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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. Rectus abdominis myocutaneous flap for primary vaginal reconstruction.

    PubMed

    Carlson, J W; Soisson, A P; Fowler, J M; Carter, J R; Twiggs, L B; Carson, L F

    1993-12-01

    Reconstructive procedures are being performed with increasing frequency in conjunction with pelvic exenterations and other radical gynecologic surgeries. The most common reconstructive procedures include continent urinary diversion, rectosigmoid anastomosis, and vaginal reconstruction. Historically, the gracilis myocutaneous flap has been the procedure of choice for vaginal reconstruction. However, the gracilis myocutaneous flap has a history of partial to severe necrosis, a propensity to prolapse, and leaves ipsilateral donor scars on the thigh. In contrast, neovaginal reconstruction using a relatively new procedure, the distally based rectus abdominis myocutaneous flaps, has the advantage of using a large, single flap that can be incorporated into the primary incision. This flap is mobilized on a long vascular pedicle, the rectus muscle. In relation to the underlying rectus muscle, the orientation of the cutaneous portion of this flap may be customized to accommodate the pelvic defect or the surgeon's preference. Depending on their primary orientation, they are referred to as either a vertical or transverse rectus abdominis myocutaneous flap. The versatility and reliability of the rectus flap is demonstrated here through the presentation of a small pilot series of seven patients. The technique was used for vaginal reconstruction, primarily in conjunction with pelvic exenteration. The flaps were mobilized from the supraumbilical area and had a flap viability of 100% for the 2 years that they have been followed. There were no postoperative incisional or flap infections. There was one infraumbilical fascial dehiscence. The advantages of primary pelvic reconstruction along with the description of the operative techniques are presented. PMID:8112640

  3. Gynecologic reconstruction with a rectus abdominis myocutaneous flap: an update.

    PubMed

    Carlson, J W; Carter, J R; Saltzman, A K; Carson, L F; Fowler, J M; Twiggs, L B

    1996-06-01

    This series reports the outcomes and significant complications associated with the rectus myocutaneous flap when used for pelvic or inguinal reconstruction in patients with gynecologic cancers. Perioperative variables were retrospectively reviewed to identify social and medical risk factors as well as intraoperative and postoperative complications that predisposed to rectus flap failure. Fifteen patients with gynecologic malignancies underwent reconstructive procedures using a vertically oriented rectus abdominis myocutaneous flap for either vaginal (n = 14) or inguinal (n = 1) reconstruction. The patients' primary cancers were cervical (n = 11), rectal (n = 1), ovarian (n = 1), vulvar (n = 1), and vaginal (n = 1). The median age was 50 years. The median follow-up was 17 months. All flaps were mobilized in conjunction with a radical salvage operation. There were no cases of vaginal prolapse and no abdominal wound infections. However, 4 patients (27%) had major postoperative morbidity in this small series. There was one wound dehiscence and three episodes of necrosis of the subcutaneous and cutaneous portions of the flap. All 4 of these patients required additional operative intervention or debridement. Eleven patients had complete healing of the flap. The rectus abdominis myocutaneous flap is a valuable option for gynecologic reconstructive procedures. Perioperative strategies for improving flap viability include the identification of risk factors that may compromise flap perfusions such as prior abdominal incisions, peripheral vascular disease, and obesity. Meticulous surgical technique is required to preserve the vascular pedicle. These strategies may be useful in preoperative counseling, the perioperative evaluation, and the intraoperative management. PMID:8641616

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

    PubMed

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

    2016-08-01

    Background Being an inevitable component of free tissue transfer, ischemia-reperfusion injury tends to contribute to flap failure. TNF-α is an important proinflammatory cytokine and a prominent mediator of the ischemia-reperfusion injury. Etanercept, a soluble TNF-α binding protein, has shown anti-inflammatory and anti-apoptotic effects in animal models of renal and myocardial ischemia-reperfusion injury. We have designed an experimental study to investigate the effect of etanercept on myocutaneous ischemia-reperfusion injury on transverse rectus abdominis myocutaneous flap model in rats. Methods Twenty-four male Sprague-Dawley rats were divided into 3 groups: In group 1 (sham), the TRAM flap was raised and sutured back without further intervention. In group 2 (control), the flap was raised and the ischemia-reperfusion protocol was followed. In group 3, etanercept (10 mg/kg, i.v.) was administered 10 minutes before reperfusion. At the end of the reperfusion period, biochemical and histolopathological evaluations were performed on serum and tissue samples. Results In the etanercept group the IMA and 8-OHdG levels (p = 0.005 and p = 0.004, respectively) were found significantly lower, and the GSH and SOD levels (p = 0.01 and p < 0.001, respectively) significantly higher in comparison to the control group. The histopathological analysis has revealed a lower degree of hyalinization, degenerated muscle fibers and nuclear change in the etanercept group compared to the control group. Conclusion The results of our experimental study indicate that etanercept offers protection against ischemia-reperfusion injury in skeletal muscle tissue, enhancing the TRAM flap viability. The ability of etanercept to induce ischemic tolerance suggests that it may be applicable in free-flap surgery. PMID:26950289

  5. Herpes Zoster in a Free Transverse Rectus Abdominis Myocutaneous Flap After Delayed Breast Reconstruction

    PubMed Central

    Lee, Jeong Hui; Ahn, Hee Chang; Chung, Min Sung

    2015-01-01

    Abstract In concert with advances in surgical reconstruction techniques and improved survival after breast cancer, both the aesthetic and functional outcomes, especially sensory recovery, of breast reconstruction have been addressed. Most studies on sensory recovery in reconstructed breasts have utilized patients’ subjective responses to touch, pain, temperature, and pressure. In contrast, this report describes a case of herpes zoster that developed in a free transverse rectus abdominis myocutaneous flap, which provides objective evidence of spontaneous reinnervation after breast reconstruction. PMID:25974118

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

    PubMed Central

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

    2008-01-01

    Introduction Breast reconstruction with autologous tissue transfer is now a standard operation, but abnormalities of the abdominal wall contour represent a complication which has led surgeons to invent techniques to minimize the morbidity of the donor site. Case presentation We report the case of a woman who had bilateral transverse rectus abdominis myocutaneous flap (TRAM-flap) breast reconstruction. The surgery led to the patient developing an enormous abdominal bulge that caused her disability in terms of abdominal wall and bowel function, pain and contour. In the absence of rectus muscle, the large defect was repaired using a combination of the abdominal wall component separation technique of Ramirez et al and additional mesh augmentation with a lightweight, large-pore polypropylene mesh (Ultrapro®). Conclusion The procedure of Ramirez et al is helpful in achieving a tension-free closure of large defects in the anterior abdominal wall. The additional mesh augmentation allows reinforcement of the thinned lateral abdominal wall. PMID:18416835

  7. Breast reconstruction with a turbocharged transverse rectus abdominis myocutaneous flap on the contralateral perforator.

    PubMed

    Sbalchiero, Juliano Carlos; de Albuquerque Leal, Paulo Roberto; dos Santos, César Cabello

    2014-11-01

    Seventeen patients were submitted to delayed unilateral breast reconstruction using pedicled, muscle-sparing turbocharged transverse rectus abdominis myocutaneous flap based on the contralateral perforator vessels. The lateral portion of the rectus abdominis muscle on the pedicled side was preserved in 12 patients. Zones II and IV were included in the flap in all cases. Mean duration of surgery was 7 hours and 15 minutes. Four complications developed in the abdominal donor site: contralateral abdominal bulging (n=1), minor suture dehiscence (n=2), and epidermolysis at the border of the abdominal flap and umbilical scar (n=1). Three partial losses (10%-30%) occurred in the reconstructed breast (17.64% of cases), whereas 2 cases of fat necrosis were associated with partial losses. One patient developed deep vein thrombosis with pulmonary embolism; however, outcome was favorable. This proved a viable alternative for breast reconstruction, with satisfactory results in most patients and acceptable morbidity and surgical time. PMID:24625511

  8. Reconstruction of large composite oromandibulomaxillary defects with free vertical rectus abdominis myocutaneous flaps.

    PubMed

    Butler, Charles E; Lewin, Jan S

    2004-02-01

    Large composite oromandibulomaxillary defects resulting from oncologic resection can be challenging to reconstruct with a single flap, and functional outcomes remain anecdotal. The purpose of this study was to evaluate the authors' surgical experience and scientifically analyze and describe the functional outcomes associated with the use of the vertical rectus abdominis myocutaneous flap for reconstruction of these defects. The records of seven patients (mean age, 62 years) who underwent composite resection including hemimandibulectomy, partial maxillectomy, partial pharyngectomy, and floor-of-mouth resection followed by immediate free vertical rectus abdominis myocutaneous flap reconstruction at The University of Texas M. D. Anderson Cancer Center (1998 to 2002) were retrospectively reviewed. The tumor type was squamous cell carcinoma in all seven cases; four patients had T4 primary lesions and three had local recurrences. Radiotherapy was used preoperatively in each of the three recurrent cases (mean dose, 70.6 Gy) and postoperatively in three of the four patients with primary tumors (mean dose, 63.0 Gy). The mean length of hospitalization was 8.7 days. There were no major flap complications, fistulas, or donor-site complications. Partial flap necrosis (4 percent of flap area) occurred in one patient and dehiscence of the neck incision occurred in another. Both cases were managed with surgical débridement and closure. A third patient developed a 0.75-cm superficial suture line abscess that healed with dressing changes. The mean postoperative follow-up was 15 months. Six of the seven patients remained tube dependent for their nutrition despite some swallowing improvement; one patient returned to full oral intake. The most common swallowing deficit was impaired laryngeal excursion, which occurred in all six patients evaluated with videofluoroscopic examination and resulted in risk for aspiration in patients and frank aspiration in 83 percent. Speech was

  9. [Perineal soft-tissue reconstruction with vertical rectus abdominis myocutan (VRAM) flap following extended abdomino-perineal resection for cancer].

    PubMed

    Bognár, Gábor; Novák, András; István, Gábor; Lóderer, Zoltán; Ledniczky, György; Ondrejka, Pál

    2012-10-01

    Perineal wound healing problems following extended abdomino-perineal resection of ano-rectal cancer represent a great challenge to the surgeon. Perineal soft-tissue reconstruction with a myocutan flap was thought to reduce surgical wound healing complications. A review of the relevant literature was carried out on perineal soft-tissue reconstruction with rectus abdominis myocutan (VRAM) flap following extended abdomino-perineal rectal resection for cancer. The more commonly used neoadjuvant chemo- and radiotherapy as well as extended surgical radicality resulted in increased perioperative risks, therefore combined procedures between the colorectal and plastic surgical teams are inevitable. This case report illustrates the above trend. PMID:23086826

  10. Initial experience with breast reconstruction using the transverse rectus abdominis myocutaneous flap: a study of 45 patients.

    PubMed Central

    Andrews, E.; Bond, J.; Dolan, S.; Kirk, S.

    1999-01-01

    Breast conserving surgery for breast cancer has led to an increased interest in reconstruction following mastectomy. The transverse rectus abdominis myocutaneous flap has been proven to give good results in terms of restoration of body symmetry with near normal contour and consistency. Furthermore, immediate reconstruction has the advantage of a single procedure with less psychological morbidity, and reduction in hospital stay and overall complication rate. The aim of this study was to review our experience with the transverse rectus abdominis myocutaneous flap procedure an initial series of 45 patients. The overall complication rate of 27% is similar to that reported in the literature, with no total flap loss and nine patients with partial flap loss. There was no delay in commencement of adjuvant chemotherapy or radiotherapy and we believe our ability to detect local recurrence has not been compromised. We consider that immediate breast reconstruction is now an integral part of the surgical treatment of breast cancer. PMID:10489808

  11. Presurgical Botulinum Toxin A Treatment Increases Angiogenesis by Hypoxia-Inducible Factor-1α/Vascular Endothelial Growth Factor and Subsequent Superiorly Based Transverse Rectus Abdominis Myocutaneous Flap Survival in a Rat Model.

    PubMed

    Park, Tae Hwan; Lee, Song Hyun; Park, Yun Joo; Lee, Young Seok; Rah, Dong Kyun; Kim, Sung Young

    2016-06-01

    To date, there have been several experimental studies to assess tissue viability of transverse rectus abdominis myocutaneous (TRAM) flaps. Botulinum toxin A (BoTA) has gained popularity in many clinical fields, for a variety of therapeutic and aesthetic purposes. In addition, there have been reports regarding the positive effect of BoTA on flap survival by various mechanisms. In this study, we hypothesized that pretreatment with BoTA could augment the survival of TRAM flaps via increased hypoxia-inducible factor (HIF)1α/vascular endothelial growth factor (VEGF)-dependent angiogenesis.Twenty-four Sprague-Dawley rats were randomly divided into 2 groups: a control group and a BoTA group. Five days before superiorly based TRAM flap elevation, the BoTA group was pretreated with BoTA, whereas the control group was pretreated with normal saline. Gross flap survival rates were assessed, and quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR) and Western blotting were performed for the evaluation of angiogenesis-related factors (CD34, HIF-1α, and VEGF).In the BoTA group, the gross flap survival rate was significantly higher than that in the control group on both ipsilateral (92.78.3 ± 5.05% vs 86.8 ± 3.88%, P = 0.009) and contralateral (91.57 ± 5.79% vs 74.28 ± 11.83%, P < 0.001) sides.The relative mRNA expression of CD34 and VEGF was significantly higher in the BoTA group than that in the control group in every zone, whereas the relative mRNA expression of HIF-1α was significantly higher in the BoTA group than that in the control group on contralateral sides. The relative protein expression of CD34, VEGF, and HIF-1α was significantly higher in the BoTA group than that in the control group in every zone.In conclusion, we demonstrate that presurgical BoTA treatment might increase angiogenesis by HIF-1α/VEGF, subsequently increase superiorly based TRAM flap survival in a rat model. PMID:25695458

  12. 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

  13. Satisfaction following Unilateral Breast Reconstruction: A Comparison of Pedicled TRAM and Free Abdominal Flaps

    PubMed Central

    Schwitzer, Jonathan A.; Miller, H. Catherine; Pusic, Andrea L.; Matros, Evan; Mehrara, Babak J.; McCarthy, Colleen M.; Lennox, Peter A.; Van Laeken, Nancy

    2015-01-01

    Background: The purpose of this study was to compare patient satisfaction following unilateral pedicled transverse rectus abdominis myocutaneous (TRAM) and free abdominal flap reconstruction. Methods: Patients who underwent unilateral breast reconstruction using pedicled TRAM or free abdominal flaps (muscle-sparing TRAM or deep inferior epigastric perforator flap) and completed the BREAST-Q were identified from 2 prospectively maintained databases. BREAST-Q scores were assessed and compared for Satisfaction with Breasts, Outcome, and Physical Well-being Chest/Abdomen. Results: Of the 138 patients who completed the BREAST-Q, 84 underwent pedicled TRAM flap reconstruction and 54 underwent free abdominal flap reconstruction. Overall, pedicled TRAM flap patients scored higher than free abdominal flap patients on all 4 BREAST-Q scales. This difference reached statistical significance in Satisfaction with Breasts (+7.74; P = 0.02). Similar results were found among patients who completed the BREAST-Q at <3 years postoperation. However, among patients at ≥3 years postoperation, there were no statistically significant differences between the 2 groups, with the pedicled flap cohort scoring higher in Satisfaction with Breasts and Physical Well-being Chest and the free abdominal flap cohort scoring higher in Satisfaction with Outcome and Physical Well-being Abdomen scores. Conclusions: Patients who underwent unilateral pedicled TRAM flap reconstruction experienced greater initial breast satisfaction than patients who underwent unilateral free abdominal flap reconstruction, but satisfaction equalized between the two over time, suggesting that long-term satisfaction may be equivalent between the 2 methods of reconstruction. PMID:26495195

  14. Variation in Tendinous Intersections of Rectus Abdominis Muscle in North Indian Population with Clinical Implications

    PubMed Central

    Haque, Mahboobul; Gupta, Amrita; Nasar, Areeba

    2015-01-01

    Aim of the study Incisions through the abdominal wall are based on anatomical principles and Rectus abdominis muscle provides an excellent myocutaneous flap. The present work was proposed to identify variations in numbers and location of tendinous intersections of the Rectus Abdominis muscle in the cadavers as a guide to the surgical procedures. Materials and Methods The study was conducted on 54 cadavers of North Indian origin allotted to undergraduate medical student for Anatomy dissection classes. Manual dissection was done to identify tendinous intersections of the Rectus Abdominis muscle with reference to number and location. Results In the present study one cadaver had five tendinous intersections (1.85%), one cadaver had four tendinous intersections (1.85%) and 52 cadavers had three tendinous intersections (96.29%). Conclusion The present study is an effort to provide data about the anatomical variation in numbers and location of tendinous intersections of the Rectus Abdomini muscles. Rectus abdominis muscle provides an excellent myocutaneous flap because the muscle belly is separated from surrounding tissue within the rectus sheath. This study is representative of a small study of the human population and only serves to illustrate the variations in the anatomy of the tendinous intersections. More extensive studies are required to establish a definitive pattern among local populations to serve as a guide for surgical procedures. PMID:26266107

  15. The platysma myocutaneous flap.

    PubMed

    Baur, Dale A; Williams, Jonathan; Alakaily, Xena

    2014-08-01

    Reconstructing defects of the oral mucosa or skin of the lower one-third of the face can be accomplished by a variety of techniques. This article presents two versions of the platysma myocutaneous flap, which is a reliable, axial pattern, pedicled flap capable of providing excellent one-stage reconstruction of such defects. As discussed herein, the superiorly based and posteriorly based versions of the flap have wide application in the oral and facial region. Also provided is a review of other uses of this flap in head and neck surgery. PMID:24958382

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

    PubMed

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

    2015-01-01

    Autologous breast reconstruction with the deep inferior epigastric perforator (DIEP) or muscle-sparing transverse rectus abdominis myocutaneous (ms-TRAM) flap is a common method in the majority of patients after mastectomy. Because of an increased perioperative risk profile the benefit in older patients is questionable. To assess the postoperative quality of life and peri- and post-operative complications of older compared to younger patients is the aim of this retrospective study. In a retrospective analysis 39 older (i.e. >60 years) and 140 younger patients (i.e. <60 years) with autologous breast reconstruction in the Department of Plastic Surgery at the University Hospital of Erlangen-Nuernberg were surveyed at least 6 month postoperative using the BREAST-Q questionnaire. Correlations were generated between comorbidities and complications. Significant differences were observed regarding hospitalization, pre-existing diseases and the choice of DIEP versus ms-TRAM flaps. Parameters such as major and minor complications, bulging or hernia and risk factors (e.g. smoking or obesity) showed no significant differences. The results of the questionnaire parameters showed no significant difference between both groups, revealing high satisfaction with the aesthetic result and an improvement in quality of life independent of age. Autologous breast reconstruction after mastectomy generates a gain in quality of life and shows a good to excellent overall satisfaction in older as well as younger patients. Despite a longer hospitalization and a different risk profile there were no significant differences regarding minor and major complications in the postoperative course. Hence autologous breast reconstruction for older patients is justified and should be taken into consideration. PMID:26400037

  17. 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

  18. 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 PRIVY ARE LOCATED IN BOTTOM RIGHT CORNER. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  19. Cholecystectomy after breast reconstruction with a pedicled autologous tram flap. Types of surgical access.

    PubMed

    Graczyk, Magdalena; Kostro, Justyna; Jankau, Jerzy; Bigda, Justyna; Skorek, Andrzej

    2014-09-01

    The number of breast reconstruction procedures has been increasing in recent years. One of the suggested treatment methods is breast reconstruction with a pedicled skin and muscle TRAM flap (transverse rectus abdominis muscle - TRAM). Surgical incisions performed during a cholecystectomy procedure may be located in the areas significant for flap survival. The aim of this paper is to present anatomical changes in abdominal walls secondary to pedicled skin and muscle (TRAM) flap breast reconstruction, which influence the planned access in cholecystectomy procedures. The authors present 2 cases of cholecystectomy performed due to cholelithiasis in female patients with a history of TRAM flap breast reconstruction procedures. The first patient underwent a traditional method of surgery 14 days after the reconstruction due to acute cholecystitis. The second patient underwent a laparoscopy due to cholelithiasis 7 years after the TRAM procedure. In both cases an abdominal ultrasound scan was performed prior to the operation, and surgical access was determined following consultation with a plastic surgeon. The patient who had undergone traditional cholecystectomy developed an infection of the postoperative wound. The wound was treated with antibiotics, vacuum therapy and skin grafting. After 7 weeks complete postoperative wound healing and correct healing of the TRAM flap were achieved. The patient who had undergone laparoscopy was discharged home on the second postoperative day without any complications. In order to plan a safe surgical access, it is necessary to know the changes in the anatomy of abdominal walls following a pedicled TRAM flap breast reconstruction procedure. PMID:25337177

  20. 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

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

    PubMed

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

    2016-02-01

    Ever since its introduction, the transverse rectus abdominis myocutaneous flap has become the mainstay of autologous breast reconstruction. However, concerns regarding donor site morbidity due to the breach of abdominal wall musculature integrity soon followed. Muscle-sparing techniques, eventually eliminating the muscle from the flap all-together with the deep inferior epigastric artery perforator flap, did not eliminate the problem of abdominal wall weakness. This led to the conclusion that motor innervation might be at fault. Studies have shown that even in the presence of an intact rectus abdominis muscle, and an intact anterior rectus sheath, denervation of the rectus abdominis muscle results in significant abdominal wall weakness leading to superior and inferior abdominal bulges, and abdominal herniation. Our aim was to establish a mathematical model to predict the location of the motor innervation to the rectus abdominis muscle, and thus provide surgeons with a tool that will allow them to reduce abdominal morbidity during deep inferior epigastric artery perforator and free muscle-sparing transverse rectus abdominis myocutaneous surgery. We dissected 42 cadaveric hemiabdomens and mapped the course of the thoracolumbar nerves. We then standardized and analyzed our findings and presented them as a relative map which can be adjusted to body type and dimensions. Our dissections show that the motor innervation is closely related to the lateral vascular supply. Thus, when possible, we support the preferred utilization of the medial vascular supply, and the preservation of the lateral supply and motor innervation. PMID:26756600

  2. 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

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

    PubMed

    Edmunds, Marie-Claire; Czopek, Alicja; Wigmore, Stephen J; Kluth, David C

    2014-01-01

    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

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

    PubMed

    Sinsel, N K; Guelinckx, P J

    1995-01-01

    Among all known flaps, the rectus abdominis muscle flap possesses an unique diversity in flap designs due to the special vascular supply of the abdominal wall. The axial vascularization of the rectus abdominis muscle gives ofF several musculocutaneous perforators, which are mainly located in the periumbilical region. Abdominal wall skin perfusion is guaranteed by spoke-wheel like vessels arising from these perforators. Subsequently several designs (muscle, myocutaneous and myosubcutaneous) are possible, by varying the included tissue and the position of the skin island. We described 7 cases where the rectus abdominis muscle was used as a muscle or myocutaneous flap for reconstruction of large defects. In most cases a pedicled transfer was necessary, possible and sufficient to reconstruct the difficult defects in various body regions. Great amounts of well perfused tissue can be transferred with still possible primary closure of the donor site. Due to its rich perfusion and constancy of vascular pattern, it represents an excellent and safe pedicled reconstructive procedure for large defects of the thorax, the abdomen, the forearm or the hip and pelvis where free tissue transfers are impossible or contraindicated. No other local transposition would have achieved this goal, due to the lack of volume and mobility. Moreover the flap is ideal for reconstruction of contour deficiencies due to the abundance of fat, as for example in breast or buttock reconstruction. However the flap is not the first choice for traumatic and infected wounds where fat tissue is not desired. PMID:8571724

  5. 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

  6. 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

  7. 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

  8. A bilobed thoracoabdominal myocutaneous flap for large thoracic defects.

    PubMed

    Charanek, Ali M

    2014-04-01

    The author presents a surgical procedure for chest-wall soft tissue reconstruction due to large losses based on a modified thoracoabdominal myocutaneous flap. Designed in a bilobed shape, it rests on the superior epigastric vessels and may include the cranial one fourth of the rectus abdominis muscle and the premuscular fascia of external oblique muscle and constitutes one of the largest flaps based on a single minor artery. Local recurrent breast tumors and adjuvant therapy associated to obesity, high blood pressure, type II diabetes, and tobacco abuse on previously debilitated patients render the usual reconstructive procedure difficulties. These become indications for this flap, whose safety is improved by maintaining the deep fascia of the external oblique muscle attached to the flap to preserve the network of the arteries close to the fascia and a wide-ranging interarterial choke anastomosis alongside the lateral projection of the flap on the thorax. Thus, a wide range of angles allows us to reach even the opposite site of the thorax over the sterna area with an easy closure of the donor site facilitated by the vertical portion of the abdominal donor site. The flap was used in 55 patients, and no serious complications, including necrosis, notable dehiscence, hematoma, seroma, or abdominal wall weakness, were observed. The overall aspect is acceptable with the visible scars over the upper part of the abdomen. PMID:23503434

  9. BEO Tram Spectral Data 2014

    DOE Data Explorer

    Torn, Margaret; Serbin, Shawn

    2015-06-10

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

  10. Upper cervicothoracic sympathetic block increases blood supply of unipedicled TRAM flap.

    PubMed

    Tsoutsos, Dimosthenis; Kakagia, Despoina; Gravvanis, Andreas; Iconomou, Thomais; Tsagkarakis, Myron; Zogogiannis, Ioannis; Dimitriou, Vassilios

    2008-09-01

    A prospective clinical study was conducted to evaluate the impact of upper cervicothoracic sympathetic block (CTGB) on blood supply of the unipedicled transverse rectus abdominis musculocutaneous (TRAM) flap. The use of the technique is first reported herein, as a manipulation improving arterial blood flow within the flap in high-risk patients, thus reducing postoperative morbidity. From March 2003 to September 2006, 28 heavy smokers, who underwent delayed breast reconstruction with unipedicled TRAM flap, were included in the study. Intraoperative upper cervicothoracic block (ganglia C5,6,7 and T1,2) was performed in 16 patients (group A), while 12 patients, who did not consent to have the blockade (group B), were the control. Clinical evaluation and thermographic monitoring of skin temperature, using the Thermacam A40 (FLIR systems, Wilsonville, OR), was used in all patients and determined the blood flow within the flap. All patients were monitored for early and late complications. In all group A patients, CTGB resulted in TRAM flap temperature increase within 9.5 to 16 min. Flap temperature elevation was found to be significantly higher (P < 0.001) and hospital stay was significantly shorter (P = 0.004) in group A patients. No CTGB or TRAM flap complications were recorded in group A patients. However, in group B, major fat necrosis occurred in 2 patients and partial (1/3) flap necrosis in 1 patient. Upper cervicothoracic sympathetic block is a reliable, safe, and useful technique for increasing blood flow within TRAM flaps in high-risk patients, like heavy smokers, and it minimizes postoperative morbidity. PMID:18724121

  11. Exploring the impacts of factors contributing to tram-involved serious injury crashes on Melbourne tram routes.

    PubMed

    Naznin, Farhana; Currie, Graham; Logan, David

    2016-09-01

    Previous research is limited regarding factors influencing tram-involved serious injury crashes. The aim of this study is to identify key vehicle, road, environment and driver related factors associated with tram-involved serious injury crashes. Using a binary logistic regression modelling approach, the following factors were identified to be significant in influencing tram-involved fatal crashes in Melbourne: tram floor height, tram age, season, traffic volume, tram lane priority and tram travel speed. Low floor trams, older trams, tram priority lanes and higher tram travelling speeds are more likely to increase tram-involved fatal crashes. Higher traffic volume decreases the likelihood of serious crashes. Fatal crashes are more likely to occur during spring and summer. Findings from this study may offer ideas for future research in the area of tram safety and help to develop countermeasures to prevent specific fatality types from occurring. PMID:27352035

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

    PubMed

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

    2016-06-01

    Patients diagnosed with breast cancer may opt to undergo surgical reconstructive flaps at the time of or after mastectomies. These surgeries leave patients with significant postoperative pain and sometimes involve large surgical beds including graft sites from the abdomen to reconstruct the breast. Consequently, multimodal methods of pain management have become highly favored. Quadratus lumborum catheters offer an opioid-sparing technique that can be performed easily and safely. We present a case of a patient who underwent a breast flap reconstruction and had bilateral quadratus lumborum catheters placed for perioperative pain control. PMID:26984687

  13. Rectus abdominis muscle strains in tennis players.

    PubMed

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

    2007-11-01

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

  14. 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

  15. TRAM1 Promotes Microglia M1 Polarization.

    PubMed

    Wang, Hanxiang; Liu, Chun; Han, Ming; Cheng, Chun; Zhang, Dongmei

    2016-02-01

    Microglia, the major immune cells of the central nervous system (CNS), can be driven to adopt M1 and M2 phenotypes. Recently, the distinct functions of M1 and M2 microglia have been intensively studied. M1-activation microglia are pro-inflammatory and may contribute to the development of several CSN disorders, while M2-activation microglia are anti-inflammatory and may promote tissue reconstruction. TRAM1 is a protein involved in translocation of nascent polypeptides and functions as a sorting adaptor of TLR4. Here, we found that TRAM1 plays an important role in microglia M1 polarization. Our results showed that the expression of TRAM1 is highly induced in LPS/interferon (IFN)-γ-stimulated BV2 cells and primary microglia cells. Flag-TRAM1 transfection, but not Flag-GFP used as a control, significantly enhanced M1 polarization by strongly increasing expression of M1 makers, such as IL-6, IL-1β, iNOS, and so on. Silence of TRAM1 effectively inhibited LPS/IFN-γ-induced expression of M1-related genes in BV2 cells. In addition, TRAM1 was found to cooperate with TLR4 to induce an M1 genetic program in Flag-TRAM1-transfected and LPS/IFN-γ-induced BV2 cells. TRAM1 is essential for LPS/IFN-γ induced expressions of adapter molecule (IRAK1, phosphorylation of TBK1, and IRF3) of TLR4. TRAM1 is also essential for phosphorylation of IκB and P65 and for P65-NF-kB translocation to nucleus. Overall, our findings showed that TRAM1 could promote microglia M1 polarization. PMID:26563450

  16. 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

  17. Colostomy with Transversus Abdominis Plane Block.

    PubMed

    Tekelioğlu, Ümit Yaşar; Demirhan, Abdullah; Şit, Mustafa; Kurt, Adem Deniz; Bilgi, Murat; Koçoğlu, Hasan

    2015-12-01

    Transversus abdominis plane (TAP) block is one of the abdominal field block. The TAP block is used for both anaesthetic management and post-operative pain therapy in lower abdominal surgery. TAP block is a procedure in which local anaesthetic agents are applied to the anatomic neurofacial space between the internal oblique and the transversus abdominis muscle. TAP block is a good method for post-operative pain control as well as allows for short operations involving the abdominal area. In this article, a case of colostomy under TAP block is presented. PMID:27366540

  18. EAST ELEVATION OF UPPER TRAM TERMINAL, PRIMARY ORE BIN,AND TRAM ...

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

    EAST ELEVATION OF UPPER TRAM TERMINAL, PRIMARY ORE BIN,AND TRAM TRESTLE, LOOKING NORTHEAST. WINCHING ENGINE AND ITS FOUNDATION IS AT TOP CENTER. SEE CA-291-50 (CT) FOR IDENTICAL COLOR TRANSPARENCY. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

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

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

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

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

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

    OVERVIEW OF UPPER TRAM TERMINAL, TRAM TRESTLE, PRIMARY ORE BIN,OVERBURDEN PILE, AND DEBRIS SCATTER,LOOKING EAST. THE MAIN ACCESS TRAIL BETWEEN THE LOWER MILL AREA IS IN THE FOREGROUND. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

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

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

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

  2. Free TRAM breast reconstruction and ipsilateral interval pedicled TRAM reconstruction for second breast in one patient.

    PubMed

    Dunlop, Rebecca L E; Caminer, David M

    2014-06-01

    Autologous breast reconstruction can give excellent cosmetic results and is preferred by some women. Donor tissue can be scarce however, especially for bilateral reconstructions and/or when a large breast is needed. In addition, the decision of which donor tissue to use in unilateral reconstruction may have an impact on a subsequent reconstruction if needed. We present a case of a patient who required a large volume unilateral reconstruction, performed using a free TRAM flap, who then re-presented 10 years later with disease in the contralateral breast. For her second reconstruction, a pedicled TRAM was used from the same side as the previous free TRAM. We believe that this sequence of reconstructions using the TRAM twice on the same side has not been previously reported. PMID:24462740

  3. Technology Investigations With the Tilt Rotor Aeroacoustic Model (TRAM)

    NASA Technical Reports Server (NTRS)

    Young, Larry A.; Yamauchi, Gloria K.; Booth, Earl; Johnson, Jeff L.; Derby, Michael R.; Sullivan, Ken; Ralston, Scott; Shockey, Gerald; Dawson, Seth; Warmbrodt, William (Technical Monitor)

    1998-01-01

    This paper introduces the Tilt Rotor Aeroacoustic Model (TRAM) project. The TRAM project is a key infrastructure investment for NASA tiltrotor research. The TRAM project consists of the development and testing of two modular, hardware-compatible, test stands: an isolated rotor configuration and a fullspan model (dual rotors with a complete airframe representation). These two test stands are inclusively called the Tilt Rotor Aeroacoustic Model (TRAM). The baseline proprotors and airframe of the TRAM test stands are nominally 1/4-scale representative of the V-22 Osprey aircraft. The research objectives of the project, the TRAM hardware design features and capabilities, illustrative examples of the type and quality of data that can be acquired with the TRAM, and the current status of the overall project will be discussed in this paper.

