=16) adults attending D University in Busan; all participants had less than obesity level BMI (BMI<30). [Methods] Bracing contraction was performed by the subjects in the hook-lying position at maximum and minimum pressure levels, five times each, using a Pressure Biofeedback Unit (PBU), and the mean measurement value was calculated. The maximum pressure level was set at 100% and the half maximum pressure level was set at 50%. Each subject's left and right abdominal muscle thicknesses were then measured by ultrasound imaging in each state: at rest, 100% contraction, and 50% contraction. [Results] No significant differences were found between the left and right sides of the transversus abdominis (TrA) at rest, 50%, or 100% contraction. The external oblique abdominis (EO) and internal oblique abdominis (IO) showed no significant difference at rest or at the 50% contraction. However, a significant difference was noted at 100% contraction for the EO and IO. [Conclusion] Application of abdominal contraction using bracing can achieve symmetry in the left and right abdominal muscles at less than the maximum contractile strength. The occurrence of asymmetry in the left and right abdominal muscles at the maximum contractile strength suggests that the most suitable contractile strength in this exercise is less than the maximum contractile strength. PMID:25540478

  13. Change in trunk muscle activities with prone bridge exercise in patients with chronic low back pain.

    PubMed

    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.

  14. Change in trunk muscle activities with prone bridge exercise in patients with chronic low back pain.

    PubMed

    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

  15. 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

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

    PubMed

    Fechner, R; Schwarz-Wings, D

    2013-06-01

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

  17. Identification of interaction sites for dimerization and adapter recruitment in Toll/interleukin-1 receptor (TIR) domain of Toll-like receptor 4.

    PubMed

    Bovijn, Celia; Ulrichts, Peter; De Smet, Anne-Sophie; Catteeuw, Dominiek; Beyaert, Rudi; Tavernier, Jan; Peelman, Frank

    2012-02-01

    Toll-like receptor signaling requires interactions of the Toll/IL-1 receptor (TIR) domains of the receptor and adapter proteins. Using the mammalian protein-protein interaction trap strategy, homology modeling, and site-directed mutagenesis, we identify the interaction surfaces in the TLR4 TIR domain for the TLR4-TLR4, TLR4-MyD88 adapter-like (MAL), and TLR4-TRIF-related adapter molecule (TRAM) interaction. Two binding sites are equally important for TLR4 dimerization and adapter recruitment. In a model based on the crystal structure of the dimeric TLR10 TIR domain, the first binding site mediates TLR4-TLR4 TIR-TIR interaction. Upon dimerization, two identical second binding sites of the TLR4 TIR domain are juxtaposed and form an extended binding platform for both MAL and TRAM. In our mammalian protein-protein interaction trap assay, MAL and TRAM compete for binding to this platform. Our data suggest that adapter binding can stabilize the TLR4 TIR dimerization. PMID:22139835

  18. Identification of Interaction Sites for Dimerization and Adapter Recruitment in Toll/Interleukin-1 Receptor (TIR) Domain of Toll-like Receptor 4*

    PubMed Central

    Bovijn, Celia; Ulrichts, Peter; De Smet, Anne-Sophie; Catteeuw, Dominiek; Beyaert, Rudi; Tavernier, Jan; Peelman, Frank

    2012-01-01

    Toll-like receptor signaling requires interactions of the Toll/IL-1 receptor (TIR) domains of the receptor and adapter proteins. Using the mammalian protein-protein interaction trap strategy, homology modeling, and site-directed mutagenesis, we identify the interaction surfaces in the TLR4 TIR domain for the TLR4-TLR4, TLR4-MyD88 adapter-like (MAL), and TLR4-TRIF-related adapter molecule (TRAM) interaction. Two binding sites are equally important for TLR4 dimerization and adapter recruitment. In a model based on the crystal structure of the dimeric TLR10 TIR domain, the first binding site mediates TLR4-TLR4 TIR-TIR interaction. Upon dimerization, two identical second binding sites of the TLR4 TIR domain are juxtaposed and form an extended binding platform for both MAL and TRAM. In our mammalian protein-protein interaction trap assay, MAL and TRAM compete for binding to this platform. Our data suggest that adapter binding can stabilize the TLR4 TIR dimerization. PMID:22139835

  19. 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.

  20. 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.

  1. 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.

  2. Algorithmic approach to lower abdominal, perineal, and groin reconstruction using anterolateral thigh flaps.

    PubMed

    Zelken, Jonathan A; AlDeek, Nidal F; Hsu, Chung-Chen; Chang, Nai-Jen; Lin, Chih-Hung; Lin, Cheng-Hung

    2016-02-01

    Lower abdominal, perineal, and groin (LAPG) reconstruction may be performed in a single stage. Anterolateral thigh (ALT) flaps are preferred here and taken as fasciocutaneous (ALT-FC), myocutaneous (ALT-MC), or vastus lateralis myocutaneous (VL-MC) flaps. We aim to present the results of reconstruction from a series of patients and guide flap selection with an algorithmic approach to LAPG reconstruction that optimizes outcomes and minimizes morbidity. Lower abdomen, groin, perineum, vulva, vagina, scrotum, and bladder wounds reconstructed in 22 patients using ALT flaps between 2000 and 2013 were retrospectively studied. Five ALT-FC, eight ALT-MC, and nine VL-MC flaps were performed. All flaps survived. Venous congestion occurred in three VL-MC flaps from mechanical cause. Wound infection occurred in six cases. Urinary leak occurred in three cases of bladder reconstruction. One patient died from congestive heart failure. The ALT flap is time tested and dependably addresses most LAPG defects; flap variations are suited for niche defects. We propose a novel algorithm to guide reconstructive decision-making.

  3. 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

  4. Repair of 50–75% full-thickness lower eyelid defects: Lateral stabilization as a guiding principle

    PubMed Central

    Perry, C Blake; Allen, Richard C

    2016-01-01

    Introduction: Repair of large defects of the lower eyelid can be difficult. A common procedure performed to address these defects is a Hughes flap. This procedure has a number of disadvantages: The eye is closed postoperatively, a second stage is required, and the edge of the flap is often erythematous. The purpose of this paper is to describe a one-stage procedure for the repair of large full-thickness defects of the lower lid as an alternative to a Hughes flap. Materials and Methods: This is a retrospective study of patients who underwent the described procedure. The procedure employs lateral stabilization of the posterior lamella with a periosteal strip, medial transposition of the lateral posterior lamella for central and medial defects, and a myocutaneous advancement flap to stabilize the anterior lamella. Results: A total of 38 patients underwent the procedure to reconstruct full-thickness defects of the lower lid ranging from 50% to 75%. All patients underwent previous Mohs excision of a skin cancer. The average follow-up was 5.6 months. Eleven patients (29%) had postoperative sequelae, but only two patients (5%) required additional treatment. Conclusion: Lateral stabilization with a periosteal strip and myocutaneous advancement flap is an excellent one-step procedure that avoids many of the complications seen with the Hughes procedure and is comparable to other techniques used for the reconstruction of subtotal, full-thickness lower lid defects. PMID:27688276

  5. Reconstruction of complex shoulder defect in a case of subclavian artery thrombosis.

    PubMed

    Satish, Chetan

    2013-06-01

    We report a case of a 24-year-old man with complex shoulder defect on the right side following a road traffic accident. The patient was found to have a subclavian artery thrombosis in its second part with good collaterals ensuring limb viability. Free-flap reconstruction was not possible because of lack of recipient vascular pedicle nearby. Pedicled flaps routinely used for this area such as pectoralis major and latissimus dorsi myocutaneous flaps could not be used as their vascular pedicles arise from the second and third parts of the axillary artery distal to the subclavian artery thrombosis. The best option we could think was the trapezius myocutaneous flap as its vascular pedicle arises from the first part of the subclavian artery proximal to the thrombosis. This article further establishes the importance of knowing the vascular supply of flaps before their clinical application. In this case the trapezius flap acts as a lifeboat for coverage of the complex shoulder defect as its vascular supply is proximal to the site of subclavian artery thrombosis.

  6. Approximation of muscle remnants improves cosmesis following hemimandibulectomy.

    PubMed

    Chaturvedi, P

    2009-10-01

    Hemimandibulectomy should be avoided whenever possible, as it results in significant deterioration in quality of life. If hemimandibulectomy is unavoidable, attempts should be made to reconstruct the bone and soft tissue defect by free tissue transfer or a pedicled flap such as a pectoralis major myocutaneous flap. Bony reconstruction may become challenging when oncological safety mandates removal of the vertical ramus or the condyle. Elderly patients and those with significant co-morbidity are not suitable for prolonged microvascular surgery. Oral cancer is a disease of impoverished nations, where most health institutions may not have the infrastructure to offer microvascular reconstruction. The pectoralis major myocutaneous flap, the workhorse for reconstruction of such defects, occasionally has limitations in terms of bulk, limited arc of rotation, shoulder dysfunction etc. Therefore, hemimandibulectomy and primary mucosal closure continues to be a common procedure in developing nations. A simple technique is proposed with which to improve cosmesis following hemimandibulectomy, utilising the locally available muscle remnants. In highly selected patients, the remaining muscles can be approximated to prevent the lateral hollow that is a common but unacceptable sequel to hemimandibulectomy. PMID:19566975

  7. [Repair of skin and soft tissue defects around the knee joints].

    PubMed

    Tan, Qian; Xu, Peng

    2015-10-01

    Skin and soft tissue defects around the knee joints are often accompanied by popliteal artery injury, patellar ligament injury, patellar fracture, and other deep tissue damage or exposure, making them challenging to repair. The principle is to repair the wound, reconstruct anatomical structure of the knee joint, and recover the knee joint function. At present the reconstruction with skin flap or myocutaneous flap is our priority. Local flap or myocutaneous flap can be used for repairing minor defects around the knee joints. Repairing with perforator flap, fascia flap, and free flap are main alternatives for covering larger and complex defects around the knee joints. During the treatment, a joint effort is mandatory, not only to repair the wound, but also to reconstruct vasculature, fix fracture, repair ligament, and finally recover the knee joint function. Therefore, the importance of multidisciplinary cooperation must be emphasized. Moreover, along with the development of new technologies, new methods, and new materials, perforator flap plays an important role in repairing skin and soft tissue defects around the knee joints.

  8. Airloads and Wake Geometry Calculations for an Isolated Tiltrotor Model in a Wind Tunnel

    NASA Technical Reports Server (NTRS)

    Johnson, Wayne

    2003-01-01

    Th 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. For many years such correlation has been performed for helicopter rotors (rotors designed for edgewise flight), but correlation activities for tiltrotors have been limited, in part by the absence of appropriate measured data. The recent test of the Tilt Rotor Aeroacoustic Model (TRAM) with a single, U4-scale V-22 rotor in the German-Dutch Wind Tunnel (DNW) now provides an extensive set of aeroacoustic, performance, and structural loads data. This paper will present calculations of airloads, wake geometry, and performance, including correlation with TRAM DNW measurements. The calculations were obtained using CAMRAD II, which is a modern rotorcraft comprehensive analysis, with advanced models intended for application to tiltrotor aircraft as well as helicopters. Comprehensive analyses have received extensive correlation with performance and loads measurements on helicopter rotors. The proposed paper is part of an initial effort to perform an equally extensive correlation with tiltrotor data. The correlation will establish the level of predictive capability achievable with current technology; identify the limitations of the current aerodynamic, wake, and structural models of tiltrotors; and lead to recommendations for research to extend tiltrotor aeromechanics analysis capability. The purpose of the Tilt Rotor Aeroacoustic Model (TRAM) experimental project is to provide data necessary to validate

  9. Effects of BOSU ball(s) during sit-ups with body weight and added resistance on core muscle activation.

    PubMed

    Saeterbakken, Atle H; Andersen, Vidar; Jansson, June; Kvellestad, Ann C; Fimland, Marius S

    2014-12-01

    The objective of this study was to assess the electromyographic activity of the rectus abdominis (upper and lower part) and external oblique during sit-ups performed on BOSU ball(s). Twenty-four men participated in a familiarization session, and in the next session, they performed the experimental tests in randomized order. The sit-ups were performed with 10 repetitions with body weight and with 10 repetition maximum (10RM) using elastic bands as external resistance under 4 different conditions: (a) on a stable surface, (b) with the BOSU ball under their feet (dome side down, lower-body instability), (c) BOSU ball under the low back (dome side up, upper-body instability), and (d) with BOSU balls under both feet and the low back (dual instability). The feet were not attached to the surface. We observed that with body weight, external oblique activation was decreased by upper-body instability and dual instability by 22-24% (p = 0.002-0.006), whereas the rectus abdominis was not affected by the surface. Using 10RM loads, the upper and lower rectus abdominis activities were increased by upper body and dual instability by 21-24% compared with that for a stable surface (P ≤ 0.001-0.036). Further, lower-body instability did not affect muscle activities significantly with either load for any condition. Hence, BOSU balls under the low back can increase and decrease abdominal muscle activation depending on the load, whereas placing a BOSU ball under the feet with the dome side down had little impact.

  10. 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

  11. 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.

  12. Quorum-dependent mannopine-inducible conjugative transfer of an Agrobacterium opine-catabolic plasmid.

    PubMed

    Wetzel, Margaret E; Kim, Kun-Soo; Miller, Marilyn; Olsen, Gary J; Farrand, Stephen K

    2014-03-01

    The Ti plasmid in Agrobacterium tumefaciens strain 15955 carries two alleles of traR that regulate conjugative transfer. The first is a functional allele, called traR, that is transcriptionally induced by the opine octopine. The second, trlR, is a nonfunctional, dominant-negative mutant located in an operon that is inducible by the opine mannopine (MOP). Based on these findings, we predicted that there exist wild-type agrobacterial strains harboring plasmids in which MOP induces a functional traR and, hence, conjugation. We analyzed 11 MOP-utilizing field isolates and found five where MOP induced transfer of the MOP-catabolic element and increased production of the acyl-homoserine lactone (acyl-HSL) quormone. The transmissible elements in these five strains represent a set of highly related plasmids. Sequence analysis of one such plasmid, pAoF64/95, revealed that the 176-kb element is not a Ti plasmid but carries genes for catabolism of MOP, mannopinic acid (MOA), agropinic acid (AGA), and the agrocinopines. The plasmid additionally carries all of the genes required for conjugative transfer, including the regulatory genes traR, traI, and traM. The traR gene, however, is not located in the MOP catabolism region. The gene, instead, is monocistronic and located within the tra-trb-rep gene cluster. A traR mutant failed to transfer the plasmid and produced little to no quormone even when grown with MOP, indicating that TraRpAoF64/95 is the activator of the tra regulon. A traM mutant was constitutive for transfer and acyl-HSL production, indicating that the anti-activator function of TraM is conserved. PMID:24363349

  13. 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.

  14. Conjugative Transfer of p42a from Rhizobium etli CFN42, Which Is Required for Mobilization of the Symbiotic Plasmid, Is Regulated by Quorum Sensing

    PubMed Central

    Tun-Garrido, Cristina; Bustos, Patricia; González, Víctor; Brom, Susana

    2003-01-01

    Rhizobium etli CFN42 contains six plasmids. Only one of them, p42a, is self-conjugative at high frequency. This plasmid is strictly required for mobilization of the symbiotic plasmid (pSym). To study the transfer mechanism of p42a, a self-transmissible cosmid clone containing its transfer region was isolated. Its sequence showed that most of the tra genes are highly similar to genes of Agrobacterium tumefaciens pTiC58 and other related plasmids. Four putative regulatory genes were identified; three of these (traI, traR, and cinR) belong to the LuxR-LuxI family. Mutagenesis of these genes confirmed their requirement for p42a transfer. We found that the conjugative transfer of p42a is dependent on quorum sensing, and consequently pSym transfer also was found to be similarly regulated, establishing a complex link between environmental conditions and pSym transfer. Although R. etli has been shown to produce different N-acyl-homoserine lactones, only one of them, a 3-oxo-C8-homoserine lactone encoded by the traI gene described here, was involved in transfer. Mutagenesis of the fourth regulatory gene, traM, had no effect on transfer. Analysis of transcriptional fusions of the regulatory genes to a reporter gene suggests a complex regulation scheme for p42a conjugative transfer. Conjugal transfer gene expression was found to be directly upregulated by TraR and the 3-oxo-C8-homoserine lactone synthesized by TraI. The traI gene was autoregulated by these elements and positively regulated by CinR, while cinR expression required traI. Finally, we did not detect expression of traM, indicating that in p42a TraM may be expressed so weakly that it cannot inhibit conjugal transfer, leading to the unrepressed transfer of p42a. PMID:12591886

  15. Quorum-Dependent Mannopine-Inducible Conjugative Transfer of an Agrobacterium Opine-Catabolic Plasmid

    PubMed Central

    Wetzel, Margaret E.; Kim, Kun-Soo; Miller, Marilyn; Olsen, Gary J.

    2014-01-01

    The Ti plasmid in Agrobacterium tumefaciens strain 15955 carries two alleles of traR that regulate conjugative transfer. The first is a functional allele, called traR, that is transcriptionally induced by the opine octopine. The second, trlR, is a nonfunctional, dominant-negative mutant located in an operon that is inducible by the opine mannopine (MOP). Based on these findings, we predicted that there exist wild-type agrobacterial strains harboring plasmids in which MOP induces a functional traR and, hence, conjugation. We analyzed 11 MOP-utilizing field isolates and found five where MOP induced transfer of the MOP-catabolic element and increased production of the acyl-homoserine lactone (acyl-HSL) quormone. The transmissible elements in these five strains represent a set of highly related plasmids. Sequence analysis of one such plasmid, pAoF64/95, revealed that the 176-kb element is not a Ti plasmid but carries genes for catabolism of MOP, mannopinic acid (MOA), agropinic acid (AGA), and the agrocinopines. The plasmid additionally carries all of the genes required for conjugative transfer, including the regulatory genes traR, traI, and traM. The traR gene, however, is not located in the MOP catabolism region. The gene, instead, is monocistronic and located within the tra-trb-rep gene cluster. A traR mutant failed to transfer the plasmid and produced little to no quormone even when grown with MOP, indicating that TraRpAoF64/95 is the activator of the tra regulon. A traM mutant was constitutive for transfer and acyl-HSL production, indicating that the anti-activator function of TraM is conserved. PMID:24363349

  16. 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. PMID:23407879

  17. The effect of trunk stabilization exercises with a swiss ball on core muscle activation in the elderly.

    PubMed

    Kim, Seong Gil; Yong, Min Sik; Na, Sang Su

    2014-09-01

    [Purpose] The purpose of this study was to investigate the effects of trunk stabilization exercise on the muscle EMG activations related to core stability. [Subjects and Methods] Fifteen elderly people in a geriatric hospital performed trunk stabilization exercises with a Swiss ball for 20 minutes five times per week for 8 weeks. Trunk muscle activations were measured using electromyography before and after the intervention. [Results] After the intervention, the muscle activations of the rectus abdominis, erector spinae, lateral low-back (quadratus lumborum and external oblique), and gluteus medius muscles increased significantly. [Conclusion] The trunk stabilization exercise with a Swiss ball significantly increased the muscle activities of the elderly.

  18. The parachute design as a new extraperitoneal method of closing a recalcitrant high-output enterocutaneous fistula: report of a case.

    PubMed

    de Weerd, Louis; Kjæve, Jørn; Nergård, Solveig

    2012-07-01

    We introduce a new method for closure of a recalcitrant high-output jejunal enterocutaneous fistula. First, a transposed rectus abdominis muscle is sutured into the fistula opening using a parachuting technique, then the muscle is covered with a skin graft and temporarily immobilized to the fistula wall and abdominal wall with a negative pressure device. This extraperitoneal method provides tension-free closure of the fistula with well-vascularized tissue, without compromising the intestinal lumen. No bowel is resected. This new technique allows for early mobilization and recommencement of enteral nutrition.

  19. Effects of a Bridging Exercise with Hip Adduction on the EMG Activities of the Abdominal and Hip Extensor Muscles in Females

    PubMed Central

    Jang, Eun-Mi; Kim, Mi-Hyun; Oh, Jae-Seop

    2013-01-01

    [Purpose] This study compared the activities of the abdominal and hip extensor muscles between the bridging exercise (BE) and bridging exercise with hip adduction (BEHA) positions in women using electromyography (EMG). [Subjects] We recruited 14 healthy adult females with no history of low back pain. [Methods] The subjects performed bridging exercises with and without hip adduction. The EMG activities of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and gluteus maximus (GM) muscles were recorded. [Result] The EMG activities of all muscles were significantly increased during the BEHA compared to the BE. [Conclusion] The bridging exercise with hip adduction produced greater activation of the abdominal and hip extensor muscles. PMID:24259933

  20. Return to Play After Sports Hernia Surgery.

    PubMed

    Choi, Ho-Rim; Elattar, Osama; Dills, Vickie D; Busconi, Brian

    2016-10-01

    Sports hernia is a condition that causes acute/chronic pain of low abdominal, groin, or adductor area in athletes. It is considered a weakness in the rectus abdominis insertion or posterior inguinal wall of lower abdomen caused by acute or repetitive injury of the structure. It is most commonly seen in soccer, ice hockey, and martial arts players who require acute cutting, pivoting, or kicking. A variety of surgical options have been reported with successful outcome and with high rates of return to the sports in a majority of cases. PMID:27543403

  1. 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.

