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Sample records for adipofascial anterolateral thigh

  1. Adipofascial Anterolateral Thigh Flap Safety: Applications and Complications

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    Tommaso Agostini

    2013-03-01

    Full Text Available BackgroundA thinned anterolateral thigh (ALT flap is often harvested to achieve optimal skin resurfacing. Several techniques have been described to thin an ALT flap including an adipocutaneous flap, an adipofascial flap and delayed debulking.MethodsBy systematically reviewing all of the available literature in English and French, the present manuscript attempts to identify the common surgical indications, complications and donor site morbidity of the adipofascial variant of the ALT flap. The studies were identified by performing a systematic search on Medline, Ovid, EMBASE, the Cochrane Database of Systematic Reviews, Current Contents, PubMed, Google, and Google Scholar.ResultsThe study selection process was adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and 15 articles were identified using the study inclusion criteria. These articles were then reviewed for author name(s, year of publication, flap dimensions and thickness following defatting, perforator type, type of transfer, complications, thinning technique, number of cases with a particular area of application and donor site morbidity.ConclusionsThe adipofascial variant of the ALT flap provides tissue to fill large defects and improve pliability. Its strong and safe blood supply permits adequate immediate or delayed debulking without vascular complications. The presence of the deep fascia makes it possible to prevent sagging by suspending and fixing the flap for functional reconstructive purposes (e.g., the intraoral cavity. Donor site morbidity is minimal, and thigh deformities can be reduced through immediate direct closure or liposuction and direct closure. A safe blood supply was confirmed by the rate of secondary flap debulking.

  2. Use of the Anterolateral Thigh in Cranio-Orbitofacial Reconstruction

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    William J. Parkes

    2011-01-01

    Full Text Available Objective. To detail the clinical outcomes of a series of patients having undergone free flap reconstruction of the orbit and periorbita and highlight the anterolateral thigh (ALT as a workhorse for addressing defects in this region. Methods. A review of 47 patients who underwent free flap reconstruction for orbital or periorbital defects between September 2006 and May 2011 was performed. Data reviewed included demographics, defect characteristics, free flap used, additional reconstructive techniques employed, length of stay, complications, and follow-up. The ALT subset of the case series was the focus of the data reviewed for this paper. Selected cases were described to highlight some of the advantages of employing the ALT for cranio-orbitofacial reconstruction. Results. 51 free flaps in 47 patients were reviewed. 38 cases required orbital exenteration. The ALT was used in 33 patients. Complications included 1 hematoma, 2 wound infections, 3 CSF leaks, and 3 flap failures. Conclusions. Free tissue transfer allows for the safe and effective reconstruction of complex defects of the orbit and periorbital structures. Reconstructive choice is dependent upon the extent of soft tissue loss, midfacial bone loss, and skullbase involvement. The ALT provides a versatile option to reconstruct the many cranio-orbitofacial defects encountered.

  3. Augmented reality and dynamic infrared thermography for perforator mapping in the anterolateral thigh.

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    Cifuentes, Ignacio Javier; Dagnino, Bruno Leonardo; Salisbury, María Carolina; Perez, María Eliana; Ortega, Claudia; Maldonado, Daniela

    2018-05-01

    Dynamic infrared thermography (DIRT) has been used for the preoperative mapping of cutaneous perforators. This technique has shown a positive correlation with intraoperative findings. Our aim was to evaluate the accuracy of perforator mapping with DIRT and augmented reality using a portable projector. For this purpose, three volunteers had both of their anterolateral thighs assessed for the presence and location of cutaneous perforators using DIRT. The obtained image of these "hotspots" was projected back onto the thigh and the presence of Doppler signals within a 10-cm diameter from the midpoint between the lateral patella and the anterior superior iliac spine was assessed using a handheld Doppler device. Hotspots were identified in all six anterolateral thighs and were successfully projected onto the skin. The median number of perforators identified within the area of interest was 5 (range, 3-8) and the median time needed to identify them was 3.5 minutes (range, 3.3-4.0 minutes). Every hotspot was correlated to a Doppler sound signal. In conclusion, augmented reality can be a reliable method for transferring the location of perforators identified by DIRT onto the thigh, facilitating its assessment and yielding a reliable map of potential perforators for flap raising.