  4. The effects of botulinum toxin A on survival of rat TRAM flap with vertical midline scar.

    PubMed

    Park, Tae Hwan; Rah, Dong Kyun; Chong, Yosep; Kim, June-kyu

    2015-01-01

    The transverse rectus abdominis musculocutaneous (TRAM) flap has been widely used in various reconstructive surgeries. Recently, there have been reports regarding the positive effect of botulinum toxin A (BoTA) on flap survival. We hypothesized that pretreatment with BoTA could augment the survival of pedicled TRAM flaps with a vertical midline scar. Twenty-four Sprague-Dawley rats were randomly divided into 2 groups, namely, control group and BoTA group. Five days after a vertical midline incision, the BoTA group was pretreated with BoTA, whereas the control group was pretreated with normal saline. Ten days after the initial incision, the TRAM flap was harvested. We evaluated the gross flap survival and analyzed the overall histologic change, lumen area of pedicle, and microvessel density with immunohistochemistry. Reverse transcription polymerase chain reaction was performed for the evaluation of angiogenesis-related factors. In the BoTA group, the gross flap survival rate was significantly higher than that in the control group on both ipsilateral and contralateral sides (P < 0.001). In the BoTA group, a significant increase in pedicle lumen area was observed (P < 0.001). In the control group, mild to moderate epidermal necrosis was seen; microvessels were relatively small compared with those of the BoTA group. According to immunohistochemistry, the number of CD31 positively stained vessels was significantly higher on the contralateral side in the control group compared to that in the BoTA group (P < 0.001). The relative messenger RNA (mRNA) expression of CD31 was significantly lower in the BoTA group than that in the control group on both ipsilateral and contralateral sides (P < 0.001). Meanwhile, the relative mRNA expression of VEGF was significantly higher in the BoTA group than in the control group on both ipsilateral and contralateral sides (P < 0.001).We believe that preoperative BoTA therapy is a feasible method to improve circulation of the rat TRAM flap

  5. Abdominal wall competence after free transverse rectus abdominis musculocutaneous flap harvest: a prospective study.

    PubMed

    Suominen, S; Asko-Seljavaara, S; Kinnunen, J; Sainio, P; Alaranta, H

    1997-09-01

    A prospective study was designed to evaluate the possible changes in abdominal wall strength following free transverse rectus abdominis musculocutaneous (TRAM) flap surgery for breast reconstruction. Twenty-two patients were examined 1 day before surgery, and at 3, 6, and 12 months postoperatively. Trunk muscle strength was measured by the same physiotherapist using an isokinetic dynamometer (Lido Multi Joint II, Loredan Biomedical Inc., Davies, CA). The peak torque and average torque for both flexion and extension at 60 degrees per second angular velocity were recorded from the curves obtained. There was a significant reduction in trunk flexion strength at 3 months postoperatively (peak torque mean, 92% of the preoperative value; p = 0.04), but this was corrected by 6 months (mean, 96%), and improved to 98% by 12 months. The patient's ability to do curled trunk sit-ups was evaluated by the same physiotherapist and graded on a scale from 1 to 6. In 9 of 19 patients the operation had no effect on sit-up performance during follow-up. In 10 of 19 patients there was a reduction of one or two grades at 3 months that did not improve by 12 months. Magnetic resonance imaging of the abdominal wall was performed on 9 patients. The mean area of the upper third of both rectus muscles was measured on the axial images. At 3 months postoperatively the mean area of the upper third of the donor muscle was significantly larger than the contralateral (p = 0.03). There was no difference in size at 6 months, and by 12 months the donor side was smaller. This prospective study shows that harvesting of a free TRAM flap can cause a subclinical reduction in abdominal strength, although this was not noticed by the patients themselves. PMID:9326701

  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. EAST ELEVATION OF UPPER TRAM TERMINAL, PRIMARY ORE BIN, AND ...

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

    EAST ELEVATION OF UPPER TRAM TERMINAL, PRIMARY ORE BIN, AND TRAM TRESTLE, LOOKING NORTHEAST. WINCHING ENGINE AND ITS FOUNDATION IS AT TOP CENTER. SEE CA-291-28 FOR IDENTICAL B&W NEGATIVE. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  9. 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

  10. 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

  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-291-46( CT) FOR IDENTICAL COLOR TRANSPARENCY. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  12. 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

  13. 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

  14. 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

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

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

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

  16. 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

  17. 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

  18. 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. A WATER SHAFT IS COVERED WITH A PROTECTIVE NET IN THE LOWER RIGHT. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  19. 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

  20. Treatment of Sternal Wound Infection Using a Free Myocutaneous Flap.

    PubMed

    Chiang, I-han; Chen, Shyi-Gen; Wang, Chih-Hsin

    2015-11-01

    Deep sternal wound infections are potentially life-threatening complications after cardiac operations because they can spread into the mediastinum and cause postoperative morbidity and mortality. We present a 65-year-old man with a history of coronary artery bypass grafting. A large sternal defect was left after debridement. After brief vacuum-assisted closure (VAC), a free myocutaneous flap of the anterolateral thigh (ALT) was used to fill the dead space. At the 9-month follow-up, the wound had healed completely without tissue loss or complications, and the patient returned to normal life. This was a successful treatment of a deep sternal wound with free flap coverage. PMID:26522542

  1. 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.

  2. 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

  3. The pedicled latissimus dorsi myocutaneous flap in head and neck reconstruction.

    PubMed

    Ong, Hui Shan; Ji, Tong; Zhang, Chen Ping

    2014-08-01

    The pedicled latissimus dorsi myocutaneous flap (PLDMF) is not the first-line reconstructive option for most clinicians; however, when treating salvage patients or those with depleted neck vessels, the PLDMF provides a valuable armamentarium. Unlike the pectoralis major myocutaneous flap or the lower island trapezius flap, the PLDMF has greater versatility in soft tissue design and a longer arc of rotation. These advantages are of great importance in managing advanced reconstructive cases. PMID:24958381

  4. Differential activity of regions of transversus abdominis during trunk rotation.

    PubMed

    Urquhart, Donna M; Hodges, Paul W

    2005-05-01

    The role of the abdominal muscles in trunk rotation is not comprehensively understood. This study investigated the electromyographic (EMG) activity of anatomically distinct regions of the abdominal muscles during trunk rotation in six subjects with no history of spinal pain. Fine-wire electrodes were inserted into the right abdominal wall; upper region of transversus abdominis (TrA), middle region of TrA, obliquus internus abdominis (OI) and obliquus externus abdominis (OE), and lower region of TrA and OI. Surface electrodes were placed over right rectus abdominis (RA). Subjects performed trunk rotation to the left and right in sitting by rotating their pelvis relative to a fixed thorax. EMG activity was recorded in relaxed supine and sitting, and during an isometric hold at end range. TrA was consistently active during trunk rotation, with the recruitment patterns of the upper fascicles opposite to that of the middle and lower fascicles. During left rotation, there was greater activity of the lower and middle regions of contralateral TrA and the lower region of contralateral OI. The upper region of ipsilateral TrA and OE were predominately active during right rotation. In contrast, there was no difference in activity of RA and middle OI between directions (although middle OI was different between directions for all but one subject). This study indicates that TrA is active during trunk rotation, but this activity varies between muscle regions. These normative data will assist in understanding the role of TrA in lumbopelvic control and movement, and the effect of spinal pain on abdominal muscle recruitment. PMID:15940481

  5. 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

  6. 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

  7. 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

  8. 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

  9. ENTERING SIDE OF TRAM HOUSE, LOOKING SOUTH SOUTHEAST UP ARRASTRA ...

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

    ENTERING SIDE OF TRAM HOUSE, LOOKING SOUTH SOUTHEAST UP ARRASTRA GULCH. ENTERING ORE BUCKETS ROLLED OF SUSPENSION CABLE ONTO UPPER STEEL RAIL, WHERE THEY WERE DISCONNECTED FROM TRACTION (LOWER) CABLE. - Shenandoah-Dives Mill, 135 County Road 2, Silverton, San Juan County, CO

  10. ORE BUCKET ON TRAM. NOTE THAT BUCKET ROLLS ALONG UPPER, ...

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

    ORE BUCKET ON TRAM. NOTE THAT BUCKET ROLLS ALONG UPPER, STATIONARY SUSPENSION CABLE, PULLED BY LOWER, MOVING TRACTION CABLE. FOREGROUND CABLES ARE FOR BUCKET'S TRIP FROM MINE TO MILL. - Shenandoah-Dives Mill, 135 County Road 2, Silverton, San Juan County, CO

  11. TRAM HOUSE INTERIOR, LOOKING WEST. NOTE ARRIVING BUCKET ON RAIL ...

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

    TRAM HOUSE INTERIOR, LOOKING WEST. NOTE ARRIVING BUCKET ON RAIL IN CENTER, DEPARTING BUCKET IN LEFT BACKGROUND, TRACTION CABLE IN PULLEYS, AND SUSPENSION CABLE ANGLING DOWN THROUGH FLOOR. - Shenandoah-Dives Mill, 135 County Road 2, Silverton, San Juan County, CO

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

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

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

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

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

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

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

  19. 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

  20. The TLR signaling adaptor TRAM interacts with TRAF6 to mediate activation of the inflammatory response by TLR4

    PubMed Central

    Verstak, Brett; Stack, Julianne; Ve, Thomas; Mangan, Matthew; Hjerrild, Kathryn; Jeon, Jannah; Stahl, Rainer; Latz, Eicke; Gay, Nick; Kobe, Bostjan; Bowie, Andrew G.; Mansell, Ashley

    2014-01-01

    TLRs act as sentinels in professional immune cells to detect and initiate the innate immune response to pathogen challenge. TLR4 is a widely expressed TLR, responsible for initiating potent immune responses to LPS. TRAM acts to bridge TLR4 with TRIF, orchestrating the inflammatory response to pathogen challenge. We have identified a putative TRAF6-binding motif in TRAM that could mediate a novel signaling function for TRAM in TLR4 signaling. TRAM and TRAF6 association was confirmed by immunoprecipitation of endogenous, ectopically expressed and recombinant proteins, which was ablated upon mutation of a key Glu residue in TRAM (TRAM E183A). TRAF6 and TRAM were observed colocalizing using confocal microscopy following ectopic expression in cells and the ability of TRAM and TRAM E183A to activate luciferase-linked reporter assays was determined in HEK293 and TRAF6-deficient cells. Importantly, TRAM-deficient macrophages reconstituted with TRAM E183A display significantly reduced inflammatory TNF-α, IL-6, and RANTES protein production compared with WT TRAM. These results demonstrate a novel role for TRAM in TLR4-mediated signaling in regulating inflammatory responses via its interaction with TRAF6, distinct from its role as a bridging adaptor between TLR4 and TRIF. PMID:24812060

  1. [Mediastinal tracheotomy in cervicofacial oncologic surgery. Contribution of the pectoralis major myocutaneous flap].

    PubMed

    Hamoir, M; Calteux, N; Robillard, T; Remacle, M; De Coninck, A; Van Den Eeckhaut, J

    1985-01-01

    Four cases of anterior mediastinal tracheostomy with myocutaneous Pectoralis Major flap are described. Resection of the manubrium, clavicular heads and the cartilages of the first and second ribs is necessary. The use of myocutaneous Pectoralis Major flap give good functional results. No infection or hemorrhage of mediastinal great vessels occurred. The indications of Anterior mediastinal tracheostomy are discussed. Stomal and peristomal recurrences following laryngectomy for carcinoma represents the indication of choice. Stomal recurrences are difficult to treat and the prognostic is poor. Prevention of the stomal recurrences is discussed. PMID:4014936

  2. 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... Trams, and similar vehicles, and systems (a) New and used trams consisting of a tractor unit, with or... modification for accessibility. (b) Each tractor unit which accommodates passengers and each trailer unit...

  3. DETAIL VIEW OF ENTRY/EXIT POINT OF TRAM BUCKETS ON THE ...

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

    DETAIL VIEW OF ENTRY/EXIT POINT OF TRAM BUCKETS ON THE LOWER TRAM TERMINAL, LOOKING SOUTHWEST. THE CABLE CARRYING EMPTY BUCKETS AT TOP RIGHT IS THINNER IN DIAMETER THAN THE CABLE CARRYING LOADED BUCKETS ON THE TOP CENTER. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  4. Ground-borne vibrations caused by trams, and control measures

    NASA Astrophysics Data System (ADS)

    Lang, J.

    1988-01-01

    Ground-borne vibrations caused by trams in streets within cities are a special problem. The vibrations propagating to the buildings close to the track and within these buildings may be felt by the inhabitants and may be heard via the structure-borne sound radiated to the rooms. In quiet sites during night-time the relevant limits are often exceeded, if the tracks are laid in the normal manner. Experiments with tracks on floating concrete slabs on mineral wool and with "barriers" in the ground alongside the track show that the vibrations reaching buildings near the track may be reduced considerably.

  5. 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

  6. 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

  7. 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.

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

    NASA Astrophysics Data System (ADS)

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

    2008-06-01

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

  9. 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.

  10. Use of a bilobed gracilis myocutaneous flap in perineal and genital reconstruction.

    PubMed

    Vyas, Raj M; Pomahac, Bohdan

    2010-08-01

    The gracilis myocutaneous flap has limited functional donor site morbidity and effectively contours genitoperineal reconstructions. When harvested using a traditional vertical skin paddle, distal-tip necrosis (secondary to inconsistent perforator anatomy) is a well-documented complication. Orienting the skin paddle transversely provides a reliable alternative with a shorter rotational arc but results in a more conspicuous deformity and smaller skin paddle when primary closure is desired. On the basis of recent anatomic studies, we designed a pedicled gracilis myocutaneous flap with a bilobed cutaneous paddle to maximally incorporate both the transverse and longitudinal dimensions of the flap's nearly circular angiosome. The bilobed design allows harvest of a larger transverse skin flap (with a shorter arc of rotation) while a shorter, more dependable vertical skin flap is inset into the transverse flap donor site (rather than inside the critical wound bed). Herein, we detail our surgical technique and provide 2 illustrative case examples. PMID:20606582

  11. Medial and Lateral Canthal Reconstruction with an Orbicularis Oculi Myocutaneous Island Flap

    PubMed Central

    Han, Jihyeon; Kwon, Sung Tack; Kim, Suk Wha

    2015-01-01

    Background The eyelid and canthal areas are common locations for cutaneous tumors. The medial canthus includes, among many other apparatuses, the canthal tendon and lacrimal canaliculi, and its characteristic thin and supple skin is hard to mimic and restore using tissue from other regions. Accordingly, reconstruction of the canthal area can prove challenging for surgeons. Although various methods, such as skin grafts and local flaps from adjacent regions, have been utilized for reconstructive purposes, they present known disadvantages. However, we were able to successfully reconstruct both lateral and medial canthal area defects by using orbicularis oculi myocutaneous island flaps. Methods Our study included seven patients who underwent medial or lateral canthal region reconstruction, using orbicularis oculi myocutaneous island flaps, between 2011 and 2014, following either cutaneous tumor excision or traumatic avulsion injury. Results Five patients had basal cell carcinoma, one had squamous cell carcinoma of the eyelid, and one had sustained a traumatic avulsion injury of the eyelid and canthal area. Entire flap loss was not observed in any patient, but one-a heavy smoker-showed partial flap loss, which healed with secondary intention and yielded acceptable results. Donor site morbidity was not observed, and all patients were satisfied with their surgical outcomes. Conclusions The canthal regions can be successfully reconstructed with orbicularis oculi myocutaneous island flaps. These flaps offer several key advantages, including similarity in texture, color, and thickness to the recipient site and a negligible incidence of donor site morbidity. PMID:25606488

  12. Output characteristics of high power cryogenic Yb:YAG TRAM laser oscillator.

    PubMed

    Furuse, Hiroaki; Kawanaka, Junji; Miyanaga, Noriaki; Chosrowjan, Haik; Fujita, Masayuki; Takeshita, Kenji; Izawa, Yasukazu

    2012-09-10

    We analyzed the output power characteristics of a cryogenically cooled Yb:YAG total-reflection active-mirror (TRAM) laser oscillator including the temperature dependence of the emission cross section and the reabsorption loss of the Yb:YAG TRAM. A CW multi-transverse mode oscillation of a 9.8 at.% doped 0.6 mm thick Yb:YAG ceramic TRAM was investigated for various pump spot sizes and compared with theoretical results. The Yb:YAG temperatures were inferred from the ratio between fluorescence intensities at 1022 nm and 1027 nm which varied significantly with temperature below 200 K. Output power calculations using evaluated temperatures were in good agreement with the experimental data measured between 77 and 200 K, and the output power suppression due to the temperature rise observed above ~140 K. To the best of our knowledge, this is the first evaluation of output power for a cryogenically cooled Yb:YAG TRAM laser. PMID:23037293

  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, LOADING PLATFORM, AND BOILER, LOOKING SOUTHEAST. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  14. 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

  15. 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. PMID:27035395

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

    PubMed Central

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

    2012-01-01

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

  17. 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

  18. Pedicled TRAM Flap in Presence of Desmoid Tumor of the Rectus Sheath; a Case Report.

    PubMed

    Khater, Ashraf

    2015-12-01

    Creating TRAM flap in obese patient is a challenging issue with a hazard of flap ischemia and breast envelope loss or sepsis. In this case we show our experience in doing an interval TRAM flap in markedly obese patient (BMI index 39) in the presence of Desmoid tumor of the anterior abdominal wall on top of previous mesh hernioplasty in the contralateral side of the tumor. Interval TRAM was decided with achieving of a complete vascular delay in the same sitting with skin sparing mastectomy. On doing abdominal ultrasonography for perforator mapping a desmoid tumor was encountered in the contralateral side. The decision was to elevate the flap together with excision of the desmoid tumor with the flap to be sutured in situ at the end of operation and after 5 days to transfer the flap to the mastectomy site. There was no major complications apart from mild wound sepsis of the breast pocket that was controlled medically. According to our proposed aesthetical score, our patient expressed the outcome as good (8/10 points). Pedicled TRAM flap creation in markedly obese patients is hazardous and we recommend this new concept of interval TRAM for this situation. Moreover the presence of desmoid tumor in the rectus sheath is not a contraindication to this flap elevation. The presence of abdominal desmoid tumor is not a contraindication for TRAM flap provided that it can be resected with sparing of perforators on one side of the rectus sheath. PMID:27065672

  19. The TIR-Domain Containing Adaptor TRAM Is Required for TLR7 Mediated RANTES Production

    PubMed Central

    Shevlin, Enda; Miggin, Sinéad M.

    2014-01-01

    Toll-like receptor 7 (TLR7) plays a vital role in the immune response to ssRNA viruses such as human rhinovirus (HRV) and Influenza, against which there are currently no treatments or vaccines with long term efficacy available. Clearly, a more comprehensive understanding of the TLR7 signaling axis will contribute to its molecular targeting. TRIF related adaptor molecule (TRAM) plays a vital role in TLR4 signaling by recruiting TRIF to TLR4, followed by endosomal trafficking of the complex and initiation of IRF3 dependent type I interferon production as well as NF-κB dependent pro-inflammatory cytokine production. Towards understanding the molecular mechanisms that regulate TLR7 functionality, we found that TRAM−/− murine macrophages exhibited a transcriptional and translational impairment in TLR7 mediated RANTES, but not TNFα, production. Suppression of TRAM expression in human macrophages also resulted in an impairment in TLR7 mediated CCL5 and IFN-β, but not TNFα, gene induction. Furthermore, suppression of endogenous human TRAM expression in human macrophages significantly impaired RV16 induced CCL5 and IFNβ, but not TNFα gene induction. Additionally, TRAM-G2A dose-dependently inhibited TLR7 mediated activation of CCL5, IFNβ and IFNα reporter genes. TLR7-mediated phosphorylation and nuclear translocation of IRF3 was impaired in TRAM−/− cells. Finally, co-immunoprecipitation studies indicated that TRAM physically interacts with MyD88 upon TLR7 stimulation, but not under basal conditions. Our results clearly demonstrate that TRAM plays a, hitherto unappreciated, role in TLR7 signaling through a novel signaling axis containing, but not limited to, MyD88, TRAM and IRF3 towards the activation of anti-viral immunity. PMID:25211222

  20. Pharmacologic manipulation of the microcirculation in cutaneous and myocutaneous flaps in pigs

    SciTech Connect

    Pang, C.Y.; Neligan, P.C.; Nakatsuka, T.; Sasaki, G.H.

    1985-04-01

    The vascular effects of isoxsuprine, diazoxide, and isoproterenol were studied in arterial buttock flaps and latissimus dorsi myocutaneous flaps in pigs. Capillary blood flow to the skin and muscles of these flaps was measured by the radioactive microsphere (15-mu diameter) technique 6 hours postoperatively under pentobarbital anesthesia. It was observed that isoproterenol, a beta-adrenergic receptor agonist, was not effective in augmentation of skin blood flow in the arterial buttock flaps. However, isoproterenol significantly increased capillary blood flow to the arterialized portion of latissimus dorsi myocutaneous flaps compared with controls. Isoxsuprine and diazoxide (vascular smooth muscle relaxants) significantly (p less than 0.05) increased total capillary blood flow to the skin of arterial buttock flaps and to the skin and muscles of the latissimus dorsi myocutaneous flaps. However, the increase in capillary blood flow occurred mainly in the arterialized portion of these flaps. The capillary blood flow, which was supplied by the small arteries in the distal portion of the arterial buttock and latissimus dorsi flaps, was not increased by treatment with isoxsuprine or diazoxide. Therefore, there was also no increase in the maximum distance of capillary blood flow from the pedicle to the distal end of the flaps. These observations led the authors to hypothesize that different sizes (diameters) of arteries in the skin and muscle have different reactivity (or sensitivity) to vasodilatory drugs. In the present experiment, the large dominant artery of the arterial buttock and latissimus dorsi flaps responded to isoxsuprine or diazoxide (vascular smooth-muscle relaxants), resulting in an increase in blood supply to the capillaries in the proximal portion of the flaps.

  1. 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

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

    PubMed Central

    Ubukata, Hitomi; Matsumura, Ayana

    2015-01-01

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

  3. 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

  4. 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. PMID:24401809

  5. Treatment of the severely infected frontal sinus with latissimus dorsi myocutaneous free flaps.

    PubMed

    Kim, Youn Hwan; Youn, Seung Ki; Kim, Jeong Tae; Kim, Sang Wha; Yi, Hyeong Joong; Kim, Chang Yeon

    2011-05-01

    In trauma patients with severe intracranial hemorrhaging, diagnosing facial bone fractures can be delayed. In frontal sinus fractures with nasofrontal duct obstruction, obliteration of the nasofrontal duct and the sinus is the current treatment of choice. But with inadequate management, ascending infections happen, and widely spread infections can involve the entire frontal soft tissues, which result in meningitis, encephalitis, and subcutaneous abscess pockets creating skin defects. In the treatment of these infections, radical debridement of all infected tissues including galea, pericranium, and surrounding soft tissues is obligatory; hence, available local vascularized flap options for obliteration of the postdebridement defect are scarce. In these situations, free-tissue transfer can be a treatment option. Although there have been numerous reports of using nonvascularized materials for obliteration of the frontal sinus, the material itself can serve as a nidus for infection, and it is generally accepted that well-vascularized tissues have greater ability to withstand local soft-tissue infection and osteomyelitis. Hence, we report 3 cases where we performed latissimus dorsi myocutaneous flaps for severe frontal sinus infections after frontal cranioplasty for severe hemorrhaging. Large bulks of muscle obliterated the nasofrontal duct and the dead space surrounding the entire frontal sinus. The latissimus dorsi myocutaneous flap is not a permanent solution for frontal sinus reconstruction, which requires a secondary bony reconstruction. However, when we face acute stages of intractable infections of the frontal sinus, it can control the infection and result in saving the patient's life. PMID:21558912

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. Cloning, mapping, and sequencing of plasmid R100 traM and finP genes.

    PubMed Central

    Fee, B E; Dempsey, W B

    1986-01-01

    The fertility control gene finP, the transfer gene traM, and the transfer origin, oriT, of plasmid R100 were isolated on a single 1.2-kilobase EcoRV fragment and were then subcloned as HaeIII fragments. The sequence of the 754-base-pair finP-containing fragment is reported here. In addition to the finP gene, the sequence includes all but two bases of the R100 traM open reading frame and apparently all of the leader mRNA sequence and amino end of the traJ gene of R100. The sequence contains two open reading frames which encode small proteins on the opposite strand from the traM and traJ genes. It also shows two sets of inverted repeats that have the characteristics of transcription terminators. One set is positioned as if it was the traM terminator, and the other set, which is downstream from the first, sits in the middle of the leader mRNA sequence for traJ. On the bottom strand, this inverted repeat has the structure of a rho-independent terminator. Other less-stable inverted repeats overlap this second terminator in the same way as is seen in attenuation sequences, and the two separate small open reading frames on the bottom strand also totally overlap the stem of the rho-independent terminator, suggesting that their translation would cause shifting of termination to the bottom strand homolog of the putative traM terminator. The finP gene product was not identified, but the gene was mapped to the sequence which contains the traJ gene. It either overlaps traJ or is antisense to it. PMID:3522549

  12. xTRAM: Estimating Equilibrium Expectations from Time-Correlated Simulation Data at Multiple Thermodynamic States

    NASA Astrophysics Data System (ADS)

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

    2014-10-01

    Computing the equilibrium properties of complex systems, such as free energy differences, is often hampered by rare events in the dynamics. Enhanced sampling methods may be used in order to speed up sampling by, for example, using high temperatures, as in parallel tempering, or simulating with a biasing potential such as in the case of umbrella sampling. The equilibrium properties of the thermodynamic state of interest (e.g., lowest temperature or unbiased potential) can be computed using reweighting estimators such as the weighted histogram analysis method or the multistate Bennett acceptance ratio (MBAR). weighted histogram analysis method and MBAR produce unbiased estimates, the simulation samples from the global equilibria at their respective thermodynamic states—a requirement that can be prohibitively expensive for some simulations such as a large parallel tempering ensemble of an explicitly solvated biomolecule. Here, we introduce the transition-based reweighting analysis method (TRAM)—a class of estimators that exploit ideas from Markov modeling and only require the simulation data to be in local equilibrium within subsets of the configuration space. We formulate the expanded TRAM (xTRAM) estimator that is shown to be asymptotically unbiased and a generalization of MBAR. Using four exemplary systems of varying complexity, we demonstrate the improved convergence (ranging from a twofold improvement to several orders of magnitude) of xTRAM in comparison to a direct counting estimator and MBAR, with respect to the invested simulation effort. Lastly, we introduce a random-swapping simulation protocol that can be used with xTRAM, gaining orders-of-magnitude advantages over simulation protocols that require the constraint of sampling from a global equilibrium.

  13. [Free rectus abdominis muscle perforating artery flaps for reconstruction of the head and neck defects].

    PubMed

    Koshima, I; Handa, T; Satoh, Y; Akisada, K; Orita, Y; Yamamoto, H

    1995-01-01

    During the past eight years, tissue defects of the head and neck region in a total of 45 patients were repaired with free rectus abdominis muscle perforating artery flaps. These flaps are subclassified into (1) reduced musculocutaneous flaps, (2) thin reduced musculocutaneous flaps, (3) paraumbilical perforator-based flaps, and (4) thin paraumbilical perforator-based flaps. The advantages of these flaps are as follows. Since the flaps involve no or only a small portion of the rectus abdominis muscle, (1) the muscle can be left intact on the abdominal wall, and (2) a thin flap can be easily created by simple defatting of the flap. These flaps overcome the major disadvantages of the conventional rectus abdominis musculocutaneous flap, i.e., bulkiness of the flap and frequent postoperative abdominal herniation. The territory of the thin flaps is within 10 cm around the perforator. These flaps are suitable for defects in the head and neck region, because simultaneous flap elevation is possible at the time of tumor resection. Paraumbilical perforator-based flaps are suitable for young females and elderly patients. PMID:7897566

  14. [Latissimus dorsi myocutaneous flap combined with implant in breast reconstruction: The technique of the dorsal bra].

    PubMed

    Bruant-Rodier, C; Chiriac, S; Baratte, A; Dissaux, C; Bodin, F

    2016-06-01

    The latissimus dorsi myocutaneous flap combined with an implant is an effective breast reconstruction solution especially in irradiated patients. The authors describe the specific technical aspects that allow them to optimize the results of this intervention. In the back, the skin paddle is drawn in the shape of a horizontal spindle so as to conceal the residual scar under the bra. In breast area, a J-shaped contraincision barring the mastectomy scar ensures a harmonious positioning of the skin paddle to the inferolateral part of the breast. After a 180° rotation, the latissimus dorsi muscle envelops the implant like a bra. Its upper edge is attached at the bottom to define the new submammary fold. Under the pectoralis major muscle, its distal end comes to fill the décolleté above the implant. PMID:26117706

  15. 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

  16. Use of synthetic mesh for the entire abdominal wall after TRAM flap transfer.

    PubMed

    Moscona, R A; Ramon, Y; Toledano, H; Barzilay, G

    1998-03-01

    Abdominal wall competence is a major concern of all plastic surgeons using the TRAM flap for breast reconstruction. Low hernia rates and adequate abdominal stability are standard expectations in abdominal wall closure. Described here is this institution's experience with the use of a large piece of synthetic mesh as a supplementary reinforcement for the entire abdominal wall in an attempt to stabilize it and achieve a superior abdominal aesthetic result. Twenty-five consecutive patients had routine reinforcement with the extended mesh technique. Mean patient follow-up was 24 months with a minimum of 1 year. No hernia or mesh-related infection were encountered and only one patient had a lower abdominal bulge. We recommend the use of a large synthetic mesh for improved strength and aesthetic quality of the abdominal wall after TRAM flap breast reconstruction. PMID:9500387

  17. 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

  18. OVERVIEW OF LOWER TRAM TERMINAL AND RELATIONSHIP TO WATER TANK,LOOKING ...

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

    OVERVIEW OF LOWER TRAM TERMINAL AND RELATIONSHIP TO WATER TANK,LOOKING NORTH FROM MAIN ACCESS ROAD. THIS IS HOW THE TERMINAL AND MILL SITE FIRST APPEAR TO VISITORS WHEN APPROACHING FROM THE ROAD FROM THE SITE'S PARKING LOT. THIS IS CONSIDERED THE FRONT END OF THE TERMINAL. ORIGINALLY THERE WAS A SECOND WATER TANK NEAR THE ONE IN UPPER LEFT. - Keane Wonder Mine, Park Route 4 (Daylight Pass Cutoff), Death Valley Junction, Inyo County, CA

  19. Recombinant production of functional full-length and truncated human TRAM/TICAM-2 adaptor protein involved in Toll-like receptor and interferon signaling.

    PubMed

    Ullah, M Obayed; Valkov, Eugene; Ve, Thomas; Williams, Simon; Mas, Caroline; Mansell, Ashley; Kobe, Bostjan

    2015-02-01

    TRAM/TICAM-2 is used by Toll-like receptor 4 (TLR4) as a bridging adaptor during the mammalian innate immune response. It recruits TRIF, another TIR domain-containing adaptor protein, to TLR4 via TIR domain interactions, which leads to the activation of transcription factors responsible for the production of type-1 interferon and cytokines. The molecular mechanisms of these dual interactions mediated by the TRAM TIR domain are not clear. To understand the molecular basis of TIR:TIR domain interactions, structural and biochemical studies of TRAM TIR domain are necessary, and require a functional soluble protein. In this paper, we report a successful purification and characterization of full-length TRAM. Because full-length TRAM likely contains unstructured regions that may be disadvantageous for structural studies, we also carried out a systematic construct design to determine the boundaries of the TRAM TIR domain. The truncated TRAM constructs were designed based on secondary structure predictions and screened by small-scale expression. Selected constructs were subjected to biophysical analyses. We show that the expressed TRAM TIR domain is functional using in vitro GST pull-down assays that demonstrate a physical interaction with the TLR4 TIR domain. We further show, by site-directed mutagenesis, that the "BB loop" regions of both the TRAM TIR domain and the TLR4 TIR domain are crucial for this physical interaction. PMID:25306876

  20. Scars and perforator-based flaps in the abdominal region: A contraindication?

    PubMed Central

    Dragu, Adrian; Unglaub, Frank; Wolf, Maya B.; Beier, Justus P.; Schnabl, Saskia M.K.; Kneser, Ulrich; Leffler, Mareike; Horch, Raymund E.

    2010-01-01

    Background Although multiple strategies for autologous breast reconstruction exist, a vertical midline scar in the abdominal wall as a result of previous laparatomy or abdominoplasty represents a major surgical challenge. To date, little research has been conducted on the regeneration potential of the abdominal wall’s superficial vascular, perforator and choke vessel system after surgery using a vertical approache. Methods We present the cases of 8 patients, of whom 7 underwent autologous breast reconstruction. One patient received a thigh reconstruction. All patients had a vertical abdominal midline scar as a result of a previous surgical intervention. In 3 of the 7 patients, the breast was reconstructed using an MS-2-vertical rectus abdominis myocutaneous (VRAM) free flap. In 4 of these patients, an MS-2-transverse rectus abdominis myocutaneous (TRAM) free flap was performed. The thigh reconstruction used a transverse deep inferior epigastric perforator (DIEP) free flap. Clinical follow-up was done 12 months after operation. Results All 3 patients who received an MS-2-VRAM had good aesthetic results. Vertical midline scars had no negative effect on surgical outcomes, perfusion and tissue viability of the 4 MS-2-TRAM and transverse DIEP free flaps. Conclusion These clinical findings indicate that the regeneration potential of the abdominal wall’s superficial vascular system in the presence of vertical surgical scars has been greatly underestimated. Use of MS-2-VRAM free flaps in patients with vertical abdominal scars seems to be a suitable and successful alternative in the reconstruction algorithm. PMID:20334747

  1. Transversus abdominis plane block for an emergency laparotomy in a high-risk, elderly patient

    PubMed Central

    Patil, Surekha S; Pawar, Shonali C; Divekar, VM; Bakhshi, Rochana G

    2010-01-01

    A 72-year-old male patient with gall bladder perforation and small intestinal obstruction from impacted gall stone was posted for emergency laparotomy. He had congestive heart failure, severe hypertension at admission and history of multiple other coexisting diseases. On admission, he developed pulmonary oedema from systolic hypertension which was controlled by ventilatory support, nitroglycerine and furosemide. Preoperative international normalized ratio was 2.34 and left ventricular ejection fraction was only 20%. Because of risk of exaggerated fall in blood pressure during induction of anaesthesia (general or neuraxial), a transversus abdominis plane block via combined Petit triangle and subcostal technique was administered and supplemented with Propofol sedation. PMID:20885876

  2. 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.

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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

  8. Use of the platysma myocutaneous flap for cervical trachea reconstruction: an experimental study in dogs.

    PubMed

    de Mello-Filho, F V; Mamede, R C; Sader, A A; Velludo, M A; Vicente, W V

    1993-10-01

    Cervical trachea reconstruction with a non-stented platysma myocutaneous door flap (NPMCF) was studied in 23 dogs. Window defects involving 5, 10, or 15 rings and the whole anterior tracheal wall were produced in 3 different groups of animals. A segmentary defect involving the resection of 3 tracheal rings but preserving the posterior membranous wall was created in another group. The results were evaluated by clinical follow-up of up to 100 days, by tracheoscopy 1 week after surgery, and by macroscopic and microscopic examination after the animals' natural death or sacrifice. The NPMCF proved to be adequate for the reconstruction of window defects limited to 5 and 10 rings, with success rates of 100% and 75%, respectively. The use of the NPMCF for tracheal reconstruction had the following main advantages: 1. relatively simple, easy, and expeditious surgery; 2. use of a single operative field; 3. availability of large amounts of donor tissue; 4. adequate thickness; 5. reliable irrigation; 6. resistance to environmental exposure as evidenced by absence of infection; and 7. 100% take rate with no granulomas or scar stenosis at the suture lines. However, luminal occlusion due to flap collapse was a 100% fatal complication when the NPMCP was used either for reconstruction of larger window tracheal defects (15 rings-group 3) or segmentary defects (group 4); this was the main limitation of the method, followed by hair growth with accumulation of secretions, which can be easily dealt with. It can be anticipated that this method has a potential for application in well-selected patients. PMID:8412455

  9. 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

  10. 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

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

    PubMed

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

    2016-06-01

    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

  12. 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

  13. 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

  14. Validation of CATHARE 3D Code Against UPTF TRAM C3 Transients

    NASA Astrophysics Data System (ADS)

    Glantz, Tony; Freitas, Roberto

    Within the nuclear reactor safety analysis, one of the events that could potentially lead to a re-criticality accident in case of a Small Break Loss of Coolant Accident (SBLOCA) in a Pressurized Water Reactor (PWR) is a boron dilution scenario followed by a coolant mixing transient. Some UPTF experiments can be interpreted as generic boron dilution experiments. In fact, the UPTF experiments were originally designed to conduct separate effects studies focused on multi-dimensional thermal hydraulic phenomena. However, in the case of experimental program TRAM, some studies are realized on the boron mixing: tests C3. Some of these tests have been used for the validation and assessment of the 3D module of CATHARE code. Results are very satisfying; CATHARE 3D code is able to reproduce correctly the main features of the UPTF TRAM C3 tests, the temperature mixing in the cold leg, the formation of a strong stratification in the upper downcomer, the perfect mixing temperature in the lower downcomer and the strong stratification in the lower plenum. These results are also compared with the CFX5 and TRIO-U codes results on these tests.

