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Sample records for abductor pollicis longus

  1. Structure and function of the abductor pollicis longus muscle.

    PubMed Central

    van Oudenaarde, E

    1991-01-01

    The abductor pollicis longus muscle was examined in dissections and histologically to study the insertions around the CMC I joint. The APL consists fundamentally of a superficial and a deep division, both terminating in one or more tendons. The deep division is proximally situated, it is covered by the extensor digitorum muscle and consists of several muscle bellies; it terminates in a central tendon. The fibres are short, obliquely attached to the tendon in a pennate manner and close together. After the passage through the extensor retinaculum the tendon separates into many branches. The superficial division is more distally situated, not covered by other muscles, lying superficial to the tendon of the deep part. The fibres are long, parallel to one another and form a thin layer. The tendon passes, together with the deep division, through the same compartment of the extensor retinaculum and inserts into MC I. If the muscle contracts, then the structures around the CMC I joint will be tensed by the deep division and MC I will be affected by the superficial division. It is to be expected that in the appropriate thumb movements the superficial part will show an isotonic contraction and the deep part, an isometric action. The superficial part, with long thin fibres, presumably has the least strength while the deep part, with its larger number of fibres, is the most powerful. The functional analysis gives the impression that the deep head will mainly support the trapezium as a platform upon which MC I moves. The superficial head will be active in moving MC I. Images Fig. 2 Fig. 3 Fig. 4 Fig. 5 PMID:2032936

  2. Variations in abductor pollicis longus and extensor pollicis brevis tendons in the Quervain syndrome: a surgical and anatomical study.

    PubMed

    Kulthanan, Teerawat; Chareonwat, Boonsong

    2007-01-01

    Eighty-two wrists of Thai cadavers and the wrists of 66 patients with de Quervain syndrome were studied, and the variation in the number of tendons and the fibro-osseous tunnel in the first extensor compartment were recorded. The abductor pollicis longus had more than one tendon in 73 of the cadavers (89%) and in 32 of the patients (49%) (p <0.001). The extensor pollicis brevis was a single tendon in 80 (98%) and 62 (94%) of cadavers and patients, respectively. There was division with the septum that made a fibro-osseous tunnel in the first extensor compartment in 30/82 (37%) cadavers and in 38/66 (58%) patients with de Quervain syndrome (p = 0.01). The results indicate that the number of fibro-osseous tunnels and multiple compartments in the first extensor compartment may be associated with a predisposition to de Quervain syndrome. PMID:17484184

  3. Anatomical variation of abductor pollicis longus in Indian population: A cadaveric study

    PubMed Central

    Tewari, Jerina; Mishra, Pravash Ranjan; Tripathy, Sujit Kumar

    2015-01-01

    Background: Many authors have reported the anatomical variation of abductor pollicis longus (APL) around the wrist and its association with de Quervain tenosynovitis (DQT), first carpo-metacarpal arthritis, and trapezio-metacarpal subluxation. From Indian subcontinent, there is only one original article and a few case reports on the variability of APL tendon insertion. Materials and Methods: Fifty formaldehyde preserved cadaveric wrists were dissected to look for the anatomical variation of APL in the Indian population. Results: The APL was found with single tendon in 2, double in 31, triple in 8, and quadruple in 8 extremities. A maximum of 6 tendon-slips were found in one cadaveric wrist. In all hands, the APL had at least one attachment to first metacarpal bone and in 46 hands (92%), there was second insertion to the trapezium bone. Of all tendon-slips of APL (n = 126), 44% of tendons (68 tendons) were inserted into the base of the first metacarpal bone. This was followed by the insertion into the trapezium in 42% tendons (52 tendons). Conclusion: Bi-tendinous APL is commonly observed on the dorsal compartment of the wrist in Indian population and these tendon-slips are commonly attached to the first metacarpal base and trapezium. This variation must be understood by the Indian Orthopedic surgeons as the response to treatment of DQT and reason for first carpo-metacarpal arthritis can be dependent on this anatomical variation. PMID:26538762

  4. Results of Abductor Pollicis Longus Suspension Ligamentoplasty for Treatment of Advanced First Carpometacarpal Arthritis

    PubMed Central

    Lee, Hyun-Joo; Kim, Poong-Taek; Deslivia, Maria Florencia; Lee, Suk-Joong; Nam, Sang-Jin

    2015-01-01

    Background Suspension ligamentoplasty using abductor pollicis longus (APL) tendon without bone tunneling, was introduced as one of the techniques for treatment of advanced first carpometacarpal (CMC) arthritis. The purpose of this study was to evaluate the radiologic and clinical results of APL suspension ligamentoplasty. Methods The medical records of 19 patients who underwent APL suspension ligamentoplasty for advanced first CMC arthritis between January 2008 and May 2012 were reviewed retrospectively. The study included 13 female and 6 male patients, whose mean age was 62 years (range, 43 to 82 years). For clinical evaluation, we assessed the grip and pinch power, radial and volar abduction angle, thumb adduction (modified Kapandji index), including visual analogue scale (VAS) and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Radiologic evaluation was performed using simple radiographs. Results The mean follow-up was 36 months (range, 19 to 73.7 months). Mean power improved from 18.3 to 27 kg for grip power, from 2.8 to 3.5 kg for tip pinch, and from 4.3 to 5.4 kg for power pinch. All patients showed decreased VAS from 7.2 to 1.7. Radial abduction improved from 71° preoperatively to 82° postoperatively. The modified Kapandji index showed improvement from 6 to 7.3, and mean DASH was improved from 41 to 17.8. The height of the space decreased from 10.8 to 7.1 mm. Only one case had a complication involving temporary sensory loss of the first dorsal web space, which resolved spontaneously. Conclusions The APL suspension ligamentoplasty for treatment of advanced first CMC arthritis yielded satisfactory functional results. PMID:26330961

  5. Rerouting extensor pollicis longus tendon transfer.

    PubMed

    Colantoni Woodside, Julie; Bindra, Randip R

    2015-04-01

    Following radial nerve palsy, loss of the extensor pollicis longus (EPL), abductor pollicis longus and extensor pollicis brevis tendons results in loss of thumb extension and radial abduction. Multiple tendon transfers are described to address the loss of thumb extension following radial palsy utilizing the palmaris longus or flexor digitorum sublimis transferred to the EPL tendon. Owing to its ulnar vector of pull, the EPL tendon is a secondary adductor of the thumb, and in order to mitigate the tendency for thumb adduction, the EPL tendon is divided at the wrist and brought subcutaneously to the radial side of the wrist for repair to the donor tendon to improve the line of pull for the donor tendon. We describe the use of a technique to reroute the EPL tendon through the first compartment in a retrograde fashion prior to repair with the donor tendon on the radial side of the wrist. The use of the first dorsal compartment provides a pulley to maintain the position of the transfer and to prevent potential bowstringing of the tendon as wrist flexion and thumb extension are attempted. because the repair is performed proximal to the extensor retinaculum, the donor tendon length is not compromised. Because the tendon is redirected through the first dorsal compartment and inserts into the distal phalanx, a single transfer attempts to restores both thumb extension and radial abduction. PMID:25746145

  6. Late rupture of extensor pollicis longus after wrist arthroscopy.

    PubMed

    Fortems, Y; Mawhinney, I; Lawrence, T; Trial, I A; Stanley, J K

    1995-06-01

    The first cases of impending rupture of the extensor pollicis longus after wrist arthroscopy are reported and the etiology is compared with extensor pollicis longus ruptures after nondisplaced or minimally displaced Colles fractures. Both cases were treated with extensor indices proprius to extensor pollicis longus transfer with good clinical results. PMID:7632309

  7. Adductor Pollicis Longus Strain in a Professional Baseball Player

    PubMed Central

    Pinkowsky, Gregory J.; Roberts, John; Allred, Jeff; Pujalte, George G.; Gallo, Robert A.

    2013-01-01

    Thenar pain can represent a significant morbidity for a baseball player who relies on manual dexterity for gripping a bat and precise and accurate throws. While osseous, ligamentous, and neurovascular pathologies are commonly considered, musculotendinous injuries are often neglected in the differential diagnosis of thenar pain. We present a case of adductor pollicis longus strain as a cause of acute thenar pain in a baseball player. Adductor pollicis longus strains should be considered in any baseball player sustaining a hyperabduction force to the thumb. PMID:24459545

  8. Anomalous bilateral contribution of extensor pollicis longus and muscle fusion of the first compartment of the wrist

    PubMed Central

    Rosa, Rodrigo César; de Oliveira, Kennedy Martinez; Léo, Jorge Alfredo; Elias, Bruno Adriano Borges; dos Santos, Paulo Ricardo; de Santiago, Hildemberg Agostinho Rocha

    2016-01-01

    Knowledge of the anatomical variations of the muscles of the first dorsal compartments of the wrist is clinically relevant to De Quervain's tenosynovitis and to reconstructive surgeries. In the literature, there are many reports of the presence of multiple insertion tendons in the first dorsal compartment of the wrist, but few reports describe occurrences of fusion and muscle contributions. This case report describes an anomalous bilateral contribution of the extensor pollicis longus. This anomalous contribution was found through a slender auxiliary tendon that crossed laterally under the extensor retinaculum, entered the first dorsal compartment of the wrist and merged with the tendon of the extensor pollicis brevis muscle. In the same cadaver in which this contribution was present, there was atypical muscle fusion of the abductor pollicis longus muscle and extensor pollicis brevis muscle. In conclusion, anomalous bilateral contribution of the extensor pollicis longus muscle and atypical muscle fusion, concomitant with a variant insertion pattern, are the highlight of this case report. Furthermore, it is concluded that additional tendons may be effectively used in reconstructive surgeries, but that there is a need for knowledge of the possible numerical and positional variations of these tendons, with a view to making more effective surgical plans. PMID:27069895

  9. Anomalous course of the extensor pollicis longus: clinical relevance.

    PubMed

    Rubin, Guy; Wolovelsky, Alejandro; Rinott, Micha; Rozen, Nimrod

    2011-11-01

    The extensor pollicis longus (EPL) is a consistent structure with rare anomalies, the most common being a group of different tendon duplications passing through the fourth compartment without symptoms. The second form comprises anomalies in the course of the EPL having significant clinical importance due to the predisposition for creating tenosynovitis of the EPL mimicking other types of tendon tenosynovitis. Clinical symptoms of radial dorsal wrist pain mimicking intersection syndrome or de-Quervain disease with the "absent snuff box" sign should raise suspicions for an anomaly in the course of the EPL. PMID:21407056

  10. Extensor Pollicis Longus Rupture after Mini TightRope Suspensionplasty.

    PubMed

    Seetharaman, Mani; Vitale, Mark A; Desai, Kapil; Crowe, John F

    2016-05-01

    Background Arthritis of the first carpometacarpal (CMC) joint has been surgically treated in multiple ways with varying levels of success as measured by subjective and objective measures. Trapeziectomy with numerous variations in suspensionplasty comprises one of the more commonly used surgical procedures. Recently, the Mini TightRope apparatus has been utilized as a new method for achieving suspensionplasty, and as such lacks significant review of use and safety in the literature. Case Description An extensor pollicis longus (EPL) rupture following a trapeziectomy and Mini TightRope suspensionplasty for CMC arthritis of the thumb is presented. The patient successfully underwent an extensor indicis proprius (EIP) to EPL transfer to treat this complication. Literature Review There is well-established documentation of injury to the extensor tendons from orthopedic hardware such as volar locking plates. Regarding use of the Mini TightRope apparatus, guidelines for placement of the suture button include caution to place the button away from the EPL tendon to minimize the chance of tendon irritation. Additionally, FiberWire sutures, a component of the apparatus, have been shown to demonstrate soft tissue reactions with adjacent inflammatory response. Published reports on adverse events utilizing this device have been limited to case reports including an index metacarpal fracture. Clinical Relevance The aim of this case report was to cite an occurrence of EPL rupture following its use and discuss the possibilities of its direct contribution. PMID:27104081

  11. Rupture of a flexor pollicis longus tendon in Scheie's syndrome. Case report.

    PubMed

    Weiss, G G; Ritt, M J; Bos, K E

    1997-09-01

    We describe a case of Scheie's syndrome with a closed rupture of the flexor pollicis longus tendon, probably caused by a combination of extrinsic and intrinsic tendon changes. Early detection of carpal tunnel syndrome in all patients who have some form of mucopolysaccharidosis in which this is a universal occurrence (such as Scheie's syndrome), is recommended. Release of the carpal tunnel prevents long term complications, as described in this case report. PMID:9299691

  12. System identification of evoked mechanomyogram from abductor pollicis brevis muscle in isometric contraction.

    PubMed

    Uchiyama, Takanori; Sakai, Hiroaki

    2013-12-01

    The purpose of this study is to verify the applicability of a sixth-order model to the mechanomyogram (MMG) system of the parallel-fibered muscle, which was identified from the MMG of the pennation muscle. The median nerve was stimulated, and an MMG and torque of the abductor pollicis brevis muscle were measured. The MMGs were detected with either a capacitor microphone or an acceleration sensor. The transfer functions between stimulation and the MMG and between stimulation and torque were identified by the singular value decomposition method. The torque and the MMG, which were detected with a capacitor microphone, DMMG, were approximated with a second- and a third-order model, respectively. The natural frequency of the torque, reflecting longitudinal mechanical characteristics, did not show a significant difference from that of the DMMG. The MMG detected with an acceleration sensor was approximated with a fourth-order model. The natural frequencies of the AMMG reflecting the muscle and subcutaneous tissue in the transverse direction were obtained. Both DMMG and AMMG have to be measured to investigate the model of the MMG system for parallel-fibered muscle. The MMG system of parallel-fibered muscle was also modeled with a sixth-order model. PMID:23934080

  13. Extensor pollicis brevis tendon can hyperextend thumb interphalangeal joint in absence of extensor pollicis longus: Case report and review of the literature.

    PubMed

    Strauch, Robert J; Strauch, Carolyn B

    2016-07-18

    We are reporting a case of extensor pollicis longus tendon rupture which did not require tendon transfer owing to the ability of the intact extensor pollicis brevis (EPB) to fully hyperextend the thumb interphalangeal joint. The thumb metacarpophalangeal joint was also able to be fully actively extended by the EPB. Previous anatomical studies have demonstrated that the insertional anatomy of the EPB tendon is highly variable and sometimes inserts onto the extensor hood and distal phalanx, which is likely the mechanism by which our patient was able to fully extend the thumb interphalangeal joint. Despite the potential for the EPB to extend the IP joint of the thumb, virtually all previously reported cases of extensor pollicis longus (EPL) tendon rupture had deficits of thumb IP extension requiring tendon transfer. This case highlights the potential ability of the EPB tendon to completely substitute for the function of the EPL tendon in providing thumb IP joint extension. PMID:27458556

  14. Extensor pollicis brevis tendon can hyperextend thumb interphalangeal joint in absence of extensor pollicis longus: Case report and review of the literature

    PubMed Central

    Strauch, Robert J; Strauch, Carolyn B

    2016-01-01

    We are reporting a case of extensor pollicis longus tendon rupture which did not require tendon transfer owing to the ability of the intact extensor pollicis brevis (EPB) to fully hyperextend the thumb interphalangeal joint. The thumb metacarpophalangeal joint was also able to be fully actively extended by the EPB. Previous anatomical studies have demonstrated that the insertional anatomy of the EPB tendon is highly variable and sometimes inserts onto the extensor hood and distal phalanx, which is likely the mechanism by which our patient was able to fully extend the thumb interphalangeal joint. Despite the potential for the EPB to extend the IP joint of the thumb, virtually all previously reported cases of extensor pollicis longus (EPL) tendon rupture had deficits of thumb IP extension requiring tendon transfer. This case highlights the potential ability of the EPB tendon to completely substitute for the function of the EPL tendon in providing thumb IP joint extension. PMID:27458556

  15. Acute calcific tendinitis of the flexor pollicis longus in an 8-year-old boy.

    PubMed

    Kheterpal, Arvin; Zoga, Adam; McClure, Kristen

    2014-10-01

    Calcific tendinitis is a common source of musculoskeletal pain in adults; however, it is rarely encountered in children. Calcific tendinitis is the most commonly encountered manifestation of hydroxyapatite deposition disease, in which calcium hydroxyapatite crystal deposition occurs in tendons. It may cause acute or chronic pain, or may be entirely asymptomatic. We describe a case of acute calcific tendinitis of the flexor pollicis longus tendon in an 8-year-old boy, who initially presented to our department for workup of a mass felt along the volar aspect of the right wrist. PMID:24867130

  16. Variant course of extensor pollicis longus tendon in the second wrist extensor compartment.

    PubMed

    Kim, Young Jun; Lee, Jae Hoon; Baek, Jong Hun

    2016-05-01

    Among the muscles involved in thumb movement, the extensor pollicis longus (EPL) tendon of the hand is considered the most consistent structure with the least variation among individuals. There have been a few reports regarding different types of supernumerary tendons; however, an abnormal course of the EPL tendon is extremely rare. We describe a case of a variant course of a single EPL tendon appearing in the second extensor compartment of the wrist. This case was observed incidentally during wrist surgery, and demonstrates a unique variation of tendon course, which has not been reported previously. The knowledge of this anatomic variation is helpful in surgical planning and for making accurate diagnoses. PMID:26253859

  17. Closed traumatic rupture of the flexor pollicis longus tendon in zone T I: a case report.

    PubMed

    Uekubo, Kazuaki; Itoh, Soichiro; Yoshioka, Taro

    2015-01-01

    A healthy 41-year-old male suffered a direct blow on the palmar side of his right thumb when folding a table, which slipped along his thumb until it was stopped at the inter-phalangeal (IP) joint, resulting in a complete rupture of the flexor pollicis longus (FPL) tendon in zone T I. The proximal tendon stump was passed through the oblique pulley, fixed to the base of the distal phalanx with a pull-out wire technique and augmented on it using a part of the distal tendon remnant. After removal of the cast and the pull-out wire three weeks postoperatively, range of motion exercise was initiated and good functional recovery was obtained. PMID:25609290

  18. A New Rerouting Technique for the Extensor Pollicis Longus in Palliative Treatment for Wrist and Finger Extension Paralysis Resulting From Radial Nerve and C5C6C7 Root Injury.

    PubMed

    Laravine, Jennifer; Cambon-Binder, Adeline; Belkheyar, Zoubir

    2016-03-01

    Wrist and finger extension paralysis is a consequence of an injury to the radial nerve or the C5C6C7 roots. Despite these 2 different levels of lesions, palliative treatment for this type of paralysis depends on the same tendon transfers. A large majority of the patients are able to compensate for a deficiency of the extension of the wrist and fingers. However, a deficiency in the opening of the first web space, which could be responsible for transfers to the abductor pollicis longus, the extensor pollicis brevis, and the extensor pollicis longus (EPL), frequently exists. The aim of this work was to evaluate the feasibility of a new EPL rerouting technique outside of Lister's tubercle. Another aim was to verify whether this technique allows a better opening of the thumb-index pinch in this type of paralysis. In the first part, we performed an anatomic study comparing the EPL rerouting technique and the frequently used technique for wrist and finger extension paralyses. In the second part, we present 2 clinical cases in which this new technique will be practiced. Preliminary results during this study favor the EPL rerouting technique. This is a simple and reproducible technique that allows for good opening of the first web space in the treatment of wrist and finger extension paralysis. PMID:26709570

  19. Cerebral Palsy Tendon Transfers: Flexor Carpi Ulnaris to Extensor Carpi Radialis Brevis and Extensor Pollicis Longus Reroutement.

    PubMed

    Bansal, Anchal; Wall, Lindley B; Goldfarb, Charles A

    2016-08-01

    The flexor carpi ulnaris to extensor carpi radialis brevis transfer and extensor pollicis longus rerouting combined with thenar release are 2 successful surgical interventions for children with spastic cerebral palsy. The goal of both procedures is to improve quality of life for patients who have previously failed conservative management, and the degree of expected improvement is predicated on several patient variables, making careful patient selection crucial for ensuring successful outcomes. Here, surgical technique is described; risk factors are discussed, and outcomes related to both procedures are presented. PMID:27387086

  20. A New Method to Control Tendon Tension in the Transfer of Extensor Indicis Proprius to Extensor Pollicis Longus Rupture.

    PubMed

    Lee, Jae Hoon; Cho, Young Joo; Chung, Duke Whan

    2015-12-01

    This study evaluated the outcomes of extensor indicis proprius (EIP) transfer based on varying degrees of thumb extension after EIP transfer and elongation of the EIP. A total of 24 cases with extensor pollicis longus (EPL) ruptures who underwent EIP to EPL transfer were analyzed prospectively. The EIP transfer was performed with neutral wrist positioning. In group I (12 cases), EIP and EPL were sutured on the thumb in neutral state at interphalangeal joint, and the mean EIP elongation of this group measured 0.2 cm (range, -0.5 to 0.5 cm). In group II (12 cases), EIP and EPL were sutured on the thumb in full extension state at interphalangeal joint, and the mean EIP elongation measured 0.7 cm (range, 0.5-1.5 cm). The mean follow-up period was 13.5 months. The 2 groups were compared based on thumb motion, grip strength, pinch power, and the Disabilities of the Arm, Shoulder, and Hand questionnaire score. Extension of the thumb at the interphalangeal joint was -5.2° in group I and 7.2° in group II, demonstrating statistically significant differences. No significant differences were found between the 2 groups in other parameters. In EIP transfer, thumb in extension after transfer and EIP elongation is recommended for restoring thumb extension at the interphalangeal joint. PMID:26418770

  1. Lesion of the hip abductor mechanism

    PubMed Central

    Caviglia, Horacio; Cambiaggi, Guillermo; Vattani, Nosrat; Landro, María Eulalia; Galatro, Gustavo

    2016-01-01

    Introduction: The disruption of the abductor muscles of the hip after hip revision surgery often causes limping, pain, and instability of the implant. The purpose of our paper is to describe a mesh technique to repair hip abductor mechanism injuries after hip revision. Patients and methods: Forty-six patients with hip abductor damage after prosthetic revision were treated. Inclusion criteria were: patients presenting with prosthetic loosening, complaint of pain, and with a positive Trendelenburg sign due to deficient abductor muscle mechanisms. Thirty-one were women (67.39%) with an average age of 64 years (34–82 years). The number of previous revision surgeries was three (two to seven). The Merle d’Aubigné score and variants before and after treatment were also reported. Results: In the postoperative follow-up after hip revision with the mesh technique, the Merle d’Aubigné score improved and the Trendelenburg sign was negative in 78.3% of the patients (p < 0.001). Also, the Trendelenburg test with the knee flexed was negative in 60.9% (p < 0.001) and the stair-climbing test was negative in 60.9% of cases (p < 0.001). The gluteus medius test in the lateral position was negative in 52.2% of patients, and in the lateral position with the knee flexed it was negative in 47.8% of patients (p < 0.001). Discussion: Repair of the abductor mechanism with the mesh technique has proven effective for both partial and total lesions. PMID:27382925

  2. Positioning Techniques to Reduce the Occurrence of DeQuervain's Tendonitis in Nursing Mothers

    ERIC Educational Resources Information Center

    Virzi, Alison

    2010-01-01

    DeQuervain's tendonitis is an inflammation of two tendons: the extensor pollicis brevis and the abductor pollicis longus as they cross in the first dorsal compartment of the wrist. Symptoms include pain, swelling along the radial aspect of the wrist, and a decrease in thumb motion. A positive Finkelstein's test at examination is seen. Frequently…

  3. A retinacular sling for subluxing tendons of the first extensor compartment. A case report.

    PubMed

    Ramesh, R; Britton, J M

    2000-04-01

    Over-zealous release of the first dorsal compartment of the wrist for de Quervain's disease or other lesions such as ganglia, may result in volar subluxation of the tendons of abductor pollicis longus and extensor pollicis brevis. This is usually asymptomatic, but may occasionally become disabling. We describe an operation using part of the extensor retinaculum to stabilise such a subluxation. PMID:10813183

  4. The anatomy of the hip abductor muscles.

    PubMed

    Flack, N A M S; Nicholson, H D; Woodley, S J

    2014-03-01

    The anatomy of the hip abductors has not been comprehensively examined, yet is important to understanding function and pathology in the gluteal region. For example, pathology of the hip abductor muscle-tendon complexes can cause greater trochanteric pain syndrome, and may be associated with gluteal atrophy and fatty infiltration. The purpose of this study was to investigate the detailed morphology of gluteus medius (GMed), gluteus minimus (GMin), and tensor fascia lata (TFL), and determine whether the muscles comprised anatomical compartments. The gluteal region from 12 cadavers was dissected and data collected on attachment sites, volume, fascicular and tendinous anatomy, and innervation. Three sites of GMed origin were identified (gluteal fossa, gluteal aponeurosis, and posteroinferior edge of the iliac crest) and the distal tendon had lateral and posterior parts. GMed was the largest in volume (27.6 ± 11.6 cm(3); GMin 14.1 ± 11.1 cm(3); TFL 1.8 ± 0.8 cm(3)). Fascicles of GMin originated from the gluteal fossa, inserting onto the deep surface of its distal tendon and the hip joint capsule. TFL was encapsulated in the fascia lata, having no bony attachment. Primary innervation patterns varied for GMed, with three or four branches supplying different regions of muscle. Distinct secondary nerve branches entered four regions of GMin; no differential innervation was observed for TFL. On the basis of architectural parameters and innervation, GMed, and GMin each comprise of four compartments but TFL is a homogenous muscle. It is anticipated that these data will be useful for future clinical and functional studies of the hip abductors. PMID:23625344

  5. Chronic exertional compartment syndrome in adductor pollicis muscle: case report.

    PubMed

    Lee, Chang-Hun; Lee, Kwang-Hyun; Lee, Seung-Hun; Kim, Yee-Suk; Chung, Ung-Seo

    2012-11-01

    We report a case of chronic exertional compartment syndrome in the adductor pollicis that was confirmed by measuring elevated compartment pressure. Specific finding of magnetic resonance imaging, increased T2 signal intensity in the involved compartment, was also useful for the diagnosis. Pain was relieved by fasciotomy through a volar approach. PMID:23040640

  6. ADDUCTOR POLLICIS MUSCLE AS PREDICTOR OF MALNUTRITION IN SURGICAL PATIENTS

    PubMed Central

    de MELO, Camila Yandara Sousa Vieira; da SILVA, Silvia Alves

    2014-01-01

    Background In the compromised nutritional status, there is excessive skeletal muscle loss and decreased inflammatory response, contributing to increased morbidity and mortality and length of stay. Aim To estimate the prevalence of malnutrition by measuring adductor pollicis muscle using cutoffs for surgical patients suggested in the literature. Methods Cross-sectional study with 151 patients scheduled for elective surgical procedure. Nutritional assessment was performed by classical anthropometric measurements: arm circumference, triceps skinfold thickness, arm muscle circumference, corrected arm muscle area, BMI and percentage of weight loss and the extent of the adductor pollicis muscle in both hands. Results The prevalence of malnutrition in patients was high. A significant association between nutritional diagnosis according to the measures of adductor pollicis muscle and arm circumference, BMI and triceps skinfold thickness but there was no association with arm muscular circumference, arm muscular area or percentage of weight loss. Conclusion The adductor pollicis muscle has proved to be a good method to diagnose muscle depletion and malnutrition in surgical patients. PMID:24676291

  7. Distally Based Abductor Hallucis Adipomuscular Flap for Forefoot Plantar Reconstruction.

    PubMed

    Lee, Sanglim; Kim, Min Bom; Lee, Young Ho; Baek, Jeong Kook; Baek, Goo Hyun

    2015-09-01

    Soft tissue and bone defects of the lower leg, ankle, and heel region often require coverage by local or distant flaps. The authors successfully used the distally based adipomuscular abductor hallucis flap for the treatment of 7 patients with soft tissue defect on the plantar forefoot after diabetic ulcer (n = 2), excision of melanoma at the medial forefoot (n = 3), and posttraumatic defects of the plantar forefoot (n = 2). The size of the defects ranged from 6 to 36 cm. All defects were covered successfully without major complications. The distally based adipomuscular flap from the abductor hallucis muscle provides a reliable coverage for small and moderate defects of the plantar and medial forefoot. This flap is often preferable to the use of free flaps because the surgery is rapidly performed and does not require microsurgical expertise. PMID:25565013

  8. A Rare Case of Adductor Longus Muscle Rupture

    PubMed Central

    van de Kimmenade, R. J. L. L.; van Bergen, C. J. A.; van Deurzen, P. J. E.; Verhagen, R. A. W.

    2015-01-01

    An adductor longus muscle rupture is a rare injury. This case report describes a 32-year-old patient with an adductor longus rupture. The trauma mechanism was a hyperabduction movement during a soccer game. Nonoperative treatment was initiated. After a follow-up of 4 years, the patient was without pain but a small swelling was still visible. This report describes the anatomy, pathophysiology, and evidence-based treatment of adductor longus rupture. PMID:25918663

  9. A rare case of adductor longus muscle rupture.

    PubMed

    van de Kimmenade, R J L L; van Bergen, C J A; van Deurzen, P J E; Verhagen, R A W

    2015-01-01

    An adductor longus muscle rupture is a rare injury. This case report describes a 32-year-old patient with an adductor longus rupture. The trauma mechanism was a hyperabduction movement during a soccer game. Nonoperative treatment was initiated. After a follow-up of 4 years, the patient was without pain but a small swelling was still visible. This report describes the anatomy, pathophysiology, and evidence-based treatment of adductor longus rupture. PMID:25918663

  10. Isolated Paralysis of the Adductor Pollicis: A Case Report

    PubMed Central

    De Maio, F.; Bisicchia, S.; Farsetti, P.; Ippolito, E.

    2011-01-01

    We report a case of isolated paralysis of the right adductor pollicis in a 30-year-old woman. Electromyographic study showed involvement of the deep motor branch of the ulnar nerve. A ganglion and an anomalous muscle were both ruled out clinically and by MRI as a possible cause of the paralysis. At surgical exploration, we found a fibrous band joining the pisiform and the hook of the hamate bone that compressed the deep motor branch of the ulnar nerve. The fibrous band was excised, and a neurolysis of the motor branch of the ulnar nerve was performed. At followup, eight months later, the patient had fully recovered strength of the adductor muscle. PMID:21991410

  11. Thickness of the adductor pollicis muscle in nutritional assessment of surgical patients

    PubMed Central

    Valente, Katarina Papera; Silva, Naira Marceli Fraga; Faioli, Amanda Barcelos; Barreto, Marina Abelha; de Moraes, Rafael Araújo Guedes; Guandalini, Valdete Regina

    2016-01-01

    ABSTRACT Objective To evaluate the correlation between thickness of the muscle adductor pollicis and anthropometric measurements, body mass index and Subjective Global Assessment in the nutritional assessment of surgical patients. Methods The study population comprised patients admitted to the general and reconstructive surgery unit of a university hospital in the city of Vitória (ES), Brazil. The inclusion criteria were patients evaluated in the first 48 hours of admission, aged ≥20 years, hemodynamically stable, with no edema or ascites. Data analysis was performed using the software Statistical Package for Social Science 21.0, significance level of 5%. Results The sample consisted of 150 patients that were candidates to surgery, mean age of 42.7±12.0 years. The most common reasons for hospitalization were surgical procedures, gastrintestinal diseases and neoplasm. Significant association was observed between thickness of adductor pollicis muscle and Subjective Global Assessment (p=0.021) and body mass index (p=0.008) for nutritional risk. Significant correlation was found between thickness of adductor pollicis muscle and arm muscle circumference, corrected arm muscle area, calf circumference and body mass index. There were no significant correlations between thickness of adductor pollicis muscle and triceps skinfold and age. Conclusion The use of thickness of adductor pollicis muscle proved to be an efficient method to detect malnutrition in surgical patients and it should be added to the screening process of hospitalized patients, since it is easy to perform, inexpensive and noninvasive. PMID:27074229

  12. Reversed palmaris longus muscle: Anatomical variant – case report and literature review

    PubMed Central

    Murabit, Amera; Gnarra, Maria; Mohamed, Adel

    2013-01-01

    The palmaris longus, a slender fusiform muscle, is especially prone to exhibiting anatomical variance relative to other muscles in the upper extremity. The most frequent anatomical variation is the completely absent palmaris longus, followed by the reversed, duplicated, bifid or hypertrophied palmaris longus muscles. The reversed palmaris longus muscle represents a structure that is tendinous proximally and muscular distally (opposite of the normal palmaris longus). The present report describes a case of reversed palmaris longus muscle, followed by a literature review to illustrate the wide spectrum of anatomical variations in the palmaris longus muscle and their clinical and surgical relevance. PMID:24431941

  13. Reversed palmaris longus muscle: Anatomical variant - case report and literature review.

    PubMed

    Murabit, Amera; Gnarra, Maria; Mohamed, Adel

    2013-01-01

    The palmaris longus, a slender fusiform muscle, is especially prone to exhibiting anatomical variance relative to other muscles in the upper extremity. The most frequent anatomical variation is the completely absent palmaris longus, followed by the reversed, duplicated, bifid or hypertrophied palmaris longus muscles. The reversed palmaris longus muscle represents a structure that is tendinous proximally and muscular distally (opposite of the normal palmaris longus). The present report describes a case of reversed palmaris longus muscle, followed by a literature review to illustrate the wide spectrum of anatomical variations in the palmaris longus muscle and their clinical and surgical relevance. PMID:24431941

  14. Adductor pollicis jamming injuries in the professional baseball player: 2 case reports.

    PubMed

    Altobelli, Grant G; Ruchelsman, David E; Belsky, Mark R; Graham, Thomas; Asnis, Peter; Leibman, Matthew I

    2013-06-01

    We characterize a mechanism of injury, injury pattern, and treatment algorithm for adductor pollicis myotendinous injuries in 2 professional baseball players. Similar to myotendinous eccentric injuries in other anatomical areas, the adductor pollicis sustains a sudden forceful eccentric load during a jammed swing, resulting in intramuscular strain or tendon rupture. Based on the reported injury mechanism, and magnetic resonance imaging features of these myotendinous injuries, the thumb of the top hand during a jammed swing was suddenly and forcefully eccentrically abducted from a contracted and adducted position, resulting in injury patterns. PMID:23707017

  15. Arthroscopic Synovectomy for Zone 2 Flexor Hallucis Longus Tenosynovitis.

    PubMed

    Lui, Tun Hing

    2015-10-01

    Tenosynovitis of the flexor hallucis longus tendon is a condition typically found in ballet dancers and sometimes in soccer players and is related to chronic overuse. It mostly involves the portion of the tendon behind the ankle joint. However, the portion of the tendon under the sustentaculum tali can also be involved. Open synovectomy requires extensive dissection. We report the technique of arthroscopic synovectomy of the deep portion of the flexor hallucis longus. PMID:26697294

  16. Arthroscopic Synovectomy for Zone 2 Flexor Hallucis Longus Tenosynovitis

    PubMed Central

    Lui, Tun Hing

    2015-01-01

    Tenosynovitis of the flexor hallucis longus tendon is a condition typically found in ballet dancers and sometimes in soccer players and is related to chronic overuse. It mostly involves the portion of the tendon behind the ankle joint. However, the portion of the tendon under the sustentaculum tali can also be involved. Open synovectomy requires extensive dissection. We report the technique of arthroscopic synovectomy of the deep portion of the flexor hallucis longus. PMID:26697294

  17. Relationship between adductor pollicis muscle thickness and subjective global assessment in a cardiac intensive care unit

    PubMed Central

    Karst, Fernanda Pickrodt; Vieira, Renata Monteiro; Barbiero, Sandra

    2015-01-01

    Objective To verify the relationship between the adductor pollicis muscle thickness test and the subjective global assessment and to correlate it with other anthropometric methods. Methods This observational cross-sectional study was conducted in the intensive care unit of a cardiology hospital in the state of Rio Grande do Sul, Brazil. The hospitalized patients underwent subjective global assessment and adductor pollicis muscle thickness tests on both hands, along with measurement of the right calf circumference. Laboratory parameters, length of stay, vital signs and electronic medical record data and tests were all collected. Results The study population included 83 patients, of whom 62% were men. The average age was 68.6 ± 12.5 years. The most common reason for hospitalization was acute myocardial infarction (34.9%), and the most common pathology was systolic blood pressure (63.9%), followed by diabetes mellitus (28.9%). According to subjective global assessment classifications, 62.7% of patients presented no nutritional risk, 20.5% were moderately malnourished and 16.9% were severely malnourished. Women had a higher nutritional risk, according to both the subjective global assessment and the adductor pollicis muscle thickness test, the cutoff for which was < 6.5mm (54.8%; p = 0.001). The pathology presenting the greatest nutritional risk was congestive heart failure (p = 0.001). Evaluation of the receiver operating characteristic (ROC) curve between adductor pollicis muscle thickness and subjective global assessment showed the accuracy of the former, with an area of 0.822. Conclusion Adductor pollicis muscle thickness proved to be a good method for evaluating nutritional risk. PMID:26761475

  18. Fibre type composition of female longus capitis and longus colli muscles.

    PubMed

    Miller, Alexandra; Woodley, Stephanie J; Cornwall, Jon

    2016-03-01

    Effective management of neck pain requires detailed knowledge of cervical muscle structure and function. Information on muscle fibre type assists in determining function; few data exist on the fibre type composition of many cervical muscles. The purpose of this study was to investigate the fibre type composition of longus capitis (LCa) and longus colli (LCo) to provide a better understanding of their function. Muscle sections were harvested unilaterally from LCa (C2-C7) and LCo (C3, C6, T1) in seven female cadavers (mean age 86 ± 9 years). Immunohistochemistry was used to identify type I and type II fibres, and stereology (random systematic sampling) used to determine fibre numbers. Data were assessed using descriptive statistics and one-way ANOVA (significance P < 0.05). Fifty-two sections were assessed (82,785 fibres; mean 1,592 ± 927 per section). LCa had a significantly greater proportion of type I fibres than LCo (64.3 % vs 55.7 %, P = 0.011). The percentage of fibre types varied significantly between individuals in LCa, but not LCo. No significant difference was found in the proportion of type I fibres between cervical levels for either LCa or LCo. LCa and LCo appear functionally different in elderly females, with LCa potentially having a more postural role (higher type I fibre proportion). Fibre types were homogenous throughout each muscle, indicating that contractile function is similar across the length of individual muscles. Further studies across a larger age-span and in males are required to determine whether results are representative of other populations. PMID:25794488

  19. Scapholunate stabilization with dynamic extensor carpi radialis longus tendon transfer.

    PubMed

    Peterson, Steven L; Freeland, Alan E

    2010-12-01

    Dynamic extensor carpi radialis longus tendon transfer to the distal pole of the scaphoid acts synchronously and synergistically with wrist motion to restore the slider crank mechanism of the scaphoid after scapholunate interosseous ligament (SLIL) injury. The procedure is designed to simulate a hypothetical dorsal radioscaphoid ligament that more closely approximates the normal viscoelastic forces acting on the scaphoid throughout all phases of wrist motion than does the static checkrein effect and motion limitations of capsulodesis or tenodesis. Extensor carpi radialis longus transfer may be independently sufficient to support normal or near-normal scapholunate and midcarpal kinematics and prevent further injury propagation in patients with partial SLIL tears and dynamic scapholunate instability. Extensor carpi radialis longus transfer alone may improve carpal congruity in patients with static scapholunate instability, but SLIL and dorsal lunate ligament repair or reconstruction is essential for favorable durable outcomes. Extensor carpi radialis longus transfer offers a simple and reasonable alternative to capsulodesis or tenodesis to support these ligament repairs or reconstructions, does not require intercarpal fixation, and allows rehabilitation to proceed expeditiously at approximately 1 month after surgery. PMID:21134618

  20. Multiple variations of the tendons of the anatomical snuffbox

    PubMed Central

    Thwin, San San; Zaini, Fazlin; Than, Myo

    2014-01-01

    INTRODUCTION Multiple tendons of the abductor pollicis longus (APL) in the anatomical snuffbox of the wrist can lead to the development of de Quervain's syndrome, which is caused by stenosing tenosynovitis. A cadaveric study was performed to establish the variations present in the tendons of the anatomical snuffbox in a Malaysian population, in the hope that this knowledge would aid clinical investigation and surgical treatment of de Quervain's tenosynovitis. METHODS Routine dissection of ten upper limbs was performed to determine the variations in the tendons of the anatomical snuffbox of the wrist. RESULTS In all the dissected upper limbs, the APL tendon of the first extensor compartment was found to have several (3–14) tendon slips. The insertion of the APL tendon slips in all upper limbs were at the base of the first metacarpal bone, trapezium and fascia of the opponens pollicis muscle; however, in seven specimens, they were also found to be attached to the fleshy belly of the abductor pollicis brevis muscle. In two specimens, double tendons of the extensor pollicis longus located in the third extensor compartment were inserted into the capsule of the proximal interphalangeal joints before being joined to the extensor expansion. In two other specimens, the first extensor compartment had two osseofibrous tunnels divided by a septum that separated the APL tendon from the extensor pollicis brevis tendon. CONCLUSION Multiple variations were found in the anatomical snuffbox region of the dissected upper limbs. Knowledge of these variations would be useful in interventional radiology and orthopaedic surgery. PMID:24452976

  1. Effects of Compliance on Trunk and Hip Integrative Neuromuscular Training on Hip Abductor Strength in Female Athletes

    PubMed Central

    SUGIMOTO, DAI; MYER, GREGORY D.; BUSH, HEATHER M.; HEWETT, TIMOTHY E.

    2014-01-01

    Sugimoto, D, Myer, GD, Bush, HM, and Hewett, TE. Effects of compliance on trunk and hip integrative neuromuscular training on hip abductor strength in female athletes. Recent studies demonstrate the link between reduced hip abductor strength and increased risk for knee injury such as patellofemoral pain syndrome in women athletes. Meta-analytic reports indicate that the efficacy of integrative neuromuscular training (INT) is associated with compliance to the prescribed programming. Thus, the purpose was to investigate the compliance effects of a trunk and hip–focused INT exercises on hip abductor strength in young women athletes. In a controlled laboratory study design, 21 high school women volleyball players (mean age = 15.6 ± 1.4 years, weight = 64.0 ± 7.4 kg, height = 171.5 ± 7.0 cm) completed isokinetic hip abductor strength testing in pre- and postintervention, which consisted of 5 phases of supervised progressive trunk and hip–focused INT exercises twice a week for 10 weeks. The compliance effects were analyzed based on the changed hip abductor strength values between pre- and postintervention and 3 different compliance groups using 1-way analysis of variance and Pearson’s correlation coefficients. The participants in the high-compliance group demonstrated significant hip abductor peak torque increases compared with noncompliance group (p = 0.02), but not between moderate-compliance and noncompliance groups (p = 0.27). The moderate correlation coefficient value (r = 0.56) was recorded between the isokinetic hip abductor peak torque changes and the 3 compliance groups. Because of the observed significant effects and moderate linear association, the effectiveness of a trunk and hip–focused INT protocol to improve hip abduction strength seems dependent on compliance. Compliance of trunk and hip–focused INT is an important aspect of increasing hip abductor strength increase in young women athletes. PMID:24751656

  2. Posterior cricoarytenoid myoplasty with medialization thyroplasty in the management of refractory abductor spasmodic dysphonia.

    PubMed

    Shaw, Gary Y; Sechtem, Phillip R; Rideout, Benji

    2003-04-01

    Of the approximately 100,000 Americans with primary (idiopathic) laryngeal dystonia, 10% to 15% are thought to havethe abductor form. Botulinum A toxin injected into the posterior cricoarytenoid muscle and/or cricothyroid muscle has been employed as the "gold standard" for therapeutic management; however, successful results are significantly less frequent than with injections for the adductor form. This report describes a new phonosurgical procedure, posterior cricoarytenoid myoplasty with medialization thyroplasty, designed for these refractory patients. Posterior cricoarytenoid myoplasty with medialization thyroplasty has been performed on 3 patients with abductor laryngeal dystonia. All patients had failed at least 5 previous botulinum A injections to the posterior cricoarytenoid and cricothyroid muscles. All patients underwent preoperative and 3 postoperative (2 weeks, 3 months, and 1 year) phonatory analyses. Analysis consisted of recording an aloud reading of a standard passage while a blinded trained speech pathologist counted prolonged voiceless consonants. The patients also completed a satisfaction survey at 1 year. The results demonstrated significant, long-lasting, uniform reduction in breathy breaks in all subjects. The participants all judged their symptoms as greatly improved. Bilateral procedures may be necessary, but should be staged to prevent possible airway compromise. When applied appropriately, posterior cricoarytenoid myoplasty with medialization thyroplasty is a viable tool in the management of refractory abductor laryngeal dystonia. PMID:12731624

  3. Recurrence of Hypertrophic Abductor Digiti Minimi Muscle of the Foot After Subtotal Resection.

    PubMed

    Schmauss, Daniel; Harder, Yves; Machens, Hans-Guenther; Lohmeyer, Joern Andreas

    2016-01-01

    Soft tissue tumors of the foot are rare, and the diagnosis is often difficult. Surgery is indicated if pain, discomfort, or functional impairment is present or to rule out malignancy. We present the case of a 14-year-old female with a painless swelling at the lateral aspect of her right foot. After radiologic imaging, including ultrasonography and magnetic resonance imaging (MRI), we performed a subtotal resection of the abductor digiti minimi muscle, preserving its motor nerve. Four months later, recurrence of the soft tissue mass was observed. MRI revealed hypertrophy of the small muscles of the foot, including the abductor digiti minimi, quadratus plantae, and flexor digiti minimi brevis. Functional impairment resulted in complete excision of the remnant abductor digiti minimi muscle and partial excision of the flexor digiti minimi brevis muscle another 7 months later. Twelve months after the secondary surgery, neither clinical nor radiologic signs of a second recurrence were found. At the last follow-up visit, the patient was satisfied with the contour of her foot and not hindered at all during sporting activities. Our findings demonstrate that subtotal resection of a bulky muscle, preserving its motor nerve, can result in reactive hypertrophy of the remnant muscle part. The patient must be informed that partial excision of an innervated muscle could result in reactive hypertrophy and must be contrasted with radical muscle excision that might be more likely to result in functional impairment. PMID:25724471

  4. Spring ligament reconstruction using the autogenous flexor hallucis longus tendon.

    PubMed

    Lee, Woo-Chun; Yi, Young

    2014-07-01

    The calcaneonavicular (spring) ligament complex is the soft tissue most often seen to fail in flatfoot pathology and is associated with deformity of the talonavicular joint. The spring ligament complex supports the talar head, preventing it from displacing into excessive plantar flexion/adduction. An anatomical reconstruction of the spring ligament should replicate this function. A new method of spring ligament reconstruction using autogenous flexor hallucis longus tendon transfer is reported. PMID:24992052

  5. Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy

    PubMed Central

    Batista, Jorge Pablo; del Vecchio, Jorge Javier; Golanó, Pau; Vega, Jordi

    2015-01-01

    Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL) travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL) described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion. PMID:26060592

  6. Hip-Abductor Fatigue and Single-Leg Landing Mechanics in Women Athletes

    PubMed Central

    Patrek, Mary F.; Kernozek, Thomas W.; Willson, John D.; Wright, Glenn A.; Doberstein, Scott T.

    2011-01-01

    Abstract Context: Reduced hip-abductor strength and muscle activation may be associated with altered lower extremity mechanics, which are thought to increase the risk for anterior cruciate ligament injury. However, experimental evidence supporting this relationship is limited. Objective: To examine the changes in single-leg landing mechanics and gluteus medius recruitment that occur after a hip-abductor fatigue protocol. Design: Descriptive laboratory study. Patients or Other Participants: Twenty physically active women (age  =  21.0 ± 1.3 years). Intervention(s): Participants were tested before (prefatigue) and after (postfatigue) a hip-abductor fatigue protocol consisting of repetitive side-lying hip abduction. Main Outcome Measure(s): Outcome measures included sagittal-plane and frontal-plane hip and knee kinematics at initial contact and at 60 milliseconds after initial contact during 5 single-leg landings from a height of 40 cm. Peak hip and knee sagittal-plane and frontal-plane joint moments during this time interval were also analyzed. Measures of gluteus medius activation, including latency, peak amplitude, and integrated signal, were recorded. Results: A small (<1°) increase in hip-abduction angle at initial contact and a small (<1°) decrease in knee-abduction (valgus) angle at 60 milliseconds after contact were observed in the postfatigue landing condition. No other kinematic changes were noted for the knee or hip at initial contact or at 60 milliseconds after initial contact. Peak external knee-adduction moment decreased 27% and peak hip adduction moment decreased 24% during the postfatigue landing condition. Gluteus medius activation was delayed after the protocol, but no difference in peak or integrated signal was seen during the landing trials. Conclusions: Changes observed during single-leg landings after hip-abductor fatigue were not generally considered unfavorable to the integrity of the anterior cruciate ligament. Further work may be

  7. A Case of the Bilateral Duplicate Palmaris Longus Muscles Coupled with the Palmaris Profundus Muscle

    PubMed Central

    Takanashi, Yuichi; Eda, Masaki; Kaidoh, Toshiyuki; Inoué, Takao

    2012-01-01

    The palmaris longus muscle is one of the most variable muscles in human anatomy. During a routine anatomical dissection for medical students at Tottori University, we found duplicate palmaris longus muscles in the bilateral forearms together with the palmaris profundus muscle in the right forearm. The bilateral aberrant palmaris longus muscles were observed at the ulnar side of the palmaris longus muscle and their distal tendons were attached to the flexor retinaculum. The palmaris profundus muscle found in the right forearm was located at the radial side of the flexor digitorum superficialis muscle. The proximal tendon was originated from the anterior surface in the middle of the radius, while the distal tendon coursed radial to the median nerve through the carpal tunnel, finally inserting into the distal part of the flexor retinaculum. Both the palmaris longus and aberrant palmaris longus muscles were innervated by the median nerve. The palmaris profundus muscle was presumably supplied by the median nerve. PMID:24031143

  8. Correlative analysis of MRI-evident abductor hip muscle degeneration and power after minimally invasive versus conventional unilateral cementless THA.

    PubMed

    Vasilakis, Ioannis; Solomou, Ekaterini; Vitsas, Vasilis; Fennema, Peter; Korovessis, Panagiotis; Siamblis, Dimitrios K

    2012-12-01

    The 2 main null hypotheses of this study were: (1) the 4-year surgical trauma-related degeneration within the hip abductor muscles after a minimally invasive approach to total hip arthroplasty would be similar to that following a conventional approach; and (2) no differences in perioperative blood loss or postoperative hip pain would be observed between the minimally invasive and conventional approaches.In 40 consecutive randomly selected adult patients with unilateral primary hip osteoarthritis, a cementless Zweymüller-Plus THA (Smith & Nephew Orthopaedics, Baar, Switzerland) was implanted by a single surgeon in 1 institution during the same period. Twenty patients underwent a minimally invasive approach (group A), and 20 patients underwent a conventional anterolateral approach (group B). Four years postoperatively, the operated and contralateral nonoperated hips of 37 available patients from both groups were examined with magnetic resonance imaging to show any changes in the gluteus medius and tensor fascia latae. Simultaneously, hip abductor power was measured bilaterally in both groups. Anthropometric data, blood loss, Short Form 36 self-assessment questionnaire, visual analog pain score, and walking distance were also analyzed.The reliability of magnetic resonance imaging and hip abductor power measurements was high. No difference was found in hip abductor power on the operated side between the 2 groups, whereas hip abductor power on the nonoperated side was significantly higher in both groups. This study revealed no mechanical and functional benefits in favor of patients undergoing minimally invasive vs conventional total hip arthroplasty. PMID:23218622

  9. Effects of ankle extensor muscle afferent inputs on hip abductor and adductor activity in the decerebrate walking cat.

    PubMed

    Bolton, D A E; Misiaszek, J E

    2012-12-01

    Electrical stimulation of the lateral gastrocnemius-soleus (LGS) nerve at group I afferent strength leads to adaptations in the amplitude and timing of extensor muscle activity during walking in the decerebrate cat. Such afferent feedback in the stance leg might result from a delay in stance onset of the opposite leg. Concomitant adaptations in hip abductor and adductor activity would then be expected to maintain lateral stability and balance until the opposite leg is able to support the body. As many hip abductors and adductors are also hip extensors, we hypothesized that stimulation of the LGS nerve at group I afferent strength would produce increased activation and prolonged burst duration in hip abductor and adductor muscles in the premammillary decerebrate walking cat. LGS nerve stimulation during the extensor phase of the locomotor cycle consistently increased burst amplitude of the gluteus medius and adductor femoris muscles, but not pectineus or gracilis. In addition, LGS stimulation prolonged the burst duration of both gluteus medius and adductor femoris. Unexpectedly, long-duration LGS stimulus trains resulted in two distinct outcomes on the hip abductor and adductor bursting pattern: 1) a change of burst duration and timing similar to medial gastrocnemius; or 2) to continue rhythmically bursting uninterrupted. These results indicate that activation of muscle afferents from ankle extensors contributes to the regulation of activity of some hip abductor and adductor muscles, but not all. These results have implications for understanding the neural control of stability during locomotion, as well as the organization of spinal locomotor networks. PMID:22972967

  10. Histochemistry of abductor hallucis muscle in children with idiopathic clubfoot and in controls.

    PubMed

    Sirca, A; Erzen, I; Pecak, F

    1990-01-01

    The histochemical composition of the abductor hallucis (AH) muscle was investigated in 39 children with idiopathic clubfoot (CF), aged 0-11 years, and in 42 controls. In the youngest group of patients (0-2 years) the percentage of type 1 (slow twitch, tonic) fibers was significantly higher than in controls. In older groups, there was no difference between patients and controls. The relative predominance of type 1 fibers could be due to immobilization, passive shortening or stretching, or primary overactivity of this muscle in CF promoted by an unknown neural factor. None of these interpretations could be proven. PMID:2358485

  11. The Influence of Hip Abductor Weakness on Frontal Plane Motion of the Trunk and Pelvis in Patients with Cerebral Palsy

    ERIC Educational Resources Information Center

    Krautwurst, Britta K.; Wolf, Sebastian I.; Heitzmann, Daniel W. W.; Gantz, Simone; Braatz, Frank; Dreher, Thomas

    2013-01-01

    Trendelenburg walking pattern is a common finding in various disorders, including cerebral palsy (CP), where it is seen in children and adults. Clinically, this deviation is viewed as a consequence of hip abductor weakness resulting in pelvic obliquity. Trunk lean to the ipsilateral side is a common compensatory mechanism to counteract pelvic…

  12. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function☆

    PubMed Central

    Almeida, Gabriel Peixoto Leão; Silva, Ana Paula de Moura Campos Carvalho e; França, Fábio Jorge Renovato; Magalhães, Maurício Oliveira; Burke, Thomaz Nogueira; Marques, Amélia Pasqual

    2016-01-01

    Objective To investigate the relationship between the q-angle and anterior knee pain severity, functional capacity, dynamic knee valgus and hip abductor torque in women with patellofemoral pain syndrome (PFPS). Methods This study included 22 women with PFPS. The q-angle was assessed using goniometry: the participants were positioned in dorsal decubitus with the knee and hip extended, and the hip and foot in neutral rotation. Anterior knee pain severity was assessed using a visual analog scale, and functional capacity was assessed using the anterior knee pain scale. Dynamic valgus was evaluated using the frontal plane projection angle (FPPA) of the knee, which was recorded using a digital camera during step down, and hip abductor peak torque was recorded using a handheld dynamometer. Results The q-angle did not present any significant correlation with severity of knee pain (r = −0.29; p = 0.19), functional capacity (r = −0.08; p = 0.72), FPPA (r = −0.28; p = 0.19) or isometric peak torque of the abductor muscles (r = −0.21; p = 0.35). Conclusion The q-angle did not present any relationship with pain intensity, functional capacity, FPPA, or hip abductor peak torque in the patients with PFPS. PMID:27069887

  13. The effect of hip abductor exercise on muscle strength and trunk stability after an injury of the lower extremities

    PubMed Central

    Kak, Hwang-Bo; Park, Sun-Ja; Park, Byun-Joon

    2016-01-01

    [Purpose] The gluteus medius, a hip abductor, controls femoral movement and stabilizes the pelvis during lower extremity mobilization. [Subjects] This study enrolled 24 subjects into control and experimental groups. [Methods] This randomized controlled study included patients who underwent arthroscopy after meniscus injury and started a rehabilitative exercise program 8 weeks after surgery. Subjects were divided into the experimental gluteus medius resistance exercise group (n=12) and the control group (n=12). The study investigated muscle strength and balance of the flexors, extensors, and abductors of the knee for 8 weeks. [Results] Strengths of knee extensors in patients who underwent rehabilitative exercise for 8 weeks were measured. Strength of the knee extensors of the experimental and control groups increased by 40% and 31%, respectively; strength of the hip flexors of the experimental and control groups increased by 31% and 18%, respectively. Strength of the hip joint muscles showed a 40% increase in the experimental group and a 14% increase in the control group. However, there was a significant difference (18%) in muscle strength of the hip abductors between the groups. Measurements of trunk lateral flexion showed a difference within a group, but no intergroup difference was found. [Conclusion] This study investigated the effect of hip abductor exercise on muscular strength and trunk stability in patients with a meniscus injury. PMID:27134387

  14. Peroneus longus transfer for drop foot in Hansen disease.

    PubMed

    Cohen, Jose Carlos; de Freitas Cabral, Elifaz

    2012-09-01

    Leprosy or Hansen's disease is a chronic infectious disease caused by the Mycobacterium leprae. Nerve injury is a central feature of the pathogenesis of leprosy that results in autonomic, sensory and motor neuropathy. One of the most common secondary disabilities caused by Hansen's disease is the drop foot and it is found in 2% to 5% of newly-diagnosed leprosy patients. Unlike the clinical picture of traumatic injury of the common peroneal nerve where both of its branches (the deep peroneal nerve and the superficial peroneal nerve) are involved, in leprosy there is the possibility of isolated involvement of the deep peroneal nerve branch, sparing the superficial peroneal branch. The article discusses the advantages of using the peroneus longus tendon transfer to the dorsum of the foot instead of the posterior tibial tendon for the correction of dropfoot in selected cases where the peroneals tendons are intact. PMID:22938641

  15. Surgical Anatomy of the Longus Colli Muscle and Uncinate Process in the Cervical Spine

    PubMed Central

    Moon, Seong-Hwan; Kim, Tae-Hwan; Oh, Jae Keun; Kim, Hyung Joon; Park, Kun-Tae; Riew, K. Daniel

    2016-01-01

    Purpose There have been a few previous reports regarding the distances between the medial borders of the longus colli to expose the disc space. However, to our knowledge, there are no reports concerning longus colli dissection to expose the uncinate processes. This study was undertaken to assess the surgical relationship between the longus colli muscle and the uncinate process in the cervical spine. Materials and Methods This study included 120 Korean patients randomly selected from 333 who had cervical spine MRIs and CTs from January 2003 to October 2013. They consisted of 60 males and 60 females. Each group was subdivided into six groups by age from 20 to 70 years or more. We measured three parameters on MRIs from C3 to T1: left and right longus colli distance and inter-longus colli distance. We also measured three parameters on CT: left and right uncinate distance and inter-uncinate distance. Results The longus colli distances, uncinate distances, and inter-uncinate distances increased from C3 to T1. The inter-longus colli distances increased from C3 to C7. There was no difference in longus colli distances and uncinate distances between males and females. There was no difference in the six parameters for the different age groups. Conclusion Although approximate guidelines, we recommend the longus colli be dissected approximately 5 mm at C3–5, 6 mm at C5–6, 7 mm at C6–7, and 8 mm at C7–T1 to expose the uncinate process to its lateral edge. PMID:27189293

  16. The Prevalence of Absence of the Palmaris Longus Muscle Tendon in the North of Iran: A Comparative Study

    PubMed Central

    Nasiri, Ebrahim; Pourghasem, Mohsen; Moladoust, Hassan

    2016-01-01

    Background: The palmaris longus is a degenerating weak flexor muscle in the anterior of the forearm. Many techniques for clinically determining the presence of the palmaris longus have been described. Ethnic variations in the prevalence of the absence of the palmaris longus are well known. Objectives: This study considered the prevalence of absence of the palmaris longus muscle tendon in the north of Iran. Patients and Methods: The presence of the palmaris longus was clinically determined in 562 men and women from the Guilan population, using the standard technique (Schaeffer’s test). In subjects with an absent palmaris longus, three other tests (Thompson, Pushpakumar and Mishra tests) were performed to confirm the absence. Results: The overall prevalence of right, left, bilateral and total absence of the palmaris longus were 4.1%, 5.2%, 3.9% and 13.2%, respectively. There was no significant difference in its absence with regard to the body side or gender (P > 0.05). Conclusions: This study demonstrated that the presence of the palmaris longus muscle tendon in the Guilan population was considerably higher than the absence of the palmaris longus tendon. The overall prevalence of right, left, bilateral and total absence of the palmaris longus was not significantly different between men and women. The prevalence of the left-absent palmaris longus was more common in the present study. PMID:27247789

  17. Peroneus longus tear and its relation to the peroneal tubercle: A review of the literature

    PubMed Central

    Palmanovich, Ezequiel; Laver, Lior; Brin, Yaron S.; Kotz, Evgeny; Hetsroni, Iftach; Mann, Gideon; Nyska, Meir

    2011-01-01

    Summary Tear of the peroneal tendon may occur in different anatomical sites. The most prevalent site is around the lateral malleolus. Tear of the peroneus longus at the level of the peroneal tubercle is unusual. Anatomically, the lateral surface of the calcaneous can be divided into thirds. The middle third includes the peroneal tubercle, which separates the peroneus longus tendon from the peroneus brevis. An anatomic variation of the peroneal tubercle may lead to chronic irritation of the peroneus longus tendon that could ultimately cause a longitudinal tear. We conducted this review aiming to clarify the anatomy, biomechanics of the tendon, and the clinical features of tear of the peroneus longus tendon on the lateral surface of the calcaneous due to an enlarged peroneal tubercle. In addition, we reviewed the diagnostic and treatment options of peroneal tendon tears at this site. PMID:23738264

  18. Tenosynovial Osteochondromatosis of the Flexor Hallucis Longus Tendon Treated by Tendoscopy.

    PubMed

    Lui, Tun Hing

    2015-01-01

    Tendosynovial chondromatosis of the foot and ankle is a rare disease entity. We reported 3 patients with tenosynovial osteochondromatosis of flexor hallucis longus. They were successfully treated by arthroscopic synovectomy and removal of the loose bodies. PMID:25979294

  19. Surgical management of a completely avulsed adductor longus muscle in a professional equestrian rider.

    PubMed

    Quah, Conal; Cottam, Andrew; Hutchinson, James

    2014-01-01

    Avulsion injuries of the adductor longus muscle tendon are rare and a challenge to manage especially in athletes. There has been little published literature on the outcome of conservative and operative treatment for these injuries. We report the first case of an acute adductor longus avulsion injury which was surgically repaired in a professional equestrian rider. Return to full preinjury function was achieved at 3 months with surgical repair using 3 suture anchors. PMID:24711943

  20. The adductor pollicis muscle: a poor predictor of clinical outcome in ICU patients.

    PubMed

    Leong Shu-Fen, Claudia; Ong, Venetia; Kowitlawakul, Yanika; Ling, Teh Ai; Mukhopadhyay, Amartya; Henry, Jeya

    2015-01-01

    No nutrition assessment tools specifically tailored for intensive care unit (ICU) patients have been developed and validated in Singapore. Studies conducted in Brazilian populations suggest that the thickness of the adductor pollicis muscle (TAPM) may be used to assess nutritional status and predict mortality of critically ill patients. The aim of this study was to determine if TAPM can be used as a predictive indicator of mortality in Singapore ICU patients. TAPM values were obtained using skinfold calipers in 229 patients admitted to the medical ICU. TAPM measured in both hands showed no significant correlation with either the primary outcome (28-day mortality) or secondary outcomes (hospital outcome and hospital length of stay). This study demonstrated that TAPM does not predict 28-day mortality and hospital outcome, and is not correlated to length of stay in Singapore ICU patients. More studies are necessary to validate the use of TAPM as an anthropometric indicator of ICU outcome in other regions of the world. PMID:26693744

  1. Extensor Pollicis Brevis tendon damage presenting as de Quervain’s disease following kettlebell training

    PubMed Central

    2013-01-01

    Kettlebell exercises are more efficient for an athlete to increase his or her muscle strength. However it carries the risk of injury especially in the beginners. A 39 year old gentleman came to our clinic with radial sided wrist pain following kettlebell exercises. Clinically patient had swelling and tenderness over the tendons in the first dorsal wrist compartment, besides Finklesten test was positive. Patient had a decreased excursion of the thumb when compared to the opposite side. Ultrasound/MRI scan revealed asymmetric thickening of the 1st compartment extensors extending from the base of the thumb to the wrist joint. Besides injury to the Extensor Pollicis Brevis (EPB) tendon by repetitive impact from kettlebell, leading to its split was identified. Detailed history showed that the injury might be due to off-centre handle holding during triceps strengthening exercises. Our report stresses the fact that kettlebell users should be taught about problems of off-center handle holding to avoid wrist injuries. Also, in Kettlebell users with De Quervains disease clinical and radiological evaluation should be done before steroid injection as this might lead to complete tendon rupture. PMID:23731737

  2. Extensor Pollicis Brevis tendon damage presenting as de Quervain's disease following kettlebell training.

    PubMed

    Karthik, Karuppaiah; Carter-Esdale, Charles William; Vijayanathan, Sanjay; Kochhar, Tony

    2013-01-01

    Kettlebell exercises are more efficient for an athlete to increase his or her muscle strength. However it carries the risk of injury especially in the beginners. A 39 year old gentleman came to our clinic with radial sided wrist pain following kettlebell exercises. Clinically patient had swelling and tenderness over the tendons in the first dorsal wrist compartment, besides Finklesten test was positive. Patient had a decreased excursion of the thumb when compared to the opposite side. Ultrasound/MRI scan revealed asymmetric thickening of the 1st compartment extensors extending from the base of the thumb to the wrist joint. Besides injury to the Extensor Pollicis Brevis (EPB) tendon by repetitive impact from kettlebell, leading to its split was identified. Detailed history showed that the injury might be due to off-centre handle holding during triceps strengthening exercises. Our report stresses the fact that kettlebell users should be taught about problems of off-center handle holding to avoid wrist injuries. Also, in Kettlebell users with De Quervains disease clinical and radiological evaluation should be done before steroid injection as this might lead to complete tendon rupture. PMID:23731737

  3. Limitations of the Vastus Lateralis Muscle as a Substitute for Lost Abductor Muscle Function: An Anatomical Study.

    PubMed

    Grob, Karl; Monahan, Rebecca; Gilbey, Helen; Ackland, Timothy; Kuster, Markus S

    2015-12-01

    Abductor insufficiency after hip arthroplasty resulting from an impaired gluteus medius and minimus remains an unsolved problem in orthopaedic surgery. The vastus lateralis (VL) was described as a functional substitute for abductor insufficiency in 2004. We carried out a macrodissection of twelve cadaveric hemipelvises to investigate the innervation of the VL and adjacent muscles to assess the extent the VL can be safely transferred. Results showed that direct muscle branches to proximal portions of the VL are too short to allow a significant shift; the shift may be as small as 13 mm. Nerves that supply the VL also extend to the vastus intermedius. This innervation pattern makes it impossible to shift the VL significantly without damaging branches to both. PMID:26264179

  4. Abductor digiti minimi muscle flap transfer to prevent wound healing complications after ORIF of calcaneal fractures

    PubMed Central

    Wang, Chao-Liang; Huang, Su-Fang; Sun, Xue-Sheng; Zhu, Tao; Lin, Chu; Li, Qiang

    2015-01-01

    Objectives: To examine the transfer of abductor digiti minimi (ADM) muscle flaps as a method for preventing wound healing complications in cases of closed calcaneal fractures treated with open reduction and internal fixation (ORIF). Method: Design: Retrospective review. Patients: Twenty-six cases of acute closed calcaneal fracture in patients at risk for serious wound complications or with serious fractures. Intervention: During the ORIF surgery, an ADM muscle flap was removed and used to cover the plate, filling the gap between the plate and skin. Main Outcome Measures: Wound healing rates, postoperative complications, and time to heal. Results: All wounds healed uneventfully, except for one case of minor superficial epithelial necrosis during the early postoperative period, which was treated conservatively. All patients regained ambulatory status with regular foot apparel. At last follow-up, the patients presented no clinical, laboratory, or radiological signs of complications. Conclusions: This ADM muscle flap transfer technique appeared to successfully prevent wound healing complications among patients undergoing ORIF for closed calcaneal fractures. This method offers a promising treatment option for calcaneal fractures in patients at high risk for serious wound complications, and future studies with greater numbers of cases are needed to further investigate its clinical application. PMID:26550221

  5. Effect of experimentally reduced distal sensation on postural response to hip abductor/ankle evertor muscle vibration.

    PubMed

    Glasser, S; Collings, R; Paton, J; Marsden, J

    2015-07-01

    This study assessed whether postural responses induced by vibratory perturbations of the hip abductors and ankle evertors, were modified when distal tactile sensation was experimentally reduced through cooling. Sixteen healthy subjects were investigated pre and post cooling. Subjects stood with their eyes closed with a stance width of 4 cm. A 2s vibratory stimulus was applied to the left or right hip abductor or ankle evertor muscle. The order of the site and side of the stimulation was randomised. The postural response to hip abductor and ankle evertor vibration was recorded using 3D motion analysis (Codamotion, Leicestershire). Medio-lateral centre of pressure motion was simultaneously recorded during quiet standing via a force plate (Kistler, UK). Pre-cooling people responded to unilateral ankle vibration with an ipsilateral translation and tilt of the pelvis, and an ipsilateral tilt of the trunk. People responded to unilateral hip vibration with a contralateral translation and tilt of the pelvis, and an ipsilateral tilt of the trunk. Following an experimental reduction in distal tactile sensation there was a significant reduction in the amplitude of pelvic tilt in response to ankle vibration (F(6.2)=P<0.05) and a significant increase in amplitude of pelvic tilt in response to hip vibration (F(5.2)=P<0.05). This suggests that the sensitivity to artificial stimulation of hip proprioception increases with distal cooling, possibly indicating a change in the gain/weighting placed upon sensory information from the hips. PMID:26153881

  6. The effects of gluteus maximus and abductor hallucis strengthening exercises for four weeks on navicular drop and lower extremity muscle activity during gait with flatfoot

    PubMed Central

    Goo, Young-Mi; Kim, Tae-Ho; Lim, Jin-Yong

    2016-01-01

    [Purpose] The purpose of the present study is to examine the effects of abductor hallucis and gluteus maximus strengthening exercises on pronated feet. [Subjects and Methods] The present study was conducted with 18 adults without no history of surgery on the foot or ankle. One group performed both gluteus maximus strengthening exercises and abductor hallucis strengthening exercises, while the other group performed only abductor hallucis strengthening exercises five times per week for four weeks. [Results] The group that performed both gluteus maximus and abductor hallucis strengthening exercises showed smaller values in the height of navicular drop than the group that performed only abductor hallucis strengthening exercises. The muscle activity of the gluteus maximus and the vastus medialis increased during heel-strike in the group that added gluteus maximus exercises, and the muscle activity of the abductor hallucis significantly increased in both groups. [Conclusion] Given the results of the present study, it can be suggested that strengthening the gluteus maximus while also performing exercises to correct the pronated foot is an effective method for achieving normal gait. PMID:27134383

  7. A variant extensor indicis muscle and the branching pattern of the deep radial nerve could explain hand functionality and clinical symptoms in the living patient

    PubMed Central

    Kumka, Myroslava

    2015-01-01

    The purpose of this study is to document the topographic anatomy of an extensor indicis (EI) muscle with a double tendon and the associated distribution of the deep branch of the radial nerve (DBRN). Both EI tendons were positioned deep to the tendons of the extensor digitorum as they traversed the dorsal osseofibrous tunnel. They then joined the medial slips of the extensor expansion of the second and third digits. In all other dissected forearms, a tendon of the EI muscle joined the medial slip of the extensor expansion to the index finger. The DBRN provided short branches to the superficial extensor muscles, long branches to the abductor pollicis longus and extensor pollicis brevis muscles, and terminated as the posterior interosseous nerve. Descending deep to the extensor pollicis longus muscle, the posterior interosseous nerve sent branches to the extensor pollicis brevis and EI muscles. Understanding of the topographic anatomy of an EI with a double tendon, and the associated distribution of the DBRN, may contribute to accurate diagnosis and treatment of hand lesions. PMID:25729087

  8. Patterns of prior offending by child abductors: a comparison of fatal and non-fatal outcomes.

    PubMed

    Beasley, James Oliver; Hayne, Anita S; Beyer, Kristen; Cramer, Gary L; Berson, Sarah Bradley; Muirhead, Yvonne; Warren, Janet I

    2009-01-01

    Our study examines the prior offending of 750 individuals who are known to be responsible for the abduction of a child under the age of 18 years. The first group comprised of 311 offenders (42%) who had abducted a child that was later located alive (found alive, referred to as FA). The second group was comprised of 439 offenders (58%) who had abducted a child that was either found murdered or was still missing and presumed dead (found murdered, referred to as FM). While males perpetrated the majority of the abductions, women perpetrated 31 (10%) of the offenses in the FA group and 10 (2%) of the offenses in the FM group. The average number of prior offenses as reflected in the NCIC criminal history of each offender was seven with these occurring over an average of 12 years. Seventy-five percent of the offenders had prior arrests for an assortment of different crimes while 25% had no known criminal history, a finding that was consistent across both the FA and FM groups. Of those with a criminal history, 41% had been arrested for assault, 40% for larceny, 35% for burglary/breaking and entering, 33% for forcible sex offenses, 25% for drug/narcotic offenses, 21% for weapons law violations, 17% for motor vehicle thefts, 15% for robbery, and 14% for kidnapping. Our findings are congruent with the theme of criminal diversity among child abductors and argue against the specificity in offending that is often assumed with this type of sexual offender. This information is relevant to our understanding of the progression in criminal offending that is manifested by offenders who abduct children and will hopefully be used by law enforcement in helping to direct and focus their investigations. PMID:19716602

  9. Acute Compartment Syndrome after Non-Contact Peroneus Longus Muscle Rupture

    PubMed Central

    Merriman, Jarrad; Villacis, Diego; Kephart, Curtis; Romano, Russ; Hatch, George F. Rick

    2015-01-01

    This case demonstrates a rare variation in the pattern of injury and the presentation of acute lateral compartment syndrome of the leg. Although uncommon, lateral compartment syndrome of the leg after an ankle inversion leading to peroneus longus muscle rupture has been previously documented. This case was unusual because there was no overt ankle injury and the patient was able to continue physical activity, in spite of a significant rupture of the peroneus longus muscle that was determined later. This case highlights the necessary vigilance clinicians must maintain when assessing non-contact injuries in patients with possible compartment syndrome. PMID:26640640

  10. Tendoscopic Excision of an Intratendinous Ganglion in the Flexor Hallucis Longus Tendon: A Case Report.

    PubMed

    Endo, Jun; Yamaguchi, Satoshi; Sasho, Takahisa

    2016-01-01

    Intratendinous ganglion cysts are rare lesions of unknown etiology that originate within a tendon. We report the case of a 34-year-old female with an intratendinous ganglion in the plantar portion of the flexor hallucis longus tendon. The intratendinous ganglion recurred after ultrasound-guided needle aspiration. Tendoscopic excision of the intratendinous ganglion cyst achieved a satisfactorily result without recurrence. PMID:25456345

  11. [Obese woman presenting as vocal cord abductor paralysis and floppy arytenoid associated with early signs of multiple system atrophy].

    PubMed

    Sakuta, Hideki; Miyamoto, Masayuki; Suzuki, Keisuke; Miyamoto, Tomoyuki; Nakajima, Itsuo; Nakamura, Toshiki; Hirata, Koichi

    2012-01-01

    In multiple system atrophy (MSA), sleep-related breathing disorders are commonly observed, including vocal cord abductor paralysis (VCAP), which can cause sudden death. In its early stage, VCAP occurs only during sleep, but as the disease progresses, it appears when both awake and asleep. We encountered a 59-year-old obese woman who had been under continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea syndrome (OSAS) for approximately one year but later developed acute respiratory failure because of VCAP. VCAP was the predominant finding that led to the diagnosis of MSA in our patient. On laryngoscopic examination, the movement of the patient's larynx was normal during wakefulness, but VCAP, paradoxical movements of the vocal cord and a floppy arytenoid were observed during drug-induced sleep. We suggest that detection of VCAP and laryngopharyngeal abnormalities such as floppy arytenoid in the early stage of MSA is important for determining treatment options. PMID:22790804

  12. A Bitendinous Palmaris Longus: Aberrant Insertions and Its Clinical Impact - A Case Report

    PubMed Central

    Iqbal, Raiz; Iqbal, Faiz

    2015-01-01

    Palmaris longus, phylogenetically a retrogressive muscle, exhibits significant anatomical variations compared to other muscles of the upper extremity. It is of great surgical importance because, it is the first option tendon for graft procedures in various cosmetic, plastic and reconstructive surgeries. It has also been widely used in various tendon transfer procedures in treating facial paralysis, ptosis correction, lip augmentation and digital pulley reconstruction. We report a rare variant pattern of Palmaris longus with duplicated tendons and with multiple insertions to thenar and hypothenar muscles, fasciae and the flexor retinaculum along with its normal continuation as palmar aponeurosis. Variations in its insertions not only contribute, but also augment the various pathological processes such as Dupuytren’s contracture, Carpal tunnel and Guyon’s syndromes. So it is of utmost importance for surgeons, physicians and radiologists, to be aware of these variations, well in advance. PMID:26155469

  13. Myofascial force transmission between transferred rat flexor carpi ulnaris muscle and former synergistic palmaris longus muscle

    PubMed Central

    Maas, Huub; Huijing, Peter A.

    2011-01-01

    Summary We investigated the extent of mechanical interaction between rat flexor carpi ulnaris (FCU) and palmaris longus (PL) muscles following transfer of FCU to the distal tendons of extensor carpi radialis brevis and longus (ECRB/L) muscles. Five weeks after recovery from surgery, isometric forces exerted at the distal tendons of FCU and PL were quantified at various FCU lengths. PL was kept at a constant length. Changing the muscle-tendon complex length of transferred FCU (by maximally 3.5 mm) decreased PL force significantly (by 7%). A linear relationship was found between changes in FCU muscle belly length, being a measure of muscle relative positions, and PL force. These results indicate that despite transfer of FCU muscle to the extensor side of the forearm, changing FCU length still affects force transmission of its, now, antagonistic PL muscle. We conclude that a transferred muscle may still be mechanically linked to its former synergistic muscles. PMID:23738260

  14. Effects of postmortem freezing on tensile failure properties of rabbit extensor digitorum longus muscle tendon complex.

