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Sample records for chronic exertional compartment

  1. Chronic Exertional Compartment Syndrome

    MedlinePlus

    ... through the pain; that can lead to permanent muscle or nerve damage. Sometimes chronic exertional compartment syndrome is mistaken for shin splints, a more common cause of leg pain in young people who do a lot of vigorous weight- ...

  2. Chronic Exertional Compartment Syndrome.

    PubMed

    Braver, Richard T

    2016-04-01

    Increased tissue pressure within a fascial compartment may be the result from any increase in volume within its contents, or any decrease in size of the fascial covering or its distensibility. This may lead to symptoms of leg tightness, pain or numbness brought about by exercise. There are multiple differential diagnoses of exercise induced leg pain and the proper diagnoses of chronic exertional compartment syndrome (CECS) is made by a careful history and by exclusion of other maladies and confirmed by compartment syndrome testing as detailed in this text. Surgical fasciotomies for the anterior, lateral, superficial and deep posterior compartments are described in detail along with ancillary procedures for chronic shin splints that should allow the athlete to return to competitive activity. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Chronic exertional compartment syndrome of the superficial posterior compartment: Soleus syndrome.

    PubMed

    Gross, Christopher E; Parekh, Bela J; Adams, Samuel B; Parekh, Selene G

    2015-01-01

    Chronic exertional compartment syndrome (CECS) represents the second most-common cause of exertional leg pain with incidence of 27-33%. CECS of the superficial posterior compartment, or soleus syndrome, is rare and has only been discussed briefly in the literature. We discuss the management of two patients with bilateral soleus syndrome or CECS of the superficial posterior compartment.

  4. Endoscopic Thermal Fasciotomy for Chronic Exertional Compartment Syndrome

    PubMed Central

    Voleti, Pramod B.; Lebrun, Drake G.; Roth, Cameron A.; Kelly, John D.

    2015-01-01

    Chronic exertional compartment syndrome is an activity-induced condition that occurs when intracompartmental pressures within an osteofascial envelope increase during exercise, leading to reversible ischemic symptoms such as pain, cramping, numbness, or weakness. Nonoperative treatment options for this condition have shown limited success and are often undesirable for the patient given the requirement for activity modification. Traditional surgical treatment options involving open or subcutaneous fasciotomies have more favorable results, but these techniques are associated with significant morbidity. Endoscopically assisted fasciotomy techniques afford the advantages of being minimally invasive, providing excellent visualization, and allowing accelerated rehabilitation. The purpose of this article is to describe a technique for performing endoscopically assisted fasciotomies for chronic exertional compartment syndrome of the lower leg using an entirely endoscopic thermal ablating device. The endoscopic thermal fasciotomy technique is associated with minimal morbidity, ensures excellent hemostasis, and affords an early return to sports. PMID:26900549

  5. Isolated Chronic Exertional Compartment Syndrome of the Lateral Lower Leg

    PubMed Central

    van Zantvoort, Aniek P.M.; de Bruijn, Johan A.; Winkes, Michiel B.; Dielemans, Jeanne P.; van der Cruijsen-Raaijmakers, Marike; Hoogeveen, Adwin R.; Scheltinga, Marc R.

    2015-01-01

    Background: Exercise-induced lower leg pain may be caused by chronic exertional compartment syndrome (CECS). The anterior (ant-CECS) or deep posterior compartment (dp-CECS) is usually affected. Knowledge regarding CECS of the lateral compartment (lat-CECS) is limited. Purpose: To describe demographic characteristics and symptoms in a consecutive series of patients with isolated CECS of the lateral compartment of the leg. Study Design: Case series; Level of evidence, 4. Methods: Since 2001, patients undergoing dynamic intracompartmental pressure (ICP) measurements for suspected CECS in a single institution were prospectively monitored. Individuals with a history possibly associated with lat-CECS and elevated ICP measurements (Pedowitz criteria) were identified. Exclusion criteria were concomitant ipsilateral ant-CECS/dp-CECS, acute compartment syndrome, recent significant trauma, peroneal nerve entrapment, or vascular claudication. Results: During an 11-year time period, a total of 26 patients with isolated lat-CECS fulfilled study criteria (15 females; median age, 21 years; range, 14-48 years). Frequently identified provocative sports were running (n = 4), walking (n = 4), field hockey (n = 3), soccer (n = 3), and volleyball (n = 2). Exercise-induced lateral lower leg pain (92%) and tightness (42%) were often reported. The syndrome was bilateral in almost two-thirds (62%, n = 16). Delay in diagnosis averaged 24 months (range, 2 months to 10 years). Conclusion: Young patients with exercise-induced pain in the lateral portions of the lower leg may suffer from isolated CECS of the lateral compartment. ICP measurements in the lateral compartment in these patients are recommended. PMID:26740955

  6. Surgical Treatment of Chronic Exertional Compartment Syndrome in Pediatric Patients.

    PubMed

    Beck, Jennifer J; Tepolt, Frances A; Miller, Patricia E; Micheli, Lyle J; Kocher, Mininder S

    2016-10-01

    Chronic exertional compartment syndrome (CECS) is a cause of leg pain in running athletes and is treated with fasciotomy after failure of nonoperative management. CECS is being seen with increased frequency in younger patients. The demographics and outcomes of fasciotomy for CECS in pediatric patients, including risk factors for treatment failure, have not been described. To describe characteristics of pediatric patients with CECS and determine surgical outcomes of the condition in this population. Case series; Level of evidence, 4. A retrospective review was performed for patients 18 years and younger treated surgically for CECS with compartment release at a single institution from 1995 to 2014. Demographic and condition characteristics, operative procedure, postoperative course, and clinical outcomes were recorded for 286 legs of 155 patients. Compartment pressure testing using the Pedowitz criteria confirmed the diagnosis in all patients. A total of 155 patients were included in the study (average patient age at presentation, 16.4 ± 1.38 years); 136 (88%) were female. All 155 patients presented with leg pain; of these patients, 8 (5%) also had neurologic symptoms, and 131 (85%) presented with bilateral symptoms requiring bilateral compartment release. Symptoms were chronic in nature, with duration over 1 year in 63% of patients. The primary sport was most commonly reported as running (25%), soccer (23%), or field hockey (12%); 50% of patients were multisport athletes. Of 286 legs, 138 (48%) had only anterior and/or lateral compartments released, while 84 (29.4%) had all 4 compartments released. Documented return to sport was seen in 79.5% of patients. Outcomes analysis was performed for 250 of 286 legs. Of these 250 legs, 47 (18.8%) had recurrent CECS requiring reoperation at a median of 1.3 years (interquartile range, 0.8-3.5) after initial compartment release. For each additional month between presentation and release, the odds of recurrence decreased by 12

  7. Chronic exertional compartment syndrome of the forearm in adolescents.

    PubMed

    García-Mata, Serafín

    2013-12-01

    Chronic exertional compartment syndrome (CECS) is a well-known process, although rare in the forearm. The diagnosis is based on history, clinical examination, and compartment pressure readings. My objective is to present the largest series of CECS of the forearm in adolescents and describe my experience in its management and evolution. I reviewed 5 patients, 4 male (competing in motorcycling or motocross) and 1 female (CECS in both the legs and forearms), aged between 15 and 18 years. Volar and dorsal compartments were affected in 3 patients and isolated volar in 2 cases. The clinical diagnosis was objectively confirmed by measuring ICP with a low-pressure digital transducer (Stryker). Open fasciotomy was carried out in 4 patients. They resumed their athletic activities 6 weeks after surgery without complications, increasing their athletic performance level in line with their preoperative status. All these patients remained asymptomatic, recovering their previous competitive levels. The results were objectively classified as excellent in all 4 cases. After a mean follow-up of 6 years, the condition has not relapsed in any of the patients. Two of the patients agreed to a new ICP measurement 1 year after the surgery, showing normal values. CECS in the forearm in adolescents is a rare condition that occurs after puberty. A high index of suspicion is necessary to diagnose it. It is based on symptoms and ICP measurements. Most patients are competing motorcyclists. Surgical treatment, involving isolated decompression of the superficial volar compartment, is safe and effective (restoring normal ICP).

  8. Chronic Exertional Compartment Syndrome in a Healthy Young Man.

    PubMed

    Joubert, Sonia V; Duarte, Manuel A

    2016-06-01

    The purpose of this case report is to describe a patient who presented with symptoms of exercise-induced compartment syndrome and was later referred for bilateral fasciotomy surgery. A 21-year-old patient presented for chiropractic care with the inability to run due to foot paresthesia and weakness. An exertion test and compartment pressure test diagnosed exercise-induced compartment syndrome. Exertion test and compartment pressure test were used to identify and diagnose exercise-induced compartment syndrome. The patient was diagnosed with exercise-induced compartment syndrome. He was treated conservatively and referred for additional testing. The orthopedic surgeon requested that 12 weeks of conservative care be provided prior to testing; treatment consisted of chiropractic care and rehabilitation exercises. Following the 12 weeks of treatment, the patient did not significantly respond to conservative care. A compartment pressure test confirmed the initial diagnosis of exercise-induced compartment syndrome. The patient underwent a unilateral fasciotomy surgery and recovered fully. Following the surgery, the patient returned to the chiropractic clinic with the same presentation in the contralateral leg. The same protocol of management resulted in the same outcome. Two years after surgical intervention, the patient continues to maintain an active lifestyle, able to run 2 to 3 miles per day without any exacerbations or symptomatology. Clinical awareness, a detailed history, and thorough examination with reproduction of symptomatology are necessary to form a proper diagnosis and treatment plan for these patients. Therefore, multidisciplinary medical communication would prove to be the most beneficial approach for the patient.

  9. Role of Repeat Muscle Compartment Pressure Measurements in Chronic Exertional Compartment Syndrome of the Lower Leg.

    PubMed

    van Zantvoort, Aniek P M; de Bruijn, Johan A; Winkes, Michiel B; Hoogeveen, Adwin R; Teijink, Joep A W; Scheltinga, Marc R

    2017-06-01

    The diagnostic gold standard for diagnosing chronic exertional compartment syndrome (CECS) is a dynamic intracompartmental pressure (ICP) measurement of the muscle. The potential role of a repeat ICP (re-ICP) measurement in patients with persistent lower leg symptoms after surgical decompression or with ongoing symptoms after an earlier normal ICP is unknown. To study whether re-ICP measurements in patients with persistent CECS-like symptoms of the lower leg may contribute to the diagnosis of CECS after both surgical decompression and a previously normal ICP measurement. Case series; Level of evidence, 4. Charts of patients who underwent re-ICP measurement of lower leg compartments (anterior [ant], deep posterior [dp], and/or lateral [lat] compartments) between 2001 and 2013 were retrospectively studied. CECS was diagnosed on the basis of generally accepted cutoff pressures for newly onset CECS (Pedowitz criteria: ICP at rest ≥15 mmHg, ≥30 mmHg after 1 minute, or ≥20 mmHg 5 minutes after a provocative test). Factors predicting recurrent CECS after surgery or after a previously normal ICP measurement were analyzed. A total of 1714 ICP measurements were taken in 1513 patients with suspected CECS over a 13-year observation period. In all, 201 (12%) tests were re-ICP measurements for persistent lower leg symptoms. Based on the proposed ICP cutoff values, CECS recurrence was diagnosed in 16 of 62 previously operated compartments (recurrence rate, 26%; 53 patients [64% female]; median age, 24 years; age range, 15-78 years). Recurrence rates were not different among the 3 lower leg CECS compartments (ant-CECS, 17%; dp-CECS, 33%; lat-CECS, 30%; χ(2) = 1.928, P = .381). Sex (χ(2) = 0.058, P = .810), age (U = 378, z = 1.840, P = .066), bilaterality (χ(2) = 0.019, P = .889), and prefasciotomy ICP did not predict recurrence. Re-ICP measurements evaluating 20 compartments with previously normal ICP measurements (15 patients [53% female]; mean age, 31 ± 10 years

  10. Role of Repeat Muscle Compartment Pressure Measurements in Chronic Exertional Compartment Syndrome of the Lower Leg

    PubMed Central

    van Zantvoort, Aniek P. M.; de Bruijn, Johan A.; Winkes, Michiel B.; Hoogeveen, Adwin R.; Teijink, Joep A. W.; Scheltinga, Marc R.

    2017-01-01

    Background: The diagnostic gold standard for diagnosing chronic exertional compartment syndrome (CECS) is a dynamic intracompartmental pressure (ICP) measurement of the muscle. The potential role of a repeat ICP (re-ICP) measurement in patients with persistent lower leg symptoms after surgical decompression or with ongoing symptoms after an earlier normal ICP is unknown. Purpose: To study whether re-ICP measurements in patients with persistent CECS-like symptoms of the lower leg may contribute to the diagnosis of CECS after both surgical decompression and a previously normal ICP measurement. Study Design: Case series; Level of evidence, 4. Methods: Charts of patients who underwent re-ICP measurement of lower leg compartments (anterior [ant], deep posterior [dp], and/or lateral [lat] compartments) between 2001 and 2013 were retrospectively studied. CECS was diagnosed on the basis of generally accepted cutoff pressures for newly onset CECS (Pedowitz criteria: ICP at rest ≥15 mmHg, ≥30 mmHg after 1 minute, or ≥20 mmHg 5 minutes after a provocative test). Factors predicting recurrent CECS after surgery or after a previously normal ICP measurement were analyzed. Results: A total of 1714 ICP measurements were taken in 1513 patients with suspected CECS over a 13-year observation period. In all, 201 (12%) tests were re-ICP measurements for persistent lower leg symptoms. Based on the proposed ICP cutoff values, CECS recurrence was diagnosed in 16 of 62 previously operated compartments (recurrence rate, 26%; 53 patients [64% female]; median age, 24 years; age range, 15-78 years). Recurrence rates were not different among the 3 lower leg CECS compartments (ant-CECS, 17%; dp-CECS, 33%; lat-CECS, 30%; χ2 = 1.928, P = .381). Sex (χ2 = 0.058, P = .810), age (U = 378, z = 1.840, P = .066), bilaterality (χ2 = 0.019, P = .889), and prefasciotomy ICP did not predict recurrence. Re-ICP measurements evaluating 20 compartments with previously normal ICP measurements (15

  11. Intramuscular compartment pressure measurement in chronic exertional compartment syndrome: new and improved diagnostic criteria.

    PubMed

    Roscoe, David; Roberts, Andrew J; Hulse, David

    2015-02-01

    Patients with chronic exertional compartment syndrome (CECS) have pain during exercise that subsides with rest. Diagnosis is usually confirmed by intramuscular compartment pressure (IMCP) measurement. Controversy exists regarding the accuracy of existing diagnostic criteria. (1) To compare dynamic IMCP measurement and anthropometric factors between patients with CECS and asymptomatic controls and (2) to establish the diagnostic utility of dynamic IMCP measurement. Cohort study (diagnosis); Level of evidence, 2. A total of 40 men aged 21 to 40 years were included in the study: 20 with symptoms of CECS of the anterior compartment and 20 asymptomatic controls. Diagnoses other than CECS were excluded with rigorous inclusion criteria and magnetic resonance imaging. The IMCP was measured continuously before, during, and after participants exercised on a treadmill, wearing identical footwear and carrying a 15-kg load. Pain experienced by study subjects increased incrementally as the study progressed (P < .001). Pain levels experienced by the case group during each phase of the exercise were significantly different (P = .021). Subjects had higher IMCP immediately upon standing at rest compared with controls (23.8 mm Hg [controls] vs 35.5 mm Hg [subjects]; P = .006). This relationship persisted throughout the exercise protocol, with the greatest difference corresponding to the period of maximal tolerable pain (68.7 mm Hg [controls] vs 114 mm Hg [subjects]; P < .001). Sensitivity and specificity were consistently higher than the existing criteria with improved diagnostic value (sensitivity = 63%, specificity = 95%; likelihood ratio = 12.5 [95% CI, 3.2-49]). Anterior compartment IMCP is elevated immediately upon standing at rest in subjects with CECS. In patients with symptoms consistent with CECS, diagnostic utility of IMCP measurement is improved when measured continuously during exercise. A cutoff of 105 mm Hg in phase 2 provides better diagnostic accuracy than do the

  12. Chronic Exertional Compartment Syndrome of the Forearm in an Elite Rower

    PubMed Central

    O'hEireamhoin, S.; Baker, J. F.; Neligan, M.

    2011-01-01

    We report a case of chronic exertional compartment syndrome (CECS) affecting the volar forearm compartment of an elite rower. CECS of the forearm is a less well recognised entity than lower limb CECS. We describe a typical history and detail a potential treatment. PMID:23198215

  13. Chronic exertional compartment syndrome in a collegiate soccer player: a case report and literature review.

    PubMed

    Farr, Derek; Selesnick, Harlan

    2008-07-01

    Chronic exertional compartment syndrome is a relatively rare condition among running athletes. In those who engage in repetitive activity, it can cause severe, debilitating leg pain. The diagnosis can be made with a thorough workup that includes history and physical examination, radiologic studies (x-rays, magnetic resonance imaging, bone scan), and compartment pressure monitoring. Most patients do not respond well to nonoperative intervention. Fasciotomy provides satisfactory relief of symptoms and helps patients return to their sports. We present the case of a high-level collegiate soccer player with chronic exertional compartment syndrome.

  14. Selective Fasciotomy for Chronic Exertional Compartment Syndrome Detected With Exercise Magnetic Resonance Imaging.

    PubMed

    Park, Sehan; Lee, Ho Seong; Seo, Sang Gyo

    2017-06-15

    Chronic exertional compartment syndrome that is refractory to conservative management should be treated with surgical fasciotomy. However, owing to the limitations of intracompartmental needle manometry in reaching a definite diagnosis, the appropriate timing for fasciotomy and on which compartment remain unclear. The authors report the case of a 22-year-old male military cadet who reported pain in his left calf when running or walking for long distances. The pain was located at the lateral aspect of the calf, from the mid-calf level to the ankle. At another hospital, nonenhanced magnetic resonance imaging had been performed, which showed no considerable abnormality. The authors used exercise magnetic resonance imaging to diagnose chronic exertional compartment syndrome. They performed selective fasciotomy on the compartment that showed a high signal intensity. As a military cadet, the patient was required to jog for more than an hour per day and perform strenuous muscle exercises. He reported that he did not have calf pain or discomfort during such activities 13 months postoperatively. The authors obtained a follow-up exercise magnetic resonance image. Compared with the preoperative magnetic resonance image, the follow-up exercise magnetic resonance image did not show high signal intensity at the lateral compartment. Exercise magnetic resonance imaging is useful in confirming the diagnosis of chronic exertional compartment syndrome and enables the performance of selective fasciotomy on the affected compartment. [Orthopedics. 201x; xx(x):xx-xx.]. Copyright 2017, SLACK Incorporated.

  15. Ultrasound-Guided Fasciotomy for Anterior Chronic Exertional Compartment Syndrome of the Leg.

    PubMed

    Balius, Ramon; Bong, David A; Ardèvol, Jordi; Pedret, Carles; Codina, David; Dalmau, Antonio

    2016-04-01

    Chronic exertional compartment syndrome is characterized by exertional pain and elevated intracompartmental pressures affecting the leg in physically active young people. In patients who have failed conservative measures, fasciotomy is the treatment of choice. This study presents a new method for performing fasciotomy using high-resolution ultrasound (US) guidance and reports on the clinical outcomes in a group of these patients. Over a 3-year period, 7 consecutive patients with a total of 9 involved legs presented clinically with anterior compartment chronic exertional compartment syndrome, which was confirmed by intracompartmental pressure measurements before and after exercise. After a US examination, fasciotomy under US guidance was performed. Preoperative and postoperative pain and activity levels were assessed as well as number of days needed to "return to play." All patients had a decrease in pain, and all except 1 returned to presymptomatic exercise levels with a median return to play of 35 days. © 2016 by the American Institute of Ultrasound in Medicine.

  16. Single minimal incision fasciotomy for chronic exertional compartment syndrome of the lower leg.

    PubMed

    Maffulli, Nicola; Loppini, Mattia; Spiezia, Filippo; D'Addona, Alessio; Maffulli, Gayle D

    2016-05-24

    Chronic exertional compartment syndrome (CECS) involves a painful increase in compartment pressure caused by exercise and relieved by rest, common in athletes. The most common site for CECS in the lower limbs is the anterior leg compartment. The aim of this study is to evaluate the outcomes of a single minimal incision fasciotomy in athletes and their capability to return to high level sport activity. The study reports mid-term results in a series of 18 consecutive athletes with chronic exertional compartment syndrome of the leg who had undergone minimally invasive fasciotomy. Between 2000 and 2007, we prospectively enrolled 18 consecutive athletes (12 males and six females, median age 27 years) with unilateral or bilateral chronic exertional compartment syndrome undergoing unilateral or bilateral minimally invasive fasciotomy. Clinical outcomes were assessed with Short-Form Health Survey-36 (SF-36) and European Quality of Life-5 Dimension (EQ-5D) scale. The ability to participate in sport before and after surgery and the time to return to training (RTT) and to sport (RTS) were recorded. The median follow-up after surgery was 36 months. Both questionnaires showed a statistically significant improvement (P < 0.0001) after surgery. At the time of the latest follow-up, 17 of 18 patients (94 %) had returned to pre-injury or higher levels of sport. Only one patient (6 %) returned to sport at lower levels than those of pre-injury status. The median time to return to training and to return to sport was 8 and 13 weeks, respectively. No severe complications or recurrence of the symptoms were recorded. Minimally invasive fasciotomy is effective and safe for athletes suffering from unilateral or bilateral chronic exertional compartment syndrome of the anterior and lateral compartments of the leg with good results in the mid-term.

  17. Chronic Exertional Compartment Syndrome of the Hand: Case Report and Literature Review.

    PubMed

    Dwyer, C Liam; Soong, Maximillian C; Kasparyan, N George

    2017-05-01

    Chronic exertional compartment syndrome (CECS) is characterized by activity-induced pain, swelling, and decreased muscle function due to increased pressure and decreased circulation within a confined muscle compartment. Although well-known to occur in the leg, involvement of the hand has rarely been reported in the literature. We present a 44 year old male with CECS involving bilateral thenar and hypothenar compartments. Symptoms were reproduced on exam by driving screws into wood with a screwdriver. Elevated compartment pressures were confirmed with a hand-held digital device which employs a rigid needle that is readily directed to specific compartments. Selective releases of the thenar and hypothenar compartments were performed under local anesthesia and forearm tourniquet in the ambulatory surgery center. At 3-month follow-up, the patient reported full use of his right hand, including woodworking, with excellent relief of symptoms. At 5 months postoperatively, he underwent identical surgical releases on the contralateral left side, with similar relief. CECS of the hand is a rare condition. Our case is unique among prior reports with regard to pattern of compartment involvement, as well as provocative maneuvers and compartment testing methods employed. This report should help foster clinical suspicion, facilitate diagnosis, and demonstrate success of targeted surgical treatment.

  18. Isolated Chronic Exertional Compartment Syndrome of the Lateral Lower Leg: A Case Series.

    PubMed

    van Zantvoort, Aniek P M; de Bruijn, Johan A; Winkes, Michiel B; Dielemans, Jeanne P; van der Cruijsen-Raaijmakers, Marike; Hoogeveen, Adwin R; Scheltinga, Marc R

    2015-11-01

    Exercise-induced lower leg pain may be caused by chronic exertional compartment syndrome (CECS). The anterior (ant-CECS) or deep posterior compartment (dp-CECS) is usually affected. Knowledge regarding CECS of the lateral compartment (lat-CECS) is limited. To describe demographic characteristics and symptoms in a consecutive series of patients with isolated CECS of the lateral compartment of the leg. Case series; Level of evidence, 4. Since 2001, patients undergoing dynamic intracompartmental pressure (ICP) measurements for suspected CECS in a single institution were prospectively monitored. Individuals with a history possibly associated with lat-CECS and elevated ICP measurements (Pedowitz criteria) were identified. Exclusion criteria were concomitant ipsilateral ant-CECS/dp-CECS, acute compartment syndrome, recent significant trauma, peroneal nerve entrapment, or vascular claudication. During an 11-year time period, a total of 26 patients with isolated lat-CECS fulfilled study criteria (15 females; median age, 21 years; range, 14-48 years). Frequently identified provocative sports were running (n = 4), walking (n = 4), field hockey (n = 3), soccer (n = 3), and volleyball (n = 2). Exercise-induced lateral lower leg pain (92%) and tightness (42%) were often reported. The syndrome was bilateral in almost two-thirds (62%, n = 16). Delay in diagnosis averaged 24 months (range, 2 months to 10 years). Young patients with exercise-induced pain in the lateral portions of the lower leg may suffer from isolated CECS of the lateral compartment. ICP measurements in the lateral compartment in these patients are recommended.

  19. Characterization of the Development of Acute-on-Chronic Exertional Compartment Syndrome A Case Report of Symmetric Compartment Syndromes and Review of the Literature.

    PubMed

    Schwartz, Andrew; Poole, Claudette; Schleien, Charles

    2017-04-01

    Acute-on-chronic exertional compartment syndrome is a rare and severe progression of the likely common and more benign chronic exertional compartment syndrome. This is a report of one 17-year-old male on a pediatric inpatient service with bilateral anterior leg pain of unknown origin. Because of the nonspecific nature of pain, a high level of suspicion is required for timely diagnosis to avoid compartment ischemia and irreversible soft tissue and nerve damage. While high-energy orthopaedic trauma, orthopaedic surgery, or closed reduction and casting are common preceding events for compartment syndrome, this patient presented with acute-on-chronic exertional compartment syndrome. A dearth of literature of this condition hampered its morbiditysparing diagnosis. While there is a spectrum of clinical findings for the acute decompensation of chronic exertional compartment syndrome, like any compartment syndrome, pain disproportionate to physical exam is the most sensitive sign. Understanding the exertional compartment syndrome spectrum is tantamount to avoid the devastating complications of a missed diagnosis of acute compartment syndrome.

  20. Endoscopic Fascia Release for Forearm Chronic Exertional Compartment Syndrome: Case Report and Surgical Technique.

    PubMed

    Miller, Elizabeth A; Cobb, Anna L; Cobb, Tyson K

    2017-09-01

    Chronic exertional compartment syndrome (CECS) of the forearm is traditionally treated with open compartment release requiring large incisions that can result in less than optimal esthetic results. The purpose of this study is to describe a case report of 2 professional motocross patients with forearm CECS treated endoscopically using a minimally invasive technique. Two professional motocross racers presented with a history of chronic proximal volar forearm pain when motocross riding. Other symptoms included paresthesia and weakness, which, at times, led to an inability to continue riding. Both failed conservative management. Compartment pressure measurements were performed before and after provocative exercises to confirm diagnosis of CECS. Release of both the volar and dorsal compartments was performed endoscopically through a single incision. Symptoms resolved after surgery. The first patient resumed riding at 1 week, competing at 3 weeks, and continues to ride competitively without symptoms at 3 years postoperative. The second patient began riding at 1 week and won second place in the National Supercross finals 5 weeks after simultaneous bilateral release. This technique is simple and effective. The cannula used protects the superficial nerves while allowing release through a small, cosmetically pleasing incision.

  1. Single minimal incision fasciotomy for the treatment of chronic exertional compartment syndrome: outcomes and complications.

    PubMed

    Drexler, Michael; Rutenberg, T Frenkel; Rozen, N; Warschawski, Y; Rath, E; Chechik, O; Rachevsky, G; Morag, G

    2017-01-01

    Chronic exertional compartment syndrome (CECS) is a common injury in young athletes, causing pain in the involved leg compartment during strenuous exercise. The gold standard treatment is fasciotomy, but most of the reports on its effectiveness include relatively small cohorts and relatively short follow-up periods. This study reports the long-term results of a large cohort of young athletes who underwent single-incision fasciotomy for CECS. This a retrospective case-series study. All patients treated by fasciotomies performed for CECS between 2007 and 2011, in a tertiary medical institution. CECS was diagnosed following history taking and clinical evaluation, and confirmed by compartment pressure measurements. Ninety-five legs that underwent single-incision subcutaneous fasciotomy were included. Data on the numerical analog scale (NAS), Tegner activity score, and quality-of-life (QOL) as measured via the short form-12 (SF-12) were retrieved from all patients preoperatively and at the end of follow-up. The average time to diagnosis was 22 months and the mean follow-up was 50.1 months. Sixty-three legs underwent anterior compartment fasciotomy (an additional 30 legs also underwent lateral compartment release), and two legs underwent lateral and peroneal compartment releases. The average change in Tegner score was an improvement of 14.6 points. Similarly, the patients reported a significant improvement in the SF-12 and NAS scores. Satisfaction rates were high (average 75.5 %). The main complications were wound infection (2 patients) and nerve injuries (4 patients). Eight patients had recurrence. Single-incision fasciotomy leads to long-term improvement in the activity level and QOL of patients with CECS.

  2. Biomechanical differences between cases with chronic exertional compartment syndrome and asymptomatic controls during walking and marching gait.

    PubMed

    Roberts, Andrew; Roscoe, David; Hulse, David; Bennett, Alexander N; Dixon, Sharon

    2017-07-18

    Chronic exertional compartment syndrome is a significant problem in military populations that may be caused by specific military activities. This study aimed to investigate the kinematic and kinetic differences in military cases with chronic exertional compartment syndrome and asymptomatic controls. 20 males with symptoms of chronic exertional compartment syndrome of the anterior compartment and 20 asymptomatic controls were studied. Three-dimensional lower limb kinematics and kinetics were compared during walking and marching. Cases were significantly shorter in stature and took a relatively longer stride in relation to leg length than controls. All kinematic differences identified were at the ankle. Cases demonstrated increased ankle plantarflexion from mid-stance to toe-off. Cases also demonstrated less ankle inversion at the end of stance and early swing phases. Lower ankle inversion moments were observed during mid-stance. The anthropometric and biomechanical differences demonstrated provide a plausible mechanism for the development of chronic exertional compartment syndrome in this population. The shorter stature in combination with the relatively longer stride length observed in cases may result in an increased demand on the anterior compartment musculature during ambulation. The results of this study, together with clinical insights and the literature suggest that the suppression of the walk-to-run stimulus during group marches may play a significant role in the development of chronic exertional compartment syndrome within a military population. The differences in joint angles and moments also suggest an impairment of the muscular control of ankle joint function, such as a reduced effectiveness of tibialis anterior. It is unclear whether this is a cause or consequence of chronic exertional compartment syndrome. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  3. Outcome of a Specific Compartment Fasciotomy Versus a Complete Compartment Fasciotomy of the Leg in One Patient With Bilateral Anterior Chronic Exertional Compartment Syndrome: A Case Report.

    PubMed

    Tjeerdsma, Jason

    2016-01-01

    Chronic exertional compartment syndrome of the leg is a debilitating lower extremity condition in which increased intracompartmental pressure impedes blood flow to the involved compartments of the distal lower extremity, resulting in ischemia and pain. Owing to the lack of success with conservative management, most surgeons perform complete release fasciotomy as the preferred method of fasciotomy to avoid an unsuccessful release or outcome. Studies have been performed regarding the outcomes of complete compartmental release versus specific compartmental release, but no study has been performed comparing complete fasciotomy and compartment-specific fasciotomy in a single patient. The purpose of the present case report was to compare the efficacy of a complete fasciotomy versus a specific fasciotomy in 1 patient with properly diagnosed bilateral anterior compartment chronic exertional compartment syndrome with an 18-month follow-up period. The Lower Extremity Functional Scale and both subscales of the Foot and Ankle Ability Measure were administered to assess the functional outcomes. Circumferential measurements and range of motion photographs were taken to compare the objective data throughout the recovery process. In general, the range of motion, circumferential measurements, and functional outcome measure scores were better for the specific compartmental fasciotomy leg than for the complete fasciotomy leg during the recovery period. The overall functional outcomes were the same for both surgical approaches, with the specific fasciotomy leg returning to baseline function 13 to 23 days before the complete fasciotomy leg. The outcomes remained unchanged 18 months after surgery. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Chronic exertional compartment syndrome of the forearm in motocross racers: findings on MRI.

    PubMed

    Gielen, Jan Louis; Peersman, Benjamin; Peersman, Geert; Roelant, Ella; Van Dyck, Pieter; Vanhoenacker, Filip; Roeykens, Johan

    2009-12-01

    The purpose of this prospective study was to demonstrate the findings of MRI in motocross racers with chronic exertional compartment syndrome (CECS) of the forearm. Racers with proven CECS and without CECS and male individuals not involved in strenuous activities with the forearm were included. Signal intensity (SI) and signal-to-noise ratio (SNR) obtained before and after exercise were compared (D-SNR). Magnetic resonance imaging after exercise showed an increase in SI and SNR in the muscles on T2-WI. The SI increase was obvious in the flexor digitorum superficialis (FDS) and profundus (FDP) in all CECS patients. In addition, a minor SI and SNR increase in the extensor carpi radialis longus (ECRL) was noted. In the non-symptomatic group of motocross racers, there was only a minor increase in SI and the SNR, which was similar in the FDP and ECRL muscles. In the untrained individuals a remarkable increase in the SI and SNR of the FDS/FDP-ECRL was noted. This increased SI and SNR was not present in the majority of non-symptomatic racers. Post-exertional MRI produces significant findings in CECS of the forearm. The motocross racers without post-exertional oedema in the FDP/FDS had no CECS.

  5. EFFECTS OF FOREFOOT RUNNING ON CHRONIC EXERTIONAL COMPARTMENT SYNDROME: A CASE SERIES

    PubMed Central

    Gregory, Robert; Alitz, Curtis; Gerber, J. Parry

    2011-01-01

    Introduction: Chronic exertional compartment syndrome (CECS) is a condition that occurs almost exclusively with running whereby exercise increases intramuscular pressure compromising circulation, prohibiting muscular function, and causing pain in the lower leg. Currently, a lack of evidence exists for the effective conservative management of CECS. Altering running mechanics by adopting forefoot running as opposed to heel striking may assist in the treatment of CECS, specifically with anterior compartment symptoms. Case Description: The purpose of this case series is to describe the outcomes for subjects with CECS through a systematic conservative treatment model focused on forefoot running. Subject one was a 21 y/o female with a 4 year history of CECS and subject two was a 21 y/o male, 7 months status-post two-compartment right leg fasciotomy with a return of symptoms and a new onset of symptoms on the contralateral side. Outcome: Both subjects modified their running technique over a period of six weeks. Kinematic and kinetic analysis revealed increased step rate while step length, impulse, and peak vertical ground reaction forces decreased. In addition, leg intracompartmental pressures decreased from pre-training to post-training. Within 6 weeks of intervention subjects increased their running distance and speed absent of symptoms of CECS. Follow-up questionnaires were completed by the subjects at 7 months following intervention; subject one reported running distances up to 12.87 km pain-free and subject two reported running 6.44 km pain-free consistently 3 times a week. Discussion: This case series describes a potentially beneficial conservative management approach to CECS in the form of forefoot running instruction. Further research in this area is warranted to further explore the benefits of adopting a forefoot running technique for CECS as well as other musculoskeletal overuse complaints. PMID:22163093

  6. Near infrared spectroscopy in the diagnosis of chronic exertional compartment syndrome.

    PubMed

    van den Brand, Johan G H; Verleisdonk, Egbert J M M; van der Werken, Christian

    2004-03-01

    Patients with chronic exertional compartment syndrome (CECS) experience pain during exercise. An abnormal increase in intracompartmental pressure (ICP) leads to impaired local tissue perfusion resulting in ischemia and pain. At cessation of exercise, pain subsides. Diagnosis is confirmed through postexercise ICP. Near infrared spectroscopy (NIRS) can measure tissue oxygen saturation (StO(2)) noninvasively. NIRS can diagnose CECS by showing tissue deoxygenation. Prospective, nonrandomized clinical trial. Volunteers completed a standardized exercise protocol. Those suspected of CECS did so preoperatively and postoperatively. StO(2) and ICP were monitored. Data were compared between volunteers and patients and prefasciotomy and postfasciotomy. Significant differences between the StO(2) values of volunteers and patients with CECS were found. Average peak exercise StO(2) value for those with CECS was lower than for the healthy (27 versus 56, P <.05). Patients showed more absolute and percentage change between baseline and peak exercise StO(2) (absolute: 60 versus 35, P <.05; percentage: 67 versus 38, P <.05). StO(2) values in legs with confirmed CECS returned to normal range postfasciotomy. All changes differed significantly with preoperative values. StO(2) can distinguish healthy from diseased legs. This study provides evidence supporting NIRS as a noninvasive, painless alternative to ICP in the diagnosis of CECS.

  7. Diagnosis of chronic exertional compartment syndrome by post-exercise MRI

    PubMed Central

    Paús, Vicente; Graieb, Ariel; Torrengo, Federico; Villalba, Francisco

    2017-01-01

    Objective: Chronic exertional compartment syndrome (CECS) is the cause of 27% of anterior leg pain in athletes. The source of pain in this condition is still debated. Measurement of intracompartmental pressure is the gold standard diagnosis, albeit an invasive study. The development and interpretation of new MRI sequences has provided a non-invasive alternative to CECS diagnosis. Post-exercise MRI is an attractive option, which is currently undergoing its validation process. Methods: 22 patients with a clinical diagnosis of CECS were included, with a median follow-up of 5 years (1-10 years). All the patients were evaluated by clinical examination, pre- and post-exercise MRI and pre-and post-exercise intracompartmental pressure measurement. Pressure was measured with Whitesides technique, and diagnosis was carried out by Pedowitz criteria. Results: Out of the total 22 patients, 19 had positive intracompartmental measurement (15 male, 4 female) and 3 had negative measurement. All the patients had a normal MRI at rest. The three patients who had negative intracompartmental measurement had a normal post-stress MRI. Out of the remaining 19 patients, the MRI detected hyperintense signal in T2 and STIR weighted in 15 of them (78,95%). Conclusions: MRI could be relevant for diagnosis, for which case the sensitivity of this method should be improved. Nevertheless, pre- and post-stress intracompartmental measurement continues to be the gold standard.

  8. Ultrasound-Guided, Percutaneous Needle Fascial Fenestration for the Treatment of Chronic Exertional Compartment Syndrome: A Case Report.

    PubMed

    Finnoff, Jonathan T; Rajasekaran, Sathish

    2016-03-01

    Chronic exertional compartment syndrome (CECS) involves a painful increase in compartment pressure caused by exercise and relieved by rest. The most common site for CECS in the lower extremity is the anterior leg compartment. We report a case of a collegiate athlete with bilateral anterior and lateral leg compartment CECS who was successfully treated with an ultrasound-guided, percutaneous needle fascial fenestration of the affected compartments in both legs and was able to return to full, unrestricted activity within 1 week of the procedure. This case highlights the potential application of this procedure for the treatment of anterior and lateral leg CECS. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  9. MODIFYING MARCHING TECHNIQUE IN MILITARY SERVICE MEMBERS WITH CHRONIC EXERTIONAL COMPARTMENT SYNDROME: A CASE SERIES

    PubMed Central

    Diebal-Lee, MAJ Angela; Poelsma, Laurens R.; Harts, Chris C.; Zimmermann, LTC Wes O.

    2016-01-01

    Background and Purpose The long-term effectiveness of both operative and non-operative management approaches for Chronic Exertional Compartment Syndrome of the lower legs (CECS) is moderate at best. Positive outcomes have recently been reported on modifying running technique in individuals with CECS. The purpose of this case series was to evaluate a training program aimed at changing marching technique in individuals with CECS, based on principles that aim to eliminate heel strike and decrease impact during foot strike. Study Design Case series. Methods Six service members with CECS underwent a five-week training program aimed at modifying marching technique. The program was comprised of foot/lower leg strengthening exercises, perception drills, and treadmill/outdoor marching bouts. Self-assessed leg condition, march endurance performance, and kinematic/kinetic measurements were assessed at baseline (T0), post-treatment (T5), and nine months post-intervention (T40). Results Moderate to fair pre- to post improvements on the self-assessed leg condition outcomes were demonstrated for most participants (4% to 73% improvements). These scores continued to improve until the 9 months follow-up. Marching performance improved during the intervention period in all but one subject, ranging from 6% to 38% improvement in marching time. Kinematic and kinetic data showed pre- to post-intervention changes that were reflective of the marching technique modification in most subjects. Post-intervention pain profiles of participants during marching showed that, in most subjects, the onset of leg pain was delayed compared to baseline. Conclusions A five-week intervention aimed at altering marching technique has demonstrated moderately promising results in a group of service members with CECS of the lower legs who had previously undergone other conservative management interventions without success. Due to the relatively small sample size and the variability in subject outcomes, further

  10. Acute exertional anterior compartment syndrome in an adolescent female.

    PubMed

    Fehlandt, A; Micheli, L

    1995-01-01

    Acute compartment syndromes usually occur as a complication of major trauma. While the chronic exertional anterior tibial compartment syndrome is well described in the sports medicine literature, reports of acute tibial compartment syndromes due to physical exertion, or repetitive microtrauma, are rare. The case of an adolescent female who developed an acute anterior compartment syndrome from running in a soccer game is described in this report. Failure to recognize the onset of an acute exertional compartment syndrome may lead to treatment delay and serious complications. Whereas the chronic exertional anterior compartment syndrome is characterized by pain that diminishes with the cessation of exercise, the onset of the acute exertional anterior compartment syndrome is heralded by pain that continues, or increases, after exercise has stopped. Compartment pressure measurement confirms the clinical diagnosis and helps guide treatment. True compartment syndromes require urgent fasciotomy.

  11. POST‐SURGICAL REHABILITATION FOLLOWING FASCIOTOMIES FOR BILATERAL CHRONIC EXERTIONAL COMPARTMENT SYNDROME IN A SPECIAL FORCES SOLDIER: A CASE REPORT

    PubMed Central

    Miller, Joseph

    2013-01-01

    Background and Purpose: The etiology of Chronic Exertional Compartment Syndrome (CECS) is still unclear. The most commonly accepted theory suggests that it is a transient but debilitating process where there is an abnormally increased intracompartmental pressure during exercise/exertion due to non‐compliant expansion of the osteofascial tissues. This most commonly occurs in the lower leg. Surgical intervention is often performed for symptom relief. However, there has been limited scientifically‐based publication on post‐surgical rehabilitation, especially with regard to return to function in the military population. The purpose of this case report is to demonstrate the utilization of a recommended post‐operative protocol in a Special Forces Soldier. Case Description: The subject presented as a 25‐year‐old US Army Special Forces Soldier, who failed 8 weeks of conservative management for the diagnosis of CECS and subsequently underwent bilateral lower leg fasciotomies of the anterior and lateral compartments. Outcomes: Following recommended protocol guidelines he was progressed rapidly and within three months deployed without restriction or complications in a demanding combat zone. Discussion: This case report illustrates that following clearly defined, scientifically‐based rehabilitation guidelines helped in addressing all of the involved structures and musculoskeletal dysfunctions that presented following the surgical intervention for CECS in a unique subject. Level of Evidence: 5 PMID:24175149

  12. Long-term results of surgical decompression of chronic exertional compartment syndrome of the forearm in motocross racers.

    PubMed

    Winkes, Michiel B; Luiten, Ernest J T; van Zoest, Wart J F; Sala, Harm A; Hoogeveen, Adwin R; Scheltinga, Marc R

    2012-02-01

    Chronic exertional compartment syndrome (CECS) is occasionally observed in the forearm flexor muscles of motocross racers. Long-term results of fasciectomy and fasciotomy for this syndrome are scarce. To study the long-term effects of 2 surgical techniques for forearm flexor CECS. Case series; Level of evidence, 4. A database of patients with forearm CECS who underwent surgery was analyzed. Long-term pain reduction (visual analog scale [VAS], 0-100) and efficacy were evaluated using a questionnaire. Data of 24 motocross racers were available for analysis. Intracompartmental pressures during rest, during provocation, and after 1 and 5 minutes of provocation were 15 ± 4, 78 ± 24, 29 ± 10, and 25 ± 7 mm Hg, respectively. Painful sensations in the forearm were reduced from 53 to 7 (median VAS; P < .001). Both fasciectomy (n = 14) and fasciotomy (n = 10) were equally effective. More than 95% (23/24) of the patients were satisfied with the postoperative result after 5 ± 2 years' follow-up. Surgical fasciotomy and fasciectomy of the forearm flexor compartment are equally successful in motocross racers suffering from forearm CECS.

  13. Intermittent claudication in diabetes mellitus due to chronic exertional compartment syndrome of the leg: an observational study of 17 patients.

    PubMed

    Edmundsson, David; Svensson, Olle; Toolanen, Göran

    2008-08-01

    Intermittent claudication in diabetes mellitus is commonly associated with arterial disease but may occur without obvious signs of peripheral circulatory impairment. We investigated whether this could be due to chronic exertional compartment syndrome (CECS). We report on 17 patients (3 men), mean age 39 (18-72) years, with diabetes mellitus--12 of which were type 1--and leg pain during walking (which was relieved at rest), without clinical signs of peripheral arterial disease. The duration of diabetes was 22 (1-41) years and 12 patients had peripheral neuropathy, retinopathy, or nephropathy. The leg muscles were tender and firm on palpation. Radiography, scintigraphy, and intramuscular pressure measurements were done during exercises to reproduce their symptoms. 16 of the 17 patients were diagnosed as having CECS. The intramuscular pressures in leg compartments were statistically significantly higher in diabetics than in physically active non-diabetics with CECS (p < 0.05). 15 of the 16 diabetics with CECS were treated with fasciotomy. At surgery, the fascia was whitish, thickened, and had a rubber-like consistency. After 1 year, 9 patients rated themselves as excellent or good in 15 of the 18 treated compartments. The walking time until stop due to leg pain increased after surgery from less than 10 min to unlimited time in 8 of 9 patients who were followed up. Intermittent claudication in diabetics may be caused by CECS of the leg. The intramuscular pressures were considerably elevated in diabetics. One pathomechanism may be fascial thickening. The results after fasciotomy are good, and the increased pain-free walking time is especially beneficial for diabetics.

  14. A NON-OPERATIVE APPROACH TO THE MANAGEMENT OF CHRONIC EXERTIONAL COMPARTMENT SYNDROME IN A TRIATHLETE: A CASE REPORT

    PubMed Central

    Gilden, Brad

    2016-01-01

    Background & Purpose Chronic Exertional Compartment Syndrome (CECS) causes significant exercise related pain secondary to increased intra-compartmental pressure (ICP) in the lower extremities. CECS is most often treated with surgery with minimal information available on non-operative approaches to care. This case report presents a case of CECS successfully managed with physical therapy. Study Design Case report Case Description A 34-year-old competitive triathlete experienced bilateral anterior and posterior lower leg pain measured with a numerical pain rating scale of 7/10 at two miles of running. Pain decreased to resting levels of 4/10 two hours post exercise. The patient was diagnosed with bilateral CECS with left lower extremity ICP at rest measured at 36 mmHg (deep posterior), 36-38 mmHg (superficial posterior), and 25 mmHg (anterior). Surgery was recommended. Interventions The patient chose non-operative care and was treated with physical therapy using the Functional Manual Therapy approach aimed at addressing myofascial restrictions, neuromuscular function and motor control deficits throughout the lower quadrant for 23 visits over 3.5 months. Outcomes At discharge the patient had returned to running pain free and training for an Olympic distance triathlon. The Lower Extremity Functional Scale improved from 62 to 80. The patient reported minimal post exercise tightness in bilateral lower extremities. Left lower extremity compartment pressure measurements at rest were in normal ranges measuring at 11 mmHg (deep posterior), 8 mmHg (superficial posterior), 19 mmHg (anterior), and 10 mmHg (lateral). Three-years post intervention the patient remained pain free with a Global Rating of Change of 6. Discussion This case report describes the successful treatment of a triathlete with Functional Manual Therapy resulting in a return to competitive sports without pain. Level of Evidence Level 4 PMID:27999729

  15. The Effectiveness of a 6-Week Intervention Program Aimed at Modifying Running Style in Patients With Chronic Exertional Compartment Syndrome

    PubMed Central

    Helmhout, Pieter H.; Diebal, Angela R.; van der Kaaden, Lisanne; Harts, Chris C.; Beutler, Anthony; Zimmermann, Wes O.

    2015-01-01

    Background: Previous studies have reported on the promising effects of changing running style in patients with chronic exertional compartment syndrome (CECS) using a 6-week training program aimed at adopting a forefoot strike technique. This study expands that work by comparing a 6-week in-house, center-based run training program with a less extensive, supervised, home-based run training program (50% home training). Hypothesis: An alteration in running technique will lead to improvements in CECS complaints and running performance, with the less supervised program producing less dramatic results. Study Design: Cohort study; Level of evidence, 3. Methods: Nineteen patients with CECS were prospectively enrolled. Postrunning intracompartmental pressure (ICP), run performance, and self-reported questionnaires were taken for all patients at baseline and after 6 weeks of running intervention. Questionnaires were also taken from 14 patients (7 center-based, 6 home-based) 4 months posttreatment. Results: Significant improvement between preintervention and postintervention rates was found for running distance (43%), ICP values (36%), and scores on the questionnaires Single Assessment Numeric Evaluation (SANE; 36%), Lower Leg Outcome Survey (LLOS; 18%), and Patient Specific Complaints (PSC; 60%). The mean posttreatment score on the Global Rating of Change (GROC) was between +4 and +5 (“somewhat better” to “moderately better”). In 14 participants (74%), no elevation of pain was reported posttreatment, compared with 3 participants (16%) at baseline; in all these cases, the running test was aborted because of a lack of cardiorespiratory fitness. Self-reported scores continued to improve 4 months after the end of the intervention program, with mean improvement rates of 48% (SANE), 26% (LLOS), and 81% (PSC). The mean GROC score improved to +6 points (“a great deal better”). Conclusion: In 19 patients diagnosed with CECS, a 6-week forefoot running intervention performed

  16. Time-dependent diffusion in skeletal muscle with the random permeable barrier model (RPBM): Application to normal controls and chronic exertional compartment syndrome patients

    PubMed Central

    Sigmund, Eric E.; Novikov, Dmitry S.; Sui, Dabang; Ukpebor, Obehi; Baete, Steven; Babb, James S.; Liu, Kecheng; Feiweier, Thorsten; Kwon, Jane; Mcgorty, KellyAnne; Bencardino, Jenny; Fieremans, Els

    2014-01-01

    Purpose To collect diffusion tensor imaging (DTI) at multiple diffusion times Td in skeletal muscle in normal subjects and chronic exertional compartment syndrome (CECS) patients and analyze the data with the random permeable barrier model (RPBM) for biophysical specificity. Materials and Methods Using an IRB-approved HIPAA-compliant protocol, seven patients with clinical suspicion of CECS and eight healthy volunteers underwent DTI of the calf muscle in a Siemens MAGNETOM Verio 3-T scanner at rest and after treadmill exertion at 4 different diffusion times. Radial diffusion values λrad were computed for each of 7 different muscle compartments and analyzed with RPBM to produce estimates of free diffusivity D0, fiber diameter a, and permeability κ. Fiber diameter estimates were compared with measurements from literature autopsy reference for several compartments. Response factors (post/pre-exercise ratios) were computed and compared between normal controls and CECS patients using a mixed-model two-way analysis of variance. Results All subjects and muscle compartments showed nearly time-independent diffusion along and strongly time-dependent diffusion transverse to the muscle fibers. RPBM estimates of fiber diameter correlated well with corresponding autopsy reference. D0 showed significant (p<0.05) increases with exercise for volunteers, and a increased significantly (p<0.05) in volunteers. At the group level, response factors of all three parameters showed trends differentiating controls from CECS patients, with patients showing smaller diameter changes (p=0.07), and larger permeability increases (p=0.07) than controls. Conclusions Time-dependent diffusion measurements combined with appropriate tissue modeling can provide enhanced microstructural specificity for in vivo tissue characterization. In CECS patients, our results suggest that high-pressure interfiber edema elevates free diffusion and restricts exercise-induced fiber dilation. Such specificity may be

  17. TRest as a New Diagnostic Variable for Chronic Exertional Compartment Syndrome of the Forearm: A Prospective Cohort Analysis of 124 Athletes.

    PubMed

    Barrera-Ochoa, Sergi; Correa-Vazquez, Eva; Gallardo-Calero, Irene; Haddad, Sleiman; Sallent, Andrea; Soldado, Francisco; Campillo-Recio, David; Mir-Bullo, Xavier

    2017-08-16

    To measure the accuracy of currently used intracompartmental pressure (ICP) diagnostic variables for forearm chronic exertional compartment syndrome (CECS) and a new ICP diagnostic variable, TRest, the recovery time between the maximum ICP and return to resting pressure. Retrospective cohort. Level evidence IV. University-affiliated tertiary hospital. Patients with suspected forearm CECS, 1990 to 2014. All patients underwent physical examination and exertional stress test, preceded and followed by measuring ICP in all suspicious CECS. Surgery was proposed when indicated. Minimum follow-up was 18 months. Final diagnosis was established at the final follow-up. Intracompartmental pressure measurements: PRest (baseline/pre-exercise pressure), P1 min (pressure 1 minute after exercise), P5 min (pressure 5 minutes after exercise), and TRest. Patients rated their pain and completed Quick-DASH in all follow-ups. Patients ultimately were classified into 4 groups (true positives, true negatives, false positives, and false negatives) for each ICP measurement relative to the final diagnosis. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. A total of 124 male athletes were diagnosed with CECS, 27 bilateral. Accuracy with standard ICP diagnostic variables was lower (sensitivity 73.5%, specificity 84.2%, positive predictive value 97%, and negative predictive value 31.4%) than with TRest (SN 100%, SP 94.7%, PPV 99.3%, and NPV 100%); 23% of patients would have been missed following the standard ICP diagnostic criteria. Diagnostic thresholds for current standard ICP measurements should be lowered. TRest, a new measure, might be more accurate.

  18. EXERTIONAL COMPARTMENT SYNDROME: REVIEW OF THE LITERATURE AND PROPOSED REHABILITATION GUIDELINES FOLLOWING SURGICAL RELEASE

    PubMed Central

    2011-01-01

    Background: There is little published information regarding postoperative management of patients with Chronic Exertional Compartment Syndrome (CECS). Reports of recurrence of symptoms following surgical decompression exist, and are not uncommon depending on the specific technique used. Recurrence suggests that more time and effort may need to be spent on implementing strategic post-operative rehabilitation management in order to avoid repeat surgical intervention or prolonged symptoms. Objective: To summarize relevant literature regarding CECS and propose scientifically-based guidelines for rehab following compartment release with the rationale based on tissue healing, muscle loading, and scar tissue formation and consideration of all tissues contained in the involved compartment. Literature review: A literature search was performed in PubMed, SPORTDiscus, CINAHL, PEDRO, and Google Scholar using the phrase: “chronic exertional compartment syndrome.” Results: No specific rehabilitation guidelines following surgical compartment release for lower extremity CECS were found in the literature search performed for this clinical commentary. Discussion: The development of the proposed post-operative guidelines may allow for improved long-term outcomes following anterior compartment release. Summary: Adequate description of long-term follow-up of outcomes following compartment release for CECS is lacking in current literature. The proposed guidelines for rehab following compartment release include consideration of tissue healing, muscle loading, scar tissue formation, and consideration of soft tissues contained in the involved compartment. Utilization of the proposed guidelines may allow for future research to be performed in order to assess outcomes following surgical intervention for CECS. PMID:21713230

  19. [Chronic compartment syndrome of the flexor muscles in the forearm due to motocross].

    PubMed

    Jeschke, J; Baur, E M; Piza-Katzer, H

    2006-04-01

    A case of a mechanic and motorcyclist is reported who developed unilateral chronic exertional compartment syndrome of the flexor muscles in the forearm. After years of discomfort and medical check-ups, a subcutaneous fasciotomy of the superficial compartments of the flexor muscles in the forearm led to a complete relief of symptoms, which allowed the patient unrestricted activity.

  20. Endoscopic decompression for chronic compartment syndrome of the forearm in motocross racers.

    PubMed

    Jans, Christophe; Peersman, Geert; Peersman, Benjamin; Van Den Langenbergh, Tom; Valk, Jody; Richart, Tom

    2015-09-01

    Sporting activities that involve repetitive stress to muscle compartments can elicit chronic exertional compartment syndrome. Its occurrence in the lower leg muscle compartments is most common, but other locations are less well known and the pathophysiology is not completely understood. In motocross racers, chronic exertional compartment syndrome can occur in the muscles of the lower arm. Currently, the only accepted treatment of correctly diagnosed chronic exertional compartment syndrome is surgical release of the fascia, which successfully relieves pain and allows patients to return to full activity. Open decompression is considered as the gold standard of treatment. This clinical paper describes our new endoscopic technique and investigates the functional outcome after surgery. We report on a series of 154 chronic exertional compartment syndromes afflicted motocross racers treated with an endoscopic release of the lower arm muscles. An MRI scan before and after strenuous exercise of the hand flexors (repetitive grip until exhaustion for 15 min) was performed to confirm the clinical diagnosis of chronic exertional compartment syndrome. Symptom severity before and after surgery was assessed using a visual analogue scale. Preoperative symptom severity scores were 1.1 ± 0.3 before exercise and 7.4 ± 1.5 after exercise. Post-operatively, these were 1.0 ± 0.2 and 1.7 ± 0.9. The pre- versus post-operative symptom scores after exercise were significantly different (p < 0.0001). No perioperative complications occurred, and at 6 weeks, all of the racers resumed their sportive activities. It can be concluded that endoscopic release of the superficial compartment of the forearms of motocross racers diagnosed with chronic exertional compartment syndrome is a valuable treatment option, with mild post-operative pain and fast recovery.

  1. Acute Exertional Rhabdomyolysis and Triceps Compartment Syndrome During a High School Football Camp

    PubMed Central

    Oh, John Y.; Laidler, Matthew; Fiala, Steven C.; Hedberg, Katrina

    2012-01-01

    Background: Acute exertional rhabdomyolysis has been infrequently reported among adolescents. In August 2010, several high school football players from one team developed rhabdomyolysis and triceps compartment syndrome following an upper arm exercise held in a non-air-conditioned wrestling room. Purpose: To confirm the diagnoses, characterize the spectrum of illnesses, and determine the factors contributing to rhabdomyolysis and triceps compartment syndromes. Study Design: Descriptive epidemiology study. Methods: The authors reviewed hospital medical records and interviewed players, coaches, school administrators, and hospital staff, using a standardized questionnaire that assessed symptoms, exposures, and activities. Results: Among 43 players, 22 (51%) experienced rhabdomyolysis (peak creatine kinase range, 2434-42 000 U/L): 22 patients had upper arm myalgia; 12 were hospitalized; 3 experienced triceps compartment syndrome; none experienced renal failure. Illnesses started 1 to 3 days after the triceps exercise. Forty players (93%) completed questionnaires. Among 19 players receiving at least 1 vote from a teammate as 1 of the 3 hardest working players, 13 (68%) experienced rhabdomyolysis versus 7 (33%) of 21 not considered hardest working (relative risk, 2.1; 95% confidence interval, 1.04-4.0). Of 40 players, 10 (25%) reported creatine supplement use, which was not associated with rhabdomyolysis. No player acknowledged use of alcohol, illicit drugs, or performance-enhancing drugs; results of performance-enhancing drug tests on the 4 players tested were negative. Environmental investigation did not identify additional factors contributing to illness. Conclusions: The upper arm exercise, possibly exacerbated by heat, led to rhabdomyolysis and compartment syndrome. Greater awareness of specific exercise hazards and prevention strategies can minimize risk for clinically significant muscle injury. PMID:23016070

  2. Acute exertional rhabdomyolysis and triceps compartment syndrome during a high school football cAMP.

    PubMed

    Oh, John Y; Laidler, Matthew; Fiala, Steven C; Hedberg, Katrina

    2012-01-01

    Acute exertional rhabdomyolysis has been infrequently reported among adolescents. In August 2010, several high school football players from one team developed rhabdomyolysis and triceps compartment syndrome following an upper arm exercise held in a non-air-conditioned wrestling room. To confirm the diagnoses, characterize the spectrum of illnesses, and determine the factors contributing to rhabdomyolysis and triceps compartment syndromes. Descriptive epidemiology study. The authors reviewed hospital medical records and interviewed players, coaches, school administrators, and hospital staff, using a standardized questionnaire that assessed symptoms, exposures, and activities. Among 43 players, 22 (51%) experienced rhabdomyolysis (peak creatine kinase range, 2434-42 000 U/L): 22 patients had upper arm myalgia; 12 were hospitalized; 3 experienced triceps compartment syndrome; none experienced renal failure. Illnesses started 1 to 3 days after the triceps exercise. Forty players (93%) completed questionnaires. Among 19 players receiving at least 1 vote from a teammate as 1 of the 3 hardest working players, 13 (68%) experienced rhabdomyolysis versus 7 (33%) of 21 not considered hardest working (relative risk, 2.1; 95% confidence interval, 1.04-4.0). Of 40 players, 10 (25%) reported creatine supplement use, which was not associated with rhabdomyolysis. No player acknowledged use of alcohol, illicit drugs, or performance-enhancing drugs; results of performance-enhancing drug tests on the 4 players tested were negative. Environmental investigation did not identify additional factors contributing to illness. The upper arm exercise, possibly exacerbated by heat, led to rhabdomyolysis and compartment syndrome. Greater awareness of specific exercise hazards and prevention strategies can minimize risk for clinically significant muscle injury.