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

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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

  1. Vascular Endothelium Growth Factor, Surgical Delay, and Skin Flap Survival

    PubMed Central

    Lineaweaver, William C.; Lei, Man-Ping; Mustain, William; Oswald, Tanya M.; Cui, Dongmei; Zhang, Feng

    2004-01-01

    Objective: Cytokines may be a mechanism by which surgical delay can increase flap survival. We previously found that preoperative vascular endothelium growth factor (VEGF) administration in the rat transverse rectus abdominis myocutaneous (TRAM) flap could improve skin paddle survival. In this study, we used partial elevation of the rat TRAM flap as a surgical delay to assess endogenous cytokine expression and tissue survival comparable to undelayed TRAM flaps. Methods: In Part I, TRAM flaps underwent surgical delay procedures; 7 days later, the flaps were completely elevated and reinset. At the same time, other flaps were raised and reinset without delay. Skin paddle survival in both groups was evaluated at 7 days. In Part II, skin biopsies from TRAM zones I to IV were taken at the time of delay and at intervals of 12, 24, 48, and 72 hours. Specimens were assessed for selected cytokine gene expression by reverse transcription-polymerase chain reaction analysis (TR-PCR). Results: Surgical delay significantly (P < 0.001) increased skin paddle survival in the delayed TRAM flaps (16.14 ± 1.53 cm, 81.9%) compared with undelayed flaps (7.68 ± 3.16 cm, 40.9%). TGF-β and PDGF expressions were not changed by surgical delay, but basic fibroblast growth factor (bFGF) and VEGF expressions increased significantly (P < 0.05 and P < 0.01) after delay. Conclusions: In the rat TRAM model, surgical delay resulted in increased VEGF expression and increased skin paddle survival. These results correlate with previous studies showing the preoperative injection of VEGF increases skin paddle survival. VEGF may be an important element in the delay phenomenon and may be an agent for pharmacological delay. PMID:15166966

  2. 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

  3. 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. PMID:27077819

  4. Squamous cell carcinoma of the heel with free latissimus dorsi myocutaneous flap reconstruction: case report and technical note.

    PubMed

    Al Maksoud, Ahmed Mahmoud; Barsoum, Adel K; Moneer, Mohammed

    2016-01-01

    Squamous cell carcinoma (SCC) is the second most common skin cancer; however, it is relatively rare on the foot. Wide excision of SCC is the recommended surgical treatment. The extent of the excision may involve resection of muscles and bone in cases of deep lesions. The functional and anatomic properties and lack of sufficient locally available tissues make the reconstruction of post-oncosurgical defects of the foot a challenging process. Heel reconstruction poses the biggest challenge due to the unique weight-bearing requirements. We present a case of a Marjolin's ulcer on the heel in a 62-year-old woman complicating a chronic non-healing wound. The heel defect was reconstructed with a free latissimus dorsi myocutaneous flap with delayed secondary closure. The outcome was successful both functionally and cosmetically. No further procedures were needed. PMID:27161144

  5. Squamous cell carcinoma of the heel with free latissimus dorsi myocutaneous flap reconstruction: case report and technical note

    PubMed Central

    Al Maksoud, Ahmed Mahmoud; Barsoum, Adel K.; Moneer, Mohammed

    2016-01-01

    Squamous cell carcinoma (SCC) is the second most common skin cancer; however, it is relatively rare on the foot. Wide excision of SCC is the recommended surgical treatment. The extent of the excision may involve resection of muscles and bone in cases of deep lesions. The functional and anatomic properties and lack of sufficient locally available tissues make the reconstruction of post-oncosurgical defects of the foot a challenging process. Heel reconstruction poses the biggest challenge due to the unique weight-bearing requirements. We present a case of a Marjolin’s ulcer on the heel in a 62-year-old woman complicating a chronic non-healing wound. The heel defect was reconstructed with a free latissimus dorsi myocutaneous flap with delayed secondary closure. The outcome was successful both functionally and cosmetically. No further procedures were needed. PMID:27161144

  6. Risk factors of recipient site infection in head and neck cancer patients undergoing pectoralis major myocutaneous flap reconstruction.

    PubMed

    Wang, Chao-Hsien; Wong, Yong-Kie; Wang, Ching-Ping; Wang, Chen-Chi; Jiang, Rong-San; Lai, Chih-Sheng; Liu, Shih-An

    2015-11-01

    The aim of this study was to investigate the factors associated with infection at the recipient site of pectoralis major myocutaneous flap (PMMF) of head and neck cancer patients. We retrospectively reviewed head and neck cancer patients who underwent PMMF reconstruction and identified those with recipient site infection. Variables of patients with and without infection were compared and associated factors were investigated by logistic regression model. A total of 478 patients were included in the final analysis and 183 patients (38.3%) developed recipient site infection. Lower margin of skin island, concurrent tracheotomy, diabetes mellitus, mandibular plate reconstruction, prior radiation, and peri-operative blood transfusion were independent factors associated with recipient site infection of PMMF. Skin island of PMMF beyond the eighth intercostal space markedly increased the risk of recipient site infection after major head and neck cancer surgery. Recognition of relevant factors associated with infection may help surgeons to identify those at risk. PMID:25359197

  7. 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

  8. 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.

  9. 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

  10. 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

  11. 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

  12. Closure and augmentation of bladder exstrophy using rectus abdominis musculo-peritoneal flap

    PubMed Central

    Agarwal, P.

    2011-01-01

    Background: The aim of this study was to investigate the efficacy of the rectus abdominis myo-peritoneal flap (RAMP) technique for the closure and augmentation of small, non-elastic, non-compliant bladder exstrophies. Materials and Methods: The RAMP technique was used in three boys with bladder exstrophy who presented late with small, non-elastic, non-compliant bladder. The clinical outcome, imaging, cystoscopy, biochemical and microbiological studies were assessed during a follow-up of 36 months. Results: Bladder closure and augmentation was achieved in all patients without any complications. There were no urinary tract infections, metabolic problems or electrolyte disturbances and the kidney function remained normal in all patients. Radiography confirmed intact function and anatomy of the urinary tract and cystoscopy showed complete coverage of the inner peritoneal layer of RAMP with uroepithelium. No stone formation or mucous production was detected. Conclusions: The RAMP technique is a good alternative for closing bladder exstrophies and achieves an increase in bladder capacity and compliance. The technique is indicated in the closure of large bladder defects, bladder exstrophies with small, inelastic, non-compliant bladder remnants and failed primary closures. PMID:22279277

  13. 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

  14. Immediate nipple reconstruction with thoracodorsal artery perforator flap in breast reconstruction by latissimus dorsi myocutaneous flap in patients with Poland's syndrome.

    PubMed

    He, Jinguang; Xu, Hua; Wang, Tao; Qiao, Yufei; Zhang, Yi; Dong, Jiasheng

    2016-01-01

    Loss of long-term projection is the major disadvantage of nipple reconstruction using local flaps. We report a technique of immediate perforator flap nipple reconstruction in breast reconstruction by latissimus dorsi (LD) myocutaneous flap in patients with Poland's syndrome. From March 2007 to July 2012, 12 female patients (age range, 15-21 years) underwent breast reconstructions and immediate nipple reconstructions. A thoracodorsal artery perforator (TAP) flap was simultaneously raised on the LD muscle flap and folded by itself to form the nipple. Both the LD flap and TAP flaps survived postoperatively. The nipple projection was measured by a caliper, and the average loss was 29% by the 1-year follow-up. Eleven patients considered the aesthetic appearance of reconstructed breast and nipple to be very good or good. The immediate nipple reconstruction with TAP flap could be safely performed and results in considerable satisfaction in breast reconstruction by LD myocutaneous flap in patients with Poland's syndrome. PMID:25752505

  15. Recurrent cystosarcoma phylloides of breast: extensive full-thickness excision of chest wall with immediate repair using steel mesh and a latissimus dorsi myocutaneous flap.

    PubMed

    Mindikoğlu, A N; Aktan, K

    1983-10-01

    The case of a young woman with a massive recurrent cystosarcoma phylloides of the breast is presented in whom a full thickness excision of the chest wall was carried out en bloc together with four ribs. The large full-thickness defect of the chest wall was reconstructed with stainless steel mesh and covered by a latissimus dorsi myocutaneous flap. The management of post-operative paradoxical movement is also described. PMID:6313105

  16. 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.

  17. Internal Oblique and Transversus Abdominis Muscle Fatigue Induced by Slumped Sitting Posture after 1 Hour of Sitting in Office Workers

    PubMed Central

    Waongenngarm, Pooriput; Rajaratnam, Bala S.; Janwantanakul, Prawit

    2015-01-01

    Background Prolonged sitting leads to low back discomfort and lumbopelvic muscle fatigue. This study examined the characteristics of body perceived discomfort and trunk muscle fatigue during 1 hour of sitting in three postures in office workers. Methods Thirty workers sat for 1 hour in one of three sitting postures (i.e., upright, slumped, and forward leaning postures). Body discomfort was assessed using the Body Perceived Discomfort scale at the beginning and after 1 hour of sitting. Electromyographic (EMG) signals were recorded from superficial lumbar multifidus, iliocostalis lumborum pars thoracis, internal oblique (IO)/transversus abdominis (TrA), and rectus abdominis muscles during 1 hour of sitting. The median frequency (MDF) of the EMG power spectrum was calculated. Results Regardless of the sitting posture, the Body Perceived Discomfort scores in the neck, shoulder, upper back, low back, and buttock significantly increased after 1 hour of sitting compared with baseline values (t(9) = −11.97 to −2.69, p < 0.05). The MDF value of the EMG signal of rectus abdominis, iliocostalis lumborum pars thoracis, and multifidus muscles was unchanged over time in all three sitting postures. Only the right and left IO/TrA in the slumped sitting posture was significantly associated with decreased MDF over time (p = 0.019 to 0.041). Conclusion Prolonged sitting led to increased body discomfort in the neck, shoulder, upper back, low back, and buttock. No sign of trunk muscle fatigue was detected over 1 hour of sitting in the upright and forward leaning postures. Prolonged slumped sitting may relate to IO/TrA muscle fatigue, which may compromise the stability of the spine, making it susceptible to injury. PMID:27014491

  18. 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

  19. Effect of Transversus Abdominis Plane Block on Cost of Laparoscopic Cholecystectomy Anesthesia

    PubMed Central

    Kokulu, Serdar; Bakı, Elif Doğan; Kaçar, Emre; Bal, Ahmet; Şenay, Hasan; Üstün, Kübra Demir; Yılmaz, Sezgin; Ela, Yüksel; Sıvacı, Remziye Gül

    2014-01-01

    Background Use of transversus abdominis plane (TAP) block for postoperative analgesia is continuously increasing. However, few studies have investigated intraoperative effects of TAP block. We aimed to study the effects of TAP block in terms of cost-effectiveness and consumption of inhalation agents. Material/Methods Forty patients undergoing laparoscopic cholecystectomy were enrolled in this study. Patients were randomly divided into 2 groups: Group 1 (n=20) patients received TAP block and Group 2 (n=20) patients did not receive TAP block. Standard anesthesia induction was used in all patients. For the maintenance of anesthesia, fractional inspired oxygen (FIO2) of 50% in air with desflurane was used with a fresh gas flow of 4 L/min. All patients were monitored with electrocardiography and for peripheral oxygen saturation (SpO2), end-tidal carbon dioxide (ET), heart rate (HR), noninvasive mean blood pressure (MBP), and bispectral index (BIS). Bilateral TAP blocks were performed under ultrasound guidance to Group 1 patients. The BIS value was maintained at between 40 and 50 during the surgery. The Dion formula was used to calculate consumption of desflurane for each patient. Results There was no difference between the groups with respect to demographic characteristics of the patients. Duration of anesthesia, surgery time, and dosage of fentanyl were similar in the 2 groups. However, the cost and consumption of desflurane was significantly lower in Group 1. Conclusions Total anesthesia consumption was lower and the cost-effectiveness of anesthesia was better in TAP block patients with general anesthesia than in non-TAP block patients undergoing laparoscopic cholecystectomy. PMID:25534331

  20. Proteasome activities in the rectus abdominis muscle of young and older individuals.

    PubMed

    Bossola, Maurizio; Pacelli, Fabio; Costelli, Paola; Tortorelli, Antonio; Rosa, Fausto; Doglietto, Giovan Battista

    2008-08-01

    Sarcopenia is one of the most striking effects of age, the causes and the pathogenic mechanisms being largely unknown. Unfortunately, there is limited information on the effect of aging on muscle protein breakdown in basal conditions. The present study aimed at investigating if skeletal muscle ubiquitn mRNA levels and proteasome activities vary with age in healthy individuals. Ub mRNA levels were measured by northern blot analysis whereas proteasome activities were determined by evaluating the cleavage of specific fluorogenic substrates in the rectus abdominis muscle of 14 healthy male individuals. Patients were divided in three groups according to the age: (1) 20-30 years (N = 3); (2) 31-64 years (N = 5); (3) > or = 65 years (N = 6). Quantitation of the ubiquitin mRNA levels (expressed in arbitrary units) (mean (SD) showed no differences among the three groups of age (20-30 years: 1352 +/- 441; 31-64 years: 1324 +/- 439; > or = 65 years: 884 +/- 400; P = 0.33). The correlation between age and muscle ubiquitin mRNA levels was not statistically significant (r = -0.4, P = 0.26). The three proteasome activities, chymotrypsin-like (CTL), trypsin-like (TL) and peptidyl-gutamyl-peptidase (PGP), expressed as nkatal x 10(-3)/mg protein, were similar in the three groups of patients stratified according to the age. There was no correlation between age with either CTL (r = 0.22, P = 0.4), PGP (r = 0.002, P = 0.9), and TL (r = 0.28, P = 0.33) activities. In conclusion, the present study shows that the skeletal muscle proteasome activities do not differ with age in healthy male individuals. PMID:18330717

  1. 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

  2. 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

  3. Medial open transversus abdominis plane (MOTAP) catheters for analgesia following open liver resection: study protocol for a randomized controlled trial

    PubMed Central

    2014-01-01

    Background The current standard for pain control following liver surgery is intravenous, patient-controlled analgesia (IV PCA) or epidural analgesia. We have developed a modification of a regional technique called medial open transversus abdominis plane (MOTAP) catheter analgesia. The MOTAP technique involves surgically placed catheters through the open surgical site into a plane between the internal oblique muscle and the transverse abdominis muscle superiorly. The objective of this trial is to assess the efficacy of this technique. Methods/design This protocol describes a multicentre, prospective, blinded, randomized controlled trial. One hundred and twenty patients scheduled for open liver resection through a subcostal incision will be enrolled. All patients will have two MOTAP catheters placed at the conclusion of surgery. Patients will be randomized to one of two parallel groups: experimental (local anaesthetic through MOTAP catheters) or placebo (normal saline through MOTAP catheters). Both groups will also receive IV PCA. The primary endpoint is mean cumulative postoperative opioid consumption over the first 2 postoperative days (48 hours). Secondary outcomes include pain intensity, patient functional outcomes, and the incidence of complications. Discussion This trial has been approved by the ethics boards at participating centres and is currently enrolling patients. Data collection will be completed by the end of 2014 with analysis mid-2015 and publication by the end of 2015. Trial registration The study is registered with http://clinicaltrials.gov ( NCT01960049; 23 September 2013) PMID:24950773

  4. Abdominal perforator vs. muscle sparing flaps for breast reconstruction

    PubMed Central

    Wu, Liza C.

    2015-01-01

    Abdominally based free flaps have become the mainstay for women that desire to use their own tissue as a means of breast reconstruction after mastectomy. As the techniques have evolved, significant effort has been invested in finding the best means of minimizing morbidity to the abdominal donor site while ensuring a viable reconstructed breast that is aesthetically pleasing. This manuscript reviews and compares the muscle sparing free transverse rectus abdominis myocutaneous (MsfTRAM), the deep inferior epigastric artery perforator (DIEP), and the superficial inferior epigastric artery (SIEA) flaps, regarding flap success rate, operative times, abdominal donor site morbidity and residual functionality, hospital lengths of stay and associated costs, impact of co-morbid conditions, and resilience after adjuvant radiation treatment. PMID:26161306

  5. Abdominal perforator vs. muscle sparing flaps for breast reconstruction.

    PubMed

    Butler, Paris D; Wu, Liza C

    2015-06-01

    Abdominally based free flaps have become the mainstay for women that desire to use their own tissue as a means of breast reconstruction after mastectomy. As the techniques have evolved, significant effort has been invested in finding the best means of minimizing morbidity to the abdominal donor site while ensuring a viable reconstructed breast that is aesthetically pleasing. This manuscript reviews and compares the muscle sparing free transverse rectus abdominis myocutaneous (MsfTRAM), the deep inferior epigastric artery perforator (DIEP), and the superficial inferior epigastric artery (SIEA) flaps, regarding flap success rate, operative times, abdominal donor site morbidity and residual functionality, hospital lengths of stay and associated costs, impact of co-morbid conditions, and resilience after adjuvant radiation treatment. PMID:26161306

  6. 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

  7. 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. PMID:25768130

  8. 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

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

    PubMed

    Voineskos, Sophocles H; Frank, Simon G; Cordeiro, Peter G

    2015-12-01

    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

  10. 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

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

    PubMed Central

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

    2015-01-01

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

  12. 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

  13. 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

  14. Reconstruction with a pectoralis major myocutaneous flap after left first rib and clavicular chest wall resection for a metastasis from laryngeal cancer.

    PubMed

    Caronia, Francesco Paolo; Fiorelli, Alfonso; Zanchini, Fabio; Santini, Mario; Lo Monte, Attilio Ignazio; Castorina, Sergio

    2016-05-01

    We presented a case of recurrent metastasis from epidermoid cancer that occurred in the left clavicle of a patient with a history of laryngeal cancer treated on April 2005 with extended hemilaryngectomy, neck dissection and chemoradiation therapy. On September 2008, he developed a left clavicular metastasis. The disease was initially well controlled by chemoradiotherapy but it recurred 17 months later. The optimal treatment plan was established by several multidisciplinary meetings and the patient subsequently underwent an en bloc resection of the left clavicle, first rib and all the other involved structures. Coverage of the thoracic defect was achieved using pectoralis major myocutaneous flap. The patient had a successful surgical outcome. At 1-year follow-up, he had no evidence of disease, a good cosmetic result and returned to normal daily activity. He died for bone metastasis with an overall 21 months post-surgical survival. PMID:25319560

  15. [Myocutaneous latissimus dorsi sliding flap in reconstruction of the lower thoracic wall in chronic fistula caused by cystic echinococcosis of the liver].

    PubMed

    Mouton, W; Schweizer, W; Zuber, J C; Tschopp, H; Blumgart, L H

    1991-07-01

    We report the successful treatment of a 47-year-old man who had a 22-year history of chronic discharge from a hepatic echinococcal cyst. Before treatment in our unit there had been 8 previous attempts to control the fistula. By means of a right thoracoabdominal incision (with resection of the 7th and 8th ribs) it was possible to perform a cystectomy with subsequent marsupialisation of the residual cyst wall to the skin. However, after 2 weeks subsequent treatment with maximal Albendazol therapy there was still a big persistent cavity which required further débridement. This resulted in resolution of the infection and allowed a definitive closure of the big cavity and the thoracoabdominal wall using a myocutaneous latissimus dorsi flap. The patient's subsequent course has been uneventful with no recurrence of the fistula. PMID:1938443

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  1. 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

  2. Transversus abdominis plane block versus local anaesthetic wound infiltration for postoperative analgesia: A systematic review and meta-analysis

    PubMed Central

    Guo, Qingduo; Li, Rui; Wang, Lixian; Zhang, Dong; Ma, Yali

    2015-01-01

    Background: Transversus abdominis plane (TAP) block and local anaesthetic wound infiltration can provide effective pain relief at the wound site after surgery. However, the relative efficacy of two techniques for postoperative analgesia remains controversial. Methods: We searched PUBMED, EMBASE and CENTRAL databases for randomized controlled trials (RCTs) comparing TAP block with wound infiltration for pain relief after surgery. The primary outcomes were pain scores at rest and on movement at 1, 8 and 24 hours postoperatively and cumulative morphine consumption over 24 hours. The secondary outcomes were time to first rescue analgesic, number of rescue analgesic use and opioids-related side-effects. Results: Nine RCTs with a total of 500 participants were included. TAP block was associated with significant lower rest and dynamic pain scores at 8 hour [MD = -1.08, 95% CI (-1.89-0.26), P = 0.009] and 24 hour [MD = -0.83, 95% CI (-1.60, -0.06), P = 0.03] postoperatively than wound infiltration, but no significant difference was found at 1 hour [MD = -0.94, 95% CI (-1.97, 0.09), P = 0.08] postoperatively. In adults, TAP block significantly reduced 24-hour overall morphine consumption by 3.85 mg [MD = -3.85, 95% CI (-7.47, -0.22), P = 0.04] compared with wound infiltration. Subgroup analysis showed that adults received TAP block appeared to have lower rest pain scores at 24 hour than children (P = 0.008). Conclusion: TAP block provides superior analgesia compared with wound infiltration in the setting of a multimodal analgesic regimen. Subgroup analysis indicated that adults may have benefits additional to the analgesic effect than children. PMID:26770326

  3. Adding magnesium sulfate to bupivacaine in transversus abdominis plane block for laparoscopic cholecystectomy: A single blinded randomized controlled trial

    PubMed Central

    Al-Refaey, K; Usama, EM; Al-Hefnawey, E

    2016-01-01

    Introduction and Aim: Use of transversus abdominis plane block (TAP) in the management of postoperative pain after the laparoscopic cholecystectomy (LC) has been a common anesthetic practice. This study evaluates the effect of adding magnesium sulfate to bupivacaine in TAP block in LC regarding postoperative analgesia and analgesic consumption. Patients and Methods: Ninety patients of American Society of Anesthesiologists I and II was divided into three groups: Control group (C group, n = 30), bupivacaine group (B group, n = 30), bupivacaine magnesium group (M group, n = 30). Results: M group showed better analgesic profile in the 1st postoperative day in the form of lower mean visual analog scale score (2.8 ± 0.6 for C group, 2.1 ± 0.5 for B group, 2.2 ± 0.5 for M group, P < 0.001), longer duration of analgesia (7 ± 2.8 h for C group, 16 ± 2.5 h for B group, 19 ± 2.2 h for M group, P < 0.006), lower morphine consumption (2 ± 0.1 mg for C group, 0.9 ± 0.1 mg for B group, 0.5 ± 0.1 mg for M group, P < 0.011). There was a significant lower incidence of postoperative nausea and vomiting (PONV) (32% for C group, 6% B group, 7% M group, P < 0.004). Conclusion: Adding MgSo4 as an adjuvant to bupivacaine in TAP block; during anesthesia for LC; improved postoperative analgesia in the form of increased duration, decreased analgesic requirements and PONV. PMID:27051371

  4. 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

  5. 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

  6. Cutaneous reinnervation of the rectus abdominis musculocutaneous flap after chest wall reconstruction: development of herpes zoster in the transplanted musculocutaneous flap.

    PubMed

    Tomita, K; Inoue, K

    1998-08-01

    We report a patient in whom herpes zoster developed in the transplanted rectus abdominis musculocutaneous flap 14 months after a chest wall reconstruction for recurrent breast cancer. Based on the distribution of the varicella zoster virus spreading along the sensory nerve fibers, we concluded that the virus spread along the reinnervated sensory nerves from the dorsal ganglia, through the intercostal nerves, and into the flap skin. It is suggested that this finding demonstrates the pathway of reinnervation into the transferred musculocutaneous flap on the chest wall. PMID:9718154

  7. 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

  8. 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

  9. 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

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

    PubMed Central

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

    2016-01-01

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

  11. 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

  12. 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

  13. A modified pectoralis major myocutaneous flap technique with improved vascular supply and an extended rotation arc for oral defects: A case report

    PubMed Central

    KANNO, TAKAHIRO; NARIAI, YOSHIKI; TATSUMI, HIROTO; KARINO, MASAAKI; YOSHINO, AYA; SEKINE, JOJI

    2015-01-01

    The pedicled pectoralis major myocutaneous (PMMC) flap is versatile, and is widely used for the treatment of surgical defects following oral cancer resection. Although free-tissue transfer of a vascularized free flap is often preferred, the clinical benefits of the PMMC flap should not be overlooked. The conventional technique of harvesting a PMMC flap involves a single vascular supply from the pectoral branch of the thoracoacromial artery. However, this approach compromises the distal skin island of the flap, and requires an indirect blood supply via communicating vessels, which increases the potential risk of partial distal flap necrosis. When harvesting a PMMC flap for oral and maxillofacial reconstruction, preservation of the lateral thoracic artery and use of the subclavian route are alternatives that ensure sufficient blood supply and an increased rotation arc. Such an approach enables the harvesting of a PMMC flap that can reach the entire oral cavity, including the infraorbital region, palate, middle pterygopalatine fossa and nasopharynx, with no risk of vascular insufficiency to the distal skin island. In conclusion, the technique described in the present study was able to improve the blood supply of the distal PMMC flap and increase its rotation arc. PMID:26722234

  14. 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

  15. The preferential contraction ratios of transversus abdominis on the variations of knee angles during abdominal drawing-in maneuver in wall support standing

    PubMed Central

    Hwang, Young-In; Kim, Jwa-Jun; Park, Du-Jin

    2014-01-01

    The objective of this study was to determine appropriate knee angles for the abdominal drawing-in maneuver (ADIM) through evaluation of changes in contraction ratios of the abdominal muscles and activity of quadriceps muscle in relation to changes in knee angles occurring while the ADIM is performed in the wall support standing (WSS). 20 subjects performed the ADIM at different knee angles (0°, 20°, 40°, 60°) in random order, standing at a point 6 inches away from the wall with the spine maintained in the neutral position. The WSS with knee flexion at 20° showed significantly higher preferential contraction ratio (PCR) of transversus abdominis (TrA) compared to other positions (0°, 40°, 60°). Therefore, performing the ADIM in the WSS with knee flexion at 20° appears to be the most appropriate position for TrA PCR. PMID:24877045

  16. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain.

    PubMed

    Fernandes da Mota, Patrícia Gonçalves; Pascoal, Augusto Gil Brites Andrade; Carita, Ana Isabel Andrade Dinis; Bø, Kari

    2015-02-01

    Diastasis recti abdominis (DRA) is an impairment characterized by a midline separation of the rectus abdominis muscles along the linea alba. It has its onset during pregnancy and the first weeks following childbirth. There is scant knowledge on both prevalence and risk factors for development of the condition. The aim of this study was to investigate the prevalence of DRA at gestational week 35 and three timepoints postpartum, possible risk factors, and the relationship between DRA and lumbo-pelvic pain. Ultrasound images of inter rectus distance (IRD) were recorded in 84 healthy primiparous women, at three locations on the linea alba. The IRD was measured at: gestational week 35 and 6-8, 12-14, and 24-26 weeks postpartum. Diagnosis of DRA was defined as 16 mm at 2 cm below the umbilicus. Independent sample t-test and binary logistic regression was used to assess differences and risk factors in women with and without DRA and women with and without lumbo-pelvic pain. P < 0.05 was considered statistically significant. The prevalence of DRA decreased from 100% at gestational week 35-39% at 6 months postpartum. No statistically significant differences were found in prepregnancy body mass index (BMI), weight gain, baby's birth weight or abdominal circumference between women with and without DRA at 6 months postpartum. Women with DRA at 6 months postpartum were not more likely to report lumbo-pelvic pain than women without DRA. DRA is prevalent at 6 months postpartum, but is not linked with lumbo-pelvic pain. PMID:25282439

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  18. Reliability of Ultrasound Imaging of the Transversus Deep Abdominial, Internal Oblique and External Oblique Muscles of Patients with Low Back Pain Performing the Drawing-in Maneuver

    PubMed Central

    Park, Sung doo

    2013-01-01

    [Purpose] The purpose of this study was to investigate the reliability of ultrasound imaging (USI) measurements of muscle thicknesses of patients with low back pain (LBP) performing the abdominal drawing-in maneuver (ADIM) [Subjects] Twenty patients with LBP were the subjects. [Methods] Muscle thickness measurements of transversus abdominis (Tra), internal obliques (IO), and external obliques (EO) muscles were measured using ultrasound imaging at rest and during performance of the ADIM. [Results] The intra-examiner reliability estimates ranged from 0.55 to 0.97 in the rest position, and from 0.82 to 0.95 during ADIM. The inter-examiner reliability estimates ranged from 0.77 to 0.98 in the rest position, and from 0.86 to 0.98 during ADIM. [Conclusion] ADIM thickness measurements of the TrA, IO, and EO muscles in patients with LBP based on the mean of 2 measures are highly reliable when taken by a single examiner and adequately reliable when taken by different examiners. PMID:24259867

  19. 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 Central

    Sugaya, Tomoaki; Abe, Yota; Sakamoto, Masaaki

    2014-01-01

    [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. PMID:25276022

  20. Levobupivacaine - dextran mixture for transversus abdominis plane block and rectus sheath block in patients undergoing laparoscopic colectomy: a randomised controlled trial.

    PubMed

    Hamada, T; Tsuchiya, M; Mizutani, K; Takahashi, R; Muguruma, K; Maeda, K; Ueda, W; Nishikawa, K

    2016-04-01

    We performed a randomised controlled double-blinded study of patients having laparoscopic colectomy with bilateral transversus abdominis plane block plus rectus sheath block, comparing a control group receiving 80 ml levobupivacaine 0.2% in saline with a dextran group receiving 80 ml levobupivacaine 0.2% in 8% low-molecular weight dextran. Twenty-seven patients were studied in each group. The mean (SD) maximum plasma concentration of levobupivacaine in the control group (1410 (322) ng.ml(-1) ) was higher than the dextran group (1141 (287) ng.ml(-1) ; p = 0.004), and was reached more quickly (50.6 (30.2) min vs 73.2 (24.6) min; p = 0.006). The area under the plasma concentration-time curve from 0 min to 240 min in the control group (229,124 (87,254) ng.min.ml(-1) ) was larger than in the dextran group (172,484 (50,502) ng.min.ml(-1) ; p = 0.007). The median (IQR [range]) of the summated numerical pain rating score at rest during the first postoperative 24 h in the control group (16 (9-20 [3-31]) was higher than in the dextran group (8 (2-11 [0-18]); p = 0.0001). In this study, adding dextran to levobupivacaine decreased the risk of levobupivacaine toxicity while providing better analgesia. PMID:26919568

  1. Magnesium sulphate as an adjuvant to bupivacaine in ultrasound-guided transversus abdominis plane block in patients scheduled for total abdominal hysterectomy under subarachnoid block

    PubMed Central

    Rana, Shelly; Verma, Ravinder Kumar; Singh, Jai; Chaudhary, Sudarshan Kumar; Chandel, Ankita

    2016-01-01

    Background and Aims: Transversus abdominis plane (TAP) block has proven to be an effective component of multimodal analgesic regimens for a variety of abdominal procedures. Magnesium sulphate (MgSO4) N-methyl-D-aspartate receptor antagonist has the potential to be an ideal adjuvant in TAP block. We studied the efficacy of MgSO4 as an adjuvant to bupivacaine in TAP block in patients scheduled for total abdominal hysterectomy (TAH) under subarachnoid block (SAB). Methods: Sixty-five women belonging to American Society of Anesthesiologists physical status 1 or 2, aged between 35 and 70 years, scheduled for TAH under SAB were recruited. Patients in Group B (n = 32) received 18 mL 0.25% bupivacaine (45 mg) with 2 mL normal saline (NS), whereas those in Group BM (n = 33) received 18 mL 0.25% bupivacaine (45 mg) with 1.5 mL (150 mg) MgSO4 and 0.5 mL NS in the ultrasound (USG)-guided TAP block performed on each side after the completion of the surgery under SAB. They were evaluated for pain at 0, 2, 4, 6, 12 and 24 h, time to first rescue analgesic and duration of postoperative analgesia were noted. Results: The post-operative visual analogue scale (VAS) scores were lower in Group BM at 4, 6 and 12 h (P < 0.05). Mean duration of analgesia was significantly prolonged in Group BM with lesser requirement of rescue analgesic (P < 0.05) up to 12 h. Conclusion: MgSO4 (150 mg) as an adjuvant to bupivacaine in USG-guided TAP block reduces post-operative pain scores, prolongs the duration of analgesia and decreases demands for rescue analgesics. PMID:27053780

  2. 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

  3. The analgesic efficacy of ultrasound-guided transversus abdominis plane block with mid-axillary approach after gynecologic laparoscopic surgery: A randomized controlled trial

    PubMed Central

    Kawahara, Ryoko; Tamai, Yutaka; Yamasaki, Kyoko; Okuno, Satoko; Hanada, Rumi; Funato, Takao

    2015-01-01

    Background and Aims: The transversus abdominis plane (TAP) block is widely used in clinical practice as a part of the multimodal analgesic regimen after abdominal surgery. The analgesic efficacy of ultrasound (US)-guided TAP block with the mid-axillary approach was investigated in patients undergoing laparoscopic gynecologic surgery in a randomized controlled clinical trial. Materials and Methods: Adult patients (n = 119) undergoing laparoscopic gynecologic surgery were randomized to undergo either TAP block with ropivacaine (Group A, n = 60) or that with saline (Group B, n = 59), in a blinded manner. Following general anesthesia, TAP block was performed bilaterally by infusion of either 20-mL 0.375% ropivacaine/one side in Group A or 20-mL saline/one side in Group B, under US guidance with a mid-axillary approach. Patient-controlled analgesia (PCA) was performed postoperatively with tramadol. The analgesic effect was postoperatively evaluated using a four-grade pain score and the prince Henry pain scale (PHS) at 0, 6, 12, and 24 h. Postoperative tramadol PCA consumption and vomiting/nausea were recorded. Statistical analyses were performed using the Mann-Whitney U-test or Fisher's exact probability test. A P < 0.05 was considered significant. Results: There was no statistically significant difference in background characteristics. The dose of remifentanil was significantly higher in Group B (P = 0.01). The pain score (P = 0.02) and PHS (P = 0.01) were significantly lower in Group A at 0 h. Tramadol PCA consumption in the period of 0-6 h (P = 0.01) and postoperative nausea (P = 0.04) were significantly less in Group A. Conclusion: Postoperative pain/nausea and PCA consumption were significantly lower in patients with TAP block in the early postoperative stage. TAP block with a mid-axillary approach holds considerable promise as a part of a balanced postoperative analgesic regimen following laparoscopic gynecologic surgery. PMID:25788776

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

    PubMed Central

    Abdelsalam, Khaled; Mohamdin, OW

    2016-01-01

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

  5. Evaluation of postoperative pain scores following ultrasound guided transversus abdominis plane block versus local infiltration following day surgery laparoscopic cholecystectomy-retrospective study

    PubMed Central

    Kadam, Vasanth Rao; Howell, Stuart; Kadam, V.