    PubMed

    Leitschuh, P H; Doherty, T J; Taylor, D C; Brooks, D E; Ryan, J B

    1996-09-01

    The tensile failures of extensor digitorum longus muscle tendon units from 16 male New Zealand White rabbits were studied in the fresh state (less than 30 minutes after death) and in the frozen/thawed state (frozen at -80 degrees C for 28 days and then warmed to 38 degrees C). Frozen/thawed extensor digitorum longus muscle tendon units had significantly lower values for load to failure (p < 0.01), energy absorbed to failure (p < 0.01), and strain at failure (p < 0.01), and they tended to fail at a different anatomic location (p < 0.01) (broadly at the fascia-muscle interface as compared with horizontally at the musculotendinous junction) than fresh units. The results of this study suggest that freezing muscle tendon units significantly alters their tensile failure characteristics. PMID:8893779

  15. Surgical treatment of the adductor longus muscle's distal tendon total rupture in a soccer player.

    PubMed

    Masionis, P; Popov, K; Kurtinaitis, J; Uvarovas, V; Porvaneckas, N

    2016-09-01

    Only a few cases of adductor longus tendon ruptures have been reported in the literature and - there are no clear criteria for conservative or surgical treatment. A case of traumatic rupture of the right distal adductor longus tendon is presented in an elite soccer player, which was surgically repaired. The condition was managed conservatively primarily. However, after 2 months, a palpable mass remained on the medial side of the thigh, and the patient had pain after moderate everyday load and insufficient strength of the right leg during physical exercise. It was decided to explore ruptured tendon surgically and reattach to the femur. Full function of the right leg was achieved at 3 months after surgical repair. At 6 months postoperatively, the patient had returned to soccer at the same level. PMID:27132783

  16. Anomalous composition of musculature of the first dorsal fibro-osseous compartment of the wrist.

    PubMed

    Dhuria, Ruchi; Mehta, Vandana; Suri, Rajesh Kumar; Rath, Gayatri

    2012-06-01

    The anomalous orientation of musculature of the first dorsal fibro-osseous compartment of the wrist is clinically relevant to De Quervian's stenosing tenosynovitis and reconstructive surgeries. Split insertion of the abductor pollicis longus (APL) is commonly found in chimpanzees, gorillas and gibbons. A comparable identical pattern of anomalous slips in humans is of anthropological and phylogenetic importance and could be a result of atavism. This case report describes an unusual fused muscle belly of the APL and extensor pollicis brevis (EPB), which split into three slips--medial, intermediate and lateral. Further, the medial slip was seen to divide into two tendons, inserting on the base of the first metacarpal along with the intermediate slip. The lateral slip divided into three tendons, inserting into the base of the proximal phalanx, base of the first metacarpal and abductor pollicis brevis muscle. The fusion and unusual insertion pattern of the APL and EPB merits documentation for reconstructive procedures such as tendon transfer and interposition arthroplasty. PMID:22711053

  17. Histochemical and morphometric characteristics of the normal human vastus medialis longus and vastus medialis obliquus muscles.

    PubMed Central

    Travnik, L; Pernus, F; Erzen, I

    1995-01-01

    The histochemical and morphometric characteristics of the vastus medialis longus and vastus medialis obliquus muscles were studied and compared with data on vastus lateralis. Cross-sections of autopsied muscles from 9 healthy men, aged 18-44 y, who had died suddenly were analysed. Data were obtained on proportions, cross-sectional diameter, and on atrophy and hypertrophy factors, of type 1, 2a, 2b, and 2c fibres. The analysis showed that the anatomical differences and the different functional demands placed on vastus medialis longus and vastus medialis obliquus are also expressed in different proportions and sizes of fibre types in the two muscles. The proportion of type 1 fibres was significantly higher (P < 0.01), and the proportion of 2b fibres was significantly lower (P < 0.01) in vastus medialis longus than in vastus medialis obliquus. The diameters of type 1 and type 2a fibres were significantly smaller (P < 0.01) in vastus medialis longus than in vastus medialis obliquus, although the differences were small. Within muscles a nonrandom arrangement of fibre types existed with the deeper portions of the muscles having more type 1 fibres than the more superficial portions. The histochemical and morphometric characteristics of vastus lateralis and vastus medialis obliquus show great similarity, reflecting the common function of both muscles which is taking part in transverse knee stability. Estimates of the limits of normality of the proportion, diameter, atrophy and hypertrophy factors of type 1, 2a, 2b, and 2c fibres might be useful in obtaining information on how different physiological and pathological conditions influence the proportion and size of different fibre types.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7592003

  18. Kienbock’s Disease treated with Interposition Arthroplasty using Ipsilateral Palmaris Longus Tendon and Muscle Belly

    PubMed Central

    Dutta, Anshuman; Sipani, Arun Kumar; Agarwala, Vikash; Srikanth, Mudiganty

    2012-01-01

    Introduction: Kienbock’s disease is an osteonecrosis of lunate bone (lunatomalacia) seen more commonly in males in the second to fourth decade of life. The exact etiology is unknown and symptoms include wrist pain and stiffness of wrist. Advanced stages of disease may require lunate excision and filling of the void by various substitutes like silicone implants, tendon grafts etc. We report a case of Kienbock’s disease with lunate excision and filling of defect by coiled palmaris longus muscle and tendon unit. Case Report: An 18 year old male student presented with progressive wrist pain and difficulty in wrist movements. Investigations revealed a diagnosis of grade 4 Kienbock’s disease. Lunate excision by a palmar approach followed by interposition arthroplasty with ipsilateral coiled Palmaris longus muscle belly along with the tendon was done under regional anaesthesia. Nine months post-operatively patient is pain free and wrist movements are full and free. Conclusion: In advanced stages of Keinbock’s disease lunate excision surgery is recommended. Post excision void can be filled with coiled Palmaris longus tendon-muscle unit together to increase the volume of the graft. This achieves snug fit, avoids the need of internal fixation, and also prevent carpal collapse. Our case shows good clinical outcome in short term with no carpal collapse by use of this procedure.

  19. Ganglion Cyst Contiguity of the Flexor Hallusis Longus Tendon in a National Swimmer

    PubMed Central

    Çirci, Esra; Özyalvaç, Osman Nuri; Tüzüner, Tolga; Ermutlu, Cenk

    2014-01-01

    Objectives: Tendinopathy of the flexor hallusis longus tendon is common in the athletes. This case is intended to be reported diagnose and treatment ganglion cyst contiguity of the flexor hallucis longus tendon that located atypical region and adversely affect the athlete's training program. Methods: 25-year-old male national swimmer was assessed with a left ankle pain. He had an intensive training program in the pool using pallets at the everyday. Pain in the left ankle was localized posterior and distal of the medial malleolus . Ankle range of motion and muscle strength was full. Neurovascular examination was normal. Radiography with anterior posterior, lateral and oblique analysis was not any unusual finding. In the evaluation with magnetic resonance imaging, thickening of the tendon sheath and effusion around the flexor hallucis longus was revealed and tendon integrity was exact. Results: Conservative treatment was planned. It was applied non-steroidal anti-inflammatory medicine, modification of the training (without or low weight pallet), platelet rich plasma (two weeks, two times peer weeks). During the six-month follow-up the patient's symptoms improved, but with the increased intensity of training at follow-up complaints started again. Professional athletes who did not respond adequately to conservative treatment surgical exposure were planned. Patient is approached the flexor hallucis longus musculotendinous junction from the posteromedial ankle at the level of the posterior talar tubercles. During the tendon exposure cyst was found at the level of talocalcaneal joint. Excision of the cyst was achieved; its size was 5x5 mm, looking transparent, well defined and soft consistency. Tenolysis is accomplished from superior to inferior to the level of the superior calcaneus. A histopathologic examination result of the cyst consistent with ganglion cyst was detected. Sport-specific training program started at the 6 weeks. There was no recurrence during the 6

  20. Lower values of handgrip strength and adductor pollicis muscle thickness are associated with hepatic encephalopathy manifestations in cirrhotic patients.

    PubMed

    Augusti, L; Franzoni, L C; Santos, L A A; Lima, T B; Ietsugu, M V; Koga, K H; Moriguchi, S M; Betting, L E; Caramori, C A; Silva, G F; Romeiro, F G

    2016-08-01

    Hepatic encephalopathy (HE) is a late complication of liver cirrhosis and is clearly associated with poor outcomes. Chronic liver insufficiency leads to progressive muscle wasting, impairing ammonia metabolism and thus increasing the risk for HE. Given the association between lean mass and adductor pollicis muscle thickness (APMT), it has been used to predict outcome and complications in many conditions, but not yet in cirrhotic patients. Therefore, this article aimed to study the association between HE manifestations and measures related to muscle mass and strength. This cross-sectional study included 54 cirrhotic outpatients with HE varying from subclinical to grade II according to the West-Haven criteria, who were submitted to neuropsychometric tests, electroencephalogram, brain Single Photon Emission Computed Tomography (SPECT), anthropometric measurements, handgrip strength (HGS) and dual energy X-ray absorptiometry exam (DXA). Multiple logistic regression analysis was performed to investigate the association between body composition measures and HE grade. Analysis of the area under the receiver operator characteristic (AUROC) curve revealed the values related to neurological manifestations (HE grades I and II). Reductions in APMT and HGS were associated with higher HE grades, suggesting a big impact caused by the loss of muscle mass and function on HE severity. The link between HE manifestations and anthropometric measures, namely APMT and HGS, point to a significant relation concerning skeletal muscles and the neurological impairment in this population. PMID:27131802

  1. Neuroanatomy and clinical analysis of the cervical sympathetic trunk and longus colli

    PubMed Central

    Yin, Zhaoyang; Yin, Jian; Cai, Jun; Sui, Tao; Cao, Xiaojian

    2015-01-01

    Abstract Anterior cervical surgery is commonly used for cervical vertebral body lesions. However, the structure of blood vessels and nerve tissues along the route of anterior cervical surgery is complex. We aimed to measure the data of the longus colli, the sympathetic trunk and the cervical sympathetic trunk (CST) ganglia in Chinese cadaver specimens. A total of 32 adult cadavers were studied. We delineated the surgical anatomy of the CST. The superior and inferior/cervicothoracic ganglia of the sympathetic trunk consistently appeared. The middle ganglion was observed in 28.1% of the specimens and there were 2 cases of unilateral double middle cervical ganglia. The inferior ganglion was observed in 25.0% of the specimens and the cervicothoracic ganglion was observed in the remaining specimens. The distance between the CST gradually decreased from the top to the bottom, and the distance between the medial edges of the longus colli gradually broadened from the top down. The average angle between the bilateral CST and the midline of the vertebra was 11.2°±1.8° on the left side and 10.3°±1.4° on the right side. The average angle between the medial margins of longus colli of both sides was 11.1°±1.9°. The CST is at high risk when LC muscle is cut transversely or is dragged heavily, especially at the levels of C6 and C7. Awareness of the regional anatomy of the CST could help surgeons to identify and preserve it during anterior cervical surgeries. PMID:26668584

  2. Neuroanatomy and clinical analysis of the cervical sympathetic trunk and longus colli.

    PubMed

    Yin, Zhaoyang; Yin, Jian; Cai, Jun; Sui, Tao; Cao, Xiaojian

    2015-11-01

    Anterior cervical surgery is commonly used for cervical vertebral body lesions. However, the structure of blood vessels and nerve tissues along the route of anterior cervical surgery is complex. We aimed to measure the data of the longus colli, the sympathetic trunk and the cervical sympathetic trunk (CST) ganglia in Chinese cadaver specimens. A total of 32 adult cadavers were studied. We delineated the surgical anatomy of the CST. The superior and inferior/cervicothoracic ganglia of the sympathetic trunk consistently appeared. The middle ganglion was observed in 28.1% of the specimens and there were 2 cases of unilateral double middle cervical ganglia. The inferior ganglion was observed in 25.0% of the specimens and the cervicothoracic ganglion was observed in the remaining specimens. The distance between the CST gradually decreased from the top to the bottom, and the distance between the medial edges of the longus colli gradually broadened from the top down. The average angle between the bilateral CST and the midline of the vertebra was 11.2°±1.8° on the left side and 10.3°±1.4° on the right side. The average angle between the medial margins of longus colli of both sides was 11.1°±1.9°. The CST is at high risk when LC muscle is cut transversely or is dragged heavily, especially at the levels of C6 and C7. Awareness of the regional anatomy of the CST could help surgeons to identify and preserve it during anterior cervical surgeries. PMID:26668584

  3. Adductor longus muscle metastasis of transitional cell carcinoma of the urinary bladder

    PubMed Central

    Koca, Irfan; Ucar, Mehmet; Bozdag, Zehra; Alkan, Samet

    2014-01-01

    Bladder cancer most commonly spreads to the lymph nodes, lungs, bones and adrenal glands. Metastasis of bladder cancer to the skeletal muscle is extremely rare, as is the case in other malignancies. We report a case of a 62-year-old male patient who presented with pain and swelling in the right lower extremity and had difficulty walking, and who was later found to have metastasis in the adductor longus muscle 3 months after the initial diagnosis of transitional cell carcinoma of the urinary bladder. The study also provides a review of the current literature. PMID:24827659

  4. Palmaris Longus Muscle's Prevalence in Different Nations and Interesting Anatomical Variations: Review of the Literature.

    PubMed

    Ioannis, Dimitriou; Anastasios, Katsourakis; Konstantinos, Natsis; Lazaros, Kostretzis; Georgios, Noussios

    2015-11-01

    The prevalence of the palmaris longus (PL) muscle varies more than any other muscle in the human body. Its absence across the world ranges between 1.5% and 63.9%. It presents with many different anomalies, discovered either clinically, intraoperatively or after anatomical examination of cadavers. This paper includes recent studies and reports about the presence and variations of the PL muscle, thereby illustrating the differences between ethnic groups, as well as emphasizing the different ways of finding it, during daily clinical and surgical practice. PMID:26491493

  5. Abductor Hallucis: Anatomical Variation and Its Clinical Implications in the Reconstruction of Chronic Nonhealing Ulcers and Defects of Foot

    PubMed Central

    Chittoria, Ravi Kumar; Pratap, Harsha; Yekappa, Suma Hottigoudar

    2015-01-01

    Abductor hallucis (AH) is an intrinsic muscle of sole of the foot. It is commonly used in the coverage of ankle and heel defects and chronic nonhealing ulcers of the foot; its use is reported to have a favorable long-term outcome. The muscle's apt bulk and size, its simple surgical isolation, absence of donor-site defect, unvaried anatomy, and long neurovascular pedicle are some of the advantages that make it a promising muscle flap. During routine cadaver dissection in the Department of Anatomy of Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India, we identified an anatomical variation in AH in both feet of a 45-year-old embalmed male Indian cadaver. The variant muscle had innumerable proximal attachments, a majority of them arising atypically in the form of tough tendinous slips from the medial intermuscular septum at the junction of central and tibial components of plantar aponeurosis, the medial surface of first metatarsal and the intermuscular septum separating AH from the flexor hallucis brevis. The tendon: muscle ratio was 1.76, higher than the normal reported ratio of 0.56±0.07. This article highlights the variation noted and its implication for clinicians. On Internet search, we did not come across the variations described in our article. Findings of the anatomical variation reported in this article could benefit surgeons who decide to use AH flaps in the future. PMID:26634184

  6. Use of adjunctive palmaris longus abductorplasty (Camitz) tendon transfer in pediatric median nerve injury.

    PubMed

    Baluch, Narges; Borschel, Gregory H

    2013-05-01

    A number of tendon transfers have been described for opponensplasty. Transfer of the palmaris longus (PL) tendon with a palmar fascial extension was initially described by Camitz. This technique has mostly been combined with carpal tunnel release in patients with long standing median neuropathy with atrophy of the thenar muscles. However, the Camitz transfer has not been previously described in the setting of pediatric median nerve injury. We report 4 cases of Camitz transfer in pediatric patients with median nerve injuries. Four children (all female; age range 3-15 yrs) underwent PL tendon transfer following median nerve injury. The causes of injury included trauma, iatrogenic injury, and neuritis of the brachial plexus. The Camitz procedure was performed at the time of median nerve decompression and/or reconstruction. All patients had excellent early return of function. Transfer of the palmaris longus tendon reliably restores palmar abduction, with minimal to no additional morbidity, in carefully selected pediatric patients with median nerve injury undergoing release of the carpal tunnel. PMID:22981385

  7. Catalase-positive microperoxisomes in rat soleus and extensor digitorum longus muscle fiber types

    NASA Technical Reports Server (NTRS)

    Riley, Danny A.; Bain, James L. W.; Ellis, Stanley

    1988-01-01

    The size, distribution, and content of catalase-reactive microperoxisomes were investigated cytochemically in three types of muscle fibers from the soleus and the extensor digitorum longus (EDL) of male rats. Muscle fibers were classified on the basis of the mitochondrial content and distribution, the Z-band widths, and the size and shape of myofibrils as the slow-twitch oxidative (SO), the fast-twitch oxidative glycolytic (FOG), and the fast-twitch glycolytic (FG) fibers. It was found that both the EDL and soleus SO fibers possessed the largest microperoxisomes. A comparison of microperoxisome number per muscle fiber area or the microperoxisome area per fiber area revealed following ranking, starting from the largest number and the area-ratio values: soleus SO, EDL SO, EDL FOG, and EDL FG.

  8. Hypogravity-induced atrophy of rat soleus and extensor digitorum longus muscles

    NASA Technical Reports Server (NTRS)

    Riley, D. A.; Ellis, S.; Slocum, G. R.; Satyanarayana, T.; Bain, J. L.; Sedlak, F. R.

    1987-01-01

    Prolonged exposure of humans to hypogravity causes weakening of their skeletal muscles. This problem was studied in rats exposed to hypogravity for 7 days aboard Spacelab 3. Hindlimb muscles were harvested 12-16 hours postflight for histochemical, biochemical, and ultrastructural analyses. The majority of the soleus and extensor digitorum longus fibers exhibited simple cell shrinkage. However, approximately 1% of the fibers in flight soleus muscles appeared necrotic. Flight muscle fibers showed increased glycogen, lower subsarcolemmal staining for mitochondrial enzymes, and fewer subsarcolemmal mitochondria. During atrophy, myofibrils were eroded by multiple focal losses of myofilaments; lysosomal autophagy was not evident. Tripeptidylaminopeptidase and calcium-activated protease activities of flight soleus fibers were significantly increased, implying a role in myofibril breakdown. Simple fiber atrophy appears to account for muscle weakening during spaceflight, but fiber necrosis is also a contributing factor.

  9. Tenosynovial chondromatosis of the flexor hallucis longus in a 17-year-old girl.

    PubMed

    Winters, Nichelle I; Thomson, A Brian; Flores, Raina R; Jordanov, Martin I

    2015-11-01

    Tenosynovial chondromatosis is a benign chondrogenic metaplasia of extra-articular synovial tissue. The most common locations for tenosynovial chondromatosis to develop are the hands and feet. The condition has rarely been reported in children. We present a case of tenosynovial chondromatosis of the flexor hallucis longus in a 17-year-old girl. The presentation was unusual not only due to the location and young age of the patient but also the absence of any palpable mass on physical exam and complete lack of calcification of the cartilage bodies. Initial diagnosis was made by MRI. The patient underwent tenosynovectomy with an excellent postoperative recovery at 6-month follow-up. Histopathology confirmed the diagnosis of tenosynovial chondromatosis. PMID:26008872

  10. Irreducible tongue-type calcaneal fracture due to interposition of flexor hallucis longus.

    PubMed

    Wong-Chung, John; O'Longain, Diarmaid; Lynch-Wong, Matthew; Julian, Harriet

    2016-06-01

    We present a rare case of interposition of the flexor hallucis longus (FHL) tendon blocking percutaneous closed reduction of a displaced tongue-type calcaneal fracture, and necessitating open repositioning of the tendon and internal fixation through a single extensile lateral approach. Although not recognized until during surgery, with a high index of suspicion, preoperative diagnosis of this injury combination should be possible on high resolution CT, thus enabling better planning of the procedure. The presence of a small sustentacular fragment, especially if markedly displaced or rotated, should further alert the physician as to increased likelihood of such tendon entrapment within the fracture. In the literature, fracture fixation and extrication of the FHL tendon have been performed via either or both lateral and medial approaches. A medial approach may prove necessary when there is severe displacement or rotation of the sustentacular fragment. Arthroscopically assisted surgery may aid in disengaging the tendon from within the fracture site. PMID:26802813

  11. Versatile but Temperamental: A Morphological Study of Palmaris Longus in the Cadaver

    PubMed Central

    Sukumaran, Tintu Thottiyil; Joseph, Susan

    2015-01-01

    Introduction: Palmaris longus (PL) is one of the most variable muscles in our body and is vestigial functionally. Its long tendon and its superficial location make it an ideal source for tendon harvesting. Variations such as absence, duplication and reversal have far reaching clinical impact. The aim of this study is to estimate the presence, variants and nerve supply of the PL. Materials and Methods: Upper extremity of 24 cadavers was dissected and PL was examined. The results were compared to other studies on the PL and literature survey was carried out. Results: Thirty nine specimens showed normal morphology and four showed complete agenesis. Other morphological variations seen included - reversed, hybrid, fusiform, fleshy and bifurcated tendon of insertion. Conclusion: Every surgeon must be aware of the variations of the versatile but temperamental PL. Prior knowledge of the layout of the muscle helps in planning intricate surgeries to which this tendon is put use to. PMID:25859436

  12. Unusual case of acute neck pain: acute calcific longus colli tendinitis.

    PubMed

    Joshi, Gunjan S; Fomin, Daren A; Joshi, Gargi S; Serano, Richard D

    2016-01-01

    Acute calcific longus colli tendinitis (ACLCT), a very rare cause of severe neck pain, dysphagia and odynophagia, is often mistaken for other common causes of neck pain. However, prompt recognition of this uncommon presentation is important to prevent unnecessary medical and surgical intervention. A 46-year-old Caucasian man presented with a 1-day history of severe neck pain, headache and odynophagia. The patient was afebrile with stable vital signs, however, the laboratory data showed mildly elevated C reactive protein and erythrocyte sedimentation rate. The physical examination was remarkable for markedly reduced cervical range of motion. MRI revealed the pathognomonic findings of paravertebral oedema and calcification. The definitive diagnosis of ACLCT was made and the patient was successfully managed with a short course of oral steroid, benzodiazepine and aural acupuncture, with complete resolution of the condition within a week. PMID:27257001

  13. Temporal changes in sarcomere lesions of rat adductor longus muscles during hindlimb reloading

    NASA Technical Reports Server (NTRS)

    Krippendorf, B. B.; Riley, D. A.

    1994-01-01

    Focal sarcomere disruptions were previously observed in adductor longus muscles of rats flown approximately two weeks aboard the Cosmos 1887 and 2044 biosatellite flights. These lesions, characterized by breakage and loss of myofilaments and Z-line streaming, resembled damage induced by unaccustomed exercise that includes eccentric contractions in which muscles lengthen as they develop tension. We hypothesized that sarcomere lesions in atrophied muscles of space flow rats were not produced in microgravity by muscle unloading but resulted from muscle reloading upon re-exposure to terrestrial gravity. To test this hypothesis, we examined temporal changes in sarcomere integrity of adductor longus muscles from rats subjected to 12.5 days of hindlimb suspension unloading and subsequent reloading by return to vivarium cages for 0, 6, 12, or 48 hours of normal weightbearing. Our ultrastructural observations suggested that muscle unloading (0 h reloading) induced myofibril misalignment associated with myofiber atrophy. Muscle reloading for 6 hours induced focal sarcomere lesions in which cross striations were abnormally widened. Such lesions were electron lucent due to extensive myofilament loss. Lesions in reloaded muscles showed rapid restructuring. By 12 hours of reloading, lesions were moderately stained foci and by 48 hours darkly stained foci in which the pattern of cross striations was indistinct at the light and electron microscopic levels. These lesions were spanned by Z-line-like electron dense filamentous material. Our findings suggest a new role for Z-line streaming in lesion restructuring: rather than an antecedent to damage, this type of Z-line streaming may be indicative of rapid, early sarcomere repair.

  14. Structural characterization of CFA/III and Longus type IVb pili from enterotoxigenic Escherichia coli.

    PubMed

    Kolappan, Subramaniapillai; Roos, Justin; Yuen, Alex S W; Pierce, Owen M; Craig, Lisa

    2012-05-01

    The type IV pili are helical filaments found on many Gram-negative pathogenic bacteria, with multiple diverse roles in pathogenesis, including microcolony formation, adhesion, and twitching motility. Many pathogenic enterotoxigenic Escherichia coli (ETEC) isolates express one of two type IV pili belonging to the type IVb subclass: CFA/III or Longus. Here we show a direct correlation between CFA/III expression and ETEC aggregation, suggesting that these pili, like the Vibrio cholerae toxin-coregulated pili (TCP), mediate microcolony formation. We report a 1.26-Å resolution crystal structure of CofA, the major pilin subunit from CFA/III. CofA is very similar in structure to V. cholerae TcpA but possesses a 10-amino-acid insertion that replaces part of the α2-helix with an irregular loop containing a 3(10)-helix. Homology modeling suggests a very similar structure for the Longus LngA pilin. A model for the CFA/III pilus filament was generated using the TCP electron microscopy reconstruction as a template. The unique 3(10)-helix insert fits perfectly within the gap between CofA globular domains. This insert, together with differences in surface-exposed residues, produces a filament that is smoother and more negatively charged than TCP. To explore the specificity of the type IV pilus assembly apparatus, CofA was expressed heterologously in V. cholerae by replacing the tcpA gene with that of cofA within the tcp operon. Although CofA was synthesized and processed by V. cholerae, no CFA/III filaments were detected, suggesting that the components of the type IVb pilus assembly system are highly specific to their pilin substrates. PMID:22447901

  15. Surgical Release of the First Extensor Compartment for Refractory de Quervain's Tenosynovitis: Surgical Findings and Functional Evaluation Using DASH Scores

    PubMed Central

    Lee, Hyun-Joo; Kim, Poong-Taek; Aminata, Iman Widya; Hong, Han-Pyo; Yoon, Jong-Pil

    2014-01-01

    Background Few studies have evaluated surgical outcomes in patients with refractory de Quervain's disease using validated outcome measures. We assessed the clinical outcomes of dorsal release of the first extensor compartment for the treatment of de Quervain's disease using the disabilities of the arm, shoulder and hand (DASH) score. Methods From October 2003 to May 2009, we retrospectively evaluated 33 patients (3 men and 30 women) who underwent surgical treatment for de Quervain's disease. All patients had a positive Finkelstein test and localized tenderness over the first dorsal compartment. All operations were performed under local anesthesia. A 2-cm-long transverse skin incision was made over the first extensor compartment and the dorsal retinaculum covering the extensor pollicis brevis was incised longitudinally. Preoperative and postoperative clinical evaluation included the use of DASH score, Finkelstein test, and visual analogue scale (VAS) score. Results In 18 patients (55%), the extensor pollicis brevis tendon compartment was separated from the abductor pollicis longus compartment. Eight patients had intracompartmental ganglia in the extensor pollicis brevis subcompartment. All patients except one had negative sign on Finkelstein test at the last follow-up. The average VAS score decreased from 7.42 preoperatively to 1.33 postoperatively (p < 0.05), and DASH score was improved from 53.2 to 3.45 (p < 0.05). There were no postoperative complications such as subluxation of the tendon of the first dorsal compartment or injury to the sensory branch of the radial nerve. Conclusions Intracompartment ganglia and the separate septum of extensor pollicis brevis are often related to de Quervain's disease. The release of the first extensor compartment for refractory de Quervain's disease resulted in good clinical outcomes with minimal morbidity. PMID:25436064

  16. The influence of passive stretch on the growth and protein turnover of the denervated extensor digitorum longus muscle.

    PubMed

    Goldspink, D F

    1978-08-15

    At 7 days after cutting the sciatic nerve, the extensor digitorum longus muscle was smaller and contained less protein than its innervated control. Correlating with these changes was the finding of elevated rates of protein degradation (measured in vitro) in the denervated tissue. However, at this time, rates of protein synthesis (measured in vitro) and nucleic acid concentrations were also higher in the denervated tissue, changes more usually associated with an active muscle rather than a disused one. These anabolic trends have, at least in part, been explained by the possible greater exposure of the denervated extensor digitorum longus to passive stretch. When immobilized under a maintained influence of stretch the denervated muscle grew to a greater extent. Although this stretch-induced growth appeared to occur predominantly through a stimulation of protein synthesis, it was opposed by smaller increases in degradative rates. Nucleic acids increased at a similar rate to the increase in muscle mass when a continuous influence of stretch was imposed on the denervated tissue. In contrast, immobilization of the denervated extensor digitorum longus in a shortened unstretched state reversed most of the stretch-induced changes; that is, the muscle became even smaller, with protein synthesis decreasing to a greater extent than breakdown after the removal of passive stretch. The present investigation suggests that stretch will promote protein synthesis and hence growth of the extensor digitorum longus even in the absence of an intact nerve supply. However, some factor(s), in addition to passive stretch, must contribute to the anabolic trends in this denervated muscle. PMID:708412

  17. Heat stress attenuates skeletal muscle atrophy of extensor digitorum longus in streptozotocin-induced diabetic rats.

    PubMed

    Nonaka, K; Une, S; Akiyama, J

    2015-09-01

    To investigate whether heat stress attenuates skeletal muscle atrophy of the extensor digitorum longus (EDL) muscle in streptozotocin-induced diabetic rats, 12-week-old male Wistar rats were randomly assigned to four groups (n = 6 per group): control (Con), heat stress (HS), diabetes mellitus (DM), and diabetes mellitus/heat stress (DM + HS). Diabetes was induced by intraperitoneal injection of streptozotocin (50 mg/kg). Heat stress was induced in the HS and DM + HS groups by immersion of the lower half of the body in hot water at 42 °C for 30 min; it was initiated 7 days after injection of streptozotocin, and was performed once a day, five times a week for 3 weeks. The muscle fiber cross-sectional area of EDL muscles from diabetic and non-diabetic rats was determined; heat stress protein (HSP) 72 and HSP25 expression levels were also analyzed by western blotting. Diabetes-induced muscle fiber atrophy was attenuated upon heat stress treatment in diabetic rats. HSP72 and HSP25 expression was upregulated in the DM + HS group compared with the DM group. Our findings suggest that heat stress attenuates atrophy of the EDL muscle by upregulating HSP72 and HSP25 expression. PMID:26551745

  18. Anatomical reconstruction of the spring ligament using peroneus longus tendon graft.

    PubMed

    Choi, Kyungjin; Lee, Samuel; Otis, James C; Deland, Jonathan T

    2003-05-01

    Posterior tibial tendon insufficiency is often associated with failure of the spring ligament and flatfoot deformity. Arch correction procedures involving bony realignment, such as lateral column lengthening or joint fusions, can predispose to arthritis. Soft tissue reconstruction may provide a more anatomical correction without these complications. The purpose of this investigation was to compare the ability of three different spring ligament reconstruction procedures to correct flatfoot deformity. A deformity model of 5 degrees - 15 degrees talonavicular abduction was created in 10 cadaver foot-ankle specimens. Three reconstructions utilizing the peroneus longus tendon were evaluated for their ability to correct talonavicular abduction and subtalar eversion under 357 N vertical GRF load. A superomedial/plantar passage of the tendon through the calcaneus and navicular was shown to be more effective than either of the other two approaches, correcting the talonavicular joint from 9.1 degrees +/- 8.1 degrees abducted to 1.0 degree +/- 6.8 degrees adducted, and the subtalar joint from 3.1 degrees +/- 3.3 degrees everted to 0.4 degrees +/- 4.2 degrees inverted. Thus, an anatomical reconstruction of a model of a failed spring ligament was demonstrated to be effective in the correction of a flatfoot deformity produced in cadaver foot-ankle specimens. PMID:12801201

  19. Responses of Electromyogram Activity in Adductor Longus Muscle of Rats to the Altered Gravity Levels

    NASA Astrophysics Data System (ADS)

    Ohira, Takashi; Wang, Xiao Dong; Terada, Masahiro; Kawano, Fuminori; Higo, Yoko; Nakai, Naoya; Ochiai, Toshimasa; Gyotoku, Jyunichirou; Nishimoto, Norihiro; Ogura, Akihiko; Ohira, Yoshinobu

    2008-06-01

    Responses of electromyogram (EMG) activities in the rostral and caudal regions of adductor longus (AL) muscle to altered gravity levels during parabolic flight of a jet airplane, as well as hindlimb suspension, were investigated in adult rats. Tonic EMGs in both regions were noted when the rats were exposed to hyper-G, as well as 1-G. The hip joints were adducted and the sedental quadrupedal position was maintained at these G levels. However, the EMG activities in these regions decreased and became phasic, when the hip joints were abducted and extended backward in μ-G environment. Such changes of joint angles caused passive shortening of sarcomeres only in the caudal region of AL. Atrophy and shift toward fast-twitch type were noted in fibers of the caudal region after 16-day unloading. Although fiber transformation was also induced in the rostral region, no atrophy was seen in fast-twitch fibers. The data may suggest that the atrophy and shift of phenotype caused by gravitational unloading in fibers of the caudal region may be related to the decrease in the neural and mechanical activities. Fiber type transformation toward fast-twitch type may be also related to the change of muscle activity from tonic to phasic patterns, which are the typical characteristics of fast-twitch muscle. However, the responses to unloading in fibers of rostral region were not related to the reduction of mechanical load.

  20. Effects of methylmercury on the motor and sensory innervation of the rat extensor digitorum longus muscle

    SciTech Connect

    Yip, R.K.; Riley, D.A.

    1987-06-01

    The histochemical study examined the effects of chronic methylmercury (MeHg) intoxication on the motor and sensory innervation of extensor digitorum longus muscles. Light microscopic examination of silver-stained axons in the intramuscular nerve bundles of MeHg-treated rats showed Wallerian-like degeneration and a reduction in the number of nerve fibers. Disrupted axons were predominantly sensory because 22.2% of spindle afferents (I/sub a/) and 90.0% of Golgi tendon organ (I/sub b/) sensory fibers were completely degenerated whereas less than 1% of motor ending were totally destroyed. Partial disruption occurred in the cholinesterase and motor terminals of 13.7% of endplates. Their results demonstrated greater vulnerability of sensory nerves than of motor nerves to MeHg-induced degeneration. Thus, the abnormal reflexes, ataxia, and muscle weakness following MeHg poisoning appear related to reduction of proprioceptive feedback from muscles and tendons irradiation to the documented lesions in the central nervous system.

  1. [Degenerative rupture of the hip abductors. Missed diagnosis with therapy-resistant trochanteric pain of the hips and positive Trendelenburg sign in elderly patients].

    PubMed

    Aepli-Schneider, N; Treumann, T; Müller, U; Schmid, L

    2012-01-01

    The cases of four elderly patients with persistent trochanteric pain and tears of the gluteus medius and/or gluteus minimus tendons detected in magnetic resonance imaging (MRI) are presented. There was no history of local trauma in any patient but three patients had a positive Trendelenburg sign. Magnetic resonance imaging showed either an obvious discontinuity of the affected tendon or an increased T2 signal above, or less specifically lateral to the greater trochanter. The presence of an elongated tendon on MRI is most likely indicative of a partial rupture of the tendon. Pain and local tenderness over the lateral aspect of the hip in clinical examination is commonly attributed to trochanteric bursitis or trochanteric pain syndrome. Partial or complete tears of the gluteus medius and/or gluteus minimus tendons are thought to represent an unusual finding. However, the true incidence and the clinical significance of hip abductor degeneration and rupture remain to be determined. More studies are needed to examine the prevalence of ruptures in asymptomatic patients, to evaluate the subsequent risk for developing osteoarthritis of the hip (caused by impaired protective reflexes originating from proprioceptive nerve endings in muscle spindles) and to determine the risk for falls related to weakness of hip abduction. Furthermore, no data exist regarding the success rate of conservative treatment. Tears of the gluteus medius and minimus tendons in the elderly population are likely to be a more common cause of pain in the greater trochanteric region than previously thought. In patients who do not respond to conservative treatment, weakness of hip abduction (positive Trendelenburg sign) and new limping should point to the possibility of hip abductor ruptures. The most useful examination technique for diagnosis is MRI. PMID:22286357

  2. Optimal Needle Placement for Extensor Hallucis Longus Muscle: A Cadaveric Study

    PubMed Central

    2016-01-01

    Objective To determine the midpoint (MD) of extensor hallucis longus muscle (EHL) and compare the accuracy of different needle electromyography (EMG) insertion techniques through cadaver dissection. Methods Thirty-eight limbs of 19 cadavers were dissected. The MD of EHL was marked at the middle of the musculotendinous junction and proximal origin of EHL. Three different needle insertion points of EHL were marked following three different textbooks: M1, 3 fingerbreadths above bimalleolar line (BML); M2, junction between the middle and lower third of tibia; M3, 15 cm proximal to the lower border of both malleoli. The distance from BML to MD (BML_MD), and the difference between 3 different points (M1–3) and MD were measured (designated D1, D2, and D3, respectively). The lower leg length (LL) was measured from BML to top of medial condyle of tibia. Results The median value of LL was 34.5 cm and BML_MD was 12.0 cm. The percentage of BML_MD to LL was 35.1%. D1, D2, and D3 were 7.0, 0.9, and 3.0 cm, respectively. D2 was the shortest, meaning needle placement following technique by Lee and DeLisa was closest to the actual midpoint of EHL. Conclusion The MD of EHL is approximately 12 cm above BML, and about distal 35% of lower leg length. Technique that recommends placing the needle at distal two-thirds of the lower leg (M2) is the most accurate method since the point was closest to muscle belly of EHL.

  3. Low-intensity resistance training attenuates dexamethasone-induced atrophy in the flexor hallucis longus muscle.

    PubMed

    Macedo, Anderson G; Krug, André L O; Herrera, Naiara A; Zago, Anderson S; Rush, James W E; Amaral, Sandra L

    2014-09-01

    This study investigated the potential protective effect of low-intensity resistance training (RT) against dexamethasone (DEX) treatment induced muscle atrophy. Rats underwent either an 8 week period of ladder climbing RT or remained sedentary. During the last 10 days of the exercise protocol, animals were submitted to a DEX treatment or a control saline injection. Muscle weights were assessed and levels of AKT, mTOR, FOXO3a, Atrogin-1 and MuRF-1 proteins were analyzed in flexor hallucis longus (FHL), tibialis anterior (TA), and soleus muscles. DEX induced blood glucose increase (+46%), body weight reduction (-19%) and atrophy in FHL (-28%) and TA (-21%) muscles, which was associated with a decrease in AKT and an increase in MuRF-1 proteins levels. Low-intensity RT prevented the blood glucose increase, attenuated the FHL atrophy effects of DEX, and was associated with increased mTOR and reductions in Atrogin-1 and MuRF-1 in FHL. In contrast, TA muscle atrophy and signaling proteins were not affected by RT. These are the first data to demonstrate that low-intensity ladder-climbing RT specifically mitigates the FHL atrophy, which is the main muscle recruited during the training activity, while not preventing atrophy in other limb muscle not as heavily recruited. The recruitment-dependent prevention of atrophy by low intensity RT likely occurs by a combination of attenuated muscle protein degradation signals and enhanced muscle protein synthesis signals including mTOR, Atrogin-1 and MuRF-1. PMID:24861267

  4. RNA-seq transcriptome analysis of extensor digitorum longus and soleus muscles in large white pigs.

    PubMed

    Zhu, Jiayu; Shi, Xin'e; Lu, Hongzhao; Xia, Bo; Li, Yuefeng; Li, Xiao; Zhang, Qiangling; Yang, Gongshe

    2016-04-01

    Skeletal muscle fibers are mainly categorized into red and white fiber types, and the ratio of red/white fibers within muscle mass plays a crucial role in meat quality such as tenderness and flavor. To better understand the molecular difference between the two muscle fibers, this study takes advantage of RNA-seq to compare differences in the transcriptome between extensor digitorum longus (EDL; white fiber) and soleus (Sol; red fiber) muscles of large white pigs. In total, 89,658,562 and 46,723,568 raw reads from EDL and Sol were generated, respectively. Comparison between the two transcriptomes revealed 561 differentially expressed genes, with 408 displaying higher and 153 lower levels of expression in Sol. Quantitative real-time polymerase chain reaction validated the differential expression of nine genes. Gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway analysis discovered several differentially enriched biological functions and processes of the two muscles. Moreover, transcriptome comparison between EDL and Sol identified many muscle-related genes (CSRP3, ACTN2, MYL1, and MYH6) and pathways related to myofiber formation, such as focal adhesion, tight junction formation, extracellular matrix (ECM)-receptor pathway, calcium signaling, and Wnt signaling. In addition, 58,362 and 58,359 single nucleotide polymorphisms were identified in EDL and Sol, respectively, and the sequence of 9069 genes was refined at the 5', 3' or both ends. Numerous novel transcripts and alternatively spliced RNAs were also identified. Our transcriptome analysis constitutes valuable sequence resource for uncovering important genes and pathways involved in muscle fiber type determination, and might help further our understanding of the molecular mechanisms in different types of muscle. PMID:26520103

  5. Palmaris Longus Muscle’s Prevalence in Different Nations and Interesting Anatomical Variations: Review of the Literature

    PubMed Central

    Ioannis, Dimitriou; Anastasios, Katsourakis; Konstantinos, Natsis; Lazaros, Kostretzis; Georgios, Noussios

    2015-01-01

    The prevalence of the palmaris longus (PL) muscle varies more than any other muscle in the human body. Its absence across the world ranges between 1.5% and 63.9%. It presents with many different anomalies, discovered either clinically, intraoperatively or after anatomical examination of cadavers. This paper includes recent studies and reports about the presence and variations of the PL muscle, thereby illustrating the differences between ethnic groups, as well as emphasizing the different ways of finding it, during daily clinical and surgical practice. PMID:26491493

  6. Allograft reconstruction of peroneus longus and brevis tendons tears arising from a single muscular belly. Case report and surgical technique.

    PubMed

    Pellegrini, Manuel J; Adams, Samuel B; Parekh, Selene G

    2015-03-01

    Anatomic variants of the peroneal tendons may cause tendon disorders. Moreover, there is a lack of evidence on how to address chronic tendon pathology when a variant of the peroneal tendons is causing the patient's symptoms. We present a patient with an uncommon peroneal muscle presentation: a single muscular belly dividing into both the peroneus longus and brevis tendons. After extensive debridement of tendinopathic tissue, primary repair or tenodesis was not possible; therefore a unique solution for this problem was performed, reconstructing both peroneal tendons using a semitendinosus allograft. PMID:25682415

  7. Efficacy of interference screw and double-docking methods using palmaris longus and GraftJacket for medial collateral ligament reconstruction of the elbow.

    PubMed

    Furukawa, Keizo; Pichora, Jamie; Steinmann, Scott; Faber, Kenneth J; Johnson, James A; King, Graham J W

    2007-01-01

    Single-strand elbow medial collateral ligament reconstruction strength was evaluated by use of double-docking and interference screw methods with either a palmaris longus tendon or GraftJacket as the reconstruction material. Thirteen upper extremities were mounted in 90 degrees of valgus orientation and subjected to cyclic valgus loading that increased progressively until failure occurred. The double-docking reconstructions outperformed the interference screw reconstructions (P < .05), whereas the palmaris longus and GraftJacket performed comparably (P > .05). The favorable initial strength of the GraftJacket make it a potentially viable alternative to the use of autogenous palmaris longus tendons; however, further studies are required to evaluate graft strength during healing. The clinical use of the double-docking technique of single-strand medial collateral ligament reconstruction should be considered because of its simplicity and initial strength. PMID:17368922

  8. Five myofibrillar lesion types in eccentrically challenged, unloaded rat adductor longus muscle--a test model

    NASA Technical Reports Server (NTRS)

    Thompson, J. L.; Balog, E. M.; Fitts, R. H.; Riley, D. A.

    1999-01-01

    Sarcomere disruptions are observed in the adductor longus (AL) muscles following voluntary reloading of spaceflown and hindlimb suspension unloaded (HSU) rat, which resemble lesions in eccentrically challenged muscle. We devised and tested an eccentric contraction (ECCON) test system for the 14-day HSU rat AL. Six to 7 hours following ECCON, ALs were fixed to allow immunostaining and electron microscopy (EM). Toluidine blue-stained histology semithin sections were screened for lesion density (#/mm2). Serial semithin sections from the ECCON group were characterized for myosin immunointensity of lesions. Five myofibrillar lesion types were identified in histological semithin sections: focal contractions; wide A-bands; opaque areas; missing A-bands; and hyperstretched sarcomeres. Lesion density by type was greater for ECCON than NonECCON ALs (P< or =0.05; focal contractions and opaque regions). Lesion density (#-of-all-five-types/mm2) was significantly different (ECCON: 23.91+/-10.58 vs. NonECCON: 5.48+/-1.28, P< or =0.05; ECCON vs. SHAM: 0.00+/-0.00; P< or = 0.025). PostECCON optimal tension decreased (Poi-drop, 17.84+/-4.22%) and was correlated to lesion density (R2=0.596), but prestretch tension demonstrated the highest correlation with lesion density (R2=0.994). In lesions, the darkly staining A-band lost the normally organized thick filament alignment to differing degrees across the different lesion types. Ranking the five lesion types by a measure of lesion length deformation (hypercontracted to hyperstretched) at the light microscopy level, related to the severity of thick filament registry loss across the lesion types at the electron microscopic level. This ranking suggested that the five lesion types seen in semithin sections at the light level represented a lesion progression sequence and paralleled myosin immunostaining loss as the distorted A-band filaments spread across the hyperlengthening lesion types. Lesion ultrastructure indicated damage involved

  9. Deep peroneal nerve palsy with isolated lateral compartment syndrome secondary to peroneus longus tear: a report of two cases and a review of the literature.

    PubMed

    Hiramatsu, Kunihiko; Yonetani, Yasukazu; Kinugasa, Kazutaka; Nakamura, Norimasa; Yamamoto, Koji; Yoshikawa, Hideki; Hamada, Masayuki

    2016-06-01

    Drop foot is typically caused by neurologic disease such as lumbar disc herniation, but we report two rare cases of deep peroneal nerve palsy with isolated lateral compartment syndrome secondary to peroneus longus tears. Both patients developed mild pain in the lower legs while playing sport, and were aware of drop foot. As compartment pressures were elevated, fasciotomy was performed immediately, and the tendon of the peroneus longus was completely detached from its proximal origin. The patients were able to return their original sports after 3 months, and clinical examination revealed no hypesthesia or muscle weakness in the deep peroneal nerve area at the time of last follow-up. The common peroneal nerve pierced the deep fascia and lay over the fibular neck, which formed the floor of a short tunnel (the so-called fibular tunnel), then passed the lateral compartment just behind the peroneus longus. The characteristic anatomical situation between the fibular tunnel and peroneus longus might have caused deep peroneal nerve palsy in these two cases after hematoma adjacent to the fibular tunnel increased lateral compartment pressure. PMID:26362782

  10. Morphological and biochemical changes in soleus and extensor digitorum longus muscles of rats orbited in Spacelab 3

    NASA Technical Reports Server (NTRS)

    Riley, D. A.; Slocum, T.; Bain, J. L. W.; Sedlak, F. R.; Elis, S.; Satyanarayana, T.

    1985-01-01

    Muscle atrophy in rats exposed to hypogravity for seven days aboard Spacelab 3 is examined. Hindlimb muscles were harvested 12-16 days postflight, and prepared for enzyme studies and electron microscopy. Simple cell shrinkage was found, with a mean fiber area decrease of 35.8 percent for soleus and 24.9 percent for extensor digitorum longus (EDL) flight muscle fibers, as compared with control muscle fibers. EDL and soleus muscles showed increases in alkaline myofibrillar ATPase, alpha glycerophosphate dehydrogenase, and glycogen, and a decrease in NADH dehydrogenase staining. The 26 percent increase in calcium activated protease suggests that the focal degradation of myofibrils is the key process of myofibril breakdown. The presence in the flight soleus muscles of one percent necrotic fibers is unexplained. The observed shift towards histochemical fast-muscle type properties is consistent with previous findings.

  11. Subtalar arthrodesis with flexor digitorum longus transfer and spring ligament repair for treatment of posterior tibial tendon insufficiency.

    PubMed

    Johnson, J E; Cohen, B E; DiGiovanni, B F; Lamdan, R

    2000-09-01

    The surgical treatment of flexible pes planovalgus deformities resulting from Stage 2 posterior tibial tendon insufficiency is controversial and many techniques have been proposed. We retrospectively reviewed the results of subtalar arthrodesis combined with spring ligament repair/reefing and flexor digitorum longus (FDL) transfer to the navicular. There were sixteen patients (seventeen feet) with an average follow-up of 27 months (9-52). All deformities were passively correctable. The average age was 56 yrs (39-78). All patients had failed conservative management, 88% had previously been treated with orthotics, and 53% had lateral pain from subfibular impingement. Two patients were noted to have degenerative changes of the subtalar joint. Successful subtalar joint fusion occurred in all patients with an average time to radiographic union of 10.1 weeks (5-24). The average AOFAS hindfoot score and Maryland foot score postoperatively was 82 and 86 respectively. Standing radiographic analysis demonstrated an average improvement in the AP talo-1st metatarsal angle of 6 degrees (24 degrees preoperative, 18 degrees postoperative). The talonavicular coverage angle improved an average of 17 degrees (34 degrees preoperative, 17 degrees postoperative). The lateral talo-1st metatarsal angle improved an average of 10 degrees (18 degrees preoperative, 8 degrees postoperative). The lateral talocalcaneal angle decreased an average of 21o (55 degrees preoperative, 34 degrees postoperative). The distance of the medial cuneiform to the floor on the lateral radiograph averaged 12mm preoperatively and 18mm postoperatively (avg. improvement 6mm). The combination of the flexor digitorum longus tendon transfer and spring ligament repair with subtalar arthrodesis is an effective and reliable procedure which provides excellent correction of hindfoot valgus as well as forefoot abduction and restoration of the height of the longitudinal arch. These results compare favorably with flexor

  12. De Qeurvian Tenosynovitis: Clinical Outcomes of Surgical Treatment with Longitudinal and Transverse Incision

    PubMed Central

    Abrisham, Syyed Jalil; Karbasi, Mohammad Hosein Akhavan; Zare, Jalil; Behnamfar, Zahra; Tafti, Arefah Dehghani; Shishesaz, Behzad

    2011-01-01

    Objectives De Quervain disease is a mechanical tenosynovitis due to inadequacy volume between abductor pollicis longus, extensor pollicis brevis and their tunnel. Treatment methods include immobilization, steroid injections, and operation. For the first time Fritz De Quervain described surgical treatment of this disease. Since then, various ways of treatment have been reported. The purpose of this study is to compare the clinical outcomes of a longitudinal incision with a transverse incision in De Quervain disease. Methods This was a randomized controlled clinical trial conducted in three hospitals in Iran, Yazd from March 2003 to September 2008. One hundred-twenty patients with De Quervain disease who did not respond to conservative treatment were operated with two different incisions. The patients were followed for three months to compare the surgical outcomes. Results During a three month follow-up, a significant difference was shown between the two methods (p=0.03). Results of surgical treatment with longitudinal incision were excellent (only 5 hypertrophic scars), but there were 13 postoperative complaints with transverse incision. Conclusion According to our findings, longitudinal incision in surgical treatment of De Quervain disease is better than transverse incision. PMID:22043391

  13. The effects of smartphone use on upper extremity muscle activity and pain threshold.

    PubMed

    Lee, Minkyung; Hong, Yunkyung; Lee, Seunghoon; Won, Jinyoung; Yang, Jinjun; Park, Sookyoung; Chang, Kyu-Tae; Hong, Yonggeun

    2015-06-01

    [Purpose] The purpose of this study was to determine whether muscle activity and pressure-induced pain in the upper extremities are affected by smartphone use, and to compare the effects of phone handling with one hand and with both hands. [Subjects] The study subjects were asymptomatic women 20-22 years of age. [Methods] The subjects sat in a chair with their feet on the floor and the elbow flexed, holding a smartphone positioned on the thigh. Subsequently, the subjects typed the Korean anthem for 3 min, one-handed or with both hands. Each subject repeated the task three times, with a 5-min rest period between tasks to minimize fatigue. Electromyography (EMG) was used to record the muscle activity of the upper trapezius (UT), extensor pollicis longus (EPL), and abductor pollicis (AP) during phone operation. We also used a dolorimeter to measure the pressure-induced pain threshold in the UT. [Results] We observed higher muscle activity in the UT, AP, and EPL in one-handed smartphone use than in its two-handed use. The pressure-induced pain threshold of the UT was lower after use of the smartphone, especially after one-handed use. [Conclusion] Our results show that smartphone operation with one hand caused greater UT pain and induced increased upper extremity muscle activity. PMID:26180311

  14. The effects of smartphone use on upper extremity muscle activity and pain threshold

    PubMed Central

    Lee, Minkyung; Hong, Yunkyung; Lee, Seunghoon; Won, Jinyoung; Yang, Jinjun; Park, Sookyoung; Chang, Kyu-Tae; Hong, Yonggeun

    2015-01-01

    [Purpose] The purpose of this study was to determine whether muscle activity and pressure-induced pain in the upper extremities are affected by smartphone use, and to compare the effects of phone handling with one hand and with both hands. [Subjects] The study subjects were asymptomatic women 20–22 years of age. [Methods] The subjects sat in a chair with their feet on the floor and the elbow flexed, holding a smartphone positioned on the thigh. Subsequently, the subjects typed the Korean anthem for 3 min, one-handed or with both hands. Each subject repeated the task three times, with a 5-min rest period between tasks to minimize fatigue. Electromyography (EMG) was used to record the muscle activity of the upper trapezius (UT), extensor pollicis longus (EPL), and abductor pollicis (AP) during phone operation. We also used a dolorimeter to measure the pressure-induced pain threshold in the UT. [Results] We observed higher muscle activity in the UT, AP, and EPL in one-handed smartphone use than in its two-handed use. The pressure-induced pain threshold of the UT was lower after use of the smartphone, especially after one-handed use. [Conclusion] Our results show that smartphone operation with one hand caused greater UT pain and induced increased upper extremity muscle activity. PMID:26180311

  15. Effect of acetoacetate on glucose metabolism in the soleus and extensor digitorum longus muscles of the rat.

    PubMed Central

    Maizels, E Z; Ruderman, N B; Goodman, M N; Lau, D

    1977-01-01

    1. The effect of acetoacetate on glucose metabolism was compared in the soleus, a slow-twitch red muscle, and the extensor digitorum longus, a muscle composed of 50% fast-twitch red and 50% white fibres. 2. When incubated for 2h in a medium containing 5 mM-glucose and 0.1 unit of insulin/ml, rates of glucose uptake, lactate release and glucose oxidation in the soleus were 19.6, 18.6 and 1.47 micronmol/h per g respectively. Acetoacetate (1.7 mM) diminished all three rates by 25-50%; however, it increased glucose conversion into glycogen. In addition, it caused increases in tissue glucose, glucose 6-phosphate and fructose 6-phosphate, suggesting inhibition of phosphofructokinase. The concentrations of citrate, an inhibitor of phosphofructokinase, and of malate were also increased. 3. Rates of glucose uptake and lactate release in the extensor digitorum longus were 50-80% of those in the soleus. Acetoacetate caused moderate increases in tissue glucose 6-phosphate and possibly citrate, but it did not decrease glucose uptake or lactate release. 4. The rate of glycolysis in the soleus was approximately five times that previously observed in the perfused rat hindquarter, a muscle preparation in which acetoacetate inhibits glucose oxidation, but does not alter glucose uptake or glycolysis. A similar rate of glycolysis was observed when the soleus was incubated with a glucose-free medium. Under these conditions, tissue malate and the lactate/pyruvate ratio in the medium were decreased, and acetoacetate did not decrease lactate release or increase tissue citrate or glucose 6-phosphate. An intermediate rate of glycolysis, which was not decreased by acetoacetate, was observed when the soleus was incubated with glucose, but not insulin. 5. The data suggest that acetoacetate glucose inhibits uptake and glycolysis in red muscle under conditions that resemble mild to moderate exercise. They also suggest that the accumulation of citrate in these circumstances is linked to the rate

  16. Numerical and areal density estimates of fibre type composition in a skeletal muscle (rat extensor digitorum longus).

    PubMed Central

    Egginton, S

    1990-01-01

    The composition of a mixed fast skeletal muscle (rat extensor digitorum longus) was examined to quantify the difference between the relative number of the three major fibre types in a representative muscle and their relative contribution to muscle cross-section, i.e. numerical (NN) and areal (AA) densities, respectively. These two indices clearly differ in their physiological relevance. While the former may be useful in describing hyperplasia, the latter allows for differences in size among fibre types. When estimated as NN, over 20% of fields contained 5-10% SO fibres and less than 5% had 75-80% FG fibres. In contrast, only 2% of fields had an AA of 5-10% for SO fibres while around 30% contained 75-80% FG fibres. The importance of a direct method for estimating AA is emphasised, as an indirect approach may have an error of 20-30% when used for oxidative fibre types. The use of an unbiased sampling regime to minimise error in determining both numerical and areal densities of different fibre types is illustrated. Images Fig. 1 Fig. 2 PMID:2139022

  17. Resisted adduction in hip neutral is a superior provocation test to assess adductor longus pain: An experimental pain study.

    PubMed

    Drew, M K; Palsson, T S; Izumi, M; Hirata, R P; Lovell, G; Chiarelli, P; Osmotherly, P G; Graven-Nielsen, T

    2016-08-01

    The criterion of long-standing groin pain diagnoses in athletes usually relies on palpation and clinical tests. An experimental pain model was developed to examine the clinical tests under standardized conditions. Pain was induced by hypertonic saline injected into the proximal adductor longus (AL) tendon or rectus femoris (RF) tendon in 15 healthy male participants. Isotonic saline was injected contralaterally as a control. Pain intensity was assessed on a visual analog scale (VAS). Resisted hip adduction at three different angles and trunk flexion were completed before, during, and after injections. Pain provocation in the presence of experimental pain was recorded as a true positive compared with pain provocation in the non-pain conditions. Similar peak VAS scores were found after hypertonic saline injections into the AL and RF and both induced higher VAS scores than isotonic saline (P < 0.01). Adduction at 0° had the greatest positive likelihood ratio (+LR = 2.8, 95%CI: 1.09-7.32) with 45° (-LR = 0.0, 95%CI: 0.00-1.90) and 90° (-LR = 0.0, 95%CI: 0.00-0.94) having the lowest negative LR. This study indicates that the 0° hip adduction test resisted at the ankles optimizes the diagnostic procedure without compromising diagnostic capacity to identify experimental groin pain. Validation in clinical populations is warranted. PMID:26247618

  18. A Case of Reverse Palmaris Longus Muscle- An Additional Muscle in the Anterior Compartment of the Forearm

    PubMed Central

    Bhat, Ashwini Lagadamane Sathynarayana; Gadahad, Mohandas Rao Kappettu

    2016-01-01

    It is uncommon to have additional muscles in the upper limb. Some of them may restrict the movements or compress the nerves and vessels, while others may go unnoticed. During the routine dissection for undergraduate medical students, we observed an additional muscle in the anterior compartment of the forearm in about 60-year-old male cadaver. The muscle had a prominent belly and a long tendon. Distally, it was attached to the flexor retinaculum by a short and thick tendon. Proximally, long tendon of the muscle passed between the flexor carpi ulnaris and palmaris longus and was attached to the common aponeurosis shared by the extensor carpi ulnaris and flexor digitorum profundus muscles. The additional muscle belly was supplied by a branch from the anterior interosseous nerve. The ulnar nerve and artery was passing deep to the fleshy belly of the muscle. The muscle reported here might compress the ulnar nerve and artery and may produce neurovascular symptoms. On the other hand, the tendon and fleshy belly of the muscle could be useful in muscle/tendon grafts. The observations made by us in the present case will supplement our knowledge of variations of the muscles in this region which could be useful for surgeons during the forearm and hand surgeries. PMID:27134851

  19. A Case of Reverse Palmaris Longus Muscle- An Additional Muscle in the Anterior Compartment of the Forearm.

    PubMed

    Marpalli, Sapna; Bhat, Ashwini Lagadamane Sathynarayana; Gadahad, Mohandas Rao Kappettu

    2016-03-01

    It is uncommon to have additional muscles in the upper limb. Some of them may restrict the movements or compress the nerves and vessels, while others may go unnoticed. During the routine dissection for undergraduate medical students, we observed an additional muscle in the anterior compartment of the forearm in about 60-year-old male cadaver. The muscle had a prominent belly and a long tendon. Distally, it was attached to the flexor retinaculum by a short and thick tendon. Proximally, long tendon of the muscle passed between the flexor carpi ulnaris and palmaris longus and was attached to the common aponeurosis shared by the extensor carpi ulnaris and flexor digitorum profundus muscles. The additional muscle belly was supplied by a branch from the anterior interosseous nerve. The ulnar nerve and artery was passing deep to the fleshy belly of the muscle. The muscle reported here might compress the ulnar nerve and artery and may produce neurovascular symptoms. On the other hand, the tendon and fleshy belly of the muscle could be useful in muscle/tendon grafts. The observations made by us in the present case will supplement our knowledge of variations of the muscles in this region which could be useful for surgeons during the forearm and hand surgeries. PMID:27134851

  20. Diabetic Muscle Infarction of the Tibialis Anterior and Extensor Hallucis Longus Muscles Mimicking the Malignant Soft-Tissue Tumor

    PubMed Central

    Mimata, Yoshikuni; Sato, Kotaro; Tokunaga, Karen; Tsukimura, Itsuko; Tada, Hiroshi; Doita, Minoru

    2015-01-01

    One of the most common causes of skeletal muscle infarction is diabetic muscle infarction (DMI), a rare complication associated with poorly controlled diabetes. We report an atypical case of DMI localized in the tibialis anterior (TA) and extensor hallucis longus (EHL) muscles of an elderly individual. A 64-year-old man with type 2 diabetes mellitus presented with a 6-month history of a palpable mass in his lower left leg. Magnetic resonance imaging (MRI) revealed that the mass exhibited heterogeneous signals on T1- and T2-weighted images and slight heterogeneous enhancement within the muscles on fat suppressed T1-weighted images. Because histopathological analysis revealed mostly necrotic muscle tissues but no neoplastic cells, we resected the affected muscles. A typical symptom of DMI is severe abrupt-onset pain in the region of the affected muscles, but the patient did not complain of pain. Therefore, the diagnosis and treatment for DMI were delayed, and widespread irreversible muscle necrosis developed. MRI findings of DMI can be similar to that of a malignant soft-tissue tumor. So, it is necessary to consider the malignant soft-tissue tumor as one of the differential diagnoses of DMI. PMID:26236522

  1. The cadaveric anatomy of the distal radius: implications for the use of volar plates

    PubMed Central

    McCann, PA; Clarke, D; Amirfeyz, R; Bhatia, R

    2012-01-01

    INTRODUCTION Fractures of the distal radius are common upper limb injuries, representing a substantial proportion of the trauma workload in orthopaedic units. With ever increasing advancements in implant technology, operative intervention is becoming more frequent. As growing numbers of surgeons are performing operative fixation of distal radial fractures, an accurate understanding of the relevant surgical anatomy is paramount. The flexor carpi radialis (FCR) tendon forms the cornerstone of the Henry approach to the volar cortex of the distal radius. A number of key neurovascular structures around the wrist are potentially at risk during this approach, especially when the FCR is mobilised and placed under retractors. METHODS In order to clarify the safe margins of the FCR approach, ten fresh frozen human cadaver limbs were dissected. The location of the radial artery, the median nerve, the palmar cutaneous branch of the median nerve and the superficial branch nerve were measured with respect to the FCR tendon. Measurements were taken on a centre-to-centre basis in the coronal plane at the watershed level. In addition, the distances between the tendons of brachioradialis, abductor pollicis longus and flexor pollicis longus, and the radial artery and median nerve were measured to create a complete picture of the anatomy of the FCR approach to the distal radius. RESULTS The structure most at risk was the palmar cutaneous branch of the median nerve. It was located on average 3.4mm from the FCR tendon. The radial artery and the main trunk of the median nerve were located 7.8mm and 8.9mm from the tendon. The superficial branch of the radial nerve was 24.4mm from the FCR tendon and 11.1mm from the brachioradialis tendon. CONCLUSIONS Operative intervention is not without complication. We believe a more accurate understanding of the surgical anatomy is key to the prevention of neurovascular damage arising from the surgical management of distal radial fractures. PMID

  2. Flexor digitorum accessorius longus muscle in resistant clubfoot patients: introduction of a new sign predicting its presence.

    PubMed

    Shaheen, Samir; Mursal, Haitham; Rabih, Mohamed; Johari, Ashok

    2015-03-01

    Clubfoot, talipes equino varus (TEV), is a common congenital foot anomaly. Some cases are resistant to conservative treatment. Many causes of resistance have been reported, among these, the presence of anomalous muscles; however, the effect of the presence of anomalous muscles on the outcome of conservative management is not well studied. These aberrant muscles are discovered during the extensive surgical release as an abnormal finding. The aim of this work is to study the demographic characteristics of patients with resistant TEV that necessitated extensive soft tissue release at Sudan Clubfoot Clinic and to document the prevalence of flexor digitorum accessorius longus (FDAL) muscle in a large series of clubfoot patients treated by extensive surgery: posteromedial release. Also, we introduce a new observation as an indication by which the surgeon can predict the presence of FDAL. On the basis of an observation that there is a special posture of the big toe in extension in relation to other flexed toes associated with the presence of FDAL, records of patients of clubfoot treated by extensive surgery between 2007 and 2012 at the Sudan Clubfoot Project were reviewed. Demographic characteristics were studied. Only patients with idiopathic TEV were included. Resistant clubfeet necessitated extensive release in 261 patients, 197 males and 64 females. Their ages ranged between 1 day and 15 years at presentation. FDAL muscle was found in 48 patients (54 feet) out of 261 patients (411 feet, 13.14%). In 46 of the 48 patients (95.8%), the presence of the FDAL could be predicted by a sign. FDAL is prevalent in 13% of resistant TEV cases requiring extensive soft tissue release, and the surgeon can expect resistant clubfoot and predict the presence of the FDAL in over 95% before he operates by observing the Samir-Adam sign. PMID:25493703

  3. S1P3 receptor influences key physiological properties of fast-twitch extensor digitorum longus muscle.

    PubMed

    Germinario, Elena; Bondì, Michela; Cencetti, Francesca; Donati, Chiara; Nocella, Marta; Colombini, Barbara; Betto, Romeo; Bruni, Paola; Bagni, Maria Angela; Danieli-Betto, Daniela

    2016-06-01

    To examine the role of sphingosine 1-phosphate (S1P) receptor 3 (S1P3) in modulating muscle properties, we utilized transgenic mice depleted of the receptor. Morphological analyses of extensor digitorum longus (EDL) muscle did not show evident differences between wild-type and S1P3-null mice. The body weight of 3-mo-old S1P3-null mice and the mean cross-sectional area of transgenic EDL muscle fibers were similar to those of wild-type. S1P3 deficiency enhanced the expression level of S1P1 and S1P2 receptors mRNA in S1P3-null EDL muscle. The contractile properties of S1P3-null EDL diverge from those of wild-type, largely more fatigable and less able to recover. The absence of S1P3 appears responsible for a lower availability of calcium during fatigue. S1P supplementation, expected to stimulate residual S1P receptors and signaling, reduced fatigue development of S1P3-null muscle. Moreover, in the absence of S1P3, denervated EDL atrophies less than wild-type. The analysis of atrophy-related proteins in S1P3-null EDL evidences high levels of the endogenous regulator of mitochondria biogenesis peroxisome proliferative-activated receptor-γ coactivator 1α (PGC-1α); preserving mitochondria could protect the muscle from disuse atrophy. In conclusion, the absence of S1P3 makes the muscle more sensitive to fatigue and slows down atrophy development after denervation, indicating that S1P3 is involved in the modulation of key physiological properties of the fast-twitch EDL muscle. PMID:26718782

  4. Toe Flexor Strength, Flexibility and Function and Flexor Hallucis Longus Tendon Morphology in Dancers and Non-Dancers.

    PubMed

    Rowley, K Michael; Jarvis, Danielle N; Kurihara, Toshiyuki; Chang, Yu-Jen; Fietzer, Abbigail L; Kulig, Kornelia

    2015-09-01

    Tendinopathy of the flexor hallucis longus (FHL), colloquially referred to as "dancer's tendinitis," is a common condition in dancers and attributed to high demand on this muscle in positions of extreme ankle plantarflexion and metatarsophalangeal (MTP)) flexion and extension. Despite such a high prevalence, there has been little research into preventative or nonsurgical interventions. As a means to identify potential targets for prevention and intervention, this study aimed to characterize toe flexors in dancers by measuring strength, flexibility, function, and FHL tendon morphology. Dancers (n=25) were compared to non-dancers (n=25) in toe flexor isometric strength, first MTP joint range of motion, foot longitudinal arch flexibility, balance ability, endurance during modified heel raises without use of the toes, and FHL tendon thickness, cross-sectional area, and peak spatial frequency. Significant differences were found in functional first MTP joint extension (dancers 101.95°, non-dancers 91.15°, p<0.001), balance ability during single-leg stance on the toes (dancers 11.43 s, non-dancers 5.90 s, p=0.013), and during modified heel raises (dancers 22.20 reps, non-dancers 28.80 reps, p=0.001). Findings indicate that dancers rely on toe flexors more than non-dancers to complete balance and heel raise tasks. Efficacy of using this modified heel raise task with the toes off the edge of a block as a means to train larger plantarflexors and as a nonsurgical intervention should be studied in the future. Improving interventions for FHL tendinopathy will be impactful for dancers, in whom this condition is highly prevalent. PMID:26395616

  5. Resistance exercise training attenuates wasting of the extensor digitorum longus muscle in mice bearing the colon-26 adenocarcinoma.

    PubMed

    al-Majid, S; McCarthy, D O

    2001-01-01

    Progressive wasting of skeletal muscle is a significant side effect of malignancy. Perturbations in protein metabolism contribute to this state of wasting. Resistance exercise increases protein synthesis and mass of healthy muscles and counteracts muscle wasting associated with several catabolic conditions. It is not known whether resistance exercise training can counteract cancer-induced muscle wasting. This study examined the effect of resistance exercise training on muscle mass and protein content in 9 mice bearing the colon-26 adenocarcinoma. The dorsiflexor (extensor digitorum longus [EDL] and tibialis anterior) and plantar flexor (soleus, plantaris, and gastrocnemius) muscles of 1 leg of the tumor-bearing and the control mice were stimulated to contract eccentrically and concentrically, respectively, using an electrical stimulation protocol consisting of 10 sets of 6 repetitions per session. The muscles were stimulated on alternate days for a total of 8 sessions. The weight and protein content of the stimulated EDL muscle in the tumor-bearing mice were significantly higher (62% and 25%, respectively) than those of the nonstimulated EDL. Training did not have significant effects on the weight or protein content of the other muscles of the tumor-bearing mice, nor did it have significant effects on the muscles of the controls. These findings demonstrated that resistance training attenuated cancer-induced muscle wasting and protein depletion in the EDL muscle. The lack of an effect of the same training protocol on the EDL muscle in the control mice suggests that the amount and intensity of exercise training that is adequate to attenuate muscle wasting may not be adequate to induce hypertrophy of healthy muscles. PMID:11547537

  6. Muscles within muscles: a tensiomyographic and histochemical analysis of the normal human vastus medialis longus and vastus medialis obliquus muscles

    PubMed Central

    Travnik, Ludvik; Djordjevič, Srdjan; Rozman, Sergej; Hribernik, Marija; Dahmane, Raja

    2013-01-01

    The aim of this study was to show the connection between structure (anatomical and histochemical) and function (muscle contraction properties) of vastus medialis obliquus (VMO) and vastus medialis longus (VML). The non-invasive tensiomyography (TMG) method was used to determine the contractile properties (contraction time; Tc) of VML and VMO muscle, as a reflection of the ratio between the slow and fast fibers in two groups of nine young men. VML and VMO significantly (P < 0.01) differ in the proportion of type 1 (59.6: 44%) and type 2b (6.3: 15%) fibers. The VML muscle is almost entirely composed of type 1 and type 2a fibers. In many samples of this muscle no type 2b fibers were found. The proportion of slow-twitch type 1 fibers is nearly twice as high as the proportion of fast-twitch type 2a fibers. These observations indicate that VML is a slower and more fatigue-resistant muscle than VMO muscle. These characteristics correspond to the different functions of the VML, which is an extensor of the knee, and to the VMO, which maintains the stable position of the patella in the femoral groove. Our results obtained by TMG provided additional evidence that muscle fibers within the segments of VM muscle were not homogenous with regard to their contractile properties, thereby confirming the histochemical results. Tc can be attributed to the higher percentage of slow-twitch fibers – type 1. The statistically shorter Tc (P ≤ 0.001) of VMO (22.8 ± 4.0 ms) compared with VML (26.7 ± 4.0 ms) in our study is consistent with previously found differences in histochemical, morphological and electrophysiological data. In conclusion, the results of this study provide evidence that the VML and VMO muscles are not only anatomically and histochemically different muscles, but also functionally different biological structures. PMID:23586984

  7. Reconstruction of the dynamic velopharyngeal function by combined radial forearm-palmaris longus tenocutaneous free flap, and superiorly based pharyngeal flap in postoncologic total palatal defect.

    PubMed

    Nuri, Takashi; Ueda, Koichi; Yamada, Akira; Okada, Masashi; Hara, Mai

    2015-04-01

    We attempted to reconstruct dynamic palatal function using a radial forearm-palmaris longus tenocutaneous free flap in conjunction with a pharyngeal flap for a postoncologic total-palate defect in a 67-year-old male patient. This reconstruction involved 3 important tasks, namely, separating the oral and nasal cavities, preserving the velopharyngeal space to avoid sleep apnea, and maintaining velopharyngeal closure to avoid nasal regurgitation during swallowing. In our technique, the radial forearm flap separates the oral and nasal cavities with an open rhinopharyngeal space, and a superiorly based pharyngeal flap, which is sutured to the posterior end of the forearm flap, limits the rhinopharyngeal space, and forms the bilateral velopharyngeal port. Furthermore, the palmaris longus tendon, which is attached to the forearm flap, is secured to the superior constrictor muscle to create a horizontal muscle sling. Contraction of the superior constrictor muscle leads to shrinkage of the sling, resulting in velopharyngeal closure. Swallowing therapy was started 4 weeks after the surgery. The patient could resume oral intake without any difficulties 6 months after the surgery. Speech intelligibility changed from severe to minimal hypernasality. PMID:25749212

  8. Effect of Electroacupuncture on the Expression of Glycyl-tRNA Synthetase and Ultrastructure Changes in Atrophied Rat Peroneus Longus Muscle Induced by Sciatic Nerve Injection Injury.

    PubMed

    Wang, Meng; Zhang, Xiao Ming; Yang, Sheng Bo

    2016-01-01

    Glycyl-tRNA synthetase (GlyRS) is one of the key enzymes involved in protein synthesis. Its mutations have been reported to cause Charcot-Marie-Tooth disease which demonstrates muscular atrophy in distal extremities, particularly manifested in peroneus muscles. In this situation, the dysfunctions of mitochondria and sarcoplasmic reticulum (SR) affect energy supply and excitation-contraction coupling of muscle fibers, therefore resulting in muscular atrophy. Although the treatment of muscular atrophy is a global urgent problem, it can be improved by electroacupuncture (EA) treatment. To investigate the mechanism underlying EA treatment improving muscular atrophy, we focused on the perspective of protein synthesis by establishing a penicillin injection-induced sciatic nerve injury model. In our model, injured rats without treatment showed decreased sciatic functional index (SFI), decreased peroneus longus muscle weight and muscle fiber cross-sectional area, aggregated mitochondria with vacuoles appearing, swollen SR, and downregulated mRNA and protein expression levels of GlyRS and myosin heavy chain IIb (MHC-IIb). The injured rats with EA treatment showed significant recovery. These results indicated that EA stimulation can alleviate peroneus longus muscular atrophy induced by iatrogenic sciatic nerve injury through promoting the recovery of GlyRS and muscle ultrastructure and increasing muscle protein synthesis. PMID:27274754

  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. Effect of Electroacupuncture on the Expression of Glycyl-tRNA Synthetase and Ultrastructure Changes in Atrophied Rat Peroneus Longus Muscle Induced by Sciatic Nerve Injection Injury

    PubMed Central

    Wang, Meng; Zhang, Xiao Ming; Yang, Sheng Bo

    2016-01-01

    Glycyl-tRNA synthetase (GlyRS) is one of the key enzymes involved in protein synthesis. Its mutations have been reported to cause Charcot-Marie-Tooth disease which demonstrates muscular atrophy in distal extremities, particularly manifested in peroneus muscles. In this situation, the dysfunctions of mitochondria and sarcoplasmic reticulum (SR) affect energy supply and excitation-contraction coupling of muscle fibers, therefore resulting in muscular atrophy. Although the treatment of muscular atrophy is a global urgent problem, it can be improved by electroacupuncture (EA) treatment. To investigate the mechanism underlying EA treatment improving muscular atrophy, we focused on the perspective of protein synthesis by establishing a penicillin injection-induced sciatic nerve injury model. In our model, injured rats without treatment showed decreased sciatic functional index (SFI), decreased peroneus longus muscle weight and muscle fiber cross-sectional area, aggregated mitochondria with vacuoles appearing, swollen SR, and downregulated mRNA and protein expression levels of GlyRS and myosin heavy chain IIb (MHC-IIb). The injured rats with EA treatment showed significant recovery. These results indicated that EA stimulation can alleviate peroneus longus muscular atrophy induced by iatrogenic sciatic nerve injury through promoting the recovery of GlyRS and muscle ultrastructure and increasing muscle protein synthesis. PMID:27274754

  11. Evaluation of the cytotoxic effects of Cyperus longus extract, fractions and its essential oil on the PC3 and MCF7 cancer cell lines

    PubMed Central

    MEMARIANI, TOKTAM; HOSSEINI, TOKTAM; KAMALI, HOSSEIN; MOHAMMADI, AMENEH; GHORBANI, MARYAM; SHAKERI, ABDOREZA; SPANDIDOS, DEMETRIOS A.; TSATSAKIS, ARISTIDIS M.; SHAHSAVAND, SHABNAM

    2016-01-01

    Cyperus longus is one of the Iranian endemic species. However, to date, and to the best of our knowledge, there are no availale academic reports on the cytotoxicity of this plant. Thus, this study was carried out to examine the in vitro anti-proliferative and anti-apoptotic effects of Cyperus longus extract, fractions and essential oil (EO) on MCF7 and PC3 cell lines. The chemical constituents of EO were identified using gas chromatography (GC)-mass spectrometry (MS) analysis. The cells were cultured in RPMI-1640 medium and incubated with various concentrations of the plant extract and fractions. Cell viability was quantified by MTT assay following 24, 48 and 72 h of exposure to (12.5–200 µg/ml) of the methanol extract, the dichloromethane (CH2Cl2), ethyl acetate (EtOAc) and water fractions, as well as the EO of the plant. The percentage of apoptotic cells was determined using propidium iodide staining of DNA fragments by flow cytometry (sub-G1 peak). The most effective fraction in the MCF7 cell line was the CH2Cl2 fraction (IC50 after 48 h, 25.34±2.01). The EtOAc fraction (IC50 after 48 h, 35.2±2.69) and the methanol extract (IC50 after 48 h, 64.64±1.64) were also found to be effective. The IC50 values obtained for the PC3 cell line were 37.97±3.87, 51.57±3.87 and 70.33±2.36 for the CH2Cl2 fraction, the EtOAc fraction and the methanol extract, respectively. Based on these data and due to the partial polarity of the most effective fraction (the CH2Cl2 fraction), we also examined the cytotoxicity of the plant EO. The IC50 values after 48 h were 22.25±4.25 and 12.55±3.65 in the PC3 and MCF7 cell lines, respectively. DNA fragmentation assay also confirmed these data. Performing GC-MS analysis for the plant EO revealed that β-himachalene (10.81%), α-caryophyllene oxide (7.6%), irisone (4.78%), β-caryophyllene oxide (4.36%), humulene oxide (12%), viridiflorol (4.73%), aristolone (6.39%) and longiverbenone (6.04%) were the main constituents. Our results

  12. Flexor digitorum brevis tendon transfer to the flexor digitorum longus tendon according to Valtin in posttraumatic flexible claw toe deformity due to extrinsic toe flexor shortening.