  2. Stretch due to Penile Prosthesis Reservoir Migration

    PubMed Central

    Baten, E.; Vandewalle, T.; van Renterghem, K.

    2016-01-01

    A 43-year old patient presented to the emergency department with stretch, due to impossible deflation of the penile prosthesis, 4 years after successful implant. A CT-scan showed migration of the reservoir to the left rectus abdominis muscle. Refilling of the reservoir was inhibited by muscular compression, causing stretch. Removal and replacement of the reservoir was performed, after which the prosthesis was well-functioning again. Migration of the penile prosthesis reservoir is extremely rare but can cause several complications, such as stretch. PMID:26793592

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

    PubMed Central

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

    2015-01-01

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

  4. 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. PMID:25134854

  5. Three cross leg flaps for lower leg reconstruction of Gustilo type III C open fracture

    PubMed Central

    Sano, Kazufumi; Ozeki, Satoru; Sugimoto, Ichiro; Ogawa, Masato

    2016-01-01

    A 60 year old male had Gustilo type III C open fracture of the right lower leg. After radical debridement, the large open defect including certain loss of the bone tissue was successfully augmented and covered, by consecutive three cross-leg flaps, which consisted of the free rectus abdominis musculocutaneous flap, the fibula osteocutaneous flap and the conventional sural flap. Although indication for amputation or preservation is decided with multiple factors in each case, a strategic combination of cross-leg flap, free flap, external fixation and vascular delay could increase the potential of preservation of the lower leg with even disastrous Gustilo type III C. PMID:27293297

  6. 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

  7. Stretch due to Penile Prosthesis Reservoir Migration.

    PubMed

    Baten, E; Vandewalle, T; van Renterghem, K

    2016-03-01

    A 43-year old patient presented to the emergency department with stretch, due to impossible deflation of the penile prosthesis, 4 years after successful implant. A CT-scan showed migration of the reservoir to the left rectus abdominis muscle. Refilling of the reservoir was inhibited by muscular compression, causing stretch. Removal and replacement of the reservoir was performed, after which the prosthesis was well-functioning again. Migration of the penile prosthesis reservoir is extremely rare but can cause several complications, such as stretch.

  8. Core Injuries Remote from the Pubic Symphysis.

    PubMed

    Belair, Jeffrey A; Hegazi, Tarek M; Roedl, Johannes B; Zoga, Adam C; Omar, Imran M

    2016-09-01

    The core, or central musculoskeletal system of the torso, is essential for participating in sports and other physical activities. Core injuries are commonly encountered in athletes and active individuals. The importance of the midline pubic plate and rectus abdominis-adductor aponeurosis for core stability and function is discussed in the literature. This review article examines other important core injuries remote from the pubic symphysis, relevant clinical features, and preferred approaches to imaging. Several specific syndromes encountered in the core are reviewed. By protocoling imaging studies and identifying pathology, radiologists can add value to the clinical decision-making process and help guide therapeutic options. PMID:27545427

  9. Transversalis fascia rediscovered.

    PubMed

    Bendavid, R; Howarth, D

    2000-02-01

    The transversalis fascia is a layer in the make-up of the posterior inguinal wall. It is the deepest, thinnest, and least important layer in terms of the prevention of herniation. It is a segment of the wider endoabdominal fascia. The true posterior wall of the inguinal canal is formed, in varying degrees, by the muscles or aponeuroses of the internal oblique and transversus abdominis. Plainly, Daedalus was not needed to show surgeons and anatomists how to make a labyrinth out of a rabbit hole! PMID:10685142

  10. Bilateral anterolateral thigh flaps for large-volume breast reconstruction.

    PubMed

    Rosenberg, Jason J; Chandawarkar, Rajiv; Ross, Merrick I; Chevray, Pierre M

    2004-01-01

    Autologous tissue reconstruction of a large breast in patients who are not candidates for a TRAM flap is a difficult problem. We present a case report of the use of bilateral free anterolateral thigh (ALT) flaps for immediate reconstruction of a unilateral large breast in a patient who had a previous abdominoplasty. Use of ALT flaps allows two or three surgical teams to work simultaneously, does not require intraoperative patient repositioning, has minimal donor-site morbidity, and can provide ample malleable soft tissue for breast reconstruction. These are advantages compared to the use of gluteal donor sites. The disadvantages include more conspicuous donor-site scarring on the anterior thighs.

  11. Overview of the Testing of a Small-Scale Proprotor

    NASA Technical Reports Server (NTRS)

    Young, Larry A.; Yamauchi, Gloria K.; Booth, Earl R., Jr.; Botha, Gavin; Dawson, Seth

    1999-01-01

    This paper presents an overview of results from the wind tunnel test of a 1/4-scale V-22 proprotor in the Duits-Nederlandse Windtunnel (DNW) in The Netherlands. The small-scale proprotor was tested on the isolated rotor configuration of the Tilt Rotor Aeroacoustic Model (TRAM). The test was conducted by a joint team from NASA Ames, NASA Langley, U.S. Army Aeroflightdynamics Directorate, and The Boeing Company. The objective of the test was to acquire a benchmark database for validating aeroacoustic analyses. Representative examples of airloads, acoustics, structural loads, and performance data are provided and discussed.

  12. Intermediate Conductance Ca2+-Activated K+ Channels Modulate Human Placental Trophoblast Syncytialization

    PubMed Central

    Díaz, Paula; Wood, Amber M.; Sibley, Colin P.; Greenwood, Susan L.

    2014-01-01

    Regulation of human placental syncytiotrophoblast renewal by cytotrophoblast migration, aggregation/fusion and differentiation is essential for successful pregnancy. In several tissues, these events are regulated by intermediate conductance Ca2+-activated K+ channels (IKCa), in part through their ability to regulate cell volume. We used cytotrophoblasts in primary culture to test the hypotheses that IKCa participate in the formation of multinucleated syncytiotrophoblast and in syncytiotrophoblast volume homeostasis. Cytotrophoblasts were isolated from normal term placentas and cultured for 66 h. This preparation recreates syncytiotrophoblast formation in vivo, as mononucleate cells (15 h) fuse into multinucleate syncytia (66 h) concomitant with elevated secretion of human chorionic gonadotropin (hCG). Cells were treated with the IKCa inhibitor TRAM-34 (10 µM) or activator DCEBIO (100 µM). Culture medium was collected to measure hCG secretion and cells fixed for immunofluorescence with anti-IKCa and anti-desmoplakin antibodies to assess IKCa expression and multinucleation respectively. K+ channel activity was assessed by measuring 86Rb efflux at 66 h. IKCa immunostaining was evident in nucleus, cytoplasm and surface of mono- and multinucleate cells. DCEBIO increased 86Rb efflux 8.3-fold above control and this was inhibited by TRAM-34 (85%; p<0.0001). Cytotrophoblast multinucleation increased 12-fold (p<0.05) and hCG secretion 20-fold (p<0.05), between 15 and 66 h. Compared to controls, DCEBIO reduced multinucleation by 42% (p<0.05) and hCG secretion by 80% (p<0.05). TRAM-34 alone did not affect cytotrophoblast multinucleation or hCG secretion. Hyposmotic solution increased 86Rb efflux 3.8-fold (p<0.0001). This effect was dependent on extracellular Ca2+, inhibited by TRAM-34 and 100 nM charybdotoxin (85% (p<0.0001) and 43% respectively) but unaffected by 100 nM apamin. In conclusion, IKCa are expressed in cytotrophoblasts and their activation inhibits the formation

  13. 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.

  14. 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.

  15. The dorsal skinfold chamber: A versatile tool for preclinical research in tissue engineering and regenerative medicine.

    PubMed

    Laschke, M W; Menger, M D

    2016-01-01

    The dorsal skinfold chamber is a rodent model for non-invasive microcirculatory analyses of striated muscle and skin tissue throughout an observation period of 2-3 weeks. In combination with intravital fluorescence microscopy, this model allows the quantitative assessment of dynamic processes such as inflammation, angiogenesis, vascular remodelling and microcirculation. Accordingly, the dorsal skinfold chamber is increasingly used for preclinical research in tissue engineering and regenerative medicine. This includes studies on biocompatibility, vascularisation and incorporation of medical implants and artificial tissue constructs. Moreover, the chamber implantation procedure has been modified to analyse primary and secondary wound healing as well as revascularisation and blood perfusion of dermal substitutes, skin grafts and myocutaneous flaps. Hence, the dorsal skinfold chamber model does not only provide deep insights into fundamental regenerative mechanisms but also represents a versatile tool for the development of novel therapeutic strategies. PMID:27646143

  16. [Pressure sores: management and treatment].

    PubMed

    Goldschmidt, D; Seron, A; Jacquerye, A; Bustillo, A; Strale, H; Haubrechts, J; Del Marmol, V

    1997-09-01

    The global management of pressure sores is best ensured with a multidisciplinary approach. We present the experience of the "Groupe de Travail Escarres" (Pressure Sore Workgroup) which gathers physicians and nurses interested with this pathology. The majority of the decubitus ulcers will heal spontaneously with a conservative treatment only. This treatment typically aims at relieving the causes that lead to pressure sores, at eliminating the necrotic tissues, at obtaining favourable local conditions to allow wound healing and at controlling the health status of the patient. Surgical treatment of pressure sores is indicated when wound healing does not occur and when the health status of the patient is sufficiently good. Defect coverage is best carried out using myocutaneous flaps since their excellent blood supply allows a good cleansing of the wound. PMID:9411658

  17. Doppler-assisted vascular pedicle flaps in eyelid and periorbital reconstruction.

    PubMed

    Yeatts, R P; Newsom, R W; Matthews, B L

    1996-09-01

    The use of a transcutaneous ultrasonic Doppler flow detector to identify the supratrochlear and superficial temporal arteries permits the design of narrow-based, thin-tipped forehead flaps for use in medial canthal and eyelid reconstruction. In the 13 cases described, the axial, vascular supply of a proposed myocutaneous forehead flap was determined with a transcutaneous ultrasonic Doppler flow detector permitting narrow-based pedicle widths of 0.8 to 1.2 cm. The design of the distal portion of the flap was determined by the primary defect. The width of the flap varied from 1.5 to 4.0 cm, with the flap's axial length limited only by the hairline. This use of the ultrasonic Doppler flow detector, permitting narrow-based, thin-tipped vascular pedicle flaps, has assisted in refining the concept of forehead flaps and has made these flaps an acceptable primary reconstructive technique in the periorbital region. PMID:8790111

  18. 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).

  19. Differences in blood flow volume and vascular resistance between free flaps: assessment in 58 cases.

    PubMed

    Takanari, Keisuke; Kamei, Yuzuru; Toriyama, Kazuhiro; Yagi, Shunjiro; Torii, Shuhei

    2009-01-01

    In free-flap transfer, blood flow in the transferred flap contributes to wound healing and to resistance against infection in the recipient site. Successful reconstructions using free tissue transfers may be required to define and choose flaps with abundant blood flow in necessary cases. We investigated blood flow in the flap by transit-time ultrasound flowmeter in 58 free-flap transfers. Flow volume was compared between flap tissues as vascular resistance in the flap was calculated. Fasciocutaneous and osteocutaneous flaps had relatively low blood flow volume, myocutaneous flaps had more, and intraperitoneal flaps had still higher blood flow volume. These differences were statistically significant. Vascular resistance significantly decreased in the same order of comparison. Our findings will help in selecting the most suitable flaps for reconstructive surgery. PMID:18942044

  20. 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.

  1. Video-atlas on minimally invasive mitral valve surgery—The David Adams technique

    PubMed Central

    Castillo, Javier G.; Milla, Federico; Anyanwu, Anelechi C.

    2013-01-01

    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). PMID:24349990

  2. [Destructive paraffinoma of the breast and thoracic wall caused by paraffin injection for mammary increase. Apropos of 3 cases with review of the literature].

    PubMed

    Zekri, A; Ho, W S; King, W W

    1996-02-01

    The injection of a high viscosity fluids into the tissues for cosmetic body contouring has been practised in the last four decades in the East and South-East of Asia. The injection of liquid paraffin for mammary augmentation was widely practised by surgeons, physician and even non medical people. Unfortunately, most of these cases ended by having different varieties of paraffinoma as a complication of a foreign body reaction. We report three cases of a destructive form of these paraffinomas ulcerating into both breasts and the anterior chest wall. One case was treated by bilateral mastectomy, radical excision of the anterior chest wall soft tissue and reconstruction by a vertical Rectus Abdominus Myocutaneous Flap. The second case had bilateral mastectomy and followed up for facial paraffinomas. The third case was just followed for up regular wound care as surgery was not indicated due to advanced age, poor general condition and the family request.

  3. The dorsal skinfold chamber: A versatile tool for preclinical research in tissue engineering and regenerative medicine.

    PubMed

    Laschke, M W; Menger, M D

    2016-09-20

    The dorsal skinfold chamber is a rodent model for non-invasive microcirculatory analyses of striated muscle and skin tissue throughout an observation period of 2-3 weeks. In combination with intravital fluorescence microscopy, this model allows the quantitative assessment of dynamic processes such as inflammation, angiogenesis, vascular remodelling and microcirculation. Accordingly, the dorsal skinfold chamber is increasingly used for preclinical research in tissue engineering and regenerative medicine. This includes studies on biocompatibility, vascularisation and incorporation of medical implants and artificial tissue constructs. Moreover, the chamber implantation procedure has been modified to analyse primary and secondary wound healing as well as revascularisation and blood perfusion of dermal substitutes, skin grafts and myocutaneous flaps. Hence, the dorsal skinfold chamber model does not only provide deep insights into fundamental regenerative mechanisms but also represents a versatile tool for the development of novel therapeutic strategies.

  4. The treatment of sublingual gland tumours.

    PubMed

    Sun, G; Yang, X; Tang, E; Wen, J; Lu, M; Hu, Q

    2010-09-01

    This study assessed the clinical and histological features and therapeutic efficacy of 25 cases of sublingual gland tumours from 1998 to 2008. There were 17 female patients and 8 male, the ratio of females to males was 2.1:1. The mean age was 48.6 years. 4 cases were benign tumours (16%). 21 cases were malignant sublingual gland tumours (84%) and of these, 18 were adenoid cystic carcinoma (86%). Adenoid cystic carcinoma was mainly of the histological type, and the other histological classifications included mucoepidermoid carcinoma, pleomorphic adenoma, myoepithelioma, oncocytoma and polymorphous low-grade adenocarcinoma. Sublingual gland tumours are rare and most are malignant. For malignant sublingual gland tumours, early diagnosis and aggressive surgical treatment, especially for tumours with nerve involvement, is the key to improving prognosis. Free radial forearm flap or pectoralis major myocutaneous flap are appropriate methods for mouth floor reconstruction. For benign sublingual gland tumours, the resection of tumour and sublingual gland is the preferred treatment.

  5. 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.

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

    PubMed Central

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

    2015-01-01

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

  7. 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. PMID:22940541

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

    PubMed

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

    2015-12-01

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

  9. Active behavior of abdominal wall muscles: Experimental results and numerical model formulation.

    PubMed

    Grasa, J; Sierra, M; Lauzeral, N; Muñoz, M J; Miana-Mena, F J; Calvo, B

    2016-08-01

    In the present study a computational finite element technique is proposed to simulate the mechanical response of muscles in the abdominal wall. This technique considers the active behavior of the tissue taking into account both collagen and muscle fiber directions. In an attempt to obtain the computational response as close as possible to real muscles, the parameters needed to adjust the mathematical formulation were determined from in vitro experimental tests. Experiments were conducted on male New Zealand White rabbits (2047±34g) and the active properties of three different muscles: Rectus Abdominis, External Oblique and multi-layered samples formed by three muscles (External Oblique, Internal Oblique, and Transversus Abdominis) were characterized. The parameters obtained for each muscle were incorporated into a finite strain formulation to simulate active behavior of muscles incorporating the anisotropy of the tissue. The results show the potential of the model to predict the anisotropic behavior of the tissue associated to fibers and how this influences on the strain, stress and generated force during an isometric contraction. PMID:27111629

  10. Abdominal muscle activation changes if the purpose is to control pelvis motion or thorax motion.

    PubMed

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

    2011-12-01

    The aim of this study was to compare trunk muscular recruitment and lumbar spine kinematics when motion was constrained to either the thorax or the pelvis. Nine healthy women performed four upright standing planar movements (rotations, anterior-posterior translations, medial-lateral translations, and horizontal circles) while constraining pelvis motion and moving the thorax or moving the pelvis while minimizing thorax motion, and four isometric trunk exercises (conventional curl-up, reverse curl-up, cross curl-up, and reverse cross curl-up). Surface EMG (upper and lower rectus abdominis, lateral and medial aspects of external oblique, internal oblique, and latissimus dorsi) and 3D lumbar displacements were recorded. Pelvis movements produced higher EMG amplitudes of the oblique abdominals than thorax motions in most trials, and larger lumbar displacements in the medial-lateral translations and horizontal circles. Conversely, thorax movements produced larger rotational lumbar displacement than pelvis motions during rotations and higher EMG amplitudes for latissimus dorsi during rotations and anterior-posterior translations and for lower rectus abdominis during the crossed curl-ups. Thus, different neuromuscular compartments appear when the objective changes from pelvis to thorax motion. This would suggest that both movement patterns should be considered when planning spine stabilization programs, to optimize exercises for the movement and muscle activations desired.

  11. The effects of sling exercise using vibration on trunk muscle activities of healthy adults.

    PubMed

    Choi, Youngin; Kang, Hyungkyu

    2013-10-01

    [Purpose] This study compared the effects of sling exercises with and without vibration on the muscular activity of the internal oblique (IO), rectus abdominis (RA), multifidus (MF), and erector spinae (ES) muscles of healthy adults. [Methods] Eleven healthy university students (11 men) with a mean age of 22.8 years were enrolled in this study. Subjects performed supine and prone bridge exercises with the knees flexed using a sling suspension system with and without vibration. The amplitudes of the EMG activities of selected trunk muscles (internal oblique, rectus abdominis, erector spinae, multifidus) were recorded. Two types of exercise conditions were executed in a random sequence for 5 seconds each. The signals detected from the middle 3 seconds (after discarding the signals of the first and the last one seconds) were used in the analysis. A 3-minute break was given after each exercise to minimize muscle fatigue. [Results] During the supine bridge exercise with vibration, the activities of the IO, RA, MF, and ES muscles were significantly higher than those of the supine bridge exercise without vibration. Additionally, during the prone bridge exercise with vibration, the activities of the IO, RA, MF, and ES were significantly higher than those of the prone bridge exercise without vibration. [Conclusion] Sling exercises with vibration improved the trunk muscle activities of healthy adults compared to the sling exercises without vibration. The information presented here is important for clinicians who use lumbar stabilization exercises as an evaluation tool or a rehabilitation exercise. PMID:24259778

  12. 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.

  13. 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.

  14. Effects of performing an abdominal hollowing exercise on trunk muscle activity during curl-up exercise on an unstable surface

    PubMed Central

    Kim, Moon-Hwan; Oh, Jae-Seop

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effects of the abdominal hollowing exercise on trunk muscle activity during the curl-up exercise on an unstable surface by measuring electromyography (EMG) activity. [Subjects] Fourteen young healthy adults (nine male, five female) voluntarily participated in this study. [Methods] Each subject was asked to perform a curl-up exercise on two supporting surfaces (stable and unstable surfaces) combined with the abdominal hollowing exercise on an unstable surface. The muscle activities of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) were measured using surface EMG during performance of the curl-up exercise. [Results] The EMG activity of the RA and EO was significantly higher on an unstable surface than on a stable surface during the curl-up exercise. The EMG activities of the TrA and IO were greater in combination with the abdominal hollowing exercise on an unstable surface than during the curl-up exercise on both a stable and unstable surface. [Conclusion] These findings suggest that the local trunk muscle activity during the curl-up exercise is more strongly affected by combination with the abdominal hollowing exercise than by performance on an unstable supporting surface. PMID:25729202

  15. 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

  16. Active behavior of abdominal wall muscles: Experimental results and numerical model formulation.

    PubMed

    Grasa, J; Sierra, M; Lauzeral, N; Muñoz, M J; Miana-Mena, F J; Calvo, B

    2016-08-01

    In the present study a computational finite element technique is proposed to simulate the mechanical response of muscles in the abdominal wall. This technique considers the active behavior of the tissue taking into account both collagen and muscle fiber directions. In an attempt to obtain the computational response as close as possible to real muscles, the parameters needed to adjust the mathematical formulation were determined from in vitro experimental tests. Experiments were conducted on male New Zealand White rabbits (2047±34g) and the active properties of three different muscles: Rectus Abdominis, External Oblique and multi-layered samples formed by three muscles (External Oblique, Internal Oblique, and Transversus Abdominis) were characterized. The parameters obtained for each muscle were incorporated into a finite strain formulation to simulate active behavior of muscles incorporating the anisotropy of the tissue. The results show the potential of the model to predict the anisotropic behavior of the tissue associated to fibers and how this influences on the strain, stress and generated force during an isometric contraction.