    2016-01-01

    Background and Aims: Postoperative pain for day surgery laparoscopic cholecystectomy has traditionally been managed with the surgeon infiltrating the wound with local anesthetic (LA). However, transversus abdominis plane (TAP) block has recently been used, although its superiority over LA remains uncertain. The primary aim was to compare LA and TAP block pain scores and analgesia used. The secondary aim was to assess satisfaction score and cost. Material and Methods: This retrospective study was commenced after ethics committee approval and ANZ clinical trial registry (ACTRN: 12612000737831). The data were collected from the theatre database and medical records of patients presenting for day case laparoscopic cholecystectomy. The sample included patients who received either bilateral port site LA infiltration with 20 ml of 0.25% Bupivacaine or bilateral TAP block with 20 ml of 0.5% ropivacaine and fentanyl postoperative pain protocol. The patients with incomplete medical records were excluded as were those admitted to an inpatient ward. Demographics and clinical characteristics were obtained from the hospital record along with pain score and postsurgery analgesia use. Postoperative pain satisfaction scores were collected by telephonic interview 30-180 days postsurgery. Results: Of 51 patients analyzed, 19 were in TAP group 29 in LA group. There were no significant differences between the LA and TAP groups with respect to postoperative pain scores (P = 0.31) or patient satisfaction scores (1 and 2+) (P = 0.36). However, fentanyl consumption in the recovery room was significantly lower in TAP group (P = 0.0079.). The consumables cost were >3 times higher in the TAP when compared to LA group. Conclusion: The performance of the TAP block with respect to pain management was comparable to LA. However, LA remains more cost effective. PMID:27006547

  6. The Type of Breast Reconstruction May Not Influence Patient Satisfaction in the Chinese Population: A Single Institutional Experience

    PubMed Central

    Chen, Jiaying; Chen, Ying; Hu, Zhen; Liu, Guangyu; Shen, Zhenzhou; Shao, Zhimin; Wu, Jiong

    2015-01-01

    Background The goal of this study was to evaluate patient satisfaction with four common types of breast reconstruction performed at our institution: latissimus dorsi myocutaneous (LDM) flap reconstruction with or without implants, pedicled transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction, and free deep inferior epigastric perforator (DIEP) flap reconstruction. Methods A custom survey consisting of questions that assessed general and aesthetic satisfaction was sent to patients who had undergone breast reconstruction in the last 5 years. The clinical data and details of the surgery were also collected from the patients who returned the surveys. We compared satisfaction rates across the four breast reconstruction types and analyzed the effects of various factors on overall general and aesthetic satisfaction rates using a binary logistic regression model. Result A total of 207 (72%) patients completed the questionnaires. Overall, significant differences in general and aesthetic satisfaction among the four procedures were not observed. A multivariate analysis revealed that the factor “complications” (p = 0.001) played a significant role in general satisfaction and that the factors “> 2 years since reconstruction” (p = 0.043) and “age > 35 years” (p = 0.05) played significant roles in overall aesthetic satisfaction. Conclusion The present study demonstrated that the type of breast reconstruction might not influence satisfaction in Chinese patients. PMID:26562294

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

    NASA Astrophysics Data System (ADS)

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

    2014-09-01

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

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

    PubMed

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

    2014-11-01

    Vascular thrombosis is one of the major postoperative complications of free flap microvascular breast reconstruction operations. It is associated with higher morbidity, higher cost, increased length of hospital stay, and potentially flap loss. Our purpose is to evaluate the rate of this complication and whether patient characteristics play a role. Using the Nationwide Inpatient Sample (NIS) database, we examined the clinical data of patients who underwent free flap breast reconstruction between 2009 and 2010 in the United States. Multivariate and univariate regression analyses were performed to identify independent risk factors of flap thrombosis. A total of 15,211 patients underwent free flap breast reconstruction surgery (immediate reconstruction: 43%). The most common flap was the free deep inferior epigastric perforator (DIEP) flap (53.6%), followed by free transverse rectus abdominis myocutaneous (TRAM) flap (43.1%), free superficial inferior epigastric artery (SIEA) flap (2%), and free gluteal artery perforator (GAP) flap (1.3%). The overall rate of flap thrombosis was 2.4 %, with the highest rate seen in the SIEA group (11.4%) and the lowest in the TRAM group (1.7%). Peripheral vascular disease (adjusted odds ration [AOR] 10.61), SIEA flap (AOR, 4.76) and delayed reconstruction (AOR, 1.42) were found to be statistically significant risk factors for flap thrombosis. Other comorbidities were not linked. While the overall rate of flap thrombosis in free flap breast reconstruction was relatively low (2.4%), Plastic Surgeons should be aware that patients with peripheral vascular disease and those undergoing free SIEA flap are at higher risk of flap thrombosis and they should closely monitor flaps to increase the chance for early salvage. PMID:24665051

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. Ultrasound-guided subcostal transversus abdominis plane blocks with liposomal bupivacaine vs. non-liposomal bupivacaine for postoperative pain control after laparoscopic hand-assisted donor nephrectomy: a prospective randomised observer-blinded study.

    PubMed

    Hutchins, J L; Kesha, R; Blanco, F; Dunn, T; Hochhalter, R

    2016-08-01

    We compared the effect of subcostal transversus abdominis plane (TAP) block with liposomal bupivacaine to TAP block with non-liposomal bupivacaine on postoperative maximal pain scores in patients undergoing donor nephrectomy. Sixty patients were prospectively randomly assigned to receive ultrasound-guided bilateral TAPs with either 1.3% liposomal bupivacaine and normal saline or 0.25% non-liposomal bupivacaine with adrenaline. There was a significant decrease in maximal pain scores in the liposomal bupivacaine TAP group when compared with the non-liposomal bupivacaine group median (IQR [range]), 24-48 h after injection, 5 (3.0-5.2 [0-10]) vs. 6 (4.5-7.0 [1--9]) p = 0.009; 48-72 h after injection, 3 (2.0-5.0 [0-8]) vs. 5 (3.0-7.0 [0-10]) p = 0.02; and in opioid use 48-72 h after injection, mean (SD) μg equivalents of fentanyl 105 (97) vs. 182 (162) p = 0.03. Liposomal bupivacaine via subcostal TAP infiltration provided superior analgesia up to 72 h after injection when compared with non-liposomal bupivacaine. PMID:27238859

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

    PubMed

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

    2014-04-01

    Mastectomy skin flap ischaemia leading to necrosis is a common occurrence. Laser-assisted indocyanine green (ICG) angiography can assist to locate these poorly perfused areas intra-operatively. Our study aims to identify specific perfusion values produced by ICG angiography that accurately predict mastectomy flap necrosis. A total of 42 patients undergoing autologous or implant-based breast reconstruction had mastectomy flaps imaged using laser-assisted ICG angiography at the completion of reconstruction. Intra-operative perfusion values were correlated with postoperative skin flap outcomes. Risk factors for abnormal perfusion were recorded and analysed. A total of 62 breast reconstructions were imaged, including 48 tissue expander reconstructions, six transverse rectus abdominis myocutaneous (TRAM) flaps, six deep inferior epigastric perforator (DIEP) flaps and two direct-to-implant reconstructions. Eight cases (13%) of full-thickness skin necrosis were identified postoperatively. A SPY Elite(®) value of ≤ 7 accurately predicted the development of flap necrosis at 88% sensitivity and 83% specificity. False-positive cases (those with perfusion values ≤ 7 which did not develop necrosis) were more likely to have a smoking history and/or to have had an epinephrine-containing tumescent solution used during mastectomy. Excluding patients with smoking or epinephrine use, a SPY value of ≤ 7 predicted flap necrosis with a sensitivity of 83% and specificity of 97%. Thus, these data suggest that laser-assisted ICG angiography predicts postoperative outcomes with high accuracy. In our series, a SPY value of ≤ 7 correlated well with mastectomy flap necrosis. Furthermore, smoking and intra-operative injections containing epinephrine should be considered when evaluating low perfusion values as they can lead to false-positive test results. PMID:24507962

  15. Pedicled Breast Flap for Soft Tissue Coverage of a Forearm Blast Injury

    PubMed Central

    Zuriarrain, Alexander; Brooks, Christopher

    2016-01-01

    Summary: This article presents the case of a 35-year-old woman who sustained a shotgun blast injury to the left forearm and chest wall causing significant soft tissue loss of the extensor compartment. The patient suffered a Gustilo IIIB open radial shaft fracture requiring orthopedic stabilization and plastic surgery intervention. As a result, the patient eventually was reconstructed with the use of a pedicled breast flap. Because of the patient’s macromastia and her large forearm wound and morbid obesity, an individualized approach was developed such that a breast flap was designed because of its proximity to the upper extremity. The advantage of this type of reconstruction is a more natural contour to the forearm with minimal donor site morbidity. Before creation of the flap, the patient expressed interest in a reduction mammaplasty because of her symptomatic macromastia. Overall, this was a 2-step operation whereby first the breast flap was created, and then a few weeks later, once the arm healed, the reduction mammaplasty was performed. Other types of flaps for upper extremity reconstruction include the rectus abdominis myocutaneous, transverse rectus abdominis myocutaneous, vertical rectus abdominis myocutaneous, groin, and latissumus dorsi. The pedicled breast flap is an innovative approach to upper extremity soft tissue coverage and can be tailored to the specific needs of patients similar to our case presentation. PMID:27104108

  16. Research of a Tram Headstock from Composite

    NASA Astrophysics Data System (ADS)

    Malkovsky, Zdenek; Kovandova, Hedvika

    2014-08-01

    The requirements for crashworthiness of railway vehicles are defined by the Railroad crashworthiness standard EN 15227. This standard is based on the findings of the characteristics of steel structures of front parts of railway vehicles. In the Czech Republic an extensive research was carried out within the project TIP FR-TI1/113 on application of composite sandwich structure elements in the design of the front cabins of a railway vehicle. The aim of the research work was to determine real possibilities of the composite sandwich structures for use in the construction of railway vehicles while considering the validity of the above-mentioned standard.

  17. Muscular, myocutaneous, and fasciocutaneous flaps in complex urethral reconstruction.

    PubMed

    Zinman, Leonard

    2002-05-01

    The ability to achieve a long-term, stable, stricture-free, hairless urethral lumen in patients with complex anterior stricture and compromised genital skin is one of the ongoing challenges of reconstructive urologic surgery. The conservative approach by endoscopic urethrotomy or dilatation with a self-catheterization schedule rarely affects a definitive cure except in the short filmy superficial strictures of the bulbous portion of the urethra. Genital fasciocutaneous island flaps are currently the golden standard for definitive, reliable resolution of anterior urethral strictures in patients who have not undergone a prior surgical procedure that may alter the penile or scrotal circulation, or those with skin loss from trauma, decubiti, radiation, or balanitis xerotica obliterans. PMID:12371235

  18. 36 CFR 1192.179 - Trams, similar vehicles and systems.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... hotels and other public accommodations, and between and within amusement parks and other recreation areas, shall comply with this section. For purposes of determining applicability of 49 CFR 37.101, 37.103,...

  19. 36 CFR 1192.179 - Trams, similar vehicles and systems.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... hotels and other public accommodations, and between and within amusement parks and other recreation areas, shall comply with this section. For purposes of determining applicability of 49 CFR 37.101, 37.103,...

  20. 36 CFR 1192.179 - Trams, similar vehicles and systems.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... hotels and other public accommodations, and between and within amusement parks and other recreation areas, shall comply with this section. For purposes of determining applicability of 49 CFR 37.101, 37.103,...

  1. 36 CFR 1192.179 - Trams, similar vehicles and systems.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... hotels and other public accommodations, and between and within amusement parks and other recreation areas, shall comply with this section. For purposes of determining applicability of 49 CFR 37.101, 37.103,...

  2. 36 CFR 1192.179 - Trams, similar vehicles and systems.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., shall comply with this section. For purposes of determining applicability of 49 CFR 37.101, 37.103, or... units, including but not limited to vehicles providing shuttle service to remote parking areas, between... addition, each such unit shall comply with § 1192.23 (b) or (c) and shall provide at least one space...

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

    PubMed

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

    2015-09-01

    Vaginal reconstruction after pelvic exenteration (PE) represents a challenge for the oncologic surgeon. Since the introduction of perforator flaps, using pedicled vertical DIEP (deep inferior epigastric perforator) flap allows to reduce the donor site complication rate. From November 2012 to December 2014, 27 PEs were performed in our institution. 13 patients who underwent PE with vaginal reconstruction and programmed DIEP procedure for gynecologic malignancies were registered. Nine patients underwent PE for recurrent disease and four for primary treatment. Six of the 13 patients have a preoperative fistula. Anterior PE was performed in 10 patients, and total PE in 3 patients. A vertical DIEP flap was performed in 10 patients using one or two medial perforators. The reasons for abortion of vertical DIEP flap procedure were: failure to localizing perforator vessels in two cases, and unavailability of plastic surgeon in one case. A vertical fascia-sparring rectus abdominis myocutaneous flap was then harvested. Median length of surgery was 335min, and 60min for DIEP harvesting and vaginal reconstruction. No flap necrosis occurred. One patient in the VRAM (vertical rectus abdominis myocutaneous) group experienced a late incisional hernia and one patient in the DIEP flap group required revision for vaginal stenosis. In our experience, DIEP flap represents our preferred choice of flap for circumferential vaginal reconstruction after PE. To achieve a high reproducibility, the technically demanding pedicled vertical DIEP flap has to be harvested by a trained surgeon, after strict evaluation of the preoperative imaging with identification and localization of perforator vessels. PMID:26121919

  4. Reconstruction of the pelvis and perineum with a free latissimus dorsi myocutaneous flap: a case report.

    PubMed

    Kieran, I; Nugent, N; Riordain, M Ó; Kelly, J

    2012-11-01

    Reconstruction of the perineum and pelvic cavity in continuity is an uncommon and difficult challenge. This case describes a 66-year-old man who presented following recurrence of a Dukes' B rectosigmoid adenocarcinoma that had been treated nine years previously by anterior resection, 5-fluorouracil and radiotherapy. His recurrent disease was treated with radical pelvic exenteration with formation of an end colostomy and urinary ileal conduit. A post-operative pelvic collection necessitated incisional drainage via the perineum. This resulted in a perineal defect in continuity with the pelvic cavity, neither of which healed in spite of alternate day packing with antiseptic dressings. The perineum and cavity were reconstructed successfully with a microvascular transfer of the latissimus dorsi using the primary gracilis pedicle as recipient donor vessels. PMID:23131218

  5. [Chest wall reconstruction after resection of malignant chest wall tumors].

    PubMed

    Ayabe, H; Oka, T; Akamine, S; Takahashi, T; Nagayasu, T

    1998-05-01

    Full-thickness chest wall resection is performed for complete removal of primary and secondary malignant chest wall tumors. Large defects of the chest wall after resection must be repaired to maintain adequate ventilation, to protect important intrathoracic structures, and to preserve cosmetic integrity. Various materials have been utilized over the years to replace the rigid chest wall. At present, Marlex mesh and a composite of Marlex mesh and methylmethacrylate are frequently used to reconstruct rigid chest wall defects. On the other hand, to replace the soft part of the chest wall and cover the rigid materials, pedicled muscle flaps, myocutaneous flaps, or omentum are used. Major pedicled flaps include the pectoralis major, rectus abdominis and latissimus dorsi muscular, and musculocutaneous flaps. Techniques are now available to repair any chest wall site, and to restore chest continuity in patients whose tumors are curatively resected. PMID:9656244

  6. Reconstruction Using Locoregional Flaps for Large Skull Base Defects.

    PubMed

    Hatano, Takaharu; Motomura, Hisashi; Ayabe, Shinobu

    2015-06-01

    We present a modified locoregional flap for the reconstruction of large anterior skull base defects that should be reconstructed with a free flap according to Yano's algorithm. No classification of skull base defects had been proposed for a long time. Yano et al suggested a new classification in 2012. The lb defect of Yano's classification extends horizontally from the cribriform plate to the orbital roof. According to Yano's algorithm for subsequent skull base reconstructive procedures, a lb defect should be reconstructed with a free flap such as an anterolateral thigh free flap or rectus abdominis myocutaneous free flap. However, our modified locoregional flap has also enabled reconstruction of lb defects. In this case series, we used a locoregional flap for lb defects. No major postoperative complications occurred. We present our modified locoregional flap that enables reconstruction of lb defects. PMID:26225296

  7. 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

  8. Hepatocellular carcinoma with extension to the diaphragm, falciform ligament, rectus abdominis and paraumbilical vein

    PubMed Central

    Kaur, R; Abdullah, BJJ; Rajasingam, V

    2008-01-01

    Hepatocellular carcinoma is the most common primary tumour of the liver. The most common extrahepatic metastatic sites are the lung, lymph nodes, bones and adrenal glands. All forms of HCC demonstrate a tendency for vascular invasion, producing extensive intrahepatic metastases and, occasionally, portal vein or inferior vena cava extension with spread into the right atrium in extreme cases. Tumour spread of abdominal diseases via hepatic ligaments has also been previously reported. We report a rare case of hepatocellular carcinoma with extension into the falciform ligament, overlying rectus sheath and adjacent diaphragm with concomitant infiltration into the recanalised paraumbilical vein. PMID:21611019

  9. Essential elements of the preoperative breast reconstruction evaluation.

    PubMed

    Cheng, Angela; Losken, Albert

    2015-04-01

    A plethora of options exist for breast reconstruction and preoperative evaluation must be thorough to lead to a successful outcome. We review multiple components of the preoperative assessment including the patient's history, goals, imaging, and key elements of the physical exam. Consideration for tumor biology, staging, need or response to chemotherapy or radiation therapy is important in deciding on immediate versus delayed reconstruction. It is also important to consider the patient's anatomy, breast size and whether the reconstruction will be unilateral or bilateral. The reconstructive surgeon must accommodate all these factors to consider partial or complete mastectomy defects and guide the patient to the most appropriate reconstructive technique whether it be an oncoplastic reduction mammoplasty, expander-based reconstruction, immediate implant reconstruction, or immediate versus delayed autologous tissue reconstruction such as the deep inferior epigastric artery perforator (DIEP)/transverse rectus abdominis muscle (TRAM), latissimus, transverse upper gracilis (TUG)/profunda femoris artery perforator (PAP), or gluteal artery perforator (GAP) flaps. PMID:26005641

  10. 49 CFR 38.179 - Trams, and similar vehicles, and systems

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... purposes of determining applicability of 49 CFR 37.101, 37.103, or 37.105 the capacity of such a vehicle or... vehicles providing shuttle service to remote parking areas, between hotels and other public...

  11. 49 CFR 38.179 - Trams, and similar vehicles, and systems

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... purposes of determining applicability of 49 CFR 37.101, 37.103, or 37.105 the capacity of such a vehicle or... vehicles providing shuttle service to remote parking areas, between hotels and other public...

  12. 49 CFR 38.179 - Trams, and similar vehicles, and systems

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... purposes of determining applicability of 49 CFR 37.101, 37.103, or 37.105 the capacity of such a vehicle or... vehicles providing shuttle service to remote parking areas, between hotels and other public accommodations...) or (c) and shall provide at least one space for wheelchair or mobility aid users complying with §...

  13. 49 CFR 38.179 - Trams, and similar vehicles, and systems

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... purposes of determining applicability of 49 CFR 37.101, 37.103, or 37.105 the capacity of such a vehicle or... vehicles providing shuttle service to remote parking areas, between hotels and other public accommodations...) or (c) and shall provide at least one space for wheelchair or mobility aid users complying with §...

  14. Internal mammary vessels as recipient vessels to the free TRAM flap.

    PubMed

    Nejedlý, A; Tvrdek, M; Kletenský, J; Pros, Z

    1995-01-01

    For the reconstruction of the breast after mastectomy, it is possible to use the internal mammary artery and vein as recipient vessels. The authors consider their experience and some new knowledge gained on the basis of 53 cases. They try to promote the indisputable advantages of the use of the mentioned recipient vessels. PMID:7653170

  15. [Evaluation of patients' satisfaction after breast reconstruction with latissimus dorsi myocutaneous flap and immediate permanent breast implant].

    PubMed

    Bognár, Gábor; Gőgh, Bettina; Novák, András; István, Gábor

    2014-04-01

    Current surgical treatment modalities for breast reconstruction include latissimus dorsi mycotaneous flap with immediate permanent breast implant (LDI). The aim of the present study was to analyze reconstruction with LDI in terms of quality of life, cosmesis and patient satisfaction. A chart analysis was carried out with the first ten patients who underwent breast reconstruction with LDI. The patients were interviewed and self-assessment quality of life was administered. They also underwent assessment of satisfaction and cosmesis. The high satisfaction and cosmesis scores in the breast reconstruction group indicate the superior results that can be achieved with breast reconstruction. PMID:24747404

  16. [Repair of large urogenital necrosis of obstetrical origin by pedicled myocutaneous plasty of the greater lip. Technique and results].

    PubMed

    Falandry, L

    1991-03-01

    The vesicovaginal fistulae encountered in Africa are a real plague. Their origin is obstetrical as a rule, and they occur in young women, often in primiparas. They are seldom simple as they have been operated repeatedly and involve associated lesions and a large loss of substance, so that they raise complex problems of repair. The experience with the treatment of 230 obstetrical fistulae by the same surgeon in Africa leads the author to describe a repair technique fit for complex fistulae, especially those involving an extensive loss of substance and associated lesions (rectovaginal fistula, perineal destruction). With a low approach, the procedure consists in using a filler tissue, namely a skin flap removed from a greater lip, for which the vasculature is maintained by the preservation of a thick musculous and fatty pedicle, cut from the fibers of the bulbocavernosus muscle. Once sutured around the orifice of the fistula, this graft closes it while fostering its healing. Out of the 14 patients treated with this technique, the results achieved were regarded as good for 10 (72%), including 7 after a first operation and 3 after second surgery. In 9 cases, there were associated lesions, including 5 rectovaginal fistulae and 4 cases of complete tearing of the perineum. We have had 4 failures, including 3 definitive ones, and a partial failure with the persistence of urine incontinence in station due to be destruction of the ureter. When the simpler Martius' procedure (on which ours is patterned) is no longer sufficient, the use of a pedicled skin-fat graft taken from the greater lip allows considerably restricting the indications of palliative surgery. Our technique increases the percentage of success for fistulae regarded as irreparable or after the usual repair procedures have failed. PMID:2055973

  17. Perfusion in free breast reconstruction flap zones assessed with positron emission tomography.

    PubMed

    Schrey, Aleksi; Kinnunen, Ilpo; Kalliokoski, Kari; Minn, Heikki; Grénman, Reidar; Vahlberg, Tero; Niemi, Tarja; Suominen, Erkki; Aitasalo, Kalle

    2010-09-01

    The aim of this pilot study was to determine the postoperative blood perfusion (BF(PET)) and perfusion heterogeneity (BF(PET) HG) in free microvascular breast reconstruction flap zones with positron emission tomography (PET). Regional BF(PET) and BF(PET) HG of the adipose tissue in medial, central, and lateral parts of 13 free flaps were assessed on the first postoperative morning with PET using oxygen-15-labeled water ([(15)O]H(2)O) in 12 patients undergoing breast reconstruction with a deep inferior epigastric perforator (DIEP) or a transverse rectus abdominis muscle (TRAM) flap. The mean BF(PET) values did not differ between DIEP and TRAM flaps (P = 0.791). The mean BF(PET) values were higher in zone III compared with zone I (P = 0.024). During follow-up, fat necrosis was identified in three patients in the medial part (zone II) of the flap. However, the adipose tissue BF(PET) assessed on the first postoperative day from all zones of the flap using PET with radiowater was normal. The BF(PET) HG was higher in the control side (i.e., in the healthy breast tissue) compared with the flap (P = 0.042). The BF(PET) HG was lower in zone III than in zone I (P = 0.03) and in zone II (P < 0.001). In this pilot study, PET was used for the first time for studying the adipose tissue perfusion in different zones in free flaps in a clinical setup, finding that the mean BF(PET) values did not differ between DIEP and TRAM flaps, and that zone II was sometimes not as well perfused as zone III supporting revisited zone division. PMID:20878725

  18. Return of lymphatic function after flap transfer for acute lymphedema.

    PubMed Central

    Slavin, S A; Van den Abbeele, A D; Losken, A; Swartz, M A; Jain, R K

    1999-01-01

    OBJECTIVE: The goals of this work were to develop animal models of lymphedema and tissue flap transfer, and to observe physiologic changes in lymphatic function that occur in these models over time, both systemically with lymphoscintigraphy (LS) and locally using fluorescence microlymphangiography (FM). SUMMARY BACKGROUND DATA: Although lymphedema has been managed by a combination of medical and surgical approaches, no effective long-term cure exists. Surgical attempts aimed at reconnecting impaired lymphatic channels or bypassing obstructed areas have failed. METHODS: The tails of rats (A groups) and mice (B groups) were used because of their different features. Lymphedema was created by ligation of the lymphatics at the tail base and quantified by diameter measurements there. In the experimental group, rectus abdominis myocutaneous flap was transferred across the ligation. In addition to the ligation (A1 and B1) and ligation + flap (A2 and B2) groups, three control groups were included: sham flap with ligation (B4), sham flap alone (B5), and normal (A3 and B3) animals. Observations were made at weekly time points for lymphatic function and continuity. RESULTS: Lymphedema was successfully created in the mouse ligation groups (B1 and B4) and sustained for the entire length of observation (up to 14 weeks). Lymphatic continuity was restored in those animals with transferred flaps across the ligation site (A2 and B2), as seen both by LS and FM. Sham flaps did not visibly affect lymphatic function nor did they cause any visible swelling in the tail. CONCLUSIONS: Acute lymphedema developing after ligation of tail lymphatics in mice can be prevented by myocutaneous flap transfer. Restored lymphatic continuity and function were demonstrable using lymphoscintigraphy and fluorescence microlymphangiography. Images Figure 2. Figure 4. Figure 5. PMID:10077056

  19. Abdominoperineal Excisions in the Treatment Regimen for Advanced and Recurrent Vulvar Cancers-Analysis of a Single-Centre Experience.

    PubMed

    Hannes, Sabine; Nijboer, Johanna M; Reinisch, Alexander; Bechstein, Wolf O; Habbe, Nils

    2015-12-01

    Vulva cancer is the fourth leading gynaecological malignancy, accounting for approximately 4 % of all gynaecological cancers. Surgery represents the treatment of choice, and cases of advanced or recurrent vulvar cancers are to date a major challenge to multidisciplinary teams. Abdominoperineal excision (APE) in combination with vulvectomy and inguinal lymphadenectomy is the only curative treatment option. Patients' files of all women with squamous cell carcinoma of the vulva who underwent abdominoperineal resection were retrospectively reviewed with special regards to technical challenges the general surgeon will face. Seven women were enrolled in this retrospective study with a median age of 71 years (range 56-79 years). In six patients, the pelvic floor after abdominoperineal excision could be closed by direct suture of the levator muscles. One woman underwent abdominoperineal resection with closure of the defect using a vertical rectus abdominis myocutaneous (VRAM) flap. All women underwent radical vulvectomy, in five patients in combination with bilateral inguinal lymph node dissection. Operation time was 377 min (range 130-505 min). The median overall survival after surgery was 27 months (range 4-84 months), with a calculated 5-year survival rate of 42 %. Women with negative lymph nodes revealed a longer survival time after surgery compared to women with lymph node metastases (15.5 vs. 72 months; p = 0.09). Abdominoperineal excisions represent a powerful tool in the multidisciplinary treatment regimen of advanced or recurrent vulvar cancer. Reconstruction of the pelvic floor usually does not require myocutaneous flaps, even when facing large tumours. Despite high complication rates, radical surgery was a feasible treatment with long-term survival potential without mortality. PMID:27011549

  20. 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

  1. 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

  2. Use of Lumbar Perforator Recipient Vessels for Salvage Chest Wall Reconstruction: A Case Report

    PubMed Central

    Sillah, Nyama M.; Shah, Jinesh; Fukudome, Eugene

    2016-01-01

    Summary: Abdominal-based free flaps are commonly used for breast reconstruction, and the internal mammary or thoracodorsal vessels are typically used as recipient sites. Conversely, free tissue transfer is less commonly used for chest wall reconstruction in the setting of chest wall recurrence, in part, because of a paucity of recipient vessels. Here, we describe a case of a 68-year-old female smoker with metastatic breast cancer, who presented with a chest wall recurrence. There was a large area of chronic ulceration with foul smelling drainage, in addition to radiation-induced tissue injury, and palliative resection was performed. The area was reconstructed with a free transverse rectus abdominis myocutaneous flap using lumbar perforators as recipient vessels, because conventional recipient sites were unavailable because of scarring from radiation and residual tumor. This case demonstrates that uncommon recipient vessels such as lumbar perforators may allow for successful palliative chest wall reconstruction. We hypothesize that the tumor burden, previous surgeries, and radiation may have rendered the recipient field relatively ischemic, thereby inducing hypertrophy of the lumbar perforators, similar to a delay phenomenon. PMID:27257572

  3. [Avoidance of complications in oncological surgery of the pelvic region : combined oncosurgical and plastic reconstruction measures].

    PubMed

    Beier, J P; Croner, R S; Lang, W; Arkudas, A; Schmitz, M; Göhl, J; Hohenberger, W; Horch, R E

    2015-03-01

    Prevention of perioperative and postoperative complications resulting from surgical oncology in the pelvic region remains a major interdisciplinary challenge. With modern interdisciplinary concepts joining forces of various surgical specialties, tumor resection can be sufficiently carried out with wide margins and the patients benefit from reduced morbidity even in complex situations. As an example chronic fistulation and secretion from the presacral cavity and sinus may result as potential sequelae from intra-abdominal and intrapelvic tumor resection, especially when neoadjuvant multimodal therapies have been applied. This can be prevented by simultaneous transplantation of for example transpelvic vertical rectus abdominis myocutaneous (VRAM) flap transfer, while extensive perineal skin and soft tissue defects may also be simultaneously reconstructed. In cases of malignant soft tissue tumors in the pelvic region a staged surgical procedure can be performed with a period of time between tumor resection and reconstruction. Thus, a histological R0 status can be secured prior to plastic reconstruction surgery in order to increase oncological safety. In cases of postresectional exposition of e. g. pelvic or femoral vessels or intrapelvic and intra-abdominal organs simultaneous flap procedure is mandatory.The reconstructive armamentarium of the plastic surgeon should contain not only pedicled but also free microsurgical flaps so that no compromise in terms of the extent of the oncological resection has to be accepted. At the same time perioperative and postoperative complications may be avoided and the patient quality of life can be preserved even in more complex cases. PMID:25620285

  4. 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

  5. Management of giant inferior triangle lumbar hernia (Petit's triangle hernia): A rare complication following delayed breast reconstruction with extended latissimus dorsi myocutaneous flap

    PubMed Central

    Munhoz, Alexandre Mendonça; Montag, Eduardo; Arruda, Eduardo Gustavo; Sturtz, Gustavo; Gemperli, Rolf

    2014-01-01

    INTRODUCTION Lumbar triangle hernia after breast reconstruction with latissimus dorsi flap (LDMF) is a very rare complication and few cases were previously described. Muscle mobilization and iatrogenic fascia defect are related etiologic factors. PRESENTATION OF CASE The authors describe a rare case of lumbar hernia in a 58-year-old woman who underwent delayed left breast reconstruction with LDMF. Two months after surgery, a progressive symptomatic lower left lumbar bulge was observed. The CT scan confirmed the diagnosis and delineated an 18 cm lumbar defect filled with lower and large bowel. At operation, the defect was exposed and the hernia sac reduced. In order to obtain stability, the remained local muscle and fascia flaps were mobilized into the defect. Additional strength was achieved with a two-layer closure of prosthetic mesh (intra/extra peritoneal). The patient is currently in the 10th postoperative year of hernia repair and satisfactory lumbar wall contour was achieved. Neither the recurrence of lumbar hernia nor symptoms compliance was noted. DISCUSSION Lumbar hernia is an uncommon complication of LDMF harvest. Although it is a rare disease, general and plastic surgeons must be on alert to avoid complications and misdiagnosis. Seroma differential diagnosis is important in order to avoid bowel perforation due to aspiration. Defect reconstruction is necessary with a muscular and fascia flaps mobilization and synthetic mesh in order to obtain a stable repair. CONCLUSION The knowledge of this rare post-operative complication following delayed breast reconstruction is crucial to its surgical management. Early surgical intervention is warranted in order to avoid severe complications. PMID:24794025

  6. 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. PMID:25441860

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

    PubMed Central

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

    2014-01-01

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

  8. Effects of fat preparation methods on the viabilities of autologous fat grafts.

    PubMed

    Minn, Kyung-Won; Min, Kyung-Hee; Chang, Hak; Kim, Sukwha; Heo, Eun-Ju

    2010-10-01

    Fat grafts are commonly used in plastic surgery, but their unpredictable absorption rates are a considerable disadvantage. Furthermore, no agreement has been reached regarding the method that best enables fat graft survival. This study aimed to evaluate the effects of different preparation methods on fat graft viability. Fat tissue was harvested from the remnants of transverse rectus abdominis musculocutaneous (TRAM) flaps by syringe aspiration. Harvested fat tissue was prepared using three different methods: centrifugation, metal sieve concentration, and cotton gauze concentration. To evaluate the viabilities of fat cells, XTT assays were performed. For the study, 18 nude mice were allocated to three groups: the centrifugation, metal sieve, and cotton gauze groups (6 mice per group). Prepared fat (1 ml) was injected into the nuchal area of the mice, and 12 weeks later, grafts were dissected to determine graft survival rates and subjected to histologic analysis. No significant differences were observed in graft survival rates and histologic findings (necrosis and vascularity) between the three groups. However, histologic analysis found the metal sieve group to have significantly lower fat cell viability and more inflammation than the other two groups. The findings suggest that the closed centrifugation technique has no advantage over the open cotton gauze technique in terms of fat graft viability, and that the metal sieve concentration method is deficient as a preparation method because it can cause grafted fat degradation. PMID:20442997

  9. Preoperative planning for DIEP breast reconstruction: early experience of the use of computerised tomography angiography with VoNavix 3D software for perforator navigation.