  4. Pedicle Anterolateral Thigh Flap Reconstruction after Pelvic Tumor Resection: A Case Report

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    Robert M. Whitfield

    2010-01-01

    Full Text Available A 47-year-old female with a locally advanced urologic malignancy previously managed with resection, diversion, and postoperative radiation therapy presented for management of her recurrent cancer that had eroded through the soft tissues of the left inner thigh and vulva. On all staging studies the tumor involved the left common femoral artery, and vein, both above and below the inguinal ligament. The difficulty with such tumors is the availability of tissue to reconstruct the defect. The patient had a history of deep venous thrombosis in the femoral venous system. A local flap was the most logical type of reconstruction. The patient had a right lower quadrant ureterostomy with a large parastomal hernia which further limited the local flap options. An anterolateral thigh flap from the opposite thigh was used to reconstruct the soft tissue deficit in this patient. This resurfaced the defect and provided coverage for the vascular reconstruction.

  5. Phalloplasty with an Innervated Island Pedicled Anterolateral Thigh Flap in a Female-to-Male Transsexual

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    Hasegawa, Kenjiro; Namba, Yuzaburo; Kimata, Yoshihiro

    2013-01-01

    Since 2001, we have been performing phalloplasty with a radial forearm free flap as the flap of first choice in female-to-male transsexuals (FTMTS). In the present case, a 22-year-old FTMTS with a negative Allen test, we achieved good results by performing phalloplasty with an innervated island pedicled anterolateral thigh flap using the "tube within a tube" technique, in which the penis and urethra are constructed with a single flap. While phalloplasty with an island-pedicled or free anterol...

  6. Free anterolateral thigh perforator flap for sacroiliac defect: First case report in pediatric population

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    Alejandro E. Ramirez

    2016-08-01

    Full Text Available Soft tissue defects of the sacroiliac area, usually can be covered by local flaps. However, for more complex defects, free flap transfers became necessary. We report a case of reconstruction with a free anterolateral thigh (ALT perforator flap for coverage of a sacroiliac bone exposure in a child. A six-years-old boy, suffered a car accident, resulting in pelvic and sacral fractures, as well as degloving injuries of the left thigh, buttocks, and trunk. The patient evolved with an unstable scar over the sacroiliac region with bone exposure. ALT free flap was performed. Left superior gluteal vessels were used as the recipient vessels. A stable coverage was achieved without complications. This is the first case reported of a free ALT perforator flap for sacroiliac coverage in the pediatric population. In cases of complex reconstruction in children, free perforator flap is a safe choice and should be considered in the algorithm of treatment.

  7. Use of the Anterolateral Thigh and Vertical Rectus Abdominis Musculocutaneous Flaps as Utility Flaps in Reconstructing Large Groin Defects

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    Edwin Jonathan Aslim

    2014-09-01

    Full Text Available BackgroundGroin dissections result in large wounds with exposed femoral vessels requiring soft tissue coverage, and the reconstructive options are diverse. In this study we reviewed our experience with the use of the pedicled anterolateral thigh and vertical rectus abdominis musculocutaneous flaps in the reconstruction of large groin wounds.MethodsGroin reconstructions performed over a period of 10 years were evaluated, with a mean follow up of two years. We included all cases with large or complex (involving perineum defects, which were reconstructed with the pedicled anterolateral thigh musculocutaneous or the vertical rectus abdominis musculocutaneous (VRAM flaps. Smaller wounds which were covered with skin grafts, locally based flaps and pedicled muscle flaps were excluded.ResultsTwenty-three reconstructions were performed for large or complex groin defects, utilising the anterolateral thigh (n=10 and the vertical rectus abdominis (n=13 pedicled musculocutaneous flaps. Femoral vein reconstruction with a prosthetic graft was required in one patient, and a combination flap (VRAM and gracilis muscle flap was performed in another. Satisfactory coverage was achieved in all cases without major complications. No free flaps were used in our series.ConclusionsThe anterolateral thigh and vertical rectus abdominis pedicled musculocutaneous flaps yielded consistent results with little morbidity in the reconstruction of large and complex groin defects. A combination of flaps can be used in cases requiring extensive cover.

  8. Feasibility and Advantages of Full Thickness Skin Graft from the Anterolateral Thigh.

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    Shin, Seung-Han; Kim, Chulkyu; Lee, Yong-Suk; Kang, Jin-Woo; Chung, Yang-Guk

    2017-12-01

    Full thickness skin graft (FTSG) gives better outcomes than split thickness skin graft (STSG), but it has the drawback of limited donor sites. Anterolateral thigh (ALT), a popular donor site of STSG, is also a popular donor site of perforator flaps. This area has the advantage of large flap size available with primary closure. Based on this we harvested FTSG instead of STSG from the ALT. We retrospectively reviewed 10 cases of FTSG from the ALT, with the recipient site of foot in 3, ankle in 2, lower leg in 2, forearm in 2, and wrist in 1 patient. In all cases elliptical full thickness skin was harvested from the ALT, and the donor site was closed primarily. The skin was defatted and placed onto the defect with vacuum-assisted closure (VAC). The skin size ranged 7-30 cm in length and 3-12 cm in width. Mean follow up period was 7 months (range, 3-13). FTSG from the ALT provided durable wound coverage, with excellent color and texture matching. Partial (< 20%) graft failure was observed in 1 case, but no additional surgery was necessary. No patient reported donor site pain at postoperative 2 weeks. No donor site complications were encountered. No patient complained a feeling of tension in the thigh at final follow-up. FTSG from the ALT is feasible with the aid of VAC. Considering the skin quality, large skin size available, early pain relief, and little donor site morbidity, the ALT should be revisited as a donor site of FTSG.