  3. Acute pediatric leg compartment syndrome in chronic myeloid leukemia.

    PubMed

    Cohen, Eric; Truntzer, Jeremy; Trunzter, Jeremy; Klinge, Steve; Schwartz, Kevin; Schiller, Jonathan

    2014-11-01

    Acute compartment syndrome is an orthopedic surgical emergency and may result in devastating complications in the setting of delayed or missed diagnosis. Compartment syndrome has a variety of causes, including posttraumatic or postoperative swelling, external compression, burns, bleeding disorders, and ischemia-reperfusion injury. Rare cases of pediatric acute compartment syndrome in the setting of acute myeloid leukemia and, even less commonly, chronic myeloid leukemia have been reported. The authors report the first known case of pediatric acute compartment syndrome in a patient without a previously known diagnosis of chronic myeloid leukemia. On initial examination, an 11-year-old boy presented with a 2-week history of progressive left calf pain and swelling after playing soccer. Magnetic resonance imaging scan showed a hematoma in the left superficial posterior compartment. The patient had unrelenting pain, intermittent lateral foot parethesias, and inability to bear weight. Subsequently, he was diagnosed with acute compartment syndrome and underwent fasciotomy and evacuation of a hematoma. Laboratory results showed an abnormal white blood cell count of 440×10(9)/L (normal, 4.4-11×10(9)) and international normalized ratio of 1.3 (normal, 0.8-1.2). Further testing included the BCR-ABL1 fusion gene located on the Philadelphia chromosome, leading to a diagnosis of chronic myeloid leukemia. Monotherapy with imatinib mesylate (Gleevec) was initiated. This report adds another unique case to the growing literature on compartment syndrome in the pediatric population and reinforces the need to consider compartment syndrome, even in unlikely clinical scenarios. Copyright 2014, SLACK Incorporated.

  4. [Compartment syndrome in pathogenesis of lower limb exertional disease in servicemen].

    PubMed

    Savka, I S; Boĭko, S A

    2002-01-01

    As many as 35 servicemen presenting with a pathological reorganization and stress fractures of shin bones and foot were examined. A measurement of the subfascial pressure was done together with a study of pulse propagation along the tibial and fibial nerves and of bioelectrical activity of foot muscles innervated by the above nerves. The subfascial pressure in the anterior and posterior deep sheaths of the shin appeared to be increased in rest, especially so in the wake of physical loads on the affected extremity even if the process was localized in the foot. The velocity of the pulse propagation along the nerves was found to be decreased, the latent period increased, amplitude decreased, the duration of M-response longer in the affected extremity, with a 38 to 47% decrease in the frequency and amplitude of biological activity of maximum muscular contraction having been recordable. The latter observation has corroborated our assumption that in weight-bearing disease of the extremities there would be present a chronic compartment-syndrome which is of reccurrent character, causes disturbances in the neuromuscular apparatus of the extremity (ischemic demyelinization of the nerve fibers and dystrophic changes in the muscles innervated by the above nerve fibers), which fact may lead to recurrences of weight-bearing disease, prolonged treatment and restoration of the function.

  5. Accessory Soleus: A Case Report of Exertional Compartment and Tarsal Tunnel Syndrome Associated With an Accessory Soleus Muscle.

    PubMed

    Carrington, Scott C; Stone, Paul; Kruse, Dustin

    2016-01-01

    An accessory soleus muscle is a rare anatomic variant that frequently presents as an asymptomatic soft tissue swelling in the posteromedial ankle. Less frequently, the anomalous muscle can cause pain and swelling with activity. We present the case of a 17-year-old male with exertional compartment syndrome and associated tarsal tunnel syndrome secondary to a very large accessory soleus muscle. After surgical excision, the patient was able to return to full activity with complete resolution of symptoms.

  6. Excruciating Low Back Pain After Strenuous Exertion: Beware of Lumbar Paraspinal Compartment Syndrome.

    PubMed

    Vanbrabant, Peter; Moke, Lieven; Meersseman, Wouter; Vanderschueren, Geert; Knockaert, Daniel

    2015-11-01

    Low back pain is extremely common and usually a minor self-limiting condition. Rarely, however, it is a harbinger of serious medical illness. Paraspinal compartment syndrome is a rare condition, but its timely recognition is important to allow adequate treatment. A 16-year-old boy presented to the Emergency Department (ED) with severe low back pain, necessitating intravenous opioids. Laboratory results showed severe rhabdomyolysis. Magnetic resonance imaging of the lumbar spine showed diffuse edema and swelling in the paraspinal muscles. Aggressive fluid therapy was started but despite narcotic analgesia the pain persisted and creatine kinase (CK) levels increased. Compartment pressures of the erector spinae were found to be increased. The decision was made to proceed with bilateral paraspinal fasciotomies. Postoperatively, the patient noted immediate pain relief with rapid decrease of CK level. The patient is pain free and resumed running and swimming 3 months after admission in the ED. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although paraspinal compartment syndrome is a rare condition, its recognition is of paramount importance to allow adequate surgical treatment, preventing muscle necrosis. Although back pain most often has a benign course, a careful history and physical examination in patients presenting with low back pain allows determination of "red flags." Mandatory further diagnostic tests can identify underlying serious illness. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Ratings of perceived exertion in adults with chronically physical challenges.

    PubMed

    Satonaka, A; Suzuki, N; Kawamura, M

    2012-10-01

    The purposes of this study were to investigate: the relationship between ratings perceived exertion (RPE) and percentage of maximal oxygen uptake (%VO2max) during submaximal exercise; the influence of daily physical activities on RPE; and the influence of aerobic fitness on RPE. The participants were thirty-eight adults with chronically physical challenges. Submaximal exercise testing was conducted to estimate VO2max. The participants themselves declared their perceived exertion just before the end of the exercise testing by indicating the Borg's 6-20 RPE scale. Measurement of continuous heart rates was employed for measurement of the intensity of daily physical activities. The relationship between %VO2max and RPE was analyzed. There was a significant correlation between %VO2max and RPE only in the active men who did daily aerobic physical activities with intensity of 30%HRR and more (N.=9, r=0.74, P=0.02). In the good fitness groups of both women and men, the actual %VO2max in 11 out of 12 participants was lower than the reference value of %VO2max of the RPE while the opposite trend was found in poor aerobic fitness group. Our results recommend that RPE should be used together with objective physiological variables such as HR for assessment of exercise intensity in people with chronically physical challenges, especially who are low in aerobic fitness or who are inactive.

  8. Compartment syndromes

    NASA Technical Reports Server (NTRS)

    Mubarak, S. J.; Pedowitz, R. A.; Hargens, A. R.

    1989-01-01

    The compartment syndrome is defined as a condition in which high pressure within a closed fascial space (muscle compartment) reduces capillary blood perfusion below the level necessary for tissue viability'. This condition occurs in acute and chronic (exertional) forms, and may be secondary to a variety of causes. The end-result of an extended period of elevated intramuscular pressure may be the development of irreversible tissue injury and Volkmann's contracture. The goal of treatment of the compartment syndrome is the reduction of intracompartmental pressure thus facilitating reperfusion of ischaemic tissue and this goal may be achieved by decompressive fasciotomy. Controversy exists regarding the critical pressure-time thresholds for surgical decompression and the optimal diagnostic methods of measuring intracompartmental pressures. This paper will update and review some current knowledge regarding the pathophysiology, aetiology, diagnosis, and treatment of the acute compartment syndrome.

  9. Compartment syndromes

    NASA Technical Reports Server (NTRS)

    Mubarak, S. J.; Pedowitz, R. A.; Hargens, A. R.

    1989-01-01

    The compartment syndrome is defined as a condition in which high pressure within a closed fascial space (muscle compartment) reduces capillary blood perfusion below the level necessary for tissue viability'. This condition occurs in acute and chronic (exertional) forms, and may be secondary to a variety of causes. The end-result of an extended period of elevated intramuscular pressure may be the development of irreversible tissue injury and Volkmann's contracture. The goal of treatment of the compartment syndrome is the reduction of intracompartmental pressure thus facilitating reperfusion of ischaemic tissue and this goal may be achieved by decompressive fasciotomy. Controversy exists regarding the critical pressure-time thresholds for surgical decompression and the optimal diagnostic methods of measuring intracompartmental pressures. This paper will update and review some current knowledge regarding the pathophysiology, aetiology, diagnosis, and treatment of the acute compartment syndrome.

  10. Intramuscular deoxygenation during exercise in patients who have chronic anterior compartment syndrome of the leg

    NASA Technical Reports Server (NTRS)

    Mohler, L. R.; Styf, J. R.; Pedowitz, R. A.; Hargens, A. R.; Gershuni, D. H.

    1997-01-01

    Currently, the definitive diagnosis of chronic compartment syndrome is based on invasive measurements of intracompartmental pressure. We measured the intramuscular pressure and the relative oxygenation in the anterior compartment of the leg in eighteen patients who were suspected of having chronic compartment syndrome as well as in ten control subjects before, during, and after exercise. Chronic compartment syndrome was considered to be present if the intramuscular pressure was at least fifteen millimeters of mercury (2.00 kilopascals) before exercise, at least thirty millimeters of mercury (4.00 kilopascals) one minute after exercise, or at least twenty millimeters of mercury (2.67 kilopascals) five minutes after exercise. Changes in relative oxygenation were measured with use of the non-invasive method of near-infrared spectroscopy. In all patients and subjects, there was rapid relative deoxygenation after the initiation of exercise, the level of oxygenation remained relatively stable during continued exercise, and there was reoxygenation to a level that exceeded the pre-exercise resting level after the cessation of exercise. During exercise, maximum relative deoxygenation in the patients who had chronic compartment syndrome (mean relative deoxygenation [and standard error], -290 +/- 39 millivolts) was significantly greater than that in the patients who did not have chronic compartment syndrome (-190 +/- 10 millivolts) and that in the control subjects (-179 +/- 14 millivolts) (p < 0.05 for both comparisons). In addition, the interval between the cessation of exercise and the recovery of the pre-exercise resting level of oxygenation was significantly longer for the patients who had chronic compartment syndrome (184 +/- 54 seconds) than for the patients who did not have chronic compartment syndrome (39 +/- 19 seconds) and the control subjects (33 +/- 10 seconds) (p < 0.05 for both comparisons).

  11. Spinning Out of Control: A 19-Year-Old Female with Spinning-Related Exertional Thigh Compartment Syndrome

    PubMed Central

    Gould, Daniel J; Han, Sukgu; Wong, Alex K

    2016-01-01

    Thigh compartment syndrome (TCS) is a rare condition caused by high pressures within the fascial compartments of the thigh, impeding capillary flow and leading to decreased perfusion, tissue hypoxia, and necrosis. TCS is most frequently associated with trauma and anticoagulation but has also rarely been associated with exercise-related injury. We present the case of a 19-year-old female who reported painful swelling in her thighs and darkening of her urine after participating in a spinning class. On physical examination, the patient was found to have tight, painful thigh compartments with extreme tenderness on passive motion. Labs revealed a marked elevation of creatine kinase and leukocytosis. The patient was diagnosed with TCS and underwent emergent decompression fasciotomy and aggressive IV fluids for protection against myoglobinuria. Due to high clinical suspicion, prompt diagnosis, and early surgery, the patient experienced excellent recovery without functional deficits.  PMID:28123920

  12. Spinning Out of Control: A 19-Year-Old Female with Spinning-Related Exertional Thigh Compartment Syndrome.

    PubMed

    Gould, Daniel J; Badash, Ido; Han, Sukgu; Wong, Alex K

    2016-12-24

    Thigh compartment syndrome (TCS) is a rare condition caused by high pressures within the fascial compartments of the thigh, impeding capillary flow and leading to decreased perfusion, tissue hypoxia, and necrosis. TCS is most frequently associated with trauma and anticoagulation but has also rarely been associated with exercise-related injury. We present the case of a 19-year-old female who reported painful swelling in her thighs and darkening of her urine after participating in a spinning class. On physical examination, the patient was found to have tight, painful thigh compartments with extreme tenderness on passive motion. Labs revealed a marked elevation of creatine kinase and leukocytosis. The patient was diagnosed with TCS and underwent emergent decompression fasciotomy and aggressive IV fluids for protection against myoglobinuria. Due to high clinical suspicion, prompt diagnosis, and early surgery, the patient experienced excellent recovery without functional deficits.

  13. Near-Infrared Monitoring of Model Chronic Compartment Syndrome In Exercising Skeletal Muscle

    NASA Technical Reports Server (NTRS)

    Hargens, Alan R.; Breit, G. A.; Gross, J. H.; Watenpaugh, D. E.; Chance, B.

    1995-01-01

    Chronic compartment syndrome (CCS) is characterized by muscle ischemia, usually in the anterior oompartment of the leg, caused by high intramuscular pressure during exercise. Dual-wave near-infrared (NIR) spectroscopy is an optical technique that allows noninvasive tracking of variations in muscle tissue oxygenation (Chance et al., 1988). We hypothesized that with a model CCS, muscle tissue oxygenation will show a greater decline during exercise and a slower recovery post-exercise than under normal conditions.

  14. Incoordination among Subcellular Compartments Is Associated with Depression-Like Behavior Induced by Chronic Mild Stress

    PubMed Central

    Xu, Aiping; Cui, Shan

    2016-01-01

    Background: Major depressive disorder is characterized as persistent low mood. A chronically stressful life in genetically susceptible individuals is presumably the major etiology that leads to dysfunctions of monoamine and hypothalamus-pituitary-adrenal axis. These pathogenic factors cause neuron atrophy in the limbic system for major depressive disorder. Cell-specific pathophysiology is unclear, so we investigated prelimbic cortical GABAergic neurons and their interaction with glutamatergic neurons in depression-like mice. Methods: Mice were treated with chronic unpredictable mild stress for 3 weeks until they expressed depression-like behaviors confirmed by sucrose preference, Y-maze, and forced swimming tests. The structures and functions of GABAergic and glutamatergic units in prelimbic cortices were studied by cell imaging and electrophysiology in chronic unpredictable mild stress-induced depression mice vs controls. Results: In depression-like mice, prelimbic cortical GABAergic neurons show incoordination among the subcellular compartments, such as decreased excitability and synaptic outputs as well as increased reception from excitatory inputs. GABAergic synapses on glutamatergic cells demonstrate decreased presynaptic innervation and increased postsynaptic responsiveness. Conclusions: Chronic unpredictable mild stress-induced incoordination in prelimbic cortical GABAergic and glutamatergic neurons dysregulates their target neurons, which may be the pathological basis for depressive mood. The rebalance of compatibility among subcellular compartments would be an ideal strategy to treat neural disorders. PMID:26506857

  15. Relationship between anxiety and dyspnea on exertion in patients with chronic obstructive pulmonary disease.

    PubMed

    de Voogd, Jacob N; Sanderman, Robbert; Postema, Klaas; van Sonderen, Eric; Wempe, Johan B

    2011-07-01

    Dyspnea limits exercise in patients with chronic obstructive pulmonary disease (COPD) and is known to induce anxiety. Little is known whether anxiety contributes to exercise-induced dyspnea, which in turn might influence the outcome of diagnostic tests. The aim of the present study was to examine the relationship between general anxiety and dyspnea on exertion in patients with COPD. Ninety patients with stable COPD participated; 44 men, mean age 61 (standard deviation (SD) 10.4), and mean forced expiratory volume in 1 second (%pred.) 40.5 (SD 16.9). All participants performed pulmonary function tests and an incremental cycle ergometry. The Modified Borg Scale was used to measure the level of dyspnea on exertion. Anxiety symptoms were assessed with the Hospital Anxiety and Depression Scale. Data were analyzed using Spearman's correlations and multivariate regression. Dyspnea on exertion was correlated with general anxiety (r=.31), age (r=-.30), and exercise capacity (r=.27). Regression analysis showed that general anxiety was associated with dyspnea on exertion, adjusted for sex, age, baseline dyspnea, and exercise capacity. Consequently, it is reasoned that results of exercise training and activities in daily living may be influenced negatively by anxiety-worsened dyspnea. Attention should be given to anxiety management in patients with COPD to optimize exercise training.

  16. Exertion of stairclimbing in normal subjects and in patients with chronic obstructive bronchitis.

    PubMed Central

    Johnson, A N; Cooper, D F; Edwards, R H

    1977-01-01

    The exertion of stairclimbing has been studied in 10 normal young men, 10 healthy middle-aged men, and 10 middle-aged men with chronic bronchitis. Subjects climbed a staircase with a total vertical ascent of 40.8 m. They were allowed to adopt the most comfortable pattern of ascent, the patients having to stop at intervales for rest pauses. Work rate was determined by timing the raising body weight over measured sections of the staircase. Perception of exertion estimated with a numerical scale, heart rate, and increase of blood lactate concentration were closely similar in all three groups at the top of the staircase. In the patients, average power output was directly dependent on lung function, as indicated by the forced expired volume in 1 second. Stairclimbing offers a simple way of studying a patient's spontaneous activity pattern in a 'real life' environment. Studies of the kind described here could usefully complement formal exercise testing in the laboratory. PMID:601733

  17. Changes in leg pain after bilateral fasciotomy to treat chronic compartment syndrome: a case series study

    PubMed Central

    2013-01-01

    Background Intracompartmental pressure (ICP) as the diagnostic gold standard in the management of chronic compartment syndrome (CCS) is debated. We present a diagnostic protocol in which the decision to operate can be based upon clinical findings alone. The aim of this study was to examine whether patients who underwent surgery for CCS based on clinical findings experienced significant long-term pain relief. Methods A standardized clinical examination, including skin sensitivity, was performed in patients with bilateral leg pain and/or cramps. Before and after a symptom-provoking step test, ICPs were measured. The primary outcome was self-reported leg pain measured on a visual analogue scale. Secondary outcomes were satisfaction with the treatment result and health-related quality of life (HRQL) measured with the SF-8 questionnaire. Postoperative data were collected after 2 years. Results Follow-up was completed for 37 of 40 patients. ICP was increased in 80.5% of the compartments examined before surgery, but did not correlate with the degree of leg pain. The remaining compartments were diagnosed as CCS based on clinical findings, despite ICPs below the threshold. Leg cramps occurred in 32 of 37 (86.5%) patients during physical activity and at night. Leg pain improved from a score of 8.0 ± 1.5 to 2.3 ± 2.1, P < 0.001. Satisfaction with the treatment result was reported by 81.1% of the patients, accompanied by normalized HRQL. Conclusions The diagnostic protocol led to a fasciotomy in all compartments of both legs, which was associated with substantial and sustained relief of leg pain, improved HRQL, and patient satisfaction. PMID:23561303

  18. Ventilatory Inefficiency and Exertional Dyspnea in Early Chronic Obstructive Pulmonary Disease.

    PubMed

    Neder, J Alberto; Berton, Danilo C; Müller, Paulo de Tarso; Elbehairy, Amany F; Rocha, Alcides; Palange, Paolo; O'Donnell, Denis E

    2017-07-01

    Exertional dyspnea is present across the spectrum of chronic obstructive pulmonary disease (COPD) severity. However, without realizing it themselves, patients may decrease daily physical activity to avoid distressing respiratory sensations. Dyspnea also may be associated with deconditioning. Cardiopulmonary exercise testing can uncover exertional dyspnea and its physiological determinants in patients with preserved or only mildly reduced FEV1. Dyspnea in mild COPD can largely be explained by increased "wasted" ventilation in the physiological dead space, which heightens the drive to breathe and worsens the inspiratory mechanical constraints. During incremental exercise testing, this is readily identified as an excessive ventilation-to-metabolic demand, that is, a high ventilation ([Formula: see text]e) to carbon dioxide output ([Formula: see text]co2) relationship. Linking increases in [Formula: see text]e/[Formula: see text]co2 to exertional dyspnea may provide objective evidence that a patient's poor exercise tolerance is not just a consequence of deconditioning. This information should prompt a proactive therapeutic approach to increase the available ventilatory reserve by, for example, giving inhaled bronchodilators. Considering that the structural determinants of ventilatory inefficiency (early emphysema, ventilation-perfusion mismatching, and microvascular disease) may progress despite only modest changes in FEV1, serial [Formula: see text]e/[Formula: see text]co2 measurements might also prove valuable to track disease progression in these symptomatic patients.

  19. Tianeptine exerts neuroprotective effects in the brain tissue of rats exposed to the chronic stress model.

    PubMed

    Della, Franciela P; Abelaira, Helena M; Réus, Gislaine Z; Antunes, Altamir R; Dos Santos, Maria Augusta B; Zappelinni, Giovanni; Steckert, Amanda V; Vuolo, Francieli; Galant, Letícia S; Dal-Pizzol, Felipe; Kapczinski, Flávio; Quevedo, João

    2012-12-01

    Animal models of chronic stress represent valuable tools by which to investigate the behavioral, endocrine and neurobiological changes underlying stress-related psychopathologies, such as major depression, and the efficacy of antidepressant therapies. The present study was aimed at investigating the neurochemical effects of the antidepressant tianeptine in rats exposed to the chronic stress model. To this aim, rats were subjected to 40days of chronic unpredictable stressful stimuli, after which the animals received saline or tianeptine (15mg/kg) once a day for 7days. Additionally, IL-6, IL-1, TNF-α levels and oxidative stress parameters were assessed in the prefrontal cortex (PFC), hippocampus (HPC), amygdala (AMY) and nucleus accumbens (NAc) in all of the experimental groups studied. The results indicated that chronic mild stress and tianeptine did not exercise any effects on cytokines in all of the structures studied; in the PFC and AMY thiobarbituric acid reactive substances (TBARS) levels were decreased in control rats treated with tianeptine in the HPC; superoxide dismutase (SOD) activity was found to have decreased in stressed rats treated with saline in the PFC, HPC, AMY and NAc, and tianeptine reversed this effect; catalase (CAT) activity was found to have decreased in the PFC, HPC and NAc of stressed rats treated with saline, but was shown to have increased in stressed rats treated with tianeptine, and tianeptine also reversed the decreases in CAT activity in stressed rats treated with saline, suggesting that tianeptine exerted antioxidant activity. In conclusion, the present findings open new vistas on the pharmacological activity of tianeptine, in particular, concerning its ability to attenuate oxidative stress.

  20. Acute and chronic over-exertion: do depressed immune responses provide useful markers?

    PubMed

    Shephard, R J; Shek, P N

    1998-04-01

    There are ethical objections to inducing cumulative muscle damage and associated decrements of performance deliberately in a healthy athlete. Available data on acute and chronic over-exertion thus include the changes of immune response observed following a single bout of exhausting exercise, sequential observations made on top-level competitors as they approach peak training periods, and longitudinal laboratory studies of heavy (but not necessarily damaging) bouts of training. In all three of these situations, subclinical muscle damage initiates an acute inflammatory response, with a resulting deterioration in physical performance. Although much smaller in degree and shorter in duration, the associated changes in immune function are similar to those seen in sepsis. There have been major advances in immunological technique over the past decade, and significant changes in a number of elements of the immune response can be identified in athletes during periods of heavy training. The most promising immunological marker of excessive training seems a decrease in salivary IgA concentration. However, no single change occurs with sufficient consistency to identify the individual competitor who is at risk of overtraining. Mechanisms can be conceived that convert a sequence of excessive training bouts into an acute and then a chronic inflammatory process, but the syndrome of overtraining has a complex overlay of biological and psychological influences. It remains more easily detected by decreases in physical performance and alterations in mood state than by changes in immune function.

  1. Ferulic acid chronic treatment exerts antidepressant-like effect: role of antioxidant defense system.

    PubMed

    Lenzi, Juliana; Rodrigues, Andre Felipe; Rós, Adriana de Sousa; de Castro, Amanda Blanski; de Castro, Bianca Blanski; de Lima, Daniela Delwing; Magro, Débora Delwing Dal; Zeni, Ana Lúcia Bertarello

    2015-12-01

    Oxidative stress has been claimed a place in pathophysiology of depression; however, the details of the neurobiology of this condition remains incompletely understood. Recently, treatments employing antioxidants have been thoroughly researched. Ferulic acid (FA) is a phenolic compound with antioxidant and antidepressant-like effects. Herein, we investigated the involvement of the antioxidant activity of chronic oral FA treatment in its antidepressant-like effect using the tail suspension test (TST) and the forced swimming test (FST) in mice. The modulation of antioxidant system in blood, hippocampus and cerebral cortex was assessed after stress induction through TST and FST. Our results show that FA at the dose of 1 mg/kg has antidepressant-like effect without affecting locomotor activity. The stress induced by despair tests was able to decrease significantly the activities of superoxide dismutase (SOD) in the blood, catalase (CAT) in the blood and cerebral cortex and glutathione peroxidase (GSH-Px) in the cerebral cortex. Thiobarbituric acid-reactive substances (TBA-RS) levels were increased significantly in the cerebral cortex. Furthermore, the results show that FA was capable to increase SOD, CAT and GSH-Px activities and decrease TBA-RS levels in the blood, hippocampus and cerebral cortex. These findings demonstrated that FA treatment in low doses is capable to exert antidepressant-like effect with the involvement of the antioxidant defense system modulation.

  2. Exertional Dyspnoea in Chronic Respiratory Diseases: From Physiology to Clinical Application.

    PubMed

    Dubé, Bruno-Pierre; Vermeulen, François; Laveneziana, Pierantonio

    2017-02-01

    Dyspnoea is a complex, highly personalized and multidimensional sensory experience, and its underlying cause and mechanisms are still being investigated. Exertional dyspnoea is one of the most frequently encountered symptoms of patients with cardiopulmonary diseases, and is a common reason for seeking medical help. As the symptom usually progresses with the underlying disease, it can lead to an avoidance of physical activity, peripheral muscle deconditioning and decreased quality of life. Dyspnoea is closely associated with quality of life, exercise (in)tolerance and prognosis in various conditions, including chronic obstructive pulmonary disease, heart failure, interstitial lung disease and pulmonary hypertension, and is therefore an important therapeutic target. Effective management and treatment of dyspnoea is an important challenge for caregivers, and therapeutic options that attempt to reverse its underlying cause have been only partially successful This "review" will attempt to shed light on the physiological mechanisms underlying dyspnoea during exercise and to translate/apply them to a broad clinical spectrum of cardio-respiratory disorders.

  3. Inter- and intra-patient clonal and subclonal heterogeneity of chronic lymphocytic leukaemia: evidence from circulating and lymph nodal compartments

    PubMed Central

    Bonina, Silvia; Messina, Monica; Chiaretti, Sabina; Ilari, Caterina; Cafforio, Luciana; Raponi, Sara; Mauro, Francesca Romana; Di Maio, Valeria; De Propris, Maria Stefania; Nanni, Mauro; Ciardullo, Carmela; Rossi, Davide; Gaidano, Gianluca; Guarini, Anna; Rabadan, Raul; Foà, Robin

    2015-01-01

    Summary Whole exome sequencing and copy number aberration (CNA) analysis was performed on cells taken from peripheral blood (PB) and lymph nodes (LN) of patients with chronic lymphocytic leukaemia (CLL). Of 64 non-silent somatic mutations, 54 (84.4%) were clonal in both compartments, 3 (4.7%) were PB-specific and 7 (10.9%) were LN-specific. Most of the LN- or PB-specific mutations were subclonal in the other corresponding compartment (variant frequency 0.5-5.3%). Of 41 CNAs, 27 (65.8%) were shared by both compartments and 7 (17.1%) were LN- or PB-specific. Overall, 6 of 9 cases (66.7%) showed genomic differences between the compartments. At subsequent relapse, Case 10, with 6 LN-specific lesions, and Case 100, with 6 LN-specific and 8 PB-specific lesions, showed, in the PB, the clonal expansion of LN-derived lesions with an adverse impact: SF3B1 mutation, BIRC3 deletion, del8(p23.3-p11.1), del9(p24.3-p13.1) and gain 2(p25.3-p14). CLL shows an intra-patient clonal heterogeneity according to the disease compartment, with both LN and PB-specific mutations/CNAs. The LN microenvironment might contribute to the clonal selection of unfavourable lesions, as LN-derived mutations/CNAs can appear in the PB at relapse. PMID:26597680

  4. Acute compartment syndrome as the initial manifestation of chronic-phase chronic myeloid leukemia: a case report and review of the literature.

    PubMed

    Nagase, Yoshikazu; Ueda, Shuji; Matsunaga, Hitomi; Yoshioka, Aya; Okada, Yoshiyuki; Machida, Tomohisa; Nakata, Keiichi; Mima, Fuka; Takeda, Risato; Hayashi, Daisuke; Iio, Sadaharu; Okita, Kohei; Narahara, Hiroyuki; Yasunaga, Yuichi; Inui, Yoshiaki; Kawata, Sumio

    2016-07-21

    Acute compartment syndrome is an orthopedic emergency requiring urgent fasciotomy to prevent irreversible damage. In hematological malignancies, acute compartment syndrome caused by severe soft tissue bleeding is extremely rare. We present a patient with chronic-phase chronic myeloid leukemia who had acute compartment syndrome caused by severe soft tissue bleeding in her right forearm. A 72-year-old Japanese woman was referred to our hospital with swelling and pain of her right forearm without a previous history of trauma. She was diagnosed with chronic-phase chronic myeloid leukemia. Extreme thrombocytosis was present, although no evidence of acquired von Willebrand disorder was found. Compartment syndrome caused by soft tissue bleeding was confirmed. An emergency fasciotomy for decompression was conducted. However, sustained postoperative bleeding occurred and required massive red cell concentrate transfusion. As her platelet count decreased by cytoreductive therapy, complete hemostasis was achieved. Patients with an extremely high platelet count might be at high risk for severe bleeding complications even without acquired von Willebrand disease. For the control of severe bleeding complications in patients with myeloproliferative disorder, the importance of thrombocyte reduction should be recognized.

  5. Catheter-based renal sympathetic denervation exerts acute and chronic effects on renal hemodynamics in swine.

    PubMed

    Tsioufis, Costas; Papademetriou, Vasilios; Dimitriadis, Kyriakos; Tsiachris, Dimitris; Thomopoulos, Costas; Park, Euljoon; Hata, Cary; Papalois, Apostolos; Stefanadis, Christodoulos

    2013-09-30

    We investigated the acute and chronic effects of catheter-based renal sympathetic denervation (RSD) on renal hemodynamics assessed by average peak velocity (APV), renal blood flow (RBF), renal flow reserve (RFR) and resistive index (RI). Sympathetic overdrive is accompanied by impaired RBF, whereas there is no data on the effects of transcatheter RSD on renal hemodynamic balance. Before and post-RSD (acutely and after 1 month), in 9 farm swines we measured APV by a 0.014-inch Doppler flow wire placed in the stem of the renal artery under baseline and hyperemic conditions, induced by intrarenal dopamine (50 μg/kg). RFR was calculated as the ratio of hyperemic to basal peak velocity, and RI was estimated as (peak systolic velocity-end-diastolic velocity)/peak systolic velocity. RSD was achieved via the lumen of the main renal artery with a specifically designed catheter connected to a radiofrequency generator according to prespecified algorithm. APV and RBF increased acutely post ablation in all animals, compared to APV and RBF before ablation (61.44 ± 32.6 vs 20.44 ± 6.38 cm/s, p<0.001 and 407.4 ± 335.1 vs 161.1 ± 76.6 ml/min, p=0.003; respectively), whereas RFR and RI were reduced (1.51 ± 0.59 vs 2.85 ± 1.33, p<0.001 and 0.67 ± 0.07 vs 0.74 ± 0.07, p=0.005; respectively). One month post ablation APV and RBF compared to APV and RBF before ablation remained significantly higher whereas RFR and RI remained lower as compared to baseline. Catheter-based RSD exerts acute and chronic effects on renal hemodynamics in a large animal model. If confirmed in humans RBF parameters may be used as direct markers of successful RSD. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  6. Perceived and measured levels of exertion of patients with chronic back pain exercising in a hydrotherapy pool.

    PubMed

    Barker, Karen L; Dawes, Helen; Hansford, Peter; Shamley, Delva

    2003-09-01

    To investigate the efficacy of using ratings of perceived exertion (RPEs) to regulate exercise intensity for patients with chronic back pain while they undergo hydrotherapy. Experimental study. Hydrotherapy pool in the United Kingdom. Twenty-six patients (16 women, 10 men) with chronic low back pain of more than 12 months in duration. All were referred for hydrotherapy after attending a back pain triage clinic. Not applicable. Main outcome measures Borg Ratings of Perceived Exertion Scale; heart rate expressed as a percentage of age-predicted maximum heart rate, computed from readings using heart rate monitors; Oswestry Disability Questionnaire; and pain score from a visual analog scale. At workloads below 55% of age-predicted maximum heart rate, great variability was found in the relation between RPE and exercise intensity. However, for workloads between 55% and 85% of age-predicted maximum heart rate, RPE had a strong correlation with relative exercise intensity during hydrotherapy. At workloads sufficient to induce an aerobic training response, and yet be safe for patients with chronic back pain, RPE was an accurate predictor of exercise intensity. At lower intensities, back and leg pain may exert a mediating influence. Further investigation is needed to determine the exact relation between back pain, exercise type, and RPE at low exercise intensities.

  7. [Electrocardiographic signs of right ventricular overload useful in improving diagnosis of chronic thromboembolic pulmonary hypertension (CTE-PH) in patients with chronic exertional dyspnea].

    PubMed

    Lewczuk, Jerzy; Ajlan, Abdul Wahab; Piszko, Piotr; Mikulewicz, Małgorzata; Jagas, Jacek; Sobkowicz, Bozena; Wrabec, Krzysztof

    2002-11-01

    The early recognition of chronic thromboembolic pulmonary hypertension (CTE-PH) is troublesome because of "honey moon" period with chronic dyspnea on exertion as the only one symptom. To find if routine electrocardiography may be useful in improving the diagnosis, value of right ventricular overload (RVO) signs in recognition echocardiographically determined chronic pulmonary hypertension (CPH) and angiographically confirmed CTE-PH in 90 consecutive patients hospitalized due to chronic exertional dyspnea was studied. CPE was found in 76.5% and CTE-PH in 33% of those patients, at least one of twelve founded electrocardiographic signs of RVO was present in 50% patients. The most frequently occurred signs: negative T wave in lead V1-V6, right axis deviation and pulmonale P wave as well as 9 other occurred at frequency below 20% signs of RVO had low to medium sensitivity and negative predictive value and 80-90% positive predictive value for diagnosing CPE and 90-100% positive predictive value for diagnosing CTE-PH. It was concluded that in patients with chronic exertional dyspnea electrocardiographic signs of RVO may be useful in initial diagnosing of CPH and CTE-PH in particular.

  8. Acute and chronic treatment with quetiapine induces antidepressant-like behavior and exerts antioxidant effects in the rat brain.

    PubMed

    Ignácio, Zuleide M; Réus, Gislaine Z; Abelaira, Helena M; de Moura, Airam B; de Souza, Thays G; Matos, Danyela; Goldim, Mariana P; Mathias, Khiany; Garbossa, Leandro; Petronilho, Fabricia; Quevedo, João

    2017-08-01

    Many studies note that changes in oxidative balance are involved in the pathogenesis of major depressive disorder (MDD) and in the success of some antidepressants. Quetiapine exerts a therapeutic response and induces changes in physiological mechanisms that appear to underlie MDD. The objective of this study was to evaluate the antidepressant and antioxidant effects of quetiapine (20 mg /kg) in adult animals. Sixty minutes after an acute treatment or the last administration of chronic treatment (14 days) with quetiapine, animals were subjected to the forced swimming test (FST) to evaluate mobility parameters. Then, the hippocampus, prefrontal cortex (CPF), amygdala and nucleus accumbens (NAc) were removed for the assessment of oxidative stress parameters. Both acute and chronic treatments exerted antidepressant-like effects. Myeloperoxidase (MPO) activity was reduced in the amygdala after acute treatment and in the hippocampus, PFC and amygdala after chronic treatment. In addition, after chronic treatment, the levels of thiobarbituric reactive species (TBARS) were reduced in the amygdala and NAc, and the protein carbonyl content was reduced in the CPF. Superoxide dismutase (SOD) activity increased in the NAc after acute and chronic treatments. Catalase (CAT) activity increased in the PFC after acute treatment and in the NAc after acute and chronic treatments. The concentration of nitrite/nitrate was lower in the CPF after chronic treatment. These results corroborate the antidepressant effect of quetiapine and indicate that quetiapine exhibits an antioxidant profile, a physiological mechanism that appears be involved in the therapeutic function of quetiapine in individuals resistant to classical antidepressant treatments.

  9. Quantification of perceived exertion during isometric force production with the Borg scale in healthy individuals and patients with chronic stroke.

    PubMed

    Hampton, Stephen; Armstrong, Gina; Ayyar, Monika Shah; Li, Sheng

    2014-01-01

    The Borg Rating of Perceived Exertion (RPE) scale is widely used for many patient populations, but the ability of patients to accurately report their RPE without visual feedback has not been studied. The objective was to determine whether the Borg scale could be used as a measure of perceived isometric exertion in healthy subjects and patients with stroke. In experiment 1, young healthy subjects (n = 15) were instructed to perform spontaneous pushes (ie, self-selected effort) without visual feedback and to produce and hold self-determined isometric finger flexion at 5 Borg levels without visual feedback. In experiment 2, subjects with chronic stroke (n = 10) were instructed to produce self-determined isometric elbow flexion at 4 perceptual levels on the impaired and nonimpaired sides. In experiment 1, young healthy subjects, asked to self-select without visual feedback (spontaneous push), tended to exert at a "somewhat hard" level, about 12% of maximal voluntary contraction (MVC). Self-selection of forces ranged from 2% of MVC (ie, very light) to 39% of MVC (ie, very hard). In experiment 2, subjects with stroke were able to distinguish different levels of perceived exertion among light (19% MVC), somewhat hard (33% MVC), and hard (63% MVC) levels; this ability was not different for the impaired and nonimpaired limbs. Both healthy subjects and subjects with stroke are able to differentiate distinct levels of perceived exertion during isometric force when prompted with the Borg scale. Efforts at lower percentages of MVC are perceived by subjects with stroke as greater-than-normal Borg RPE levels.

  10. Near-infrared spectroscopy for monitoring of tissue oxygenation of exercising skeletal muscle in a chronic compartment syndrome model

    NASA Technical Reports Server (NTRS)

    Breit, G. A.; Gross, J. H.; Watenpaugh, D. E.; Chance, B.; Hargens, A. R.

    1997-01-01

    Variations in the levels of muscle hemoglobin and of myoglobin oxygen saturation can be detected non-invasively with near-infrared spectroscopy. This technique could be applied to the diagnosis of chronic compartment syndrome, in which invasive testing has shown increased intramuscular pressure associated with ischemia and pain during exercise. We simulated chronic compartment syndrome in ten healthy subjects (seven men and three women) by applying external compression, through a wide inflatable cuff, to increase the intramuscular pressure in the anterior compartment of the leg. The tissue oxygenation of the tibialis anterior muscle was measured with near-infrared spectroscopy during gradual inflation of the cuff to a pressure of forty millimeters of mercury (5.33 kilopascals) during fourteen minutes of cyclic isokinetic dorsiflexion and plantar flexion of the ankle. The subjects exercised with and without external compression. The data on tissue oxygenation for each subject then were normalized to a scale of 100 per cent (the baseline value, or the value at rest) to 0 per cent (the physiological minimum, or the level of oxygenation achieved by exercise to exhaustion during arterial occlusion of the lower extremity). With external compression, tissue oxygenation declined at a rate of 1.4 +/- 0.3 per cent per minute (mean and standard error) during exercise. After an initial decrease at the onset, tissue oxygenation did not decline during exercise without compression. The recovery of tissue oxygenation after exercise was twice as slow with compression (2.5 +/- 0.6 minutes) than it was without the use of compression (1.3 +/- 0.2 minutes).

  11. Extracellular cathepsin K exerts antimicrobial activity and is protective against chronic intestinal inflammation in mice.

    PubMed

    Sina, Christian; Lipinski, Simone; Gavrilova, Olga; Aden, Konrad; Rehman, Ateequr; Till, Andreas; Rittger, Andrea; Podschun, Rainer; Meyer-Hoffert, Ulf; Haesler, Robert; Midtling, Emilie; Pütsep, Katrin; McGuckin, Michael A; Schreiber, Stefan; Saftig, Paul; Rosenstiel, Philip

    2013-04-01

    Cathepsin K is a lysosomal cysteine protease that has pleiotropic roles in bone resorption, arthritis, atherosclerosis, blood pressure regulation, obesity and cancer. Recently, it was demonstrated that cathepsin K-deficient (Ctsk(-/-) ) mice are less susceptible to experimental autoimmune arthritis and encephalomyelitis, which implies a functional role for cathepsin K in chronic inflammatory responses. Here, the authors address the relevance of cathepsin K in the intestinal immune response during chronic intestinal inflammation. Chronic colitis was induced by administration of 2% dextran sodium sulphate (DSS) in distilled water. Mice were assessed for disease severity, histopathology and endoscopic appearance. Furthermore, DSS-exposed Ctsk(-/-) mice were treated by rectal administration of recombinant cathepsin K. Intestinal microflora was assessed by real-time PCR and 16srDNA molecular fingerprinting of ileal and colonic mucosal and faecal samples. Using Ctsk(-/-) mice, the authors demonstrate a protective role of cathepsin K against chronic DSS colitis. Dissecting the underlying mechanisms the authors found cathepsin K to be present in intestinal goblet cells and the mucin layer. Furthermore, a direct cathepsin K-mediated bactericidal activity against intestinal bacteria was demonstrated, which potentially explains the alteration of intestinal microbiota observed in Ctsk(-/-) mice. Rectal administration of recombinant cathepsin K in DSS-treated Ctsk(-/-) mice ameliorates the severity of intestinal inflammation. These data identify extracellular cathepsin K as an intestinal antibacterial factor with anti-inflammatory potential and suggest that topical administration of cathepsin K might provide a therapeutic option for patients with inflammatory bowel disease.

  12. Salidroside exerts protective effects against chronic hypoxia-induced pulmonary arterial hypertension via AMPKα1-dependent pathways

    PubMed Central

    Chen, Mayun; Cai, Hui; Yu, Chang; Wu, Peiliang; Fu, Yangyang; Xu, Xiaomei; Fan, Rong; Xu, Cunlai; Chen, Yanfan; Wang, Liangxing; Huang, Xiaoying

    2016-01-01

    Salidroside, an active ingredient isolated from Rhodiola rosea, has shown to exert protective effects against chronic hypoxia-induced pulmonary arterial hypertension (PAH). However, the underlying mechanisms were not well known. Based on our recent reports, we predicted the involvement of adenosine monophosphate-activated protein kinase (AMPK) mediated effects in salidroside regulation of PAH. Firstly, to prove the hypothesis, rats were exposed to chronic hypoxia and treated with increasing concentrations of salidroside or a selective AMPK activator-5’-aminoimidazole-4-carboxamide ribonucleoside (AICAR) for 4 weeks. After salidroside or AICAR treatment, the chronic hypoxia-induced right ventricular hypertrophy and pulmonary artery remodeling were attenuated. Then the effects of salidroside or AICAR on hypoxia-induced excess cellular proliferation and apoptosis resistance of pulmonary arterial smooth muscle cells (PASMCs), which contributed to pulmonary arterial remodeling, were investigated. Our results suggested salidroside, as well as AICAR, reversed hypoxia-induced PASMCs proliferation and apoptosis resistance while AMPK inhibitor Compound C enhanced the effects of hypoxia. To reveal the potential cellular mechanisms, activation of AMPKα1 and expression of the genes related to proliferation and apoptosis were analyzed in PASMCs after salidroside treatment under hypoxia conditions. The results demonstrated salidroside as well as AICAR might inhibit chronic hypoxia-induced PASMCs proliferation via AMPKα1-P53-P27/P21 pathway and reverse apoptosis resistance via AMPKα1-P53-Bax/Bcl-2-caspase 9-caspase 3 pathway. PMID:27069536

  13. Salidroside exerts protective effects against chronic hypoxia-induced pulmonary arterial hypertension via AMPKα1-dependent pathways.

    PubMed

    Chen, Mayun; Cai, Hui; Yu, Chang; Wu, Peiliang; Fu, Yangyang; Xu, Xiaomei; Fan, Rong; Xu, Cunlai; Chen, Yanfan; Wang, Liangxing; Huang, Xiaoying

    2016-01-01

    Salidroside, an active ingredient isolated from Rhodiola rosea, has shown to exert protective effects against chronic hypoxia-induced pulmonary arterial hypertension (PAH). However, the underlying mechanisms were not well known. Based on our recent reports, we predicted the involvement of adenosine monophosphate-activated protein kinase (AMPK) mediated effects in salidroside regulation of PAH. Firstly, to prove the hypothesis, rats were exposed to chronic hypoxia and treated with increasing concentrations of salidroside or a selective AMPK activator-5'-aminoimidazole-4-carboxamide ribonucleoside (AICAR) for 4 weeks. After salidroside or AICAR treatment, the chronic hypoxia-induced right ventricular hypertrophy and pulmonary artery remodeling were attenuated. Then the effects of salidroside or AICAR on hypoxia-induced excess cellular proliferation and apoptosis resistance of pulmonary arterial smooth muscle cells (PASMCs), which contributed to pulmonary arterial remodeling, were investigated. Our results suggested salidroside, as well as AICAR, reversed hypoxia-induced PASMCs proliferation and apoptosis resistance while AMPK inhibitor Compound C enhanced the effects of hypoxia. To reveal the potential cellular mechanisms, activation of AMPKα1 and expression of the genes related to proliferation and apoptosis were analyzed in PASMCs after salidroside treatment under hypoxia conditions. The results demonstrated salidroside as well as AICAR might inhibit chronic hypoxia-induced PASMCs proliferation via AMPKα1-P53-P27/P21 pathway and reverse apoptosis resistance via AMPKα1-P53-Bax/Bcl-2-caspase 9-caspase 3 pathway.

  14. Capturing the post-exertional exacerbation of fatigue following physical and cognitive challenge in patients with chronic fatigue syndrome.

    PubMed

    Keech, Andrew; Sandler, Carolina X; Vollmer-Conna, Ute; Cvejic, Erin; Lloyd, Andrew R; Barry, Benjamin K

    2015-12-01

    To design and validate an instrument to capture the characteristic post-exertional exacerbation of fatigue in patients with chronic fatigue syndrome (CFS). Firstly, patients with CFS (N=19) participated in five focus group discussions to jointly explore the nature of fatigue and dynamic changes after activity, and inform development of a self-report instrument - the Fatigue and Energy Scale (FES). The psychometric properties of the FES were then examined in two case-control challenge studies: a physically-demanding challenge (moderate-intensity aerobic exercise; N=10 patients), and a cognitively-demanding challenge (simulated driving; N=11 patients). Finally, ecological validity was evaluated by recording in association with tasks of daily living (N=9). Common descriptors for fatigue included 'exhaustion', 'tiredness', 'drained of energy', 'heaviness in the limbs', and 'foggy in the head'. Based on the qualitative data, fatigue was conceptualised as consisting of 'physical' and 'cognitive' dimensions. Analysis of the psychometric properties of the FES showed good sensitivity to the changing symptoms during a post-exertional exacerbation of fatigue following both physical exercise and driving simulation challenges, as well as tasks of daily living. The 'fatigue' experienced by patients with CFS covers both physical and cognitive components. The FES captured the phenomenon of a post-exertional exacerbation of fatigue commonly reported by patients with CFS. The characteristics of the symptom response to physical and cognitive challenges were similar. Both the FES and the challenge paradigms offer key tools to reliably investigate biological correlates of the dynamic changes in fatigue. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Chronic antidepressants induce redistribution and differential activation of alphaCaM kinase II between presynaptic compartments.

    PubMed

    Barbiero, Valentina S; Giambelli, Roberto; Musazzi, Laura; Tiraboschi, Ettore; Tardito, Daniela; Perez, Jorge; Drago, Filippo; Racagni, Giorgio; Popoli, Maurizio

    2007-12-01

    Changes in synaptic plasticity are involved in pathophysiology of depression and in the mechanism of antidepressants. Ca(2+)/calmodulin (CaM) kinase II, a protein kinase involved in synaptic plasticity, has been previously shown to be a target of antidepressants. We previously found that antidepressants activate the kinase in hippocampal neuronal cell bodies by increasing phosphorylation at Thr(286), reduce the kinase phosphorylation in synaptic membranes, and in turn its phosphorylation-dependent interaction with syntaxin-1 and the release of glutamate from hippocampal synaptosomes. Here, we investigated the chronic effect of different antidepressants (fluoxetine, desipramine, and reboxetine) on the expression and function of the kinase in distinct subcellular compartments in order to dissect the different kinase pools affected. Acute treatments did not induce any change in the kinase. In total tissue extracts chronic drug treatments induced activation of the kinase; in hippocampus (HC), but not in prefrontal/frontal cortex, this was partially accounted for by increased Thr(286) phosphorylation, suggesting the involvement of different mechanisms of activation. In synaptosomes, all drugs reduced the kinase phosphorylation, particularly in HC where, upon fractionation of the synaptosomal particulate into synaptic vesicles and membranes, we found that the drugs induced a redistribution and differential activation of the kinase between membranes and vesicles. Furthermore, a large decrease in the level and phosphorylation of synapsin I located at synaptic membranes was consistent with the observed decrease of CaM kinase II. Overall, antidepressants induce a complex pattern of modifications in distinct subcellular compartments; at presynaptic level, these changes are in line with a dampening of glutamate release.

  16. Simvastatin treatment exerts antidepressant-like effect in rats exposed to chronic mild stress.

    PubMed

    Lin, Pao-Yen; Chang, Alice Y W; Lin, Tsu-Kung

    2014-09-01

    Hyperlipidemia is associated with increased risk of coronary artery disease and stroke, both of which, in turn, are risk factors of old-age depression. Statins are extensively used for decreasing cholesterol levels. Clinical investigations revealed that long-term use of statins appeared to be associated with a lower risk of anxiety and depression. However, the antidepressant property of statins has not been well examined. This study aimed at examining the antidepressant-like effects of statins in rats exposed to chronic mild stress (CMS). We found that animals exposed to CMS for 4 weeks developed depressive-like state, shown by forced swim test and sucrose preference test. However, these CMS-induced behavioral changes were reversed by simvastatin (5 or 10mg/kg/day) for 14 days, comparable to imipramine (10mg/kg/day) treatment. Locomotor activity and anxiety-like behaviors were not altered by CMS or these treatments. These results demonstrated antidepressant-like effects of statin in CMS model of rats and suggested the potential that statins could be used to facilitate antidepressant treatment in clinical setting.

  17. Vitexin exerts cardioprotective effect on chronic myocardial ischemia/reperfusion injury in rats via inhibiting myocardial apoptosis and lipid peroxidation

    PubMed Central

    Che, Xia; Wang, Xin; Zhang, Junyan; Peng, Chengfeng; Zhen, Yilan; Shao, Xu; Zhang, Gongliang; Dong, Liuyi

    2016-01-01

    Purpose: The aim of this study was to explore the cardioprotective effect of vitexin on chronic myocardial ischemia/reperfusion injury in rats and potential mechanisms. Methods: A chronic myocardial ischemia/reperfusion injury model was established by ligating left anterior descending coronary for 60 minutes, and followed by reperfusion for 14 days. After 2 weeks ischemia/reperfusion, cardiac function was measured to assess myocardial injury. The level of ST segment was recorded in different periods by electrocardiograph. The change of left ventricular function and myocardial reaction degree of fibrosis of heart was investigated by hematoxylin and eosin (HE) staining and Sirius red staining. Endothelium-dependent relaxations due to acetylcholine were observed in isolated rat thoracic aortic ring preparation. The blood samples were collected to measure the levels of MDA, the activities of SOD and NADPH in serum. Epac1, Rap1, Bax and Bcl-2 were examined by using Western Blotting. Results: Vitexin exerted significant protective effect on chronic myocardial ischemia/reperfusion injury, improved obviously left ventricular diastolic function and reduced myocardial reactive fibrosis degree in rats of myocardial ischemia. Medium and high-dose vitexin groups presented a significant decrease in Bax, Epac1 and Rap1 production and increase in Bcl-2 compared to the I/R group. It may be related to preventing myocardial cells from apoptosis, improving myocardial diastolic function and inhibiting lipid peroxidation. Conclusions: Vitexin is a cardioprotective herb, which may be a promising useful complementary and alternative medicine for patients with coronary heart disease. PMID:27648122

  18. Nordic walking enhances oxygen uptake without increasing the rate of perceived exertion in patients with chronic obstructive pulmonary disease.

    PubMed

    Barberan-Garcia, Anael; Arbillaga-Etxarri, Ane; Gimeno-Santos, Elena; Rodríguez, Diego Agustín; Torralba, Yolanda; Roca, Josep; Vilaró, Jordi

    2015-01-01

    In healthy subjects, Nordic walking (NW) generates higher oxygen uptake (V˙O2) than standard walking at an equal rate of perceived exertion (RPE). The feasibility and positive outcomes of NW in patients with chronic obstructive pulmonary disease (COPD) have been reported. The aim of the current study is to assess the physiological responses and RPE during NW in COPD patients. In 15 COPD patients [mean (SD) age 67 (9) years] with a forced expiratory volume in the 1st s of 55% (15)], V˙O2, minute ventilation and heart rate were measured with a portable system during the 6-min walking test (6MWT), incremental shuttle walking test (SWT), 6-min NW on solid ground (6mNWground) and 6-min NW on soft dry beach sand (6mNWsand). The RPE using a modified Borg scale was assessed after each test. 6mNWground and 6mNWsand showed a higher V˙O2 plateau compared with the 6MWT and peak V˙O2 measured during SWT [mean (SD) V˙O2 21 (3), 22 (4), 18 (4) and 19 (5) ml·kg(-1)·min(-1), respectively; p < 0.05 each]. However, no differences in RPE were observed among 6mNWground, 6MWT and SWT [modified Borg scale score for dyspnea 4.2 (2.0), 4.1 (1.8) and 4.3 (1.7), respectively; nonsignificant]. However, RPE in 6mNWsand was significantly higher than in all the other exercise protocols [modified Borg scale score for dyspnea 5.2 (2.2); p < 0.05]. In COPD patients, the use of Nordic poles generates higher V˙O2 than standard walking with no differences in the dyspnea score. The results indicate the potential to enhance community-based training programs in these patients. © 2015 S. Karger AG, Basel.

  19. Exertional leg pain: teasing out arterial entrapments.

    PubMed

    Pham, Thomas T; Kapur, Rahul; Harwood, Marc I

    2007-12-01

    Vascular causes of exertional lower extremity pain are relatively rare, but may be the answer in athletes refractory to treatment for the more common overuse syndromes of the lower extremities. It is important to differentiate these vascular causes from chronic exertional compartment syndrome (CECS), medial tibial stress syndrome (MTSS), and stress fractures in order to develop appropriate treatment plans, avoid complications, and return athletes to play expeditiously. Important vascular etiologies to be considered are popliteal artery entrapment syndrome (PAES), endofibrotic disease, popliteal artery aneurysm, cystic adventitial disease, and peripheral arterial dissections. The diagnostic workup involves angiography or noninvasive vascular studies such as Doppler ultrasound or magnetic resonance angiography in both the neutral and provocative positions. Treatment of these vascular abnormalities typically involves surgical correction of the vascular anomaly.

  20. Changes in Muscle Oxygen Saturation Have Low Sensitivity in Diagnosing Chronic Anterior Compartment Syndrome of the Leg.

    PubMed

    Rennerfelt, Kajsa; Zhang, Qiuxia; Karlsson, Jón; Styf, Jorma

    2016-01-06

    Near-infrared spectroscopy measures muscle oxygen saturation (StO2) in the skeletal muscle and has been proposed as a noninvasive tool for diagnosing chronic anterior compartment syndrome (CACS). The purpose of this study was to investigate the diagnostic value of changes in StO2 during and after exercise in patients with CACS. The study comprised 159 consecutive patients with exercise-induced leg pain. Near-infrared spectroscopy was used to measure StO2 continuously before, during, and after an exercise test. One minute post-exercise, intramuscular pressure was recorded in the same muscle. The cohort was divided into patients with CACS (n = 87) and patients without CACS (n = 72) according to the CACS diagnostic criteria. Reoxygenation at rest after exercise was calculated as the time period required for the level of muscular StO2 to reach 50% (T50), 90% (T90), and 100% (T100) of the baseline value. The lowest level of StO2 during exercise was 1% (range, 1% to 36%) in the patients with CACS and 3% (range, 1% to 54%) in the patients without CACS. The sensitivity was 34% and the specificity was 43% when an StO2 level of ≤8% at peak exercise was used to indicate CACS. The sensitivity and the specificity were only 1% when an StO2 level of ≤50% at peak exercise was used to indicate CACS. The time period for reoxygenation was seven seconds (range, one to forty-three seconds) at T50, twenty-eight seconds (range, seven to seventy-seven seconds) at T90, and forty-two seconds (range, seven to 200 seconds) at T100 in the patients with CACS and ten seconds (range, one to forty-nine seconds) at T50, thirty-two seconds (range, four to 138 seconds) at T90, and forty-eight seconds (range, four to 180 seconds) at T100 in the patients without CACS. When thirty seconds or more at T90 was set as the cutoff value for a prolonged time for reoxygenation, indicating a diagnosis of CACS, the sensitivity was 38% and the specificity was 50%. Changes in muscle oxygen saturation during and

  1. When exercise causes exertional rhabdomyolysis.

    PubMed

    Furman, Janet

    2015-04-01

    Exertional rhabdomyolysis is a clinical condition caused by intense, repetitive exercise or a sudden increase in exercise in an untrained person, although rhabdomyolysis can occur in trained athletes. In many cases, the presentation of early, uncomplicated rhabdomyolysis is subtle, but serious complications such as renal failure, compartment syndrome, and dysrhythmias may arise if severe exertional rhabdomyolysis is undiagnosed or untreated. Management is further complicated by the lack of concrete management guidelines for treating rhabdomyolysis and returning patients to activity.

  2. Sources, transport and fate of PAHs in sediments and superficial water of a chronically polluted semi-enclosed body of seawater: linking of compartments.

    PubMed

    Rojo-Nieto, Elisa; Sales, Diego; Perales, José Antonio

    2013-05-01

    This paper describes a study of the occurrence, levels and temporal evolution of PAHs in a bay characterized by persistent chronic impacts. A total of 40 samples, 20 of sediment and 20 of water, were taken at each of five different stations, in four sampling campaigns. Analyses of pollutants have been made using GC-MS. Results indicate that in a coastal environment subjected to chronic pollution by pyrolytic PAHs, episodes of petrogenic pollution, like oil-spills, can be identified by the combination of different source ratios. Results also indicate that, in the study area, PAHs are transported from superficial water to sediment. This conclusion is based on the degree of coincidence found in the presence/absence of individual PAHs in both compartments and in their petrogenic/pyrolytic nature, the positive sedimentation rate in the study area, together with the performance of the analyses of unfiltered water and the distribution of sources of PAHs found.

  3. Single and chronic L-serine treatments exert antidepressant-like effects in rats possibly by different means.

    PubMed

    Nagasawa, Mao; Otsuka, Tsuyoshi; Togo, Yuki; Yamanaga, Masakazu; Yoshida, Junki; Uotsu, Nobuo; Teramoto, Sachiyuki; Yasuo, Shinobu; Furuse, Mitsuhiro

    2017-06-06

    In the present study, the effects of both single (6 mmol L-serine/10 ml/kg orally administrated) and chronic (2% L-serine solution freely given for 28 days) treatments on depression-like behavior were evaluated in Wistar rats, representing the control, and Wistar Kyoto rats, representing an animal model of depression. Both single and chronic L-serine treatments decreased the duration of immobility, which is an index of a depressive-like state, in the forced swimming test in both strains. However, the decreases in the duration of immobility appear to be regulated differently by the different mechanisms involved in single and chronic L-serine treatments. In the prefrontal cortex and hippocampus, single L-serine treatment increased the concentrations of L-serine, but not D-serine, while chronic L-serine treatment increased those of D-serine, but not L-serine. These data suggest that the antidepressant-like effects of single and chronic L-serine treatments may have been induced by the increased L-serine and D-serine concentrations, respectively, in the brain. In addition, chronic L-serine treatment increased cystathionine concentrations in the hippocampus and prefrontal cortex in Wistar rats, but not in Wistar Kyoto rats, suggesting that Wistar Kyoto rats have an abnormality in the serine-cystathionine metabolic pathway. In conclusion, single and chronic L-serine treatments may induce antidepressant-like effects via the different mechanisms related to serine metabolism in the brain.