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

    PubMed

    Brown, Stephen H M; Carr, John Austin; Ward, Samuel R; Lieber, Richard L

    2012-08-01

    Abdominal wall muscles have a unique morphology suggesting a complex role in generating and transferring force to the spinal column. Studying passive mechanical properties of these muscles may provide insights into their ability to transfer force among structures. Biopsies from rectus abdominis (RA), external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) were harvested from male Sprague-Dawley rats, and single muscle fibers and fiber bundles (4-8 fibers ensheathed in their connective tissue matrix) were isolated and mechanically stretched in a passive state. Slack sarcomere lengths were measured and elastic moduli were calculated from stress-strain data. Titin molecular mass was also measured from single muscle fibers. No significant differences were found among the four abdominal wall muscles in terms of slack sarcomere length or elastic modulus. Interestingly, across all four muscles, slack sarcomere lengths were quite long in individual muscle fibers (>2.4 µm), and demonstrated a significantly longer slack length in comparison to fiber bundles (p < 0.0001). Also, the extracellular connective tissue matrix provided a stiffening effect and enhanced the resistance to lengthening at long muscle lengths. Titin molecular mass was significantly less in TrA compared to each of the other three muscles (p < 0.0009), but this difference did not correspond to hypothesized differences in stiffness.

  18. 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

  19. 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.

  20. 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. PMID:25879794

  1. Comparison of Abdominal Muscle Thickness with Vaginal Pressure Changes in Healthy Women

    PubMed Central

    Kim, Bo-In; Hwang-Bo, Gak; Kim, Ha-Roo

    2014-01-01

    [Purpose] The purpose of this study was to verify the efficacy of a pelvic floor muscle exercise program by comparing subjects’ muscle thickness with changes in vaginal pressure. [Subjects] Two groups of female participants without a medical history of pelvic floor muscle dysfunction were evaluated. The mean age of Group I was 33.5 years and that of Group II was 49.69 years. [Methods] The participants were instructed to perform a pelvic floor muscle contraction. While measuring the vaginal pressure of the pelvic floor muscle, biofeedback was given on five levels, and the thicknesses of the transversus abdominis, external oblique, and internal oblique muscles were measured with ultrasound. [Results] The thickness of the transversus abdominis muscle was significantly increased at 30 cmH2O in Group I, and at 20 cmH2O in Group II. The thickness of the internal oblique abdominal muscle significantly increased at maximum contraction in Group II. [Conclusion] Different abdominal muscles contracted depending on vaginal pressure. The result may be used to create and implement an exercise program that effectively strengthens the pelvic floor muscles. PMID:24707099

  2. The effects of sling exercise using vibration on trunk muscle activities of healthy adults.

    PubMed

    Choi, Youngin; Kang, Hyungkyu

    2013-10-01

    [Purpose] This study compared the effects of sling exercises with and without vibration on the muscular activity of the internal oblique (IO), rectus abdominis (RA), multifidus (MF), and erector spinae (ES) muscles of healthy adults. [Methods] Eleven healthy university students (11 men) with a mean age of 22.8 years were enrolled in this study. Subjects performed supine and prone bridge exercises with the knees flexed using a sling suspension system with and without vibration. The amplitudes of the EMG activities of selected trunk muscles (internal oblique, rectus abdominis, erector spinae, multifidus) were recorded. Two types of exercise conditions were executed in a random sequence for 5 seconds each. The signals detected from the middle 3 seconds (after discarding the signals of the first and the last one seconds) were used in the analysis. A 3-minute break was given after each exercise to minimize muscle fatigue. [Results] During the supine bridge exercise with vibration, the activities of the IO, RA, MF, and ES muscles were significantly higher than those of the supine bridge exercise without vibration. Additionally, during the prone bridge exercise with vibration, the activities of the IO, RA, MF, and ES were significantly higher than those of the prone bridge exercise without vibration. [Conclusion] Sling exercises with vibration improved the trunk muscle activities of healthy adults compared to the sling exercises without vibration. The information presented here is important for clinicians who use lumbar stabilization exercises as an evaluation tool or a rehabilitation exercise.

  3. Adriaan van den Spiegel (1578-1625): anatomist, physician, and botanist.

    PubMed

    Ghosh, Sanjib Kumar; Sharma, Suranjali; Biswas, Sudipa; Chakraborty, Soumya

    2014-10-01

    Adriaan van den Spiegel (1578-1625) was a Flemish anatomist and physician. He was one of the most prominent anatomists at the University of Padua during the 17th century and became professor of anatomy and surgery there in 1619. He was privileged to have two of the most accomplished anatomists of that period, Fabricius ab Aquapendente and Iulius Casserius, as his teachers. His anatomical works were published after his death by his pupil Bucretius and his son-in-law Liberalis Crema, with illustrations procured from Casserius's unpublished anatomical atlas. He contributed significantly to establishing basic morphological facts about the developing embryo in his text De formato foetu liber singularis. In his book De humani corporis fabrica libri decem, Spiegel's lobe (caudate lobe) of the liver and the linea semilunaris (Spiegel's line) on the lateral side of the rectus abdominis muscle were described for the first time. Subsequently, Spigelian aponeurosis (between the lateral margin of the rectus abdominis and the linea semilunaris) and Spigelian hernia (lateral ventral hernia) were named after him. He was a renowned physician in his time and was the first to give a detailed description of malaria. He made significant contributions as a botanist: the genus Spigelia, which has six species, is named after him.

  4. Comparison of the electromyographic activity of the anterior trunk during the execution of two Pilates exercises - teaser and longspine - for healthy people.

    PubMed

    Dias, Josilainne Marcelino; Menacho, Maryela de Oliveira; Mazuquin, Bruno Fles; Obara, Karen; Mostagi, Fernanda Queiroz Ribeiro Cerci; Lima, Tarcísio Brandão; Moura, Felipe Arruda; Abrão, Taufik; Iversen, Maura Daly; Cardoso, Jefferson Rosa

    2014-10-01

    This study compared abdominal electromyographic (EMG) activity during the performance of Pilates' exercises. 16 females participated in the study. EMG signals of the rectus abdominis (RA) and external oblique (EO) were recorded during Longspine performed on the mat, Cadillac, and Reformer and the Teaser performed on the mat, Cadillac, and Combo-chair. Values were normalized by the EMG peak of a dynamic task and divided in concentric and eccentric phases. Longspine performed on the mat increased EO activity in the concentric phase more than on the Reformer and the Cadillac (Mean Difference (MD)=12.2%; 95% Confidence Interval (CI) [3.36; 21.04]; p=.04). Differences in the eccentric phase of the RA favored the mat compared to the Reformer (MD=5.20%; 95% CI [-0.55; 10.95]; p=.02). Significant differences in eccentric contraction of the RA were found for teaser exercise performed on the mat versus Cadillac (MD=1.1%; 95% CI [-4.13; 6.33]; p=.04) and the mat versus the Combo-chair (MD=6.3%; 95% CI [1.31; 11.29]; p=.005). Higher concentric activation values for the EO were found when the teaser exercise was performed on the Cadillac. Exercises performed on the mat required greater rectus abdominis activation. PMID:25048643

  5. Core Muscle Activity during TRX Suspension Exercises with and without Kinesiology Taping in Adults with Chronic Low Back Pain: Implications for Rehabilitation.

    PubMed

    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.

  6. 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.

  7. 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).

  8. Antagonism between MyD88- and TRIF-dependent signals in B7RP-1 up-regulation.

    PubMed

    Zhou, Zuping; Hoebe, Kasper; Du, Xin; Jiang, Zhengfan; Shamel, Louis; Beutler, Bruce

    2005-06-01

    Type I interferons (IFN) play a critical role in the Toll-like receptor (TLR)-mediated expression of B7 costimulatory family members. For example, LPS-induced up-regulation of CD80 (B7.1) and CD86 (B7.2) is abrogated in antigen-presenting cells (APC) deficient in TRIF or TRAM, two adaptors that are responsible for TLR4-mediated production of Type I IFN. In this report, we demonstrate that LPS-induced up-regulation of B7-related protein 1 (B7RP-1), a ligand for ICOS, is dependent primarily upon the MyD88-dependent signaling pathway. Signaling via the TRIF pathway sharply limits MyD88-dependent B7RP-1 up-regulation. Hence, LPS induces significantly higher B7RP-1 expression on TRIF- or TRAM-deficient mouse peritoneal macrophages and on TRIF-deficient mouse splenic B cells as compared to wild-type cells. Further studies reveal that Type I IFN are general suppressors of TLR-mediated up-regulation of B7RP-1. These data indicate that Type I IFN play a dual role in the TLR-mediated expression of B7 costimulatory family members and suggest that they may act to limit B7RP-1 expression and thus limit signals derived from B7RP-1-ICOS interaction.

  9. The Immunohistochemical Evaluation of Solid Pseudopapillary Tumors of the Pancreas and Pancreatic Neuroendocrine Tumors Reveals ERO1Lβ as a New Biomarker.

    PubMed

    Xie, Junjie; Zhu, Yi; Chen, Hao; Shi, Minmin; Gu, Jiangning; Zhang, Jiaqiang; Shen, Baiyong; Deng, Xiaxing; Zhan, Xi; Peng, Chenghong

    2016-01-01

    Solid pseudopapillary tumor of the pancreas (SPTP) is a class of low-grade malignant tumors that carry a favorable prognosis after surgery. Our group has reported that dysfunctions in the endoplasmic reticulum (ER) protein processing pathway may play a role in tumor development. However, alterations of this pathway in other pancreatic tumors had not been well investigated. In this study, we collected 35 SPTP and pancreatic neuroendocrine tumor (PNET) specimens and described the clinicopathological features of them. We performed immunohistochemistry (IHC) for 6 representative proteins (ERO1Lβ, TRAM1, GRP94, BIP, P4HB, and PDIA4) involved in the ER pathway in both SPTP and PNET specimens. We compared the IHC scoring results of tumors and matched normal pancreas tissues and demonstrated that these proteins were downregulated in SPTP specimens. Five of these proteins (TRAM1, GRP94, BIP, P4HB, and PDIA4) did not display significant changes between PNET and normal pancreas tissue. However, ERO1Lβ was upregulated in PNET tissues compared to the normal tissues, which could be used as a pathological biomarker in the future.

  10. [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. PMID:26490068

  11. Hyperspectral Study of the Arctic Tundra Ecosystem Using an Automated Robotic Cart System

    NASA Astrophysics Data System (ADS)

    Goswami, S.; Gamon, J. A.; Houser, P.; Matharasi, K.; Tweedie, C. E.

    2007-12-01

    Our study in the NSF Biocomplexity project is carried on by collecting spectral data with the help of an automated robotic tram system over the drying arctic lake bed. The robotic cart samples three 300 meter long transects spread across the lake basin automatically, taking reflectance measurements at each meter using a dual detector spectrometer designed to correct for changing sky conditions. Surface reflectance data were collected for three consecutive years for 2005, 2006 and 2007 as part of the project, which provides a baseline dataset of surface conditions. Three spectral indices, Normalized Difference Vegetation Index (NDVI), a measure of vegetation 'greenness', the Photochemical Reflectance Index (PRI), a measure of carotenoid pigment levels, and the Water Band Index (WBI), a measure of vegetation moisture content, are calculated from the optical data collected to study the surface conditions of the lakebed. Comparison of three years NDVI data showed different greenness conditions of the surface. Peak season NDVI values were the lowest in 2005 compared to 2006 and 2007. WBI values for the two dry years 2005 and 2007 were similar for all the tramlines except for the beginning of the season. PRI values for the two dry years 2005 and 2007 had similar trends for all the tramlines except for the beginning of the season. This tram system along with the cyberinfrastucture tools that we are developing gives us the opportunity for developing a technology to the next level to facilitate the research in the field of environmental science and terrestrial ecology.

  12. Evidence in favor of a calcium-sensing receptor in arterial endothelial cells: studies with calindol and Calhex 231.

    PubMed

    Weston, Arthur H; Absi, Mais; Ward, Donald T; Ohanian, Jacqueline; Dodd, Robert H; Dauban, Philippe; Petrel, Christophe; Ruat, Martial; Edwards, Gillian

    2005-08-19

    Small increases in extracellular Ca2+ dilate isolated blood vessels. In the present study, the possibility that a vascular, extracellular Ca2+-sensing receptor (CaSR) could mediate these vasodilator actions was investigated. Novel ligands that interact with the CaSR were used in microelectrode recordings from rat isolated mesenteric and porcine coronary arteries. The major findings were that (1) raising extracellular Ca2+ or adding calindol, a CaSR agonist, produced concentration-dependent hyperpolarizations of vascular myocytes, actions attenuated by Calhex 231, a negative allosteric modulator of CaSR. (2) Calindol-induced hyperpolarizations were inhibited by the intermediate conductance, Ca2+-sensitive K+ (IKCa) channel inhibitors, TRAM-34, and TRAM-39. (3) The effects of calindol were not observed in the absence of endothelium. (4) CaSR mRNA and protein were present in rat mesenteric arteries and in porcine coronary artery endothelial cells. (5) CaSR and IKCa proteins were restricted to caveolin-poor membrane fractions. We conclude that activation of vascular endothelial CaSRs opens endothelial cell IKCa channels with subsequent myocyte hyperpolarization. The endothelial cell CaSR may have a physiological role in the control of arterial blood pressure. PMID:16037572

  13. 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.

  14. Molecular and structural analysis of Legionella DotI gives insights into an inner membrane complex essential for type IV secretion

    PubMed Central

    Kuroda, Takuya; Kubori, Tomoko; Thanh Bui, Xuan; Hyakutake, Akihiro; Uchida, Yumiko; Imada, Katsumi; Nagai, Hiroki

    2015-01-01

    The human pathogen Legionella pneumophila delivers a large array of the effector proteins into host cells using the Dot/Icm type IVB secretion system. Among the proteins composing the Dot/Icm system, an inner membrane protein DotI is known to be crucial for the secretion function but its structure and role in type IV secretion had not been elucidated. We report here the crystal structures of the periplasmic domains of DotI and its ortholog in the conjugation system of plasmid R64, TraM. These structures reveal a striking similarity to VirB8, a component of type IVA secretion systems, suggesting that DotI/TraM is the type IVB counterpart of VirB8. We further show that DotI and its partial paralog DotJ form a stable heterocomplex. R64 TraM, encoded by the conjugative plasmid lacking DotJ ortholog, forms a homo-hexamer. The DotI-DotJ complex is distinct from the core complex, which spans both inner and outer membranes to form a substrate conduit, and seems not to stably associate with the core complex. These results give insight into VirB8-family inner membrane proteins essential for type IV secretion and aid towards understanding the molecular basis of secretion systems essential for bacterial pathogenesis. PMID:26039110

  15. Amplification characteristics of a cryogenic Yb³⁺:YAG total-reflection active-mirror laser.

    PubMed

    Furuse, Hiroaki; Sakurai, Toshimitsu; Chosrowjan, Haik; Kawanaka, Junji; Miyanaga, Noriaki; Fujita, Masayuki; Ishii, Shinya; Izawa, Yasukazu

    2014-03-20

    We have studied the amplification characteristics of a cryogenically cooled Yb³⁺:YAG total-reflection active-mirror (TRAM) ceramic laser including wavefront distortion, birefringence loss, small signal gain (SSG), and temperature rise for developing high-performance master oscillator power amplifier (MOPA) systems. A 0.6 mm thick Yb³⁺:YAG ceramic sample was used, and maximum pump intensity ~10  kW/cm² was reached. The transmitted wavefront was measured by using a Shack-Hartmann wavefront sensor, and we evaluated the thermal lens focal length and Strehl ratio for different pump conditions. We have also observed a butterfly-like leakage profile of thermally induced birefringence loss at the maximum pump intensity. From SSG measurements, we obtained moderate laser gain of G=3 for one bounce with a near aberration-free wavefront. Gain calculations, which included also temperature dependence of the emission cross section and reabsorption of Yb³⁺:YAG, were in good agreement with the experiments. These experimental results will be useful as benchmark data for numerical simulations of temperature distribution in TRAM and for designing multikilowatt-class high-performance MOPA systems.

  16. 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.

  17. Activation of K+ channel by 1-EBIO rescues the head and neck squamous cell carcinoma cells from Ca2+ ionophore-induced cell death

    PubMed Central

    Yin, Ming Zhe; Park, Seok-Woo; Kang, Tae Wook; Kim, Kyung Soo; Yoo, Hae Young; Lee, Junho; Hah, J. Hun; Sung, Myung Hun

    2016-01-01

    Ion channels in carcinoma and their roles in cell proliferation are drawing attention. Intracellular Ca2+ ([Ca2+]i)-dependent signaling affects the fate of cancer cells. Here we investigate the role of Ca2+-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 Ca2+-activated Cl- channels (Ano-1) and Ca2+-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 Ca2+ overloaded condition. Pharmacological modulation of SK4 might provide an intriguing novel tool for the anti-cancer strategy in HNSCC. PMID:26807020

  18. 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

  19. Selective visual processing across competition episodes: a theory of task-driven visual attention and working memory

    PubMed Central

    Schneider, Werner X.

    2013-01-01

    The goal of this review is to introduce a theory of task-driven visual attention and working memory (TRAM). Based on a specific biased competition model, the ‘theory of visual attention’ (TVA) and its neural interpretation (NTVA), TRAM introduces the following assumption. First, selective visual processing over time is structured in competition episodes. Within an episode, that is, during its first two phases, a limited number of proto-objects are competitively encoded—modulated by the current task—in activation-based visual working memory (VWM). In processing phase 3, relevant VWM objects are transferred via a short-term consolidation into passive VWM. Second, each time attentional priorities change (e.g. after an eye movement), a new competition episode is initiated. Third, if a phase 3 VWM process (e.g. short-term consolidation) is not finished, whereas a new episode is called, a protective maintenance process allows its completion. After a VWM object change, its protective maintenance process is followed by an encapsulation of the VWM object causing attentional resource costs in trailing competition episodes. Viewed from this perspective, a new explanation of key findings of the attentional blink will be offered. Finally, a new suggestion will be made as to how VWM items might interact with visual search processes. PMID:24018722

  20. K+ channel expression during B cell differentiation: implications for immunomodulation and autoimmunity.

    PubMed

    Wulff, Heike; Knaus, Hans-Günther; Pennington, Michael; Chandy, K George

    2004-07-15

    Using whole-cell patch-clamp, fluorescence microscopy and flow cytometry, we demonstrate a switch in potassium channel expression during differentiation of human B cells from naive to memory cells. Naive and IgD(+)CD27(+) memory B cells express small numbers of the voltage-gated Kv1.3 and the Ca(2+)-activated intermediate-conductance IKCa1 channel when quiescent, and increase IKCa1 expression 45-fold upon activation with no change in Kv1.3 levels. In contrast, quiescent class-switched memory B cells express high levels of Kv1.3 ( approximately 2000 channels/cell) and maintain their Kv1.3(high) expression after activation. Consistent with their channel phenotypes, proliferation of naive and IgD(+)CD27(+) memory B cells is suppressed by the specific IKCa1 inhibitor TRAM-34 but not by the potent Kv1.3 blocker Stichodactyla helianthus toxin, whereas the proliferation of class-switched memory B cells is suppressed by Stichodactyla helianthus toxin but not TRAM-34. These changes parallel those reported for T cells. Therefore, specific Kv1.3 and IKCa1 inhibitors may have use in therapeutic manipulation of selective lymphocyte subsets in immunological disorders. PMID:15240664

  1. 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.