    PubMed

    Gonçalves, H; Kajetanek, C; Graff, W; Thiongo, M; Laporte, C

    2015-04-01

    Claw toe deformity after posterior leg compartment syndrome is rare but incapacitating. When the mechanism is flexor digitorum longus (FDL) shortening due to ischemic contracture of the muscle after posterior leg syndrome, a good treatment option is the Valtin procedure in which the flexor digitorum brevis (FDB) is transferred to the FDL after FDL tenotomy. The Valtin procedure reduces the deformity by lengthening and reactivating the FDL. Here, we report the outcomes of FDB to FDL transfer according to Valtin in 10 patients with posttraumatic claw toe deformity treated a mean of 34 months after the injury. Toe flexion was restored in all 10 patients, with no claw toe deformity even during dorsiflexion of the ankle. PMID:25703152

  13. Musculoskeletal Management of a Patient With a History of Chronic Ankle Sprains: Identifying Rupture of Peroneal Brevis and Peroneal Longus With Diagnostic Ultrasonography

    PubMed Central

    Bruin, Dick B.; von Piekartz, Harry

    2014-01-01

    Objective The purpose of this case report is to describe the use of mobilization and eccentric exercise training for a patient with ankle pain and a history of chronic ankle sprains and discuss the course of diagnostic decision making when the patient did not respond to care. Clinical Features A 48-year-old police officer who had sustained multiple ankle sprains throughout his life presented with pain and restriction in his ability to walk, run, and work. The Global Rating of Change Scale score was − 6, the Numeric Pain Rating Scale score was 7/10, and the Lower Extremity Functional Scale score was − 33. Palpation of the peroneus longus and brevis muscles and inversion with overpressure reproduced the chief concern (Numeric Pain Rating Scale 7/10). The patient was initially diagnosed with chronic peroneal tendinopathy. Intervention and Outcome Treatment included lateral translation mobilization of the talocrural joint combined with eccentric exercise using an elastic band for the peroneal muscles. The patient reported improvement in pain and function during the course of intervention but not as rapidly as expected. Therefore, follow-up ultrasonographic imaging and radiography were performed. These studies revealed partial rupture of the peroneal brevis muscle and total rupture of the peroneal longus muscle. Conclusion A patient with long-term concerns of the foot complex with a diagnosis of peroneal tendinopathy showed slight improvement with eccentric exercises combined with manual therapy of the talocrural joint. After a course of treatment but minimal response, a diagnosis of tendon rupture was confirmed with diagnostic ultrasonography. Clinicians should be aware that when injuries do not improve with care, tendon rupture should be considered. PMID:25225470

  14. Partial arthroscopic trapeziectomy with ligament reconstruction to treat primary thumb basal joint osteoarthritis.

    PubMed

    Desmoineaux, P; Delaroche, C; Beaufils, P

    2012-11-01

    Since the outcome of partial trapeziectomy is not always satisfactory, we proposed using arthroscopy to perform partial trapeziectomy and to perform ligament reconstruction with the abductor pollicis longus tendon. A tendon strip was left intact at its insertion at the base of the first metacarpal and then slipped into the trapeziectomy space. It was fixed into a blind tunnel at the base of the second metacarpal with a bioabsorbable interference screw. Forty-nine patients were surgically treated between 2006 and 2009. With an average follow-up of 3.6 years, 83.5% of patients were satisfied with the procedure; 96% of thumbs were stable and 74% were pain free. The average recovery time was 4.5 months. There were four cases of radial nerve branch irritation and one case of flexor carpi radialis tendinitis; there were no cases of complex regional pain syndrome. This minimally-invasive technique is a less-aggressive treatment approach for thumb carpometacarpal joint arthritis, which simplify postoperative recovery. PMID:23098774

  15. Arthroscopic Release of Flexor Hallucis Longus Tendon Sheath in Female Ballet Dancers: Dynamic Pathology, Surgical Technique, and Return to Dancing Performance.

    PubMed

    Funasaki, Hiroki; Hayashi, Hiroteru; Sakamoto, Kanako; Tsuruga, Rei; Marumo, Keishi

    2015-12-01

    Stenosing tenosynovitis of the flexor hallucis longus (FHL) tendon is known as a major overuse lesion in female dancers. We describe arthroscopic surgical techniques in relation to the dynamic pathology of the disease. Crepitus and pain on moving the great toe with the ankle in plantar flexion on preoperative examination confirm the diagnosis of FHL stenosing tenosynovitis even if the os trigonum is not evident. The ankle is approached through standard posterolateral and posteromedial portals. A 4.0-mm-diameter 30° arthroscope is used. Soft tissues around the talus are cleared with a motorized shaver and a radiofrequency device. The posterior aspects of the talus, os trigonum, and FHL tendon surrounded by the tendon sheath are visualized. The dynamic pathology of the FHL tendon is well observed on passive motion of the great toe. The prominent bone fragment of the talus is removed and the tendon sheath is cut with a retrograde knife and a motorized shaver from the superior border down to the entrance of the fibro-osseous tunnel. Arthroscopic release of the FHL tendon sheath is a useful and easy method to directly approach the dynamic pathology of FHL tenosynovitis in female ballet dancers. PMID:27284509

  16. Low Median Nerve Transfers (Opponensplasty).

    PubMed

    Chadderdon, Robert Christopher; Gaston, R Glenn

    2016-08-01

    Opposition is the placement of the thumb opposite the fingers into a position from which it can work. This motion requires thumb palmar abduction, flexion, and pronation, which are provided by the abductor pollicis brevis, flexor pollicis brevis (FPB), and opponens pollicis. In the setting of a median nerve palsy, this function is typically lost, although anatomic variations and the dual innervation of the FPB may prevent complete loss at times. There are multiple well described and accepted tendon transfers to restore opposition, none of which have been proven to be superior to the others. PMID:27387078

  17. EMG and force production of the flexor hallucis longus muscle in isometric plantarflexion and the push-off phase of walking.

    PubMed

    Péter, Annamária; Hegyi, András; Stenroth, Lauri; Finni, Taija; Cronin, Neil J

    2015-09-18

    Large forces are generated under the big toe in the push-off phase of walking. The largest flexor muscle of the big toe is the flexor hallucis longus (FHL), which likely contributes substantially to these forces. This study examined FHL function at different levels of isometric plantarflexion torque and in the push-off phase at different speeds of walking. FHL and calf muscle activity were measured with surface EMG and plantar pressure was recorded with pressure insoles. FHL activity was compared to the activity of the calf muscles. Force and impulse values were calculated under the big toe, and were compared to the entire pressed area of the insole to determine the relative contribution of big toe flexion forces to the ground reaction force. FHL activity increased with increasing plantarflexion torque level (F=2.8, P=0.024) and with increasing walking speed (F=11.608, P<0.001). No differences were observed in the relative contribution of the force under the big toe to the entire sole between different plantarflexion torque levels (F=0.836, P=0.529). On the contrary, in the push-off phase of walking, peak force under the big toe increased at a higher rate than force under the other areas of the plantar surface (F=3.801, P=0.018), implying a greater relative contribution to total force at faster speeds. Moreover, substantial differences were found between isometric plantarflexion and walking concerning FHL activity relative to that of the calf muscles, highlighting the task-dependant behaviour of FHL. PMID:26100463

  18. Quantitative power measurement of extensor hallucis longus. A simple objective test in evaluation of low-back pain with neurological involvement.

    PubMed

    Finsterbush, A; Frankel, U; Arnon, R

    1983-03-01

    Clinical evaluation of a patient with low-back problem is based mainly upon the subjective impressions of the physician. Accuracy in neurologic evaluation and follow-up of these patients depends upon objective and quantitative procedures. A handy instrument, simple to use by the clinician in his office, was developed in our laboratory and tested on healthy volunteers and patients with low-back problems. The instrument measures or records the power of the extensor hallucis longus. Weakness of this muscle represents the vast majority of root involvement in discogenic lesions. The measurement is compared with the result obtained on the contralateral side. The instrument includes a mobile mechanical spring gauge of 100-2000-gr range and a leg splint. A single channel polygraph can be connected to record the measurement. The technique was tested on healthy volunteers and good reproducibility and accuracy were found. Seventy-five patients were examined and the power of EHL measured. The patients were divided into three groups according to the nature of their back problems: 1) acute discogenic; 2) chronic low back problems with acute exacerbations; and 3) acute trauma. The quantitative measurements of EHL were of great help in evaluating and following treatment of patients with discogenic lesions and in deciding further surgical treatments. The test was valuable in evaluating malingeres and compensation cases. Eight of the patients with chronic, recurrent low-back problems were found to have weakness of EHL; further investigations showed root pressure mostly due to osteophytes pressing on the nerve roots. After acute trauma, the EHL power test also revealed weakness in patients with higher lumbar injuries, probably because of spreading. PMID:6222488

  19. Changes in the Capillarity of the Rat Extensor Digitorum Longus Muscle 4 Weeks after Nerve Injury Studied by 2D Measurement Methods.

    PubMed

    Čebašek, Vita; Ribarič, Samo

    2016-01-01

    We have previously shown by 3D study that 2 weeks after nerve injury there was no change in the length of capillaries per muscle fibre length in rat extensor digitorum longus muscle (EDL). The primary goal of the present 2D study was to determine the capillarity of rat EDL 4 weeks after various modes of nerve injury. Additionally, we wished to calculate the same capillary/fibre parameters that were used in our 3D stereological study. EDL muscles derived from denervated (4 weeks after nerve injury), re-innervated (4 weeks after two successive nerve crushes) and age-matched controls from the beginning (CON-1) and the end (CON-2) of the experiment were analysed in two ways. Global indices of capillarity, such as capillary density (CD) and capillary/fibre (C/F) ratio, were determined by automatic analysis, local indices as the number (CAF) and the length of capillaries around individual muscle fibres (Lcap) in relation to muscle fibre size were estimated manually by tracing the muscle fibre outlines and the transversally and longitudinally cut segments of capillaries seen in 5-µm-thin muscle cross sections. Four weeks after both types of nerve injury, CD increased in comparison to the CON-2 group (p < 0.001) due to atrophied muscle fibres in denervated muscles and probably proliferation of capillaries in re-innervated ones. Higher C/F, CAF (both p < 0.001) and Lcap (p < 0.01) in re-innervated than denervated EDL confirmed this assumption. Calculated capillary/fibre parameters were comparable to our previous 3D study, which strengthens the practical value to the adapted 2D method used in this study. PMID:27023720

  20. Alteration of excitation-contraction coupling mechanism in extensor digitorum longus muscle fibres of dystrophic mdx mouse and potential efficacy of taurine

    PubMed Central

    De Luca, Annamaria; Pierno, Sabata; Liantonio, Antonella; Cetrone, Michela; Camerino, Claudia; Simonetti, Simonetta; Papadia, Francesco; Camerino, Diana Conte

    2001-01-01

    No clear data is available about functional alterations in the calcium-dependent excitation-contraction (e-c) coupling mechanism of dystrophin-deficient muscle of mdx mice. By means of the intracellular microelectrode ‘point' voltage clamp method, we measured the voltage threshold for contraction (mechanical threshold; MT) in intact extensor digitorum longus (EDL) muscle fibres of dystrophic mdx mouse of two different ages: 8–12 weeks, during the active regeneration of hind limb muscles, and 6–8 months, when regeneration is complete. The EDL muscle fibres of 8–12-week-old wildtype animals had a more negative rheobase voltage (potential of equilibrium for contraction- and relaxation-related calcium movements) with respect to control mice of 6–8 months. However, at both ages, the EDL muscle fibres of mdx mice contracted at more negative potentials with respect to age-matched controls and had markedly slower time constants to reach the rheobase. The in vitro application of 60 mM taurine, whose normally high intracellular muscle levels play a role in e-c coupling, was without effect on 6–8-month-old wildtype EDL muscle, while it significantly ameliorated the MT of mdx mouse. HPLC determination of taurine content at 6–8 months showed a significant 140% rise of plasma taurine levels and a clear trend toward a decrease in amino acid levels in hind limb muscles, brain and heart, suggesting a tissue difficulty in retaining appropriate levels of the amino acid. The data is consistent with a permanent alteration of e-c coupling in mdx EDL muscle fibres. The alteration could be related to the proposed increase in intracellular calcium, and can be ameliorated by taurine, suggesting a potential therapeutic role of the amino acid. PMID:11226135

  1. Increase of the cytotoxic effect of Bothrops jararacussu venom on mouse extensor digitorum longus and soleus by potassium channel blockers and by Na(+)/K(+)-ATPase inhibition.

    PubMed

    Tomaz, Marcelo A; Fernandes, Fabrício F A; El-Kik, Camila Z; Moraes, Raphael A M; Calil-Elias, Sabrina; Saturnino-Oliveira, Jeison; Martinez, Ana Maria B; Ownby, Charlotte L; Melo, Paulo A

    2008-09-15

    We investigated the myotoxicity of Bothrops jararacussu crude venom and other cytolytic agents on mouse isolated extensor digitorum longus (EDL) and soleus (SOL) muscles, which present distinct properties: EDL is a fast-twitch, white muscle with predominantly glycolytic fibers, while SOL is slow-twitch, red muscle with predominantly oxidative fibers. Muscles were exposed to B. jararacussu crude venom (25 microg/ml) and other crotaline venoms (Agkistrodon contortrix laticinctus; Crotalus viridis viridis; Crotalus durissus terrificus) at the same concentration. Basal creatine kinase (CK) release to bathing solution was 0.43+/-0.06 for EDL and 0.29+/-0.06 for SOL (U g(-)(1) h(-)(1), n=36 for each muscle). Sixty minutes after exposure to B. jararacussu venom, EDL presented higher increase in the rate of CK release than SOL, respectively, 13.2+/-1.5 and 2.9+/-0.7 U g(-)(1)h(-)(1), n=10-12. Muscle denervation, despite decreasing CK content, did not affect sensitivities to B. jararacussu venom. Ouabain and potassium channel blockers (TEA; clotrimazole; glibenclamide) increased the rate of CK release by B. jararacussu in EDL and SOL muscles, decreasing and almost abolishing the different sensitivity. When we exposed EDL or SOL muscles to Naja naja, Apis mellifera venoms (25 microg/ml), or Triton X-100 (0.01%), they showed similar rate of CK release. Our present data suggest that a mechanism involving intracellular calcium regulation or potassium channels may participate in the different sensitivity of EDL and SOL to B. jararacussu venom. PMID:18675839

  2. Flexor Carpi Radialis to Palmaris Longus Tendon Transfer for Spontaneous Rupture of the Flexor Carpi Radialis Tendon-A Review of an Uncommon Finding and Surgical Technique for Operative Correction.

    PubMed

    Shearin, Jonathan Winkworth; Walters, Brian; Yang, S Steven

    2016-10-01

    Spontaneous ruptures of the flexor carpi radialis tendon (FCR) are rare and associated with systemic inflammatory diseases, localized tendinopathy related to scaphotrapezial-trapezoidal arthritis, or chronic immunosuppression from corticosteroids. While most cases do not require operative intervention, some patients develop weakness, impaired range of motion, and persistent pain. Previously reported surgical options include synovectomy, tendon stump resection, and osteophyte removal. We describe a surgical technique for patients with persistent symptomatology following FCR rupture in which the FCR is transposed end-to-side to the palmaris longus tendon. Three cases using this technique are presented with follow-up of 4-9 months that were collected at Lenox Hill Hospital. All three patients did well regarding specific outcome measures: grip strength, range of motion, and functional activity. FCR transfer to palmaris is an alternative to other surgical options for the spontaneous rupture of the FCR tendon in patients who remain symptomatic despite a course of non-operative therapy. PMID:27595965

  3. Anatomy of the pectoral and forelimb muscles of wildtype and green fluorescent protein-transgenic axolotls and comparison with other tetrapods including humans: a basis for regenerative, evolutionary and developmental studies

    PubMed Central

    Diogo, R; Tanaka, E M

    2012-01-01

    stated in the literature, A. mexicanum has a muscle coracoradialis that has both a well developed proximal fleshy belly and a distal long and thin tendon, supporting the idea that this muscle very likely corresponds to at least part of the amniote biceps brachii. Our observations also: (i) confirmed that the flexores digitorum minimi, interphalangeus digiti 3, pronator quadratus and palmaris profundus 1 are present as distinct muscles in A. mexicanum, supporting the idea that the latter muscle does not correspond to the pronator accessorius of reptiles; (ii) confirmed that the so-called extensor antebrachii radialis is present as a distinct muscle in this species and, importantly, indicated that this muscle corresponds to the supinator of other tetrapods; (iii) showed that, contrary to some other urodeles, including some other Ambystoma species, there is no distinct muscle epitrochleoanconeus in A. mexicanum and; (iv) showed that the ulnar and radial bundles of the abductor et extensor digiti 1 correspond to the abductor pollicis longus and extensor pollicis longus of other tetrapods, respectively. PMID:22957800

  4. Effects of spaceflight in the adductor longus muscle of rats flown in the Soviet Biosatellite COSMOS 2044. A study employing neural cell adhesion molecule (N-CAM) immunocytochemistry and conventional morphological techniques (light and electron microscopy)

    NASA Technical Reports Server (NTRS)

    D'Amelio, F.; Daunton, N. G.

    1992-01-01

    The effects of spaceflight upon the "slow" muscle adductor longus were examined in rats flown in the Soviet Biosatellite COSMOS 2044. The techniques employed included standard methods for light microscopy, neural cell adhesion molecule (N-CAM) immunocytochemistry and electron microscopy. Light microscopic observations revealed myofiber atrophy and segmental necrosis accompanied by cellular infiltrates composed of macrophages, leukocytes and mononuclear cells. Neural cell adhesion molecule immunoreactivity (N-CAM-IR) was seen on the myofiber surface and in regenerating myofibers. Ultrastructural alterations included Z band streaming, disorganization of myofibrillar architecture, sarcoplasmic degradation, extensive segmental necrosis with apparent preservation of the basement membrane, degenerative phenomena of the capillary endothelium and cellular invasion of necrotic areas. Regenerating myofibers were identified by the presence of increased amounts of ribosomal aggregates and chains of polyribosomes associated with myofilaments. The principal electron microscopic changes of the neuromuscular junctions showed axon terminals with a decrease or absence of synaptic vesicles replaced by microtubules and neurofilaments, degeneration of axon terminals, vacant axonal spaces and changes suggestive of axonal sprouting. The present observations suggest that alterations such as myofibrillar disruption and necrosis, muscle regeneration and denervation and synaptic remodeling at the level of the neuromuscular junction may take place during spaceflight.

  5. Family Abductors: Descriptive Profiles and Preventive Interventions. Juvenile Justice Bulletin.

    ERIC Educational Resources Information Center

    Johnston, Janet R.; Girdner, Linda K.

    Parental abduction encompasses a broad array of illegal behaviors that involves one parent taking, detaining, concealing, or enticing away his or her child from the parent having custodial access. When the abducted parent intends to permanently alter custodial access by hiding the child or removing the child to another locale, the effects on the…

  6. Stenosing Tenosynovitis Due to Excessive Texting in an Adolescent Girl: A Case Report.

    PubMed

    Johnson, Jason D; Gaspar, Michael P; Shin, Eon K

    2016-04-01

    We present a case report of stenosing tenosynovitis of the flexor pollicis longus tendon in an adolescent girl who required surgical release after failing conservative measures. The patient had no other risk factors, aside from her excessive texting, which we postulate led to her condition. Although there have been a few reports of tendinitis and tenosynovitis secondary to texting, we believe this is the first in the literature to report trigger thumb requiring surgical release in an adolescent. PMID:27616827

  7. Traumatic Thumb Radial Sagittal Band Injury Mimicking EPL Rupture.

    PubMed

    Dissanayake, Ravi M; Moore, Peter; McCarten, Gregory M

    2016-06-01

    We present the case of a closed traumatic disruption of the thumb radial sagittal band (RSB) that sonographically mimicked rupture of the extensor pollicis longus (EPL) tendon. This injury was treated with primary repair of the RSB and lead to a good functional outcome for the patient. This case report highlights how early recognition and treatment can lead to a good functional outcome. PMID:27454647

  8. Pattern of monosynaptic Ia connections in the cat forelimb.

    PubMed Central

    Fritz, N; Illert, M; de la Motte, S; Reeh, P; Saggau, P

    1989-01-01

    extension in case of the undirectional projections onto supinator and abductor pollicis longus motoneurones). 6. The motor nuclei to some multifunctional muscles display a negative correlation between different heteronymous Ia inputs: motoneurones with a large input from one muscle show a significant tendency to receive a smaller input from another muscle and vice versa. This organization leads to subpopulations of neurones with different convergence patterns within the same motor nucleus. 7. Motor nuclei with bidirectional Ia relations between each other displayed similar convergence and projection patterns. They were combined into 'Ia synergistic groups.' One motor nucleus may belong to several groups.(ABSTRACT TRUNCATED AT 400 WORDS) Images Fig. 1 PMID:2533610

  9. Experiment K-7-18: Effects of Spaceflight in the Muscle Adductor Longus of Rats Flown in the Soviet Biosatellite Cosmos 2044. Part 1; A Study Employing Neural Cell Adhesion Molecules (N-CAM) Immunocytochemistry and Conventional Morphological Techniques (Light and Electron Microscopy)

    NASA Technical Reports Server (NTRS)

    Daunton, N. G.; DAmelio, F.; Wu, L.; Ilyina-Kakueva, E. I.; Krasnov, I. B.; Hyde, T. M.; Sigworth, S. K.

    1994-01-01

    The effects of spaceflight upon the 'slow' muscle adductor longus was examined in rats flown in the Soviet Biosatellite COSMOS 2044. Three groups - synchronous, vivarium and basal served as controls. The techniques employed included standard methods for light microscopy, N-CAM immunocytochemistry and electron microscopy. Light microscopic observations revealed myofiber atrophy, contraction bands and segmental necrosis accompanied by cellular infiltrates composed of macrophages, leucocytes and mononuclear cells. N-CAM immunoreactivity was seen (N-CAM-IR) on the myofiber surface, satellite cells and in regenerating myofibers reminiscent of myotubes. Ultrastructural alterations included Z band streaming, disorganization of myofibrillar architecture, sarcoplasmic degradation, extensive segmental necrosis with preservation of the basement membrane, degenerative phenomena of the capillary endothelium and cellular invasion of necrotic areas. Regenerating myofibers were identified by the presence of increased amounts of ribosomal aggregates and chains of polyribosomes associated with myofilaments that displayed varied distributive patterns. The principal electron microscopic changes of the neuromuscular junctions consisted of a decrease or absence of synaptic vesicles, degeneration of axon terminals, increased number of microtubules, vacant axonal spaces and axonal sprouting. The present observations indicate that major alterations such as myofibrillar disruption and necrosis, muscle regeneration and denervation and synaptic remodeling at the level of the neuromuscular junction may take place during spaceflight.

  10. Prevalence of ulnar-to-median nerve motor fiber anastomosis (Riché-Cannieu communicating branch) in hand: An electrophysiological study

    PubMed Central

    Ahadi, Tannaz; Raissi, Gholam Reza; Yavari, Masood; Majidi, Lobat

    2016-01-01

    Background: Two main muscles studied in the hand for evaluation of median nerve injuries are opponens pollicis (OP) and abductor pollicis brevis (APB). However, Riché-Cannieu communicating branch (RCCB) may limit the use of these muscles in electrodiagnosis. This condition is confusing in the case of median nerve injuries. This study was conducted to evaluate the prevalence of RCCB. Methods: Twenty-three consecutive cases of complete median nerve injury were studied. Evoked responses via stimulation of median and ulnar nerves in the wrist and recording with needle in the thenar area were studied. Results: Of the patients, 82.6% exhibited RCCB. In 14 (60.8%) cases the OP and in 19(82.6%) cases APB was supplied by the ulnar nerve. Conclusion: RCCB was detected to be 60.8% in OP and 82.6% in APB, so OP is preferable to APB in the study of median nerve. PMID:27390694

  11. [Methodology and normal values in recording evoked motor potentials following transcranial stimulation in the human].

    PubMed

    Ludolph, A C; Elger, C E; Gössling, J H; Hugon, J

    1987-03-01

    Electric non-invasive stimulation of the motor cortex was performed in 19 healthy subjects. Muscle responses were recorded with surface electrodes from the abductor, pollicis brevis and anterior tibial muscle. The mean central motor latencies for pathways regulating the function of the upper limbs was 4.5 msec (standard deviation 0.5 msec), the corresponding latency for the lower limbs was 9.6 msec (standard deviation 1.2 msec). The reproducibility of latencies and configuration of the potentials obtained indicates that the method described can be used as a reliable method in the diagnosis of affections of the motor system. PMID:3106003

  12. Flexor Hallucis Longus Tendon Transfer for Calcific Insertional Achilles Tendinopathy.

    PubMed

    Howell, Michael A; Catanzariti, Alan R

    2016-01-01

    Calcific insertional Achilles tendinopathy can result in significant pain and disability. Although some patients respond to nonoperative therapy, many patients are at risk for long-term morbidity and unpredictable clinical outcomes. There is no evidence-based data to support the timing of operative invention, choice of procedures, or whether equinus requires treatment. This article suggests the need for a classification system based on physical examination and imaging to help guide treatment. There is an obvious need for evidence-based studies evaluating outcomes and for properly conducted scientific research to establish appropriate treatment protocols. PMID:26590729

  13. Diagnosis of Severe Carpal Tunnel Syndrome Using Nerve Conduction Study and Ultrasonography.

    PubMed

    Fujimoto, Kazuhiro; Kanchiku, Tsukasa; Kido, Kenji; Imajo, Yasuaki; Funaba, Masahiro; Taguchi, Toshihiko

    2015-10-01

    This study investigated the correlation between nerve conduction study and ultrasonographic findings for assessment of the usefulness of ultrasonography in determining carpal tunnel syndrome severity. Hands of adults with carpal tunnel syndrome were assessed using ultrasound and nerve conduction studies and grouped according to median nerve cross-sectional area (CSA). There were significant differences (p < 0.01) in mean median nerve CSA between controls, patients with median sensory nerve conduction velocity ≤40 m/s and patients with absent sensory nerve action potential and between controls, patients with median nerve distal motor latency ≥4.5 ms and patients with absent compound muscle action potentials of the abductor pollicis brevis. This is the first report to define median nerve CSA cutoff values (18 mm(2)) for determining carpal tunnel syndrome severity in patients with absent compound muscle action potentials of the abductor pollicis brevis. Median nerve CSA values below the cutoff values should prompt clinicians to consider other disorders, such as cervical compressive myelopathy. PMID:26111913

  14. Electromyographic correlates of learning during robotic surgical training in virtual reality.

    PubMed

    Suh, Irene H; Mukherjee, Mukul; Schrack, Ryan; Park, Shi-Hyun; Chien, Jung-Hung; Oleynikov, Dmitry; Siu, Ka-Chun

    2011-01-01

    The purpose of this study was to investigate the muscle activation and the muscle frequency response of the dominant arm muscles (flexor carpi radialis and extensor digitorum) and hand muscles (abductor pollicis and first dorsal interosseous) during robotic surgical skills training in a virtual environment. The virtual surgical training tasks consisted of bimanual carrying, needle passing and mesh alignment. The experimental group (n=5) was trained by performing four blocks of the virtual surgical tasks using the da Vinci™ surgical robot. During the pre- and post-training tests, all subjects were tested by performing a suturing task on a "life-like" suture pad. The control group (n=5) performed only the suturing task without any virtual task training. Differences between pre- and post-training tests were significantly greater in the virtual reality group, as compared to the control group in the muscle activation of the hand muscle (abductor pollicis) for both the suture tying and the suture running (p<0.05). In conclusion, changes in electrographic activity shows that training in virtual reality leads to specific changes in neuromotor control of robotic surgical tasks. PMID:21335869

  15. Pediatric diaphyseal forearm fractures: epidemiology and treatment in an urban population during a 10-year period, with special attention to titanium elastic nailing and its complications.

    PubMed

    Lyman, Amanda; Wenger, Daniel; Landin, Lennart

    2016-09-01

    This study aims to describe the epidemiology of pediatric diaphyseal forearm fractures in an urban population and the complications of titanium elastic nailing. The medical records of 456 consecutive fractures were reviewed. The annual incidence was 0.7/1000 children. Eighty-six (19%) fractures in 83 children were titanium elastic nailed. The complication rate was 24%. Dorsal entry to the radius was associated with extensor pollicis longus rupture and radial entry was associated with sensory nerve deficit in three cases each. Seventy-eight (94%) of the operated patients recovered completely. Titanium elastic nailing is effective, but associated with a high rate of complications, most of which resolve spontaneously. PMID:26919620

  16. Tendon Transfers in the Rheumatoid Hand for Reconstruction.

    PubMed

    O'Sullivan, Michael Brody; Singh, Hardeep; Wolf, Jennifer Moriatis

    2016-08-01

    Long-standing rheumatoid arthritis can result in spontaneous tendon rupture caused by attrition of the tendons. Ruptures of the ulnar-sided extensor tendons, flexor pollicis longus, and the flexor digitorum profundus can be seen. Primary repair of these tendon ruptures is frequently not possible because of delayed presentation and tendon damage by the disease process. Tendon transfers are the preferred method of treatment in patients with rheumatoid arthritis. At surgery, it is critical to address the underlying cause of rupture to prevent future tendon ruptures. Rates of tendon rupture may decrease due to improved medications for rheumatoid arthritis. PMID:27387084

  17. Morphometric studies of the muscular branch of the median nerve.

    PubMed

    Olave, E; Prates, J C; Gabrielli, C; Pardi, P

    1996-10-01

    The branch from the median nerve to the thenar muscles has a proximal and lateral (recurrent) course and is vulnerable to lesions that affect these muscles. Because of its anatomical-clinical importance, this branch was studied in 60 palmar regions from 30 cadavers of adult individuals of both sexes, aged between 23 and 77 y. It arose from the lateral branch of the median nerve in 83.3% of the cases. Its origin was distal to the flexor retinaculum in 48.3%, at the distal margin of the retinaculum in 31.6%, in the carpal tunnel in 18.3% and proximal to the retinaculum in 1.7%; it pierced the retinaculum in 15%. The point of recurrence of the branch was localised topographically to 34.6 +/- 3.6 mm from the distal wrist crease; the angle between its recurrent course and the longitudinal axis of the hand averaged 66.8 degrees. In 50% of the cases the muscular branch innervated abductor pollicis brevis (APB), opponens pollicis (OP) and the superficial head of flexor pollicis brevis (FPB), in 40% it supplied only APB and OP, and in 10% a short muscular branch gave rise to independent branches in the palm and which supplied APB, OP and the superficial head of FPB. The so called "accessory thenar branch' was found in 38.3%. PMID:8886966

  18. Automatic assessment of volume asymmetries applied to hip abductor muscles in patients with hip arthroplasty

    NASA Astrophysics Data System (ADS)

    Klemt, Christian; Modat, Marc; Pichat, Jonas; Cardoso, M. J.; Henckel, Joahnn; Hart, Alister; Ourselin, Sebastien

    2015-03-01

    Metal-on-metal (MoM) hip arthroplasties have been utilised over the last 15 years to restore hip function for 1.5 million patients worldwide. Althoug widely used, this hip arthroplasty releases metal wear debris which lead to muscle atrophy. The degree of muscle wastage differs across patients ranging from mild to severe. The longterm outcomes for patients with MoM hip arthroplasty are reduced for increasing degrees of muscle atrophy, highlighting the need to automatically segment pathological muscles. The automated segmentation of pathological soft tissues is challenging as these lack distinct boundaries and morphologically differ across subjects. As a result, there is no method reported in the literature which has been successfully applied to automatically segment pathological muscles. We propose the first automated framework to delineate severely atrophied muscles by applying a novel automated segmentation propagation framework to patients with MoM hip arthroplasty. The proposed algorithm was used to automatically quantify muscle wastage in these patients.

  19. Prognostic value of cortical magnetic stimulation in spinal cord injury.

    PubMed

    Clarke, C E; Modarres-Sadeghi, H; Twomey, J A; Burt, A A

    1994-08-01

    Cortical magnetic stimulation was performed in a consecutive series of 10 patients presenting within 15 days of traumatic spinal cord injury. In those patients with complete paraplegia or quadriplegia, motor evoked potentials at presentation were absent below the level of the lesion. Six months after the injury, potentials had returned in the biceps brachii and abductor pollicis brevis muscles in some quadriplegic cases, but remained absent from the tibialis anterior in all of this group. None of those with a complete lesion made a significant functional recovery. Of the three patients with incomplete quadriplegia, two showed a significant recovery after 6 months. Motor evoked potentials were recordable below the level of the lesion at presentation in these cases, although the latencies were prolonged. In the remaining patient who failed to improve, potentials were unrecordable throughout the study. This small pilot study suggests that cortical magnetic stimulation may be useful in refining the prognosis in patients with an incomplete spinal cord injury. PMID:7970860

  20. [The cervical somatosensory evoked potential and its relation to F-wave activity].

    PubMed

    Strenge, H

    1989-06-01

    In 6 healthy volunteers aged 18-25 years cervical somatosensory evoked potentials (CEPs) were recorded following stimulation of the right median nerve at the wrist. At the same time the antidromically elicited individual F-waves evoked by any single impulse were recorded from the abductor pollicis brevis muscle. By means of selective averaging of the neck responses it could be shown that there was a close relationship between an F-wave-activity of 120-150 microV/stimulus or more during the trial and the appearance or the enhancement of a negative peak occurring 0.5-1.4 ms after the main CEP component N13. An F-wave-activity of more than 224 microV/stimulus regularly resulted in a total change of the CEP configuration. PMID:2503360

  1. Effects of nicotine gum on F waves in non-smokers.

    PubMed

    Strenge, H; Schmidt, G; Niederberger, U; Porschke, H; Schütz, H W

    1996-01-01

    The effects of chewing gum, containing 0 and 4 mg nicotine, on F waves were studied in healthy volunteers in a repeated measure design. F responses were recorded from the abductor pollicis brevis muscle following stimulation of the median nerve at the wrist. The persistence and various amplitude measures were analysed. Chewing a 4 mg nicotine gum, with a considerable rise in systemic nicotine (6.4-37.4 ng/ml), failed to produce significant effects on F wave parameters in relation to the placebo baseline. The analysis of different F wave amplitude ranges, however, revealed significant nicotine-induced changes: a dose-related decrease of F responses > or = 500 microV and an increase of F waves between 200-290 microV. This may be due to an activation of Renshaw cells in the spinal cord. PMID:8934149

  2. Carpal tunnel syndrome in Mucopolysaccharidoses. A report of four cases in child.

    PubMed

    Bona, I; Vial, C; Brunet, P; Couturier, J C; Girard-Madoux, M; Bady, B; Guibaud, P

    1994-12-01

    Carpal tunnel syndrome (CTS) is very uncommon in childhood. Sixty-five cases are reported in the literature, principally due to metabolic diseases. In Mucopolysaccharidoses, prospective studies (Wraith and Alani, 1990) found a bilateral CTS in about 90%. We report four cases of Mucopolysaccharidoses, diagnosed on clinical and biological data (two cases of Hurler disease, and two cases of Hunter disease), in children aged less than five years. Each child had claw hands, without thenar atrophy. Median nerve conduction studies and electromyography confirm the CTS. Motor and sensory nerve conductions are normal in other nerves. Concentric needle studies show in two cases, on abductor pollicis brevis, spontaneous activities as repetitive discharges, fasciculations and multiplets. Median nerve stimulations reveal responses with late potentials during 70 ms due to reinnervation. The physiopathology of those carpal tunnel syndromes is discussed. PMID:7882890

  3. Psychophysiological patterns during cell phone text messaging: a preliminary study.

    PubMed

    Lin, I-Mei; Peper, Erik

    2009-03-01

    This study investigated the psychophysiological patterns associated with cell phone text messaging (texting). Twelve college students who were very familiar with texting were monitored with surface electromyography (SEMG) from the shoulder (upper trapezius) and thumb (abductor pollicis brevis/opponens pollicis); blood volume pulse (BVP) from the middle finger, temperature from the index finger, and skin conductance (SC) from the palm of the non-texting hand; and respiration from the thorax and abdomen. The counter-balanced procedure consisted of a 2 min pre-baseline, 1 min receiving text messages, 2 min middle baseline, 1 min sending text messages and 2 min post-baseline. The results indicated that all subjects showed significant increases in respiration rate, heart rate, SC, and shoulder and thumb SEMG as compared to baseline measures. Eighty-three percentage of the participants reported hand and neck pain during texting, and held their breath and experienced arousal when receiving text messages. Subjectively, most subjects were unaware of their physiological changes. The study suggests that frequent triggering of these physiological patterns (freezing for stability and shallow breathing) may increase muscle discomfort symptoms. Thus, participants should be trained to inhibit these responses to prevent illness and discomfort. PMID:19199025

  4. The tabatière anatomique.

    PubMed

    Tubbs, R Shane; Salter, E George; Oakes, W Jerry

    2006-05-01

    There is scant detailed information regarding the tabatière anatomique (anatomical snuff box) in the literature. The authors dissected this area in 15 adult cadavers (30 sides) and made measurements and observations of this region. We found that the average mean width and length of this geometric area was 4 cm and 6 cm, respectively. Although the dimensions of the tabatière anatomique tended to be larger among male specimens this trend did not reach statistical significance (P > 0.05). There was no statistical difference between left and right sides. The majority (70%) of specimens was noted to have connections between the cephalic vein and the vena comitantes of the radial artery within the tabatière anatomique. Five specimens were noted to have a muscular branch to the abductor pollicis brevis muscle arising from the dorsalis pollicis artery in the tabatière anatomique. The dorsalis pollicis artery was found to originate in the tabatière anatomique in all specimens. One right-sided specimen was noted to have an intraosseous branch of the radial artery that entered the styloid process of the radius. A well-formed collection of fat was noted between the styloid process and base of the first metacarpal in all specimens. This fat pad completely covered the radial artery in the majority of specimens and had loose connections to both the first and second dorsal compartments. The branches of the superficial branch of the radial nerve always originated distal to the tendon of the EPB muscle. These data may prove useful to the surgeon or clinician who operates or examines this interesting anatomical area. PMID:16283634

  5. Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis

    PubMed Central

    Menon, Parvathi; Vucic, Steve

    2014-01-01

    The split hand phenomenon refers to predominant wasting of thenar muscles and is an early and specific feature of amyotrophic lateral sclerosis (ALS). A novel split hand index (SI) was developed to quantify the split hand phenomenon, and its diagnostic utility was assessed in ALS patients. The split hand index was derived by dividing the product of the compound muscle action potential (CMAP) amplitude recorded over the abductor pollicis brevis and first dorsal interosseous muscles by the CMAP amplitude recorded over the abductor digiti minimi muscle. In order to assess the diagnostic utility of the split hand index, ALS patients were prospectively assessed and their results were compared to neuromuscular disorder patients. The split hand index was significantly reduced in ALS when compared to neuromuscular disorder patients (P<0.0001). Limb-onset ALS patients exhibited the greatest reduction in the split hand index, and a value of 5.2 or less reliably differentiated ALS from other neuromuscular disorders. Consequently, the split hand index appears to be a novel diagnostic biomarker for ALS, perhaps facilitating an earlier diagnosis. PMID:24637778

  6. Characteristics of corticospinal projections to the intrinsic hand muscles in skilled harpists.

    PubMed

    Buick, Alison R; Kennedy, Niamh C; Carson, Richard G

    2016-01-26

    The process of learning to play a musical instrument necessarily alters the functional organisation of the cortical motor areas that are involved in generating the required movements. In the case of the harp, the demands placed on the motor system are quite specific. During performance, all digits with the sole exception of the little finger are used to pluck the strings. With a view to elucidating the impact of having acquired this highly specialised musical skill on the characteristics of corticospinal projections to the intrinsic hand muscles, focal transcranial magnetic stimulation (TMS) was used to elicit motor evoked potentials (MEPs) in three muscles (of the left hand): abductor pollicis brevis (APB); first dorsal interosseous (FDI); and abductor digiti minimi (ADM) in seven harpists. Seven non-musicians served as controls. With respect to the FDI muscle-which moves the index finger, the harpists exhibited reliably larger MEP amplitudes than those in the control group. In contrast, MEPs evoked in the ADM muscle-which activates the little finger, were smaller in the harpists than in the non-musicians. The locations on the scalp over which magnetic stimulation elicited discriminable responses in ADM also differed between the harpists and the non-musicians. This specific pattern of variation in the excitability of corticospinal projections to these intrinsic hand muscles exhibited by harpists is in accordance with the idiosyncratic functional demands that are imposed in playing this instrument. PMID:26673887

  7. Effect of Paired-Pulse Electrical Stimulation on the Activity of Cortical Circuits

    PubMed Central

    Saito, Kei; Onishi, Hideaki; Miyaguchi, Shota; Kotan, Shinichi; Fujimoto, Shuhei

    2015-01-01

    Objective: We investigated the transient effect of short-duration paired-pulse electrical stimulation (ppES) on corticospinal excitability and the after-effect of long-duration ppES on excitability, short-latency afferent inhibition (SAI), and afferent facilitation (AF). Methods: A total of 28 healthy subjects participated in two different experiments. In Experiment 1, motor-evoked potentials (MEPs) were measured in the abductor pollicis brevis (APB) and abductor digiti minimi (ADM) muscles before and immediately after short-duration ppES (5 s) at various inter-pulse intervals (2, 3, 4, 5, 6, 7, 10, 15, 20, and 30 ms). In Experiment 2, MEPs, SAI, and AF were measured before, immediately, and 20 and 40 min after long-duration ppES (20 min, inter-pulse interval of 5 and 15 ms) and peripheral electrical stimulation (20 min, 10 and 20 Hz). Results: Short-duration ppES with inter-pulse intervals of 5 and 20 ms significantly increased MEP measured in APB but not in ADM. Long-duration ppES with an inter-pulse interval of 5 ms significantly decreased SAI but not MEPs in APB. In contrast, long-duration ppES did not affect ADM. Conclusion: The afferent inputs induced by ppES-5 ms were effective for transiently increasing MEP and sustaining SAI reduction. PMID:26733847

  8. Absence of split hand in the flail arm variant of ALS.

    PubMed

    Sun, Xian; Zhang, Zhecheng; Liu, Na

    2016-04-01

    Flail arm syndrome (FAS), a variant of amyotrophic lateral sclerosis (ALS), has many similarities with upper limb onset ALS (UL-ALS). This study analyzed the compound muscle action potentials (CMAPs) recorded from abductor pollicis brevis (APB) and abductor digiti minimi (ADM) muscles in patients presenting these two types of ALS variants, compared to normal controls. The APB/ADM CMAP amplitude ratio was lower in the UL-ALS group (mean±SEM: 0.56±0.37), consistent with a split hand, compared to the FAS (1.05±0.29) or control (1.11±0.30) groups. An abnormally reduced APB/ADM CMAP amplitude ratio (<0.6) was found in 40% of UL-ALS patients and 11% of FAS patients. However, absent CMAP in the APB or extremely low APB/ADM CMAP amplitude ratio (<0.25) were observed only in UL-ALS patients (27%) and could be used as diagnostic criteria to differentiate UL-ALS from FAS variant. PMID:27157380

  9. [The Linburg-Comstock phenomenon: a review].

    PubMed

    Kirchberger, Michael C; Hahn, P; Unglaub, F; Leclère, F M; Spies, C K

    2015-02-01

    Simultaneous flexion of thumb and fingers is described as the Linburg-Comstock phenomenon. Congenital and acquired coupling of the flexor pollicis longus (FPL) and flexor digitorum profundus (FDP) tendons is the reason for this clinical entity. Additionally, coupling of the FPL and the flexor digitorum superficialis II or III has been described. The coupling can be between the muscles, the tendon sheaths or the tendons themselves. Asymptomatic and symptomatic coupling should be differentiated. In general symptomatic congenital or acquired coupling demands surgical intervention. We report about a 35-year-old patient with a congenital asymptomatic coupling of FPL and FDP-II who suffered a distorsion of the thumb. Afterwards she complained of pain and strength loss. An accessory tendon of 3 mm in diameter and 3.5 cm length between FPL and FDP-II was identified during surgery. The patient recovered completely after resection of this coupling. PMID:25706178

  10. The musculoskeletal loading profile of the thumb during pipetting based on tendon displacement

    PubMed Central

    Wu, John Z.; Sinsel, Erik W.; Shroyer, Justin F.; Welcome, Daniel E.; Zhao, Kristin D.; An, Kai-Nan; Buczek, Frank L.

    2016-01-01

    Strong evidence indicates that highly repetitive manual work is associated with the development of upper extremity musculoskeletal disorders (MSDs). One of the occupational activities that involves highly repetitive and forceful hand work is manual pipetting in chemical or biological laboratories. In the current study, we quantified tendon displacement as a parameter to assess the cumulative loading exposure of the musculoskeletal system in the thumb during pipetting. The maximal tendon displacement was found in the flexor pollicis longus (FPL) tendon. Assuming that subjects’ pipetting rates were maintained constant during a period of 1 h, the average accumulated tendon displacement in the FPL reached 29 m, which is in the lower range of those observed in other occupational activities, such as typing and nail gun operations. Our results showed that tendon displacement data contain relatively small standard deviations, despite high variances in thumb kinematics, suggesting that the tendon displacements may be useful in evaluating the musculoskeletal loading profile. PMID:24018066

  11. Quality Control of Motor Unit Number Index (MUNIX) Measurements in 6 Muscles in a Single-Subject “Round-Robin” Setup

    PubMed Central

    Neuwirth, Christoph; Burkhardt, Christian; Alix, James; Castro, José; de Carvalho, Mamede; Gawel, Malgorzata; Goedee, Stephan; Grosskreutz, Julian; Lenglet, Timothée; Moglia, Cristina; Omer, Taha; Schrooten, Maarten; Weber, Markus

    2016-01-01

    Background Motor Unit Number Index (MUNIX) is a neurophysiological measure that provides an index of the number of lower motor neurons in a muscle. Its performance across centres in healthy subjects and patients with Amyotrophic Lateral Sclerosis (ALS) has been established, but inter-rater variability between multiple raters in one single subject has not been investigated. Objective To assess reliability in a set of 6 muscles in a single subject among 12 examiners (6 experienced with MUNIX, 6 less experienced) and to determine variables associated with variability of measurements. Methods Twelve raters applied MUNIX in six different muscles (abductor pollicis brevis (APB), abductor digiti minimi (ADM), biceps brachii (BB), tibialis anterior (TA), extensor dig. brevis (EDB), abductor hallucis (AH)) twice in one single volunteer on consecutive days. All raters visited at least one training course prior to measurements. Intra- and inter-rater variability as determined by the coefficient of variation (COV) between different raters and their levels of experience with MUNIX were compared. Results Mean intra-rater COV of MUNIX was 14.0% (±6.4) ranging from 5.8 (APB) to 30.3% (EDB). Mean inter-rater COV was 18.1 (±5.4) ranging from 8.0 (BB) to 31.7 (AH). No significant differences of variability between experienced and less experienced raters were detected. Conclusion We provide evidence that quality control for neurophysiological methods can be performed with similar standards as in laboratory medicine. Intra- and inter-rater variability of MUNIX is muscle-dependent and mainly below 20%. Experienced neurophysiologists can easily adopt MUNIX and adequate teaching ensures reliable utilization of this method. PMID:27135747

  12. [Influence of long-used staphylokinase derivative on hemoagglutinative and fibrinolytic systems].

    PubMed

    Wang, Yuan-Yuan; Long, Min-Hui; Wang, Jin-Feng; Zhu, He; Wang, Min; Zou, Min-Ji; Liu, Shen; Xu, Tao; Wang, Jia-Xi; Xu, Dong-Gang

    2009-06-01

    This study was aimed to explore the influence of staphylokinase derivative (SAKD) on the hemoagglutinative and fibrinolytic systems, and to determine the safety of the staphylokinase derivative in application. The normal and model rats each 30 were divided into normal saline, SAKD and rSAK groups. The hemorrhage, bleeding time (BT), blood platelet count (BPC), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (Fg), D-dimer (D-D), plasminogen (PLG) and plasmin inhibitor activity (PI) were detected before and after the administration with staphylokinase derivative 0.5 mg/kg body weight, once three days for consecutive 15 days. The results indicated that one case of normal rats with SAKD and two cases of high fat diet model group had mild hemorrhage, all of which showed automatic hemostasis; and 3 cases in rSAK group had mild hemorrhage. And the platelet counting, D-D, PLG and PI in all groups did not significantly change. The rats of high fat diet group treated with SAKD showed the significant extension of APTT, PT and TT times, and the decrease of Fg time (p < 0.05). All the experimental results demonstrated that the influence of SAKD on the hemagglutination of the normal animals was lower, however, which can improve the high-hemagglutination status of the rats with high fat diet. It is concluded that the SAKD at the dosage of this study has the higher safety, which can alleviate the high hemagglutination symptoms of the rats with high fat diet. PMID:19549385

  13. Tenosynovial Osteochondromatosis of the Flexor Hallucis Longus in a Division I Tennis Player.

    PubMed

    Thomsen, Timothy W; Hogrefe, Christopher P; Hall, Mederic M; Amendola, Annunziato

    2015-11-01

    Tenosynovial (extra-articular) chondromatosis (TC) is a condition characterized by the cartilaginous proliferation of synovial cells derived from the synovial lining of bursa and tendon sheaths. These lesions are often multinodular and most commonly present with complaints of swelling or pain. Treatment of TC primarily entails surgical excision. There are no known reports of TC in collegiate athletes. We present a case of TC in a Division I tennis player. PMID:25514138

  14. Flexor carpi ulnaris transfer for radial nerve palsy: functional testing of long-term results.

    PubMed

    Raskin, K B; Wilgis, E F

    1995-09-01

    Controversy persists over the use of the flexor carpi ulnaris for transfer to the extensor digitorum communis in the treatment of radial nerve palsy. Six patients with complete, irreparable radial nerve palsies were treated in part with the flexor carpi ulnaris to extensor digitorum communis tendon transfer (standard transfers: pronator teres to extensor carpi radialis brevis, flexor carpi ulnaris to extensor digitorum communis, and palmaris longus to the rerouted extensor pollicis longus) and were functionally tested for long-term results. The average follow-up time was 8 years (range, 3-15). A control group was comprised of 10 volunteers of similar demographics. This study evaluates the long-term functional recovery in three categories: range of motion, dynamic power of wrist motion, and functional ability as determined by work simulation techniques. The activities simulated were swinging a hammer, sawing wood, tightening screws, and using pliers. A functional range of motion was maintained in all patients, and the power of wrist motion was sufficient to perform all activities of daily living. The work simulation testing revealed no significant difference between the tendon transfer patients and control group with respect to hand dominance and normal variance. All patients were able to perform the simulated work with the same variance in power as the control group. Despite the obvious anatomic loss, wrist function is not significantly impaired after flexor carpi ulnaris tendon transfer for radial nerve palsy. PMID:8522738

  15. Using mouse cranial muscles to investigate neuromuscular pathology in vivo.

    PubMed

    Murray, L M; Gillingwater, T H; Parson, S H

    2010-11-01

    Neuromuscular pathology is a classic hallmark of many diseases such as muscular dystrophy, myasthenia gravis, amyotrophic lateral sclerosis and spinal muscular atrophy. It is also a feature of many congenital and acquired myopathies and neuropathies such as diabetic neuropathy and toxin-exposure. The availability of experimentally accessible nerve-muscle preparations from rodent models in which pathological events can be studied in nerve and muscle, as well as at the neuromuscular junction, is therefore of fundamental importance for investigating neuromuscular disease. The group of small cranial muscles, which move the ear in the mouse provide ideal experimental preparations for the study of neuromuscular disease in vivo, but information regarding their anatomical and functional characteristics is currently lacking. Here, we provide a detailed description of the levator auris longus, auricularis superior, abductor auris longus and interscutularis muscles. In addition, we briefly review their differential fibre type and developmental characteristics, which can be exploited to aid our understanding of neuromuscular vulnerability and to provide preferable alternatives to more traditional muscle preparations such as gastrocnemius, soleus and diaphragm. PMID:20637618

  16. Primary Motor Cortex Representation of Handgrip Muscles in Patients with Leprosy

    PubMed Central

    Rangel, Maria Luíza Sales; Sanchez, Tiago Arruda; Moreira, Filipe Azaline; Hoefle, Sebastian; Souto, Inaiacy Bittencourt; da Cunha, Antônio José Ledo Alves

    2015-01-01

    Background Leprosy is an endemic infectious disease caused by Mycobacterium leprae that predominantly attacks the skin and peripheral nerves, leading to progressive impairment of motor, sensory and autonomic function. Little is known about how this peripheral neuropathy affects corticospinal excitability of handgrip muscles. Our purpose was to explore the motor cortex organization after progressive peripheral nerve injury and upper-limb dysfunction induced by leprosy using noninvasive transcranial magnetic stimulation (TMS). Methods In a cross-sectional study design, we mapped bilaterally in the primary motor cortex (M1) the representations of the hand flexor digitorum superficialis (FDS), as well as of the intrinsic hand muscles abductor pollicis brevis (APB), first dorsal interosseous (FDI) and abductor digiti minimi (ADM). All participants underwent clinical assessment, handgrip dynamometry and motor and sensory nerve conduction exams 30 days before mapping. Wilcoxon signed rank and Mann-Whitney tests were performed with an alpha-value of p<0.05. Findings Dynamometry performance of the patients’ most affected hand (MAH), was worse than that of the less affected hand (LAH) and of healthy controls participants (p = 0.031), confirming handgrip impairment. Motor threshold (MT) of the FDS muscle was higher in both hemispheres in patients as compared to controls, and lower in the hemisphere contralateral to the MAH when compared to that of the LAH. Moreover, motor evoked potential (MEP) amplitudes collected in the FDS of the MAH were higher in comparison to those of controls. Strikingly, MEPs in the intrinsic hand muscle FDI had lower amplitudes in the hemisphere contralateral to MAH as compared to those of the LAH and the control group. Taken together, these results are suggestive of a more robust representation of an extrinsic hand flexor and impaired intrinsic hand muscle function in the hemisphere contralateral to the MAH due to leprosy. Conclusion Decreased

  17. Cortical Motor Circuits after Piano Training in Adulthood: Neurophysiologic Evidence.

    PubMed

    Houdayer, Elise; Cursi, Marco; Nuara, Arturo; Zanini, Sonia; Gatti, Roberto; Comi, Giancarlo; Leocani, Letizia

    2016-01-01

    The neuronal mechanisms involved in brain plasticity after skilled motor learning are not completely understood. We aimed to study the short-term effects of keyboard training in music-naive subjects on the motor/premotor cortex activity and interhemispheric interactions, using electroencephalography and transcranial magnetic stimulation (TMS). Twelve subjects (experimental group) underwent, before and after a two week-piano training: (1) hand-motor function tests: Jamar, grip and nine-hole peg tests; (2) electroencephalography, evaluating the mu rhythm task-related desynchronization (TRD) during keyboard performance; and (3) TMS, targeting bilateral abductor pollicis brevis (APB) and abductor digiti minimi (ADM), to obtain duration and area of ipsilateral silent period (ISP) during simultaneous tonic contraction of APB and ADM. Data were compared with 13 controls who underwent twice these measurements, in a two-week interval, without undergoing piano training. Every subject in the experimental group improved keyboard performance and left-hand nine-hole peg test scores. Pre-training, ISP durations were asymmetrical, left being longer than right. Post-training, right ISPAPB increased, leading to symmetrical ISPAPB. Mu TRD during motor performance became more focal and had a lesser amplitude than in pre-training, due to decreased activity over ventral premotor cortices. No such changes were evidenced in controls. We demonstrated that a 10-day piano-training was associated with balanced interhemispheric interactions both at rest and during motor activation. Piano training, in a short timeframe, may reshape local and inter-hemispheric motor cortical circuits. PMID:27309353

  18. Intracortical inhibition and facilitation in different representations of the human motor cortex.

    PubMed

    Chen, R; Tam, A; Bütefisch, C; Corwell, B; Ziemann, U; Rothwell, J C; Cohen, L G

    1998-12-01

    Intracortical inhibition and facilitation in different representations of the human motor cortex. J. Neurophysiol. 80: 2870-2881, 1998. Intracortical inhibition (ICI) and intracortical facilitation (ICF) of the human motor cortex can be studied with paired transcranial magnetic stimulation (TMS). Plastic changes and some neurological disorders in humans are associated with changes in ICI and ICF. Although well characterized in the hand representation, it is not known if ICI and ICF vary across different body part representations. Therefore we studied ICI and ICF in different motor representations of the human motor cortex. The target muscles were rectus abdominus (RA), biceps brachii (BB), abductor pollicis brevis (APB), quadriceps femoris (QF), and abductor hallucis (AH). For each muscle, we measured the rest and active motor thresholds (MTs), the motor-evoked potential (MEP) stimulus-response curve (MEP recruitment), ICI, and ICF. The effects of different interstimulus intervals (ISIs) were studied with a conditioning stimulus (CS) intensity of 80% active MT. The effects of different CS intensities were studied at ISI of 2 ms for ICI and ISI of 15 ms for ICF. MT was lowest for APB, followed by BB, AH, and QF, and was highest for RA. Except for BB, MEP recruitment was generally steeper for muscles with lower MT. ICI and ICF were present in all the motor representations tested. The stimulus intensity necessary to elicit ICI was consistently lower than that required to elicit ICF, suggesting that they are mediated by separate mechanisms. Despite wide differences in MT and MEP recruitment, the absolute CS intensities (expressed as percentage of the stimulator's output) required to elicit ICI and ICF appear unrelated to MT and MEP recruitment in the different muscles tested. These findings suggest that the intracortical mechanisms for inhibition and facilitation in different motor representations are not related to the strength of corticospinal projections. PMID

  19. Effects of subthalamic nucleus stimulation on motor cortex plasticity in Parkinson disease

    PubMed Central

    Kim, Sang Jin; Udupa, Kaviraja; Ni, Zhen; Moro, Elena; Gunraj, Carolyn; Mazzella, Filomena; Lozano, Andres M.; Hodaie, Mojgan; Lang, Anthony E.

    2015-01-01

    Objective: We hypothesized that subthalamic nucleus (STN) deep brain stimulation (DBS) will improve long-term potentiation (LTP)-like plasticity in motor cortex in Parkinson disease (PD). Methods: We studied 8 patients with PD treated with STN-DBS and 9 age-matched healthy controls. Patients with PD were studied in 4 sessions in medication (Med) OFF/stimulator (Stim) OFF, Med-OFF/Stim-ON, Med-ON/Stim-OFF, and Med-ON/Stim-ON states in random order. Motor evoked potential amplitude and cortical silent period duration were measured at baseline before paired associated stimulation (PAS) and at 3 different time intervals (T0, T30, T60) up to 60 minutes after PAS in the abductor pollicis brevis and abductor digiti minimi muscles. Results: Motor evoked potential size significantly increased after PAS in controls (+67.7% of baseline at T30) and in patients in the Med-ON/Stim-ON condition (+55.8% of baseline at T30), but not in patients in the Med-OFF/Stim-OFF (−0.4% of baseline at T30), Med-OFF/Stim-ON (+10.3% of baseline at T30), and Med-ON/Stim-OFF conditions (+17.3% of baseline at T30). Cortical silent period duration increased after PAS in controls but not in patients in all test conditions. Conclusions: Our findings suggest that STN-DBS together with dopaminergic medications restore LTP-like plasticity in motor cortex in PD. Restoration of cortical plasticity may be one of the mechanisms of how STN-DBS produces clinical benefit. PMID:26156511

  20. Pattern Differences of Small Hand Muscle Atrophy in Amyotrophic Lateral Sclerosis and Mimic Disorders

    PubMed Central

    Fang, Jia; Liu, Ming-Sheng; Guan, Yu-Zhou; Du, Hua; Li, Ben-Hong; Cui, Bo; Ding, Qing-Yun; Cui, Li-Ying

    2016-01-01

    Background: Amyotrophic lateral sclerosis (ALS) and some mimic disorders, such as distal-type cervical spondylotic amyotrophy (CSA), Hirayama disease (HD), and spinobulbar muscular atrophy (SBMA) may present with intrinsic hand muscle atrophy. This study aimed to investigate different patterns of small hand muscle involvement in ALS and some mimic disorders. Methods: We compared the abductor digiti minimi/abductor pollicis brevis (ADM/APB) compound muscle action potential (CMAP) ratios between 200 ALS patients, 95 patients with distal-type CSA, 88 HD patients, 43 SBMA patients, and 150 normal controls. Results: The ADM/APB CMAP amplitude ratio was significantly higher in the ALS patients (P < 0.001) than that in the normal controls. The ADM/APB CMAP amplitude ratio was significantly reduced in the patients with distal-type CSA (P < 0.001) and the HD patients (P < 0.001) compared with that in the normal controls. The patients with distal-type CSA had significantly lower APB CMAP amplitude than the HD patients (P = 0.004). The ADM/APB CMAP amplitude ratio was significantly lower in the HD patients (P < 0.001) than that in the patients with distal-type CSA. The ADM/APB CMAP amplitude ratio of the SBMA patients was similar to that of the normal controls (P = 0.862). An absent APB CMAP and an abnormally high ADM/APB CMAP amplitude ratio (≥4.5) were observed exclusively in the ALS patients. Conclusions: The different patterns of small hand muscle atrophy between the ALS patients and the patients with mimic disorders presumably reflect distinct pathophysiological mechanisms underlying different disorders, and may aid in distinguishing between ALS and mimic disorders. PMID:26996473

  1. Differences in Dysfunction of Thenar and Hypothenar Motoneurons in Amyotrophic Lateral Sclerosis

    PubMed Central

    Fang, Jia; Cui, Liying; Liu, Mingsheng; Guan, Yuzhou; Li, Xiaoguang; Li, Dawei; Cui, Bo; Shen, Dongchao; Ding, Qingyun

    2016-01-01

    This study aimed to determine differences in spinal motoneuron dysfunction between the abductor pollicis brevis (APB) and the abductor digiti minimi (ADM) in amyotrophic lateral sclerosis (ALS) patients based on studying F-waves. Forty ALS patients and 20 normal controls (NCs) underwent motor nerve conduction studies on both median and ulnar nerves, including F-waves elicited by 100 electrical stimuli. The F-wave persistence (P < 0.05), index repeating neuron (RN; P < 0.001), and index repeater F-waves (Freps; P < 0.001) significantly differed between the APB and the ADM in the NC participants. For the hands of the ALS patients that lacked detectable wasting or weakness and exhibited either no or mild impairment of discrete finger movements, significantly reduced F-wave persistence (P < 0.001), increased index RN (P < 0.001), and increased index Freps (P < 0.001) were observed in APB in comparison with the normal participants, with relatively normal ADM F-wave parameters. For the hands of ALS patients that exhibited wasting and weakness, the mean F-wave amplitude (P < 0.05), the F/M amplitude ratio (P < 0.05), F-wave persistence (P < 0.001), index RN (P < 0.05), and index Freps (P < 0.05) significantly differed between APB and ADM. The differences in the dysfunction of motoneurons innervating APB and ADM are unique manifestations in ALS patients. The F-wave persistence (P = 0.002), index RN (P < 0.001), and index Freps (P < 0.001) in the APB seemed to differentiate ALS from the NCs more robustly than the ADM/APB Compound muscle action potential (CMAP) amplitude ratio. Thus, F-waves may reveal subclinical alterations in anterior horn cells, and may potentially help to distinguish ALS from mimic disorders. PMID:27014030

  2. Cortical dysfunction underlies the development of the split-hand in amyotrophic lateral sclerosis.

    PubMed

    Menon, Parvathi; Kiernan, Matthew C; Vucic, Steve

    2014-01-01

    The split-hand phenomenon, a specific feature of amyotrophic lateral sclerosis (ALS), refers to preferential wasting of abductor pollicis brevis (APB) and first dorsal interosseous (FDI) with relative preservation of abductor digiti minimi (ADM). The pathophysiological mechanisms underlying the split-hand phenomenon remain elusive and resolution of this issue would provide unique insights into ALS pathophysiology. Consequently, the present study dissected out the relative contribution of cortical and peripheral processes in development of the split-hand phenomenon in ALS. Cortical and axonal excitability studies were undertaken on 26 ALS patients, with motor responses recorded over the APB, FDI and ADM muscles. Results were compared to 21 controls. Short interval intracortical inhibition (SICI), a biomarker of cortical excitability, was significantly reduced across the range of intrinsic hand muscles (APB(SICI ALS) 0.3±2.0%, APB(SICI controls) 16.0±1.9%, P<0.0001; FDI(SICI ALS) 2.7±1.7%, FDI(SICI controls) 14.8±1.9%, P<0.0001; ADM(SICI ALS) 2.6±1.5%, ADM(SICI controls) 9.7±2.2%, P<0.001), although the reduction was most prominent when recorded over APB/FDI. Changes in SICI were accompanied by a significant increase in motor evoked potential amplitude and reduction of cortical silent period duration, all indicative of cortical hyperexcitability, and these were most prominent from the APB/FDI. At a peripheral level, a significant increase in strength-duration time constant and reduction in depolarising threshold electrotonus were evident in ALS, although these changes did not follow a split-hand distribution. Cortical dysfunction contributed to development of the split-hand in ALS, thereby implying an importance of cortical hyperexcitability in ALS pathogenesis. PMID:24475241

  3. Differences in Dysfunction of Thenar and Hypothenar Motoneurons in Amyotrophic Lateral Sclerosis.

    PubMed

    Fang, Jia; Cui, Liying; Liu, Mingsheng; Guan, Yuzhou; Li, Xiaoguang; Li, Dawei; Cui, Bo; Shen, Dongchao; Ding, Qingyun

    2016-01-01

    This study aimed to determine differences in spinal motoneuron dysfunction between the abductor pollicis brevis (APB) and the abductor digiti minimi (ADM) in amyotrophic lateral sclerosis (ALS) patients based on studying F-waves. Forty ALS patients and 20 normal controls (NCs) underwent motor nerve conduction studies on both median and ulnar nerves, including F-waves elicited by 100 electrical stimuli. The F-wave persistence (P < 0.05), index repeating neuron (RN; P < 0.001), and index repeater F-waves (Freps; P < 0.001) significantly differed between the APB and the ADM in the NC participants. For the hands of the ALS patients that lacked detectable wasting or weakness and exhibited either no or mild impairment of discrete finger movements, significantly reduced F-wave persistence (P < 0.001), increased index RN (P < 0.001), and increased index Freps (P < 0.001) were observed in APB in comparison with the normal participants, with relatively normal ADM F-wave parameters. For the hands of ALS patients that exhibited wasting and weakness, the mean F-wave amplitude (P < 0.05), the F/M amplitude ratio (P < 0.05), F-wave persistence (P < 0.001), index RN (P < 0.05), and index Freps (P < 0.05) significantly differed between APB and ADM. The differences in the dysfunction of motoneurons innervating APB and ADM are unique manifestations in ALS patients. The F-wave persistence (P = 0.002), index RN (P < 0.001), and index Freps (P < 0.001) in the APB seemed to differentiate ALS from the NCs more robustly than the ADM/APB Compound muscle action potential (CMAP) amplitude ratio. Thus, F-waves may reveal subclinical alterations in anterior horn cells, and may potentially help to distinguish ALS from mimic disorders. PMID:27014030

  4. Cathodal transcutaneous spinal direct current stimulation (tsDCS) improves motor unit recruitment in healthy subjects.

    PubMed

    Bocci, Tommaso; Vannini, Beatrice; Torzini, Antonio; Mazzatenta, Andrea; Vergari, Maurizio; Cogiamanian, Filippo; Priori, Alberto; Sartucci, Ferdinando

    2014-08-22

    Transcutaneous spinal direct current stimulation (tsDCS) is a new promising technique for modulating spinal cord function in humans. However, its effects on corticospinal pathways and lower motorneuron excitability are poorly understood. We studied the effects of tsDCS on motor unit recruitment by evaluating changes in motor unit number (MUNE) and peripheral silent period (PSP) after sham (s-tsDCS), anodal (a-tsDCS) and cathodal (c-tsDCS) tsDCS applied either over the cervical or the lower thoracic spinal cord in healthy subjects. For the calculation of MUNE we used the multipoint incremental technique recording from either the ulnar nerve innervated abductor digiti minimi (ADM) or the median nerve innervated abductor pollicis brevis (APB) muscle. c-tsDCS dramatically increases MUNE values following cervical polarization, while sham and anodal polarization have no significant effect (APB: F(4,99)=26.4, p<0.001, two-way repeated measures ANOVA with "time" and "stimulation" as factors; ADM: F(4,99)=22.1, p<0.0001). At the same time, c-tsDCS dampened PSP respect to sham and anodal conditions (p<0.0001). Interestingly, also thoracic c-tsDCS significantly improved motor unit recruitment compared with both s-tsDCS and a-tsDCS (APB: F(4,99)=20.1, p<0.0001; ADM: F(4,99)=16.6, p<0.0001). Our data in healthy subjects suggest that tsDCS, possibly also through supraspinal effects, could provide a novel therapeutic tool in managing several pathological conditions characterized by reduced motor unit recruitment, such as stroke and spinal cord injuries. PMID:24970753

  5. Cortical Motor Circuits after Piano Training in Adulthood: Neurophysiologic Evidence

    PubMed Central

    Nuara, Arturo; Zanini, Sonia; Gatti, Roberto; Comi, Giancarlo; Leocani, Letizia

    2016-01-01

    The neuronal mechanisms involved in brain plasticity after skilled motor learning are not completely understood. We aimed to study the short-term effects of keyboard training in music-naive subjects on the motor/premotor cortex activity and interhemispheric interactions, using electroencephalography and transcranial magnetic stimulation (TMS). Twelve subjects (experimental group) underwent, before and after a two week-piano training: (1) hand-motor function tests: Jamar, grip and nine-hole peg tests; (2) electroencephalography, evaluating the mu rhythm task-related desynchronization (TRD) during keyboard performance; and (3) TMS, targeting bilateral abductor pollicis brevis (APB) and abductor digiti minimi (ADM), to obtain duration and area of ipsilateral silent period (ISP) during simultaneous tonic contraction of APB and ADM. Data were compared with 13 controls who underwent twice these measurements, in a two-week interval, without undergoing piano training. Every subject in the experimental group improved keyboard performance and left-hand nine-hole peg test scores. Pre-training, ISP durations were asymmetrical, left being longer than right. Post-training, right ISPAPB increased, leading to symmetrical ISPAPB. Mu TRD during motor performance became more focal and had a lesser amplitude than in pre-training, due to decreased activity over ventral premotor cortices. No such changes were evidenced in controls. We demonstrated that a 10-day piano-training was associated with balanced interhemispheric interactions both at rest and during motor activation. Piano training, in a short timeframe, may reshape local and inter-hemispheric motor cortical circuits. PMID:27309353

  6. Does the MUNIX Method Reflect Clinical Dysfunction in Amyotrophic Lateral Sclerosis

    PubMed Central

    Gawel, Malgorzata; Kuzma-Kozakiewicz, Magdalena

    2016-01-01

    Abstract The aim of our study was to assess the usefulness of the MUNIX method in reflecting the clinical dysfunction in patients with amyotrophic lateral sclerosis (ALS), as well as to assess an intra-rater reproducibility of MUNIX. The study group consisted of a total of 15 ALS patients. The mean age of symptoms onset was 55 years, and the mean disease duration was 10 months. The muscle strength and patients’ functional status were assessed according to the Medical Research Council (MRC) and by ALS functional rating scale revised (ALSFRS-R), respectively. The MUNIX was performed in 6 muscles: abductor pollicis brevis (APB), abductor digiti minimi (ADM), biceps brachii (BB), tibial anterior (TA), extensor digitorum brevis (EDB), and abductor hallucis (AH), unilaterally, at a less affected side. Both muscle-specific and global MRC and MUNIX scores were calculated. In 11 patients, the study protocol was repeated at least twice every 3 months. An additional testing of the intra-rater reliability was performed at the first visit. There were no significant differences between MUNIX test and re-test values in the APB, ADM, BB, TA, EDB, and AH muscles (P >0.05). The highest variability of the test–retest values was found in the BB muscle (7.53%). Although there was a significant test–retest difference in the global MUNIX score (P = 0.02), the variability of the results was as low as 1.26%. The MUNIX value correlated with the muscle-specific MRC score in ABP, ADM, TA, EDB and AH (P <0.05), and the global MUNIX values correlated with global MRC scores (P <0.05). There was also a significant correlation between the global MUNIX score and the clinical dysfunction measured by the ALSFRS-R scale (P <0.05). The global MUNIX showed a higher monthly decline (4.3%) as compared with ALFRS-R (0.7%) and the MRC global score (0.5%). This study confirms that the MUNIX method is a sensitive, reliable, and accurate tool reflecting both motor dysfunction and disease

  7. Double cortical stimulation in amyotrophic lateral sclerosis.

    PubMed Central

    Yokota, T; Yoshino, A; Inaba, A; Saito, Y

    1996-01-01

    OBJECTIVE: Transcranial double magnetic stimulation on the motor cortex was used to investigate central motor tract function in 16 patients with amyotrophic lateral sclerosis, five with spinal muscular atrophy, and 16 age matched normal controls. METHODS: Surface EMG responses were recorded from the relaxed abductor pollicis brevis (APB) muscle. RESULTS: Responses to test stimuli were markedly attenuated by a subthreshold conditioning stimulus given at a condition-test (C-T) interval of 1-4 ms in normal controls and patients with spinal muscular atrophy, but attenuation was mild in patients with amyotrophic lateral sclerosis. In the normal controls this suppression was caused by activation of the intracortical inhibitory mechanism because responses to electrical test stimuli and the H wave were not suppressed by the same magnetic subthreshold conditioning stimulus. In amyotrophic lateral sclerosis the effect of the conditioning cortical stimulus on the H wave was also in the normal range. CONCLUSION: The intracortical inhibitory mechanism may be impaired in patients with amyotrophic lateral sclerosis. PMID:8971106

  8. Spinal motor neuron excitability during the cutaneous silent period.

    PubMed

    Leis, A A; Stĕtkárová, I; Berić, A; Stokić, D S

    1995-12-01

    The physiologic mechanisms generating the cutaneous silent period (CSP) remain uncertain. It is not known whether the CSP occurs because of inexcitability of the spinal motor neuron. We therefore, assessed excitability of the motor neuron during the CSP using F-wave responses. H-reflexes were also elicited during the CSP. Electrical stimulation to the fifth digit produced the CSP in the voluntarily contracting abductor pollicis brevis muscle (APB). Median nerve stimulation at the wrist elicited control F or H responses during isometric APB contraction (condition 1) and in resting muscle (condition 2). Control amplitudes were compared to those elicited in the midst of the CSP. In Condition 1, F-wave amplitudes and frequency during the CSP were unchanged compared with controls. However, F-waves were increased in amplitude and frequency during the CSP (P < 0.001) relative to responses elicited in resting muscle (condition 2). H-reflexes during the CSP were suppressed (P < 0.001) compared with controls elicited during contraction (condition 1), but facilitated relative to the resting state (condition 2) in which no H-reflexes were elicitable. We conclude that spinal motor neurons remain excitable to antidromic volleys at the same time that the corticospinal volley is inhibited to produce the CSP. Moreover, motor neuron excitability appears to be increased during the CSP compared to the relaxed state. PMID:7477071

  9. [Neurological Signs and Symptoms of True Neurogenic Thoracic Outlet Syndrome].

    PubMed

    Higashihara, Mana; Konoeda, Fumie; Sonoo, Masahiro

    2016-05-01

    Thoracic outlet syndrome (TOS) is a well-known disorder, but many aspects of its pathology, including its definition, has been disputed. True neurogenic TOS (TN-TOS) is a rare but well-defined clinical condition. TN-TOS results from the compression of the C8/T1 roots (dominant for the T1 root) or the proximal lower trunk of the brachial plexus by a fibrous band. The band extends from the first rib to either the tip of an elongated C7 transverse process or a rudimentary cervical rib. The most common presenting symptoms of TN-TOS are insidious-onset atrophy and weakness of the intrinsic hand muscles, predominantly in the thenar eminence and radial digit flexors. Nerve conduction studies demonstrate pathognomonic findings: severely attenuated compound muscle action potential of the abductor pollicis brevis muscle, and usually, loss of the sensory nerve action potential of the medial antebrachial cutaneous nerve. Numbness and sensory loss are typically observed, mainly in the medial forearm, although they are usually mild, and may be absent in some patients. Severe pain or paresthesia proximal to the elbow is not observed. The classical concept of TOS underlie nonspecific neurogenic TOS. It has been primarily diagnosed using provocative maneuvers. However, there is controversy regarding its pathological conceptualization and existence, as objective evidence of the disease is still lacking. PMID:27156505

  10. Mechanisms of central motor reorganization in pediatric hemiplegic patients.

    PubMed

    Maegaki, Y; Maeoka, Y; Ishii, S; Shiota, M; Takeuchi, A; Yoshino, K; Takeshita, K

    1997-06-01

    Twenty hemiplegic patients were studied with transcranial magnetic stimulation (TMS). Motor evoked potentials (MEPs) of the biceps brachii (BB) and the abductor pollicis brevis muscles (APB) were recorded on both sides simultaneously. TMS was carried out with an 8-shaped coil over different scalp positions in the intact hemisphere. Bilateral MEPs of BB were elicited in patients with later childhood lesions as well as early lesion, but those of APB were only elicited in the latter (up to 2 years). In patients with prenatal or birth lesion on BB and in all patients on APB, cortical maps of MEP amplitude of paretic and non-paretic sides showed similar distributions. There were no remarkable differences in mean latency between both sides, and correlation coefficients of MEP amplitude between both sides were high in these patients. In patients with postnatal lesion on BB, MEP maps of both sides showed different distributions, ipsilateral MEP latencies were delayed and correlation coefficients were low. We suspect that ipsilateral MEPs after early lesion derive from axonal sprouting both in the proximal and the distal muscles. After postnatal lesion, other mechanisms of ipsilateral motor projection take place in the proximal muscles, but not in the distal ones. PMID:9266555

  11. Depression of corticomotor excitability after muscle fatigue induced by electrical stimulation and voluntary contraction

    PubMed Central

    Kotan, Shinichi; Kojima, Sho; Miyaguchi, Shota; Sugawara, Kazuhiro; Onishi, Hideaki

    2015-01-01

    In this study, we examined the effect of muscle fatigue induced by tetanic electrical stimulation (ES) and submaximal isometric contraction on corticomotor excitability. Experiments were performed in a cross-over design. Motor-evoked potentials (MEPs) were elicited by transcranial magnetic stimulation (TMS). Corticomotor excitability was recorded before and after thumb opposition muscle fatigue tasks, in which 10% of the maximal tension intensity was induced by tetanic ES or voluntary contraction (VC). The participants were 10 healthy individuals who performed each task for 10 min. Surface electrodes placed over the abductor pollicis brevis (APB) muscle recorded MEPs. F- and M-waves were elicited from APB by supramaximal ES of the median nerve. After the tetanic ES- and VC tasks, MEP amplitudes were significantly lower than before the task. However, F- and M-wave amplitudes remained unchanged. These findings suggest that corticospinal excitability is reduced by muscle fatigue as a result of intracortical inhibitory mechanisms. Our results also suggest that corticomotor excitability is reduced by muscle fatigue caused by both VC and tetanic ES. PMID:26150781

  12. [Wound closure after irrigation with Octenisept® without possibility for drainage].