  4. Anatomical variations within the deep posterior compartment of the leg and important clinical consequences.

    PubMed

    Hislop, M; Tierney, P

    2004-09-01

    The management of musculoskeletal conditions makes up a large part of a sports medicine practitioner's practice. A thorough knowledge of anatomy is an essential component of the armament necessary to decipher the large number of potential conditions that may confront these practitioners. To cloud the issue further, anatomical variations may be present, such as supernumerary muscles, thickened fascial bands or variant courses of nerves and blood vessels, which can themselves manifest as acute or chronic conditions that lead to significant morbidity or limitation of activity. There are a number of contentious areas within the literature surrounding the anatomy of the leg, particularly involving the deep posterior compartment. Conditions such as chronic exertional compartment syndrome, tibial periostitis (shin splints), peripheral nerve entrapment and tarsal tunnel syndrome may all be affected by subtle anatomical variations. This paper primarily focuses on the deep posterior compartment of the leg and uses the gross dissection of cadaveric specimens to describe definitively the anatomy of the deep posterior compartment. Variant fascial attachments of flexor digitorum longus are documented and potential clinical sequelae such as chronic exertional compartment syndrome and tarsal tunnel syndrome are discussed.

  5. Statins dose-dependently exert a significant chemopreventive effect on colon cancer in patients with chronic obstructive pulmonary disease: A population-based cohort study

    PubMed Central

    Hsu, Yi-Ping; Sung, Li-Chin; Kao, Pai-Feng; Lin, Chao-Feng; Wu, Alexander T.H.; Yuan, Kevin Sheng-Po; Wu, Szu-Yuan

    2016-01-01

    Purpose We evaluated the chemopreventive effect of statins on colon cancer in patients with chronic obstructive pulmonary disease (COPD) and identified the statin exerting the strongest chemopreventive effect. Methods Using the National Health Insurance Research Database, we identified patients who received a COPD diagnosis in Taiwan between January 1, 2001, and December 31, 2012, and included them in the study cohort. Each patient was followed to assess the colon cancer risk and protective factors. A propensity score was derived using a logistic regression model to estimate the effect of statins by accounting for covariates predicted during the intervention (statins). To examine the dose–response relationship, we categorized statin doses into four groups in each cohort [<28, 28–90, 91–365, and >365 cumulative defined daily dose]. Results Compared with the statin nonusers, the adjusted hazard ratio (aHR) for colon cancer decreased in the statin users (aHR = 0.52, 95% confidence interval = 0.44, 0.62). Hydrophilic statins exerted a stronger preventive effect against colon cancer. Regarding the statin type, lovastatin, pravastatin, and fluvastatin nonsignificantly reduced the colon cancer risk in the patients with COPD. Compared with the statin nonusers, the aHRs for colon cancer decreased in the individual statin users (rosuvastatin, simvastatin, and atorvastatin: aHRs = 0.28, 0.64, and 0.65, respectively). In the sensitivity analysis, statins dose-dependently reduced the colon cancer risk. Conclusions Statins dose-dependently exert significant chemopreventive effects on colon cancer in patients with COPD, with rosuvastatin exerting the largest chemopreventive effect. PMID:27542242

  6. Resveratrol exerts anti-inflammatory and neuroprotective effects to prevent memory deficits in rats exposed to chronic unpredictable mild stress.

    PubMed

    Yazir, Yusufhan; Utkan, Tijen; Gacar, Nejat; Aricioglu, Feyza

    2015-01-01

    A number of studies have recently focused on the neuroprotective and anti-inflammatory effects of resveratrol. In prior studies, we described its beneficial effects on scopolamine-induced learning deficits in rats. The aim of this study was to investigate the effects of resveratrol on emotional and spatial cognitive functions, neurotropic factor expression, and plasma levels of proinflammatory cytokines in rats exposed to chronic unpredictable mild stress (CUMS), which is known to induce cognitive deficits. Resveratrol (5 or 20mg/kg) was administered intraperitoneally for 35 days. Rats in the CUMS group and in the 5mg/kg resveratrol+CUMS group performed poorly in tasks designed to assess emotional and spatial learning and memory. The 20mg/kg resveratrol+CUMS group showed improved performance compared to the CUMS group. In addition, the CUMS procedure induced lower expression of brain-derived neurotrophic factor and c-Fos in hippocampal CA1 and CA3 and in the amygdala of stressed rats. These effects were reversed by chronic administration of resveratrol (20mg/kg). In addition, plasma levels of tumor necrosis factor-alpha and interleukin-1 beta were increased by CUMS, but were restored to normal by resveratrol. These results indicate that resveratrol significantly attenuates the deficits in emotional learning and spatial memory seen in chronically stressed rats. These effects may be related to resveratrol-mediated changes in neurotrophin factor expression in hippocampus and in levels of proinflammatory cytokines in circulation.

  7. 450K-array analysis of chronic lymphocytic leukemia cells reveals global DNA methylation to be relatively stable over time and similar in resting and proliferative compartments.

    PubMed

    Cahill, N; Bergh, A-C; Kanduri, M; Göransson-Kultima, H; Mansouri, L; Isaksson, A; Ryan, F; Smedby, K E; Juliusson, G; Sundström, C; Rosén, A; Rosenquist, R

    2013-01-01

    In chronic lymphocytic leukemia (CLL), the microenvironment influences gene expression patterns; however, knowledge is limited regarding the extent to which methylation changes with time and exposure to specific microenvironments. Using high-resolution 450K arrays, we provide the most comprehensive DNA methylation study of CLL to date, analyzing paired diagnostic/follow-up samples from IGHV-mutated/untreated and IGHV-unmutated/treated patients (n=36) and patient-matched peripheral blood and lymph node samples (n=20). On an unprecedented scale, we revealed 2239 differentially methylated CpG sites between IGHV-mutated and unmutated patients, with the majority of sites positioned outside annotated CpG islands. Intriguingly, CLL prognostic genes (for example, CLLU1, LPL, ZAP70 and NOTCH1), epigenetic regulator (for example, HDAC9, HDAC4 and DNMT3B), B-cell signaling (for example, IBTK) and numerous TGF-β and NF-κB/TNF pathway genes were alternatively methylated between subgroups. Contrary, DNA methylation over time was deemed rather stable with few recurrent changes noted within subgroups. Although a larger number of non-recurrent changes were identified among IGHV-unmutated relative to mutated cases over time, these equated to a low global change. Similarly, few changes were identified between compartment cases. Altogether, we reveal CLL subgroups to display unique methylation profiles and unveil methylation as relatively stable over time and similar within different CLL compartments, implying aberrant methylation as an early leukemogenic event.

  8. Chronic Testosterone Replacement Exerts Cardioprotection against Cardiac Ischemia-Reperfusion Injury by Attenuating Mitochondrial Dysfunction in Testosterone-Deprived Rats

    PubMed Central

    Pongkan, Wanpitak; Chattipakorn, Siriporn C.; Chattipakorn, Nipon

    2015-01-01

    Background Although testosterone deficiency is associated with increased risks of heart disease, the benefits of testosterone therapy are controversial. Moreover, current understanding on the cardiac effect of testosterone during cardiac ischemia-reperfusion (I/R) periods is unclear. We tested the hypothesis that testosterone replacement attenuates the impairment of left ventricular (LV) function and heart rate variability (HRV), and reduces the infarct size and arrhythmias caused by I/R injury in orchiectomized (ORX) rats. Methodology ORX or sham-operated male Wistar rats (n = 24) were randomly divided and received either testosterone (2 mg/kg, subcutaneously administered) or the vehicle for 8 weeks. The ejection fraction (EF) and HRV were determined at baseline and the 4th and 8th week. I/R was performed by left anterior descending coronary artery ligation for 30 minutes, followed by a 120-minute reperfusion. LV pressure, arrhythmia scores, infarct size and cardiac mitochondrial function were determined. Results Prior to I/R, EF and HRV were impaired in the ORX group, but were restored in the testosterone-treated group. During I/R, arrhythmia scores and the infarct size were greater, and cardiac mitochondrial function was impaired, whereas the time to 1st VT/VF onset and the LV end-systolic pressure were decreased in the ORX group when compared to the sham group. Testosterone replacement attenuated the impairment of these parameters in ORX rats during I/R injury, but did not show any benefit or adverse effect in non-ORX rats. Conclusions Testosterone replacement restores cardiac function and autonomic regulation, and exerts cardioprotective effects during the I/R period via mitochondrial protection in ORX rats. PMID:25822979

  9. Chronic Alcohol Exposure and the Circadian Clock Mutation Exert Tissue-Specific Effects on Gene Expression in Mouse Hippocampus, Liver, and Proximal Colon.

    PubMed

    Summa, Keith C; Jiang, Peng; Fitzpatrick, Karrie; Voigt, Robin M; Bowers, Samuel J; Forsyth, Christopher B; Vitaterna, Martha H; Keshavarzian, Ali; Turek, Fred W

    2015-10-01

    Chronic alcohol exposure exerts numerous adverse effects, although the specific mechanisms underlying these negative effects on different tissues are not completely understood. Alcohol also affects core properties of the circadian clock system, and it has been shown that disruption of circadian rhythms confers vulnerability to alcohol-induced pathology of the gastrointestinal barrier and liver. Despite these findings, little is known of the molecular interactions between alcohol and the circadian clock system, especially regarding implications for tissue-specific susceptibility to alcohol pathologies. The aim of this study was to identify changes in expression of genes relevant to alcohol pathologies and circadian clock function in different tissues in response to chronic alcohol intake. Wild-type and circadian Clock(Δ19) mutant mice were subjected to a 10-week chronic alcohol protocol, after which hippocampal, liver, and proximal colon tissues were harvested for gene expression analysis using a custom-designed multiplex magnetic bead hybridization assay that provided quantitative assessment of 80 mRNA targets of interest, including 5 housekeeping genes and a predetermined set of 75 genes relevant for alcohol pathology and circadian clock function. Significant alterations in expression levels attributable to genotype, alcohol, and/or a genotype by alcohol interaction were observed in all 3 tissues, with distinct patterns of expression changes observed in each. Of particular interest was the finding that a high proportion of genes involved in inflammation and metabolism on the array was significantly affected by alcohol and the Clock(Δ19) mutation in the hippocampus, suggesting a suite of molecular changes that may contribute to pathological change. These results reveal the tissue-specific nature of gene expression responses to chronic alcohol exposure and the Clock(Δ19) mutation and identify specific expression profiles that may contribute to tissue

  10. Endoscopic Fasciotomy of the Superficial and Deep Posterior Compartments of the Leg.

    PubMed

    Lui, Tun Hing

    2017-06-01

    Chronic exertional compartment syndrome is a rare cause of lower leg pain incurred during sports activities and typically affects young athletes who need to return to their activity level as quickly as possible. Nonoperative treatments are often unsuccessful and fasciotomy of the involved compartment is the treatment of choice. Endoscopically assisted release of the anterior and deep compartments is proven to be safe and effective. Endoscopically assisted deep posterior compartment release via an incision 1 to 3 cm behind the medial tibial border has high risk of injury to the great saphenous and perforating veins and the saphenous nerve. The purpose of this Technical Note is to describe the details of endoscopic fasciotomy of the superficial and deep posterior compartments of the leg. The operative field of this approach is away from the saphenous vein and nerve. Moreover, the tibial insertion of the soleus muscle does not need to be released to gain access to the proximal part of the deep posterior compartment.

  11. Isolated medial foot compartment syndrome after ankle sprain.

    PubMed

    Cortina, Josep; Amat, Carles; Selga, Jordi; Corona, Pablo Salvador

    2014-03-01

    Foot compartment syndrome is a serious potential complication of foot crush injury, fractures, surgery, and vascular injury. An acute compartment syndrome isolated to the medial compartment of the foot after suffering an ankle sprain is a rare complication. We report the case of a 31-year-old man who developed a medial foot compartment syndrome after suffering a deltoid ligament rupture at ankle while playing football. The patient underwent a medial compartment fasciotomy with resolution of symptoms. Compartment syndromes of the foot are rare and have been reported to occur after severe trauma. But, there are some reports in the literature of acute exertional compartment syndrome. In our case, the compartment syndrome appeared after an ankle sprain without vascular injuries associated. Copyright © 2013 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  12. Overuse injuries: tendinopathies, stress fractures, compartment syndrome, and shin splints.

    PubMed

    Wilder, Robert P; Sethi, Shikha

    2004-01-01

    Approximately 50% of all sports injuries are secondary to overuse and result from repetitive microtrauma that causes local tissue damage. Injuries are most likely with changes in mode, intensity, or duration of training and can accumulate before symptoms appear. Intrinsic factors contributing to injuries are individual bio-mechanical abnormalities such as malalignments, muscle imbalance, inflexibility, weakness, and instability. Contributing extrinsic (avoidable) factors include poor technique, improper equipment, and improper changes in duration or frequency of activity. Injuries are often related to biomechanical abnormalities removed from the specific injury site, requiring evaluation of the entire kinetic chain. This article discusses common overuse injuries of the lower leg, ankle, and foot: tendinopathies, stress fractures, chronic exertional compartment syndrome, and shin splints.

  13. Compartmented electrode structure

    DOEpatents

    Vissers, Donald R.; Shimotake, Hiroshi; Gay, Eddie C.; Martino, Fredric J.

    1977-06-14

    Electrodes for secondary electrochemical cells are provided with compartments for containing particles of the electrode reactant. The compartments are defined by partitions that are generally impenetrable to the particles of reactant and, in some instances, to the liquid electrolyte used in the cell. During cycling of the cell, reactant material initially loaded into a particular compartment is prevented from migrating and concentrating within the lower portion of the electrode or those portions of the electrode that exhibit reduced electrical resistance.

  14. Compartment Syndrome in Children.

    PubMed

    Hosseinzadeh, Pooya; Hayes, Christopher B

    2016-07-01

    Compartment syndrome in children can present differently than adults. Increased analgesic need should be considered the first sign of evolving compartment syndrome in children. Children with supracondylar humerus fractures, floating elbow injuries, operatively treated forearm fractures, and tibia fractures are at high risk for developing compartment syndrome. Elbow flexion beyond 90° in supracondylar humerus fractures and closed treatment of forearm fractures in floating elbow injuries are associated with increased risk of compartment syndrome. Prompt diagnosis and treatment with fasciotomy in children result in excellent long-term outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Muscle activity and head kinematics in unconstrained movements in subjects with chronic neck pain; cervical motor dysfunction or low exertion motor output?

    PubMed Central

    2013-01-01

    Background Chronic neck pain after whiplash associated disorders (WAD) may lead to reduced displacement and peak velocity of neck movements. Dynamic neck movements in people with chronic WAD are also reported to display altered movement patterns such as increased irregularity, which is suggested to signify impaired motor control. As movement irregularity is strongly related to the velocity and displacement of movement, we wanted to examine whether the increased irregularity in chronic WAD could be accounted for by these factors. Methods Head movements were completed in four directions in the sagittal plane at three speeds; slow (S), preferred (P) and maximum (M) in 15 men and women with chronic WAD and 15 healthy, sex and age-matched control participants. Head kinematics and measures of movement smoothness and symmetry were calculated from position data. Surface electromyography (EMG) was recorded bilaterally from the sternocleidomastoid and splenius muscles and the root mean square (rms) EMG amplitude for the accelerative and decelerative phases of movement were analyzed. Results The groups differed significantly with regard to movement velocity, acceleration, displacement, smoothness and rmsEMG amplitude in agonist and antagonist muscles for a series of comparisons across the test conditions (range 17 – 121%, all p-values < 0.05). The group differences in peak movement velocity and acceleration persisted after controlling for movement displacement. Controlling for differences between the groups in displacement and velocity abolished the difference in measures of movement smoothness and rmsEMG amplitude. Conclusions Simple, unconstrained head movements in participants with chronic WAD are accomplished with reduced velocity and displacement, but with normal muscle activation levels and movement patterns for a given velocity and displacement. We suggest that while reductions in movement velocity and displacement are robust changes and may be of clinical

  16. Water compartments in cells.

    PubMed

    Fullerton, Gary D; Cameron, Ivan L

    2007-01-01

    Human experience in the macrobiological world leads scientists to visualize water compartments in cells analogous to the bladder in the human pelvis or ventricles in the brain. While such water-filled cellular compartments likely exist, the volume contributions are insignificant relative to those of biomolecular hydration compartments. The purpose of this chapter is to identify and categorize the molecular water compartments caused by proteins, the primary macromolecular components of cells. The categorical changes in free energy of water molecules on proteins cause these compartments to play dominant roles in osmoregulation and provide important adjuncts to fundamental understanding of osmosensing and osmosignaling mechanisms. Water compartments possess differences in molecular motion, enthalpy, entropy, freezing point depression, and other properties because of electrostatic interaction of polar water molecules with electric fields generated by covalently bound pairs of opposite charge caused by electronegative oxygen and nitrogen atoms of the protein. Macromolecules, including polypeptides, polynucleotides, and polysaccharides, are stiff molecular chains with restricted folding capacities due to inclusion of rigid ring structures or double amide bonds in the backbone sequence. This creates "irreducible spatial charge separation" between positive and negative partial charges, causing elevated electrostatic energy. In the fully hydrated in vivo state of living cells the high dielectric coefficient of water reduces protein electrostatic free energy by providing polar "water bridge networks" between charges, thereby creating four measurably different compartments of bound water with distinct free energy differences.

  17. Single compartment drug delivery

    PubMed Central

    Cima, Michael J.; Lee, Heejin; Daniel, Karen; Tanenbaum, Laura M.; Mantzavinou, Aikaterini; Spencer, Kevin C.; Ong, Qunya; Sy, Jay C.; Santini, John; Schoellhammer, Carl M.; Blankschtein, Daniel; Langer, Robert S.

    2014-01-01

    Drug design is built on the concept that key molecular targets of disease are isolated in the diseased tissue. Systemic drug administration would be sufficient for targeting in such a case. It is, however, common for enzymes or receptors that are integral to disease to be structurally similar or identical to those that play important biological roles in normal tissues of the body. Additionally, systemic administration may not lead to local drug concentrations high enough to yield disease modification because of rapid systemic metabolism or lack of sufficient partitioning into the diseased tissue compartment. This review focuses on drug delivery methods that physically target drugs to individual compartments of the body. Compartments such as the bladder, peritoneum, brain, eye and skin are often sites of disease and can sometimes be viewed as “privileged,” since they intrinsically hinder partitioning of systemically administered agents. These compartments have become the focus of a wide array of procedures and devices for direct administration of drugs. We discuss the rationale behind single compartment drug delivery for each of these compartments, and give an overview of examples at different development stages, from the lab bench to phase III clinical trials to clinical practice. We approach single compartment drug delivery from both a translational and a technological perspective. PMID:24798478

  18. Chronic administration of oral vasopressin type 2 receptor antagonist tolvaptan exerts both myocardial and renal protective effects in rats with hypertensive heart failure.

    PubMed

    Morooka, Hanako; Iwanaga, Yoshitaka; Tamaki, Yodo; Takase, Toru; Akahoshi, Yasumitsu; Nakano, Yoshimasa; Fujiki, Hiroyuki; Miyazaki, Shunichi

    2012-07-01

    Although recent clinical trials have demonstrated the efficacy of the oral vasopressin (AVP) type 2 receptor (V2R) antagonist tolvaptan, its long-term effects on the myocardium and kidney in heart failure (HF) are not clear. We examined the chronic effects of tolvaptan administration on both the myocardium and kidney in a rat hypertensive HF model. Not only circulating AVP level but also myocardial AVP and V1a receptor (V1aR) expressions, renal V1aR, and V2R expressions were significantly upregulated during the transition to HF. The animals were chronically treated with low-dose or high-dose (HD) tolvaptan or vehicle from the left ventricular (LV) hypertrophic stage. Chronic tolvaptan treatment persistently increased urine volume but did not affect blood pressure. In the HD group, the animal survival significantly improved (log-rank test, P<0.01). At the HF stage, the progression of LV dysfunction was prevented and lung congestion was suppressed. Activation of atrial natriuretic peptide, endothelin-1, AVP, and V1aR mRNA levels were significantly suppressed in the LV myocardium. Meanwhile, renal histopathologic damage was ameliorated and renal function was improved in the HD group at the HF stage. Concomitantly, not only activation of aquaporin-2 but also those of V2R, V1aR, renin, and endothelin-1 in the kidney were significantly suppressed (all P<0.05). These results indicate that chronic tolvaptan treatment has beneficial effects by preventing not only the progression of LV dysfunction but also that of renal injury in hypertensive rats with HF. The underlying mechanism may be related to the suppression of myocardial and renal neurohumoral activation.

  19. Chronic Kidney Disease and Risk of Presenting with Acute Myocardial Infarction versus Stable Exertional Angina in Adults with Coronary Heart Disease

    PubMed Central

    Go, Alan S.; Bansal, Nisha; Chandra, Malini; Lathon, Phenius V.; Fortmann, Stephen P.; Iribarren, Carlos; Hsu, Chi-yuan; Hlatky, Mark A.

    2011-01-01

    Objective To examine whether kidney dysfunction is associated with the type of clinical presentation of coronary heart disease (CHD). Background Reduced kidney function increases risk of developing CHD, but it is not known whether it also influences the acuity of clinical presentation, which has important prognostic implications. Methods We conducted a case-control study of subjects whose first clinical presentation of CHD was either acute myocardial infarction or stable exertional angina between October 2001-December 2003. Glomerular filtration rate (eGFR) before the incident event was estimated using calibrated serum creatinine and the abbreviated MDRD equation. Patient characteristics and use of medications were ascertained from self-report and health plan databases. We used multivariable logistic regression to examine the association of reduced eGFR and CHD presentation. Results We studied 803 adults with incident acute myocardial infarction and 419 adults with incident stable exertional angina who had a baseline eGFR ≤130 ml/min/1.73 m2. Mean eGFR was lower among subjects with acute myocardial infarction compared with stable angina. Compared with eGFR 90–130 ml/min/1.73 m2, we found a strong, graded independent association between reduced eGFR and presenting with acute myocardial infarction: adjusted odds ratio (OR) 1.36 (95% CI: 0.99 to 1.86) for eGFR 60–89 ml/min/1.73 m2, OR 1.55 (0.92 to 2.62) for eGFR 45–59 ml/min/1.73 m2 and OR 3.82 (1.55 to 9.46) for eGFR <45 ml/min/1.73 m2 (P<0.001 for trend). Conclusion eGFR less than 45 ml/min/1.73 m2 is a strong, independent predictor of presenting with acute myocardial infarction versus stable angina as the initial manifestation of CHD. PMID:21958887

  20. Hesperidin exerts antidepressant-like effects in acute and chronic treatments in mice: possible role of l-arginine-NO-cGMP pathway and BDNF levels.

    PubMed

    Donato, Franciele; de Gomes, Marcelo Gomes; Goes, André Tiago Rossito; Filho, Carlos Borges; Del Fabbro, Lucian; Antunes, Michelle S; Souza, Leandro Cattelan; Boeira, Silvana Peterini; Jesse, Cristiano Ricardo

    2014-05-01

    Hesperidin (4'-methoxy-7-O-rutinosyl-3',5-dihydroxyflavanone), a naturally occurring flavanone glycoside, was previously shown to produce an antidepressant-like effect with modultation of the serotonergic 5-HT1A and kappa-opioid receptors. In this study, the signaling mechanisms underlying their antidepressant-like effects were further evaluated by investigating in acute and chronic treatments. Results showed that chronic treatment of hesperidin or hesperitin (0.1, 0.3 and 1mg/kg, intraperitoneal, i.p.) have an antidepressant-like effect in the mouse tail suspension test (TST) without modified the locomotor activity in the open field test. Pretreatment with l-arginine (a nitric oxide (NO) precursor), sildenafil (a phosphodiesterase 5 inhibitor) or S-nitroso-N-acetyl-penicillamine (a NO donor) significantly reversed the reduction in immobility time elicited by acute treatment with hesperidin (0.3mg/kg) in the TST. Hesperidin (0.01mg/kg, a sub-effective dose in acute treatment) produced an additive antidepressant-like effect with N(G)-nitro-l-arginine (an inhibitor of nitric oxide synthase (NOS)) or 7-nitroindazole (a neuronal NOS inhibitor) in the TST. Pretreatment of animals with methylene blue (an inhibitor of NOS/soluble guanylate cyclase (sGC)) or ODQ (a specific inhibitor sGS) caused an additive effect with hesperidin in the TST. Hesperidin in the acute (1mg/kg) and chronic (0.1, 0.3 and 1mg/kg) treatments caused a significant decrease in nitrate/nitrite (NOX) levels in the hippocampus of mice. Chronic treatment with hesperidin (0.3 and 1mg/kg) also resulted in an increase in hippocampal brain-derived neurotrophic factor (BDNF) levels. These results demonstrated that the antidepressant-like effect of hesperidin is likely mediated by inhibition of l-arginine-NO-cGMP pathway and by increased of the BDNF levels in hippocampus. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. DNA Virus Replication Compartments

    PubMed Central

    Schmid, Melanie; Speiseder, Thomas; Dobner, Thomas

    2014-01-01

    Viruses employ a variety of strategies to usurp and control cellular activities through the orchestrated recruitment of macromolecules to specific cytoplasmic or nuclear compartments. Formation of such specialized virus-induced cellular microenvironments, which have been termed viroplasms, virus factories, or virus replication centers, complexes, or compartments, depends on molecular interactions between viral and cellular factors that participate in viral genome expression and replication and are in some cases associated with sites of virion assembly. These virus-induced compartments function not only to recruit and concentrate factors required for essential steps of the viral replication cycle but also to control the cellular mechanisms of antiviral defense. In this review, we summarize characteristic features of viral replication compartments from different virus families and discuss similarities in the viral and cellular activities that are associated with their assembly and the functions they facilitate for viral replication. PMID:24257611

  2. Atraumatic painless compartment syndrome.

    PubMed

    Blanchard, Scott; Griffin, Gregory D; Simon, Erin L

    2013-12-01

    Acute compartment syndrome is a time-sensitive diagnosis and surgical emergency because it poses a threat to life and the limbs. It is defined by Matsen et al (Surg Gynecol Obstet. 1978;147(6):943–949) as "a condition in which increased pressure within a limited space compromises the circulation and function of the tissues within that space." The most common cause of compartment syndrome is traumatic injury. A variety of other conditions such as vascular injuries, bleeding disorders, thrombosis, fasciitis, gas gangrene, rhabdomyolysis, prolonged limb compression, cellulitis, and nephrotic syndrome may also cause compartment syndrome. Patients who are elderly, have preexisting nerve damage, or have psychopathology may have an atypical presentation. This case highlights the first report of a 75-year-old woman who developed painless bilateral compartment syndrome in the absence of traumatic injury.

  3. Galactoglucomannan-rich hemicellulose extract from Norway spruce (Picea abies) exerts beneficial effects on chronic prostatic inflammation and lower urinary tract symptoms in vivo.

    PubMed

    Konkol, Yvonne; Vuorikoski, Heikki; Tuomela, Johanna; Holmbom, Bjarne; Bernoulli, Jenni

    2017-08-01

    Galactoglucomannan (GGM) is the main hemicellulose class in wood of coniferous trees and could be potentially utilized as a possible health-promoting substance for food and pharmaceutical industry. Our aim was to evaluate effects of orally administered GGM-rich extract from Norway spruce in a rat model of chronic prostatitis associated with lower urinary tract symptoms (LUTS). Prostatic inflammation and LUTS was induced in male rats using testosterone and 17β-estradiol exposure for 18 weeks. Rats were treated with 2% GGM dissolved in drinking water during weeks 13-18. Pelvic pain response, LUT function and histopathological evaluation of the prostate were assessed. The results show that hormonal exposure induced LUTS seen as decreased urine flow rate, increased bladder pressure, voiding times, bladder capacity and residual urine volumes. GGM had positive effects on urodynamical parameters by decreasing the basal bladder pressure, increasing the urine flow rate and volume, reducing the residual volume and increasing micturition intervals. GGM reduced the extent of the hormone exposure-induced prostatic inflammation. Increase of pelvic pain induced by hormone exposure was only slightly affected by GGM treatment. The results suggest that orally administered GGM may have potential usage for improving lower urinary tract function associated with chronic prostatic inflammation. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Comparative effects of propranolol and verapamil alone and in combination on left ventricular function and volumes in patients with chronic exertional angina: a double-blind, placebo-controlled, randomized, crossover study with radionuclide ventriculography

    SciTech Connect

    Johnston, D.L.; Gebhardt, V.A.; Donald, A.; Kostuk, W.J.

    1983-12-01

    With the use of equilibrium radionuclide ventriculography the effects on left ventricular (LV) function of 160 mg oral propranolol daily and 360 mg verapamil daily alone and in combination were compared in 18 patients with chronic exertional angina. A randomized, double-blind, placebo-controlled, crossover protocol was used. The reduction in exercise rate-pressure product induced by the combination (118 +/- 28 mm Hg/min) was significantly greater than that by propranolol (135 +/- 27 mm Hg/min) or verapamil alone (163 +/- 28 mm Hg/min). In patients at rest, neither single nor combined therapy altered global or regional left ventricular ejection fractions (EFs). Verapamil, but not propranolol, increased cardiac volumes of resting subjects; used in combination, no further increase in LV volume occurred. With placebo, exercise global EF did not decrease from the level at rest and therefore no drug effect could be demonstrated for this parameter of LV function. By an evaluation of normalized regional EF measurements the combination was shown to reduce exercise-induced hypokinesis (placebo 52 +/- 20%, combination 61 +/- 23%. No significant improvement was noted with propranolol or verapamil alone; only the combination prevented a significant increase in end-systolic and end-diastolic volumes during exercise. Thus, propranolol and verapamil, used alone in moderate doses, exert no beneficial effect on exercise LV function as measured by EF and volume changes, and resting function deteriorates slightly with verapamil.

  5. Unpredictable chronic mild stress exerts anxiogenic-like effects and activates neurons in the dorsal and caudal region and in the lateral wings of the dorsal raphe nucleus.

    PubMed

    Lopes, Danielle A; Lemes, Jéssica A; Melo-Thomas, Liana; Schor, Herbert; de Andrade, José S; Machado, Carla M; Horta-Júnior, José A C; Céspedes, Isabel C; Viana, Milena B

    2016-01-15

    In previous studies, we verified that exposure to unpredictable chronic mild stress (UCMS) facilitates avoidance responses in the elevated T-maze (ETM) and increased Fos-immunoreactivity in different brain structures involved in the regulation of anxiety, including the dorsal raphe (DR). Since, it has been shown that the DR is composed of distinct subpopulations of serotonergic and non-serotonergic neurons, the present study investigated the pattern of activation of these different subnuclei of the region in response to this stress protocol. Male Wistar rats were either unstressed or exposed to the UCMS procedure for two weeks and, subsequently, analyzed for Fos-immunoreactivity (Fos-ir) in serotonergic cells of the DR. To verify if the anxiogenic effects observed in the ETM could be generalized to other anxiety models, a group of animals was also tested in the light/dark transition test after UCMS exposure. Results showed that the UCMS procedure decreased the number of transitions and increased the number of stretched attend postures in the model, an anxiogenic effect. UCMS exposure also increased Fos-ir and the number of double-labeled neurons in the mid-rostral subdivision of the dorsal part of the DR and in the mid-caudal region of the lateral wings. In the caudal region of the DR there was a significant increase in the number of Fos-ir. No significant effects were found in the other DR subnuclei. These results corroborate the idea that neurons of specific subnuclei of the DR regulate anxiety responses and are differently activated by chronic stress exposure. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. The Impact Exerted on Clinical Outcomes of Patients With Chronic Heart Failure by Aldosterone Receptor Antagonists: A Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    De Vecchis, Renato; Cantatrione, Claudio; Mazzei, Damiana; Barone, Augusto; Maurea, Nicola

    2017-01-01

    Background Aldosterone receptor antagonists (ARAs) have been associated with improved clinical outcomes in patients with heart failure with reduced left ventricular ejection fraction (HFREF), but not in those with heart failure with preserved left ventricular ejection fraction (HFpEF). With the aim to study this topic more deeply, we carried out a meta-analysis of selective and non-selective ARAs in HFREF and HFpEF. Methods We searched PubMed and Scopus databases. We decided to incorporate in the meta-analysis only randomized controlled trials (RCTs) of ARAs in patients with chronic heart failure (CHF) if they met the following criteria: experimental groups included patients with CHF treated with ARAs in addition to the conventional therapy; control groups included patients with CHF receiving conventional therapy without ARAs. Outcomes of interest were all-cause death, hospitalizations from cardiovascular cause, hyperkalemia, or gynecomastia. Results We detected 15 studies representing 15,671 patients. ARAs were associated with a reduced odds of all-cause death (odds ratio (OR): 0.79; 95% confidence interval (CI): 0.73 - 0.87) and hospitalizations from cardiovascular cause (OR: 0.73; 95% CI: 0.61 - 0.89). However, subgroup analysis showed that these advantages were limited to HFREF (all-cause death: OR: 0.77, 95% CI: 0.69 - 0.84; hospitalizations from cardiovascular cause: OR: 0.66, 95% CI: 0.51 - 0.85), but they did not affect the HFpEF group (all-cause death: OR: 0.91, 95% CI: 0.76 - 1.1; hospitalizations from cardiovascular cause: OR: 0.85, 95% CI: 0.7 - 1.09). ARAs increased the risk of hyperkalemia (OR: 2.17; 95% CI: 1.88 - 2.5). Non-selective ARAs, but not selective ARAs, increased the risk of gynecomastia (OR: 8.22, 95% CI: 4.9 - 13.81 vs. OR: 0.74, 95% CI: 0.43 - 1.27). Conclusions ARAs reduced the risk of adverse cardiac events in HFREF but not HFpEF. In particular, ARA use in HFpEF patients is questionable, since in this CHF type, no significant

  7. Myeloid Derived Suppressor Cells (MDSCs) Are Increased and Exert Immunosuppressive Activity Together with Polymorphonuclear Leukocytes (PMNs) in Chronic Myeloid Leukemia Patients

    PubMed Central

    Giallongo, Cesarina; Parrinello, Nunziatina; Tibullo, Daniele; La Cava, Piera; Romano, Alessandra; Chiarenza, Annalisa; Barbagallo, Ignazio; Palumbo, Giuseppe A.; Stagno, Fabio; Vigneri, Paolo; Di Raimondo, Francesco

    2014-01-01

    Tumor immune tolerance can derive from the recruitment of suppressor cell population, including myeloid derived suppressor cells (MDSCs), able to inhibit T cells activity. We identified a significantly expanded MDSCs population in chronic myeloid leukemia (CML) patients at diagnosis that decreased to normal levels after imatinib therapy. In addition, expression of arginase 1 (Arg1) that depletes microenvironment of arginine, an essential aminoacid for T cell function, resulted in an increase in patients at diagnosis. Purified CML CD11b+CD33+CD14-HLADR- cells markedly suppressed normal donor T cell proliferation in vitro. Comparing CML Gr-MDSCs to autologous polymorphonuclear leukocytes (PMNs) we observed a higher Arg1 expression and activity in PMNs, together with an inhibitory effect on T cells in vitro. Our data indicate that CML cells create an immuno-tolerant environment associated to MDSCs expansion with immunosuppressive capacity mediated by Arg1. In addition, we demonstrated for the first time also an immunosuppressive activity of CML PMNs, suggesting a strong potential immune escape mechanism created by CML cells, which control the anti-tumor reactive T cells. MDSCs should be monitored in imatinib discontinuation trials to understand their importance in relapsing patients. PMID:25014230

  8. Myeloid derived suppressor cells (MDSCs) are increased and exert immunosuppressive activity together with polymorphonuclear leukocytes (PMNs) in chronic myeloid leukemia patients.

    PubMed

    Giallongo, Cesarina; Parrinello, Nunziatina; Tibullo, Daniele; La Cava, Piera; Romano, Alessandra; Chiarenza, Annalisa; Barbagallo, Ignazio; Palumbo, Giuseppe A; Stagno, Fabio; Vigneri, Paolo; Di Raimondo, Francesco

    2014-01-01

    Tumor immune tolerance can derive from the recruitment of suppressor cell population, including myeloid derived suppressor cells (MDSCs), able to inhibit T cells activity. We identified a significantly expanded MDSCs population in chronic myeloid leukemia (CML) patients at diagnosis that decreased to normal levels after imatinib therapy. In addition, expression of arginase 1 (Arg1) that depletes microenvironment of arginine, an essential aminoacid for T cell function, resulted in an increase in patients at diagnosis. Purified CML CD11b+CD33+CD14-HLADR- cells markedly suppressed normal donor T cell proliferation in vitro. Comparing CML Gr-MDSCs to autologous polymorphonuclear leukocytes (PMNs) we observed a higher Arg1 expression and activity in PMNs, together with an inhibitory effect on T cells in vitro. Our data indicate that CML cells create an immuno-tolerant environment associated to MDSCs expansion with immunosuppressive capacity mediated by Arg1. In addition, we demonstrated for the first time also an immunosuppressive activity of CML PMNs, suggesting a strong potential immune escape mechanism created by CML cells, which control the anti-tumor reactive T cells. MDSCs should be monitored in imatinib discontinuation trials to understand their importance in relapsing patients.

  9. Acute compartment syndrome.

    PubMed

    Via, Alessio Giai; Oliva, Francesco; Spoliti, Marco; Maffulli, Nicola

    2015-01-01

    acute compartment syndrome (ACS) is one of the few true emergencies in orthopedics and traumatology. It is a painful condition caused by the increase interstitial pressure (intracompart-mental pressure - ICP) within a closed osteofascial compartment which impair local circulation. It occurs most often in the legs, but it can affects also the arms, hands, feet, and buttocks. It usually develops after a severe injury such as fractures or crush injury, but it can also occurs after a relatively minor injury and it may be iatrogenic. Uncommon causes of ACS have been also described, that suggest surgeons to pay great attention to this serious complication. Diagnosing ACS is difficult in clinical practice, even among expert surgeons. Currently, the diagnosis is made on the basis of physical examination and repeated ICP measures. ICP higher than 30 mmHg of diastolic blood pressure is significant of compartment syndrome. Once diagnosis is made, fasciotomy to release the affected compartment should be performed as early as possible because delayed decompression would lead to irreversible ischemic damage to muscles and peripheral nerves. acute compartment syndrome is a surgical emergency. There is still little consensus among authors about diagnosis and treatment of these serious condition, in particular about the ICP at which fasciotomy is absolutely indicated and the timing of wound closure. New investigations are needed in order to improve diagnosis and treatment of ACS.

  10. Psoas compartment block.

    PubMed

    Brooks, D M

    2000-05-01

    The psoas compartment acts as a conduit for the nerve roots of the lumbar plexus. Originating at approximately the 12th thoracic vertebrae, this potential compartment continues on caudally, bordered posterolaterally by fascia of the quadratus lumborum and iliacus muscles, medially by the fascia of the psoas major muscle, and anteriorly by the transversalis fascia. This natural "gutter" acts as a repository for local anesthetic agents and provides an excellent method of unilateral anterior lower extremity anesthesia. After elicitation of a motor evoked response in the muscles of the anterior thigh, 30 to 40 milliliters of local anesthetic is incrementally injected into the compartment. Spread of the anesthetic to all roots of the plexus occurs in 15 to 20 minutes. Profound sensory and motor blockade can be achieved providing surgical anesthesia as well as long duration postoperative pain relief.

  11. Exertional Rhabdomyolysis after Spinning

    PubMed Central

    Jeong, Youjin; Oh, Eun-Jung; Ahn, Ah-Leum; Choi, Jae-Kyung; Cho, Dong-Yung

    2016-01-01

    Any strenuous muscular exercise may trigger rhabdomyolysis. We report an episode of clinically manifested exertional rhabdomyolysis due to stationary cycling, commonly known as spinning. Reports of spinning-related rhabdomyolysis are rare in the English literature, and the current case appears to be the first such case reported in South Korea. A previously healthy 21-year-old Asian woman presented with severe thigh pain and reddish-brown urinary discoloration 24–48 hours after attending a spinning class at a local gymnasium. Paired with key laboratory findings, her symptoms were suggestive of rhabdomyolysis. She required hospital admission to sustain renal function through fluid resuscitation therapy and fluid balance monitoring. Because exertional rhabdomyolysis may occur in any unfit but otherwise healthy individual who indulges in stationary cycling, the potential health risks of this activity must be considered. PMID:27900075

  12. Exertional Rhabdomyolysis after Spinning.

    PubMed

    Jeong, Youjin; Kweon, Hyuk-Jung; Oh, Eun-Jung; Ahn, Ah-Leum; Choi, Jae-Kyung; Cho, Dong-Yung

    2016-11-01

    Any strenuous muscular exercise may trigger rhabdomyolysis. We report an episode of clinically manifested exertional rhabdomyolysis due to stationary cycling, commonly known as spinning. Reports of spinning-related rhabdomyolysis are rare in the English literature, and the current case appears to be the first such case reported in South Korea. A previously healthy 21-year-old Asian woman presented with severe thigh pain and reddish-brown urinary discoloration 24-48 hours after attending a spinning class at a local gymnasium. Paired with key laboratory findings, her symptoms were suggestive of rhabdomyolysis. She required hospital admission to sustain renal function through fluid resuscitation therapy and fluid balance monitoring. Because exertional rhabdomyolysis may occur in any unfit but otherwise healthy individual who indulges in stationary cycling, the potential health risks of this activity must be considered.

  13. Molecular and functional analysis of the stem cell compartment of chronic myelogenous leukemia reveals the presence of a CD34- cell population with intrinsic resistance to imatinib.

    PubMed

    Lemoli, Roberto M; Salvestrini, Valentina; Bianchi, Elisa; Bertolini, Francesco; Fogli, Miriam; Amabile, Marilina; Tafuri, Agostino; Salati, Simona; Zini, Roberta; Testoni, Nicoletta; Rabascio, Cristina; Rossi, Lara; Martin-Padura, Ines; Castagnetti, Fausto; Marighetti, Paola; Martinelli, Giovanni; Baccarani, Michele; Ferrari, Sergio; Manfredini, Rossella

    2009-12-10

    We show the molecular and functional characterization of a novel population of lineage-negative CD34-negative (Lin(-)CD34(-)) hematopoietic stem cells from chronic myelogenous leukemia (CML) patients at diagnosis. Molecular karyotyping and quantitative analysis of BCR-ABL transcript demonstrated that approximately one-third of CD34(-) cells are leukemic. CML Lin(-)CD34(-) cells showed kinetic quiescence and limited clonogenic capacity. However, stroma-dependent cultures induced CD34 expression on some cells and cell cycling, and increased clonogenic activity and expression of BCR-ABL transcript. Lin(-)CD34(-) cells showed hematopoietic cell engraftment rate in 2 immunodeficient mouse strains similar to Lin-CD34(+) cells, whereas endothelial cell engraftment was significantly higher. Gene expression profiling revealed the down-regulation of cell-cycle arrest genes and genes involved in antigen presentation and processing, while the expression of genes related to tumor progression, such as angiogenic factors, was strongly up-regulated compared with normal counterparts. Phenotypic analysis confirmed the significant down-regulation of HLA class I and II molecules in CML Lin(-)CD34(-) cells. Imatinib mesylate did not reduce fusion transcript levels, BCR-ABL kinase activity, and clonogenic efficiency of CML Lin(-)CD34(-) cells in vitro. Moreover, leukemic CD34(-) cells survived exposure to BCR-ABL inhibitors in vivo. Thus, we identified a novel CD34(-) leukemic stem cell subset in CML with peculiar molecular and functional characteristics.

  14. Neonatal compartment syndrome.

    PubMed

    Martin, B; Treharne, L

    2016-09-01

    A term neonate was born with a grossly swollen and discoloured left hand and forearm. He was transferred from the local hospital to the plastic surgical unit, where a diagnosis of compartment syndrome was made and he underwent emergency forearm fasciotomies at six hours of age. Following serial debridements of necrotic tissue, he underwent split-thickness skin grafting of the resultant defects of his forearm, hand and digits. At the clinic follow-up appointment two months after the procedure, he was found to have developed severe flexion contractures despite regular outpatient hand therapy and splintage. He has had further reconstruction with contracture release, use of artificial dermal matrix, and K-wire fixation of the thumb and wrist. Despite this, the long term outcome is likely to be an arm with poor function. The key learning point from this case is that despite prompt transfer, diagnosis and appropriate surgical management, the outcome for neonatal compartment syndrome may still be poor.

  15. Resveratrol exerts antidepressant properties in the chronic unpredictable mild stress model through the regulation of oxidative stress and mTOR pathway in the rat hippocampus and prefrontal cortex.

    PubMed

    liu, Song; Li, Tong; Liu, Hansen; Wang, Xueer; Bo, Shishi; Xie, Yunkai; Bai, Xuemei; Wu, Lin; Wang, Zhen; Liu, Dexiang

    2016-04-01

    Depression is one of the most common neuropsychiatric disorders and has been associated with oxidative stress and brain protein alterations. Resveratrol is a natural polyphenol enriched in Polygonum cuspidatum and has diverse biological activities including potent antidepressant-like effects. The present study attempts to explore the mechanisms underlying the antidepressant-like action of resveratrol by measuring oxidative stress parameters and phosphorylation of AKT/mTOR pathway in the rat hippocampus and prefrontal cortex (PFC) exposed to the chronic unpredictable mild stress (CUMS). Male Wistar rats were subjected to CUMS protocol for a period of 4 weeks to induce depressive-like behavior. The results showed that resveratrol treatment (80 mg/kg/i.p. 4 weeks) significantly reversed the CUMS-induced behavioral abnormalities (reduced sucrose preference, increased immobility time and decreased locomotor activity) and biochemical changes (increased lipid peroxidation and decreased superoxide dismutase). Additionally, CUMS exposure significantly decreased phosphorylation of Akt and mTOR in the hippocampus and PFC, while resveratrol treatment normalized these parameters. In conclusion, our study showed that resveratrol exerted antidepressant-like effects in CUMS rats, which was mediated in part by its antioxidant action, up-regulation of phosphor-Akt and mTOR levels in the hippocampus and PFC.

  16. Enriched Flavonoid Fraction from Cecropia pachystachya Trécul Leaves Exerts Antidepressant-like Behavior and Protects Brain Against Oxidative Stress in Rats Subjected to Chronic Mild Stress.

    PubMed

    Ortmann, Caroline F; Réus, Gislaine Z; Ignácio, Zuleide M; Abelaira, Helena M; Titus, Stephanie E; de Carvalho, Pâmela; Arent, Camila O; Dos Santos, Maria Augusta B; Matias, Beatriz I; Martins, Maryane M; de Campos, Angela M; Petronilho, Fabricia; Teixeira, Leticia J; Morais, Meline O S; Streck, Emilio L; Quevedo, João; Reginatto, Flávio H

    2016-05-01

    The purpose of this study was to assess the effect of an enriched C-glycosyl flavonoids fraction (EFF-Cp) from Cecropia Pachystachya leaves on behavior, mitochondrial chain function, and oxidative balance in the brain of rats subjected to chronic mild stress. Male Wistar rats were divided into experimental groups (saline/no stress, saline/stress, EFF-Cp/no stress, and EFF-Cp/stress). ECM groups were submitted to stress for 40 days. On the 35th ECM day, EFF-Cp (50 mg/kg) or saline was administrated and the treatments lasted until the 42nd day. On the 41st and 42nd days, the animals were submitted to the splash test and the forced swim test. After these behavioral tests, the enzymatic activity of mitochondrial chain complexes and oxidative stress were analyzed. EFF-Cp reversed the depressive-like behavior induced by ECM. It also reversed the increase in thiobarbituric acid reactive species, myeloperoxidase activity, and nitrite/nitrate concentrations in some brain regions. The reduced activities of the antioxidants superoxide dismutase and catalase in some brain regions were also reversed by EFF-Cp. The most pronounced effect of EFF-Cp on mitochondrial complexes was an increase in complex IV activity in all studied regions. Thus, it is can be concluded that EFF-Cp exerts an antidepressant-like effect and that oxidative balance may be an important physiological process underlying these effects.

  17. Bacterial translocation - impact on the adipocyte compartment.

    PubMed

    Kruis, Tassilo; Batra, Arvind; Siegmund, Britta

    2014-01-06

    Over the last decade it became broadly recognized that adipokines and thus the fat tissue compartment exert a regulatory function on the immune system. Our own group described the pro-inflammatory function of the adipokine leptin within intestinal inflammation in a variety of animal models. Following-up on this initial work, the aim was to reveal stimuli and mechanisms involved in the activation of the fat tissue compartment and the subsequent release of adipokines and other mediators paralleled by the infiltration of immune cells. This review will summarize the current literature on the possible role of the mesenteric fat tissue in intestinal inflammation with a focus on Crohn's disease (CD). CD is of particular interest in this context since the transmural intestinal inflammation has been associated with a characteristic hypertrophy of the mesenteric fat, a phenomenon called "creeping fat." The review will address three consecutive questions: (i) What is inducing adipocyte activation, (ii) which factors are released after activation and what are the consequences for the local fat tissue compartment and infiltrating cells; (iii) do the answers generated before allow for an explanation of the role of the mesenteric fat tissue within intestinal inflammation? With this review we will provide a working model indicating a close interaction in between bacterial translocation, activation of the adipocytes, and subsequent direction of the infiltrating immune cells. In summary, the models system mesenteric fat indicates a unique way how adipocytes can directly interact with the immune system.

  18. Neonatal compartment syndrome

    PubMed Central

    Martin, B; Treharne, L

    2016-01-01

    A term neonate was born with a grossly swollen and discoloured left hand and forearm. He was transferred from the local hospital to the plastic surgical unit, where a diagnosis of compartment syndrome was made and he underwent emergency forearm fasciotomies at six hours of age. Following serial debridements of necrotic tissue, he underwent split-thickness skin grafting of the resultant defects of his forearm, hand and digits. At the clinic follow-up appointment two months after the procedure, he was found to have developed severe flexion contractures despite regular outpatient hand therapy and splintage. He has had further reconstruction with contracture release, use of artificial dermal matrix, and K-wire fixation of the thumb and wrist. Despite this, the long term outcome is likely to be an arm with poor function. The key learning point from this case is that despite prompt transfer, diagnosis and appropriate surgical management, the outcome for neonatal compartment syndrome may still be poor. PMID:27138850

  19. Compartment Syndrome of the Hand.

    PubMed

    Oak, Nikhil R; Abrams, Reid A

    2016-07-01

    Hand compartment syndrome has many etiologies; untreated, it has dire functional consequences. Intracompartmental pressure exceeding capillary filling pressure causes decreased tissue perfusion resulting in progressive ischemic death of compartment contents. Clinical findings can evolve. Serial physical examinations are recommended and, if equivocal, interstitial pressure monitoring is indicated. Definitive management is emergent fasciotomies with incisions designed to decompress the involved hand compartments, which could include the thenar, hypothenar, and interosseous compartments, and the carpal tunnel. Careful wound care, edema management, splinting, and hand therapy are critical. Therapy should start early postoperatively, possibly before wound closure. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. COMPARTMENTED REACTOR FUEL ELEMENT

    DOEpatents

    Cain, F.M. Jr.

    1962-09-11

    A method of making a nuclear reactor fuel element of the elongated red type is given wherein the fissionable fuel material is enclosed within a tubular metal cladding. The method comprises coating the metal cladding tube on its inside wall with a brazing alloy, inserting groups of cylindrical pellets of fissionable fuel material into the tube with spacing members between adjacent groups of pellets, sealing the ends of the tubes to leave a void space therewithin, heating the tube and its contents to an elevated temperature to melt the brazing alloy and to expand the pellets to their maximum dimensions under predetermined operating conditions thereby automatically positioning the spacing members along the tube, and finally cooling the tube to room temperature whereby the spacing disks become permanently fixed at their edges in the brazing alloy and define a hermetically sealed compartment for each fl group of fuel pellets. Upon cooling, the pellets contract thus leaving a space to accommodate thermal expansion of the pellets when in use in a reactor. The spacing members also provide lateral support for the tubular cladding to prevent collapse thereof when subjected to a reactor environment. (AEC)

  1. Non-invasive neurosensory testing used to diagnose and confirm successful surgical management of lower extremity deep distal posterior compartment syndrome

    PubMed Central

    2009-01-01

    Background Chronic exertional compartment syndrome (CECS) is characterized by elevated pressures within a closed space of an extremity muscular compartment, causing pain and/or disability by impairing the neuromuscular function of the involved compartment. The diagnosis of CECS is primarily made on careful history and physical exam. The gold standard test to confirm the diagnosis of CECS is invasive intra-compartmental pressure measurements. Sensory nerve function is often diminished during symptomatic periods of CECS. Sensory nerve function can be documented with the use of non-painful, non-invasive neurosensory testing. Methods Non-painful neurosensory testing of the myelinated large sensory nerve fibers of the lower extremity were obtained with the Pressure Specified Sensory Device™ in a 25 year old male with history and invasive compartment pressures consistent with CECS both before and after running on a tread mill. After the patient's first operation to release the deep distal posterior compartment, the patient failed to improve. Repeat sensory testing revealed continued change in his function with exercise. He was returned to the operating room where a repeat procedure revealed that the deep posterior compartment was not completely released due to an unusual anatomic variant, and therefore complete release was accomplished. Results The patient's symptoms numbness in the plantar foot and pain in the distal calf improved after this procedure and his repeat sensory testing performed before and after running on the treadmill documented this improvement. Conclusion This case report illustrates the principal that non-invasive neurosensory testing can detect reversible changes in sensory nerve function after a provocative test and may be a helpful non-invasive technique to managing difficult cases of persistent lower extremity symptoms after failed decompressive fasciotomies for CECS. It can easily be performed before and after exercise and be repeated at

  2. Decompressive laparotomy for abdominal compartment syndrome

    PubMed Central

    Kimball, E.; Malbrain, M.; Nesbitt, I.; Cohen, J.; Kaloiani, V.; Ivatury, R.; Mone, M.; Debergh, D.; Björck, M.

    2016-01-01

    Background The effect of decompressive laparotomy on outcomes in patients with abdominal compartment syndrome has been poorly investigated. The aim of this prospective cohort study was to describe the effect of decompressive laparotomy for abdominal compartment syndrome on organ function and outcomes. Methods This was a prospective cohort study in adult patients who underwent decompressive laparotomy for abdominal compartment syndrome. The primary endpoints were 28‐day and 1‐year all‐cause mortality. Changes in intra‐abdominal pressure (IAP) and organ function, and laparotomy‐related morbidity were secondary endpoints. Results Thirty‐three patients were included in the study (20 men). Twenty‐seven patients were surgical admissions treated for abdominal conditions. The median (i.q.r.) Acute Physiology And Chronic Health Evaluation (APACHE) II score was 26 (20–32). Median IAP was 23 (21–27) mmHg before decompressive laparotomy, decreasing to 12 (9–15), 13 (8–17), 12 (9–15) and 12 (9–14) mmHg after 2, 6, 24 and 72 h. Decompressive laparotomy significantly improved oxygenation and urinary output. Survivors showed improvement in organ function scores, but non‐survivors did not. Fourteen complications related to the procedure developed in eight of the 33 patients. The abdomen could be closed primarily in 18 patients. The overall 28‐day mortality rate was 36 per cent (12 of 33), which increased to 55 per cent (18 patients) at 1 year. Non‐survivors were no different from survivors, except that they tended to be older and on mechanical ventilation. Conclusion Decompressive laparotomy reduced IAP and had an immediate effect on organ function. It should be considered in patients with abdominal compartment syndrome. PMID:26891380

  3. Neurovascular impairment and compartment syndrome.

    PubMed

    Wright, Elizabeth

    2009-04-01

    Compartment syndrome is a potential complication of musculoskeletal trauma and surgery. Early identification of compartment syndrome is critical because, if left untreated, it may result in limb loss or death. Nurses routinely perform neurovascular observations as a part of the patient's essential care in hospital. However, there is limited literature on the assessment and early identification of compartment syndrome in children, although most authors agree on assessment criteria such as pain, warmth, colour, movement, sensation and pulses. Improved approaches to assessment and early recognition may be required so that effective action can be taken to reduce the severity of the outcome.

  4. [Compartment syndrome following adder bites].

    PubMed

    Roed, Casper; Bayer, Lasse; Lebech, Anne-Mette Kjaer; Poulsen, Jesper Brøndum; Katzenstein, Terese

    2009-01-26

    Bites from the adder, Vipera Berus, can have serious clinical consequences due to systemic effects. Meanwhile, the local swelling calls for attention as well. Two cases of seven- and eleven-year-old boys are reported. The first patient was bitten in the 5th toe, the second in the thumb. Both developed fasciotomy-requiring compartment syndrome of the lower and upper limb, respectively. Recognition of this most seldom complication of an adder bite is vital to save the limb. We recommend that the classical signs and symptoms of compartment syndrome serve as indication for surgery. However, compartment pressure measurement can be helpful in the assessment of children.

  5. Biodistribution of titanium dioxide from biologic compartments.

    PubMed

    Olmedo, Daniel G; Tasat, Deborah R; Guglielmotti, María Beatriz; Cabrini, Rómulo Luis

    2008-09-01

    The layer of titanium dioxide (TiO(2)) of the implant is chronically exposed to the internal electrolyte milieu in the peri-implant biological compartment. Corrosion results from electrochemical attack and ensuing gradual degradation of the metallic materials and is thus of biological interest when these biomaterials are employed in clinical implantology. Herein we evaluated and compared the chronic effect and the biodistribution of TiO(2) administered subcutaneously or intraperitoneally. We propose that the compartmentalization of titanium in the area of subcutaneous injection would reproduce the biological compartment of the implant and its microenvironment from which metal ions could be released and migrate systemically. Potential TiO(2) deposits were identified and characterized in skin, liver and lung by histological and EDX analyses. After both treatments, the skin, liver, and lungs exhibited histological evidence of TiO(2) deposits. In order to characterize in situ macrophage-like cells, tissue sections were immunohistochemically stained for CD68. Tissue specimens from all organs assayed showed positive staining for anti-macrophage monoclonal antibody CD68 (PGM1). Despite the compartmentalization of titanium within nodular areas in rats treated subcutaneously, systemic migration occurred. We concluded that systemic migration of TiO(2) occurred regardless of the administration route.

  6. Rare times rare: The hyponatremia, rhabdomyolysis, anterior compartment syndrome sequence.

    PubMed

    Dubin, Ina; Gelber, Moshe; Schattner, Ami

    2016-05-01

    Primary polydipsia occurs in up to 25% of patients with chronic psychiatric disorders (especially schizophrenia), related to the disease, its treatment or both. Urine output fails to match intake >10 L/day and water intoxication may develop. Rhabdomyolysis is a rare complication of hyponatremia, and an acute anterior compartment syndrome of the leg, an emergency, may be very rarely associated.

  7. Total exertion: zen, psychoanalysis, life.

    PubMed

    Cooper, Paul C

    2011-09-01

    This paper integrates Zen and psychoanalytic concepts; introduces the Zen concept of total exertion; elaborates the profound implications that the notion of total exertion has for the psychoanalytic encounter and the psychotherapist's capacity for maintaining an optimal attentional stance; addresses anxiety-driven interferences to both the psychoanalytic process and deepened Zen practice. Clinical vignettes, personal experiences, poetry and psychoanalytic theory serve to demonstrate the abstract aspects of the discussion.

  8. Dual-Compartment Inflatable Suitlock

    NASA Technical Reports Server (NTRS)

    Kennedy, Kriss J.; Guirgis, Peggy L.; Boyle, Robert M.