  9. Risk factors for delayed healing at the free anterolateral thigh flap donor site

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    Yoshiro Abe

    2018-01-01

    Full Text Available Background The free anterolateral thigh (ALT flap has been widely used for various kinds of reconstructions. However, delayed healing at the donor site occasionally occurs due to wound dehiscence or the partial loss of grafted skin at the donor site. The aim of the present study was to identify reliable predictive factors for delayed healing at the donor site after the harvest of a free ALT flap. Methods This study included 52 patients who underwent reconstructive procedures using free ALT flaps. The delayed healing group included patients with wounds at the donor site that had not healed over 3 weeks after surgery, and the normal healing group included patients who showed wound healing within 3 weeks after surgery. Multivariate logistic regression models were created to identify the risk factors for delayed healing at the ALT flap donor site. Results Among the 52 patients, 24 (46.2% showed delayed healing at the donor site, and 6 patients required additional operative treatment. A high preoperative body mass index (BMI, smoking, and skin grafting were found to be significantly associated with delayed healing at the ALT donor site. Of the 37 patients who underwent skin grafting, 23 (62% experienced delayed healing at the donor site. Conclusions A high preoperative BMI, smoking, and skin grafting were risk factors for delayed healing at the free ALT donor site. Skin grafting at the ALT donor site should be avoided in patients with a high BMI or a habit of smoking.

  10. Reconstruction of trochanteric pressure sores with pedicled anterolateral thigh myocutaneous flaps.

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    Wang, Chih-Hsin; Chen, Shih-Yi; Fu, Ju-Peng; Dai, Niann-Tzyy; Chen, Shao-Liang; Chen, Tim-Mo; Chen, Shyi-Gen

    2011-05-01

    To provide an alternative choice for covering trochanteric pressure sores, we report on a modified pedicle anterolateral thigh (ALT) myocutaneous flap based on the descending branch of the lateral circumflex femoral artery. From August 2007 to January 2010, 20 consecutive patients (10 men and 10 women) underwent 21 pedicled ALT myocutaneous flaps for reconstruction of trochanteric pressure sores. The flap was designed and elevated, resembling the ALT perforator flap including part of the vastus lateralis muscle but without skeletonisation of the perforators. The mean age of patients was 79.4 years (range: 46-103). The mean follow-up period was 13.9 months (range: 3-32). The flaps were 8-21 cm long and 5-11 cm wide. All flaps healed without major complications. All donor sites were closed primarily without skin grafting and showed good aesthetic results. No recurrence was observed. This modified design of pedicled ALT myocutaneous flap without skeletonisation of perforators is a reliable and easily harvested flap for reconstruction of trochanteric pressure sores with limited morbidity. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

  11. Modified Design of Anterolateral Thigh Flap for Total Pharyngolaryngectomy Reconstruction: A Single-Center Experience.

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    Cheng, Li-Yen; Chen, Cha-Chun; Lin, Hwang-Chi; Jeng, Chu-Hsu; Lin, Shang-Hsi; Chen, Wei-Nung Jim; Lin, Yu-Hsien; Hao, Sheng-Po

    2018-07-01

    Defects after total pharyngolaryngectomy for hypopharyngeal cancer often require reconstruction via free tissue transfer. Recently, anterolateral thigh (ALT) flap has become the gold standard in many centers because of its advantages with respect to versatility, minimal donor-site morbidity, good speech quality, and relatively low fistula and anastomotic leakage rates. Moreover, ALT allows 2 surgical teams to work simultaneously. However, the height of the parallelogram in the ALT design for neoesophagus reconstruction is usually set at a minimum of 9.4 cm (circumference, 2πr) for smooth food passage. Because this height exceeds 8 cm, the donor site may not be closed primarily, which highly depends on the patient's body habitus and the skin tone or quality and requires other methods, such as local flap or skin graft for wound closure, which subsequently increase operating time and donor-site complication rate. Thus, we aimed to construct a simple and modified ALT design that will not only include the advantages described earlier but also provide adequate donor-site primary closure without jeopardizing complication rates. Ten patients with hypopharyngeal cancer underwent reconstructive surgery using our modified ALT design after total pharyngolaryngectomy between 2010 and 2017. Our modified ALT design converts this "classical" shape into a parallelogram so that the height of the modified design is always less than 8 cm, thus allowing for easy primary closure of the wound. The donor-site defects of all 10 patients were closed primarily. No donor-site complications and partial or total flap loss were observed. One patient experienced persistent wound infection with dehiscence, for which debridement was performed. The stricture and fistula rates were 10% (n = 1) and 20% (n = 2), respectively. The mean follow-up time is approximately 1 year. Minimizing donor-site morbidity is an important goal in reconstructive surgery. Our modified ALT flap design is simple, enabling