    PubMed

    Högele, A M; Neu, J

    2011-01-01

    A 39-year-old patient suffered a stab wound of the right thenar prominence after an accident with a screwdriver. In the first hospital the deep wound was irrigated with octenidine dihydrochloride/2-phenoxyethanol and closed by suture. During the further course pressure pain and numbness of the right thenar and swelling of the right hand occurred. Three weeks after the accident an operative revision of the wound in a second hospital was performed. The intraoperative findings showed inflammation and necrosis of the right m. abductor pollicis brevis, but no infection with pus.The patient accused the first hospital of irrigating the tissue of his right hand with Octenisept®. The expert option of the Arbitration Board identified improper care in the first hospital with insufficient excision of the wound and incorrect use of the Octenisept® solution. Against the explicit advice of the manufacturing company the wound had been sutured without the possibility of drainage for the Octenisept® solution. PMID:21229225

  13. Motor Unit Number Estimation and Motor Unit Action Potential Analysis in Carpal Tunnel Syndrome

    PubMed Central

    Sohn, Min Kyun; Jee, Sung Ju; Kim, Young-Jae; Shin, Hyun-Dae

    2011-01-01

    Objective To evaluate the clinical significance of motor unit number estimation (MUNE) and quantitative analysis of motor unit action potential (MUAP) in carpal tunnel syndrome (CTS) according to electrophysiologic severity, ultrasonographic measurement and clinical symptoms. Method We evaluated 78 wrists of 45 patients, who had been diagnosed with CTS and 42 wrists of 21 healthy controls. Median nerve conduction studies, amplitude and duration of MUAP, and the MUNE of the abductor pollicis brevis were measured. The cross sectional area (CSA) of the median nerve at the pisiform and distal radioulnar joint level was determined by high resolution ultrasonography. Clinical symptom of CTS was assessed using the Boston Carpal Tunnel Questionnaire (BCTQ). Results The MUNE, the amplitude and the duration of MUAP of the CTS group were significantly different from those found in the control group. The area under the ROC curve was 0.944 for MUNE, 0.923 for MUAP amplitude and 0.953 for MUAP duration. MUNE had a negative correlation with electrophysiologic stage of CTS, amplitude and duration of MUAP, CSA at pisiform level, and the score of BCTQ. The amplitude and duration of MUAP had a positive correlation with the score of BCTQ. The electrophysiologic stage was correlated with amplitude but not with the duration of MUAP. Conclusion MUNE, amplitude and duration of MUAP are useful tests for diagnosis of CTS. In addition, the MUNE serves as a good indicator of CTS severity. PMID:22506210

  14. When anger dominates the mind: Increased motor corticospinal excitability in the face of threat.

    PubMed

    Hortensius, Ruud; de Gelder, Beatrice; Schutter, Dennis J L G

    2016-09-01

    Threat demands fast and adaptive reactions that are manifested at the physiological, behavioral, and phenomenological level and are responsive to the direction of threat and its severity for the individual. Here, we investigated the effects of threat directed toward or away from the observer on motor corticospinal excitability and explicit recognition. Sixteen healthy right-handed volunteers completed a transcranial magnetic stimulation (TMS) task and a separate three-alternative forced-choice emotion recognition task. Single-pulse TMS to the left primary motor cortex was applied to measure motor evoked potentials from the right abductor pollicis brevis in response to dynamic angry, fearful, and neutral bodily expressions with blurred faces directed toward or away from the observer. Results showed that motor corticospinal excitability increased independent of direction of anger compared with fear and neutral. In contrast, anger was better recognized when directed toward the observer compared with when directed away from the observer, while the opposite pattern was found for fear. The present results provide evidence for the differential effects of threat direction on explicit recognition and motor corticospinal excitability. In the face of threat, motor corticospinal excitability increases independently of the direction of anger, indicative of the importance of more automatic reactions to threat. PMID:27325519

  15. Inspiratory resistances facilitate the diaphragm response to transcranial stimulation in humans

    PubMed Central

    Locher, Chrystèle; Raux, Mathieu; Fiamma, Marie-Noelle; Morélot-Panzini, Capucine; Zelter, Marc; Derenne, Jean-Philippe; Similowski, Thomas; Straus, Christian

    2006-01-01

    Background Breathing in humans is dually controlled for metabolic (brainstem commands) and behavioral purposes (suprapontine commands) with reciprocal modulation through spinal integration. Whereas the ventilatory response to chemical stimuli arises from the brainstem, the compensation of mechanical loads in awake humans is thought to involve suprapontine mechanisms. The aim of this study was to test this hypothesis by examining the effects of inspiratory resistive loading on the response of the diaphragm to transcranial magnetic stimulation. Results Six healthy volunteers breathed room air without load (R0) and then against inspiratory resistances (5 and 20 cmH2O/L/s, R5 and R20). Ventilatory variables were recorded. Transcranial magnetic stimulation (TMS) was performed during early inspiration (I) or late expiration (E), giving rise to motor evoked potentials (MEPs) in the diaphragm (Di) and abductor pollicis brevis (APB). Breathing frequency significantly decreased during R20 without any other change. Resistive breathing had no effect on the amplitude of Di MEPs, but shortened their latency (R20: -0.903 ms, p = 0.03) when TMS was superimposed on inspiration. There was no change in APB MEPs. Conclusion Inspiratory resistive breathing facilitates the diaphragm response to TMS while it does not increase the automatic drive to breathe. We interpret these findings as a neurophysiological substratum of the suprapontine nature of inspiratory load compensation in awake humans. PMID:16875504

  16. Usefulness of magnetic motor evoked potentials in the surgical treatment of hemiplegic patients with intractable epilepsy.

    PubMed

    Kamida, Tohru; Baba, Hiroshi; Ono, Kenji; Yonekura, Masato; Fujiki, Minoru; Kobayashi, Hidenori

    2003-09-01

    Five hemiplegic patients with intractable epilepsy were studied with transcranial magnetic stimulation (TMS) before and after various surgical treatments. These patients had unilateral widespread cerebral lesions acquired at various times, including congenital, infantile and childhood injury. Motor evoked potentials (MEPs) of the abductor pollicis brevis (APB) muscles were simultaneously recorded on both sides following TMS of the motor cortex in the respective hemisphere using a figure-8 or circular coil. In all patients with congenital disease, the abolition of motor function in the affected hemisphere was estimated by magnetic MEPs, and the hemiplegia did not deteriorate after functional hemispherectomy (HS) was performed in two of them. In two patients with acquired disease, HS was not performed because it was shown by magnetic maps that the motor function in the affected hemisphere remained. Furthermore, it was shown by electric MEPs using subdural electrodes that a patient who had had encephalitis in early childhood had a reorganised motor area in the parietal cortex of the affected hemisphere. The present findings indicate that magnetic MEPs are a very useful non-invasive method of assessing whether the motor area in the affected hemisphere can be resected in hemiplegic patients with intractable epilepsy. PMID:12915083

  17. Excitatory and inhibitory mechanisms in Wilson's disease: investigation with magnetic motor cortex stimulation.

    PubMed

    Perretti, A; Pellecchia, M T; Lanzillo, B; Campanella, G; Santoro, L

    2001-11-15

    We have evaluated cortical excitability in nine patients affected by Wilson's disease (WD) using transcranial magnetic (TMS) and electric (TES) cortical stimulation and central silent period (CSP) data. A clinical score was derived from the sum of scores assigned to extrapyramidal, pyramidal and cerebellar signs. All patients underwent TMS. Motor evoked potentials (MEPs) from abductor pollicis brevis (APB) and tibialis anterior (TA) muscles were recorded. MEP threshold and amplitude, central motor conduction time (CMCT), CSP threshold, CSP and peripheral silent period (PSP) duration were measured. Three patients also underwent transcranial bifocal electric cortical stimulation (TES) and MEPs were recorded from the APB muscle, and CMCT, MEP threshold and amplitude were measured. TMS MEPs were absent from relaxed muscles in six patients and from contracted muscles in three. CMCT was prolonged in six patients. APB CMCT correlated with clinical score. In three patients in whom TMS revealed abnormal or no MEP, TES MEPs were of normal threshold and amplitude. The CSP threshold was increased in seven patients, and CSP was absent in one. These results suggest an intracortical presynaptic motor dysfunction in WD. PMID:11701150

  18. Modulation of Cortical Inhibitory Circuits after Cathodal Transcranial Direct Current Stimulation over the Primary Motor Cortex

    PubMed Central

    Sasaki, Ryoki; Miyaguchi, Shota; Kotan, Shinichi; Kojima, Sho; Kirimoto, Hikari; Onishi, Hideaki

    2016-01-01

    Here, we aimed to evaluate whether cathodal transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) and primary somatosensory cortex (S1) can modulate cortical inhibitory circuits. Sixteen healthy subjects participated in this study. Cathodal tDCS was positioned over the left M1 (M1 cathodal) or left S1 (S1 cathodal) with an intensity of 1 mA for 10 min. Sham tDCS was applied for 10 min over the left M1 (sham). Motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) were recorded from the right abductor pollicis brevis (APB) muscle before the intervention (pre) and 10 and 30 min after the intervention (post 1 and post 2, respectively). Cortical inhibitory circuits were evaluated using short-interval intracortical inhibition (SICI) and short-latency afferent inhibition (SAI). M1 cathodal decreased single-pulse MEP amplitudes at post 1 and decreased SAI at post 1 and post 2; however, SICI did not exhibit any change. S1 cathodal and sham did not show any changes in MEP amplitudes at any of the three time points. These results demonstrated that cathodal tDCS over the M1 not only decreases the M1 excitability but also affects the cortical inhibitory circuits related to SAI. PMID:26869909

  19. Early changes in corticospinal excitability when seeing fearful body expressions.

    PubMed

    Borgomaneri, Sara; Vitale, Francesca; Avenanti, Alessio

    2015-01-01

    Quick inhibition of approach tendencies in response to signals of potential threats is thought to promote survival. However, little is known about the effect of viewing fearful expressions on the early dynamics of the human motor system. We used the high temporal resolution of single-pulse and paired-pulse transcranial magnetic stimulation (TMS) over the motor cortex to assess corticospinal excitability (CSE) and intracortical facilitation (ICF) during observation of happy, fearful and neutral body postures. To test motor circuits involved in approach tendencies, CSE and ICF were recorded from the first dorsal interosseous (FDI), a muscle involved in grasping, and the abductor pollicis brevis (APB), which served as a control. To test early motor dynamics, CSE and ICF were measured 70-90 ms after stimulus onset. We found a selective reduction in CSE in the FDI when participants observed fearful body expressions. No changes in ICF or in the excitability of APB were detected. Our study establishes an extremely rapid motor system reaction to observed fearful body expressions. This motor modulation involves corticospinal downstream projections but not cortical excitatory mechanisms, and appears to reflect an inhibition of hand grasping. Our results suggest a fast visuo-motor route that may rapidly inhibit inappropriate approaching actions. PMID:26388400

  20. Axonal conduction velocity and force of single human motor units.

    PubMed

    Dengler, R; Stein, R B; Thomas, C K

    1988-02-01

    Tungsten microelectrodes of the type used for microneurography have been used to record motor units selectively from the first dorsal interosseous and abductor pollicis brevis muscles of normal subjects and patients who had had complete sections of the ulnar or median nerve. After determining the recruitment threshold and the twitch tension (spike-triggered averaging) of a single unit, its nerve was stimulated at the wrist and the elbow using surface electrodes. By adjusting the position of the surface electrode and the stimulus intensity and by using computerized subtraction of responses just above and below threshold for a given unit, the same motor unit could often be identified in response to stimulation at both sites and its conduction velocity determined. The twitch tension and recruitment threshold of the motor units were closely correlated with the conduction velocity of the motor axons in normal subjects. Preliminary data from patients suggests that this method should be applicable to patients with a number of neuromuscular disorders. PMID:3343989

  1. Effect of galvanic vestibular stimulation on movement-related cortical potential.

    PubMed

    Lee, Jeong-Woo

    2015-06-01

    [Purpose] This study examined the effects of galvanic vestibular stimulation on motion-related cortical potential. [Subjects and Methods] Fourty healthy female adult subjects each received galvanic vestibular stimulation or sham treatment. For galvanic vestibular stimulation, the anode and cathode were applied to the right and left mastoid processes, respectively, for 10 minutes. Motion-related cortical potential was tested pre- and post-treatment. To measure motion-related cortical potential, surface electromyography signals were generated by 50 thumb abductions with electrode application on the abductor pollicis brevis of the left (i.e., non-dominant) hand. [Results] The negative slope cortical potential on the C3 area (i.e., dominant hand) and cortical negative slope and motor potential on the C4 area (i.e., non-dominant hand) showed significant interaction effects. The galvanic vestibular stimulation group showed an increased negative slope amplitude in the C3 area, and increased negative slope and motor potential amplitudes in the C4 area compared to the sham group. [Conclusion] Galvanic vestibular stimulation increases the negative slope and motor potential amplitudes of the homonymous brain cortex area, which controls hand function and motion-related cortical potential, and the negative slope amplitude of the opposite cortical area, thus activating the brain areas for hand function. PMID:26180369

  2. Effect of galvanic vestibular stimulation on movement-related cortical potential

    PubMed Central

    Lee, Jeong-Woo

    2015-01-01

    [Purpose] This study examined the effects of galvanic vestibular stimulation on motion-related cortical potential. [Subjects and Methods] Fourty healthy female adult subjects each received galvanic vestibular stimulation or sham treatment. For galvanic vestibular stimulation, the anode and cathode were applied to the right and left mastoid processes, respectively, for 10 minutes. Motion-related cortical potential was tested pre- and post-treatment. To measure motion-related cortical potential, surface electromyography signals were generated by 50 thumb abductions with electrode application on the abductor pollicis brevis of the left (i.e., non-dominant) hand. [Results] The negative slope cortical potential on the C3 area (i.e., dominant hand) and cortical negative slope and motor potential on the C4 area (i.e., non-dominant hand) showed significant interaction effects. The galvanic vestibular stimulation group showed an increased negative slope amplitude in the C3 area, and increased negative slope and motor potential amplitudes in the C4 area compared to the sham group. [Conclusion] Galvanic vestibular stimulation increases the negative slope and motor potential amplitudes of the homonymous brain cortex area, which controls hand function and motion-related cortical potential, and the negative slope amplitude of the opposite cortical area, thus activating the brain areas for hand function. PMID:26180369

  3. Enhancement of motor coordination by applying high frequency repetitive TMS on the sensory cortex.

    PubMed

    Choi, Eun-Hi; Yoo, Woo-Kyoung; Ohn, Suk Hoon; Ahn, SeungHo; Kim, Han Jun; Jung, Kwang-Ik

    2016-06-01

    The sensory function plays an important role for successful motor performance. We investigated the modulating effects of high frequency repetitive transcranial magnetic stimulation (rTMS) on sensory discrimination and motor coordination. Twenty healthy participants were assigned into two random groups; the real- and sham-rTMS group. Total of 900 rTMS pulses at a frequency of 10Hz (stimulus intensity of 90% RMT) were given over deltoid representational areas of the somatosensory cortex. Sensory discrimination ability was evaluated using two-point discrimination test. Motor coordination was measured by the latency difference between the synchronized contraction of deltoid and abductor pollicis brevis muscles before and after rTMS. The sensory discrimination was significantly increased only in the deltoid area and the difference in the latency of synchronized contraction of two muscles was significantly shortened after real-rTMS compared sham condition, which had tendency of negative correlation following real-rTMS condition. The results of this study demonstrated rTMS-induced enhancement of sensorimotor integration, which may contribute to develop effective therapeutic strategies for rehabilitation of various sensorimotor disorders in the clinical setting. PMID:26978587

  4. Diagnostic Value of the Second Lumbrical-Interosseous Distal Motor Latency Comparison Test in Severe Carpal Tunnel Syndrome

    PubMed Central

    Lee, SangHun; Kim, DongHyun; Cho, Hee-Mun; Nam, Ho-Sung

    2016-01-01

    Objective To examine the usefulness of the second lumbrical-interosseous (2L-INT) distal motor latency (DML) comparison test in localizing median neuropathy to the wrist in patients with absent median sensory and motor response in routine nerve conduction studies. Methods Electrodiagnostic results from 1,705 hands of patients with carpal tunnel syndrome (CTS) symptoms were reviewed retrospectively. All subjects were evaluated using routine nerve conduction studies: median sensory conduction recorded from digits 1 to 4, motor conduction from the abductor pollicis brevis muscle, and the 2L-INT DML comparison test. Results Four hundred and one hands from a total of 1,705 were classified as having severe CTS. Among the severe CTS group, 56 hands (14.0%) showed absent median sensory and motor response in a routine nerve conduction study, and, of those hands, 42 (75.0%) showed an abnormal 2L-INT response. Conclusion The 2L-INT DML comparison test proved to be a valuable electrodiagnostic technique in localizing median mononeuropathy at the wrist, even in the most severe CTS patients. PMID:26949669

  5. Development of myasthenia gravis after interferon alpha therapy.

    PubMed

    Gurtubay, I G; Morales, G; Aréchaga, O; Gállego, J

    1999-03-01

    Interferon (IFN) alpha is now used in the treatment of some malignant diseases and chronic viral hepatitis. There have been several reports of development of autoantibodies and autoimmune diseases or the deterioration of preexisting disorders in patients under treatment. We enclose a case of myasthenia gravis (MG) which developed after six weeks of treatment as fluctuating bilateral ptosis, intermittent diplopia, and mild weakness of limb and neck muscles. A test dose of edrophonium chloride was administered, resulting in improved muscle strength. Elevated anti acetylcholine receptor (AChR) antibody titer was found. Single fiber electromyography showed an increased jitter from extensor digitorum communis, frequently accompanied by transmission blocking. Repetitive electric 3 Hz stimulation of the abductor pollicis brevis muscle, revealed an abnormal decrement of 28% in compound motor action potential. Myasthenia gravis was diagnosed and the patient was given pyridostigmine, immunoglobulines and prednisone with benefit. Six months latter he developed an acute myasthenic crisis with severe respiratory failure and high anti AChR antibody titer. IFN-alpha can induce MG or simply manifests a preexisting subclinical disease, but otherwise its therapeutic efficacy in MG has been shown in experimental and clinical studies. Autoimmune mechanisms, as the release of different cytokines as IFN, by immunocompetent cells, may be involved in the pathogenesis of both MG and chronic active hepatitis. Autoantibody production against postsynaptic membrane structures by IFN-alpha could be the underlying pathophysiology. PMID:10207675

  6. Facilitatory effect of paired-pulse stimulation by transcranial magnetic stimulation with biphasic wave-form.

    PubMed

    Julkunen, Petro; Järnefelt, Gustaf; Savolainen, Petri; Laine, Jarmo; Karhu, Jari

    2016-08-01

    Transcranial magnetic stimulation (TMS) is used to probe corticospinal excitability by stimulating the motor cortex. Our aim was to enhance the effects of biphasic TMS by coupling a suprathreshold test pulse and a following subthreshold priming pulse to induce short-interval intracortical facilitation (SICF), which is conventionally produced with monophasic TMS. Biphasic TMS could potentially induce the SICF effect with better energy-efficiency and with lower stimulus intensities. This would make the biphasic paired-pulses better applicable in patients with reduced cortical excitability. A prototype stimulator was built to produce biphasic paired-pulses. Resting motor thresholds (rMTs) from the right and left hand abductor pollicis brevis muscles, and the right tibialis anterior muscle of eight healthy volunteers were determined using single-pulse paradigm with neuronavigated TMS. The rMTs and MEPs were measured using single-pulses and three paired-pulse setups (interstimulus interval, ISI of 3, 7 or 15ms). The rMTs were lower and MEPs were higher with biphasic paired-pulses compared to single-pulses. The SICF effect was greatest at 3ms ISI. This suggests that the application of biphasic paired-pulses to enhance stimulation effects is possible. PMID:27215172

  7. Reversal of Peroneal Tenodesis With Allograft Reconstruction of the Peroneus Brevis and Longus: Case Report and Surgical Technique.

    PubMed

    Pellegrini, Manuel J; Adams, Samuel B; Parekh, Selene G

    2014-06-24

    Chronic peroneal tendinopathy and tears represent a challenging clinical situation. Traditionally, tenodesis of the torn tendon to the remaining healthy tendon has been advocated if more than half of the tendon is compromised. Allograft reconstructions have been reserved for patients with functional muscles and both peroneal tendons extensively compromised. We report a unique case of a peroneal tenodesis takedown and reconstruction of both peroneal tendons using semitendinosus allograft. A description of the surgical technique and tips are provided. Peroneal tendon function is crucial to maintain a balanced hindfoot. To the best of our knowledge, reconstruction of both peroneal tendons after a tenodesis has not been previously reported. Allograft reconstruction of the peroneal tendons arises as a feasible alternative in patients with residual pain and weakness after a failed tenodesis surgery LEVELS OF EVIDENCE: Therapeutic Level IV, case study. PMID:24962697

  8. Do we really need new medical information about the Turin Shroud?

    PubMed

    Bevilacqua, M; Fanti, G; D'Arienzo, M; De Caro, R

    2014-02-01

    Image processing of the Turin Shroud (TS) shows that the Man represented in it has undergone an under glenoidal dislocation of the humerus on the right side and lowering of the shoulder, and has a flattened hand and enophthalmos; conditions that have not been described before, despite several studies on the subject. These injuries indicate that the Man suffered a violent blunt trauma to the neck, chest and shoulder from behind, causing neuromuscular damage and lesions of the entire brachial plexus. The posture of the left claw-hand is indicative of an injury of the lower brachial plexus, as is the crossing of the hands on the pubis, not above the pubis as it would normally be, and are related to traction of the limbs as a result of the nailing to the patibulum. The disappearance of the thumbprints is because of entrainment of the flexor pollicis longus tendons while the nails were driven through the wrists. The blunt chest trauma, which resulted in the body falling forwards, was the direct cause of a lung contusion and haemothorax, confirmed by the post-mortem leakage of clots and serum from the chest caused by the stabbing with the spear, and was a likely cause of cardiac contusion. All the evidence is in favour of the hypothesis that the TS Man is Jesus of Nazareth. PMID:24135252

  9. Median nerve deformation and displacement in the carpal tunnel during index finger and thumb motion.

    PubMed

    van Doesburg, Margriet H M; Yoshii, Yuichi; Villarraga, Hector R; Henderson, Jacqueline; Cha, Stephen S; An, Kai-Nan; Amadio, Peter C

    2010-10-01

    The purpose of this study was to investigate the deformation and displacement of the normal median nerve in the carpal tunnel during index finger and thumb motion, using ultrasound. Thirty wrists from 15 asymptomatic volunteers were evaluated. Cross-sectional images during motion from full extension to flexion of the index finger and thumb were recorded. On the initial and final frames, the median nerve, flexor pollicis longus (FPL), and index finger flexor digitorum superficialis (FDS) tendons were outlined. Coordinate data were recorded and median nerve cross-sectional area, perimeter, aspect ratio of the minimal-enclosing rectangle, and circularity in extension and flexion positions were calculated. During index finger flexion, the tendon moves volarly while the nerve moves radially. With thumb flexion, the tendon moves volarly, but the median nerve moves toward the ulnar side. In both motions, the area and perimeter of the median nerve in flexion were smaller than in extension. Thus, during index finger or thumb flexion, the median nerve in a healthy human subject shifts away from the index finger FDS and FPL tendons while being compressed between the tendons and the flexor retinaculum in the carpal tunnel. We are planning to compare these data with measurements in patients with carpal tunnel syndrome (CTS) and believe that these parameters may be useful tools for the assessment of CTS and carpal tunnel mechanics with ultrasound in the future. PMID:20225286

  10. [Diagnosis and therapy of psychogenic paralyses in the hand region].

    PubMed

    Tizian, C; Berger, A; Kunert, P

    1985-09-01

    Beside the importance of its prehensile function the human hand plays an essential role in the conveyance of expression. Manual gestures support the mimic and confirm the spoken word. Based on the psychofunctional connection between mimic and gesture the hand becomes an outlet for psychogenic disorders. The resultant projection of emotional processes into motor disorders has been a matter of conjecture etiologically. Psychogenic manifestation in isolated motor disorders of the hand is considered to be either a functional nervous disorder or a focal dystonia. In comparison to the conversion phenomena reported up until now, in which flexor muscle units of the hand are involved with increased muscular activity (spasm), the cases presented here are characterized by a functional motor disorder manifested as an isolated paralysis of a selective extensor muscle unit (M. extensor pollicis longus) of the hand. After a multidisciplinary approach including clinical morphology, neurology, EMG and psychiatry the final diagnosis of a psychogenic paralysis of the hand is made using direct electro-stimulation of the neuromuscular unit with a needle electrode under simultaneous elimination of the psychic influence (general anesthesia without muscular relaxation). Through such confirmed motor inactivity the psychic genesis of the clinically existing paralysis is proven. Through immediate introduction of a multimodal therapy including physical and psychiatric treatment psychogenic paralyses of the hand can be restored totally. PMID:4065716

  11. Mirror-image trigger thumb in dichorionic identical twins.

    PubMed

    Wang, Eric D; Xu, Xiaoti; Dagum, Alexander B

    2012-06-01

    The congenital vs acquired etiology of pediatric trigger thumb is the subject of considerable debate. Existing case reports of bilateral presentation in identical twins and first-degree familial association support the congenital hypothesis. However, prospective studies have yet to report a neonate presenting with this anomaly at birth. This article describes the first known set of dichorionic, monozygotic identical twins with unilateral trigger thumbs, affecting contralateral (mirror-image) hands and with asynchronous age at presentation (11 months and 18 months, respectively).Pediatric trigger thumb is caused by a mismatch between the flexor pollicis longus tendon and its A1 synovial pulley. Four sets of twins have been previously reported in the literature with trigger thumb. Of these, 3 sets were monozygotic twins who had bilaterally affected thumbs. Together with the absence of trauma, a congenital etiology was suggested. The fact that pediatric trigger thumb is generally seen several months after birth was felt to be due to infants holding their thumbs clutched in their palms until 6 months. However, no confirmed cases of trigger thumb have been diagnosed at birth in several large prospective studies of newborns.In the current case, the asynchronous presentation of unilateral trigger thumbs in identical twins does not support a solely congenital cause. Furthermore, the mirror-image presentation contradicts current embryological understanding of the temporal course of twinning and the determination of laterality. Thus, a multifactorial etiology is supported with both a genetic and acquired component affecting the development of this condition. PMID:22691680

  12. Multiple ruptures of the extensor tendons after volar fixation for distal radius fracture: a case report.

    PubMed

    Caruso, Giancarlo; Vitali, Andrea; del Prete, Ferdinando

    2015-12-01

    A 62-year-old woman was admitted to our hospital after a bicycle accident with a displaced left (non-dominant) distal radius fracture. After closed reduction a long cast was applied. Due to loss of reduction, twenty-four days later open reduction internal fixation with locking compression plate (LCP) was performed. The patient returned to her normal activities but nineteen months after surgery showed functional impairment of the left thumb for Extensor Pollicis Longus (EPL) injury for which she necessitated transposition surgery. Twenty-six months after ORIF, functional deficit of the extension of the third and fourth left finger was noted secondary to injury of extensor tendons. Ultrasound and CT scan showed protrusion of the angular stability screws in LCP plate that caused a progressive wear resulting in rupture of the extensor tendons. Another tendon transposition surgery was performed with dorsal approach while the plate was removed utilising the original volar incision. Reconstruction of distal radius fractures with volar plating, requires accurate plate application with precise measurement of the length of the screws in order to prevent dorsal protrusion and thus avoiding tendon injuries. PMID:26738455

  13. Cadaver study of the topography of the musculotendinous junction of the finger extensor muscles: applicability to tendon rupture following closed wrist trauma.

    PubMed

    Lepage, D; Tatu, L; Loisel, F; Vuillier, F; Parratte, B

    2015-09-01

    Rupture of the extensor pollicis longus (EPL) tendon in the wrist is a delayed complication that can occur after wrist injury. Several etiology-related hypotheses have been made to explain these ruptures. The one most commonly accepted is necrosis at the musculotendinous junction of the EPL, which is compressed between the extensor retinaculum and dorsal aspect of the radius. To confirm this hypothesis, we performed an anatomical study to show the close relationship between the extensor retinaculum and the musculotendinous junction of the EPL muscle. We calculated the distance between the musculotendinous junction of the various finger extensor muscles and the proximal edge of the extensor retinaculum. We were able to show that this junction is located under the extensor retinaculum for the extensor indicis (EI) and EPL muscles, but the latter is in the third extensor compartment, which is a tight, confined space. Any pressure increase in this space following trauma, for example, can bring about compartment syndrome at this musculotendinous junction, which some authors have found to be poorly vascularized. PMID:25577541

  14. Delineation of extensor tendon of the hand by MRI: usefulness of "soap-bubble" mip processing technique.

    PubMed

    Tsujimoto, Yumiko; Ryoke, Koji; Yamagami, Nobuo; Uchio, Yuji; Tanaka, Shigeko

    2015-01-01

    To evaluate the capability of the "Soap-Bubble" maximum intensity projection (MIP) processing technique in visualisation of extensor tendons of the hand, 36 intact subjects and seven patients with surgically confirmed extensor tendon rupture were examined. Three-dimensional T1-weighted turbo spin echo (3DT1TFE) MRI was performed using a sensitivity encoding flex coil, followed by Soap-Bubble MIP processing. For patients with extensor tendon ruptures, MRI findings and intraoperative findings were compared. As results, with only 3DT1TFE sequence, the entire extensor tendons that run along the arch of the hand were not shown on one image, but were visualised with addition of Soap-Bubble MIP. Although delineation of the extensor pollicis longus was poor in 27/43 subjects, it was much improved by the combination of water-suppression technique. MRI findings and intraoperative findings agreed in all patients. Soap-Bubble MIP processing with addition of water-suppression technique is considered useful for visualising the extensor tendons of the hand. PMID:25609281

  15. Thumb Reconstruction Using Foucher’s Flap

    PubMed Central

    Kola, Nardi

    2016-01-01

    BACKGROUND: Extensive pulp defects of the thumb, with the exposure of tendon or bone, are challenging reconstructive problems. Surgical treatment includes the use of local, regional, and free flaps. AIM: This paper is focused in Foucher’s neuro vascular flap. First DMCA or Foucher’s pedicle flap is a successful thumb reconstruction method, especially in patients not disturbed by its cosmetic appearance. MATERIAL AND METHODS: The first dorsal metacarpal artery (FDMCA) arises from the radial artery in the first intermetacarpal space, just distal to the tendon of the extensor pollicis longus. Pulp area of the thumb is the area where Foucher’s flap is more utilizable. This technique has other applications such as first web reconstruction, thumb lengthening, and following resection of tumors on the dorsum of the hand. RESULTS: We have in study 7 cases with work related trauma in two years period of time, between 2012 and 2014. We had only one partial flap survival and all the other flaps survived entirely. We have also taken in consideration subjective satisfaction with a range score from 4 to 10, cold intolerance, flap area and donor site sensibility with a range score from low to medium to normal. CONCLUSION: Careful pedicle discovery, secured elevation, pedicle strangulation prevention are very important for flap survival.

  16. The influence of changes in trunk and pelvic posture during single leg standing on hip and thigh muscle activation in a pain free population

    PubMed Central

    2014-01-01

    Background Thigh muscle injuries commonly occur during single leg loading tasks and patterns of muscle activation are thought to contribute to these injuries. The influence trunk and pelvis posture has on hip and thigh muscle activation during single leg stance is unknown and was investigated in a pain free population to determine if changes in body posture result in consistent patterns of changes in muscle activation. Methods Hip and thigh muscle activation patterns were compared in 22 asymptomatic, male subjects (20–45 years old) in paired functionally relevant single leg standing test postures: Anterior vs. Posterior Trunk Sway; Anterior vs. Posterior Pelvic Rotation; Left vs. Right Trunk Shift; and Pelvic Drop vs. Raise. Surface EMG was collected from eight hip and thigh muscles calculating Root Mean Square. EMG was normalized to an “upright standing” reference posture. Repeated measures ANOVA was performed along with associated F tests to determine if there were significant differences in muscle activation between paired test postures. Results In right leg stance, Anterior Trunk Sway (compared to Posterior Sway) increased activity in posterior sagittal plane muscles, with a concurrent deactivation of anterior sagittal plane muscles (p: 0.016 - <0.001). Lateral hip abductor muscles increased activation during Left Trunk Shift (compared to Right) (p :≤ 0.001). Lateral Pelvic Drop (compared to Raise) decreased activity in hip abductors and increased hamstring, adductor longus and vastus lateralis activity (p: 0.037 - <0.001). Conclusion Changes in both trunk and pelvic posture during single leg stance generally resulted in large, predictable changes in hip and thigh muscle activation in asymptomatic young males. Changes in trunk position in the sagittal plane and pelvis position in the frontal plane had the greatest effect on muscle activation. Investigation of these activation patterns in clinical populations such as hip and thigh muscle injuries may

  17. 3D-MRI rendering of the anatomical structures related to acupuncture points of the Dai mai, Yin qiao mai and Yang qiao mai meridians within the context of the WOMED concept of lateral tension: implications for musculoskeletal disease

    PubMed Central

    Moncayo, Roy; Rudisch, Ansgar; Kremser, Christian; Moncayo, Helga

    2007-01-01

    Background A conceptual model of lateral muscular tension in patients presenting thyroid associated ophthalmopathy (TAO) has been recently described. Clinical improvement has been achieved by using acupuncture on points belonging to the so-called extraordinary meridians. The aim of this study was to characterize the anatomical structures related to these acupuncture points by means of 3D MRI image rendering relying on external markers. Methods The investigation was carried out the index case patient of the lateral tension model. A licensed medical acupuncture practitioner located the following acupuncture points: 1) Yin qiao mai meridian (medial ankle): Kidney 3, Kidney 6, the plantar Kidney 6 (Nan jing description); 2) Yang qiao mai meridian (lateral ankle): Bladder 62, Bladder 59, Bladder 61, and the plantar Bladder 62 (Nan jing description); 3) Dai mai meridian (wait): Liver 13, Gall bladder 26, Gall bladder 27, Gall bladder 28, and Gall bladder 29. The points were marked by taping a nitro-glycerin capsule on the skin. Imaging was done on a Siemens Magnetom Avanto MR scanner using an array head and body coil. Mainly T1-weighted imaging sequences, as routinely used for patient exams, were used to obtain multi-slice images. The image data were rendered in 3D modus using dedicated software (Leonardo, Siemens). Results Points of the Dai mai meridian – at the level of the waist – corresponded to the obliquus externus abdominis and the obliquus internus abdominis. Points of the Yin qiao mai meridian – at the medial side of the ankle – corresponded to tendinous structures of the flexor digitorum longus as well as to muscular structures of the abductor hallucis on the foot sole. Points of the Yang qiao mai meridian – at the lateral side of the ankle – corresponded to tendinous structures of the peroneus brevis, the peroneous longus, and the lateral surface of the calcaneus and close to the foot sole to the abductor digiti minimi. Conclusion This non

  18. Thoracic limb morphology of the red panda (Ailurus fulgens) evidenced by osteology and radiography.

    PubMed

    Makungu, Modesta; Groenewald, Hermanus B; du Plessis, Wencke M; Barrows, Michelle; Koeppel, Katja N

    2015-01-01

    The red panda (Ailurus fulgens) is distributed primarily in the Himalayas and southern China. It is classified as a vulnerable species by the International Union for Conservation of Nature. The aim of this study was to describe the normal osteology and radiographic anatomy of the thoracic limb of the red panda. Radiography of the right thoracic limb was performed in seven captive adult red pandas. Radiographic findings were correlated with bone specimens from three adult animals. The scapula was wide craniocaudally and presented with a large area for the origin of the teres major muscle. The square-shaped major tubercle did not extend proximal to the head of the humerus. The medial epicondyle was prominent. A supracondylar foramen was present. The radial tuberosity and sesamoid bone for the abductor digiti I longus were prominent. The accessory carpal bone was directed palmarolaterally. Metacarpal bones were widely spread. The thoracic limb morphology of the red panda evidenced by osteology and radiography indicated flexibility of the thoracic limb joints and well-developed flexor and supinator muscles, which are important in arboreal quadrupedal locomotion. Knowledge gained during this study may prove useful in identifying skeletal material or remains and diagnosing musculoskeletal diseases and injuries of the thoracic limb. PMID:26244684

  19. Comparative and functional myology of the prehensile tail in New World monkeys.

    PubMed

    Lemelin, P

    1995-06-01

    The caudal myology of prehensile-tailed monkeys (Cebus apella, Alouatta palliata, Alouatta seniculus, Lagothrix lagotricha, and Ateles paniscus) and nonprehensile-tailed primates (Eulemur fulvus, Aotus trivirgatus, Callithrix jacchus, Pithecia pithecia, Saimiri sciureus, Macaca fascicularis, and Cercopithecus aethiops) was examined and compared in order to identify muscular differences that correlate with osteological features diagnostic of tail prehensility. In addition, electrophysiological stimulation was carried out on different segments of the intertransversarii caudae muscle of an adult spider monkey (Ateles geoffroyi) to assess their action on the prehensile tail. Several important muscular differences characterize the prehensile tail of New World monkeys compared to the nonprehensile tail of other primates. In atelines and Cebus, the mass of extensor caudae lateralis and flexor caudae longus muscles is more uniform along the tail, and their long tendons cross a small number of vertebrae before insertion. Also, prehensile-tailed monkeys, especially atelines, are characterized by well-developed flexor and intertransversarii caudae muscles compared to nonprehensile-tailed primates. Finally, Ateles possesses a bulkier abductor caudae medialis and a more cranial origin for the first segment of intertransversarii caudae than do other prehensile-tailed platyrrhines. These myological differences between nonprehensile-tailed and prehensile-tailed primates, and among prehensile-tailed monkeys, agree with published osteological and behavioral data. Caudal myological similarities and differences found in Cebus and atelines, combined with tail-use data from the literature, support the hypothesis that prehensile tails evolved in parallel in Cebus and atelines. PMID:7595958

  20. Short-term peripheral nerve stimulation ameliorates axonal dysfunction after spinal cord injury

    PubMed Central

    Kiernan, Matthew C.; Macefield, Vaughan G.; Lee, Bonne B.; Lin, Cindy S.-Y.

    2015-01-01

    There is accumulating evidence that peripheral motor axons deteriorate following spinal cord injury (SCI). Secondary axonal dysfunction can exacerbate muscle atrophy, contribute to peripheral neuropathies and neuropathic pain, and lead to further functional impairment. In an attempt to ameliorate the adverse downstream effects that developed following SCI, we investigated the effects of a short-term peripheral nerve stimulation (PNS) program on motor axonal excitability in 22 SCI patients. Axonal excitability studies were undertaken in the median and common peroneal nerves (CPN) bilaterally before and after a 6-wk unilateral PNS program. PNS was delivered percutaneously over the median nerve at the wrist and CPN around the fibular head, and the compound muscle action potential (CMAP) from the abductor pollicis brevis and tibialis anterior was recorded. Stimulus intensity was above motor threshold, and pulses (450 μs) were delivered at 100 Hz with a 2-s on/off cycle for 30 min 5 days/wk. SCI patients had consistently high thresholds with a reduced CMAP consistent with axonal loss; in some patients the peripheral nerves were completely inexcitable. Nerve excitability studies revealed profound changes in membrane potential, with a “fanned-in” appearance in threshold electrotonus, consistent with membrane depolarization, and significantly reduced superexcitability during the recovery cycle. These membrane dysfunctions were ameliorated after 6 wk of PNS, which produced a significant hyperpolarizing effect. The contralateral, nonstimulated nerves remained depolarized. Short-term PNS reversed axonal dysfunction following SCI, may provide an opportunity to prevent chronic changes in axonal and muscular function, and may improve rehabilitation outcomes. PMID:25787956

  1. Basic study on the influence of inhibition induced by the magnetic stimulation on the peripheral nerve

    NASA Astrophysics Data System (ADS)

    Sato, Aya; Torii, Tetsuya; Iwahashi, Masakuni; Iramina, Keiji

    2015-05-01

    The purpose of this study is to analyze the inhibition mechanism of magnetic stimulation on motor function. A magnetic stimulator with a flat figure-eight coil was used to stimulate the peripheral nerve of the antebrachium. The intensity of magnetic stimulation was 0.8 T, and the stimulation frequency was 1 Hz. The amplitudes of the motor-evoked potentials (MEPs) at the abductor pollicis brevis muscle and first dorsal interosseous muscle were used to evaluate the effects of magnetic stimulation. The effects of magnetic stimulation were evaluated by analyzing the MEP amplitude before and after magnetic stimulation to the primary motor cortex. The results showed that MEP amplitude after magnetic stimulation compared with before magnetic stimulation decreased. Because there were individual differences in MEP amplitude induced by magnetic stimulation, the MEP amplitude after stimulation was normalized by the amplitude of each participant before stimulation. The MEP amplitude after stimulation decreased by approximately 58% (p < 0.01) on average compared with before stimulation. Previous studies suggested that magnetic stimulation to the primary motor cortex induced an increase or a decrease in MEP amplitude. Furthermore, previous studies have shown that the alteration in MEP amplitude was induced by cortical excitability based on magnetic stimulation. The results of this study showed that MEP amplitude decreased following magnetic stimulation to the peripheral nerve. We suggest that the decrease in MEP amplitude found in this study was obtained via the feedback from a peripheral nerve through an afferent nerve to the brain. This study suggests that peripheral excitement by magnetic stimulation of the peripheral nerve may control the central nervous system via afferent feedback.

  2. Patients with spastic hemiplegia at different recovery stages: evidence of reciprocal modulation of early/late reflex responses.

    PubMed

    Ibrahim, I K; el-Abd, M A; Dietz, V

    1993-04-01

    Reflex electromyographic (EMG) muscle responses were recorded from abductor pollicis brevis (APB) and tibialis anterior (TA) muscles of fifty patients with spastic hemiplegia. Responses in the muscles were evoked during voluntary muscle contraction (about 20% of maximum voluntary effort) by submaximal but suprathreshold electrical stimulation of the median (at the wrist) and common peroneal (at the neck of the fibula) nerves respectively. Three EMG peaks (R1, R2 and R3) could be recorded after the direct muscle response (M). There was only a slight difference in R1-R2 latency interval of about 5 ms between upper and lower limbs on the unaffected side of the patients making it unlikely that this late response of the lower limb involves a long loop pathway, although this possibility cannot be discounted for the later, R3, response. Reflex behaviour was analysed for three clinical identifiable recovery stages of voluntary movements in the spastic limbs (synergistic, isolated and useful movements). The major finding was that an increase in the amplitude of the early response "R1" was associated with a decreased amplitude and delayed latency of the late response "R2" on the spastic side. The amplitude of R1 in the three different recovery stages decreased significantly, whereas the amplitude of R2 increased significantly with improvement of the functional stage of the limb. A significant negative linear correlation was found between R1 and R2 amplitude changes in upper as well as lower limbs. A refractoriness of the motor neuron pool as a possible explanation for the decreased R2 amplitude could be discounted. These findings together with recent work on reflex development in children support the hypothesis of reciprocal modulation of early and late reflex signals by supraspinal motor centers. PMID:8482959

  3. Major motor-functional determinants associated with poor self-reported health-related quality of life in myasthenia gravis patients.

    PubMed

    Cioncoloni, David; Casali, Stefania; Ginanneschi, Federica; Carone, Marisa; Veronica, Boni; Rossi, Alessandro; Giannini, Fabio

    2016-05-01

    Myasthenia gravis (MG) is an autoimmune neuromuscular disorder in which disabling muscle weakness may affect health-related quality of life (HRQoL). The aim of this study was to investigate which common motor-functional deficits and corresponding severity are most determinant of poor HRQoL in these patients. In 41 patients, the dichotomized first item of the Italian Myasthenia Gravis Questionnaire (IMGQ), categorizing patients who report "good" and "poor" HRQoL, was chosen as dependent-outcome variable. All items composing the myasthenia gravis-specific scale (MG-ADL), i.e. talking, chewing, swallowing, breathing, impairment of ability to brush teeth or comb hair, impairment of ability to rise from chair, double vision, and eyelid droop were acquired as independent variables and dichotomized. Stepwise backward LR multivariable logistic regression analysis was performed. In addition, the main characteristics of patients were compared. MG-ADL items "chewing" ≥1, i.e. "fatigue chewing solid food", and "breathing" ≥2, i.e. "shortness of breath at rest" proved to be significant determinants. Higher dose of corticosteroid therapy was significantly (p = 0.027; r s  = -0.35), correlated with poor HRQoL. At diagnosis, a decremental response to repetitive nerve stimulation (RNS) from the abductor pollicis brevis was significantly more frequent in patients with poor HRQoL. In conclusion, impaired "chewing" and "breathing" functions indicate the need for careful planning of rehabilitation, re-education and patient management. Moreover, decremental response to RNS at diagnosis may identify patients at risk for poor HRQoL. PMID:27038315

  4. Mutation in the Na+ channel subunit SCN1B produces paradoxical changes in peripheral nerve excitability.

    PubMed

    Kiernan, Matthew C; Krishnan, Arun V; Lin, Cindy S-Y; Burke, David; Berkovic, Samuel F

    2005-08-01

    To determine the effect of an established mutation of the beta1 subunit of Na(+) channels on nerve excitability, studies were undertaken in patients diagnosed with generalized epilepsy with febrile seizures plus (GEFS+). Multiple nerve excitability measurements were used to investigate the membrane properties of sensory and motor axons in five patients (aged 18-55 years) who were currently experiencing no seizures and were not on anticonvulsants. There was no history of paraesthesiae, fasciculation or cramps to suggest hyperexcitability of peripheral nerve axons. The median nerve was stimulated at the wrist, and compound muscle action potentials (CMAPs) were recorded from abductor pollicis brevis and the antidromic compound sensory nerve action potential (CSAPs) from digit 2. Stimulus-response behaviour, strength-duration time constant, threshold electrotonus, current-threshold relationship and the recovery of excitability following a supramaximal conditioning stimulus were recorded using threshold tracking. Compared with normal controls (n = 29), the axons of patients were of higher threshold. CMAPs and CSAPs were relatively small, although individual values remained within the normal ranges. Refractoriness and relative refractory period (markers of transient Na(+) channel function) were significantly reduced in GEFS+ patients with established mutations in SCN1B (P < 0.05), and strength-duration time constants (dependent on persistent Na(+) conductances) were reduced. It is suggested that, in peripheral nerve axons, the mutation underlying GEFS+ reduces the number of functioning Na(+) channels at the node of Ranvier and that this rather than any change in gating of individual channels dominates axonal excitability in these patients. PMID:15857929

  5. Motor Cortical Plasticity to Training Started in Childhood: The Example of Piano Players.

    PubMed

    Chieffo, Raffaella; Straffi, Laura; Inuggi, Alberto; Gonzalez-Rosa, Javier J; Spagnolo, Francesca; Coppi, Elisabetta; Nuara, Arturo; Houdayer, Elise; Comi, Giancarlo; Leocani, Letizia

    2016-01-01

    Converging evidence suggest that motor training is associated with early and late changes of the cortical motor system. Transcranial magnetic stimulation (TMS) offers the possibility to study plastic rearrangements of the motor system in physiological and pathological conditions. We used TMS to characterize long-term changes in upper limb motor cortical representation and interhemispheric inhibition associated with bimanual skill training in pianists who started playing in an early age. Ipsilateral silent period (iSP) and cortical TMS mapping of hand muscles were obtained from 30 strictly right-handed subjects (16 pianists, 14 naïve controls), together with electromyographic recording of mirror movements (MMs) to voluntary hand movements. In controls, motor cortical representation of hand muscles was larger on the dominant (DH) than on the non-dominant hemisphere (NDH). On the contrary, pianists showed symmetric cortical output maps, being their DH less represented than in controls. In naïve subjects, the iSP was smaller on the right vs left abductor pollicis brevis (APB) indicating a weaker inhibition from the NDH to the DH. In pianists, interhemispheric inhibition was more symmetric as their DH was better inhibited than in controls. Electromyographic MMs were observed only in naïve subjects (7/14) and only to voluntary movement of the non-dominant hand. Subjects with MM had a lower iSP area on the right APB compared with all the others. Our findings suggest a more symmetrical motor cortex organization in pianists, both in terms of muscle cortical representation and interhemispheric inhibition. Although we cannot disentangle training-related from preexisting conditions, it is possible that long-term bimanual practice may reshape motor cortical representation and rebalance interhemispheric interactions, which in naïve right-handed subjects would both tend to favour the dominant hemisphere. PMID:27336584

  6. Motor Cortical Plasticity to Training Started in Childhood: The Example of Piano Players

    PubMed Central

    Inuggi, Alberto; Gonzalez-Rosa, Javier J.; Spagnolo, Francesca; Coppi, Elisabetta; Nuara, Arturo; Houdayer, Elise; Comi, Giancarlo; Leocani, Letizia

    2016-01-01

    Converging evidence suggest that motor training is associated with early and late changes of the cortical motor system. Transcranial magnetic stimulation (TMS) offers the possibility to study plastic rearrangements of the motor system in physiological and pathological conditions. We used TMS to characterize long-term changes in upper limb motor cortical representation and interhemispheric inhibition associated with bimanual skill training in pianists who started playing in an early age. Ipsilateral silent period (iSP) and cortical TMS mapping of hand muscles were obtained from 30 strictly right-handed subjects (16 pianists, 14 naïve controls), together with electromyographic recording of mirror movements (MMs) to voluntary hand movements. In controls, motor cortical representation of hand muscles was larger on the dominant (DH) than on the non-dominant hemisphere (NDH). On the contrary, pianists showed symmetric cortical output maps, being their DH less represented than in controls. In naïve subjects, the iSP was smaller on the right vs left abductor pollicis brevis (APB) indicating a weaker inhibition from the NDH to the DH. In pianists, interhemispheric inhibition was more symmetric as their DH was better inhibited than in controls. Electromyographic MMs were observed only in naïve subjects (7/14) and only to voluntary movement of the non-dominant hand. Subjects with MM had a lower iSP area on the right APB compared with all the others. Our findings suggest a more symmetrical motor cortex organization in pianists, both in terms of muscle cortical representation and interhemispheric inhibition. Although we cannot disentangle training-related from preexisting conditions, it is possible that long-term bimanual practice may reshape motor cortical representation and rebalance interhemispheric interactions, which in naïve right-handed subjects would both tend to favour the dominant hemisphere. PMID:27336584

  7. Modulation of motor activity by cutaneous input: inhibition of the magnetic motor evoked potential by digital electrical stimulation.

    PubMed

    Clouston, P D; Kiers, L; Menkes, D; Sander, H; Chiappa, K; Cros, D

    1995-04-01

    We examined the inhibitory effect of a brief train of digital (D2) electrical stimuli at 4 times perception threshold on transcranial magnetic motor evoked potentials (MEPs) recorded from abductor pollicis brevis (APB) and flexor carpi radialis (FCR) muscles ipsilateral to the side of D2 stimulation. We compared this to the inhibitory effect of ipsilateral D2 stimulation on averaged rectified EMG recorded at 10% maximum voluntary contraction and on F-responses and H-reflexes recorded from these same muscles. We also compared MEPs recorded following D2 stimulation just above perception threshold to MEPs following higher intensity D2 stimulation. As well, we assessed the effect of preceding D2 stimulation on MEPs recorded from a relaxed versus tonically contracted hand muscle. D2 stimulation elicited a triphasic response of modest MEP facilitation followed by inhibition and further facilitation. The duration and onset of MEP inhibition correlated with those of the initial period of rectified EMG inhibition, however, the magnitude of MEP inhibition was generally less than the magnitude of EMG inhibition, consistent with a greater inhibitory effect of digital afferents on smaller motor neurons. MEPs were not facilitated during the rebound of EMG activity (the E2 period) that usually followed the initial period of EMG inhibition (I1 period). The behavior of H-reflexes and F-responses following ipsilateral D2 stimulation suggested that inhibition of both EMG and MEPs is not mediated via presynaptic inhibition of Ia afferents, and that inhibition is augmented by descending rather than segmental input to spinal motor neurons. Tonic contraction of the target muscle during D2 stimulation decreased the inhibitory effect of the preceding digital stimulus possibly due to recruitment of larger spinal motor neurons less likely to be inhibited by cutaneous input. PMID:7537203

  8. Changes in corticospinal drive to spinal motoneurones following tablet-based practice of manual dexterity.

    PubMed

    Larsen, Lisbeth H; Jensen, Thor; Christensen, Mark S; Lundbye-Jensen, Jesper; Langberg, Henning; Nielsen, Jens B

    2016-02-01

    The use of touch screens, which require a high level of manual dexterity, has exploded since the development of smartphone and tablet technology. Manual dexterity relies on effective corticospinal control of finger muscles, and we therefore hypothesized that corticospinal drive to finger muscles can be optimized by tablet-based motor practice. To investigate this, sixteen able-bodied females practiced a tablet-based game (3 × 10 min) with their nondominant hand requiring incrementally fast and precise pinching movements involving the thumb and index fingers. The study was designed as a semirandomized crossover study where the participants attended one practice- and one control session. Before and after each session electrophysiological recordings were obtained during three blocks of 50 precision pinch movements in a standardized setup resembling the practiced task. Data recorded during movements included electroencephalographic (EEG) activity from primary motor cortex and electromyographic (EMG) activity from first dorsal interosseous (FDI) and abductor pollicis brevis (APB) muscles. Changes in the corticospinal drive were evaluated from coupling in the frequency domain (coherence) between EEG-EMG and EMG-EMG activity. Following motor practice performance improved significantly and a significant increase in EEG-EMGAPB and EMGAPB-EMGFDI coherence in the beta band (15-30 Hz) was observed. No changes were observed after the control session. Our results show that tablet-based motor practice is associated with changes in the common corticospinal drive to spinal motoneurons involved in manual dexterity. Tablet-based motor practice may be a motivating training tool for stroke patients who struggle with loss of dexterity. PMID:26811055

  9. Inducing LTD-Like Effect in the Human Motor Cortex with Low Frequency and Very Short Duration Paired Associative Stimulation: An Exploratory Study.

    PubMed

    Srivanitchapoom, Prachaya; Park, Jung E; Thirugnanasambandam, Nivethida; Panyakaew, Pattamon; Ramos, Vesper Fe Marie; Pandey, Sanjay; Wu, Tianxia; Hallett, Mark

    2016-01-01

    Introduction. Paired associative stimulation (PAS) is an established technique to investigate synaptic plasticity in the human motor cortex (M1). Classically, to induce long-term depression- (LTD-) or long-term potentiation-like effects in the human M1, studies have used low frequency and long duration trains of PAS. In the present study, we explored an LTD-like effect using very short duration and low frequency of PAS10 ms protocols in human M1. Methods. Six protocols of low frequency PAS10 ms (ranging from 0.2 Hz to 1 Hz) were investigated with very short durations of 1 and 2 minutes stimulation. Six healthy volunteers were included in each protocol. We obtained motor-evoked potentials from right abductor pollicis brevis muscle before and after applying PAS10 ms up to 30 minutes. After we found PAS10 ms protocol which induced an LTD-like effect, we tested that protocol on additional 5 subjects. Results. One-way repeated-measures ANOVA showed that only the group of 1-minute stimulation of 0.25 Hz induced an LTD-like effect. When adding the additional subjects, the effect remained and lasted for 30 minutes. Conclusion. Low frequency and very short duration of PAS10 ms potentially induced an LTD-like effect in human M1. With further verification, this method might be useful for research relating to synaptic plasticity by reducing the duration of study and minimizing subject discomfort. PMID:26904298

  10. The effect of dual-task difficulty on the inhibition of the motor cortex.

    PubMed

    Corp, Daniel T; Rogers, Mark A; Youssef, George J; Pearce, Alan J

    2016-02-01

    Dual-tasking is intrinsic to many daily activities, including walking and driving. However, the activity of the primary motor cortex (M1) in response to dual-tasks (DT) is still not well characterised. A recent meta-analysis (Corp in Neurosci Biobehav Rev 43:74-87, 2014) demonstrated a reduction in M1 inhibition during dual-tasking, yet responses were not consistent between studies. It was suggested that DT difficulty might account for some of this between-study variability. The aim of this study was to investigate whether corticospinal excitability and M1 inhibition differed between an easier and more difficult dual-task. Transcranial magnetic stimulation (TMS) was applied to participants' abductor pollicis brevis muscle representation during a concurrent pincer grip task and stationary bike-riding. The margin of error in which to maintain pincer grip force was reduced to increase task difficulty. Compared to ST conditions, significantly increased M1 inhibition was demonstrated for the easier, but not more difficult, DT. However, there was no significant difference in M1 inhibition between easy and difficult DTs. The difference in difficulty between the two tasks may not have been wide enough to result in significant differences in M1 inhibition. Increased M1 inhibition for the easy DT condition was in opposition to the reduction in M1 inhibition found in our meta-analysis (Corp in Neurosci Biobehav Rev 43:74-87, 2014). We propose that this may be partially explained by differences in the timing of the TMS pulse between DT studies. PMID:26514811

  11. Lengthened Cutaneous Silent Period in Fibromyalgia Suggesting Central Sensitization as a Pathogenesis

    PubMed Central

    Koo, Yong Seo; Kim, Byung-Jo

    2016-01-01

    The pathogenesis of fibromyalgia (FM) has not been clearly elucidated, but central sensitization, which plays an important role in the development of neuropathic pain, is considered to be the main mechanism. The cutaneous silent period (CSP), which is a spinal reflex mediated by A-delta cutaneous afferents, is useful for the evaluation of sensorimotor integration at the spinal and supraspinal levels. To understand the pathophysiology of FM, we compared CSP patterns between patients with FM and normal healthy subjects. Twenty-four patients with FM diagnosed in accordance with the 1990 American College of Rheumatology classification system and 24 age- and sex-matched healthy volunteers were recruited. The CSP was measured from the abductor pollicis brevis muscle. Demographic data, number of tender points, and visual analog scale and FM impact questionnaire scores were collected. The measured CSP and clinical parameters of the patient and control groups were compared. In addition, possible correlations between the CSP parameters and the other clinical characteristics were analyzed. Mean CSP latencies did not differ between patients (55.50 ± 10.97 ms) and healthy controls (60.23 ± 11.87 ms; p = 0.158), although the mean CSP duration was significantly longer in patients (73.75 ± 15.67 ms) than in controls (63.50 ± 14.05 ms; p = 0.021). CSP variables did not correlate with any clinical variables. The significantly longer CSP duration in FM patients suggests central dysregulation at the spinal and supraspinal levels, rather than peripheral small fiber dysfunction. PMID:26871583

  12. Predictability of Motor Outcome According to the Time of Motor Evoked Potentials From the Onset of Stroke in Patients With Putaminal Hemorrhage

    PubMed Central

    Kwon, Yong Min; Jang, Sung Ho

    2015-01-01

    Objective To determine the predictability of motor evoked potentials (MEP) in patients with putaminal hemorrhage (PH) according to the time of MEP from the onset of stroke. Methods Sixty consecutive patients with PH from January 2006 to November 2013 were retrospectively reviewed. Motor function of affected extremities was measured at onset time and at six months after the onset. Patients were classified into two groups according to the time of MEP from the onset of stroke: early MEP group (within 15 days from onset) and late MEP group (16-30 days from onset). Patients were also classified into two groups according to the presence of MEP on the affected abductor pollicis brevis (APB): MEP (+) group-patients (showing MEP in the affected APB) and MEP (-) group-patients (no MEP in the affected APB). Motor outcome was compared between the two early and late MEP groups or between the presence and absence of MEP in the affected APB groups. Results For patients with MEP (+), a larger portion in the late MEP group showed good prognosis compared to the early MEP group (late MEP, 94.4%; early MEP, 80%). In contrast, in patients with MEP (-), a larger portion of patients in the late MEP group showed bad prognosis compared to the early MEP group (late MEP, 80%; early MEP, 71.4%). No significant improvement of MI between MEP (+) and MEP (-) was observed when MEP was performed early or late. Conclusion Our results revealed that the predictability of motor outcome might be better if MEP is performed late compared to that when MEP is performed early in patients with PH. PMID:26361591

  13. Short-term peripheral nerve stimulation ameliorates axonal dysfunction after spinal cord injury.

    PubMed

    Lee, Michael; Kiernan, Matthew C; Macefield, Vaughan G; Lee, Bonne B; Lin, Cindy S-Y

    2015-05-01

    There is accumulating evidence that peripheral motor axons deteriorate following spinal cord injury (SCI). Secondary axonal dysfunction can exacerbate muscle atrophy, contribute to peripheral neuropathies and neuropathic pain, and lead to further functional impairment. In an attempt to ameliorate the adverse downstream effects that developed following SCI, we investigated the effects of a short-term peripheral nerve stimulation (PNS) program on motor axonal excitability in 22 SCI patients. Axonal excitability studies were undertaken in the median and common peroneal nerves (CPN) bilaterally before and after a 6-wk unilateral PNS program. PNS was delivered percutaneously over the median nerve at the wrist and CPN around the fibular head, and the compound muscle action potential (CMAP) from the abductor pollicis brevis and tibialis anterior was recorded. Stimulus intensity was above motor threshold, and pulses (450 μs) were delivered at 100 Hz with a 2-s on/off cycle for 30 min 5 days/wk. SCI patients had consistently high thresholds with a reduced CMAP consistent with axonal loss; in some patients the peripheral nerves were completely inexcitable. Nerve excitability studies revealed profound changes in membrane potential, with a "fanned-in" appearance in threshold electrotonus, consistent with membrane depolarization, and significantly reduced superexcitability during the recovery cycle. These membrane dysfunctions were ameliorated after 6 wk of PNS, which produced a significant hyperpolarizing effect. The contralateral, nonstimulated nerves remained depolarized. Short-term PNS reversed axonal dysfunction following SCI, may provide an opportunity to prevent chronic changes in axonal and muscular function, and may improve rehabilitation outcomes. PMID:25787956

  14. Exogenously Applied Muscle Metabolites Synergistically Evoke Sensations of Muscle Fatigue and Pain in Human Subjects

    PubMed Central

    Pollak, Kelly A.; Swenson, Jeffrey D.; Vanhaitsma, Timothy A.; Hughen, Ronald W.; Jo, Daehyun; Light, Kathleen C.; Schweinhardt, Petra; Amann, Markus; Light, Alan R.

    2013-01-01

    The perception of fatigue is common in many disease states, however, the mechanisms of sensory muscle fatigue are not understood. In mice, rats and cats, muscle afferents signal metabolite production in skeletal muscle using a complex of ASIC, P2X and TRPV1 receptors. Endogenous muscle agonists for these receptors are combinations of protons, lactate, and ATP. Here we applied physiological concentrations of these agonists to muscle interstitium in human subjects to determine if this combination could activate sensations, and if so determined how these subjects described these sensations. Ten volunteers received infusions (0.2 ml over 30-s) containing protons, lactate and ATP under the fascia of a thumb muscle, abductor pollicis brevis (APB). Infusion of individual metabolites at maximum amounts evoked no fatigue or pain. Metabolite combinations found in resting muscles (pH 7.4+300nM ATP+1mM lactate) also evoked no sensation. The infusion of a metabolite-combination found in muscle during moderate endurance-exercise (pH 7.3+400nM ATP+5 mM lactate) produced significant fatigue sensations. Infusion of a metabolite-combination associated with vigorous exercise (pH 7.2+500nM ATP+10mM lactate) produced stronger sensations of fatigue and some ache. Higher levels of metabolites (as found with ischemic exercise) caused more ache but no additional fatigue-sensation. Thus, in a dose-dependent manner, intramuscular infusion of combinations of protons, lactate, and ATP leads to fatigue-sensation and eventually pain, probably through activation of ASIC, P2X, and TRPV1 receptors. This is the first demonstration in humans that metabolites normally produced by exercise act in combination to activate sensory neurons that signal sensations of fatigue and muscle pain. PMID:24142455

  15. Motor cortical hyperexcitability in idiopathic scoliosis: could focal dystonia be a subclinical etiological factor?

    PubMed Central

    Tormos, José María; Barrios, Carlos; Pascual-Leone, Alvaro

    2009-01-01

    The aetiology of idiopathic scoliosis (IS) remains unknown; however, there is a growing body of evidence suggesting that the spine deformity could be the expression of a subclinical nervous system disorder. A defective sensory input or an anomalous sensorimotor integration may lead to an abnormal postural tone and therefore the development of a spine deformity. Inhibition of the motor cortico-cortical excitability is abnormal in dystonia. Therefore, the study of cortico-cortical inhibition may shed some insight into the dystonia hypothesis regarding the pathophysiology of IS. Paired pulse transcranial magnetic stimulation was used to study cortico-cortical inhibition and facilitation in nine adolescents with IS, five teenagers with congenital scoliosis (CS) and eight healthy age-matched controls. The effect of a previous conditioning stimulus (80% intensity of resting motor threshold) on the amplitude of the motor-evoked potential induced by the test stimulus (120% of resting motor threshold) was examined at various interstimulus intervals (ISIs) in both abductor pollicis brevis muscles. The results of healthy adolescents and those with CS showed a marked inhibitory effect of the conditioning stimulus on the response to the test stimulus at interstimulus intervals shorter than 6 ms. These findings do not differ from those reported for normal adults. However, children with IS revealed an abnormally reduced cortico-cortical inhibition at the short ISIs. Cortico-cortical inhibition was practically normal on the side of the scoliotic convexity while it was significantly reduced on the side of the scoliotic concavity. In conclusion, these findings support the hypothesis that a dystonic dysfunction underlies in IS. Asymmetrical cortical hyperexcitability may play an important role in the pathogenesis of IS and represents an objective neurophysiological finding that could be used clinically. PMID:20033462

  16. Cortical inhibitory deficits in premanifest and early Huntington's disease.

    PubMed

    Philpott, April L; Cummins, Tarrant D R; Bailey, Neil W; Churchyard, Andrew; Fitzgerald, Paul B; Georgiou-Karistianis, Nellie

    2016-01-01

    Although progress has been made towards understanding the gross cortical and subcortical pathology of Huntington's disease (HD), there remains little understanding of the progressive pathophysiological changes that occur in the brain circuits underlying the disease. Transcranial magnetic stimulation (TMS) enables investigation of the functional integrity of cortico-subcortical pathways, yet it has not been widely applied in HD research to date. This study sought to characterise profiles of cortical excitability, including inhibition and facilitation, in groups of premanifest and symptomatic HD participants via the use of TMS. We also investigated the clinical, neurocognitive and psychiatric correlates of cortical excitability to better understand the development of phenotypic heterogeneity. The sample comprised 16 premanifest HD, 12 early symptomatic HD and 17 healthy control participants. Single- and paired-pulse TMS protocols were administered to the left primary motor cortex, with surface electromyography recorded from the abductor pollicis brevis muscle. Short-interval cortical inhibition was significantly reduced in symptomatic HD, compared with premanifest HD and controls, and was significantly correlated with pathological burden and neurocognitive performance. There was also reduced long-interval cortical inhibition in both premanifest and symptomatic HD, compared with controls, which was associated with pathological burden and psychiatric disturbances. Motor thresholds, cortical silent periods and intracortical facilitation did not differ across groups. Our results provide important new insights into pathophysiological changes in cortico-subcortical circuits across disease stages in HD. We propose that neurophysiological measures obtained via TMS have potential utility as endophenotypic biomarkers in HD, given their association with both pathological burden and clinical phenotype. PMID:26416671

  17. [Concurrence of myasthenia gravis, polymyositis, thyroiditis and eosinophilia in a patient with type B1 thymoma].

    PubMed

    Inoue, Manabu; Kojima, Yasuhiro; Shinde, Akiyo; Satoi, Hitoshi; Makino, Fumi; Kanda, Masutarou; Shibasaki, Hiroshi

    2007-07-01

    We presented a 43-year-old Japanese woman who acutely developed weakness of all extremities and difficulty in swallowing and drooping of eyelids, characterized by easy fatigability at the end of December, 2005. On general physical examination, she had moderate goiter. No cervical lymphadenopathy, cardiac murmur, or skin rash was noted. Neurologically, she had blepharoptosis, more on the right, only in the upright position with easy fatigability and marked weakness in the neck flexor, trunk, and all limb muscles much more proximally than distally. She had neither muscular atrophy nor upper motor neuron sign. Laboratory data showed slight leukocytosis with eosinophilia (up to 31%), and serum creatine kinase was markedly increased to over 2,000 IU/l. TSH receptor antibody (11.9%) and anti-acetylcholine receptor antibody (46.6 nmol/L) were also increased. Edrophonium test was positive. Electrophysiologically, muscle evoked potentials by repetitive motor nerve stimulation showed 13% and 50% waning in abductor pollicis brevis and deltoid muscle, respectively, at low frequency and no waxing at high frequency. Needle EMG showed fibrillation potentials and positive sharp waves in proximal muscles. Polymyositis was diagnosed by muscle biopsy which showed infiltration of lymphocytes in the endomysium and around non-necrotic muscle fibers. Upper arm muscle MRI showed multifocal high signal intensity lesions on T2-weighted images which were likely related to myositis. This finding is atypical for polymyositis. X-ray and CT of chest showed a mass lesion in the left pulmonary hilum, which was histologically diagnosed as type B1 thymoma. Thus, the present case had myasthenia gravis, polymyositis, thyroidititis and eosinophilia associated with type B1 thymoma. After the thymectomy, corticosteroid administration and immunoadsorption therapy, clinical symptoms and all laboratory abnormalities markedly improved. PMID:17710886

  18. Transient impairment of the axolemma following regional anaesthesia by lidocaine in humans

    PubMed Central

    Moldovan, Mihai; Lange, Kai Henrik Wiborg; Aachmann-Andersen, Niels Jacob; Kjær, Troels Wesenberg; Olsen, Niels Vidiendal; Krarup, Christian

    2014-01-01

    The local anaesthetic lidocaine is known to block voltage-gated Na+ channels (VGSCs), although at high concentration it was also reported to block other ion channel currents as well as to alter lipid membranes. The aim of this study was to investigate whether the clinical regional anaesthetic action of lidocaine could be accounted for solely by the block of VGSCs or whether other mechanisms are also relevant. We tested the recovery of motor axon conduction and multiple measures of excitability by ‘threshold-tracking’ after ultrasound-guided distal median nerve regional anaesthesia in 13 healthy volunteers. Lidocaine caused rapid complete motor axon conduction block localized at the wrist. Within 3 h, the force of the abductor pollicis brevis muscle and median motor nerve conduction studies returned to normal. In contrast, the excitability of the motor axons at the wrist remained markedly impaired as indicated by a 7-fold shift of the stimulus–response curves to higher currents with partial recovery by 6 h and full recovery by 24 h. The strength–duration properties were abnormal with markedly increased rheobase and reduced strength–duration time constant. The changes in threshold during electrotonus, especially during depolarization, were markedly reduced. The recovery cycle showed increased refractoriness and reduced superexcitability. The excitability changes were only partly similar to those previously observed after poisoning with the VGSC blocker tetrodotoxin. Assuming an unaltered ion-channel gating, modelling indicated that, apart from up to a 4-fold reduction in the number of functioning VGSCs, lidocaine also caused a decrease of passive membrane resistance and an increase of capacitance. Our data suggest that the lidocaine effects, even at clinical ‘sub-blocking’ concentrations, could reflect, at least in part, a reversible structural impairment of the axolemma. PMID:24710060

  19. Apparent transverse compressive material properties of the digital flexor tendons and the median nerve in the carpal tunnel.

    PubMed

    Main, Erin K; Goetz, Jessica E; Rudert, M James; Goreham-Voss, Curtis M; Brown, Thomas D

    2011-03-15

    Carpal tunnel syndrome is a frequently encountered peripheral nerve disorder caused by mechanical insult to the median nerve, which may in part be a result of impingement by the adjacent digital flexor tendons. Realistic finite element (FE) analysis to determine contact stresses between the flexor tendons and median nerve depends upon the use of physiologically accurate material properties. To assess the transverse compressive properties of the digital flexor tendons and median nerve, these tissues from ten cadaveric forearm specimens were compressed transversely while under axial load. The experimental compression data were used in conjunction with an FE-based optimization routine to determine apparent hyperelastic coefficients (μ and α) for a first-order Ogden material property definition. The mean coefficient pairs were μ=35.3 kPa, α=8.5 for the superficial tendons, μ=39.4 kPa, α=9.2 for the deep tendons, μ=24.9 kPa, α=10.9 for the flexor pollicis longus (FPL) tendon, and μ=12.9 kPa, α=6.5 for the median nerve. These mean Ogden coefficients indicate that the FPL tendon was more compliant at low strains than either the deep or superficial flexor tendons, and that there was no significant difference between superficial and deep flexor tendon compressive behavior. The median nerve was significantly more compliant than any of the flexor tendons. The material properties determined in this study can be used to better understand the functional mechanics of the carpal tunnel soft tissues and possible mechanisms of median nerve compressive insult, which may lead to the onset of carpal tunnel syndrome. PMID:21194695

  20. Local subcutaneous and muscle pain impairs detection of passive movements at the human thumb

    PubMed Central

    Weerakkody, N S; Blouin, J S; Taylor, J L; Gandevia, S C

    2008-01-01

    Activity in both muscle spindle endings and cutaneous stretch receptors contributes to the sensation of joint movement. The present experiments assessed whether muscle pain and subcutaneous pain distort proprioception in humans. The ability to detect the direction of passive movements at the interphalangeal joint of the thumb was measured when pain was induced experimentally in four sites: the flexor pollicis longus (FPL), the subcutaneous tissue overlying this muscle, the flexor carpi radialis (FCR) muscle and the subcutaneous tissue distal to the metacarpophalangeal joint of thumb. Tests were conducted when pain was at a similar subjective intensity. There was no significant difference in the ability to detect flexion or extension under any painful or non-painful condition. The detection of movement was significantly impaired when pain was induced in the FPL muscle, but pain in the FCR, a nearby muscle that does not act on the thumb, had no effect. Subcutaneous pain also significantly impaired movement detection when initiated in skin overlying the thumb, but not in skin overlying the FPL muscle in the forearm. These findings suggest that while both muscle and skin pain can disturb the detection of the direction of movement, the impairment is site-specific and involves regions and tissues that have a proprioceptive role at the joint. Also, pain induced in FPL did not significantly increase the perceived size of the thumb. Proprioceptive mechanisms signalling perceived body size are less disturbed by a relevant muscle nociceptive input than those subserving movement detection. The results highlight the complex relationship between nociceptive inputs and their influence on proprioception and motor control. PMID:18467366

  1. Risk stratification for the recurrence of trigger thumb after surgical release in the paediatric patient.

    PubMed

    Edwards, D S; Richards, R H

    2016-08-01

    Trigger thumb, or stenosing tenovaginitis, is a relatively uncommon condition affecting the flexor pollicis longus tendon of children. The condition is characterized by the formation of a nodule within the tendon and thickening of the tendon sheath as it passes through the flexor pulley of the thumb at the level of the metacarpo-phalangeal joint. The optimum age for surgical intervention continues to be discussed. The aim of this study is to establish the temporal relationship and surgical variables to determine factors that may contribute to recurrence of the condition. A retrospective analysis of the entire surgical logbook and patient notes of a stand-alone consultant paediatric orthopaedic practice was scrutinized. 94 patients, 107 thumbs, over a 13-year period were operated on for trigger thumb. The recurrence rate was found to be 5.61 %. The average age of patients at primary release who went on to recurrence was 2.8 years, which is significantly younger than those that did not recur (p = 0.044). Sensitivity analysis revealed that the primary procedure at an age of less than 2.5 years confers a higher risk of recurrence. The data presented here advocate surgical release of trigger thumb after 2½ years of age, a senior surgeon as lead operator and a transverse skin incision at the level of the nodule or a more extensive "zig-zag" one to clearly see the structures to be released. We recommend that the surgeon ensures the stenosing pulley and sheath are released in their entirety. PMID:27352865

  2. New postcranial fossils of Australopithecus afarensis from Hadar, Ethiopia (1990-2007).

    PubMed

    Ward, Carol V; Kimbel, William H; Harmon, Elizabeth H; Johanson, Donald C

    2012-07-01

    Renewed fieldwork at Hadar, Ethiopia, from 1990 to 2007, by a team based at the Institute of Human Origins, Arizona State University, resulted in the recovery of 49 new postcranial fossils attributed to Australopithecus afarensis. These fossils include elements from both the upper and lower limbs as well as the axial skeleton, and increase the sample size of previously known elements for A. afarensis. The expanded Hadar sample provides evidence of multiple new individuals that are intermediate in size between the smallest and largest individuals previously documented, and so support the hypothesis that a single dimorphic species is represented. Consideration of the functional anatomy of the new fossils supports the hypothesis that no functional or behavioral differences need to be invoked to explain the morphological variation between large and small A. afarensis individuals. Several specimens provide important new data about this species, including new vertebrae supporting the hypothesis that A. afarensis may have had a more human-like thoracic form than previously appreciated, with an invaginated thoracic vertebral column. A distal pollical phalanx confirms the presence of a human-like flexor pollicis longus muscle in A. afarensis. The new fossils include the first complete fourth metatarsal known for A. afarensis. This specimen exhibits the dorsoplantarly expanded base, axial torsion and domed head typical of humans, revealing the presence of human-like permanent longitudinal and transverse arches and extension of the metatarsophalangeal joints as in human-like heel-off during gait. The new Hadar postcranial fossils provide a more complete picture of postcranial functional anatomy, and individual and temporal variation within this sample. They provide the basis for further in-depth analyses of the behavioral and evolutionary significance of A. afarensis anatomy, and greater insight into the biology and evolution of these early hominins. PMID:22652491

  3. Treatment of Progressive First Metatarsophalangeal Hallux Valgus Deformity: A Biomechanically Based Muscle-Strengthening Approach.