    2013-01-01

    There is a need for an improvement over current NASA Extravehicular Activity (EVA) technology. The technology must allow the capacity for quicker, more efficient egress/ingress, allow for shirtsleeve suit maintenance, be compact in transport, and be applicable to environments ranging from planetary surface (partial-g) to orbital or deep space zero-g environments. The technology must also be resistant to dust and other foreign contaminants that may be present on or around a planetary surface. The technology should be portable, and be capable of docking with a variety of habitats, ports, stations, vehicles, and other pressurized modules. The Dual-Compartment Inflatable Suitlock (DCIS) consists of three hard inline bulkheads, separating two cylindrical membrane-walled compartments. The Inner Bulkhead can be fitted with a variety of hatch types, docking flanges, and mating hardware, such as the Common Berthing Mechanism (CBM), for the purpose of mating with vehicles, habitats, and other pressurized modules. The Inner Bulkhead and Center Bulkhead function as the end walls of the Inner Compartment, which during operations, would stay pressurized, either matching the pressure of the habitat or acting as a lower-pressure transitional volume. The Inner Compartment contains donning/doffing fixtures and inner suit-port hatches. The Center Bulkhead has two integrated suit-ports along with a maintenance hatch. The Center Bulkhead and Outer Bulkhead function as the end walls of the Outer Compartment, which stays at vacuum during normal operations. This allows the crewmember to quickly don a suit, and egress the suitlock without waiting for the Outer Compartment to depressurize. The Outer Compartment can be pressurized infrequently for both nominal and off-nominal suit maintenance tasks, allowing shirtsleeve inspections and maintenance/repair of the environmental suits. The Outer Bulkhead has a pressure-assisted hatch door that stays open and stowed during EVA operations, but can

  9. Dual-Compartment Inflatable Suitlock

    NASA Technical Reports Server (NTRS)

    Howe, Scott; Kennedy, Kriss J.; Guirgis, Peggy L.

    2012-01-01

    A paper discusses a dual-compartment inflatable suitlock (DCIS) for Extra - vehicular Activity (EVA) that will allow for dust control, suit maintenance, and efficient EVA egress/ingress. The expandable (inflatable technologies) aspect of the design will allow the unit to stow in a compact package for transport. The DCIS consists of three hard, in line bulkheads, separating two cylindrical membrane-walled compartments. The inner bulkhead can be fitted with a variety of hatch types, docking flanges, and mating hardware, such as the common berthing mechanism (CBM), for the purpose of mating with vehicles, habitats, and other pressurized modules. The inner bulkhead and center bulkhead function as the end walls of the inner compartment, which, during operations, would stay pressurized, either matching the pressure of the habitat or acting as a lower-pressure transitional volume. The suited crewmember can quickly don a suit, and egress the suitlock without waiting for the compartment to depressurize. The outer compartment can be pressurized infrequently, when a long dwell time is expected prior to the next EVA, or during off-nominal suit maintenance tasks, allowing shirtsleeve inspections and maintenance of the space suits. The outer bulkhead has a pressure-assisted hatch door that stays open and stowed routinely, but can be closed for suit maintenance and pressurization as needed.

  10. Unloader Braces for Medial Compartment Knee Osteoarthritis

    PubMed Central

    Ramsey, Dan K.; Russell, Mary E.

    2009-01-01

    Background: For persons with unicompartment knee osteoarthritis (OA), off-unloader braces are a mechanical intervention designed to reduce pain, improve physical function, and possibly slow disease progression. Pain relief is thought to be mediated by distracting the involved compartment via external varus or valgus forces applied to the knee. In so doing, tibiofemoral alignment is improved, and load is shifted off the degenerative compartment, where exposure to potentially damaging and provocative mechanical stresses are reduced. Objectives: To provide a synopsis of the evidence documented in the scientific literature concerning the efficacy of off-loader knee braces for improving symptomatology associated with painful disabling medial compartment knee OA. Search Strategy: Relevant peer-reviewed publications were retrieved from a MEDLINE search using the terms with the reference terms osteoarthritis, knee, and braces (per Medical Subject Headings), plus a manual search of bibliographies from original and review articles and appropriate Internet resources. Results: For persons with combined unicompartment knee OA and mild to moderate instability, the strength of recommendation reported by the Osteoarthritis Research Society International in the ability of off-loader knee braces to reduce pain, improve stability, and diminish the risk of falling was 76% (95% confidence interval, 69%-83%). The more evidence the treatment is effective, the higher the percentage. Conclusions: Given the encouraging evidence that off-loader braces are effective in mediating pain relief in conjunction with knee OA and malalignment, bracing should be fully used before joint realignment or replacement surgery is considered. With the number of patients with varus deformities and knee pain predicted to increase as the population ages, a reduction of patient morbidity for this widespread chronic condition in combination with this treatment modality could have a positive impact on health care

  11. Exertional Rhabdomyolysis in the Athlete

    PubMed Central

    Tietze, David C.; Borchers, James

    2014-01-01

    Context: Exertional rhabdomyolysis is a relatively uncommon but potentially fatal condition affecting athletes that requires prompt recognition and appropriate management. Evidence Acquisition: A search of the PubMed database from 2003 to 2013 using the term exertional rhabdomyolysis was performed. Further evaluation of the bibliographies of articles expanded the evidence. Study Design: Clinical review. Level of Evidence: Level 3. Results: Exertional rhabdomyolysis (ER) is a relatively uncommon condition with an incidence of approximately 29.9 per 100,000 patient years but can have very serious consequences of muscle ischemia, cardiac arrhythmia, and death. The athlete will have pain, weakness, and swelling in the muscles affected as well as significantly elevated levels of creatine kinase (CK). Hydration is the foundation for any athlete with ER; management can also include dialysis or surgery. Stratifying the athlete into high- or low-risk categories can determine if further workup is warranted. Conclusion: Exertional rhabdomyolysis evaluation requires a history, physical examination, and serology for definitive diagnosis. Treatment modalities should include rest and hydration. Return to play and future workup should be determined by the risk stratification of the athlete. Strength-of-Recommendation Taxonomy (SORT): C. PMID:24982707

  12. Exploring Water-Tight Compartments.

    ERIC Educational Resources Information Center

    Fishman, Steve

    John Dewey employed the phrase "water-tight compartments" to mark deficiencies of integration within an individual's personality. For Dewey, the self is complex, but a strong personality integrates its various habits so that they reinforce rather than conflict with one another. Dewey's focus on this problem of personality has relevance…

  13. Compartment syndrome: diagnosis, management, and unique concerns in the twenty-first century.

    PubMed

    Garner, Matthew R; Taylor, Samuel A; Gausden, Elizabeth; Lyden, John P

    2014-07-01

    Compartment syndrome is an elevation of intracompartmental pressure to a level that impairs circulation. While the most common etiology is trauma, other less common etiologies such as burns, emboli, and iatrogenic injuries can be equally troublesome and challenging to diagnose. The sequelae of a delayed diagnosis of compartment syndrome may be devastating. All care providers must understand the etiologies, high-risk situation, and the urgency of intervention. This study was conducted to perform a comprehensive review of compartment syndrome discussing etiologies, risk stratification, clinical progression, noninvasive and invasive monitoring, documentation, medical-legal implication, and our step-by-step approach to compartment syndrome prevention, detection, and early intervention. A literature search was performed using the PubMed Database and the following search terms: "Compartment syndrome AND Extremity," "Compartment syndrome AND Gluteal," and Compartment syndrome AND Paraspinal." A total of 2,068 articles were identified. Filters allowed for the exclusion of studies not printed in English (359) and those focusing on exertional compartment syndrome (84), leaving a total of 1,625 articles available for review. The literature provides details regarding the etiologies, risk stratification, clinical progression, noninvasive and invasive monitoring, documentation, medical-legal implication, and our step-by-step approach to compartment syndrome prevention, detection, and early intervention. The development and progression of compartment syndrome is multifactorial, and as complexity of care increases, the opportunity for the syndrome to be missed is increased. Recent changes in the structure of in-hospital medical care including resident work hour restrictions and the incorporation of midlevel providers have increased the frequency of "signouts" or "patient handoffs" which present opportunities for the syndrome to be mismanaged. The changing dynamics of the health

  14. The Orbital Workshop Shower Compartment

    NASA Technical Reports Server (NTRS)

    1972-01-01

    This photograph shows technicians performing a checkout of the Metabolic Analyzer (center background) and the Ergometer (foreground) in the Orbital Workshop (OWS). The shower compartment is at right. The Ergometer (Skylab Experiment M171) evaluated man's metabolic effectiveness and cost of work in space environment. Located in the experiment and work area of the OWS, the shower compartment was a cylindrical cloth enclosure that was folded flat when not in use. The bottom ring of the shower was fastened to the floor and contained foot restraints. The upper ring contained the shower head and hose. To use the shower, the astronaut filled a pressurized portable bottle with heated water and attached the bottle to the ceiling. A flexible hose cornected the water bottle to a handheld shower head. The astronaut pulled the cylindrical shower wall up into position and bathed, using liquid soap. Both soap and water were carefully rationed, having been premeasured for economical use.

  15. The Orbital Workshop Sleep Compartment

    NASA Technical Reports Server (NTRS)

    1972-01-01

    This wide-angle view is of the Orbital Workshop (OWS) sleep compartment, located in the lower level of the OWS. Each crewman was assigned a small space for sleeping and zipped themselves into sleeping bags stretched against the wall. Because of the absence of gravity, sleeping comfort was achieved in any position relative to the spacecraft; body support was not necessary. Sleeping could be accommodated quite comfortably in a bag that held the body at a given place in Skylab.

  16. 36 CFR 1192.127 - Sleeping compartments.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Intercity Rail Cars and Systems § 1192.127 Sleeping compartments. (a) Sleeping compartments required to be... controls, call buttons, electrical outlets, etc.) shall be mounted no more than 48 inches, and no less than...

  17. 36 CFR 1192.127 - Sleeping compartments.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Intercity Rail Cars and Systems § 1192.127 Sleeping compartments. (a) Sleeping compartments required to be... controls, call buttons, electrical outlets, etc.) shall be mounted no more than 48 inches, and no less than...

  18. Method and apparatus to assess compartment syndrome

    NASA Technical Reports Server (NTRS)

    Ueno, Toshiaki (Inventor); Hargens, Alan R. (Inventor); Yost, William T. (Inventor)

    2008-01-01

    A method and apparatus for measuring pressure buildup in a body compartment that encases muscular tissue. The method includes assessing the body compartment configuration and identifying the effect of pulsatile components on at least one compartment dimension. This process is used in preventing tissue necrosis, and in decisions of whether to perform surgery on the body compartment for prevention of Compartment Syndrome. An apparatus is used for measuring excess pressure in the body compartment having components for imparting ultrasonic waves such as a transducer, placing the transducer to impart the ultrasonic waves, capturing the reflected imparted ultrasonic waves, and converting them to electrical signals, a pulsed phase-locked loop device for assessing a body compartment configuration and producing an output signal, and means for mathematically manipulating the output signal to thereby categorize pressure build-up in the body compartment from the mathematical manipulations.

  19. Orbiter Crew Compartment Integration-Stowage

    NASA Technical Reports Server (NTRS)

    Morgan, L. Gary

    2007-01-01

    This viewgraph presentation describes the Orbiter Crew Compartment Integration (CCI) stowage. The evolution of orbiter crew compartment stowage volume is also described, along with photographs presented of the on-orbit volume stowage capacity.

  20. Rare times rare: The hyponatremia, rhabdomyolysis, anterior compartment syndrome sequence

    PubMed Central

    Dubin, Ina; Gelber, Moshe

    2016-01-01

    Lesson Primary polydipsia occurs in up to 25% of patients with chronic psychiatric disorders (especially schizophrenia), related to the disease, its treatment or both. Urine output fails to match intake >10 L/day and water intoxication may develop. Rhabdomyolysis is a rare complication of hyponatremia, and an acute anterior compartment syndrome of the leg, an emergency, may be very rarely associated. PMID:27186379

  1. 14 CFR 29.771 - Pilot compartment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Pilot compartment. 29.771 Section 29.771... Pilot compartment. For each pilot compartment— (a) The compartment and its equipment must allow each pilot to perform his duties without unreasonable concentration or fatigue; (b) If there is provision for...

  2. 14 CFR 27.771 - Pilot compartment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Pilot compartment. 27.771 Section 27.771... Pilot compartment. For each pilot compartment— (a) The compartment and its equipment must allow each pilot to perform his duties without unreasonable concentration or fatigue; (b) If there is provision for...

  3. 14 CFR 23.771 - Pilot compartment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Pilot compartment. 23.771 Section 23.771... Cargo Accommodations § 23.771 Pilot compartment. For each pilot compartment— (a) The compartment and its equipment must allow each pilot to perform his duties without unreasonable concentration or fatigue; (b...

  4. 14 CFR 23.771 - Pilot compartment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Pilot compartment. 23.771 Section 23.771... Cargo Accommodations § 23.771 Pilot compartment. For each pilot compartment— (a) The compartment and its equipment must allow each pilot to perform his duties without unreasonable concentration or fatigue; (b...

  5. 14 CFR 25.771 - Pilot compartment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Pilot compartment. 25.771 Section 25.771... Pilot compartment. (a) Each pilot compartment and its equipment must allow the minimum flight crew... pilot, the airplane must be controllable with equal safety from either pilot seat. (d) The pilot...

  6. 49 CFR 38.127 - Sleeping compartments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 1 2014-10-01 2014-10-01 false Sleeping compartments. 38.127 Section 38.127... SPECIFICATIONS FOR TRANSPORTATION VEHICLES Intercity Rail Cars and Systems § 38.127 Sleeping compartments. (a) Sleeping compartments required to be accessible shall be designed so as to allow a person using...

  7. 36 CFR 1192.127 - Sleeping compartments.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true Sleeping compartments. 1192.127 Section 1192.127 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS... Intercity Rail Cars and Systems § 1192.127 Sleeping compartments. (a) Sleeping compartments required to...

  8. 49 CFR 38.127 - Sleeping compartments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 1 2012-10-01 2012-10-01 false Sleeping compartments. 38.127 Section 38.127... SPECIFICATIONS FOR TRANSPORTATION VEHICLES Intercity Rail Cars and Systems § 38.127 Sleeping compartments. (a) Sleeping compartments required to be accessible shall be designed so as to allow a person using...

  9. 14 CFR 25.787 - Stowage compartments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Personnel and Cargo Accommodations § 25.787 Stowage compartments. (a) Each compartment for the stowage of cargo, baggage, carry-on articles, and... to compartments located below, or forward, of all occupants in the airplane. If the airplane has a...

  10. 14 CFR 25.787 - Stowage compartments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Personnel and Cargo Accommodations § 25.787 Stowage compartments. (a) Each compartment for the stowage of cargo, baggage, carry-on articles, and... to compartments located below, or forward, of all occupants in the airplane. If the airplane has a...

  11. 49 CFR 38.127 - Sleeping compartments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Sleeping compartments. 38.127 Section 38.127... SPECIFICATIONS FOR TRANSPORTATION VEHICLES Intercity Rail Cars and Systems § 38.127 Sleeping compartments. (a) Sleeping compartments required to be accessible shall be designed so as to allow a person using...

  12. 49 CFR 38.127 - Sleeping compartments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false Sleeping compartments. 38.127 Section 38.127... SPECIFICATIONS FOR TRANSPORTATION VEHICLES Intercity Rail Cars and Systems § 38.127 Sleeping compartments. (a) Sleeping compartments required to be accessible shall be designed so as to allow a person using...

  13. Acute Compartment Syndrome of the Leg.

    PubMed

    Konda, Sanjit R; Kester, Benjamin S; Fisher, Nina; Behery, Omar A; Crespo, Alexander M; Egol, Kenneth A

    2017-08-01

    Acute compartment syndrome (ACS) is well known among orthopaedic surgeons. The timely diagnosis and management of ACS is crucial to avoiding its sequelae, including renal failure, ischemic contractures, and limb loss. Despite its relative importance, ACS poses a challenge to many residents and clinicians as diagnosis relies largely on clinical judgment. Timely diagnosis and thorough compartment release are essential to optimizing outcomes in ACS. This video highlights a clinical case in which compartment syndrome of the leg was considered, diagnosed, and surgically managed. This video will present the indications for compartment release and a video-guided demonstration of compartment checks using an arterial line transducer, a 4-compartment fasciotomy with 2 incisions, and temporizing vessel loop closure. Compartment syndrome can be a devastating complication of common fractures. It is essential that orthopaedic practitioners understand the immediacy of intervention. We have a responsibility to provide timely, accurate diagnosis along with expedient surgical management.

  14. Bacterial Translocation – Impact on the Adipocyte Compartment

    PubMed Central

    Kruis, Tassilo; Batra, Arvind; Siegmund, Britta

    2013-01-01

    Over the last decade it became broadly recognized that adipokines and thus the fat tissue compartment exert a regulatory function on the immune system. Our own group described the pro-inflammatory function of the adipokine leptin within intestinal inflammation in a variety of animal models. Following-up on this initial work, the aim was to reveal stimuli and mechanisms involved in the activation of the fat tissue compartment and the subsequent release of adipokines and other mediators paralleled by the infiltration of immune cells. This review will summarize the current literature on the possible role of the mesenteric fat tissue in intestinal inflammation with a focus on Crohn’s disease (CD). CD is of particular interest in this context since the transmural intestinal inflammation has been associated with a characteristic hypertrophy of the mesenteric fat, a phenomenon called “creeping fat.” The review will address three consecutive questions: (i) What is inducing adipocyte activation, (ii) which factors are released after activation and what are the consequences for the local fat tissue compartment and infiltrating cells; (iii) do the answers generated before allow for an explanation of the role of the mesenteric fat tissue within intestinal inflammation? With this review we will provide a working model indicating a close interaction in between bacterial translocation, activation of the adipocytes, and subsequent direction of the infiltrating immune cells. In summary, the models system mesenteric fat indicates a unique way how adipocytes can directly interact with the immune system. PMID:24432024

  15. [Fascia compartment syndrome of the iliac-psoas compartment].

    PubMed

    Klammer, A

    1983-01-01

    The iliacus compression syndrome has a kind of exceptional position--as to genesis, development and therapy--in comparison with the other compartment-compression syndromes of the limbs. Indeed there exist similar pathophysiological, rules, but the special anatomic facts enlarge the etiological, differential-diagnostic and therapeutic spectrum. Thus, concerning the frequency of causes, not the trauma but the spontaneous bleeding in coagulation disturbances takes the first place, and unusual causes, such as rupturing aortic aneurysms, have to be included in the differential diagnostic discussion. The finest diagnostic sign besides pain is the palsy of the Nervus Femoralis. As to the treatment, operative measures are possible. The exact knowledge of the anatomy is important for the understanding of the specialties mentioned above.

  16. Puerarin, isolated from Kudzu root (Willd.), attenuates hepatocellular cytotoxicity and regulates the GSK-3β/NF-κB pathway for exerting the hepatoprotection against chronic alcohol-induced liver injury in rats.

    PubMed

    Li, Rong; Liang, Tao; He, Qiaoling; Guo, Chao; Xu, Lingyuan; Zhang, Kefeng; Duan, Xiaoqun

    2013-09-01

    Puerarin (PR) has been utilized as a phytomedicine to managing liver disease in China. Thus, this study aimed to evaluate the potential PR-mediated hepatoprotective role against chronic alcohol-induced liver injury in rats. The results indicated that serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and pro-inflammatory cytokines were significantly reduced following PR treatment, while the albumin (ALB) level was increased. Meanwhile, intrahepatic contents of alcohol dehydrogenase (ADH), aldehyde dehydrogenase (ALDH) were elevated. Pathological examination showed that alcohol-lesioned hepatocytes were mitigated through the PR treatment. In addition, the endogenous levels of glycogen synthase kinase-3β (GSK-3β) at the protein level and β-catenin expression at the mRNA level were notably down-regulated, whereas the tumor necrosis factor alpha (TNF-α) and nuclear factor-kappa B (NF-κB) proteins in the liver tissue were effectively decreased following the PR treatment. Together, these findings demonstrate that PR mediates hepatoprotection against alcohol-induced liver injury. The mechanisms underlying the cytoprotective effects of PR are associated with inhibiting immunotoxicity in hepatocytes and regulating the GSK-3β/NF-κB pathway, thereby maintaining metabolic homeostasis in the liver tissue.

  17. Curcumin exerts antinociceptive effects by inhibiting the activation of astrocytes in spinal dorsal horn and the intracellular extracellular signal-regulated kinase signaling pathway in rat model of chronic constriction injury.

    PubMed

    Ji, Feng-Tao; Liang, Jiang-Jun; Liu, Ling; Cao, Ming-Hui; Li, Feng

    2013-03-01

    Activation of glial cells and the extracellular signal-regulated kinase (ERK) signaling pathway play an important role in the development and maintenance of neuropathic pain. Curcumin can alleviate the symptom of inflammatory pain by inhibiting the production and release of interleukin and tumor necrosis factor. However, whether curcumin affects neuropathic pain induced by nerve injury and the possible mechanism involved are still unknown. This study investigated the effects of tolerable doses of curcumin on the activation of astrocytes and ERK signaling in the spinal dorsal horn in rat model of neuropathic pain. Adult male Sprague-Dawley rats were randomly divided into three groups: a control (sham operated) group, and chronic constriction injury groups (to induce neuropathic pain) that were either untreated or treated with curcumin. Thermal and mechanical hyperalgesia thresholds were measured. The distribution and morphological changes of astrocytes were observed by immunofluorescence. Western blotting was used to detect changes in the expression of glial fibrillary acid protein (GFAP) and phosphorylated ERK. Injured rats showed obvious mechanical allodynia and thermal hyperalgesia. The number of GFAP-positive astrocytes, and the fluorescence intensity of GFAP were significantly increased in the spinal dorsal horn of injured compared with control rats. The soma of astrocytes also appeared hypertrophied in injured animals. Expression of GFAP and phosphorylated ERK was also significantly increased in the spinal dorsal horn of injured compared with control rats. Curcumin reduced the injury-induced thermal and mechanical hyperalgesia, the increase in the fluorescence intensity of GFAP and the hypertrophy of astrocytic soma, activation of GFAP and phosphorylation of ERK in the spinal dorsal horn. Curcumin can markedly alleviate nerve injury-induced neuropathic pain in rats. The analgesic effect of curcumin may be attributed to its inhibition of astrocyte hypertrophy

  18. Chronic Lower Leg Pain in Athletes

    PubMed Central

    Brewer, Rachel Biber; Gregory, Andrew J. M.

    2012-01-01

    Context: Chronic lower leg pain in athletes can be a frustrating problem for patients and a difficult diagnosis for clinicians. Myriad approaches have been suggested to evaluate these conditions. With the continued evolution of diagnostic studies, evidence-based guidance for a standard approach is unfortunately sparse. Evidence Acquisition: PubMed was searched from January 1980 to May 2011 to identify publications regarding chronic lower leg pain in athletes (excluding conditions related to the foot), including differential diagnosis, clinical presentation, physical examination, history, diagnostic workup, and treatment. Results: Leg pain in athletes can be caused by many conditions, with the most frequent being medial tibial stress syndrome; chronic exertional compartment syndrome, stress fracture, nerve entrapment, and popliteal artery entrapment syndrome are also considerations. Conservative management is the mainstay of care for the majority of causes of chronic lower leg pain; however, surgical intervention may be necessary. Conclusion: Chronic lower extremity pain in athletes includes a wide differential and can pose diagnostic dilemmas for clinicians. PMID:23016078

  19. Acute compartment syndrome caused by uncontrolled hypothyroidism.

    PubMed

    Modi, Anar; Amin, Hari; Salzman, Matthew; Morgan, Farah

    2017-06-01

    Acute compartment syndrome is increased tissue pressure exceeding perfusion pressure in a closed compartment resulting in nerve and muscle ischemia. Common precipitating causes are crush injuries, burns, substance abuse, osseous or vascular limb trauma. This is a case of 42year old female with history of hypothyroidism who presented to emergency room with acute onset of severe pain and swelling in right lower extremity. Physical examination was concerning for acute compartment syndrome of right leg which was confirmed by demonstration of elevated compartmental pressures. No precipitating causes were readily identified. Further laboratory testing revealed uncontrolled hypothyroidism. Management included emergent fasciotomy and initiating thyroid hormone replacement. This case represents a rare association between acute compartment syndrome and uncontrolled hypothyroidism. We also discuss the pathogenesis of compartment syndrome in hypothyroid patients and emphasize the importance of evaluating for less common causes, particularly in setting of non-traumatic compartment syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Independent Active Contraction of Extraocular Muscle Compartments

    PubMed Central

    Shin, Andrew; Yoo, Lawrence; Demer, Joseph L.

    2015-01-01

    Purpose. Intramuscular innervation of horizontal rectus extraocular muscle (EOMs) is segregated into superior and inferior (transverse) compartments, whereas all EOMs are also divided into global (GL) and orbital (OL) layers with scleral and pulley insertions, respectively. Mechanical independence between both types of compartments has been demonstrated during passive tensile loading. We examined coupling between EOM compartments during active, ex vivo contraction. Methods. Fresh bovine EOMs were removed, and one compartment of each was coated with hydrophobic petrolatum. Contraction of the uncoated compartment was induced by immersion in a solution of 50 mM CaCl2 at 38°C labeled with sodium fluorescein dye, whereas tensions in both compartments were monitored by strain gauges. Control experiments omitted petrolatum so that the entire EOM contracted. After physiological experiments, EOMs were sectioned transversely to demonstrate specificity of CaCl2 permeation by yellow fluorescence dye excited by blue light. Results. In control experiments without petrolatum, both transverse and GL and OL compartments contracted similarly. Selective compartmental omission of petrolatum caused markedly independent compartmental contraction whether measured at the GL or the OL insertions or for transverse compartments at the scleral insertion. Although some CaCl2 spread occurred, mean (±SD) tension in the coated compartments averaged only 10.5 ± 3.3% and 6.0 ± 1.5% in GL/OL and transverse compartments, respectively relative to uncoated compartments. Fluorescein penetration confirmed selective CaCl2 permeation. Conclusions. These data confirm passive tensile findings of mechanical independence of EOM compartments and extend results to active contraction. EOMs behave actively as if composed of mechanically independent parallel fiber bundles having different insertional targets, consistent with the active pulley and transverse compartmental hypotheses. PMID:25503460

  1. Abdominal Compartment Syndrome After Hip Arthroscopy

    DTIC Science & Technology

    2010-01-01

    K. Intra- abdominal compartment syndrome as a complication of ruptured abdomi- nal aortic aneurysm repair. Am Surg 1989;55:396-402. 6. Sugrue M...00-00-2010 to 00-00-2010 4. TITLE AND SUBTITLE Abdominal Compartment Syndrome After Hip Arthroscopy 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Author’s personal copy Case Report Abdominal Compartment Syndrome After

  2. Can intramuscular glucose levels diagnose compartment syndrome?

    PubMed

    Doro, Christopher J; Sitzman, Thomas J; O'Toole, Robert V

    2014-02-01

    Compartment syndrome is difficult to diagnose, particularly in patients who are not able to undergo adequate clinical examination. Current methods rely on pressure measurements within the compartment, have high false-positive rates, and do not reliably indicate presence of muscle ischemia. We hypothesized that measurement of intramuscular glucose and oxygen can identify compartment syndrome with high sensitivity and specificity. Compartment syndrome was created in 12 anesthetized adult mixed-sex beagles, in the craniolateral compartment of a lower leg, by infusion of lactated Ringer's solution with normal serum concentration of glucose. The contralateral leg served as a control. Hydrostatic pressure, oxygen tension, and glucose concentration were recorded with commercially available probes. Compartment syndrome was maintained for 8 hours, and the animals were recovered. Two weeks later, compartment and control legs underwent muscle biopsy. Specimens were reviewed by a blinded pathologist. Within 15 minutes of creating compartment syndrome, glucose concentration and oxygen tension in the experimental limb were significantly lower than in the control limb (glucose, p = 0.02; oxygen, p = 0.007; two-tailed t test). Intramuscular glucose concentration of less than 97 mg/dL was 100% sensitive (95% confidence interval [CI], 73-100%) and 75% specific (95% CI, 40-94%) for the presence of compartment syndrome. Partial pressure of oxygen less than 30 mm Hg was 100% sensitive (95% CI, 72-100%) and 100% specific (95% CI, 69-100%) for the presence of compartment syndrome. Pathology confirmed compartment syndrome in all experimental limbs. Our results show that intramuscular glucose concentration and partial pressure of oxygen rapidly identify muscle ischemia with high sensitivity and specificity after experimentally created compartment syndrome in this animal model.

  3. Emerging Technologies and Their Applications in Lipid Compartment Measurement

    PubMed Central

    Heymsfield, Steven B.; Hu, Houchun Harry; Shen, Wei; Carmichael, Owen

    2015-01-01

    Non-Communicable diseases (NCDs), including obesity, are emerging as the major health concern of the 21st century. Excess adiposity and related NCD metabolic disturbances have stimulated development of new lipid compartment measurement technologies to help us understand cellular energy exchange, to refine phenotypes, and to develop predictive markers of adverse clinical outcomes. Recent advances now allow for quantification of multiple intracellular lipid and adipose tissue compartments that can be evaluated across the human lifespan. With magnetic resonance methods leading the way, newer approaches will give molecular structural and metabolic information beyond the laboratory in real-world settings. The union between these new technologies and the growing NCD population is creating an exciting interface advancing our understanding of chronic disease mechanisms. PMID:26596676

  4. Compartment syndrome after tibial plateau fracture.

    PubMed

    Pitta, Guilherme Benjamin Brandão; Dos Santos, Thays Fernanda Avelino; Dos Santos, Fernanda Thaysa Avelino; da Costa Filho, Edelson Moreira

    2014-01-01

    Fractures of the tibial plateau are relatively rare, representing around 1.2% of all fractures. The tibia, due to its subcutaneous location and poor muscle coverage, is exposed and suffers large numbers of traumas, not only fractures, but also crush injuries and severe bruising, among others, which at any given moment, could lead compartment syndrome in the patient. The case is reported of a 58-year-old patient who, following a tibial plateau fracture, presented compartment syndrome of the leg and was submitted to decompressive fasciotomy of the four right compartments. After osteosynthesis with internal fixation of the tibial plateau using an L-plate, the patient again developed compartment syndrome.

  5. 36 CFR 1192.127 - Sleeping compartments.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Sleeping compartments. 1192.127 Section 1192.127 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS... compartment. (c) Controls and operating mechanisms (e.g., heating and air conditioning controls, lighting...

  6. Compartmented mode workstation (CMW) comparisons

    SciTech Connect

    Tolliver, J.S.

    1995-12-31

    As the Compartmented Mode Workstation (CMW) market has matured, several vendors have released new versions of their CMW operating systems. These include a new version from SecureWare (CMW + Version 2.4), and Sun`s CMW 1.1 (also known as Trusted Solaris 1.1). EC is now shipping MLS+ 3.0 for DEC Alpha platforms. Relatively new entries in the market include Loral B1/CMW for IBM RS/6000 platforms and a SecureWare-based CMW for HP platforms (HP-UX 10.09). With all these choices it is time for a comparative analysis of the features offered by the various vendors. The authors have three of the above five CMW systems plus HP-UX BLS 9.09, which is a multilevel secure operating system (OS) targeted at the B1 level but not a CMW. Each is unique in sometimes obvious, sometimes subtle ways, a situation that requires knowing and keeping straight a variety of commands to do the same thing on each system. Some vendors offer extensive GUI tools for system administration; some require entering command-line commands for certain system administration tasks. They examine the differences in system installation, system administration, and system operating among the systems. They look at trusted networking among the various systems and differences in the network databases and label encodings files. They examine the user interface on the various systems from logging in to logging out.

  7. [Reiteration on abdominal compartment syndrome].

    PubMed

    Xia, Guang-Xia

    2008-04-01

    Since we called for the attention of the occurrence of abdominal compartment syndrome in 2002, forty cases of this complication have been recognized and reported by six burn units in this journal, including three cases accompanied with massive pleural effusion (1601 - 3240 mL). Most cases emerged after "aggressive" fluid resuscitation, especially after massive infusion of crystalloid fluid. The idea "more fluid no harm" should be corrected. The goal of early fluid resuscitation in burn is to correct the hypovolemia and cell hypoxia, and circulating fluid just serves as a carrier in bringing O2 to the cells and carrying out CO2 and other metabolites from tissues. In face of "leaking while infusing", heavy accumulation of fluid in the third spaces may worsen the cell hypoxia. Some of the parameters we get from invasive monitoring systems can be misleading. Now, the trend of overloading should be prevented, and it behaves us to study the regime of lower fluid volume with proper contents in burn shock resuscitation.

  8. Spontaneous Extensor Carpi Ulnaris Compartment Syndrome.

    PubMed

    Stewart, Sarah K; Singleton, James A G

    2016-06-01

    We report a case of isolated compartment syndrome within the extensor carpi ulnaris (ECU) compartment in the forearm of a 40-year-old diabetic man. Magnetic resonance imaging of his forearm showed isolated changes in the ECU muscle belly; compartment syndrome was confirmed on manometry. In view of the short history of symptoms and his diabetic status, the patient was managed conservatively. Twenty-four hours after onset of the symptoms, the pain and swelling resolved and he was able to be discharged. To date, 3 cases of ECU compartment syndrome secondary to trauma have been reported. This report illustrates a case of confirmed compartment syndrome without antecedent trauma, highly unusual in terms of both its etiology and its anatomical location. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  9. Recurrent Lower-Extremity Compartment Syndrome after Four-Compartment Fasciotomy Secondary to Acute Limb Ischemia.

    PubMed

    Kerkar, Ashwini P; Farber, Alik; Kalish, Jeffrey A; Siracuse, Jeffrey J

    2016-01-01

    Lower-extremity compartment syndrome is a limb-threatening event necessitating emergent treatment using fasciotomy. Recurrent compartment syndrome is rare and has only been reported after trauma and in conjunction with underlying connective tissue disorders. In this report, we present a case of recurrent lower-extremity compartment syndrome caused by ischemia-reperfusion injury, in a patient previously treated with adequate 4-compartment fasciotomies. As such, this is the first reported case of recurrent compartment syndrome in the setting of ischemia-reperfusion injury that required treatment with 4-compartment fasciotomies on both occasions. This case demonstrates that fasciotomy is not protective against the development of recurrent compartment syndrome due to ischemia-reperfusion injury and that patients at high risk require monitoring. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Abdominal compartment syndrome: a concise clinical review.

    PubMed

    An, Gary; West, Michael A

    2008-04-01

    There has been an increased awareness of the presence and clinical importance of abdominal compartment syndrome. It is now appreciated that elevations of abdominal pressure occur in a wide variety of critically ill patients. Full-blown abdominal compartment syndrome is a clinical syndrome characterized by progressive intra-abdominal organ dysfunction resulting from elevated intra-abdominal pressure. This review provides a current, clinically focused approach to the diagnosis and management of abdominal compartment syndrome, with a particular emphasis on intensive care. Source data were obtained from a PubMed search of the medical literature, with an emphasis on the time period after 2000. PubMed "related articles" search strategies were likewise employed frequently. Additional information was derived from the Web site of the World Society of the Abdominal Compartment Syndrome (http://www.wsacs.org). The detrimental impact of elevated intra-abdominal pressure, progressing to abdominal compartment syndrome, is recognized in both surgical and medical intensive care units. The recent international abdominal compartment syndrome consensus conference has helped to define, characterize, and raise awareness of abdominal compartment syndrome. Because of the frequency of this condition, routine measurement of intra-abdominal pressure should be performed in high-risk patients in the intensive care unit. Evidence-based interventions can be used to minimize the risk of developing elevated intra-abdominal pressure and to aggressively treat intra-abdominal hypertension when identified. Surgical decompression remains the gold standard for rapid, definitive treatment of fully developed abdominal compartment syndrome, but nonsurgical measures can often effectively affect lesser degrees of intra-abdominal hypertension and abdominal compartment syndrome.

  11. Contrast media-induced compartment syndrome.

    PubMed

    Wilson, Bettye G

    2011-01-01

    Intravascular (IV) contrast media are essential in many cases to enhance the diagnostic capabilities of medical imaging procedures. Much is known about the indications, contraindications, and adverse events associated with their use. This Directed Reading focuses on extravasation and IV contrast media-induced compartment syndrome, a less frequent, although serious, adverse event. In addition to describing the compartments within the forearm, wrist, and hand, the article explains how compartment syndrome develops, techniques used to treat the condition, and prevention strategies. ©2011 by the American Society of Radiologic Technologists.

  12. Compartment syndrome after tibial plateau fracture☆

    PubMed Central

    Pitta, Guilherme Benjamin Brandão; dos Santos, Thays Fernanda Avelino; dos Santos, Fernanda Thaysa Avelino; da Costa Filho, Edelson Moreira

    2014-01-01

    Fractures of the tibial plateau are relatively rare, representing around 1.2% of all fractures. The tibia, due to its subcutaneous location and poor muscle coverage, is exposed and suffers large numbers of traumas, not only fractures, but also crush injuries and severe bruising, among others, which at any given moment, could lead compartment syndrome in the patient. The case is reported of a 58-year-old patient who, following a tibial plateau fracture, presented compartment syndrome of the leg and was submitted to decompressive fasciotomy of the four right compartments. After osteosynthesis with internal fixation of the tibial plateau using an L-plate, the patient again developed compartment syndrome. PMID:26229779

  13. 49 CFR 38.127 - Sleeping compartments.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... SPECIFICATIONS FOR TRANSPORTATION VEHICLES Intercity Rail Cars and Systems § 38.127 Sleeping compartments. (a...., heating and air conditioning controls, lighting controls, call buttons, electrical outlets, etc.) shall be...

  14. [Acute compartment syndrome following snake bite].

    PubMed

    Wagner, H E; Barbier, P; Frey, H P; Janggen, F M; Rothen, H U

    1986-04-01

    The experience with snake bites, causing local complications is discussed. Whenever systemic envenomation occurs, antivenin is the treatment of choice. Tissue necroses are treated by early debridement and a possible closed compartment syndrome demands the open fasciotomy.

  15. Reflections on the Design of Exertion Games.

    PubMed

    Mueller, Florian Floyd; Altimira, David; Khot, Rohit Ashot

    2015-02-01

    The design of exertion games (i.e., digital games that require physical effort from players) is a difficult intertwined challenge of combining digital games and physical effort. To aid designers in facing this challenge, we describe our experiences of designing exertion games. We outline personal reflections on our design processes and articulate analyses of players' experiences. These reflections and analyses serve to highlight the unique opportunities of combining digital games and physical effort. The insights we seek aim to enhance the understanding of exertion game design, contributing to the advancement of the field, and ultimately resulting in better games and associated player experiences.

  16. Aircraft Cargo Compartment Fire Test Simulation Program

    NASA Technical Reports Server (NTRS)

    Blumke, R. E.

    1977-01-01

    The objective of the test was to assess fire containment and fire extinguishment in the cargo by reducing the ventilation through the cargo compartment. Parameters which were measured included ignition time, burnthrough time, and physical damage to the cargo liner, composition of selected combustible gases, temperature-time histories, heat flux, and detector response. The ignitor load was made of a typical cargo consisting of filled cardboard cartons occupying 50% of the compartment volume.

  17. Anatomic Landmarks for the First Dorsal Compartment

    PubMed Central

    Hazani, Ron; Engineer, Nitin J.; Cooney, Damon; Wilhelmi, Bradon J.

    2008-01-01

    Objective: Knowledge of anatomic landmarks for the first dorsal compartment can assist clinicians with management of de Quervain's disease. The radial styloid, the scaphoid tubercle, and Lister's tubercle can be used as superficial landmarks for the first dorsal compartment. Methods: Thirty-two cadaveric wrists were dissected, and measurements were taken from the predetermined landmarks to the extensor retinaculum. The compartments were also inspected for variability of the abductor pollicis longus tendon and intracompartmental septations. Results: The average length of the extensor retinaculum from its proximal to distal extent measured approximately 2.2 cm. The distal aspect of the radial styloid was 0.3 cm distal to the distal aspect of the extensor retinaculum, and the distance between the distal aspect of the extensor retinaculum and the APL-Lister's-Scaphoid juncture was approximately 0.5 cm. A separate compartment for the extensor pollicis brevis was noted in 35% of the specimens. The abductor pollicis longus tendon demonstrated great variability with 1, 2, 3, or 4 slips in 9%, 30%, 43%, or 26% of the specimens, respectively. Conclusion: The superficial bony prominences of the radial wrist can be used reliably as anatomic landmarks for the first dorsal compartment. PMID:19092992

  18. Compartment syndrome in infants and toddlers.

    PubMed

    Broom, Alexander; Schur, Mathew D; Arkader, Alexandre; Flynn, John; Gornitzky, Alex; Choi, Paul D

    2016-10-01

    To study the cause, diagnosis, treatment and outcome of acute compartment syndrome in infants and toddlers aged <3 years. Fifteen patients aged <3 years with acute compartment syndrome were identified from two large pediatric trauma centers over a fifteen-year period. All children underwent fasciotomy. The mechanism of injury, time of injury, time to diagnosis, compartment pressures, time to fasciotomy, and outcome at the time of the latest follow-up were recorded. Nine (60 %) of fifteen patients developed compartment syndrome secondary to trauma, four (4/15, 27 %) due to infection, and two (2/15, 13 %) due to intravenous infiltration. The average time from injury or hospital admission to fasciotomy was 31.8 h (range 2.9-136.3 h). In general, the functional outcome was excellent at the latest follow-up with thirteen (13/15, 87 %) patients having an excellent outcome. No cases of Volkmann's ischemia were noted at the time of fasciotomy, even when performed as late as 5 days after injury. Compared to the general pediatric population, the diagnosis of compartment syndrome in infants and toddlers may be further delayed, i.e., >24 h after injury. Despite delays in diagnosis and time to treatment, the present study shows that outcomes in infants and toddlers remain favorable even when fasciotomy is performed 48-72 h after injury. Case series, level IV.

  19. Post-dialysis urea concentration: comparison between one- compartment model and two-compartment model

    NASA Astrophysics Data System (ADS)

    Tamrin, N. S. Ahmad; Ibrahim, N.

    2014-11-01

    The reduction of the urea concentration in blood can be numerically projected by using one-compartment model and two-compartment model with no variation in body fluid. This study aims to compare the simulated values of post-dialysis urea concentration for both models with the clinical data obtained from the hospital. The clinical assessment of adequacy of a treatment is based on the value of Kt/V. Further, direct calculation using clinical data and one-compartment model are presented in the form of ratio. It is found that the ratios of postdialysis urea concentration simulated using two-compartment model are higher compared to the ratios of post-dialysis urea concentration using one-compartment model. In addition, most values of post-dialysis urea concentration simulated using two-compartment model are much closer to the clinical data compared to values simulated using one-compartment model. Kt/V values calculated directly using clinical data are found to be higher than Kt/V values derived from one-compartment model.

  20. Compartment Syndrome of the Leg Associated With Fracture: An Algorithm to Avoid Releasing the Posterior Compartments.

    PubMed

    Tornetta, Paul; Puskas, Brian L; Wang, Kevin

    2016-07-01

    The purpose of this study is to report on a prospective series of patients in whom an algorithm was used to attempt to avoid releasing the posterior compartments in patients with lower leg compartment syndrome (CS) and the safety of such a practice. Prospective cohort study. Level 1 trauma center. A consecutive series of 39 patients was managed by one surgeon for CS using the reported protocol. Patients diagnosed with a CS of the leg were managed with a single operative protocol. After a standard anterior and lateral compartment release through a full-length lateral incision was performed, the superficial and deep posterior compartments were measured with the heel resting on a bolster. Using the preoperative diastolic blood pressure, a ΔP < 30 was considered to be a positive finding warranting a separate medial incision for release of the posterior compartments. If the ΔP was ≥30, the posterior compartments were not released. Need for medial release or development of posterior CS or sequelae. A consecutive series of 39 patients were managed by 1 surgeon for CS using the described protocol. Two patients with an isolated posterior CS were excluded. The other 37 had clinical symptoms or compartment pressures consistent with anterior compartment involvement. Of 37 patients, 21 had (57%) symptoms suggesting posterior compartment involvement. The preoperative pressure measurements averaged 41 mm Hg with an average ΔP of 38. After full-length release of the anterior and lateral compartments, only 3/37 (8%) required a posterior release for a ΔP of <30 mm Hg. The lowest ΔP in the posterior compartments of the remaining 34 patients averaged 59 (32-86). The compartment pressures in the superficial and deep posterior compartments decreased by 22 mm Hg and 24 mm Hg, respectively, after the anterolateral release. None of the patients who had only an anterolateral release developed sequelae of a missed posterior CS. The use of the reported algorithm is effective in

  1. Space Shuttle crew compartment debris-contamination

    NASA Technical Reports Server (NTRS)

    Goodman, Jerry R.; Villarreal, Leopoldo J.

    1992-01-01

    Remedial actions undertaken to reduce debris during manned flights and ground turnaround operations at Kennedy Space Center and Palmdale are addressed. They include redesign of selected ground support equipment and Orbiter hardware to reduce particularization/debris generation; development of new detachable filters for air-cooled avionics boxes; application of tape-on screens to filter debris; and implementation of new Orbiter maintenance and turnaround procedures to clean filters and the crew compartment. Most of these steps were implemented before the return-to-flight of STS-26 in September 1988 which resulted in improved crew compartment habitability and less potential for equipment malfunction.

  2. AFT view of the Transfer Compartment

    NASA Image and Video Library

    2012-04-22

    ISS030-E-241385 (22 April 2012) --- Photographed from the transfer compartment between the Zarya Functional Cargo Block (FGB) and the Zvezda Service Module of the International Space Station, Russian cosmonauts Anton Shkaplerov (left), Oleg Kononenko (right) and Anatoly Ivanishin, all Expedition 30 flight engineers, monitor data at the manual TORU docking system controls in Zvezda during approach and docking operations of the unpiloted ISS Progress 47 resupply vehicle. Progress 47 docked automatically to the Pirs Docking Compartment via the Kurs automated rendezvous system at 10:39 a.m. (EDT) on April 22, 2012.

  3. AFT view of the Transfer Compartment

    NASA Image and Video Library

    2012-04-22

    ISS030-E-241386 (22 April 2012) --- Photographed from the transfer compartment between the Zarya Functional Cargo Block (FGB) and the Zvezda Service Module of the International Space Station, Russian cosmonauts Anton Shkaplerov (left), Oleg Kononenko (right) and Anatoly Ivanishin, all Expedition 30 flight engineers, monitor data at the manual TORU docking system controls in Zvezda during approach and docking operations of the unpiloted ISS Progress 47 resupply vehicle. Progress 47 docked automatically to the Pirs Docking Compartment via the Kurs automated rendezvous system at 10:39 a.m. (EDT) on April 22, 2012.

  4. [The perichromatin compartment of the cell nucleus].

    PubMed

    Bogoliubov, D S

    2014-01-01

    In this review, the data on the structure and composition of the perichromatin compartment, a special border area between the condensed chromatin and the interchromatin space of the cell nucleus, are discussed in the light of the concept of nuclear functions in complex nuclear architectonics. Morphological features, molecular composition and functions of main extrachromosomal structures of the perichromatin compartment, perichromatin fibrils (PFs) and perichromatin granules (PGs) including nuclear stress-bodies (nSBs) that are derivates of the PGs under heat shock, are presented. A special attention was paid to the features of the molecular compositions of PFs and PGs in different cell types and at different physiological conditions.

  5. Respiratory and leg muscles perceived exertion during exercise at altitude.

    PubMed

    Aliverti, A; Kayser, B; Lo Mauro, A; Quaranta, M; Pompilio, P; Dellacà, R L; Ora, J; Biasco, L; Cavalleri, L; Pomidori, L; Cogo, A; Pellegrino, R; Miserocchi, G

    2011-07-31

    We compared the rate of perceived exertion for respiratory (RPE,resp) and leg (RPE,legs) muscles, using a 10-point Borg scale, to their specific power outputs in 10 healthy male subjects during incremental cycle exercise at sea level (SL) and high altitude (HA, 4559 m). Respiratory power output was calculated from breath-by-breath esophageal pressure and chest wall volume changes. At HA ventilation was increased at any leg power output by ∼ 54%. However, for any given ventilation, breathing pattern was unchanged in terms of tidal volume, respiratory rate and operational volumes of the different chest wall compartments. RPE,resp scaled uniquely with total respiratory power output, irrespectively of SL or HA, while RPE,legs for any leg power output was exacerbated at HA. With increasing respective power outputs, the rate of change of RPE,resp exponentially decreased, while that of RPE,legs increased. We conclude that RPE,resp uniquely relates to respiratory power output, while RPE,legs varies depending on muscle metabolic conditions. Copyright © 2011 Elsevier B.V. All rights reserved.

  6. Fiber based optical tweezers for simultaneous in situ force exertion and measurements in a 3D polyacrylamide gel compartment.

    PubMed

    Ti, Chaoyang; Thomas, Gawain M; Ren, Yundong; Zhang, Rui; Wen, Qi; Liu, Yuxiang

    2015-07-01

    Optical tweezers play an important role in biological applications. However, it is difficult for traditional optical tweezers based on objective lenses to work in a three-dimensional (3D) solid far away from the substrate. In this work, we develop a fiber based optical trapping system, namely inclined dual fiber optical tweezers, that can simultaneously apply and measure forces both in water and in a 3D polyacrylamide gel matrix. In addition, we demonstrate in situ, non-invasive characterization of local mechanical properties of polyacrylamide gel by measurements on an embedded bead. The fiber optical tweezers measurements agree well with those of atomic force microscopy (AFM). The inclined dual fiber optical tweezers provide a promising and versatile tool for cell mechanics study in 3D environments.

  7. Fiber based optical tweezers for simultaneous in situ force exertion and measurements in a 3D polyacrylamide gel compartment

    PubMed Central

    Ti, Chaoyang; Thomas, Gawain M; Ren, Yundong; Zhang, Rui; Wen, Qi; Liu, Yuxiang

    2015-01-01

    Optical tweezers play an important role in biological applications. However, it is difficult for traditional optical tweezers based on objective lenses to work in a three-dimensional (3D) solid far away from the substrate. In this work, we develop a fiber based optical trapping system, namely inclined dual fiber optical tweezers, that can simultaneously apply and measure forces both in water and in a 3D polyacrylamide gel matrix. In addition, we demonstrate in situ, non-invasive characterization of local mechanical properties of polyacrylamide gel by measurements on an embedded bead. The fiber optical tweezers measurements agree well with those of atomic force microscopy (AFM). The inclined dual fiber optical tweezers provide a promising and versatile tool for cell mechanics study in 3D environments. PMID:26203364

  8. 24 CFR 3280.111 - Toilet compartments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... URBAN DEVELOPMENT MANUFACTURED HOME CONSTRUCTION AND SAFETY STANDARDS Planning Considerations § 3280.111... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Toilet compartments. 3280.111 Section 3280.111 Housing and Urban Development Regulations Relating to Housing and Urban Development...

  9. Gluteal Compartment Syndrome Secondary to Pelvic Trauma

    PubMed Central

    Taype Zamboni, Danilo E. R.; Carabelli, Guido S.; Barla, Jorge D.; Sancineto, Carlos F.

    2016-01-01

    Gluteal compartment syndrome (GCS) is extremely rare when compared to compartment syndrome in other anatomical regions, such as the forearm or the lower leg. It usually occurs in drug users following prolonged immobilization due to loss of consciousness. Another possible cause is trauma, which is rare and has only few reports in the literature. Physical examination may show tense and swollen buttocks and severe pain caused by passive range of motion. We present the case of a 70-year-old man who developed GCS after prolonged anterior-posterior pelvis compression. The physical examination revealed swelling, scrotal hematoma, and left ankle extension weakness. An unstable pelvic ring injury was diagnosed and the patient was taken to surgery. Measurement of the intracompartmental pressure was measured in the operating room, thereby confirming the diagnosis. Emergent fasciotomy was performed to decompress the three affected compartments. Trauma surgeons must be aware of the possibility of gluteal compartment syndrome in patients who have an acute pelvic trauma with buttock swelling and excessive pain of the gluteal region. Any delay in diagnosis or treatment can be devastating, causing permanent disability, irreversible loss of gluteal muscles, sciatic nerve palsy, kidney failure, or even death. PMID:27579205

  10. 14 CFR 25.771 - Pilot compartment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Pilot compartment. 25.771 Section 25.771 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... (established under § 25.1523) to perform their duties without unreasonable concentration or fatigue. (b) The...

  11. 14 CFR 29.771 - Pilot compartment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Pilot compartment. 29.771 Section 29.771 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... pilot to perform his duties without unreasonable concentration or fatigue; (b) If there is provision for...

  12. 14 CFR 23.771 - Pilot compartment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Pilot compartment. 23.771 Section 23.771 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... equipment must allow each pilot to perform his duties without unreasonable concentration or fatigue; (b...

  13. 14 CFR 23.771 - Pilot compartment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Pilot compartment. 23.771 Section 23.771 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... equipment must allow each pilot to perform his duties without unreasonable concentration or fatigue; (b...

  14. 14 CFR 27.771 - Pilot compartment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Pilot compartment. 27.771 Section 27.771 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... pilot to perform his duties without unreasonable concentration or fatigue; (b) If there is provision for...

  15. 14 CFR 29.771 - Pilot compartment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Pilot compartment. 29.771 Section 29.771 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... pilot to perform his duties without unreasonable concentration or fatigue; (b) If there is provision for...

  16. 14 CFR 25.771 - Pilot compartment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Pilot compartment. 25.771 Section 25.771 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... (established under § 25.1523) to perform their duties without unreasonable concentration or fatigue. (b) The...

  17. 14 CFR 23.771 - Pilot compartment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Pilot compartment. 23.771 Section 23.771 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... equipment must allow each pilot to perform his duties without unreasonable concentration or fatigue; (b...

  18. 14 CFR 27.771 - Pilot compartment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Pilot compartment. 27.771 Section 27.771 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... pilot to perform his duties without unreasonable concentration or fatigue; (b) If there is provision for...

  19. 14 CFR 29.771 - Pilot compartment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Pilot compartment. 29.771 Section 29.771 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... pilot to perform his duties without unreasonable concentration or fatigue; (b) If there is provision for...

  20. 14 CFR 25.771 - Pilot compartment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Pilot compartment. 25.771 Section 25.771 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... (established under § 25.1523) to perform their duties without unreasonable concentration or fatigue. (b) The...

  1. 14 CFR 27.771 - Pilot compartment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Pilot compartment. 27.771 Section 27.771 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... pilot to perform his duties without unreasonable concentration or fatigue; (b) If there is provision for...

  2. COPD Patients with Exertional Desaturation Are at a Higher Risk of Rapid Decline in Lung Function

    PubMed Central

    Kim, Changhwan; Park, Yong Bum; Park, So Young; Park, Sunghoon; Kim, Cheol-Hong; Park, Sang Myeon; Lee, Myung-Goo; Hyun, In-Gyu; Jung, Ki-Suck

    2014-01-01

    Purpose A recent study demonstrated that exertional desaturation is a predictor of rapid decline in lung function in patients with chronic obstructive pulmonary disease (COPD); however, the study was limited by its method used to detect exertional desaturation. The main purpose of this study was to explore whether exertional desaturation assessed using nadir oxygen saturation (SpO2) during the 6-minute walk test (6MWT) can predict rapid lung function decline in patients with COPD. Materials and Methods A retrospective analysis was performed on 57 patients with moderate to very severe COPD who underwent the 6MWT. Exertional desaturation was defined as a nadir SpO2 of <90% during the 6MWT. Rapid decline was defined as an annual rate of decline in forced expiratory volume in 1 second (FEV1) ≥50 mL. Patients were divided into rapid decliner (n=26) and non-rapid decliner (n=31) groups. Results A statistically significant difference in exertional desaturation was observed between rapid decliners and non-rapid decliners (17 vs. 8, p=0.003). No differences were found between the groups for age, smoking status, BODE index, and FEV1. Multivariate analysis showed that exertional desaturation was a significant independent predictor of rapid decline in patients with COPD (relative risk, 6.8; 95% CI, 1.8 to 25.4; p=0.004). Conclusion This study supports that exertional desaturation is a predictor of rapid lung function decline in male patients with COPD. PMID:24719141

  3. Extraocular Muscle Compartments in Superior Oblique Palsy

    PubMed Central

    Suh, Soh Youn; Clark, Robert A.; Le, Alan; Demer, Joseph L.

    2016-01-01

    Purpose To investigate changes in volumes of extraocular muscle (EOM) compartments in unilateral superior oblique (SO) palsy using magnetic resonance imaging (MRI). Methods High-resolution, surface-coil MRI was obtained in 19 patients with unilateral SO palsy and 19 age-matched orthotropic control subjects. Rectus EOMs and the SO were divided into two anatomic compartments for volume analysis in patients with unilateral SO palsy, allowing comparison of total compartmental volumes versus controls. Medial and lateral compartmental volumes of the SO muscle were compared in patients with isotropic (round shape) versus anisotropic (elongated shape) SO atrophy. Results The medial and lateral compartments of the ipsilesional SO muscles were equally atrophic in isotropic SO palsy, whereas the lateral compartment was significantly smaller than the medial in anisotropic SO palsy (P = 0.01). In contrast to the SO, there were no differential compartmental volume changes in rectus EOMs; however, there was significant total muscle hypertrophy in the ipsilesional inferior rectus (IR) and lateral rectus (LR) muscles and contralesional superior rectus (SR) muscles. Medial rectus (MR) volume was normal both ipsi- and contralesionally. Conclusions A subset of patients with SO palsy exhibit selective atrophy of the lateral, predominantly vertically acting SO compartment. Superior oblique atrophy is associated with whole-muscle volume changes in the ipsilesional IR, ipsilesional LR, and contralesional SR; however, SO muscle atrophy is not associated with compartmentally selective volume changes in the rectus EOMs. Selective compartmental SO pathology may provide an anatomic mechanism that explains some of the variability in clinical presentations of SO palsy. PMID:27768791

  4. The estimated sensitivity and specificity of compartment pressure monitoring for acute compartment syndrome.

    PubMed

    McQueen, Margaret M; Duckworth, Andrew D; Aitken, Stuart A; Court-Brown, Charles M

    2013-04-17

    The aim of our study was to document the estimated sensitivity and specificity of continuous intracompartmental pressure monitoring for the diagnosis of acute compartment syndrome. From our prospective trauma database, we identified all patients who had sustained a tibial diaphyseal fracture over a ten-year period. A retrospective analysis of 1184 patients was performed to record and analyze the documented use of continuous intracompartmental pressure monitoring and the use of fasciotomy. A diagnosis of acute compartment syndrome was made if there was escape of muscles at fasciotomy and/or color change in the muscles or muscle necrosis intraoperatively. A diagnosis of acute compartment syndrome was considered incorrect if it was possible to close the fasciotomy wounds primarily at forty-eight hours. The absence of acute compartment syndrome was confirmed by the absence of neurological abnormality or contracture at the time of the latest follow-up. Of 979 monitored patients identified, 850 fit the inclusion criteria with a mean age of thirty-eight years (range, twelve to ninety-four years), and 598 (70.4%) were male (p < 0.001). A total of 152 patients (17.9%) underwent fasciotomy for the treatment of acute compartment syndrome: 141 had acute compartment syndrome (true positives), six did not have it (false positives), and five underwent fasciotomy despite having a normal differential pressure reading, with subsequent operative findings consistent with acute compartment syndrome (false negatives). Of the 698 patients (82.1%) who did not undergo fasciotomy, 689 had no evidence of any late sequelae of acute compartment syndrome (true negatives) at a mean follow-up time of fifty-nine weeks. The estimated sensitivity of intracompartmental pressure monitoring for suspected acute compartment syndrome was 94%, with an estimated specificity of 98%, an estimated positive predictive value of 93%, and an estimated negative predictive value of 99%. The estimated sensitivity and

  5. Reflections on the Institute of Medicine's systemic exertion intolerance disease.

    PubMed

    Jason, Leonard A; Sunnquist, Madison; Brown, Abigail; McManimen, Stephanie; Furst, Jacob

    2015-01-01

    The Institute of Medicine (IOM) in the United States has recently proposed that the term systemic exertion intolerance disease (SEID) replace chronic fatigue syndrome. In addition, the IOM proposed a new case definition for SEID, which includes substantial reductions or impairments in the ability to engage in pre‑illness activities, unrefreshing sleep, postexertional malaise, and either cognitive impairment or orthostatic intolerance. Unfortunately, these recommendations for a name change were not vetted with patient and professional audiences, and the new criteria were not evaluated with data sets of patients and controls. A recent poll suggests that the majority of patients reject this new name. In addition, studies have found that prevalence rates will dramatically increase with the new criteria, particularly due to the ambiguity revolving around exclusionary illnesses. Findings suggest that the new criteria select more patients who have less impairment and fewer symptoms than several other criteria. The implications of these findings are discussed in the current review.

  6. Schistosomiasis Japonica During Pregnancy Is Associated With Elevated Endotoxin Levels in Maternal and Placental Compartments

    PubMed Central

    McDonald, Emily A.; Pond-Tor, Sunthorn; Jarilla, Blanca; Sagliba, Marianne J.; Gonzal, Annaliza; Amoylen, Amabelle J.; Olveda, Remigio; Acosta, Luz; Gundogan, Fusun; Ganley-Leal, Lisa M.; Kurtis, Jonathan D.; Friedman, Jennifer F.