  12. Reconstructive Surgery for Severe Penile Inadequacy: Phalloplasty with a Free Radial Forearm Flap or a Pedicled Anterolateral Thigh Flap

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    N. Lumen

    2008-01-01

    Full Text Available Objectives. Severe penile inadequacy in adolescents is rare. Phallic reconstruction to treat this devastating condition is a major challenge to the reconstructive surgeon. Phallic reconstruction using the free radial forearm flap (RFF or the pedicled anterolateral thigh flap (ALTF has been routinely used in female-to-male transsexuals. Recently we started to use these techniques in the treatment of severe penile inadequacy. Methods. Eleven males (age 15 to 42 years were treated with a phallic reconstruction. The RFF is our method of choice; the ALTF is an alternative when a free flap is contraindicated or less desired by the patient. The RFF was used in 7 patients, the ALTF in 4 patients. Mean followup was 25 months (range: 4–49 months. Aesthetic and functional results were evaluated. Results. There were no complications related to the flap. Aesthetic results were judged as “good” in 9 patients and “moderate” in 2 patients. Sensitivity in the RFF was superior compared to the ALTF. Four patients developed urinary complications (stricture and/or fistula. Six patients underwent erectile implant surgery. In 2 patients the erectile implant had to be removed due to infection or erosion. Conclusion. In case of severe penile inadequacy due to whatever condition, a phalloplasty is the preferred treatment nowadays. The free radial forearm flap is still the method of choice. The anterolateral thigh flap can be a good alternative, especially when free flaps are contraindicated, but sensitivity is markedly inferior in these flaps.

  13. Reverse Anterolateral Thigh Flap to Revise a Below-knee Amputation Stump at the Mid-tibial Level

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    Parviz Lionel Sadigh, MB ChB

    2013-12-01

    Full Text Available Summary: The reconstruction of defects around the knee often poses a challenge due to the limited availability of local soft tissues. Indeed, this same problem is encountered when attempting to revise a below-knee amputation stump. Moreover, due to a paucity of recipient vessels in those who have undergone previous amputation secondary to trauma, free-flap reconstruction is often challenging and not always successful. We report a case of a reverse anterolateral thigh (ALT flap used to revise a long below-knee amputation stump. Previous reports in the literature attest to the versatility of the reverse ALT to cover defects around the knee and proximal tibia, but to our knowledge, this is the first report of a reverse ALT reaching to the mid-tibial level.

  14. [COMPARISON OF REPAIR EFFECT BETWEEN CHIMERIC ANTEROLATERAL THIGH FLAP AND SERIES-WOUND FLAPS FOR DEFECT AFTER RESECTION OF ORAL AND MAXILLOFACIAL CANCER].

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    Yang, Heping; Zhang, Hongwu; Chen, Haidi; Yang, Shuxiong; Wang, Jun; Hu, Dawang

    2016-04-01

    To compare the effectiveness of complex defects repair between using chimeric anterolateral thigh flap and series-wound flaps after resection of oral and maxillofacial cancer. After resection of oral and maxillofacial cancer, defect was repaired with chimeric anterolateral thigh flap in 39 patients between January 2011 and July 2014 (chimeric anterolateral thigh flap group); and defect was repaired with series-wound flaps in 35 patients between January 2009 and December 2010 (series-wound flaps group). There was no significant difference in gender, age, duration of disease, tumor type, tumor staging, defect location, and defect area between 2 groups (P > 0.05). The operation time, flap harvesting and microvascular anastomosis time, stomach tube extraction time, and oral feeding time were recorded and compared between 2 groups, and postoperative complications were observed; the effectiveness was evaluated according to clinical efficacy evaluation table of bone and soft tissue defects reconstruction surgery in oral and maxillofacial region. Vascular crisis occurred in 2 cases of chimeric anterolateral thigh flap group, and 4 cases of series-wound flaps group. Partial necrosis appeared at distal end of a series-wound flaps, and oral fistula and infection developed in 3 series-wound flaps. The other flaps and the grafted skin at donor site survived; wounds at recipient site healed by first intention. The operation time, stomach tube extraction time, and oral feeding time of chimeric anterolateral thigh flap group were significantly shorter than those of series-wound flaps group (P oral closure function, chew, language performance, and swallowing scores of the chimeric anterolateral thigh-flap group were significantly better than those of the series-wound flaps group (P oral cavity holding water test, and occlusion scores between the 2 groups (P > 0.05). Using chimeric anterolateral thigh flap for defect repair after resection of oral and maxillofacial cancer can