    PubMed

    Glasoe, Ward M

    2016-07-01

    Synopsis Hallux valgus is a progressive deformity of the first metatarsophalangeal joint that changes the anatomy and biomechanics of the foot. To date, surgery is the only treatment to correct this deformity, though the recurrence rate is as high as 15%. This clinical commentary provides instruction in a strengthening approach for treatment of hallux valgus deformity, by addressing the moment actions of 5 muscles identified as having the ability to counter the hallux valgus process. Unlike surgery, muscle strengthening does not correct the deformity, but, instead, reduces the pain and associated gait impairments that affect the mobility of people who live with the disorder. This review is organized in 4 parts. Part 1 defines the terms of foot motion and posture. Part 2 details the anatomy and biomechanics, and describes how the foot is changed with deformity. Part 3 details the muscles targeted for strengthening; the intrinsics being the abductor hallucis, adductor hallucis, and the flexor hallucis brevis; the extrinsics being the tibialis posterior and fibularis longus. Part 4 instructs the exercise and reviews the related literature. Instructions are given for the short-foot, the toe-spread-out, and the heel-raise exercises. The routine may be performed by almost anyone at home and may be adopted into physical therapist practice, with intent to strengthen the foot muscles as an adjunct to almost any protocol of care, but especially for the treatment of hallux valgus deformity. J Orthop Sports Phys Ther 2016;46(7):596-605. Epub 6 Jun 2016. doi:10.2519/jospt.2016.6704. PMID:27266887

  4. Electrophysiology and nerve biopsy in men exposed to lead

    PubMed Central

    Buchthal, F.; Behse, F.

    1979-01-01

    ABSTRACT Twenty lead-exposed men were selected on the basis of a maximum level of lead in the blood of 70-140 μg/100 ml within the past year. There was no clinical evidence of neuropathy attributable to lead and haemoglobin levels were normal. In individuals, maximum motor and sensory conduction and the amplitude of the evoked potentials were normal or borderline in the median, peroneal and sural nerves, except in the distal portion of the deep peroneal nerve. In this nerve, motor conduction was slowed because of compression by metal-lined safety shoes; changes in this segment are not included in the findings. When the average conduction velocity in lead-exposed men was compared with the average in nerves of controls matched for age, distal motor latency was slightly prolonged in the median nerve. The average latency for proximal muscle supplied by the peroneal nerve was prolonged, and the maximum motor conduction velocity was slowed in the median nerve from elbow to wrist (0·01 > p <0·001). In addition, the average maximum sensory conduction was slightly slowed along the distal and intermediate portion of the superficial peroneal and sural nerves (p <0·001). The average minimum sensory conduction velocities were normal, as were the average amplitudes of the evoked muscle action potentials and the average ratio of amplitude of the muscle action potential evoked by stimuli at a proximal and a distal nerve site. The average amplitude of the sensory potentials recorded in the median and the superficial peroneal nerves tended to be increased. Electromyography of the abductor pollicis brevis and anterior tibial muscles showed that the only abnormality was an increased incidence of polyphasic potentials in the anterior tibial muscle of seven men. Neither the slowing in conduction nor the histological findings in the sural nerves of eight men were related to the level of lead in the blood. The slight slowing in conduction suggests a minor defect in the excitable

  5. Nerve excitability changes in critical illness polyneuropathy.

    PubMed

    Z'Graggen, W J; Lin, C S Y; Howard, R S; Beale, R J; Bostock, H

    2006-09-01

    Patients in intensive care units frequently suffer muscle weakness and atrophy due to critical illness polyneuropathy (CIP), an axonal neuropathy associated with systemic inflammatory response syndrome and multiple organ failure. CIP is a frequent and serious complication of intensive care that delays weaning from mechanical ventilation and increases mortality. The pathogenesis of CIP is not well understood and no specific therapy is available. The aim of this project was to use nerve excitability testing to investigate the changes in axonal membrane properties occurring in CIP. Ten patients (aged 37-76 years; 7 males, 3 females) were studied with electrophysiologically proven CIP. The median nerve was stimulated at the wrist and compound action potentials were recorded from abductor pollicis brevis muscle. Strength-duration time constant, threshold electrotonus, current-threshold relationship and recovery cycle (refractoriness, superexcitability and late subexcitability) were recorded using a recently described protocol. In eight patients a follow-up investigation was performed. All patients underwent clinical examination and laboratory investigations. Compared with age-matched normal controls (20 subjects; aged 38-79 years; 7 males, 13 females), CIP patients exhibited reduced superexcitability at 7 ms, from -22.3 +/- 1.6% to -7.6 +/- 3.1% (mean +/- SE, P approximately 0.0001) and increased accommodation to depolarizing (P < 0.01) and hyperpolarizing currents (P < 0.01), indicating membrane depolarization. Superexcitability was reduced both in patients with renal failure and without renal failure. In the former, superexcitability correlated with serum potassium (R = 0.88), and late subexcitability was also reduced (as also occurs owing to hyperkalaemia in patients with chronic renal failure). In patients without renal failure, late subexcitability was normal, and the signs of membrane depolarization correlated with raised serum bicarbonate and base excess

  6. Modulation of amplitude and latency of motor evoked potential by direction of transcranial magnetic stimulation

    NASA Astrophysics Data System (ADS)

    Sato, Aya; Torii, Tetsuya; Iwahashi, Masakuni; Itoh, Yuji; Iramina, Keiji

    2014-05-01

    The present study analyzed the effects of monophasic magnetic stimulation to the motor cortex. The effects of magnetic stimulation were evaluated by analyzing the motor evoked potentials (MEPs). The amplitude and latency of MEPs on the abductor pollicis brevis muscle were used to evaluate the effects of repetitive magnetic stimulation. A figure eight-shaped flat coil was used to stimulate the region over the primary motor cortex. The intensity of magnetic stimulation was 120% of the resting motor threshold, and the frequency of magnetic stimulation was 0.1 Hz. In addition, the direction of the current in the brain was posterior-anterior (PA) or anterior-posterior (AP). The latency of MEP was compared with PA and AP on initial magnetic stimulation. The results demonstrated that a stimulus in the AP direction increased the latency of the MEP by approximately 2.5 ms. MEP amplitude was also compared with PA and AP during 60 magnetic stimulations. The results showed that a stimulus in the PA direction gradually increased the amplitude of the MEP. However, a stimulus in the AP direction did not modulate the MEP amplitude. The average MEP amplitude induced from every 10 magnetic pulses was normalized by the average amplitude of the first 10 stimuli. These results demonstrated that the normalized MEP amplitude increased up to approximately 150%. In terms of pyramidal neuron indirect waves (I waves), magnetic stimulation inducing current flowing backward to the anterior preferentially elicited an I1 wave, and current flowing forward to the posterior elicited an I3 wave. It has been reported that the latency of the I3 wave is approximately 2.5 ms longer than the I1 wave elicitation, so the resulting difference in latency may be caused by this phenomenon. It has also been reported that there is no alteration of MEP amplitude at a frequency of 0.1 Hz. However, this study suggested that the modulation of MEP amplitude depends on stimulation strength and stimulation direction.

  7. Task-dependent changes of intracortical inhibition.

    PubMed

    Liepert, J; Classen, J; Cohen, L G; Hallett, M

    1998-02-01

    The motor-evoked potential (MEP) to transcranial magnetic stimulation (TMS) is inhibited when preceded by a subthreshold TMS stimulus at short intervals (1-6 ms; intracortical inhibition, ICI) and is facilitated when preceded by a subthreshold TMS at longer intervals (10-15 ms; intracortical facilitation, ICF). We studied changes in ICI and ICF associated with two motor tasks requiring a different selectivity in fine motor control of small hand muscles (abductor pollicis brevis muscle, APB, and fourth dorsal interosseous muscle, 4DIO). In experiment 1 (exp. 1), nine healthy subjects completed four sets (5 min duration each) of repetitive (1 Hz) thumb movements. In experiment 2 (exp. 2), the subjects produced the same number of thumb movements, but complete relaxation of 4DIO was demanded. Following free thumb movements (exp. 1), amplitudes of MEPs in response to both single and paired TMS showed a trend to increase with the number of exercise sets in both APB and 4DIO. By contrast, more focal, selective thumb movements involving APB with relaxation of 4DIO (exp. 2) caused an increase in MEP amplitudes after single and paired pulses only in APB, while a marked decrease in MEPs after paired pulses, but not after single TMS, in the actively relaxed 4DIO. This effect was more prominent for the interstimulus interval (ISI) of 1-3 ms than for longer ISIs (8 ms, 10 ms, and 15 ms). F-wave amplitudes reflecting excitability of the alpha motoneuron pool were unaltered in APB and 4DIO, suggesting a supraspinal origin for the observed changes. We conclude that plastic changes of ICI and ICF within the hand representation vary according to the selective requirements of the motor program. Performance of more focal tasks may be associated with a decrease in ICI in muscles engaged in the training task, while at the same time ICI may be increased in an actively relaxed muscle, also required for a focal performance. Additionally, our data further supports the idea that ICI and ICF

  8. Endoscopic Repair of a Gluteus Medius Tear at the Musculotendinous Junction

    PubMed Central

    Yanke, Adam B.; Hart, Michael A.; McCormick, Frank; Nho, Shane J.

    2013-01-01

    Abductor tendon tears are an increasingly recognized clinical entity in patients with lateral thigh pain and weakness. These “rotator cuff tears of the hip” typically result from chronic, nontraumatic rupture of the anterior fibers of the gluteus medius. Although the abductor tendon typically tears from the osseous insertion, the case discussed here ruptured at the musculotendinous junction. This is the first report of this abductor tear subtype and its endoscopic repair. PMID:23875152

  9. Looped Versus Single-Stranded Flexor Tendon Repairs: A Cadaveric Mechanical Study

    PubMed Central

    Calfee, Ryan P.; Boone, Sean; Stepan, Jeffrey G.; Osei, Daniel A.; Thomopoulos, Stavros; Boyer, Martin I.

    2015-01-01

    Purpose To compare the tensile properties of 4-strand modified Kessler flexor tendon repairs using a looped or single-stranded suture. Methods We evaluated the mechanical properties of 4-strand Kessler zone II core suture repairs using either looped or single-stranded suture in human flexor digitorum profundus and flexor pollicis longus tendons. Forty repairs were performed on tendons from bilateral cadaveric hands: 20 matched tendons were divided into equal groups of 3-0 looped and 3-0 single-strand repairs and 20 additional matched tendons were divided into equal groups of 4-0 looped and 4-0 single-strand repairs. Repaired tendons were tested in uniaxial tension to failure to determine mechanical properties and failure modes. Data were analyzed to determine the effect of repair type (ie, looped vs single-stranded) for each suture caliber (ie, 3-0 and 4-0). Results Single-strand repairs with 3-0 suture demonstrated a significantly greater maximum load to failure and a significantly higher force at 2-mm gap compared with repairs with looped 3-0 suture. All 8 looped repairs with 3-0 suture failed by suture pullout whereas 7 of 8 repairs with 3-0 single-stranded suture failed by suture breakage. The mechanical properties of looped versus single-stranded repairs with 4-0 caliber suture were not statistically different. Repairs with 4-0 caliber suture failed by suture breakage in 8 of 10 single-strand repairs and failed by suture pullout in 6 of 10 repairs with looped suture. Conclusions In a time-0 ex vivo human cadaveric core suture model, the mechanical properties of a 4-strand repair using 3-0 single-stranded suture were significantly better than the same 4-strand repair performed with looped suture. Clinical relevance Four-strand flexor tendon repairs with 3-0 suture are mechanically superior when performed with single-strand suture versus looped suture. PMID:25801581

  10. [Differential treatment of fractures of the distal radius].

    PubMed

    Oestern, H J; Hüls, E

    1994-01-01

    repositions. Nevertheless, a rupture of the tendon of the M. extensor pollicis longus takes place in a certain percentage of cases (less than 0.2%) due to the unusual vascularization of this tendon. The dystrophy of Sudeck has become a relatively rare occurrence. A connection between a compression syndrome of the median nerve and the dystrophy of Sudeck has been discussed. The differentiated management has led to a change from a purely conservative treatment to a more varied treatment of the fractures of the distal radius. In our own patients conservative treatment was carried out in 27.5%. PMID:7975940

  11. Musculoskeletal Disorders of the Upper Extremities Due to Extensive Usage of Hand Held Devices

    PubMed Central

    2014-01-01

    Objective The use of hand held devices (HHD) such as mobile phones, game controls, tablets, portable media players and personal digital assistants have increased dramatically in past decade. While sending a text message or using the controls of the HHD the users need to use their thumb and other palm muscles extensively. The objective of this study was to describe the risk factors and clinical features of the musculoskeletal disorders (MSDs) arising due to usage of hand held devices and to evaluate the effectiveness of a sequenced rehabilitation protocol. Methods A retrospective report analysis of 70 subjects, who were diagnosed to have a MSD affecting the upper extremities, was conducted. Medical charts from a tertiary level rehabilitation centre from 2005–2013 were analysed. All the subjects reported pain in their upper extremities following extensive usage of HHD and were examined and diagnosed to have a MSD by an orthopaedic and rehabilitation physician. After the assessment and diagnosis, all the patients underwent rehabilitation using a sequenced protocol. Results All the subjects reported pain in the thumb and forearm with associated burning, numbness and tingling around the thenar aspect of the hand, and stiffness of wrist and hand. 43 subjects had symptoms on the right side; 9 on left and 18 had bilateral symptoms. Correlation was found between hand dominance and MSD. 33 subjects complained of onset of symptoms following extensive text messaging. All the subjects were diagnosed to have tendinosis of Extensor Pollicis Longus and Myofascial Pain Syndrome affecting the 1st interossei, thenar group of muscles and Extensor Digitorum Communis. 23 of the subjects were senior executives, among these 7 were CEO’s of major multinational companies in India. All the subjects recovered completely following the rehabilitation. Conclusions The study concluded that mobile phones and gadgets that promoted the predominant usage of thumb or only one finger while texting

  12. Evidence for a contribution of the motor cortex to the long-latency stretch reflex of the human thumb.

    PubMed Central

    Capaday, C; Forget, R; Fraser, R; Lamarre, Y

    1991-01-01

    1. In normal subjects, transcranial magnetic stimulation of the hand region of the motor cortex evokes motor responses only in contralateral hand muscles at a latency of about 19-24 ms. In contrast, stimulation of the motor cortex of three mirror movement subjects evoked, nearly simultaneously, motor responses in hand muscles on both sides of the body at latencies similar to those of normal subjects. In these subjects no other neuroanatomical pathways appear to be abnormally directed across the mid-line. Thus, their mirror movements are probably due to a projection of the corticospinal tract to homologous motoneurone pools on each side of the body. 2. We reasoned that if the motor cortex contributes to the generation of long-latency stretch reflex responses then in these mirror movement subjects stretching a muscle on one side of the body should produce long-latency reflex responses in the ipsilateral and the homologous contralateral muscle. 3. To test this idea experiments were done on normal human subjects and on the subjects with mirror movements. The electromyographic (EMG) activity of the flexor pollicis longus muscle (FPL) on each side of the body was recorded. Stretch of the distal phalanx of the thumb of one hand produced a series of distinct reflex EMG responses in the ipsilateral FPL. The earliest response, when present, began at 25 ms (S.D. = 3.5 ms) and was followed by responses at 40 (S.D. = 3.9 ms) and 56 ms (S.D. = 4.3 ms). There was no difference, either in timing or intensity, between the ipsilateral FPL EMG responses of normal subjects and those of the mirror movement subjects. 4. No response of any kind was observed in the contralateral (unstretched) FPL of normal subjects. In contrast, we observed in all three mirror movement subjects EMG responses in the contralateral (unstretched) FPL beginning at 45-50 ms. The latency of this response is considerably shorter than the fastest voluntary kinaesthetic reaction time, which was on average 130 ms (S

  13. Comparison of Isokinetic Hip Abduction and Adduction Peak Torques and Ratio Between Sexes

    PubMed Central

    Sugimoto, Dai; Mattacola, Carl G.; Mullineaux, David R.; Palmer, Thomas G.; Hewett, Timothy E.

    2014-01-01

    Objective To evaluate hip abductor and adductor peak torque outputs and compare their ratios between sexes. Design A cross-sectional laboratory-controlled study. Setting Participants visited a laboratory and performed an isokinetic hip abductor and adductor test. All participants performed 2 sets of 5 repetitions of concentric hip abduction and adduction in a standing position at 60 degrees per second. Gravity was determined as a function of joint angle relative to the horizontal plane and was corrected by normalizing the weight of the limb on an individual basis. Participants A total of 36 collegiate athletes. Independent Variable Sex (20 females and 16 males). Main Outcome Measures Bilateral peak hip abductor and adductor torques were measured. The 3 highest peak torque values were averaged for each subject. Results Independent t tests were used to compare sex differences in hip abductor and adductor peak torques and the abductor:adductor peak torque ratios. Males demonstrated significantly greater hip abductor peak torque compared with females (males 1.29 ± 0.24 Nm/kg, females 1.13 ± 0.20 Nm/kg; P = 0.03). Neither hip adductor peak torque nor their ratios differed between sexes. Conclusions Sex differences in hip abductor strength were observed. The role of weaker hip abductors in females deserves further attention and may be a factor for higher risk of knee pathologies. PMID:24905541

  14. Vertebral muscles of the back and tail of the albino rat (Rattus norvegicus albinus).

    PubMed

    Brink, E E; Pfaff, D W

    1980-01-01

    The dorsal and ventral vertebral muscles of the back and the tail of the albino Norway rat are described and discussed. These muscles were analyzed because they are undoubtably used during the sexual posturing, lordosis, of the female rat, as well as participating in a variety of other behaviors. The muscles are described by region (thoracic-lumbar or sacrocaudal), and the classifications of Vallois are followed where possible. Of the epaxial (dorsal) muscles, the three longitudinal systems of muscles, the transversospinalis, the longissimus, and the iliocostalis systems, can be identified in the albino rat. Muscles of the transversospinalis system are fused in the lumbar region, distinct and specialized in the thoracic region, and form the tail muscle extensor caudae medialis caudally. The iliocostalis system of the lumbar region is fused with one component of the lumbar longissimus system to form lateral longissimus. Anteriorly, iliocostalis thoracis and cervicis represent the iliocostalis system. The lumbar longissimus system is represented by the longissimus component of lateral longissimus, medial longissimus, and a short-fiber component. Longissimus dorsi is the anterior continuation of the longissimus portion of the lateral longissimus. The short-fiber component also continues into the thoracic region, where it becomes difficult to separate out from longissimus dorsi. Medial longissimus represents the excursion into the lumbar region of the long, tendinous, tailbase-tail muscle, longissimus caudae; the caudal portion of this muscle is extensor caudae lateralis. The remaining dorsal muscle described is the tail muscle, abductor caudae dorsalis. The hyposomal (ventral) muscles described are quadratus lumborum and the intertransversarii, present in the lumbar region; the muslces iliococcygeus, pubococcygeus and coccygeus which arise from the medial face of the pelvis and insert onto the proximal tail; the long, tendinous, tail muscles, flexor caudae brevis and

  15. Low-frequency rTMS in patients with subacute ischemic stroke: clinical evaluation of short and long-term outcomes and neurophysiological assessment of cortical excitability

    PubMed Central

    Blesneag, AV; Slăvoacă, DF; Popa, L; Stan, AD; Jemna, N; Isai Moldovan, F; Mureșanu, DF

    2015-01-01

    . Discussion:These results demonstrated that LF-rTMS treatment enhances rebalance of the excitability patterns in both hemispheres and led us to question the “one size fits all” approach widely used in rTMS interventions. Abbreviations: Amax = maximum amplitude, Amean = AM = averaged amplitude, APB = abductor pollicis brevis, CL = contralesional, DTI = diffusion tensor imaging, EEG = electroencephalography, EMG = electromyography, FMA-UE = Fugl-Meyer Assessment for Upper Extremity, HS = hot spot, IHC = interhemispheric functional connectivity, IL = ipsilesional, LF-rTMS = low-frequency repetitive transcranial magnetic stimulation, MCA = middle cerebral artery, MEP(s) = motor evoked potential(s), NIBS = non-invasive brain stimulation, rMT = resting motor threshold, RP = responsive points, rTMS = repetitive transcranial magnetic stimulation, TMS = transcranial magnetic stimulation PMID:26351545

  16. Not without a fair fight: failed abductions of females in wild hamadryas baboons.

    PubMed

    Pines, Mathew; Swedell, Larissa

    2011-07-01

    In contrast to other papionin monkeys, hamadryas baboons are characterized by female-biased dispersal. Given that hamadryas females do not disperse voluntarily, one mechanism for female transfer between bands is thought to be abductions during aggressive intergroup conflict. To date, however, no successful abductions have been witnessed. We describe three abduction events at the Filoha field site in Ethiopia, two interband and one intraband, in which the abductors successfully separated a female from her leader male for several minutes or hours. In each case, the original leader male located the abductor and retrieved the female, even if it involved entering the social sphere of another band. These observations suggest that a hamadryas leader male will risk injury and loss of additional females in his attempt to retrieve a female from an abductor unless the abductor has openly challenged the leader for possession of his female and physically defeated him. PMID:21359653

  17. Experiment K-7-18: Effects of Spaceflight in the Muscle Adductor Longus of Rats Flown in the Soviet Biosatellite Cosmos 2044. Part 2; Quantitative Autoradiographic Analysis of Gaba (Benzodiazepine) and Muscarinic (Cholinergic) Receptors in the Forebrain of Rats Flown on Cosmos 2044

    NASA Technical Reports Server (NTRS)

    Wu, L.; Daunton, N. G.; Krasnov, I. B.; DAmelio, F.; Hyde, T. M.; Sigworth, S. K.

    1994-01-01

    Quantitative autoradiographic analysis of receptors for GABA and acetylcholine in the forebrain of rats flown on COSMOS 2044 was undertaken as part of a joint US-Soviet study to determine the effects of microgravity on the central nervous system, and in particular on the sensory and motor portions of the forebrain. Changes in binding of these receptors in tissue from animals exposed to microgravity would provide evidence for possible changes in neural processing as a result of exposure to microgravity. Tritium-labelled diazepam and Quinuclidinyl-benzilate (QNB) were used to visualize GABA (benzodiazepine) and muscarinic (cholinergic) receptors, respectively. The density of tritium-labelled radioligands bound to various regions in the forebrain of both flight and control animals were measured from autoradiograms. Data from rats flown in space and from ground-based control animals that were not exposed to microgravity were compared.

  18. Ulnar Nerve Tendon Transfers for Pinch.

    PubMed

    Cook, Shane; Gaston, R Glenn; Lourie, Gary M

    2016-08-01

    Power and tip pinch are an integral part of intrinsic hand function that can be significantly compromised with dysfunction of the ulnar nerve. Loss of power pinch is one component that can significantly affect an individual's ability to perform simple daily tasks. Tip pinch is less affected, as this task has significant contributions from the median nerve. To restore power pinch, the primary focus must be on restoring the action of the adductor pollicis primarily, and if indicated the first dorsal interosseous muscle and flexor pollicis brevis. PMID:27387080

  19. Effect of hindlimb suspension and clenbuterol treatment on polyamine levels in skeletal muscle

    NASA Technical Reports Server (NTRS)

    Abukhalaf, Imad K.; von Deutsch, Daniel A.; Wineski, Lawrence E.; Silvestrov, Natalia A.; Abera, Saare A.; Sahlu, Sinafikish W.; Potter, David E.; Thierry-Palmer, M. (Principal Investigator)

    2002-01-01

    Polyamines are unbiquitous, naturally occurring small aliphatic, polycationic, endogenous compounds. They are involved in many cellular processes and may serve as secondary or tertiary messengers to hormonal regulation. The relationship of polyamines and skeletal muscle mass of adductor longus, extensor digitorum longus, and gastrocnemius under unloading (hindlimb suspension) conditions was investigated. Unloading significantly affected skeletal muscle polyamine levels in a fiber-type-specific fashion. Under loading conditions, clenbuterol treatment increased all polyamine levels, whereas under unloading conditions, only the spermidine levels were consistently increased. Unloading attenuated the anabolic effects of clenbuterol in predominately slow-twitch muscles (adductor longus), but had little impact on clenbuterol's action as a countermeasure in fast- twitch muscles such as the extensor digitorum longus. Spermidine appeared to be the primary polyamine involved in skeletal muscle atrophy/hypertrophy. Copyright 2002 S. Karger AG, Basel.

  20. Does anterior knee pain severity and function relate to the frontal plane projection angle and trunk and hip strength in women with patellofemoral pain?

    PubMed

    Almeida, Gabriel Peixoto Leão; Carvalho E Silva, Ana Paula de Moura Campos; França, Fábio Jorge Renovato; Magalhães, Maurício Oliveira; Burke, Thomaz Nogueira; Marques, Amélia Pasqual

    2015-07-01

    The aim of the present study was to determine the relationship between knee pain severity and function with the frontal plane projection angle (FPPA) and trunk and hip peak torque (PT) in women with patellofemoral pain (PFPS). Twenty-two women with PFPS were assessed. Knee pain severity (KPS) was assessed with an 11-point visual analog scale and function with an Anterior Knee Pain Scale. The FPPA was recorded with a digital camera. PT of extensors, abductors, and the lateral rotators of hip and lateral core stability were measured with a handheld dynamometer. FPPA was the only predictor for the KPS. Regarding predictors of function, PT of lateral core stability and the extensor and abductor of the hip explained 41.4% of the function. Increase in FPPA was associated with greater KPS, and the lowest PT of lateral core stability, hip abductors, and extensors was associated with lower function in women with PFPS. PMID:26118529

  1. Effect of selected anthelmintics on three common helminths in the brown pelican (Pelecanus occidentalis).

    PubMed

    Grimes, J; Suto, B; Greve, J H; Albers, H F

    1989-01-01

    The effect of selected anthelmintics (albendazole, fenbendazole, piperazine dihydrochloride and clorsulon) against three major helminths (Contracaecum multipapillatum, Mesostephanus appendiculatoides, and Phagicola longus) were studied in 29 brown pelicans (Pelecanus occidentalis). Albendazole and fenbendazole were highly effective against all three parasites. Clorsulon had moderate effect against M. appendiculatoides and poor effect against C. multipapillatum and P. longus. Piperazine dihydrochloride had no effect against these helminths. PMID:2915399

  2. [Anesthetic Management of a Patient with Facioscapulohumeral Muscular Dystrophy: Importance of Monitoring Neuromuscular Function at Multiple Sites].

    PubMed

    Matsui, Shuhei; Tanaka, Satoshi; Kiyosawa, Kenkichi; Tanaka, Toshiyuki; Kawamata, Mikito

    2015-12-01

    A 39-year-old female with facioscapulohumeral muscular dystrophy (FSHD) was scheduled for thoracoscopic resection of an anterior mediastinal tumor. She had slowly progressive weakness and atrophy in the fascial and shoulder girdle muscles. General anesthesia was induced and maintained with propofol, remifentanil, and fentanyl combined with thoracic paravertebral block. Rocuronium-induced neuromuscular blockade was evaluated with acceleromyography at the corrugator supercilii, masseter, and adductor pollicis muscles. There was no reaction at the atrophic corrugator supercilii muscle in response to train-of-four (TOF) stimulation even before rocuronium administration. In contrast twitch responses at the masseter and adductor pollicis muscles to TOF stimulation could be evoked and the duration of action of rocuronium was found to be similar to that of the normal population. The perioperative course was uneventful. Neuromuscular monitoring sites should be carefully selected in FSHD patients because of possible inability to monitor neuromuscular function at the atrophic muscles. PMID:26790332

  3. Trends in infant abductions (2005).

    PubMed

    Nahirny, Cathy

    2005-01-01

    Infant kidnapping in healthcare facilities has been sharply reduced since the 1990s when educational programs and tagging systems were introduced. However, infant abductors in recent years have changed their methods of operation to meet improved nursery safeguards. In this updated report, the author warns of some new dangers posed by the Internet. PMID:16535955

  4. The Effect of Visual and Auditory Enhancements on Excitability of the Primary Motor Cortex during Motor Imagery: A Pilot Study

    ERIC Educational Resources Information Center

    Ikeda, Kohei; Higashi, Toshio; Sugawara, Kenichi; Tomori, Kounosuke; Kinoshita, Hiroshi; Kasai, Tatsuya

    2012-01-01

    The effect of visual and auditory enhancements of finger movement on corticospinal excitability during motor imagery (MI) was investigated using the transcranial magnetic stimulation technique. Motor-evoked potentials were elicited from the abductor digit minimi muscle during MI with auditory, visual and, auditory and visual information, and no…

  5. Compressive neuropathy of the first branch of the lateral plantar nerve: a study by magnetic resonance imaging*

    PubMed Central

    Rodrigues, Rogéria Nobre; Lopes, Alexia Abuhid; Torres, Jardélio Mendes; Mundim, Marina Franco; Silva, Lênio Lúcio Gavio; Silva, Breno Rabelo de Carvalho e

    2015-01-01

    Objective To assess the prevalence of isolated findings of abnormalities leading to entrapment of the lateral plantar nerve and respective branches in patients complaining of chronic heel pain, whose magnetic resonance imaging exams have showed complete selective fatty atrophy of the abductor digiti quinti muscle. Materials and Methods Retrospective, analytical, and cross-sectional study. The authors selected magnetic resonance imaging of hindfoot of 90 patients with grade IV abductor digiti quinti muscle atrophy according to Goutallier and Bernageau classification. Patients presenting with minor degrees of fatty muscle degeneration (below grade IV) and those who had been operated on for nerve decompression were excluded. Results A female prevalence (78.8%) was observed, and a strong correlation was found between fatty muscle atrophy and plantar fasciitis in 21.2%, and ankle varices, in 16.8% of the patients. Conclusion Fatty atrophy of the abductor digiti quinti muscle is strongly associated with neuropathic alterations of the first branch of the lateral plantar nerve. The present study showed a significant association between plantar fasciitis and ankle varices with grade IV atrophy of the abductor digiti quinti muscle. PMID:26811554

  6. Isokinetic imbalance of hip muscles in soccer players with osteitis pubis.

    PubMed

    Mohammad, Walaa Sayed; Abdelraouf, Osama Ragaa; Elhafez, Salam Mohamed; Abdel-Aziem, Amr Almaz; Nassif, Nagui Sobhi

    2014-01-01

    In this study, we compared the isokinetic torques of hip flexors/extensors and abductors/adductors in soccer players suffering from osteitis pubis (OP), with normal soccer players. Twenty soccer male athletes with OP and 20 normal soccer athletes were included in this study. Peak torque/body weight (PT/BW) was recorded from hip flexor/extensor and abductor/adductor muscles during isokinetic concentric contraction modes at angular velocity of 2.1 rad · s(-1), for both groups. The results showed a significant difference between the normal and OP groups for hip flexors (P < 0.05). The normal group had significant, lower PT/BW value than the OP group for their hip flexors (P < 0.05). The hip flexor/extensor PT ratio of OP affected and non-affected limbs was significantly different from that of normal dominant and non-dominant limbs. There were no significant differences between the normal and OP groups for hip extensor, adductor and abductor muscles (P > 0.05). Regarding the hip adductor/abductor PT ratio, there was no significant difference between the normal and OP groups of athletes (P > 0.05). The OP group displayed increase in hip flexor strength that disturbed the hip flexor/extensor torque ratio of OP. Therefore, increasing the hip extensor strength should be part of rehabilitation programmes of patients with OP. PMID:24499182

  7. Evaluation of Peer Training for Teaching Abduction Prevention Skills

    ERIC Educational Resources Information Center

    Tarasenko, Melissa A.; Miltenberger, Raymond G.; Brower-Breitwieser, Carrie; Bosch, Amanda

    2010-01-01

    Child abduction is a serious problem, with approximately 100 children killed each year by nonfamily abductors. Training programs to teach children the correct skills to use if they ever come into contact with a stranger can be effective when they incorporate behavioral skills training (BST) and in-situ training (IST) into their protocol. However,…

  8. Case report. Recovery of shoulder movement in patients with complete axillary nerve palsy.

    PubMed Central

    Palmer, S. H.; Ross, A. C.

    1998-01-01

    Classical anatomical teaching suggests that the deltoid muscle is the main abductor of the shoulder. We present three cases of proven complete paralysis of the deltoid with an almost full range of movement of the shoulder owing to the compensatory action of accessory muscles. The mechanisms by which this occurs are described. PMID:10209411

  9. Inter-Tester Reliability and Precision of Manual Muscle Testing and Hand-Held Dynamometry in Lower Limb Muscles of Children with Spina Bifida

    ERIC Educational Resources Information Center

    Mahony, Kate; Hunt, Adrienne; Daley, Deborah; Sims, Susan; Adams, Roger

    2009-01-01

    Reliability and measurement precision of manual muscle testing (MMT) and hand-held dynamometry (HHD) were compared for children with spina bifida. Strength measures were obtained of the hip flexors, hip abductors, and knee extensors of 20 children (10 males, 10 females; mean age 9 years 10 months; range: 5 to 15 years) by two experienced physical…

  10. Reduction-oxidation state and protein degradation in skeletal muscle of fasted and refed rats

    NASA Technical Reports Server (NTRS)

    Fagan, Julie M.; Tischler, Marc E.

    1986-01-01

    Redox state and protein degradation were measured in isolated muscles of fasted (up to 10 d) and refed (up to 4 d) 7- to 14-wk-old rats. Protein degradation in the extensor digitorum longus muscle, but not in the soleus muscle, was greater in the fasted rats than in weight-matched muscle from fed rats. The NAD couple was more oxidized in incubated and fresh extensor digitorum longus muscles and in some incubated soleus muscles of fasted rats than in weight-matched muscle from fed rats. In the extensor digitorum longus muscle of refed or prolonged fasted rats, protein degradation was slower and the NAD couple was more reduced than in the fed state. Therefore, oxidation of the NAD couple was associated with increased muscle breakdown during fasting, whereas reduction of the NAD couple was associated with muscle conservation and deposition.

  11. The effects of eye coordination during deep cervical flexor training on the thickness of the cervical flexors

    PubMed Central

    Moon, Hyun-Ju; Goo, Bong-Oh; Kwon, Hae-Yeon; Jang, Jun-Hyeok

    2015-01-01

    [Purpose] The purpose of this study was to identify changes in the thicknesses of the cervical flexors according to eye coordination during deep cervical flexor training. [Subjects and Methods] Twenty normal adults were randomly selected, and during their deep cervical flexor training and eye tracking, the thicknesses of the longus colli and the sternocleidomastoid were measured using ultrasonic waves. [Results] The thickness of the longus colli statistically significantly increased when deep cervical flexor training and eye coordination were performed simultaneously. However, the thickness of the sternocleidomastoid did not show statistically significant differences according to eye coordination. [Conclusion] Eye coordination during deep cervical flexor training is likely to increase the thickness of the longus colli selectively. PMID:26834355

  12. Nutrient pathways of flexor tendons in primates

    SciTech Connect

    Manske, P.R.; Lesker, P.A.

    1982-09-01

    The perfusion and diffusion pathways to the flexor profundus tendons of 40 monkeys were investigated by measuring the uptake of tritiated proline by various tendon segments. In the absence of all vascular connections, the process of diffusion provides nutrients to all areas of flexor tendon and in this study the process of diffusion was greater. The distal segment of tendon was observed to be profused most rapidly. The proximal tendon segment is perfused from both the muscular-tendinous junction and the vinculum longus; vincular segment perfusion is via the vinculum longus vessels alone; central segment perfusion is shared by the vinculum longus and vinculum brevis vasculature. The distal segment uptake is by both the process of diffusion or vinculum brevis perfusion. The osseous attachment at the distal phalanx contributes little to tendon nutrition.

  13. Motor units in cross-reinnervated fast and slow twitch muscle of the cat.

    PubMed Central

    Bagust, J; Lewis, D M; Westerman, R A

    1981-01-01

    1. Isometric contractile properties of motor units were measured in cross-reinnervated fast (flexor digitorum longus) and slow (soleus) twitch muscles of the cat. All but one cross was at least 95% pure. 2. There was a reduction in the number of motor units in all muscles, but totals remained about equal in cross-reinnervated soleus and flexor digitorum longus. 3. Motor unit tensions (mean and maximum values) were higher in cross-reinnervated soleus than in cross-reinnervated flexor digitorum longus, reversing the differences between normal muscles. This was due to increases in muscle mass and in the tension developed per unit cross-sectional area. There were motor unit tensions larger and smaller than those seen in normal muscle, but the range was comparable with that seen in self-reinnervated muscle. 4. The changes in twitch time to peak of whole muscle following cross-reinnervations resulted from a change over the whole range of motor units. The conversion of soleus was less complete than that of flexor digitorum longus, and the time to peak of its fastest motor unit was twice as long as any seen in normal flexor digitorum longus. 5. In neither of the cross-reinnervated muscles were the fast contracting motor units larger than the slow contracting ones, and in cross-reinnervated soleus they were smaller. 6. Axonal conduction velocity was correlated with motor unit tension in both muscles and with twitch time to peak in cross-reinnervated flexor digitorum longus, but in all cases less clearly than in normal muscles. 7. The ratio of twitch to tetanic tension increased with increasing twitch time to peak, as in normal muscles. PMID:7277217

  14. Painful Os Peroneum Syndrome: Underdiagnosed Condition in the Lateral Midfoot Pain.

    PubMed

    Chagas-Neto, Francisco Abaete; de Souza, Barbara Nogueira Caracas; Nogueira-Barbosa, Marcello Henrique

    2016-01-01

    Os peroneum is an accessory ossicle located within the peroneus longus tendon. The painful os peroneum syndrome (POPS) results from a wide spectrum of conditions, including fractures, diastases, and other causes. POPS can result in tenosynovitis or discontinuity of the peroneus longus tendon with a clinical presentation of pain in the lateral aspect of the midfoot. Authors report a typical case of POPS, illustrating this entity through different imaging methods (radiographs, ultrasound, and magnetic resonance imaging). We emphasize the prevalence of this ossicle and discuss painful complications. PMID:27478674

  15. Painful Os Peroneum Syndrome: Underdiagnosed Condition in the Lateral Midfoot Pain

    PubMed Central

    de Souza, Barbara Nogueira Caracas

    2016-01-01

    Os peroneum is an accessory ossicle located within the peroneus longus tendon. The painful os peroneum syndrome (POPS) results from a wide spectrum of conditions, including fractures, diastases, and other causes. POPS can result in tenosynovitis or discontinuity of the peroneus longus tendon with a clinical presentation of pain in the lateral aspect of the midfoot. Authors report a typical case of POPS, illustrating this entity through different imaging methods (radiographs, ultrasound, and magnetic resonance imaging). We emphasize the prevalence of this ossicle and discuss painful complications. PMID:27478674

  16. Chronic Posttraumatic Dislocation of Radial Head With Ulnar Nerve Entrapment in a Child: A Case Report and Literature Review.

    PubMed

    Cai, Jiangyu; Wang, Wei; Yu, Shiyang; Yan, Hede; Zhan, Yulin; Fan, Cunyi

    2016-06-01

    We present an unusual case of chronic posttraumatic anteromedial dislocation of radial head with direct ulnar nerve entrapment in a child. Ulnar nerve decompression, open reduction of the radial head, and annular ligament reconstruction using a palmaris longus tendon graft were performed, and a satisfactory functional outcome was achieved at the 15-month follow-up. Through a review of literature, we conclude that early diagnosis and management for radial head dislocation are recommended to avoid nerve symptoms. Besides, open reduction and annular ligament reconstruction with a palmaris longus tendon graft would be an alternative surgery during chronic phase. PMID:27171922

  17. The action of the beta-agonist clenbuterol on protein metabolism in innervated and denervated phasic muscles.

    PubMed Central

    Maltin, C A; Hay, S M; Delday, M I; Lobley, G E; Reeds, P J

    1989-01-01

    1. Clenbuterol treatment in innervated and denervated phasic extensor digitorum longus, plantaris and gastrocnemius muscles from rats caused a significant increase in RNA and protein contents in all muscles except denervated extensor digitorum longus. 2. All muscles showed an increase in the fractional rate of protein synthesis (Ks) with clenbuterol, but the temporal response varied. 3. The data suggest that the effect of clenbuterol on protein metabolism in innervated muscles is muscle-type specific, and demonstrate the homology of response for denervated muscles. Images Fig. 1. PMID:2803256

  18. Imaging of adductor-related groin pain.

    PubMed

    Pesquer, L; Reboul, G; Silvestre, A; Poussange, N; Meyer, P; Dallaudière, B

    2015-09-01

    Groin pain is a common condition in athletes and results from various causes. Osteitis pubis, adductor dysfunction, inguinal hernia, or a combination of all three entities, generally explains the onset of symptoms. Adductor longus tendinopathy is the main cause of adductor-related groin pain. It leads to a significant reduction of sports participation and can require surgical management. Diagnosis is based on ultrasonography and magnetic resonance imaging. Asymptomatic findings (tendinosis, calcifications, cortical erosions) are common in athletes and care should be taken when assessing groin pain. The most specific sign of tendinopathy is an intratendinous tear of the adductor longus. PMID:25823982

  19. Associations between iliotibial band injury status and running biomechanics in women.

    PubMed

    Foch, Eric; Reinbolt, Jeffrey A; Zhang, Songning; Fitzhugh, Eugene C; Milner, Clare E

    2015-02-01

    Iliotibial band syndrome (ITBS) is a common overuse knee injury that is twice as likely to afflict women compared to men. Lower extremity and trunk biomechanics during running, as well as hip abductor strength and iliotibial band flexibility, are factors believed to be associated with ITBS. The purpose of this cross-sectional study was to determine if differences in lower extremity and trunk biomechanics during running exist among runners with current ITBS, previous ITBS, and controls. Additionally, we sought to determine if isometric hip abductor strength and iliotibial band flexibility were different among groups. Twenty-seven female runners participated in the study. Participants were divided into three equal groups: current ITBS, previous ITBS, and controls. Overground running trials, isometric hip abductor strength, and iliotibial band flexibility were recorded for all participants. Discrete joint and segment biomechanics, as well as hip strength and flexibility measures were analyzed using a one-way analysis of variance. Runners with current ITBS exhibited 1.8 (1.5)° greater trunk ipsilateral flexion and 7 (6)° less iliotibial band flexibility compared to runners with previous ITBS and controls. Runners with previous ITBS exhibited 2.2 (2.9) ° less hip adduction compared to runners with current ITBS and controls. Hip abductor strength 3.3 (2.6) %BM×h was less in runners with previous ITBS but not current ITBS compared to controls. Runners with current ITBS may lean their trunk more towards the stance limb which may be associated with decreased iliotibial band flexibility. PMID:25701012

  20. Evaluation and management of chronic total hip instability.

    PubMed

    Sheth, N P; Melnic, C M; Paprosky, W G

    2016-01-01

    Given the increasing number of total hip arthroplasty procedures being performed annually, it is imperative that orthopaedic surgeons understand factors responsible for instability. In order to treat this potentially complex problem, we recommend correctly classifying the type of instability present based on component position, abductor function, impingement, and polyethylene wear. Correct classification allows the treating surgeon to choose the appropriate revision option that ultimately will allow for the best potential outcome. PMID:26733640

  1. Endoscopic Treatment of Gluteus Medius Tears: A Review.

    PubMed

    Lerebours, Frantz R; Cohn, Randy; Youm, Thomas

    2016-03-01

    Greater trochanteric pain syndrome (GTPS) is a term used to describe disorders of the peritrochanteric region. This constellation of conditions includes greater trochanteric bursitis, gluteus medius (GM) tears, and external coxa saltans or snapping hip syndrome. Tears of the abductor mechanism, more specifically gluteus medius tears, have recently gained a considerable amount of interest in the orthopaedic literature. Abductor tears were first described by Bunker and Kagan in the late 1990s. They used the rotator cuff as an analogous structure to describe the pathological process associated with gluteus medius tears. Tears of the gluteus medius tendon can often be difficult to recognize. The clinical presentation is often attributed to trochanteric bursal inflammation, without any further workup. Provocative hip physical examination findings are an important key to proper diagnosis of abductor injuries. Depending on the size of the tear, patients with abductor tendon pathology may present with a Trendelenburg gait and reduced resisted abduction strength accompanied by pain. Initial noninvasive management of greater trochanteric pain syndrome includes oral or topical anti-inflammatory medication and activity modification. Physical therapy or other treatment modalities can be considered, with a focus on core strengthening, truncal alignment, and iliotibial band stretching. Gluteus medius tears have historically been repaired in an open fashion; however, the advent of new endoscopic surgery techniques has allowed for a less invasive approach. Access to the peritrochanteric space affords the surgeon with access to pathology associated with the greater trochanter, iliotibial band, trochanteric bursa, sciatic nerve, short external-rota tors, iliopsoas tendon, and the gluteus medius and minimus tendon attachments. Over the last decade, we have seen rapid technological advances in hip arthroscopy, improved diagnostic imaging and interpretation, and an improved

  2. CIRCUMFERENTIAL PROXIMAL FEMORAL ALLOGRAFTS IN REVISION SURGERY ON TOTAL HIP ARTHROPLASTY: CASE REPORTS WITH A MINIMUM FOLLOW-UP OF 20 YEARS

    PubMed Central

    Roos, Bruno Dutra; Roos, Milton Valdomiro; Júnior, Antero Camisa

    2015-01-01

    Among the options for femoral reconstruction in total hip arthroplasty (THA) revision procedures, in cases of extensive circumferential defects, is the use of proximal femoral allografts. This technique makes it possible to correct the hip abductor mechanism and the leg length discrepancy, as well as presenting osteoconductive potential. The authors report the clinical and radiographic results from two cases of THA revision using this technique, with a minimum follow-up of 20 years. PMID:27042652

  3. Greater Trochanter Reconstruction in Unstabl Intertrochanteric Fractures Treated With Cemented Bipolar Hemiarthroplasty: A Technical Note

    PubMed Central

    Subramanian, G V; Guravareddy, A V; Reddy, Anil Kumar K R; Chiranjeevi, T

    2012-01-01

    Cemented Bipolar arthroplasty is an established method for treatment of comminuted Intertrochanteric fractures. Reconstruction of greater trochanter is an essential technical step to avoid complications like abductor lurch gait. We here describe a technique of reconstruction and fixation of greater trochanter using cancellous screws with wide washers made of reconstruction plate and tension band wiring. This gives a stable fixation of greater trochanter and avoids cut out, slippage of implants.

  4. Greater Trochanter Reconstruction in Unstabl Intertrochanteric Fractures Treated With Cemented Bipolar Hemiarthroplasty: A Technical Note.

    PubMed

    Subramanian, G V; Guravareddy, A V; Reddy, Anil Kumar K R; Chiranjeevi, T

    2012-01-01

    Cemented Bipolar arthroplasty is an established method for treatment of comminuted Intertrochanteric fractures. Reconstruction of greater trochanter is an essential technical step to avoid complications like abductor lurch gait. We here describe a technique of reconstruction and fixation of greater trochanter using cancellous screws with wide washers made of reconstruction plate and tension band wiring. This gives a stable fixation of greater trochanter and avoids cut out, slippage of implants. PMID:27298870

  5. The dropped big toe.

    PubMed

    Satku, K; Wee, J T; Kumar, V P; Ong, B; Pho, R W

    1992-03-01

    Surgical procedures for exposure of the upper third of the fibula have been known to cause weakness of the long extensor of the big toe post-operatively. The authors present three representative cases of surgically induced dropped big toe. From cadaveric dissection, an anatomic basis was found for this phenomenon. The tibialis anterior and extensor digitorum longus muscles have their origin at the proximal end of the leg and receive their first motor innervation from a branch that arises from the common peroneal or deep peroneal nerve at about the level of the neck of the fibula. However, the extensor hallucis longus muscle originates in the middle one-third of the leg and the nerves innervating this muscle run a long course in close proximity to the fibula for up to ten centimeters from a level below the neck of the fibula before entering the muscle. Surgical intervention in the proximal one-third of the fibula just distal to the origin of the first motor branch to the tibialis anterior and extensor digitorum longus muscles carries a risk of injury to the nerves innervating the extensor hallucis longus. PMID:1519891

  6. Computed tomography of the carotid space and related cervical spaces. Part 1. Anatomy

    SciTech Connect

    Silver, A.J.; Mawad, M.E.; Hilal, S.K.; Sane, P.; Ganti, S.R.

    1984-03-01

    The carotid space, parapharyngeal space, and paraspinal space are described. The carotid space is shown on computed tomography (CT) to be posterior to the parapharyngeal space and separated from it by the styloid apparatus. The paraspinal space is posterior to the carotid space and separated from it by the longus and anterior scalene muscles.

  7. Tarsal Tunnel Syndrome Secondary to an Unreported Ossicle of the Talus: A Case Report.

    PubMed

    Sweed, Tamer Ahmed; Ali, Seyed Asghar; Choudhary, Surabhi

    2016-01-01

    Tarsal tunnel syndrome (TTS) is a compression neuropathy of the posterior tibial nerve in the tarsal tunnel. In about 80% of patients, a specific cause can be identified for TTS. We present a case of TTS secondary to an ossicle in close relation to the talus that, to our knowledge, has not previously been reported. A 26-year-old male presented with left ankle and foot pain that increased with activity and playing football. He had a tingling sensation and paresthesia in the sole and medial border of the foot along the distribution of the medial and lateral plantar nerves. Clinically, he had hard swelling at the floor of the tarsal tunnel, and Tinel's sign was positive. Computed tomography showed an accessory ossicle articulating with the posteromedial aspect of the talus, separating the flexor digitorum longus and flexor hallucis longus tendons, with tenosynovitis of the tibialis posterior, flexor digitorum longus and flexor hallucis longus tendons. Surgical release of the tarsal tunnel and excision of the ossicle were performed. Postoperatively, the patient showed dramatic improvement and had no complications or recurrence of symptoms after 8 months of follow-up. More interestingly, to the best of our knowledge, this ossicle has not been previously reported to cause TTS. PMID:25441278

  8. An Analysis of Superintendent-CEO Evaluation as Compared to Executive Officer Evaluation in Private Education, Higher Education, Non-Profit Organizations, and For-Profit Corporations

    ERIC Educational Resources Information Center

    Hentze, Brandon T.

    2010-01-01

    The accountability movement of the early 1990s, along with the No Child Left Behind legislation of 2001, required a change in the role of the school district superintendent. The long-used model of superintendent-manager was no longer appropriate to lead school districts in this new era of accountability. A new model of the superintendency emerged…

  9. Unrecognized acute exertional compartment syndrome of the leg and treatment.

    PubMed

    Popovic, Nebojsa; Bottoni, Craig; Cassidy, Charles

    2011-04-01

    Acute-on-chronic exertional compartment syndrome is rare and may be easily missed without a high degree of awareness and clinical suspicion. We report a case of unrecognized acute-on-chronic exertional compartment syndrome in a recreational soccer player. The late sequela of this condition, foot drop, was successfully treated with transfer of the peroneus longus tendon. PMID:21667742

  10. The effects of hip external rotator exercises and toe-spread exercises on lower extremity muscle activities during stair-walking in subjects with pronated foot

    PubMed Central

    Goo, Young-Mi; Kim, Da-Yeon; Kim, Tae-Ho

    2016-01-01

    [Purpose] The purpose of the present study was to examine the effects of toe-spread (TS) exercises and hip external rotator strengthening exercises for pronated feet on lower extremity muscle activities during stair-walking. [Subjects and Methods] The participants were 20 healthy adults with no present or previous pain, no past history of surgery on the foot or the ankle, and no foot deformities. Ten subjects performed hip external rotator strengthening exercises and TS exercises and the remaining ten subjects performed only TS exercises five times per week for four weeks. [Results] Less change in navicular drop height occurred in the group that performed hip external rotator exercises than in the group that performed only TS exercises. The group that performed only TS exercises showed increased abductor hallucis muscle activity during both stair-climbing and -descending, and the group that performed hip external rotator exercises showed increased muscle activities of the vastus medialis and abductor hallucis during stair-climbing and increased muscle activity of only the abductor hallucis during stair-descending after exercise. [Conclusion] Stair-walking can be more effectively performed if the hip external rotator muscle is strengthened when TS exercises are performed for the pronated foot. PMID:27134364

  11. The effect of hip joint muscle exercise on muscle strength and balance in the knee joint after meniscal injury.

    PubMed

    Park, Sun Ja; Kim, Young Mi; Kim, Ha Roo

    2016-04-01

    [Purpose] This study aimed to evaluate the effect of hip muscle strengthening on muscle strength and balance in the knee joint after a meniscal injury. [Subjects and Methods] This randomized control study enrolled 24 patients who had undergone arthroscopic treatment after a meniscal injury and began a rehabilitative exercise program 8 weeks after surgery. Subjects were divided into 2 groups of 12 subjects each: gluteus medius resistance exercise group and control group. This study investigated muscle strength and balance in the knee joint flexor, extensor, and abductor during an 8-week period. [Results] Measurements of knee extensor muscle strength revealed no significant difference between the control group and the experimental group. Measurements of abductor muscle strength, however, identified a significant difference between the 2 groups. The groups did not differ significantly with regard to balance measurements. [Conclusion] The results of this study suggest that this subject should be approached in light of the correlation between the hip abductor and injury to the lower extremities. PMID:27190461

  12. The effect of hip joint muscle exercise on muscle strength and balance in the knee joint after meniscal injury

    PubMed Central

    Park, Sun Ja; Kim, Young Mi; Kim, Ha Roo

    2016-01-01

    [Purpose] This study aimed to evaluate the effect of hip muscle strengthening on muscle strength and balance in the knee joint after a meniscal injury. [Subjects and Methods] This randomized control study enrolled 24 patients who had undergone arthroscopic treatment after a meniscal injury and began a rehabilitative exercise program 8 weeks after surgery. Subjects were divided into 2 groups of 12 subjects each: gluteus medius resistance exercise group and control group. This study investigated muscle strength and balance in the knee joint flexor, extensor, and abductor during an 8-week period. [Results] Measurements of knee extensor muscle strength revealed no significant difference between the control group and the experimental group. Measurements of abductor muscle strength, however, identified a significant difference between the 2 groups. The groups did not differ significantly with regard to balance measurements. [Conclusion] The results of this study suggest that this subject should be approached in light of the correlation between the hip abductor and injury to the lower extremities. PMID:27190461

  13. Surgical exposure and cement removal in revision total hip arthroplasty.

    PubMed

    Mallory, T H

    1992-10-01

    The surgical approach in revision total hip arthroplasty (THA) must conform to the preoperative goals of revision surgery. Factors to be considered include adequate visualization, assessment of remaining bone stock, presence or absence of cement, status of the trochanter, leg length discrepancies, and previous surgical approaches. To maintain neurovascular structures, blood supply to the involved bone, postoperative abductor function, stability, and gait normalcy, an anterolateral approach is best used. Three anterolateral approaches are used to address various aspects of revision THA. Approach 1 allows for exposure of the acetabulum and proximal femur. The associated abductor muscle split allows for excellent proximal exposure. Approach 2 is performed when acetabular reconstruction is neither complex nor involved, and when extended access to the femur is necessary. The lateral-distal incision is determined by the need for adequate femur exposure for implant removal, cement removal, and any bone grafting procedures to reconstitute osseous structures. Approach 3 is further developed proximally to expose necessary anatomic regions of the acetabulum while preserving the underlying neurovascular structures. Using special instrumentation and controlled femoral perforations, cement mantles are quickly removed, minimizing damage to the bone and preserving the osseous structures. For all three approaches, abductor muscle separation repair and/or reattachment is performed with a heavy, no. 5, nonabsorbable suture. Postoperative patient management depends on the degree of dissection and extent of reconstruction. PMID:10147935

  14. A Wider Pelvis Does Not Increase Locomotor Cost in Humans, with Implications for the Evolution of Childbirth

    PubMed Central

    Warrener, Anna G.; Lewton, Kristi L.; Pontzer, Herman; Lieberman, Daniel E.

    2015-01-01

    The shape of the human female pelvis is thought to reflect an evolutionary trade-off between two competing demands: a pelvis wide enough to permit the birth of large-brained infants, and narrow enough for efficient bipedal locomotion. This trade-off, known as the obstetrical dilemma, is invoked to explain the relative difficulty of human childbirth and differences in locomotor performance between men and women. The basis for the obstetrical dilemma is a standard static biomechanical model that predicts wider pelves in females increase the metabolic cost of locomotion by decreasing the effective mechanical advantage of the hip abductor muscles for pelvic stabilization during the single-leg support phase of walking and running, requiring these muscles to produce more force. Here we experimentally test this model against a more accurate dynamic model of hip abductor mechanics in men and women. The results show that pelvic width does not predict hip abductor mechanics or locomotor cost in either women or men, and that women and men are equally efficient at both walking and running. Since a wider birth canal does not increase a woman’s locomotor cost, and because selection for successful birthing must be strong, other factors affecting maternal pelvic and fetal size should be investigated in order to help explain the prevalence of birth complications caused by a neonate too large to fit through the birth canal. PMID:25760381

  15. An Integrated Musculoskeletal Countermeasure Battery for Long-Duration Lunar Missions

    NASA Technical Reports Server (NTRS)

    Lang, T. F.; Streeper, T. S.; Cavanagh, P. R.; Saeed, I. H.; Carpenter, R. D.; Frassetto, L. A.; Lee, S. M. C.; Grodsinsky, C. M.; Funk, J.; Hanson, A. M.; Bloomberg, J. J.; Mulavara, A. P.; Sibonga, J. D.

    2011-01-01

    During extended periods of skeletal unloading, losses in strength and density of the proximal femur will occur. In long-duration spaceflight, resistive exercise is used to replace the normal loads exerted on the spine and hip. At the present time, there is no conclusive evidence that hip bone loss has been prevented in this scenario. Our group has recently developed and clinically evaluated a multifunctional exercise system, the Combined Countermeasure Device (CCD). The CCD comprises a low-footprint Stuart Platform for lower-body resistance exercise and balance training, and a cardiovascular exercise bicycle. A consideration for resistance exercise was targeting of the hip abductor and adductor muscles, which attach directly at the hip and which should subject it to the largest loads. In our training study, we found that CCD exercise increased hip adductor and abductor strength, and modeling results suggest that this exercise exerts forces on the hip of approx. 4-6 body weights at 1g, compared to forces of approx.2.5 body weight y squatting exercise. In our current study, we hypothesize that abductor and adductor exercise will increase the density and strength of the proximal femur.

  16. Shorter, rough trunnion surfaces are associated with higher taper wear rates than longer, smooth trunnion surfaces in a contemporary large head metal-on-metal total hip arthroplasty system.

    PubMed

    Brock, Timothy M; Sidaginamale, Raghavendra; Rushton, Steven; Nargol, Antoni V F; Bowsher, John G; Savisaar, Christina; Joyce, Tom J; Deehan, David J; Lord, James K; Langton, David J

    2015-12-01

    Taper wear at the head-neck junction is a possible cause of early failure in large head metal-on-metal (LH-MoM) hip replacements. We hypothesized that: (i) taper wear may be more pronounced in certain product designs; and (ii) an increased abductor moment arm may be protective. The tapers of 104 explanted LH-MoM hip replacements revised for adverse reaction to metal debris (ARMD) from a single manufacturer were analyzed for linear and volumetric wear using a co-ordinate measuring machine. The mated stem was a shorter 12/14, threaded trunnion (n=72) or a longer, smooth 11/13 trunnion (n=32). The abductor moment arm was calculated from pre-revision radiographs. Independent predictors of linear and volumetric wear included taper angle, stem type, and the horizontal moment arm. Tapers mated with the threaded 12/14 trunnion had significantly higher rates of volumetric wear (0.402 mm3/yr vs. 0.123 mm3/yr [t=-2.145, p=0.035]). There was a trend to larger abductor moment arms being protective (p=0.055). Design variation appears to play an important role in taper-trunnion junction failure. We recommend that surgeons bear these findings in mind when considering the use of a short, threaded trunnion with a cobalt-chromium head. PMID:26135357

  17. Comparative histochemical composition of muscle fibres in a pre- and a postvertebral muscle of the cervical spine

    PubMed Central

    BOYD-CLARK, L. C.; BRIGGS, C. A.; GALEA, M. P.

    2001-01-01

    References to histochemistry are extensive for human limb muscles but occur less frequently in relation to vertebral muscle. Most vertebral muscle literature has been concerned with muscle fibre characteristics in the lumbar and thoracic spine, due in large part to the incidence of low back pain and idiopathic scoliosis. However few studies have investigated the histochemical composition of neck muscles in humans: and, to our knowledge, no previous study has examined the antagonistic longus colli and multifidus muscle pair. In addition, while age-related segmental degeneration is most prominent between C5 and C7, it is not known whether these osteoligamentous changes are paralleled by changes in muscle fibre ratio. Tissue blocks comprising muscle and bone from C5–C7 segments were harvested at autopsy from 16 subjects with ages ranging from 4 to 77 years. The prevertebral longus colli and postvertebral multifidus muscle pairs were randomly selected from one or other side in each subject. The tissue was frozen, sectioned and histochemically stained for myofibrillar adenosine triphosphatase. Analysis of muscle fibre types was performed by light microscopy. Wilcoxon paired t-tests were used to ascertain whether intramuscular and intermuscular differences in fibre composition were significant. In addition, correlation and regression analyses were used to determine whether fibre type proportions changed in either muscle with increasing age. The present study has revealed histochemical differences between longus colli and multifidus at the level of the C5–C7 vertebral segments. Multifidus comprises a significantly greater proportion of type I than type II fibres. Longus colli comprises a significantly greater proportion of type II fibres than multifidus. Further there were no changes in fibre type proportion in either muscle with increasing age. These observations suggest that longus colli responds equally to postural and phasic demands, whereas multifidus is

  18. Medial Tibial Stress Syndrome: Muscles Located at the Site of Pain.

    PubMed

    Brown, Ato Ampomah

    2016-01-01

    Objective. The purpose of this study was to examine the relationship between the location of the MTSS pain (posteromedial border of tibia) and the muscles that originate from that site. Method. The study was conducted in the Department of Anatomy of the School of Medical Sciences, University of Cape Coast, and involved the use of 22 cadaveric legs (9 paired and 4 unpaired) from 11 males and 2 females. Findings. The structures that were thus observed to attach directly to the posteromedial border of the tibia were the soleus, the flexor digitorum longus, and the deep crural fascia. The soleus and flexor digitorum longus muscles were observed to attach directly to the posteromedial border of the tibia. The tibialis posterior muscle had no attachment to this site. Conclusion. The findings of this study suggest that if traction is the cause of MTSS then soleus and the flexor digitorum muscles and not the tibialis posterior muscle are the likely cause of MTSS. PMID:27066291

  19. Pattern of arborization of the motor nerve terminals in the fast and slow mammalian muscles.

    PubMed

    Tomas, J; Santafé, M; Fenoll, R; Mayayo, E; Batlle, J; Lanuza, A; Piera, V

    1992-01-01

    A silver impregnation method and a morphometric approach were used to define differences existing in the motor nerve terminal branching pattern between a fast-twitch muscle (extensor digitorum longus) and a slow-twitch one (soleus) of the normal adult rat. Because no single measure can describe precisely all geometrical properties (ie both topology and metrics) of the nerve terminals, we evaluated morphologic parameters defining length and angular characteristics in the different terminal segments classified according to their centrifugal order. The main results indicate that the distal free-end segments in the extensor digitorum longus muscle are shorter and less divergent than in the soleus nerve terminals. The endings in the two muscles have different fractal dimensions. Findings are discussed in the context of the hypothetical mechanisms governing motor nerve terminal size and complexity. PMID:1628112

  20. Medial Tibial Stress Syndrome: Muscles Located at the Site of Pain

    PubMed Central

    Brown, Ato Ampomah

    2016-01-01

    Objective. The purpose of this study was to examine the relationship between the location of the MTSS pain (posteromedial border of tibia) and the muscles that originate from that site. Method. The study was conducted in the Department of Anatomy of the School of Medical Sciences, University of Cape Coast, and involved the use of 22 cadaveric legs (9 paired and 4 unpaired) from 11 males and 2 females. Findings. The structures that were thus observed to attach directly to the posteromedial border of the tibia were the soleus, the flexor digitorum longus, and the deep crural fascia. The soleus and flexor digitorum longus muscles were observed to attach directly to the posteromedial border of the tibia. The tibialis posterior muscle had no attachment to this site. Conclusion. The findings of this study suggest that if traction is the cause of MTSS then soleus and the flexor digitorum muscles and not the tibialis posterior muscle are the likely cause of MTSS. PMID:27066291

  1. Hindlimb immobilization - Length-tension and contractile properties of skeletal muscle

    NASA Technical Reports Server (NTRS)

    Witzmann, F. A.; Kim, D. H.; Fitts, R. H.

    1982-01-01

    Casts were placed around rat feet in plantar flexion position to immobilize the soleus muscle in a shortened position, while the other foot was fixed in dorsal flexion to set the extensor digitorum longus in a shortened position. The total muscular atrophy and contractile properties were measured at 1, 2, 4, 7, 14, 21, 28, 35, and 42 days after immobilization, with casts being replaced every two weeks. The slow twitch soleus and the fast-twitch vastus lateralis and longus muscles were excised after termination of the experiment. The muscles were then stretched and subjected to electric shock to elicit peak tetanic tension and peak tetanic tension development. Force velocity features of the three muscles were assayed in a series of afterloaded contractions and fiber lengths were measured from subsequently macerated muscle. All muscles atrophied during immobilization, reaching a new steady state by day 21. Decreases in fiber and sarcomere lengths were also observed.

  2. The influence of a medio-lateral unstable sole on invertor and evertor activation while descending stairs

    PubMed Central

    Yang, Ki-sik; Park, Kyungyeon; Choi, Bo-ram

    2016-01-01

    [Purpose] This study examined the effects of a medio-lateral unstable sole on invertor and evertor activation while descending stairs. [Subjects and Methods] The subjects were 30 university students with no history of ankle sprain. They descended stairs while wearing the medio-lateral unstable sole or with bare feet. Electromyography was used to record the activity of the tibialis anterior and peroneus longus and brevis muscles and paired t-tests were used to assess statistical significance. [Results] The medio-lateral unstable sole group showed increased tibialis anterior and peroneus longus and brevis muscle activation compared to the barefoot group. [Conclusion] Medio-lateral unstable sole can be used with exercises to prevent further ankle damage by activating both the inversion and eversion muscles.

  3. Calcific retropharyngeal tendinitis. [Radiological findings

    SciTech Connect

    Karasick, D.; Karasick, S.

    1981-12-01

    Calcific retropharyngeal tendinitis is an imflammation of the longus colli muscle tendon which is located on the anterior surface of the verterbral column extending from the atlas to the third thoracic vertebra. The acute inflammatory condition is selflimiting with symptoms consisting of a gradually increasing neck pain often associated with throat pain and difficulty swallowing. The pain is aggravated by head and neck movement. Clinically the condition can be confused with retropharyngeal absecess, meningitis, infectious spondylitis, and post-traumatic muscle spasm. The radiographic features of this condition consist of pre-vertebral soft tissue swelling from C1 to C4 and amorphous calcific density in the longus colli tendon anterior to the body of C2 and inferior to the anterior arch of C1.

  4. Recurrent anterior instability of the radial head: case report.

    PubMed

    Itadera, Eichi; Ueno, Keisuke

    2014-02-01

    We present a case of recurrent anterior instability of the radial head presenting 4 weeks after injury. A 16-year-old girl injured the right upper extremity while playing volleyball. Thereafter, she felt a recurrent click associated with pain in the elbow when rotating the forearm. Image intensifier findings implied that the radial head would anteriorly dislocate with contraction of the biceps brachii. Annular ligament reconstruction using the palmaris longus tendon graft relieved the instability. PMID:24332619

  5. Postinfective skin contracture: a rare cause of fifth metatarsophalangeal joint subluxation

    PubMed Central

    Prakash, Jatin; Mehtani, Anil

    2014-01-01

    Dislocation or subluxation of the metatarsophalangeal joint (MTP) is common and usually follows a traumatic event. Non-traumatic causes usually include inflammatory arthritis (rheumatoid arthritis), connective tissue disorders, crowded shoewear or flexor digitorum longus tendon contracture. We present a very unusual case of subluxation of the fifth MTP joint following a postboil skin contracture. The case was treated with the release of contracture by Z-plasty. It resulted in concentric reduction of the joint and normal skin healing. PMID:25199201

  6. Arthroscopic pubic symphysis debridement and adductor enthesis repair in athletes with athletic pubalgia: technical note and video illustration.

    PubMed

    Hopp, Sascha; Tumin, Masjudin; Wilhelm, Peter; Pohlemann, Tim; Kelm, Jens

    2014-11-01

    We elaborately describe our novel arthroscopic technique of the symphysis pubis in athletes with osteitis pubis and concomitant adductor enthesopathy who fail to conservative treatment modalities. The symphysis pubis is debrided arthroscopically and the degenerated origin of adductor tendon (enthesis) is excised and reattached. With our surgical procedure the stability of the symphysis pubis is successfully preserved and the adductor longus enthesopathy simultaneously addressed in the same setting. PMID:25055756

  7. Six new species of Triomicrus Sharp from southern China (Coleoptera: Staphylinidae: Pselaphinae).

    PubMed

    Shen, Jia-Wei; Yin, Zi-Wei; Li, Li-Zhen

    2015-01-01

    Seven species of the genus Triomicrus Sharp are recognized in southern China, six of them are described as new: T. acutus  and T. nanlingensis Shen & Yin, sp. n. (Guangdong), T. pinnatus Shen & Yin, sp. n. (Guangdong and Hunan), T. cochlis Shen & Yin, sp. n. (Guangdong, Hunan and Guangxi), and T. cavus Shen & Yin, sp. n. and T. longus Shen & Yin, sp. n. (Guangxi). A key for the identification of Triomicrus in southern China is presented. PMID:26624728

  8. Postinfective skin contracture: a rare cause of fifth metatarsophalangeal joint subluxation.

    PubMed

    Prakash, Jatin; Mehtani, Anil

    2014-01-01

    Dislocation or subluxation of the metatarsophalangeal joint (MTP) is common and usually follows a traumatic event. Non-traumatic causes usually include inflammatory arthritis (rheumatoid arthritis), connective tissue disorders, crowded shoewear or flexor digitorum longus tendon contracture. We present a very unusual case of subluxation of the fifth MTP joint following a postboil skin contracture. The case was treated with the release of contracture by Z-plasty. It resulted in concentric reduction of the joint and normal skin healing. PMID:25199201

  9. Coexistence of twitch potentiation and tetanic force decline in rat hindlimb muscle

    NASA Technical Reports Server (NTRS)

    Rankin, Lucinda L.; Enoka, Roger M.; Volz, Kathryn A.; Stuart, Douglas G.

    1988-01-01

    The effect of whole-muscle fatigue on the isometric twitch was investigated in various hindlimb muscles of anesthetized rats, using an experimental protocol designed to assess the levels of fatigability in motor units. The results of EMG and force measurements revealed the existence of a linear relationship between fatigability and the magnitude of the twitch force following the fatigue test in both soleus and extensor digitorum longus muscles.

  10. A Comparison of Muscle Activities in the Lower Extremity between Flat and Normal Feet during One-leg Standing

    PubMed Central

    Lee, Ju-Eun; Park, Ga-Hyeon; Lee, Yun-Seop; Kim, Myoung-Kwon

    2013-01-01

    [Purpose] This study examined the differences in muscle activation between flat and normal feet in the one-leg standing position which delivers the greatest load to the lower extremity. [Subjects] This study was conducted with 23 adults, 12 with normal feet and 12 with flat feet, with ages ranging from 21 to 30 years old, who had no neurological history or gait problems. [Methods] The leg used for one leg standing was the dominant leg of the subjects. The experimenter instructed the subjects to raise the non-dominant leg with their eyes open, and the subjects maintained a posture with the non-dominant leg's knee flexed at 90° and the hip joint flexed at 45° for six seconds. In the position of one-leg standing, a horizontal rod was set at the height of the waist line of the subjects who lightly placed two fingers of each hand on the rod to prevent inclination of the trunk to one side. Measurements were taken three times and the maximum value was used. A surface electromyogram (TeleMyo 2400T, Noraxon Co., USA) was used to measure muscle activities. [Results] We compared muscle activities between flat and normal foot, and the results show a significant difference between normal and flat feet in the muscle activity of the abductor hallucis muscle. [Conclusion] The subjects with flat feet had relatively lower activation of the abductor hallucis muscle than those with normal feet during one leg standing. We infer from this that the abductor hallucis muscle of flat foot doesn't work as well as a dynamic stabilizer, compared to a normal foot, during one leg standing. PMID:24259915

  11. Walking with wider steps increases stance phase gluteus medius activity

    PubMed Central

    Kubinski, Samantha N.; McQueen, Christina A.; Sittloh, Keir A.; Dean, Jesse C.

    2014-01-01

    Increases in step width have been reported for several clinical populations, including older adults and stroke survivors. These populations often also exhibit decreased hip abductor strength, suggesting that walking with wider steps may be an adaptive response in order to reduce the mechanical demands on the hip abductors. The purpose of this study was to quantify the relationship between step width and gluteus medius (GM) activity during walking. Fourteen young, uninjured adults walked on a treadmill at 1.25 m/s for four step width conditions (Normal, Narrow, Medium, and Wide) while step width and stance phase GM electromyographic (EMG) activity were quantified. We also measured hip abduction torque and GM activity during maximum voluntary isometric contractions (MVICs) at three hip angles (neutral, abducted 10°, and abducted 20°). During walking trials, GM activity was significantly (p<0.0001) influenced by step width; compared to Normal walking, GM activity was 47% higher with Wide steps and 24% lower with Narrow steps. We also observed a weak positive correlation (r=0.18±0.14) between step width and GM activity during Normal walking, as GM activity was higher with wider steps. These results cannot be attributed to changes in GM conformation under the recording electrode, as GM activity was not influenced by hip angle during MVICs. The increased GM activity with wider steps does not support the proposal that increasing step width would be a beneficial adaptation to weakened hip abductors. A likely alternative explanation is that increased step width is a response to decreased gait balance. PMID:25300241

  12. A Morphometric Study of the Obturator Nerve around the Obturator Foramen

    PubMed Central

    Jo, Se Yeong; Chang, Jae Chil; Bae, Hack Gun; Oh, Jae-Sang; Heo, Juneyoung

    2016-01-01

    Objective Obturator neuropathy is a rare condition. Many neurosurgeons are unfamiliar with the obturator nerve anatomy. The purpose of this study was to define obturator nerve landmarks around the obturator foramen. Methods Fourteen cadavers were studied bilaterally to measure the distances from the nerve root to relevant anatomical landmarks near the obturator nerve, including the anterior superior iliac spine (ASIS), the pubic tubercle, the inguinal ligament, the femoral artery, and the adductor longus. Results The obturator nerve exits the obturator foramen and travels infero-medially between the adductors longus and brevis. The median distances from the obturator nerve exit zone (ONEZ) to the ASIS and pubic tubercle were 114 mm and 30 mm, respectively. The median horizontal and vertical distances between the pubic tubercle and the ONEZ were 17 mm and 27 mm, respectively. The shortest median distance from the ONEZ to the inguinal ligament was 19 mm. The median inguinal ligament lengths from the ASIS and the median pubic tubercle to the shortest point were 103 mm and 24 mm, respectively. The median obturator nerve lengths between the ONEZ and the adductor longus and femoral artery were 41 mm and 28 mm, respectively. Conclusion The obturator nerve exits the foramen 17 mm and 27 mm on the horizontal and sagittal planes, respectively, from the pubic tubercle below the pectineus muscle. The shallowest area is approximately one-fifth medially from the inguinal ligament. This study will help improve the accuracy of obturator nerve surgeries to better establish therapeutic plans and decrease complications. PMID:27226861

  13. Extending the use of the gracilis muscle flap in perineal reconstruction surgery.

    PubMed

    Goldie, Stephen J; Almasharqah, Riyadh; Fogg, Quentin A; Anderson, William

    2016-08-01

    Reconstruction of the perineum is required following oncological resections. Plastic surgical techniques can be used to restore the aesthetics and function of the perineum. The gracilis myocutaneous flap provides a substantial skin paddle, with minimal donor site morbidity. The flap is pedicled on a perforator from the medial circumflex femoral artery, giving it limited reach across the perineum. Tunnelling the flap under the adductor longus muscle may free up more of the arterial pedicle, increasing its reach. On three female cadavers, bilateral gracilis flaps were raised in the standard surgical manner, giving six flaps in total. With the flaps pedicled across the perineum, the distance from the tip of each flap was measured to the anterior superior iliac spine (ASIS). The flaps were then tunnelled under the adductor longus muscle. The distances to the ASIS were measured again. The average pedicle length was greater than 7 cm. Tunnelling the flap under the adductor longus muscle increased the reach by more than 4 cm on average. Cadaveric dissection has shown that tunnelling of the flap in a novel way increase its reach across the perineum. This additional flexibility improves its use clinically and is of benefit to plastic surgeons operating in perineal reconstruction. PMID:27221783

  14. Function after correction of a clawed great toe by a modified Robert Jones transfer.

    PubMed

    Breusch, S J; Wenz, W; Döderlein, L

    2000-03-01

    We carried out a cross-sectional study in 51 patients (81 feet) with a clawed hallux in association with a cavus foot after a modified Robert Jones tendon transfer. The mean follow-up was 42 months (9 to 88). In all feet, concomitant procedures had been undertaken, such as extension osteotomy of the first metatarsal and transfer of the tendon of the peroneus longus to peroneus brevis, to correct the underlying foot deformity. All patients were evaluated clinically and radiologically. The overall rate of patient satisfaction was 86%. The deformity of the hallux was corrected in 80 feet. Catching of the big toe when walking barefoot, transfer lesions and metatarsalgia, hallux flexus, hallux limitus and asymptomatic nonunion of the interphalangeal joint were the most frequent complications. Hallux limitus was more likely when elevation of the first ray occurred (p = 0.012). Additional transfer of the tendon of peroneus longus to peroneus brevis was a significant risk factor for elevation of the first metatarsal (p < 0.0001). The deforming force of extensor hallucis longus is effectively eliminated by the Jones transfer, but the mechanics of the first metatarsophalangeal joint are altered. The muscle balance and stability of the entire first ray should be taken into consideration in the management of clawed hallux. PMID:10755436

  15. Hindlimb myology of the monk parakeet (Aves, Psittaciformes).

    PubMed

    Carril, Julieta; Mosto, María C; Picasso, Mariana B J; Tambussi, Claudia P

    2014-07-01

    We studied the hindlimb myology of the monk parakeet (Myiopsitta monachus). Like all parrots, it has zygodactyl feet enabling perching, climbing, hanging, moving easily among trees, and handling food. Muscles were described and weighed, and physiological cross-sectional area (PCSA) of four flexors and one extensor was calculated. In comparison to other muscles, the M. tibialis cranialis and the M. fibularis brevis show increased development and high PCSA values, and therefore, large potential force production. Also, a large proportion of muscle mass was involved in flexing the digits. We hypothesize that these muscle traits are associated with the arboreal locomotion and food manipulation habits. In the monk parakeet, the M. extensor digitorum longus sends a branch to the hallux, and the connection between the M. flexor digitorum longus and the M. flexor hallucis longus is type I (Gadow's classification). We reaffirm the presence of the M. ambiens as a plesiomorphic condition that disappears in most members of the order. Among Psittaciformes, the M. fibularis brevis is stronger and the M. fibularis weaker in arboreal species than in basal terrestrial ones (e.g., Strigops). PMID:24500894

  16. Targeted Deletion of Collagen V in Tendons and Ligaments Results in a Classic Ehlers-Danlos Syndrome Joint Phenotype

    PubMed Central

    Sun, Mei; Connizzo, Brianne K.; Adams, Sheila M.; Freedman, Benjamin R.; Wenstrup, Richard J.; Soslowsky, Louis J.; Birk, David E.