  2. Selective visual processing across competition episodes: a theory of task-driven visual attention and working memory.

    PubMed

    Schneider, Werner X

    2013-10-19

    The goal of this review is to introduce a theory of task-driven visual attention and working memory (TRAM). Based on a specific biased competition model, the 'theory of visual attention' (TVA) and its neural interpretation (NTVA), TRAM introduces the following assumption. First, selective visual processing over time is structured in competition episodes. Within an episode, that is, during its first two phases, a limited number of proto-objects are competitively encoded-modulated by the current task-in activation-based visual working memory (VWM). In processing phase 3, relevant VWM objects are transferred via a short-term consolidation into passive VWM. Second, each time attentional priorities change (e.g. after an eye movement), a new competition episode is initiated. Third, if a phase 3 VWM process (e.g. short-term consolidation) is not finished, whereas a new episode is called, a protective maintenance process allows its completion. After a VWM object change, its protective maintenance process is followed by an encapsulation of the VWM object causing attentional resource costs in trailing competition episodes. Viewed from this perspective, a new explanation of key findings of the attentional blink will be offered. Finally, a new suggestion will be made as to how VWM items might interact with visual search processes. PMID:24018722

  3. Dorsal Penile Nerve Block With Ropivacaine-Reduced Postoperative Catheter-Related Bladder Discomfort in Male Patients After Emergence of General Anesthesia

    PubMed Central

    Li, Jing-yi; Yi, Ming-liang; Liao, Ren

    2016-01-01

    Abstract Catheter-related bladder discomfort (CRBD) is a distressing symptom complex after surgery, especially in male patients who have had urinary catheterization under general anesthesia. In this prospective, randomized, controlled trial, we compared dorsal penile nerve block (DPNB) with 0.33% ropivacaine with intravenous tramadol 1.5 mg kg−1 in prevention of CRBD, as well as the incidences of postoperative side effects. Fifty-eight male patients aged 18 to 50 years, undergoing elective liver surgery and limb surgery with urinary catheterization, were enrolled and divided randomly into 2 groups. In the DPNB group, patients were given dorsal penile nerve block with 15 mL of 0.33% ropivacaine, and in the tramadol intravenous administration (TRAM) group, patients were given 1.5 mg kg−1 tramadol after the completion of surgery before extubation. The primary outcome was the incidence of CRBD, and the secondary outcomes included the severity of CRBD, postoperative side effects, postoperative pain, and the acceptance of urinary catheterization. Patients were evaluated upon arrival to postanesthetic care unit (PACU), at 0.5, 1, 2, 4, and 6 hours after patients’ arrival in the PACU for outcomes. The incidence of CRBD was significantly lower in the DPNB group than in the TRAM group, either upon arrival to PACU (10.3% vs 37.9%, P = 0.015), or at 0.5 hours (3.4% vs 34.5%, P = 0.003), 1 hours (3.4% vs 37.9%, P = 0.001), 2 hours (6.9% vs 34.5%, P = 0.010), and 4 hours (6.9% vs 27.6%, P = 0.039) after patients’ arrival in PACU. Compared with the TRAM group, the severity of postoperative CRBD upon arrival to PACU (P = 0.011) and at 0.5 hours (P = 0.005), 1 hours (P = 0.002), 2 hours (P = 0.005), 4 hours (P = 0.017), and 6 hours (P = 0.047) after patients’ arrival in PACU were all significantly reduced in the DPNB group. The incidences of postoperative nausea, vomiting, dizziness, and sedation

  4. TRIF mediates Toll-like receptor 5-induced signaling in intestinal epithelial cells.

    PubMed

    Choi, Yoon Jeong; Im, Eunok; Chung, Hyo Kyun; Pothoulakis, Charalabos; Rhee, Sang Hoon

    2010-11-26

    Toll-like receptors (TLRs) associate with adaptor molecules (MyD88, Mal/TIRAP, TRAM, and TRIF) to mediate signaling of host-microbial interaction. For instance, TLR4 utilizes the combination of both Mal/TIRAP-MyD88 (MyD88-dependent pathway) and TRAM-TRIF (MyD88-independent pathway). However, TLR5, the specific receptor for flagellin, is known to utilize only MyD88 to elicit inflammatory responses, and an involvement of other adaptor molecules has not been suggested in TLR5-dependent signaling. Here, we found that TRIF is involved in mediating TLR5-induced nuclear factor κB (NFκB) and mitogen-activated protein kinases (MAPKs), specifically JNK1/2 and ERK1/2, activation in intestinal epithelial cells. TLR5 activation by flagellin permits the physical interaction between TLR5 and TRIF in human colonic epithelial cells (NCM460), whereas TLR5 does not interact with TRAM upon flagellin stimulation. Both primary intestinal epithelial cells from TRIF-KO mice and TRIF-silenced NCM460 cells significantly reduced flagellin-induced NFκB (p105 and p65), JNK1/2, and ERK1/2 activation compared with control cells. However, p38 activation by flagellin was preserved in these TRIF-deficient cells. TRIF-KO intestinal epithelial cells exhibited substantially reduced inflammatory cytokine (keratinocyte-derived cytokine, macrophage inflammatory protein 3α, and IL-6) expression upon flagellin, whereas control cells from TRIF-WT mice showed robust cytokine expression by flagellin. Compare with TRIF-WT mice, TRIF-KO mice were resistant to in vivo intestinal inflammatory responses: flagellin-mediated exacerbation of colonic inflammation and dextran sulfate sodium-induced experimental colitis. We conclude that in addition to MyD88, TRIF mediates TLR5-dependent responses and, thereby regulates inflammatory responses elicited by flagellin/TLR5 engagement. Our findings suggest an important role of TRIF in regulating host-microbial communication via TLR5 in the gut epithelium.

  5. Understanding the role of soil erosion on co2-c loss using (13)c isotopic signatures in abandoned Mediterranean agricultural land.

    PubMed

    Novara, Agata; Keesstra, Saskia; Cerdà, Artemio; Pereira, Paulo; Gristina, Luciano

    2016-04-15

    Understanding soil water erosion processes is essential to evaluate the redistribution of soil organic carbon (SOC) within a landscape and is fundamental to assess the role of soil erosion in the global carbon (C) budget. The main aim of this study was to estimate the C redistribution and losses using (13)C natural abundance. Carbon losses in soil sediment, dissolved organic carbon (DOC) and CO2 emission were determined. Four bounded parallel plots were installed on a 10% slope. In the upper part of the plots, C3soil was replaced with C4soil. The SOC and δ(13)C were measured after 145.2mm rainfall in the upper (2m far from C4strip), middle (4m far from C4strip) lower (6m far from C4strip) trams of the plot and in the sediments collected in the Gerlach collector at the lower part of the plot. A laboratory incubation experiment was performed to evaluate the CO2 emission rate of soils in each area. OC was mainly lost in the sediments as 2.08g(-)(2) of C was lost after 145.2mm rainfall. DOC losses were only 5.61% of off-site OC loss. Three months after the beginning of the experiment, 15.90% of SOC in the upper tram of the plot had a C4 origin. The C4-SOC content decreased along the 6m length of the plot, and in the sediments collected by the Gerlach collector. CO2 emission rate was high in the upper plot tram due to the high SOC content. The discrimination of CO2 in C3 and C4 portion permitted to increase our level of understanding on the stability of SOC and its resilience to decomposition. The transport of sediments along the plot increased SOC mineralization by 43%. Our study underlined the impact of rainfall in C losses in soil and water in abandoned Mediterranean agriculture fields and the consequent implications on the C balance.

  6. 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.

  7. 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.

  8. Understanding the role of soil erosion on co2-c loss using (13)c isotopic signatures in abandoned Mediterranean agricultural land.

    PubMed

    Novara, Agata; Keesstra, Saskia; Cerdà, Artemio; Pereira, Paulo; Gristina, Luciano

    2016-04-15

    Understanding soil water erosion processes is essential to evaluate the redistribution of soil organic carbon (SOC) within a landscape and is fundamental to assess the role of soil erosion in the global carbon (C) budget. The main aim of this study was to estimate the C redistribution and losses using (13)C natural abundance. Carbon losses in soil sediment, dissolved organic carbon (DOC) and CO2 emission were determined. Four bounded parallel plots were installed on a 10% slope. In the upper part of the plots, C3soil was replaced with C4soil. The SOC and δ(13)C were measured after 145.2mm rainfall in the upper (2m far from C4strip), middle (4m far from C4strip) lower (6m far from C4strip) trams of the plot and in the sediments collected in the Gerlach collector at the lower part of the plot. A laboratory incubation experiment was performed to evaluate the CO2 emission rate of soils in each area. OC was mainly lost in the sediments as 2.08g(-)(2) of C was lost after 145.2mm rainfall. DOC losses were only 5.61% of off-site OC loss. Three months after the beginning of the experiment, 15.90% of SOC in the upper tram of the plot had a C4 origin. The C4-SOC content decreased along the 6m length of the plot, and in the sediments collected by the Gerlach collector. CO2 emission rate was high in the upper plot tram due to the high SOC content. The discrimination of CO2 in C3 and C4 portion permitted to increase our level of understanding on the stability of SOC and its resilience to decomposition. The transport of sediments along the plot increased SOC mineralization by 43%. Our study underlined the impact of rainfall in C losses in soil and water in abandoned Mediterranean agriculture fields and the consequent implications on the C balance. PMID:26820936

  9. 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 Central

    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. PMID:25642098

  10. A microcalorimetric study of the sodium-potassium-pump and thermogenesis in human skeletal muscle.

    PubMed

    Fagher, B; Sjögren, A; Monti, M

    1987-11-01

    Thermogenesis in human skeletal muscle was monitored by measurement of heat production using perfusion microcalorimetry. Heat production significantly correlated with relative body weight. The energy expenditure of the Na-K-pump (delta P), assessed after inhibition by ouabain in Krebs-Ringer phosphate buffer containing glucose and insulin, amounted to 6% of the total heat production in vastus lateralis muscle. Muscle potassium positively correlated with delta P (r = 0.84, P less than 0.005). For rectus abdominis muscle delta P was 8-15%; 95% confidence interval for the difference was 3-5% when comparison was made with vastus lateralis. The finding of a positive relationship between delta P and muscle magnesium (r = 0.68, P less than 0.04) is possibly explained by the dependence of ATP hydrolysis on internal magnesium. Our data on resting thermogenesis in small muscle samples agree to previous estimates of O2 consumption in human skeletal muscle in vivo.

  11. Core Stabilization Exercise Prescription, Part I

    PubMed Central

    Brumitt, Jason; Matheson, J. W.; Meira, Erik P.

    2013-01-01

    Context: Injury to the low back can cause significant pain and dysfunction, which can affect an athlete’s performance and result in time lost from sport. A common conservative treatment is therapeutic core stabilization exercises, which can address pain and musculoskeletal dysfunction in patients with low back pathology. Evidence Acquisition: MEDLINE and CINAHL were searched (from 1966 to March 2013) to identify relevant research. Keywords and keyword combinations searched included motor control exercise, segmental stabilization, core stabilization, transversus abdominis, multifidi, and low back pain. Results: There are 2 popular rehabilitation strategies to assess core function and promote core stabilization. Each has been developed based on biomechanical models of lumbar segmental stability and observed motor control dysfunction in patients with low back pain. Conclusion: Controversy exists among clinical and research groups as to the optimal strategy for an athlete with low back pain. PMID:24427424

  12. 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

  13. Functional anatomy of the trunk musculature in the slow loris (Nycticebus coucang).

    PubMed

    Curtis, D J

    1995-08-01

    Lorisid locomotor and postural behaviour exhibits a number of features that distinguish it clearly from other primates. The comparative myological study of the trunk in the slow loris (Nycticebus coucang) and the squirrel monkey (Saimiri sp.) presented here reveals differences that are related to unique aspects of lorisid positional behaviour. While quadrupedal running and leaping requires flexion and extension of the spine, slow climbing quadrupedalism in lorisids depends on spinal lateral flexion and rotation. The contrasting development of the epaxial musculature in the two species dissected reflects these different requirements. Bipedal suspension is a common posture in the lorisids during which rotation and dorsiflexion of the head is made possible by the robustly developed deep, dorsal, cervical musculature. The long lower lever arm in the M. rectus abdominis may play a significant role in the ventroflexion required to regain a quadrupedal stance.

  14. 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

  15. 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

  16. Breeds and muscle types modulate performance of near-infrared reflectance spectroscopy to predict the fatty acid composition of bovine meat.

    PubMed

    Mourot, B P; Gruffat, D; Durand, D; Chesneau, G; Mairesse, G; Andueza, D

    2015-01-01

    This study aims to assess near-infrared reflectance spectroscopy feasibility for predicting beef fatty acid (FA) composition. Experimental scheme included four breeds (Angus, Blond d'Aquitaine, Charolais, Limousin) and three muscles, Longissimus thoracis (LT), Rectus abdominis (RA), Semitendinosus (ST). The results showed that 1) increasing FA content variability with several breeds increased calibration model reliability (R(2)CV>0.86) for the major individual and groups of FA unless polyunsaturated FAs, 2) Longissimus thoracis FAs were better predicted than RA FAs while no ST FAs were correctly predicted (R(2)CV<0.71). This difference could be explained by FA content, FA variability or specific muscle physico-chemical characteristics.

  17. 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.

  18. Assessing viability of extracorporeal preserved muscle transplants using external field stimulation: a novel tool to improve methods prolonging bridge-to-transplantation time.

    PubMed

    Taeger, Christian D; Friedrich, Oliver; Dragu, Adrian; Weigand, Annika; Hobe, Frieder; Drechsler, Caroline; Geppert, Carol I; Arkudas, Andreas; Münch, Frank; Buchholz, Rainer; Pollmann, Charlotte; Schramm, Axel; Birkholz, Torsten; Horch, Raymund E; Präbst, Konstantin

    2015-01-01

    Preventing ischemia-related cell damage is a priority when preserving tissue for transplantation. Perfusion protocols have been established for a variety of applications and proven to be superior to procedures used in clinical routine. Extracorporeal perfusion of muscle tissue though cumbersome is highly desirable since it is highly susceptible to ischemia-related damage. To show the efficacy of different perfusion protocols external field stimulation can be used to immediately visualize improvement or deterioration of the tissue during active and running perfusion protocols. This method has been used to show the superiority of extracorporeal perfusion using porcine rectus abdominis muscles perfused with heparinized saline solution. Perfused muscles showed statistically significant higher ability to exert force compared to nonperfused ones. These findings can be confirmed using Annexin V as marker for cell damage, perfusion of muscle tissue limits damage significantly compared to nonperfused tissue. The combination of extracorporeal perfusion and external field stimulation may improve organ conservation research. PMID:26145230

  19. 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

  20. 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.

  1. 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.

  2. [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.

  3. [Tissue equivalent for the closure of extended urethral defects].

    PubMed

    Milanov, N O; Adamian, R T; Rogovaia, O S; Vasil'ev, A V; Zhidkov, I L; Lipskiĭ, K B; Guliaev, I V; Suvorov, N A; Tagabilev, D G; Kiselev, I V; Terskikh, V V

    2011-01-01

    The aim of the present work was to develop a method for culturing epidermal keratinocytes to be used in a tissue equivalent for the closure of extended urethral defects. The experiment was carried out using 15 rabbits. Skin biopsies were obtained from the inner surface of the ear. The tissue equivalent consisted of collagen gel with embedded fibroblasts and epidermal keratinocytes grown on its surface; lavsan-mesh endoprosthesis served as the framework. Prefabrication of the neourethral plate was performed on the superficial fascia of m. rectus abdominis. The neourethral tube was formed after engraftment which was complete in all 15 animals. A histological study revealed morphological similarity of the neourethral tube thus engineered and the normal urethra.

  4. A case of gastropericardial fistula of a gastric tube after esophagectomy: a case report and review

    PubMed Central

    2010-01-01

    A 65-year-old man who had received an esophagectomy 10 years earlier was admitted to our hospital for right chest pain. Preoperative examinations showed pneumopericardium, a retrosternal gastric tube, and an active gastric tube ulcer. We diagnosed gastropericardial fistula of the gastric tube ulcer. Emergency surgery included lavage and drainage of the pericardial cavity and plombage of the rectus abdominis muscle flap to the posterior space of the gastric tube. Total parental nutrition and/or enteric nutrition were provided. Due to minor leakage from the ulcer, the patient could start oral intake on the postoperative 49th day, and was discharged from the hospital on the postoperative 86th day after physical rehabilitation. He has been free from complications for more than 33 months after surgery. Here, we review the literature and discuss the etiology and treatment of choice for this rare yet lethal complication in the follow-up after esophagectomy. PMID:20663167

  5. Excellent postoperative analgesia with the addition of hyaluronidase to lignocaine for subcostal TAP block used in conjunction with systemic analgesia for laparoscopic cholecystectomy

    PubMed Central

    Johnson, Mark Zachary; O'Connor, Therese C

    2014-01-01

    Subcostal transversus abdominis plane (TAP) blocks provide good postoperative analgesia for laparoscopic cholecystectomies. We hypothesised that adding hyaluronidase may improve the efficacy of this technique by increasing spread of the local anaesthetic (LA). In this case, we performed a bilateral ultrasound-guided subcostal TAP block using lignocaine (40 mL 1%) with hyaluronidase (75 IU/mL) for postoperative analgesia following elective laparoscopic cholecystectomy. It was used in combination with intraoperative morphine, diclofenac and paracetamol. Regular paracetamol was administered postoperatively. We monitored serial serum lignocaine levels and recorded the patient's visual analogue scale (VAS) pain scores postoperatively. We found that the patient experienced excellent analgesia throughout the postoperative period and that the serum lignocaine levels did not exceed the therapeutic range. PMID:24510699

  6. 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

  7. Delayed torrential haemorrhage after firearm injury

    PubMed Central

    Kumar, Pankaj; Singhal, Maneesh; Sagar, Sushma; Gupta, Amit

    2014-01-01

    A 30-year-old man was referred to us after 48 days of gunshot injury to left groin, with torrential bleeding from a pseudoaneurysm of the left external iliac artery. He was successfully managed with a team of specialists involving trauma surgeon, vascular and plastic surgeon, general surgeons and intervention radiologist with the help of critical care specialists. He required judicious debridement, a transverse rectus abdominis musculocutaneous flap, stenting of the external iliac artery, repair of the external iliac vein and ligation of the bilateral internal iliac artery. He had prolonged intensive care unit stay with open abdomen requiring specialised care. Errors in regular assessment of patient by clinical and radiological examination along with failure in early adequate debridement were responsible for trauma suffered by him. Though it is a rare injury, these devastating complications can occur after any gunshot injury and proper management guidelines must be established. PMID:24810442

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. The BTB domains of the potassium channel tetramerization domain proteins prevalently assume pentameric states.

    PubMed

    Smaldone, Giovanni; Pirone, Luciano; Pedone, Emilia; Marlovits, Thomas; Vitagliano, Luigi; Ciccarelli, Luciano

    2016-06-01

    Potassium channel tetramerization domain-containing (KCTD) proteins are involved in fundamental physio-pathological processes. Here, we report an analysis of the oligomeric state of the Bric-à-brack, Tram-track, Broad complex (BTB) domains of seven distinct KCTDs belonging to five major clades of the family evolution tree. Despite their functional and sequence variability, present electron microscopy data highlight the occurrence of well-defined pentameric states for all domains. Our data also show that these states coexist with alternative forms which include open pentamers. Thermal denaturation analyses conducted using KCTD1 as a model suggest that, in these proteins, different domains cooperate to their overall stability. Finally, negative-stain electron micrographs of KCTD6(BTB) in complex with Cullin3 show the presence of assemblies with a five-pointed pinwheel shape. PMID:27152988

  14. 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.

  15. Intra-Individual Variability of Surface Electromyography in Front Crawl Swimming.

    PubMed

    Martens, Jonas; Daly, Daniel; Deschamps, Kevin; Fernandes, Ricardo Jorge Pinto; Staes, Filip

    2015-01-01

    The variability of electromyographic (EMG) recordings between and within participants is a complex problem, rarely studied in swimming. The importance of signal normalization has long been recognized, but the method used might influence variability. The aims of this study were to: (i) assess the intra-individual variability of the EMG signal in highly skilled front crawl swimmers, (ii) determine the influence of two methods of both amplitude and time normalization of the EMG signal on intra-individual variability and of time normalization on muscle activity level and (iii) describe the muscle activity, normalized using MVIC, in relation to upper limb crawl stroke movements. Muscle activity of rectus abdominis and deltoideus medialis was recorded using wireless surface EMG in 15 adult male competitive swimmers during three trials of 12.5 m front crawl at maximal speed without breathing. Two full upper limb cycles were analyzed from each of the swimming trials, resulting in six full cycles used for the intra-individual variability assessment, quantified with the coefficient of variation (CV), coefficient of quartile variation (CQV) and the variance ratio (VR). The results of this study support previous findings on EMG patterns of deltoideus medialis and rectus abdominis as prime mover during the recovery (45% activity relative to MVIC), and stabilizer of the trunk during the pull (14.5% activity) respectively. The intra-individual variability was lower (VR of 0.34-0.47) when compared to other cyclic movements. No meaningful differences were found between variability measures CV or VR when applying either of the amplitude or the time normalization methods. In addition to reporting the mean amplitude and standard deviation, future EMG studies in swimming should also report the intra-individual variability, preferably using VR as it is independent of peak amplitude, provides a good measure of repeatability and is insensitive to mean EMG amplitude and the degree of

  16. Effects of replacing free weights with elastic band resistance in squats on trunk muscle activation.

    PubMed

    Saeterbakken, Atle H; Andersen, Vidar; Kolnes, Maria K; Fimland, Marius S

    2014-11-01

    The purpose of this study was to assess the effects of adding elastic bands to free-weight squats on the neuromuscular activation of core muscles. Twenty-five resistance trained women with 4.6 ± 2.1 years of resistance training experience participated in the study. In randomized order, the participants performed 6 repetition maximum in free-weight squats, with and without elastic bands (i.e., matched relative intensity between exercises). During free-weight squats with elastic bands, some of the free weights were replaced with 2 elastic bands attached to the lowest part of the squat rack. Surface electromyography (EMG) activity was measured from the erector spinae, external oblique, and rectus abdominis, whereas a linear encoder measured the vertical displacement. The EMG activities were compared between the 2 lifting modalities for the whole repetition and separately for the eccentric, concentric, and upper and lower eccentric and concentric phases. In the upper (greatest stretch of the elastic band), middle, and lower positions in squats with elastic bands, the resistance values were approximately 117, 105, and 93% of the free weight-only trial. Similar EMG activities were observed for the 2 lifting modalities for the erector spinae (p = 0.112-0.782), external oblique (p = 0.225-0.977), and rectus abdominis (p = 0.315-0.729) in all analyzed phases. In conclusion, there were no effects on the muscle activity of trunk muscles of substituting some resistance from free weights with elastic bands in the free-weight squat.