  15. Emergency repair of upper extremity large soft tissue and vascular injuries with flow-through anterolateral thigh free flaps.

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    Zhan, Yi; Fu, Guo; Zhou, Xiang; He, Bo; Yan, Li-Wei; Zhu, Qing-Tang; Gu, Li-Qiang; Liu, Xiao-Lin; Qi, Jian

    2017-12-01

    Complex extremity trauma commonly involves both soft tissue and vascular injuries. Traditional two-stage surgical repair may delay rehabilitation and functional recovery, as well as increase the risk of infections. We report a single-stage reconstructive surgical method that repairs soft tissue defects and vascular injuries with flow-through free flaps to improve functional outcomes. Between March 2010 and December 2016 in our hospital, 5 patients with severe upper extremity trauma received single-stage reconstructive surgery, in which a flow-through anterolateral thigh free flap was applied to repair soft tissue defects and vascular injuries simultaneously. Cases of injured artery were reconstructed with the distal trunk of the descending branch of the lateral circumflex femoral artery. A segment of adjacent vein was used if there was a second artery injury. Patients were followed to evaluate their functional recoveries, and received computed tomography angiography examinations to assess peripheral circulation. Two patients had post-operative thumb necrosis; one required amputation, and the other was healed after debridement and abdominal pedicle flap repair. The other 3 patients had no major complications (infection, necrosis) to the recipient or donor sites after surgery. All the patients had achieved satisfactory functional recovery by the end of the follow-up period. Computed tomography angiography showed adequate circulation in the peripheral vessels. The success of these cases shows that one-step reconstructive surgery with flow-through anterolateral thigh free flaps can be a safe and effective treatment option for patients with complex upper extremity trauma with soft tissue defects and vascular injuries. Copyright © 2017. Published by Elsevier Ltd.

  16. Immediate reconstruction of maxillectomy defects using anterolateral thigh free flap in patients from a low resource region.

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    Liu, Wei Wei; Peng, Han Wei; Guo, Zhu Ming; Zhang, Quan; Yang, An Kui

    2012-11-01

    To report the reliability and reconstructive outcome of using anterolateral thigh (ALT) flap with or without titanium mesh to repair maxillectomy defects in a patient from a low resource region (LRR). Retrospective review. Clinical data of patients with oral-maxillofacial cancers who underwent maxillectomy and reconstruction using ALT flap in two tertiary cancer centers in southern China were retrospectively reviewed. Reconstructive techniques, flap survival, postoperative oral functions, and surgical complications were reported. Apart from one total flap loss, 18 of the 19 free ALT flaps survived. Titanium mesh was used in two patients with total maxillectomy defects. Eighteen of the 19 patients resumed a normal oral diet. Fourteen patients had good speech, except one patient with poor pronunciation, and four patients had average speech. One patient presented with postoperative palatal fistula. No other complications were observed. The application of ALT flaps with or without titanium mesh to repair maxillectomy defects is straightforward and reliable and has an acceptable reconstructive outcome. It might be a suitable procedure for patients from an LRR. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  17. Aesthetic and Functional Outcomes of the Innervated and Thinned Anterolateral Thigh Flap in Reconstruction of Upper Limb Defects

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    Carlos Alberto Torres-Ortíz Zermeño

    2014-01-01

    Full Text Available Background. The anterolateral thigh (ALT flap has been widely described in reconstruction of the upper extremity. However, some details require refinement to improve both functional and aesthetic results. Methods. After reconstruction of upper extremity defects using thinned and innervated ALT flaps, functional and aesthetic outcomes were evaluated with the QuickDASH scale and a Likert scale for aesthetic assessment of free flaps, respectively. Results. Seven patients with a mean follow-up of 11.57 months and average flap thickness of 5 mm underwent innervation by an end-to-end neurorrhaphy. The average percentage of disability (QuickDASH was 21.88% with tenderness, pain, temperature, and two-point discrimination present in 100% of cases, and the aesthetic result gave an overall result of 15.40 (good with the best scores in color and texture. Conclusions. Simultaneous thinning and innervation of the ALT flap lead to a good cosmetic result and functional outcome with a low percentage of disability, which could result in minor surgical procedures and better recovery of motor and sensory function. Level of Evidence. IV.