    2016-01-01

    Collagen V mutations underlie classic Ehlers-Danlos syndrome, and joint hypermobility is an important clinical manifestation. We define the function of collagen V in tendons and ligaments, as well as the role of alterations in collagen V expression in the pathobiology in classic Ehlers-Danlos syndrome. A conditional Col5a1flox/flox mouse model was bred with Scleraxis-Cre mice to create a targeted tendon and ligament Col5a1-null mouse model, Col5a1Δten/Δten. Targeting was specific, resulting in collagen V–null tendons and ligaments. Col5a1Δten/Δten mice demonstrated decreased body size, grip weakness, abnormal gait, joint laxity, and early-onset osteoarthritis. These gross changes were associated with abnormal fiber organization, as well as altered collagen fibril structure with increased fibril diameters and decreased fibril number that was more severe in a major joint stabilizing ligament, the anterior cruciate ligament (ACL), than in the flexor digitorum longus tendon. The ACL also had a higher collagen V content than did the flexor digitorum longus tendon. The collagen V–null ACL and flexor digitorum longus tendon both had significant alterations in mechanical properties, with ACL exhibiting more severe changes. The data demonstrate critical differential regulatory roles for collagen V in tendon and ligament structure and function and suggest that collagen V regulatory dysfunction is associated with an abnormal joint phenotype, similar to the hypermobility phenotype in classic Ehlers-Danlos syndrome. PMID:25797646

  17. Effects of balance training by knee joint motions on muscle activity in adult men with functional ankle instability

    PubMed Central

    Nam, Seung-min; Kim, Won-bok; Yun, Chang-kyo

    2016-01-01

    [Purpose] This study examined the effects of balance training by applying knee joint movements on muscle activity in male adults with functional ankle instability. [Subjects and Methods] 28 adults with functional ankle instability, divided randomly into an experimental group, which performed balance training by applying knee joint movements for 20 minutes and ankle joint exercises for 10 minutes, and a control group, which performed ankle joint exercise for 30 minutes. Exercises were completed three times a week for 8 weeks. Electromyographic values of the tibialis anterior, peroneus longus, peroneus brevis, and the lateral gastrocnemius muscles were obtained to compare and analyze muscle activity before and after the experiments in each group. [Results] The experimental group had significant increases in muscle activity in the tibialis anterior, peroneus longus, and lateral gastrocnemius muscles, while muscle activity in the peroneus brevis increased without significance. The control group had significant increases in muscle activity in the tibialis anterior and peroneus longus, while muscle activity in the peroneus brevis and lateral gastrocnemius muscles increased without significance. [Conclusion] In conclusion, balance training by applying knee joint movements can be recommended as a treatment method for patients with functional ankle instability. PMID:27313386

  18. Targeted deletion of collagen V in tendons and ligaments results in a classic Ehlers-Danlos syndrome joint phenotype.

    PubMed

    Sun, Mei; Connizzo, Brianne K; Adams, Sheila M; Freedman, Benjamin R; Wenstrup, Richard J; Soslowsky, Louis J; Birk, David E

    2015-05-01

    Collagen V mutations underlie classic Ehlers-Danlos syndrome, and joint hypermobility is an important clinical manifestation. We define the function of collagen V in tendons and ligaments, as well as the role of alterations in collagen V expression in the pathobiology in classic Ehlers-Danlos syndrome. A conditional Col5a1(flox/flox) mouse model was bred with Scleraxis-Cre mice to create a targeted tendon and ligament Col5a1-null mouse model, Col5a1(Δten/Δten). Targeting was specific, resulting in collagen V-null tendons and ligaments. Col5a1(Δten/Δten) mice demonstrated decreased body size, grip weakness, abnormal gait, joint laxity, and early-onset osteoarthritis. These gross changes were associated with abnormal fiber organization, as well as altered collagen fibril structure with increased fibril diameters and decreased fibril number that was more severe in a major joint stabilizing ligament, the anterior cruciate ligament (ACL), than in the flexor digitorum longus tendon. The ACL also had a higher collagen V content than did the flexor digitorum longus tendon. The collagen V-null ACL and flexor digitorum longus tendon both had significant alterations in mechanical properties, with ACL exhibiting more severe changes. The data demonstrate critical differential regulatory roles for collagen V in tendon and ligament structure and function and suggest that collagen V regulatory dysfunction is associated with an abnormal joint phenotype, similar to the hypermobility phenotype in classic Ehlers-Danlos syndrome. PMID:25797646

  19. A New Specimen of Carroll’s Mystery Hupehsuchian from the Lower Triassic of China

    PubMed Central

    Chen, Xiao-hong; Motani, Ryosuke; Cheng, Long; Jiang, Da-yong; Rieppel, Olivier

    2015-01-01

    A new specimen of an enigmatic hupehsuchian genus is reported. The genus was first recognized by Robert L. Carroll and Zhi-ming Dong in 1991, who refrained from naming it because of the poor quality of the only specimen known at the time. After more than two decades, we finally report a second specimen of this genus, which remained unprepared until recently. The new specimen preserves most of the skeleton except the skull, allowing us to erect a new genus and species, Eretmorhipis carrolldongi. The new species shares many characters with Parahupehsuchus longus, including the strange axial skeleton that forms a bony body tube. However, the body tube is short in the new species, being limited to the pectoral region. The vertebral count and limb morphology considerably differ between the new species and P. longus. The forelimb of E. carrolldongi is markedly larger than its hind limb as in Hupehsuchus nanchangensis but unlike in P. longus. The new species is unique among hupehsuchians in a list of features. It has manual and pedal digits that spread radially, forming manus and pes that are almost as wide as long. The third-layer elements of the dermal armor are unusually large, spanning four vertebral segments, yet there are substantial gaps among them. With the addition of the unique paddle, it is now clear that Hupehsuchia had diverse forelimb morphologies spanning from paddles to flippers, unlike ichthyopterygians that were taxonomically more diverse yet only had flippers. PMID:26017585

  20. Ecophysiological constraints of two invasive plant species under a saline gradient: Halophytes versus glycophytes

    NASA Astrophysics Data System (ADS)

    Duarte, B.; Santos, D.; Marques, J. C.; Caçador, I.

    2015-12-01

    Salt marsh environments are harsh environments where salinity comprises one of the most important species distribution shaping factor, presenting sediment salinities from 0 to 855 mM (0-50 ppt). Invasive species have often a high colonizing potential, due to its high plasticity and adaptation ability. Spartina patens is an invasive species already spread along several Mediterranean countries, like France and Spain. Cyperus longus is typically a freshwater species that has been spreading across the Mediterranean. In order to evaluate the ecophysiological fitness of these species, mesocosmos trials were performed subjecting both species to increasing realistic salinity levels and their photochemical and biochemical feedback was evaluated. Both species presented very different behaviours. S. patens appears to be insensitive to salt stress, mostly due to elevated proline concentrations in its leaves allowing it to maintain its osmotic balance, and thus preventing the damaging of its photochemical mechanisms. C. longus, on the other hand, was highly affected by elevated salt levels mostly due to the lack of osmotic balance driven by an incapacity to counteract the elevated ionic strength of the external medium by osmocompatible solutes. S. patens is physiologically highly adapted to saline environments and thus is capable to colonize all the marsh saline environments, while C. longus appears to be an opportunistic invader colonizing the marsh during periods of lower salinities typical from rainy seasons.

  1. All-Endoscopic Single-Row Repair of Full-Thickness Gluteus Medius Tears

    PubMed Central

    Levy, David M.; Bogunovic, Ljiljana; Grzybowski, Jeffrey S.; Kuhns, Benjamin D.; Bush-Joseph, Charles A.; Nho, Shane J.

    2016-01-01

    Abductor tendon tears typically develop insidiously in middle-aged women and can lead to debilitating lateral hip pain and a Trendelenburg limp. The gluteus medius tendon is most commonly torn and may show fatty degeneration over time, similar to the rotator cuff muscles of the shoulder. Endoscopic repair offers a therapeutic alternative to traditional open techniques. This article describes the workup, examination, and endoscopic repair of a full-thickness gluteus medius tear presenting as lateral hip pain and weakness. The surgical repair for this case used a single-row suture anchor technique. In addition, the indications and technique for a double-row repair will be discussed. PMID:27073767

  2. Tendon Transfers for the Hypoplastic Thumb.

    PubMed

    Wall, Lindley B; Goldfarb, Charles A

    2016-08-01

    Thumb hypoplasia is a component of radial longitudinal deficiency. The severity of hypoplasia can range from a slightly smaller thumb to a complete absence. Types II and IIIA hypoplastic thumbs are candidates for reconstruction to improve function, stability, and strength. There are 2 commonly used tendon transfers that can augment thumb opposition strength: the Huber abductor digiti minimi muscle transfer and the flexor digitorum superficialis opposition transfer. Both transfers use ulnar-sided structures to augment the thenar musculature. The Huber opposition transfer increases thenar bulk, but does not provide additional tissue for metacarpophalangeal stability. PMID:27387085

  3. [Sleep and autonomic function: sleep related breathing disorders in Parkinson's disease and related disorders].

    PubMed

    Suzuki, Keisuke; Miyamoto, Masayuki; Miyamoto, Tomoyuki; Hirata, Koichi

    2014-01-01

    In patients with multiple system atrophy (MSA), sleep related breathing disorders (SRBD), including obstructive and central sleep apnea, vocal cord abductor paralysis and dysrhythmic breathing pattern, are frequently observed. SRBD may have a considerable impact on variation of autonomic nervous activity during sleep. The previous studies correlated upper airway muscle dysfunction related parkinsonism with increased prevalence of SRBD in patients with Parkinson's disease (PD). However, recently, the clinical significance of SRBD and its impact on sleepiness and disease severity have been debated. In this review, we discuss sleep and autonomic function, especially, SRBD in PD and related disorders, including the previous studies from our department. PMID:25672703

  4. Rehabilitation of Extra-Articular Sources of Hip Pain in Athletes

    PubMed Central

    Nicholas, Stephen J.

    2007-01-01

    Among people who participate in sports, extra-articular soft tissue injuries around the hip are common. The hamstring, quadriceps, adductor, and abductor muscle groups are often the site of soft tissue injury. Overlapping conditions make it difficult to identify the primary cause of hip pain and dysfunction. A proper evaluation and diagnosis of the impairment are crucial for the selection of interventions and quick return to play. The purpose of the clinical commentary is to present an evidence based stepwise progression in the evaluation and treatment of several common soft tissue injuries of the hip. PMID:21509140

  5. Subject-specific musculoskeletal modelling in patients before and after total hip arthroplasty.

    PubMed

    Wesseling, Mariska; De Groote, Friedl; Meyer, Christophe; Corten, Kristoff; Simon, Jean-Pierre; Desloovere, Kaat; Jonkers, Ilse

    2016-11-01

    The goal of this study was to define the effect on hip contact forces of including subject-specific moment generating capacity in the musculoskeletal model by scaling isometric muscle strength and by including geometrical information in control subjects, hip osteoarthritis and total hip arthroplasty patients. Scaling based on dynamometer measurements decreased the strength of all flexor and abductor muscles. This resulted in a model that lacked the capacity to generate joint moments required during functional activities. Scaling muscle forces based on functional activities and inclusion of MRI-based geometrical detail did not compromise the model strength and resulted in hip contact forces comparable to previously reported measured contact forces. PMID:27123960

  6. Greater Trochanteric Pain Syndrome.

    PubMed

    Redmond, John M; Chen, Austin W; Domb, Benjamin G

    2016-04-01

    Patients who have lateral hip pain historically have been diagnosed with trochanteric bursitis and treated with nonsteroidal anti-inflammatory medications, corticosteroid injections, and physical therapy. Although this strategy is effective for most patients, a substantial number of patients continue to have pain and functional limitations. Over the past decade, our understanding of disorders occurring in the peritrochanteric space has increased dramatically. Greater trochanteric pain syndrome encompasses trochanteric bursitis, external coxa saltans (ie, snapping hip), and abductor tendinopathy. A thorough understanding of the anatomy, examination findings, and imaging characteristics aids the clinician in treating these patients. Open and endoscopic treatment options are available for use when nonsurgical treatment is unsuccessful. PMID:26990713

  7. Biomechanics of the hip and birth in early Homo.

    PubMed

    Ruff, C B

    1995-12-01

    A complex of traits in the femur and pelvis of Homo erectus and early "erectus-like" specimens has been described, but never satisfactorily explained. Here the functional relationships between pelvic and femoral structure in humans are explored using both theoretical biomechanical models and empirical tests within modern samples of diverse body form (Pecos Amerindians, East Africans). Results indicate that a long femoral neck increases mediolateral bending of the femoral diaphysis and decreases gluteal abductor and hip joint reaction forces. Increasing biacetabular breadth along with femoral neck length further increases M-L bending of the femoral shaft and maintains abductor and joint reaction forces at near "normal" levels. When compared to modern humans, Homo erectus and early "erectus-like" specimens are characterized by a long femoral neck and greatly increased M-L relative to A-P bending strength of the femoral shaft, coupled with no decrease in hip joint size and a probable increase in abductor force relative to body size. All of this strongly suggests that biacetabular breadth as well as femoral neck length was relatively large in early Homo. Several features preserved in early Homo partial hip bones also indicate that the true (lower) pelvis was very M-L broad, as well as A-P narrow. This is similar to the lower pelvic shape of australopithecines and suggests that nonrotational birth, in which the newborn's head is oriented transversely through the pelvic outlet, characterized early Homo as well as Australopithecus. Because M-L breadth of the pelvis is constrained by other factors, this may have limited increases in cranial capacity within Homo until rotational birth was established during the late Middle Pleistocene. During or after the transition to rotational birth biacetabular breadth decreased, reducing the body weight moment arm about the hip and allowing femoral neck length (abductor moment arm) to also decrease, both of which reduced M-L bending of

  8. Sevoflurane enhances neuromuscular blockade by increasing the sensitivity of skeletal muscle to neuromuscular blockers

    PubMed Central

    Ye, Ling; Zuo, Yunxia; Zhang, Peng; Yang, Pingliang

    2015-01-01

    The aim of this study was to investigate the effects of sevoflurane on skeletal muscle contractility. In the first part, twenty-two American Society of Anesthesiology (ASA I-II) female adult patients undergoing elective hysterectomy surgery inhaled sevoflurane 1.0, 1.5 and 2.0 minimum alveolar concentrations (MAC) in succession. Neuromuscular function was assessed at each dose. In the second part, forty-four ASA I-II female adult patients were randomized into four groups: group 1 (propofol + atracurium, sevoflurane 0 MAC), and groups 2 to 4 (atracurium + sevoflurane 1.0, 1.5 and 2.0 MAC, respectively). In group 1, patients were anesthetized by propofol. Then 0.01 mg/kg atracurium was injected into the tested arm intravenously after the arterial blood flow was blocked using a tourniquet. For the other 3 groups, patients inhaled 1.0 MAC, 1.5 MAC, or 2.0 MAC of sevoflurane. Then 0.01 mg/kg atracurium was injected. Neuromuscular function was recorded for the 4 groups. Neuromuscular function was assessed by acceleromyography measurement of evoked responses to train-of four (TOF) stimuli (2 Hz for 2 s applied every 12 s) at the adductor pollicis using a TOF-GuardTM neuromuscular transmission monitor. Amplitudes of first response (T1) in each TOF sequence and the ratios of fourth TOF response (T4) to the first were similar at 1.0 MAC, 1.5 MAC, and 2.0 MAC sevoflurane. Compared to baseline, there was no significant change in the TOF value after inhaling 1.0 MAC, 1.5 MAC, or 2.0 MAC sevoflurane. Compared to group 1, there was no significant difference in atracurium onset time (time to reach TOF ratio = 0.25) in group 2 ( 5.6 ± 1.8 min vs. 6.5 ± 1.7 min, P>0.05), or degree of adductor pollicis block (subject number with TOF ratio = 0, 5 vs. 2 subjects, p = 0.3). However, inhaling 1.5 or 2.0 MAC sevoflurane decreased atracurium onset time (4.6 ± 1.5 min and 4.0 ± 1.3 min vs. 6.5 ± 1.7 min, P<0.01 and P<0.001, respectively), and enhanced the block degree (9 and 10 vs. 2

  9. Neuromuscular block after intra-arterially injected acetylcholine

    PubMed Central

    Tonali, P.; Gambi, D.

    1973-01-01

    The neuromuscular depolarizing block induced by intra-arterially injected ACh was studied to determine the variability in the same subject and in different subjects without disorders at the motor end-plate. Amplitude of action potentials of the opponens pollicis muscle evoked by intermittent repetitive supramaximal stimulation of the median nerve at the wrist were recorded for one hour from the beginning of ACh injection. The features of prompt and late depression stages after the injection were analysed statistically. Re-testing of the same subjects after a while shows that, in spite of all efforts to maintain the same experimental conditions, variations do occur in late depression. Time course and duration are particularly affected, while the degree of depression is altered but slightly. The presence of such variations limits this test to evaluation of the influence of other factors only within their already established statistical limits. Images PMID:4350703

  10. The Vascularized Medial Femoral Corticoperiosteal Flap for Thumb Reconstruction

    PubMed Central

    Amin, Kavit; Darhouse, Nagham; Sivakumar, Bran; Floyd, David

    2015-01-01

    Summary: We present an interesting method of shaping a vascularized medial femoral condyle (MFC) flap into a “neophalanx” for phalangeal reconstruction. Our patient presented with limited strength and function secondary to fracture nonunion of the proximal phalanx of the dominant thumb. Following excision of the pseudarthrosis, an MFC corticoperiosteal flap was harvested, sculpted into a prism shape and inset. The superomedial genicular pedicle was anastomosed to the princeps pollicis artery and a cephalic tributary. On follow-up, new bone growth was seen on radiographs and the patient had substantially improved function, with full metacarpophalangeal extension, a Kapandji score of 9, and a markedly reduced Disabilities of the Arm, Shoulder and Hand score of 2.68. The MFC flap is useful for reconstruction of bony defects, with minimal donor morbidity. This versatile vascularized flap can be crafted to requisite shapes and is useful for small defects in the hand, including phalangeal reconstruction. PMID:26495205

  11. From the brachial plexus to the hand, multiple connections between the median and ulnar nerves may serve as bypass routes for nerve fibres.

    PubMed

    Yang, H; Gil, Y; Kim, S; Bang, J; Choi, H; Lee, H Y

    2016-07-01

    Axons from the median and ulnar nerves can pass to each other through aberrant connections between them. Multiple interconnections between the nerves may provide a detour route for nerve fibres going to the hand. We investigated the incidence of variations and the associations between them in 90 cadaveric upper limbs. In 91% of upper limbs, one to five variations were found, with several statistically significant associations. The contribution of the C8 nerve to the lateral cord was positively associated with an accessory contribution of the lateral cord to the ulnar nerve. The latter variation showed positive association with the occurrence of any of the variations in the hand itself. Ulnar innervation of the superficial head of the flexor pollicis brevis was positively associated with the Riche-Cannieu communication. The co-existence of the variations and their associations may be the explanation for unusual clinical findings related to median and ulnar conduction, which appear contrary to anatomical knowledge. PMID:26763269

  12. Neuromuscular block after intra-arterially injected acetylcholine. 1. Introduction, methods, and technique.

    PubMed

    Tonali, P; Gambi, D

    1973-04-01

    The neuromuscular depolarizing block induced by intra-arterially injected ACh was studied to determine the variability in the same subject and in different subjects without disorders at the motor end-plate. Amplitude of action potentials of the opponens pollicis muscle evoked by intermittent repetitive supramaximal stimulation of the median nerve at the wrist were recorded for one hour from the beginning of ACh injection. The features of prompt and late depression stages after the injection were analysed statistically. Re-testing of the same subjects after a while shows that, in spite of all efforts to maintain the same experimental conditions, variations do occur in late depression. Time course and duration are particularly affected, while the degree of depression is altered but slightly. The presence of such variations limits this test to evaluation of the influence of other factors only within their already established statistical limits. PMID:4350703

  13. Efficacy and Safety of a New Botulinum Toxin Type A Free of Complexing Proteins

    PubMed Central

    Oh, Hyun-Mi; Park, Joo Hyun; Song, Dae Heon; Chung, Myung Eun

    2015-01-01

    MT10107 is botulinum neurotoxin type A derived drug which utilizes the 150 kDa portion without complexing proteins and human serum albumin contents. To evaluate the efficacy and the safety of MT10107, it was compared with onabotulinumtoxinA in this double-blind, randomized controlled trial. Twenty-five healthy males received a randomly selected dose of MT10107 into the extensor digitorum brevis (EDB) muscle of one foot, and an equivalent dose of onabotulinumtoxinA (BOTOX) was injected into the contralateral EDB muscle. While efficacy of the administered substance was determined by measuring paretic effects on the EDB, the local spread of toxin effects was evaluated by the paretic effects on the nearby abductor hallucis (AH) and abductor digiti quinti (ADQ) muscles. Paretic effects were defined as the percentage of reduction of the compound muscle action potential (CMAP) amplitudes, measured at 14, 30, 90 days after the injection, compared to the baseline value. Intergroup (MT10107 and onabotulinumtoxinA) differences were not significant in the percentage reduction of the amplitudes in the EDB muscles. In this study, there was no significant difference in efficacy and safety between the two test drugs. MT10107 may be effective and safe as much as onabotulinumtoxinA to produce the desired paretic effect. PMID:26712786

  14. A comparison of the diagnostic accuracy of MARS MRI and ultrasound of the painful metal-on-metal hip arthroplasty

    PubMed Central

    Siddiqui, Imran A; Sabah, Shiraz A; Satchithananda, Keshthra; Lim, Adrian K; Cro, Suzie; Henckel, Johann; Skinner, John A

    2014-01-01

    Background and purpose Metal artifact reduction sequence (MARS) MRI and ultrasound scanning (USS) can both be used to detect pseudotumors, abductor muscle atrophy, and tendinous pathology in patients with painful metal-on-metal (MOM) hip arthroplasty. We wanted to determine the diagnostic test characteristics of USS using MARS MRI as a reference for detection of pseudotumors and muscle atrophy. Patients and methods We performed a prospective cohort study to compare MARS MRI and USS findings in 19 consecutive patients with unilateral MOM hips. Protocolized USS was performed by consultant musculoskeletal radiologists who were blinded regarding clinical details. Reports were independently compared with MARS MRI, the imaging gold standard, to calculate predictive values. Results The prevalence of pseudotumors on MARS MRI was 68% (95% CI: 43–87) and on USS it was 53% (CI: 29–76). The sensitivity of USS in detecting pseudotumors was 69% (CI 39–91) and the specificity was 83% (CI: 36–97). The sensitivity of detection of abductor muscle atrophy was 47% (CI: 24–71). In addition, joint effusion was detected in 10 cases by USS and none were seen by MARS MRI. Interpretation We found a poor agreement between USS and MARS MRI. USS was inferior to MARS MRI for detection of pseudotumors and muscle atrophy, but it was superior for detection of joint effusion and tendinous pathologies. MARS MRI is more advantageous than USS for practical reasons, including preoperative planning and longitudinal comparison. PMID:24694273

  15. ARTHROPLASTY FOR TRAPEZIUM EXCISION AND TENDON INTERPOSITION IN RHIZARTHROSIS CASES: PROSPECTIVE STUDY

    PubMed Central

    Junior, Walter Gomes Pinheiro; Chaim, Renan Moukbel; de Carvalho, Henrique Bella Freire; Albertoni, Walter Manna; Faloppa, Flávio; Santos, João Baptista Gomes dos

    2015-01-01

    Objective: To prospectively evaluate the results from a series of patients who underwent surgical treatment for rhizarthrosis using the technique of trapezium resection associated with interposition of yarn from the long abductor tendon of the thumb. Methods: From May to August 2005, ten patients underwent surgical treatment for rhizarthrosis. Patients with primary osteoarthrosis of the trapezium-metacarpal joint, in stages II, III and IV of the Eaton classification, with persistent pain that was refractory to clinical treatment, were included. For the functional assessment, the visual analogue scale, DASH questionnaire and Buck-Gramcko score were used. For the overall assessment on the patients, strength measurements were made for palm grip, pulp to pulp pinch, lateral pinch, three-point pinch, opposition and radial and palmar abductions. The migration index for the first metacarpal was also determined on radiographs at rest and under stress. Results: The pain relief was considered to be good (p = 0.005), with functional improvements in modules 2 (p = 0.02) and 3 (p = 0.022) of DASH. The Buck-Gramcko score showed one excellent and three very good results. There was an improvement in almost all of the overall assessment and was only non-significant regarding lateral pinch and abduction. For all patients, there was migration of the first metacarpal. Conclusion: Trapeziectomy associated with interposition of yarn from the long abductor tendon of the thumb was shown to be a relatively simple and effective technique for pain relief and functional improvement. PMID:27026990

  16. Compensatory mechanisms during walking in response to muscle weakness in spinal muscular atrophy, type III.

    PubMed

    Matjacić, Zlatko; Olensek, Andrej; Krajnik, Janez; Eymard, Bruno; Zupan, Anton; Praznikar, Ales

    2008-05-01

    Our knowledge on altered neurological control of walking due to weakness of various muscle groups of the lower extremities is limited. The aim of this study was to assess kinematic, kinetic and electromyographic (EMG) walking patterns in a functionally homogeneous group of seven subjects with spinal muscular atrophy, type III (SMA group) and compare them with normal data obtained from nine healthy subjects (CONTROL group) in order to identify characteristic compensatory changes. Muscle strength at the ankle and knee joints was assessed using isokinetic dynamometry to determine variability in muscle strength: this was found to be similar in the two groups. Kinematic, kinetic and EMG patterns were assessed during walking in the SMA and CONTROL groups. The results showed changes in the activity of ankle plantarflexors and associated control of the center of pressure during loading response and midstance, which facilitated minimization of the external flexion moment acting on the knee and hip in the SMA group. Additionally, we identified distinct and consistent changes in the control of hip rotators that act to rapidly extend the hip early in stance phase and in the control of contralateral hip abductors that act delay weight shift onto the leg entering the stance phase. From these results we can conclude that the most important muscle groups compensating for reduced strength in knee and hip muscles are the ankle plantarflexors, hip rotators and hip abductors. This finding would have direct application in rehabilitation treatment programs. PMID:17980600

  17. Greater trochanteric fixation using a cable system for partial hip arthroplasty: a clinical and finite element analysis.

    PubMed

    Ozan, Fırat; Koyuncu, Semmi; Pekedis, Mahmut; Altay, Taşkın; Yıldız, Hasan; Toker, Gökhan

    2014-01-01

    The aim of the study was to investigate the efficacy of greater trochanteric fixation using a multifilament cable to ensure abductor lever arm continuity in patients with a proximal femoral fracture undergoing partial hip arthroplasty. Mean age of the patients (12 men, 20 women) was 84.12 years. Mean follow-up was 13.06 months. Fixation of the dislocated greater trochanter with or without a cable following load application was assessed by finite element analysis (FEA). Radiological evaluation was based on the distance between the fracture and the union site. Harris hip score was used to evaluate final results: outcomes were excellent in 7 patients (21.8%), good in 17 patients (53.1%), average in 5 patients (15.6%), and poor in 1 patient (9.3%). Mean abduction angle was 20.21°. Union was achieved in 14 patients (43.7%), fibrous union in 12 (37.5%), and no union in 6 (18.7%). FEA showed that the maximum total displacement of the greater trochanter decreased when the fractured bone was fixed with a cable. As the force applied to the cable increased, the displacement of the fractured trochanter decreased. This technique ensures continuity of the abductor lever arm in patients with a proximal femoral fracture who are undergoing partial hip arthroplasty surgery. PMID:25177703

  18. Neural correlates of abnormal sensory discrimination in laryngeal dystonia

    PubMed Central

    Termsarasab, Pichet; Ramdhani, Ritesh A.; Battistella, Giovanni; Rubien-Thomas, Estee; Choy, Melissa; Farwell, Ian M.; Velickovic, Miodrag; Blitzer, Andrew; Frucht, Steven J.; Reilly, Richard B.; Hutchinson, Michael; Ozelius, Laurie J.; Simonyan, Kristina

    2015-01-01

    Aberrant sensory processing plays a fundamental role in the pathophysiology of dystonia; however, its underpinning neural mechanisms in relation to dystonia phenotype and genotype remain unclear. We examined temporal and spatial discrimination thresholds in patients with isolated laryngeal form of dystonia (LD), who exhibited different clinical phenotypes (adductor vs. abductor forms) and potentially different genotypes (sporadic vs. familial forms). We correlated our behavioral findings with the brain gray matter volume and functional activity during resting and symptomatic speech production. We found that temporal but not spatial discrimination was significantly altered across all forms of LD, with higher frequency of abnormalities seen in familial than sporadic patients. Common neural correlates of abnormal temporal discrimination across all forms were found with structural and functional changes in the middle frontal and primary somatosensory cortices. In addition, patients with familial LD had greater cerebellar involvement in processing of altered temporal discrimination, whereas sporadic LD patients had greater recruitment of the putamen and sensorimotor cortex. Based on the clinical phenotype, adductor form-specific correlations between abnormal discrimination and brain changes were found in the frontal cortex, whereas abductor form-specific correlations were observed in the cerebellum and putamen. Our behavioral and neuroimaging findings outline the relationship of abnormal sensory discrimination with the phenotype and genotype of isolated LD, suggesting the presence of potentially divergent pathophysiological pathways underlying different manifestations of this disorder. PMID:26693398

  19. A clinical comparative study of anatomic parameters before and after total hip replacement on congenital dysplasia

    PubMed Central

    Huang, Ziqiang; Zhou, Yonggang; Chai, Wei; Ji, Weiping; Cui, Guopeng; Ma, Miaoqun; Zhu, Yin

    2016-01-01

    [Purpose] To study preoperative and postoperative hip circumference data of various types of congenital dysplasia of the hip treated with total hip replacement, including the femoral offset, femoral neck length, height, and hip abductor arm parameters. [Subjects and Methods] This study included seventy-eight cases of congenital dysplasia of the hip (I–III type). Furthermore, four parameters were measured, including the preoperative and postoperative femoral offset. Statistical data analysis was performed using the SPSS 13.0 software. [Results] The femoral offset was 33.3 ± 8.4 mm (preoperative) and 39.1 ± 7.1 mm (postoperative). The femoral head height was 59.5 ± 8.7 mm (preoperative) and 68.8 ± 11.0 mm (postoperative). The femoral neck length was 50.8 ± 10.8 mm (preoperative) and 61.5 ± 10.4 mm (postoperative). The hip abductor arm was 54.3 ± 9.6 mm (preoperative) 64.7 ± 10.1 mm (postoperative). The preoperative and postoperative parameters showed statistical differences. Furthermore, no significant differences were evidenced when comparing the postoperative hip parameters with the normal data parameters. [Conclusion] Total hip replacement on congenital dysplasia of the hip could lead to the rebuilt of an almost normal physiological anatomy for each hip case (type I–III). PMID:27512242

  20. A clinical comparative study of anatomic parameters before and after total hip replacement on congenital dysplasia.

    PubMed

    Huang, Ziqiang; Zhou, Yonggang; Chai, Wei; Ji, Weiping; Cui, Guopeng; Ma, Miaoqun; Zhu, Yin

    2016-07-01

    [Purpose] To study preoperative and postoperative hip circumference data of various types of congenital dysplasia of the hip treated with total hip replacement, including the femoral offset, femoral neck length, height, and hip abductor arm parameters. [Subjects and Methods] This study included seventy-eight cases of congenital dysplasia of the hip (I-III type). Furthermore, four parameters were measured, including the preoperative and postoperative femoral offset. Statistical data analysis was performed using the SPSS 13.0 software. [Results] The femoral offset was 33.3 ± 8.4 mm (preoperative) and 39.1 ± 7.1 mm (postoperative). The femoral head height was 59.5 ± 8.7 mm (preoperative) and 68.8 ± 11.0 mm (postoperative). The femoral neck length was 50.8 ± 10.8 mm (preoperative) and 61.5 ± 10.4 mm (postoperative). The hip abductor arm was 54.3 ± 9.6 mm (preoperative) 64.7 ± 10.1 mm (postoperative). The preoperative and postoperative parameters showed statistical differences. Furthermore, no significant differences were evidenced when comparing the postoperative hip parameters with the normal data parameters. [Conclusion] Total hip replacement on congenital dysplasia of the hip could lead to the rebuilt of an almost normal physiological anatomy for each hip case (type I-III). PMID:27512242

  1. [Anatomical variants of the medial calcaneal nerve and the Baxter nerve in the tarsal tunnel].

    PubMed

    Martín-Oliva, X; Elgueta-Grillo, J; Veliz-Ayta, P; Orosco-Villaseñor, S; Elgueta-Grillo, M; Viladot-Perice, R

    2013-01-01

    The tarsal tunnel is composed of the posterior border of the medial malleoulus, the posterior aspect of the talus and the medial aspect of the calcaneus. The medial calcaneal nerve emerges from the posterior aspect of the posterior tibial nerve in 75% of cases and from the lateral plantar nerve in the remaining 25%. Finally, the medial calcaneal nerve ends as a single terminal branch in 79% of cases and in numerous terminal branches in the remaining 21%. To describe the anatomical variants of the posterior tibial nerve and its terminal branches. To describe the steps for tarsal tunnel release. To describe Baxter nerve release. The anatomical variants of the posterior tibial nerve and its terminal branches within the tarsal tunnel were studied. Then the Lam technique was performed; it consists of: 1) opening of the laciniate ligament, 2) opening of the fascia over the abductor hallucis muscle, 3) exoneurolysis of the posterior tibial nerve and its terminal branches, identifying the emergence and pathway of the medial calcaneal branch, the lateral plantar nerve and its Baxter nerve branch and the medial plantar nerve. Baxter nerve was found in 100% of cases. In 100% of cases in our series the nerve going to the abductor digiti minimi muscle of the foot was found; 87.5% of cases had two terminal branches. The dissections proved that a crucial step was the release of the distal tarsal tunnel. PMID:24701749

  2. Comments and corrections on 3D modeling studies of locomotor muscle moment arms in archosaurs.

    PubMed

    Bates, Karl; Maidment, Susannah C R; Schachner, Emma R; Barrett, Paul M

    2015-01-01

    In a number of recent studies we used computer modeling to investigate the evolution of muscle leverage (moment arms) and function in extant and extinct archosaur lineages (crocodilians, dinosaurs including birds and pterosaurs). These studies sought to quantify the level of disparity and convergence in muscle moment arms during the evolution of bipedal and quadrupedal posture in various independent archosaur lineages, and in doing so further our understanding of changes in anatomy, locomotion and ecology during the group's >250 million year evolutionary history. Subsequent work by others has led us to re-evaluate our models, which revealed a methodological error that impacted on the results obtained from the abduction-adduction and long-axis rotation moment arms in our published studies. In this paper we present corrected abduction-adduction and long axis rotation moment arms for all our models, and evaluate the impact of this new data on the conclusions of our previous studies. We find that, in general, our newly corrected data differed only slightly from that previously published, with very few qualitative changes in muscle moments (e.g., muscles originally identified as abductors remained abductors). As a result the majority of our previous conclusions regarding the functional evolution of key muscles in these archosaur groups are upheld. PMID:26500810

  3. Excitability of the infraspinatus, but not the middle deltoid, is affected by shoulder elevation angle.

    PubMed

    Lin, Yin-Liang; Christie, Anita; Karduna, Andrew

    2015-06-01

    Although both the rotator cuff and deltoid muscle serve as shoulder abductors, they play different roles in shoulder movement. While the deltoid is a primary abductor, the rotator cuff is a stabilizer. They have different anatomic structures for force production and demonstrate different neuromuscular control at different shoulder angles, as measured by electromyographic activity. Corticospinal excitability may be associated with different neuromuscular control of the deltoid and rotator cuff at different angles. The purpose of this study was to investigate how shoulder joint position influences the corticospinal excitability of the deltoid and rotator cuff muscles. Transcranial magnetic stimulation was used to measure the corticospinal excitability of the middle deltoid and infraspinatus at 0° and 90° of arm elevation. Three parameters, a plateau value, exponential parameter, and threshold, were calculated from the input-output curve of the corticospinal pathway. The plateau value of the infraspinatus was significantly higher at 90° of arm elevation, while there is no difference in the excitability in the middle deltoid between elevation angles. The plateau value of the middle deltoid at 90° was 5 % lower than that at 0°, but the plateau value of infraspinatus at 90° was 55 % higher than that at 0°. This suggests that the modulation of excitability varies with shoulder angle and reveals different neurological mechanism for the roles of the deltoid and rotator cuff. PMID:25814379

  4. How human gait responds to muscle impairment in total knee arthroplasty patients: Muscular compensations and articular perturbations.

    PubMed

    Ardestani, Marzieh M; Moazen, Mehran

    2016-06-14

    Post-surgical muscle weakness is prevalent among patients who undergo total knee arthroplasty (TKA). We conducted a probabilistic multi-body dynamics (MBD) to determine whether and to what extent habitual gait patterns of TKA patients may accommodate strength deficits in lower extremity muscles. We analyzed muscular and articular compensations in response to various muscle impairments, and the minimum muscle strength requirements needed to preserve TKA gait patterns in its habitual status. Muscle weakness was simulated by reducing the strength parameter of muscle models in MBD analysis. Using impaired models, muscle and joint forces were calculated and compared versus those from baseline gait i.e. TKA habitual gait before simulating muscle weakness. Comparisons were conducted using a relatively new statistical approach for the evaluation of gait waveforms, i.e. Spatial Parameter Mapping (SPM). Principal component analysis was then conducted on the MBD results to quantify the sensitivity of every joint force component to individual muscle impairment. The results of this study contain clinically important, although preliminary, suggestions. Our findings suggested that: (1) hip flexor and ankle plantar flexor muscles compensated for hip extensor weakness; (2) hip extensor, hip adductor and ankle plantar flexor muscles compensated for hip flexor weakness; (3) hip and knee flexor muscles responded to hip abductor weakness; (4) knee flexor and hip abductor balanced hip adductor impairment; and (5) knee extensor and knee flexor weakness were compensated by hip extensor and hip flexor muscles. Future clinical studies are required to validate the results of this computational study. PMID:27063251

  5. The core and hip in soccer athletes compared by gender.

    PubMed

    Brophy, R H; Chiaia, T A; Maschi, R; Dodson, C C; Oh, L S; Lyman, S; Allen, A A; Williams, R J

    2009-09-01

    Gender differences in hip and core strength and range of motion may contribute to the gender based variance in injury risk. This study was designed to test the primary hypothesis that hip and core strength, flexibility and lower extremity dynamic alignment differ in male and female soccer athletes. Ninety-eight collegiate soccer players (54 male, 44 female) participated in this study. Athletes were evaluated for hip range of motion, and hip and abdominal strength. Both male and female soccer players demonstrated limited hip rotation, with less hip internal rotation in males (p<0.0001), and poor abdominal core control, although the males are stronger (p=0.02). Overall hip ROM is shifted towards internal rotation in females compared to males. Female soccer players also have a significant side-to-side disparity in hip abductor strength (p<0.0001), not present in males. The shift in hip ROM towards internal rotation combined with the hip abductor imbalance may be associated with a position of ACL risk with internally rotated hips and valgus knees in female soccer players. Limitations in hip and core strength and range of motion may play a role in the disparity between the male and female rate of ACL injury. PMID:19585403

  6. Comments and corrections on 3D modeling studies of locomotor muscle moment arms in archosaurs

    PubMed Central

    Maidment, Susannah C.R.; Schachner, Emma R.; Barrett, Paul M.

    2015-01-01

    In a number of recent studies we used computer modeling to investigate the evolution of muscle leverage (moment arms) and function in extant and extinct archosaur lineages (crocodilians, dinosaurs including birds and pterosaurs). These studies sought to quantify the level of disparity and convergence in muscle moment arms during the evolution of bipedal and quadrupedal posture in various independent archosaur lineages, and in doing so further our understanding of changes in anatomy, locomotion and ecology during the group’s >250 million year evolutionary history. Subsequent work by others has led us to re-evaluate our models, which revealed a methodological error that impacted on the results obtained from the abduction–adduction and long-axis rotation moment arms in our published studies. In this paper we present corrected abduction–adduction and long axis rotation moment arms for all our models, and evaluate the impact of this new data on the conclusions of our previous studies. We find that, in general, our newly corrected data differed only slightly from that previously published, with very few qualitative changes in muscle moments (e.g., muscles originally identified as abductors remained abductors). As a result the majority of our previous conclusions regarding the functional evolution of key muscles in these archosaur groups are upheld. PMID:26500810

  7. Severe Pelvic Obliquity Affects Femoral Offset in Patients with Total Hip Arthroplasty but Not Leg-Length Inequality

    PubMed Central

    Zhou, Xiaoxiao; Wang, Qi; Zhang, Xianlong; Chen, Yunsu; Peng, Xiaochun; Mao, Yuanqing; Yang, Yang; Fu, Beigang; Wang, Xiuhui; Tang, Tingting

    2015-01-01

    Leg-length inequality is an extensively studied complication of total hip arthroplasty in normal patients. However, few studies have focused on the pelvic obliquity of coronal pelvic malrotation. We hypothesized that pelvic obliquity with a fixed abduction/adduction contracture deformity of the hip may intraoperatively affect the release of soft tissues, ultimately resulting in a leg-length inequality. This study also investigated whether the femoral and vertical offsets of total hip arthroplasty were correlated with pelvic obliquity. This prospective study divided 98 patients into six groups based on the inclination of pelvic obliquity before total hip arthroplasty. Leg-length inequality, variation of pelvic obliquity, offset, and vertical offset were measured after total hip arthroplasty. Leg-length inequality and vertical offset were not significantly different among groups, whereas the variation of pelvic obliquity was significantly higher in type IIC pelvic obliquity than in other groups. Type IC pelvic obliquity had a significantly shorter offset than did the other groups, which may have been an important factor leading to type IC pelvic obliquity. Pelvic obliquity exhibited no significant effect on leg-length inequality in patients with total hip arthroplasty. A shorter offset may be caused by the higher tension of the abductor in the operated hip, which may result in the formation of type IC pelvic obliquity. Releasing the abductor contracture and restoring femoral offset are important for increasing hip stability and maintaining pelvic balance following total hip arthroplasty. PMID:26673427

  8. Comparison of functional outcome of total hip arthroplasties involving four surgical approaches.

    PubMed

    Mostardi, R A; Askew, M J; Gradisar, I A; Hoyt, W A; Snyder, R; Bailey, B

    1988-01-01

    One hundred thirty-seven total hip arthroplasty patients had a follow-up evaluation consisting of an orthopaedic physical evaluation, isokinetic strength testing, and collection of demographic and surgical information from medical records. The intraoperative variables of surgical time and blood loss and the functional outcome status of the subjects, as demonstrated by D'Aubigne--Postel ratings and isokinetic strength tests, were compared for various trochanteric management techniques: no osteotomy; complete Charnley-type osteotomy; sharp abductor release; and a wafer technique, in which a wafer of bone was osteotomized from the trochanter to release the abductors. A comparison of the mean values for the variables indicated that the wafer and sharp techniques were superior to the complete and no osteotomy techniques. The wafer technique resulted in statistically significant superior isokinetic strength measured in adduction, flexion, and extension. Surgical time was significantly greater in the complete osteotomy cases and blood loss was least in the wafer cases, although these differences were not significant. PMID:3183682

  9. Efficacy and Safety of a New Botulinum Toxin Type A Free of Complexing Proteins.

    PubMed

    Oh, Hyun-Mi; Park, Joo Hyun; Song, Dae Heon; Chung, Myung Eun

    2016-01-01

    MT10107 is botulinum neurotoxin type A derived drug which utilizes the 150 kDa portion without complexing proteins and human serum albumin contents. To evaluate the efficacy and the safety of MT10107, it was compared with onabotulinumtoxinA in this double-blind, randomized controlled trial. Twenty-five healthy males received a randomly selected dose of MT10107 into the extensor digitorum brevis (EDB) muscle of one foot, and an equivalent dose of onabotulinumtoxinA (BOTOX) was injected into the contralateral EDB muscle. While efficacy of the administered substance was determined by measuring paretic effects on the EDB, the local spread of toxin effects was evaluated by the paretic effects on the nearby abductor hallucis (AH) and abductor digiti quinti (ADQ) muscles. Paretic effects were defined as the percentage of reduction of the compound muscle action potential (CMAP) amplitudes, measured at 14, 30, 90 days after the injection, compared to the baseline value. Intergroup (MT10107 and onabotulinumtoxinA) differences were not significant in the percentage reduction of the amplitudes in the EDB muscles. In this study, there was no significant difference in efficacy and safety between the two test drugs. MT10107 may be effective and safe as much as onabotulinumtoxinA to produce the desired paretic effect. PMID:26712786

  10. Effects of an auditory biofeedback device on plantar pressure in patients with chronic ankle instability.

    PubMed

    Donovan, Luke; Feger, Mark A; Hart, Joseph M; Saliba, Susan; Park, Joseph; Hertel, Jay

    2016-02-01

    Chronic ankle instability (CAI) patients have been shown to have increased lateral column plantar pressure throughout the stance phase of gait. To date, traditional CAI rehabilitation programs have been unable to alter gait. We developed an auditory biofeedback device that can be worn in shoes that elicits an audible cue when an excessive amount of pressure is applied to a sensor. This study determined whether using this device can decrease lateral plantar pressure in participants with CAI and alter surface electromyography (sEMG) amplitudes (anterior tibialis, peroneus longus, medial gastrocnemius, and gluteus medius). Ten CAI patients completed baseline treadmill walking while in-shoe plantar pressures and sEMG were measured (baseline condition). Next, the device was placed into the shoe and set to a threshold that would elicit an audible cue during each step of the participant's normal gait. Then, participants were instructed to walk in a manner that would not trigger the audible cue, while plantar pressure and sEMG measures were recorded (auditory feedback (AUD FB) condition). Compared to baseline, there was a statistically significant reduction in peak pressure in the lateral midfoot-forefoot and central forefoot during the AUD FB condition. In addition, there were increases in peroneus longus and medial gastrocnemius sEMG amplitudes 200ms post-initial contact during the AUD FB condition. The use of this auditory biofeedback device resulted in decreased plantar pressure in the lateral column of the foot during treadmill walking in CAI patients and may have been caused by the increase in sEMG activation of the peroneus longus. PMID:27004629

  11. Muscle Reaction Time During a Simulated Lateral Ankle Sprain After Wet-Ice Application or Cold-Water Immersion

    PubMed Central

    Thain, Peter K.; Bleakley, Christopher M.; Mitchell, Andrew C. S.

    2015-01-01

    Context Cryotherapy is used widely in sport and exercise medicine to manage acute injuries and facilitate rehabilitation. The analgesic effects of cryotherapy are well established; however, a potential caveat is that cooling tissue negatively affects neuromuscular control through delayed muscle reaction time. This topic is important to investigate because athletes often return to exercise, rehabilitation, or competitive activity immediately or shortly after cryotherapy. Objective To compare the effects of wet-ice application, cold-water immersion, and an untreated control condition on peroneus longus and tibialis anterior muscle reaction time during a simulated lateral ankle sprain. Design Randomized controlled clinical trial. Setting University of Hertfordshire human performance laboratory. Patients or Other Participants A total of 54 physically active individuals (age = 20.1 ± 1.5 years, height = 1.7 ± 0.07 m, mass = 66.7 ± 5.4 kg) who had no injury or history of ankle sprain. Intervention(s) Wet-ice application, cold-water immersion, or an untreated control condition applied to the ankle for 10 minutes. Main Outcome Measure(s) Muscle reaction time and muscle amplitude of the peroneus longus and tibialis anterior in response to a simulated lateral ankle sprain were calculated. The ankle-sprain simulation incorporated a combined inversion and plantar-flexion movement. Results We observed no change in muscle reaction time or muscle amplitude after cryotherapy for either the peroneus longus or tibialis anterior (P > .05). Conclusions Ten minutes of joint cooling did not adversely affect muscle reaction time or muscle amplitude in response to a simulated lateral ankle sprain. These findings suggested that athletes can safely return to sporting activity immediately after icing. Further evidence showed that ice can be applied before ankle rehabilitation without adversely affecting dynamic neuromuscular control. Investigation in patients with acute ankle sprains is

  12. Outcome of radial head preserving operations in missed Monteggia fracture in children

    PubMed Central

    Garg, Parag; Baid, Prashant; Sinha, Shivam; Ranjan, Rajeev; Bandyopadhyay, Utpal; Mitra, SR

    2011-01-01

    Background: The dislocated radial head in missed Monteggia fracture loses its concave articular surface and displays hypertrophic changes and flattened humeral capitellum configuration, thereby limiting the range of motion. We evaluated the results of open reduction in missed Monteggia fractures by various techniques. Materials and Methods: Sixty-three missed Monteggia fractures were included in the analysis. We performed four combinations of operation: Group I: 22 patients treated with modified Hirayama ulnar osteotomy plus annular ligament reconstruction with free Palmaris longus grafting; Group II:18 patients treated with modified Hirayama ulnar osteotomy plus annular ligament reconstruction by the Bell Tawse's procedure; Group III-9: patients treated with only modified Hirayama's osteotomy; and Group IV: 14 patients treated with transverse osteotomy of ulna and annular ligament reconstruction by the Bell Tawse's procedure. During followup these cases were assessed for the following parameters: 1) range of motion and 2) mayo elbow performance index (MEPI). Results were noted on follow ups at 3, 6, 12 months and then on yearly basis. Sixty-three patients were followed up for an average duration of 5.6 years (range 3-8 years). Results: The mean range of motion was increased by 45°, 30°, 45°, 20° for Group I, II, III and IV respectively. The average increase in MEPI scores was also almost on the same lines. There was one case of frank dislocation in group III and six cases of subluxation, two each in Groups II, III, and IV. For Annular ligament reconstruction, amongst two procedures, Groups II and IV (Bell Tawse group), had a significant extension lag contributing to the lower increase in the range of motion as compared to the Palmaris longus reconstruction group (group I). Conclusion: Hirayama's osteotomy is inherently more stable than the simple transverse osteotomy and it should be combined with annular ligament reconstruction. Palmaris longus graft for

  13. Digital image analysis of striated skeletal muscle tissue injury during reperfusion after induced ischemia

    NASA Astrophysics Data System (ADS)

    Rosero Salazar, Doris Haydee; Salazar Monsalve, Liliana

    2015-01-01

    Conditions such as surgical procedures or vascular diseases produce arterial ischemia and reperfusion injuries, which generate changes in peripheral tissues and organs, for instance, in striated skeletal muscle. To determine such changes, we conducted an experimental method in which 42 male Wistar rat were selected, to be undergone to tourniquet application on the right forelimb and left hind limb, to induce ischemia during one and three hours, followed by reperfusion periods starting at one hour and it was prolonged up to 32 days. Extensor carpi radialis longus and soleus respectively, were obtained to be processed for histochemical and morphometric analysis. By means of image processing and detection of regions of interest, variations of areas occupied by muscle fibers and intramuscular extracellular matrix (IM-ECM) throughout reperfusion were observed. In extensor carpi radialis longus, results shown reduction in the area occupied by muscle fibers; this change is significant between one hour and three hours ischemia followed by 16 hours, 48 hours and 32 days reperfusión (p˂0.005). To compare only periods of reperfusión that continued to three hours ischemia, were found significant differences, as well. For area occupied by IM-ECM, were identified increments in extensor carpi radialis longus by three hours ischemia and eight to 16 days reperfusion; in soleus, was observed difference by one hour ischemia with 42 hours reperfusion, and three hours ischemia followed by four days reperfusion (p˂0.005). Skeletal muscle develops adaptive changes in longer reperfusion, to deal with induced injury. Descriptions beyond 32 days reperfusion, can determine recovering normal pattern.

  14. Use of superficial peroneal nerve graft for treating peripheral nerve injuries☆

    PubMed Central

    Ribak, Samuel; da Silva Filho, Paulo Roberto Ferreira; Tietzmann, Alexandre; Hirata, Helton Hiroshi; de Mattos, Carlos Augusto; da Gama, Sérgio Augusto Machado

    2016-01-01

    Objective To evaluate the clinical results from treating chronic peripheral nerve injuries using the superficial peroneal nerve as a graft donor source. Methods This was a study on eleven patients with peripheral nerve injuries in the upper limbs that were treated with grafts from the sensitive branch of the superficial peroneal nerve. The mean time interval between the dates of the injury and surgery was 93 days. The ulnar nerve was injured in eight cases and the median nerve in six. There were three cases of injury to both nerves. In the surgery, a longitudinal incision was made on the anterolateral face of the ankle, thus viewing the superficial peroneal nerve, which was located anteriorly to the extensor digitorum longus muscle. Proximally, the deep fascia between the extensor digitorum longus and the peroneal longus muscles was dissected. Next, the motor branch of the short peroneal muscle (one of the branches of the superficial peroneal nerve) was identified. The proximal limit of the sensitive branch was found at this point. Results The average space between the nerve stumps was 3.8 cm. The average length of the grafts was 16.44 cm. The number of segments used was two to four cables. In evaluating the recovery of sensitivity, 27.2% evolved to S2+, 54.5% to S3 and 18.1% to S3+. Regarding motor recovery, 72.7% presented grade 4 and 27.2% grade 3. There was no motor deficit in the donor area. A sensitive deficit in the lateral dorsal region of the ankle and the dorsal region of the foot was observed. None of the patients presented complaints in relation to walking. Conclusions Use of the superficial peroneal nerve as a graft source for treating peripheral nerve injuries is safe and provides good clinical results similar to those from other nerve graft sources. PMID:26962502

  15. No effect of hypergravity on adult rat ventral horn neuron size or SDH activity

    NASA Technical Reports Server (NTRS)

    Roy, R. R.; Ishihara, A.; Moran, M. M.; Wade, C. E.; Edgerton, V. R.

    2001-01-01

    BACKGROUND: Spaceflights of short duration (approximately 2 wk) result in adaptations in the size and/or metabolic properties of a select population of motoneurons located in the lumbosacral region of the rat spinal cord. A decrease in succinate dehydrogenase (SDH, an oxidative marker enzyme) activity of moderately sized (500-800 microm2) motoneurons in the retrodorsolateral region of the spinal cord (L6) has been observed after a 14-d flight. HYPOTHESIS: Our hypothesis was that exposure to short-term hypergravity would result in adaptations in the opposite direction, reflecting a continuum of morphological and biochemical responses in the spinal motoneurons from zero gravity to hypergravity. METHODS: Young, male rats were centrifuged at either 1.5 or 2.0 G for 2 wk. The size and SDH activity of a population of motoneurons in the retrodorsolateral region of the spinal cord (L5) were determined and compared with age-matched rats maintained at 1.0 G. The absolute and relative (to body weight) masses of the soleus, gastrocnemius, adductor longus and tibialis anterior muscles were compared among the three groups. RESULTS: There were no effects of either hypergravity intervention on the motoneuron properties. Rats maintained under hypergravity conditions gained less body mass than rats kept at 1.0 G. For the 1.5 and 2.0 G groups, the muscle absolute mass was smaller and relative mass similar to that observed in the 1.0 G rats, except for the adductor longus. The adductor longus absolute mass was similar to and the relative mass larger in both hypergravity groups than in the 1.0 G group. CONCLUSIONS: Our hypothesis was rejected. The findings suggest that rat motoneurons are more responsive to short-term chronic exposure to spaceflight than to hypergravity conditions.

  16. Diagnosis and clinical manifestations of calcium pyrophosphate and basic calcium phosphate crystal deposition diseases.

    PubMed

    Ea, Hang-Korng; Lioté, Frédéric

    2014-05-01

    Basic calcium phosphate and pyrophosphate calcium crystals are the 2 main calcium-containing crystals that can deposit in all skeletal tissues. These calcium crystals give rise to numerous manifestations, including acute inflammatory attacks that can mimic alarming and threatening differential diagnoses, osteoarthritis-like lesions, destructive arthropathies, and calcific tendinitis. Awareness of uncommon localizations and manifestations such as intraspinal deposition (eg, crowned dens syndrome, tendinitis of longus colli muscle, massive cervical myelopathy compression) prevents inappropriate procedures and cares. Coupling plain radiography, ultrasonography, computed tomography, and synovial fluid analysis allow accurate diagnosis by directly or indirectly identifying the GRAAL of microcrystal-related symptoms. PMID:24703344

  17. Problems in analysis of data from muscles of rats flown in space

    NASA Technical Reports Server (NTRS)

    Tischler, M. E.; Henriksen, E.; Jacob, S.; Satarug, S.; Cook, P.

    1988-01-01

    Comparison of hindlimb muscles of rats flown on Spacelab-3 or tail-traction-suspended showed that 11-17 h reloading post-flight might have altered the results. Soleus atrophied, plantaris, gastrocnemius and extensor digitorum longus grew slower, and tibialis anterior grew normally. In both flight and simulated soleus and plantaris, higher tyrosine and greater glutamine/glutamate ratio indicated negative protein balance and increased glutamine production, respectively, relative to controls. Aspartate was lower in these muscles. Reloading generally decreased tyrosine, but increased aspartate and glutamine/glutamate. These data showed that at 12 h of reloading after flight is characterized by reversal to varying extents of effects of unloading.

  18. Problems in analysis of data from muscles of rats flow in space

    NASA Technical Reports Server (NTRS)

    Tischler, Marc E.; Henriksen, Erik; Jacob, Stephan; Satarug, Soisungwan; Cook, Paul

    1988-01-01

    Comparison of hind-limb muscles of rats flown on Spacelab-3 or tail-traction-suspended showed that 11-17 h reloading postflight might have altered the results. Soleus atrophied; plantaris, gastrocnemius, and extensor digitorum longus grew slower; and tibialis anteiror grew normally. In both flight and simulated soleus and plantaris, higher tyrosine and greater glutamine/glutamate ratio indicated negative protein balance and increased glutamine production, respectively, relative to controls. Aspartate was lower in these muscles. Reloading generally decreased tyrosine, but increased aspartate and glutamine/glutamate. These data showed that 12 h of reloading after flight is characterized by reversal, to varying extents, of the effects of unloading.

  19. Skeletal muscle metabolism in hypokinetic rats

    NASA Technical Reports Server (NTRS)

    Tischler, M. E.

    1984-01-01

    Muscle growth, protein metabolism, and amino acid metabolism were studied in various groups of rats. Certain groups were adrenaliectomized; some rats were suspended while others (the controls) were weight bearing. Results show that: (1) metabolic changes in the extensor digitorum longus muscle of suspended rats are due primarily to increased circulating glucocorticoids; (2) metabolic changes in the soleus muscle due to higher steroid levels are probably potentiated by greater numbers of steroid receptors; and (3) not all metabolic responses of the soleus muscle to unloading are due to the elevated levels of glucocorticoids or the increased sensitivity of this muscle to these hormones.

  20. Structures at risk with medial double hindfoot fusion: a cadaveric study.

    PubMed

    Galli, Melissa M; Scott, Ryan T; Bussewitz, Bradly; Hatic, Safet; Hyer, Christopher F

    2014-01-01

    Although discussed as an alternative to triple arthrodesis for hindfoot correction, the published data surrounding the medial double arthrodesis, or fusion of the subtalar and talonavicular joints, has not addressed the proximity of the anatomic structures at risk. A total of 10 cadaver specimens were used to examine the risk of damage to the neurovascular and tendinous structures of the posterior medial hindfoot when performing the medial double arthrodesis. The distance of the reviewed structures was measured in relation to the standardized point of the middle facet of the calcaneus (mean ± standard deviation and range). The proximity of the middle facet to the posterior tibial tendon was 1.88 ± 2.65 (range 0 to 6.65) mm, to the flexor digitorum longus tendon was 5.34 ± 4.79 (range -3.14 to 12.79) mm, to the flexor hallucis longus tendon was 19.08 ± 4.84 (range 13.04 to 27.31) mm, and to the neurovascular bundle was 21.19 ± 7.84 (range 8.36 to 34.26) mm. At the level of the middle facet, the posterior tibial tendon was the largest tendon, measuring 7.14 ± 2.21 (range 3.31 to 10.23) mm by 2.95 ± 0.88 mm (range 1.86 to 4.24 mm; area 22.37 ± 12.23 mm(2), range 6.16 to 43.38 mm) followed by the flexor digitorum longus tendon at 4.25 ± 1.25 (range 1.74 to 5.95) mm by 2.25 ± 0.96 mm (range 1.41 to 4.79 mm; area 8.88 ± 2.62 mm(2), range 6.12 to 14.52 mm) and flexor hallucis longus tendon at 5.75 ± 2.05 (range 2.27 to 8.91) mm by 2.75 ± 0.82 mm (range 1.35 to 4.13 mm; area 16.81 ± 10.05 mm(2), range 4.81 to 36.80 mm). During dissection for the medial double arthrodesis, one can encounter critical anatomic structures, including artery, vein, nerve, and tendon. Our cadaveric investigation found a mean safe distance of more than 2 cm between the middle facet of the talocalcaneal articulation and the inferiorly located neurovascular bundle using the medial double arthrodesis approach. PMID:24751588

  1. Acute Prevertebral Calcific Tendinitis

    PubMed Central

    Tamm, Alexander; Jeffery, Caroline C; Ansari, Khalid; Naik, Sandeep

    2015-01-01

    We present a case of neck pain in a middle-aged woman, initially attributed to a retropharyngeal infection and treated with urgent intubation. With the help of computed tomography, the diagnosis was later revised to acute prevertebral calcific tendinitis, a self-limiting condition caused by abnormal calcium hydroxyapatite deposition in the longus colli muscles. It is critical to differentiate between these two disease entities due to dramatic differences in management. A discussion of acute prevertebral calcific tendinitis and its imaging findings is provided below. PMID:27252789

  2. Insulin effect on amino acid uptake by unloaded rat hindlimb muscles

    NASA Technical Reports Server (NTRS)

    Jaspers, S. R.; Tischler, M. E.

    1988-01-01

    The effect of insulin on the uptake of alpha-amino-isobutyric acid (AIB) by unloaded rat hindlimb muscles was investigated using soleus and extensor digitorum longus (EDL) muscles from intact and adrenalectomized (ADX) rats that were tail-casted for six days. It was found that, at insulin levels above 0.00001 units/ml, the in vitro rate of AIB uptake by muscles from intact animals was stimulated more in the weight bearing muscles than in unloaded ones. In ADX animals, this differential response to insulin was abolished.

  3. Foot and ankle problems in dancers.

    PubMed

    Kadel, Nancy

    2014-11-01

    The dancer's foot and ankle are subjected to high forces and unusual stresses in training and performance. Injuries are common in dancers, and the foot and ankle are particularly vulnerable. Ankle sprains, ankle impingement syndromes, flexor hallucis longus tendonitis, cuboid subluxation, stress fractures, midfoot injuries, heel pain, and first metatarsophalangeal joint problems including hallux valgus, hallux rigidus, and sesamoid injuries will be reviewed. This article will discuss these common foot and ankle problems in dancers and give typical clinical presentation and diagnostic and treatment recommendations. PMID:25442161

  4. Repeated stimuli for axonal growth causes motoneuron death in adult rats: the effect of botulinum toxin followed by partial denervation.

    PubMed

    White, C M; Greensmith, L; Vrbová, G

    2000-01-01

    Axons of motoneurons to tibialis anterior and extensor digitorum longus muscles of adult rats were induced to sprout by injecting botulinum toxin into them, by partial denervation or by a combination of the two procedures. Ten weeks later, the number of motoneurons innervating the control and operated tibialis anterior and extensor digitorum longus muscles was established by retrograde labelling with horseradish peroxidase. In the same preparations, the motoneurons were also stained with a Nissl stain (gallocyanin) to reveal motoneurons in the sciatic pool. Examination of the spinal cords from animals treated with botulinum toxin showed that the number of retrogradely labelled cells and those stained with gallocyanin in the ventral horn on the treated compared to the control side was unchanged. In rats that had their L4 spinal nerve sectioned on one side, the number of retrogradely labelled cells on the operated side was 48+/-3% (n = 5) of that present in the control unoperated ventral horn. Thus, just over half the innervation was removed by cutting the L4 spinal nerve. Counts made from gallocyanin-stained sections showed that 94+/-4% (n = 5) of motoneurons were present in the ventral horn on the operated side. Thus, section of the L4 spinal nerve did not lead to any death of motoneurons. In rats that had their muscles injected with botulinum toxin three weeks prior to partial denervation, the number of retrogradely labelled cells was reduced from 48+/-3% (n = 5) to 35+/-4% (n = 5). Moreover, only 67+/-5% (n = 5) of motoneurons stained with gallocyanin, suggesting that a proportion of motoneurons died after this combined procedure. This result was supported by experiments in which motor unit numbers in extensor digitorum longus muscles were determined by measurements of stepwise increments of force in response to stimulation of the motor nerve with increasing stimulus intensity. In partially denervated extensor digitorum longus muscles, 16.6+/-0.7 (n = 5) motor

  5. Primary Epidural Varicosis as a Rare Cause of Sciatica: A Case Report

    PubMed Central

    Omidi-Kashani, Farzad; Hasankhani, Ebrahim Ghayem; Fathi, Mahdi

    2015-01-01

    Non-discogenic sciatica can be caused by any lesion along the course of the lumbosacral nerve roots and sciatic nerve. We aim to present a rare case of refractory sciatica in an otherwise healthy 25-year-old man. He complained of left leg pain without significant back pain. Extensor hallucis longus muscle was weak on the left side with limited straight leg rising. On magnetic resonance imaging, a space-occupying lesion resembling a sequestrated disc was noted that after surgical decompression, epidural varicosis was demonstrated. PMID:26538785

  6. Transformer design tradeoffs

    NASA Technical Reports Server (NTRS)

    Mclyman, W. T.

    1976-01-01

    Material was presented to assist transformer designers in the transition from long-used English units to the less familiar metric equivalents. A coordination between the area product numbers ap (product of window and core cross-section areas) and current density J was developed for a given regulation and temperature rise. Straight-line relationships for Ap and Volume, Ap and surface area At and, Ap and weight were developed. These relationships can now be used as new tools to simplify and standardize the process of transformer design. They also made it possible to design transformers of small bulk and volume or to optimize efficiency.

  7. Isolation, Culture, Functional Assays, and Immunofluorescence of Myofiber-Associated Satellite Cells.

    PubMed

    Vogler, Thomas O; Gadek, Katherine E; Cadwallader, Adam B; Elston, Tiffany L; Olwin, Bradley B

    2016-01-01

    Adult skeletal muscle stem cells, termed satellite cells, regenerate and repair the functional contractile cells in adult skeletal muscle called myofibers. Satellite cells reside in a niche between the basal lamina and sarcolemma of myofibers. Isolating single myofibers and their associated satellite cells provides a culture system that partially mimics the in vivo environment. We describe methods for isolating and culturing intact individual myofibers and their associated satellite cells from the mouse extensor digitorum longus muscle. Following dissection and isolation of individual myofibers we provide protocols for myofiber transplantation, satellite cell transfection, immune detection of satellite cell antigens, and assays to examine satellite cell self-renewal and proliferation. PMID:27492171

  8. All-Inside Posterior Cruciate Ligament Reconstruction: GraftLink Technique

    PubMed Central

    Prince, Matthew R.; Stuart, Michael J.; King, Alexander H.; Sousa, Paul L.; Levy, Bruce A.

    2015-01-01

    Posterior cruciate ligament (PCL) injuries account for nearly 20% of knee ligament injuries. PCL injuries can occur in isolation or, more commonly, in the setting of multiligamentous knee injuries. Isolated PCL disruptions are commonly treated nonoperatively; however, symptomatic grade III injuries, as well as PCL injuries found in multiligamentous injuries, are frequently treated surgically. Several reconstructive techniques exist for the treatment of PCL deficiency without a clear optimal approach. We describe our preferred operative technique to reconstruct the PCL using an all-inside arthroscopic approach with a quadrupled tibialis anterior or peroneus longus allograft with both tibial and femoral suspensory fixation. PMID:26900564

  9. Design parameters for toroidal and bobbin magnetics. [conversion from English to metric units

    NASA Technical Reports Server (NTRS)

    Mclyman, W. T.

    1974-01-01

    The adoption by NASA of the metric system for dimensioning to replace long-used English units imposes a requirement on the U.S. transformer designer to convert from the familiar units to the less familiar metric equivalents. Material is presented to assist in that transition in the field of transformer design and fabrication. The conversion data makes it possible for the designer to obtain a fast and close approximation of significant parameters such as size, weight, and temperature rise. Nomographs are included to provide a close approximation for breadboarding purposes. For greater convenience, derivations of some of the parameters are also presented.

  10. Design parameters of toroidal and bobbin magnetics

    NASA Technical Reports Server (NTRS)

    Mclyman, W. T.

    1973-01-01

    The adoption by NASA of the metric system for dimensioning to replace the long-used English units imposes a requirement on the U.S. transformer designer to convert from the familiar units to the less familiar metric equivalents. Material is presented to assist in that transition in the field of transformer design and fabrication. The conversion data makes it possible for the designer to obtain a fast and close approximation of significant parameters such as size, weight, and temperature rise. Nomographs are included to provide a close approximation for breadboarding purposes. For greater convenience, derivations of some of the parameters are also presented.

  11. Diagnosing adductor muscle avulsion at the symphysis pubis with ultrasound.

    PubMed

    Chen, David J; Caldera, Franklin E; Kim, Woojin

    2014-04-01

    A 58-yr-old woman presented after experiencing left hip and groin pain for 1 mo. She denies any history of trauma, falls or any bruising, or history of sports injury or extreme physical exertion before her symptoms. On ultrasonography, she was found to have an avulsion tear at the origin of the adductor muscles, predominantly involving the adductor longus and brevis muscles. The treatment course was conservative: nonsteroidal anti-inflammatory drugs for pain control and physical therapy for muscle strengthening and balance improvement. Upon follow-up, she demonstrated significant improvement and resolution of her pain. PMID:24196970

  12. Unilateral Adolescent Pes Planus After a Bimalleolar Ankle Fracture: A Case Report.

    PubMed

    Phillips, Staton L; Williams, Daniel; Jeyaseelan, Luckshmana; Bryce, Elaine; Alyas, Faisal; Vemulapalli, Krishna

    2016-01-01

    We present the case of a 14-year-old female who presented with unilateral pes planus 30 months after a bimalleolar ankle fracture dislocation. At surgery, the tibialis posterior tendon was encased in fracture callus within the syndesmosis and required reconstruction using flexor digitorum longus transfer. Dislocation of the tibialis posterior tendon and entrapment within the tibiofibular syndesmosis has been previously reported. To our knowledge, this is the first case report tibialis posterior tendon syndesmotic entrapment presenting with unilateral pes planus. PMID:25648274

  13. All-Inside Posterior Cruciate Ligament Reconstruction: GraftLink Technique.

    PubMed

    Prince, Matthew R; Stuart, Michael J; King, Alexander H; Sousa, Paul L; Levy, Bruce A

    2015-10-01

    Posterior cruciate ligament (PCL) injuries account for nearly 20% of knee ligament injuries. PCL injuries can occur in isolation or, more commonly, in the setting of multiligamentous knee injuries. Isolated PCL disruptions are commonly treated nonoperatively; however, symptomatic grade III injuries, as well as PCL injuries found in multiligamentous injuries, are frequently treated surgically. Several reconstructive techniques exist for the treatment of PCL deficiency without a clear optimal approach. We describe our preferred operative technique to reconstruct the PCL using an all-inside arthroscopic approach with a quadrupled tibialis anterior or peroneus longus allograft with both tibial and femoral suspensory fixation. PMID:26900564

  14. Morphometric Study of the Upper Thoracic Sympathetic Ganglia

    PubMed Central

    Lee, Sang Beom; Park, Sukh Que; Cho, Sung Jin; Choi, Soon Kwan; Bae, Hack Gun

    2011-01-01

    Objective Morphometric data for the sympathetic ganglia (SG) of the upper thoracic spine was investigated to identify the exact location of the SG in order to reduce normal tissue injury in the thoracic cavity during thoracoscopic sympathectomy. Methods In 46 specimens from 23 formalin-fixed adult cadavers, the authors measured the shortest distance from the medial margin of the T1, T2 and T3 SG to the most prominent point and medial margin of the corresponding rib heads, and to the lateral margin of the longus colli muscle. In addition, the distance between the most prominent point of the rib head and the lateral margin of longus colli muscle and the width of each SG were measured. Results The shortest distance from the medial margin of the SG to the prominent point of corresponding rib head was on average 1.9 mm on T1, 4.2 mm, and 4.1 mm on T2, T3. The distance from the medial margin of the SG to the medial margin of the corresponding rib head was 4.2 mm on T1, 5.9 mm, and 6.3 mm on T2, T3. The mean distance from the medial margin of the SG to the lateral margin of the longus colli muscle was 6.7 mm on T1, 8.8 mm, 9.9 and mm on T2, T3. The mean distance between the prominent point of the rib head and the lateral margin of the longus colli muscle was 4.8 mm on T1, 4.6 mm, and 5.9 mm on T2, T3. The mean width of SG was 6.1 mm on T1, 4.1 mm, and 3.1 mm on T2, T3. Conclusion We present morphometric data to assist in surgical planning and the localization of the upper thoracic SG during thoracoscopic sympathectomy. PMID:21892401

  15. beta-adrenergic effects on carbohydrate metabolism in the unweighted rat soleus muscle

    NASA Technical Reports Server (NTRS)

    Kirby, Christopher R.; Tischler, Marc E.

    1990-01-01

    The effect of unweighting on the response of the soleus-muscle carbohydrate metabolism to a beta-adrenergic agonist (isoproterenol) was investigated in rats that were subjected to three days of tail-cast suspension. It was found that isoproterenol promoted glycogen degradation in soleus from suspended rats to a higher degree than in weighted soleus from control rats, and had no effect in unweighted digitorum longus. However, isoproterenol did not have a greater inhibitory effect on the net uptake of tritium-labeled 2-deoxy-glucose by the unweighted soleus and that isoproterenol inhibited hexose phosphorylation less in the unweighted than in the control muscle.

  16. Notes on the genus Ismarus Haliday (Hymenoptera, Diapriidae) from China

    PubMed Central

    Liu, Jing-xian; Chen, Hua-yan; Xu, Zai-fu

    2011-01-01

    Abstract The Chinese species of the genus Ismarus Haliday, 1835, are revised for the first time. Three new species from the Oriental region of China and belonging to Ismarus halidayi-group are described and illustrated: Ismarus longus sp. n., Ismarus nigritrochanter sp. n. and Ismarus parvicellus sp. n. Two species are newly reported for the Chinese fauna: Ismarus dorsiger (Haliday, 1831) and Ismarus halidayi Foerster, 1850. A key to the Chinese species of the genus is provided. The type specimens are deposited in the Hymenopteran Collection of South China Agricultural University, Guangzhou (SCAU). PMID:21852927

  17. Hallux checkrein deformity resulting from the scarring of long flexor muscle belly - case report.

    PubMed

    Boszczyk, Andrzej; Zakrzewski, Piotr; Pomianowski, Stanisław

    2015-01-01

    A case of posttraumatic checkrein deformity of the hallux is presented. This deformity is most often caused by scarring of the muscle belly or tethering of the tendon. A 22-year old woman developed a hallux checkrein deformity after a bimaleolar fracture. Intraoperatively, a linear scar tethering the muscle belly to the posterior tibia was observed. Resection of the scar allowed for full flexor hallucis longus mobility. Full hallux range of motion as well as foot function was restored. The cause of the checkrein deformity in our patient was a scar tethering the flexor hallucis belly to the posterior tibia. PMID:25759157

  18. Morphofunctional responses to anaemia in rat skeletal muscle

    PubMed Central

    Esteva, Santiago; Panisello, Pere; Casas, Mireia; Torrella, Joan Ramon; Pagés, Teresa; Viscor, Ginés

    2008-01-01

    Adult male Sprague-Dawley rats were randomly assigned to two groups: control and anaemic. Anaemia was induced by periodical blood withdrawal. Extensor digitorum longus and soleus muscles were excised under pentobarbital sodium total anaesthesia and processed for transmission electron microscopy, histochemical and biochemical analyses. Mitochondrial volume was determined by transmission electron microscopy in three different regions of each muscle fibre: pericapillary, sarcolemmal and sarcoplasmatic. Muscle samples sections were also stained with histochemical methods (SDH and m-ATPase) to reveal the oxidative capacity and shortening velocity of each muscle fibre. Determinations of fibre and capillary densities and fibre type composition were made from micrographs of different fixed fields selected in the equatorial region of each rat muscle. Determination of metabolites (ATP, inorganic phosphate, creatine, creatine phosphate and lactate) was done using established enzymatic methods and spectrophotometric detection. Significant differences in mitochondrial volumes were found between pericapillary, sarcolemmal and sarcoplasmic regions when data from animal groups were tested independently. Moreover, it was verified that anaemic rats had significantly lower values than control animals in all the sampled regions of both muscles. These changes were associated with a significantly higher proportion of fast fibres in anaemic rat soleus muscles (slow oxidative group = 63.8%; fast glycolytic group = 8.2%; fast oxidative glycolytic group = 27.4%) than in the controls (slow oxidative group = 79.0%; fast glycolytic group = 3.9%; fast oxidative glycolytic group = 17.1%). No significant changes were detected in the extensor digitorum longus muscle. A significant increase was found in metabolite concentration in both the extensor digitorum longus and soleus muscles of the anaemic animals as compared to the control group. In conclusion, hypoxaemic hypoxia causes a reduction in

  19. Influence of electrical stimulation on hip joint adductor muscle activity during maximum effort

    PubMed Central

    Nakano, Sota; Wada, Chikamune

    2016-01-01

    [Purpose] This study investigated whether hip adductor activity was influenced by electrical stimulation of the tensor fascia lata muscle. [Subjects and Methods] The subjects were 16 nondisabled males. Each subject was asked to adduct the hip joint with maximum effort. The electromyogram of the adductor longus was recorded under two experimental conditions, with and without electrical stimulation of the tensor fascia lata. [Results] In the presence of electrical stimulation, muscle activity decreased to 72.9% (57.8–89.3%) of that without stimulation. [Conclusion] These results suggested that inactivation of the adductor group was promoted by electrical stimulation of the tensor fascia lata. PMID:27313387

  20. Evaluation of an in vitro muscle contraction model in mouse primary cultured myotubes.

    PubMed

    Manabe, Yasuko; Ogino, Shinya; Ito, Miyuki; Furuichi, Yasuro; Takagi, Mayumi; Yamada, Mio; Goto-Inoue, Naoko; Ono, Yusuke; Fujii, Nobuharu L

    2016-03-15

    To construct an in vitro contraction model with the primary cultured myotubes, we isolated satellite cells from the mouse extensor digitorum longus. Differentiated myotubes possessed a greater number of sarcomere assemblies and higher expression levels of myosin heavy chain, cytochrome c oxidase IV, and myoglobin than in C2C12 myotubes. In agreement with these results regarding the sarcomere assemblies and protein expressions, the primary myotubes showed higher contractile activity stimulated by the electric pulses than that in the C2C12 myotubes. These data suggest that mouse primary myotubes will be a valuable research tool as an in vitro muscle contraction model. PMID:26548957

  1. Metabolism of branched-chain amino acids in leg muscles from tail-cast suspended intact and adrenalectomized rats

    NASA Technical Reports Server (NTRS)

    Jaspers, Stephen R.; Henriksen, Erik; Jacob, Stephan; Tischler, Marc E.