  17. 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

  18. 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

  19. Intra-Individual Variability of Surface Electromyography in Front Crawl Swimming.

    PubMed

    Martens, Jonas; Daly, Daniel; Deschamps, Kevin; Fernandes, Ricardo Jorge Pinto; Staes, Filip

    2015-01-01

    The variability of electromyographic (EMG) recordings between and within participants is a complex problem, rarely studied in swimming. The importance of signal normalization has long been recognized, but the method used might influence variability. The aims of this study were to: (i) assess the intra-individual variability of the EMG signal in highly skilled front crawl swimmers, (ii) determine the influence of two methods of both amplitude and time normalization of the EMG signal on intra-individual variability and of time normalization on muscle activity level and (iii) describe the muscle activity, normalized using MVIC, in relation to upper limb crawl stroke movements. Muscle activity of rectus abdominis and deltoideus medialis was recorded using wireless surface EMG in 15 adult male competitive swimmers during three trials of 12.5 m front crawl at maximal speed without breathing. Two full upper limb cycles were analyzed from each of the swimming trials, resulting in six full cycles used for the intra-individual variability assessment, quantified with the coefficient of variation (CV), coefficient of quartile variation (CQV) and the variance ratio (VR). The results of this study support previous findings on EMG patterns of deltoideus medialis and rectus abdominis as prime mover during the recovery (45% activity relative to MVIC), and stabilizer of the trunk during the pull (14.5% activity) respectively. The intra-individual variability was lower (VR of 0.34-0.47) when compared to other cyclic movements. No meaningful differences were found between variability measures CV or VR when applying either of the amplitude or the time normalization methods. In addition to reporting the mean amplitude and standard deviation, future EMG studies in swimming should also report the intra-individual variability, preferably using VR as it is independent of peak amplitude, provides a good measure of repeatability and is insensitive to mean EMG amplitude and the degree of

  20. 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

  1. Intra-Individual Variability of Surface Electromyography in Front Crawl Swimming

    PubMed Central

    Martens, Jonas; Daly, Daniel; Deschamps, Kevin; Fernandes, Ricardo Jorge Pinto; Staes, Filip

    2015-01-01

    The variability of electromyographic (EMG) recordings between and within participants is a complex problem, rarely studied in swimming. The importance of signal normalization has long been recognized, but the method used might influence variability. The aims of this study were to: (i) assess the intra-individual variability of the EMG signal in highly skilled front crawl swimmers, (ii) determine the influence of two methods of both amplitude and time normalization of the EMG signal on intra-individual variability and of time normalization on muscle activity level and (iii) describe the muscle activity, normalized using MVIC, in relation to upper limb crawl stroke movements. Muscle activity of rectus abdominis and deltoideus medialis was recorded using wireless surface EMG in 15 adult male competitive swimmers during three trials of 12.5 m front crawl at maximal speed without breathing. Two full upper limb cycles were analyzed from each of the swimming trials, resulting in six full cycles used for the intra-individual variability assessment, quantified with the coefficient of variation (CV), coefficient of quartile variation (CQV) and the variance ratio (VR). The results of this study support previous findings on EMG patterns of deltoideus medialis and rectus abdominis as prime mover during the recovery (45% activity relative to MVIC), and stabilizer of the trunk during the pull (14.5% activity) respectively. The intra-individual variability was lower (VR of 0.34–0.47) when compared to other cyclic movements. No meaningful differences were found between variability measures CV or VR when applying either of the amplitude or the time normalization methods. In addition to reporting the mean amplitude and standard deviation, future EMG studies in swimming should also report the intra-individual variability, preferably using VR as it is independent of peak amplitude, provides a good measure of repeatability and is insensitive to mean EMG amplitude and the degree of

  2. Weaning marginally affects glucose transporter (GLUT4) expression in calf muscles and adipose tissues.

    PubMed

    Hocquette, J F; Castiglia-Delavaud, C; Graulet, B; Ferré, P; Picard, B; Vermorel, M

    1997-08-01

    The nutritional regulation of glucose transporter GLUT4 was studied in eight muscles and four adipose tissues from two groups of preruminant (PR) or ruminant (R) calves of similar age (170 d), empty body weight (194 kg) at slaughter, and level of net energy intake from birth onwards. Isocitrate dehydrogenase (EC 1.1.1.41) activity in muscles was not different between PR and R except in masseter muscle from the cheek (+71% in R; P < 0.003), which becomes almost constantly active at weaning for food chewing. Basal and maximally-insulin-stimulated glucose transport rate (GTR) per g tissue wet weight in rectus abdominis muscle were significantly higher in R calves (+31 and 41% respectively; P < 0.05). GLUT4 protein contents did not differ in muscles from PR and R except in masseter (+74% in R; P < 0.05) indicating that the increased GTR in rectus abdominis cannot be accounted for by an enhanced GLUT4 expression. GLUT4 mRNA levels did not differ between the two groups of animals in all muscles suggesting a regulation of GLUT4 at the protein level in masseter. GLUT4 number expressed on a per cell basis was lower in adipose tissue from R calves (-39%; P < 0.05) and higher in internal than in peripheral adipose tissues. In summary, the regulation of GLUT4 in calves at weaning differs markedly from that previously described in rodents (for review, see Girard et al. 1992). Furthermore, significant inter-individual variations were shown for metabolic activities in muscle and for biochemical variables in adipose tissue.

  3. Relationships between thyroid status, tissue oxidative metabolism, and muscle differentiation in bovine fetuses.

    PubMed

    Cassar-Malek, I; Picard, B; Kahl, S; Hocquette, J F

    2007-07-01

    The temporal relationships between thyroid status and differentiation of liver, heart and different skeletal muscles were examined in 42 bovine fetuses from day 110 to day 260 of development using principal component analysis of the data. Plasma concentrations of reverse-triiodothyronine (rT(3)) and thyroxine (T(4)) increased during development from day 110 to day 210 or 260, respectively, whereas concentration of triiodothyronine (T(3)) and hepatic type-1 5'-deiodinase activity (5'D1) increased from day 180 onwards. On day 260, high T(4) and rT(3) and low T(3) concentrations were observed together with a mature 5'D1 activity. Cytochrome-c oxidase (COX) activity expressed per mg protein increased at day 180 in masseter and near birth in masseter, rectus abdominis and cutaneus trunci muscles (P<0.05). Significant changes in citrate synthase (CS) activity per mg protein were observed between day 110 and day 180 in the liver and between day 210 and day 260 in the liver, the heart and the longissimus thoracis muscle (P<0.05). Muscle contractile differentiation was shown by the disappearance of the fetal myosin heavy chain from day 180 onwards. A positive correlation (r>0.47, P<0.01) was shown between thyroid status parameters (5'D1, concentrations of T(4) and T(3)) and COX activity in muscles known to be oxidative after birth (masseter, rectus abdominis) but not in liver and heart, nor in muscles known to be glycolytic after birth (cutaneus trunci, longissimus thoracis). A similar correlation was found between thyroid parameters and CS activity in liver and masseter. Results indicate that elevation of plasma T(3) concentrations in the last gestational trimester could be involved in the differentiation of oxidative skeletal muscles.

  4. 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

  5. The superior epigastric artery does not pass through Larrey's space (trigonum sternocostale).

    PubMed

    Baudoin, Y-P; Hoch, M; Protin, X-M; Otton, B-J; Ginon, B; Voiglio, E-J

    2003-01-01

    The passage of the superior epigastric artery (SEA), the terminal branch of the internal thoracic artery (ITA), through the inferior orifice of the thorax differs in different reports. According to some, it passes through Larrey's space (trigonum sternocostale), therefore through a diaphragmatic orifice, but according to others it passes in front of the diaphragm and the transverse abdominal muscle. The aim of this study was to determine the position of the SEA in its thoracoabdominal segment. We carried out a series of 14 dissections (10 on embalmed cadavers and 4 on unembalmed cadavers), and a study of images from the Visible Human Project. Dissections always led to the same conclusions. After having dissected the trigonum sternocostale, we observed that no vascular element was present in the space, which was obstructed downwards by the parietal peritoneum and limited forwards by the aponeurosis of the transverse abdominal muscle. Inferior digitations of transversus thoracis were joined with the transversus abdominis. The SEA passed in front of the plane formed by these two muscles while the sternal and costal parts of the diaphragm were behind this plane. Whatever the level of the section of the Visible Human Project, there was always a musculoaponeurotic plane between Larrey's space and the superior epigastric artery and both veins. Larrey's space, or trigonum sternocostale, was limited medially by the lateral border of the sternal part of the diaphragm, laterally by the medial border of the costal part of the diaphragm, and anteriorly by the musculoaponeurotic plane formed by the transversus thoracis above and the transversus abdominis, below without a clear boundary between those muscles. The SEA, the terminal branch of the ITA, passed in front of this musculoaponeurotic plane.

  6. Electromyographic activity of selected trunk muscles during stabilization exercises using a gym ball.

    PubMed

    Mori, A

    2004-01-01

    Trunk stabilization is very important for the injured lower back. The use of a gym ball, the surface of which is labile, is becoming more popular for strengthening the trunk muscles and challenging the motor control system in trunk stabilization exercises. However, little is known about the activity of the trunk muscles during such exercises. The purpose of this study was to compare the electromyographic (EMG) activity of the trunk muscles during seven stabilization exercises using a gym ball. Eleven healthy men (19.9 +/- 1.8 years old) without low back pain volunteered to participate in the study. Bipolar surface electrodes were attached to the right side of the upper and lower rectus abdominis, the obliquus externus abdominis and the upper and lower back extensor muscles. EMG signals were recorded during seven types of stabilization exercises using a gym ball and normalized to maximal voluntary contraction (% MVC). A two-way analysis of variance (ANOVA) was performed on % MVC from each task for each of the five trunk muscle sites (p < 0.05). Push-up exercise, supporting with both hands on the gym ball and toes on the floor in prone position, resulted in the highest activity of all abdominal muscles, and an exercise of the lifting the gym ball up, holding it actively between both legs with both knees flexed in supine position resulted in the lowest. Lifting up of the pelvis in a bridged position exercise, supporting the head with the gym ball and with the feet on the floor in supine position, resulted in higher muscle activity of the back extensor muscles than another exercise. It is very important for physical therapists to make clear the purpose of the trunk stabilization exercises, because different kinds of exercises with the gym ball demand various levels of muscular activity and use of various parts of the trunk muscles.

  7. Primary mandibular reconstruction: analysis of 64 cases and evaluation of interface radiation dosimetry on bridging plates

    SciTech Connect

    Gullane, P.J. )

    1991-06-01

    The combination of a myocutaneous flap or free cutaneous tissue transfer with a three-dimensional bendable reconstruction plate either of stainless steel or titanium has provided very satisfactory results in primary restoration of mandibular defects following surgical resections in irradiated patients or in those who require postoperative radiotherapy. Sixty-four cases have been treated and evaluated prospectively using this technique. Fifty-three of the patients had the soft-tissue defect restored with a myocutaneous flap, 8 had a free cutaneous tissue flap, 2 were reconstructed with tongue flaps, and 1 closed primarily. The stainless steel plate of the A.O. type was used in 53 cases and the titanium plate system and hollow screws in the other 11 cases. A success rate of 78.9% was found with a median follow-up of 384 days. Thirty of the 64 cases had preoperative irradiation and 15 were treated postoperatively. A plate failure rate of 23% was encountered in those treated with preoperative irradiation and in 20% with those having postoperative irradiation. Forty-nine of the 64 patients or 76.5% experienced no perioperative complications. Five or 7.8% of the complications were minor. Ten patients or 15.6% experienced a major complication with one death due to a myocardial infarct. A radiation dosimetric model was employed using both stainless steel and titanium. The results from this study showed that, when using a parallel pair of beams, an excess dose of irradiation for the lowest energy cobalt-60 is 13%, for 6 mV it is 15%, and for 18 mV it is 20%. The excess tissue dose, both for stainless steel and titanium plates, extends for about 0.2 mm for cobalt-60, 1.1 mm at 6 mV, and for 25 mm at 18 mV. Patients with plates, therefore, can be treated safely with postoperative irradiation using either cobalt-60 or 6-mV energy.

  8. Targeted inhibition of KCa3.1 channel attenuates airway inflammation and remodeling in allergic asthma.

    PubMed

    Yu, Zhi-Hua; Xu, Jian-Rong; Wang, Yan-Xia; Xu, Guang-Ni; Xu, Zu-Peng; Yang, Kai; Wu, Da-Zheng; Cui, Yong-Yao; Chen, Hong-Zhuan

    2013-06-01

    KCa3.1 has been suggested to be involved in regulating cell activation, proliferation, and migration in multiple cell types, including airway inflammatory and structural cells. However, the contributions of KCa3.1 to airway inflammation and remodeling and subsequent airway hyperresponsiveness (AHR) in allergic asthma remain to be explored. The main purpose of this study was to elucidate the roles of KCa3.1 and the potential therapeutic value of KCa3.1 blockers in chronic allergic asthma. Using real-time PCR, Western blotting, or immunohistochemical analyses, we explored the precise role of KCa3.1 in the bronchi of allergic mice and asthmatic human bronchial smooth muscle cells (BSMCs). We found that KCa3.1 mRNA and protein expression were elevated in the bronchi of allergic mice, and double labeling revealed that up-regulation occurred primarily in airway smooth muscle cells. Triarylmethane (TRAM)-34, a KCa3.1 blocker, dose-dependently inhibited the generation and maintenance of the ovalbumin-induced airway inflammation associated with increased Th2-type cytokines and decreased Th1-type cytokine, as well as subepithelial extracellular matrix deposition, goblet-cell hyperplasia, and AHR in a murine model of asthma. Moreover, the pharmacological blockade and gene silencing of KCa3.1, which was evidently elevated after mitogen stimulation, suppressed asthmatic human BSMC proliferation and migration, and arrested the cell cycle at the G0/G1 phase. In addition, the KCa3.1 activator 1-ethylbenzimidazolinone-induced membrane hyperpolarization and intracellular calcium increase in asthmatic human BSMCs were attenuated by TRAM-34. We demonstrate for the first time an important role for KCa3.1 in the pathogenesis of airway inflammation and remodeling in allergic asthma, and we suggest that KCa3.1 blockers may represent a promising therapeutic strategy for asthma.

  9. Blood Brain Barrier KCa3.1 Channels: Evidence for a Role in Brain Na Uptake and Edema in Ischemic Stroke

    PubMed Central

    Chen, Yi-Je; Wallace, Breanna K.; Yuen, Natalie; Jenkins, David P.; Wulff, Heike; O’Donnell, Martha E.

    2014-01-01

    Background and Purpose KCa3.1, a calcium-activated potassium channel, regulates ion and fluid secretion in the lung and gastrointestinal tract. It is also expressed on vascular endothelium where it participates in blood pressure regulation. However, the expression and physiological role of KCa3.1 in blood-brain barrier (BBB) endothelium has not been investigated. BBB endothelial cells transport Na+ and Cl− from the blood into the brain transcellularly through the cooperation of multiple co-transporters, exchangers, pumps and channels. In the early stages of cerebral ischemia, when the BBB is intact, edema formation occurs by processes involving increased BBB transcellular Na+ transport. This study evaluated whether KCa3.1 is expressed on and participates in BBB ion transport. Methods The expression of KCa3.1 on cultured cerebral microvascular endothelial cells (CMEC), isolated microvessels and brain sections was evaluated by Western blot and immunohistochemistry. Activity of KCa3.1 on CMEC was examined by K+ flux assays and patch-clamp. Magnetic resonance spectroscopy and imaging were used to measure brain Na+ uptake and edema formation in rats with focal ischemic stroke following TRAM-34 treatment. Results KCa3.1 current and channel protein were identified on bovine CMEC and freshly isolated rat microvessels. In situ KCa3.1 expression on BBB endothelium was confirmed in rat and human brain sections. TRAM-34 treatment significantly reduced Na+ uptake, and cytotoxic edema in the ischemic brain. Conclusions BBB endothelial cells exhibit KCa3.1 protein and activity and pharmacological blockade of KCa3.1 appears to provide an effective therapeutic approach for reducing cerebral edema formation in the first 3 hours of ischemic stroke. PMID:25477223

  10. 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.

  11. 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. PMID:25185649

  12. 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. PMID

  13. Lisinopril alters contribution of nitric oxide and K(Ca) channels to vasodilatation in small mesenteric arteries of spontaneously hypertensive rats.

    PubMed

    Albarwani, S; Al-Siyabi, S; Al-Husseini, I; Al-Ismail, A; Al-Lawati, I; Al-Bahrani, I; Tanira, M O

    2015-01-01

    To investigate lisinopril effect on the contribution of nitric oxide (NO) and K(Ca) channels to acetylcholine (ACh)-induced relaxation in isolated mesenteric arteries of spontaneously hypertensive rats (SHRs). Third branch mesenteric arteries isolated from lisinopril treated SHR rats (20 mg/kg/day for ten weeks, SHR-T) or untreated (SHR-UT) or normotensive WKY rats were mounted on tension myograph and ACh concentration-response curves were obtained. Westernblotting of eNOS and K(Ca) channels was performed. ACh-induced relaxations were similar in all groups while L-NMMA and indomethacin caused significant rightward shift only in SHR-T group. Apamin and TRAM-34 (SK(Ca) and IK(Ca) channels blockers, respectively) significantly attenuated ACh-induced maximal relaxation by similar magnitude in vessels from all three groups. In the presence of L-NMMA, indomethacin, apamin and TRAM-34 further attenuated ACh-induced relaxation only in SHR-T. Furthermore, lisinopril treatment increased expression of eNOS, SK(Ca) and BK(Ca) proteins. Lisinopril treatment increased expression of eNOS, SK(Ca), BK(Ca) channel proteins and increased the contribution of NO to ACh-mediated relaxation. This increased role of NO was apparent only when EDHF component was blocked by inhibiting SK(Ca) and IK(Ca) channels. Such may suggest that in mesenteric arteries, non-EDHF component functions act as a reserve system to provide compensatory vasodilatation if (and when) hyperpolarization that is mediated by SK(Ca) and IK(Ca) channels is reduced.

  14. Apical Ca2+-activated potassium channels in mouse parotid acinar cells.

    PubMed

    Almassy, Janos; Won, Jong Hak; Begenisich, Ted B; Yule, David I

    2012-02-01

    Ca(2+) activation of Cl and K channels is a key event underlying stimulated fluid secretion from parotid salivary glands. Cl channels are exclusively present on the apical plasma membrane (PM), whereas the localization of K channels has not been established. Mathematical models have suggested that localization of some K channels to the apical PM is optimum for fluid secretion. A combination of whole cell electrophysiology and temporally resolved digital imaging with local manipulation of intracellular [Ca(2+)] was used to investigate if Ca(2+)-activated K channels are present in the apical PM of parotid acinar cells. Initial experiments established Ca(2+)-buffering conditions that produced brief, localized increases in [Ca(2+)] after focal laser photolysis of caged Ca(2+). Conditions were used to isolate K(+) and Cl(-) conductances. Photolysis at the apical PM resulted in a robust increase in K(+) and Cl(-) currents. A localized reduction in [Ca(2+)] at the apical PM after photolysis of Diazo-2, a caged Ca(2+) chelator, resulted in a decrease in both K(+) and Cl(-) currents. The K(+) currents evoked by apical photolysis were partially blocked by both paxilline and TRAM-34, specific blockers of large-conductance "maxi-K" (BK) and intermediate K (IK), respectively, and almost abolished by incubation with both antagonists. Apical TRAM-34-sensitive K(+) currents were also observed in BK-null parotid acini. In contrast, when the [Ca(2+)] was increased at the basal or lateral PM, no increase in either K(+) or Cl(-) currents was evoked. These data provide strong evidence that K and Cl channels are similarly distributed in the apical PM. Furthermore, both IK and BK channels are present in this domain, and the density of these channels appears higher in the apical versus basolateral PM. Collectively, this study provides support for a model in which fluid secretion is optimized after expression of K channels specifically in the apical PM.

  15. 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.

  16. Activation of the KCa3.1 channel contributes to traumatic scratch injury-induced reactive astrogliosis through the JNK/c-Jun signaling pathway.