  18. Intraoperative use of indocyanine green angiography for selecting the more reliable perforator of the anterolateral thigh flap: A comparison study.

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    La Padula, Simone; Hersant, Barbara; Meningaud, Jean Paul

    2018-03-30

    Anatomical variability of anterolateral thigh flap (ALT) perforators has been reported. The aim of this study is to assess if the use of intraoperative indocyanine green angiography (iICGA) can help surgeons to choose the ALT flap best perforator to be preserved. A retrospective study was conducted in 28 patients with open tibial fracture, following a road traffic crash, who had undergone ALT flap. Patients were classified into two groups: ICGA group (iICGA was used to select the more reliable perforator) and control group. The mean tissue loss size of the ICGA group (n = 13, 11 men and 2 women, mean age: 52 ± 6 years) was of 16.6 cm × 12.2 cm. The mean defect size of the control group (n = 15, 14 men and 1 women, mean age: 50 ± 5.52 years) was of 15.3 cm × 11.1 cm. Statistical analysis was performed to analyze and compare the results. ICGA allowed preserving only the most functional perforator, that provided the best ALT flap perfusion in 10 out of the 13 cases (77%). ICGA allowed a significant operative time reduction (160 ± 23 vs. 202 ± 48 minutes; P < .001). One case of distal necrosis was observed in the ICGA group (mean follow-up 12.3 months), while partial skin necrosis occurred in three cases of the control group (mean follow-up 13.1 months); P = .35. No additional coverage was required and a successful bone healing was observed in both groups. These findings suggest that iICGA is an effective method that allows to select the most reliable ALT flap perforators and to reduce operative time. © 2018 Wiley Periodicals, Inc.

  19. For Vol.67, No.5 pp325-331 Phalloplasty with an Innervated Island Pedicled Anterolateral Thigh Flap in a Female-to-Male Transsexual

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    Hasegawa, Kenjiro; Namba, Yuzaburo; Kimata, Yoshihiro

    2014-01-01

    Since 2001, we have been performing phalloplasty with a radial forearm free flap as the flap of firstchoice in female-to-male transsexuals (FTMTS). In the present case, a 22-year-old FTMTS with anegative Allen test, we achieved good results by performing phalloplasty with an innervated islandpedicled anterolateral thigh flap using the “tube within a tube” technique, in which the penis and urethraare constructed with a single flap. As compared to a forearm flap, use of an innervated islandpedi...

  20. The Role of the Distal Runoff Vessel of the Descending Branch of the Lateral Circumflex Femoral System in Anterolateral Thigh Flap Surgery: A Case Series and Literature Review.

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    He, Xiao-Qing; Zhu, Yue-Liang; Wang, Yi; Mei, Liang-Bin; Jin, Tao; Xu, Yong-Qing

    2016-01-01

    As a distal portion of the descending branch of the lateral circumflex femoral system (LCFS), the role of the distal runoff vessel in anterolateral thigh (ALT) flap surgery has long been overlooked. Recently, however, the distal runoff vessel has been increasingly used in many aspects of ALT flap surgery, and it has exhibited superior properties in solving some difficult problems. Fourteen ALT flaps using the distal runoff vessel of the descending branch of the LCFS for extremity defects were retrospectively reviewed, and recent reports on using the distal runoff vessel were reviewed to determine the role of this vessel in ALT flap surgery. In our series, the distal runoff vessel was used as a flow-through pattern in 10 cases, as a recombined chimeric flap in 2 cases, and as a backup vessel for flap salvage in 2 cases. All of the ALT flaps completely survived. None of the donor sites presented with additional morbidity as a result of harvesting the distal runoff vessel. In the literature review, the following are 5 other options for using the distal runoff vessel: in interposition artery and vein grafts, as the pedicle of the reverse-flow ALT flap, as the recipient vessel, to avoid twisting, and as a monitoring method. The distal runoff vessel of the descending branch of the LCFS could be used for many aspects of the ALT flap surgery, and this vessel plays an irreplaceable role in some difficult reconstruction surgeries.

  1. [Assessment of the quality of life of oral cancer patients after reconstruction with free anterolateral thigh perforator flaps].