    1989-01-01

    The effects of muscle unloading, adrenalectomy, and cortisol treatment on the metabolism of branched-chain amino acids in the soleus and extensor digitorum longus of tail-cast suspended rats were investigated using C-14-labeled lucine, isoleucine, and valine in incubation studies. It was found that, compared to not suspended controls, the degradation of branched-chain amino acids in hind limb muscles was accelerated in tail-cast suspended rats. Adrenalectomy was found to abolish the aminotransferase flux and to diminish the dehydrogenase flux in the soleus. The data also suggest that cortisol treatment increases the rate of metabolism of branched-chain amino acids at the dehydrogenase step.

  2. Effects of stretching and disuse on amino acids in muscles of rat hind limbs

    NASA Technical Reports Server (NTRS)

    Jaspers, Stephen R.; Henriksen, Erik J.; Satarug, Soisungwan; Tischler, Marc E.

    1989-01-01

    The effects of disuse and passive stretch on the concentrations of amino acids and ammonia in the unloaded soleus muscle was investigated in hindquarter-suspended (for six days by casting one foot in dorsiflexion) tail-casted rats. For a comparison with the condition of unloading, amino acids and ammonia were also measured in shortened extensor digitorum longus in the same casted limb and in denervated leg muscles. The results obtained suggest that passive stretch diminishes some of the characteristic alterations of amino acid concentrations due to unloading. This effect of stretch is considered to be due to the maintenance of muscle tension.

  3. Clenbuterol, a beta(2)-agonist, retards atrophy in denervated muscles

    NASA Technical Reports Server (NTRS)

    Zeman, Richard J.; Ludemann, Robert; Etlinger, Joseph D.

    1987-01-01

    The effects of a beta(2) agonist, clenbuterol, on the protein content as well as on the contractile strength and the muscle fiber cross-sectional area of various denervated muscles from rats were investigated. It was found that denervated soleus, anterior tibialis, and gastrocnemius muscles, but not the extensor digitorum longus, of rats treated for 2-3 weeks with clenbuterol contained 95-110 percent more protein than denervated controls. The twofold difference in the protein content of denervated solei was paralleled by similar changes in contractile strength and muscle fiber cross-sectional area.

  4. Simulation of tremor on 3-dimentional musculoskeletal model of wrist joint and experimental verification?

    PubMed

    Yao, Peng; Zhang, Dingguo; Hayashibe, Mitsuhiro

    2012-01-01

    A musculoskeletal model that allows to simulate the tremor of wrist joint with three degrees of freedom (DoFs) is developed. The model includes five muscles, extensor carpi radialis brevis, extensor carpi radialis longus, extensor carpi ulnaris, flexor carpi radialis and flexor carpi ulnaris. Simulation of tremor generation based on the 3-DoF model is performed. The tremor disorder can be generated in two directions: flexion-extension and radia-ulnar deviation. Accordingly, experiment is conducted on healthy subjects to verify the feasibility of artificial tremor generation via functional electrical stimulation (FES). Simulation results have shown qualitative agreement with the experimental results. PMID:23367007

  5. [Incidence of scalp involvement by Demodex folliculorum Simon ectoparasites in a pathologic-anatomic and forensic medicine autopsy sample].

    PubMed

    Hellerich, U; Metzelder, M

    1994-01-01

    29% of unselected pathological and forensic autopsy cases revealed mites of the species Demodex folliculorum longus and brevis in hair follicles and sebaceous glands of the scalp. The attack by these parasites was equal in male and female subjects and correlated to the number of sebaceous glands but not to the density of hair follicles. However there was a tendency to an increased number of parasites inhabiting the scalp of people of advanced age, dark hair colour or with a bald head. A chronic lymphocytic infiltration of the skin was conspicuous in more than 70% of cases with Demodicosis folliculorum. PMID:7811138

  6. Surgical approach in primary total hip arthroplasty: anatomy, technique and clinical outcomes

    PubMed Central

    Petis, Stephen; Howard, James L.; Lanting, Brent L.; Vasarhelyi, Edward M.

    2015-01-01

    Total hip arthroplasty (THA) has revolutionized the treatment of hip arthritis. A number of surgical approaches to the hip joint exist, each with unique advantages and disadvantages. The most commonly used approaches include the direct anterior, direct lateral and posterior approaches. A number of technical intricacies allow safe and efficient femoral and acetabular reconstruction when using each approach. Hip dislocation, abductor insufficiency, fracture and nerve injury are complications of THA, although their relative risk varies by approach. Numerous clinical trials have sought to elicit differences in patient-reported outcomes, complication rates and return to function among the surgical approaches. This review outlines some of the technical pearls of performing a THA through either a direct anterior, direct lateral or posterior approach. A literature review outlines the impact of surgical approach on clinical outcomes and clinically relevant complication rates. PMID:25799249

  7. Isokinetic performance of hip muscles after revision total hip arthroplasty via previous anterolateral approach.

    PubMed

    Cankaya, Deniz; Aydin, Cemal; Karakus, Dilek; Toprak, Ali; Ozkurt, Bulent; Tabak, Yalçın

    2015-09-01

    We investigated the isokinetic performance of hip muscles and clinical outcomes after revision total hip arthroplasty (THA) via same anterolateral approach used in primary surgery. Thirty patients who had undergone previous THA via an anterolateral approach underwent both acetabular and femoral component revision after aseptic loosening. The Harris Hip Score (HHS) was evaluated during a minimum 2-year follow-up. The isokinetic muscle strength of the operated and nonoperated hips was assessed 1 year after surgery. The HHS improved from 49.0 to 77.4. Operated and nonoperated hips exhibited similar isokinetic performance during all measurements (flexion, extension, and abduction) (p>0.05). This prospective study showed that the anterolateral approach preserves abductor strength after revision THA in aseptic cases with acceptable functional and clinical results. The main clinical relevance of this study is that the same anterolateral approach used in previous primary THA is also safe and viable for revision THA. PMID:26435233

  8. Vocal fold paresis in Shy-Drager syndrome.

    PubMed

    Hanson, D G; Ludlow, C L; Bassich, C J

    1983-01-01

    Twelve patients with Shy-Drager syndrome (SDS) presenting symptoms of multiple nervous system atrophy and orthostatic hypotension were examined for laryngeal movement disorders and vocal impairment in speech. Vocal fold abductor paresis was found in 11 patients and was bilateral in 10. Speech task performance was recorded in SDS patients, Parkinson patients and age- and sex-matched controls. Trained listeners with inter-rated reliability greater than or equal to .85 judged each recording on 20 attributes while blind to speaker identity. SDS patients had a breathy and strained voice quality, reduced loudness, monopitch and monoloudness, imprecise consonants, variations in rate and rate-slowing, suggesting a flaccid type of dysarthria. In comparison with Parkinson patients, SDS patients had excess vocal hoarseness, intermittent glottal fry and a slow and deliberate speaking rate. Orthostatic hypotension, laryngeal stridor, hoarseness, intermittent glottal fry and slow speech rate were found to be discriminating symptoms of SDS. PMID:6824289

  9. Combined Anterior and Posterior Approach in Total Hip Arthroplasty for Crowe IV Dysplasia or Ankylosed Hips.

    PubMed

    Lee, Young-Kyun; Kim, Ki-Choul; Ha, Yong-chan; Koo, Kyung-Hoi

    2015-05-01

    We evaluated 70 patients (71 hips) who underwent complex total hip arthroplasty (THA) through the combined anterior and posterior approach. Sixty-five patients (32 dislocated hips and 34 ankylosed hips) were followed-up at a minimum of 3 years (median, 6 years; range, 3-10 years). Seven patients (10.6%), who had transient paresthesia on the anterior thigh, recovered within 3 months. All patients had a good clinical outcome in terms of range of motion, pain and recovery of walking. At the latest follow-up, all prostheses had bone-ingrown stability without any detectable wear or osteolysis. The combined approach allows an excellent exposure of the acetabulum for accurate cup alignment, leg lengthening and mobilization of joint in complex THA without trochanteric osteotomy, excessive abductor release and femoral shortening osteotomy. PMID:25682205

  10. Influence of Lateral Muscle Loading in the Proximal Femur after Fracture Stabilization with a Trochanteric Gamma Nail (TGN)

    NASA Astrophysics Data System (ADS)

    Sitthiseripratip, Kriskrai; Mahaisavariya, Banchong; Suwanprateeb, Jintamai; Bohez, Erik; Vander Sloten, Jos

    The purpose of this study was to investigate the influence of lateral muscle loading on the stress/strain distributions of the trochanteric Gamma nail (TGN) fixation within the healed, trochanteric and subtrochanteric femoral fractures by means of a finite element method. The effect of three muscle groups, the abductors (ABD), the vastus lateralis (VL) and the iliotibial band (ITB), were investigated. The analytical results showed that addition of lateral muscle forces, iliotibial band and vastus lateralis, produced compensation of forces and reduction of bending moments in the bone and in the trochanteric Gamma nail especially in the lateral aspect. The iliotibial band produced a higher impact as compared to the vastus lateralis. Therefore in the finite element analysis of the proximal femur with the trochanteric Gamma nail fracture fixation should include the lateral muscle forces to simulate load condition with maximal physiological relevance to the closed nailing technique.

  11. Effectiveness of therapeutic physical exercise in the treatment of patellofemoral pain syndrome: a systematic review

    PubMed Central

    Alba-Martín, Pablo; Gallego-Izquierdo, T; Plaza-Manzano, Gustavo; Romero-Franco, Natalia; Núñez-Nagy, Susana; Pecos-Martín, Daniel

    2015-01-01

    [Purpose] The aim of this study was to analyze the effectiveness of conservative treatment of patellofemoral pain syndrome with physical exercise. [Subjects and Methods] A computer-based review conducted of four databases (PubMed, the Cochrane Library, PEDro, and the University Library) was completed based on the inclusion criteria of patellofemoral pain syndrome patients treated with physical exercise methods and examination with self-reported pain and/or functional questionnaires. [Results] The findings of ten clinical trials of moderate to high quality were evaluated to determine the effectiveness of physical exercise as conservative management for patellofemoral pain syndrome. [Conclusion] The intervention programs that were most effective in relieving pain and improving function in patellofemoral pain syndrome included proprioceptive neuromuscular facilitation stretching and strengthening exercises for the hip external rotator and abductor muscles and knee extensor muscles. PMID:26311988

  12. Salter-Harris type III and IV displaced fracture of the hallux in young gymnasts: A series of four cases at 1-year follow-up.

    PubMed

    Perugia, Dario; Fabbri, Mattia; Guidi, Marco; Lepri, Marco; Masi, Vincenzo

    2014-12-01

    The purpose of this study was to describe four exceptional cases of Salter-Harris type III and IV fractures of the proximal phalanx of the hallux in young high-level gymnasts. All gymnasts underwent the same mechanism of injury of hyperadduction, which indicates a role of the abductor hallucis muscle in the genesis and displacement of these fractures. An open reduction and internal fixation was performed to achieve an anatomical reduction and avoid chronic disability. At 1-year follow-up, all patients had an excellent American Orthopaedic Foot and Ankle Society (AOFAS) score (100 points), and there was no shortening or angulation of the first ray and no evidence of degenerative joint disease on X-ray. Moreover, all the gymnasts had returned to pre-injury levels of sporting activity. To our knowledge, there are no previous studies that address these types of injuries and how they are handled in gymnasts. PMID:25457317

  13. Clinical evaluation of a true percutaneous technique for antegrade femoral nailing.

    PubMed

    Ziran, Bruce H; Smith, Wade R; Zlotolow, D A; Manion, C; Grosskreuz, R; Agudelo, Juan F; Morgan, Steven J

    2005-10-01

    From July 1997 to March 2001, 209 consecutive patients with 215 femoral shaft fractures amenable to antegrade femoral nailing were enrolled. A true percutaneous insertion technique was performed using a stab wound incision. One hundred ninety-seven (92%) fractures achieved primary union with anatomic or near anatomic alignment. Eighteen (8%) healing problems and two deep infections (1%) responded to repeat interventions. There was one iatrogenic complication related to an anterior starting point. External blood loss was minimal (generally <100 cc). Incisions averaged 16 mm and healed uneventfully. At one-year follow-up only 10% of patients had hip abductor pain. The percutaneous technique appears to be a safe and effective alternative to the standard technique. Hip pain at one year appears decreased compared to reports using a traditional approach. PMID:16237882

  14. Histochemical study of posterior cricoarytenoid muscle reinnervation by a nerve-muscle pedicle in the cat.

    PubMed

    Fata, J J; Malmgren, L T; Gacek, R R; Dum, R; Woo, P

    1987-01-01

    Reinnervation of the posterior cricoarytenoid (PCA) muscle with a nerve-muscle pedicle (NMP) has been proposed for patients with bilateral abductor vocal cord paralysis. Since its success has been controversial, a glycogen depletion histochemical technique was used to examine reinnervation. An ansa cervicalis NMP was implanted into the denervated PCA in nine cats. Eight months later, vocal cord activity was evaluated. The NMP nerve was stimulated extensively in seven cats (experimental group). Optical densities of NMP-supplied PCA muscle fibers from experimental and control groups were compared to detect differences in glycogen content. The results demonstrated quantitative evidence of reinnervation in two experimental animals. Electrical stimulation of the NMP produced abduction in one of these two animals, but was never observed during spontaneous respiration or airway occlusion. These observations indicate that reinnervation can occur but abduction requires electrical stimulation. The NMP technique may be more successful with an electrical pacer. PMID:3674642

  15. Surgical Treatment of Pediatric Upper Limb Spasticity: The Shoulder.

    PubMed

    Seruya, Mitchel; Johnson, Joshua D

    2016-02-01

    The shoulder joint is essential for placing the hand in a functional position for reach and overhead activities. This depends on the delicate balance between abductor/adductor and internal/external rotator muscles. Spasticity alters this equilibrium, limiting the interaction of the upper limb with the environment. Classically, pediatric patients with upper limb spasticity present with an adduction and internal rotation contracture of the shoulder. These contractures are typically secondary to spasticity of the pectoralis major and subscapularis muscles and sometimes attributed to the latissimus dorsi muscle. Fractional lengthening, Z-step lengthening, or tendon release of the contributing muscle groups may help correct the adduction and internal rotation contractures. With proper diagnosis, a well-executed surgical plan, and a consistent hand rehabilitation regimen, successful surgical outcomes can be achieved. PMID:26869863

  16. Age-related differences in the maintenance of frontal plane dynamic stability while stepping to targets

    PubMed Central

    Hurt, Christopher P.; Grabiner, Mark D.

    2015-01-01

    Older adults may be vulnerable to frontal plane dynamic instability, which is of clinical significance. The purpose of the current investigation was to examine the age-related differences in frontal plane dynamic stability by quantifying the margin of stability and hip abductor moment generation of subjects performing a single crossover step and sidestep to targets that created three different step widths during forward locomotion. Nineteen young adults (9 males, age: 22.9±3.1 years, height: 174.3±10.2 cm, mass: 71.7±13.0 kg) and 18 older adults (9 males, age: 72.8±5.2 years, height: 174.9±8.6 cm, mass: 78.0±16.3 kg) participated. For each walking trial, subjects performed a single laterally-directed step to a target on a force plate. Subjects were instructed to “perform the lateral step and keep walking forward”. The peak hip abductor moment of the stepping limb was 42% larger by older adults compared to younger adults (p<0.001). Older adults were also more stable than younger adults at all step targets (p<0.001). Older adults executed the lateral step with slower forward-directed and lateral-directed velocity despite similar step widths. Age-related differences in hip abduction moments may reflect greater muscular effort by older adults to reduce the likelihood of becoming unstable. The results of this investigation, in which subjects performed progressively larger lateral-directed steps, provide evidence that older adults may not be more laterally unstable than younger adults. However, age-related differences in this study could also reflect a compensatory strategy by older adults to ensure stability while performing this task. PMID:25627870

  17. Transcutaneous spinal direct current stimulation modulates human corticospinal system excitability.

    PubMed

    Bocci, Tommaso; Marceglia, Sara; Vergari, Maurizio; Cognetto, Valeria; Cogiamanian, Filippo; Sartucci, Ferdinando; Priori, Alberto

    2015-07-01

    This study aimed to assess the effects of thoracic anodal and cathodal transcutaneous spinal direct current stimulation (tsDCS) on upper and lower limb corticospinal excitability. Although there have been studies assessing how thoracic tsDCS influences the spinal ascending tract and reflexes, none has assessed the effects of this technique over upper and lower limb corticomotor neuronal connections. In 14 healthy subjects we recorded motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) from abductor hallucis (AH) and hand abductor digiti minimi (ADM) muscles before (baseline) and at different time points (0 and 30 min) after anodal or cathodal tsDCS (2.5 mA, 20 min, T9-T11 level). In 8 of the 14 subjects we also tested the soleus H reflex and the F waves from AH and ADM before and after tsDCS. Both anodal and cathodal tsDCS left the upper limb MEPs and F wave unchanged. Conversely, while leaving lower limb H reflex unchanged, they oppositely affected lower limb MEPs: whereas anodal tsDCS increased resting motor threshold [(mean ± SE) 107.33 ± 3.3% increase immediately after tsDCS and 108.37 ± 3.2% increase 30 min after tsDCS compared with baseline] and had no effects on MEP area and latency, cathodal tsDCS increased MEP area (139.71 ± 12.9% increase immediately after tsDCS and 132.74 ± 22.0% increase 30 min after tsDCS compared with baseline) without affecting resting motor threshold and MEP latency. Our results show that tsDCS induces polarity-specific changes in corticospinal excitability that last for >30 min after tsDCS offset and selectively affect responses in lower limb muscles innervated by lumbar and sacral motor neurons. PMID:25925328

  18. Reliability of new software in measuring cervical multifidus diameters and shoulder muscle strength in a synchronized way; an ultrasonographic study

    PubMed Central

    Rahnama, Leila; Rezasoltani, Asghar; Khalkhali-Zavieh, Minoo; Rahnama, Behnam; Noori-Kochi, Farhang

    2015-01-01

    OBJECTIVES: This study was conducted with the purpose of evaluating the inter-session reliability of new software to measure the diameters of the cervical multifidus muscle (CMM), both at rest and during isometric contractions of the shoulder abductors in subjects with neck pain and in healthy individuals. METHOD: In the present study, the reliability of measuring the diameters of the CMM with the Sonosynch software was evaluated by using 24 participants, including 12 subjects with chronic neck pain and 12 healthy individuals. The anterior-posterior diameter (APD) and the lateral diameter (LD) of the CMM were measured in a resting state and then repeated during isometric contraction of the shoulder abductors. Measurements were taken on separate occasions 3 to 7 days apart in order to determine inter-session reliability. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and smallest detectable difference (SDD) were used to evaluate the relative and absolute reliability, respectively. RESULTS: The Sonosynch software has shown to be highly reliable in measuring the diameters of the CMM both in healthy subjects and in those with neck pain. The ICCs 95% CI for APD ranged from 0.84 to 0.94 in subjects with neck pain and from 0.86 to 0.94 in healthy subjects. For LD, the ICC 95% CI ranged from 0.64 to 0.95 in subjects with neck pain and from 0.82 to 0.92 in healthy subjects. CONCLUSIONS: Ultrasonographic measurement of the diameters of the CMM using Sonosynch has proved to be reliable especially for APD in healthy subjects as well as subjects with neck pain. PMID:26443975

  19. SURGICAL MANAGEMENT OF VOCAL CORD PARALYSIS: THE NEED FOR CAREFUL PATIENT SELECTION

    PubMed Central

    Kokong, DD; Adoga, AA; Bakari, A; Okundia, PO; Onakoya, PA; Nwaorgu, OGB

    2015-01-01

    Background Vocal cord paralysis is one of the challenging laryngeal clinical entities confronting the Laryngologist and indeed, the Phono-surgeon. The ability to maintain an effective balance between voice and airway function to ensure good quality of life requires expertise. This study is therefore designed to highlight our experience on surgical management of vocal cord paralysis. Method Clinical notes of all patients that met the inclusion criteria for this study on vocal cord paralysis over a ten-year period were analysed. Data was generated from patients’ case files retrieved using standard codes according to the International Classification of Diseases (ICD-10). Results From the 7,941 new ENT cases seen, 26 patients had vocal cord paralysis (VCP) giving a prevalence of 0.3%. The male to female ratio was 1: 4.2 with a mean age of 45.7years ± 6.3. Their ages ranged from 21–80 years. Thyroidectomy was the main causal factor in 46.2% while idiopathic causes was documented in 23.1%. Twenty-three patients (88.5%) had unilateral VCP from which 21(91.3%) were abductor paralysis. The ratio of Left: Right VCP was 3:1. All the 3 bilateral cases were abductor paralysis. Neurotropic agents only, were effective in cases of unilateral VCP. However, in those with bilateral paralysis, two had tracheostomy only, while the third had a laryngo-fissure, arytenoidoplasty and endo-laryngeal stenting in addition. All were successfully decannulated with good voice quality. Conclusion With these observations, we suggest the choice of appropriate surgical technique, timing and careful patient selection in order to preserve voice, curtail operative sequelae and achieve good quality of life (QoL) which is the overall management strategy, be borne in mind. PMID:26709328

  20. The Efficacy of Intraoperative Neurophysiological Monitoring Using Transcranial Electrically Stimulated Muscle-evoked Potentials (TcE-MsEPs) for Predicting Postoperative Segmental Upper Extremity Motor Paresis After Cervical Laminoplasty

    PubMed Central

    Manabe, Hideki; Izumi, Bunichiro; Tanaka, Hiroyuki; Kawai, Kazumi; Tanaka, Nobuhiro

    2016-01-01

    Study Design: Prospective study. Objective: To investigate the efficacy of transcranial electrically stimulated muscle-evoked potentials (TcE-MsEPs) for predicting postoperative segmental upper extremity palsy following cervical laminoplasty. Summary of Background Data: Postoperative segmental upper extremity palsy, especially in the deltoid and biceps (so-called C5 palsy), is the most common complication following cervical laminoplasty. Some papers have reported that postoperative C5 palsy cannot be predicted by TcE-MsEPs, although others have reported that it can be predicted. Methods: This study included 160 consecutive cases that underwent open-door laminoplasty, and TcE-MsEP monitoring was performed in the biceps brachii, triceps brachii, abductor digiti minimi, tibialis anterior, and abductor hallucis. A >50% decrease in the wave amplitude was defined as an alarm point. According to the monitoring alarm, interventions were performed, which include steroid administration, foraminotomies, etc. Results: Postoperative deltoid and biceps palsy occurred in 5 cases. Among the 155 cases without segmental upper extremity palsy, there were no monitoring alarms. Among the 5 deltoid and biceps palsy cases, 3 had significant wave amplitude decreases in the biceps during surgery, and palsy occurred when the patients awoke from anesthesia (acute type). In the other 2 cases in which the palsy occurred 2 days after the operation (delayed type), there were no significant wave decreases. In all of the cases, the palsy was completely resolved within 6 months. Discussion: The majority of C5 palsies have been reported to occur several days after surgery, but some of them have been reported to occur immediately after surgery. Our results demonstrated that TcE-MsEPs can predict the acute type, whereas the delayed type cannot be predicted. Conclusions: A >50% wave amplitude decrease in the biceps is useful to predict acute-type segmental upper extremity palsy. Further examination

  1. A comparison of respiratory and peripheral muscle strength, functional exercise capacity, activities of daily living and physical fitness in patients with cystic fibrosis and healthy subjects.

    PubMed

    Arikan, Hulya; Yatar, İlker; Calik-Kutukcu, Ebru; Aribas, Zeynep; Saglam, Melda; Vardar-Yagli, Naciye; Savci, Sema; Inal-Ince, Deniz; Ozcelik, Ugur; Kiper, Nural

    2015-01-01

    There are limited reports that compare muscle strength, functional exercise capacity, activities of daily living (ADL) and parameters of physical fitness of cystic fibrosis (CF) patients with healthy peers in the literature. The purpose of this study was to assess and compare respiratory and peripheral muscle strength, functional exercise capacity, ADL and physical fitness in patients with CF and healthy subjects. Nineteen patients with CF (mean forced expiratory volume in one second-FEV1: 86.56±18.36%) and 20 healthy subjects were included in this study. Respiratory (maximal inspiratory pressure-MIP and maximal expiratory pressure-MEP) and peripheral muscle strength (quadriceps, shoulder abductors and hand grip strength) were evaluated. Functional exercise capacity was determined with 6min walk test (6MWT). ADL was assessed with Glittre ADL test and physical fitness was assessed with Munich fitness test (MFT). There were not any statistically significant difference in MIP, %MIP, MEP and %MEP values between two groups (p>0.05). %Peripheral muscle strength (% quadriceps and shoulder abductors strength), 6MWT distance and %6MWT distance were significantly lower in patients with CF than those of healthy subjects (p<0.05). Glittre ADL-test time was significantly longer in patients with CF than healthy subjects (p<0.05). According to Munich fitness test, the number of bouncing a ball, hanging score, distance of standing vertical jumping and standing vertical jumping score were significantly lower in patients with CF than those of healthy subjects (p<0.05). Peripheral muscle strength, functional exercise capacity, ADL performance and speed, coordination, endurance and power components of physical fitness are adversely affected in mild-severe patients with CF compared to healthy peers. Evaluations must be done in comprehensive manner in patients with CF with all stages. PMID:26241869

  2. The rate of force development scaling factor (RFD-SF): protocol, reliability, and muscle comparisons.

    PubMed

    Bellumori, Maria; Jaric, Slobodan; Knight, Christopher A

    2011-07-01

    Performing a set of isometric muscular contractions to varied amplitudes with instructions to generate force most rapidly reveals a strong linear relationship between peak forces (PF) achieved and corresponding peak rates of force development (RFD). The slope of this relationship, termed the RFD scaling factor (RFD-SF), quantifies the extent to which RFD scales with contraction amplitude. Such scaling allows relative invariance in the time required to reach PF regardless of contraction size. Considering the increasing use of this relationship to study quickness and consequences of slowness in older adults and movement disorders, our purpose was to further develop the protocol to measure RFD-SF. Fifteen adults (19-28 years) performed 125 rapid isometric contractions to a variety of force levels in elbow extensors, index finger abductors, and knee extensors, on 2 days. Data were used to determine (1) how the number of pulses affects computation of the RFD-SF, (2) day-to-day reliability of the RFD-SF, and (3) the nature of RFD-SF differences between diverse muscle groups. While sensitive to the number of pulses used in its computation (P<.05), RFD-SF was reliable when computed with >50 pulses (ICC>.7) and more so with 100-125 pulses (ICC=.8-.92). Despite differences in size and function across muscles, RFD-SF was generally similar (i.e., only 8.5% greater in elbow extensors than in index finger abductors and knee extensors; P=.049). Results support this protocol as a reliable means to assess how RFD scales with PF in rapid isometric contractions as well as a simple, non-invasive probe into neuromuscular health. PMID:21656219

  3. Association of hip and pelvic geometrywith tibiofemoral osteoarthritis: Multicenter Osteoarthritis Study (MOST)

    PubMed Central

    Boissonneault, A; Lynch, JA; Wise, BL; Segal, NA; Gross, KD; Murray, DW; Nevitt, MC; Pandit, HG

    2014-01-01

    Objective Lateral tibiofemoral osteoarthritis (OA) is overall less common than medial tibiofemoral OA, but it is more prevalent in women. This may be explained by sex differences in hip and pelvic geometry. The aim of this study is to explore sex differences in hip and pelvic geometry and determine if such parameters are associated with the presence of compartment-specific knee OA. Methods This case-control study reports on 1,328 hips/knees from 664 participants and is an ancillary to the Multicenter Osteoarthritis Study (MOST). Of the 1,328 knees, 219 had lateral OA, 260 medial OA, and 849 no OA. Hip and pelvic measurements were taken from full-limb radiographs on the ipsilateral side of the knee of interest. After adjusting for covariates, means were compared between sexes and also between knees with medial and lateral OA versus no OA using separate regression models. Results Women were shown to have a reduced femoral offset (mean 40.9 mm vs. 45.9 mm; p=0.001) and more valgus neck-shaft angle (mean 128.4° vs. 125.9°; p<0.001) compared to men. Compared to those with no OA, knees with lateral OA were associated with a reduced femoral offset (p=0.012), increased height of hip centre (p=0.003), more valgus neck-shaft angle (p=0.042), and increased abductor angle (p=0.031). Knees with medial OA were associated with a more varus neck-shaft angle (p=0.043) and a decreased abductor angle (p=0.003). Conclusion These data suggest anatomical variations at the hip and pelvis are associated with compartment-specific knee OA and may help to explain sex differences in patterns of knee OA. PMID:24971867

  4. Tendon insertion at the base of the proximal phalanx of the hallux: surgical implications.

    PubMed

    Becerro de Bengoa Vallejo, Ricardo; Losa Iglesias, Marta Elena; Jules, Kevin T

    2012-01-01

    Hallux valgus, limitus, and rigidus are conditions affecting the first metatarsophalangeal joint that can be treated by arthroplasty. Excessive arthroplasty can compromise the insertion of the tendons at the base of the proximal phalanx of the hallux, leading to first metatarsophalangeal joint plantarflexion weakness, cock-up toe deformity, and altered forefoot loading. The present study investigated the anatomic length of insertion of the medial and lateral flexor hallucis brevis, extensor hallucis brevis, abductor hallucis, and adductor hallucis tendons into the base of the hallux proximal phalanx and the amount of bone that can be safely resected without compromising the insertional limits. A total of 43 specimens (22 right and 21 left) from 22 embalmed cadavers (11 male and 11 female) were dissected. The insertion lengths of the 5 tendons were measured, along with the dimensions of the hallux proximal phalanx. No statistically significant differences were found in any proximal phalanx measurements or tendon insertion lengths according to side (p > .05). Significant differences were found between the genders in most dimensions of the hallux proximal phalanx (p < .05). The medial insertion site, where the medial flexor brevis tendon and distal abductor hallucis muscle join, was longer than the lateral site (p < .001). To preserve the tendon's insertion, hallux proximal phalanx resection should not exceed 3 mm. Resection of the tendons is ensured by removal of more than 7.88 mm and 9.37 mm in females and males, respectively. When performing hallux arthroplasty of the first metatarsophalangeal joint, we recommend calculating the length of the tendon insertions, instead of the length of the hallux proximal phalanx. PMID:22789484

  5. [Experimental vocal cord abduction impairment with an artificial vocal cord].

    PubMed

    Isozaki, Eiji; Tobisawa, Shinsuke; Nishizawa, Misato; Nakayama, Hideto; Fukui, Kotaro; Takanishi, Asuo

    2009-07-01

    Non-invasive positive pressure ventilation (NPPV) has recently been applied to the patients with multiple system atrophy (MSA) with various respiratory complications including vocal cord abduction impairment and respiratory disturbance by the central origin. Any consensus guidelines on setting up the inspiratory positive airway pressure (IPAP) and expiratory one (EPAP), however, have not been raised yet. To investigate this problem, we made the upper airway tract model with moderately and severely narrow glottis using a training/test lung and the artificial vocal cord which was developed for a humanoid talking robot in Waseda University. The artificial vocal cord was molded out of a high performance thermoplastic rubber in imitation of the human larynx. Previous studies using with a high-speed camera and a sound analyzer showed that the artificial vocal cord resembled human larynx closely both morphologically and functionally. The opening and closing movements of the artificial vocal cord were observed fiberscopically under various conditions of IPAP (4-20 cmH2O) and EPAP (4-10 cmH2O). The maximal glottic width during inspiration and expiration were measured by a pair of calipers on the video-monitored display. Both of the moderately and the severely narrow artificial vocal cords without non-paralytic factors showed typical paradoxical movement showing adduction in inspiration and abduction in expiration, which is characteristic to vocal cord abductor impairment seen in MSA. In the model with moderately severe narrow glottis, this paradoxical movement was released under any positive pressures of continuous (CPAP) and bilevel (Bilevel PAP) modes. In the model with severely narrow glottis, however, there existed a threshold in setting up the optimal EPAP to release the paradoxical movement. In conclusion, EPAP-leading procedure seems to be preferable to IPAP-leading procedure to dilate the narrow glottis as a pneumatic splint in the managements of the patients with

  6. The effect of current flow direction on motor hot spot allocation by transcranial magnetic stimulation.

    PubMed

    Stephani, Caspar; Paulus, Walter; Sommer, Martin

    2016-01-01

    The objective of this study was to investigate the significance of pulse configurations and current direction for corticospinal activation using transcranial magnetic stimulation (TMS). In 11 healthy subjects (8 female), a motor map for the motor evoked potentials (MEPs) recorded from the first dorsal interosseus (FDI), abductor digiti minimi (ADM), extensor carpi radialis, and biceps brachii (BB) muscles of the dominant side was established. Starting from a manually determined hot spot of the FDI representation, we measured MEPs at equal oriented points on an hexagonal grid, with 7 MEPs recorded at each point, using the following pulse configurations: posteriorly directed monophasic (Mo-P), anteriorly directed monophasic (Mo-A), biphasic with the more relevant second cycle oriented posteriorly (Bi-P) as well as a reversed biphasic condition (Bi-A). For each pulse configuration, a hot spot was determined and a center of gravity (CoG) was calculated. We found that the factor current direction had an effect on location of the CoG-adjusted hot spot in the cranio-caudal axis but not in the latero-medial direction with anteriorly directed pulses locating the CoG more anteriorly and vice versa. In addition, the CoG for the FDI was more laterally than the cortical representations for the abductor digiti minimi (ADM) and extensor carpi radialis (ECR) which were registered as well. The results indicate that direction of the current pulse should be taken into account for determination of the motor representation of a muscle by TMS. PMID:26733248

  7. Recovery of nerve conduction after a pneumatic tourniquet: observations on the hind-limb of the baboon1

    PubMed Central

    Fowler, T. J.; Danta, G.; Gilliatt, R. W.

    1972-01-01

    A small pneumatic cuff inflated around the knee was used to produce tourniquet paralysis in baboons. A cuff pressure of 1,000 mm Hg maintained for one to three hours produced paralysis of distal muscles lasting up to three months. Nerve conduction studies showed that most of the motor fibres to the abductor hallucis muscle were blocked at the level of the cuff and that they conducted impulses normally in their distal parts. There was a significant correlation between the duration of compression and that of the subsequent conduction block. When tested two to three weeks after the tourniquet, the amplitude of the response of m. abductor hallucis to nerve stimulation distal to the cuff was usually slightly reduced compared with the precompression figure. This was assumed to mean that a small proportion of the motor fibres had undergone Wallerian degeneration as a result of compression. Maximal motor conduction velocity was reduced in recovering nerves. It was also reduced when a cuff pressure of 500 mm Hg was used, which was insufficient to produce persistent conduction block. In such cases a reduced velocity without evidence of block could be demonstrated 24 hours after compression. Ascending nerve action potentials were recorded from the sciatic nerve in the thigh, with stimulation at the ankle. Before compression the fastest afferent fibres had a significantly higher velocity than the fastest motor fibres in the same nerve trunk. Results after compression suggested that the high-velocity afferent fibres had a susceptibililty to the procedure similar to that of the fastest motor fibres. PMID:4628467

  8. Fast and singular muscle responses initiate the startle response of Pantodon buchholzi (Osteoglossomorpha).

    PubMed

    Starosciak, A K; Kalola, R P; Perkins, K P; Riley, J A; Saidel, W M

    2008-01-01

    The startle response of Pantodon buchholzi, the African butterfly fish, is a complete or incomplete ballistic jump resulting from abduction of the pectoral fins. This study analyzed the neuromuscular basis for such a jump by recording in vivo electromyograms (emgs) from the muscles of abduction, the muscularis abductor superficialis (MAS) and the muscularis abductor profundus (MAP). The motor neurons innervating the MAS muscle were localized by retrograde transport of biocytin. The latency between stimulus and the evoked emg in the MAS was less than 5 ms; the latency of the MAP was about 6.5 ms. A single emg was recorded per jump. High speed video demonstrated that onset of a startle movement began within 10 ms of the onset of fin abduction. The emg associated with this movement is short (<2 ms) and followed by a variably-shaped, slower and smaller potential of 10-30 ms duration. The brief period between stimulus and startle response of Pantodon suggests a Mauthner neuron-related response, only with the behavior occurring in the vertical plane. The MAS may act only in a startle response, whereas the MAP might have a role in other behaviors. Elicited jumping habituates after a single trial. Electrophysiological evidence is presented indicating that the innervating motor neurons are suppressed for seconds following a stimulus. The neurons innervating the MAS are located at the medullary-spinal cord junction and possess an average radius of approximately 17.9 mum. These fish have been historically described as 'fresh water' flying fish. As a single emg occurs per startle response, repetitive pectoral activity generating flying cannot be supported. Pantodon 'flight' is ballistic. PMID:18032886

  9. Combined lower body endurance and upper body resistance training improves performance and health parameters in healthy active elderly.

    PubMed

    Verney, Julien; Kadi, Fawzi; Saafi, Mohamed A; Piehl-Aulin, Karin; Denis, Christian

    2006-06-01

    We investigated the effects of combined lower body (LB) endurance and upper body (UB) resistance training on endurance, strength, blood lipid profile and body composition in active older men. Ten healthy still active men (73+/-4 years, V(O2) peak: 36 (31-41) ml min-1 kg-1) were tested before and after 14 weeks of combined training (3 times week-1). Training consisted of 3x12 min of high intensity interval training on a bicycle for endurance interspersed by 3x12 min of UB resistance exercises. V(O2) peak during leg cycling and arm cranking, isokinetic torque of knee extensor and shoulder abductor and the cross-sectional area (CSA) of several muscles from UB and LB were measured. Sagittal abdominal diameter (SAD) and abdominal fat area were measured on MRI scans. Total body composition was assessed by hydrostatic weighing (HW) and dual-energy X-ray absorptiometry (DEXA). Blood lipid profile was assessed before and after training. By the end of the training period, V(O2) peak (l min-1) increased significantly by 9 and 16% in leg cycling and arm cranking tests, respectively. Maximal isokinetic torque increased both for the knee extensor and shoulder abductor muscle groups. CSA increased significantly in deltoid muscle. Percentage of body fat decreased by 1.3% (P<0.05) and abdominal fat and SAD decreased by 12 and 6%, respectively (P<0.01). There was also a significant decrease in total cholesterol and low-density lipoprotein. Thus, combined LB endurance and UB resistance training can improve endurance, strength, body composition and blood lipid profile even in healthy active elderly. PMID:16770464

  10. Scaling of form and function in the xenarthran femur: a 100-fold increase in body mass is mitigated by repositioning of the third trochanter

    PubMed Central

    Milne, Nick; O'Higgins, Paul

    2012-01-01

    How animals cope with increases in body size is a key issue in biology. Here, we consider scaling of xenarthrans, particularly how femoral form and function varies to accommodate the size range between the 3 kg armadillo and its giant relative the 300 kg glyptodont. It has already been noted that femoral morphology differs between these animals and suggested that this reflects a novel adaptation to size increase in glyptodont. We test this idea by applying a finite element analysis of coronal plane forces to femoral models of these animals, simulating the stance phase in the hind limb; where the femur is subject to bending owing to longitudinal compressive as well as abduction loads on the greater trochanter. We use these models to examine the hypothesis that muscles attaching on the third trochanter (T3) can reduce this bending in the loaded femur and that the T3 forces are more effective at reducing bending in glyptodont where the T3 is situated at the level of the knee. The analysis uses traditional finite element methods to produce strain maps and examine strains at 200 points on the femur. The coordinates of these points before and after loading are also used to carry out geometric morphometric (GM) analyses of the gross deformation of the model in different loading scenarios. The results show that longitudinal compressive and abductor muscle loading increases bending in the coronal plane, and that loads applied to the T3 reduce that bending. In the glyptodont model, the T3 loads are more effective and can more readily compensate for the bending owing to longitudinal and abductor loads. This study also demonstrates the usefulness of GM methods in interpreting the results of finite element analyses. PMID:22673355

  11. Targeted interventions for patellofemoral pain syndrome (TIPPS): classification of clinical subgroups

    PubMed Central

    Selfe, James; Callaghan, Michael; Witvrouw, Erik; Richards, James; Dey, Maria Paola; Sutton, Chris; Dixon, John; Martin, Denis; Stokes, Maria; Janssen, Jessie; Ritchie, Elizabeth; Turner, David

    2013-01-01

    Introduction Patellofemoral pain (PFP) can cause significant pain leading to limitations in societal participation and physical activity. An international expert group has highlighted the need for a classification system to allow targeted intervention for patients with PFP; we have developed a work programme systematically investigating this. We have proposed six potential subgroups: hip abductor weakness, quadriceps weakness, patellar hypermobility, patellar hypomobility, pronated foot posture and lower limb biarticular muscle tightness. We could not uncover any evidence of the relative frequency with which patients with PFP fell into these subgroups or whether these subgroups were mutually exclusive. The aim of this study is to provide information on the clinical utility of our classification system. Methods and analysis 150 participants will be recruited over 18 months in four National Health Services (NHS) physiotherapy departments in England. Inclusion criteria: adults 18–40 years with PFP for longer than 3 months, PFP in at least two predesignated functional activities and PFP elicited by clinical examination. Exclusion criteria: prior or forthcoming lower limb surgery; comorbid illness or health condition; and lower limb training or pregnancy. We will record medical history, demographic details, pain, quality of life, psychomotor movement awareness and knee temperature. We will assess hip abductor and quadriceps weakness, patellar hypermobility and hypomobility, foot posture and lower limb biarticular muscle tightness. The primary analytic approach will be descriptive. We shall present numbers and percentages of participants who meet the criteria for membership of (1) each of the subgroups, (2) none of the subgroups and (3) multiple subgroups. Exact (binomial) 95% CIs for these percentages will also be presented. Ethics and dissemination This study has been approved by National Research Ethics Service (NRES) Committee North West—Greater Manchester

  12. Mechanisms underlying parallel reductions in aerobic capacity in non-migratory threespine stickleback (Gasterosteus aculeatus) populations.

    PubMed

    Dalziel, Anne C; Ou, Michelle; Schulte, Patricia M

    2012-03-01

    Non-migratory, stream-resident populations of threespine stickleback, Gasterosteus aculeatus, have a lower maximum oxygen consumption ((O(2),max)) than ancestral migratory marine populations. Here, we examined laboratory-bred stream-resident and marine crosses from two locations (West and Bonsall Creeks) to determine which steps in the oxygen transport and utilization cascade evolved in conjunction with, and thus have the potential to contribute to, these differences in (O(2),max). We found that West Creek stream-resident fish have larger muscle fibres (not measured in Bonsall fish), Bonsall Creek stream-resident fish have smaller ventricles, and both stream-resident populations have evolved smaller pectoral adductor and abductor muscles. However, many steps of the oxygen cascade did not evolve in stream-resident populations (gill surface area, hematocrit, mean cellular hemoglobin content and the activities of mitochondrial enzymes per gram ventricle and pectoral muscle), arguing against symmorphosis. We also studied F1 hybrids to determine which traits in the oxygen cascade have a genetic architecture similar to that of (O(2),max). In West Creek, (O(2),max), abductor and adductor size all showed dominance of marine alleles, whereas in Bonsall Creek, (O(2),max) and ventricle mass showed dominance of stream-resident alleles. We also found genetically based differences among marine populations in hematocrit, ventricle mass, pectoral muscle mass and pectoral muscle pyruvate kinase activity. Overall, reductions in pectoral muscle mass evolved in conjunction with reductions in (O(2),max) in both stream-resident populations, but the specific steps in the oxygen cascade that have a genetic basis similar to that of (O(2),max), and are thus predicted to have the largest impact on (O(2),max), differ among populations. PMID:22323197

  13. Distribution of radioactive cesium and its seasonal variations in cattle living in the "difficult-to-return zone" of the Fukushima nuclear accident.

    PubMed

    Sato, Itaru; Sasaki, Jun; Satoh, Hiroshi; Deguchi, Yoshitaka; Otani, Kumiko; Okada, Keiji

    2016-04-01

    The amount of radioactive cesium in various tissues of cattle which lived in the highly contaminated area designated as the "difficult-to-return zone", was measured in May and December of 2014. The average concentration of radioactive cesium in the skeletal muscles ranged from 3900 to 5500 Bq/kg, and there was no significant difference between May and December. The sirloin (in December), tenderloin and top round (in May and December) showed significantly higher concentrations of cesium than the neck muscle, which is generally used for the radioactivity inspection. The Longus colli muscle, which is also used for the inspection in some institutions, showed the same radioactivity as the neck muscle. Study results indicated that relative cesium concentrations in internal organs were higher in May compared to December. There were high correlations of cesium concentration between the blood and other tissues. However, regression coefficients between the blood and muscles were significantly higher in December than those in May. When radioactivity in the neck or Longus colli muscles between 50 to 100 Bq/kg is detected, the slaughtered cattle should be re-inspected using another muscle, such as top round or sirloin, to prevent marketing of meat that violates the criteria of the Food Sanitation Act. PMID:26279453

  14. Effects of different types of exercise on muscle activity and balance control

    PubMed Central

    Kim, Mi-Kyoung; Choi, Jung-Hyun; Gim, Min-A; Kim, Young-Hwan; Yoo, Kyung-Tae

    2015-01-01

    [Purpose] This study analyzed the effects of isotonic, isokinetic, and isometric exercises of ankle joint muscles on lower extremity muscle activity and balance control. [Subjects and Methods] The subjects were 30 healthy adults (15 males) in their 20s who were randomly assigned to three different exercise method groups of 10 people each. The isokinetic exercise group performed three sets at an angular velocity of 60°/sec, including a single rest period after every set of 10 repetitions. The isometric exercise group performed three sets consisting of three 15 repetitions of a 15-second exercise followed by a 5-second rest. [Results] Multivariate analysis of variance revealed that depending on the exercise method, the non-dominant tibialis anterior, gastrocnemius muscle, and peroneus longus showed significant differences in muscle activity for weight-bearing non-dominant sides; when the dominant side was weight-bearing, the dominant gastrocnemius and peroneus longus showed significant differences in muscle activity; and the non-dominant and dominant sides showed significant differences in balance control depending on the duration of support in the area. [Conclusion] Muscle fatigue from the three exercise methods produced a decline in muscle activity and balance control; due to the fatigue before exercise, the side that did not perform the exercises was affected. PMID:26180340

  15. Electromyographic analysis of lower limb muscles during the golf swing performed with three different clubs.

    PubMed

    Marta, Sérgio; Silva, Luís; Vaz, João Rocha; Castro, Maria António; Reinaldo, Gustavo; Pezarat-Correia, Pedro

    2016-01-01

    The aim of this study was to describe and compare the EMG patterns of select lower limb muscles throughout the golf swing, performed with three different clubs, in non-elite middle-aged players. Fourteen golfers performed eight swings each using, in random order, a pitching wedge, 7-iron and 4-iron. Surface electromyography (EMG) was recorded bilaterally from lower limb muscles: tibialis anterior, peroneus longus, gastrocnemius medialis, gastrocnemius lateralis, biceps femoris, semitendinosus, gluteus maximus, vastus medialis, rectus femoris and vastus lateralis. Three-dimensional high-speed video analysis was used to determine the golf swing phases. Results showed that, in average handicap golfers, the highest muscle activation levels occurred during the Forward Swing Phase, with the right semitendinosus and the right biceps femoris muscles producing the highest mean activation levels relative to maximal electromyography (70-76% and 68-73% EMG(MAX), respectively). Significant differences between the pitching wedge and the 4-iron club were found in the activation level of the left semitendinosus, right tibialis anterior, right peroneus longus, right vastus medialis, right rectus femuris and right gastrocnemius muscles. The lower limb muscles showed, in most cases and phases, higher mean values of activation on electromyography when golfers performed shots with a 4-iron club. PMID:26197882

  16. Cold-water immersion alters muscle recruitment and balance of basketball players during vertical jump landing.

    PubMed

    Macedo, Christiane de Souza Guerino; Vicente, Rafael Chagas; Cesário, Mauricio Donini; Guirro, Rinaldo Roberto de Jesus

    2016-01-01

    The purpose of this study was to evaluate the effects of cold-water immersion on the electromyographic (EMG) response of the lower limb and balance during unipodal jump landing. The evaluation comprised 40 individuals (20 basketball players and 20 non-athletes). The EMG response in the lateral gastrocnemius, tibialis anterior, fibular longus, rectus femoris, hamstring and gluteus medius; amplitude and mean speed of the centre of pressure, flight time and ground reaction force (GRF) were analysed. All volunteers remained for 20 min with their ankle immersed in cold-water, and were re-evaluated immediately post and after 10, 20 and 30 min of reheating. The Shapiro-Wilk test, Friedman test and Dunn's post test (P < 0.05) were used. The EMG response values decreased for the lateral gastrocnemius, tibialis anterior, fibular longus and rectus femoris of both athletes and non-athletes (P < 0.05). The comparison between the groups showed that the EMG response was lower for the athletes. Lower jump flight time and GRF, greater amplitude and mean speed of centre of pressure were predominant in the athletes. Cold-water immersion decreased the EMG activity of the lower limb, flight time and GRF and increased the amplitude and mean speed of centre of pressure. PMID:26058795

  17. When phosphorylated at Thr148, the β2-subunit of AMP-activated kinase does not associate with glycogen in skeletal muscle.

    PubMed

    Xu, Hongyang; Frankenberg, Noni T; Lamb, Graham D; Gooley, Paul R; Stapleton, David I; Murphy, Robyn M

    2016-07-01

    The 5'-AMP-activated protein kinase (AMPK), a heterotrimeric complex that functions as an intracellular fuel sensor that affects metabolism, is activated in skeletal muscle in response to exercise and utilization of stored energy. The diffusibility properties of α- and β-AMPK were examined in isolated skeletal muscle fiber segments dissected from rat fast-twitch extensor digitorum longus and oxidative soleus muscles from which the surface membranes were removed by mechanical dissection. After the muscle segments were washed for 1 and 10 min, ∼60% and 75%, respectively, of the total AMPK pools were found in the diffusible fraction. After in vitro stimulation of the muscle, which resulted in an ∼80% decline in maximal force, 20% of the diffusible pool became bound in the fiber. This bound pool was not associated with glycogen, as determined by addition of a wash step containing amylase. Stimulation of extensor digitorum longus muscles resulted in 28% glycogen utilization and a 40% increase in phosphorylation of the downstream AMPK target acetyl carboxylase-CoA. This, however, had no effect on the proportion of total β2-AMPK that was phosphorylated in whole muscle homogenates measured by immunoprecipitation. These findings suggest that, in rat skeletal muscle, β2-AMPK is not associated with glycogen and that activation of AMPK by muscle contraction does not dephosphorylate β2-AMPK. These findings question the physiological relevance of the carbohydrate-binding function of β2-AMPK in skeletal muscle. PMID:27099349

  18. Effect of anesthesia on glucose production and utilization in rats

    SciTech Connect

    Penicaud, L.; Ferre, P.; Kande, J.; Leturque, A.; Issad, T.; Girard, J.

    1987-03-01

    This study was undertaken to determine the effects of pentobarbital anesthesia (50 mg/kg ip) on glucose kinetics and individual tissue glucose utilization in vivo, in chronically catheterized rats. Glucose turnover studies were carried out using (3-/sup 3/H) glucose as tracer. A transient hyperglycemia and an increased glucose production were observed 3 min after induction of anesthesia. However, 40 min after induction of anesthesia, glycemia returned to the level observed in awake animals, whereas glucose turnover was decreased by 30% as compared with unanesthetized rats. These results are discussed with regard to the variations observed in plasma insulin, glucagon, and catecholamine levels. Glucose utilization by individual tissues was studied by the 2-(1-/sup 3/H) deoxyglucose technique. A four- to fivefold decrease in glucose utilization was observed in postural muscles (soleus and adductor longus), while in other nonpostural muscles (epitrochlearis, tibialis anterior, extensor digitorum longus, and diaphragm) and other tissues (white and brown adipose tissues) anesthesia did not modify the rate of glucose utilization. A decrease in glucose utilization was also observed in the brain.

  19. Application of temperature gradient gel electrophoresis to the study of yeast diversity in the estuary of the Tagus river, Portugal.

    PubMed

    Gadanho, Mário; Sampaio, José Paulo

    2004-12-01

    Temperature gradient gel electrophoresis (TGGE) was employed for the assessment of yeast diversity in the estuary of the Tagus river (Portugal). The molecular detection of yeasts was carried out directly from water samples and, in parallel, a cultivation approach by means of an enrichment step was employed. A nested PCR was employed to obtain a fungal amplicon containing the D2 domain of the 26S rRNA gene. For identification the TGGE bands were extracted, re-amplified, and sequenced. Fourteen fungal taxa were detected and all except one were yeasts. Most yeast sequences corresponded to members of the Ascomycota and only three belonged to the Basidiomycota. Five yeasts (four ascomycetes and one basidiomycete) could not be identified to the species level due to the uniqueness of their sequences. The number of species detected after enrichment was higher than the number of taxa found using the direct detection method. This suggests that some yeast populations are present in densities that are below the detection threshold of the method. With respect to the analysis of the yeast community structure, our results indicate that the dominant populations belong to Debaryomyces hansenii, Rhodotorula mucilaginosa, Cryptococcus longus, and to an uncultured basidiomycetous yeast phylogenetically close to Cr. longus. The combined analysis of direct detection and cultivation approaches indicates a similar community structure at the two sampled sites since nine species were present at both localities. PMID:15556087

  20. An ¹⁸F-FDG PET study of cervical muscle in parkinsonian anterocollis.

    PubMed

    Revuelta, Gonzalo J; Montilla, Jaime; Benatar, Michael; Freeman, Alan; Wichmann, Thomas; Jinnah, Hyder A; Delong, Mahlon R; Factor, Stewart A

    2014-05-15

    The underlying etiology of parkinsonian anterocollis has been the subject of recent debate. The purpose of this study is to test the hypothesis that anterocollis in parkinsonian syndromes is associated with dystonia of the deep cervical flexors (longus colli and capitis). Eight patients with anterocollis, six in the setting of parkinsonism and two primary cervical dystonia control subjects with anterocollis underwent prospective structured clinical evaluations (interview, examination and rating scales), systematic electromyography of the cervical extensor musculature and (18)F-FDG PET/CT studies of cervical muscles to examine evidence of hypermetabolism or overactivity of deep cervical flexors. Subjects with parkinsonian anterocollis were found to have hypermetabolism of the extensor and sub-occipital muscles but not in the cervical flexors (superficial or deep). EMG abnormalities were observed in all evaluated patients, but only one patient was definitely myopathic. Meanwhile, both dystonia controls exhibited hypermetabolism of cervical flexors (including the longus colli). In conclusion, we were able to demonstrate hypermetabolism of superficial and deep cervical flexors with muscle (18)F-FDG PET/CT in dystonic anterocollis patients, but not in parkinsonian anterocollis patients. The hypermetabolic changes seen in parkinsonian anterocollis patients in posterior muscles may be compensatory. Alternative explanations for anterocollis include myopathy of the cervical extensors, or unbalanced rigidity of the cervical flexors, but this remains to be proven. PMID:24725739

  1. Taxonomy of European Damaeidae VIII. Contribution to classification of genus Damaeus C. L. Koch, 1835, with a review of Adamaeus Norton, 1978 and Paradamaeus Bulanova-Zachvatkina, 1957 and redescription of three species.

    PubMed

    Miko, Ladislav

    2015-01-01

    Adamaeus Norton, 1978 and Paradamaeus Bulanova-Zachvatkina, 1957, two subgenera of genus Damaeus C. L. Koch, 1835, are reviewed on the basis of the redescription of their type species. Subgenus Eudamaeus Pérez-Iñigo, 1987 and genus Tectodamaeus Aoki, 1984 are reviewed and their relation to Damaeus is discussed. Damaeus firmus Kunst, 1957 is redescribed and placed into the nominate subgenus. Damaeus helveticus (Schweizer, 1956) n.comb. is redescribed and placed into the nominate subgenus, its synonymy with Damaeus (Adamaeus) onustus C.L.Koch, 1844 is rejected. Damaeus alpinus (Schweizer, 1956) n.comb. is redescribed and placed into the nominate subgenus. Lectotypes and paralectotypes of Damaeus firmus Kunst, 1957; Damaeus helveticus (Schweizer, 1956) and Damaeus alpinus (Schweizer, 1956) are indicated. Based on published reviews and redescriptions, new diagnoses for Tectodamaeus Aoki, 1984, Damaeus C. L. Koch, 1835 and its subgenera are proposed, and a list of all known European species of Damaeus C. L. Koch, 1835 is provided. Tectodamaeus longus Xie & Yang, 2009 is newly combined to Damaeus as D. longus (Xie & Yang, 2009) n.comb. PMID:26249946

  2. Effects of subacute pyridostigmine administration on mammalian skeletal muscle function. (Reannouncement with new availability information)

    SciTech Connect

    Adler, M.; Deshpande, S.S.; Foster, R.E.; Maxwell, D.M.; Albuquerque, E.X.

    1992-12-31

    The subacute effects of pyridostigmine bromide were investigated on the contractile properties of rat extensor digitorum longus (EDL) and diaphragm muscles. The cholinesterase inhibitor was delivered via subcutaneously implanted osmotic minipumps (Alzet) at 9 microns g h-1 (low dose) or 60 micro g h-1 (high dose). Animals receiving high-dose pyridostigmine pumps exhibited marked alterations in muscle properties within the first day of exposure that persisted for the remaining 13 days. With 0.1 Hz stimulation, EDL twitch tensions of treated animals were elevated relative to control. Repetitive stimulation at frequencies > 1 Hz led a use-dependent depression in the amplitude of successive twitches during the train. Recovery from pyridostigmine was essentially complete by 1 day of withdrawal. Rats implanted with low-dose pyridostigmine pumps showed little or no alteration of in vivo twitch tensions during the entire 14 days of treatment. Diaphragm and EDL muscles excised from pyridostigmine-treated rats and tested in vitro showed no significant alterations in twitch and tetanic tensions and displayed the same sensitivity as muscles of control animals to subsequent pyridostigmine exposures. In the presence of atropine, subacutely administered pyridostigmine protected rats from two LD5O doses of the irreversible cholinesterase inhibitor, soman. In the absence of atropine, the LD50 of soman was not altered by subacute pyridostigmine treatment. Extensor digitorum longus; diaphragm; twitch tension; ACh release; subacute; Alzet pumps; tolerance; anticholinesterase; pyridostigmine; soman.

  3. Contribution of proteolysis and de novo synthesis to alanine production in diabetic rat skeletal muscle: a 15N/1H nuclear magnetic resonance study.

    PubMed

    Meynial-Denis, D; Chavaroux, A; Foucat, L; Mignon, M; Prugnaud, J; Bayle, G; Renou, J P; Arnal, M

    1997-10-01

    To assess the role of leucine as a precursor of alanine alpha-amino nitrogen in skeletal muscle during diabetes, extensor digitorum longus muscles from control (n = 7 experiments) and streptozotocin-diabetic rats (n = 8 experiments) were isolated and superfused with [15N]leucine (3 mmol/l) in the presence of glucose (10 mmol/l) for 2 h. Muscle perchloric acid extraction was performed at the end of superfusion in order to quantify newly synthesized alanine by 15N/1H nuclear magnetic resonance. Release of [15N]alanine in the superfusion medium was also measured. The pool of newly synthesized [15N]alanine was significantly increased (approximately 40%) in extensor digitorum longus muscles from streptozotocin-diabetic rats. Whereas a significant enhancement of total alanine release from muscle was induced by diabetes (20%), only a slight increase in [15N]alanine release was detectable under our experimental conditions. Consequently, we conclude that streptozotocin-diabetes in growing rats induces in skeletal muscle: 1) an increase in nitrogen exchange between leucine and alanine leading to newly synthesized [15N]alanine; and 2) an increase of total alanine release from muscle originating from both proteolysis and de novo synthesis. PMID:9349596

  4. Reconstruction of large dorsal digital defects with arterialized venous flaps: our experience and comprehensive review of literature.

    PubMed

    Yan, Hede; Fan, Cunyi; Zhang, Feng; Gao, Weiyang; Li, Zhijie; Zhang, Xiaolei

    2013-06-01

    Coverage of the dorsal aspect of the fingers is difficult, especially when the defect is large and multiple digits are involved with composite tissue loss and very few conventional flaps are suitable in dealing with such situation. The purpose of this study was to present our experience of reconstruction of the large dorsal digital defects with the arterialized venous flap (AVF) and evaluate its merits and demerits in this clinical setting with a comprehensive review of literature. From August 2008 to December 2010, 7 composite palmaris longus venous flaps and 5 AVFs were used in the reconstruction of extensive dorsal digital injuries in 8 patients, and a comprehensive review of literature regarding the reconstruction of dorsal digital defects with AVFs was carried out. All the flaps survived completely. The outcomes were very satisfactory for functional recovery, aesthetic appearance, and sensation restoration at an average follow-up of 11.8 months; the literature review also revealed the similar results. On the basis of our experience and literature review, AVFs are reliable and good candidates for resurfacing large dorsal digital defects when local flaps are not available or insufficient for coverage. Composite AVF with palmaris longus tendon is an optimal choice for 1-stage reconstruction of dorsal composite finger injuries. PMID:23364671

  5. Skeletal muscle fiber, nerve, and blood vessel breakdown in space-flown rats

    NASA Technical Reports Server (NTRS)

    Riley, D. A.; Ilyina-Kakueva, E. I.; Ellis, S.; Bain, J. L.; Slocum, G. R.; Sedlak, F. R.

    1990-01-01

    Histochemical and ultrastructural analyses were performed postflight on hind limb skeletal muscles of rats orbited for 12.5 days aboard the unmanned Cosmos 1887 biosatellite and returned to Earth 2 days before sacrifice. The antigravity adductor longus (AL), soleus, and plantaris muscles atrophied more than the non-weight-bearing extensor digitorum longus, and slow muscle fibers were more atrophic than fast fibers. Muscle fiber segmental necrosis occurred selectively in the AL and soleus muscles; primarily, macrophages and neutrophils infiltrated and phagocytosed cellular debris. Granule-rich mast cells were diminished in flight AL muscles compared with controls, indicating the mast cell secretion contributed to interstitial tissue edema. Increased ubiquitination of disrupted myofibrils implicated ubiquitin in myofilament degradation. Mitochondrial content and succinic dehydrogenase activity were normal, except for subsarcolemmal decreases. Myofibrillar ATPase activity of flight AL muscle fibers shifted toward the fast type. Absence of capillaries and extravasation of red blood cells indicated failed microcirculation. Muscle fiber regeneration from activated satellite cells was detected. About 17% of the flight AL end plates exhibited total or partial denervation. Thus, skeletal muscle weakness associated with spaceflight can result from muscle fiber atrophy and segmental necrosis, partial motor denervation, and disruption of the microcirculation.

  6. Maintenance of skeletal muscle energy homeostasis during prolonged wintertime fasting in the raccoon dog (Nyctereutes procyonoides).

    PubMed

    Kinnunen, Sanni; Mänttäri, Satu; Herzig, Karl-Heinz; Nieminen, Petteri; Mustonen, Anne-Mari; Saarela, Seppo

    2015-05-01

    The raccoon dog (Nyctereutes procyonoides) is a canid species with autumnal fattening and prolonged wintertime fasting. Nonpathological body weight cycling and the ability to tolerate food deficiency make this species a unique subject for studying physiological mechanisms in energy metabolism. AMP-activated protein kinase (AMPK) is a cellular energy sensor regulating energy homeostasis. During acute fasting, AMPK promotes fatty acid oxidation and enhances glucose uptake. We evaluated the effects of prolonged fasting on muscle energy metabolism in farm-bred raccoon dogs. Total and phosphorylated AMPK and acetyl-CoA carboxylase (ACC), glucose transporter 4 (GLUT 4), insulin receptor and protein kinase B (Akt) protein expressions of hind limb muscles were determined by Western blot after 10 weeks of fasting. Plasma insulin, leptin, ghrelin, glucose and free fatty acid levels were measured, and muscle myosin heavy chain (MHC) isoform composition analyzed. Fasting had no effects on AMPK phosphorylation, but total AMPK expression decreased in m. rectus femoris, m. tibialis anterior and m. extensor digitorum longus resulting in a higher phosphorylation ratio. Decreased total expression was also observed for ACC. Fasting did not influence GLUT 4, insulin receptor or Akt expression, but Akt phosphorylation was lower in m. flexor digitorum superficialis and m. extensor digitorum longus. Three MHC isoforms (I, IIa and IIx) were detected without differences in composition between the fasted and control animals. The studied muscles were resistant to prolonged fasting indicating that raccoon dogs have an effective molecular regulatory system for preserving skeletal muscle function during wintertime immobility and fasting. PMID:25652584

  7. Thoracic epaxial muscles in living archosaurs and ornithopod dinosaurs.

    PubMed

    Organ, Christopher Lee

    2006-07-01

    Crocodylians possess the same thoracic epaxial muscles as most other saurians, but M. transversospinalis is modified by overlying osteoderms. Compared with crocodylians, the thoracic epaxial muscles of birds are reduced in size, disrupted by the synsacrum, and often modified by intratendinous ossification and the notarium. A phylogenetic perspective is used to determine muscle homologies in living archosaurs (birds and crocodylians), evaluate how the apparent disparity evolved, and reconstruct the thoracic epaxial muscles in ornithopod dinosaurs. The avian modifications of the epaxial musculoskeletal system appear to have coevolved with the synsacrum and notarium. The lattice of ossified tendons in iguanodontoidean dinosaurs (Hadrosauridae and Iguanodontidae) is homologized to M. transversospinalis in crocodylians and M. longus colli dorsalis, pars thoracica in birds. Birds have an arrangement of tendons within M. longus colli dorsalis, pars thoracica identical to that observed in the epaxial ossified tendons of iguanodontoid dinosaurs. Moreover, many birds (such as grebes and turkeys) ossify these tendons, resulting in a two- or three-layered lattice of ossified tendons, a morphology also seen in iguanodontoid dinosaurs. Although the structure of M. transversospinalis appears indistinguishable between birds and iguanodontoid dinosaurs, intratendinous ossification within this epaxial muscle evolved convergently. PMID:16779820

  8. Chronic Ankle Instability and Neural Excitability of the Lower Extremity

    PubMed Central

    McLeod, Michelle M.; Gribble, Phillip A.; Pietrosimone, Brian G.

    2015-01-01

    Context Neuromuscular dysfunction of the leg and thigh musculature, including decreased strength and postural control, is common in patients with chronic ankle instability (CAI). Understanding how CAI affects specific neural pathways may provide valuable information for targeted therapies. Objective To investigate differences in spinal reflexive and corticospinal excitability of the fibularis longus and vastus medialis between limbs in patients with unilateral CAI and between CAI patients and participants serving as healthy controls. Design Case-control study. Setting Research laboratory. Patients or Other Participants A total of 56 participants volunteered, and complete data for 21 CAI patients (9 men, 12 women; age = 20.81 ± 1.63 years, height = 171.57 ± 11.44 cm, mass = 68.84 ± 11.93 kg) and 24 healthy participants serving as controls (7 men, 17 women; age = 22.54 ± 2.92 years, height = 172.35 ± 10.85 cm, mass = 69.15 ± 12.30 kg) were included in the final analyses. Control participants were matched to CAI patients on sex, age, and limb dominance. We assigned “involved” limbs, which corresponded with the involved limbs of the CAI patients, to control participants. Main Outcome Measure(s) Spinal reflexive excitability was assessed via the Hoffmann reflex and normalized to a maximal muscle response. Corticospinal excitability was assessed using transcranial magnetic stimulation. Active motor threshold (AMT) was defined as the lowest transcranial magnetic stimulation intensity required to elicit motor-evoked potentials equal to or greater than 100 μV in 5 of 10 consecutive stimuli. We obtained motor-evoked potentials (MEPs) at percentages ranging from 100% to 140% of AMT. Results Fibularis longus MEP amplitudes were greater in control participants than in CAI patients bilaterally at 100% AMT (control involved limb: 0.023 ± 0.031; CAI involved limb: 0.014 ± 0.008; control uninvolved limb: 0.021 ± 0.022; CAI uninvolved limb: 0.015 ± 0.007; F1,41 = 4

  9. Motor-Neuron Pool Excitability of the Lower Leg Muscles After Acute Lateral Ankle Sprain

    PubMed Central

    Klykken, Lindsey W.; Pietrosimone, Brian G.; Kim, Kyung-Min; Ingersoll, Christopher D.; Hertel, Jay

    2011-01-01

    Context: Neuromuscular deficits in leg muscles that are associated with arthrogenic muscle inhibition have been reported in people with chronic ankle instability, yet whether these neuromuscular alterations are present in individuals with acute sprains is unknown. Objective: To compare the effect of acute lateral ankle sprain on the motor-neuron pool excitability (MNPE) of injured leg muscles with that of uninjured contralateral leg muscles and the leg muscles of healthy controls. Design: Case-control study. Setting: Laboratory. Patients or Other Participants: Ten individuals with acute ankle sprains (6 females, 4 males; age = 19.2 ± 3.8 years, height = 169.4 ± 8.5 cm, mass = 66.3 ±11.6 kg) and 10 healthy individuals (6 females, 4 males; age = 20.6 ± 4.0 years, height = 169.9 ± 10.6 cm, mass = 66.3 ± 10.2 kg) participated. Intervention(s): The independent variables were group (acute ankle sprain, healthy) and limb (injured, uninjured). Separate dependent t tests were used to determine differences in MNPE between legs. Main Outcome Measure(s): The MNPE of the soleus, fibularis longus, and tibialis anterior was measured by the maximal Hoffmann reflex (Hmax) and maximal muscle response (Mmax) and was then normalized using the Hmax:Mmax ratio. Results: The soleus MNPE in the ankle-sprain group was higher in the injured limb (Hmax:Mmax = 0.63; 95% confidence interval [CI], 0.46, 0.80) than in the uninjured limb (Hmax:Mmax = 0.47; 95% CI, 0.08, 0.93) (t6 = 3.62, P = .01). In the acute ankle-sprain group, tibialis anterior MNPE tended to be lower in the injured ankle (Hmax:Mmax = 0.06; 95% CI, 0.01, 0.10) than in the uninjured ankle (Hmax:Mmax = 0.22; 95% CI, 0.09, 0.35), but this finding was not different (t9 = −2.01, P = .07). No differences were detected between injured (0.22; 95% CI, 0.14, 0.29) and uninjured (0.25; 95% CI, 0.12, 0.38) ankles for the fibularis longus in the ankle-sprain group (t9 = −0.739, P = .48). We found no side-to-side differences in

  10. Foot posture influences the electromyographic activity of selected lower limb muscles during gait

    PubMed Central

    2009-01-01

    Background Some studies have found that flat-arched foot posture is related to altered lower limb muscle function compared to normal- or high-arched feet. However, the results from these studies were based on highly selected populations such as those with rheumatoid arthritis. Therefore, the objective of this study was to compare lower limb muscle function of normal and flat-arched feet in people without pain or disease. Methods Sixty adults aged 18 to 47 years were recruited to this study. Of these, 30 had normal-arched feet (15 male and 15 female) and 30 had flat-arched feet (15 male and 15 female). Foot posture was classified using two clinical measurements (the arch index and navicular height) and four skeletal alignment measurements from weightbearing foot x-rays. Intramuscular fine-wire electrodes were inserted into tibialis posterior and peroneus longus under ultrasound guidance, and surface EMG activity was recorded from tibialis anterior and medial gastrocnemius while participants walked barefoot at their self-selected comfortable walking speed. Time of peak amplitude, peak and root mean square (RMS) amplitude were assessed from stance phase EMG data. Independent samples t-tests were performed to assess for significant differences between the normal- and flat-arched foot posture groups. Results During contact phase, the flat-arched group exhibited increased activity of tibialis anterior (peak amplitude; 65 versus 46% of maximum voluntary isometric contraction) and decreased activity of peroneus longus (peak amplitude; 24 versus 37% of maximum voluntary isometric contraction). During midstance/propulsion, the flat-arched group exhibited increased activity of tibialis posterior (peak amplitude; 86 versus 60% of maximum voluntary isometric contraction) and decreased activity of peroneus longus (RMS amplitude; 25 versus 39% of maximum voluntary isometric contraction). Effect sizes for these significant findings ranged from 0.48 to 1.3, representing moderate to

  11. Resistance to atracurium-induced neuromuscular blockade in patients with intractable seizure disorders treated with anticonvulsants.

    PubMed

    Tempelhoff, R; Modica, P A; Jellish, W S; Spitznagel, E L

    1990-12-01

    Previous studies have demonstrated that, with the exception of atracurium, resistance to the neuromuscular blocking effects of various muscle relaxants develops in patients receiving anticonvulsant therapy. We studied the effects of 0.5 mg/kg IV atracurium in 53 neurosurgical patients: 21 nonepileptic patients receiving no anticonvulsant therapy (MED = 0); 14 epileptic patients treated with carbamazepine for years (MED = 1); and 18 epileptic patients treated with carbamazepine plus either phenytoin or valproic acid for years (MED = 2). The evoked compound electromyogram of the adductor pollicis brevis was recorded, and results were analyzed using analysis of covariance, with weight and age as covariables. The onset time was not significantly different among the three groups. Times for recovery of baseline and train-of-four responses to stimuli were significantly shorter in the MED = 1 and MED = 2 groups than in control patients (MED = 0). The recovery index (time between 25% and 75% recovery of baseline electromyogram values) was progressively shorter in the three groups (MED = 0: 8.02 min; MED = 1: 5.93 min; MED = 2: 1.96 min; P less than 0.001). This study demonstrates that atracurium, when used on epileptic patients requiring long-term (that is, years of) anticonvulsant therapy, has a shorter duration of action than when used in nonepileptic patients. PMID:2240640

  12. 31P nuclear magnetic resonance studies of high energy phosphates and pH in human muscle fatigue. Comparison of aerobic and anaerobic exercise.

    PubMed Central

    Miller, R G; Boska, M D; Moussavi, R S; Carson, P J; Weiner, M W

    1988-01-01

    The goal of these experiments was to investigate the relationship of ATP, phosphocreatine (PCr), inorganic phosphate (Pi), monobasic phosphate (H2PO4-), and pH to human muscle fatigue. Phosphates and pH were measured in adductor pollicis using 31P nuclear magnetic resonance at 2.0 Tesla. The force of muscle contraction was simultaneously measured with a force transducer. The effects of aerobic and anaerobic exercise were compared using two exercise protocols: 4 min sustained maximal voluntary contraction (MVC) and 40 min of repeated intermittent contractions (75% MVC). The sustained maximal contraction produced a rapid decline of MVC and PCr, and was accompanied by a rapid rise of Pi, H+, and H2PO4-. Intermittent exercise produced steady state changes of MVC, pH, and phosphates. No significant changes of ATP were found in either protocol. During fatiguing exercise, PCr and Pi had a nonlinear relationship with MVC. H+ showed a more linear correlation, while H2PO4- showed the best correlation with MVC. Furthermore, the correlations between MVC and H2PO4- were similar in sustained (r = 0.70) and intermittent (r = 0.73) exercise. The highly significant linear relationship between increases of H+ and H2PO4- and the decline of MVC strongly suggests that both H+ and H2PO4- are important determinants of human muscle fatigue. PMID:3350969

  13. History dependence of the electromyogram: Implications for isometric steady-state EMG parameters following a lengthening or shortening contraction.

    PubMed

    Jones, Alexis A; Power, Geoffrey A; Herzog, Walter

    2016-04-01

    Residual force enhancement (RFE) and force depression (FD) refer to an increased or decreased force following an active lengthening or shortening contraction, respectively, relative to the isometric force produced at the same activation level and muscle length. Our intent was to determine if EMG characteristics differed in the RFE or FD states compared with a purely isometric reference contraction for maximal and submaximal voluntary activation of the adductor pollicis muscle. Quantifying these alterations to EMG in history-dependent states allows for more accurate modeling approaches for movement control in the future. For maximal voluntary contractions (MVC), RFE was 6-15% (P<0.001) and FD was 12-19% (P<0.001). The median frequency of the EMG was not different between RFE, FD and isometric reference contractions for the 100% and 40% MVC intensities (P>0.05). However, root mean square EMG (EMGRMS) amplitude for the submaximal contractions was higher in the FD and lower in the RFE state, respectively (P<0.05). For maximal contractions, EMGRMS was lower for the FD state but was the same for the RFE state compared to the isometric reference contractions (P>0.05). Neuromuscular efficiency (NME; force/EMG) was lower in the force depressed state and higher in the force enhanced state (P<0.05) compared to the isometric reference contractions. EMG spectral properties were not altered between the force-enhanced and depressed states relative to the isometric reference contractions, while EMG amplitude measures were. PMID:26891078

  14. Appropriate dosing of sugammadex to reverse deep rocuronium-induced neuromuscular blockade in morbidly obese patients.