    PubMed

    Pacifico, M D; See, M S; Cavale, N; Collyer, J; Francis, I; Jones, M E; Hazari, A; Boorman, J G; Smith, R W

    2009-11-01

    The deep inferior epigastric perforator (DIEP) flap is normally the first choice in breast reconstruction; however, due to the considerable vascular anatomical variation and the learning curve for the procedure, muscle-sparing transverse rectus abdominis musculocutaneous (TRAM) flaps are still frequently performed to reduce the rate of complications. Accurate preoperative investigation of the perforators would allow better operative preparation and possibly shorten the learning curve. In an effort to increase accuracy of preoperative planning and to aid preoperative decision-making in free abdominal flap breast reconstruction, we have acquired the use of VoNavix, software that creates three dimensional images from computerised tomography angiography (CTA) data. The use of the VoNavix software for analysis of CTA provides superior imaging that can be viewed in theatre. It, together with CTA, enables decisions to be made preoperatively, including: which side to raise the flap; whether to aim for a medial or lateral row perforator; whether to take a segment of muscle and whether to expect an easy or difficult dissection. We have now performed over 60 free abdominal flap breast reconstructions aided with CTA, and 10 of these cases also used VoNavix technology. This paper presents our initial experience with the use of this software, illustrated with three patient examples. The advantages and disadvantages are discussed. PMID:18708309

  10. Essential elements of the preoperative breast reconstruction evaluation

    PubMed Central

    Cheng, Angela

    2015-01-01

    A plethora of options exist for breast reconstruction and preoperative evaluation must be thorough to lead to a successful outcome. We review multiple components of the preoperative assessment including the patient’s history, goals, imaging, and key elements of the physical exam. Consideration for tumor biology, staging, need or response to chemotherapy or radiation therapy is important in deciding on immediate versus delayed reconstruction. It is also important to consider the patient’s anatomy, breast size and whether the reconstruction will be unilateral or bilateral. The reconstructive surgeon must accommodate all these factors to consider partial or complete mastectomy defects and guide the patient to the most appropriate reconstructive technique whether it be an oncoplastic reduction mammoplasty, expander-based reconstruction, immediate implant reconstruction, or immediate versus delayed autologous tissue reconstruction such as the deep inferior epigastric artery perforator (DIEP)/transverse rectus abdominis muscle (TRAM), latissimus, transverse upper gracilis (TUG)/profunda femoris artery perforator (PAP), or gluteal artery perforator (GAP) flaps. PMID:26005641

  11. 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

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

    PubMed

    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

  13. Microvascular Reconstructions of Full-Thickness Oncological Chest Wall Defects

    PubMed Central

    Tukiainen, Erkki; Popov, Pentscho; Asko-Seljavaara, Sirpa

    2003-01-01

    Objective: To evaluate the suitability of microvascular flaps for the reconstruction of extensive full-thickness defects of the chest wall. Summary Background Data: Chest wall defects are conventionally reconstructed with pedicular musculocutaneous flaps or the omentum. Sometimes, however, these flaps have already been used, are not reliable due to previous operations or radiotherapy, or are of inadequate size. In such cases, microvascular flaps offer the only option for reconstruction. Methods: From 1988 to 2001, 26 patients with full-thickness resections of the chest wall underwent reconstruction with microvascular flaps. There were 8 soft tissue sarcomas, 8 recurrent breast cancers, 5 chondrosarcomas, 2 desmoid tumors, 1 large cell pulmonary cancer metastasis, 1 renal cancer metastasis, and 1 bronchopleural fistula. The surgery comprised 5 extended forequarter amputations, 5 lateral resections, 8 thoracoabdominal resections, and 8 sternal resections. The mean diameter of a resection was 28 cm. The soft tissue defect was reconstructed with 16 tensor fasciae latae, 5 tensor fascia latae combined with rectus femoris, and 3 transversus rectus abdominis myocutaneous flaps. In 2 patients with a forequarter amputation, the remnant forearm was used as the osteomusculocutaneous free flap. Results: There were no flap losses or perioperative mortality. Four patients needed tracheostomy owing to prolonged respiratory difficulties. The mean survival time for patients with sarcomas was 39 months and for those with recurrent breast cancer 18 months. Conclusions: Extensive chest wall resections are possible with acceptable results. In patients with breast cancer, the surgery may offer valuable palliation and in those with sarcomas it can be curative. PMID:14631216

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

    PubMed Central

    2012-01-01

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

  15. 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

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

    PubMed

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

    2016-01-01

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

  17. 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

  18. 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.

  19. [Immediate vaginal reconstruction with a musculocutaneous flap from the gracilis muscle after extended abdomino-perineal resection].

    PubMed

    Sezeur, A; Hautefeuille, P; Trevidic, P

    1995-01-01

    Reconstruction of a functional vagina after radical abdomino-perineal resection is a difficult surgical problem. The use of the gracilis myocutaneous flap provides a satisfactory solution. This article describes the surgical procedure of immediate vaginal reconstruction using the gracilis myocutaneous flap. Unfortunately, this technique is still not widely used by surgical teams. Nevertheless, it is a useful flap because of its low morbidity and the satisfying result of the functional neovaginal cavity. PMID:8526447

  20. Transfer Protein TraY of Plasmid R1 Stimulates TraI-Catalyzed oriT Cleavage In Vivo

    PubMed Central

    Karl, Wolfgang; Bamberger, Martina; Zechner, Ellen L.

    2001-01-01

    The effect of TraY protein on TraI-catalyzed strand scission at the R1 transfer origin (oriT) in vivo was investigated. As expected, the cleavage reaction was not detected in Escherichia coli cells expressing tral and the integration host factor (IHF) in the absence of other transfer proteins. The TraM dependence of strand scission was found to be inversely correlated with the presence of TraY. Thus, the TraY and TraM proteins could each enhance cleaving activity at oriT in the absence of the other. In contrast, no detectable intracellular cleaving activity was exhibited by TraI in an IHF mutant strain despite the additional presence of both TraM and TraY. An essential role for IHF in this reaction in vivo is, therefore, implied. Mobilization experiments employing recombinant R1 oriT constructions and a heterologous conjugative helper plasmid were used to investigate the independent contributions of TraY and TraM to the R1 relaxosome during bacterial conjugation. In accordance with earlier observations, traY was dispensable for mobilization in the presence of traM, but mobilization did not occur in the absence of both traM and traY. Interestingly, although the cleavage assays demonstrate that TraM and TraY independently promote strand scission in vivo, TraM remained essential for mobilization of the R1 origin even in the presence of TraY. These findings suggest that, whereas TraY and TraM function may overlap to a certain extent in the R1 relaxosome, TraM additionally performs a second function that is essential for successful conjugative transmission of plasmid DNA. PMID:11208788

  1. 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. PMID:25481128

  2. 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.

  3. 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

  4. 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

  5. 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

  6. 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; ...

  7. 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

  8. Breast reconstruction - natural tissue

    MedlinePlus

    ... a breast implant; DIEP flap; DIEAP flap; Gluteal free flap; Transverse upper gracilis flap; TUG ... is medicine that keeps you asleep and pain-free. For TRAM surgery: The surgeon makes a cut ( ...

  9. 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

  10. An in silico approach towards the identification of novel inhibitors of the TLR-4 signaling pathway.

    PubMed

    Mahita, Jarjapu; Harini, K; Rao Pichika, Mallikarjuna; Sowdhamini, Ramanathan

    2016-06-01

    Precise functioning and fine-tuning of Toll-like receptor 4 (TLR4) signaling is a critical requirement for the smooth functioning of the innate immune system, since aberrant TLR4 activation causes excessive production of pro-inflammatory cytokines and interferons. This can result in life threatening conditions such as septic shock and other inflammatory disorders. The TRIF-related adaptor molecule (TRAM) adaptor protein is unique to the TLR4 signaling pathway and abrogation of TRAM-mediated TLR4 signaling is a promising strategy for developing therapeutics aimed at disrupting TRAM interactions with other components of the TLR4 signaling complex. The VIPER motif from the vaccinia virus-producing protein, A46 has been reported to disrupt TRAM-TLR4 interactions. We have exploited this information, in combination with homology modeling and docking approaches, to identify a potential binding site on TRAM lined by the BB loop and αC helix. Virtual screening of commercially available small molecules targeting the binding site enabled to short-list 12 small molecules to abrogate TRAM-mediated TLR4 signaling. Molecular dynamics and molecular mechanics calculations have been performed for the analysis of these receptor-ligand interactions. PMID:26264972

  11. Effects of tramadol and dexketoprofen on analgesia and gastrointestinal transit in mice.

    PubMed

    Miranda, H F; Puig, M M; Romero, M A; Prieto, J C

    2009-02-01

    The purpose of the present study was to evaluate the nature of the antinociceptive interaction among dexketoprofen (DEX), a mixed inhibitor of the cyclo-oxygenases, and tramadol (TRAM), a weak opioid with monoaminergic activity that inhibits norepinephrine and serotonin re-uptake. We assessed antinociception in the acetic acid writhing test, the tail flick and the formalin (FT) tests, and gastrointestinal transit (GIT) after the administration of a charcoal meal. The analysis of the interaction was carried out using isobolograms and interaction indexes or the fixed-dose method GIT. The administration of DEX or TRAM individually induced dose-dependent antinociception in all the algesiometric tests. In the three tests, TRAM was between 5.2 (FT, phase I) and 35 times (FT, Phase II) more potent than DEX. When testing combinations at different potency ratios (1 : 1, 1 : 3, 3 : 1), we could demonstrate synergy in all algesiometric tests, only when drugs were combined in a 1 : 1 proportion. Interestingly, the proportion of the drugs in the combination could change the type of interaction from synergy to antagonism. On the inhibition of GIT, a dose-related inhibition was established for TRAM, but not for DEX. Using a fixed-dose protocol, we could demonstrate antagonism between DEX and TRAM on the inhibition of GIT. The results of the present study suggest that a combination of DEX and TRAM in a 1 : 1 proportion could be adequate to use in future clinical trials in humans. PMID:19267773

  12. Multiensemble Markov models of molecular thermodynamics and kinetics.

    PubMed

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

    2016-06-01

    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

  13. 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

  14. 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

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

    PubMed Central

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

    2016-01-01

    Abstract 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.

  16. 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

  17. [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. PMID:9768175

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

    PubMed

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

    2016-01-01

    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

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

    PubMed

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

    2012-01-01

    This study investigated the effects of age and inactivity due to being chronically bedridden on atrophy of trunk muscles. The subjects comprised 33 young women (young group) and 41 elderly women who resided in nursing homes or chronic care institutions. The elderly subjects were divided into two groups: independent elderly group who were able to perform activities of daily living involving walking independently (n = 28) and dependent elderly group who were chronically bedridden (n = 13). The thickness of the following six trunk muscles was measured by B-mode ultrasound: the rectus abdominis, external oblique, internal oblique, transversus abdominis, thoracic erector spinae (longissimus) and lumbar multifidus muscles. All muscles except for the transversus abdominis and lumbar multifidus muscles were significantly thinner in the independent elderly group compared with those in the young group. The thicknesses of all muscles in the dependent elderly group was significantly smaller than that in the young group, whereas there were no differences between the dependent elderly and independent elderly groups in the muscle thicknesses of the rectus abdominis and internal oblique muscles. In conclusion, our results suggest that: (1) age-related atrophy compared with young women was less in the deep antigravity trunk muscles than the superficial muscles in the independent elderly women; (2) atrophy associated with chronic bed rest was more marked in the antigravity muscles, such as the back and transversus abdominis. PMID:21472438

  20. [Flap-reconstruction in mouth and oropharynx. A clinical comparison of methods (author's transl)].

    PubMed

    Eitschberger, E; Weidenbecher, M

    1981-10-01

    The possible methods for plastic reconstruction after resection of malignant tumors in the mouth and oropharynx are reported. A total of 165 patients, operated upon between 1973 and 1980, has been reviewed. The tumor was located 26 times in the tongue, 4 times within the base of the tongue, 27 times in the floor of the mouth, 10 times in the floor of the mouth and in the tongue and 80 times in the tonsils. For reconstruction 8 times the deltopectoral flap, 51 times the forehead flap, 42 times the tongue flap, 7 times the myocutaneous sternocleido-mastoideus island flap were used. 8 times other methods were applied, like for instance skin grafts, and in 41 cases a primary closure of the defect was possible. Complete necrosis of the flap were rare, more frequent in contrast were partial dehiscences with or without a fistula. Thus in the forehead flap 5 times a necrosis occurred whereas in 15 cases a dehiscence was seen. Even better results were achieved for the deltopectoral- and tongue flap. In contrast, the skin island of the myocutaneous sternocleidomastoideus flaps all became necrotic, but only once a temporary fistula developed. Of the pectoralis myocutaneous island flaps the first two became necrotic, probably due to lack of surgical experience. Taking into account the surgical expenditure, the functional as well as cosmetical results, the methods may be scaled according to clinical value as follows: The pectoralis major myocutaneous island flap and the tongue flap equally range on the first place, followed by the myocutaneous sternocleidomastoideus island flap, and on the 3. and 4. place by the deltopectoral and forehead flap. PMID:7287523

  1. 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

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

    PubMed Central

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

    2016-01-01

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

  3. Comparison of the Effects of Hollowing and Bracing Exercises on Cross-sectional Areas of Abdominal Muscles in Middle-aged Women

    PubMed Central

    Koh, Hyung-Woo; Cho, Sung-Hyoun; Kim, Cheol-Yong

    2014-01-01

    [Purpose] The purpose of this study was to examine the effects of hollowing and bracing exercises on cross-sectional areas of abdominal muscles. [Subjects] Thirty healthy female adults participated in this study. The exclusion criteria were orthopedic or neurologic diseases. [Methods] The subjects of this study were assigned randomly to one of two groups, each with 15 people. Each group performed a 60-minute exercise program, one performed a bracing exercise, and the other performed a hollowing exercise, with both groups performing the exercise three times a week for six weeks. [Results] The changes in cross-sectional areas after the bracing exercise showed statistically significant differences in the left rectus abdominis and both internal and external obliques. The changes in cross-sectional areas after the hollowing exercise showed statistically significant differences in the left and right transversus abdominis and left rectus abdominis. [Conclusion] Performing bracing exercises rather than hollowing exercises is more effective for activating the abdominal muscles. PMID:24648652

  4. 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.

  5. 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

  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. Zig-zag active-mirror laser with cryogenic Yb3+:YAG/YAG composite ceramics.

    PubMed

    Furuse, Hiroaki; Kawanaka, Junji; Miyanaga, Noriaki; Saiki, Taku; Imasaki, Kazuo; Fujita, Masayuki; Takeshita, Kenji; Ishii, Shinya; Izawa, Yasukazu

    2011-01-31

    We report on a novel amplifier configuration concept for a 10 kW laser system using a zig-zag optical path based on a cryogenic Yb:YAG Total-Reflection Active-Mirror (TRAM) laser. The laser material is a compact composite ceramic, in which three Yb:YAG TRAMs are combined in series to increase the output power. Output powers of up to 214 W with a slope efficiency of 63% have been demonstrated for CW operation, even at a quite low pump intensity of less than 170 W/cm2. Further scaling could achieve output powers of more than 10 kW. PMID:21369064

  9. 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

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

    PubMed Central

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

    2012-01-01

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

  11. 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…

  12. 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

  13. Abdominal muscle paralysis associated with herpes zoster.

    PubMed

    Gottschau, P; Trojaborg, W

    1991-10-01

    We describe a 77-year-old women with cutaneous herpes zoster in the area of the right T9-T11 dermatomes complicated by abdominal muscle paralysis. Four months after onset of paralysis, stimulation of appropriate intercostal nerves failed to evoke responses from the corresponding segments of the rectus abdominis muscle. Three months later EMG of these muscle segments revealed profuse denervation activity and spontaneous long-lasting burst of high frequency discharges. Magnetic stimulation applied transcranially and peripherally at T10 evoked responses from the left, but not from the right paralytic rectus abdominis muscle. Electric stimulation of right T10 elicited a markedly delayed, prolonged and polyphasic response in the transverse abdominis muscle and EMG revealed polyphasia and increased motor unit potential duration in muscle segments underlying herpes zoster eruption. One and a half years after onset, the paralysis of the rectus abdominis muscle was still present. A survey of the literature concerning this rare type of zoster paralysis is presented. PMID:1837649

  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. PMID:27390406

  15. [Imaging features of pubalgia].

    PubMed

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

    2011-06-01

    Pubalgia is a generic term used to describe groin pain due to a multitude of different etiologies such as skeletal (microtraumatic pubic symphysis arthropathy), muscular (adductor or rectus abdominis disorders), or abdominal wall (inguinal hernia) disorders. Diagnosis relies mainly on MRI for musculoskeletal disorders and ultrasound for abdominal wall disorders. PMID:21704249

  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. 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

  18. [Gingival fibromatosis with oligophrenia and self-injurious behavior].

    PubMed

    Fehlow, P

    1990-01-01

    It is reported on a 14-year-old girl with a hirsutism gingival fibromatosis syndrome, which is combined with moderate generalised muscle hypotonia, inhibition of physical maturation, severe scoliosis, diastasis recti abdominis and aplasia of a rib. Psychically there are idioty, autism and severe selfinjurious behaviour. PMID:2377378

  19. 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.

  20. 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

  1. Resection and reconstruction of giant cervical metastatic cancer using a pectoralis major muscular flap transfer: A prospective study of 16 patients

    PubMed Central

    ZHANG, XIANGMIN; LIU, FOLIN; LAN, XIAOLIN; HUANG, JING; LUO, KEQING; LI, SHAOJIN

    2015-01-01

    If not promptly or properly treated, certain cervical metastatic cancers that develop from unknown primary tumors may rapidly grow into giant tumors that can invade the blood vessels, muscle and skin. The present study examined the feasibility and efficacy of radical neck dissection combined with reconstruction using the pectoralis major myocutaneous flap for the treatment of giant cervical metastatic cancers that have developed from unknown primary tumors and have invaded the skin. A total of 16 patients who met the inclusion criteria were subjected to radical neck dissection to adequately resect invaded skin, and the pectoralis major myocutaneous flap was used to repair the large skin defect created in the cervical region. Following the surgery, the patients received concurrent chemoradiotherapy. The pectoralis major myocutaneous flap survived in all 16 patients, with no cases of flap necrosis. In addition, no post-operative lymphedema, paresthesia or dysfunction of an upper extremity occurred due to the cutting of a pectoralis major muscle. In 9 cases, patients were satisfied with their post-operative shoulder movement at the donor site; in the remaining 7 cases, patients felt greater weakness in this region following surgery relative to prior to surgery. The 14 male patients were generally satisfied with the post-operative appearance of the donor region, whereas the 2 female patients were dissatisfied with the appearance of this region. Follow-up for 6–53 months after the patients were discharged following surgery and chemotherapy revealed that the recurrence of cervical tumors in 6 cases. Overall, radical neck dissection combined with the use of the pectoralis major myocutaneous flap for reconstruction is a feasible approach for the treatment of giant cervical metastatic cancers that have developed from unknown primary tumors and have invaded the skin. Post-operative concurrent chemoradiotherapy should be administered to improve the local control rate and

  2. 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.

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

    ERIC Educational Resources Information Center

    Wahlstrom, Ralph L.

    2012-01-01

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

  4. 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...

  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. 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...

  7. 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....

  8. 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....

  9. Technological Solutions for Visually Impaired People in Sweden.

    ERIC Educational Resources Information Center

    Lindstrom, J. I.

    1990-01-01

    This article discusses technology available in Sweden for visually impaired and deaf-blind people. It describes systems for stop announcements on buses and trams, queuing systems in shops and banks, text telephones, synthetic speech or braille displays of newspapers and other information sources, and home computers. Ideas for the future are also…

  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. 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

  12. The Quorum-sensing Protein TraR of Agrobacterium tumefaciens is Susceptible to Intrinsic and TraM-mediated Proteolytic Instability

    PubMed Central

    Costa, Esther D.; Chai, Yunrong; Winans, Stephen C.

    2012-01-01

    Summary TraR of Agrobacterium tumefaciens is a LuxR-type transcription factor that regulates genes required for replication and conjugation of the tumor-inducing (Ti) plasmid. TraR binds the pheromone 3-oxo-octanoylhomoserine lactone (OOHL) and requires this molecule for folding into a protease-resistant, soluble conformation. Even after binding to OOHL, TraR is degraded at readily detectable rates. Here we show that the N-terminal domain of TraR, which binds OOHL, is more resistant to degradation than the full length protein, suggesting that sites on the C-terminal DNA binding domain (TraR(171-234)) enhance protein turnover. A fusion between GFP and TraR-(171-234) was poorly fluorescent, and truncations of this fusion protein allowed us to identify residues in this domain that contribute to protein degradation. TraR activity was previously shown to be inhibited by the antiactivator TraM. These proteins form 2:2 complexes that fail to bind DNA sequences. Here we show that TraM sharply decreased the accumulation of TraR in whole cells, indicating that TraM facilitates proteolysis of TraR. The TraM component of these complexes is spared from proteolysis, and could therefore act catalytically. PMID:22515735

  13. 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 ...

  14. 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

  15. 30 CFR 75.523-1 - Deenergization of self-propelled electric face equipment installation requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the event of an emergency. The requirements of this paragraph (a) shall be met as follows: (1) On and... that will quickly deenergize the tramming motors of the equipment in the event of an emergency. (c) An...-propelled electric face equipment in the event of an emergency. The Director of Technical Support...

  16. 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

  17. 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

  18. 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

  19. 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...

  20. 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....

  1. 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...

  2. 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....

  3. The effects of Kv1.3 and IKCa1 channel inhibition on cytokine production and calcium influx of T lymphocytes in rheumatoid arthritis and ankylosing spondylitis.

    PubMed

    Toldi, Gergely; Munoz, Luis; Herrmann, Martin; Schett, Georg; Balog, Attila

    2016-04-01

    Kv1.3 and IKCa1 lymphocyte potassium channels have been implicated as important targets of selective immunomodulation. We compared the alterations in cytokine production upon selective inhibition of Kv1.3 or IKCa1 channels (by MGTX and TRAM, respectively) in healthy donors (HD), RA and AS patients. We also determined calcium influx kinetics and its sensitivity to Kv1.3 and IKCa1 channel inhibition following PHA activation in CD4, Th1, Th2 and CD8 cells as well as monocytes. The application of TRAM resulted in a lower production of TNF-a and IL1-RA in all three study groups. Inhibition by TRAM had contrary effects on the production of IL-1b and IL-5: While their production was increased by PBMCs of RA patients, this effect was not observed in HD and AS PBMCs. While treatment with MGTX resulted in a similar decrease in calcium influx in the CD4 and Th2 subsets across all study groups, TRAM treatment had opposite effects on RA and HD samples: It decreased calcium influx in the Th2 and CD8 subsets in RA, while only Th1 cells were affected in HDs. The effects of IKCa1 channel inhibition are controversial in samples of RA and AS patients, since it shifts the inflammatory balance into the pro-inflammatory direction. PMID:26280090

  4. 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

  5. 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

  6. 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

  7. 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

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

    PubMed Central

    Fekete, Richard A.; Frost, Laura S.

    2000-01-01

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

  9. 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

  10. 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.

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

    NASA Astrophysics Data System (ADS)

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

    2014-09-01

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

  12. 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

  13. The effects of bridge exercise with the abdominal drawing-in maneuver on an unstable surface on the abdominal muscle thickness of healthy adults

    PubMed Central

    Cho, Misuk

    2015-01-01

    [Purpose] The purpose of this study was to determine the impact of a bridge exercise with an abdominal drawing-in maneuver (ADIM) performed with different surface conditions on abdominal muscle thickness. [Subjects] Thirty subjects were randomly divided into an unstable bridge exercise group (UBE group, n=15) and a stable bridge exercise group (SBE group, n=15). [Methods] After 6 weeks of performing bridge exercises accompanied by ADIM, the change in the muscle thicknesses of the transverse abdominis (TrA) and internal oblique abdominis (IOA) muscles was assessed using ultrasonography. [Results] After 6 weeks of exercise, the TrA was significantly altered in the SBEG, and the TrA and IOA were both significantly changed in the UBEG. [Conclusion] When performing bridge exercises to increase the Tra and the IO muscle thicknesses, exercising on an unstable surface is recommended. PMID:25642086

  14. Intercostal nerve conduction study in man.

    PubMed Central

    Pradhan, S; Taly, A

    1989-01-01

    A new surface technique for the conduction study of the lower intercostal nerves has been developed and applied to 30 normal subjects. The problem of the short available nerve segment of the intercostal nerves and the bizzare compound motor action potential (CMAP) of inconsistent latency while recording over the intercostal muscles, is overcome by applying recording electrodes over the rectus abdominis muscle and stimulating the nerves at two points at a fair distance away. With the use of multiple recording sites over the rectus abdominis, the motor points for different intercostal nerves were delineated. CMAP of reproducible latencies and waveforms with sharp take-off points were obtained. Conduction velocity of the intercostal nerves could be determined. PMID:2526200

  15. Teaching video neuroimages: Beevor sign: when the umbilicus is pointing to neurologic disease.

    PubMed

    Mathys, Jan; De Marchis, Gian Marco

    2013-01-01

    A 57-year-old man with genetically proven facioscapulohumeral muscular dystrophy (FSHMD 1A) demonstrated Beevor sign (video on the Neurology Web site at www.neurology.org). The upward movement of the umbilicus in a supine patient flexing the neck or sitting up is named after the British neurologist Charles Edward Beevor (1854-1908). He described a "marked elevation of the umbilicus in the act of sitting up" due to a paralyzed infraumbilical part of the rectus abdominis muscle, indicating a lesion of the spinal cord between the segments T10 and T12 or its nerve roots.(1) Beevor sign may also be present, as in our patient, in myopathies affecting the abdominal muscles, particularly in FSHMD, in which predominant involvement of the lower part of the rectus abdominis muscle is typical.(2). PMID:23296136

  16. 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

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

    PubMed Central

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

    2016-01-01

    [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

  18. 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

  19. The impact of the pelvic floor muscles on dynamic ventilation maneuvers

    PubMed Central

    Park, Hankyu; Hwang, Byoungha; Kim, Yeoungsung

    2015-01-01

    [Purpose] The aim of the present study was to examine the impact of the pelvic floor muscles (PFM) on dynamic ventilation maneuvers. [Subjects and Methods] The subjects were 19 healthy female adults in their 20s who consented to participate in the present study. Electromyography (EMG) was used to examine respiratory muscle activity, and a spirometer was used to examine vital capacity before and during contraction of the PFM. [Results] There were statistically significant differences in the sternocleidomastoid (SCM), rectus abdominis (RA), external oblique (EO), transverse abdominis/internal oblique (TrA/IO), and maximal voluntary ventilation (MVV) when the PFM was contracted. [Conclusion] Contraction of the PFM can be effective in promoting activation of the respiratory muscles and vital capacity. Therefore, the PFM should be considered to improve the effects of respiratory activity. PMID:26644664

  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. PMID:26473519

  1. 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.

  2. Effects of bridge exercise performed on an unstable surface on lumbar stabilizing muscles according to the knee angle

    PubMed Central

    Lee, Sangyong; Park, Jungseo; Lee, Daehee

    2015-01-01

    [Purpose] This study aimed to determine the effects of bridge exercise performed on an unstable surface on lumbar stabilizing muscles according to the knee angle. [Subjects] Fifteen healthy adult men were selected for this study. [Methods] The study subjects performed the bridge exercise on an unstable surface and a stable surface, with the knees at different angles (45°, 90°, and 120°). An aero-step device was used as the unstable surface, and the flat ground was used as the stable surface. External oblique, internal oblique, and rectus abdominis muscle activities were assessed and compared using electromyography. [Results] The study results demonstrated that performing the bridge exercise on an unstable surface with a knee angle of 120° led to a greater increase in the external oblique, internal oblique, and rectus abdominis muscle activities than when performed on a stable surface. [Conclusion] The bridge exercise with the knees at a 120° angle was found to be an effective intervention for increasing the external oblique, internal oblique, and rectus abdominis muscle activities. PMID:26357450

  3. 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

  4. 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. PMID:22909340

  5. Abdominal wall muscle elasticity and abdomen local stiffness on healthy volunteers during various physiological activities.

    PubMed

    Tran, D; Podwojewski, F; Beillas, P; Ottenio, M; Voirin, D; Turquier, F; Mitton, D

    2016-07-01

    The performance of hernia treatment could benefit from more extensive knowledge of the mechanical behavior of the abdominal wall in a healthy state. To supply this knowledge, the antero-lateral abdominal wall was characterized in vivo on 11 healthy volunteers during 4 activities: rest, pullback loading, abdominal breathing and the "Valsalva maneuver". The elasticity of the abdominal muscles (rectus abdominis, obliquus externus, obliquus internus and transversus abdominis) was assessed using ultrasound shear wave elastography. In addition, the abdomen was subjected to a low external load at three locations: on the midline (linea alba), on the rectus abdominis region and on lateral muscles region in order to evaluate the local stiffness of the abdomen, at rest and during "Valsalva maneuver". The results showed that the "Valsalva maneuver" leads to a statistically significant increase of the muscle shear modulus compared to the other activities. This study also showed that the local stiffness of the abdomen was related to the activity. At rest, a significant difference has been observed between the anterior (0.5N/mm) and the lateral abdomen locations (1N/mm). Then, during the Valsalva maneuver, the local stiffness values were similar for all locations (ranging from 1.6 to 2.2N/mm). This work focuses on the in vivo characterization of the mechanical response of the human abdominal wall and abdomen during several activities. In the future, this protocol could be helpful for investigation on herniated patients. PMID:26994992

  6. 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

  7. Relationship between spinal range of motion and trunk muscle activity during trunk rotation

    PubMed Central

    Sugaya, Tomoaki; Sakamoto, Masaaki; Nakazawa, Rie; Wada, Naoki

    2016-01-01

    [Purpose] The aim of this study was to clarify the relationship between spinal range of motion and trunk muscle activity during trunk rotation using a three-dimensional motion analysis system and surface electromyography. [Subjects and Methods] The subjects comprised 11 healthy men. A three-dimensional motion analysis system measured the trunk rotational angle of 4 segments of the thoracic vertebrae and 2 segments of the lumbar vertebrae. Surface electromyography measured the activities of the unilateral latissimus dorsi, lumbar multifidus, rectus abdominis, external oblique, internal oblique, and transversus abdominis muscles. [Results] During ipsilateral rotation at thoracic vertebral levels, the muscle activity of the latissimus dorsi and external oblique was significantly increased compared with the activity in the 0–10% range of trunk rotation. During early ipsilateral rotation at lumbar vertebral levels, the muscle activity of the internal oblique and transversus abdominis was significantly increased compared with that in the 0–10% range of trunk rotation. During contralateral rotation at both thoracic and lumbar vertebral levels, the muscle activity of the external oblique was significantly increased compared with that in the 0–10% range of trunk rotation. [Conclusion] This study indicates that it is important to consider vertebral segments and spinal range of motion during trunk rotation. PMID:27065549

  8. 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

  9. [Analysis of deaths caused by rail-vehicles in the materials collected by the Department of Forensic Medicine in Bydgoszcz in the years 1992-2002].

    PubMed

    Bloch-Bogusławska, Elzbieta; Engelgardt, Piotr; Wolska, Ewa; Paradowska, Agnieszka

    2006-01-01

    The analysis focused on cases of death following accidents involving rail-vehicles, in which autopsies were performed at the Department of Forensic Medicine in Bydgoszcz in the years 1992-2002. Sixty-five individuals died in train accidents (80%), 16 people (20%) were victims of tram accidents (20%). Males constituted 86% of the material, while females accounted for 14%. The highest number of rail-vehicle accidents was observed in 1992. The most common reason of death was multiorgan injury. In the subgroup of tram accidents, the authors noted no injuries of the highest severity, such as limb amputations, amputations or crushing of the head, or fragmentation or rupturing of the trunk. On the other hand, in railroad accidents, the percentage of the above injuries was 26%, 44% and 24.5%, respectively. The most severe injuries were noted in the group of people hit by a train while in prone position. PMID:17131763

  10. Different dimerisation mode for TLR4 upon endosomal acidification?

    PubMed Central

    Gangloff, Monique

    2012-01-01

    TLR4 is unique among pathogen-recognition receptors in that it initiates different pathways in different cellular locations. Binding of a bridging factor, Mal, allows recruitment of an adapter protein, MyD88, at the plasma membrane, which leads to the production of proinflammatory cytokines. Upon internalization, TLR4 uses a different bridging factor, TRAM, to activate a MyD88-independent pathway that results in type I interferon expression. Interestingly, both Mal and TRAM are localised initially at the plasma membrane. In this Opinion, I suggest a possible mechanism by which endosomal acidification triggers the differential adaptor usage of TLR4. I discuss the evidence of the pH sensitivity of TLR4 and propose a new dimerisation mode for TLR4 based on the crystal structure of the related receptor TLR3 bound to its ligand, double-stranded RNA. PMID:22196451

  11. Different dimerisation mode for TLR4 upon endosomal acidification?

    PubMed

    Gangloff, Monique

    2012-03-01

    TLR4 is unique among pathogen-recognition receptors in that it initiates different pathways in different cellular locations. Binding of a bridging factor, Mal, allows recruitment of an adapter protein, MyD88, at the plasma membrane, which leads to the production of proinflammatory cytokines. Upon internalization, TLR4 uses a different bridging factor, TRAM, to activate a MyD88-independent pathway that results in type I interferon expression. Interestingly, both Mal and TRAM are localised initially at the plasma membrane. In this Opinion, I suggest a possible mechanism by which endosomal acidification triggers the differential adaptor usage of TLR4. I discuss the evidence of the pH sensitivity of TLR4 and propose a new dimerisation mode for TLR4 based on the crystal structure of the related receptor TLR3 bound to its ligand, double-stranded RNA. PMID:22196451

  12. 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.

  13. 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

  14. Control techniques for an automated mixed traffic vehicle

    NASA Technical Reports Server (NTRS)

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

    1977-01-01

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

  15. 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.

  16. 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...

  17. Secure surveillance videotapes

    SciTech Connect

    Resnik, W.M.; Kadner, S.P.; Olsen, R.; Chitumbo, K.; Pepper, S.

    1995-12-31

    With assistance from the US Program for Technical Assistance to IAEA Safeguards (POTAS), Aquila Technologies Group developed the Tamper-Resistant Analog Media (TRAM-1000) system to provide standard VHS surveillance video tapes with an enhanced tamper-indicating capability. This project represents further implementation of the partnership approach in facilities including light water reactors with MOX facilities. These facilities use Uniplex Digiquad system video tapes. The partnership approach ensures that one organization can exchange the tapes in a machine without the presence of the other, without losing continuity of information. The TRAM-1000 system development project was accomplished in two stages. In the first stage of the project, the original system delivered to the IAEA, consists of three parts: (1) the tamper detection unit, (2) a specially augmented VHS video tape, and (3) an HP-95 reader. The tamper detection unit houses a VACOSS active fiber-optic seal and an electronic identification tag (E-TAG) reader. In the second stage of the project, the original TRAM-1000 was modified to its current design based on agency input. After delivery of the original TRAM-1000 system to the IAEA, it was reviewed by inspectors. The inspectors felt that the initial system`s tape storage/transport method could be simplified. Rather than threading the fiber through the tape spindles, the inspectors suggested that the tape be placed in a bag capable of being sealed. Also, a more flexible fiber-optic cable was recommended. As a result of these suggestions, Aquila developed a tamper-proof bag specifically for holding a surveillance video tape and sealable with a VACOSS fiber optical seal.

  18. 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.

  19. 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

  20. 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.

  1. Ca2+-activated K+ channels of small and intermediate conductance control eNOS activation through NAD(P)H oxidase.

    PubMed

    Gaete, Pablo S; Lillo, Mauricio A; Ardiles, Nicolás M; Pérez, Francisco R; Figueroa, Xavier F

    2012-03-01

    Ca(2+)-activated K(+) channels (K(Ca)) and NO play a central role in the endothelium-dependent control of vasomotor tone. We evaluated the interaction of K(Ca) with NO production in isolated arterial mesenteric beds of the rat. In phenylephrine-contracted mesenteries, acetylcholine (ACh)-induced vasodilation was reduced by NO synthase (NOS) inhibition with N(ω)-nitro-L-arginine (L-NA), but in the presence of tetraethylammonium, L-NA did not further affect the response. In KCl-contracted mesenteries, the relaxation elicited by 100 nM ACh or 1 μM ionomycin was abolished by L-NA, tetraethylammonium, or simultaneous blockade of small-conductance K(Ca) (SK(Ca)) channels with apamin and intermediate-conductance K(Ca) (IK(Ca)) channels with triarylmethane-34 (TRAM-34). Apamin-TRAM-34 treatment also abolished 100 nM ACh-activated NO production, which was associated with an increase in superoxide formation. Endothelial cell Ca(2+) buffering with BAPTA elicited a similar increment in superoxide. Apamin-TRAM-34 treatment increased endothelial NOS phosphorylation at threonine 495 (P-eNOS(Thr495)). Blockade of NAD(P)H oxidase with apocynin or superoxide dismutation with PEG-SOD prevented the increment in superoxide and changes in P-eNOS(Thr495) observed during apamin and TRAM-34 application. Our results indicate that blockade of SK(Ca) and IK(Ca) activates NAD(P)H oxidase-dependent superoxide formation, which leads to inhibition of NO release through P-eNOS(Thr495). These findings disclose a novel mechanism involved in the control of NO production. PMID:22210378

  2. Extended V-Y Advancement Flap Reconstruction of a Large Posterior Upper Midline Trunk Defect

    PubMed Central

    Fukudome, Eugene Y.; Bharadia, Deepak R.; Helm, Douglas L.