    2014-01-01

    Schistosomiasis affects approximately 40 million women of reproductive age and has been linked to elevated levels of circulating endotoxin in nonpregnant individuals. We have evaluated endotoxin levels in maternal, placental, and newborn blood collected from women residing in Leyte, Philippines. Endotoxin levels in both maternal and placental compartments in pregnant women with schistosomiasis were 1.3- and 2.4-fold higher, respectively, than in uninfected women. In addition, higher concentrations of endotoxin in placental blood were associated with premature birth, acute chorioamnionitis, and elevated proinflammatory cytokines. By promoting endotoxemia, schistosomiasis may exert additional, maladaptive influences on pregnancy outcomes. PMID:23964108

  7. The force exerted by a fireball

    SciTech Connect

    Makrinich, G.; Fruchtman, A.

    2014-02-15

    The force exerted by a fireball was deduced both from the change of the equilibrium position of a pendulum and from the change in the pendulum oscillation period. That measured force was found to be several times larger than the force exerted by the ions accelerated across the double layer that is assumed to surround the fireball. The force enhancement that is expected by ion-neutral collisions in the fireball is evaluated to be too small to explain the measured enhanced force. Gas pressure increase, due to gas heating through electron-neutral collisions, as recently suggested [Stenzel et al., J. Appl. Phys. 109, 113305 (2011)], is examined as the source for the force enhancement.

  8. Myeloperoxidase Exerts Microbicidal Activity against Mycobacterium tuberculosis

    PubMed Central

    Borelli, Violetta; Banfi, Elena; Perrotta, Maria Giovanna; Zabucchi, Giuliano

    1999-01-01

    We investigated the antimycobacterial role of myeloperoxidase (MPO), one of the most abundant granule proteins in human neutrophils. Our data indicate that purified MPO, in the presence of hydrogen peroxide, exerts a consistent killing activity against Mycobacterium tuberculosis H37Rv and against a clinical isolate. The activity is time and dose dependent and requires the presence of chloride ions in the assay medium. PMID:10417186

  9. Forces exerted during microneurosurgery: a cadaver study

    PubMed Central

    Marcus, Hani J; Zareinia, Kourosh; Gan, Liu Shi; Yang, Fang Wei; Lama, Sanju; Yang, Guang-Zhong; Sutherland, Garnette R

    2014-01-01

    Background A prerequisite for the successful design and use of robots in neurosurgery is knowledge of the forces exerted by surgeons during neurosurgical procedures. The aim of the present cadaver study was to measure the surgical instrument forces exerted during microneurosurgery. Methods An experimental apparatus was set up consisting of a platform for human cadaver brains, a Leica microscope to provide illumination and magnification, and a Quanser 6 Degrees-Of-Freedom Telepresence System for tissue manipulation and force measurements. Results The measured forces varied significantly depending on the region of the brain (P = 0.016) and the maneuver performed (P < 0.0001). Moreover, blunt arachnoid dissection was associated with greater force exertion than sharp dissection (0.22 N vs. 0.03 N; P = 0.001). Conclusions The forces necessary to manipulate brain tissue were surprisingly low and varied depending on the anatomical structure being manipulated, and the maneuver performed. Knowledge of such forces could well increase the safety of microsurgery. © 2014 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons, Ltd. PMID:24431265

  10. Raised intracompartmental pressure and compartment syndromes.

    PubMed

    Mars, M; Hadley, G P

    1998-07-01

    Raised intracompartmental pressure (ICP) has become recognized as the final common pathway of a variety of pathologies which lead to failure of the microcirculation with resultant tissue hypoxia and cell death. While commonly seen after trauma, either accidental or operative, raised ICP may result from either an increase in the volume of tissue within a closed osseo-fascial or fascial compartment or by the application of an external force compressing a compartment, and it is associated with a wide variety of insults. The advent of reproducible techniques of measuring ICP has added science to a well-recognized clinical picture and allowed a rational approach to management. Controversies still remain, particularly in regard to the level of pressure at which intervention becomes mandatory, and the role of prophylactic interventions. This review attempts to present current thinking on the pathophysiology of the microcirculation and the background to these controversies.

  11. Compartment syndrome in patients with haemophilia

    PubMed Central

    Donaldson, James; Goddard, Nicholas

    2015-01-01

    Background Acute compartment syndrome (ACS) is an uncommon but potentially devastating condition. Methods and results There are scattered case reports and case series in the literature of ACS in persons with haemophilia (PWH), and even fewer in PWH and inhibitors. The management of compartment syndrome in these scenarios is controversial and often anecdotal. In addition haematological outcomes are frequently quoted but functional outcomes are generally overlooked. This article aims to provide an overview of ACS and its contemporary management. We also review the literature and outcomes of patients with haemophilia who develop ACS in an effort to assess the best treatment modality. Conclusion In the majority of cases ACS settles with normalisation of the clotting cascade. Specialist haematological input is mandatory before surgical intervention should be considered, especially in PWH and inhibitors. PMID:26566325

  12. Chronic pancreatitis.

    PubMed

    Kleeff, Jorg; Whitcomb, David C; Shimosegawa, Tooru; Esposito, Irene; Lerch, Markus M; Gress, Thomas; Mayerle, Julia; Drewes, Asbjørn Mohr; Rebours, Vinciane; Akisik, Fatih; Muñoz, J Enrique Domínguez; Neoptolemos, John P

    2017-09-07

    Chronic pancreatitis is defined as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress. Potential causes can include toxic factors (such as alcohol or smoking), metabolic abnormalities, idiopathic mechanisms, genetics, autoimmune responses and obstructive mechanisms. The pathophysiology of chronic pancreatitis is fairly complex and includes acinar cell injury, acinar stress responses, duct dysfunction, persistent or altered inflammation, and/or neuro-immune crosstalk, but these mechanisms are not completely understood. Chronic pancreatitis is characterized by ongoing inflammation of the pancreas that results in progressive loss of the endocrine and exocrine compartment owing to atrophy and/or replacement with fibrotic tissue. Functional consequences include recurrent or constant abdominal pain, diabetes mellitus (endocrine insufficiency) and maldigestion (exocrine insufficiency). Diagnosing early-stage chronic pancreatitis is challenging as changes are subtle, ill-defined and overlap those of other disorders. Later stages are characterized by variable fibrosis and calcification of the pancreatic parenchyma; dilatation, distortion and stricturing of the pancreatic ducts; pseudocysts; intrapancreatic bile duct stricturing; narrowing of the duodenum; and superior mesenteric, portal and/or splenic vein thrombosis. Treatment options comprise medical, radiological, endoscopic and surgical interventions, but evidence-based approaches are limited. This Primer highlights the major progress that has been made in understanding the pathophysiology, presentation, prevalence and management of chronic pancreatitis and its complications.

  13. [Arthritis of the Medial Knee Joint Compartment].

    PubMed

    Matziolis, G; Röhner, E

    2015-10-01

    23 % of all persons older than 65 years suffer from osteoarthritis of the medial compartment of the knee joint, a very common situation in orthopaedic practice 1. As a result of the demographic trend the number of patients is expected to increase in the future. Based on specific joint biomechanics and kinematics the medial knee joint compartment is more frequently affected than the lateral. Only an understanding of the functional anatomy and underlying pathology allows a critical evaluation of different available conservative and operative treatment options. This article gives an overview of diagnostic and therapeutic strategies of osteoarthritis of the medial knee joint. Frequently performed surgeries, e.g. high tibial osteotomy (HTO), unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) will be presented in a comparative manner. The actual scientific evidence will be given with the goal of an evidence based therapy that is adopted to stage and pathology of osteoarthritis of the medial compartment of the knee joint. Georg Thieme Verlag KG Stuttgart · New York.

  14. Compartment-Specific Phosphorylation of Squid Neurofilaments.

    PubMed

    Grant, Philip; Pant, Harish C

    2016-01-01

    Studies of the giant axon and synapse of third-order neurons in the squid stellate ganglion have provided a vast literature on neuronal physiology and axon transport. Large neuronal size also lends itself to comparative biochemical studies of cell body versus axon. These have focused on the regulation of synthesis, assembly, posttranslational modification and function of neuronal cytoskeletal proteins (microtubules (MTs) and neurofilaments (NFs)), the predominant proteins in axoplasm. These contribute to axonal organization, stability, transport, and impulse transmission responsible for rapid contractions of mantle muscles underlying jet propulsion. Studies of vertebrate NFs have established an extensive literature on NF structure, organization, and function; studies of squid NFs, however, have made it possible to compare compartment-specific regulation of NF synthesis, assembly, and function in soma versus axoplasm. Since NFs contain over 100 eligible sites for phosphorylation by protein kinases, the compartment-specific patterns of phosphorylation have been a primary focus of biochemical studies. We have learned that NF phosphorylation is tightly compartmentalized; extensive phosphorylation occurs only in the axonal compartment in squid and in vertebrate neurons. This extensive phosphorylation plays a key role in organizing NFs, in association with microtubules (MTs), into a stable, dynamic functional lattice that supports axon growth, diameter, impulse transmission, and synaptic activity. To understand how cytoskeletal phosphorylation is topographically regulated, the kinases and phosphatases, bound to NFs isolated from cell bodies and axoplasm, have also been studied. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Perfluoroalkyl acid distribution in various plant compartments ...

    EPA Pesticide Factsheets

    Crop uptake of perfluoroalkyl acids (PFAAs) from biosolids-amended soil has been identified as a potential pathway for PFAA entry into the terrestrial food chain. This study compared the uptake of PFAAs in greenhouse-grown radish (Raphanus sativus), celery (Apium graveolens var.dulce), tomato (Lycopersicon lycopersicum), and sugar snap pea (Pisum sativum var. macrocarpon) from an industrially impacted biosolids-amended soil, a municipal biosolids­ amended soil, and a control soil. Individual concentrations of PFAAs, on a dry weight basis, in mature, edible portions of crops grown in soil amended with PFAA industrially impacted biosolids were highest for perfluorooctanoate (PFOA; 67 ng/g) in radish root, perfluorobutanoate (PFBA;232 ng/g) in celery shoot, and PFBA (150 ng/g) in pea fruit. Comparatively, PFAA concentrations in edible compartments of crops grown in the municipal biosolids-amended soil and in the control soil were less than 25 ng/g. Bioaccumulation factors (BAFs) were calculated for the root, shoot, and fruit compartments (as applicable) of all crops grown in the industrially impacted soil. BAFs were highest for PFBA in the shoots of all crops, as well as in the fruit compartment of pea. Root­ soil concentration factors (RCFs) for tomato and pea were independent of PFAA chain length, while radish and celery RCFs showed a slight decrease with increasing chain length. Shoot-soil concentration factors (SCFs) for all crops showed a decrease with incre

  16. 14 CFR 29.787 - Cargo and baggage compartments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Personnel and Cargo Accommodations § 29.787 Cargo and baggage compartments. (a) Each cargo and baggage compartment must be...

  17. 14 CFR 27.787 - Cargo and baggage compartments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Personnel and Cargo Accommodations § 27.787 Cargo and baggage compartments. (a) Each cargo and baggage compartment must be...

  18. 14 CFR 23.773 - Pilot compartment view.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Pilot compartment view. 23.773 Section 23... Personnel and Cargo Accommodations § 23.773 Pilot compartment view. (a) Each pilot compartment must be— (1) Arranged with sufficiently extensive, clear and undistorted view to enable the pilot to safely taxi...

  19. 14 CFR 25.772 - Pilot compartment doors.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Pilot compartment doors. 25.772 Section 25... § 25.772 Pilot compartment doors. For an airplane that has a lockable door installed between the pilot... pilot compartment if the cockpit door becomes jammed. (c) There must be an emergency means to enable a...

  20. 14 CFR 23.773 - Pilot compartment view.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Pilot compartment view. 23.773 Section 23... Personnel and Cargo Accommodations § 23.773 Pilot compartment view. (a) Each pilot compartment must be— (1) Arranged with sufficiently extensive, clear and undistorted view to enable the pilot to safely taxi...

  1. 14 CFR 27.773 - Pilot compartment view.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Pilot compartment view. 27.773 Section 27... § 27.773 Pilot compartment view. (a) Each pilot compartment must be free from glare and reflections that could interfere with the pilot's view, and designed so that— (1) Each pilot's view is sufficiently...

  2. 14 CFR 25.772 - Pilot compartment doors.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Pilot compartment doors. 25.772 Section 25... § 25.772 Pilot compartment doors. For an airplane that has a lockable door installed between the pilot... pilot compartment if the cockpit door becomes jammed. (c) There must be an emergency means to enable a...

  3. 14 CFR 29.773 - Pilot compartment view.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Pilot compartment view. 29.773 Section 29... Accommodations § 29.773 Pilot compartment view. (a) Nonprecipitation conditions. For nonprecipitation conditions, the following apply: (1) Each pilot compartment must be arranged to give the pilots a sufficiently...

  4. 14 CFR 29.773 - Pilot compartment view.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Pilot compartment view. 29.773 Section 29... Accommodations § 29.773 Pilot compartment view. (a) Nonprecipitation conditions. For nonprecipitation conditions, the following apply: (1) Each pilot compartment must be arranged to give the pilots a sufficiently...

  5. 14 CFR 25.365 - Pressurized compartment loads.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Pressurized compartment loads. 25.365... an engine disintegration; (2) Any opening in any pressurized compartment up to the size Ho in square... small compartment. The size Ho must be computed by the following formula: Ho=PAs where,...

  6. 46 CFR 169.627 - Compartments containing diesel fuel tanks.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Compartments containing diesel fuel tanks. 169.627... SCHOOL VESSELS Machinery and Electrical Ventilation § 169.627 Compartments containing diesel fuel tanks. Unless they are adequately ventilated, enclosed compartments or spaces containing diesel fuel tanks and...

  7. Compartment Syndrome of the Hand: A Little Thought about Diagnosis

    PubMed Central

    Reichman, Eric F.

    2016-01-01

    Compartment syndrome of the forearm is a well described entity but there have been relatively few case reports in the emergency medicine literature of hand compartment syndromes (HCS). Prompt recognition and treatment of this potential limb threat are essential to minimize morbidity and mortality. Presented is a case of a documented hand compartment syndrome following a motor vehicle collision. PMID:27293917

  8. Microspectroscopy of the photosynthetic compartment of algae.

    PubMed

    Evangelista, Valtere; Frassanito, Anna Maria; Passarelli, Vincenzo; Barsanti, Laura; Gualtieri, Paolo

    2006-01-01

    We performed microspectroscopic evaluation of the pigment composition of the photosynthetic compartments of algae belonging to different taxonomic divisions and higher plants. The feasibility of microspectroscopy for discriminating among species and/or phylogenetic groups was tested on laboratory cultures. Gaussian bands decompositions and a fitting algorithm, together with fourth-derivative transformation of absorbance spectra, provided a reliable discrimination among chlorophylls a, b and c, phycobiliproteins and carotenoids. Comparative analysis of absorption spectra highlighted the evolutionary grouping of the algae into three main lineages in accordance with the most recent endosymbiotic theories.

  9. [Intraabdominal hypertension and abdominal compartment syndrome].

    PubMed

    Sonne, Morten; Hillingsø, Jens

    2008-02-11

    Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare conditions with high mortality. IAH is an intraabdominal pressure (IAP) above 12 mmHg and ACS an IAP above 20 mmHg with evidence of organ dysfunction. IAP is measured indirectly via the bladder or stomach. Various medical and surgical conditions increase the intraabdominal volume. When the content exceeds the compliance of the abdominal wall, the IAP rises. Increased IAP affects the functioning of the brain, lungs, circulation, kidneys, and bowel. The treatment of ACS is a reduction of IAP.

  10. Actin: its cumbersome pilgrimage through cellular compartments

    PubMed Central

    Schleicher, Michael

    2008-01-01

    In this article, we follow the history of one of the most abundant, most intensely studied proteins of the eukaryotic cells: actin. We report on hallmarks of its discovery, its structural and functional characterization and localization over time, and point to present days’ knowledge on its position as a member of a large family. We focus on the rather puzzling number of diverse functions as proposed for actin as a dual compartment protein. Finally, we venture on some speculations as to its origin. PMID:18438682

  11. Acute compartment syndrome of forearm and hand

    PubMed Central

    Chandraprakasam, T.; Kumar, R. Ashok

    2011-01-01

    The diagnosis and treatment of the acute compartment syndrome is of paramount importance. Unless the viscious cycle is intervened at an appropriately early time it will result in irreversible damage leading to disability. In this review article we are discussing the basic pathophysiological process through which the various aetiological factors causing increased compartmental pressure lead to the progressive death of muscles and nerves. We also discuss the various clinical features that aid in the diagnosis and the role of intracompartmental pressure measurements. Finally we hope to ascertain the basic principles and the surgical techniques for treating this condition effectively. PMID:22022031

  12. Ultrasonic Apparatus and Method to Assess Compartment Syndrome

    NASA Technical Reports Server (NTRS)

    Yost, William T. (Inventor); Ueno, Toshiaki (Inventor); Hargens, Alan R. (Inventor)

    2009-01-01

    A process and apparatus for measuring pressure buildup in a body compartment that encases muscular tissue. The method includes assessing the body compartment configuration and identifying the effect of pulsatible components on compartment dimensions and muscle tissue characteristics. This process is used in preventing tissue necrosis, and in decisions of whether to perform surgery on the body compartment for prevention of Compartment Syndrome. An apparatus is used for measuring pressure build-up in the body compartment having components for imparting ultrasonic waves such as a transducer, placing the transducer to impart the ultrasonic waves, capturing the imparted ultrasonic waves, mathematically manipulating the captured ultrasonic waves and categorizing pressure build-up in the body compartment from the mathematical manipulations.

  13. Virtual exertions: evoking the sense of exerting forces in virtual reality using gestures and muscle activity.

    PubMed

    Chen, Karen B; Ponto, Kevin; Tredinnick, Ross D; Radwin, Robert G

    2015-06-01

    This study was a proof of concept for virtual exertions, a novel method that involves the use of body tracking and electromyography for grasping and moving projections of objects in virtual reality (VR). The user views objects in his or her hands during rehearsed co-contractions of the same agonist-antagonist muscles normally used for the desired activities to suggest exerting forces. Unlike physical objects, virtual objects are images and lack mass. There is currently no practical physically demanding way to interact with virtual objects to simulate strenuous activities. Eleven participants grasped and lifted similar physical and virtual objects of various weights in an immersive 3-D Cave Automatic Virtual Environment. Muscle activity, localized muscle fatigue, ratings of perceived exertions, and NASA Task Load Index were measured. Additionally, the relationship between levels of immersion (2-D vs. 3-D) was studied. Although the overall magnitude of biceps activity and workload were greater in VR, muscle activity trends and fatigue patterns for varying weights within VR and physical conditions were the same. Perceived exertions for varying weights were not significantly different between VR and physical conditions. Perceived exertion levels and muscle activity patterns corresponded to the assigned virtual loads, which supported the hypothesis that the method evoked the perception of physical exertions and showed that the method was promising. Ultimately this approach may offer opportunities for research and training individuals to perform strenuous activities under potentially safer conditions that mimic situations while seeing their own body and hands relative to the scene. © 2014, Human Factors and Ergonomics Society.

  14. Compartment-specific Control of Reactive Oxygen Species Scavenging by Antioxidant Pathway Enzymes.

    PubMed

    Dey, Swati; Sidor, Agnieszka; O'Rourke, Brian

    2016-05-20

    Oxidative stress arises from an imbalance in the production and scavenging rates of reactive oxygen species (ROS) and is a key factor in the pathophysiology of cardiovascular disease and aging. The presence of parallel pathways and multiple intracellular compartments, each having its own ROS sources and antioxidant enzymes, complicates the determination of the most important regulatory nodes of the redox network. Here we quantified ROS dynamics within specific intracellular compartments in the cytosol and mitochondria and determined which scavenging enzymes exert the most control over antioxidant fluxes in H9c2 cardiac myoblasts. We used novel targeted viral gene transfer vectors expressing redox-sensitive GFP fused to sensor domains to measure H2O2 or oxidized glutathione. Using genetic manipulation in heart-derived H9c2 cells, we explored the contribution of specific antioxidant enzymes to ROS scavenging and glutathione redox potential within each intracellular compartment. Our findings reveal that antioxidant flux is strongly dependent on mitochondrial substrate catabolism, with availability of NADPH as a major rate-controlling step. Moreover, ROS scavenging by mitochondria significantly contributes to cytoplasmic ROS handling. The findings provide fundamental information about the control of ROS scavenging by the redox network and suggest novel interventions for circumventing oxidative stress in cardiac cells.

  15. Supraspinatus and infraspinatus compartment syndrome following scapular fracture

    PubMed Central

    Kenny, Ryan M.; Beiser, Christopher W.; Patel, Arun

    2013-01-01

    Acute compartment syndrome occurs when pressure within a confined fascial space rises to a level impairing microvascular perfusion to surrounding tissues.[1234567] The majority of the reported literature is based on lower extremity compartment syndrome, but any muscle group within an osteofascial compartment has the potential to develop compartment syndrome. We report a case of a 64-year-old male who developed an acute compartment syndrome of both the supraspinatus and infraspinatus after sustaining a severely comminuted scapula fracture. Diagnosis of compartment syndrome was made after intracompartmental pressure measurements of the supraspinatus and infraspinatus revealed pressures within 30 mmHg of the diastolic blood pressure, prompting emergency decompressive fasciotomy. At final follow-up, the examination revealed full shoulder strength with near-full range of motion. There were no signs of sequelae from compartment syndrome at any point. Few case reports describe compartment syndrome of the periscapular fascial compartments. However, these cases were either retrospectively diagnosed[89] or diagnosed via magnetic resonance imaging (MRI) findings and lab values.[910] Surgical management of acute compartment syndrome of the supraspinatus has been reported in only one other case.[10] To our knowledge, we report the only case of a patient with acute compartment syndrome of both the supraspinatus and infraspinatus compartments treated with emergent decompressive fasciotomy. Due to the devastating complications and functional loss of a missed diagnosis of compartment syndrome, a high index of clinical suspicion for developing compartment syndrome must be maintained in every fracture setting, regardless of anatomic location or rarity of reported cases. PMID:23858293

  16. Supraspinatus and infraspinatus compartment syndrome following scapular fracture.

    PubMed

    Kenny, Ryan M; Beiser, Christopher W; Patel, Arun

    2013-01-01

    Acute compartment syndrome occurs when pressure within a confined fascial space rises to a level impairing microvascular perfusion to surrounding tissues.[1234567] The majority of the reported literature is based on lower extremity compartment syndrome, but any muscle group within an osteofascial compartment has the potential to develop compartment syndrome. We report a case of a 64-year-old male who developed an acute compartment syndrome of both the supraspinatus and infraspinatus after sustaining a severely comminuted scapula fracture. Diagnosis of compartment syndrome was made after intracompartmental pressure measurements of the supraspinatus and infraspinatus revealed pressures within 30 mmHg of the diastolic blood pressure, prompting emergency decompressive fasciotomy. At final follow-up, the examination revealed full shoulder strength with near-full range of motion. There were no signs of sequelae from compartment syndrome at any point. Few case reports describe compartment syndrome of the periscapular fascial compartments. However, these cases were either retrospectively diagnosed[89] or diagnosed via magnetic resonance imaging (MRI) findings and lab values.[910] Surgical management of acute compartment syndrome of the supraspinatus has been reported in only one other case.[10] To our knowledge, we report the only case of a patient with acute compartment syndrome of both the supraspinatus and infraspinatus compartments treated with emergent decompressive fasciotomy. Due to the devastating complications and functional loss of a missed diagnosis of compartment syndrome, a high index of clinical suspicion for developing compartment syndrome must be maintained in every fracture setting, regardless of anatomic location or rarity of reported cases.

  17. Exertional rhabdomyolysis after spinning: case series and review of the literature.

    PubMed

    Ramme, Austin J; Vira, Shaleen; Alaia, Michael J; VAN DE Leuv, Jonathan; Rothberg, Robert C

    2016-06-01

    Spinning is a popular indoor stationary cycling program that uses group classes as a motivational tool. Exertional rhabdomyolysis (ER) is frequently reported in athletes and military recruits; however, infrequently it has been reported after spinning class. ER is diagnosed by clinical history, physical exam, and laboratory values. Hydration, electrolyte management, and pain control are key components to treatment of this condition. Severe cases can be complicated by acute renal failure, compartment syndrome, arrhythmia, and disseminated intravascular coagulation. We describe three cases of admission due to rhabdomyolysis after spinning. The diagnosis, admission criteria, and medical treatment of ER are presented in the context of a literature review. A retrospective review of three cases with review of the current literature. The medical and laboratory records of three patient cases were reviewed. A search of the PubMed database was used to perform a comprehensive review of exertional rhabdomyolysis. Our institution's IRB reviewed this study. We report three cases of exertional rhabdomyolysis after spinning and describe the diagnostic workup and medical management of these patients. The diagnosis of ER is made by clinical history, physical exam, and laboratory values. The disease spectrum ranges from mild to severe with the potential of serious complications in some patients. We demonstrate three cases of ER in deconditioned individuals who presented to the emergency department for evaluation. Careful medical management and patient monitoring resulted in improved patient symptomatology and eventual return to physical activity.

  18. Subcellular storage compartments of bacteriopheophorbide sensitizers

    NASA Astrophysics Data System (ADS)

    Moser, Joerg G.; Dembeck, U.; Hubert, M.; Spengler, Bernhard; Bayer, Rainer; Wagner, Birgit

    1994-03-01

    Fluorescence colocalization with the Golgi specific stain, NBD-ceramide, and the mitochondrial localizing stain, Rhodamine 123, confirmed the earlier assumption that the Golgi apparatus is one of the prominent storage compartments for bacteriopheophorbide esters in OAT 75 SCLC cells and several amelanotic melanoma cell lines (A375, Melur SP18, SkAMel 25). Furthermore, a diffuse staining of mitochondria, of non-structured cytoplasm, and an additional storage in melanine vesicles of the amelanotic melanoma cells suggests further storage compartments with quantitatively different contributions to the phototoxicity of bacteriochlorophyll-derived photosensitizers. Independent observations of early phototoxic effects on microfilamentous networks, enzymatic activities (succinate dehydrogenase, lactate dehydrogenase), and redistribution phenomena following primary uptake of the sensitizers let us assume that only a part of the 108 molecules taken up by a cell contribute directly to phototoxicity. Thus it may be asked if a proper subcellular positioning of only a few sensitizer molecules may have similar phototoxic effects as the huge amounts stored at apparently ineffective sites.

  19. Remote detection of pressure compartments. Topical report

    SciTech Connect

    Surdam, R.C.; Boyd, N.; Jiao, Z.; Maucione, D.; Kubicheck, S.

    1996-02-01

    A significant portion of the Cretaceous shale section in the Rocky Mountain Laramide Basins (RMLB) is anomalously pressured and gas saturated. The top of the anomalously pressured zone is identified by marked increases in sonic transit time, hydrocarbon production index (P.I.), clay diagenesis (smectite to illite), and vitrinite reflectance gradients. The driving mechanism of anomalous pressure development and compartmentalization is the generation and storage of liquid hydrocarbons that subsequently partially react to gas, converting the fluid-flow system to a multiphase regime in which capillarity controls permeability; the result is elevated displacement pressure within the shales. Sandstone reservoirs within this anomalously pressured shale section are subdivided stratigraphically and diagenetically into relatively small, isolated pressure or fluid-flow compartments. The saturation of these compartments with hydrocarbons and the subsequent oil-to-gas reaction causes explusion of a significant portion of the free water, resulting in anomalously pressured gas accumulations characterized by depletion drive. The determination of the position and configuration of the pressure boundary between normal and anomalously pressured regimes and the detection and delineation of porosity/permeability `sweet spots` below this boundary are the two most important elements in exploring for basin center gas in the RMLB.

  20. Plasma bupivacaine concentrations following psoas compartment block.

    PubMed

    Odoom, J A; Zuurmond, W W; Sih, I L; Bovill, J; Osterlöf, G; Oosting, H V

    1986-02-01

    Fourteen patients undergoing hip replacement surgery under psoas compartment block combined with general anaesthesia were studied. Group 1 (n = 7) received plain and Group 2 (n = 7) received 0.25% bupivacaine with adrenaline. The mean maximum peak concentrations were 1.93 (SEM 0.46) micrograms/ml and 1.04 (SEM 0.19) micrograms/ml at 10 minutes in groups 1 and 2 respectively. Bupivacaine concentrations were higher at all times in the group which received plain than the group receiving solution containing adrenaline. These differences were statistically significant at 10, 15 (p less than 0.05) and 30 minutes (p less than 0.025). The highest recorded plasma bupivacaine concentration was 4.54 micrograms/ml in one patient receiving plain bupivacaine. No patient developed any signs of toxic symptoms. The duration of analgesia was longer (p less than 0.005) in the group receiving bupivacaine with adrenaline. Bupivacaine 0.25% with adrenaline 1:200 000 is safe for psoas compartment block, and is recommended for hip surgery.

  1. Multi-compartment microscopic diffusion imaging.

    PubMed

    Kaden, Enrico; Kelm, Nathaniel D; Carson, Robert P; Does, Mark D; Alexander, Daniel C

    2016-10-01

    This paper introduces a multi-compartment model for microscopic diffusion anisotropy imaging. The aim is to estimate microscopic features specific to the intra- and extra-neurite compartments in nervous tissue unconfounded by the effects of fibre crossings and orientation dispersion, which are ubiquitous in the brain. The proposed MRI method is based on the Spherical Mean Technique (SMT), which factors out the neurite orientation distribution and thus provides direct estimates of the microscopic tissue structure. This technique can be immediately used in the clinic for the assessment of various neurological conditions, as it requires only a widely available off-the-shelf sequence with two b-shells and high-angular gradient resolution achievable within clinically feasible scan times. To demonstrate the developed method, we use high-quality diffusion data acquired with a bespoke scanner system from the Human Connectome Project. This study establishes the normative values of the new biomarkers for a large cohort of healthy young adults, which may then support clinical diagnostics in patients. Moreover, we show that the microscopic diffusion indices offer direct sensitivity to pathological tissue alterations, exemplified in a preclinical animal model of Tuberous Sclerosis Complex (TSC), a genetic multi-organ disorder which impacts brain microstructure and hence may lead to neurological manifestations such as autism, epilepsy and developmental delay. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  2. Multi-compartment microscopic diffusion imaging

    PubMed Central

    Kaden, Enrico; Kelm, Nathaniel D.; Carson, Robert P.; Does, Mark D.; Alexander, Daniel C.

    2017-01-01

    This paper introduces a multi-compartment model for microscopic diffusion anisotropy imaging. The aim is to estimate microscopic features specific to the intra- and extra-neurite compartments in nervous tissue unconfounded by the effects of fibre crossings and orientation dispersion, which are ubiquitous in the brain. The proposed MRI method is based on the Spherical Mean Technique (SMT), which factors out the neurite orientation distribution and thus provides direct estimates of the microscopic tissue structure. This technique can be immediately used in the clinic for the assessment of various neurological conditions, as it requires only a widely available off-the-shelf sequence with two b-shells and high-angular gradient resolution achievable within clinically feasible scan times. To demonstrate the developed method, we use high-quality diffusion data acquired with a bespoke scanner system from the Human Connectome Project. This study establishes the normative values of the new biomarkers for a large cohort of healthy young adults, which may then support clinical diagnostics in patients. Moreover, we show that the microscopic diffusion indices offer direct sensitivity to pathological tissue alterations, exemplified in a preclinical animal model of Tuberous Sclerosis Complex (TSC), a genetic multi-organ disorder which impacts brain microstructure and hence may lead to neurological manifestations such as autism, epilepsy and developmental delay. PMID:27282476

  3. Raised compartment pressures are frequently observed with tibial shaft fractures despite the absence of compartment syndrome: A prospective cohort study.

    PubMed

    Ho, Kelvin Lor Kah; Sing, Nicholas Yeoh Ching; Wong, Khai Phang; Huat, Andy Wee Teck

    2017-01-01

    To measure the intracompartmental pressures surrounding tibial fractures not exhibiting any clinical evidence of compartment syndrome. Our hypothesis was that pressures often exceed the recommended threshold of fasciotomy despite the absence of compartment syndrome, and hence diagnosis based on pressure measurements alone is unreliable. Thirteen consecutive patients with closed tibial shaft fractures without clinical suspicion of compartment syndrome, and who were planned for intramedullary nailing, were prospectively enrolled. Compartment pressures ( P) in all four compartments of the affected leg were measured at the start of surgery and immediately after tibial reaming, and differential pressures (delta P) were calculated based on the diastolic blood pressure prior to induction of anaesthesia. No patients required reoperation in the post-operative period, as a result of an undiagnosed compartment syndrome. Using commonly quoted threshold pressure criteria, 62% (using P > 30 mmHg) and 23% of patients (using delta P < 30 mmHg) have been incorrectly diagnosed with compartment syndrome. We conclude that raised compartment pressures are frequently seen in patients with tibial shaft fractures; but in most cases, it does not equate to the presence of compartment syndrome. Diagnosis of compartment syndrome based on intracompartmental pressure measurements alone may result in unnecessary fasciotomies in a sizeable number of patients. Compartment syndrome remains a clinical diagnosis, and one which always needs to be considered when managing tibial fractures.

  4. Cold thermoregulatory responses following exertional fatigue.

    PubMed

    Castellani, John W; Sawka, Michael N; DeGroot, David W; Young, Andrew J

    2010-06-01

    Participants in prolonged, physically demanding cold-weather activities are at risk for a condition called "thermoregulatory fatigue". During cold exposure, the increased gradient favoring body heat loss to the environment is opposed by physiological responses and clothing and behavioral strategies that conserve body heat stores to defend body temperature. The primary human physiological responses elicited by cold exposure are shivering and peripheral vasoconstriction. Shivering increases thermogenesis and replaces body heat losses, while peripheral vasoconstriction improves thermal insulation of the body and retards the rate of heat loss. A body of scientific literature supports the concept that prolonged and/or repeated cold exposure, fatigue induced by sustained physical exertion, or both together, can impair the shivering and vasoconstrictor responses to cold ("thermoregulatory fatigue"). The mechanisms accounting for this thermoregulatory impairment are not clear, but there is evidence to suggest that changes in central thermoregulatory control or peripheral sympathetic responsiveness to cold lead to thermoregulatory fatigue and increased susceptibility to hypothermia.

  5. Traction forces exerted by epithelial cell sheets

    NASA Astrophysics Data System (ADS)

    Saez, A.; Anon, E.; Ghibaudo, M.; du Roure, O.; Di Meglio, J.-M.; Hersen, P.; Silberzan, P.; Buguin, A.; Ladoux, B.

    2010-05-01

    Whereas the adhesion and migration of individual cells have been well described in terms of physical forces, the mechanics of multicellular assemblies is still poorly understood. Here, we study the behavior of epithelial cells cultured on microfabricated substrates designed to measure cell-to-substrate interactions. These substrates are covered by a dense array of flexible micropillars whose deflection enables us to measure traction forces. They are obtained by lithography and soft replica molding. The pillar deflection is measured by video microscopy and images are analyzed with home-made multiple particle tracking software. First, we have characterized the temporal and spatial distributions of traction forces of cellular assemblies of various sizes. The mechanical force balance within epithelial cell sheets shows that the forces exerted by neighboring cells strongly depend on their relative position in the monolayer: the largest deformations are always localized at the edge of the islands of cells in the active areas of cell protrusions. The average traction stress rapidly decreases from its maximum value at the edge but remains much larger than the inherent noise due to the force resolution of our pillar tracking software, indicating an important mechanical activity inside epithelial cell islands. Moreover, these traction forces vary linearly with the rigidity of the substrate over about two decades, suggesting that cells exert a given amount of deformation rather than a force. Finally, we engineer micropatterned substrates supporting pillars with anisotropic stiffness. On such substrates cellular growth is aligned with respect to the stiffest direction in correlation with the magnitude of the applied traction forces.

  6. Traction forces exerted by epithelial cell sheets.

    PubMed

    Saez, A; Anon, E; Ghibaudo, M; du Roure, O; Di Meglio, J-M; Hersen, P; Silberzan, P; Buguin, A; Ladoux, B

    2010-05-19

    Whereas the adhesion and migration of individual cells have been well described in terms of physical forces, the mechanics of multicellular assemblies is still poorly understood. Here, we study the behavior of epithelial cells cultured on microfabricated substrates designed to measure cell-to-substrate interactions. These substrates are covered by a dense array of flexible micropillars whose deflection enables us to measure traction forces. They are obtained by lithography and soft replica molding. The pillar deflection is measured by video microscopy and images are analyzed with home-made multiple particle tracking software. First, we have characterized the temporal and spatial distributions of traction forces of cellular assemblies of various sizes. The mechanical force balance within epithelial cell sheets shows that the forces exerted by neighboring cells strongly depend on their relative position in the monolayer: the largest deformations are always localized at the edge of the islands of cells in the active areas of cell protrusions. The average traction stress rapidly decreases from its maximum value at the edge but remains much larger than the inherent noise due to the force resolution of our pillar tracking software, indicating an important mechanical activity inside epithelial cell islands. Moreover, these traction forces vary linearly with the rigidity of the substrate over about two decades, suggesting that cells exert a given amount of deformation rather than a force. Finally, we engineer micropatterned substrates supporting pillars with anisotropic stiffness. On such substrates cellular growth is aligned with respect to the stiffest direction in correlation with the magnitude of the applied traction forces.

  7. Posterior arm compartment syndrome after a combined supracondylar humeral and capitellar fractures in an adolescent: a case report.

    PubMed

    Mai, Matthew C; Beck, Ryan; Gabriel, Keith; Singh, Krishna Anjali

    2011-01-01

    Supracondylar humeral fractures in children are common, with associated bony injuries typically being fractures of the forearm or distal radius. To our knowledge, a combined supracondylar humeral fracture associated with a Hahn-Steinthal capitellar fracture has not been reported earlier. Similarly, posterior arm compartment syndrome is extremely rare, with most instances having occurred after chronic compression and bleeding into the compartments from anticoagulation, direct trauma including crush, or tendon ruptures. Only 2 cases have been reported after a fracture of the humerus. One of these described fractures was localized to a distal shaft and the other involved the surgical neck. No cases have been reported in children, nor have any been reported after a supracondylar humeral fracture. In this case report, we describe a patient who presented with an ipsilateral Wilkins type-3A supracondylar humeral fracture, Hahn-Steinthal capitellar fracture, Salter-Harris II distal radius fracture, and posterior arm compartment syndrome. The patient was taken to the operative room for closed reduction and percutaneous pinning of the radius fracture with open reduction, internal fixation of the distal humeral fractures. Elevated compartment pressure measurements were anticipated because of the nature of the injuries. After fixation of the fractures, the mobile wad, volar, and dorsal compartments measured 9, 9, and 8 mm Hg, respectively. The absolute pressure in the posterior arm compartment was measured multiple times in different locations ranging from 34 to 39 mm Hg. The patient's blood pressure throughout the case averaged 115/65 mm Hg. A diagnosis of posterior arm compartment syndrome was confirmed and the fascia was released. Our patient ultimately suffered 2 uncommon injuries involving the arm. She sustained a complex fracture of the distal humerus with an extension type supracondylar fracture, a separate Hahn-Steinthal capitellar fracture, and isolated posterior arm

  8. 20 CFR 220.132 - Physical exertion requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Physical exertion requirements. 220.132... ACT DETERMINING DISABILITY Vocational Considerations § 220.132 Physical exertion requirements. To determine the physical exertion requirements of work in the national economy, jobs are classified as...

  9. Differentiated Ratings of Perceived Exertion during Physical Exercise

    DTIC Science & Technology

    1982-01-01

    MEDICINE AND SCIENCE IN SPORTS AND EXERCISE VOl 14, No 5. Pp 397-405. 1982 -1982 Differentiated ratings of perceived exertion during physical ...that PANDOLF, KENT B. Differentiated ratings of perceived exertion utilizes differentiated ratings of perceived exertion (RPE) during physical exercise ...in the eval- Specific instructions and procedures for the utilization uation of effort sensations during physical exercise . Ekblom and Goldbarg (17

  10. Perceived Exertion of the PACER in High School Students

    ERIC Educational Resources Information Center

    Smith, John D.; Holmes, Patricia A.

    2013-01-01

    The purpose of this study was to explore high school students' perceived exertion after participating in the Progressive Aerobic Cardiovascular Endurance Run (PACER). Immediately after completing the PACER, students (N = 792) indicated their perceived exertion on the OMNI rating of perceived exertion (RPE) for children (1-10 scale). All students,…

  11. The Orbital Workshop Waste Management Compartment

    NASA Technical Reports Server (NTRS)

    1972-01-01

    This image is a wide-angle view of the Orbital Workshop waste management compartment. The waste management facilities presented a unique challenge to spacecraft designers. In addition to collection of liquid and solid human wastes, there was a medical requirement to dry all solid human waste products and to return the residue to Earth for examination. Liquid human waste (urine) was frozen for return to Earth. Total quantities of each astronaut's liquid and solid wastes were precisely measured. Cabin air was drawn into the toilet, shown on the wall at right in this photograph, and over the waste products to generate a flow of the waste in the desired direction. The air was then filtered for odor control and antiseptic purposes prior to being discharged back into the cabin.

  12. The Orbital Workshop Waste Management Compartment

    NASA Technical Reports Server (NTRS)

    1972-01-01

    This image is a wide-angle view of the Orbital Workshop waste management compartment. The waste management facilities presented a unique challenge to spacecraft designers. In addition to collection of liquid and solid human wastes, there was a medical requirement to dry all solid human waste products and to return the residue to Earth for examination. Liquid human waste (urine) was frozen for return to Earth. Total quantities of each astronaut's liquid and solid wastes were precisely measured. Cabin air was drawn into the toilet, shown on the wall at right in this photograph, and over the waste products to generate a flow of the waste in the desired direction. The air was then filtered for odor control and antiseptic purposes prior to being discharged back into the cabin.

  13. Compartment syndrome and regional anaesthesia: Critical review.

    PubMed

    Klucka, Jozef; Stourac, Petr; Stouracova, Alena; Masek, Michal; Repko, Martin

    2017-05-24

    Acute compartment syndrome (ACS) is a potential orthopaedic/traumatology emergency. Without prompt, precise diagnosis and immediate treatment with surgical decompressive fasciotomy it can lead to neurological dysfunction and disability. The role of regional anaesthesia (RA) in patients at risk for ACS/ and in those with developed ACS is controversial. The aim of this critical review was to answer the question, whether regional anaesthesia can delay the diagnosis. The authors use an evidence-based approach to discuss these high risk patients in considering RA as a method of choice for effective analgesia. To the date of data collection, there was no single case report identified where RA alone led to delay in ACS diagnosis and surgical treatment. In four clinical cases, epidural analgesia can be associated with delayed ACS diagnosis. Frequent clinical evaluation and breakthrough pain despite a functional RA in combination with intracompartment pressure measurement remains the keystone of recommended management for patients at risk of ACS.

  14. Production of compartmented cultures of rat sympathetic neurons.

    PubMed

    Campenot, Robert B; Lund, Karen; Mok, Sue-Ann

    2009-01-01

    The compartmented culture, in which primary neurons plated in a proximal compartment send their axons under silicone grease barriers and into left and right distal compartments, has enhanced the experimental capabilities of neuronal cultures. Treatments can be applied separately to cell bodies/proximal axons or distal axons, and cell bodies/proximal axons and distal axons can be separately harvested and analyzed. Distal axons can be axotomized, and the neurons can be studied while their axons regenerate. Construction of the culture dishes requires 3 h for 48 cultures, and preparing the neurons also requires 3 h. Compartmented cultures provide enough cellular material for biochemical analyses such as immunoblotting. The uses of compartmented cultures have included studies of neurotrophic factor retrograde signaling, axonal transport, and axonal protein and lipid biosynthesis. Here we focus on sympathetic neurons cultured from neonatal rats and provide protocols for the production and some of the uses of compartmented cultures.

  15. An Update on the Anatomy of the Forehead Compartments.

    PubMed

    Cotofana, Sebastian; Mian, Asima; Sykes, Jonathan M; Redka-Swoboda, Wolfgang; Ladinger, Andrea; Pavicic, Tatjana; Schenck, Thilo L; Benslimane, Fahd; Ingallina, Fabio; Schlattau, Alexander

    2017-04-01

    The forehead is one of the most frequent locations for neuromodulator and soft tissue filler applications; however, the underlying anatomy is still poorly understood. Thus far, the presence of deep forehead compartments has not been confirmed. Twenty Caucasian cephalic specimens, 15 fresh frozen (six female and nine male) and five with formalin-phenol embalmment (three female and two male) were investigated using contrast-enhanced computed tomographic scans, dye injections, and anatomical dissections. Three superficial (one central and two lateral) and three deep (one central and two lateral) forehead compartments were identified. The superficial fat compartments were found within the subcutaneous fat tissue (layer 2) and measured 2.1 × 4.6 mm for the superficial central forehead compartments and the right superficial lateral forehead compartments and 2.6 × 3.2 cm for the left superficial lateral forehead compartments, with a mean volume of 2.5, 3.1, and 3.4 cc, respectively. The deep fat compartments were identified deep to the frontalis muscle but superficial to the periosteum with an extent of 6.4 × 5.9 cm for the deep central forehead compartments, 2.6 × 5.8 cm for the right deep lateral forehead compartments, and 2.7 × 5.8 cm for the left deep lateral forehead compartments, and a mean volume of 9.1, 1.6, and 1.4 cc, respectively. The results presented in this study increase the understanding of the forehead anatomy. Understanding the presence of the superficial and the deep forehead compartments allows one to change the signs of frontal aging. The deep forehead compartments are in general avascular planes and permit blunt dissection for access to the supraorbital region.

  16. Vehicle hydraulic system that provides heat for passenger compartment

    DOEpatents

    Bartley, Bradley E.; Blass, James R.; Gibson, Dennis H.

    2001-01-01

    A vehicle includes a vehicle housing which defines a passenger compartment. Attached to the vehicle housing is a hydraulic system, that includes a hydraulic fluid which flows through at least one passageway within the hydraulic system. Also attached to the vehicle housing is a passenger compartment heating system. The passenger compartment heating system includes a heat exchanger, wherein a portion of the heat exchanger is a segment of the at least one passageway of the hydraulic system.

  17. Compartment syndrome after hypocalcemic tetany: a case report.

    PubMed

    Luzzi, Richard; Burghardt, Rolf D; Herzenberg, John E; Zuckerberg, Aaron L

    2008-09-01

    Compartment syndrome results from pathologically elevated muscle tissue pressure within a closed space. It is almost always related to either trauma or reperfusion after loss of arterial inflow from occlusion of a major blood vessel. We present an unusual case of nontraumatic and nonvascular compartment syndrome after hypocalcemia-induced sustained tetany in a 2-year-10-month-old male child after a neuroblastoma tumor resection. This particular cause of compartment syndrome has been described only once before in an adult patient.

  18. The definition of exertion-related cardiac events.

    PubMed

    Rai, M; Thompson, P D

    2011-02-01

    Vigorous physical activity increases the risk of sudden cardiac death (SCD) and acute myocardial infarction (AMI) but there is no standard definition as to what constitutes an exertion-related cardiac event, specifically the time interval between physical exertion and cardiac event. A systematic review of studies related to exertion-related cardiac events was performed and the time interval between exertion and the event or the symptoms leading to the event was looked for in all the articles selected for inclusion. A total of 12 of 26 articles "suggested" or "defined" exertion-related events as those events whose symptoms started during or within 1 h of exertion. Others used definitions of 0.5 h, 2 h, "during exertion", "during or immediately post exertion" and "during or within several hours after exertion". It is suggested, therefore, that the definition of an exertion-related cardiac event be established as a cardiac event in which symptoms started during or within 1 h of physical exertion.

  19. The myofascial compartments of the foot: a cadaver study.

    PubMed

    Ling, Z X; Kumar, V P

    2008-08-01

    Compartment syndrome of the foot requires urgent surgical treatment. Currently, there is still no agreement on the number and location of the myofascial compartments of the foot. The aim of this cadaver study was to provide an anatomical basis for surgical decompression in the event of compartment syndrome. We found that there were three tough vertical fascial septae that extended from the hindfoot to the midfoot on the plantar aspect of the foot. These septae separated the posterior half of the foot into three compartments. The medial compartment containing the abductor hallucis was surrounded medially by skin and subcutaneous fat and laterally by the medial septum. The intermediate compartment, containing the flexor digitorum brevis and the quadratus plantae more deeply, was surrounded by the medial septum medially, the intermediate septum laterally and the main plantar aponeurosis on its plantar aspect. The lateral compartment containing the abductor digiti minimi was surrounded medially by the intermediate septum, laterally by the lateral septum and on its plantar aspect by the lateral band of the main plantar aponeurosis. No distinct myofascial compartments exist in the forefoot. Based on our findings, in theory, fasciotomy of the hindfoot compartments through a modified medial incision would be sufficient to decompress the foot.

  20. Acute exercise-induced bilateral thigh compartment syndrome.

    PubMed

    Boland, Michael R; Heck, Chris

    2009-03-01

    Acute compartment syndrome of the thigh is rare due to the space's ability to accommodate large volumes of fluid and, with the exception of the lateral septum, its thin compliant linings. This article describes a case of bilateral exercise-induced severe compartment syndrome treated with anterior and posterior fasciotomies. A 29-year-old man was admitted to intensive care with myoglobinuria. His left thigh was evaluated 18 hours later for compartment syndrome. The patient reported that 14 hours prior to initial presentation, he had participated in a 1-hour session of vigorous basketball. He gradually developed bilateral moderately severe thigh pain and tea-colored urine. Physical examination revealed pain secondary to passive stretch of both knees at 20 degrees flexion, plus firm anterior and posterior compartments to palpation. A handheld pressure monitor revealed the following compartment pressures: left anterior 80 mm Hg; left posterior 75 mm Hg; right anterior 45 mm Hg; and right posterior 50 mm Hg. Bilateral emergent anterior and posterior compartment fasciotomies were performed. The patient developed a significant severe distal motor and sensory neurological deficit on the left side, which recovered to 3/5 motor strength and protective sensation. At 6-month follow-up, he ambulated with the assistance of a left ankle foot orthosis. Acute severe compartment syndrome can occur following vigorous exercise. We recommend fasciotomies after exercise-induced acute compartment syndrome rather than initial observation because of the severity of morbidity associated with undertreated compartment syndrome.

  1. Coping with the diagnostic complexities of the compartment syndrome

    NASA Technical Reports Server (NTRS)

    Mubarak, S. J.; Hargens, A. R.; Karkal, S. S.

    1988-01-01

    This review recognizes that, given the various complexities associated with the condition, no pat answers can be given to fit every patient with the compartment syndrome. The authors first give a definition of the syndrome, together with a brief account of how this self-perpetuating pathologic cycle is triggered. Next, they delineate specific anatomical features of compartments that are likely to be involved, and follow this with an inventory of symptoms and signs to look for in suspected cases. After sorting out the entities that can mimic the compartment syndrome, the authors describe three essential techniques of measuring tissue pressure, which can prove invaluable in diagnosing the compartment syndrome.

  2. Central compartment neck dissection for thyroid cancer. Technical considerations.

    PubMed

    Pai, Sara I; Tufano, Ralph P

    2008-01-01

    The central compartment of the neck is a common site of local metastasis for thyroid carcinoma. Therefore, knowledge of the surgical techniques employed during a central compartment neck dissection is important to master for any surgeon who manages thyroid cancer patients. We review the anatomical boundaries of the central compartment of the neck as well as discuss the lymphatic drainage patterns of the thyroid gland. We advocate standardization of the surgical approach to the central compartment in order to minimize morbidity and ensure comprehensive removal of all lymph nodes when indicated, which can reduce the need for reoperative dissections. Copyright 2008 S. Karger AG, Basel.

  3. Lateral canthotomy and cantholysis: emergency management of orbital compartment syndrome.

    PubMed

    Rowh, Adam D; Ufberg, Jacob W; Chan, Theodore C; Vilke, Gary M; Harrigan, Richard A

    2015-03-01

    Orbital compartment syndrome is a sight-threatening emergency. Vision may be preserved when timely intervention is performed. To present a case of orbital compartment syndrome caused by traumatic retrobulbar hemorrhage and the procedure of lateral canthotomy and cantholysis, reviewed with photographic illustration. Lateral canthotomy and cantholysis are readily performed at the bedside with simple instruments. The procedure may prevent irreversible blindness in cases of acute orbital compartment syndrome. Emergency physicians should be familiar with lateral canthotomy and cantholysis in the management of orbital compartment syndrome to minimize the chance of irreversible visual loss. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Compartment Syndrome After Varicose Vein Surgery Evidenced by CT Images.

    PubMed

    Wang, Sheng-Min; Kim, Maru

    2016-03-01

    A 21-year-old man developed compartment syndrome after a varicose vein surgery. Because of a lack of appropriate diagnostic apparatus, it was not possible to measure calf pressure. The only diagnostic tool available was computed tomography (CT). With the aid of CT, faster diagnosis of the compartment syndrome was possible, leading to appropriate management. By providing unique CT images of a patient before and after having compartment syndrome and after a fasciotomy, this study could add valuable references for diagnosis of compartment syndrome using CT. © The Author(s) 2014.

  5. Femoral vessel entrapment and compartment syndromes following snakebite.

    PubMed

    Blaylock, Roger S

    2003-08-01

    A 15-year-old patient who had been bitten on the ankle by a snake presented with swelling extending to the chest wall, with significant haemostatic abnormalities. Compartment and femoral vessel entrapment syndromes are presented. Compartment syndrome is easily mimicked by snakebite without a compartment syndrome. Current measurement of intracompartmental pressure, diastolic or mean arterial blood pressure and resulting equations used to determine the need for fasciotomy do not take into account regional venous or arterial pressures. Combined vessel entrapment and compartment syndromes due to snakebite warrant urgent surgery once hypovolaemia and coagulopathy have been controlled.

  6. Soft tissue vibrations within one soft tissue compartment.

    PubMed

    Boyer, Katherine A; Nigg, Benno M

    2006-01-01

    The concept of muscle tuning suggests that vibrations of the soft tissue compartments of the leg initiated by impacts are minimized by muscular activity prior to heel-strike of heel-toe running. For the quantification of muscle tuning it has been assumed (1) that the soft tissue compartment acts as one lumped mass and (2) that vibration energy dissipation does occur within one muscle. The purpose of this study was to test these two assumptions. It was hypothesized that (H1) the movement of the soft tissue compartment is not homogeneous, (H2) the vibration frequencies for different muscles within one soft tissue compartment are different and (3) attenuation of vibration movement within one muscle does occur. Soft tissue vibrations were measured using accelerometers on four locations on the quadriceps soft tissue compartment during heel-toe running. There were differences in the peak soft tissue acceleration and time of peak acceleration between accelerometer locations. The dominant frequency was similar throughout the soft tissue compartment, however; there was an attenuation of high-frequency vibration energy between distal and proximal points overlying one muscle. This evidence suggests that accelerometer placement is important when quantifying the acceleration magnitude and timing of peak soft tissue compartment but not when estimating the resonant vibration characteristics of a soft tissue compartment. It also provides initial evidence to support the idea that vibration control through muscle tuning may be achieved through changes in energy dissipating properties within the soft tissue compartment.

  7. Negative radiation pressure exerted on kinks

    NASA Astrophysics Data System (ADS)

    Forgács, Péter; Lukács, Árpád; Romańczukiewicz, Tomasz

    2008-06-01

    The interaction of a kink and a monochromatic plane wave in one dimensional scalar field theories is studied. It is shown that in a large class of models the radiation pressure exerted on the kink is negative, i.e. the kink is pulled towards the source of the radiation. This effect has been observed by numerical simulations in the ϕ4 model, and it is explained by a perturbative calculation assuming that the amplitude of the incoming wave is small. Quite importantly the effect is shown to be robust against small perturbations of the ϕ4 model. In the sine-Gordon (SG) model the time-averaged radiation pressure acting on the kink turns out to be zero. The results of the perturbative computations in the SG model are shown to be in full agreement with an analytical solution corresponding to the superposition of a SG kink with a cnoidal wave. It is also demonstrated that the acceleration of the kink satisfies Newton’s law.

  8. Exercise Device Would Exert Selectable Constant Resistance

    NASA Technical Reports Server (NTRS)

    Smith, Damon C.

    2003-01-01

    An apparatus called the resistive exercise device (RED) has been proposed to satisfy a requirement for exercise equipment aboard the International Space Station (ISS) that could passively exert a selectable constant load on both the outward and return strokes. The RED could be used alone; alternatively, the RED could be used in combination with another apparatus called the treadmill with vibration isolation and stabilization (TVIS), in which case the combination would be called the subject load device (SLD). The basic RED would be a passive device, but it could incorporate an electric motor to provide eccentric augmentation (augmentation to make the load during inward movement greater than the load during outward movement). The RED concept represents a unique approach to providing a constant but selectable resistive load for exercise for the maintenance and development of muscles. Going beyond the original ISS application, the RED could be used on Earth as resistive weight training equipment. The advantage of the RED over conventional weight-lifting equipment is that it could be made portable and lightweight.

  9. Negative radiation pressure exerted on kinks

    SciTech Connect

    Forgacs, Peter; Lukacs, Arpad; Romanczukiewicz, Tomasz

    2008-06-15

    The interaction of a kink and a monochromatic plane wave in one dimensional scalar field theories is studied. It is shown that in a large class of models the radiation pressure exerted on the kink is negative, i.e. the kink is pulled towards the source of the radiation. This effect has been observed by numerical simulations in the {phi}{sup 4} model, and it is explained by a perturbative calculation assuming that the amplitude of the incoming wave is small. Quite importantly the effect is shown to be robust against small perturbations of the {phi}{sup 4} model. In the sine-Gordon (SG) model the time-averaged radiation pressure acting on the kink turns out to be zero. The results of the perturbative computations in the SG model are shown to be in full agreement with an analytical solution corresponding to the superposition of a SG kink with a cnoidal wave. It is also demonstrated that the acceleration of the kink satisfies Newton's law.

  10. Fisetin exerts antihyperalgesic effect in a mouse model of neuropathic pain: engagement of spinal serotonergic system.

    PubMed

    Zhao, Xin; Wang, Chuang; Cui, Wu-Geng; Ma, Qing; Zhou, Wen-Hua

    2015-03-12

    Fisetin, a natural flavonoid, has been shown in our previous studies to exert antidepressant-like effect. As antidepressant drugs are clinically used to treat chronic neuropathic pain, this work aimed to investigate the potential antinociceptive efficacies of fisetin against neuropathic pain and explore mechanism(s). We subjected mice to chronic constriction injury (CCI) by loosely ligating the sciatic nerves, and Hargreaves test or von Frey test was used to assess thermal hyperalgesia or mechanical allodynia, respectively. Chronic fisetin treatment (5, 15 or 45 mg/kg, p.o.) ameliorated thermal hyperalgesia (but not mechanical allodynia) in CCI mice, concomitant with escalated levels of spinal monoamines and suppressed monoamine oxidase (MAO)-A activity. The antihyperalgesic action of fisetin was abolished by chemical depletion of spinal serotonin (5-HT) but potentiated by co-treatment with 5-HTP, a precursor of 5-HT. Moreover, intraperitoneal (i.p.) or intrathecal (i.t.) co-treatment with 5-HT7 receptor antagonist SB-258719 completely abrogated fisetin's antihyperalgesia. These findings confirm that chronic fisetin treatment exerts antinociceptive effect on thermal hyperalgesia in neuropathic mice, with spinal serotonergic system (coupled with 5-HT7) being critically involved. Of special benefit, fisetin attenuated co-morbidly behavioral symptoms of depression and anxiety (evaluated in forced swim test, novelty suppressed feeding test and light-dark test) evoked by neuropathic pain.