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    Na, Deng; Wei, He; Rui, Li; Wenlu, Li; Ning, Gao; Wen, Zhang

    2015-04-01

    This study aims to evaluate the quality of life (QOL) of patients who underwent resection of oral cancer and reconstruction by free anierolateral thigh perforator flaps (ALTF). A total of 32 patients with oral and maxillofacial malignancies who had undergone the resection of oral cancer and reconstruction by ALTF were retrospectively analyzed. At 12 months postoperatively, the QOL of these patients was assessed by using the 14-item oral health impact profile (OHIP-14) and the medical outcome study short form-36 (SF-36) questionnaires. A total of 32 questionnaires were collected. In SF-36, the highest scoring domains were bodily pain (78.58 ± 14.82), physical functioning (72.08 ± 27.86), and the role of physical (60.00 ± 42.63), whereas the lowest scoring domains were role-emotional (41.67 ± 39.62), followed by mental health (50.75 ± 13.07) and health transition (54.17 ± 21.75). In OHIP-14, the lowest scoring domains were social disability (34.50 ± 11.32) and handicap (36.04 ± 12.05), indicating the functional recovery was better; and the highest scoring domains were physical pain (73.50 ± 18.96) and psychological discomfort (60.17 ± 20.66), indicating the functional recovery was worse. The ALTF is an ideal selection for the reconstruction of oral defects after cancer resection. In using this flap, the basic social need of patients after surgery can be satisfied. Moreover, the appearance and the functions of chewing, deglutition, and speech can be restored in varying degrees. Thus, ALTF can improve the patients' QOL.

  2. Sequential chimeric medial femoral condyle and anterolateral thigh flow-through flaps for one-stage reconstructions of composite bone and soft tissue defects: Report of three cases.

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    Henn, Dominic; Abouarab, Mohamed H; Hirche, Christoph; Hernekamp, Jochen F; Schmidt, Volker J; Kneser, Ulrich; Kremer, Thomas

    2017-10-01

    Small recalcitrant non-unions with poor perfusion require reconstruction with vascularized bone flaps. Cases with concomitant large soft tissue defects are especially challenging, since vascularized soft tissue transfer is often indicated and distant microvascular anastomoses may be required. We introduce a sequential chimeric free flap composed of a medial femoral condyle corticoperiosteal flap anastomosed to an anterolateral thigh flow-through flap (MFC-ALT flap) and report its use for reconstruction of small non-unions with concomitant large soft tissue defects in three exemplary patients. Two female and one male patients ages 39-58 years suffered from composite bone and soft tissue defects of the lower extremity and clavicle caused by tumor resection and postoperative radiation resp. infected tibial pilon fracture. The sizes of the soft tissue defects ranged from 15-23 × 4.5-6 cm and the sizes of the bone defects ranged from 1.5-4 × 2-4 cm. Defect reconstructions were performed in all cases with sequential chimeric MFC-ALT flaps with sizes ranging from 2-4 × 1.6-4 cm for the MFC and 21-23 × 7-8 cm for the ALT skin paddles. Functional reconstructions were achieved in all cases resulting in stable unions and soft tissue coverage enabling the patients to bear full weight without assistance on 5-months follow-up. Postoperative course was uneventful and complications were restricted to a small skin necrosis at the suture line in one case. MFC-ALT flaps may be a safe, and effective procedure for one-stage reconstructions of small, irregularly shaped bone defects with concomitant large soft tissue loss or surrounding instable scarring, particularly in cases of recalcitrant non-unions after radiation exposure. © 2017 Wiley Periodicals, Inc.

  3. Treatment of ischial pressure sores with double adipofascial turnover flaps.

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    Lin, Haodong; Hou, Chunlin; Xu, Zhen; Chen, Aiming

    2010-01-01

    Despite a variety of flap reconstruction options, the ischium remains the most difficult pressure sore site to treat. This article describes the authors' successful surgical procedure for coverage of ischial ulcers using double adipofascial turnover flaps.After debridement, the adipofascial flaps are harvested both cephalad and caudal to the defect. The flaps are then turned over to cover the exposed bone in a manner so as to overlap the 2 flaps. The skin is then closed with sutures in 2 layers. A total of 15 patients with ischial sores were treated using this surgical procedure.The follow-up period ranged from 11 to 159 months, with a mean of 93.6 months. Overall, 86.7% of the flaps (13 of 15) healed primarily. One patient had a recurrent grade II ischial pressure sore again 11 months after the operation. The other 14 patients did not have a recurrence.Treatment of ischial pressure sores with adipofascial turnover flaps provides an easy, minimally invasive procedure, with preservation of future flap options, and a soft-tissue supply sufficient for covering the bony prominence and filling dead space. This technique is a reliable and safe reconstructive modality for the management of minor ischial pressure sores.

  4. Adipofascial sural artery flap for foot and ankle reconstruction in children: for better aesthetic outcome

    International Nuclear Information System (INIS)

    Mahmood, F.