    2016-01-01

    Summary: Large posterior upper trunk defects can be challenging to reconstruct. Trapezius or latissimus dorsi myocutaneous flaps are principally utilized for reconstruction; however, some defects may not be amenable to this standard approach. Here, we describe a patient with a full-thickness skin and subcutaneous tissue loss of the upper back and inferior cervical region after dermatofibrosarcoma protuberans resection. A large, extended V-Y flap was used for closure of this wound secondary to its location, size, and orientation. This approach preserves shoulder function, allows for readvancement of the flap as needed, and is a reconstructive option for patients with large upper back defects.

  3. [The gracilis muscle as musculocutaneous flap. Evaluation of 20 cases].

    PubMed

    Gholam, D; Trevidic, P; Kleimann, P; Hautefeuille, P; Nicoletis, C

    1991-01-01

    The use of gracilis as muscular or myocutaneous flap is very well-known. The authors report 20 cases of gracilis flap including 13 reconstructions of the vaginal cavity following extended abdomino-perineal resection. Some technical points concerning the localization of the cutaneous part of the flap and the pedicle dissection are discussed. The use of gracilis flap is still limited in surgical teams following extended abdomino-perineal resection, nevertheless it is a very useful flap because of its low morbidity, the shortening of patient hospitalization and the very satisfying aesthetic result of the neo-vaginal cavity. PMID:1726389

  4. Platysma flap using dual skin paddles.

    PubMed

    Mustafa, El Muiz A; Bhatia, Sunil K; Hammond, Doug E

    2016-07-01

    The platysma myocutaneous flap is rarely reported as an option for reconstruction in the head and neck. In our experience it is a reliable flap that is easy to raise, has a limited risk of morbidity at the donor site, and allows for early recommencement of oral function. We report a patient with an unusually aggressive orocutaneous fistula that complicated the simple extraction of teeth. We modified the platysma flap to provide two independent skin paddles so we could reconstruct both the intraoral and cutaneous defects simultaneously with a good clinical outcome. PMID:26947107

  5. Autologous Microvascular Breast Reconstruction

    PubMed Central

    Ramakrishnan, Venkat

    2013-01-01

    Autologous microvascular breast reconstruction is widely accepted as a key component of breast cancer treatment. There are two basic donor sites; the anterior abdominal wall and the thigh/buttock region. Each of these regions provides for a number of flaps that are successfully utilised in breast reconstruction. Refinement of surgical technique and the drive towards minimising donor site morbidity whilst maximising flap vascularity in breast reconstruction has seen an evolution towards perforator based flap reconstructions, however myocutaneous flaps are still commonly practiced. We review herein the current methods of autologous microvascular breast reconstruction. PMID:23362474

  6. Metastatic breast cancer with right ventricular erosion.

    PubMed

    Chou, Wei-Han; Chi, Nai-Hsin; Wang, Yi-Chia; Huang, Chi-Hsiang

    2016-03-01

    Cancer that has metastasized to the heart and pericardium has a dismal outcome. Individualized treatment to preserve the quality of life and reduce surgical mortality is important. We describe a 57-year old woman who had a recurrence of breast cancer 23 years after the initial complete treatment. Cardiac metastasis with poor anterior chest wall healing led to right ventricular rupture, which caused hypovolaemic shock. The right ventricular wall defect was repaired with a percutaneous patch and a myocutaneous flap without cardiopulmonary bypass. The patient was discharged home after intensive wound care. Our patient shows that even with complete initial treatment, clinicians should be alert for the recurrence of breast cancer. PMID:25890934

  7. Extended V-Y Advancement Flap Reconstruction of a Large Posterior Upper Midline Trunk Defect.

    PubMed

    Fukudome, Eugene Y; Bharadia, Deepak R; Helm, Douglas L; Sinha, Indranil

    2016-05-01

    Large posterior upper trunk defects can be challenging to reconstruct. Trapezius or latissimus dorsi myocutaneous flaps are principally utilized for reconstruction; however, some defects may not be amenable to this standard approach. Here, we describe a patient with a full-thickness skin and subcutaneous tissue loss of the upper back and inferior cervical region after dermatofibrosarcoma protuberans resection. A large, extended V-Y flap was used for closure of this wound secondary to its location, size, and orientation. This approach preserves shoulder function, allows for readvancement of the flap as needed, and is a reconstructive option for patients with large upper back defects. PMID:27579237

  8. Surgical Management of Necrotizing Mediastinitis With Large Aortic Pseudoaneurysm.

    PubMed

    Chevalier, Andrew T; Khaja, Minhaj S; Yang, Bo

    2016-05-01

    We report a patient with necrotizing mediastinitis complicated by a giant retrosternal mycotic pseudoaneurysm and prosthetic valve endocarditis successfully managed with a redo sternotomy under hypothermic circulatory arrest. The approach then included extensive débridement of the mediastinum, replacement of the ascending aorta and aortic arch with selective antegrade cerebral perfusion, redo aortic valve replacement, and wound closure with omental flap and myocutaneous flap. After a 2-year survival, the patient suffered reinfection from hemodialysis. Our approach is also applicable to more common presentations of mediastinitis. PMID:27106461

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. Extensive full-thickness eyelid reconstruction with rotation flaps through “subcutaneous tunnel” and palatal mucosal grafts

    PubMed Central

    Cheng, Jian-Xia; Zuo, Lan; Huang, Xin-Yu; Cui, Ji-Zhe; Wu, Shuai; Du, Yuan-Yuan

    2015-01-01

    AIM To reconstruct the extensive full-thickness defects of eyelids is a challenge for the plastic surgeon because of their complex anatomy and special functions. This article presents and discusses an improved surgical technique in which the orbicularis oculi myocutaneous flap is rotated through a “subcutaneous tunnel” in conjunction with a palatal mucosal graft employed for lining. METHODS Data from 22 eyes with extensive full-thickness eyelid defects from various causes between 2009 and 2013 were analyzed in this study. After the different layers of eyelid were separated completely, a temporally based orbicularis oculi myocutaneous flap was designed following fishtail lines and was mobilized, leaving the base of the pedicle intact with a submuscular tissue attachment. The flap was then rotated through a “subcutaneous tunnel” to the defect, and the donor site was closed primarily. Posterior lamellar reconstruction was performed with a mucosal graft harvested from the hard palate. RESULTS All the flaps were survived without any healing problems. There was no corneal irritation, flap contraction, or significant donor-site morbidity in the follow-up period. The incision scars were almost invisible. The defects were repaired completely, and the evaluations showed satisfactory function and appearance. CONCLUSION This technique is an improved single-stage operation and can be applied to repair large, full-thickness eyelid defects from various causes. With our method, the functional and aesthetic results can be obtained in either the upper or lower eyelids. PMID:26308255

  14. Treatment of recurrent head and neck carcinoma involving the carotid artery: carotid reconstruction with ePTFE graft.

    PubMed

    He, Xiang-bo; Li, Jing-jia; Chen, Yue-hong; Shu, Chang; Tang, Qing-lai; Yang, Xin-ming

    2011-12-01

    The aim of our study is to investigate the feasibility of reconstructing the carotid artery using expanded polytetraflouroethylene (ePTFE) in patients with recurrent head and neck carcinoma involving the carotid artery. Ten patients, who had recurrent head and neck carcinoma involving the carotid artery, received carotid artery resection and reconstruction with ePTFE, tissue defects were repaired by pectoralis major myocutaneous flap. Results show that eight patients did not present any vascular and neurologic complications. One patient presented slight hemiparesis, another patient developed wound infection and pharyngocutaneous fistula. The mean follow-up period was 33.1 ± 16.0 months. The 2-year survival rate was 50% (5/10), and there was one patient who survived for 60 months without locoreginal recurrence or distant metastasis. En bloc resection of tumor and involved carotid-associated ePTFE reconstruction provide effective improvement in the locoregional control of the recurrent head and neck carcinoma. The pedicle pectoralis major myocutaneous flap can provide not only wound bed with affluent blood supply for the vascular grafts, but also reparation of skin or the tissue defects of oropharynx and hypopharynx. PMID:21400255

  15. Reconstruction of knee joint soft tissue and patellar tendon defects using a composite anterolateral thigh flap with vascularized fascia lata.

    PubMed

    Kuo, Yur-Ren; An, Po-Chung; Kuo, Mei-Hui; Kueh, Nai-Siong; Yao, Sheng-Fa; Jeng, Seng-Feng

    2008-01-01

    Reconstruction of a complex knee trauma with knee joint exposure and composite soft tissue and patellar tendon deficiency remains a challenging task. Multiple-stage reconstruction is time-consuming and produces considerable suffering for patients. Early mobilization following knee reconstruction has achieved good outcomes. Herein, we reported one-stage reconstruction with an ALT myocutaneous flap with vascularized fascia lata was utilized for one patient with a large complex knee joint soft tissue defect, and segmental deficiency of the patellar tendon. The fascia lata sheet was rolled to mimic a patellar tendon. The exposed knee joint was obturated by the vastus lateralis muscle of the ALT myocutaneous flap. The skin and soft tissue defect was reconstructed using the skin paddle of the ALT flap. The patient's postoperative course was uneventful. An MRI examination demonstrated good continuity of the reconstructed patellar tendon. The active ROM of the injured knee reached 100 degrees (extension deficiency 20 degrees and flexion 120 degrees ) at 5 years. Objective functional assessment of the patella-femoral joint utilized a kinetic communicator machine (Kin-Com 500H, Chattecx, Chattanooga, TN, USA) revealed still mild extension insufficiency. However, the patient reported that he was able to perform normal daily activities without difficulty at 5-year follow-up. PMID:18215803

  16. Abdominal muscle size and symmetry at rest and during abdominal hollowing exercises in healthy control subjects

    PubMed Central

    Mannion, A F; Pulkovski, N; Toma, V; Sprott, H

    2008-01-01

    The symmetry of, and physical characteristics influencing, the thickness of the lateral abdominal muscles at rest and during abdominal exercises were examined in 57 healthy subjects (20 men, 37 women; aged 22–62 years). M-mode ultrasound images were recorded from the abdominal muscles at rest and during abdominal hollowing exercises in hook-lying. The fascial lines bordering the transvs. abdominis, obliquus internus and obliquus externus were digitized and the absolute thickness, relative thickness (% of total lateral thickness) and contraction ratio (thickness during hollowing/thickness at rest), as well as the asymmetry (difference between sides expressed as a percent of the smallest value for the two sides) for each of these parameters were determined for each muscle. Both at rest and during hollowing, obliquus internus was the thickest and transvs. abdominis the thinnest muscle. There were no significant differences between left and right sides for group mean thicknesses of any muscle; however, individual asymmetries were evident, with mean values for the different muscles ranging from 11% to 26%; asymmetry was much less for the contraction ratios (mean % side differences, 5–14% depending on muscle). Body mass was the most significant positive predictor of absolute muscle thickness, for all muscles at rest and during hollowing, accounting for 30–44% variance. Body mass index explained 20–30% variance in transvs. abdominis contraction ratio (negative relationship). The influence of these confounders must be considered in comparative studies of healthy controls and back pain patients, unless groups are very carefully matched. Asymmetries observed in patients should be interpreted with caution, as they are also common in healthy subjects. PMID:19172732

  17. [The alimentary canal of the Siberian chipmunk (Eutamias sibiricus, Laxm. 1769): macroscopic and light microscopic examination].

    PubMed

    Nieters, M; Schnorr, B; Kressin, M

    2003-06-01

    The canalis alimentarius of the Burunduk (Eutamias sibiricus), a rodent belonging to the family Sciuridae, were examined macroscopically (12 animals) and light microscopically (three animals). The esophagus is lined with a stratified non-keratinized squamous epithelium. The one-chambered stomach is of a simple type covered with a glandular mucous membrane. When empty and moderately filled, the stomach looks like a curved sack and lies intrathoracally. The filled stomach extends to the left and ventrally into the regio abdominis media. The greater omentum covers incompletely ventrally and in a part laterally the intestinal mass. The intestinal canal averages about 780 mm in length, that is 6.5 as long as the whole body. The relative length of the small intestine compared with the large intestine is 36-64%. The U-shaped Duodenum is composed of a Pars cranialis, descendens and ascendens and possesses a Plica duodenocolica as well as a Plica duodenocolica accessoria. The Jejunum averages about 420 mm length and is mainly located in the right and ventral part of the regio abdominis media. As in other rodents, the cecum is well developed. The length of the ascending colon averages about the body length and forms an Ansa proximalis and two parallel loops, Ansa media and Ansa distalis coli, both lying in the right Cavum abdominis. Peculiar for the colon are Noduli lymphatici solitarii surrounding cavities lined by a surface epithelium. According to the anatomical structure of the gut and based on physiological diet facts the Burunduk is not a mere herbivore but has to be classified as an omnivore depending upon uptake of animal food protein. PMID:12823102

  18. 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

  19. 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

  20. Magnetic resonance imaging for pain after surgical treatment for athletic pubalgia and the "sports hernia".

    PubMed

    Zoga, Adam C; Meyers, William C

    2011-09-01

    Magnetic resonance (MR) imaging technique and findings in the setting of athletic pubalgia, including injury at the rectus abdominis/adductor aponeurosis, are becoming widely recognized. A subset of these patients is treated with various pelvic floor repairs, mesh reinforcements, and tendon releases. Most of these patients do well after intervention, but some have persistent or refractory groin pain, and others eventually develop new injuries in the pubic region or elsewhere about the pelvic girdle. This review describes the expected and some unexpected MRI findings in patients with recurrent or persistent groin pain after a "sports hernia" repair. PMID:21928160

  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. PMID:25134854

  2. Magnetic resonance imaging of athletic pubalgia and the sports hernia: current understanding and practice.

    PubMed

    Khan, Waseem; Zoga, Adam C; Meyers, William C

    2013-02-01

    Magnetic resonance imaging (MRI) has become the standard imaging modality for activity-related groin pain. Lesions, including rectus abdominis/adductor aponeurosis injury and osteitis pubis, can be accurately identified and delineated in patients with clinical conditions termed athletic pubalgia, core injury, and sports hernia. A dedicated noncontrast athletic pubalgia MRI protocol is easy to implement and should be available at musculoskeletal MR imaging centers. This article will review pubic anatomy, imaging considerations, specific lesions, and common MRI findings encountered in the setting of musculoskeletal groin pain. PMID:23168185

  3. Reconstruction of the penis in transsexual patients.

    PubMed

    Veselý, J; Barinka, L; Santi, P; Berrino, P; Muggianu, M

    1992-01-01

    In the article, the authors offer a review of the modalities available for phalloplasty in transsexual patients. The classic methods for multi-stage transplantation of tubulized flaps in the lumbar and inguinal regions, in mid-thigh as well as current methods for one-stage reconstruction are discussed. The paper contains the case report of a transsexual patient undergoing one-stage reconstruction of the penis using m. rectus abdominis with the inferior pedicle, urethral reconstruction by a skin graft from simultaneous mastectomy with a free forearm flap covering the muscle. The paper examines the pros and cons of each method for reconstruction. PMID:1375425

  4. 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

  5. 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

  6. 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

  7. KCa3.1 mediates activation of fibroblasts in diabetic renal interstitial fibrosis

    PubMed Central

    Huang, Chunling; Shen, Sylvie; Ma, Qing; Gill, Anthony; Pollock, Carol A.; Chen, Xin-Ming

    2014-01-01

    Background Fibroblast activation plays a critical role in diabetic nephropathy (DN). The Ca2+-activated K+ channel KCa3.1 mediates cellular proliferation of many cell types including fibroblasts. KCa3.1 has been reported to be a potential molecular target for pharmacological intervention in a diverse array of clinical conditions. However, the role of KCa3.1 in the activation of myofibroblasts in DN is unknown. These studies assessed the effect of KCa3.1 blockade on renal injury in experimental diabetes. Methods As TGF-β1 plays a central role in the activation of fibroblasts to myofibroblasts in renal interstitial fibrosis, human primary renal interstitial fibroblasts were incubated with TGF-β1 +/− the selective inhibitor of KCa3.1, TRAM34, for 48 h. Two streptozotocin-induced diabetic mouse models were used in this study: wild-type KCa3.1+/+ and KCa3.1−/− mice, and secondly eNOS−/− mice treated with or without a selective inhibitor of KCa3.1 (TRAM34). Then, markers of fibroblast activation and fibrosis were determined. Results Blockade of KCa3.1 inhibited the upregulation of type I collagen, fibronectin, α-smooth muscle actin, vimentin and fibroblast-specific protein-1 in renal fibroblasts exposed to TGF-β1 and in kidneys from diabetic mice. TRAM34 reduced TGF-β1-induced phosphorylation of Smad2/3 and ERK1/2 but not P38 and JNK MAPK in interstitial fibroblasts. Conclusions These results suggest that blockade of KCa3.1 attenuates diabetic renal interstitial fibrogenesis through inhibiting activation of fibroblasts and phosphorylation of Smad2/3 and ERK1/2. Therefore, therapeutic interventions to prevent or ameliorate DN through targeted inhibition of KCa3.1 deserve further consideration. PMID:24166472

  8. Blockade of KCa3.1 Ameliorates Renal Fibrosis Through the TGF-β1/Smad Pathway in Diabetic Mice

    PubMed Central

    Huang, Chunling; Shen, Sylvie; Ma, Qing; Chen, Jason; Gill, Anthony; Pollock, Carol A.; Chen, Xin-Ming

    2013-01-01

    The Ca2+-activated K+ channel KCa3.1 mediates cellular signaling processes associated with dysfunction of vasculature. However, the role of KCa3.1 in diabetic nephropathy is unknown. We sought to assess whether KCa3.1 mediates the development of renal fibrosis in two animal models of diabetic nephropathy. Wild-type and KCa3.1−/− mice, and secondly eNOS−/− mice, had diabetes induced with streptozotocin and then were treated with/without a selective inhibitor of KCa3.1 (TRAM34). Our results show that the albumin-to-creatinine ratio significantly decreased in diabetic KCa3.1−/− mice compared with diabetic wild-type mice and in diabetic eNOS−/− mice treated with TRAM34 compared with diabetic mice. The expression of monocyte chemoattractant protein-1 (MCP-1), intercellular adhesion molecule 1 (ICAM1), F4/80, plasminogen activator inhibitor type 1 (PAI-1), and type III and IV collagen significantly decreased (P < 0.01) in kidneys of diabetic KCa3.1−/− mice compared with diabetic wild-type mice. Similarly, TRAM34 reduced the expression of the inflammatory and fibrotic markers described above in diabetic eNOS−/− mice. Furthermore, blocking the KCa3.1 channel in both animal models led to a reduction of transforming growth factor-β1 (TGF-β1) and TGF-β1 type II receptor (TβRII) and phosphorylation of Smad2/3. Our results provide evidence that KCa3.1 mediates renal fibrosis in diabetic nephropathy through the TGF-β1/Smad signaling pathway. Blockade of KCa3.1 may be a novel target for therapeutic intervention in patients with diabetic nephropathy. PMID:23656889

  9. 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

  10. Identification of genes involved in the sensitivity to antitumour drug 17-allylamino,17-demethoxygeldanamycin (17AAG).

    PubMed

    Barresi, Vincenza; Fortuna, Cosimo G; Garozzo, Roberta; Musumarra, Giuseppe; Scirè, Salvatore; Condorelli, Daniele F

    2006-05-01

    In the present study we analysed the gene expression database provided by the National Cancer Institute in an attempt to correlate activity profiles of geldanamycin, 17AAG and 11 other analogues in 60 human tumor cell lines with their gene expression profiles determined by the cDNA microarray technique. On the basis of the activity profiles two classes of geldanamycin analogues could be distinguished, having geldanamycin and 17AAG, respectively, as prototype compounds (denominated as gelda-like and 17AAG-like classes). Application of the "soft" statistical methodology of PLS (partial least squares modelling in latent variables or projections to latent structures) allowed us to evaluate the influence of each gene expression target in determining the therapeutical responses. The transcript encoding the translocating chain-associated membrane protein (TRAM) showed a significant statistical correlation with activity profiles of 17AAG. In order to validate the role of TRAM in determining sensitivity to 17AAG we induced a selective knocking-down of this transcript by the RNA interference methodology in H226 non-small cell lung carcinoma cell line. The efficiency of double-stranded RNA oligonucleotides (short-interfering RNAs, siRNAs) was determined by measuring TRAM mRNA levels by quantitative real-time RT-PCR at different times (24-72 hours) after siRNA lipotransfection. A significant increase in chemosensitivity to 17AAG was observed in siRNA-silenced cells. Although a number of factors may affect tumour sensitivity to 17AAG the present methodology allowed us to dissect out a single parameter which may be partly responsible for its activity. PMID:16880941

  11. Commuter exposure to particulate matter in public transportation modes in Hong Kong

    NASA Astrophysics Data System (ADS)

    Chan, L. Y.; Lau, W. L.; Lee, S. C.; Chan, C. Y.

    This study examined commuter's exposure to respirable suspended particulate matters while commuting in public transportation modes. The survey was conducted between October 1999 and January 2000 in Hong Kong. A total of eight public transportation modes, that are bus, tram, public light bus, taxi, ferry, Kowloon-Canton Railway, Mass Transit Railway and Light Rail Transit, were selected in the study. They were grouped into four categories: (T1) railway transport; (T2) non-air-conditioned roadway transport; (T3) air-conditioned roadway transport and (T4) marine transport. Both PM 10 and PM 2.5 levels were investigated. The results indicate that the particulate level is greatly affected by the mode of transport as well as the ventilation system of the transport. The overall average PM 10 concentration level in T2 (147 μg m -3) is the highest and is followed by T4 (81 μg m -3) and T3 (65 μg m -3). The PM 10 level in T1 (50 μg m -3) is the lowest. Notably, the commuter exposure in tram (175 μg m -3) is the highest among all the monitored commuting modes. Commuting modes such as railway and air-conditioned vehicle are recommended as a substitute for non-air-conditioned vehicle. The PM 2.5 to PM 10 ratio in transports ranged from 63% to 78%. Higher PM 2.5 to PM 10 ratio is found in vehicles with air-conditioning system. For the double deck vehicle, higher PM 10 level has resulted in the lower deck. The average upper-deck to lower-deck PM 10 ratio is 0.836, 0.751 and 0.738 in air-conditioned bus, non-air-conditioned bus and non-air-conditioned tram, respectively. Typical concentration profiles in different transports are also presented.

  12. Targeted inhibition of KCa3.1 attenuates TGF-β-induced reactive astrogliosis through the Smad2/3 signaling pathway

    PubMed Central

    Chen, Hongzhuan; Geller, Herbert M.

    2014-01-01

    Reactive astrogliosis, characterized by cellular hypertrophy and various alterations in gene expressionand proliferative phenotypes, is considered to contribute to brain injuries and diseases as diverse as trauma, neurodegeneration, and ischemia. KCa3.1, a potassium channel protein, has been reported to be up-regulated in reactive astrocytes after spinal cord injury in vivo. However, little is known regarding the exact role of KCa3.1 in reactive astrogliosis. To elucidate the role of KCa3.1 in regulating reactive astrogliosis, we investigated the effects of either blocking or knockout of KCa3.1 channels on the production of astrogliosis and astrocytic proliferation in response to transforming growth factor (TGF)-β in primary cultures of mouse astrocytes. We found that TGF-β increased KCa3.1 protein expression in astrocytes, with a concomitant marked increase in the expression of reactive astrogliosis, including glial fibrillary acidic protein (GFAP) and chondroitin sulfate proteoglycans (CSPGs). These changes were significantly attenuated by the KCa3.1 inhibitor TRAM-34. Similarly, the increase in GFAP and CSPGs in response to TGF-β was attenuated in KCa3.1−/− astrocytes. TRAM-34 also suppressed astrocytic proliferation. Additionally, the TGF-β-induced phosphorylation of Smad2 and Smad3 proteins was reduced with either inhibition of KCa3.1 with TRAM-34 or in KCa3.1−/− astrocytes. These findings highlight a novel role for the KCa3.1 channel in reactive astrogliosis phenotypic modulation and provide a potential target for therapeutic intervention for brain injuries. PMID:24606313

  13. 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.

  14. 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.

  15. 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.

  16. Towards to an Oncology Database (ONCOD) using a data warehousing approach

    PubMed Central

    Wang, Xiaoming; Liu, Lili; Fackenthal, James; Chang, Paul; Newstead, Gilliam; Chmura, Steven; Foster, Ian; Olopade, Olufunmilayo I

    2012-01-01

    While data warehousing approaches have been increasingly adopted in the biomedical informatics community for individualized data integration, effectively dealing with data integration, access, and application remains a challenging issue. In this report, focusing on ontology data, we describe how to use an established data warehouse system, named TRAM, to provide a data mart layer to address this issue. Our effort has resulted in a twofold achievement: 1) a model data mart tailored to facilitate oncology data integration and application (ONCOD), and 2) a flexible system architecture that has potential to be customized to support other data marts for various major medical fields. PMID:22779060

  17. Regulation of hematopoietic development by ZBTB transcription factors.

    PubMed

    Maeda, Takahiro

    2016-09-01

    Hematopoietic development is governed by the coordinated expression of lineage- and differentiation stage-specific genes. Transcription factors play major roles in this process and their perturbation may underlie hematologic and immunologic disorders. Nearly 1900 transcription factors are encoded in the human genome: of these, 49 BTB (for broad-complex, tram-track and bric à brac)-zinc finger transcription factors referred to as ZBTB or POK proteins have been identified. ZBTB proteins, including BCL6, PLZF, ThPOK and LRF, exhibit a broad spectrum of functions in normal and malignant hematopoiesis. This review summarizes developmental and molecular functions of ZBTB proteins relevant to hematology. PMID:27250345

  18. 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

  19. 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

  20. Comparison of Abdominal Muscle Activity in Relation to Knee Angles during Abdominal Drawing-in Exercises Using Pressure Biofeedback

    PubMed Central

    Lee, Jun-Cheol; Lee, Su-Kyoung; Kim, Kyoung

    2013-01-01

    [Purpose] The leg angles that are the most effective for abdominal muscle activation were investigated by performing abdominal drawing-in exercises at different leg angles with a biofeedback pressure unit. [Methods] Subjects were asked to adopt a supine position, and the tip of the biofeedback pressure unit was placed under the posterior superior iliac spine. Then, the pressure was adjusted to 40 mmHg while referring to the pressure gauge connected to the biofeedback pressure unit. Subjects were instructed to increase the pressure by 10 mmHg using the drawing-in technique upon the oral instruction, “Start,” and to maintain the drawn-in state. The time during which the pressure was maintained within an error range of ±1–2mmHg was measured in seconds. [Result] During the abdominal drawing-in exercises, the activity of the rectus abdominis, the internal and external obliques, and the transverse abdominis increased as the knee joint flexion angle increased from 45° to 120°. [Conclusion] When trunk stabilization exercises are performed at the same pressure to reduce damage after the acute phase of low back pain, trunk muscle strength can be efficiently increased by increasing the knee joint angle gradually, while performing abdominal drawing-in exercises with a biofeedback pressure unit. PMID:24259770

  1. Biomechanical and Electromyographic Comparisons of Isometric Trunk Flexor Endurance Test Postures: Prone Plank Versus V-Sit.

    PubMed

    Musalem, Lindsay L; Stankovic, Tatjana; Glisic, Drazen; Cook, Gillian E; Beach, Tyson A

    2015-12-01

    The objective of this study was to investigate why holding times on 2 different tests of isometric trunk flexor endurance capacity (prone plank and v-sit) are weakly correlated. Body position and ground reaction force data from 10 men and 10 women were used to conduct static biomechanical analyses of both test postures, and bilateral activations of the rectus abdominis, internal and external obliques, latissimus dorsi, and lumbar and thoracic erector spinae were measured in a second sample of 15 men and 15 women while holding the test postures. No between-posture differences in net low back flexor moments were found (P = .111), but the lumbar spine was 28° more flexed in the v-sit than in the plank (P < .001). No between-posture differences were detected in the rectus abdominis (P = .397), external obliques (P = .204), internal obliques (P = .226), or lumbar erector spinae (P = .116) activation levels, but those of the thoracic erector spinae (P = .0253) and latissimus dorsi (P < .001) were greater in the plank than in the v-sit. Altogether, the findings suggest that differences between plank and v-sit holding times are most likely related to between-test differences in lumbar spine postures and shoulder demands. PMID:26252077

  2. 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

  3. The effect of flexi-bar exercise with vibration on trunk muscle thickness and balance in university students in their twenties.

    PubMed

    Lee, Seong-Jin; Kim, Yong-Nam; Lee, Dong-Kyu

    2016-04-01

    [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

  4. 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

  5. Influence of Baclofen on Laryngeal and Spinal Motor Drive During Cough in the Anesthetized Cat

    PubMed Central

    Castillo, Daniel; Pitts, Teresa

    2016-01-01

    Objectives/Hypothesis The antitussive properties of (±) baclofen on laryngeal muscle activities have not been determined. The hypothesis of this study was that administration of (±) baclofen would suppress upper airway muscle motor activity in a dose-dependent manner during cough. Study Design This is a prospective, preclinical, hypothesis-driven, paired design. Methods Electromyograms of the parasternal, rectus abdominis, thyroarytenoid, posterior cricoarytenoid, and thyrohyoid were measured, along with esophageal pressure. Cough was elicited by mechanical stimulation of the lumen of the intrathoracic trachea in spontaneously breathing cats. Results Baclofen (±) (3–10 µg kg−1 i.a.) induced decreases in the electromyogram amplitude of the rectus abdominis motor drive during coughing, the inspiratory and active expiratory (E1) phases of cough, and cough number per epoch. There was no effect of (±) baclofen on the EMG amplitudes of any of the laryngeal muscles, the parasternal, or the duration of the passive expiratory (E2) phase. Conclusions Results from the present study indicate differential control mechanisms for laryngeal and inspiratory motor drive during cough, providing evidence of a control system regulating laryngeal activity and inspiratory spinal drive that is divergent from the control of expiratory spinal motoneurons. PMID:23670824

  6. Motor control of the trunk during a modified clean and jerk lift.

    PubMed

    Eriksson Crommert, M; Ekblom, M M; Thorstensson, A

    2014-10-01

    The purpose of the present study was to investigate the pattern of trunk muscle activation and intra-abdominal pressure (IAP) in a somewhat modified version of the clean and jerk lift. Nine healthy physically active male amateurs performed the exercise with a 30-kg barbell. Muscle activity was registered with electromyography from transversus abdominis (TrA) and obliquus internus (OI) using intramuscular electrodes and from rectus abdominis (RA) and erector spinae (ES) with surface electrodes. IAP was recorded with a nasogastric catheter. Measurements were made in various static positions throughout the lift and in the transitional phases separating them, both during lifting and lowering. The results demonstrated that the innermost abdominal muscle, TrA, showed increased activation levels in the two highest positions, whereas ES was most active, together with the highest IAP, in the lowest position. OI and RA showed generally little activation and no obvious trend throughout the lift. The results strengthen the view of a contributing role of TrA to the upright control of the trunk and indicate that the clean and jerk lift might constitute a whole-body exercise, still targeting the TrA muscle, in late-stage rehabilitation, especially for athletes during return to sports. PMID:23489349

  7. Systematic review of core muscle activity during physical fitness exercises.

    PubMed

    Martuscello, Jason M; Nuzzo, James L; Ashley, Candi D; Campbell, Bill I; Orriola, John J; Mayer, John M

    2013-06-01

    A consensus has not been reached among strength and conditioning specialists regarding what physical fitness exercises are most effective to stimulate activity of the core muscles. Thus, the purpose of this article was to systematically review the literature on the electromyographic (EMG) activity of 3 core muscles (lumbar multifidus, transverse abdominis, quadratus lumborum) during physical fitness exercises in healthy adults. CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, PubMed, SPORTdiscus, and Web of Science databases were searched for relevant articles using a search strategy designed by the investigators. Seventeen studies enrolling 252 participants met the review's inclusion/exclusion criteria. Physical fitness exercises were partitioned into 5 major types: traditional core, core stability, ball/device, free weight, and noncore free weight. Strength of evidence was assessed and summarized for comparisons among exercise types. The major findings of this review with moderate levels of evidence indicate that lumbar multifidus EMG activity is greater during free weight exercises compared with ball/device exercises and is similar during core stability and ball/device exercises. Transverse abdominis EMG activity is similar during core stability and ball/device exercises. No studies were uncovered for quadratus lumborum EMG activity during physical fitness exercises. The available evidence suggests that strength and conditioning specialists should focus on implementing multijoint free weight exercises, rather than core-specific exercises, to adequately train the core muscles in their athletes and clients. PMID:23542879

  8. Effect of core muscle thickness and static or dynamic balance on prone bridge exercise with sling by shoulder joint angle in healthy adults

    PubMed Central

    Park, Mi Hwa; Yu, Jae Ho; Hong, Ji Heon; Kim, Jin Seop; Jung, Sang Woo; Lee, Dong Yeop

    2016-01-01

    [Purpose] To date, core muscle activity detected using ultrasonography during prone bridge exercises has not been reported. Here we investigated the effects of core muscle thickness and balance on sling exercise efficacy by shoulder joint angle in healthy individuals. [Subjects and Methods] Forty-three healthy university students were enrolled in this study. Ultrasonography thickness of external oblique, internal oblique, and transversus abdominis during sling workouts was investigated. Muscle thickness was measured on ultrasonography imaging before and after the experiment. Dynamic balance was tested using a functional reaching test. Static balance was tested using a Tetrax Interactive Balance System. [Results] Different muscle thicknesses were observed during the prone bridge exercise with the shoulder flexed at 60°, 90° or 120°. Shoulder flexion at 60° and 90° in the prone bridge exercise with a sling generated the greatest thickness of most transversus abdominis muscles. Shoulder flexion at 120° in the prone bridge exercise with a sling generated the greatest thickness of most external oblique muscles. [Conclusion] The results suggest that the prone bridge exercise with shoulder joint angle is an effective method of increasing global and local muscle strength. PMID:27134390

  9. Neuromuscular independence of abdominal wall muscles as demonstrated by middle-eastern style dancers.

    PubMed

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

    2008-08-01

    Previous studies analyzing neuromuscular independence of the abdominal wall have involved a participant population with no specific training in separating individual muscle segments. We chose to study nine women trained in the art of middle-eastern dance, anticipating they may have unique skills in motor control. Specifically, we were searching for evidence of separation of upper rectus abdominis (URA) from lower rectus abdominis (LRA), as well as understanding what role the oblique muscles play in abdominal wall synergies. EMG analysis was done on eight trunk muscles bilaterally as the dancers participated in 30 dance, planar, and curl-up activities. The filtered data were then cross-correlated to determine the time lag between pairs of signals. Only three dance movements demonstrated consistent evidence of an ability to separate URA/LRA activation timing. The external and internal oblique muscles tend to align themselves temporally with the LRA. However, these findings were only evident in these three specific "belly-roll" conditions, all with low levels of muscle activation, and no external torque. Evidence of significantly different activation levels (% MVC) between URA/LRA was demonstrated in eight conditions, all of which required various pelvis movements with minimal thorax motion. PMID:17329127

  10. Impact of Different Body Positions on Bioelectrical Activity of the Pelvic Floor Muscles in Nulliparous Continent Women

    PubMed Central

    Chmielewska, Daria; Stania, Magdalena; Sobota, Grzegorz; Kwaśna, Krystyna; Błaszczak, Edward; Taradaj, Jakub; Juras, Grzegorz

    2015-01-01

    We examined pelvic floor muscles (PFM) activity (%MVC) in twenty nulliparous women by body position during exercise as well as the activation of abdominal muscles and the gluteus maximus during voluntary contractions of the PFMs. Pelvic floor muscle activity was recorded using a vaginal probe during five experimental trials. Activation of transversus abdominis, rectus abdominis, and gluteus maximus during voluntary PFM contractions was also assessed. Significant differences in mean normalized amplitudes of baseline PFM activity were revealed between standing and lying (P < 0.00024) and lying and ball-sitting positions (P < 0.0053). Average peak, average time before peak, and average time after peak did not differ significantly during the voluntary contractions of the PFMs. Baseline PFM activity seemed to depend on the body position and was the highest in standing. Pelvic floor muscles activity during voluntary contractions did not differ by position in continent women. Statistically significant differences between the supine lying and sitting positions were only observed during a sustained 60-second contraction of the PFMs. PMID:25793212

  11. The effect of backpack heaviness on trunk-lower extremity muscle activities and trunk posture.

    PubMed

    Al-Khabbaz, Yusuf S S M; Shimada, Tomoaki; Hasegawa, Masashi

    2008-08-01

    The purpose of the present study is to analyze trunk-lower extremity muscle activities and trunk postural changes during the carriage of different backpacks. Nineteen male university students (21+/-3 years) participated in the experiment's four standing modes: (1) unloaded standing, (2) 10% body weight (BW) load (in the form of a backpack), (3) 15% BW load and (4) 20% BW load. Bilateral rectus abdominis, erector spinae, vastus medialis and biceps femoris muscle activities were recorded using surface electromyography (SEMG), while trunk inclination, side flexion and rotation were measured by using VICON 250 during all standing modes. The results showed that rectus abdominis muscle activities increased progressively and disproportionably as the backpack load increased. As for the trunk posture, almost the same backward inclination was adapted even with increasing backpack heaviness. Twenty percent BW backpack causes the most significant muscular and postural changes so it should be avoided. However, it is recommended to study other backpack factors such as frequency of usage, usage time, type of the backpack and age to come up with a complete usage recommendation. PMID:18329270

  12. 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

  13. 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

  14. Electromechanical delay of abdominal muscles is modified by low back pain prevention exercise.

    PubMed

    Szpala, Agnieszka; Rutkowska-Kucharska, Alicja; Drapala, Jaroslaw

    2014-01-01

    The objective of the research was to assess the effect of a 4-week-long training program on selected parameters: electromechanical delay (EMD) and amplitude of electromyographic signal (EMG). Fourteen female students of the University School of Physical Education participated in the study. Torques and surface electromyography were evaluated under static conditions. Surface electrodes were glued to both sides of the rectus abdominis (RA), external oblique (EO), and erector spinae (ES) muscles. The 4-week-long program was aimed at strengthening the abdominal muscles and resulted in increased EMD during maximum torque production by flexors of the trunk, increased amplitudes of the signals of the erector spinae ( p = 0.005), and increased EMG amplitude asymmetry of the lower ( p = 0.013) and upper part ( p = 0.006) of the rectus abdominis muscle. In a training program composed of a large number of repetitions of strength exercises, in which the training person uses their own weight as the load (like in exercises such as curl-ups), the process of recruitment of motor units is similar to that found during fatiguing exercises and plyometric training. PMID:25307027

  15. Cylindroma-like basaloid anal cancer presenting as a large pelvic mass in a patient with ulcerative colitis

    PubMed Central

    Chen, Sugong; Tan, Sanda A.; Shon, Wonwoo; Shaw, Christiana M.