  11. Fisetin exerts antihyperalgesic effect in a mouse model of neuropathic pain: engagement of spinal serotonergic system

    PubMed Central

    Zhao, Xin; Wang, Chuang; Cui, Wu-Geng; Ma, Qing; Zhou, Wen-Hua

    2015-01-01

    Fisetin, a natural flavonoid, has been shown in our previous studies to exert antidepressant-like effect. As antidepressant drugs are clinically used to treat chronic neuropathic pain, this work aimed to investigate the potential antinociceptive efficacies of fisetin against neuropathic pain and explore mechanism(s). We subjected mice to chronic constriction injury (CCI) by loosely ligating the sciatic nerves, and Hargreaves test or von Frey test was used to assess thermal hyperalgesia or mechanical allodynia, respectively. Chronic fisetin treatment (5, 15 or 45 mg/kg, p.o.) ameliorated thermal hyperalgesia (but not mechanical allodynia) in CCI mice, concomitant with escalated levels of spinal monoamines and suppressed monoamine oxidase (MAO)-A activity. The antihyperalgesic action of fisetin was abolished by chemical depletion of spinal serotonin (5-HT) but potentiated by co-treatment with 5-HTP, a precursor of 5-HT. Moreover, intraperitoneal (i.p.) or intrathecal (i.t.) co-treatment with 5-HT7 receptor antagonist SB-258719 completely abrogated fisetin's antihyperalgesia. These findings confirm that chronic fisetin treatment exerts antinociceptive effect on thermal hyperalgesia in neuropathic mice, with spinal serotonergic system (coupled with 5-HT7) being critically involved. Of special benefit, fisetin attenuated co-morbidly behavioral symptoms of depression and anxiety (evaluated in forced swim test, novelty suppressed feeding test and light-dark test) evoked by neuropathic pain. PMID:25761874

  12. 14 CFR 29.855 - Cargo and baggage compartments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Cargo and baggage compartments. 29.855 Section 29.855 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION...) They cannot be damaged by the movement of cargo in the compartment; and (2) Their breakage or failure...

  13. 14 CFR 27.855 - Cargo and baggage compartments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Cargo and baggage compartments. 27.855 Section 27.855 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... by the movement of cargo in the compartment; and (2) Their breakage or failure will not create a fire...

  14. 14 CFR 25.855 - Cargo or baggage compartments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Cargo or baggage compartments. 25.855 Section 25.855 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... movement of cargo in the compartment, and (2) Their breakage or failure will not create a fire hazard. (f...

  15. 14 CFR 27.855 - Cargo and baggage compartments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Cargo and baggage compartments. 27.855 Section 27.855 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... by the movement of cargo in the compartment; and (2) Their breakage or failure will not create a fire...

  16. Acute compartment syndrome of the thigh after weight training.

    PubMed Central

    Bidwell, J P; Gibbons, C E; Godsiff, S

    1996-01-01

    Compartment syndrome of the thigh is a rare but serious condition that is normally associated with closed trauma or compressive injury. A case of acute compartment syndrome of the thigh occurred in a 16 year old boy after intensive weight training. There was no evidence of muscle tear or focal haemorrhage during subsequent fasciotomy. PMID:8889126

  17. 14 CFR 25.857 - Cargo compartment classification.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... access provisions are being used, no hazardous quantity of smoke, flames, or extinguishing agent, will enter any compartment occupied by the crew or passengers; (3) There is a separate approved smoke... compartment but in which— (1) There is a separate approved smoke detector or fire detector system to give...

  18. 14 CFR 23.1192 - Engine accessory compartment diaphragm.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Engine accessory compartment diaphragm. 23... Powerplant Powerplant Fire Protection § 23.1192 Engine accessory compartment diaphragm. For aircooled radial engines, the engine power section and all portions of the exhaust sytem must be isolated from the engine...

  19. 14 CFR 23.1192 - Engine accessory compartment diaphragm.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Engine accessory compartment diaphragm. 23... Powerplant Powerplant Fire Protection § 23.1192 Engine accessory compartment diaphragm. For aircooled radial engines, the engine power section and all portions of the exhaust sytem must be isolated from the engine...

  20. 14 CFR 23.1192 - Engine accessory compartment diaphragm.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Engine accessory compartment diaphragm. 23... Powerplant Powerplant Fire Protection § 23.1192 Engine accessory compartment diaphragm. For aircooled radial engines, the engine power section and all portions of the exhaust sytem must be isolated from the engine...

  1. 14 CFR 25.855 - Cargo or baggage compartments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Fire Protection § 25... attached to) the airplane structure. (c) Ceiling and sidewall liner panels of Class C compartments must.... (d) All other materials used in the construction of the cargo or baggage compartment must meet...

  2. 14 CFR 25.855 - Cargo or baggage compartments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Fire Protection § 25... attached to) the airplane structure. (c) Ceiling and sidewall liner panels of Class C compartments must.... (d) All other materials used in the construction of the cargo or baggage compartment must meet...

  3. 14 CFR 23.1192 - Engine accessory compartment diaphragm.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Engine accessory compartment diaphragm. 23... Powerplant Powerplant Fire Protection § 23.1192 Engine accessory compartment diaphragm. For aircooled radial engines, the engine power section and all portions of the exhaust sytem must be isolated from the...

  4. Fungal community assemblage of different soil compartments in mangrove ecosystem.

    PubMed

    Sanka Loganathachetti, Dinesh; Poosakkannu, Anbu; Muthuraman, Sundararaman

    2017-08-17

    The fungal communities of different soil compartments in mangrove ecosystem are poorly studied. We sequenced the internal transcribed spacer (ITS) regions to characterize the fungal communities in Avicennia marina root-associated soils (rhizosphere and pneumatophore) and bulk soil compartments. The rhizosphere but not pneumatophore soil compartment had significantly lower fungal species richness than bulk soil. However, bulk soil fungal diversity (Shannon diversity index) was significantly higher than both pneumatophore and rhizosphere soil compartments. The different soil compartments significantly affected the fungal community composition. Pairwise sample analyses showed that bulk soil microbial community composition significantly different from rhizosphere and pneumatophore soil compartments. There was, however no significant difference observed between rhizosphere and pneumatophore soil fungal community composition and they shared relatively more OTUs between them. Further, there was a significant correlation observed between fungal community compositional changes and carbon or nitrogen availability of different soil compartments. These results suggest that few characteristics such as fungal richness and taxa abundance of rhizosphere and pneumatophore soil compartments were significantly different in mangrove ecosystem.

  5. 9 CFR 354.241 - Cleaning of rooms and compartments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... INSPECTION AND CERTIFICATION VOLUNTARY INSPECTION OF RABBITS AND EDIBLE PRODUCTS THEREOF Maintenance of... compartments. Rooms, compartments, or other parts of the official plant shall be kept clean and in sanitary... light fixtures in the official plant shall be kept clean. (c) All docks and rooms shall be kept clean...

  6. Spontaneous Compartment Syndrome of the Hand in Systemic Sclerosis.

    PubMed

    Tanagho, Andy; Hatab, Sameh; Youssef, Sally; Ansara, Sameh

    2015-09-01

    Compartment syndrome refers to a condition of compromised circulation within a limited space due to increased pressure within that space. The reduced tissue perfusion results in reduced venous drainage, leading to increased interstitial tissue pressure and subsequent compromised arterial flow. Although not as common as compartment syndrome of the leg and forearm, compartment syndrome of the hand is not rare and can lead to devastating sequelae as a result of tissue necrosis. Compartment syndrome of the hand has several etiologies, including trauma, arterial injury, thermal injury, and constrictive bandaging. The cardinal clinical sign is pain that is aggravated by passive stretching of the muscles within the involved compartments. Extremity function is usually restored with expeditious fasciotomy of the involved myofascial compartments, and complications, such as intrinsic muscular dysfunction and Volkmann's ischemic contracture, can usually be prevented. There are no reported cases of compartment syndrome of the hand in patients with systemic sclerosis or Raynaud's phenomenon. Systemic sclerosis is a form of scleroderma that affects the skin and internal organs. The limited cutaneous subset affects the skin of the extremities but is associated with a set of characteristic features that includes calcinosis, Raynaud's phenomenon, esophageal involvement, sclerodactyly, and telangiectasia. This report describes an unusual case of a patient who had spontaneous compartment syndrome of the hand. The patient's concomitant limited cutaneous systemic sclerosis may have played a role in this unusual occurrence. The diagnosis was based on the clinical picture, and the symptoms resolved after surgical decompression. Copyright 2015, SLACK Incorporated.

  7. A case of delayed presentation of thigh compartment syndrome.

    PubMed

    Wardi, Gabriel; Görtz, Simon; Snyder, Brian

    2014-05-01

    Thigh compartment syndrome is a rare and devastating process. It generally occurs within hours to days of a traumatic event, although cases have been reported nearly 2 weeks after the initial event. To evaluate the literature describing the timing between inciting event and presentation of thigh compartment syndromes, with a focus on delayed presentations of this rare condition. To describe the unique properties of thigh compartments, and finally, to review the anatomy and techniques needed to measure the compartment pressures of the thigh. A case of a 54-year-old man is presented. He sustained trauma to his thigh 17 days prior to presenting to our ED with severe, sudden-onset pain in his right thigh. Compartment pressures were measured and confirmed the diagnosis of compartment syndrome caused by two large intramuscular hematomas. No other contributing events were identified. Compartment syndrome in the thigh should be considered in patients with a concerning examination and a history of recent trauma. This particular case represents the longest reported time between injury and development of a thigh compartment syndrome. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Radiographic predictors of compartment syndrome in tibial plateau fractures.

    PubMed

    Ziran, Bruce H; Becher, Stephen John

    2013-11-01

    The purpose of this article was to evaluate the relationship of radiographic features of tibial plateau fractures to the development of compartment syndrome. We hypothesized that the direction and degree of initial displacement of the femur on the tibia, and the amount of tibial widening (TW), were correlated with the development of compartment syndrome. Retrospective case-control study. Single level 1 trauma center. Retrospective evaluation of 158 patients with 162 plateau fractures. Grouping with and without compartment syndrome. The following data were obtained: age, sex, Schatzker and OTA/AO classification, open/closed status, TW, and femoral displacement (FD). A univariate statistical and a logistical regression analysis were performed to determine significance. The overall rate of compartment syndrome was 11%. Univariate analysis found both the TW and FD to be significant with respect to development of compartment syndrome (P < 0.05). Higher Schatzker (IV-VI) and OTA/AO grades were also correlated (P < 0.05) with increased incidence of compartment syndrome. Logistic regression found FD and Schatzker grade to be significant. Our study is the first to identify easily obtained radiographic parameters that correlate to the occurrence compartment syndrome. There may also be a relationship between TW and FD, as noted by regression result. This study helps to assess which patients with a fracture are at higher risk for developing a compartment syndrome. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

  9. 7 CFR 58.510 - Rooms and compartments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Rooms and Compartments § 58... avoided. Rooms, compartments, coolers, and dry storage space in which any raw material, packaging or...

  10. 7 CFR 58.510 - Rooms and compartments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Rooms and Compartments § 58... avoided. Rooms, compartments, coolers, and dry storage space in which any raw material, packaging or...

  11. 7 CFR 58.510 - Rooms and compartments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Rooms and Compartments § 58... avoided. Rooms, compartments, coolers, and dry storage space in which any raw material, packaging or...

  12. 7 CFR 58.510 - Rooms and compartments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Rooms and Compartments § 58... avoided. Rooms, compartments, coolers, and dry storage space in which any raw material, packaging or...

  13. 7 CFR 58.510 - Rooms and compartments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Rooms and Compartments § 58... avoided. Rooms, compartments, coolers, and dry storage space in which any raw material, packaging or...

  14. 49 CFR 179.220-9 - Compartment tanks.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Compartment tanks. 179.220-9 Section 179.220-9... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS REGULATIONS SPECIFICATIONS FOR TANK CARS Specifications for Non-Pressure Tank Car Tanks (Classes DOT-111AW and 115AW) § 179.220-9 Compartment tanks....

  15. 14 CFR 121.314 - Cargo and baggage compartments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... the certificate holder for operation under this part that has at least one Class D compartment that...: (a) Each Class C or Class D compartment, as defined in § 25.857 of this Chapter in effect on June 16... capability of the liner to safely contain a fire. (c) After March 19, 2001, each Class D...

  16. Glucose transporter 4: cycling, compartments and controversies

    PubMed Central

    Dugani, Chandrasagar B; Klip, Amira

    2005-01-01

    Insulin promotes glucose uptake into muscle and adipose tissues through glucose transporter 4 (GLUT4). In unstimulated cells, rapid endocytosis, slow exocytosis and dynamic or static retention cause GLUT4 to concentrate in early recycling endosomes, the trans-Golgi network and vesicle-associated protein 2-containing vesicles. The coordinated action of phosphatidylinositol 3-kinase effectors, protein kinase Akt, atypical protein kinase C (aPKC) and Akt substrate of 160-kDa (AS160), regulates the GLUT4 cycle by affecting its translocation, fusion with the plasma membrane, internalization and sorting. We review the evidence that supports such cycling, evaluate current models proposing static or dynamic retention, and highlight how distinct steps of GLUT4 transport are regulated by insulin signals. In particular, fusion seems to be regulated by aPKC (via munc18) and Akt (via syntaxin4-interacting protein (synip)). AS160 participates in GLUT4 intracellular retention, and possibly fusion, through candidate ras-related GTP-binding protein (Rab)2, Rab8, Rab10 and/or Rab14. The localization of the insulin-sensitive GLUT4 compartment and the precise target of insulin-derived signals remain open for future investigation. PMID:16319959

  17. Compartment in vertical flow reactor for ferruginous mine water

    NASA Astrophysics Data System (ADS)

    Hur, Won; Cheong, Young-Wook; Yim, Gil-Jae; Ji, Sang-Woo; Hong, Ji-Hye

    2014-05-01

    Mine effluents contain varying concentrations of ferrous ion along with other metal ions. Fe(II) that quickly oxidizes to form precipitates in the presence of oxygen under net alkaline or neutral conditions. Thus, passive treatment methods are designed for the mine water to reside in an open containment area so as to allow simultaneous oxidation and precipitation of Fe(II), such as in a lagoon or an oxidation pond. A vertical flow reactor (VFR) was also suggested to remediate ferruginous mine drainage passing down through an accreting bed of ochre. However, VFR has a limited operation time until the system begins to overflow. It was also demonstrated that two-compartment VFR has a longer operation time than single compartment VFR of same size. In this study, a mathematical model was developed as a part of efforts to explore the operation of VFR, showing dynamic changes in head differences, ochre depth and Fe(II)/Fe(III) concentration in the effluent flow. The analysis shows that Fe(II) oxidation and ochre formation should be balanced with permeability of ochre bed to maximize VFR operation time and minimize residual Fe(II) in the effluent. The model demonstrates that two compartment VFR can have a longer operation time than a single-compartment VFR and that an optimum compartment ratio exists that maximize VFR operation time. Accelerated Fe(II) oxidation significantly affects the optimum ratio of compartment area and reduced residual Fe(II) in the effluent. VFR operation time can be significantly prolonged by increasing the rate of ochre formation not by accelerated Fe(II) oxidation. Taken together, ochre forms largely in the first compartment while overflowed mine water with reduced iron contents is efficiently filtered in the second compartment. These results provide us a better understanding of VFR operation and optimum design criteria for maximum operation time in a two-compartment VFR. Rapid ochre accretion in the first compartment maintains constant hydraulic

  18. Contamination control of the space shuttle Orbiter crew compartment

    NASA Technical Reports Server (NTRS)

    Bartelson, Donald W.

    1986-01-01

    Effective contamination control as applied to manned space flight environments is a discipline characterized and controlled by many parameters. An introduction is given to issues involving Orbiter crew compartment contamination control. An effective ground processing contamination control program is an essential building block to a successful shuttle mission. Personnel are required to don cleanroom-grade clothing ensembles before entering the crew compartment and follow cleanroom rules and regulations. Prior to crew compartment entry, materials and equipment must be checked by an orbiter integrity clerk stationed outside the white-room entrance for compliance to program requirements. Analysis and source identification of crew compartment debris studies have been going on for two years. The objective of these studies is to determine and identify particulate generating materials and activities in the crew compartment. Results show a wide spectrum of many different types of materials. When source identification is made, corrective action is implemented to minimize or curtail further contaminate generation.

  19. Bilaterally Symmetrical Lower Extremity Compartment Syndrome following Massive Transfusion.

    PubMed

    Karaoren, Gulsah; Bakan, Nurten; Tomruk, Senay Goksu; Topaç, Zelin; Kurtulmuş, Tuhan; Irkören, Saime

    2016-01-01

    Compartment syndrome is a serious condition characterized by raised intracompartmental pressure, which develops following trauma. Well leg compartment syndrome (WLCS) is a term reserved for compartment syndrome in a nontraumatic setting, usually resulting from prolonged lithotomy position during surgery. In literature, 8 cases have been reported regarding well leg compartment syndrome in a supine position and bilateral symmetrical involvement was observed in only 2 cases. In WLCS etiology, lengthy surgery, lengthy hypotension, and extremity malpositioning have been held responsible but one of the factors with a role in the etiology may have been the tissue oedema and impaired microcirculation formed from the effect of vasoactive mediators expressed into the circulation associated with the massive blood transfusion. The case is presented here regarding symmetrical lower extremity compartment syndrome after surgery in which massive transfusion was made for gross haemorrhage from an abdominal injury. In conclusion, blood transfusion applied at the required time is life-saving but potential risks must always be considered.

  20. The effects of interaction compartments on stability for competitive systems.

    PubMed

    Rozdilsky, Ian D; Stone, Lewi; Solow, Andrew

    2004-03-21

    The interactions between species are unlikely to be randomly arranged, and there is increasing evidence that most interactions occur within small species sub-groups, or compartments, that do not strongly interact with one another. We examine whether arranging the interactions of a competitive system into compartments influences the system properties of linear stability, feasibility, reactivity, and biomass stability, thereby altering the likelihood of species persistence. Model Lotka-Volterra systems of diffuse competition were analysed with interactions arranged randomly and in compartments. It was found, using a variety of dynamical measures, that arranging interactions into compartments enhances the likelihood of species persistence. Since many natural competitive systems appear to have interactions arranged within compartments, this may be an outcome of the positive attributes that this form of organization offers.

  1. The Effect of Exertion on Heart Rate and Rating of Perceived Exertion in Acutely Concussed Individuals.

    PubMed

    Hinds, Andrea; Leddy, John; Freitas, Michael; Czuczman, Natalie; Willer, Barry

    2016-08-01

    Research suggests that one physiological effect of concussion is a disruption in regulation of autonomic nervous system control that affects the balance between parasympathetic and sympathetic output. While changes in heart rate after concussion have been observed, the nature of the heart rate change during progressive exercise has not been well evaluated in acutely symptomatic patients. Additionally, little is known about the relationship between HR and RPE in this population. We compared changes in heart rate and perceived effort during graded treadmill exertion in recently concussed patients to elucidate the effect of brain injury on cardiovascular response to exercise. Resting HR, HR on exercise initiation, and changes in HR and RPE during the Buffalo Concussion Treadmill Test (BCTT) were compared on two test visits: When patients were symptomatic (acute) and after recovery. Results were compared with the test-retest results obtained from a control group consisting of healthy, non-concussed individuals. Patients had a significantly lower HR at onset of exercise when acutely concussed as compared to when recovered and reported greater perceived exertion at every exercise intensity level when symptomatic, despite exercising at lower workloads, than when recovered. Sympathetic response to increased exertion was not affected by concussion - HR increased in response to exercise at a comparable rate in both tests. These differences observed in response to exercise between the first BCTT and follow-up evaluation in initially concussed patients were not present in non-concussed individuals. Our results suggest that during the acute phase after concussion, acutely concussed patients demonstrated an impaired ability to shift from parasympathetic to sympathetic control over heart rate at the onset of exercise. Changes in the autonomic nervous system after concussion may be more complex than previously reported. Continued evaluation of autonomic regulatory effects in the

  2. The Effect of Exertion on Heart Rate and Rating of Perceived Exertion in Acutely Concussed Individuals

    PubMed Central

    Hinds, Andrea; Leddy, John; Freitas, Michael; Czuczman, Natalie; Willer, Barry

    2016-01-01

    Objective Research suggests that one physiological effect of concussion is a disruption in regulation of autonomic nervous system control that affects the balance between parasympathetic and sympathetic output. While changes in heart rate after concussion have been observed, the nature of the heart rate change during progressive exercise has not been well evaluated in acutely symptomatic patients. Additionally, little is known about the relationship between HR and RPE in this population. Methods We compared changes in heart rate and perceived effort during graded treadmill exertion in recently concussed patients to elucidate the effect of brain injury on cardiovascular response to exercise. Resting HR, HR on exercise initiation, and changes in HR and RPE during the Buffalo Concussion Treadmill Test (BCTT) were compared on two test visits: When patients were symptomatic (acute) and after recovery. Results were compared with the test-retest results obtained from a control group consisting of healthy, non-concussed individuals. Results Patients had a significantly lower HR at onset of exercise when acutely concussed as compared to when recovered and reported greater perceived exertion at every exercise intensity level when symptomatic, despite exercising at lower workloads, than when recovered. Sympathetic response to increased exertion was not affected by concussion - HR increased in response to exercise at a comparable rate in both tests. These differences observed in response to exercise between the first BCTT and follow-up evaluation in initially concussed patients were not present in non-concussed individuals. Conclusion Our results suggest that during the acute phase after concussion, acutely concussed patients demonstrated an impaired ability to shift from parasympathetic to sympathetic control over heart rate at the onset of exercise. Changes in the autonomic nervous system after concussion may be more complex than previously reported. Continued evaluation of

  3. A human cadaver fascial compartment pressure measurement model.

    PubMed

    Messina, Frank C; Cooper, Dylan; Huffman, Gretchen; Bartkus, Edward; Wilbur, Lee

    2013-10-01

    Fresh human cadavers provide an effective model for procedural training. Currently, there are no realistic models to teach fascial compartment pressure measurement. We created a human cadaver fascial compartment pressure measurement model and studied its feasibility with a pre-post design. Three faculty members, following instructions from a common procedure textbook, used a standard handheld intra-compartment pressure monitor (Stryker(®), Kalamazoo, MI) to measure baseline pressures ("unembalmed") in the anterior, lateral, deep posterior, and superficial posterior compartments of the lower legs of a fresh human cadaver. The right femoral artery was then identified by superficial dissection, cannulated distally towards the lower leg, and connected to a standard embalming machine. After a 5-min infusion, the same three faculty members re-measured pressures ("embalmed") of the same compartments on the cannulated right leg. Unembalmed and embalmed readings for each compartment, and baseline readings for each leg, were compared using a two-sided paired t-test. The mean baseline compartment pressures did not differ between the right and left legs. Using the embalming machine, compartment pressure readings increased significantly over baseline for three of four fascial compartments; all in mm Hg (±SD): anterior from 40 (±9) to 143 (±44) (p = 0.08); lateral from 22 (±2.5) to 160 (±4.3) (p < 0.01); deep posterior from 34 (±7.9) to 161 (±15) (p < 0.01); superficial posterior from 33 (±0) to 140 (±13) (p < 0.01). We created a novel and measurable fascial compartment pressure measurement model in a fresh human cadaver using a standard embalming machine. Set-up is minimal and the model can be incorporated into teaching curricula. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Smoke/Gas Hazards - Shipboard Compartment Fires,

    DTIC Science & Technology

    1984-04-01

    SERIES )~~~ ~ louse)nmI [. ( Ill ..lm !® m .ൽ ,m--, ’ - |0r -- PLNTVeOI -"-.I PW mmin j PLnTP Co •L ") p-muom - - o" ’ FIGURE 6. EXPERIMETAL ARRANGEMET OF...350 (10 min.) 27 chronic exposure values are for 10 minute peak exposures throughout an eight hour work day. The "TWA" values are cronic exposure

  5. Insulin influences autophagy response distinctively in macrophages of different compartments.

    PubMed

    Sunahara, Karen K S; Nunes, Fernanda P B; Baptista, Marisa A P; Strell, Carina; Sannomiya, Paulina; Westerberg, Lisa S; Martins, Joilson O

    2014-01-01

    Diabetes mellitus (DM) is characterized by hyperglycemia, associated to a lack or inefficiency of the insulin to regulate glucose metabolism. DM is also marked by alterations in a diversity of cellular processes that need to be further unraveled. In this study, we examined the autophagy pathway in diabetic rat macrophages before and after treatment with insulin. Bone marrow-derived macrophages (BMM), bronchoalveolar lavage (BAL) and splenic tissue of diabetic male Wistar rats (alloxan, 42 mg/kg, i.v., 10 days) and control rats (physiological saline, i.v.). Some diabetic rats were given neutral protamine Hagedorn insulin (4 IU, s.c.) 8 h before experiments. For characterization of the model and evaluation of the effect of insulin on the autophagic process, the following analyzes were performed: (a) concentrations of cytokines: interleukin (IL)-1β, tumor necrosis factor (TNF)-α, IL-6, IL-4, IL-10, cytokine-induced neutrophil chemoattractant (CINC)-1 and CINC-2 in the BAL supernatant was measured by ELISA; (b) characterization of alveolar macrophage (AM) of the BAL as surface antigens (MHCII, pan-macrophage KiM2R, CD11b) and autophagic markers (protein microtubule-associated light chain (LC)3, autophagy protein (Atg)12 by flow cytometry and confocal microscopy (c) study of macrophages differentiated from the bone marrow by flow cytometry and confocal microscopy (d) histology of the spleen by immunohistochemistry associated with confocal microscopy. Interestingly, insulin exerted antagonistic effects on macrophages from different tissues. Macrophages from bronchoalveolar lavage (BAL) enhanced their LC3 autophagosome bound content after treatment with insulin whereas splenic macrophages from red pulp in diabetic rats failed to enhance their Atg 12 levels compared to control animals. Insulin treatment in diabetic rats did not change LC3 content in bone marrow derived macrophages (BMM). M1 and M2 macrophages behaved accordingly to the host they were derived from

  6. Functional outcome of tibial fracture with acute compartment syndrome and correlation to deep posterior compartment pressure

    PubMed Central

    Goyal, Saumitra; Naik, Monappa A; Tripathy, Sujit Kumar; Rao, Sharath K

    2017-01-01

    AIM To measure single baseline deep posterior compartment pressure in tibial fracture complicated by acute compartment syndrome (ACS) and to correlate it with functional outcome. METHODS Thirty-two tibial fractures with ACS were evaluated clinically and the deep posterior compartment pressure was measured. Urgent fasciotomy was needed in 30 patients. Definite surgical fixation was performed either primarily or once fasciotomy wound was healthy. The patients were followed up at 3 mo, 6 mo and one year. At one year, the functional outcome [lower extremity functional scale (LEFS)] and complications were assessed. RESULTS Three limbs were amputated. In remaining 29 patients, the average times for clinical and radiological union were 25.2 ± 10.9 wk (10 to 54 wk) and 23.8 ± 9.2 wk (12 to 52 wk) respectively. Nine patients had delayed union and 2 had nonunion who needed bone grafting to augment healing. Most common complaint at follow up was ankle stiffness (76%) that caused difficulty in walking, running and squatting. Of 21 patients who had paralysis at diagnosis, 13 (62%) did not recover and additional five patients developed paralysis at follow-up. On LEFS evaluation, there were 14 patients (48.3%) with severe disability, 10 patients (34.5%) with moderate disability and 5 patients (17.2%) with minimal disability. The mean pressures in patients with minimal disability, moderate disability and severe disability were 37.8, 48.4 and 58.79 mmHg respectively (P < 0.001). CONCLUSION ACS in tibial fractures causes severe functional disability in majority of patients. These patients are prone for delayed union and nonunion; however, long term disability is mainly because of severe soft tissue contracture. Intra-compartmental pressure (ICP) correlates with functional disability; patients with relatively high ICP are prone for poor functional outcome. PMID:28567342

  7. Functional outcome of tibial fracture with acute compartment syndrome and correlation to deep posterior compartment pressure.

    PubMed

    Goyal, Saumitra; Naik, Monappa A; Tripathy, Sujit Kumar; Rao, Sharath K

    2017-05-18

    To measure single baseline deep posterior compartment pressure in tibial fracture complicated by acute compartment syndrome (ACS) and to correlate it with functional outcome. Thirty-two tibial fractures with ACS were evaluated clinically and the deep posterior compartment pressure was measured. Urgent fasciotomy was needed in 30 patients. Definite surgical fixation was performed either primarily or once fasciotomy wound was healthy. The patients were followed up at 3 mo, 6 mo and one year. At one year, the functional outcome [lower extremity functional scale (LEFS)] and complications were assessed. Three limbs were amputated. In remaining 29 patients, the average times for clinical and radiological union were 25.2 ± 10.9 wk (10 to 54 wk) and 23.8 ± 9.2 wk (12 to 52 wk) respectively. Nine patients had delayed union and 2 had nonunion who needed bone grafting to augment healing. Most common complaint at follow up was ankle stiffness (76%) that caused difficulty in walking, running and squatting. Of 21 patients who had paralysis at diagnosis, 13 (62%) did not recover and additional five patients developed paralysis at follow-up. On LEFS evaluation, there were 14 patients (48.3%) with severe disability, 10 patients (34.5%) with moderate disability and 5 patients (17.2%) with minimal disability. The mean pressures in patients with minimal disability, moderate disability and severe disability were 37.8, 48.4 and 58.79 mmHg respectively (P < 0.001). ACS in tibial fractures causes severe functional disability in majority of patients. These patients are prone for delayed union and nonunion; however, long term disability is mainly because of severe soft tissue contracture. Intra-compartmental pressure (ICP) correlates with functional disability; patients with relatively high ICP are prone for poor functional outcome.

  8. Duality of the murine CD8 compartment

    PubMed Central

    Genolet, Raphaël; Leignadier, Julie; Østerås, Magne; Farinelli, Laurent; Stevenson, Brian J.; Luescher, Immanuel F.

    2014-01-01

    CD8αβ plays crucial roles in the thymic selection, differentiation, and activation of some, but not all, CD8+ T cells, whereas CD8αα does not. To investigate these roles, we produced mice that expressed transgene P14 T-cell receptor β (TCRβ) chain and CD8β or did not (WT and KO mice, respectively). The primary CD8+ T-cell response to acute lymphocytic choriomeningitis virus (LCMV) infection was predominantly Db/GP33 specific and CD8 independent in KO mice and was mostly CD8 dependent in WT mice. Cytotoxic T lymphocytes (CTL) from KO mice failed to mobilize intracellular Ca2+ and to kill via perforin/granzyme. Their strong Fas/FasL-mediated cytotoxicity and IFN-γ response were signaled via a Ca2+-independent, PI3K-dependent pathway. This was also true for 15–20% of CD8-independent CTL found in WT mice. Conversely, the perforin/granzyme-mediated killing and IFN-γ response of CD8-dependent CTL were signaled via a Ca2+, p56lck, and nuclear factor of activated T cells-dependent pathway. Deep sequencing of millions of TCRα chain transcripts revealed that the TCR repertoires of preimmune CD8+ T cells were highly diverse, but those of LCMV Db/GP33-specific CTL, especially from KO mice, were narrow. The immune repertoires exhibited biased use of Vα segments that encoded different complementary-determining region 1α (CDR1α) and CDR2α sequences. We suggest that TCR from WT CD8-independent T cells may engage MHC–peptide complexes in a manner unfavorable for efficient CD8 engagement and Ca2+ signaling but permissive for Ca2+-independent, PI3K-dependent signaling. This duality of the CD8 compartment may provide organisms with broader protective immunity. PMID:24594598

  9. Two distinct Ca2+ compartments show differential sensitivity to thrombin, ADP and vasopressin in human platelets.

    PubMed

    López, Jose J; Redondo, Pedro C; Salido, Ginés M; Pariente, Jose A; Rosado, Juan A

    2006-03-01

    Recent studies propose the existence of two distinct Ca2+ compartments in human platelets based on the expression of different SERCA isoforms with distinct sensitivity to thapsigargin and 2,5-di-(tert-butyl)-1,4-hydroquinone (TBHQ). Using fura-2-loaded human platelets we have found that depletion of the TBHQ sensitive store reduces thrombin--but not ADP--or vasopressin (AVP)-induced Ca2+ release. Redistribution of cytosolic Ca2+ after thrombin stimulation resulted in overloading of the TBHQ-sensitive store. This phenomenon was not observed with ADP or AVP. We found that NAADP decreases the Ca2+ concentration into the stores in permeabilized platelets, which is prevented by depletion of the TBHQ-sensitive store. Nimodipine, an inhibitor of the NAADP receptor, reduced thrombin-induced Ca2+ release from the TBHQ-sensitive stores, without having any effect on the responses elicited by ADP or AVP. Finally, the phospholipase C inhibitor, U-73122, abolished ADP- and AVP-induced Ca2+ release, suggesting that their responses are entirely dependent on IP3 generation. In contrast, treatment with both U-73122 and nimodipine was required to abolish thrombin-induced Ca2+ release. We suggest that thrombin evokes Ca2+ release from TBHQ-sensitive and insensitive stores, which requires both NAADP and IP3, respectively, while ADP and AVP exert an IP3-dependent release of Ca2+ from the TBHQ-insensitive compartment in human platelets.

  10. Perivascular adipose tissue: An unique fat compartment relevant for the cardiometabolic syndrome.

    PubMed

    Siegel-Axel, D I; Häring, H U

    2016-03-01

    Type 2 diabetes and its major risk factor, obesity, are an increasing worldwide health problem. The exact mechanisms that link obesity with insulin resistance, type 2 diabetes, hypertension, cardiovascular complications and renal diseases, are still not clarified sufficiently. Adipose tissue in general is an active endocrine and paracrine organ that may influence the development of these disorders. Excessive body fat in general obesity may also cause quantitative and functional alterations of specific adipose tissue compartments. Beside visceral and subcutaneous fat depots which exert systemic effects by the release of adipokines, cytokines and hormones, there are also locally acting fat depots such as peri- and epicardial fat, perivascular fat, and renal sinus fat. Perivascular adipose tissue is in close contact with the adventitia of large, medium and small diameter arteries, possesses unique features differing from other fat depots and may act also independently of general obesity. An increasing number of studies are dealing with the "good" or "bad" characteristics and functions of normally sized and dramatically increased perivascular fat mass in lean or heavily obese individuals. This review describes the origin of perivascular adipose tissue, its different locations, the dual role of a physiological and unphysiological fat mass and its impact on diabetes, cardiovascular and renal diseases. Clinical studies, new imaging methods, as well as basic research in cell culture experiments in the last decade helped to elucidate the various aspects of the unique fat compartment.

  11. Compartment syndrome causes systemic inflammation in a rat.

    PubMed

    Lawendy, A-R; Bihari, A; Sanders, D W; Badhwar, A; Cepinskas, G

    2016-08-01

    Compartment syndrome results from increased intra-compartmental pressure (ICP) causing local tissue ischaemia and cell death, but the systemic effects are not well described. We hypothesised that compartment syndrome would have a profound effect not only on the affected limb, but also on remote organs. Using a rat model of compartment syndrome, its systemic effects on the viability of hepatocytes and on inflammation and circulation were directly visualised using intravital video microscopy. We found that hepatocellular injury was significantly higher in the compartment syndrome group (192 PI-labelled cells/10(-1) mm(3), standard error of the mean (sem) 51) compared with controls (30 PI-labelled cells/10(-1) mm(3), sem 12, p < 0.01). The number of adherent venular white blood cells was significantly higher for the compartment syndrome group (5 leukocytes/30s/10 000 μm(2), sem 1) than controls (0.2 leukocytes/30 s/10 000 μm(2), sem 0.2, p < 0.01). Volumetric blood flow was not significantly different between the two groups, although there was an increase in the heterogeneity of perfusion. Compartment syndrome can be accompanied by severe systemic inflammation and end organ damage. This study provides evidence of the relationship between compartment syndrome in a limb and systemic inflammation and dysfunction in a remote organ. Cite this article: Bone Joint J 2016; 98-B:1132-7. ©2016 The British Editorial Society of Bone & Joint Surgery.

  12. Stochastic Turing patterns: analysis of compartment-based approaches.

    PubMed

    Cao, Yang; Erban, Radek

    2014-12-01

    Turing patterns can be observed in reaction-diffusion systems where chemical species have different diffusion constants. In recent years, several studies investigated the effects of noise on Turing patterns and showed that the parameter regimes, for which stochastic Turing patterns are observed, can be larger than the parameter regimes predicted by deterministic models, which are written in terms of partial differential equations (PDEs) for species concentrations. A common stochastic reaction-diffusion approach is written in terms of compartment-based (lattice-based) models, where the domain of interest is divided into artificial compartments and the number of molecules in each compartment is simulated. In this paper, the dependence of stochastic Turing patterns on the compartment size is investigated. It has previously been shown (for relatively simpler systems) that a modeler should not choose compartment sizes which are too small or too large, and that the optimal compartment size depends on the diffusion constant. Taking these results into account, we propose and study a compartment-based model of Turing patterns where each chemical species is described using a different set of compartments. It is shown that the parameter regions where spatial patterns form are different from the regions obtained by classical deterministic PDE-based models, but they are also different from the results obtained for the stochastic reaction-diffusion models which use a single set of compartments for all chemical species. In particular, it is argued that some previously reported results on the effect of noise on Turing patterns in biological systems need to be reinterpreted.

  13. Treatment of Atypical Compartment Syndrome Due to Proteus Infection.

    PubMed

    Stull, Justin; Bhat, Suneel; Miller, Andrew J; Hoffman, Ryan; Wang, Mark L

    2017-01-01

    Compartment syndrome is an orthopedic emergency with a multitude of etiologies. Although it is most commonly associated with trauma to the extremity, hematoma and infection are 2 rare etiologies of insidious compartment syndrome. Proteus mirabilis is an opportunistic gram-negative species that can infect the respiratory tract, urinary tract, and open wounds. The authors present the case of a 69-year-old woman who developed tissue necrosis and compartment syndrome secondary to an untreated hematoma infected by P mirabilis. This case involves an atypical presentation caused by an untreated infected hematoma, emphasizing the need for a high index of suspicion. Current literature supports immediate surgical intervention in the clinical scenario of fulminant compartment syndrome, regardless of compartment pressure findings. The probability of compartment syndrome in the patient presenting with pain, paresthesias, paresis, and pain with passive stretch, all of which were positive findings in this patient, has been reported to be 98%. Thus, Doppler evaluation and intercompartmental pressures were considered but forgone to expedite operative treatment. Emergent 4-compartment fasciotomies, with excision and debridement of nonviable tissue, are potentially limb-saving procedures, intended to limit loss of function and obviate the need for lower extremity amputation. The decision was made to perform a dual-incision fasciotomy to avoid contamination of the uninvolved compartments with a standard single-incision approach. To date, this represents the first report in the English literature of the insidious onset of tissue necrosis secondary to a Proteus-infected hematoma, highlighting a unique etiology of atypical compartment syndrome. [Orthopedics. 2017; 40(1):e176-e178.]. Copyright 2016, SLACK Incorporated.

  14. Silent compartment syndrome in children: a report of five cases.

    PubMed

    Lee, Christopher; Lightdale-Miric, Nina; Chang, Emory; Kay, Robert

    2014-09-01

    Compartment syndrome does not always present classically in the pediatric population, making clinical diagnosis uniquely challenging. The purpose of this study was to identify signs and symptoms of compartment syndrome that may help risk-stratify pediatric patients upon presentation, as well as to report outcomes of 'silent' compartment syndrome in children. A retrospective review of cases of 'silent' compartment syndrome at a level I pediatric trauma center between 2000 and 2010 was conducted. Patient demographics and clinical data were reviewed, including complications and patient outcomes. Radiographs taken at presentation, on intraoperative fluoroscopy, and at postoperative follow-up were reviewed for fracture type, and severity and outcome analyses. Five patients were found to have compartment syndrome without the presence of significant pain at rest or on passive range of motion. The study included three male and two female patients with a median age of 7 years. Three upper-extremity and two lower-extremity fractures were involved. The mean time from presentation to surgery was 14 h. At presentation, three of five patients had muscle paralysis, whereas at diagnosis of compartment syndrome, four of five had paralysis. Of the classic five P's, a maximum of two were found at diagnosis. The mean clinical follow-up period was 11 months (2-26 months). Long-term complications from compartment syndrome were found in one of five patients, who at the most recent follow-up, continued to be debilitated. This study reviews a series of cases of 'silent' compartment syndrome and confirms its atypical presentation. It is recommended that caution be used when assessing fractures with high risk for compartment syndrome in children, especially those complicated by nerve injury, as they do not always present in the classic manner, with missed diagnosis leading to significant functional deficits. IV.

  15. Force Exertion Capacity Measurements in Haptic Virtual Environments

    ERIC Educational Resources Information Center

    Munih, Marko; Bardorfer, Ales; Ceru, Bojan; Bajd, Tadej; Zupan, Anton

    2010-01-01

    An objective test for evaluating functional status of the upper limbs (ULs) in patients with muscular distrophy (MD) is presented. The method allows for quantitative assessment of the UL functional state with an emphasis on force exertion capacity. The experimental measurement setup and the methodology for the assessment of maximal exertable force…

  16. Exertional Rhabdomyolysis: What Is It and Why Should We Care?

    ERIC Educational Resources Information Center

    Thomas, David Q.; Carlson, Kelli A.; Marzano, Amy; Garrahy, Deborah

    2012-01-01

    Exertional rhabdomyolysis gained increased attention recently when 13 football players from the University of Iowa developed this condition after an especially demanding practice session and were hospitalized. Exertional rhabdomyolysis may lead to severe kidney stress, kidney failure, and even sudden death. Anyone who does physical exercise at a…

  17. 20 CFR 220.135 - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... limitations. (a) General. The claimant's impairment(s) and related symptoms, such as pain, may cause... as pain, are exertional, nonexertional, or a combination of both. (b) Exertional limitations. When... pain, affect only the claimant's ability to meet the strength demands of jobs (sitting,...

  18. 20 CFR 220.135 - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... limitations. (a) General. The claimant's impairment(s) and related symptoms, such as pain, may cause... as pain, are exertional, nonexertional, or a combination of both. (b) Exertional limitations. When... pain, affect only the claimant's ability to meet the strength demands of jobs (sitting,...

  19. 20 CFR 220.135 - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... limitations. (a) General. The claimant's impairment(s) and related symptoms, such as pain, may cause... as pain, are exertional, nonexertional, or a combination of both. (b) Exertional limitations. When... pain, affect only the claimant's ability to meet the strength demands of jobs (sitting,...

  20. 20 CFR 220.135 - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... limitations. (a) General. The claimant's impairment(s) and related symptoms, such as pain, may cause... as pain, are exertional, nonexertional, or a combination of both. (b) Exertional limitations. When... pain, affect only the claimant's ability to meet the strength demands of jobs (sitting,...

  1. Using Ratings of Perceived Exertion in Physical Education

    ERIC Educational Resources Information Center

    Lagally, Kristen M.

    2013-01-01

    Ratings of perceived exertion have been shown to be a valid method of monitoring physical activity intensity for both adults and children. As such, this subjective method may serve as an alternative to objective measurements for assessing students' performance on national standards 2 and 4. The OMNI-Child perceived exertion scales were…

  2. Exertional Rhabdomyolysis: What Is It and Why Should We Care?

    ERIC Educational Resources Information Center

    Thomas, David Q.; Carlson, Kelli A.; Marzano, Amy; Garrahy, Deborah

    2012-01-01

    Exertional rhabdomyolysis gained increased attention recently when 13 football players from the University of Iowa developed this condition after an especially demanding practice session and were hospitalized. Exertional rhabdomyolysis may lead to severe kidney stress, kidney failure, and even sudden death. Anyone who does physical exercise at a…

  3. Using Ratings of Perceived Exertion in Physical Education

    ERIC Educational Resources Information Center

    Lagally, Kristen M.

    2013-01-01

    Ratings of perceived exertion have been shown to be a valid method of monitoring physical activity intensity for both adults and children. As such, this subjective method may serve as an alternative to objective measurements for assessing students' performance on national standards 2 and 4. The OMNI-Child perceived exertion scales were…

  4. Compartment syndrome obscured by post-operative epidural analgesia

    PubMed Central

    Azam, Md. Quamar; Ali, Mir Sadat; Al Ruwaili, Majed; Al Sayed, Hassan Noori

    2012-01-01

    Compartment syndrome is an orthopedic emergency that require early recognition and urgent intervention to avoid catastrophic complications. High index of suspicion is required for early diagnosis based on a constellation of signs and symptoms that include pain out of proportion and worsened by passive stretching, altered sensorium and palpable tenseness. Any event thus, that masks pain, may lead to delay the diagnosis of compartment syndrome. We report here a case of polytrauma where post-operative analgesia was administered using epidural catheter, which obscured pain and lead to delay in recognition of compartment syndrome. Authors wish to share a lesson, learned at the expense of tragedy. PMID:24765418

  5. Compartment Syndrome of the Calf Due to Nicolau Syndrome

    PubMed Central

    Enshaei, Ali; Afshar, Ahmadreza

    2016-01-01

    We report a case of Nicolau syndrome in a 15 months old girl following an intramuscular injection of penicillin 6.3.3 in her left buttock. This case is unique because she developed compartment syndrome in her left calf far from her injection site. Her toe’s tips gangrened in the course of her ailment. We hypothesized that the compartment syndrome might be produced by a probable intra-arterial injection that had produced embolic obstruction of the small and medium size arteries in her leg or a probable perineural or periarteial injection had produced secondary sympathetic stimulation, extensive vasospasm, compromised microcirculation and the development of compartment syndrome. PMID:26894227

  6. Compartment Syndrome of the Calf Due to Nicolau Syndrome.

    PubMed

    Enshaei, Ali; Afshar, Ahmadreza

    2016-01-01

    We report a case of Nicolau syndrome in a 15 months old girl following an intramuscular injection of penicillin 6.3.3 in her left buttock. This case is unique because she developed compartment syndrome in her left calf far from her injection site. Her toe's tips gangrened in the course of her ailment. We hypothesized that the compartment syndrome might be produced by a probable intra-arterial injection that had produced embolic obstruction of the small and medium size arteries in her leg or a probable perineural or periarteial injection had produced secondary sympathetic stimulation, extensive vasospasm, compromised microcirculation and the development of compartment syndrome.

  7. Current thinking about acute compartment syndrome of the lower extremity

    PubMed Central

    Shadgan, Babak; Menon, Matthew; Sanders, David; Berry, Gregg; Martin, Claude; Duffy, Paul; Stephen, David; O’Brien, Peter J.

    2010-01-01

    Acute compartment syndrome of the lower extremity is a clinical condition that, although uncommon, is seen fairly regularly in modern orthopedic practice. The pathophysiology of the disorder has been extensively described and is well known to physicians who care for patients with musculoskeletal injuries. The diagnosis, however, is often difficult to make. In this article, we review the clinical risk factors of acute compartment syndrome of the lower extremity, identify the current concepts of diagnosis and discuss appropriate treatment plans. We also describe the Canadian medicolegal environment in regard to compartment syndrome of the lower extremity. PMID:20858378

  8. Backpropagation ANN-based prediction of exertional heat illness.

    PubMed

    Aggarwal, Yogender; Karan, Bhuwan Mohan; Das, Barda Nand; Aggarwal, Tarana; Sinha, Rakesh Kumar

    2007-12-01

    Exertional heat illness is primarily a multi-system disorder results from the combined effect of exertional and thermoregulation stress. The severity of exertional heat illness can be classified as mild, intermediate and severe from non-specific symptoms like thirst, myalgia, poor concentration, hysteria, vomiting, weakness, cramps, impaired judgement, headache, diarrhea, fatigue, hyperventilation, anxiety, and nausea to more severe symptoms like exertional dehydration, heat cramps, heat exhaustion, heat injury, heatstroke, rhabdomyolysis, and acute renal failure. At its early stage, it is quite difficult to find out the severity of disease with manual screening because of overlapping of symptoms. Therefore, one need to classify automatically the disease based on symptoms. The 7:10:1 backpropagation artificial neural network model has been used to predict the clinical outcome from the symptoms that are routinely available to clinicians. The model has found to be effective in differentiating the different stages of exertional heat-illness with an overall performance of 100%.

  9. Exertional myopathy in whooping cranes (Grus americana) with prognostic guidlelines

    USGS Publications Warehouse

    Hanley, C.S.; Thomas, N.J.; Paul-Murphy, P.; Hartup, B.K.

    2005-01-01

    Exertional myopathy developed in three whooping cranes (Grus americana) secondary to routine capture, handling, and trauma. Presumptive diagnosis of exertional myopathy was based on history of recent capture or trauma, clinical signs, and elevation of aspartate aminotransferase, alanine aminotransferase, creatine kinase, lactate dehydrogenase, and serum potassium. Treatments were attempted in each case, but ultimately were not successful. Gross and microscopic lesions at necropsy confirmed the diagnosis in each case, with the leg musculature most severely affected. Guidelines for determining prognosis of exertional myopathy in cranes have been included based on the analysis of these cases and others in the literature. As treatment is largely unrewarding, prevention remains the key in controlling exertional myopathy. Identification of predisposing factors and proper handling, immobilization, and transportation techniques can help prevent development of exertional myopathy in cranes.

  10. Exertional myopathy in whooping cranes (Grus americana) with prognostic guidelines.

    PubMed

    Hanley, Christopher S; Thomas, Nancy J; Paul-Murphy, Joanne; Hartup, Barry K

    2005-09-01

    Exertional myopathy developed in three whooping cranes (Grus americana) secondary to routine capture, handling, and trauma. Presumptive diagnosis of exertional myopathy was based on history of recent capture or trauma, clinical signs, and elevation of aspartate aminotransferase, alanine aminotransferase, creatine kinase, lactate dehydrogenase, and serum potassium. Treatments were attempted in each case, but ultimately were not successful. Gross and microscopic lesions at necropsy confirmed the diagnosis in each case, with the leg musculature most severely affected. Guidelines for determining prognosis of exertional myopathy in cranes have been included based on the analysis of these cases and others in the literature. As treatment is largely unrewarding, prevention remains the key in controlling exertional myopathy. Identification of predisposing factors and proper handling, immobilization, and transportation techniques can help prevent development of exertional myopathy in cranes.

  11. Reactive oxygen species exert opposite effects on Tyr23 phosphorylation of the nuclear and cortical pools of annexin A2

    PubMed Central

    Grindheim, Ann Kari; Hollås, Hanne; Raddum, Aase M.; Saraste, Jaakko; Vedeler, Anni

    2016-01-01

    ABSTRACT Annexin A2 (AnxA2) is a multi-functional and -compartmental protein whose subcellular localisation and functions are tightly regulated by its post-translational modifications. AnxA2 and its Tyr23-phosphorylated form (pTyr23AnxA2) are involved in malignant cell transformation, metastasis and angiogenesis. Here, we show that H2O2 exerts rapid, simultaneous and opposite effects on the Tyr23 phosphorylation status of AnxA2 in two distinct compartments of rat pheochromocytoma (PC12) cells. Reactive oxygen species induce dephosphorylation of pTyr23AnxA2 located in the PML bodies of the nucleus, whereas AnxA2 associated with F-actin at the cell cortex is Tyr23 phosphorylated. The H2O2-induced responses in both compartments are transient and the pTyr23AnxA2 accumulating at the cell cortex is subsequently incorporated into vesicles and then released to the extracellular space. Blocking nuclear export by leptomycin B does not affect the nuclear pool of pTyr23AnxA2, but increases the amount of total AnxA2 in this compartment, indicating that the protein might have several functions in the nucleus. These results suggest that Tyr23 phosphorylation can regulate the function of AnxA2 at distinct subcellular sites. PMID:26644180

  12. Self-reported post-exertional fatigue in Gulf War veterans: roles of autonomic testing.

    PubMed

    Li, Mian; Xu, Changqing; Yao, Wenguo; Mahan, Clare M; Kang, Han K; Sandbrink, Friedhelm; Zhai, Ping; Karasik, Pamela A

    2014-01-07

    To determine if objective evidence of autonomic dysfunction exists from a group of Gulf War veterans with self-reported post-exertional fatigue, we evaluated 16 Gulf War ill veterans and 12 Gulf War controls. Participants of the ill group had self- reported, unexplained chronic post-exertional fatigue and the illness symptoms had persisted for years until the current clinical study. The controls had no self-reported post-exertional fatigue either at the time of initial survey nor at the time of the current study. We intended to identify clinical autonomic disorders using autonomic and neurophysiologic testing in the clinical context. We compared the autonomic measures between the 2 groups on cardiovascular function at both baseline and head-up tilt, and sudomotor function. We identified 1 participant with orthostatic hypotension, 1 posture orthostatic tachycardia syndrome, 2 distal small fiber neuropathy, and 1 length dependent distal neuropathy affecting both large and small fiber in the ill group; whereas none of above definable diagnoses was noted in the controls. The ill group had a significantly higher baseline heart rate compared to controls. Compound autonomic scoring scale showed a significant higher score (95% CI of mean: 1.72-2.67) among ill group compared to controls (0.58-1.59). We conclude that objective autonomic testing is necessary for the evaluation of self-reported, unexplained post-exertional fatigue among some Gulf War veterans with multi-symptom illnesses. Our observation that ill veterans with self-reported post-exertional fatigue had objective autonomic measures that were worse than controls warrants validation in a larger clinical series.

  13. Effects of chronic treatment with a water-alcohol extract from Erythrina mulungu on anxiety-related responses in rats.

    PubMed

    Onusic, Gustavo Massaro; Nogueira, Regina Lúcia; Pereira, Ana Maria Soares; Flausino Júnior, Otavio Aparecido; Viana, Milena de Barros

    2003-11-01

    We investigated the effects of chronic oral treatment with a water-alcohol extract from the inflorescence of Erythrina mulungu (Leguminosae-Papilionaceae) (EM, 50, 100, 200 mg/kg) in rats submitted to different anxiety models: the elevated T-maze (ETM, for inhibitory avoidance and escape measurements), the light/dark transition, and the cat odor test. These models were selected for their capacity to elicit specific subtypes of anxiety disorders as recognized in clinical practice. Treatment with EM impaired inhibitory avoidance latencies in a way similar to the reference drug, diazepam (DZP). Additionally, both EM and DZP increased the number of transitions and the time spent in the lighted compartment of the light/dark transition model. Furthermore, neither EM nor DZP altered behavioral responses of rats to a cloth impregnated with cat odor. In contrast to DZP, however, EM also altered ETM one-way escape. These results were not due to motor alterations since no significant effects were detected in the number of crossings or rearings in the arena. The present observations suggest that chronic EM exerts anxiolytic-like effects in defensive behaviors related to generalized anxiety and panic disorder. Although alkaloids appear to be one of the main constituents of EM, the possible mechanisms through which the extract exerts its anxiolytic action should be further investigated.

  14. Compartment pressure monitoring during anterior cruciate ligament reconstruction.

    PubMed

    Amendola, A; Faber, K; Willits, K; Miniaci, A; Labib, S; Fowler, P

    1999-09-01

    A prospective double blind randomized study was carried out using 20 healthy males with anterior cruciate ligament (ACL) insufficiency undergoing bone-patellar tendon-bone ACL reconstruction. The subjects were randomized into either water or saline irrigation and then underwent identical reconstructive procedures using an arthroscopic pump. Continuous preoperative, intraoperative, and postoperative pressures were monitored using the slit catheter technique. Blood pressure and compartment pressure measurements were continuously recorded and noted at all stages of the procedure. Mean preoperative anterior and posterior compartment pressures were similar in both groups. No significant differences were noted between the anterior and posterior compartments of each group. No difference between water and saline irrigation was identified throughout the procedure. In both groups, postoperative pressures were slightly lower in the anterior and posterior compartments compared with preoperative pressures, but not significantly.

  15. 14 CFR 23.787 - Baggage and cargo compartments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... inertial load factor is 9g and assuming the maximum allowed baggage or cargo weight for the compartment. (b... means to protect the occupants from injury when the baggage or cargo is subjected to the inertial...

  16. 14 CFR 23.787 - Baggage and cargo compartments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... inertial load factor is 9g and assuming the maximum allowed baggage or cargo weight for the compartment. (b... means to protect the occupants from injury when the baggage or cargo is subjected to the inertial...

  17. 14 CFR 23.787 - Baggage and cargo compartments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... inertial load factor is 9g and assuming the maximum allowed baggage or cargo weight for the compartment. (b... means to protect the occupants from injury when the baggage or cargo is subjected to the inertial...

  18. 14 CFR 23.787 - Baggage and cargo compartments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... inertial load factor is 9g and assuming the maximum allowed baggage or cargo weight for the compartment. (b... means to protect the occupants from injury when the baggage or cargo is subjected to the inertial...

  19. 14 CFR 23.787 - Baggage and cargo compartments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... inertial load factor is 9g and assuming the maximum allowed baggage or cargo weight for the compartment. (b... means to protect the occupants from injury when the baggage or cargo is subjected to the inertial...

  20. 10. Interior view of communications compartment. View toward front of ...

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

    10. Interior view of communications compartment. View toward front of aircraft. - Offutt Air Force Base, Looking Glass Airborne Command Post, Looking Glass Aircraft, On Operational Apron covering northeast half of Project Looking Glass Historic District, Bellevue, Sarpy County, NE

  1. 11. Interior view of communications compartment. View toward rear of ...

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

    11. Interior view of communications compartment. View toward rear of aircraft. - Offutt Air Force Base, Looking Glass Airborne Command Post, Looking Glass Aircraft, On Operational Apron covering northeast half of Project Looking Glass Historic District, Bellevue, Sarpy County, NE

  2. 19 CFR 123.24 - Sealing of conveyances or compartments.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...; DEPARTMENT OF THE TREASURY CUSTOMS RELATIONS WITH CANADA AND MEXICO Shipments in Transit Through Canada or Mexico § 123.24 Sealing of conveyances or compartments. (a) Sealing required. Merchandise in transit...

  3. The pathophysiology, diagnosis and current management of acute compartment syndrome.

    PubMed

    Donaldson, James; Haddad, Behrooz; Khan, Wasim S

    2014-01-01

    Acute compartment syndrome (ACS) is a surgical emergency warranting prompt evaluation and treatment. It can occur with any elevation in interstitial pressure in a closed osseo-fascial compartment. Resultant ischaemic damage may be irreversible within six hours and can result in long-term morbidity and even death. The diagnosis is largely clinical with the classical description of 'pain out of proportion to the injury'. Compartment pressure monitors can be a helpful adjunct where the diagnosis is in doubt. Initial treatment is with the removal of any constricting dressings or casts, avoiding hypotension and optimizing tissue perfusion by keeping the limb at heart level. If symptoms persist, definitive treatment is necessary with timely surgical decompression of all the involved compartments. This article reviews the pathophysiology, diagnosis and current management of ACS.

  4. FEATURE 3, LARGE GUN POSITION, SHOWING MULTIPLE COMPARTMENTS, VIEW FACING ...

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

    FEATURE 3, LARGE GUN POSITION, SHOWING MULTIPLE COMPARTMENTS, VIEW FACING SOUTH. - Naval Air Station Barbers Point, Anti-Aircraft Battery Complex-Large Gun Position, East of Coral Sea Road, northwest of Hamilton Road, Ewa, Honolulu County, HI

  5. Condensation on crew compartment aft flight deck window W10

    NASA Image and Video Library

    1982-03-30

    STS003-24-211 (22-30 March 1982) --- Crew compartment aft flight deck viewing window W10 fogged with condensation. The condensation is a result of the spacecraft's position in relation to the sun. Photo credit: NASA

  6. Kononenko uses laptop computer in the SM Transfer Compartment

    NASA Image and Video Library

    2012-03-21

    ISS030-E-161167 (21 March 2012) --- Russian cosmonaut Oleg Kononenko, Expedition 30 flight engineer, uses a computer in the transfer compartment of the International Space Station?s Zvezda Service Module. Russia's Zarya module is visible in the background.

  7. 14 CFR 27.1193 - Cowling and engine compartment covering.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... part of the cowling or engine compartment in the normal ground and flight attitudes. (c) No drain may... covering must be provided to preclude hazardous damage to rotors or critical control components in the...

  8. Kononenko uses laptop computer in the SM Transfer Compartment

    NASA Image and Video Library

    2012-03-21

    ISS030-E-161169 (21 March 2012) --- Russian cosmonaut Oleg Kononenko, Expedition 30 flight engineer, works in the transfer compartment of the International Space Station?s Zvezda Service Module. Russia's Zarya module is visible in the background.

  9. 2. INTERIOR, SOUTHWEST VIEW (STORAGE COMPARTMENTS). Vanadium Corporation of ...