    PubMed

    Yi, Mengni; Dou, Fangfang; Lu, Qin; Yu, Zhihua; Chen, Hongzhuan

    2016-06-15

    Reactive astrogliosis is widely considered to contribute to pathogenic responses to stress and brain injury and to diseases as diverse as ischemia and neurodegeneration. We previously found that expression of the intermediate-conductance calcium-activated potassium channel (KCa3.1) involved in TGF-β-activated astrogliosis. In the present study, we investigated whether migration of cortical astrocytes following mechanical scratch injury involves the KCa3.1 channel, which contributes to Ca(2+)-mediated migration in other cells. We found that scratch injury increased the expression of KCa3.1 protein in reactive astrocytes. Application of the KCa3.1 blocker TRAM-34 decreased glial fibrillary acidic protein (GFAP) expression and slowed migration in a concentration-dependent manner. Application of the Ca(2+) chelators, EGTA and BAPTA-AM, also slowed the migration of astrocytes. Blockade or genetic deletion of KCa3.1 both slowed and dramatically reduced the scratch injuries induced the sharp rise in astrocytes Ca(2+) concentrations. The scratch injury-induced phosphorylation of JNK and c-Jun proteins was also attenuated both by blockade of KCa3.1 with TRAM-34 and in KCa3.1(-/-) astrocytes. Using KCa3.1 knockout mice, we further confirmed that deletion of KCa3.1 reduced expression of GFAP in an in vivo stab wound model. Taken together, our findings highlight a novel role for KCa3.1 in phenotypic modulation of reactive astrocytes and in astrocyte mobilization in response to mechanical stress, providing a potential target for therapeutic intervention in brain injuries.

  17. Pharmacological activation of small conductance calcium-activated potassium channels with naphtho[1,2-d]thiazol-2-ylamine decreases guinea pig detrusor smooth muscle excitability and contractility.

    PubMed

    Parajuli, Shankar P; Soder, Rupal P; Hristov, Kiril L; Petkov, Georgi V

    2012-01-01

    Small conductance Ca²⁺-activated K⁺ (SK) and intermediate conductance Ca(2+)-activated K⁺ (IK) channels are thought to be involved in detrusor smooth muscle (DSM) excitability and contractility. Using naphtho[1,2-d]thiazol-2-ylamine (SKA-31), a novel and highly specific SK/IK channel activator, we investigated whether pharmacological activation of SK/IK channels reduced guinea pig DSM excitability and contractility. We detected the expression of all known isoforms of SK (SK1-SK3) and IK channels at mRNA and protein levels in DSM by single-cell reverse transcription-polymerase chain reaction and Western blot. Using the perforated patch-clamp technique on freshly isolated DSM cells, we observed that SKA-31 (10 μM) increased SK currents, which were blocked by apamin (1 μM), a selective SK channel inhibitor. In current-clamp mode, SKA-31 (10 μM) hyperpolarized the cell resting membrane potential, which was blocked by apamin (1 μM) but not by 1-[(2-chlorophenyl)diphenylmethyl]-1H-pyrazole (TRAM-34) (1 μM), a selective IK channel inhibitor. SKA-31 (10 nM-10 μM) significantly inhibited the spontaneous phasic contraction amplitude, frequency, duration, and muscle force in DSM isolated strips. The SKA-31 inhibitory effects on DSM contractility were blocked by apamin (1 μM) but not by TRAM-34 (1 μM), which did not per se significantly affect DSM spontaneous contractility. SK channel activation with SKA-31 reduced contractions evoked by electrical field stimulation. SKA-31 effects were reversible upon washout. In conclusion, SK channels, but not IK channels, mediate SKA-31 effects in guinea pig DSM. Pharmacological activation of SK channels reduces DSM excitability and contractility and therefore may provide a novel therapeutic approach for controlling bladder dysfunction.

  18. Characteristics of Kcnn4 channels in the apical membranes of an intestinal epithelial cell line.

    PubMed

    Basalingappa, Kanthesh M; Rajendran, Vazhaikkurichi M; Wonderlin, William F

    2011-11-01

    Intermediate-conductance K(+) (Kcnn4) channels in the apical and basolateral membranes of epithelial cells play important roles in agonist-induced fluid secretion in intestine and colon. Basolateral Kcnn4 channels have been well characterized in situ using patch-clamp methods, but the investigation of Kcnn4 channels in apical membranes in situ has been hampered by a layer of mucus that prevents seal formation. In the present study, we used patch-clamp methods to characterize Kcnn4 channels in the apical membrane of IEC-18 cells, a cell line derived from rat small intestine. A monolayer of IEC-18 cells grown on a permeable support is devoid of mucus, and tight junctions enable selective access to the apical membrane. In inside-out patches, Ca(2+)-dependent K(+) channels observed with iberiotoxin (a Kcnma1/large-conductance, Ca(2+)-activated K(+) channel blocker) and apamin (a Kcnn1-3/small-conductance, Ca(2+)-activated K(+) channel blocker) present in the pipette solution exhibited a single-channel conductance of 31 pS with inward rectification. The currents were reversibly blocked by TRAM-34 (a Kcnn4 blocker) with an IC(50) of 8.7 ± 2.0 μM. The channels were not observed when charybdotoxin, a peptide inhibitor of Kcnn4 channels, was added to the pipette solution. TRAM-34 was less potent in inhibiting Kcnn4 channels in patches from apical membranes than in patches from basolateral membranes, which was consistent with a preferential expression of Kcnn4c and Kcnn4b isoforms in apical and basolateral membranes, respectively. The expression of both isoforms in IEC-18 cells was confirmed by RT-PCR and Western blot analyses. This is the first characterization of Kcnn4 channels in the apical membrane of intestinal epithelial cells.

  19. 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.

  20. BRAF and MEK inhibition variably affect GD2-specific chimeric antigen receptor (CAR) T-cell function in vitro.

    PubMed

    Gargett, Tessa; Fraser, Cara K; Dotti, Gianpietro; Yvon, Eric S; Brown, Michael P

    2015-01-01

    Cancer immunotherapy has long been used in the treatment of metastatic melanoma, and an anti-CTLA-4 monoclonal antibody treatment has recently been approved by the US Food and Drug Administration. Targeted therapies such as small molecule kinase inhibitors targeting deregulated mitogen-activated protein kinase (MAPK) signaling have markedly improved melanoma control in up to 50% of metastatic disease patients and have likewise been recently approved. Combination therapies for melanoma have been proposed as a way to exploit the high-level but short-term responses associated with kinase inhibitor therapies and the low-level but longer-term responses associated with immunotherapy. Cancer immunotherapy now includes adoptive transfer of autologous tumor-specific chimeric antigen receptor (CAR) T cells and this mode of therapy is a candidate for combination with small molecule drugs. This paper describes CART cells that target GD2-expressing melanoma cells and investigates the effects of approved MAPK pathway-targeted therapies for melanoma [vemurafenib (Vem), dabrafenib (Dab), and trametinib (Tram)] on the viability, activation, proliferation, and cytotoxic T lymphocyte activity of these CAR T cells, as well as on normal peripheral blood mononuclear cells. We report that, although all these drugs lead to inhibition of stimulated T cells at high concentrations in vitro, only Vem inhibited T cells at concentrations equivalent to reported plasma concentrations in treated patients. Although the combination of Dab and Tram also resulted in inhibition of T-cell effector functions at some therapeutic concentrations, Dab itself had little adverse effect on CAR T-cell function. These findings may have implications for novel therapeutic combinations of adoptive CAR T-cell immunotherapy and MAPK pathway inhibitors.

  1. Tranilast Increases Vasodilator Response to Acetylcholine in Rat Mesenteric Resistance Arteries through Increased EDHF Participation

    PubMed Central

    Sastre, Esther; Caracuel, Laura; Callejo, María; Balfagón, Gloria

    2014-01-01

    Background and Purpose Tranilast, in addition to its capacity to inhibit mast cell degranulation, has other biological effects, including inhibition of reactive oxygen species, cytokines, leukotrienes and prostaglandin release. In the current study, we analyzed whether tranilast could alter endothelial function in rat mesenteric resistance arteries (MRA). Experimental Approach Acetylcholine-induced relaxation was analyzed in MRA (untreated and 1-hour tranilast treatment) from 6 month-old Wistar rats. To assess the possible participation of endothelial nitric oxide or prostanoids, acetylcholine-induced relaxation was analyzed in the presence of L-NAME or indomethacin. The participation of endothelium-derived hyperpolarizing factor (EDHF) in acetylcholine-induced response was analyzed by preincubation with TRAM-34 plus apamin or by precontraction with a high K+ solution. Nitric oxide (NO) and superoxide anion levels were measured, as well as vasomotor responses to NO donor DEA-NO and to large conductance calcium-activated potassium channel opener NS1619. Key Results Acetylcholine-induced relaxation was greater in tranilast-incubated MRA. Acetylcholine-induced vasodilation was decreased by L-NAME in a similar manner in both experimental groups. Indomethacin did not modify vasodilation. Preincubation with a high K+ solution or TRAM-34 plus apamin reduced the vasodilation to ACh more markedly in tranilast-incubated segments. NO and superoxide anion production, and vasodilator responses to DEA-NO or NS1619 remained unmodified in the presence of tranilast. Conclusions and Implications Tranilast increased the endothelium-dependent relaxation to acetylcholine in rat MRA. This effect is independent of the nitric oxide and cyclooxygenase pathways but involves EDHF, and is mediated by an increased role of small conductance calcium-activated K+ channels. PMID:24992476

  2. [Perforator flaps--the evolution of a reconstructive surgical technique].

    PubMed

    Klein, S; Hage, J J; de Weerd, L

    2005-10-22

    Trauma, oncological resections and pressure sores can cause major soft tissue defects. The evolution of cutaneous, myocutaneous, and fasciocutaneous flaps currently makes possible the restoration of contour and, in many cases, function. This evolution was closely related to the increased understanding of the vascular anatomy of the skin and subcutis and has led to the development of perforator flaps. A perforator flap is a large flap of skin that survives on a single vascular stalk that perforates the muscle, referred to in briefas a 'perforator'. This has its origin in a larger vascular stalk that runs beneath the muscle. The vascular stalk of such a perforator flap can be lengthened by dissecting the perforator from the muscle in continuity with the vessels running beneath the muscle. Moreover, the larger diameter of these vessels facilitates the creation of a vascular anastomosis in the receptor area. By the use of such perforator flaps, proper innervation and a good blood supply to the flap can be combined with less morbidity at the donor site. Important possibilities include the filling of a dorsal (decubitus) defect and breast reconstruction.

  3. Utility of the omentum in sacral reconstruction following total sacrectomy due to recurrent and irradiated giant cell tumour of the spine.

    PubMed

    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.

  4. Local flap therapy for the treatment of pressure sore wounds.

    PubMed

    Wettstein, Reto; Tremp, Mathias; Baumberger, Michael; Schaefer, Dirk J; Kalbermatten, Daniel F

    2015-10-01

    The aim of this study was to analyse the effectiveness of an interdisciplinary cooperation between conservative and surgical disciplines for the treatment of pressure sores (PS). From January 2004 to December 2005, a single-centre study was performed with paraplegic and tetraplegic patients presenting with PS grades III-V. Outcome measures were defect size, grade, method of reconstruction, complication and recurrence rate as well as average length of hospitalisation. A total of 119 patients aged 22-84 years with totally 170 PS were included. The most common PS were located in the ischial region (47%), followed by the sacral (18%), trochanteric (11%), foot (9%) and the malleolar (8%) regions. Defect sizes ranged between 4 and 255 cm(2) . Grade IV was the most common PS (68%), followed by grade III (30%) and grade V (2%) PS. For wound closure, fasciocutaneous flaps were used most frequently (71%), followed by skin grafts (10%) and myocutaneous flaps (7%). Postoperative follow-up ranged between 6 and 38 months. The overall complication and recurrence rate was 26% and 11%, respectively. If no complication occurred, the average duration of hospitalisation stay after the first debridement was 98 ± 62 days. In conclusion, our treatment concept is reliable, effective and results in a low recurrence rate. The complication rate, even though favourable when compared with the literature, still needs to be improved.

  5. The infrahyoid flap: a comprehensive review of an often overlooked reconstructive method.

    PubMed

    Deganello, Alberto; Leemans, C René

    2014-08-01

    The infrahyoid flap is a myocutaneous pedicled flap mainly nourished by the superior thyroid vessels through the perforators of the infrahyoid muscles. This thin and pliable flap provides a skin island of about 7 by 4 cm from the central part of the anterior neck. The flap can be transferred on its pedicle of superior thyroid artery and vein to reconstruct medium sized head and neck defects created after cancer ablation. We have successfully used this flap in a series of 40 cases with no total flap loss and with 1 case of superficial skin necrosis. The aim of this review is to highlight the clinical usefulness of this pedicled flap even in the microvascular free flap era. A comprehensive review of the available literature reporting on the infrahyoid flap has been carried out using a web search. The history of the infrahyoid flap, the surgical technique with technical innovations, the clinical utility and limitations of this flap, are reported and discussed. Among the 7 larger series (cohort larger than 50 cases) a total of 956 flaps were performed, and the global success rate was 91.7%, with failures being mainly related to partial skin necrosis, as the rate of total (skin and muscle) flap necrosis was only 1%. This flap is reliable, easy to harvest during neck dissection, oncologically safe, it does carry a negligible donor site morbidity. This paper highlights how the infrahyoid flap can represent an excellent reconstructive solution in selected patients and head and neck sites. PMID:24856306

  6. The Use of Composite Flaps in the Management of Large Full-Thickness Defects of the Lower Eyelid

    PubMed Central

    Fang, Shuo; Yang, Chao; Zhang, Yuntong; Xue, Chunyu; Bi, Hongda; Dai, Haiying; Xing, Xin

    2016-01-01

    Abstract To describe a modified surgical procedure that uses a combination of the tarsoconjunctival flap, orbicularis myocutaneous advancement flap, and paranasal-island flap to correct extensive full-thickness lower eyelid defects in functioning eyes. From May 2010 to December 2013, a total of 15 patients had reconstructive surgeries of large to giant lower eyelid defect, with an average 19-month follow-up. The musculocutaneous flaps were harvested from both orbicularis and paranasal regions and clinical outcomes were recorded and analyzed. No major complications were observed in any of the patients. All the patients showed aesthetic eyelid contour, good color, and texture match as well as no obvious scar formation. The mean Marginal Reflex Distance-2 measured 4 months after surgery was 4.9 ± 0.4 mm. Reconstruction of a large defect in the lower eyelid with a tarsoconjunctival flap and the composite neighboring musculocutaneous flaps is a reliable and reproducible method. With proper design and well-executed precision, excellent functional and aesthetic results can be achieved by this elegant procedure without any major complications. PMID:26765467

  7. The Free-style Gluteal Perforator Flap in the Thinning and Delay Process for Perineal Reconstruction After Necrotizing Fasciitis.

    PubMed

    Horta, Ricardo; Nascimento, Ricardo; Silva, Alvaro; Amarante, Jose

    2016-06-01

    Perineal wounds present a special challenge for reconstructive surgeons. The vacuum-assisted closure device is useful as a temporizing measure or for wounds too large or contaminated for immediate reconstruction. Compared to traditional myocutaneous flaps, perforator flaps provide thinner fasciocutaneous flaps for perineal reconstruction with favorable results and fewer donor site morbidities. The upper and lower gluteal regions are rich in perforators, which allow for more versatile flap design according to the defect. The authors combined the principles of free-style perforator flaps, flap delay, and thinning of perforator flaps to restore perineal function and aesthetics. The procedure was undertaken in a 72-year-old female who was obese with the diagnosis of necrotizing fasciitis secondary to perineal abscess. After 3 months, the flap achieved adequate and durable reconstruction with acceptable aesthetic contour and patient satisfaction; there was no loss of function at donor sites. Clinical applications and technical refinements of freestyle pedicled perforator flaps can be extended to the perineal region. Because of its many advantages and its versatility, freestyle pedicled perforator flaps constitute a valued reconstructive option and, when indicated, an alternative to pedicled axial flaps or even free flaps, in addition to vacuum therapy, to simplify the reconstructive procedure. PMID:27434419

  8. Vaginal reconstruction

    SciTech Connect

    Lesavoy, M.A.

    1985-05-01

    Vaginal reconstruction can be an uncomplicated and straightforward procedure when attention to detail is maintained. The Abbe-McIndoe procedure of lining the neovaginal canal with split-thickness skin grafts has become standard. The use of the inflatable Heyer-Schulte vaginal stent provides comfort to the patient and ease to the surgeon in maintaining approximation of the skin graft. For large vaginal and perineal defects, myocutaneous flaps such as the gracilis island have been extremely useful for correction of radiation-damaged tissue of the perineum or for the reconstruction of large ablative defects. Minimal morbidity and scarring ensue because the donor site can be closed primarily. With all vaginal reconstruction, a compliant patient is a necessity. The patient must wear a vaginal obturator for a minimum of 3 to 6 months postoperatively and is encouraged to use intercourse as an excellent obturator. In general, vaginal reconstruction can be an extremely gratifying procedure for both the functional and emotional well-being of patients.

  9. 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.

  10. Prefabricated Composite Graft for Eyelid Reconstruction.

    PubMed

    Nicoletti, Giovanni; Jaber, Omar; Tresoldi, Marco Mario; Pellegatta, Tommaso; Faga, Angela

    2015-10-01

    The authors propose a prefabricated chondromucosal composite graft to reconstruct full-thickness defects of the lower eyelid. The technique was used in a patient suffering from a locally invasive basal cell carcinoma of the lower eyelid, who had previously undergone an extensive submucosal nasal septum resection. One week prior to the eyelid resection, the anterior skin surface of the auricular concha was replaced with a full-thickness oral mucosa graft. One week later, a full-thickness excision of the right lower eyelid was performed and the prefabricated chondromucosal auricular graft was used to restore the posterior lamella. The anterior lamella was reconstructed with a bipedicled myocutaneous flap from the upper eyelid. Because of the patient's scheduling needs, the medial pedicle of the flap was divided 28 days later and the lateral one after further 37 days. All the procedures were performed under local anesthesia. This technique adds a simple key detail to other time-honored reliable techniques, thus outlining an extremely convenient sequence for full-thickness eyelid reconstruction. The easily prepared prefabricated chondromucosal graft might be associated with any of the previously described flaps, thus providing a versatile and reliable method of posterior lamella reconstruction. PMID:26579869

  11. 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

  12. Reconstruction of an extensive peri-orbital defect secondary to mucormycosis in a patient with myelodysplasia.

    PubMed

    Murphy, Adrian D; Williamson, Peter A; Vesely, Martin

    2013-03-01

    We present the case of a 68-year old gentleman with previously diagnosed myelodysplastic syndrome with pancytopenia who presented with exophthalmia, rhinorrhea, and ophthalmoplegia. Nasal endoscopy revealed black necrotic lesions. He was diagnosed with rhino-orbital mucormycosis and commenced on intravenous antifungals. Despite this therapy he progressed to have total unilateral loss of visual acuity and cutaneous necrosis. He underwent emergency orbital exenteration and extensive cheek and sinus debridement. Necrotic lesions were found in the orbit, the maxillary and ethmoidal sinuses. He underwent reconstruction of this defect using a free myocutaneous ALT flap with a segment of vastus lateralis. Prior to surgery his anemia and thrombocytopenia were addressed with packed red cell and platelet transfusions as well as preoperative thromboelastography (TEG) to measure functional fibrinogen to platelet ratio. Intraoperative platelet administration was guided by repeated TEG analysis. There were no significant intraoperative or postoperative bleeding complications and both flap and donor site healed unremarkably. Few reports exist in the literature related to free tissue transfer in patients with hematological disorders but low platelet count has been implicated in an increased complication rate.

  13. A Minimal Access Far-Lateral Approach to Foramen Magnum Lesions

    PubMed Central

    Kryzanski, James T.; Robertson, Jon H.; Heilman, Carl B.

    2014-01-01

    Objectives The far-lateral approach is widely used to treat pathology of the ventral foramen magnum. Numerous methods of exposure have been described, most of which utilize long skin incisions and myocutaneous flaps. Here we present our experience with gaining exposure through a small paramedian incision using a muscle-splitting technique. Design A cadaveric anatomical study was first performed to verify the feasibility of the approach. We then describe our experience with using the approach in 13 patients. A retrospective chart review was performed and data regarding pathology, imaging, and complications were collected. Results The cadaveric study confirmed that a small paramedian muscle-splitting approach allows sufficient exposure to approach many foramen magnum lesions. Our case series included 10 patients with meningioma, one brainstem glioblastoma, one posterior inferior cerebellar artery aneurysm, and one odontoid pannus. The exposure was adequate in all cases. For the meningioma patients, six had gross total resections and four had subtotal resection because of tumor adherence to neurovascular structures. Two patients experienced postoperative cardiovascular complications. There were no new neurologic deficits, cerebrospinal fluid leaks, or wound complications. Conclusions A small paramedian incision may be used to gain exposure and perform successful far-lateral approaches. The small exposure is likely to reduce the risk of local complications such as cerebrospinal fluid fistula and pseudomeningocele when compared with larger exposures. PMID:25093146

  14. [Cover flaps for loss of substance on the heel. Apropos of 8 cases].