    2015-01-01

    Basaloid cancers of the lower gastrointestinal tract are rare. The lack of mucosal involvement of this type of tumor is uncharacteristic and, to our knowledge, has not been described. In addition, the cylindroma-like appearance of this cancer has only a few examples in the literature. A 51-year-old male presented to us with a history of ulcerative colitis (UC) and obstruction of the anal canal. Imaging and colonoscopy revealed an entirely extraluminal tumor. Percutaneous biopsy yielded a diagnosis of cylindroma-like basaloid carcinoma of the anal region. Neoadjuvant chemotherapy and radiation resulted in stable disease by RECIST criteria. Surgical planning ensued, which led to R0 resection of the tumor, total colectomy and end ileostomy for his UC, and reconstruction of the perineal defect with a rectus myocutaneous flap. Surveillance at 6 months demonstrated no evidence of disease. PMID:26224891

  16. Early metastasis to anterior abdominal wall following radical cystectomy: A rare presentation

    PubMed Central

    Sawant, Ajit; Bansal, Sumit; Pawar, Prakash; Kasat, Gaurav

    2016-01-01

    Abdominal wall metastasis from urothelial cancer is extremely rare and very few such cases have been reported in the literature. As such the treatment protocols are not so well defined. We present an interesting case of a 65-year-old male patient, known case of chronic kidney disease, who presented with a large, fungating infraumbilical mass 8 months postradical cystectomy. The mass involved full thickness anterior abdominal wall and small bowel including the ileal conduit. Wide excision of the mass along with adhered bowel loops and partial excision of the ileal conduit with right ureteric reimplant was performed. The large defect in the anterior abdominal wall was closed using a mesh (permanent with a bioresorbable coating inside) and myocutaneous thigh flap. The histopathological examination of the excised mass was consistent with secondary from the urothelial tumor. PMID:27453672

  17. Reconstruction of a Severely Crushed Leg with Interpositional Vessel Grafts and Latissimus Dorsi Flap

    PubMed Central

    Park, Chan Woo; Hwang, Kyu Tae; Kim, Jeong Tae

    2012-01-01

    We present a case of a near total amputation at the distal tibial level, in which the patient emphatically wanted to save the leg. The anterior and posterior tibial nerves were intact, indicating a high possibility of sensory recovery after revascularization. The patient had open fractures at the tibia and fibula, but no bone shortening was performed. The posterior tibial vessels were reconstructed with an interposition saphenous vein graft from the contralateral side and a usable anterior tibial artery graft from the undamaged ipsilateral distal portions. The skin and soft tissue defects were covered using a subatmospheric pressure system for demarcating the wound, and a latissimus dorsi myocutaneous free flap for definite coverage of the wound. At 6 months after surgery, the patient was ambulatory without requiring additional procedures. Replantation without bone shortening, with use of vessel grafts and temporary coverage of the wound with subatmospheric pressure dressings before definite coverage, can shorten recovery time. PMID:22872848

  18. Free Flap Reconstruction for Complex Scalp and Forehead Defects with Associated Full-Thickness Calvarial Bone Resections

    PubMed Central

    Larrañaga, Juan; Rios, Alfredo; Franciosi, Edgardo; Mazzaro, Eduardo; Figari, Marcelo

    2012-01-01

    Extensive defects of the scalp and forehead associated with calvarial bone resections demand complex reconstructions. Free flaps offer vascularized tissue of excellent quality and quantity. We report six patients with extensive scalp and forehead defects associated with calvarial bone resections reconstructed with free flaps. Five patients also required a cranioplasty. The flaps used were two anterolateral thigh flaps, one vastus lateralis flap, one myocutaneous latissimus dorsi flap, one latissimus dorsi flap, and one radial forearm flap. All flaps survived with no partial necrosis. There were no donor site complications. One patient presented an exposure of the alloplastic material used for cranioplasty. We strongly recommend the use of free flaps for this kind of reconstruction. PMID:24294403

  19. 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.

  20. Management of radionecrosis of the vulva and distal vagina

    SciTech Connect

    Roberts, W.S.; Hoffman, M.S.; LaPolla, J.P.; Ruas, E.; Fiorica, J.V.; Cavanagh, D. )

    1991-05-01

    Twelve patients were seen between January 1983 and June 1989 with the clinical diagnosis of radionecrosis of the vulva or distal vagina. Seven patients received radiation for vulvar cancer, three for distal vaginal cancer, and two for recurrent endometrial cancer. No patient healed spontaneously and the mean delay in surgical therapy was 8.5 months. The radionecrotic site was treated with local therapy, radical local excision (with or without colostomy), or exenteration. The operative defect was closed primarily in three patients and covered with local flaps or myocutaneous flaps in seven patients. The two patients with local care still have radionecrotic ulcers. One of three patients who were closed primarily continues to have an ulcer. All other patients have healed satisfactorily except one who died after two attempts to correct the problem. Radionecrosis of the vulva and distal vagina should generally be treated surgically.

  1. 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

  2. [Primary thinning and de-epithelialization of microsurgical transplants from the lateral thigh].

    PubMed

    Wolff, K D; Plath, T; Frege, J; Hoffmeister, B

    2000-03-01

    To expand the indicational spectrum of the myocutaneous vastus lateralis flap, which is often too voluminous for intraoral application, we performed extreme, primary thinning of the fat and muscle component of this microsurgical transplant in 14 patients. After subfascial localization of the 0.5- to 1.0-mm-thick perforating vessel, it is exposed through the fascia and muscles up to its exit from the descending branch of the lateral circumflex femoral artery. After isolating the perforating vessel, it is no longer necessary to include parts of the vastus lateralis muscle in the flap. The fatty tissue of the remaining epifascial fat component is completely removed except for a ca. 1- to 2-cm-wide cuff of fatty tissue and fascia around the perforating vessel. When performing this primary radical removal of the subcutaneous fatty tissue, care should be taken not to injure the deep subdermal vascular plexus. In addition to the thinning procedure, de-epithelialization of the skin was performed using scalpel blade dissection (five patients) or carbon dioxide laser (6 W, five patients). This thinning technique was used for covering ten intraoral and four extraoral defects and enabled the raising of skin flaps with a thickness of 3-5 mm even in obese patients. The vessel pedicle length of thinned flaps was between 12 and 16 cm; flap size varied between 4 x 5 and 9 x 15 cm, and the donor sites were directly closed. In one case, there was a partial necrosis (20%), but the remaining flaps healed without complications. On the intraoral flaps, a thin, smooth and pliable surface developed after re-epithelialization within 3-6 weeks. The described method expands the application possibilities of the myocutaneous vastus lateralis flap for a large number of intraoral and flat defects with minimal donor-site morbidity. PMID:10851881

  3. Reconstruction of severely infected gluteal osteoradionecrosis using negative-pressure wound therapy and latissimus dorsi musculocutaneous flaps.

    PubMed

    Kim, Sang Wha; Youn, Dong Geun; Hwang, Kyu Tae; Kim, Jeong Tae; Kim, Youn Hwan

    2016-01-01

    Radiotherapy is mandatory for aggressive cancer treatment. Unfortunately, the high-energy radiation used can lead to severe osteoradionecrosis. Radical debridement of devitalized bone and soft tissue coupled with reconstruction using well-vascularized tissues is the accepted treatment for this condition. However, osteoradionecrosis cannot be controlled easily or rapidly. The aim of this study was to present the results of the use of serial negative-pressure wound therapy (NPWT) in combination with a latissimus dorsi myocutaneous flap for treatment of gluteal osteoradionecrosis in a consecutive series of patients. Between January 2003 and December 2012, nine patients underwent reconstruction using serial NPWT and latissimus dorsi myocutaneous flaps. We applied negative-pressure dressings for at least 8 weeks. Final reconstruction was performed after the infection was controlled. The superior gluteal artery and vein were used as recipient vessels in all the cases. The mean interval between operation and radiation therapy was 28.3 ± 8.3 years, and the mean number of debridement performed was 6.3 ± 1. NPWT dressings were applied for 8-12 weeks (mean, 9.3 ± 2 weeks). The defects ranged in size from 14 × 8 cm to 18 × 15 cm. The flap size ranged from 15 × 10 cm to 18 × 15 cm. All flaps survived uneventfully except in one patient who experienced chronic seroma and wound dehiscence. There were no recurrences of osteomyelitis during the follow-up periods (mean, 14 ± 6.1 months). Based on the results obtained from this consecutive series of patients, we suggest that this methodology may provide an alternative approach for the treatment of severe osteoradionecrosis of the gluteal region. PMID:25641653

  4. 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.

  5. 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

  6. Tethered lifting systems for measurements in the lower atmosphere

    NASA Astrophysics Data System (ADS)

    Jensen, Michael Lamar

    2000-10-01

    This work defines a Tethered Lifting System for measurements in the lower atmosphere, its design and development, and applications for its use. Using historical kite research and the unique capabilities of tethered lifting platforms as motivation, a complete system has been created offering the complementary benefits of parafoil kites and tethered balloons as lifting platforms. Support systems including tethers, winching systems and payload data collection and telemetry systems round out the Tethered Lifting System to provide a complete atmospheric measurement system. The kite platforms have been enhanced by the invention and development of a wind-powered Tether Rover for Atmospheric Research (WindTRAM), providing rapid profiling and precise positioning capabilities. Design of the WindTRAM and implementation of onboard feedback control are covered in detail, as they comprise the most novel contribution of this research. The breadth of possible applications for these technologies is touched upon by examination of some of the specific research applications undertaken by the researchers at the Cooperative Institute for Research in the Environmental Sciences during the last decade.

  7. 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. PMID:27020659

  8. 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

  9. Activation of K(+) channel by 1-EBIO rescues the head and neck squamous cell carcinoma cells from Ca(2+) ionophore-induced cell death.

    PubMed

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

    2016-01-01

    Ion channels in carcinoma and their roles in cell proliferation are drawing attention. Intracellular Ca(2+) ([Ca(2+)]i)-dependent signaling affects the fate of cancer cells. Here we investigate the role of Ca(2+)-activated K(+) channel (SK4) in head and neck squamous cell carcinoma cells (HNSCCs) of different cell lines; SNU-1076, OSC-19 and HN5. Treatment with 1 µM ionomycin induced cell death in all the three cell lines. Whole-cell patch clamp study suggested common expressions of Ca(2+)-activated Cl(-) channels (Ano-1) and Ca(2+)-activated nonselective cation channels (CAN). 1-EBIO, an activator of SK4, induced outward K(+) current (ISK4) in SNU-1076 and OSC-19. In HN5, ISK4 was not observed or negligible. The 1-EBIO-induced current was abolished by TRAM-34, a selective SK4 blocker. Interestingly, the ionomycin-induced cell death was effectively prevented by 1-EBIO in SNU-1076 and OSC-19, and the rescue effect was annihilated by combined TRAM-34. Consistent with the lower level of ISK4, the rescue by 1-EBIO was least effective in HN5. The results newly demonstrate the role of SK4 in the fate of HNSCCs under the Ca(2+) overloaded condition. Pharmacological modulation of SK4 might provide an intriguing novel tool for the anti-cancer strategy in HNSCC. PMID:26807020

  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. 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

  12. 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

  13. 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

  14. Dorsal Penile Nerve Block With Ropivacaine-Reduced Postoperative Catheter-Related Bladder Discomfort in Male Patients After Emergence of General Anesthesia: A Prospective, Randomized, Controlled Study.

    PubMed

    Li, Jing-Yi; Yi, Ming-Liang; Liao, Ren

    2016-04-01

    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 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 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 were decreased

  15. The induction of endochondral bone formation by transforming growth factor-β3: experimental studies in the non-human primate Papio ursinus

    PubMed Central

    Ripamonti, Ugo; Nathaniel Ramoshebi, L; Teare, June; Renton, Louise; Ferretti, Carlo

    2008-01-01

    Abstract Transforming growth factor-β3 (TGF-β3), a multi-functional growth modulator of embryonic development, tissue repair and morphogenesis, immunoregulation, fibrosis, angiogenesis and carcinogenesis, is the third mammalian isoform of the TGF-β subfamily of proteins. The pleiotropism of the signalling proteins of the TGF-β superfamily, including the TGF-β proteins per se, are highlighted by the apparent redundancy of soluble molecular signals initiating de novo endochondral bone induction in the primate only. In the heterotopic bioassay for bone induction in the subcutaneous site of rodents, the TGF-β3 isoform does not initiate endochondral bone formation. Strikingly and in marked contrast to the rodent bioassay, recombinant human (h)TGF-β3, when implanted in the rectus abdominis muscle of adult non-human primates Papio ursinus at doses of 5, 25 and 125 μg per 100 mg of insoluble collagenous matrix as carrier, induces rapid endochondral bone formation resulting in large corticalized ossicles by day 30 and 90. In the same animals, the delivery of identical or higher doses of theTGF-β3 protein results in minimal repair of calvarial defects on day 30 with limited bone regeneration across the pericranial aspect of the defects on day 90. Partial restoration of the bone induction cascade by the hTGF-β3 protein is obtained by mixing the hTGF-β3 device with minced fragments of autogenous rectus abdominis muscle thus adding responding stem cells for further bone induction by the hTGF-β3 protein. The observed limited bone induction in hTGF-β3/treated and untreated calvarial defects in Papio ursinus and therefore by extension to Homo sapiens, is due to the influence of Smad-6 and Smad-7 down-stream antagonists of the TGF-β signalling pathway. RT-PCR, Western and Northern blot analyses of tissue specimens generated by the TGF-β3 isoform demonstrate robust expression of Smad-6 and Smad-7 in orthotopic calvarial sites with limited expression in heterotopic

  16. 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

  17. Aldosterone induces active K+ secretion by enhancing mucosal expression of Kcnn4c and Kcnma1 channels in rat distal colon

    PubMed Central

    Singh, Satish K.; O'Hara, Bryan; Talukder, Jamilur R.

    2012-01-01

    Although both Kcnn4c and Kcnma1 channels are present on colonic mucosal membranes, only Kcnma1 has been suggested to mediate K+ secretion in the colon. Therefore, studies were initiated to investigate the relative roles of Kcnn4c and Kcnma1 in mediating aldosterone (Na-free diet)-induced K+ secretion. Mucosal to serosal (m-s), serosal to mucosal (s-m), and net 86Rb+ (K+ surrogate) fluxes as well as short circuit currents (Isc; measure of net ion movement) were measured under voltage clamp condition in rat distal colon. Active K+ absorption, but not K+ secretion, is present in normal, while aldosterone induces active K+ secretion (1.04 ± 0.26 vs. −1.21 ± 0.15 μeq·h−1·cm−2; P < 0.001) in rat distal colon. Mucosal VO4 (a P-type ATPase inhibitor) inhibited the net K+ absorption in normal, while it significantly enhanced net K+ secretion in aldosterone animals. The aldosterone-induced K+ secretion was inhibited by the mucosal addition of 1) either Ba2+ (a nonspecific K+ channel blocker) or charybdotoxin (CTX; a common Kcnn4 and Kcnma1 channel blocker) by 89%; 2) tetraethyl ammonium (TEA) or iberiotoxin (IbTX; a Kcnma1 channel blocker) by 64%; and 3) TRAM-34 (a Kcnn4 channel blocker) by 29%. TRAM-34, but not TEA, in the presence of IbTX further significantly inhibited the aldosterone-induced K+ secretion. Thus the aldosterone-induced Ba2+/CTX-sensitive K+ secretion consists of IbTX/TEA-sensitive (Kcnma1) and IbTX/TEA-insensitive fractions. TRAM-34 inhibition of the IbTX-insensitive fraction is consistent with the aldosterone-induced K+ secretion being mediated partially via Kcnn4c. Western and quantitative PCR analyses indicated that aldosterone enhanced both Kcnn4c and Kcnma1α protein expression and mRNA abundance. In vitro exposure of isolated normal colonic mucosa to aldosterone also enhanced Kcnn4c and Kcnma1α mRNA levels, and this was prevented by exposure to actinomycin D (an RNA synthesis inhibitor). These observations indicate that aldosterone

  18. Simultaneous bilateral breast reconstruction with the transverse rectus abdominus musculocutaneous free flap.

    PubMed Central

    Khouri, R K; Ahn, C Y; Salzhauer, M A; Scherff, D; Shaw, W W

    1997-01-01

    OBJECTIVE: The purpose of the study was to assess the results and morbidity associated with simultaneous bilateral TRAM free flap breast reconstruction and describe refinements in its surgical technique. SUMMARY BACKGROUND DATA: Bilateral prophylactic total mastectomies might be an agreeable option for those patients at highest risk for breast cancer if autogenous tissue breast reconstruction could be performed with reasonable technical ease and acceptable morbidity. However, some surgeons harbor reservations regarding the extensiveness of the surgery, the associated morbidity, and the aesthetic quality of the resulting outcome. METHODS: A multicenter retrospective review of clinical experience with 120 consecutive patients who underwent 240 simultaneous bilateral TRAM free flap breast reconstructions was developed. RESULTS: The average operating time, including the time required for the breast ablative portion of the procedures, was 8.6 hours. The average length of hospitalization was 7.6 days. However, for the last 40 patients, these figures were reduced to 7.1 hours and 6.1 days, respectively. Nonautologous blood transfusions were needed in 33 cases (28%), but only 1 was required in the last 40 patients. Thromboses developed in six of 240 flaps (2.5%): 4 were arterial and 2 were venous. Re-exploration allowed us to restore circulation in five flaps, whereas one flap was unsalvageable and was replaced successfully with an alternate flap. An uncomplicated deep vein thromboses developed in one patient with a history of recurrent deep vein thromboses that had no adverse effect on her outcome. Minor complications developed in 18 patients (15%) (e.g., hematoma, partial wound necrosis, wound infection, or prolonged postoperative ileus) that did not affect the long-term outcome. Fourteen patients (11.6%) had abdominal wall weakness or hernias. Follow-up time averaged 37.2 months (range, 14-62 months). On last follow-up, patients' self-reported overall satisfaction with

  19. Athletic injuries of the lateral abdominal wall: review of anatomy and MR imaging appearance.

    PubMed

    Stensby, J Derek; Baker, Jonathan C; Fox, Michael G

    2016-02-01

    The lateral abdominal wall is comprised of three muscles, each with a different function and orientation. The transversus abdominus, internal oblique, and external oblique muscles span the abdominal cavity between the iliocostalis lumborum and quadratus lumborum posteriorly and the rectus abdominis anteriorly. The lateral abdominal wall is bound superiorly by the lower ribs and costal cartilages and inferiorly by the iliac crest and inguinal ligament. The lateral abdominal wall may be acutely or chronically injured in a variety of athletic endeavors, with occasional acute injuries in the setting of high-energy trauma such as motor vehicle collisions. Injuries to the lateral abdominal wall may result in lumbar hernia formation, unique for its high incarceration rate, and also Spigelian hernias. This article will review the anatomy, the magnetic resonance (MR) imaging approach, and the features and complications of lateral abdominal wall injuries. PMID:26450606

  20. 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

  1. 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

  2. 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

  3. Antagonist coactivation of trunk stabilizer muscles during Pilates exercises.

    PubMed

    Rossi, Denise Martineli; Morcelli, Mary Hellen; Marques, Nise Ribeiro; Hallal, Camilla Zamfolini; Gonçalves, Mauro; Laroche, Dain P; Navega, Marcelo Tavella

    2014-01-01

    The purpose of this study was to compare the antagonist coactivation of the local and global trunk muscles during mat-based exercises of Skilled Modern Pilates. Twelve women performed five exercises and concurrently, surface EMG from internal oblique (OI), multifidus (MU), rectus abdominis (RA) and iliocostalis lumborum (IL) muscles was recorded bilaterally. The percentage of antagonist coactivation between local (OI/MU) and global muscles (RA/IL) was calculated. Individuals new to the practice of these exercises showed differences in coactivation of the trunk muscles between the exercises and these results were not similar bilaterally. Thus, in clinical practice, the therapist should be aware of factors such as compensation and undesirable rotation movements of the trunk. Moreover, the coactivation of global muscles was higher bilaterally in all exercises analyzed. This suggests that the exercises of Skilled Modern Pilates only should be performed after appropriate learning and correct execution of all principles, mainly the Centering Principle. PMID:24411147

  4. Chest wall reconstruction using iliac bone allografts and muscle flaps.

    PubMed

    Garcia-Tutor, Emilio; Yeste, Luis; Murillo, Julio; Aubá, Cristina; Sanjulian, Mikel; Torre, Wenceslao

    2004-01-01

    Technically we can divide full-thickness thoracic reconstruction into 2 parts: providing a rigid support and ensuring well-vascularized coverage. Since 1986, the authors' center has had ample experience with bone banks and the use of cryopreserved bone grafts, which led them to consider the possibility of using these grafts for full-thickness chest wall reconstruction. They describe 3 patients in whom resection of the tumor and reconstruction of the thorax were carried out using iliac bone allografts covered with muscle flaps (1 pectoralis major and 2 rectus abdominis). None of the patients experienced breathing difficulties, pain, or instability after 14 months, 18 months, and 11 years of follow-up. The result of the reconstruction was excellent in all 3 patients in terms of function and aesthetics. The advantage of allografts compared with synthetic materials is their potential integration; they can become part of the host patient's living tissue. PMID:14676700

  5. [Safe and Effective Analgesia with Bilateral Continuous TAP Block for a Patient with Marfan Syndrome after Open Abdominal Aortic Aneurysm Repair].

    PubMed

    Katakura, Yumi; Sakurai, Asako; Endo, Masaru; Hamada, Takako; Nomoto, Mayuko; Yamada, Hiroshi; Takeda, Koji

    2016-06-01

    A patient with Marfan syndrome underwent emergency open abdominal aortic aneurysm repair. She was referred to our department for postoperative analgesia. Taking the risk of possible dural ectasia into consideration, we avoided epidural block. Alternatively, we performed bilateral continuous transversus abdominis plane (TAP) block with sufficient analgesia. Lumbosacral dural ectasia is frequently observed in patients with Marfan syndrome. A few reports described that their fragile dura may contribute to an increased risk of dural puncture and postdural puncture headache (PDPH). Thus, in planning neuraxial block for a patient with Marfan syndrome, the possible consequences of lumbosacral dural ectasia should be considered. A case we herein present shows bilateral continuous TAP block could be a safe and effective alternative to epidural block. PMID:27483660

  6. Effects of a Pelvic Belt on the EMG Activity of the Abdominal Muscles during a Single-leg Hold in the Hook-lying Position on a Round Foam Roll.

    PubMed

    Kim, Yu-Ri; Kim, Ji-Won; An, Duk-Hyun; Yoo, Won-Gyu; Oh, Jae-Seop

    2013-07-01

    [Purpose] This study investigated the effects of a pelvic belt on the electromyography (EMG) activity of the abdominal muscles during a single-leg hold in the hook-lying position on a round foam roll. [Subjects] Seventeen healthy female volunteers were recruited for this study. [Methods] The participants performed single-leg-hold exercises on a round foam roll with and without a pelvic belt. Surface EMG was recorded from the rectus abdominis (RA), internal oblique (IO), and external oblique (EO) bilaterally. [Results] The EMG activity of the bilateral RA, EO, and IO was significantly lower when the pelvic belt applied. [Conclusions] Our finding that the bilateral EO, IO, and RA muscles were less active with a pelvic belt during trunk-stabilizing exercises on an unstable surface suggests that the pelvic belt provided "form closure". PMID:24259855

  7. 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

  8. Some pharmacological effects of the nematocide, morantel

    PubMed Central

    Bamgbose, S. O. A.; Marquis, V. O.; Salako, L. A.

    1973-01-01

    1. In isolated nerve-muscle preparations as well as in nerve-muscle preparations in intact anaesthetized animals, morantel exhibited neuromuscular blocking properties similar to those of depolarizing blockers. The drug also caused spastic paralysis of 3 day-old chicks and contracture of the isolated toad rectus abdominis muscle. 2. Morantel caused contraction of the guinea-pig and rabbit isolated small intestine. This effect was antagonized by atropine and hexamethonium. 3. Morantel caused an increase in the blood pressure of the anaesthetized rat and cat and contraction of the nictitating membrane of the anaesthetized cat. These effects were antagonized by hexamethonium. 4. It was concluded that morantel (like the related compound pyrantel) has acetylcholine-like action and that its structure is consistent with such action. PMID:4352084

  9. 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

  10. [General anesthesia for a boy with Wolf-Hirschhorn syndrome].

    PubMed

    Kondo, Satoko; Okuyama, Katsumi; Ikemoto, Koudai; Furuya, Atsushi; Matsukawa, Takashi

    2013-12-01

    Wolf-Hirschhorn syndrome (WHS) is a rare chromosomal abnormality in which there is deletion of the short arm of chromosome no. 4. Features of the condition include severe psychomotor retardation, characteristic facies and various congenital midline fusion anomalies. We report the anesthetic management in a 6-year-old boy with WHS, scheduled for renal biopsy under general anesthesia. Anesthesia was induced and maintained with sevoflurane and nitrous oxide in oxygen. Mask ventilation was performed easily. After establishment of mask ventilation, laryngeal mask airway (LMA) was inserted smoothly without muscle relaxant and an adequate airway was established with a LMA. He has episodes of transient deterioration in renal function with physical stress. To decrease renal effects of perioperative stress, transversus abdominis plane (TAP) block and intravenous patient controlled analgesia (IV-PCA) were administered for postoperative analgesia. The operation ended without any complications. Anesthetic emergence was rapid and he had no pain and decline in renal function. PMID:24498785

  11. Rectus sheath hematoma: three case reports

    PubMed Central

    Kapan, Selin; Turhan, Ahmet N; Alis, Halil; Kalayci, Mustafa U; Hatipoglu, Sinan; Yigitbas, Hakan; Aygun, Ersan

    2008-01-01

    Introduction Rectus sheath hematoma is an uncommon cause of acute abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. It could occur spontaneously or after trauma. They are usually located infraumblically and often misdiagnosed as acute abdomen, inflammatory diseases or tumours of the abdomen. Case presentation We reported three cases of rectus sheath hematoma presenting with a mass in the abdomen and diagnosed by computerized tomography. The patients recovered uneventfully after bed rest, intravenous fluid replacement, blood transfusion and analgesic treatment. Conclusion Rectus sheath hematoma is a rarely seen pathology often misdiagnosed as acute abdomen that may lead to unnecessary laparotomies. Computerized tomography must be chosen for definitive diagnosis since ultrasonography is subject to error due to misinterpretation of the images. Main therapy is conservative management. PMID:18221529

  12. The Role of Magnetic Resonance Imaging in Athletic Pubalgia and Core Muscle Injury.

    PubMed

    Coker, Dana J; Zoga, Adam C

    2015-08-01

    Magnetic resonance imaging (MRI) has become the standard of care imaging modality for a difficult, often misunderstood spectrum of musculoskeletal injury termed athletic pubalgia or core muscle injury. Armed with a dedicated noncontrast athletic pubalgia protocol and a late model phased array receiver coil, the musculoskeletal imager can play a great role in effective diagnosis and treatment planning for lesions, including osteitis pubis, midline pubic plate lesions, and rectus abdominis/adductor aponeurosis injury. Beyond these established patterns of MRI findings, there are many confounders and contributing pathologies about the pelvis in patients with activity related groin pain, including internal and periarticular derangements of the hip. The MRI is ideally suited to delineate the extent of expected injury and to identify the unexpected visceral and musculoskeletal lesions. PMID:26244616

  13. Spectrum of MRI findings in clinical athletic pubalgia.

    PubMed

    Zajick, Donald C; Zoga, Adam C; Omar, Imran M; Meyers, William C

    2008-03-01

    Athletic pubalgia is a frequently encountered syndrome for clinicians who treat active patients participating in a wide variety of athletic endeavors worldwide. Pathologies associated with this clinical scenario span anatomically from the pubic symphysis to the hip and include a myriad of poorly understood and incompletely described musculoskeletal entities, many of which are centered about the pubic symphysis and its tendinous attachments. In this article, we discuss the relevant anatomy and pathophysiology for the most frequently encountered of these disorders, using magnetic resonance (MR) images as a guide. We describe an MR imaging protocol tailored to clinical athletic pubalgia. We then review reproducible MRI patterns of pathology about the pubic symphysis, the rectus abdominis/adductor aponeurosis and the inguinal ring, as well as a group of clinically confounding entities remote from the symphysis but visible by MRI. PMID:18382940

  14. Comparison of trunk muscle activities in lifting and lowering tasks at various heights

    PubMed Central

    Lee, Hyun; Hong, Ji Heon

    2016-01-01

    [Purpose] Biomechanical data for manual material handling are important for appropriate engineering design. The goal of this study was to investigate differences in trunk muscle activity in lifting and lowering tasks at various heights. [Subjects and Methods] Thirty healthy, young adult subjects performed 6 asymmetrical lifting and lowering tasks at various heights. Trunk muscle activity of the abdominal external oblique muscle (EO), rectus abdominis muscle (RA), and lumbar erector spinae muscles (ES) were recorded using surface electromyography (EMG). [Results] The EMG activities of the bilateral ES differed significantly among heights. The left EO activity in the ankle to knee lifting task was significantly increased compared with that of the knee to ankle lowering task. However, there were no significant differences in the right EO, bilateral ES, or RA between lifting and lowering tasks. [Conclusion] The results show that the optimal range for manual material handling was at trunk height, not only for lifting but also for lowering tasks. PMID:27065548

  15. Free thin paraumbilical perforator-based flaps.

    PubMed

    Koshima, I; Moriguchi, T; Soeda, S; Tanaka, H; Umeda, N

    1992-07-01

    A free paraumbilical perforator-based flap fed by a muscle perforator from the inferior deep epigastric artery and with no muscle was used in 13 patients. Among them, a free thin paraumbilical perforator-based flap with a thin layer of fat, to protect the subdermal plexus of the vessels, was used in seven patients. The dominant pedicle perforator of this thin flap is usually located around the umbilicus and a large flap can be obtained. Its critical length-to-breath ratio is considered to be 4:3. The advantages of this flap are a long and large vascular pedicle, rare postoperative abdominal herniation, little bulkiness of the flap, and a relatively large skin territory. The disadvantages are technical difficulties in dissection of the perforator and anatomical variation in the location of the perforator. We believe this flap largely overcomes the problems of the conventional rectus abdominis musculocutaneous flap. PMID:1386718

  16. Single port-assisted fully laparoscopic abdominoperineal resection (APR) with immediate V-RAM flap reconstruction of the perineal defect.

    PubMed

    Ali, Sayid; Moftah, Mohamed; Ajmal, Nadeem; Cahill, Ronan A

    2012-09-01

    Abdominoperineal resection (APR) of anorectal cancers after neoadjuvant chemoradiotherapy may incur significant perineal morbidity. While vertical rectus abdominis muscle (V-RAM) flaps can fill the pelvic resection space with health tissue, their use has previously been described predominantly in association with laparotomy. Here, we describe a means of combination laparoscopic APR with V-RAM flap reconstruction that allows structural preservation of the entire abdominal wall throughout the oncological resection and of the deep parietal layers after V-RAM donation. Furthermore, a single port access device used at the end colostomy site allows a second senior surgeon assist with an additional two working instruments for the purpose of improved pelvic tissue retraction, especially useful in obese patients. PMID:22644717

  17. 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.

  18. Evaluation of the cholinomimetic actions of trimethylsulfonium, a compound present in the midgut gland of the sea hare Aplysia brasiliana (Gastropoda, Opisthobranchia).