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

    2. INTERIOR, SOUTHWEST VIEW (STORAGE COMPARTMENTS). - Vanadium Corporation of America (VCA) Naturita Mill, Mine Warehouse, 3 miles Northwest of Naturita, between Highway 141 & San Miguel River, Naturita, Montrose County, CO

  10. Abdominal compartment syndrome successfully treated with neuromuscular blockade

    PubMed Central

    Chiles, Kris T; Feeney, Colin M

    2011-01-01

    A 48 year old male admitted to the intensive care unit after a cardiac arrest complicated by a stroke intra-operatively during automatic implantable cardioverter defibrillator placement. He post-operatively developed a rigid abdomen, elevated peak and plateau pressures, hypoxia and renal insufficiency. He was diagnosed with abdominal compartment syndrome with an intra-abdominal compartment pressure of 40mmHg. The patient was administered 10 mg of intravenous cisatracuriumbesylate in preparation for bedside surgical abdominal decompression. Cisatracurium eliminated the patients need for surgical intervention by reducing his abdominal compartment pressures to normal and improving his hypoxia and renal function. This case illustrates that neuromuscular blockade should be attempted in patients with abdominal compartment syndrome prior to surgical intervention. PMID:22013257

  11. A Case of Acute Atraumatic Compartment Syndrome of the Thigh.

    PubMed

    Gutfraynd, Alexander; Philpott, Sheila

    2016-09-01

    In the absence of trauma, compartment syndrome of the thigh is rare. Several case reports have described compartment syndrome in the presence of trauma, comorbid medical conditions, and acute muscle overuse. Very few reports have demonstrated an acute onset of atraumatic thigh compartment syndrome. A 24-year-old man presented to the Emergency Department (ED) with a painful and swollen left thigh immediately after a night of dancing at a concert. He was found to have an elevated intracompartmental quadriceps pressure of 45 mm Hg in the ED, which led to his transfer to the operating room for an emergent fasciotomy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although acute, atraumatic compartment syndrome of the thigh is a rare entity, failure to diagnose it promptly can lead to muscle necrosis, permanent neurologic deficits, and amputation. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Diagnosis of compartment syndrome using a microwave-based detector

    NASA Astrophysics Data System (ADS)

    Ling, Geoffrey S. F.; Riechers, Ronald G., Sr.; Pasala, Krishna M.; Blanchard, Jeremy; Rosner, Michael; Jarell, Abel; Yun, Catherine; Garcia-Pinto, Patricia; Song, Ki-Il; Day, Keith; Riechers, Ronald G., Jr.; Zeidman, Seth M.; Rhee, Peter; Ecklund, James M.; Fitzpatrick, Thomas; Lockhart, Stephen

    2002-07-01

    A novel method for identifying compartment syndrome is presented. This method is based on a novel device that uses electromagnetic waves in the microwave radio frequency (RF) region and a modified algorithm previously used for the estimation of the angle of arrival of radar signals. In this study, we employ this radio frequency triage tool (RAFT) to the clinical condition of compartment syndrome, which is a clinical condition where blood or edema in the muscle compartment of the leg leads to critical sichemia of that exptremity. In anesthetized pigs, RAFT, can detect changes in the RF signature from a leg is due to 2cc or greater of either blood or slaine (a surrogate of edema). These results are compared to clinical examination. RAFT is superior to clinical examination in its ability to detect compartment syndrome in pgis.

  13. The Pathophysiology, Diagnosis and Current Management of Acute Compartment Syndrome

    PubMed Central

    Donaldson, James; Haddad, Behrooz; Khan, Wasim S

    2014-01-01

    Acute compartment syndrome (ACS) is a surgical emergency warranting prompt evaluation and treatment. It can occur with any elevation in interstitial pressure in a closed osseo-fascial compartment. Resultant ischaemic damage may be irreversible within six hours and can result in long-term morbidity and even death. The diagnosis is largely clinical with the classical description of ‘pain out of proportion to the injury’. Compartment pressure monitors can be a helpful adjunct where the diagnosis is in doubt. Initial treatment is with the removal of any constricting dressings or casts, avoiding hypotension and optimizing tissue perfusion by keeping the limb at heart level. If symptoms persist, definitive treatment is necessary with timely surgical decompression of all the involved compartments. This article reviews the pathophysiology, diagnosis and current management of ACS. PMID:25067973

  14. 9. Interior view of electronics compartment. View toward rear of ...

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

    9. Interior view of electronics compartment. View toward rear of aircraft. - Offutt Air Force Base, Looking Glass Airborne Command Post, Looking Glass Aircraft, On Operational Apron covering northeast half of Project Looking Glass Historic District, Bellevue, Sarpy County, NE

  15. Four open mammillary and catenary compartment models for pharmacokinetics studies.

    PubMed

    de Biasi, J

    1989-11-01

    A mathematical method is proposed to solve a fourth degree equation which gives the eigenvalues of the matrix connected with a four open compartment model used in pharmacokinetic studies. As examples, the method is applied to mammillary and catenary models.

  16. Fire spread and percolation in polydisperse compartment structures

    NASA Astrophysics Data System (ADS)

    Zekri, N.; Zekri, L.; Lallemand, C.; Pizzo, Y.; Kaiss, A.; Clerc, J.-P.; Porterie, B.

    2012-11-01

    In this paper, we employ a cellular automata and percolation analysis to model fire spread in polydisperse amorphous massively multi-compartmented structures (e.g. naval vessels, high-rise buildings, warehouses, or nuclear plants). Various shapes and sizes of compartments are considered. Each compartment is composed of nc equal-size cells. It is found that increasing nc increases fingering and lacunarities of fire patterns, and subsequently front roughness. However, this also increases the probability of fire propagation throughout the system as the percolation threshold presents a power-law decrease with nc -1 for small values of nc. For large polydisperse compartments, the propagation/non propagation transition seems to be size-independent. A special emphasis is put on the dynamics of fire propagation. Further study is needed to evaluate network properties that should help in developing better strategies to reduce fire consequences.

  17. Dynamics of the Establishment of Multinucleate Compartments in Fusarium oxysporum

    PubMed Central

    Shahi, Shermineh; Beerens, Bas; Manders, Erik M. M.

    2014-01-01

    Nuclear dynamics can vary widely between fungal species and between stages of development of fungal colonies. Here we compared nuclear dynamics and mitotic patterns between germlings and mature hyphae in Fusarium oxysporum. Using fluorescently labeled nuclei and live-cell imaging, we show that F. oxysporum is subject to a developmental transition from a uninucleate to a multinucleate state after completion of colony initiation. We observed a special type of hypha that exhibits a higher growth rate, possibly acting as a nutrient scout. The higher growth rate is associated with a higher nuclear count and mitotic waves involving 2 to 6 nuclei in the apical compartment. Further, we found that dormant nuclei of intercalary compartments can reenter the mitotic cycle, resulting in multinucleate compartments with up to 18 nuclei in a single compartment. PMID:25398376

  18. Fire safety arrangement of inhabited pressurized compartments of manned spacecraft

    NASA Astrophysics Data System (ADS)

    Bolodian, Ivan; Melikhov, Anatoliy; Tanklevskiy, Leonid

    2017-06-01

    The article deals with innovative technical solutions that provide fire safety in inhabited pressurized compartments of manned spacecraft by means of a fireproof device of inhabited pressurized compartments via application of engineering means of fire prevention and fire spreading prevention by lowering fire load in an inhabited pressurized module up to the point when the maximum possible levels of fire factors in an inhabited pressurized compartment of a manned spacecraft are prevented. Represented technical solutions are used at the present time according to stated recommendations during provision of fire safety of equipment created by a number of Russian organizations for equipage of inhabited pressurized compartments of spacecraft of the Russian segment of International space station.

  19. Comparison of tissue oxygenation and compartment pressure following tibia fracture.

    PubMed

    Hansen, Erik N; Manzano, Givenchy; Kandemir, Utku; Mok, James M

    2013-08-01

    We investigated the ability of direct continuous measurement of intramuscular tissue oxygenation (PmO(2)) to detect acute ischaemia in the leg in patients at risk for acute extremity compartment syndrome. Following tibia fracture treated by intramedullary nailing, we compared the proportions of PmO(2) and compartment pressure (CP) measurements that met the warning criteria for compartment syndrome. Participants included 10 patients sustaining acute isolated closed tibia shaft fractures treated by intramedullary nailing. A tissue oxygenation probe and a CP probe were percutaneously placed into the anterior compartment of the leg. PmO(2) and CP in the anterior compartment were measured in the injured leg for 48 h postoperatively. Measurements meeting the warning criteria were defined as PmO(2) < 10 mmHg, CP > 30 mmHg and perfusion pressure ΔP < 30 mmHg. None of the patients developed compartment syndrome. Comparison of CP and PmO(2) showed a CP > 30 mmHg in 50.39% of CP measurements in all patients and a PmO(2) < 10 mmHg in 0.75% of PmO(2) measurements in two patients (P = 0.005). Comparison of ΔP and PmO(2) showed a ΔP < 30 mmHg in 31.01% of ΔP measurements in nine patients and a PmO(2) < 10 mmHg in 0.76% of PmO(2) measurements in one patient (P = 0.01). In the absence of compartment syndrome, pressure measurements following tibia fracture treated with intramedullary nailing often met the warning criteria, whereas PmO(2) did not, suggesting that measurement of intramuscular tissue oxygenation may represent a potential method for the identification of acute compartment syndrome that deserves continued investigation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Intra-abdominal hypertension and abdominal compartment syndrome.

    PubMed

    Early, Gerald L; Wesp, Julie; Augustin, Stanley M

    2012-01-01

    Abdominal compartment syndrome (ACS) is seen with increasing frequency in the critically-ill. Elevated intraabdominal pressures interfere with vital organ function and contribute to mortality. Prevention, when possible and early recognition of occurrence with timely therapy will improve survival. Measurement of bladder pressures plays a critical role in diagnosis and guiding therapy. Treatment includes non-invasive and invasive methodologies designed to decrease the volume of abdominal contents and invasive methods to increase the compartment dimensions.

  1. Contralateral compartment syndrome inoculated by invasive group A streptococcus

    PubMed Central

    Chen, Huiwen; Mcphillips, Sean Thomas; Chundi, Vishnu

    2016-01-01

    Compartment syndrome is a rare but a well-documented complication in patients with trauma-induced group A streptococcus infection. Here, we present a case of a male who developed compartment syndrome on the left lower extremity after an injury inoculated by group A streptococcus on the right lower extremity. The patient was resuscitated with antibiotics, urgent fasciotomy, and immunoglobulin. The patient was eventually transferred to a burn center for further care. PMID:27802865

  2. Memory re-differentiation and reduced lymphocyte activation in chronic HCV-infected patients receiving direct-acting antivirals.

    PubMed

    Burchill, M A; Golden-Mason, L; Wind-Rotolo, M; Rosen, H R

    2015-12-01

    Recently, the treatment of HCV has advanced significantly due to the introduction of direct-acting antivirals (DAAs). Studies using interferon (IFN)-containing regimens failed to consistently show restoration of immunologic responses. Therefore, IFN-free DAA formulations provide a unique opportunity to dissect the immunologic effect of HCV cure. This study investigates the restoration of the immune compartment as a consequence of rapid viral clearance in patients successfully treated with DAAs and in the absence of IFN and ribavirin. Here, we evaluate the immunologic changes that occurred following DAA-mediated HCV cure. Peripheral blood from nineteen previously treatment-naïve patients with chronic HCV genotype 1a/1b who received an IFN and ribavirin-free regimen of daclatasvir, asunaprevir and BMS-791325 was evaluated. Immune reconstitution occurs in patients in whom HCV was successfully eradicated via DAA therapy. Restoration of the CD4(+) T-cell compartment in the peripheral blood and a re-differentiation of the T lymphocyte memory compartment resulted in a more effector memory cell population and a reduction in expression in the co-inhibitory molecule TIGIT in bulk T lymphocytes. Furthermore, we observed a partial reversal of the exhausted phenotype in HCV-specific CD8(+) T cells and a dampening of the activation state in peripheral NK cells. Collectively, our data provide the groundwork for dissecting the effect of DAA therapy on the immune system and identifying novel mechanisms by which chronic HCV infection exerts immunosuppressive effects on T cells through the recently described co-inhibitory molecule TIGIT.

  3. Prior Acute Mental Exertion in Exercise and Sport

    PubMed Central

    Silva-Júnior, Fernando Lopes e; Emanuel, Patrick; Sousa, Jordan; Silva, Matheus; Teixeira, Silmar; Pires, Flávio; Machado, Sérgio; Arias-Carrion, Oscar

    2016-01-01

    Introduction: Mental exertion is a psychophysiological state caused by sustained and prolonged cognitive activity. The understanding of the possible effects of acute mental exertion on physical performance, and their physiological and psychological responses are of great importance for the performance of different occupations, such as military, construction workers, athletes (professional or recreational) or simply practicing regular exercise, since these occupations often combine physical and mental tasks while performing their activities. However, the effects of implementation of a cognitive task on responses to aerobic exercise and sports are poorly understood. Our narrative review aims to provide information on the current research related to the effects of prior acute mental fatigue on physical performance and their physiological and psychological responses associated with exercise and sports. Methods: The literature search was conducted using the databases PubMed, ISI Web of Knowledge and PsycInfo using the following terms and their combinations: “mental exertion”, “mental fatigue”, “mental fatigue and performance”, “mental exertion and sports” “mental exertion and exercise”. Results: We concluded that prior acute mental exertion affects effectively the physiological and psychophysiological responses during the cognitive task, and performance in exercise. Conclusion: Additional studies involving prior acute mental exertion, exercise/sports and physical performance still need to be carried out in order to analyze the physiological, psychophysiological and neurophysiological responses subsequently to acute mental exertion in order to identify cardiovascular factors, psychological, neuropsychological associates. PMID:27867415

  4. Differential gene expression in anatomical compartments of the human eye

    PubMed Central

    Diehn, Jennifer J; Diehn, Maximilian; Marmor, Michael F; Brown, Patrick O

    2005-01-01

    Background The human eye is composed of multiple compartments, diverse in form, function, and embryologic origin, that work in concert to provide us with our sense of sight. We set out to systematically characterize the global gene expression patterns that specify the distinctive characteristics of the various eye compartments. Results We used DNA microarrays representing approximately 30,000 human genes to analyze gene expression in the cornea, lens, iris, ciliary body, retina, and optic nerve. The distinctive patterns of expression in each compartment could be interpreted in relation to the physiology and cellular composition of each tissue. Notably, the sets of genes selectively expressed in the retina and in the lens were particularly large and diverse. Genes with roles in immune defense, particularly complement components, were expressed at especially high levels in the anterior segment tissues. We also found consistent differences between the gene expression patterns of the macula and peripheral retina, paralleling the differences in cell layer densities between these regions. Based on the hypothesis that genes responsible for diseases that affect a particular eye compartment are likely to be selectively expressed in that compartment, we compared our gene expression signatures with genetic mapping studies to identify candidate genes for diseases affecting the cornea, lens, and retina. Conclusion Through genome-scale gene expression profiling, we were able to discover distinct gene expression 'signatures' for each eye compartment and identified candidate disease genes that can serve as a reference database for investigating the physiology and pathophysiology of the eye. PMID:16168081

  5. Modulatory compartments in cortex and local regulation of cholinergic tone.

    PubMed

    Coppola, Jennifer J; Ward, Nicholas J; Jadi, Monika P; Disney, Anita A

    2016-09-01

    Neuromodulatory signaling is generally considered broad in its impact across cortex. However, variations in the characteristics of cortical circuits may introduce regionally-specific responses to diffuse modulatory signals. Features such as patterns of axonal innervation, tissue tortuosity and molecular diffusion, effectiveness of degradation pathways, subcellular receptor localization, and patterns of receptor expression can lead to local modification of modulatory inputs. We propose that modulatory compartments exist in cortex and can be defined by variation in structural features of local circuits. Further, we argue that these compartments are responsible for local regulation of neuromodulatory tone. For the cholinergic system, these modulatory compartments are regions of cortical tissue within which signaling conditions for acetylcholine are relatively uniform, but between which signaling can vary profoundly. In the visual system, evidence for the existence of compartments indicates that cholinergic modulation likely differs across the visual pathway. We argue that the existence of these compartments calls for thinking about cholinergic modulation in terms of finer-grained control of local cortical circuits than is implied by the traditional view of this system as a diffuse modulator. Further, an understanding of modulatory compartments provides an opportunity to better understand and perhaps correct signal modifications that lead to pathological states.

  6. Understanding the Mismatch Between Coaches' and Players' Perceptions of Exertion.

    PubMed

    Brink, Michel S; Kersten, Anna W; Frencken, Wouter G P

    2017-04-01

    A mismatch between the training exertion intended by a coach and the exertion perceived by players is well established in sports. However, it is unknown whether coaches can accurately observe exertion of individual players during training. Furthermore, the discrepancy in coaches' and players' perceptions has not been explained. To determine the relation between intended and observed training exertion by the coach and perceived training exertion by the players and establish whether on-field training characteristics, intermittent endurance capacity, and maturity status explain the mismatch. During 2 mesocycles of 4 wk (in November and March), rating of intended exertion (RIE), rating of observed exertion (ROE), and rating of perceived exertion (RPE) were monitored in 31 elite young soccer players. External and internal training loads were objectively quantified with accelerometers (PlayerLoad) and heart-rate monitors (TRIMPmod). Results of an interval shuttle-run test (ISRT) and age at peak height velocity (APHV) were determined for all players. RIE, ROE, and RPE were monitored in 977 training sessions. The correlations between RIE and RPE (r = .58; P < .01) and between ROE and RPE (r = .64; P < .01) were moderate. The mean difference between RIE and RPE was -0.31 ± 1.99 and between ROE and RPE was -0.37 ± 1.87. Multilevel analyses showed that PlayerLoad and ISRT predicted RIE and ROE. Coaches base their intended and observed exertion on what they expect players will do and what they actually did on the field. When doing this, they consider the intermittent endurance capacity of individual players.

  7. [Acute cardiovascular complications of vigorous physical exertion by untrained persons].

    PubMed

    Hart, H Ch; Hart, W

    2002-08-10

    Physical exertion has paradoxical effects: regular physical activity offers protection against cardiovascular diseases, but, on the other hand, it has been shown that strenuous exercise can provoke coronary heart disease and sudden death. The risks of vigorous exertion apply particularly to untrained individuals and persons with a sedentary lifestyle. Physical exertion can cause a myocardial infarction or sudden death in people who were considered perfectly healthy before this event. In most cases, the mechanism of this is probably a rupture at the site of a vulnerable atherosclerotic plaque, with local activation of coagulation. Disturbances in cardiac rhythm may also be a cause of these complications.

  8. Compartment Syndrome of the Gluteus Medius Occurred without Bleeding or Trauma: A Case Report.

    PubMed

    Kong, Gyu-Min; Kwon, Yong-Uk; Park, Jun-Ho

    2015-12-01

    Compartment syndrome is an ischemic change resulting from an increase in compartment pressure. Initially, patients present with direct tenderness and swelling, and the weak circulation secondary to compartment syndrome can eventually lead to motor and sensory impairment. If the increase in pressure results in neurological impairment, emergency intervention is required to decompress the compartment. Typically, compartment syndrome develops on forearms or lower legs. The gluteal compartment is rarely the location of compartment syndrome and only a few cases have been presented in the literature with trauma or hematoma. We have treated a patient with gluteal compartment syndrome who presented with no history of trauma or hemorrhage and present that case report here.

  9. The role of each compartment in a two-compartment vertical flow reactor for ferruginous mine water treatment.

    PubMed

    Yim, G J; Cheong, Y W; Hong, J H; Hur, W

    2014-10-01

    A vertical flow reactor (VFR) has been suggested for remediation of ferruginous mine drainage that passes down through an accreting bed of ochre. However, a VFR has a limited operation time until the system begins to overflow. In this study, a mathematical model was developed as a part of the effort to explore the operation of a VFR, showing dynamic changes in the head differences, ochre depths, and Fe(II)/Fe(III) concentrations in the effluent flow. The analysis showed that VFR operation time extended from 148.5 days to 163 days in an equally divided and to 168.4 days in asymmetrically (0.72:0.28) divided two-compartment VFR, suggesting that an optimum compartment ratio exists that maximizes the VFR operation time. A constant head filtration in the first compartment maximized filtration efficiency and thus prolonged VFR longevity in the two-compartment VFR. Fe(II) oxidation and ochre formation should be balanced with the permeability of the ochre bed to maximize the VFR operation time and minimize the residual Fe(II) in the effluent. Accelerated Fe(II) oxidation affected the optimum ratio of the compartment area and reduced the residual Fe(II) in the effluent. The VFR operation time can be prolonged significantly from 764 days to 3620 days by increasing the rate of ochre formation, much more than by accelerating the Fe(II) oxidation. During the prolonged VFR operation, ochre formed largely in the first compartment, while overflowing mine water with reduced iron content was effectively filtered in the second compartment. These results not only provide a better understanding of VFR operation but also suggest the direction of evolution of two-compartment VFR toward a compact and highly efficient facility integrated with an aerated cascade and with automatic coagulant feeding. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Compartment-specific quantitative gene expression analysis after laser microdissection from archival renal allograft biopsies.

    PubMed

    Serinsöz, E; Bock, O; Kirsch, T; Haller, H; Lehmann, U; Kreipe, H; Mengel, M

    2005-03-01

    Various immunological and non-immunological pathomechanisms are responsible for the cellular damage in renal allografts. Since the kidney is an anatomically complex organ with functional and morphological heterogeneous compartments (interstitium, tubuli, vessels, glomeruli), the local response to injury maybe variable, therefore, the identification of local pathomechanisms is important. To elucidate any discrepancies in quantitative mRNA expression profiles between a total specimen analysis and a cell-specific evaluation after laser microdissection. Real-time RT-PCR was performed for complement component C3 and heme oxygenase-1 (HO-1) genes compared to the housekeeping gene beta-actin using whole section RNA extracted from formalin-fixed and paraffin-embedded archival material of 16 explanted, rejected renal allografts. Ten non-transplant nephrectomies served as controls. For five cases from each group, five different compartments of the organs (interstitium, proximal tubuli, distal tubuli, vessels, glomeruli) were microdissected and quantitative analysis for C3 and HO-1 was performed identically. Whole section mRNA expression analysis: the data showed a constant expression of the housekeeping gene beta-actin, a 7-fold increased expression of C3 and a 3-fold decreased expression of HO-1 in the allograft group as compared to the control group. mRNA expression results from microdissected compartments: in the control group, C3 and HO-1 expression could only be detected in the proximal tubuli of all cases whereas all five compartments analyzed from the rejecting kidneys showed expression of the two genes. In the allografts, expression levels of the investigated genes varied considerably not only among the different compartments but between individual cases as well. Laser microdissection combined with real-time RT-PCR is a feasible approach for retrospective quantitative gene expression analysis in formalin-fixed and paraffin-embedded renal allograft specimens. As shown

  11. Exertional heat stroke, rhabdomyolysis and susceptibility to malignant hyperthermia.

    PubMed

    Thomas, J; Crowhurst, T

    2013-09-01

    Unexpectedly severe exertional heat stroke and rhabdomyolysis should prompt a clinician to look for susceptibility to malignant hyperthermia. We report a case of exertional heat stroke and rhabdomyolysis in a man later determined to have the malignant hyperthermia phenotype. We review the existing literature regarding this association and suggest future research that could address areas of remaining clinical uncertainty. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

  12. Aerobic Fitness and Risk of Ventricular Arrhythmia Following Physical Exertion.

    PubMed

    Chahal, Harpreet S; Mostofsky, Elizabeth; Mittleman, Murray A; Suskin, Neville; Speechley, Mark; Skanes, Allan C; Leong-Sit, Peter; Manlucu, Jaimie; Yee, Raymond; Klein, George J; Gula, Lorne J

    2016-04-01

    Brief episodes of physical exertion are associated with an immediately greater risk of cardiovascular events. Previous studies on the risk of ventricular arrhythmia (VA) shortly after exertion have not assessed if this risk differs according to the level of aerobic fitness or sedentary behaviour. Therefore, we conducted a prospective cohort study of patients with implantable cardioverter-defibrillators (ICDs) with a nested case-crossover analysis to examine the risk of VA shortly after exertion and whether this risk is modified by aerobic fitness and sedentary behaviour. Ninety-seven consecutive patients were recruited at the time of ICD implantation and 30 confirmed events occurred among patients who completed interviews about physical exertion preceding ICD therapy. We compared the frequency of exertion within an hour of ICD discharge to each patient's usual frequency of exertion reported at the time of ICD implantation. Within an hour of episodes of exertion, the risk of VA was 5.3 (95% confidence interval [CI], 2.7-10.6) times greater compared with periods of rest. The association was higher among patients with aerobic fitness below the median (relative risk [RR] = 17.5; 95% CI, 5.2-58.5) than for patients with aerobic fitness above the median (RR, 1.2; 95% CI, 0.4-4.2; P homogeneity = 0.002) and higher among patients who were sedentary (RR, 52.8; 95% CI, 10.1-277) compared with individuals who were not sedentary (RR, 3.2; 95% CI, 1.3-7.6; P homogeneity = 0.0002). Within 1 hour of episodes of exertion, there is an increased risk of VA, especially among individuals with lower levels of aerobic fitness and with sedentary behaviour. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  13. Rab5 activity regulates GLUT4 sorting into insulin-responsive and non-insulin-responsive endosomal compartments: a potential mechanism for development of insulin resistance.

    PubMed

    Tessneer, Kandice L; Jackson, Robert M; Griesel, Beth A; Olson, Ann Louise

    2014-09-01

    Glucose transporter isoform 4 (GLUT4) is the insulin-responsive glucose transporter mediating glucose uptake in adipose and skeletal muscle. Reduced GLUT4 translocation from intracellular storage compartments to the plasma membrane is a cause of peripheral insulin resistance. Using a chronic hyperinsulinemia (CHI)-induced cell model of insulin resistance and Rab5 mutant overexpression, we determined these manipulations altered endosomal sorting of GLUT4, thus contributing to the development of insulin resistance. We found that CHI induced insulin resistance in 3T3-L1 adipocytes by retaining GLUT4 in a Rab5-activity-dependent compartment that is unable to equilibrate with the cell surface in response to insulin. Furthermore, CHI-mediated retention of GLUT4 in this non-insulin-responsive compartment impaired filling of the transferrin receptor (TfR)-positive and TfR-negative insulin-responsive storage compartments. Our data suggest that hyperinsulinemia may inhibit GLUT4 by chronically maintaining GLUT4 in the Rab5 activity-dependent endosomal pathway and impairing formation of the TfR-negative and TfR-positive insulin-responsive GLUT4 pools. This model suggests that an early event in the development of insulin-resistant glucose transport in adipose tissue is to alter the intracellular localization of GLUT4 to a compartment that does not efficiently equilibrate with the cell surface when insulin levels are elevated for prolonged periods of time.

  14. Do placebo expectations influence perceived exertion during physical exercise?

    PubMed

    Mothes, Hendrik; Leukel, Christian; Seelig, Harald; Fuchs, Reinhard

    2017-01-01

    This study investigates the role of placebo expectations in individuals' perception of exertion during acute physical exercise. Building upon findings from placebo and marketing research, we examined how perceived exertion is affected by expectations regarding a) the effects of exercise and b) the effects of the exercise product worn during the exercise. We also investigated whether these effects are moderated by physical self-concept. Seventy-eight participants conducted a moderate 30 min cycling exercise on an ergometer, with perceived exertion (RPE) measured every 5 minutes. Beforehand, each participant was randomly assigned to 1 of 4 conditions and watched a corresponding film clip presenting "scientific evidence" that the exercise would or would not result in health benefits and that the exercise product they were wearing (compression garment) would additionally enhance exercise benefits or would only be worn for control purposes. Participants' physical self-concept was assessed via questionnaire. Results partially demonstrated that participants with more positive expectations experienced reduced perceived exertion during the exercise. Furthermore, our results indicate a moderator effect of physical self-concept: Individuals with a high physical self-concept benefited (in terms of reduced perceived exertion levels) in particular from an induction of generally positive expectations. In contrast, individuals with a low physical self-concept benefited when positive expectations were related to the exercise product they were wearing. In sum, these results suggest that placebo expectations may be a further, previously neglected class of psychological factors that influence the perception of exertion.

  15. Musical agency reduces perceived exertion during strenuous physical performance.

    PubMed

    Fritz, Thomas Hans; Hardikar, Samyogita; Demoucron, Matthias; Niessen, Margot; Demey, Michiel; Giot, Olivier; Li, Yongming; Haynes, John-Dylan; Villringer, Arno; Leman, Marc

    2013-10-29

    Music is known to be capable of reducing perceived exertion during strenuous physical activity. The current interpretation of this modulating effect of music is that music may be perceived as a diversion from unpleasant proprioceptive sensations that go along with exhaustion. Here we investigated the effects of music on perceived exertion during a physically strenuous task, varying musical agency, a task that relies on the experience of body proprioception, rather than simply diverting from it. For this we measured psychologically indicated exertion during physical workout with and without musical agency while simultaneously acquiring metabolic values with spirometry. Results showed that musical agency significantly decreased perceived exertion during workout, indicating that musical agency may actually facilitate physically strenuous activities. This indicates that the positive effect of music on perceived exertion cannot always be explained by an effect of diversion from proprioceptive feedback. Furthermore, this finding suggests that the down-modulating effect of musical agency on perceived exertion may be a previously unacknowledged driving force for the development of music in humans: making music makes strenuous physical activities less exhausting.

  16. Musical agency reduces perceived exertion during strenuous physical performance

    PubMed Central

    Fritz, Thomas Hans; Hardikar, Samyogita; Demoucron, Matthias; Niessen, Margot; Demey, Michiel; Giot, Olivier; Li, Yongming; Haynes, John-Dylan; Villringer, Arno; Leman, Marc

    2013-01-01

    Music is known to be capable of reducing perceived exertion during strenuous physical activity. The current interpretation of this modulating effect of music is that music may be perceived as a diversion from unpleasant proprioceptive sensations that go along with exhaustion. Here we investigated the effects of music on perceived exertion during a physically strenuous task, varying musical agency, a task that relies on the experience of body proprioception, rather than simply diverting from it. For this we measured psychologically indicated exertion during physical workout with and without musical agency while simultaneously acquiring metabolic values with spirometry. Results showed that musical agency significantly decreased perceived exertion during workout, indicating that musical agency may actually facilitate physically strenuous activities. This indicates that the positive effect of music on perceived exertion cannot always be explained by an effect of diversion from proprioceptive feedback. Furthermore, this finding suggests that the down-modulating effect of musical agency on perceived exertion may be a previously unacknowledged driving force for the development of music in humans: making music makes strenuous physical activities less exhausting. PMID:24127588

  17. Bilaterally Symmetrical Lower Extremity Compartment Syndrome following Massive Transfusion

    PubMed Central

    Karaoren, Gulsah; Bakan, Nurten; Tomruk, Senay Goksu; Topaç, Zelin; Kurtulmuş, Tuhan; Irkören, Saime

    2016-01-01

    Compartment syndrome is a serious condition characterized by raised intracompartmental pressure, which develops following trauma. Well leg compartment syndrome (WLCS) is a term reserved for compartment syndrome in a nontraumatic setting, usually resulting from prolonged lithotomy position during surgery. In literature, 8 cases have been reported regarding well leg compartment syndrome in a supine position and bilateral symmetrical involvement was observed in only 2 cases. In WLCS etiology, lengthy surgery, lengthy hypotension, and extremity malpositioning have been held responsible but one of the factors with a role in the etiology may have been the tissue oedema and impaired microcirculation formed from the effect of vasoactive mediators expressed into the circulation associated with the massive blood transfusion. The case is presented here regarding symmetrical lower extremity compartment syndrome after surgery in which massive transfusion was made for gross haemorrhage from an abdominal injury. In conclusion, blood transfusion applied at the required time is life-saving but potential risks must always be considered. PMID:26885421

  18. Numerical modelling of crural fascia mechanical interaction with muscular compartments.

    PubMed

    Pavan, Piero G; Pachera, Paola; Natali, Arturo N

    2015-05-01

    The interaction of the crural fascia with muscular compartments and surrounding tissues can be at the origin of different pathologies, such as compartment syndrome. This pathology consists in the onset of excessive intracompartmental pressure, which can have serious consequences for the patient, compromising blood circulation. The investigation of compartment syndrome etiology also takes into account the alteration of crural fascia mechanical properties as a cause of the syndrome, where the fascial stiffening would result in the rise of intracompartmental pressure. This work presents a computational approach toward evaluating some biomechanical aspects of the problem, within the context of a more global viewpoint. Finite element analyses of the interaction phenomena of the crural fascia with adjacent regions are reported here. This study includes the effects of a fascial stiffness increase along the proximal-distal direction and their possible clinical implications. Furthermore, the relationship between different pre-strain levels of the crural fascia in the proximal-distal direction and the rise of internal pressure in muscular compartments are considered. The numerical analyses can clarify which aspects could be directly implied in the rise of compartment syndrome, leading to greater insight into muscle-fascia mechanical phenomena, as well as promoting experimental investigation and clinical analysis of the syndrome.

  19. Assessment of Malpractice Claims Associated With Acute Compartment Syndrome.

    PubMed

    DePasse, John Mason; Sargent, Rachel; Fantry, Amanda J; Bokshan, Steven L; Palumbo, Mark A; Daniels, Alan H

    2017-06-01

    Because acute compartment syndrome is one of the few limb-threatening and life-threatening orthopaedic conditions and is difficult to diagnose, it is a frequent source of litigation. Understanding the factors that lead to plaintiff verdicts and higher indemnity payments may improve patient care by identifying common pitfalls. The VerdictSearch legal claims database was queried for the term "compartment syndrome." After 46 cases were excluded for missing information or irrelevancy, 139 cases were reviewed. The effects of plaintiff demographics, mechanism of injury, and complications were assessed. Of 139 cases, 37 (27%) were settled, 69 (50%) resulted in a defendant ruling, and 33 (24%) resulted in a plaintiff ruling. Juries were more likely to rule in favor of juvenile plaintiffs than adult patients (P = 0.002) and female plaintiffs than male plaintiffs (P = 0.008), but indemnity payments were not affected by the age or sex of the plaintiff. Plaintiffs who experienced acute compartment syndrome as a complication of surgery were more likely to win their suit and receive higher awards (P < 0.05), compared with those in whom the condition developed as a result of trauma. Amputation or delay in diagnosis or treatment did not affect plaintiff verdicts or awards. Defendants were more likely to lose a lawsuit concerning the management of acute compartment syndrome if the patient was a woman or child or if acute compartment syndrome developed as a complication of a surgical procedure.

  20. Elevated compartment pressures from copperhead envenomation successfully treated with antivenin.

    PubMed

    Mazer-Amirshahi, Maryann; Boutsikaris, Amy; Clancy, Cathleen

    2014-01-01

    Copperhead envenomation causes local soft tissue effects; however, associated compartment syndrome is rare. We report a case of a 17-month-old with significantly elevated compartment pressures successfully treated with antivenin and supportive care. A 17-month-old girl sustained a copperhead bite to the foot and presented with circumferential edema, erythema, and ecchymosis of the foot and distal ankle. The patient had palpable pulses and was neurologically intact. Four vials of Crotalidae polyvalent immune Fab was initiated and additional doses were administered in an attempt to achieve local control. Within 10 h of presentation, the patient's edema extended to the groin, although sensation was maintained and pulses were documented by Doppler. Lower-extremity compartment pressures were measured and were most notable for an anterior pressure of 85 mm Hg, despite having received 12 vials of antivenin. Fasciotomy was deferred and the patient received two additional six-vial doses of antivenin to achieve local control. Compartment pressures improved with a 2.2-cm mean decrease in limb diameter within 48 h. Maintenance dosing was initiated and the patient ultimately received a total of 26 vials of antivenin. The patient did not develop significant coagulopathy or thrombocytopenia. Swelling continued to improve with return of limb function. In this case, early and aggressive treatment with antivenin may have avoided invasive fasciotomy, and its use should be considered in patients with copperhead envenomation and significantly elevated compartment pressures. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Measurement of compartment elasticity using pressure related ultrasound: a method to identify patients with potential compartment syndrome.

    PubMed

    Sellei, R M; Hingmann, S J; Kobbe, P; Weber, C; Grice, J E; Zimmerman, F; Jeromin, S; Gansslen, A; Hildebrand, F; Pape, H C

    2015-01-01

    PURPOSE OF THE STUDY Decision-making in treatment of an acute compartment syndrome is based on clinical assessment, supported by invasive monitoring. Thus, evolving compartment syndrome may require repeated pressure measurements. In suspected cases of potential compartment syndromes clinical assessment alone seems to be unreliable. The objective of this study was to investigate the feasibility of a non-invasive application estimating whole compartmental elasticity by ultrasound, which may improve accuracy of diagnostics. MATERIAL AND METHODS In an in-vitro model, using an artificial container simulating dimensions of the human anterior tibial compartment, intracompartmental pressures (p) were raised subsequently up to 80 mm Hg by infusion of saline solution. The compartmental depth (mm) in the cross-section view was measured before and after manual probe compression (100 mm Hg) upon the surface resulting in a linear compartmental displacement (Δd). This was repeated at rising compartmental pressures. The resulting displacements were related to the corresponding intra-compartmental pressures simulated in our model. A hypothesized relationship between pressures related compartmental displacement and the elasticity at elevated compartment pressures was investigated. RESULTS With rising compartmental pressures, a non-linear, reciprocal proportional relation between the displacement (mm) and the intra-compartmental pressure (mm Hg) occurred. The Pearson's coefficient showed a high correlation (r2 = -0.960). The intraobserver reliability value kappa resulted in a statistically high reliability (κ = 0.840). The inter-observer value indicated a fair reliability (κ = 0.640). CONCLUSIONS Our model reveals that a strong correlation between compartmental strain displacements assessed by ultrasound and the intra-compartmental pressure changes occurs. Further studies are required to prove whether this assessment is transferable to human muscle tissue. Determining the complete

  2. Challenging Return to Play Decisions: Heat Stroke, Exertional Rhabdomyolysis, and Exertional Collapse Associated With Sickle Cell Trait.

    PubMed

    Asplund, Chad A; O'Connor, Francis G

    2016-01-01

    Sports medicine providers frequently return athletes to play after sports-related injuries and conditions. Many of these conditions have guidelines or medical evidence to guide the decision-making process. Occasionally, however, sports medicine providers are challenged with complex medical conditions for which there is little evidence-based guidance and physicians are instructed to individualize treatment; included in this group of conditions are exertional heat stroke (EHS), exertional rhabdomyolysis (ER), and exertional collapse associated with sickle cell trait (ECAST). The MEDLINE (2000-2015) database was searched using the following search terms: exertional heat stroke, exertional rhabdomyolysis, and exertional collapse associated with sickle cell trait. References from consensus statements, review articles, and book chapters were also utilized. Clinical review. Level 4. These entities are unique in that they may cause organ system damage capable of leading to short- or long-term detriments to physical activity and may not lend to complete recovery, potentially putting the athlete at risk with premature return to play. With a better understanding of the pathophysiology of EHS, ER, and ECAST and the factors associated with recovery, better decisions regarding return to play may be made. © 2015 The Author(s).

  3. A case of nonisland pedicled foot fillet flap for below-knee amputation stump wound: treatment option for compartment syndrome after fibular free flap surgery.

    PubMed

    Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong

    2014-02-01

    Despite the frequent use of the fibular free flap, there have been no reports of severe compartment syndrome of the donor leg that necessitated limb amputation. A 66-yr-old man had a fibular osseous free flap transfer from the left leg to the mandible that was complicated by postoperative compartment syndrome. An extensive chronic leg wound resulted, which was treated with multiple debridements and finally with below-knee amputation. Successful coverage of the below-knee amputation stump was accomplished with a nonisland pedicled foot fillet flap. Various foot fillet flaps may be used acutely as a free or an island pedicled flap, but dissection of the vascular pedicle may be difficult in a chronically inflamed wound because of inflammation and adhesions to surrounding tissue. The nonisland pedicled foot fillet flap may be considered as a useful option for treatment of a chronically inflamed stump wound after below-knee amputation.

  4. Psittacine paranasal sinus--a new definition of compartments.

    PubMed

    Artmann, A; Henninger, W

    2001-12-01

    Documentation of the psittacine paranasal sinuses has been limited. To provide more published detail, spiral computed tomography (CT) was used to scan the cephalic and cervical region from cadavers of 10 psittacine birds (Ara ararauna, Ara chloroptera, Ara macao, and Anodorhynchus hyacinthinus). Skeletal studies, histologic examinations, and evaluation of deep-frozen sections and anatomic preparations confirmed the results of the CT scans. New morphologic details of the paranasal sinus and some compartments were discovered. The paranasal sinuses of these macaws consist of two unpaired rostral compartments, followed caudally by eight paired compartments. Histologic examinations revealed that the walls of the paranasal sinuses consist of flat or cubic monolayer epithelium with underlying connective tissue. The described method of CT examination of these macaws, especially the positioning, scan orientation and parameters, and documentation of the normal paranasal sinus, provides a basis for future clinical use of CT.

  5. Fire safety evaluation of aircraft lavatory and cargo compartments

    NASA Technical Reports Server (NTRS)

    Kourtides, D. A.; Parker, J. A.; Hilado, C. J.; Anderson, R. A.; Tustin, E.; Arnold, D. E.; Gaume, J. G.; Binding, A. T.; Mikeska, J. L.

    1975-01-01

    Large-scale aircraft lavatory and cargo compartment fire tests are described. Tests were conducted to evaluate the effectiveness of these compartments to contain fire and smoke. Two tests were conducted and are detailed. Test 1 involved a production Boeing 747 lavatory of the latest design installed in an enclosure outside the aircraft, to collect gases and expose animals to these gases. Results indicate that the interior of the lavatory was completely burned, evolving smoke and combustion products in the enclosure. Test 2 involved a simulated Douglas DC-10 cargo compartment retro-fitted with standard fiberglass liner. The fire caused excessive damage to the liner and burned through the ceiling in two areas. Test objectives, methods, materials, and results are presented and discussed.

  6. A total and biosafe liquefaction compartment for MELiSSA

    NASA Astrophysics Data System (ADS)

    Verstraete, W.; Albrecht, T.; Kübe, J.; Dussap, G.; Creuly, C.

    2005-10-01

    Envisaging long-duration space missions and settlements on the Moon or even on more distant planets means considering the production of food and the recycling of scarce, valuable chemical species from waste. ESA's MELiSSA project (Micro-Ecological Life Support System Alternative) is studying, in which five different compartments degrade waste into basic chemicals and then assimilate them into food, clean water and a breathable atmosphere. Crucial to the success of such a closed system is the absolute efficiency of the first compartment, in which all waste is biologically degraded into easily assimilable basic compounds. In order to ease this strenuous task and to ensure total and biosafe liquefaction of the waste, this MAP project is studying additional technologies that complement MELiSSA's waste degrading compartment.

  7. Hypothyroid-induced acute compartment syndrome in all extremities

    PubMed Central

    Musielak, Matthew C.; Chae, Jung Hee

    2016-01-01

    Acute compartment syndrome (ACS) is an uncommon complication of uncontrolled hypothyroidism. If unrecognized, this can lead to ischemia, necrosis and potential limb loss. A 49-year-old female presented with the sudden onset of bilateral lower and upper extremity swelling and pain. The lower extremity anterior compartments were painful and tense. The extensor surface of the upper extremities exhibited swelling and pain. Motor function was intact, however, limited due to pain. Bilateral lower extremity fasciotomies were performed. Postoperative Day 1, upper extremity motor function decreased significantly and paresthesias occurred. She therefore underwent bilateral forearm fasciotomies. The pathogenesis of hypothyroidism-induced compartment syndrome is unclear. Thyroid-stimulating hormone-induced fibroblast activation results in increased glycosaminoglycan deposition. The primary glycosaminoglycan in hypothyroid myxedematous changes is hyaluronic acid, which binds water causing edema. This increases vascular permeability, extravasation of proteins and impaired lymphatic drainage. These contribute to increased intra-compartmental pressure and subsequent ACS. PMID:28003319

  8. Acute Compartment Syndrome of the Limbs: Current Concepts and Management

    PubMed Central

    Mabvuure, Nigel Tapiwa; Malahias, Marco; Hindocha, Sandip; Khan, Wasim; Juma, Ali

    2012-01-01

    Acute compartment syndrome (ACS) of the limb refers to a constellation of symptoms, which occur following a rise in the pressure inside a limb muscle compartment. A failure or delay in recognising ACS almost invariably results in adverse outcomes for patients. Unrecognised ACS can leave patients with nonviable limbs requiring amputation and can also be life–threatening. Several clinical features indicate ACS. Where diagnosis is unclear there are several techniques for measuring intracompartmental pressure described in this review. As early diagnosis and fasciotomy are known to be the best determinants of good outcomes, it is important that surgeons are aware of the features that make this diagnosis likely. This clinical review discusses current knowledge on the relevant clinical anatomy, aetiology, pathophysiology, risk factors, clinical features, diagnostic procedures and management of an acute presentation of compartment syndrome. PMID:23248724

  9. [Chronic sports injuries of the knee joint].

    PubMed

    Mannil, M; Andreisek, G; Weishaupt, D; Fischer, M A

    2016-05-01

    Chronic sports injuries of the knee joint are common and mainly caused by repetitive (micro) trauma and exertion. Chronic insertion tendinopathies and avulsion fractures and symptoms related to entrapment, friction and impingement can be pathophysiologically distinguished in athletes. In this review, we depict the characteristic magnetic resonance imaging (MRI) findings of the most commonly occurring pathologies.

  10. Unloader braces for medial compartment knee osteoarthritis: implications on mediating progression.

    PubMed

    Ramsey, Dan K; Russell, Mary E

    2009-09-01

    For persons with unicompartment knee osteoarthritis (OA), off-unloader braces are a mechanical intervention designed to reduce pain, improve physical function, and possibly slow disease progression. Pain relief is thought to be mediated by distracting the involved compartment via external varus or valgus forces applied to the knee. In so doing, tibiofemoral alignment is improved, and load is shifted off the degenerative compartment, where exposure to potentially damaging and provocative mechanical stresses are reduced. To provide a synopsis of the evidence documented in the scientific literature concerning the efficacy of off-loader knee braces for improving symptomatology associated with painful disabling medial compartment knee OA. Relevant peer-reviewed publications were retrieved from a MEDLINE search using the terms with the reference terms osteoarthritis, knee, and braces (per Medical Subject Headings), plus a manual search of bibliographies from original and review articles and appropriate Internet resources. For persons with combined unicompartment knee OA and mild to moderate instability, the strength of recommendation reported by the Osteoarthritis Research Society International in the ability of off-loader knee braces to reduce pain, improve stability, and diminish the risk of falling was 76% (95% confidence interval, 69%-83%). The more evidence the treatment is effective, the higher the percentage. Given the encouraging evidence that off-loader braces are effective in mediating pain relief in conjunction with knee OA and malalignment, bracing should be fully used before joint realignment or replacement surgery is considered. With the number of patients with varus deformities and knee pain predicted to increase as the population ages, a reduction of patient morbidity for this widespread chronic condition in combination with this treatment modality could have a positive impact on health care costs and the economic productivity and quality of life of the

  11. Intense basketball-simulated exercise induces muscle damage in men with elevated anterior compartment pressure.

    PubMed

    Kostopoulos, Nikos; Fatouros, Ioannis G; Siatitsas, Ioannis; Baltopoulos, Panagiotis; Kambas, Antonios; Jamurtas, Athanasios Z; Fotinakis, Panagiotis

    2004-08-01

    The purpose of the present investigation was to examine the levels of muscle soreness, muscle damage, and performance output in men with (S, n = 24) or without (A, n = 24) chronic compartment syndrome (CACS)-related symptoms after an intense 10-minute basketball-simulated exercise. Anterior compartment pressure (ICP), muscle soreness perception, creatine kinase (CK) and lactate dehydrogenase (LDH) activities, myoglobin (Mb) concentration, leg strength, and knee joint range of motion (KJRM) were measured at rest, immediately after exercise, and at 24, 48, 72 and 96 hours postexercise (ICP was also measured at 5, 15, and 30 minutes postexercise). ICP, muscle soreness, CK, LDH, and myoglobin increased (p < 0.05) immediately postexercise and during the next 4 days of recovery in both groups. However, S demonstrated a far more pronounced and prolonged (p < 0.05) response than A. Leg strength and KJRM declined (p < 0.05) in both groups, but S demonstrated a greater (p < 0.05) performance deterioration than A. The results of this study suggest that intense basketball-simulated exercise increases ICP, muscle soreness, and indices of muscle damage with a concomitant decrease of performance. Men with CACS-related symptoms and/or history appear more sensitive to muscle damage and soreness than asymptomatic men, probably due to a compromised blood flow to the muscle producing fluid shifts from vascular to interstitial space and further increasing compartment pressure and muscle cell disruption. Results of the present investigation provide evidence to support proper diagnosis, monitoring, care, and preventive measures for symptomatic individuals prior to participation in activities such as basketball.

  12. Exertional rhabdomyolysis: physiological response or manifestation of an underlying myopathy?

    PubMed Central

    Scalco, Renata S; Snoeck, Marc; Quinlivan, Ros; Treves, Susan; Laforét, Pascal; Jungbluth, Heinz; Voermans, Nicol C

    2016-01-01

    Exertional rhabdomyolysis is characterised by muscle breakdown associated with strenuous exercise or normal exercise under extreme circumstances. Key features are severe muscle pain and sudden transient elevation of serum creatine kinase (CK) levels with or without associated myoglobinuria. Mild cases may remain unnoticed or undiagnosed. Exertional rhabdomyolysis is well described among athletes and military personnel, but may occur in anybody exposed to unaccustomed exercise. In contrast, exertional rhabdomyolysis may be the first manifestation of a genetic muscle disease that lowers the exercise threshold for developing muscle breakdown. Repeated episodes of exertional rhabdomyolysis should raise the suspicion of such an underlying disorder, in particular in individuals in whom the severity of the rhabdomyolysis episodes exceeds the expected response to the exercise performed. The present review aims to provide a practical guideline for the acute management and postepisode counselling of patients with exertional rhabdomyolysis, with a particular emphasis on when to suspect an underlying genetic disorder. The pathophysiology and its clinical features are reviewed, emphasising four main stepwise approaches: (1) the clinical significance of an acute episode, (2) risks of renal impairment, (3) clinical indicators of an underlying genetic disorders and (4) when and how to recommence sport activity following an acute episode of rhabdomyolysis. Genetic backgrounds that appear to be associated with both enhanced athletic performance and increased rhabdomyolysis risk are briefly reviewed. PMID:27900193

  13. Superior Mesenteric Artery Syndrome with Abdominal Compartment Syndrome

    PubMed Central

    Reece, Kevin; Day, Rachel

    2016-01-01

    Superior Mesenteric Artery (SMA) syndrome is a condition in which the duodenum becomes compressed between the SMA and the aorta, resulting in bowel obstruction which subsequently compresses surrounding structures. Pressure on the inferior vena cava (IVC) and aorta decreases cardiac output which compromises distal blood flow, resulting in abdominal compartment syndrome with ischemia and renal failure. A 15-year-old male with SMA syndrome presented with 12 hours of pain, a distended, rigid abdomen, mottled skin below the waist, and decreased motor and sensory function in the lower extremities. Exploratory laparotomy revealed ischemic small bowel and stomach with abdominal compartment syndrome. Despite decompression, the patient arrested from hyperkalemia following reperfusion. PMID:28003918

  14. Neutral buoyancy testing of a shuttle orbiter crew compartment

    NASA Technical Reports Server (NTRS)

    Rosener, A. A.; Stephenson, M. L.

    1973-01-01

    The architectural and man-machine aspects of a shuttle orbiter crew compartment were examined. All phases of the Orbiter's flight mode from launch through zero gravity, reentry, and ferry flight are considered. The data provides an initial design criteria that treats the crew compartment as a total system and provides data that has a direct contribution to the development of flight hardware. Primary interest was centered on the design of the galley, hygiene facility, passenger couches, airlock, work station, and flight deck access. The man-machine interface emphasis was placed on identifying and developing solutions for problems in mobility/restraint, ingress/egress, accessibility, and volume utilization.

  15. Acute compartment syndrome of the thigh in a rugby player

    PubMed Central

    Smith, Richard David James; Rust-March, Holly; Kluzek, Stefan

    2015-01-01

    In the absence of obvious trauma, diagnosis of acute compartment syndrome (ACS) of the thigh can easily be delayed, as disproportional pain is not always present. We present a case of ACS of the anterior right thigh compartment in a healthy, semiprofessional rugby player with normal coagulation, who sustained a seemingly innocuous blow during a rugby match. Following early surgical fasciotomy, he returned to his preinjury playing standards within 12 months. Our literature review suggests that high muscle mass, young, athletic males participating in a contact sport are mostly at risk of developing ACS of the thigh. PMID:26250368

  16. Chronic leg pain in a division ii field hockey player: a case report.

    PubMed

    Snowden, Julie; Becker, Jonathan A; Brosky, Joseph A; Hazle, Charles

    2014-02-01

    Exertional compartment syndromes in athletes represent a diagnostic and management challenge for clinicians. The clinical presentation of exertional compartment syndrome is similar to other more common musculoskeletal disorders. A lack of special tests or unique diagnostic identifiers for use in decision making by out-patient clinicians complicates early recognition of this disorder and may delay optimal management. The purpose of this case report is to retrospectively explore the clinical presentation and the decision-making during the course of care of a field hockey athlete eventually determined to have exertional compartment syndrome. Suggestions to assist in recognition and guidance in patient management are included as well as the procedures required for differential diagnosis. Procedures utilized during conservative care are also described in detail. 5 (Single Case Report).

  17. CHRONIC LEG PAIN IN A DIVISION II FIELD HOCKEY PLAYER: A CASE REPORT

    PubMed Central

    Snowden, Julie; Becker, Jonathan A.; Hazle, Charles

    2014-01-01

    Exertional compartment syndromes in athletes represent a diagnostic and management challenge for clinicians. The clinical presentation of exertional compartment syndrome is similar to other more common musculoskeletal disorders. A lack of special tests or unique diagnostic identifiers for use in decision making by out‐patient clinicians complicates early recognition of this disorder and may delay optimal management. The purpose of this case report is to retrospectively explore the clinical presentation and the decision‐making during the course of care of a field hockey athlete eventually determined to have exertional compartment syndrome. Suggestions to assist in recognition and guidance in patient management are included as well as the procedures required for differential diagnosis. Procedures utilized during conservative care are also described in detail. Level of Evidence: 5 (Single Case Report) PMID:24567863

  18. Signal transduction by cholera toxin: processing in vesicular compartments does not require acidification.

    PubMed

    Lencer, W I; Strohmeier, G; Moe, S; Carlson, S L; Constable, C T; Madara, J L

    1995-10-01

    In the polarized human intestinal epithelial cell line T84, signal transduction by cholera toxin (CT) follows a complex series of events in which CT enters the apical endosome and moves through multiple vesicular compartments before it activates adenylate cyclase. As with processing of many other surface ligands, it has been suggested that CT must enter acidic vesicles to exert its downstream effects. To determine if intravesicular pH may regulate signal transduction by CT, we examined the cAMP-dependent Cl- secretory response [short-circuit current (Isc)] to CT in T84 cell monolayers treated with chloroquine (500 microM), methylamine (50 mM), NH4Cl (10 mM), nigericin (4 microM), or bafilomycin A1 (1 microM). Each of these reagents collapsed intravesicular pH gradients as confirmed by accumulation of acridine orange within subcellular compartments of living T84 cells imaged by confocal epifluorescence microscopy. Both acidotropic amines and nigericin inhibited the cAMP-dependent Cl secretory response in T84 cells. However, none of these reagents specifically affected adenylate cyclase itself or coupling of adenylate cyclase with the heterotrimeric guanosinetriphosphatase Gs as judged by the secretory response to the adenosine 3',5'-cyclic monophosphate (cAMP) agonists vasoactive intestinal peptide (VIP), forskolin, or 8-bromo-cAMP. In vitro enzyme-linked immunosorbent assay showed that CT binding to ganglioside GM1 was not dependent on pH between 5.0 and 10. Maximal Isc elicited by apical CT relative to maximal Isc elicited by VIP was not affected by pretreatment with chloroquine, methylamine, NH4Cl, or bafilomycin AI. Nigericin was the only reagent to inhibit CT-induced Isc (5 +/- 2% maximal response to VIP). The data indicate that low intravesicular pH will have little or no effect on CT association with its membrane receptor GM1, or on subsequent processing/signal transduction events.

  19. A case of mitochondrial cytopathy with exertion induced dystonia

    PubMed Central

    Chandra, Sadanandavalli Retnaswami; Issac, Thomas Gregor

    2015-01-01

    Paroxysmal dystonias are a group of relatively benign hyperkinetic childhood movement disorders of varied etiology. Mitochondrial diseases are well known to produce persistent dystonias as sequelae, but paroxysmal exertion induced dystonia has been reported in only one case to the best of our knowledge. Two siblings born to consanguineous parents presented with early-onset exertion induced dystonia, which was unresponsive to diphenylhydantoin and carbamazepine. A trial with valproate in one of the siblings turned fatal within 24 h. Based on this clue, the second child was investigated and found to suffer from complex I deficiency with a paternally inherited dominant nuclear DNA mutation, which is responsive to the mitochondrial cocktail. Exertion induced dystonia can be a rare manifestation of complex I deficiency. PMID:26557169

  20. The role of exercise in the etiology of exertional heatstroke.

    PubMed

    Hubbard, R W

    1990-02-01

    Exertional heatstroke usually occurs among healthy, fit individuals who are motivated to perform strenuous exercise because of peer pressure, discipline, or athletic competition. In fact, exertional heatstroke deaths among high school athletes in the United States (ranked third only to head and neck injuries and heart failures), and the reluctance of race directors to cancel or postpone mass participation road races during periods of severe heat and humidity, emphasize a continuing need for widespread dissemination of information. The purposes of this symposium are 1) to convey essential information to the members of ACSM who are involved in exercise prescription, patient care, or athletic training; and 2) to disseminate recent scientific theories and research concerning exertional heatstroke.

  1. Human immunodeficiency virus type 1 Gag proteins are processed in two cellular compartments.

    PubMed Central

    Kaplan, A H; Swanstrom, R

    1991-01-01

    The structural proteins of the retroviral capsid are translated as a polyprotein (the Gag precursor) that is cleaved by a virally encoded protease. Processing of the human immunodeficiency virus type 1 Gag precursor Pr55 was analyzed through a combination of pulse-chase labeling, cell fractionation, and immunoprecipitation. We observed a membrane-associated processing pathway for the Gag precursor that gives rise to virions. In addition, we found that a significant amount of processing occurs in the cytoplasm of infected cells resulting in the intracellular accumulation of appropriately processed viral proteins. This observation suggests the viral protease is active in the cytoplasmic compartment of the cell. Processing of the Gag protein was blocked in both compartments by the addition of a viral protease inhibitor. A comparison of the amount of cytoplasmic processing seen in lytically infected cells with that seen in chronically infected cells showed that cytoplasmic processing was associated with the lytic infection. These observations raise the possibility that activation of the human immunodeficiency virus type 1 protease in the cytoplasm of lytically infected cells might result in the cleavage of cellular proteins and thus contribute to cytotoxicity. Images PMID:2034693

  2. Amyloidogenic amyloid-β-peptide variants induce microbial agglutination and exert antimicrobial activity

    PubMed Central

    Spitzer, Philipp; Condic, Mateja; Herrmann, Martin; Oberstein, Timo Jan; Scharin-Mehlmann, Marina; Gilbert, Daniel F.; Friedrich, Oliver; Grömer, Teja; Kornhuber, Johannes; Lang, Roland; Maler, Juan Manuel

    2016-01-01

    Amyloid-β (Aβ) peptides are the main components of the plaques found in the brains of patients with Alzheimer’s disease. However, Aβ peptides are also detectable in secretory compartments and peripheral blood contains a complex mixture of more than 40 different modified and/or N- and C-terminally truncated Aβ peptides. Recently, anti-infective properties of Aβ peptides have been reported. Here, we investigated the interaction of Aβ peptides of different lengths with various bacterial strains and the yeast Candida albicans. The amyloidogenic peptides Aβ1-42, Aβ2-42, and Aβ3p-42 but not the non-amyloidogenic peptides Aβ1-40 and Aβ2-40 bound to microbial surfaces. As observed by immunocytochemistry, scanning electron microscopy and Gram staining, treatment of several bacterial strains and Candida albicans with Aβ peptide variants ending at position 42 (Aβx-42) caused the formation of large agglutinates. These aggregates were not detected after incubation with Aβx-40. Furthermore, Aβx-42 exerted an antimicrobial activity on all tested pathogens, killing up to 80% of microorganisms within 6 h. Aβ1-40 only had a moderate antimicrobial activity against C. albicans. Agglutination of Aβ1-42 was accelerated in the presence of microorganisms. These data demonstrate that the amyloidogenic Aβx-42 variants have antimicrobial activity and may therefore act as antimicrobial peptides in the immune system. PMID:27624303

  3. A Technique for Establishing True Levels of Muscle Strength Exertion

    DTIC Science & Technology

    1980-01-01

    performed -"aximal or submaximal isometric strength exertions. The exertions tested were elbow flexion, finger flexion, knee flexion and knee...190.1 167.11 17.3350 Buttock-Knee Length (cm) 54.1 66.7 59.29 3.2106 Knee Height, sitting (cm) 46.5 58.7 52.91 2.8737 Shoulder- Elbow Length (cm) 29.3...propped the elbow of the right arm on the arm rest, extended the fore- arm directly forward so that the cuff was exactly above the load cell, with

  4. Two-Compartment Pharmacokinetic Models for Chemical Engineers

    ERIC Educational Resources Information Center

    Kanneganti, Kumud; Simon, Laurent

    2011-01-01

    The transport of potassium permanganate between two continuous-stirred vessels was investigated to help chemical and biomedical engineering students understand two-compartment pharmacokinetic models. Concepts of modeling, mass balance, parameter estimation and Laplace transform were applied to the two-unit process. A good agreement was achieved…

  5. 9 CFR 354.241 - Cleaning of rooms and compartments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Cleaning of rooms and compartments... Sanitary Conditions and Precautions Against Contamination of Products § 354.241 Cleaning of rooms and... rooms shall be of such construction as readily to permit their thorough cleaning, and such docks...