    PubMed

    Mulfinger, C; Bardot, J; Legre, R; Aubert, J P; Magalon, G; Bureau, H

    1993-10-01

    The anatomical and function characteristics of the heel region explain the large number of methods used and the differences of opinion particularly in relation to the repair of weightbearing zones. Our study is based on 28 patients in whom we performed: ten regional flaps, six cross-leg flaps, sixteen microsurgical flaps. The temporal fascia free flap provides good results on the posterior surface with minimal sequelae at the donor site. The medial plantar flap appears to be the most suitable flap for weight-bearing zones. Cross-lep flaps allow satisfactory repair of the weightbearing zone, but the scarred appearance of the donor site is inaesthetic and immobilisation is uncomfortable. The problem of large defects is still not resolved and no really satisfactory method is available among the various distant, skin, myocutaneous, pure muscle or cross-leg flaps. The solution may reside in a combination of two flaps allowing better adaptation to the morphology of the heel. The importance of heel sensation, particularly in the weight-bearing zone, led to the concept of the use of sensitive or resensitised flaps. After a review of the literature and our results, we did not find any correlation between the sensitivity obtained and the success of the reconstruction. It therefore seems useless to perform microscopic nerve sutures in order to resensitise distant heel flaps. The patient's cooperation is essential in every case to compensate for the decreased sensitivity by means of increased visual surveillance and the wearing of suitable shoes.

  15. Keyhole Flap Nipple Reconstruction.

    PubMed

    Chen, Joseph I; Cash, Camille G; Iman, Al-Haj; Spiegel, Aldona J; Cronin, Ernest D

    2016-05-01

    Nipple-areola reconstruction is often one of the final but most challenging aspects of breast reconstruction. However, it is an integral and important component of breast reconstruction because it transforms the mound into a breast. We performed 133 nipple-areola reconstructions during a period of 4 years. Of these reconstructions, 76 of 133 nipple-areola complexes were reconstructed using the keyhole flap technique. The tissue used for the keyhole dermoadipose flap technique include transverse rectus abdominus myocutaneous flaps (60/76), latissimus dorsi flaps (15/76), or mastectomy skin flaps after tissue expanders (1/76). The average patient follow-up was 17 months. The design of the flap is based on a keyhole configuration. The base of the flap determines the width of the future nipple, whereas the length of the flap determines the projection. We try to match the projection of the contralateral nipple if present. The keyhole flap is simple to construct yet reliable. It provides good symmetry and projection and avoids the creation of new scars. The areola is then tattooed approximately 3 months after the nipple reconstruction. PMID:27579228

  16. 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.

  17. [The Current Role of Salvage-Surgery of Recurrent Tumors in the Larynx and Pharynx].

    PubMed

    Stuck, B A; Rothmeier, N; Mattheis, S; Dominas, N; Lang, S

    2016-05-01

    Over the past 20 years, the therapeutic concepts for the treatment of head and neck cancer have evolved and non-surgical treatment strategies have gained in importance. However, despite improved organ preservation protocols and primary chemoradiation, tumor recurrence is still frequent. Under these conditions, salvage surgery if often the only remaining curative treatment option. Over the past 30 years, advancements in plastic-reconstructive surgery have broadened the surgical spectrum in the head and neck area, offering new treatment options for salvage surgery in recurrent cancer of the pharynx and larynx. Survival after salvage surgery mainly depends on the primary treatment modality as well as the localization and tumor stage at the time of initial diagnosis and local recurrence. For the reconstruction of defects after salvage surgery, pedicled flaps and microvascular free flaps may be utilized. The most frequently used flaps in these situations are the pectoralis major island- or the myocutaneous latissimus dorsi island flap. The radial forearm and the ALT-flap are potentially applicable free flaps. With the use of these flaps, vital tissue is transferred into the previously irradiated area, hereby allowing for reconstruction and functional preservation of the resected area and preventing complications such as fistulas. The expected morbidity and the likelihood of surgical success must be assessed thoroughly in every individual case prior to performing salvage surgery. This review aims to support decision making in these situations. PMID:27135424

  18. Three-Directional Reconstruction of a Massive Perineal Defect after Wide Local Excision of Extramammary Paget's Disease.

    PubMed

    Cho, Seung Woo; Chang, Hak; Kwon, Sung Tack

    2016-09-01

    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

  19. Characterization and management of mandibular fractures: lessons learned from Iraq and Afghanistan.

    PubMed

    Tucker, David I; Zachar, Michael R; Chan, Rodney K; Hale, Robert G

    2013-03-01

    Fractures of the mandible are among the most common facial injuries. Invasiveness of treatment should be determined by the extent of injury: degree of displacement, number of fractures, the patient's health status, and concomitant injuries. Complex, comminuted, and avulsive injuries frequently seen in combat will require coordination with multiple specialties to provide the best treatment. Stabilization treatment with arch bars or external fixators and splints is often desirable when fractures are highly comminuted or the soft tissue envelope is compromised by tissue loss or burns. In severe injuries, many times reconstruction will take several surgeries. Debridement of necrotic tissue and devascularized bone and skin grafting often are necessary before reconstruction. Microvascular or myocutaneous flaps should be considered with significant tissue loss and osteocutaneous flaps when large continuity defects are present. Most mandible fractures are repaired in a single operation. Those caused by explosives and high-velocity projectiles are more complex. Research should continue to focus on improving outcomes for these patients. Advances in tissue engineering, bone regeneration, and composite tissue allografting will have to continue if we hope to restore facial form and function for our combat wounded.

  20. 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.

  1. Results of Hydraulic Tests in Miocene Tuffaceous Rocks at the C-Hole Complex, 1995 to 1997, Yucca Mountain, Nye County, Nevada

    USGS Publications Warehouse

    Geldon, Arthur L.; Umari, Amjad M.A.; Fahy, Michael F.; Earle, John D.; Gemmell, James M.; Darnell, Jon

    2002-01-01

    Four hydraulic tests were conducted by the U.S. Geological Survey at the C-hole complex at Yucca Mountain, Nevada, between May 1995 and November 1997. These tests were conducted as part of ongoing investigations to determine the hydrologic and geologic suitability of Yucca Mountain as a potential site for permanent underground storage of high-level nuclear waste. The C-hole complex consists of three 900-meter-deep boreholes that are 30.4 to 76.6 meters apart. The C-holes are completed in fractured, variably welded tuffaceous rocks of Miocene age. Six hydrogeologic intervals occur within the saturated zone in these boreholes - the Calico Hills, Prow Pass, Upper Bullfrog, Lower Bullfrog, Upper Tram, and Lower Tram intervals. The Lower Bullfrog and Upper Tram intervals contributed about 90 percent of the flow during hydraulic tests. The four hydraulic tests conducted from 1995 to 1997 lasted 4 to 553 days. Discharge from the pumping well, UE-25 c #3, ranged from 8.49 to 22.5 liters per second in different tests. Two to seven observation wells, 30 to 3,526 meters from the pumping well, were used in different tests. Observation wells included UE-25 c #1, UE-25 c #2, UE-25 ONC-1, USW H-4, UE-25 WT #14, and UE-25 WT #3 in the tuffaceous rocks and UE-25 p #1 in Paleozoic carbonate rocks. In all hydraulic tests, drawdown in the pumping well was rapid and large (2.9-11 meters). Attributable mostly to frictional head loss and borehole-skin effects, this drawdown could not be used to analyze hydraulic properties. Drawdown and recovery in intervals of UE-25 c #1 and UE-25 c #2 and in other observation wells typically was less than 51 centimeters. These data were analyzed. Hydrogeologic intervals in the C-holes have layered heterogeneity related to faults and fracture zones. Transmissivity, hydraulic conductivity, and storativity generally increase downhole. Transmissivity ranges from 4 to 1,600 meters squared per day; hydraulic conductivity ranges from 0.1 to 50 meters per day

  2. The functional coupling of the deep abdominal and paraspinal muscles: the effects of simulated paraspinal muscle contraction on force transfer to the middle and posterior layer of the thoracolumbar fascia.

    PubMed

    Vleeming, A; Schuenke, M D; Danneels, L; Willard, F H

    2014-10-01

    The thoracolumbar fascia (TLF) consists of aponeurotic and fascial layers that interweave the paraspinal and abdominal muscles into a complex matrix stabilizing the lumbosacral spine. To better understand low back pain, it is essential to appreciate how these muscles cooperate to influence lumbopelvic stability. This study tested the following hypotheses: (i) pressure within the TLF's paraspinal muscular compartment (PMC) alters load transfer between the TLF's posterior and middle layers (PLF and MLF); and (ii) with increased tension of the common tendon of the transversus abdominis (CTrA) and internal oblique muscles and incremental PMC pressure, fascial tension is primarily transferred to the PLF. In cadaveric axial sections, paraspinal muscles were replaced with inflatable tubes to simulate paraspinal muscle contraction. At each inflation increment, tension was created in the CTrA to simulate contraction of the deep abdominal muscles. Fluoroscopic images and load cells captured changes in the size, shape and tension of the PMC due to inflation, with and without tension to the CTrA. In the absence of PMC pressure, increasing tension on the CTrA resulted in anterior and lateral movement of the PMC. PMC inflation in the absence of tension to the CTrA resulted in a small increase in the PMC perimeter and a larger posterior displacement. Combining PMC inflation and tension to the CTrA resulted in an incremental increase in PLF tension without significantly altering tension in the MLF. Paraspinal muscle contraction leads to posterior displacement of the PLF. When expansion is combined with abdominal muscle contraction, the CTrA and internal oblique transfers tension almost exclusively to the PLF, thereby girdling the paraspinal muscles. The lateral border of the PMC is restrained from displacement to maintain integrity. Posterior movement of the PMC represents an increase of the PLF extension moment arm. Dysfunctional paraspinal muscles would reduce the posterior

  3. The functional coupling of the deep abdominal and paraspinal muscles: the effects of simulated paraspinal muscle contraction on force transfer to the middle and posterior layer of the thoracolumbar fascia

    PubMed Central

    Vleeming, A; Schuenke, M D; Danneels, L; Willard, F H

    2014-01-01

    The thoracolumbar fascia (TLF) consists of aponeurotic and fascial layers that interweave the paraspinal and abdominal muscles into a complex matrix stabilizing the lumbosacral spine. To better understand low back pain, it is essential to appreciate how these muscles cooperate to influence lumbopelvic stability. This study tested the following hypotheses: (i) pressure within the TLF's paraspinal muscular compartment (PMC) alters load transfer between the TLF's posterior and middle layers (PLF and MLF); and (ii) with increased tension of the common tendon of the transversus abdominis (CTrA) and internal oblique muscles and incremental PMC pressure, fascial tension is primarily transferred to the PLF. In cadaveric axial sections, paraspinal muscles were replaced with inflatable tubes to simulate paraspinal muscle contraction. At each inflation increment, tension was created in the CTrA to simulate contraction of the deep abdominal muscles. Fluoroscopic images and load cells captured changes in the size, shape and tension of the PMC due to inflation, with and without tension to the CTrA. In the absence of PMC pressure, increasing tension on the CTrA resulted in anterior and lateral movement of the PMC. PMC inflation in the absence of tension to the CTrA resulted in a small increase in the PMC perimeter and a larger posterior displacement. Combining PMC inflation and tension to the CTrA resulted in an incremental increase in PLF tension without significantly altering tension in the MLF. Paraspinal muscle contraction leads to posterior displacement of the PLF. When expansion is combined with abdominal muscle contraction, the CTrA and internal oblique transfers tension almost exclusively to the PLF, thereby girdling the paraspinal muscles. The lateral border of the PMC is restrained from displacement to maintain integrity. Posterior movement of the PMC represents an increase of the PLF extension moment arm. Dysfunctional paraspinal muscles would reduce the posterior

  4. Dietary Lecithin Decreases Skeletal Muscle COL1A1 and COL3A1 Gene Expression in Finisher Gilts

    PubMed Central

    Akit, Henny; Collins, Cherie; Fahri, Fahri; Hung, Alex; D’Souza, Daryl; Leury, Brian; Dunshea, Frank

    2016-01-01

    Simple Summary In this study, the effect of dietary lecithin on skeletal muscle gene expression of collagen precursors and enzymes was investigated in gilts. Thirty-six finisher gilts were fed with diets containing either 0, 4, 20 or 80 g/kg soybean lecithin for six weeks. Then, rectus abdominis muscle was sampled and analyzed for eight genes involved in collagen synthesis and degradation (COL1A1, COL3A1, MMP-1, MMP-13, TIMP-1, TIMP-3, lysyl oxidase and α-subunit P4H) using quantitative real-time PCR. The results showed that lecithin down-regulated COL1A1 and COL3A1 as well as tended to down-regulate α-subunit P4H expression. Abstract The purpose of this study was to investigate the effect of dietary lecithin on skeletal muscle gene expression of collagen precursors and enzymes involved in collagen synthesis and degradation. Finisher gilts with an average start weight of 55.9 ± 2.22 kg were fed diets containing either 0, 4, 20 or 80 g/kg soybean lecithin prior to harvest for six weeks and the rectus abdominis muscle gene expression profile was analyzed by quantitative real-time PCR. Lecithin treatment down-regulated Type I (α1) procollagen (COL1A1) and Type III (α1) procollagen (COL3A1) mRNA expression (p < 0.05, respectively), indicating a decrease in the precursors for collagen synthesis. The α-subunit of prolyl 4-hydroxylase (P4H) mRNA expression also tended to be down-regulated (p = 0.056), indicating a decrease in collagen synthesis. Decreased matrix metalloproteinase-1 (MMP-1) mRNA expression may reflect a positive regulatory response to the reduced collagen synthesis in muscle from the pigs fed lecithin (p = 0.035). Lecithin had no effect on tissue inhibitor metalloproteinase-1 (TIMP-1), matrix metalloproteinase-13 (MMP-13) and lysyl oxidase mRNA expression. In conclusion, lecithin down-regulated COL1A1 and COL3A1 as well as tended to down-regulate α-subunit P4H expression. However, determination of muscle collagen content and solubility are required

  5. Commuter exposure to aromatic VOCs in public transportation modes in Hong Kong.

    PubMed

    Lau, Wai-Lun; Chan, Lo-Yin

    2003-06-01

    This study investigated commuter exposure to aromatic volatile organic compounds (VOCs) in different commuting microenvironments. In Hong Kong, more than 90% of the local citizens rely on public transport facilities in their daily commutes. During five winter months in late 2001 and early 2002, in-vehicle monitoring was performed in nine popular public transportation modes: tram, public light bus, air-conditioned bus, non-air-conditioned bus, taxi, ferry and three railway systems (Mass Transit Railway-MTR, Kowloon-Canton Railway-KCR and Light Rail Transit-LRT). These transports were grouped into three categories: railway transport, roadway transport and marine transport. Air samples of benzene, toluene, ethylbenzene and m/p/o-xylene were collected by canisters and analysed by gas chromatography and mass selective detector technique. Results indicated that the in-vehicle VOC exposure levels were greatly influenced by the mode of transport. For benzene, mean concentration ranged from 4.8 to 6.1 microg x m(-3) in roadway transports, 3.0-3.8 microg x m(-3) in railway transports and it was 2.1 microg x m(-3) in ferry. Regardless of the results in MTR and air-conditioned buses, the VOC levels in roadway transport were the highest and was followed by railway transport. The exposure levels in marine transport were the lowest. The TEX concentrations were found to be substantially higher in air-conditioned buses and MTR trains than in other transports, suggesting the existence of additional solvent-related sources in their vehicle interiors. Measurements in non-air-conditioned double deck vehicles indicate that there was slightly higher VOC levels in the lower deck than in the upper deck microenvironment. The average upper to lower deck exposure ratio ranged from 0.79 to 0.87 in trams and 0.78-0.83 in non-air-conditioned buses, depending on the compound of concern. The VOC exposure levels of public transport commuters in Hong Kong are far lower than those in most oversea

  6. Vasoactivity of the gasotransmitters hydrogen sulfide and carbon monoxide in the chicken ductus arteriosus.

    PubMed

    van der Sterren, Saskia; Kleikers, Pamela; Zimmermann, Luc J I; Villamor, Eduardo

    2011-10-01

    Besides nitric oxide (NO) and carbon monoxide (CO), hydrogen sulfide (H(2)S) is a third gaseous messenger that may play a role in controlling vascular tone and has been proposed to serve as an O(2) sensor. However, whether H(2)S is vasoactive in the ductus arteriosus (DA) has not yet been studied. We investigated, using wire myography, the mechanical responses induced by Na(2)S (1 μM-1 mM), which forms H(2)S and HS(-) in solution, and by authentic CO (0.1 μM-0.1 mM) in DA rings from 19-day chicken embryos. Na(2)S elicited a 100% relaxation (pD(2) 4.02) of 21% O(2)-contracted and a 50.3% relaxation of 62.5 mM KCl-contracted DA rings. Na(2)S-induced relaxation was not affected by presence of the NO synthase inhibitor l-NAME, the soluble guanylate cyclase (sGC) inhibitor ODQ, or the K(+) channel inhibitors tetraethylammonium (TEA; nonselective), 4-aminopyridine (4-AP, K(V)), glibenclamide (K(ATP)), iberiotoxin (BK(Ca)), TRAM-34 (IK(Ca)), and apamin (SK(Ca)). CO also relaxed O(2)-contracted (60.8% relaxation) and KCl-contracted (18.6% relaxation) DA rings. CO-induced relaxation was impaired by ODQ, TEA, and 4-AP (but not by L-NAME, glibenclamide, iberiotoxin, TRAM-34 or apamin), suggesting the involvement of sGC and K(V) channel stimulation. The presence of inhibitors of H(2)S or CO synthesis as well as the H(2)S precursor L-cysteine or the CO precursor hemin did not significantly affect the response of the DA to changes in O(2) tension. Endothelium-dependent and -independent relaxations were also unaffected. In conclusion, our results indicate that the gasotransmitters H(2)S and CO are vasoactive in the chicken DA but they do not suggest an important role for endogenous H(2)S or CO in the control of chicken ductal reactivity.

  7. The temporal evolution of three-dimensional lightning parameters and their suitability for thunderstorm tracking and nowcasting

    NASA Astrophysics Data System (ADS)

    Meyer, V. K.; Höller, H.; Betz, H. D.

    2013-01-01

    Total lightning (TL) data has been found to provide valuable information about the internal dynamics of a thunderstorm allowing conclusions about its further development as well as indicating potential of thunderstorm-related severe weather at the ground. This paper investigates electrical discharge correlations of strokes and flashes with respect to the temporal evolution of thunderstorms in case studies as well as by statistical means. The recently developed algorithm li-TRAM (tracking and monitoring of lightning-cells, Meyer et al., 2012) has been employed to track and monitor thunderstorms based on three-dimensionally resolved TL lightning data provided as stroke events by the European lightning location network LINET. From statistical investigation of 863 suited thunderstorm life-cycles the cell area turned out to correlate well with (a) the total discharge rate, (b) the in-cloud (IC) discharge rate, and (c) the mean IC discharge height per lightning-cell as identified by li-TRAM. All three parameter correlations consistently show an abrupt change in discharge characteristics around a cell area of 170 km2. Statistical investigations supported by the comparison of three case studies - selected to represent a single storm, a multi-cell and a supercell - strongly suggest that the correlation functions include the temporal evolution as well as the storm type. With the help of volumetric radar data, it can also be suggested that the well defined break observed at 170 km2 marks the region, where the transition occurs from short-lived and rather simple structured single storm cells to better organized, more persistent, and more complex structured thunderstorm forms, e.g. multi-cells and super-cells. All three storm-types experience similar discharge characteristics during their growing and dissipating phases. However, while the poorly organized and short-lived cells preferentially remain small during a short mature phase, mainly the more persistent thunderstorm types

  8. The temporal evolution of three-dimensional lightning parameters and their suitability for thunderstorm tracking and nowcasting

    NASA Astrophysics Data System (ADS)

    Meyer, V. K.; Höller, H.; Betz, H. D.