    PubMed

    Loupec, T; Frasca, D; Rousseau, N; Faure, J-P; Mimoz, O; Debaene, B

    2016-03-01

    In morbidly obese patients, the speed of reversal of neuromuscular blockade with sugammadex based on ideal body weight is still matter of debate. In this single-center, randomised, double-blinded study, neuromuscular blockade was monitored in 50 patients using acceleromyography at the adductor pollicis. At the end of surgery with deep rocuronium-induced neuromuscular blockade, patients randomly received sugammadex 4 mg.kg(-1) (high dose group), 2 mg.kg(-1) (middle dose group), or 1 mg.kg(-1) (low dose group) of ideal body weight. After administration of the first dose of sugammadex, the mean (SD) recovery time (censored at 600 s) from deep neuromuscular blockade was significantly shorter (p < 0.001) in the high-dose group (n = 14; 255 (63) s) vs the middle-dose group (n = 13; 429 (102) s), or low-dose group (n = 4; 581 (154) s). Success rate from neuromuscular blockade reversal defined by a train-of-four ≥ 0.9 within 10 min after sugammadex administration, were 93%, 77% and 22% for these high, middle and low-dose groups respectively (p < 0.05 vs low-dose group). In morbidly obese patients, 4 mg.kg(-1) of ideal body weight of sugammadex allows suitable reversal of deep rocuronium-induced neuromuscular blockade. Monitoring remains essential to detect residual curarisation or recurarisation. PMID:26685122

  15. Muscle Fatigue Affects the Interpolated Twitch Technique When Assessed Using Electrically-Induced Contractions in Human and Rat Muscles

    PubMed Central

    Neyroud, Daria; Cheng, Arthur J.; Bourdillon, Nicolas; Kayser, Bengt; Place, Nicolas; Westerblad, Håkan

    2016-01-01

    The interpolated twitch technique (ITT) is the gold standard to assess voluntary activation and central fatigue. Yet, its validity has been questioned. Here we studied how peripheral fatigue can affect the ITT. Repeated contractions at submaximal frequencies were produced by supramaximal electrical stimulations of the human adductor pollicis muscle in vivo and of isolated rat soleus fiber bundles; an extra stimulation pulse was given during contractions to induce a superimposed twitch. Human muscles fatigued by repeated 30-Hz stimulation trains (3 s on–1 s off) showed an ~80% reduction in the superimposed twitch force accompanied by a severely reduced EMG response (M-wave amplitude), which implies action potential failure. Subsequent experiments combined a less intense stimulation protocol (1.5 s on–3 s off) with ischemia to cause muscle fatigue, but which preserved M-wave amplitude. However, the superimposed twitch force still decreased markedly more than the potentiated twitch force; with ITT this would reflect increased “voluntary activation.” In contrast, the superimposed twitch force was relatively spared when a similar protocol was performed in rat soleus bundles. Force relaxation was slowed by >150% in fatigued human muscles, whereas it was unchanged in rat soleus bundles. Accordingly, results similar to those in the human muscle were obtained when relaxation was slowed by cooling the rat soleus muscles. In conclusion, our data demonstrate that muscle fatigue can confound the quantification of central fatigue using the ITT.

  16. Effect of isoflurane and sevoflurane on the magnitude and time course of neuromuscular block produced by vecuronium, pancuronium and atracurium.

    PubMed

    Vanlinthout, L E; Booij, L H; van Egmond, J; Robertson, E N

    1996-03-01

    We have compared the ability of equipotent concentrations of isoflurane and sevoflurane to enhance the effect of non-depolarizing neuromuscular blocking drugs. Ninety ASA I and II patients of both sexes, aged 18-50 yr, were stratified into three blocker groups (Vec, Pan and Atr), to undergo neuromuscular block with vecuronium (n = 30), pancuronium (n = 30) or atracurium (n = 30), respectively. Within each group, patients were allocated randomly to one of three anaesthetic subgroups to undergo maintenance of anaesthesia with: (1) alfentanil-nitrous oxide-oxygen (n = 10); (2) alfentanil-nitrous oxide-oxygen-isoflurane (n = 10); or (3) alfentanil-nitrous oxide-oxygen-sevoflurane (n = 10) anaesthesia. During maintenance of anaesthesia, end-tidal concentrations of isoflurane, sevoflurane and nitrous oxide were 0.95, 1.70 and 70%, respectively. Both the evoked integrated electromyogram and mechanomyogram of the adductor pollicis brevis muscle were measured simultaneously. In the Vec and Pan groups, a total dose of 40 micrograms kg-1 of vecuronium or pancuronium, respectively, was given, and in the Atr group a total dose of atracurium 100 micrograms kg-1. Each blocker was given in four equal doses and administered cumulatively. We showed that 0.95% isoflurane and 1.70% sevoflurane (corresponding to 0.8 MAC of each inhalation anaesthetic, omitting the MAC contribution of nitrous oxide) augmented and prolonged the neuromuscular block produced by vecuronium, pancuronium and atracurium to a similar degree. PMID:8785139

  17. Factors affecting magnitude and time course of neuromuscular block produced by suxamethonium.

    PubMed

    Vanlinthout, L E; van Egmond, J; de Boo, T; Lerou, J G; Wevers, R A; Booij, L H

    1992-07-01

    This study was designed to identify factors that significantly alter the magnitude and duration of suxamethonium-induced neuromuscular block in patients with an apparently normal genotype for pseudocholinesterase. One hundred and fifty-six adults (ages 18-65 yr) were allocated to 13 subgroups. Patients in each subgroup received suxamethonium 50-2000 micrograms kg-1. The mechanographic response of the adductor pollicis brevis muscle to ulnar nerve stimulation was recorded. The ED50 was found to be 167 micrograms kg-1, ED90 was 316 micrograms kg-1 and ED95 was 392 micrograms kg-1. The duration of action (delta t) was in agreement with earlier published results. The magnitude of block was dose-related and decreased with increasing onset time (ton) and pseudocholinesterase activity (PChA). Neither age nor gender affected the degree of suxamethonium-induced block. Delta t was dose-related, decreased with increasing PChA, and was shorter for women. Age and ton had no effect on delta t. PMID:1637599

  18. The artery blood supply variant of the upper limb

    PubMed Central

    MASLARSKI, IVAN

    2015-01-01

    Variations of arterial patterns in the upper limb have represented the most common subject of vascular anatomy. Different types of artery branching pattern of the upper limb are very important for orthopedists in angiographic and microvascular surgical practice. The brachial artery (BA) is the most important vessel in the normal vascular anatomy of the upper limb. The classical pattern of the palmar hand region distribution shows the superficial palmar arch. Normally this arch is formed by the superficial branch of the ulnar artery and completed on the lateral side by one of these arteries: the superficial palmar branch of the radial artery, the princeps pollicis artery, the superficial palmar branch of the radial artery or the median artery. After the routine dissection of the right upper limb of an adult male cadaver, we found a very rare variant of the superficial arch artery – a division in a higher level brachial artery. We found this division at 10.4 cm from the beginning of the brachial artery. This superficial brachial artery became a radial artery and was not involved in the formation of the palm arch. In the forearm region, the artery variant was present with the median artery and the ulnar artery, which form the superficial palm arch. PMID:26733754

  19. Residual force enhancement following shortening is speed-dependent

    PubMed Central

    Fortuna, Rafael; Power, Geoffrey A.; Mende, Esther; Seiberl, Wolfgang; Herzog, Walter

    2016-01-01

    The steady-state isometric force following active muscle shortening or lengthening is smaller (force depression; FD) or greater (residual force enhancement; RFE) than a purely isometric contraction at the corresponding length. The mechanisms underlying these phenomena are not explained within the context of the cross-bridge theory and are rarely studied in concert. Previous studies have shown RFE to be speed-independent. In the present study, we investigated if RFE preceded by active shortening is time-dependent by electrically evoking RFE in the human adductor pollicis muscle. The results shown that a slow stretch following FD fully re-established RFE compared to higher speeds of stretch. The mechanism(s) responsible for the recovery of RFE following a preceding shortening contraction (FD) might be associated with the recovery of cross-bridge based force and/or the re-engagement of a passive structural element (titin). Voluntary interaction with one’s environment involves highly coordinated shortening and lengthening muscle contractions. Therefore comprehending these history-dependent muscle properties in the context of movement control is paramount in understanding the behavior of in vivo motor control. PMID:26869508

  20. Changes in motor cortical excitability during human muscle fatigue.

    PubMed Central

    Taylor, J L; Butler, J E; Allen, G M; Gandevia, S C

    1996-01-01

    1. The excitability of the motor cortex was investigated during fatiguing con of the elbow flexors in human subjects. During sustained contractions at 30 and 1 voluntary force (MVC), the short-latency electromyographic responses (EMG) evoke brachii and brachioradialis by transcranial magnetic stimulation increased in si EMG in the elbow flexors following the evoked muscle potential (silent period), duration during a sustained MVC but not during 30% MVCs nor during a sustained M muscle (adductor pollicis). 2. When the blood supply to brachioradialis was blocked with sphygmomanometer cuff sustained MVC, the changes in EMG responses to transcranial stimulation rapidly control values, This suggests that changes in these responses during fatigue wer small-diameter muscle afferents. 3. Tendon vibration during sustained MVCs indicated that the changes in the resp cortial stimulation were not mediated by reduced muscle spindle inputs. 4. Muscle action potentials evoked in brachioradialis by electrical stimulation cervicomedullary junction did not increase in size during sustained MVCs. Thus, cortically evoked responses during sustained MVCs reflects a change in cortical Although the silent period following cervicomedullary stimulation lengthened, it substantially shorter than the cortically evoked silent period. 5. The altered EMG responses to transcranial stimulation during fatigue suggest exitation and increased inhibition in the motor cortex. As these changes were un manipulation of afferent input they presumably result from intrinsic cortical pr altered voluntary drive to the motor cortex. Images Figure 1 PMID:8821148

  1. Nutritional assessment of institutionalized elderly

    PubMed Central

    Volpini, Milena Maffei; Frangella, Vera Silvia

    2013-01-01

    ABSTRACT Objective: To define the nutritional profile of institutionalized elderly individuals. Methods: Comparative correlation and quantitative field study conducted in a Long-Stay Institution in Sao Paulo (SP), Brazil, between December 2010 and January 2012. To define nutritional diagnosis, data were collected from patient files, such as body mass index, circumferences, triceps skinfold, muscle area of the arm, thickness of the adductor pollicis, handgrip strength, and biochemical test results. The anthropometric variables were presented as mean, standard deviation, and percentages, and were grouped by gender and stratified by age. The level of statistical significance was p<0.05. Results: One hundred and two elderly individuals were selected, and 84 were females. Excess weight was the most common anthropometric diagnosis in men (n=11; 61%), with the detection of protein depletion in those aged 70 years, and possible cases of sarcopenic obesity. All women were in good health conditions (n=84; 100%). However, in 27% (n=23) of them, protein depletion was evident. Conclusion: More anthropometric studies are necessary which would allow a definition of local reference standards, stratified by gender and age group. The difference between populations and factors, such as inclusion and exclusion criteria, and methodological characteristics, limit the use of international standards, interfering in the reliability of the nutritional diagnosis. PMID:23579741

  2. Residual force enhancement following shortening is speed-dependent.

    PubMed

    Fortuna, Rafael; Power, Geoffrey A; Mende, Esther; Seiberl, Wolfgang; Herzog, Walter

    2016-01-01

    The steady-state isometric force following active muscle shortening or lengthening is smaller (force depression; FD) or greater (residual force enhancement; RFE) than a purely isometric contraction at the corresponding length. The mechanisms underlying these phenomena are not explained within the context of the cross-bridge theory and are rarely studied in concert. Previous studies have shown RFE to be speed-independent. In the present study, we investigated if RFE preceded by active shortening is time-dependent by electrically evoking RFE in the human adductor pollicis muscle. The results shown that a slow stretch following FD fully re-established RFE compared to higher speeds of stretch. The mechanism(s) responsible for the recovery of RFE following a preceding shortening contraction (FD) might be associated with the recovery of cross-bridge based force and/or the re-engagement of a passive structural element (titin). Voluntary interaction with one's environment involves highly coordinated shortening and lengthening muscle contractions. Therefore comprehending these history-dependent muscle properties in the context of movement control is paramount in understanding the behavior of in vivo motor control. PMID:26869508

  3. [Monitoring of neuromuscular blocking].

    PubMed

    Chamorro, C; Silva, J A

    2008-02-01

    Neuromuscular blockade monitoring aims should be based on effectiveness criteria, that is, to administer the lowest effective dose, and on security criteria, avoiding overdosage and detecting possible residual blockade before patient extubation. A neuromuscular blockade monitoring and usage protocol should be available with predefined objectives for each patient to achieve the minimum effective doses. Maintenance of a light blockade level probably influences the decrease in complications associated with these drugs' use. Train-of-four monitoring, along with muscular movement detection allow adjustment to meet these aims. Ulnar nerve stimulation with response detection in the adductor pollicis muscle is the recommended neurostimulation in critically ill patients, while facial neurostimulation is recommended in situations where edema or skin temperature prevent correct ulnar nerve stimulation. Ensuring adequate sedation and analgesia in a paralysed patient is essential. An inadequately sedated but paralysed patient may subsequently suffer serious psychological and emotional stress. Bispectral index monitoring with sedative doses adjusted to 40-60 values assures, in most situations, correct sedation. PMID:18405539

  4. Metabolomic Analysis of Oxidative and Glycolytic Skeletal Muscles by Matrix-Assisted Laser Desorption/IonizationMass Spectrometric Imaging (MALDI MSI)

    NASA Astrophysics Data System (ADS)

    Tsai, Yu-Hsuan; Garrett, Timothy J.; Carter, Christy S.; Yost, Richard A.

    2015-06-01

    Skeletal muscles are composed of heterogeneous muscle fibers that have different physiological, morphological, biochemical, and histological characteristics. In this work, skeletal muscles extensor digitorum longus, soleus, and whole gastrocnemius were analyzed by matrix-assisted laser desorption/ionization mass spectrometry to characterize small molecule metabolites of oxidative and glycolytic muscle fiber types as well as to visualize biomarker localization. Multivariate data analysis such as principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) were performed to extract significant features. Different metabolic fingerprints were observed from oxidative and glycolytic fibers. Higher abundances of biomolecules such as antioxidant anserine as well as acylcarnitines were observed in the glycolytic fibers, whereas taurine and some nucleotides were found to be localized in the oxidative fibers.

  5. Using a Posterior Compartment Fasciotomy and Paratenon Closure in Acute Achilles Tendon Repair.

    PubMed

    Saper, David; Lybrand, Kyle; Creevy, William; Li, Xinning

    2016-07-01

    Soft tissue management, dissection, and handling are of paramount importance during Achilles tendon repair. Although surgical repairs of Achilles tendons have predictably excellent outcomes, complications including wound infection and stiffness are not uncommon. The authors' surgical technique for Achilles tendon repair includes tagging the posterior paratenon for later layered repair and incising the posterior fascia, exposing the flexor hallucis longus muscle belly. This posterior compartment fasciotomy allows for both hematoma evacuation away from the tenuous posterior skin and mobilization of the posterior paratendon for complete closure over the repaired Achilles tendon. With this modified technique, the authors report a 1% infection rate and a 1% failure rate. [Orthopedics. 2016; 39(4):e790-e793.]. PMID:27158828

  6. Role of glucocorticoids in increased muscle glutamine production in starvation

    NASA Technical Reports Server (NTRS)

    Tischler, Marc E.; Henriksen, Erik J.; Cook, Paul H.

    1988-01-01

    The role of glucocorticoids in the synthesis of muscle glutamine during starvation was investigated in adrenalectomized fasted rats injected with cortisol (1 mg/100 g body weight). It was found that administration of cortisol in vivo increased (compared to nontreated starved adrenalectomized controls) the glutamine/glutamate ratio and the activity of glutamine synthetase in the diaphragm and the extensor digitorum muscles, and that these effects were abolished by prior treatment with actinomycin D or proflavine. The results obtained in in vitro experiments, using fresh-frozen soleus, extensor digitorum longus, and diaphragm muscle preparations, supported the in vivo indications of the cortisol-enhanced glutamine synthesis and protein turnover in starved adrenalectomized animals.

  7. Synthesis of amino acids in weight bearing and non-weight bearing leg muscles of suspended rats

    NASA Technical Reports Server (NTRS)

    Tischler, M. E.; Jaspers, S. R.

    1982-01-01

    The effect of hypokinesia (HYP) for 6 days on the de novo synthesis of glutamine (GLN) and glutamate (GLU), and of alanine was tested in isolated leg muscles of intact, adrenalectomized (ADX) and ADX cortisol-treated rats. The net synthesis of GLN and GLU was lower in soleus muscles of HYP animals of these three groups of rats. The synthesis of alanine was lowered by HYP in ADX animals and apparently raised by HYP in ADX cortisol-treated rats. No HYP effect was seen in the extensor digitorum longus (EDL) muscles of these animals. Although ADX lowered the synthesis of GLN and GLU in soleus muscles of control rats, while cortisol treatment restored this process to near normal, neither ADX nor cortisol treatment produced any effect in the HYP animals. However, effects of ADX and cortisol treatment on synthesis of GLN and GLU in EDL muscles and of alanine in both muscles seemed normal in HYP animals.

  8. MRI in DNM2-related centronuclear myopathy: evidence for highly selective muscle involvement.

    PubMed

    Schessl, Joachim; Medne, Livija; Hu, Ying; Zou, Yaqun; Brown, Mark J; Huse, Jason T; Torigian, Drew A; Jungbluth, Heinz; Goebel, Hans-Hilmar; Bönnemann, Carsten G

    2007-01-01

    Dynamin 2 has recently been recognized as a causative gene for the autosomal dominant form of centronuclear myopathy (dominant centronuclear myopathy). Here we report an affected father and daughter with dynamin 2 related AD CNM with predominantly distal onset of weakness. In addition to the diagnostic central location of myonuclei the muscle biopsy also showed core-like structures. Muscle MRI in the lower leg revealed prominent involvement of the soleus, but also of the gastrocnemius and the tibialis anterior whereas in the thigh there was a consistent pattern of selective involvement of adductor longus, semimembranosus, biceps femoris, rectus femoris, and vastus intermedius with relative sparing of vastus lateralis and medialis, sartorius, gracilis, and partly of the semitendinosus. These characteristic findings on muscle MRI confirm similar findings reported for CT imaging in dynamin 2 related dominant centronuclear myopathy and may help to differentiate this disorder from central core disease and other myopathies. PMID:17134899

  9. [Reconstructions after inveterated fractures and dislocations of the foot].

    PubMed

    Zwipp, H

    2014-11-01

    Inveterated fractures or dislocations of the foot which are defined as being more than 6-12 weeks old can be secondarily reconstructed anatomically in only very rare cases. All other cases need reorientation of all axes of the foot requiring single or combined joint fusion. In cases of significant posttraumatic bone necrosis the dead bone has to be radically resected and substituted by an autogenous bone graft from the iliac crest. Old cases of dislocation, for example after subtalar dislocation without anatomical reduction, need reorientation of the foot axes by performing arthrodesis. Subluxation of the medial Lisfranc joint after an unrecognized rupture of Lisfranc ligament can be controlled later by anatomical repair of this ligament by using half of the extensor digitorum longus tendon and thus avoiding arthrodesis. PMID:25338655

  10. [Reconstructions after inveterated fractures and dislocations of the foot].

    PubMed

    Zwipp, H

    2014-01-01

    Inveterated fractures or dislocations of the foot which are defined as being more than 6-12 weeks old can be secondarily reconstructed anatomically in only very rare cases. All other cases need reorientation of all axes of the foot requiring single or combined joint fusion. In cases of significant posttraumatic bone necrosis the dead bone has to be radically resected and substituted by an autogenous bone graft from the iliac crest. Old cases of dislocation, for example after subtalar dislocation without anatomical reduction, need reorientation of the foot axes by performing arthrodesis. Subluxation of the medial Lisfranc joint after an unrecognized rupture of Lisfranc ligament can be controlled later by anatomical repair of this ligament by using half of the extensor digitorum longus tendon and thus avoiding arthrodesis. PMID:24441651

  11. Quantification of sarcomere length distribution in whole muscle frozen sections.

    PubMed

    O'Connor, Shawn M; Cheng, Elton J; Young, Kevin W; Ward, Samuel R; Lieber, Richard L

    2016-05-15

    Laser diffraction (LD) is a valuable tool for measuring sarcomere length (Ls), a major determinant of muscle function. However, this method relies on few measurements per sample that are often extrapolated to whole muscle properties. Currently it is not possible to measure Ls throughout an entire muscle and determine how Ls varies at this scale. To address this issue, we developed an actuated LD scanner for sampling large numbers of sarcomeres in thick whole muscle longitudinal sections. Sections of high optical quality and fixation were produced from tibialis anterior and extensor digitorum longus muscles of Sprague-Dawley rats (N=6). Scans produced two-dimensional Ls maps, capturing >85% of the muscle area per section. Individual Ls measures generated by automatic LD and bright-field microscopy showed excellent agreement over a large Ls range (ICC>0.93). Two-dimensional maps also revealed prominent regional Ls variations across muscles. PMID:26994184

  12. Skeletal muscle recovery after tenotomy and 7-day delayed muscle length restoration.

    PubMed

    Abrams, R A; Tsai, A M; Watson, B; Jamali, A; Lieber, R L

    2000-05-01

    Rabbit extensor digitorum longus (EDL) tendons were cut with the muscle active (active tenotomy, AT) or with the EDL at rest (passive tenotomy, PT). One, 7, and 21 days after tenotomy, contractile testing was performed. A second experiment was performed in which EDL tendons underwent PT and, after a 7-day delay, muscle-tendon units were restored to their original length. Maximum isometric tension dropped precipitously 1 day after either AT or PT to approximately 50% of normal and continued to decline by day 7. In contrast to PT, where peak tension (P(0)) decreased further by 21 days, after AT, P(0) partially recovered. Differences in muscle mass, cross-sectional area, fiber type, and sarcomere number did not explain the differential response. One day after length restoration of muscles, P(0) rapidly increased by approximately 40%. These observations have implications for understanding the outcome of muscle-tendon unit injury and surgical repair. PMID:10797393

  13. Rupture of the posterior tibial tendon. Evaluation of injury of the spring ligament and clinical assessment of tendon transfer and ligament repair.

    PubMed

    Gazdag, A R; Cracchiolo, A

    1997-05-01

    Eighteen of twenty-two patients who were having a tendon transfer to treat rupture of the posterior tibial tendon had evidence of injury to the spring ligament. The injury consisted of a longitudinal tear in the ligament in seven patients, a lax ligament without a gross tear in seven, and a complete rupture of the ligament in four. The ruptured posterior tibial tendon was treated with transfer of the flexor digitorum longus in twenty of the twenty-two patients. A variety of methods were used to repair the ligament. It is essential to determine the status of the spring ligament when patients are managed for rupture of the posterior tibial tendon. Patients who have a torn or lax spring ligament in addition to the ruptured posterior tibial tendon may have more severe abnormalities of the hindfoot than those who have only a ruptured tendon. PMID:9160939

  14. Differential effect of denervation on free radical scavenging enzymes in slow and fast muscle of rat

    NASA Technical Reports Server (NTRS)

    Asayama, K.; Dettbarn, W. D.; Burr, I. M.

    1985-01-01

    To determine the effect of denervation on the free radical scavenging systems in relation to the mitochondrial oxidative metabolism in the slow twitch soleus and fast twitch extensor digitorum longus (EDL) muscles, the sciatic nerve of the rat was crushed in the mid-thigh region and the muscle tissue levels of 5 enzymes were studied 2 and 5 weeks following crush. Radioimmunoassays were utilized for the selective measurement of cuprozinc (cytosolic) and mangano (mitochondrial) superoxide dismutases. These data represent the first systematic report of free radical scavening systems in slow and fast muscles in response to denervation. Selective modification of cuprozinc and manganosuperoxide dismutases and differential regulation of GSH-peroxidase was demonstrated in slow and fast muscle.

  15. Muscle sarcomere lesions and thrombosis after spaceflight and suspension unloading

    SciTech Connect

    Riley, D.A.; Ellis, S.; Giometti, C.S.; Hoh, J.F.Y.; Ilyina-Kakueva, E.I.; Oganov, V.S.; Slocum, G.R.; Bain, J.L.W.; Sedlak, F.R. )

    1992-08-01

    Extended exposure of humans to spaceflight produces a progressive loss of skeletal muscle strength. This process must be understood to design effective countermeasures. The present investigation examined hindlimb muscles from flight rats killed as close to landing as possible. Spaceflight and tail suspension-hindlimb unloading (unloaded) produced significant decreases in fiber cross-sectional areas of the adductor longus (AL), a slow-twitch antigravity muscle. However, the mean wet weight of the flight AL muscles was near normal, whereas that of the suspension unloaded AL muscles was significantly reduced. Interstitial edema within the flight AL, but not in the unloaded AL, appeared to account for this apparent disagreement.In both conditions, the slow-twitch oxidative fibers atrophied more than the fast-twitch oxidative-glycolytic fibers. Microcirculation was also compromised by spaceflight, such that there was increased formation of thrombi in the postcapillary venules and capillaries.

  16. Skeletal muscle response to spaceflight, whole body suspension, and recovery in rats

    NASA Technical Reports Server (NTRS)

    Musacchia, X. J.; Steffen, J. M.; Fell, R. D.; Dombrowski, M. J.

    1990-01-01

    The effects of a 7-day spaceflight (SF), 7- and 14-day-long whole body suspension (WBS), and 7-day-long recovery on the muscle weight and the morphology of the soleus and the extensor digitorum longus (EDL) of rats were investigated. It was found that the effect of 7-day-long SF and WBS were highly comparable for both the soleus and the EDL, although the soleus muscle from SF rats showed greater cross-sectional area reduction than that from WBS rats. With a longer duration of WBS, there was a continued reduction in cross-sectional fast-twitch fiber area. Muscle plasticity, in terms of fiber and capillary responses, showed differences in responses of the two types of muscles, indicating that antigravity posture muscles are highly susceptible to unloading.

  17. Case Report: A case report highlighting bilateral EDB wasting as a clinical marker for lumbar canal stenosis

    PubMed Central

    Kumar, Bijoy Mohan; Munakomi, Sunil

    2015-01-01

    Herein we discuss a case of a 55 year old male presenting with history suggestive of sciatica on the left leg. Straight leg raising (SLR) test was positive at 45 degrees on the left side. His ankle reflex was absent and the power of extensor hallusus longus (EHL) was 4/5 on the same side. MRI lumbosacral spine revealed left paramedian disc prolapsed on L4/L5 level with spinal canal diameter of 9mm.However since his bilateral extensor digitorm brevis (EDB) were wasted, we suspected associated lumbar canal stenosis and thereby opted for laminectomy and discectomy in this case. Intraoperatively dural wasting, hypertrophied facets and narrow canal were confirmed. Laminectomy, medial facectectomy and discectomy were carried out. The patient recovered uneventfully with resolution of his sciatica-like pain. Bilateral EDB wasting thereby provides a clinical clue to the underlying lumbar canal stenosis and can help in making correct therapeutic decisions. PMID:26535113

  18. Contractile properties of rat fast-twitch skeletal muscle during reinnervation - Effects of testosterone and castration

    NASA Technical Reports Server (NTRS)

    Yeagle, S. P.; Mayer, R. F.; Max, S. R.

    1983-01-01

    The peroneal nerve of subject rats were crushed 1 cm from the muscle in order to examine the isometric contractile properties of skeletal muscle in the recovery sequency during reinnervation of normal, castrated, and testosterone-treated rats. The particular muscle studied was the extensor digitorum longus, with functional reinnervation first observed 8-9 days after nerve crush. No evidence was found that either castration or testosterone injections altered the process of reinnervation after the nerve crush, with the conclusion being valid at the 0.05 p level. The most reliable index of reinnervation was found to be the twitch:tetanus ratio, a factor of use in future studies of the reinnervation of skeletal muscle.

  19. Physiological changes in fast and slow muscle with simulated weightlessness

    NASA Technical Reports Server (NTRS)

    Dettbarn, W. D.; Misulis, K. E.

    1984-01-01

    A rat hindlimb suspension model of simulated weightlessness was used to examine the physiological characteristics of skeletal muscle. The physiological sequelae of hindlimb suspension were compared to those of spinal cord section, denervation by sciatic nerve crush, and control. Muscle examined were the predominantly slow (Type 1) soleus (SOL) and the predominantly fast (Type 2) extensor digitorum longus (EDL). Two procedures which alter motor unit activity, hindlimb suspension and spinal cord section, produce changes in characteristics of skeletal muscles that are dependent upon fiber type. The SOL develops characteristics more representative of a fast muscle, including smaller Type 1 fiber proportion and higher AChE activity. The EDL, which is already predominantly fast, loses most of its few Type 1 fibers, thus also becoming faster. These data are in agreement with the studies in which rats experienced actual weightlessness.

  20. MRI of the tibioastragalus anticus of Gruber muscle: a rare accessory muscle and normal anatomical variant.

    PubMed

    Berkowitz, Yaron; Mushtaq, Nadeem; Amiras, Dimitri

    2016-06-01

    We present the case of a 31-year-old man who sustained a hyperplantar flexion injury of his right ankle, and was evaluated using computed tomography and MRI to assess for osseous and ligamentous injury. The MRI and CT studies demonstrated a tibioastragalus anticus of Gruber (TAAG) muscle in the lower limb's anterior compartment. To our knowledge, the imaging of this muscle has not been previously described. The TAAG muscle arises from the lower third of the anterolateral tibia and the interosseous membrane. Its tendon passes laterally, deep to the tibialis anterior and extensor hallucis longus tendons, and inserts onto the anterior superolateral neck of the talus in a fan-like manner. Knowledge and recognition of this tendon are important for both diagnostic accuracy and surgical planning, and could potentially be used as a tendon transfer or graft in the appropriate clinical setting. The presence of this accessory muscle should not be confused with a pathological condition. PMID:27037809

  1. Shear Modulus of the Lower Leg Muscles in Patients with Medial Tibial Stress Syndrome.

    PubMed

    Akiyama, Kei; Akagi, Ryota; Hirayama, Kuniaki; Hirose, Norikazu; Takahashi, Hideyuki; Fukubayshi, Toru

    2016-08-01

    This study aimed to investigate the in vivo kinematics of shear modulus of the lower leg muscles in patients with medial tibial stress syndrome (MTSS). The study population included 46 limbs with MTSS and 40 healthy limbs. The shear modulus of the medial head of the gastrocnemius, lateral head of the gastrocnemius, soleus, peroneus longus and tibialis anterior muscles were measured using shear wave ultrasound elastography. As a result, the shear modulus of the lower leg muscles was significantly greater in patients with MTSS than in healthy patients (p < 0.01). Based on the differences in shear modulus of lower leg muscles between the patients with MTSS and healthy patients, the measurements obtained via shear wave ultrasound elastography could be used to evaluate risk factors of MTSS. PMID:27129903

  2. New and emerging treatments in dermatology: acne.

    PubMed

    Katsambas, A; Dessinioti, C

    2008-01-01

    Topical retinoids, benzoyl peroxide, azelaic acid, and topical and oral antibiotics remain the milestone of treatment for mild to moderate acne vulgaris. Oral isotretinoin is useful for the treatment of severe nodular acne, treatment-resistant acne, and acne with a risk of physical or psychological scarring. Hormonal treatment in female acne is useful in resistant or late-onset acne. With increasing concerns regarding teratogenicity of isotretinoin and increasing antibiotic resistance, there is a clear need for therapeutic alternatives to these long-used treatments. Research in the pathogenesis of acne has allowed for new therapies and future perspectives regarding acne to evolve. They include low-dose long-term isotretinoin regimens, insulin-sensitizing agents, 5alpha-reductase type 1 inhibitors, topical photodynamic therapy, new combination formulations, dietary interventions, and antiinflammatory agents such as lipoxygenase inhibitors. PMID:18394082

  3. Giant cell tumour of tendon sheath with simultaneous two tendon involvement of the foot treated with excision of the tumour and reconstruction of the flexor retinaculum using tibialis posterior tendon in a paediatric patient: A rare case report.

    PubMed

    Tiwari, Vivek; Ansari, Tahir; Mittal, Samarth; Sharma, Pankaj; Nalwa, Aasma

    2015-12-01

    Giant cell tumour of tendon sheath is a benign soft tissue tumour arising from the tendon sheath. The involvement of foot and ankle by such tumours is relatively rare. Children are not commonly afflicted by this condition. All such tumours are reported to arise either from a single tendon sheath or one joint. We report a case of giant cell tumour of tendon sheath in a 12-year-old child, arising simultaneously from the tendon sheaths of tibialis posterior and flexor digitorum longus tendons, as well as extending into the ankle joint. It was treated by complete excision of the mass along with the tendon sheaths with reconstruction of the flexor retinaculum. The location of the tumour, age of the patient, diffuse nature of the tumour and novel technique of reconstruction of the flexor retinaculum make this case extremely rare and the first to be reported in literature. PMID:26564735

  4. The validity of an animal model for experiments related to weightlessness

    NASA Technical Reports Server (NTRS)

    Musacchia, X. J.; Steffen, J. M.

    1983-01-01

    Animal evolution has witnessed morphological and physiological adaptations to gravitational forces. In the rat, hind limb muscles can be used to illustrate a range of load bearing functions: soleus - gastrocnemius = plantaris - extensor digitorum longus (EDL). A harness suspension apparatus is used to induce hypokinesia and hypodynamia (H&H) and to simulate responses comparable to those seen in weightlessness (i.e., COSMOS experiments). After one and two weeks of suspension H&H, there is muscle atrophy with a loss in muscle mass; the result of loss in muscle protein. Concommitantly, there is a decrease in RNA, but not in DNA content. The effects are greatest in the soleus and least in the EDL. These recent findings, in concert with earlier reports of increased nitrogenous excretion, suggest that both decreased protein synthesis and increased protein catabolism are characteristic of muscle atrophy. Recovery is seen in terms of reversal of these effects after removal from suspension.

  5. Muscle protein and glycogen responses to recovery from hypogravity and unloading by tail-cast suspension

    NASA Technical Reports Server (NTRS)

    Henriksen, E. J.; Tischler, M. E.; Jacob, S.; Cook, P. H.

    1985-01-01

    Previous studies in this laboratory using the tail-bast hindlimb suspension model have shown that there are specific changes in protein and carbohydrate metabolism in the soleus muscle due to unloading. For example, 6 days of unloading caused a 27% decrease in mass and a 60% increase in glycogen content in the soleus muscle, while the extensor digitorum longus muscle was unaffected. Also, fresh tissue tyrosine and its in vitro release from the muscle are increased in the unloaded soleus, indicating that this condition causes a more negative protein balance. With these results in mind, studies to investigate the effect of hypogravity on protein and carbohydrate metabolism in a number of rat hindlimb muscles were carried out.

  6. Muscle protein and glycogen responses to recovery from hypogravity and unloading by tail-cast suspension

    NASA Technical Reports Server (NTRS)

    Henriksen, E. J.; Tischler, M. E.; Jacob, S.; Cook, P. H.

    1985-01-01

    Previous studies in this laboratory using the tail-bast hindlimb suspension model have shown that there are specific changes in protein and carbohydrate metabolism in the soleus muscle due to unloading. For example, 6 days of unloading caused a 27 percent decrease in mass and a 60 percent increse in glycogen content in the soleus muscle, while the extensor digitorum longus muscle was unaffected. Also, fresh tissue tyrosine and its in vitro release from the muscle are increased in the unloaded soleus, indicating that this condition causes a more negative protein balance. With these results in mind, studies to investigate the effect of hypogravity on protein and carbohydrate metabolism in a number of rat hindlimb muscles were carried out.

  7. Effect of hindlimb immobilization on the fatigability of skeletal muscle

    NASA Technical Reports Server (NTRS)

    Witzmann, F. A.; Kim, D. H.; Fitts, R. H.

    1983-01-01

    The effect of 6 weeks of disuse atrophy produced by hindlimb immobilization was studied in situ (33.5 C) in the soleus and extensor digitorum longus muscles of rats. The results indicate that disuse causes preferential alterations in the isometric contractile properties of slow-twitch, as opposed to fast-twitch, skeletal muscles. During continuous contractile activity, atrophied muscles were found to have lower ATP levels and an apparent increase in their dependence on anaerobic metabolism, as reflected by the more extensive depletion of glycogen and enhanced lactate formation. Although the atrophied muscles were determined to have fewer cross bridges and thus generated lower tension, the pattern of decline in active cross-bridge formation and tetanic tension during contractile activity was found to proceed in a manner similar to controls.

  8. Metabolomic Analysis of Oxidative and Glycolytic Skeletal Muscles by Matrix-Assisted Laser Desorption/Ionization Mass Spectrometric Imaging (MALDI MSI)

    PubMed Central

    Tsai, Yu-Hsuan; Garrett, Timothy J.; Carter, Christy S.; Yost, Richard A.

    2015-01-01

    Skeletal muscles are composed of heterogeneous muscle fibers that have different physiological, morphological, biochemical, and histological characteristics. In this work, skeletal muscles extensor digitorum longus, soleus, and whole gastrocnemius were analyzed by matrix-assisted laser desorption/ionization mass spectrometry to characterize small molecule metabolites of oxidative and glycolytic muscle fiber types as well as to visualize biomarker localization. Multivariate data analysis such as principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) were performed to extract significant features. Different metabolic fingerprints were observed from oxidative and glycolytic fibers. Higher abundances of biomolecules such as antioxidant anserine as well as acylcarnitines were observed in the glycolytic fibers, whereas taurine and some nucleotides were found to be localized in the oxidative fibers. PMID:25893271

  9. Dystrophin expression following the transplantation of normal muscle precursor cells protects mdx muscle from contraction-induced damage.

    PubMed

    Rousseau, Joel; Dumont, Nicolas; Lebel, Carl; Quenneville, Simon P; Côté, Claude H; Frenette, Jérome; Tremblay, Jacques P

    2010-01-01

    Duchenne muscular dystrophy (DMD) is the most frequent muscular dystrophy. Currently, there is no cure for the disease. The transplantation of muscle precursor cells (MPCs) is one of the possible treatments, because it can restore the expression of dystrophin in DMD muscles. In this study, we investigated the effects of myoblasts injected with cardiotoxin on the contractile properties and resistance to eccentric contractions of transplanted and nontransplanted muscles. We used the extensor digitorum longus (EDL) as a model for our study. We conclude that the sole presence of dystrophin in a high percentage of muscle fibers is not sufficient by itself to increase the absolute or the specific force in the EDL of transplanted mdx muscle. This lack of strength increase may be due to the extensive damage that was produced by the cardiotoxin, which was coinjected with the myoblasts. However, the dystrophin presence is sufficient to protect muscle from eccentric damage as indicated by the force drop results. PMID:20650035

  10. Modulation of the cytosolic androgen receptor in striated muscle by sex steroids

    NASA Technical Reports Server (NTRS)

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

    1982-01-01

    The influence of orchiectomy (GDX) and steroid administration on the level of the cytosolic androgen receptor in the rat levator ani muscle and in rat skeletal muscles (tibialis anterior and extensor digitorum longus) was studied. Androgen receptor binding to muscle cytosol was measured using H-3 methyltrienolone (R1881) as ligand, 100 fold molar excess unlabeled R1881 to assess nonspecific binding, and 500 fold molar excess of triamcinolone acetonide to prevent binding to glucocorticoid and progestin receptors. Results demonstrate that modification of the levels of sex steroids can alter the content of androgen receptors of rat striated muscle. Data suggest that: (1) cytosolic androgen receptor levels increase after orchiectomy in both levator ani muscle and skeletal muscle; (2) the acute increase in receptor levels is blocked by an inhibitor of protein synthesis; and (3) administration of estradiol-17 beta to castrated animals increases receptor binding in levator ani muscle but not in skeletal muscle.

  11. Fifth metatarsal stress fractures in elite basketball players: evaluation of forces acting on the fifth metatarsal.

    PubMed

    Guettler, Joseph H; Ruskan, Gregory J; Bytomski, Jeffrey R; Brown, Cristopher R; Richardson, Jan K; Moorman, Claude T

    2006-11-01

    Our hypothesis in this study was that significant forces act on the fifth metatarsal during certain maneuvers commonly performed while playing basketball and that medial arch support influences these forces. Eleven male collegiate basketball players participated in this study. Electronic pressure sensors capable of dynamic readings were inserted into the players' shoes, and surface electromyographic (EMG) electrodes were placed over the peroneus longus and brevis muscles. The players performed 3 common maneuvers postulated to place maximal stress on the fifth metatarsal. The maneuvers were performed in a standard basketball shoe, then in a shoe with an orthosis supporting the arch. During each of these maneuvers, EMG activity of the ankle everters was recorded, along with maximal force, total work, and time elapsed beneath the fifth metatarsal. PMID:17152977

  12. Effect of inaction on function of fast and slow muscle spindles

    NASA Technical Reports Server (NTRS)

    Arutyunyan, R. S.

    1980-01-01

    There is no data on the comparative effect of tenotomy on the function of the muscle spindles of fast and slow muscles. This study covers this question. The experiments were conducted on cats. The musuculus extensor digitorum longus (m. EDL) was selected as the fast muscle, and the musculus soleus (m. Sol.) as the slow. In a comparison of the spontaneous activity of primary and secondary endings of the fast and slow muscle spindles (i.e., the activity with complete relaxation of the muscles) normally no difference between them was successfully found. The authors recorded the integrative, and not the individual activity, and secondly, under conditions of such recording technique, those slight changes that are observed in the fast muscle receptors could remain unnoticed.

  13. Posterior ankle impingement syndrome.

    PubMed

    Maquirriain, Javier

    2005-10-01

    Posterior ankle impingement syndrome is a clinical disorder characterized by posterior ankle pain that occurs in forced plantar flexion. The pain may be acute as a result of trauma or chronic from repetitive stress. Pathology of the os trigonum-talar process is the most common cause of this syndrome, but it also may result from flexor hallucis longus tenosynovitis, ankle osteochondritis, subtalar joint disease, and fracture. Patients usually report chronic or recurrent posterior ankle pain caused or exacerbated by forced plantar flexion or push-off maneuvers, such as may occur during dancing, kicking, or downhill running. Diagnosis of posterior ankle impingement syndrome is based primarily on clinical history and physical examination. Radiography, scintigraphy, computed tomography, and magnetic resonance imaging depict associated bone and soft-tissue abnormalities. Symptoms typically improve with nonsurgical management, but surgery may be required in refractory cases. PMID:16224109

  14. Role of glucocorticoids in the response of rat leg muscles to reduced activity

    NASA Technical Reports Server (NTRS)

    Jaspers, Stephen R.; Tischler, Marc E.

    1986-01-01

    Adrenalectomy did not prevent atrophy of rat soleus muscle during 6 days of tail cast suspension. Cortisol treatment enhanced the atrophy and caused atrophy of the weight-bearing soleus and both extensor digitorum longus (EDL) muscles. Unloading led to increased sarcoplasmic protein concentration in the soleus but cortisol administration increased the myhofibrillar (+stromal) protein concentration in both muscles. Suspension of hindlimbs of adrenalectomized animals led to faster protein degradation, slower sarcoplasmic protein degradation, and faster myofibrillar protein synthesis in the isolated soleus, whereas with cortisol-treated animals, the difference in synthesis of myofibrillar proteins was enhanced and that of sarcoplasmic proteins was abolished. Both soleus and EDL of suspended, cortisol-treated animals showed faster protein degradation. It is unlikely that any elevation in circulating glucocorticoids was solely responsible for atrophy of the soleus in this model, but catabolic amounts of glucocorticoids could alter the response of muscle to unloading.

  15. Extended indications for foot and ankle arthroscopy.

    PubMed

    Hsu, Andrew R; Gross, Christopher E; Lee, Simon; Carreira, Dominic S

    2014-01-01

    Advances in foot and ankle arthroscopy have allowed surgeons to diagnose and treat a broadening array of disorders that were previously limited to open procedures. Arthroscopy of the posterior ankle, subtalar joint, and first metatarsophalangeal joint and tendoscopy can be used to address common foot and ankle ailments, with the potential benefits of decreased pain, fast recovery, and low complication rates. Posterior ankle and subtalar arthroscopy can be used to manage impingement, arthrofibrosis, synovitis, arthritis, fractures, and osteochondral defects. First metatarsophalangeal joint arthroscopy can address osteophytes, chronic synovitis, osteochondral defects, and degenerative joint disease. Tendoscopy is a minimally invasive alternative for evaluation and débridement of the Achilles, posterior tibial, flexor hallucis longus, and peroneal tendons. PMID:24382875

  16. Transcriptional regulation of decreased protein synthesis during skeletal muscle unloading

    NASA Technical Reports Server (NTRS)

    Howard, G.; Steffen, J. M.; Geoghegan, T. E.

    1989-01-01

    The regulatory role of transcriptional alterations in unloaded skeletal muscles was investigated by determining levels of total muscle RNA and mRNA fractions in soleus, gastrocnemius, and extensor digitorum longus (EDL) of rats subjected to whole-body suspension for up to 7 days. After 7 days, total RNA and mRNA contents were lower in soleus and gastrocnemius, compared with controls, but the concentrations of both RNAs per g muscle were unaltered. Alpha-actin mRNA (assessed by dot hybridization) was significantly reduced in soleus after 1, 3, and 7 days of suspension and in gastrocnemius after 3 and 7 days, but was unchanged in EDL. Protein synthesis directed by RNA extracted from soleus and EDL indicated marked alteration in mRNAs coding for several small proteins. Results suggest that altered transcription and availability of specific mRNAs contribute significantly to the regulation of protein synthesis during skeletal muscle unloading.

  17. Effect of inactivity and passive stretch on protein turnover in phasic and postural rat muscles

    NASA Technical Reports Server (NTRS)

    Loughna, P.; Goldspink, G.; Goldspink, D. F.

    1986-01-01

    Muscle atrophy in humans can occur during prolonged bed rest, plaster cast immobilization, and space flight. In the present study, the suspension model used by Musacchia et al. (1983) is employed to investigate changes in protein synthesis and degradation in fast-twitch phasic (extensor digitorum longus) and slow-twitch postural (soleus) muscles in the rat, following hypokinesia and hypodynamia. In addition, the use of passive stretch was examined as a means of preventing atrophy. The obtained results suggest that the mechanisms controlling the processes of protein synthesis and protein breakdown during muscle disuse atrophy may be independent of each other. It appears, however, that the muscle atrophy due to hypokinesia and hypodynamia can be temporarily prevented by passively stretching a muscle.

  18. Insertional Characteristics of the Peroneus Tertius Tendon: Revisiting the Anatomy of an Underestimated Muscle.

    PubMed

    Ercikti, Nurcan; Apaydin, Nihal; Kocabiyik, Necdet; Yazar, Fatih

    2016-01-01

    The present study was performed to describe the morphologic characteristics of the peroneus tertius (PT) tendon, evaluate the variations in its insertion point, investigate the interconnections with the tendons of the extensor digitorum longus, and discuss whether these insertion differences of the muscle tension might have an effect on fracture formation. The length and width of the PT tendon and the width at its midpoint were measured in 44 lower extremities. The data obtained were compared statistically. The PT was found to occur in 2 types according to the number of tendons: type 1, a single tendon without a slip; and type 2, 2 tendons with a slip. It has been suggested that the PT tendon could contribute to avulsion fractures of the tuberosity of the fifth metatarsal bone. Therefore, to understand the mechanism of Jones fracture, knowledge of the PT tendon would be beneficial to determine the insertion points. PMID:26860045

  19. Influence of spaceflight on rat skeletal muscle

    NASA Technical Reports Server (NTRS)

    Martin, Thomas P.; Edgerton, V. Reggie; Grindeland, Richard E.

    1988-01-01

    The effect of a 7-day spaceflight (aboard NASA's SL-3) on the size and the metabolism of single fibers from several rat muscles was investigated along with the specificity of these responses as related to the muscle type and the size of fibers. It was found that the loss of mass after flight was varied from 36 percent in the soleus to 15 percent in the extensor digitorum longus. Results of histochemical analyses showed that the succinate dehydrogenase (SDH) activity in muscles of flight-exposed rats was maintained at the control levels, whereas the alpha-glycerol phosphate dehydrogenase (GPD) activity was either maintained or increased. The analyses of the metabolic profiles of ATPase, SDH, and GPD indicated that, in some muscles, there was an increase in the poportion of fast oxidative-glycolytic fibers.

  20. Fluid collection in the retropharyngeal space: A wide spectrum of various emergency diseases.

    PubMed

    Tomita, Hayato; Yamashiro, Tsuneo; Ikeda, Hirotaka; Fujikawa, Atsuko; Kurihara, Yoshiko; Nakajima, Yasuo

    2016-07-01

    Fluid collections in the retropharyngeal space (RPS) result from a wide spectrum of diseases, including retropharyngeal abscess, cervical osteomyelitis, and calcific tendinitis of the longus colli muscle. These conditions should be managed by different specialties; beginning with care in the emergency room, physicians from orthopedics, pediatrics, otolaryngology, and oncology are in charge of the treatment. Since these diseases demonstrate similar fluid collections in the RPS on computed tomography (CT) and magnetic resonance imaging (MRI), the radiologist's diagnosis based on the characteristic imaging findings is very important to identify the primary disease. Also, since some of the diseases require immediate surgical intervention to avoid life-threatening mediastinitis or airway obstruction, radiologists must distinguish these diseases correctly and provide recommendations for their management to physicians. Understanding clinical features and imaging findings of these fluid collections in the RPS is crucial for the best care. PMID:27235871

  1. Muscle protein analysis. II. Two-dimensional electrophoresis of normal and diseased human skeletal muscle

    SciTech Connect

    Giometti, C.S.; Barany, M.; Danon, M.J.; Anderson, N.G.

    1980-07-01

    High-resolution two-dimensional electrophoresis was used to analyze the major proteins of normal and pathological human-muscle samples. The normal human-muscle pattern contains four myosin light chains: three that co-migrate with the myosin light chains from rabbit fast muscle (extensor digitorum longus), and one that co-migrates with the light chain 2 from rabbit slow muscle (soleus). Of seven Duchenne muscular dystrophy samples, four yielded patterns with decreased amounts of actin and myosin relative to normal muscle, while three samples gave patterns comparable to that for normal muscle. Six samples from patients with myotonic dystrophy also gave normal patterns. In nemaline rod myopathy, in contrast, the pattern was deficient in two of the fast-type myosin light chains.

  2. Glucocorticoid sensitivity, disuse, and the regulation of muscle mass

    NASA Technical Reports Server (NTRS)

    Almon, R. R.; Dubois, D. C.

    1983-01-01

    A new noninvasive immobilization procedure to be used on rats has been developed to study immobilization-induced muscle hypersensitivity to normal glucocorticoid concentration, subsequent muscle atrophy, and atrophy recovery. The immobilization procedure involves encasing the hind limb in a light-weight plasticlike cast (10 percent the usual plaster weight), completely resistant to animal gnawing. The effects of right-angle immobilization of the ankle on the slow fiber soleus, and the fast fiber extensor digitorum longus, resemble the effects of weightlessness. The increased concentration of glucocorticoid receptor sites in immobilized and denervated muscle is discussed, along with the chronic loss of muscle mass that occurs in practically all dystrophies. It is concluded that lack of mechanical work in a zero gravity environment is a major cause of glucocorticoid hypersensitivity in the body's musculature.

  3. Slow to fast alterations in skeletal muscle fibers caused by clenbuterol, a beta(2)-receptor agonist

    NASA Technical Reports Server (NTRS)

    Zeman, Richard J.; Ludemann, Robert; Easton, Thomas G.; Etlinger, Joseph D.

    1988-01-01

    The effects of a beta(2)-receptor agonist, clenbuterol, and a beta(2) antagonist, butoxamine, on the skeletal muscle fibers of rats were investigated. It was found that chronic treatment of rats with clenbuterol caused hypertrophy of histochemically identified fast-twitch, but not slow-twitch, fibers within the soleus, while in the extensor digitorum longus the mean areas of both fiber types were increased; in both muscles, the ratio of the number of fast-twitch to slow-twitch fibers was increased. In contrast, a treatment with butoxamine caused a reduction of the fast-twitch fiber size in both muscles, and the ratio of the fast-twitch to slow-twitch fibers was decreased.

  4. Role of Glucocorticoids in the Response to Unloading of Muscle Protein and Amino Acid Metabolism

    NASA Technical Reports Server (NTRS)

    Tischler, M. E.; Jaspers, S. R.

    1985-01-01

    Intact control (weight bearing) and suspended rats gained weight at a similar rate during a 6 day period. Adrenaectomized (adx) weight bearing rats gained less weight during this period while adrenalectomized suspended rats showed no significant weight gain. Cortisol treatment of both of these groups of animals caused a loss of body weight. Results from these studies show several important findings: (1) Metabolic changes in the extensor digitorum longus muscle of suspended rats are due primarily to increased circulating gluccorticoids; (2) Metabolic changes in the soleus due to higher steroid levels are probably potentiated by greater numbers of receptors; and (3) Not all metabolic responses in the unloaded soleus muscle are due to direct action of elevated glucocorticoids or increased sensitivity to these hormones.

  5. Peroneal tendon tears, surgical management and its complications.

    PubMed

    Cerrato, Rebecca A; Myerson, Mark S

    2009-06-01

    Peroneal tendon injuries in the athlete are recognized with increasing frequency as a pathologic entity. Once considered uncommon, they have been attributed to many cases of persistent lateral ankle symptoms after a "typical" ankle sprain. Acute tears of the peroneus brevis, and less commonly the peroneus longus, have been implicated in sport activities and are often coexistent with peroneal instability. Subluxation typically occurs when the foot is in a dorsiflexed position and the peroneal muscles strongly contract, causing an eversion force simultaneously. Peroneal instability, as well as tearing, has been linked to ballet dancing, skiing, soccer, tennis, American football, running, basketball, and ice skating. This article discusses the mechanism of injury, methods of patient evaluation and management, complications, and outcomes. PMID:19501808

  6. Acute effects of hindlimb unweighting on satellite cells of growing skeletal muscle

    NASA Technical Reports Server (NTRS)

    Schultz, Edward; Darr, Kevin C.; Macius, Allison

    1994-01-01

    The proliferative behavior of satellite cells in growing rat soleus and extensor digitorum longus muscles was examined at short periods after initiation of hindlimb unweighting. Mitotic activity of satellite cells in both muscles decreased below weight-bearing control levels within 24 h of initiation of hindlimb unweighting. This satellite cell response was equal to or greater than 48 h before any atrophic morphological changes that take place in the muscles. Suppression of mitotic activity was most severe in the soleus muscle where continuous infusion of label demonstrated that virtually all mitotic activity was abolished between 3 and 5 days. The results of this study suggest that satellite cell mitotic activity is a sensitive indicator of primary atrophic changes occurring in growing myofibers and may be a predictor of future morphological changes.

  7. Defects in oxygen supply to skeletal muscle of prediabetic ZDF rats.

    PubMed

    Ellis, Christopher G; Goldman, Daniel; Hanson, Madelyn; Stephenson, Alan H; Milkovich, Stephanie; Benlamri, Amina; Ellsworth, Mary L; Sprague, Randy S

    2010-06-01

    In humans, prediabetes is characterized by marked increases in plasma insulin and near normal blood glucose levels as well as microvascular dysfunction of unknown origin. Using the extensor digitorum longus muscle of 7-wk inbred male Zucker diabetic fatty rats fed a high-fat diet as a model of prediabetes, we tested the hypothesis that hyperinsulinemia contributes to impaired O(2) delivery in skeletal muscle. Using in vivo video microscopy, we determined that the total O(2) supply to capillaries in the extensor digitorum longus muscle of prediabetic rats was reduced to 64% of controls with a lower O(2) supply rate per capillary and higher O(2) extraction resulting in a decreased O(2) saturation at the venous end of the capillary network. These findings suggest a lower average tissue Po(2) in prediabetic animals. In addition, we determined that insulin, at concentrations measured in humans and Zucker diabetic fatty rats with prediabetes, inhibited the O(2)-dependent release of ATP from rat red blood cells (RBCs). This inability to release ATP could contribute to the impaired O(2) delivery observed in rats with prediabetes, especially in light of the finding that the endothelium-dependent relaxation of resistance arteries from these animals is not different from controls and is not altered by insulin. Computational modeling confirmed a significant 8.3-mmHg decrease in average tissue Po(2) as well as an increase in the heterogeneity of tissue Po(2), implicating a failure of a regulatory system for O(2) supply. The finding that insulin attenuates the O(2)-dependent release of ATP from RBCs suggests that this defect in RBC physiology could contribute to a failure in the regulation of O(2) supply to meet the demand in skeletal muscle in prediabetes. PMID:20207810

  8. Ultrasound-guided stellate ganglion block: safety and efficacy.

    PubMed

    Narouze, Samer

    2014-06-01

    Cervical sympathetic and stellate ganglion blocks (SGB) provide a valuable diagnostic and therapeutic benefit to sympathetically maintained pain syndromes in the head, neck, and upper extremity. With the ongoing efforts to improve the safety of the procedure, the techniques for SGB have evolved over time, from the use of the standard blind technique, to fluoroscopy, and recently to the ultrasound (US)-guided approach. Over the past few years, there has been a growing interest in the ultrasound-guided technique and the many advantages that it might offer. Fluoroscopy is a reliable method for identifying bony surfaces, which facilitates identifying the C6 and C7 transverse processes. However, this is only a surrogate marker for the cervical sympathetic trunk. The ideal placement of the needle tip should be anterolateral to the longus colli muscle, deep to the prevertebral fascia (to avoid spread along the carotid sheath) but superficial to the fascia investing the longus colli muscle (to avoid injecting into the muscle substance). Identifying the correct fascial plane can be achieved with ultrasound guidance, thus facilitating the caudal spread of the injectate to reach the stellate ganglion at C7-T1 level, even if the needle is placed at C6 level. This allows for a more effective and precise sympathetic block with the use of a small injectate volume. Ultrasound-guided SGB may also improve the safety of the procedure by direct visualization of vascular structures (inferior thyroidal, cervical, vertebral, and carotid arteries) and soft tissue structures (thyroid, esophagus, and nerve roots). Accordingly, the risk of vascular and soft tissue injury may be minimized. PMID:24760493

  9. Cerivastatin induces type-I fiber-, not type-II fiber-, predominant muscular toxicity in the young male F344 rats.

    PubMed

    Obayashi, Hisakuni; Nezu, Yoshikazu; Yokota, Hatsue; Kiyosawa, Naoki; Mori, Kazuhiko; Maeda, Naoyuki; Tani, Yoshiro; Manabe, Sunao; Sanbuissho, Atsushi

    2011-08-01

    3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are associated with adverse skeletal muscle toxicity, but the underlying mechanism remains unclear. To investigate the pathological mechanism of statin-induced myotoxicity, cerivastatin (20 ppm; corresponding to 2 mg/kg/day) was dietarily administered to young male F344 rats for 10 days, and time-course clinical observations, measurement of plasma creatine kinase activity, and light and electron microscopy of type I fiber-predominant skeletal muscle (soleus) or type II fiber-predominant skeletal muscles (extensor digitorum longus and tibialis anterior), were performed. Clinical symptoms including weakness of hind limbs, staggering gait and body weight loss, accompanied by marked plasma creatinine kinase elevation in rats fed cerivastatin at around Day 6 to 8. Interestingly, microscopic examination revealed that cerivastatin-induced muscle damages characterized by hypercontraction (opaque) and necrosis of the fibers were of particular abundance in the soleus muscle at Day 8, whereas these histological lesions in the extensor digitorum longus and tibialis anterior were negligible, even at Day 9. Prior to manifestation of muscle damage, swollen mitochondria and autophagic vacuoles in the soleus were observed as the earliest ultra structural changes at Day 6; then activated lysosomes, disarray of myofibril and dilated sarcoplasmic reticulum vesicles became ubiquitous at Day 8. These results demonstrate that cerivastatin induces type I fiber-predominant muscles injury, which is associated with mitochondrial damage, in young male F344 rats. Since the rat exhibiting type I fiber-targeted injury is a unique animal model for statin-induced myotoxicity, it will be useful for gaining insight into mechanisms of statin-induced myotoxicity. PMID:21804308

  10. Leg muscle volume during 30-day 6-degree head-down bed rest with isotonic and isokinetic exercise training

    NASA Technical Reports Server (NTRS)

    Greenleaf, J. E.; Lee, P. L.; Ellis, S.; Selzer, R. H.; Ortendahl, D. A.

    1994-01-01

    Magnetic resonance imaging (MRI) was used to compare the effect of two modes of lower-extremity exercise training on the mass (volume) of posterior leg group (PLG) muscles (soleus, flexor hallucis longus, tibialis posterior, lateral and medial gastrocnemius, and flexor digitorum longus) on 19 men (ages 32-42 years) subjected to intense dynamic-isotonic (ITE, cycle ergometer, number of subjects (N) = 7), isokinetic (IKE, torque egrometer, N = 7), and no exercise (NOE, N = 5) training for 60 min/day during head-down bed rest (HDBR). Total volume of the PLG muscles decreased (p less than 0.05) similarly: ITE = 4.3 +/- SE 1.6%, IKE = 7.7 +/- 1.6%, and NOE = 6.3 +/- 0.8%; combined volume (N = 19) loss was 6.1 +/- 0.9%. Ranges of volume changes were 2.6% to -9.0% (ITE), -2.1% to -14.9% (IKE), and -3.4% to -8/1% (NOE). Correlation coefficients (r) of muscle volume versus thickness measured with ultrasonography were: ITE r + 0.79 (p less than 0.05), IKE r = 0.27 (not significant (NS)), and NOE r = 0.63 (NS). Leg-muscle volume and thickness were highly correlated (r = 0.79) when plasma volume was maintained during HDBR with ITE. Thus, neither intensive lower extremity ITE nor IKE training influence the normal non-exercised posterior leg muscle atrophy during HDBR. The relationship of muscle volume and thickness may depend on the mode of exercise training associated with the maintenance of plasma volume.

  11. Three-Dimensional Muscle Architecture and Comprehensive Dynamic Properties of Rabbit Gastrocnemius, Plantaris and Soleus: Input for Simulation Studies

    PubMed Central

    Siebert, Tobias; Leichsenring, Kay; Rode, Christian; Wick, Carolin; Stutzig, Norman; Schubert, Harald; Blickhan, Reinhard; Böl, Markus

    2015-01-01

    The vastly increasing number of neuro-muscular simulation studies (with increasing numbers of muscles used per simulation) is in sharp contrast to a narrow database of necessary muscle parameters. Simulation results depend heavily on rough parameter estimates often obtained by scaling of one muscle parameter set. However, in vivo muscles differ in their individual properties and architecture. Here we provide a comprehensive dataset of dynamic (n = 6 per muscle) and geometric (three-dimensional architecture, n = 3 per muscle) muscle properties of the rabbit calf muscles gastrocnemius, plantaris, and soleus. For completeness we provide the dynamic muscle properties for further important shank muscles (flexor digitorum longus, extensor digitorum longus, and tibialis anterior; n = 1 per muscle). Maximum shortening velocity (normalized to optimal fiber length) of the gastrocnemius is about twice that of soleus, while plantaris showed an intermediate value. The force-velocity relation is similar for gastrocnemius and plantaris but is much more bent for the soleus. Although the muscles vary greatly in their three-dimensional architecture their mean pennation angle and normalized force-length relationships are almost similar. Forces of the muscles were enhanced in the isometric phase following stretching and were depressed following shortening compared to the corresponding isometric forces. While the enhancement was independent of the ramp velocity, the depression was inversely related to the ramp velocity. The lowest effect strength for soleus supports the idea that these effects adapt to muscle function. The careful acquisition of typical dynamical parameters (e.g. force-length and force-velocity relations, force elongation relations of passive components), enhancement and depression effects, and 3D muscle architecture of calf muscles provides valuable comprehensive datasets for e.g. simulations with neuro-muscular models, development of more realistic muscle models, or

  12. Interactive effects of growth hormone and exercise on muscle mass in suspended rats

    NASA Technical Reports Server (NTRS)

    Grindeland, Richard E.; Roy, Roland R.; Edgerton, V. Reggie; Grossman, Elena J.; Mukku, Venkat R.; Jiang, Bian; Pierotti, David J.; Rudolph, Ingrid

    1994-01-01

    Measures to attenuate muscle atrophy in rats in response to simulated microgravity (hindlimb suspension (HS)) have been only partially successful. In the present study, hypophysectomized rats were in HS for 7 days, and the effects of recombinant human growth hormone (GH), exercise (Ex), or GH+Ex on the weights, protein concentrations, and fiber cross-sectional areas (CSAs) of hindlimb muscles were determined. The weights of four extensor muscles, i.e., the soleus (Sol), medial (MG) and lateral (LG) gastrocnemius, and plantaris (Plt), and one adductor, i.e., the adductor longus (AL), were decreased by 10-22% after HS. Fiber CSAs were decreased by 34% in the Sol and by 1 17% in the MG after HS. In contrast, two flexors, i.e., the tibialis anterior (TA) and extensor digitorum longus (EDL), did not atrophy. In HS rats, GH treatment alone maintained the weights of the fast extensors (MG, LG, Plt) and flexors (TA, EDL) at or above those of control rats. This effect was not observed in the slow extensor (Sol) or AL. Exercise had no significant effect on the weight of any muscle in HS rats. A combination of GH and Ex treatments yielded a significant increase in the weights of the fast extensors and in the CSA of both fast and slow fibers of the MG and significantly increased Sol weight and CSA of the slow fibers of the Sol. The AL was not responsive to either GH or Ex treatments. Protein concentrations of the Sol and MG were higher only in the Sol of Ex and GH+Ex rats. These results suggest that while GH treatment or intermittent high intensity exercise alone have a minimal effect in maintaining the mass of unloaded muscle, there is a strong interactive effect of these two treatments.

  13. Sheep YAP1 temporal and spatial expression trend and its relation with MyHCs expression.

    PubMed

    Gao, W; Sun, W; Su, R; Lv, X Y; Wang, Q Z; Li, D; Musa, H H; Chen, L; Zhou, H; Xu, H S; Hua, W H

    2016-01-01

    RT-PCR was used to study the temporal and spatial pattern of Yes-associated protein 1 (YAP1) and myosin heavy chain (MyHC) expression in four different skeletal muscles (i.e., longissimus dorsi muscle, soleus muscle, gastrocnemius muscle, and extensor digitorum longus) and three growth stages (i.e., 2 days old, 2 and 6 months old) of Hu Sheep. The results showed that YAP1 was differentially expressed in skeletal muscles of sheep, that expression increased gradually with age, and that there were high levels of expression in the gastrocnemius muscle and lower levels in the longissimus dorsi muscle. MyHCI was expressed at high levels in the soleus muscle and at lower levels in the longissimus dorsi muscle. In contrast, MyHCIIA and MyHCIIX were expressed at high levels in the extensor digitorum longus and at lower levels in the soleus muscle. The expression of MyHCI and MyHCIIA decreased with increasing age while that of MyHCIIX increased. YAP1 expression was negatively correlated with MyHCII (P < 0.01) and positively correlated with MyHCIIX (P < 0.01) across all growth stages and skeletal muscle types studied. We speculate that after birth, the thicker muscle fiber diameter is associated with the high expression of MyHCIIX. Therefore, we conclude that YAP1 expression affects sheep muscle fiber development after birth and provides important genetic information for the selection candidate genes for sheep muscle growth. PMID:27173191

  14. Correlation between sheep YAP1 temporal and spatial expression trends and MSTN and MyoG gene expression.

    PubMed

    Lv, X Y; Sun, W; Su, R; Li, D; Wang, Q Z; Musa, H H; Chen, L; Zhang, Y F; Wu, W Z

    2015-01-01

    The aim of the current study was to investigate the effects of Yes-associated protein 1 (YAP1) gene expression after birth on the development of muscle and the relationship between YAP1 and myostatin (MSTN) and myogenin (MyoG). Reverse transcription polymerase chain reaction was used to analyze the trends in YAP1, MSTN, and MyoG temporal and spatial expression levels in various skeletal muscles (i.e., longissimus dorsi muscle, soleus muscle, gastrocnemius muscle, and extensor digitorum longus) and across 3 different growth stages (i.e., 2 days old, 2 and 6 months old) of Hu Sheep. The results showed that YAP1 expression was significantly different in the skeletal muscles of sheep; the expression level gradually increased with age; it was highly expressed in the gastrocnemius muscle and minimally expressed in the longissimus dorsi muscle. MSTN, a negative regulator of skeletal muscle development, was minimally expressed in the soleus muscle and might be related to the enlargement of muscle fiber diameter. MyoG, an important factor in regulating skeletal muscle development, was minimally expressed in the longissimus dorsi muscle and extensor digitorum longus, and highly expressed in the gastrocnemius and soleus muscles; it might inhibit the enlargement of muscle fiber diameter after birth. YAP1 expression was significantly (P < 0.05) or extremely significantly (P < 0.01) and positively correlated with MSTN and MyoG at 2 days old, 2 and 6 months old. YAP1 expression was related to muscle fiber development after birth and might be a candidate gene for the regulation of muscle growth. PMID:25966090

  15. The morphology of the cervico-thoracic sympathetic system in donkeys (Equus asinus L.).

    PubMed

    Ozgel, O; Duzler, A; Dursun, N; Beyaz, F

    2009-04-01

    Five adult donkeys of both sexes, used in applied anatomy classes, and perfused with formalin for teaching purposes, constituted the study material. Ganglion cervicale caudale of the examined materials has observed to exhibit individually variable situation as to extend on the left side of the median line, at the alignment of the first and second intercostal spaces and on the right side between the level of the first and third costa. The ganglion extended more caudally on the right side of median line. The lateral surface of the ganglion was determined to be covered with the m. scalenus medius. On the both sides of the median plane, the ganglion cervicale caudale was seen to be situated on the lateral surface of the m. longus colli. On the left side, the ganglion overlapped the oesophagus in two cadavers and on the right side it was situated within a groove between the m. longus colli and trachea in three cadavers. The rami communicantes received by the ganglion cervicale caudale originated from the eighth cervical and first thoracic spinal segments. The ganglion cervicale caudale was formed by the coalescence of the last cervical and first three thoracic sympathetic ganglia. The ganglion cervicale caudale gave off branches that formed the rami communicantes, plexus cardiacus, n. vertebralis and ansa subclavia. One branch extended from the ganglion to the plexus brachialis. in one specimen, two sympathetic-parasympathetic communicating branches were observed to extend from the ansa subclavia and near by the origin of the truncus sympathicus to the n. vagus. In one of the donkeys examined, a branch originating from the ganglion cervicale caudale on the left side of the median plane was determined to end on the ligamentum arteriosum. A microscopic ganglion structure suggesting the existence of the ganglion cervicale medium was determined in a donkey. PMID:19183351

  16. Ergonomic evaluation of the operating characteristics of the 6MF-30 portable pneumatic extinguisher.

    PubMed

    Wang, Linjie; Li, Wenbin; Chen, Jinglian

    2015-11-01

    The 6MF-30 portable pneumatic extinguisher, which is one of the most widely used pieces of equipment for fighting forest fires in China, can produce great physical discomfort for the wearer. To mitigate the physical discomfort associated with the use of the 6MF-30, the operating characteristics of this machine were ergonomically evaluated. Fourteen subjects were instructed to operate the 6MF-30 portable pneumatic extinguisher using three different carrying postures (oblique strap, vertical strap and no strap) two different motions (stationary and swinging) during a simulated firefighting task. Dependent measures included heart rate (HR), electromyography (EMG) data and a subjective assessment (measured as the degree of fatigue in the left arm, right arm and waist). The EMG data were acquired from the palmaris longus and the biceps brachii of the left arm of each subject. Variance analysis indicated that the effects of the carrying posture on the HR (p < 0.001), the EMG data of the left arm (the p value of the palmaris longus is 0.001 and the p value of the biceps brachii is 0.015), and the degree of fatigue of the left and right arms (p < 0.001) were significant, while the effects of motion on all of the dependent measures, and the effects of carrying posture on the degree of fatigue of the waist were not significant. The effect of an oblique strap on the whole-body load is minimal, and the use of the equipment without a strap produced significantly greater physical discomfort for the wearer than did the oblique strap and the vertical strap. The results suggest that the strap of the 6MF-30 can help Chinese forest firefighters to lessen physical stress when operating the 6MF-30, and the use of the oblique strap should be adopted as the standard position. PMID:26154202

  17. A Multidisciplinary Evaluation of the Effectiveness of Cyclosporine A in Dystrophic Mdx Mice

    PubMed Central

    De Luca, Annamaria; Nico, Beatrice; Liantonio, Antonella; Paola Didonna, Maria; Fraysse, Bodvael; Pierno, Sabata; Burdi, Rosa; Mangieri, Domenica; Rolland, Jean-François; Camerino, Claudia; Zallone, Alberta; Confalonieri, Paolo; Andreetta, Francesca; Arnoldi, Elisa; Courdier-Fruh, Isabelle; Magyar, Josef P.; Frigeri, Antonio; Pisoni, Michela; Svelto, Maria; Conte-Camerino, Diana

    2005-01-01

    Chronic inflammation is a secondary reaction of Duchenne muscular dystrophy and may contribute to disease progression. To examine whether immunosuppressant therapies could benefit dystrophic patients, we analyzed the effects of cyclosporine A (CsA) on a dystrophic mouse model. Mdx mice were treated with 10 mg/kg of CsA for 4 to 8 weeks throughout a period of exercise on treadmill, a protocol that worsens the dystrophic condition. The CsA treatment fully prevented the 60% drop of forelimb strength induced by exercise. A significant amelioration (P < 0.05) was observed in histological profile of CsA-treated gastrocnemius muscle with reductions of nonmuscle area (20%), centronucleated fibers (12%), and degenerating area (50%) compared to untreated exercised mdx mice. Consequently, the percentage of normal fibers increased from 26 to 35% in CsA-treated mice. Decreases in creatine kinase and markers of fibrosis were also observed. By electrophysiological recordings ex vivo, we found that CsA counteracted the decrease in chloride conductance (gCl), a functional index of degeneration in diaphragm and extensor digitorum longus muscle fibers. However, electrophysiology and fura-2 calcium imaging did not show any amelioration of calcium homeostasis in extensor digitorum longus muscle fibers. No significant effect was observed on utrophin levels in diaphragm muscle. Our data show that the CsA treatment significantly normalized many functional, histological, and biochemical endpoints by acting on events that are independent or downstream of calcium homeostasis. The beneficial effect of CsA may involve different targets, reinforcing the usefulness of immunosuppressant drugs in muscular dystrophy. PMID:15681831

  18. Use and fibre type composition in limb muscles of cats.

    PubMed

    Kernell, D; Hensbergen, E

    1998-12-01

    As a background for studies concerning the effects of training on the properties and fibre type composition of skeletal muscle, information is needed concerning the normal duration of muscle use per day. Data of this kind were collected from adult cats, using implanted electrodes for electromyographic recording from hindlimb muscles acting across the ankle joint: extensor digitorum longus (EDL), tibialis anterior (TA), peroneus longus (PL), lateral gastrocnemius (LG) and soleus (SOL). The accumulated duration of any recorded activity was expressed, for each electrode site, as a percentage of total sampling time ("duty time"). As measured intermittently across 24 h periods (4 min sampling per 30 min), these duty times were markedly and significantly different among the various muscles, averages varying from 1.9% for EDL up to 9.5% for posterior PL and 13.9% for SOL. The distribution of activity across the various muscles was markedly different between highly active periods (mid-day) and periods of rest (mid-night). The 24 h duty times were strongly and significantly correlated to duty times obtained for only mid-day activity but not to those for only mid-night activity. Following the end of the physiological measurements, the animals were sacrificed and the muscles were analyzed with regard to fibre type composition (histochemistry). There was a significant positive correlation between the 24 h duty time and the percentage of type I fibres ("slow"). In the Discussion, the present results from cats are briefly compared to previously published data for humans. PMID:10099959

  19. Correction of Multiple Striated Muscles in Murine Pompe Disease Through Adeno-associated Virus-Mediated Gene Therapy

    PubMed Central

    Sun, Baodong; Young, Sarah P.; Li, Ping; Di, Chunhui; Brown, Talmage; Salva, Maia Z.; Li, Songtao; Bird, Andrew; Yan, Zhen; Auten, Richard; Hauschka, Stephen D.; Koeberl, Dwight D.

    2009-01-01

    Glycogen storage disease type II (GSD-II; Pompe disease; MIM 232300) stems from the deficiency of acid-α-glucosidase (GAA; acid maltase; EC 3.2.1.20), which primarily involves cardiac and skeletal muscles. We hypothesized that systemic administration of an adeno-associated virus (AAV) vector containing a muscle specific regulatory cassette could drive efficacious transgene expression in GAA-knockout (GAA-KO) mice. AAV2/8 vectors containing the muscle creatine kinase (CK1) or hybrid α-myosin heavy chain enhancer-/muscle creatine kinase enhancer-promoter (MHCK7) cassettes were compared. The CK1 reduced glycogen content by approximately 50% in the heart and quadriceps, in comparison to untreated GAA-KO mice, whereas the MHCK7 containing vector reduced glycogen content even further: >95% in heart and >75% in the diaphragm and quadriceps. Administration of the MHCK7-containing vector significantly increased striated muscle function as assessed by increased Rotarod times at 18 weeks post-injection, whereas the CK1-containing vector did not increase Rotarod performance. Transduction efficiency was evaluated with an AAV2/8 vector in which MHCK7 drives alkaline-phosphatase, revealing that many more myofibers were transduced in the quadriceps than in the gastrocnemius. An AAV2/9 vector containing the MHCK7 cassette corrected GAA deficiency in the skeletal muscles of the distal limb, including the gastrocnemius, extensor digitalis longus, and soleus; furthermore, glycogen accumulations were substantially cleared by hGAA expression therein. Importantly, type IIb myofibers in the extensor digitalis longus were transduced, thereby correcting a myofiber type that is unresponsive to enzyme replacement therapy. In summary, AAV8 and AAV9-pseudotyped vectors containing the MHCK7 regulatory cassette achieved enhanced efficacy in Pompe disease mice. PMID:18560415

  20. Evolution of Skin Temperature after the Application of Compressive Forces on Tendon, Muscle and Myofascial Trigger Point

    PubMed Central

    Magalhães, Marina Figueiredo; Dibai-Filho, Almir Vieira; de Oliveira Guirro, Elaine Caldeira; Girasol, Carlos Eduardo; de Oliveira, Alessandra Kelly; Dias, Fabiana Rodrigues Cancio; Guirro, Rinaldo Roberto de Jesus

    2015-01-01

    Some assessment and diagnosis methods require palpation or the application of certain forces on the skin, which affects the structures beneath, we highlight the importance of defining possible influences on skin temperature as a result of this physical contact. Thus, the aim of the present study is to determine the ideal time for performing thermographic examination after palpation based on the assessment of skin temperature evolution. Randomized and crossover study carried out with 15 computer-user volunteers of both genders, between 18 and 45 years of age, who were submitted to compressive forces of 0, 1, 2 and 3 kg/cm2 for 30 seconds with a washout period of 48 hours using a portable digital dynamometer. Compressive forces were applied on the following spots on the dominant upper limb: myofascial trigger point in the levator scapulae, biceps brachii muscle and palmaris longus tendon. Volunteers were examined by means of infrared thermography before and after the application of compressive forces (15, 30, 45 and 60 minutes). In most comparisons made over time, a significant decrease was observed 30, 45 and 60 minutes after the application of compressive forces (p < 0.05) on the palmaris longus tendon and biceps brachii muscle. However, no difference was observed when comparing the different compressive forces (p > 0.05). In conclusion, infrared thermography can be used after assessment or diagnosis methods focused on the application of forces on tendons and muscles, provided the procedure is performed 15 minutes after contact with the skin. Regarding to the myofascial trigger point, the thermographic examination can be performed within 60 minutes after the contact with the skin. PMID:26070073