    PubMed

    Kerchove, C M; Markus, R P; Freitas, J C; Costa-Lotufo, L V

    2002-04-01

    Trimethylsulfonium, a compound present in the midgut gland of the sea hare Aplysia brasiliana, negatively modulates vagal response, indicating a probable ability to inhibit cholinergic responses. In the present study, the pharmacological profile of trimethylsulfonium was characterized on muscarinic and nicotinic acetylcholine receptors. In rat jejunum the contractile response induced by trimethylsulfonium (pD2 = 2.46 +/- 0.12 and maximal response = 2.14 +/- 0.32 g) was not antagonized competitively by atropine. The maximal response (Emax) to trimethylsulfonium was diminished in the presence of increasing doses of atropine (P<0.05), suggesting that trimethylsulfonium-induced contraction was not related to muscarinic stimulation, but might be caused by acetylcholine release due to presynaptic stimulation. Trimethylsulfonium displaced [3H]-quinuclidinyl benzilate from rat cortex membranes with a low affinity (Ki = 0.5 mM). Furthermore, it caused contraction of frog rectus abdominis muscles (pD2 = 2.70 +/- 0.06 and Emax = 4.16 +/- 0.9 g), which was competitively antagonized by d-tubocurarine (1, 3 or 10 microM) with a pA2 of 5.79, suggesting a positive interaction with nicotinic receptors. In fact, trimethylsulfonium displaced [3H]-nicotine from rat diaphragm muscle membranes with a Ki of 27.1 microM. These results suggest that trimethylsulfonium acts as an agonist on nicotinic receptors, and thus contracts frog skeletal rectus abdominis muscle and rat jejunum smooth muscle via stimulation of postjunctional and neuronal prejunctional nicotinic cholinoreceptors, respectively. PMID:11960200

  19. 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

  20. 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

  1. Lumbopelvic motor control and low back pain in elite soccer players: a cross-sectional study.

    PubMed

    Grosdent, Stéphanie; Demoulin, Christophe; Rodriguez de La Cruz, Carlos; Giop, Romain; Tomasella, Marco; Crielaard, Jean-Michel; Vanderthommen, Marc

    2016-06-01

    This study aimed to investigate the relationship between the history of low back pain and quality of lumbopelvic motor control in soccer players. Forty-three male elite soccer players (mean age, 18.2 ± 1.4 years) filled in questionnaires related to low back pain and attended a session to assess lumbopelvic motor control by means of five tests (the bent knee fall out test, the knee lift abdominal test, the sitting knee extension test, the waiter's bow and the transversus abdominis test). A physiotherapist, blinded to the medical history of the participants, scored (0 = failed, 1 = correct) the performance of the players for each of the tests resulting in a lumbopelvic motor control score ranging from 0 to 5. Forty-seven per cent of the soccer players reported a disabling low back pain episode lasting at least two consecutive days in the previous year. These players scored worse lumbopelvic motor control than players without a history of low back pain (lumbopelvic motor control score of 1.8 vs. 3.3, P < 0.01). The between-groups difference was particularly marked for the bent knee fall out test, the knee lift abdominal test and the transversus abdominis test (P < 0.01). In conclusion, most soccer players with a history of low back pain had an altered lumbopelvic motor control. Further research should examine whether lumbopelvic motor control is etiologically involved in low back pain episodes in soccer players. PMID:26407007

  2. 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

  3. 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

  4. 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

  5. Balance recovery is compromised and trunk muscle activity is increased in chronic obstructive pulmonary disease.

    PubMed

    Smith, Michelle D; Chang, Angela T; Hodges, Paul W

    2016-01-01

    Increased respiration in chronic obstructive pulmonary disease (COPD) requires greater abdominal muscle activation, which may impact on contribution of the trunk to postural control. This study aimed to determine whether recovery of balance from postural perturbations and trunk muscle activity differs in people with and without COPD before and/or after exercise. Electromyography (EMG) of the obliquus internus (OI) and externus (OE) abdominis, rectus abdominis (RA), erector spinae (ES) and deltoid muscles was recorded with surface electrodes during rapid shoulder flexion and extension. Time taken to regain baseline centre of pressure velocity (vCOP) and the number of postural adjustments following arm movement was calculated from force plate data. Time to recover balance in the direction of postural disturbance (anteroposterior vCOP) was longer in COPD, particularly more severe COPD, than controls. Mediolateral vCOP (perpendicular to the perturbation) and the number of postural adjustments did not differ between groups, but people with more severe COPD were less successful at returning their mediolateral vCOP to baseline. Abdominal muscle EMG was similar between groups, but controls had greater ES EMG during arm movements. Individuals with more severe COPD had greater OE and RA EMG both before and during arm movement compared to those with less severe COPD and controls. Following exercise, OE and ES EMG increased in people with less severe COPD. This study shows that severe COPD is associated with impaired ability to recover balance and greater trunk muscle activity during postural challenges. Augmented trunk muscle activity may limit the contribution of trunk movements to balance recovery and could contribute to increased falls risk. PMID:26471324

  6. Refining the course of the thoracolumbar nerves: a new understanding of the innervation of the anterior abdominal wall.

    PubMed

    Rozen, W M; Tran, T M N; Ashton, M W; Barrington, M J; Ivanusic, J J; Taylor, G I

    2008-05-01

    Previous descriptions of the thoracolumbar spinal nerves innervating the anterior abdominal wall have been inconsistent. With modern surgical and anesthetic techniques that involve or may damage these nerves, an improved understanding of the precise course and variability of this anatomy has become increasingly important. The course of the nerves of the anterior abdominal is described based on a thorough cadaveric study and review of the literature. Twenty human cadaveric hemi-abdominal walls were dissected to map the course of the nerves of the anterior abdominal wall. Dissection included a comprehensive tracing of nerves and their branches from their origins in five specimens. The branching pattern and course of all nerves identified were described. All thoracolumbar nerves that innervate the anterior abdominal wall were found to travel as multiple mixed segmental nerves, which branch and communicate widely within the transversus abdominis plane (TAP). This communication may occur at multiple locations, including large branch communications anterolaterally (intercostal plexus), and in plexuses that run with the deep circumflex iliac artery (DCIA) (TAP plexus) and the deep inferior epigastric artery (DIEA) (rectus sheath plexus). Rectus abdominis muscle is innervated by segments T6-L1, with a constant branch from L1. The umbilicus is always innervated by a branch of T10. As such, identification or damage to individual nerves in the TAP or within rectus sheath is unlikely to involve single segmental nerves. An understanding of this anatomy may contribute to explaining clinical outcomes and preventing complications, following TAP blocks for anesthesia and DIEA perforator flaps for breast reconstruction. PMID:18428988

  7. Trunk Muscle Activation at the Initiation and Braking of Bilateral Shoulder Flexion Movements of Different Amplitudes

    PubMed Central

    Eriksson Crommert, M.; Halvorsen, K.; Ekblom, M. M.

    2015-01-01

    The aim of this study was to investigate if trunk muscle activation patterns during rapid bilateral shoulder flexions are affected by movement amplitude. Eleven healthy males performed shoulder flexion movements starting from a position with arms along sides (0°) to either 45°, 90° or 180°. EMG was measured bilaterally from transversus abdominis (TrA), obliquus internus (OI) with intra-muscular electrodes, and from rectus abdominis (RA), erector spinae (ES) and deltoideus with surface electrodes. 3D kinematics was recorded and inverse dynamics was used to calculate the reactive linear forces and torque about the shoulders and the linear and angular impulses. The sequencing of trunk muscle onsets at the initiation of arm movements was the same across movement amplitudes with ES as the first muscle activated, followed by TrA, RA and OI. All arm movements induced a flexion angular impulse about the shoulders during acceleration that was reversed during deceleration. Increased movement amplitude led to shortened onset latencies of the abdominal muscles and increased level of activation in TrA and ES. The activation magnitude of TrA was similar in acceleration and deceleration where the other muscles were specific to acceleration or deceleration. The findings show that arm movements need to be standardized when used as a method to evaluate trunk muscle activation patterns and that inclusion of the deceleration of the arms in the analysis allow the study of the relationship between trunk muscle activation and direction of perturbing torque during one and the same arm movement. PMID:26562017

  8. Pharmacological study on angusticeps-type toxins from mamba snake venoms.

    PubMed

    Lee, C Y; Tsai, M C; Tsaur, M L; Lin, W W; Carlsson, F H; Joubert, F J

    1985-05-01

    Five angusticeps-type toxins, F7, F8 and C10S2C2 from Dendroaspis angusticeps and C and FS2 from D. polylepis polylepis, were tested for action on the chick biventer cervicis nerve-muscle, the frog rectus abdominis muscle and the mouse phrenic nerve-diaphragm preparations. In the chick muscle, none of these toxins exhibited any stimulatory effect up to 100 micrograms/ml. In the frog muscle, the response to acetylcholine, but not to carbachol, was enhanced dose dependently by F7 and C. No appreciable effect was observed with the other three toxins. In the mouse diaphragm, also only F7 and C augmented responses to indirect stimulation and produced spontaneous fasciculations. On tetanic stimulation, a marked Wedensky inhibition was observed. Their stimulatory effect was abolished by d-tubocurarine. In the presence of d-tubocurarine as well as in the denervated mouse diaphragm, neither toxin increased responses to direct stimulation. In low-calcium (0.6 mM) or high magnesium (4.2 mM) medium, the stimulatory effect of both toxins was markedly attenuated. The resting membrane potential of the mouse diaphragm was not changed. The amplitude and frequency of MEPPs and the quantal content and the half-decay time of EPPs was increased. Both toxins also produced a stimulatory effect on the isolated guinea-pig ileum, which was abolished by atropine. In the rat atrial preparation, both toxins caused negative inotropic and chronotropic effects, which were reversed by atropine. If pretreated with atropine, these effects were completely prevented. Both F7 and C markedly inhibited the cholinesterase activity of the homogenized mouse diaphragm and frog rectus abdominis muscle but not that of the chick biventer cervicis muscle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3158733

  9. Absence of synergy for monosynaptic Group I inputs between abdominal and internal intercostal motoneurons

    PubMed Central

    Ford, T. W.; Meehan, C. F.

    2014-01-01

    Internal intercostal and abdominal motoneurons are strongly coactivated during expiration. We investigated whether that synergy was paralleled by synergistic Group I reflex excitation. Intracellular recordings were made from motoneurons of the internal intercostal nerve of T8 in anesthetized cats, and the specificity of the monosynaptic connections from afferents in each of the two main branches of this nerve was investigated. Motoneurons were shown by antidromic excitation to innervate three muscle groups: external abdominal oblique [EO; innervated by the lateral branch (Lat)], the region of the internal intercostal muscle proximal to the branch point (IIm), and muscles innervated from the distal remainder (Dist). Strong specificity was observed, only 2 of 54 motoneurons showing excitatory postsynaptic potentials (EPSPs) from both Lat and Dist. No EO motoneurons showed an EPSP from Dist, and no IIm motoneurons showed one from Lat. Expiratory Dist motoneurons fell into two groups. Those with Dist EPSPs and none from Lat (group A) were assumed to innervate distal internal intercostal muscle. Those with Lat EPSPs (group B) were assumed to innervate abdominal muscle (transversus abdominis or rectus abdominis). Inspiratory Dist motoneurons (assumed to innervate interchondral muscle) showed Dist EPSPs. Stimulation of dorsal ramus nerves gave EPSPs in 12 instances, 9 being in group B Dist motoneurons. The complete absence of heteronymous monosynaptic Group I reflex excitation between muscles that are synergistically activated in expiration leads us to conclude that such connections from muscle spindle afferents of the thoracic nerves have little role in controlling expiratory movements but, where present, support other motor acts. PMID:24920027

  10. [Simulation of homicide to hide child's suicide].

    PubMed

    Schmidt, P; Driever, F; Madea, B

    2001-01-01

    A case of pretending a homicide to conceal a child suicide is reported in which characteristic findings of the postmortem examination and conclusions from the analysis of forensic autopsy series provided substantial support for the police investigation. In the late night hours of a spring day the police authorities were informed that a 10-year-old girl had been found dead on a playground near its parents' house. As injuries of the neck were recognized by the police officers a homicide investigation was initiated. The post mortem examination showed a furrow symmetrically slanting from the front to the nape of the neck, discrete punctate haemorrhages of the skin of the face and numerous 'tram-line' bruises of the back, buttocks and extremities. These findings indicated as cause and manner of death suicidal hanging following corporal punishment. Confronted with these conclusions the mother immediately made a corresponding confession. PMID:11591060

  11. The KCTD family of proteins: structure, function, disease relevance

    PubMed Central

    2013-01-01

    The family of potassium channel tetramerizationdomain (KCTD) proteins consists of 26 members with mostly unknown functions. The name of the protein family is due to the sequence similarity between the conserved N-terminal region of KCTD proteins and the tetramerization domain in some voltage-gated potassium channels. Dozens of publications suggest that KCTD proteins have roles in various biological processes and diseases. In this review, we summarize the character of Bric-a-brack,Tram-track, Broad complex(BTB) of KCTD proteins, their roles in the ubiquitination pathway, and the roles of KCTD mutants in diseases. Furthermore, we review potential downstream signaling pathways and discuss future studies that should be performed. PMID:24268103

  12. 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.

  13. Reconstruction of late Holocene glacier retreat and relevant climatic and topographic patterns in southeastern Tibet by glacier mapping and equilibrium line altitude calculation

    NASA Astrophysics Data System (ADS)

    Loibl, David; Lehmkuhl, Frank

    2014-05-01

    Temperate glaciers in the eastern Nyainqêntanglha range, southeastern Tibet, are highly sensitive to climate change and are therefore of particular high interest for research on late Holocene changes of the monsoonal climate in High Asia. However, due to the remoteness of the area, the scarcity of empirical data, and the challenges to remote sensing work posed by cloud and snow cover, knowledge about the glacier dynamics and changes is still very limited. We applied a remote sensing approach that allowed a comprehensive regional glacier survey despite the few available data. Geomorphologic characteristics, distribution and late Holocene changes of 1964 glaciers were mapped from one of the few appropriate late summer satellite images: a Landsat ETM+ scene from September 23, 1999. The glacier dataset was subsequently parameterized by DEM supported measurements. Complex climate-relief-glacier interactions were studied in detail for three large glaciers in neighboring valleys. Despite their spatial proximity, these display strong heterogeneity in terms of catchment morphology, debris cover, and glacier characteristics. The results of this case study then provided the conceptual basis to use geomorphological evidence, i.e. trimlines and latero-frontal moraines, to obtain quantitative data on the changes since the Little Ice Age (LIA) maximum glacier advance. Statistical analysis of glacier length change revealed an average retreat of ~ 40 % and a trend towards stronger retreat for smaller glaciers. An evaluation of different methods to calculate equilibrium line altitudes (ELAs) indicates that an optimized toe-to-ridge altitude method (TRAM) outperforms other methods in settings with complex topography and a lack of mass-balance measurements. However, a large number of glacier measurements is crucial for high quality TRAM results and special attention has to be paid to different morphological glacier characteristics: debris-cover, reconstitution, valley floor

  14. 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.

  15. 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.

  16. 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

  17. Breast reconstruction with the fasciocutaneous infragluteal free flap (FCI).

    PubMed

    Papp, Christoph; Windhofer, Christian; Gruber, Sabine

    2007-02-01

    Thin patients who will not accept breast reconstruction with foreign material may not have enough tissue associated with the TRAM or latissimus muscle to achieve an acceptable reconstruction. We feel the next choice is tissue from the infragluteal region raised and moved as a free fasciocutaneous flap (FCI) based on the descending branch of the inferior gluteal artery. This (FCI) has not been described for this to our knowledge. Thirty-five FCI flaps were done for 28 patients between 1998 and 2005 for autologous breast reconstruction, as well as simultaneous augmentation of the contralateral breast in 4 of these patients. There was no flap loss. Complications include seroma, scar pain, and fat necrosis and are reported and discussed. We suggest that the FCI flap be considered as a worthy alternative for autologous breast reconstruction in thin patients. PMID:17245137

  18. Adaptors in toll-like receptor signaling and their potential as therapeutic targets.

    PubMed

    Ve, Thomas; Gay, Nicholas J; Mansell, Ashley; Kobe, Bostjan; Kellie, Stuart

    2012-10-01

    To initiate the innate immune response, Toll-like receptors (TLRs) associate with cytoplasmic adaptor proteins through TIR (Toll/interleukin-1 receptor) domain interactions. The four principal signaling adaptor proteins include MyD88, MAL, TRIF and TRAM, and the fifth protein SARM, involved in negative regulation of TLR pathways, is usually considered a part of the TIR domain-containing adaptor protein group. Other TIR domain-containing proteins have also been shown to regulate these signaling pathways, including ST2 and SIGIRR, as well as several bacterial and viral TIR domain-containing proteins that modulate these pathways as virulence factors. TLR pathways and the adaptor proteins are associated with a number of diseases, including infection, sepsis, inflammatory, allergic and autoimmune diseases and cancer. We review our current understanding of the structure and function of adaptor proteins and their regulatory proteins, their association with disease and their potential as therapeutic targets in human disease. PMID:22664090

  19. 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.

  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. PMID:25415284

  1. The Ca2+-Activated K+ Channel KCa3.1 as a Potential New Target for the Prevention of Allograft Vasculopathy

    PubMed Central

    Chen, Yi-Je; Lam, Jenny; Gregory, Clare R.; Schrepfer, Sonja; Wulff, Heike

    2013-01-01

    Allograft vasculopathy (AV) remains one of the major challenges to the long-term functioning of solid organ transplants. Although its exact pathogenesis remains unclear, AV is characterized by both fibromuscular proliferation and infiltration of CD4+ memory T cells. We here tested whether two experimental immunosuppressants targeting K+ channels might be useful for preventing AV. PAP-1 inhibits the voltage-gated Kv1.3 channel, which is overexpressed on CCR7− memory T cells and we therefore hypothesize that it should suppress the memory T cell component of AV. Based on its previous efficacy in restenosis and kidney fibrosis we expected that the KCa3.1 blocker TRAM-34 would primarily affect smooth muscle and fibroblast proliferation and thus reduce intimal hyperplasia. Using immunohistochemistry we demonstrated the presence of Kv1.3 on infiltrating T cells and of KCa3.1 on lymphocytes as well as on proliferating neointimal smooth muscle cells in human vasculopathy samples and in a rat aorta transplant model developing chronic AV. Treatment of PVG rats receiving orthotopically transplanted aortas from ACI rats with TRAM-34 dose-dependently reduced aortic luminal occlusion, intimal hyperplasia, mononuclear cell infiltration and collagen deposition 120 days after transplantation. The Kv1.3 blocker PAP-1 in contrast did not reduce intima hyperplasia despite drastically reducing plasma IFN-γ levels and inhibiting lymphocyte infiltration. Our findings suggest that KCa3.1 channels play an important role in the pathogenesis of chronic AV and constitute an attractive target for the prevention of arteriopathy. PMID:24312257

  2. 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. PMID:26825543

  3. 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

  4. Aromatase Inhibitor-Associated Bone Fractures: A Case-Cohort GWAS and Functional Genomics

    PubMed Central

    Liu, Mohan; Goss, Paul E.; Ingle, James N.; Kubo, Michiaki; Furukawa, Yoichi; Batzler, Anthony; Jenkins, Gregory D.; Carlson, Erin E.; Nakamura, Yusuke; Schaid, Daniel J.; Chapman, Judy-Anne W.; Shepherd, Lois E.; Ellis, Matthew J.; Khosla, Sundeep; Wang, Liewei

    2014-01-01

    Bone fractures are a major consequence of osteoporosis. There is a direct relationship between serum estrogen concentrations and osteoporosis risk. Aromatase inhibitors (AIs) greatly decrease serum estrogen levels in postmenopausal women, and increased incidence of fractures is a side effect of AI therapy. We performed a discovery case-cohort genome-wide association study (GWAS) using samples from 1071 patients, 231 cases and 840 controls, enrolled in the MA.27 breast cancer AI trial to identify genetic factors involved in AI-related fractures, followed by functional genomic validation. Association analyses identified 20 GWAS single nucleotide polymorphism (SNP) signals with P < 5E-06. After removal of signals in gene deserts and those composed entirely of imputed SNPs, we applied a functional validation “decision cascade” that resulted in validation of the CTSZ-SLMO2-ATP5E, TRAM2-TMEM14A, and MAP4K4 genes. These genes all displayed estradiol (E2)-dependent induction in human fetal osteoblasts transfected with estrogen receptor-α, and their knockdown altered the expression of known osteoporosis-related genes. These same genes also displayed SNP-dependent variation in E2 induction that paralleled the SNP-dependent induction of known osteoporosis genes, such as osteoprotegerin. In summary, our case-cohort GWAS identified SNPs in or near CTSZ-SLMO2-ATP5E, TRAM2-TMEM14A, and MAP4K4 that were associated with risk for bone fracture in estrogen receptor-positive breast cancer patients treated with AIs. These genes displayed E2-dependent induction, their knockdown altered the expression of genes related to osteoporosis, and they displayed SNP genotype-dependent variation in E2 induction. These observations may lead to the identification of novel mechanisms associated with fracture risk in postmenopausal women treated with AIs. PMID:25148458

  5. 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. PMID:27163196

  6. Cyclic AMP-induced K+ secretion occurs independently of Cl- secretion in rat distal colon.

    PubMed

    Sandle, Geoffrey I; Rajendran, Vazhaikkurichi M

    2012-08-01

    cAMP induces both active Cl(-) and active K(+) secretion in mammalian colon. It is generally assumed that a mechanism for K(+) exit is essential to maintain cells in the hyperpolarized state, thus favoring a sustained Cl(-) secretion. Both Kcnn4c and Kcnma1 channels are located in colon, and this study addressed the questions of whether Kcnn4c and/or Kcnma1 channels mediate cAMP-induced K(+) secretion and whether cAMP-induced K(+) secretion provides the driving force for Cl(-) secretion. Forskolin (FSK)-enhanced short-circuit current (indicator of net electrogenic ion transport) and K(+) fluxes were measured simultaneously in colonic mucosa under voltage-clamp conditions. Mucosal Na(+) orthovanadate (P-type ATPase inhibitor) inhibited active K(+) absorption normally present in rat distal colon. In the presence of mucosal Na(+) orthovanadate, serosal FSK induced both K(+) and Cl(-) secretion. FSK-induced K(+) secretion was 1) not inhibited by either mucosal or serosal 1-[(2-chlorophenyl) diphenylmethyl]-1H-pyrazole (TRAM-34; a Kcnn4 channel blocker), 2) inhibited (92%) by mucosal iberiotoxin (Kcnma1 channel blocker), and 3) not affected by mucosal cystic fibrosis transmembrane conductance regulator inhibitor (CFTR(inh)-172). By contrast, FSK-induced Cl(-) secretion was 1) completely inhibited by serosal TRAM-34, 2) not inhibited by either mucosal or serosal iberiotoxin, and 3) completely inhibited by mucosal CFTR(inh)-172. These results indicate that cAMP-induced colonic K(+) secretion is mediated via Kcnma1 channels located in the apical membrane and most likely contributes to stool K(+) losses in secretory diarrhea. On the other hand, cAMP-induced colonic Cl(-) secretion requires the activity of Kcnn4b channels located in the basolateral membrane and is not dependent on the concurrent activation of apical Kcnma1 channels. PMID:22648950

  7. Energy and wear optimisation of train longitudinal dynamics and of traction and braking systems

    NASA Astrophysics Data System (ADS)

    Conti, R.; Galardi, E.; Meli, E.; Nocciolini, D.; Pugi, L.; Rindi, A.

    2015-05-01

    Traction and braking systems deeply affect longitudinal train dynamics, especially when an extensive blending phase among different pneumatic, electric and magnetic devices is required. The energy and wear optimisation of longitudinal vehicle dynamics has a crucial economic impact and involves several engineering problems such as wear of braking friction components, energy efficiency, thermal load on components, level of safety under degraded or adhesion conditions (often constrained by the current regulation in force on signalling or other safety-related subsystem). In fact, the application of energy storage systems can lead to an efficiency improvement of at least 10% while, as regards the wear reduction, the improvement due to distributed traction systems and to optimised traction devices can be quantified in about 50%. In this work, an innovative integrated procedure is proposed by the authors to optimise longitudinal train dynamics and traction and braking manoeuvres in terms of both energy and wear. The new approach has been applied to existing test cases and validated with experimental data provided by Breda and, for some components and their homologation process, the results of experimental activities derive from cooperation performed with relevant industrial partners such as Trenitalia and Italcertifer. In particular, simulation results are referred to the simulation tests performed on a high-speed train (Ansaldo Breda Emu V250) and on a tram (Ansaldo Breda Sirio Tram). The proposed approach is based on a modular simulation platform in which the sub-models corresponding to different subsystems can be easily customised, depending on the considered application, on the availability of technical data and on the homologation process of different components.

  8. Plasmid R1 Conjugative DNA Processing Is Regulated at the Coupling Protein Interface▿

    PubMed Central

    Mihajlovic, Sanja; Lang, Silvia; Sut, Marta V.; Strohmaier, Heimo; Gruber, Christian J.; Koraimann, Günther; Cabezón, Elena; Moncalián, Gabriel; de la Cruz, Fernando; Zechner, Ellen L.

    2009-01-01

    Selective substrate uptake controls initiation of macromolecular secretion by type IV secretion systems in gram-negative bacteria. Type IV coupling proteins (T4CPs) are essential, but the molecular mechanisms governing substrate entry to the translocation pathway remain obscure. We report a biochemical approach to reconstitute a regulatory interface between the plasmid R1 T4CP and the nucleoprotein relaxosome dedicated to the initiation stage of plasmid DNA processing and substrate presentation. The predicted cytosolic domain of T4CP TraD was purified in a predominantly monomeric form, and potential regulatory effects of this protein on catalytic activities exhibited by the relaxosome during transfer initiation were analyzed in vitro. TraDΔN130 stimulated the TraI DNA transesterase activity apparently via interactions on both the protein and the DNA levels. TraM, a protein interaction partner of TraD, also increased DNA transesterase activity in vitro. The mechanism may involve altered DNA conformation as TraM induced underwinding of oriT plasmid DNA in vivo (ΔLk = −4). Permanganate mapping of the positions of duplex melting due to relaxosome assembly with TraDΔN130 on supercoiled DNA in vitro confirmed localized unwinding at nic but ruled out formation of an open complex compatible with initiation of the TraI helicase activity. These data link relaxosome regulation to the T4CP and support the model that a committed step in the initiation of DNA export requires activation of TraI helicase loading or catalysis. PMID:19767437

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

    PubMed Central

    Almassy, Janos; Won, Jong Hak; Begenisich, Ted B.

    2012-01-01

    Ca2+ 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 [Ca2+] was used to investigate if Ca2+-activated K channels are present in the apical PM of parotid acinar cells. Initial experiments established Ca2+-buffering conditions that produced brief, localized increases in [Ca2+] after focal laser photolysis of caged Ca2+. 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 [Ca2+] at the apical PM after photolysis of Diazo-2, a caged Ca2+ 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 [Ca2+] 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. PMID:22291145

  10. 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

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

    PubMed Central

    Basalingappa, Kanthesh M.; Wonderlin, William F.

    2011-01-01

    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, Ca2+-dependent K+ channels observed with iberiotoxin (a Kcnma1/large-conductance, Ca2+-activated K+ channel blocker) and apamin (a Kcnn1–3/small-conductance, Ca2+-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 IC50 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. PMID:21868633

  12. KCa3.1 inhibition switches the phenotype of glioma-infiltrating microglia/macrophages

    PubMed Central

    Grimaldi, A; D'Alessandro, G; Golia, M T; Grössinger, E M; Di Angelantonio, S; Ragozzino, D; Santoro, A; Esposito, V; Wulff, H; Catalano, M; Limatola, C

    2016-01-01

    Among the strategies adopted by glioma to successfully invade the brain parenchyma is turning the infiltrating microglia/macrophages (M/MΦ) into allies, by shifting them toward an anti-inflammatory, pro-tumor phenotype. Both glioma and infiltrating M/MΦ cells express the Ca2+-activated K+ channel (KCa3.1), and the inhibition of KCa3.1 activity on glioma cells reduces tumor infiltration in the healthy brain parenchyma. We wondered whether KCa3.1 inhibition could prevent the acquisition of a pro-tumor phenotype by M/MΦ cells, thus contributing to reduce glioma development. With this aim, we studied microglia cultured in glioma-conditioned medium or treated with IL-4, as well as M/MΦ cells acutely isolated from glioma-bearing mice and from human glioma biopsies. Under these different conditions, M/MΦ were always polarized toward an anti-inflammatory state, and preventing KCa3.1 activation by 1-[(2-Chlorophenyl)diphenylmethyl]-1H-pyrazole (TRAM-34), we observed a switch toward a pro-inflammatory, antitumor phenotype. We identified FAK and PI3K/AKT as the molecular mechanisms involved in this phenotype switch, activated in sequence after KCa3.1. Anti-inflammatory M/MΦ have higher expression levels of KCa3.1 mRNA (kcnn4) that are reduced by KCa3.1 inhibition. In line with these findings, TRAM-34 treatment, in vivo, significantly reduced the size of tumors in glioma-bearing mice. Our data indicate that KCa3.1 channels are involved in the inhibitory effects exerted by the glioma microenvironment on infiltrating M/MΦ, suggesting a possible role as therapeutic targets in glioma. PMID:27054329

  13. Blockade of KCa3.1 potassium channels protects against cisplatin-induced acute kidney injury.

    PubMed

    Chen, Cheng-Lung; Liao, Jiunn-Wang; Hu, Oliver Yoa-Pu; Pao, Li-Heng

    2016-09-01

    Tubular cell apoptosis significantly contributes to cisplatin-induced acute kidney injury (AKI) pathogenesis. Although KCa3.1, a calcium-activated potassium channel, participates in apoptosis, its involvement in cisplatin-induced AKI is unknown. Here, we found that cisplatin treatment triggered an early induction of KCa3.1 expression associated with HK-2 cell apoptosis, the development of renal tubular damage, and apoptosis in mice. Treatment with the highly selective KCa3.1 blocker TRAM-34 suppressed cisplatin-induced HK-2 cell apoptosis. We further assessed whether KCa3.1 mediated cisplatin-induced AKI in genetic knockout and pharmacological blockade mouse models. KCa3.1 deficiency reduced renal function loss, renal tubular damage, and the induction of the apoptotic marker caspase-3 in the kidneys of cisplatin-treated KCa3.1 (-/-) mice. Pharmacological blockade of KCa3.1 by TRAM-34 similarly attenuated cisplatin-induced AKI in mice. Furthermore, we dissected the mechanisms underlying cisplatin-induced apoptosis reduction via KCa3.1 blockade. We found that KCa3.1 blockade attenuated cytochrome c release and the increase in the intrinsic apoptotic mediators Bax, Bak, and caspase-9 after cisplatin treatment. KCa3.1 blocking inhibited the cisplatin-induced activation of the endoplasmic reticulum (ER) stress mediator caspase-12, which is independent of calcium-dependent protease m-calpain activation. Taken together, KCa3.1 blockade protects against cisplatin-induced AKI through the attenuation of apoptosis by interference with intrinsic apoptotic and ER stress-related mediators, providing a potential target for the prevention of cisplatin-induced AKI. PMID:26438401

  14. 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.

  15. Reconstructive cranioplasty using a porcine small intestinal submucosal graft.

    PubMed

    Sheahan, D E; Gillian, T D

    2008-05-01

    A six-year-old border collie was presented with a solid mass on the dorsal cranium. Histological examination showed the mass to be a multilobular tumour of bone. A magnetic resonance imaging scan confirmed deformation of the dorsal cranium with compression of the cerebral hemispheres. A craniotomy was performed to excise the mass and overlying skin, resulting in a substantial deficit of calvarium and skin. A cranioplasty using a small intestinal submucosal (SIS) graft was performed to reconstruct the calvarial defect. A local myocutaneous advancement flap was elevated and positioned over the cranioplasty to close the skin deficit. The outcome of this reconstruction was aesthetic and functional. The small intestinal submucosal graft provided satisfactory mechanical support and was a suitable physical barrier in place of the calvarial bone. Histological examination of the small intestinal submucosal graft 128 days after implantation showed that the graft had been replaced by a dense network of collagenous tissue, with small focal areas of partially mineralised woven bone merging with a fibrocartilaginous matrix of the deeper margin. Histological examination also confirmed regrowth of the multilobular tumour of bone in the region of the small intestinal submucosal graft indicating that it is only a suitable implant if adequate surgical margins are obtained. PMID:18373537

  16. [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

  17. Keyhole Flap Nipple Reconstruction

    PubMed Central

    Cash, Camille G.; Iman, Al-Haj; Spiegel, Aldona J.; Cronin, Ernest D.

    2016-01-01

    Summary: 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.

  18. Coverage of Amputation Stumps Using a Latissimus Dorsi Flap With a Serratus Anterior Muscle Flap: A Comparative Study.

    PubMed

    Kim, Sang Wha; Jeon, Seung Bae; Hwang, Kyu Tae; Kim, Youn Hwan

    2016-01-01

    Amputation of the extremities is a definitive reconstructive option, and surgeons should aim to preserve maximum overall function. If the exposed bone cannot be adequately covered using local tissues, the stump can be reconstructed using a number of well-described free flap transfer techniques. Between January 2002 and December 2011, 31 patients with severe injuries to the lower extremities underwent above-the-knee, below-the-knee, and Chopart and Ray amputations. Bony stumps were covered using latissimus dorsi myocutaneous flaps alone (group 1), or together with serratus anterior muscle flaps (group 2). The groups were compared with respect to age, flap survival, skin flap size, immediate complications, wound sloughing, deep ulceration, need for bone amputation, limb visual analog scale score, time to prosthesis, and follow-up duration. The mean area of the latissimus dorsi skin flap was 255.9 cm, and immediate complications occurred in 8 (25.8%) patients. In the double-padding group, there were fewer cases of deep ulceration than in the single-flap group, and prostheses could be worn sooner. There were no statistically significant differences in other parameters. Successful reconstruction of amputation stumps requires an adequate, durable, weight-bearing, and well-contoured soft tissue cover. A latissimus dorsi musculocutaneous flap together with a serratus anterior muscle flap provides well-vascularized muscle tissue and a durable skin paddle, leading to less ulceration than conventional flap techniques. PMID:25003415

  19. 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.

  20. A new surgical strategy for breast conservation in locally advanced breast cancer that achieves a good locoregional control rate: preliminary report.

    PubMed

    Moneer, M; Ismael, S; Khaled, H; El-Gantery, M; Zaghloul, M S; El-Didi, M

    2001-06-01

    The scope of breast conserving surgery has recently expanded to include locally advanced breast cancer (LABC) patients who are downstaged following neoadjuvant chemotherapy (NACT). However, the efficacy of this approach in achieving adequate locoregional control of disease is in doubt. Some reports have attributed the failure to the association of NACT-induced tumour downstaging which can leave multifocal in situ and invasive lesions around the main tumour mass. In the present study, in order to eradicate all possible tumour satellites, a very wide local excision that included the whole original tumour-bearing area was performed regardless of the expected wide defect. This defect was then immediately reconstructed by an ipsilateral pedicled latissimus dorsi myocutaneous (LDM) flap. The study included 26 patients with LABC without evidence of primary tumour-multicentricity. Tumours were downstaged following NACT. The early cosmetic outcome was good in the majority of cases. Early complications were minimal. Twenty-two patients had a mean follow up period of 30.2 (range 7-50) months. In those evaluable cases, locoregional control of the disease was excellent (100%) but distant metastases occurred in seven cases (31.8%). PMID:14965588