    2013-05-01

    Total lightning (TL) data have been found to provide valuable information about the internal dynamics of a thunderstorm allowing conclusions about its further development as well as indicating potential of thunderstorm-related severe weather at the ground. This paper investigates electrical discharge correlations of strokes and flashes with respect to the temporal evolution of thunderstorms in case studies as well as by statistical means. The recently developed algorithm li-TRAM (tracking and monitoring of lightning cells, Meyer et al., 2013) has been employed to track and monitor thunderstorms based on three-dimensionally resolved TL data provided as stroke events by the European lightning location network LINET. From statistical investigation of 863 suited thunderstorm life cycles, the cell area turned out to correlate well with (a) the total discharge rate, (b) the in-cloud (IC) discharge rate, and (c) the mean IC discharge height per lightning cell as identified by li-TRAM. All three parameter correlations consistently show an abrupt change in discharge characteristics around a cell area of 170 km2. Statistical investigations supported by the comparison of three case studies - selected to represent a single storm, a multi-cell and a supercell - strongly suggest that the correlation functions include the temporal evolution as well as the storm type. With the help of volumetric radar data, it can also be suggested that the well-defined break observed at 170 km2 marks the region where the transition occurs from short-lived and rather simple structured single storm cells to better organized, more persistent, and more complex structured thunderstorm forms, e.g. multi-cells and supercells. All three storm types experience similar discharge characteristics during their growing and dissipating phases. However, while the poorly organized and short-lived cells preferentially remain small during a short mature phase, mainly the more persistent thunderstorm types develop

  9. OM85-BV Induced the Productions of IL-1β, IL-6, and TNF-α via TLR4- and TLR2-Mediated ERK1/2/NF-κB Pathway in RAW264.7 Cells

    PubMed Central

    Luan, Hong; Zhang, Qian; Wang, Le; Wang, Chuanxiao; Zhang, Miao; Xu, Xiaoli; Zhou, Huan; Li, Xing'ai; Xu, Qing; He, Fan

    2014-01-01

    Broncho-Vaxom (OM85-BV) is an extract mixture from 8 strains of Gram+ and Gram− bacteria and plays an important role in anti-infection immune response by regulating macrophage activity and cytokine productions. However, the mechanism by which OM85-BV enhances the cytokine expression is still obscure. In this study, we evaluated the effects of OM85-BV on the productions of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α) in RAW264.7 murine macrophages. Exposure of RAW264.7 cells to 100 μg/mL OM85-BV upregulated the expression of IL-1β, IL-6, and TNF-α at the mRNA and protein levels in a time- and dose-dependent manner. In addition, OM85-BV induced extracellular signal-regulated kinase (ERK) 1/2 and nuclear factor-kappa B (NF-κB) phosphorylation. Pretreatment with U0126 or Bay11-7082, respectively, could decrease IL-1β, IL-6, and TNF-α productions induced by OM85-BV. Application of Toll-like receptor (TLR) 4 or TLR2 small-interfering RNA (siRNA) into RAW264.7 cells could inhibit the productions of cytokines and ERK1/2 and NF-κB phosphorylation induced by OM85-BV. Consistent with this, downregulating either myeloid differentiation factor 88 (MyD88) or TRIF-related adaptor molecule (TRAM) gene with MyD88-siRNA or TRAM-siRNA separately could reduce the productions of cytokines and ERK1/2 and NF-κB phosphorylation induced by OM85-BV. Our study demonstrated that the productions of IL-1β, IL-6, and TNF-α induced by OM85-BV in RAW264.7 cells were through TLR4 and TLR2 signaling pathway-mediated activation of ERK1/2 and NF-κB. PMID:24605772

  10. The effect of commuting microenvironment on commuter exposures to vehicular emission in Hong Kong

    NASA Astrophysics Data System (ADS)

    Chan, L. Y.; Chan, C. Y.; Qin, Y.

    Vehicular exhaust emission has gradually become the major air pollution source in modern cities and traffic related exposure is found to contribute significantly to total human exposure level. A comprehensive survey was conducted from November 1995 to July 1996 in Hong Kong to assess the effect of traffic-induced air pollution inside different commuting microenvironments on commuter exposure. Microenvironmental monitoring is performed for six major public commuting modes (bus, light bus, MTR, railway, tram, ferry), plus private car and roadside pavement. Traffic-related pollutants, CO, NO x, THC and O 3 were selected as the target pollutants. The results indicate that commuter exposure is highly influenced by the choice of commuting microenvironment. In general, the exposure level in decreasing order of measured pollutant level for respective commuting microenvironments are: private car, the group consisting light bus, bus, tram and pavement, MTR and train, and finally ferry. In private car, the CO level is several times higher than that in the other microenvironments with a trip averaged of 10.1 ppm and a maximum of 24.9 ppm. Factors such as the body position of the vehicle, intake point of the ventilation system, fuel used, ventilation, transport mode, road and driving conditions were used in the analysis. Inter-microenvironment, intra-microenvironment and temporal variation of CO concentrations were used as the major indicator. The low body position and low intake point of the ventilation system of the private car are believed to be the cause of higher intake of exhaust of other vehicles and thus result in high pollution level in this microenvironment. Compared with other metropolis around the world and the Hong Kong Air Quality Objectives (HKAQO), exposure levels of commuter to traffic-related air pollution in Hong Kong are relatively low for most pollutants measured. Only several cases of exceedence of HKAQO by NO 2 were recorded. The strong prevailing wind

  11. Current status of breast reconstruction in China: an experience of 951 breast reconstructions from a single institute

    PubMed Central

    Huang, Nai-Si; Quan, Chen-Lian; Ma, Lin-Xiao-Xi; Si, Jing; Chen, Jia-Jian; Yang, Ben-Long; Huang, Xiao-Yan; Liu, Guang-Yu; Shen, Zhen-Zhou; Shao, Zhi-Min

    2016-01-01

    Background Since mastectomy remained the primary strategy for treating breast cancer in China, post-mastectomy reconstruction is of great importance in the Chinese population. The current study aimed to assess the current status of breast reconstruction in China. Methods We reviewed all patients who received breast reconstruction from August 2000 to July 2015 in the Department of Breast Surgery in our institute. Patients’ baseline characteristics, reconstruction strategy, final pathology and loco-regional recurrence (LRR) information were collected. Results A total of 951 breast reconstructions were conducted during the past 15 years, among which 247 (27.0%) were abdominal flap reconstruction; 471 (51.5%) were latissimus dorsi myocutaneous ± implant; and 233 (25.5%) were prosthesis-based reconstruction. The majority of cases (78.1%) were invasive breast cancer and up to 894 cases (94.0%) were immediate reconstruction. Prosthesis-based reconstruction rapidly increased in recent years, and was associated with bilateral reconstruction, contralateral augmentation and higher complications. 18 patients (2.0%) developed local-regional recurrence at the median follow-up time of 26.6 months (range, 3.7–62.0 months). A total of 66 nipple-areolar complex-sparing mastectomies (NSMs) (6.9%) were performed, none of which developed recurrence. Conclusions Breast reconstruction cases increased over the 15 years with the change of paradigm. Most strikingly, prosthesis-based reconstruction rapidly gained its prevalence and became the most common strategy. NSM was only performed for highly selected patients. Patients with breast reconstruction were able to achieve satisfactory loco-regional control in our cohort. PMID:27294034

  12. Necessity of Surgical Site Closed Suction Drain for Pterional Craniotomy

    PubMed Central

    Choi, Su Yong; Yoon, Sung Min; Yoo, Chan Jong; Kim, Young Bo; Kim, Woo Kyung

    2015-01-01

    Objective The aim of this study was to assess the benefit of using a prophylactic surgical site closed suction drain in pterional craniotomy. Materials and Methods A retrospective review was conducted on 607 consecutive patients who underwent a pterional craniotomy for treatment of intracranial anterior circulation aneurysms over a 5-year period. Between January 2000 and December 2004, 607 patients were divided into two groups, those who had a prophylactic suction drain during closure of the surgical site (drain group, DG) and those who did not (non-drain group, NDG). Head computed tomography (CT) was taken routinely on postoperative day (POD) 1, 7, and 14. Patients' demographics, incidence of surgical site complications, and courses of surgical site healing which were evaluated radiologically by the thickness of the surgical site myocutaneous layer, were analyzed between DG and NDG. Results Patients' demographics and characteristics did not differ significantly between the two groups. The head CT showed that the degree of changes in the postoperative surgical site thickness was 148% at POD 1, 209% at POD 7, and 198% at POD 14 in DG, and 118% at POD 1, 152% at POD 7, and 158% at POD 14 in NDG compared to the preoperative value. Postoperative surgical site hematoma was 7.9% (22/274) in DG and 2.4% (8/333) in NDG. Conclusion Prophylactic use of an epidural and/or subgaleal closed suction drain does not appear to be necessary for prevention of postoperative surgical site hematoma as well as for promotion of surgical site healing in pterional craniotomy. PMID:26523255

  13. Combined pulmonary and thoracic wall resection for stage III lung cancer.

    PubMed Central

    Shah, S. S.; Goldstraw, P.

    1995-01-01

    BACKGROUND--Carcinoma of the lung with thoracic wall involvement constitutes stage III disease. The management of patients with this condition is complicated. However, improvement in perioperative care coupled with advances in surgical technique have enabled a more aggressive approach to the problem to be adopted. METHODS--A retrospective review was carried out of 58 patients (40 men) of mean age 63 years who underwent thoracotomy for lung cancer with chest wall invasion between 1980 and 1993. RESULTS--Chest wall resection was performed in 55 patients (94.8%); in three patients the discovery of N2 disease at operation precluded resection. The TNM status was T3N0M0 in 38 patients, T3N1M0 in 13, and T3N2M0 in seven. Squamous cell carcinoma was the commonest cell type (26 patients). Reconstruction of the chest wall was performed in 29 patients (Marlex mesh in six, Marlex-methacrylate in 22, myocutaneous flap in one patient). The morbidity and mortality were 22.4% and 3.4% respectively. Follow up was complete in 51 patients. Nineteen (37.2%) survived > or = 5 years. The absolute five year survival for N0 and N1 disease was 44.7% and 38.4%, respectively. No patients with N2 disease survived five years. CONCLUSIONS--In patients with carcinoma of the lung and chest wall invasion, combined pulmonary and thoracic wall resection offers the prospect of cure with minimal morbidity and mortality. The prognosis of patients with coexistent N2 disease remains poor. PMID:7570416

  14. Systematic Review and Operative Technique of Recalcitrant Pressure Ulcers Using a Fillet Flap Technique

    PubMed Central

    Rao, Venkat K.

    2016-01-01

    Background: The purpose of this article is to describe the indications, operative technique, outcomes, and systematic review of the literature on the reconstruction of patients with end-stage pressure ulcers using a fillet flap technique. In this technique, the femur, tibia, and fibula are removed from the thigh and leg, and the soft tissue is used as a pedicled, or free, myocutaneous flap for reconstruction. Long-term outcomes, salient surgical technique of flap elevation, and design are detailed for patients who had a fillet of leg flap for reconstruction of extensive pressure ulcers. Methods: The indications, surgical technique, and postoperative outcomes of 5 patients who had pedicled fillet flaps are reviewed including patient age, sex, underlying comorbidities, duration of paraplegia, operative technique, and complications. A systematic review of the literature was performed searching PubMed, Cochrane Database, and Medline with the following MeSH terms: pressure ulcer, pressure sore, decubitus ulcer, fillet flap, and fillet flap. Inclusion criteria were use of a fillet technique, article data on the number of reconstructions before fillet flap, complications, and English language. Results: Most of our patients were male 75% (n = 3) with an average age of 47.5 years, had been paralyzed for an average of 16 years, and had few medical comorbidities. Two patients (3 flaps) required hip disarticulation, 1 patient had a bilateral fillet flaps, and 3 patients had resection of tibia/fibula. After following patients for an average of 1.4 years (4 mo to 2 yr), complications were limited to 1 patient who had partial-thickness flap loss at the distal skin flap that healed by secondary intention and 1 patient who had ulcer recurrence because of noncompliance. Four articles met inclusion criteria for systematic review and 3 were excluded. Conclusions: The fillet of leg flap remains a useful and reliable method of reconstructing end-stage pressure ulcers. PMID:27622082

  15. Continuous tissue oxygen tension measurement as a monitor of free-flap viability.

    PubMed

    Hirigoyen, M B; Blackwell, K E; Zhang, W X; Silver, L; Weinberg, H; Urken, M L

    1997-03-01

    Early recognition of vascular compromise within microvascular free-tissue transfers is essential if reexploration is to prove successful. Tissue oxygen tension is increasingly recognized to be a sensitive and reliable index of tissue perfusion, and preliminary studies suggest that it may be of value in the assessment of free-flap viability. We describe our investigation into the application of an implantable microcatheter oxygen sensor in the monitoring of free flaps used in head and neck and extremity reconstruction. In a preliminary study using the rabbit model, we sought to evaluate the response of oxygen tension as an index of tissue perfusion in myocutaneous (n = 20) and osteomyocutaneous flaps (n = 5) under conditions of arterial and venous occlusion. A clinical study was then undertaken to evaluate the role of this method in the monitoring of surface and buried free flaps. In 30 heterogeneous free-tissue transfers, sensors placed intraoperatively were used to provide continuous information about flap oxygen tension (mean monitoring period 3.2 +/- 0.8 days). The data generated were correlated with changes in clinical parameters and routine flap observations. Results for experimental and clinical data have confirmed the efficacy of continuous tissue oxygen measurements using this device as a method that provides an objective, recordable index of free-tissue transfer viability in a variety of circumstances and vascular events. Tissue oxygen tension is a suitable index by which to evaluate flap viability with the probe placed in muscle or bone but is unreliable when used for the monitoring of revascularized cutaneous flaps. PMID:9047197

  16. Rare complication after VAC-therapy in the treatment of deep sore ulcers in a paraplegic patient.

    PubMed

    Citak, Mustafa; Backhaus, Manuel; Meindl, Renate; Muhr, Gert; Fehmer, Tobias

    2010-12-01

    The VAC-therapy is a safe, easy, and effective therapy for the management of chronic wounds. Known advantages of the VAC technique are the quicker wound healing by stimulating the blood flow, the formation of granulation tissue, angiogenesis, and cell proliferation. The use of negative pressure treatment can decrease the number of dressing changes and length of hospital stay. However, some related complications after and during VAC therapy have been described. We here describe a rare complication during the treatment of severe os ischium sore with VAC therapy, which has not been reported in the literature yet. We report about a 43-year-old paraplegic patient, referred to our clinic from a regional hospital where he had been admitted 2 months earlier, presenting with a necrotizing fasciitis after VAC therapy during the treatment of fourth grade os ischium sore. After operative debridement and long-term antibiotics with Ciprofloxacin soft tissue closure was performed using a myocutaneous tensor fascia lata flap. Temporary stabilization was achieved by a triangle external fixateur attached to the right femur and the pelvis. After 1 week the tapping point of the muscle flap could be covered with local skin mesh-graft from the right calf as a donor site. The patient was mobilized in a wheelchair and was discharged home 3 months after admission. The VAC technique is a safe, easy, and effective means in chronic wound care management. However, the described rare complication should be kept in mind. The clinical management of VAC therapy requires a distinct indication and close clinical monitoring by experienced medical professionals. The use of VAC therapy in fourth grade sores may have deleterious consequences for the patient.

  17. Karydakis flap for post-proctectomy perineal sinus: A case series and review

    PubMed Central

    Au, S.; Moyes, L.H.; Telfer, J.R.C.; Anderson, J.H.

    2016-01-01

    Introduction Persistent perineal sinus (PPS) may occur in up to 38% of patients undergoing proctectomy. The available therapeutic options range from simple but ineffective to relatively successful but complex. The Karydakis procedure is a straightforward day-case operation, commonly performed by general surgeons in the treatment of pilonidal disease, a not dissimilar pathology to PPS. This report is the first in the literature describing the use of Karydakis procedure in patients who developed PPS after proctectomy for Crohn’s disease. Presentation of case Two patients, both of whom suffered from Crohn’s disease and a PPS, underwent a Karydakis procedure as first-line treatment for PPS. Case 1 had a relatively superficial PPS while Case 2 had a deeper, more complex and longstanding PPS. Both patients had no post-operative complications and were discharged on the same day. They achieved complete healing in eight weeks and eight months respectively. The follow up range was 8–16 months. Discussion Various techniques, including complex myocutaneous flap reconstruction, have been described in the literature to treat PPS. In contrast to these complex techniques, Karydakis operation is a simple day case procedure that was successful in treating PPS in our patients. While there is robust data regarding low recurrence rates following a Karydakis flap for pilonidal disease, there is no existing data for the indication outlined in this report. Conclusion While it requires further assessment, the Karydakis operation has potential as a simple, safe and effective first-line treatment in selected patients with PPS while not precluding more complex operative options in the future. PMID:27138449

  18. [Treatment of thoracic and abdominal cavity perforation complicated by Henoch-Schonlein purpura nephritis in a patient with high-voltage electric burn].

    PubMed

    Zhang, Wei; Xie, Wei-guo; Min, Wei-xiong; Wang, De-yun; Zhang, Jia; Wan, Shi-yong

    2013-10-01

    A 55-year-old male patient suffered from severe high-voltage electric burn with an area of 20%TBSA full-thickness injury. The injury involved the distal end of left upper limb, right trunk, and whole abdominal wall. Fracture of the 7th-10th ribs was found in the right side of chest, with perforation of abdominal cavity, and bilateral pleural effusion was found. Part of the small intestine was necrotic and exposed. At the early stage, xeno-acellular dermal matrix was grafted after debridement of abdominal wound; peritoneal lavage was performed; negative pressure drainage was performed in orificium fistula of intestine for promoting the adhesion between perforated intestine and abdominal scar. Two orificium fistulas formed after closure of abdominal granulation wound by autologous skin grafting. Eschar of chest wall and denatured ribs were retained. The risk of infection of thoracic cavity was decreased by promoting the adhesion between lung tissue and chest wall. During the treatment, the patient was diagnosed with Henoch-Schonlein purpura nephritis by renal biopsy, with the symptoms of purpura in the lower limbs, heavy proteinuria, severe hypoalbuminemia, edema, etc. After control of kidney damage by immunosuppressive treatment instead of glucocorticoid, alleviation of the levels of proteinuria and blood albumin, free latissimus dorsi myocutaneous flap was excised to repair chest wall, and free skin graft was excised to repair intestinal fistula. After all the wounds were successfully covered, the patient was treated with glucocorticoid combined with immunosuppressants for more than 1 year. The patient was followed up for 3 years, and his renal function was completely recovered with satisfactory clinical outcome.

  19. Systematic Review and Operative Technique of Recalcitrant Pressure Ulcers Using a Fillet Flap Technique

    PubMed Central

    Rao, Venkat K.

    2016-01-01

    Background: The purpose of this article is to describe the indications, operative technique, outcomes, and systematic review of the literature on the reconstruction of patients with end-stage pressure ulcers using a fillet flap technique. In this technique, the femur, tibia, and fibula are removed from the thigh and leg, and the soft tissue is used as a pedicled, or free, myocutaneous flap for reconstruction. Long-term outcomes, salient surgical technique of flap elevation, and design are detailed for patients who had a fillet of leg flap for reconstruction of extensive pressure ulcers. Methods: The indications, surgical technique, and postoperative outcomes of 5 patients who had pedicled fillet flaps are reviewed including patient age, sex, underlying comorbidities, duration of paraplegia, operative technique, and complications. A systematic review of the literature was performed searching PubMed, Cochrane Database, and Medline with the following MeSH terms: pressure ulcer, pressure sore, decubitus ulcer, fillet flap, and fillet flap. Inclusion criteria were use of a fillet technique, article data on the number of reconstructions before fillet flap, complications, and English language. Results: Most of our patients were male 75% (n = 3) with an average age of 47.5 years, had been paralyzed for an average of 16 years, and had few medical comorbidities. Two patients (3 flaps) required hip disarticulation, 1 patient had a bilateral fillet flaps, and 3 patients had resection of tibia/fibula. After following patients for an average of 1.4 years (4 mo to 2 yr), complications were limited to 1 patient who had partial-thickness flap loss at the distal skin flap that healed by secondary intention and 1 patient who had ulcer recurrence because of noncompliance. Four articles met inclusion criteria for systematic review and 3 were excluded. Conclusions: The fillet of leg flap remains a useful and reliable method of reconstructing end-stage pressure ulcers.

  20. Voice prosthesis insertion after endoscopic balloon-catheter dilatation in case of a stenotic hypopharyngo-oesophageal junction.

    PubMed

    Móricz, Péter; Gerlinger, Imre; Solt, Jeno; Somogyvári, Krisztina; Pytel, József

    2007-12-01

    Stenosis of the hypopharyngo-oesophageal junction can be a rare complication of laryngectomy and/or partial pharyngectomy and makes the insertion of voice prosthesis extremely difficult. This study describes the authors' experiences gained by endoscopic balloon-catheter dilatation of hypopharyngo-oesophageal stenoses prior to implantation of voice prostheses in four cases. In two patients a single balloon-catheter dilatation resulted in wide enough pharyngo-oesophageal lumen on the long run. The average prosthesis wearing-times were 6.8 months in case 1 and 4.6 months in case 2, corresponding to the published literature data. In case 3, repeated dilatation of the pharyngo-oesophageal transition had proved to be unsuccessful despite taking every effort with the endoscopic balloon-catheter method. Having excised the stenotic segment, reconstruction with pectoralis major myocutaneous flap (PMMF) was indicated. Eighteen months later, a repeated restenosis was observed and a free jejunal flap needed to be performed as a final solution. In case 4, the insertion was carried out into a previously dilated jejunal free flap, which became gradually ischemic and stenotic since the major head-and neck procedure was carried out that resulted in prosthesis rejection after just 1 week. The authors emphasize that correct indication of pedicled and free flaps in head and neck reconstruction is a prerequisite from the aspect of prevention of pharyngo-oesophageal strictures. Endoscopic balloon-catheter dilatation is a safe and established method for dilatating hypopharyngo-oesophageal stenoses of different origin. The procedure provides maximum patient benefit with minimal trauma and morbidity; moreover, facilitates insertion of voice prostheses. However, a single balloon-catheter dilatation cannot always result in wide enough oesophageal lumen on the long run (case 3). Insertion of a voice prosthesis into a previously dilated ischemic jejunal segment is challenging and avoidable due