  6. 19 CFR 123.24 - Sealing of conveyances or compartments.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 1 2012-04-01 2012-04-01 false Sealing of conveyances or compartments. 123.24 Section 123.24 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CBP RELATIONS WITH CANADA AND MEXICO Shipments in Transit Through Canada or Mexico...

  7. Compartment syndrome of the foot in a child.

    PubMed

    Sharma, A K; Sharaf, I; Ajay, S

    2001-06-01

    We report a case of a 12-year-old boy with acute compartment syndrome of the foot following a road-traffic accident. Due to the rarity of the injury, there was a delay in diagnosing the injury. An emergency fasciotomy was performed 19 hours after the injury. The foot healed with a mild extension contracture of the second toe.

  8. 12. Interior view of battle staff compartment showing the general's ...

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

    12. Interior view of battle staff compartment showing the general's chair. View toward front of aircraft. - Offutt Air Force Base, Looking Glass Airborne Command Post, Looking Glass Aircraft, On Operational Apron covering northeast half of Project Looking Glass Historic District, Bellevue, Sarpy County, NE

  9. STS-120 crew in the Orbiter Docking Compartment (ODC)

    NASA Image and Video Library

    2006-10-25

    S120-E-006402 (25 Oct. 2007) --- STS-120 crewmembers gather in the Orbiter Docking Compartment (ODS) after hatch opening between the International Space Station and Space Shuttle Discovery. Pictured (clockwise) are astronauts George Zamka (white shirt), pilot; Daniel Tani, Stephanie Wilson, Doug Wheelock, Scott Parazynski and European Space Agency's (ESA) Paolo Nespoli, all mission specialists. Astronaut Pam Melroy, commander, is out of frame.

  10. 9 CFR 354.241 - Cleaning of rooms and compartments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Cleaning of rooms and compartments. 354.241 Section 354.241 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF..., water, and dirt. (i) All equipment in the toilet room and locker room, as well as the room itself,...

  11. 14 CFR 23.853 - Passenger and crew compartment interiors.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... insulation covering, air ducting, joint and edge covering, cargo compartment liners, insulation blankets, cargo covers and transparencies, molded and thermoformed parts, air ducting joints, and trim strips... significantly to the propagation of a fire, materials in items not specified in paragraphs (d)(3)(i), (ii),...

  12. 14 CFR 23.853 - Passenger and crew compartment interiors.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... insulation covering, air ducting, joint and edge covering, cargo compartment liners, insulation blankets, cargo covers and transparencies, molded and thermoformed parts, air ducting joints, and trim strips... significantly to the propagation of a fire, materials in items not specified in paragraphs (d)(3)(i), (ii),...

  13. 14 CFR 23.853 - Passenger and crew compartment interiors.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... insulation covering, air ducting, joint and edge covering, cargo compartment liners, insulation blankets, cargo covers and transparencies, molded and thermoformed parts, air ducting joints, and trim strips... significantly to the propagation of a fire, materials in items not specified in paragraphs (d)(3)(i), (ii),...

  14. 14 CFR 23.853 - Passenger and crew compartment interiors.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... insulation covering, air ducting, joint and edge covering, cargo compartment liners, insulation blankets, cargo covers and transparencies, molded and thermoformed parts, air ducting joints, and trim strips... significantly to the propagation of a fire, materials in items not specified in paragraphs (d)(3)(i), (ii),...

  15. 38. Port side of engine compartment at salon deck level, ...

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

    38. Port side of engine compartment at salon deck level, with salon wall panels removed to show engine frame. Main connecting rod from crank to walking beam appears at extreme right of view, top of cylinder and piston rod appear at extreme left. - Ferry TICONDEROGA, Route 7, Shelburne, Chittenden County, VT

  16. FEATURE 3, LARGE GUN POSITION, SHOWING MULTIPLE COMPARTMENTS, VIEW FACING ...

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

    FEATURE 3, LARGE GUN POSITION, SHOWING MULTIPLE COMPARTMENTS, VIEW FACING SOUTH (with scale stick). - Naval Air Station Barbers Point, Anti-Aircraft Battery Complex-Large Gun Position, East of Coral Sea Road, northwest of Hamilton Road, Ewa, Honolulu County, HI

  17. 14 CFR 29.855 - Cargo and baggage compartments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... accessories whose damage or failure would affect safe operation, unless those items are protected so that— (1... endangering the safety of a rotorcraft or its occupants must be designed, or must have a device, to ensure... area may be considered a cargo compartment and, in addition to paragraphs (a) through (d) of...

  18. Digital Microscopy Assessment of Angiogenesis in Different Breast Cancer Compartments

    PubMed Central

    Rogojanu, Radu; Croitoru, Camelia; Jitaru, Daniela; Tarniceriu, Cristina; Carasevici, Eugen

    2013-01-01

    Background/Aim. Tumour angiogenesis defined by microvessel density (MVD) is generally accepted as a prognostic factor in breast cancer. However, due to variability of measurement systems and cutoffs, it is questionable to date whether it contributes to predictive outline. Our study aims to grade vascular heterogeneity by comparing clear-cut compartments: tumour associated stroma (TAS), tumour parenchyma, and tumour invasive front. Material and Methods. Computerized vessel area measurement was performed using a tissue cytometry system (TissueFAXS) on slides originated from 50 patients with breast cancer. Vessels were marked using immunohistochemistry with CD34. Regions of interest were manually defined for each tumour compartment. Results. Tumour invasive front vascular endothelia area was 2.15 times higher than that in tumour parenchyma and 4.61 times higher than that in TAS (P < 0.002). Worth to mention that the lymph node negative subgroup of patients show a slight but constant increase of vessel index in all examined compartments of breast tumour. Conclusion. Whole slide digital examination and region of interest (ROI) analysis are a valuable tool in scoring angiogenesis markers and disclosing their prognostic capacity. Our study reveals compartments' variability of vessel density inside the tumour and highlights the propensity of invasive front to associate an active process of angiogenesis with potential implications in adjuvant therapy. PMID:24073397

  19. 14 CFR 121.314 - Cargo and baggage compartments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... and baggage compartments. For each transport category airplane type certificated after January 1, 1958... sidewall liner panels which are constructed of: (1) Glass fiber reinforced resin; (2) Materials which meet... number of each airplane listed in the operations specifications issued to the certificate holder...

  20. 14 CFR 121.314 - Cargo and baggage compartments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... and baggage compartments. For each transport category airplane type certificated after January 1, 1958... sidewall liner panels which are constructed of: (1) Glass fiber reinforced resin; (2) Materials which meet... number of each airplane listed in the operations specifications issued to the certificate holder...

  1. 46 CFR 174.075 - Compartments assumed flooded: general.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Compartments assumed flooded: general. 174.075 Section 174.075 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SUBDIVISION AND STABILITY SPECIAL RULES PERTAINING TO SPECIFIC VESSEL TYPES Special Rules Pertaining to Mobile Offshore Drilling...

  2. 46 CFR 174.075 - Compartments assumed flooded: general.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Compartments assumed flooded: general. 174.075 Section 174.075 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SUBDIVISION AND STABILITY SPECIAL RULES PERTAINING TO SPECIFIC VESSEL TYPES Special Rules Pertaining to Mobile Offshore Drilling...

  3. Two-Compartment Pharmacokinetic Models for Chemical Engineers

    ERIC Educational Resources Information Center

    Kanneganti, Kumud; Simon, Laurent

    2011-01-01

    The transport of potassium permanganate between two continuous-stirred vessels was investigated to help chemical and biomedical engineering students understand two-compartment pharmacokinetic models. Concepts of modeling, mass balance, parameter estimation and Laplace transform were applied to the two-unit process. A good agreement was achieved…

  4. Test strips detect different CO2 concentrations in closed compartments

    NASA Technical Reports Server (NTRS)

    1965-01-01

    Four different test strips, using crystal violet for one pair of strips and basic fuchsin as a dye for the second pair, give unambiguous colorimetric indications of four different concentrations of carbon dioxide in the atmosphere of a closed compartment. Tetraethylene pentamine is used as a dye decoloring agent.

  5. Gluteal Compartment Syndrome following an Iliac Bone Marrow Aspiration

    PubMed Central

    Vega-Najera, Carlos; Leal-Contreras, Carlos; Leal-Berumen, Irene

    2013-01-01

    The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS) secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis. PMID:24392235

  6. Pettit in Fisheye View of SM Transfer Compartment

    NASA Image and Video Library

    2012-05-12

    ISS031-E-030465 (12 May 2012) --- A fisheye lens attached to an electronic still camera was used to capture this image of NASA astronaut Don Pettit, Expedition 31 flight engineer, in the transfer compartment between the Zarya Functional Cargo Block (FGB) and the Zvezda Service Module of the International Space Station.

  7. Does oedema following lower limb revascularisation cause compartment syndromes?

    PubMed Central

    Scott, D. J.; Allen, M. J.; Bell, P. R.; McShane, M.; Barnes, M. R.

    1988-01-01

    Oedema of the leg, particularly the calf, is a well-recognised complication following lower limb reconstructive vascular surgery, but its effect on the limb is unknown. In this study, anterior compartment pressures and calf circumference were measured in both the operated and non-operated limbs following femoropopliteal bypass in 15 patients. All the patients developed lower limb swelling, which was significantly greater than the non-operated limb, P less than 0.05 paired t test (day 2-5). There was a significant difference in the mean anterior compartment pressures between the operated and non-operated limbs on the third and fourth postoperative days for the overall and below knee group, P less than 0.05 (paired t test). However, none of the patients developed signs, symptoms or pressures indicative of a compartment syndrome. These results suggest that the oedema following reconstructive vascular surgery is subcutaneous rather than compartmental in origin and that compartment pressure measurements should only be undertaken if a fasciotomy is being contemplated. Images fig. 2 PMID:3207329

  8. Canthal cutdown for emergent treatment of orbital compartment syndrome.

    PubMed

    Strand, Andrew T; Czyz, Craig N; Gibson, Amanda

    2017-08-16

    This article evaluates the use of a "canthal cutdown" technique in orbital compartment syndrome in a cadaveric model. Twelve cadaver orbits were used to simulate orbital compartment syndrome using a blood analog solution. Two pressure probes, in different orbital locations, were used to monitor orbital pressure. Pressure was monitored during successive procedures: canthotomy, cantholysis, and canthal cutdown. Orbits were then re-injected with solution, simulating an active orbital hemorrhage, and pressure measurements were recorded over a 10-minute duration. No statistically significant difference was found between the two orbital pressure monitoring devices at each measurement point (p = 0.99). Significant pressure reductions, for both probes, were observed after canthal cutdown compared to initial measurement after injection of 20 mL blood analog (p < 0.001 and p = 0.005). When comparing the orbital pressure following canthotomy and inferior cantholysis versus canthal cutdown, the cutdown procedure provided an additional 74% in orbital pressure reduction (p =0.01). After re-injection of 10 mL of solution and 10 minutes of egress, pressure returned to baseline (probe 1: baseline 7 mm Hg vs. post-cutdown at 10 minutes 7 mm Hg; p = 0.83; and probe 2: 5 mm Hg vs. 5 mm Hg; p = 0.83). The canthal cutdown technique provides further reduction in orbital pressure versus canthotomy and cantholysis alone. The technique may be effective for treatment of static orbital compartment syndrome and temporizing treatment of compartment syndrome from active orbital hemorrhages.

  9. 14 CFR 121.269 - Extinguishing agent container compartment temperature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... temperature. 121.269 Section 121.269 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF....269 Extinguishing agent container compartment temperature. Precautions must be taken to insure that the extinguishing agent containers are installed in places where reasonable temperatures can be...

  10. 14 CFR 121.269 - Extinguishing agent container compartment temperature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... temperature. 121.269 Section 121.269 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF....269 Extinguishing agent container compartment temperature. Precautions must be taken to insure that the extinguishing agent containers are installed in places where reasonable temperatures can be...

  11. 14 CFR 121.269 - Extinguishing agent container compartment temperature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... temperature. 121.269 Section 121.269 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF....269 Extinguishing agent container compartment temperature. Precautions must be taken to insure that the extinguishing agent containers are installed in places where reasonable temperatures can be...

  12. 14 CFR 121.269 - Extinguishing agent container compartment temperature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... temperature. 121.269 Section 121.269 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF....269 Extinguishing agent container compartment temperature. Precautions must be taken to insure that the extinguishing agent containers are installed in places where reasonable temperatures can be...

  13. 14 CFR 125.167 - Extinguishing agent container compartment temperature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... temperature. 125.167 Section 125.167 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Requirements § 125.167 Extinguishing agent container compartment temperature. Precautions must be taken to ensure that the extinguishing agent containers are installed in places where reasonable temperatures can...

  14. 14 CFR 121.269 - Extinguishing agent container compartment temperature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... temperature. 121.269 Section 121.269 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF....269 Extinguishing agent container compartment temperature. Precautions must be taken to insure that the extinguishing agent containers are installed in places where reasonable temperatures can be...

  15. 14 CFR 125.167 - Extinguishing agent container compartment temperature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... temperature. 125.167 Section 125.167 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Requirements § 125.167 Extinguishing agent container compartment temperature. Precautions must be taken to ensure that the extinguishing agent containers are installed in places where reasonable temperatures can...

  16. 14 CFR 125.167 - Extinguishing agent container compartment temperature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... temperature. 125.167 Section 125.167 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Requirements § 125.167 Extinguishing agent container compartment temperature. Precautions must be taken to ensure that the extinguishing agent containers are installed in places where reasonable temperatures can...

  17. 14 CFR 125.167 - Extinguishing agent container compartment temperature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... temperature. 125.167 Section 125.167 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Requirements § 125.167 Extinguishing agent container compartment temperature. Precautions must be taken to ensure that the extinguishing agent containers are installed in places where reasonable temperatures can...

  18. 14 CFR 125.167 - Extinguishing agent container compartment temperature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... temperature. 125.167 Section 125.167 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Requirements § 125.167 Extinguishing agent container compartment temperature. Precautions must be taken to ensure that the extinguishing agent containers are installed in places where reasonable temperatures can...

  19. 49 CFR 179.220-9 - Compartment tanks.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Compartment tanks. 179.220-9 Section 179.220-9 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for...

  20. 49 CFR 179.200-9 - Compartment tanks.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Compartment tanks. 179.200-9 Section 179.200-9 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for...

  1. 49 CFR 179.200-9 - Compartment tanks.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Compartment tanks. 179.200-9 Section 179.200-9 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for...

  2. 49 CFR 179.200-9 - Compartment tanks.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Compartment tanks. 179.200-9 Section 179.200-9 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SPECIFICATIONS FOR TANK CARS Specifications for...

  3. 14 CFR 27.855 - Cargo and baggage compartments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Cargo and baggage compartments. 27.855 Section 27.855 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Fire Protection §...

  4. 9 CFR 354.221 - Rooms and compartments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Rooms and compartments. 354.221 Section 354.221 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... needs of the inspection in the plant may require. They shall be equipped with locks and keys and...

  5. 9 CFR 354.221 - Rooms and compartments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Rooms and compartments. 354.221 Section 354.221 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... needs of the inspection in the plant may require. They shall be equipped with locks and keys and...

  6. 9 CFR 354.221 - Rooms and compartments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Rooms and compartments. 354.221 Section 354.221 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... needs of the inspection in the plant may require. They shall be equipped with locks and keys and...

  7. 9 CFR 354.221 - Rooms and compartments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Rooms and compartments. 354.221 Section 354.221 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... needs of the inspection in the plant may require. They shall be equipped with locks and keys and...

  8. Activated Pancreatic Stellate Cells Sequester CD8+ T-Cells to Reduce Their Infiltration of the Juxtatumoral Compartment of Pancreatic Ductal Adenocarcinoma

    PubMed Central

    Ene-Obong, Abasi; Clear, Andrew J.; Watt, Jennifer; Wang, Jun; Fatah, Rewas; Riches, John C.; Marshall, John F.; Chin-Aleong, Joanne; Chelala, Claude; Gribben, John G.; Ramsay, Alan G.; Kocher, Hemant M.

    2013-01-01

    Background & Aims Pancreatic ductal adenocarcinoma (PDAC) is characterized by a prominent desmoplastic microenvironment that contains many different immune cells. Activated pancreatic stellate cells (PSCs) contribute to the desmoplasia. We investigated whether distinct stromal compartments are differentially infiltrated by different types of immune cells. Method We used tissue microarray analysis to compare immune cell infiltration of different pancreatico-biliary diseased tissues (PDAC, ampullary carcinoma, cholangiocarcinoma, mucinous cystic neoplasm, chronic inflammation, and chronic pancreatitis), and juxtatumoral stromal (<100 μm from tumor) and panstromal compartments. We investigated the association between immune infiltrate and patient survival times. We analyzed T-cell migration and tumor infiltration in LSL-KrasG12D/+; LSL-Trp53R172H/+; Pdx-1-Cre (KPC) mice, and the effects of all-trans retinoic acid (ATRA) on these processes. Results Juxtatumoral compartments in PDAC samples from 2 independent groups of patients contained increased numbers of myeloperoxidase+ and CD68+ cells, compared with panstromal compartments. However, juxtatumoral compartments of PDACs contained fewer CD8+, FoxP3+, CD56+, or CD20+ cells than panstromal compartments, a distinction absent in ampullary carcinomas and cholangiocarcinomas. Patients with PDACs that had high densities of CD8+ T-cells in the juxtatumoral compartment had longer survival times than patients with lower densities. In KPC mice, administration of ATRA, which renders PSCs quiescent, increased numbers of CD8+ T-cells in juxtatumoral compartments. We found that activated PSCs express cytokines, chemokines, and adhesion molecules that regulate T-cell migration. In vitro migration assays showed that CD8+ T-cells from PDAC patients had increased chemotaxis towards activated PSCs, which secrete CXCL12, compared with quiescent PSC or tumor cells. These effects could be reversed by knockdown of CXCL12 or treatment of

  9. Increased number and altered phenotype of lymphatic vessels in peripheral lung compartments of patients with COPD

    PubMed Central

    2013-01-01

    Background De novo lymphatic vessel formation has recently been observed in lungs of patients with moderate chronic obstructive pulmonary disease (COPD). However, the distribution of lymphatic vessel changes among the anatomical compartments of diseased lungs is unknown. Furthermore, information regarding the nature of lymphatic vessel alterations across different stages of COPD is missing. This study performs a detailed morphometric characterization of lymphatic vessels in major peripheral lung compartments of patients with different severities of COPD and investigates the lymphatic expression of molecules involved in immune cell trafficking. Methods Peripheral lung resection samples obtained from patients with mild (GOLD stage I), moderate-severe (GOLD stage II-III), and very severe (GOLD stage IV) COPD were investigated for podoplanin-immunopositive lymphatic vessels in distinct peripheral lung compartments: bronchioles, pulmonary blood vessels and alveolar walls. Control subjects with normal lung function were divided into never smokers and smokers. Lymphatics were analysed by multiple morphological parameters, as well as for their expression of CCL21 and the chemokine scavenger receptor D6. Results The number of lymphatics increased by 133% in the alveolar parenchyma in patients with advanced COPD compared with never-smoking controls (p < 0.05). In patchy fibrotic lesions the number of alveolar lymphatics increased 20-fold from non-fibrotic parenchyma in the same COPD patients. The absolute number of lymphatics per bronchiole and artery was increased in advanced COPD, but numbers were not different after normalization to tissue area. Increased numbers of CCL21- and D6-positive lymphatics were observed in the alveolar parenchyma in advanced COPD compared with controls (p < 0.01). Lymphatic vessels also displayed increased mean levels of immunoreactivity for CCL21 in the wall of bronchioles (p < 0.01) and bronchiole-associated arteries (p < 0

  10. Increased number and altered phenotype of lymphatic vessels in peripheral lung compartments of patients with COPD.

    PubMed

    Mori, Michiko; Andersson, Cecilia K; Graham, Gerard J; Löfdahl, Claes-Göran; Erjefält, Jonas S

    2013-06-11

    De novo lymphatic vessel formation has recently been observed in lungs of patients with moderate chronic obstructive pulmonary disease (COPD). However, the distribution of lymphatic vessel changes among the anatomical compartments of diseased lungs is unknown. Furthermore, information regarding the nature of lymphatic vessel alterations across different stages of COPD is missing. This study performs a detailed morphometric characterization of lymphatic vessels in major peripheral lung compartments of patients with different severities of COPD and investigates the lymphatic expression of molecules involved in immune cell trafficking. Peripheral lung resection samples obtained from patients with mild (GOLD stage I), moderate-severe (GOLD stage II-III), and very severe (GOLD stage IV) COPD were investigated for podoplanin-immunopositive lymphatic vessels in distinct peripheral lung compartments: bronchioles, pulmonary blood vessels and alveolar walls. Control subjects with normal lung function were divided into never smokers and smokers. Lymphatics were analysed by multiple morphological parameters, as well as for their expression of CCL21 and the chemokine scavenger receptor D6. The number of lymphatics increased by 133% in the alveolar parenchyma in patients with advanced COPD compared with never-smoking controls (p < 0.05). In patchy fibrotic lesions the number of alveolar lymphatics increased 20-fold from non-fibrotic parenchyma in the same COPD patients. The absolute number of lymphatics per bronchiole and artery was increased in advanced COPD, but numbers were not different after normalization to tissue area. Increased numbers of CCL21- and D6-positive lymphatics were observed in the alveolar parenchyma in advanced COPD compared with controls (p < 0.01). Lymphatic vessels also displayed increased mean levels of immunoreactivity for CCL21 in the wall of bronchioles (p < 0.01) and bronchiole-associated arteries (p < 0.05), as well as the alveolar

  11. Multimodal delivery of irinotecan from microparticles with two distinct compartments.

    PubMed

    Rahmani, Sahar; Park, Tae-Hong; Dishman, Acacia Frances; Lahann, Joerg

    2013-11-28

    In the last several decades, research in the field of drug delivery has been challenged with the fabrication of carrier systems engineered to deliver therapeutics to the target site with sustained and controlled release kinetics. Herein, we report the fabrication of microparticles composed of two distinct compartments: i) one compartment containing a pH responsive polymer, acetal-modified dextran, and PLGA (polylactide-co-glycolide), and ii) one compartment composed entirely of PLGA. We demonstrate the complete release of dextran from the microparticles during a 10-hour period in an acidic pH environment and the complete degradation of one compartment in less than 24h. This is in congruence with the stability of the same microparticles in neutral pH over the 24-hour period. Such microparticles can be used as pH responsive carrier systems for drug delivery applications where their cargo will only be released when the optimum pH window is reached. The feasibility of the microparticle system for such an application was confirmed by encapsulating a cancer therapeutic, irinotecan, in the compartment containing the acetal-modified dextran polymer and the pH dependent release over a 5-day period was studied. It was found that upon pH change to an acidic environment, over 50% of the drug was first released at a rapid rate for 10h, similar to that observed for the dextran release, before continuing at a more controlled rate for 4 days. As such, these microparticles can play an important role in the fabrication of novel drug delivery systems due to the selective, controlled, and pH responsive release of their encapsulated therapeutics.

  12. Plasma compartment filling after exercise or heat exposure.

    PubMed

    Jimenez, Chantal; Koulmann, Nathalie; Mischler, Isabelle; Allevard, Anne-Marie; Launay, Jean-Claude; Savourey, Gustave; Melin, Bruno

    2002-10-01

    The present study was assessed to study the restoration of the vascular compartment by rehydration after heat exposure or exercise. Eight subjects completed four trials in a randomized order: 2.7% dehydration of body mass by passive controlled hyperthermia once with rehydration and once without rehydration during recovery, and 2.7% dehydration of body mass by treadmill exercise once with rehydration and once without rehydration during recovery. An isotonic glucose electrolyte beverage was provided twice during the recovery period for a total volume, which was equivalent to the target value of body mass loss during dehydration procedures. Plasma volume (PV) was measured using Evans Blue dilution technique, and PV changes (deltaPV) were determined using hematocrit and hemoglobin measurements. PV was better maintained during exercise than during heat exposure, and the difference in deltaPV between the two patterns of dehydration was maintained during the first 3 h of recovery. Plasma protein seemed to be accountable for the difference in deltaPV during heat exposure and exercise but not during the 270 min of recovery. Rehydration partly restored body fluid losses, but the plasma compartment was privileged, because 26-30% of the net fluid gain was found in the plasma compartment (about 300 mL). Rehydration restored plasma osmolality and diminished the drive for arginin-vasopressin response. The similar selective retention of water in the plasma compartment might essentially be explained by osmotic factors provided by the beverage. As PV was completely restored by rehydration after exercise and only partly restored after heat exposure, the volume of ingested beverage should be higher after heat exposure to completely restore the plasma compartment.

  13. Compartment syndrome after Bothrops jararaca snakebite: monitoring, treatment, and outcome.

    PubMed

    Bucaretchi, Fábio; de Capitani, Eduardo Mello; Hyslop, Stephen; Mello, Sueli Moreira; Madureira, Paulo Roberto; Zanardi, Veronica; Ferreira, Daniel M; Meirelles, Guilerme V; Fernandes, Luciane C R

    2010-01-01

    To report the outcome of a patient who developed compartment syndrome after Bothrops jararaca snakebite. A 39-year-old male was admitted 5 h after being bitten on the lower right leg. Physical examination revealed tense swelling, ecchymosis, hypoesthesia, and intense local pain that worsened after passive stretching, limited right foot dorsiflexion, and gingival bleeding. The case was classified as moderate/severe and eight vials of bothropic antivenom (AV) were infused 1 h postadmission. The main laboratory findings upon admission were incoagulable blood (incoagulable PT, aPTT, and INR), thrombocytopenia, serum creatine kinase (CK) of 580 U/L (reference value < 170 U/L), and a serum venom level of 33.7 ng/mL (ELISA; cutoff = 2.3 ng/mL). High anterior compartment pressure (60 mmHg) was identified 8 h post bite, with progressively lower pressures after AV administration and limb elevation (36 mmHg; 19 h post bite). However, moderate pain and limited foot dorsiflexion persisted. In addition, there was a progressive increase in serum CK (6,729 U/L; 45 h post bite), as well as marked edema and hemorrhage of the anterior compartment detected by magnetic resonance imaging (MRI) at 48 h post bite. A fasciotomy done after a further increase in intracompartmental pressure (66 mmHg, 57 h post bite) revealed hemorrhage/necrosis of the anterior tibial muscle that subsequently required partial resection. The patient developed a local infection (day 15 post bite) and a permanent fibular palsy. Compartment syndrome is an unusual but severe complication of snakebites. MRI, in conjunction with subfascial pressure measurements, may be useful in the diagnosis of compartment syndrome after snakebites.

  14. 20 CFR 416.969a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....969a Section 416.969a Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME... of jobs by various exertional levels (sedentary, light, medium, heavy, and very heavy) in terms of... assessment along with your age, education, and work experience to decide if you can adjust to any other...

  15. 20 CFR 404.1569a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....1569a Section 404.1569a Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS... of jobs by various exertional levels (sedentary, light, medium, heavy, and very heavy) in terms of... assessment along with your age, education, and work experience to decide if you can adjust to any other...

  16. Perception of Forces Exerted by Objects in Collision Events

    ERIC Educational Resources Information Center

    White, Peter A.

    2009-01-01

    Impressions of force are commonplace in the visual perception of objects interacting. It is proposed that these impressions have their source in haptically mediated experiences of exertion of force in actions on objects. Visual impressions of force in interactions between objects occur by a kind of generalization of the proprioceptive impression…

  17. 20 CFR 404.1569a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Exertional and nonexertional limitations. 404.1569a Section 404.1569a Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404...

  18. 20 CFR 404.1567 - Physical exertion requirements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Physical exertion requirements. 404.1567 Section 404.1567 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404.1567...

  19. 20 CFR 404.1569a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Exertional and nonexertional limitations. 404.1569a Section 404.1569a Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404...

  20. 20 CFR 404.1567 - Physical exertion requirements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Physical exertion requirements. 404.1567 Section 404.1567 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404.1567...

  1. 20 CFR 404.1567 - Physical exertion requirements.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Physical exertion requirements. 404.1567 Section 404.1567 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404.1567...

  2. 20 CFR 404.1569a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Exertional and nonexertional limitations. 404.1569a Section 404.1569a Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404...

  3. 20 CFR 404.1567 - Physical exertion requirements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Physical exertion requirements. 404.1567 Section 404.1567 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404.1567...

  4. 20 CFR 404.1569a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Exertional and nonexertional limitations. 404.1569a Section 404.1569a Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404...

  5. Perception of Forces Exerted by Objects in Collision Events

    ERIC Educational Resources Information Center

    White, Peter A.

    2009-01-01

    Impressions of force are commonplace in the visual perception of objects interacting. It is proposed that these impressions have their source in haptically mediated experiences of exertion of force in actions on objects. Visual impressions of force in interactions between objects occur by a kind of generalization of the proprioceptive impression…

  6. Exertional heat illness: emerging concepts and advances in prehospital care.

    PubMed

    Pryor, Riana R; Roth, Ronald N; Suyama, Joe; Hostler, David

    2015-06-01

    Exertional heat illness is a classification of disease with clinical presentations that are not always diagnosed easily. Exertional heat stroke is a significant cause of death in competitive sports, and the increasing popularity of marathons races and ultra-endurance competitions will make treating many heat illnesses more common for Emergency Medical Services (EMS) providers. Although evidence is available primarily from case series and healthy volunteer studies, the consensus for treating exertional heat illness, coupled with altered mental status, is whole body rapid cooling. Cold or ice water immersion remains the most effective treatment to achieve this goal. External thermometry is unreliable in the context of heat stress and direct internal temperature measurement by rectal or esophageal probes must be used when diagnosing heat illness and during cooling. With rapid recognition and implementation of effective cooling, most patients suffering from exertional heat stroke will recover quickly and can be discharged home with instructions to rest and to avoid heat stress and exercise for a minimum of 48 hours; although, further research pertaining to return to activity is warranted.

  7. Perceived Exertion: An Old Exercise Tool Finds New Applications.

    ERIC Educational Resources Information Center

    Monahan, Terry

    1988-01-01

    Perceived exertion scales, based on subjective perception of energy output, are gaining respect as prescribing and monitoring tools for individual exercise programs. A review of recent literature indicates growing research interest in applications for individuals who are elderly, inactive, or subject to medical conditions such as angina. (IAH)

  8. Perceived Exertion: An Old Exercise Tool Finds New Applications.

    ERIC Educational Resources Information Center

    Monahan, Terry

    1988-01-01

    Perceived exertion scales, based on subjective perception of energy output, are gaining respect as prescribing and monitoring tools for individual exercise programs. A review of recent literature indicates growing research interest in applications for individuals who are elderly, inactive, or subject to medical conditions such as angina. (IAH)

  9. 20 CFR 416.969a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., such as pain, may cause limitations of function or restrictions which limit your ability to meet... or restrictions imposed by your impairment(s) and related symptoms, such as pain, are exertional... imposed by your impairment(s) and related symptoms, such as pain, affect only your ability to meet...

  10. 20 CFR 416.969a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., such as pain, may cause limitations of function or restrictions which limit your ability to meet... or restrictions imposed by your impairment(s) and related symptoms, such as pain, are exertional... imposed by your impairment(s) and related symptoms, such as pain, affect only your ability to meet...

  11. 20 CFR 404.1567 - Physical exertion requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Physical exertion requirements. 404.1567 Section 404.1567 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... economy, we classify jobs as sedentary, light, medium, heavy, and very heavy. These terms have the same...

  12. 20 CFR 416.967 - Physical exertion requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Physical exertion requirements. 416.967 Section 416.967 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE... economy, we classify jobs as sedentary, light, medium, heavy, and very heavy. These terms have the same...

  13. Are the Measurements of Attention Allocation and Perceived Exertion Trustworthy?

    ERIC Educational Resources Information Center

    Meir, Gily; Hutchinson, Jasmin C.; Habeeb, Christine M.; Boiangin, Nataniel M.; Shaffer, Cory; Basevitch, Itay; Tenenbaum, Gershon

    2015-01-01

    Two studies examined the trustworthiness of commonly used measurement scales for ratings of perceived exertion (RPE) and state attentional focus (SAF) during exercise. In Study 1, participants (N = 24, 14 female) performed a treadmill graded-exercise test. The order of scale presentation during the task was manipulated (i.e., RPE followed by SAF…

  14. Are the Measurements of Attention Allocation and Perceived Exertion Trustworthy?

    ERIC Educational Resources Information Center

    Meir, Gily; Hutchinson, Jasmin C.; Habeeb, Christine M.; Boiangin, Nataniel M.; Shaffer, Cory; Basevitch, Itay; Tenenbaum, Gershon

    2015-01-01

    Two studies examined the trustworthiness of commonly used measurement scales for ratings of perceived exertion (RPE) and state attentional focus (SAF) during exercise. In Study 1, participants (N = 24, 14 female) performed a treadmill graded-exercise test. The order of scale presentation during the task was manipulated (i.e., RPE followed by SAF…

  15. Chronic Cough

    MedlinePlus

    Chronic cough Overview By Mayo Clinic Staff A chronic cough is a cough that lasts eight weeks or longer in adults, or four weeks in children. A chronic cough is more than just an annoyance. A chronic ...

  16. Statins can exert dual, concentration dependent effects on HCV entry in vitro.

    PubMed

    Blanchet, Matthieu; Le, Quoc-Tuan; Seidah, Nabil G; Labonté, Patrick

    2016-04-01

    Statins are used daily by a large and increasing number of individuals worldwide. They were initially designed as 3-hydroxy-3-methylglutharyl-coenzyme A reductase (HMG-CoAR) inhibitors to treat patients with hypercholesterolemia. Recent studies on HCV chronically infected individuals have suggested that their use in vivo in combination with PEG-IFN and ribavirin favor the sustained viral response (SVR). Herein, we describe the effects of a set of statins on HCV entry and on HCV key entry factors in vitro. Our results suggest that all tested statins exert a proviral effect through the upregulation of LDLR. Interestingly, at higher concentration, we also provide evidence of a yet unknown competing antiviral effect of statins (except for pravastatin) through the downregulation of CLDN-1. Importantly, this work enlightens the blunt proviral effect of pravastatin at the entry step of HCV in vitro. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. A case of occult compartment syndrome and nonresolving rhabdomyolysis.

    PubMed

    Minnema, Brian J; Neligan, Peter C; Quraishi, Nasir A; Fehlings, Michael G; Prakash, Suma

    2008-06-01

    A 32-year-old African male presented with 10 hours of severe back pain. Initial computed tomography scan of the back showed no abnormality, and initial laboratory investigations were consistent with rhabdomyolysis. Despite stopping potential causative medications, aggressive intravenous hydration, and urine alkalinization, his creatinine kinase continued to steadily climb. Thirty-six hours after admission, a magnetic resonance imaging of his back was done because of new swelling over the right paraspinal muscles and loss of sensation in this region. Marked swelling of the right erector spinae muscles was observed, and right and left compartment pressure measurements were 108 and 21 mm Hg, respectively. He had urgent fasciotomy after which his rhabdomyolysis and pain recovered. Our case highlights the need for early consideration of compartment syndrome as a possible cause of back pain in the setting of rhabdomyolysis. Rhabdomyolysis can present in the absence of late complications such as neurological and vascular compromise.

  18. p73-induced apoptosis: A question of compartments and cooperation

    SciTech Connect

    Dobbelstein, Matthias; Strano, Sabrina; Roth, Judith; Blandino, Giovanni . E-mail: blandino@ifo.it

    2005-06-10

    The transcriptionally active forms of p73 are capable of inducing apoptosis, and the isoforms termed TAp73 are important players when E2F and its oncogenic activators induce programmed cell death. However, the conditions under that TAp73 can kill a cell remain to be clarified. Recently, it has been found that p73 proteins are not merely floating in the nucleoplasm but rather can associate with specific compartments in the cell. Examples of intranuclear compartments associated with p73 proteins include the PML oncogenic domains and the nuclear matrix. In addition, p73 is found in the cytoplasm. It remains to be seen whether p73 might also associate with mitochondria, in analogy with p53. The relocalization of p73 is expected to be mediated by specific binding partners, mostly other proteins. Here, we discuss the possibility that the compartmentalization of p73, and the cooperation with the corresponding binding partners, might decide about its apoptosis-inducing activity.

  19. Head and neck fascia and compartments: no space for spaces.

    PubMed

    Guidera, Alice K; Dawes, Patrick J D; Fong, Amy; Stringer, Mark D

    2014-07-01

    An accurate understanding of the arrangement of cervical fascia and its associated compartments is essential for differential diagnosis, predicting the spread of disease, and surgical management. The purpose of this detailed review is to summarize the anatomic, clinical, and radiological literature to determine what is known about the arrangement of cervical fascia and to highlight controversies and consensus. The current terminology used to describe cervical fascia and compartments is replete with confusing synonyms and inconsistencies, creating important interdisciplinary differences in understanding. The term "spaces" is inappropriate. A modified nomenclature underpinned by evidence-based anatomic and radiologic findings is proposed. This should not only enhance our understanding of cervical anatomy but also facilitate clearer interdisciplinary communication.

  20. Abdominal Compartment Syndrome as a Complication of Fluid Resuscitation.

    PubMed

    Harrell, Bradley R; Miller, Sarah

    2017-06-01

    Fluid resuscitation is a primary concern of nurse clinicians. Excessive resuscitation with crystalloids places patients at particular risk for many subsequent complications that carry associated increases in mortality and morbidity. Intra-abdominal hypertension and abdominal compartment syndrome are deadly complications of third spacing and capillary leak that occur secondary to excessive fluid resuscitation. Careful consideration is necessary when achieving fluid balance in acutely ill patients, including reducing the use of crystalloids, implementing damage control resuscitation, and establishing measurable resuscitation endpoints. Nurse clinicians are capable of reducing mortality in intra-abdominal hypertension and abdominal compartment syndrome patients by incorporating the latest evidence in fluid resuscitation techniques. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. CoMIC, the hidden dynamics of mitochondrial inner compartments.

    PubMed

    Cho, Bongki; Sun, Woong

    2017-08-14

    Mitochondria have evolutionarily, functionally and structurally distinct outer- (OMM) and inner-membranes (IMM). Thus, mitochondrial morphology is controlled by independent but coordinated activity of fission and fusion of the OMM and IMM. Constriction and division of the OMM are mediated by endocytosis-like machineries, which include dynamin-related protein 1 with additional cytosolic vesicle scissoring machineries such as actin filament and Dynamin 2. However, structural alteration of the IMM during mitochondrial division has been poorly understood. Recently, we found that the IMM and the inner compartments undergo transient and reversible constriction prior to the OMM division, which we termed CoMIC, Constriction of Mitochondrial Inner Compartment. In this short review, we further discuss the evolutionary perspective and the regulatory mechanism of CoMIC during mitochondrial division.

  2. Understanding tumor heterogeneity as functional compartments - superorganisms revisited

    PubMed Central

    2011-01-01

    Compelling evidence broadens our understanding of tumors as highly heterogeneous populations derived from one common progenitor. In this review we portray various stages of tumorigenesis, tumor progression, self-seeding and metastasis in analogy to the superorganisms of insect societies to exemplify the highly complex architecture of a neoplasm as a system of functional "castes." Accordingly, we propose a model in which clonal expansion and cumulative acquisition of genetic alterations produce tumor compartments each equipped with distinct traits and thus distinct functions that cooperate to establish clinically apparent tumors. This functional compartment model also suggests mechanisms for the self-construction of tumor stem cell niches. Thus, thinking of a tumor as a superorganism will provide systemic insight into its functional compartmentalization and may even have clinical implications. PMID:21619636

  3. Understanding tumor heterogeneity as functional compartments--superorganisms revisited.

    PubMed

    Grunewald, Thomas G P; Herbst, Saskia M; Heinze, Jürgen; Burdach, Stefan

    2011-05-27

    Compelling evidence broadens our understanding of tumors as highly heterogeneous populations derived from one common progenitor. In this review we portray various stages of tumorigenesis, tumor progression, self-seeding and metastasis in analogy to the superorganisms of insect societies to exemplify the highly complex architecture of a neoplasm as a system of functional "castes."Accordingly, we propose a model in which clonal expansion and cumulative acquisition of genetic alterations produce tumor compartments each equipped with distinct traits and thus distinct functions that cooperate to establish clinically apparent tumors. This functional compartment model also suggests mechanisms for the self-construction of tumor stem cell niches. Thus, thinking of a tumor as a superorganism will provide systemic insight into its functional compartmentalization and may even have clinical implications.

  4. During vertebrate development, arteries exert a morphological control over the venous pattern through physical factors

    NASA Astrophysics Data System (ADS)

    Al-Kilani, Alia; Lorthois, Sylvie; Nguyen, Thi-Hanh; Le Noble, Ferdinand; Cornelissen, Annemiek; Unbekandt, Mathieu; Boryskina, Olena; Leroy, Loïc; Fleury, Vincent

    2008-05-01

    The adult vasculature is comprised of three distinct compartments: the arteries, which carry blood away from the heart and display a divergent flow pattern; the capillaries, where oxygen and nutrient delivery from blood to tissues, as well as metabolic waste removal, occurs; and the veins, which carry blood back to the heart and are characterized by a convergent flow pattern. These compartments are organized in series as regard to flow, which proceeds from the upstream arteries to the downstream veins through the capillaries. However, the spatial organization is more complex, as veins may often be found paralleling the arteries. The factors that control the morphogenesis of this hierarchically branched vascular network are not well characterized. Here, we explain how arteries exert a morphological control on the venous pattern. Indeed, during vertebrate development, the following transition may be observed in the spatial organization of the vascular system: veins first develop in series with the arteries, the arterial and venous territories being clearly distinct in space (cis-cis configuration). But after some time, new veins grow parallel to the existing arteries, and the arterial and venous territories become overlapped, with extensive and complex intercalation and interdigitation. Using physical arguments, backed up by experimental evidence (biological data from the literature and in situ optical and mechanical measurements of the chick embryo yolk-sac and midbrain developing vasculatures), we explain how such a transition is possible and why it may be expected with generality, as organisms grow. The origin of this transition lies in the remodeling of the capillary tissue in the vicinity of the growing arteries. This remodeling lays down a prepattern for further venous growth, parallel to the existing arterial pattern. Accounting for the influence of tissue growth, we show that this prepatterned path becomes favored as the body extends. As a consequence, a

  5. Elimination Behavior of Shelter Dogs Housed in Double Compartment Kennels

    PubMed Central

    Wagner, Denae; Newbury, Sandra; Kass, Philip; Hurley, Kate

    2014-01-01

    For animals in confinement housing the housing structure has tremendous potential to impact well being. Dogs in animal shelters are often housed in one of two types of confinement housing – single kennels and rooms or double compartment kennels and rooms most often separated by a guillotine door. This study examines the effect of housing on the location of elimination behavior in dogs housed in double compartment kennels were the majority of the dogs were walked daily. One side of the kennel contained the food, water and bed and the other side was empty and available except during cleaning time. Location of urination and defecation was observed daily for 579 dogs housed in indoor double compartment kennels for a total of 4440 days of observation. There were 1856 days (41.9%) when no elimination was noted in the kennel. Feces, urine or both were observed in the kennel on 2584 days (58.1%). When elimination occurred in the kennel the probability of fecal elimination on the opposite side of the bed/food/water was 72.5% (95% CI 69.05% to 75.69%). The probability of urination on the opposite side of the bed/food/water was 77.4% (95% CI 74.33% to 80.07%). This study demonstrates the strong preference of dogs to eliminate away from the area where they eat, drink and sleep. Double compartment housing not only allows this – it allows staff the ability to provide safe, efficient, humane daily care and confers the added benefits of reducing risks for disease transmission for the individual dog as well as the population. PMID:24825357

  6. Elimination behavior of shelter dogs housed in double compartment kennels.

    PubMed

    Wagner, Denae; Newbury, Sandra; Kass, Philip; Hurley, Kate

    2014-01-01

    For animals in confinement housing the housing structure has tremendous potential to impact well being. Dogs in animal shelters are often housed in one of two types of confinement housing - single kennels and rooms or double compartment kennels and rooms most often separated by a guillotine door. This study examines the effect of housing on the location of elimination behavior in dogs housed in double compartment kennels were the majority of the dogs were walked daily. One side of the kennel contained the food, water and bed and the other side was empty and available except during cleaning time. Location of urination and defecation was observed daily for 579 dogs housed in indoor double compartment kennels for a total of 4440 days of observation. There were 1856 days (41.9%) when no elimination was noted in the kennel. Feces, urine or both were observed in the kennel on 2584 days (58.1%). When elimination occurred in the kennel the probability of fecal elimination on the opposite side of the bed/food/water was 72.5% (95% CI 69.05% to 75.69%). The probability of urination on the opposite side of the bed/food/water was 77.4% (95% CI 74.33% to 80.07%). This study demonstrates the strong preference of dogs to eliminate away from the area where they eat, drink and sleep. Double compartment housing not only allows this - it allows staff the ability to provide safe, efficient, humane daily care and confers the added benefits of reducing risks for disease transmission for the individual dog as well as the population.

  7. Compartment syndrome after total knee arthroplasty: regarding a clinical case.

    PubMed

    Pinheiro, Ana Alexandra da Costa; Marques, Pedro Miguel Dantas Costa; Sá, Pedro Miguel Gomes; Oliveira, Carolina Fernandes; da Silva, Bruno Pombo Ferreira; de Sousa, Cristina Maria Varino

    2015-01-01

    Although compartment syndrome is a rare complication of total knee arthroplasty, it is one of the most devastating complications. It is defined as a situation of increased pressure within a closed osteofascial space that impairs the circulation and the functioning of the tissues inside this space, thereby leading to ischemia and tissue dysfunction. Here, a clinical case of a patient who was followed up in orthopedic outpatient consultations due to right gonarthrosis is presented. The patient had a history of arthroscopic meniscectomy and presented knee flexion of 10° before the operation, which consisted of total arthroplasty of the right knee. The operation seemed to be free from intercurrences, but the patient evolved with compartment syndrome of the ipsilateral leg after the operation. Since compartment syndrome is a true surgical emergency, early recognition and treatment of this condition through fasciotomy is crucial in order to avoid amputation, limb dysfunction, kidney failure and death. However, it may be difficult to make the diagnosis and cases may not be recognized if the cause of compartment syndrome is unusual or if the patient is under epidural analgesia and/or peripheral nerve block, which thus camouflages the main warning sign, i.e. disproportional pain. In addition, edema of the limb that underwent the intervention is common after total knee arthroplasty operations. This study presents a review of the literature and signals that the possible rarity of cases is probably due to failure to recognize this condition in a timely manner and to placing these patients in other diagnostic groups that are less likely, such as neuropraxia caused by using a tourniquet or peripheral nerve injury.

  8. Compartment syndrome after total knee arthroplasty: regarding a clinical case☆

    PubMed Central

    Pinheiro, Ana Alexandra da Costa; Marques, Pedro Miguel Dantas Costa; Sá, Pedro Miguel Gomes; Oliveira, Carolina Fernandes; da Silva, Bruno Pombo Ferreira; de Sousa, Cristina Maria Varino

    2015-01-01

    Although compartment syndrome is a rare complication of total knee arthroplasty, it is one of the most devastating complications. It is defined as a situation of increased pressure within a closed osteofascial space that impairs the circulation and the functioning of the tissues inside this space, thereby leading to ischemia and tissue dysfunction. Here, a clinical case of a patient who was followed up in orthopedic outpatient consultations due to right gonarthrosis is presented. The patient had a history of arthroscopic meniscectomy and presented knee flexion of 10° before the operation, which consisted of total arthroplasty of the right knee. The operation seemed to be free from intercurrences, but the patient evolved with compartment syndrome of the ipsilateral leg after the operation. Since compartment syndrome is a true surgical emergency, early recognition and treatment of this condition through fasciotomy is crucial in order to avoid amputation, limb dysfunction, kidney failure and death. However, it may be difficult to make the diagnosis and cases may not be recognized if the cause of compartment syndrome is unusual or if the patient is under epidural analgesia and/or peripheral nerve block, which thus camouflages the main warning sign, i.e. disproportional pain. In addition, edema of the limb that underwent the intervention is common after total knee arthroplasty operations. This study presents a review of the literature and signals that the possible rarity of cases is probably due to failure to recognize this condition in a timely manner and to placing these patients in other diagnostic groups that are less likely, such as neuropraxia caused by using a tourniquet or peripheral nerve injury. PMID:26401507

  9. Shaped Charge Jet/Propellant Interactions in a Vented Compartment.

    DTIC Science & Technology

    1979-12-01

    the vented ammunition compartment. One of these was the Susquehanna Instruments Model ST-4 tourmaline transducer, a nonresonant transducer capable of...S1-4 tourmaline gauges and those at positons 3 and 4 were Kistler Model 617A tourmaline gauges. Thin strips of metal were welded over the trans- ducers...two different types of piezoelectric transducers. One was a fast almost totally non- resonant though somewhat temperature sensitive Tourmaline bar gauge

  10. Closeup view of the reflective insulation protecting the Crew Compartment ...

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

    Close-up view of the reflective insulation protecting the Crew Compartment bulkhead, orbiter structure and landing gear housing in the void created by the removal of the Forward Reaction Control System Module from the forward section of the Orbiter Discovery. This image was taken from the service platform in the Orbiter Processing Facility at Kennedy Space Center. - Space Transportation System, Orbiter Discovery (OV-103), Lyndon B. Johnson Space Center, 2101 NASA Parkway, Houston, Harris County, TX

  11. Ruptured Baker's cyst with compartment syndrome: an extremely unusual complication.

    PubMed

    Hamlet, Mark; Galanopoulos, Ilias; Mahale, Avinash; Ashwood, Neil

    2012-12-20

    A 69-year-old man presented with sudden onset of pain with acute tense swelling of his left leg. Initially he was treated empirically with antibiotics for cellulitis while the possibility of deep vein thrombosis was ruled out. His symptoms gradually worsened with progressive distal neurological deficit and increasing pain. Further investigations suggested that he had a ruptured Baker's cyst in the calf with development of compartment syndrome.

  12. Ruptured Baker's cyst with compartment syndrome: an extremely unusual complication

    PubMed Central

    Hamlet, Mark; Galanopoulos, Ilias; Mahale, Avinash; Ashwood, Neil

    2012-01-01

    A 69-year-old man presented with sudden onset of pain with acute tense swelling of his left leg. Initially he was treated empirically with antibiotics for cellulitis while the possibility of deep vein thrombosis was ruled out. His symptoms gradually worsened with progressive distal neurological deficit and increasing pain. Further investigations suggested that he had a ruptured Baker's cyst in the calf with development of compartment syndrome. PMID:23264161

  13. Closeup view if the starboard side of the crew compartment ...

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

    Close-up view if the starboard side of the crew compartment mid-deck of the Orbiter Discovery. This is a close up view of the galley for meal preparations. In the center right of the image is stowage lockers that are designated to store meals for the mission. This photograph was taken at Kennedy Space Center. - Space Transportation System, Orbiter Discovery (OV-103), Lyndon B. Johnson Space Center, 2101 NASA Parkway, Houston, Harris County, TX

  14. Measuring Compartment Size and Gas Solubility in Marine Mammals

    DTIC Science & Technology

    2015-09-30

    Koopman, H.N. and A.J. Westgate, Solubility of nitrogen in marine mammal blubber depends on its lipid composition. Journal of Experimental Biology ...1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Measuring Compartment Size and Gas Solubility in Marine ...Mammals Michael Moore Biology Department Woods Hole Oceanographic Institution Woods Hole, MA 02543 phone: (508) 289-3228 fax: (508) 457

  15. Independent Passive Mechanical Behavior of Bovine Extraocular Muscle Compartments

    PubMed Central

    Shin, Andrew; Yoo, Lawrence; Chaudhuri, Zia; Demer, Joseph L.

    2012-01-01

    Purpose. Intramuscular innervation of horizontal rectus extraocular muscles (EOMs) is segregated into superior and inferior (transverse) compartments, while all EOMs are also divided into global (GL) and orbital (OL) layers with scleral and pulley insertions, respectively. We sought evidence of potential independent action by examining passive mechanical coupling between EOM compartments. Methods. Putative compartments of each of the six whole bovine anatomical EOMs were separately clamped to a physiologically controlled, dual channel microtensile load cell (5-mN force resolution) driven by independent, high-speed, linear motors having 20-nm position resolution. One channel at a time was extended or retracted by 3 to 5 mm, with the other channel stationary. Fiducials distributed on the EOM global surface enabled optical tracking of local deformation. Loading rates of 5 to 100 mm/sec were applied to explore speeds from slow vergence to saccades. Control loadings employed transversely loaded EOM and isotropic latex. Results. All EOM bellies and tendons exhibited substantial compartmental independence when loaded in the physiologic direction, both between OL and GL, and for arbitrary transverse parsings of EOM width ranging from 60%:40% to 80%:20%. Intercompartmental force coupling in the physiologic direction was less than or equal to 10% in all six EOMS even for saccadic loading rates. Coupling was much higher for nonphysiologic transverse EOM loading and isotropic latex. Optical tracking demonstrated independent strain distribution between EOM compartments. Conclusions. Substantial mechanical independence exists among physiologically loaded fiber bundles in bovine EOMs and tendons, providing biomechanical support for the proposal that differential compartmental function in horizontal rectus EOMs contributes to novel torsional and vertical actions. PMID:23188730

  16. Bacterial assemblages differ between compartments within the coral holobiont

    NASA Astrophysics Data System (ADS)

    Sweet, M. J.; Croquer, A.; Bythell, J. C.

    2011-03-01

    It is widely accepted that corals are associated with a diverse and host species-specific microbiota, but how they are organized within their hosts remains poorly understood. Previous sampling techniques (blasted coral tissues, coral swabs and milked mucus) may preferentially sample from different compartments such as mucus, tissue and skeleton, or amalgamate them, making comparisons and generalizations between studies difficult. This study characterized bacterial communities of corals with minimal mechanical disruption and contamination from water, air and sediments from three compartments: surface mucus layer (SML), coral tissue and coral skeleton. A novel apparatus (the `snot sucker') was used to separate the SML from tissues and skeleton, and these three compartments were compared to swab samples and milked mucus along with adjacent environmental samples (water column and sediments). Bacterial 16S rRNA gene diversity was significantly different between the various coral compartments and environmental samples (PERMANOVA, F = 6.9, df = 8, P = 0.001), the only exceptions being the complete crushed coral samples and the coral skeleton, which were similar, because the skeleton represents a proportionally large volume and supports a relatively rich microflora. Milked mucus differed significantly from the SML collected with the `snot sucker' and was contaminated with zooxanthellae, suggesting that it may originate at least partially from the gastrovascular cavity rather than the tissue surface. A common method of sampling the SML, surface swabs, produced a bacterial community profile distinct from the SML sampled using our novel apparatus and also showed contamination from coral tissues. Our results indicate that microbial communities are spatially structured within the coral holobiont, and methods used to describe these need to be standardized to allow comparisons between studies.

  17. Diagnosis of Compartment Syndrome Based on Tissue Oxygenation

    DTIC Science & Technology

    2013-10-01

    measured with microprobes has been shown to be highly correlated with tissue oxygenation and the extent of ischemia reperfusion injury .3 Near-infrared...Tissue Oxygenation PRINCIPAL INVESTIGATOR: Hubert Kim, M.D., Ph.D. CONTRACTING ORGANIZATION: Northern California Institute for...SUBTITLE Diagnosis of Compartment Syndrome based on Tissue Oxygenation 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-10-1-1024 5c. PROGRAM ELEMENT

  18. Measuring Compartment Size and Gas Solubility in Marine Mammals

    DTIC Science & Technology

    2014-09-30

    dissection data were collected from one spotted dolphin , one bottlenose dolphin , three common dolphins , one elephant seal, three californian sea lions and...deviation for body compartments of three common dolphins of similar age (subadults and adults) but with different body condition. Muscle was the most...AL, Dennison SE, Early G, Garner MM, Hayward BA, Lentell BJ, Rotstein DS (2009) Gas Bubbles in Seals, Dolphins , and Porpoises Entangled and Drowned

  19. The pseudo-compartment method for coupling partial differential equation and compartment-based models of diffusion.

    PubMed

    Yates, Christian A; Flegg, Mark B

    2015-05-06

    Spatial reaction-diffusion models have been employed to describe many emergent phenomena in biological systems. The modelling technique most commonly adopted in the literature implements systems of partial differential equations (PDEs), which assumes there are sufficient densities of particles that a continuum approximation is valid. However, owing to recent advances in computational power, the simulation and therefore postulation, of computationally intensive individual-based models has become a popular way to investigate the effects of noise in reaction-diffusion systems in which regions of low copy numbers exist. The specific stochastic models with which we shall be concerned in this manuscript are referred to as 'compartment-based' or 'on-lattice'. These models are characterized by a discretization of the computational domain into a grid/lattice of 'compartments'. Within each compartment, particles are assumed to be well mixed and are permitted to react with other particles within their compartment or to transfer between neighbouring compartments. Stochastic models provide accuracy, but at the cost of significant computational resources. For models that have regions of both low and high concentrations, it is often desirable, for reasons of efficiency, to employ coupled multi-scale modelling paradigms. In this work, we develop two hybrid algorithms in which a PDE in one region of the domain is coupled to a compartment-based model in the other. Rather than attempting to balance average fluxes, our algorithms answer a more fundamental question: 'how are individual particles transported between the vastly different model descriptions?' First, we present an algorithm derived by carefully redefining the continuous PDE concentration as a probability distribution. While this first algorithm shows very strong convergence to analytical solutions of test problems, it can be cumbersome to simulate. Our second algorithm is a simplified and more efficient implementation of

  20. Fluoxetine Exerts Age-Dependent Effects on Behavior and Amygdala Neuroplasticity in the Rat

    PubMed Central

    Homberg, Judith R.; Olivier, Jocelien D. A.; Blom, Tom; Arentsen, Tim; van Brunschot, Chantal; Schipper, Pieter; Korte-Bouws, Gerdien; van Luijtelaar, Gilles; Reneman, Liesbeth

    2011-01-01

    The selective serotonin reuptake inhibitor (SSRI) Prozac® (fluoxetine) is the only registered antidepressant to treat depression in children and adolescents. Yet, while the safety of SSRIs has been well established in adults, serotonin exerts neurotrophic actions in the developing brain and thereby may have harmful effects in adolescents. Here we treated adolescent and adult rats chronically with fluoxetine (12 mg/kg) at postnatal day (PND) 25 to 46 and from PND 67 to 88, respectively, and tested the animals 7–14 days after the last injection when (nor)fluoxetine in blood plasma had been washed out, as determined by HPLC. Plasma (nor)fluoxetine levels were also measured 5 hrs after the last fluoxetine injection, and matched clinical levels. Adolescent rats displayed increased behavioral despair in the forced swim test, which was not seen in adult fluoxetine treated rats. In addition, beneficial effects of fluoxetine on wakefulness as measured by electroencephalography in adults was not seen in adolescent rats, and age-dependent effects on the acoustic startle response and prepulse inhibition were observed. On the other hand, adolescent rats showed resilience to the anorexic effects of fluoxetine. Exploratory behavior in the open field test was not affected by fluoxetine treatment, but anxiety levels in the elevated plus maze test were increased in both adolescent and adult fluoxetine treated rats. Finally, in the amygdala, but not the dorsal raphe nucleus and medial prefrontal cortex, the number of PSA-NCAM (marker for synaptic remodeling) immunoreactive neurons was increased in adolescent rats, and decreased in adult rats, as a consequence of chronic fluoxetine treatment. No fluoxetine-induced changes in 5-HT1A receptor immunoreactivity were observed. In conclusion, we show that fluoxetine exerts both harmful and beneficial age-dependent effects on depressive behavior, body weight and wakefulness, which may relate, in part, to differential fluoxetine