    2015-01-01

    Wheel spoke injury of the ankle and foot is very common in children and its reconstruction is challenging. Reverse flow sural artery fasciocutaneous flap is versatile for this area but lead to significant donor site morbidity. Free tissue transfer is an option in children which needs a micro-vascular expertise, expensive equipment and long operating time. Method: Fifteen adipofascial flaps were done for foot and ankle coverage from June 2011 to June 2014 at CH and ICH Lahore. The efficacy of adipofascial sural artery flap for the coverage of these defects was evaluated. Results: Fifteen children presented with defects of foot and ankle, 11 (73%) were male and 4 (27%) were female. Their age ranged from 1 - 13 years. All patients had trauma to the foot due to wheel spoke injury. Flaps were used to cover tendoachilles and malleoli. In one patient there was flap tip necrosis with partial graft loss which healed with dressings. Donor site aesthetic outcome was satisfactory in all cases. Mean follow-up was I year. Conclusion: Adipofascial Sural artery flap is quick and safe with wide arc of rotation, minimal donor site morbidity and better aesthetic outcome and it does not sacrifice major extremity vessel. (author)

  5. Composite grafting with pulp adipofascial advancement flaps for treating non-replantable fingertip amputations.

    Science.gov (United States)

    Lai, Hsin-Ti; Wu, Sheng-Hua; Lai, Ya-Wei; Hsieh, Tung-Ying; Lee, Su-Shin; David Wang, Hui-Min; Chang, Kao-Ping; Lin, Sin-Daw; Lai, Chung-Sheng; Huang, Shu-Hung

    2016-11-01

    Non-replantable fingertip amputation is still a clinical challenge. We performed modified composite grafting with pulp adipofascial advancement flap for Hirase IIA fingertip amputations. Results from a series of patients are presented and achieved better outcome than traditional composite grafting. From September 2012 to April 2014, fourteen patients with sixteen digits were included in our study. Mean age of patients was 43.9 years (20-71 years). All of our patients underwent this procedure under digital block anesthesia. We performed pulp adipofascial advancement flap for better soft tissue coverage of bone exposure stump first. The amputated parts were defatted, trimming, and reattached as composite graft. Age and gender of patients, injured finger, Hirase classification, mechanism of trauma, overall graft survival area, two-point discrimination (2PD) (mm) at six-month, length of shortening of digit, The average disabilities of the arm, shoulder, and hand (DASH) score and subjective self-evaluation questionnaire at 6 month were recorded. Average graft survival area was 89% (75-100%). Average length of shortening was 2.2 mm (1.8-3.5 mm). 2PD at six-month after surgery was 6.3 mm in average (5-8 mm). Average DASH score at 6 month was 1.45 (0.83-2.5). The self-evaluated aesthetic results showed twelve patients (85.7%) were very satisfied, and no patient was completely unsatisfied. In Hirase zone IIA traumatic fingertip amputation where replantation is difficult, our modified technique of composite grafting with pulp adipofascial advancement flap provided an alternative choice with high successful rate, acceptable functional and aesthetic outcomes. © 2016 Wiley Periodicals, Inc. Microsurgery, 2016. © 2015 Wiley Periodicals, Inc. Microsurgery 36:651-657, 2016. © 2016 Wiley Periodicals, Inc.

  6. Three-dimensional analysis and classification of arteries in the skin and subcutaneous adipofascial tissue by computer graphics imaging.

    Science.gov (United States)

    Nakajima, H; Minabe, T; Imanishi, N

    1998-09-01

    To develop new types of surgical flaps that utilize portions of the skin and subcutaneous tissue (e.g., a thin flap or an adipofascial flap), three-dimensional investigation of the vasculature in the skin and subcutaneous tissue has been anticipated. In the present study, total-body arterial injection and three-dimensional imaging of the arteries by computer graphics were performed. The full-thickness skin and subcutaneous adipofascial tissue samples, which were obtained from fresh human cadavers injected with radio-opaque medium, were divided into three distinct layers. Angiograms of each layer were introduced into a personal computer to construct three-dimensional images. On a computer monitor, each artery was shown color-coded according to the three portions: the deep adipofascial layer, superficial adipofascial layer, and dermis. Three-dimensional computerized images of each artery in the skin and subcutaneous tissue revealed the components of each vascular plexus and permitted their classification into six types. The distribution of types in the body correlated with the tissue mobility of each area. Clinically, appreciation of the three-dimensional structure of the arteries allowed the development of several new kinds of flaps.

  7. The Dorsoulnar Artery Perforator Adipofascial Flap in the Treatment of Distal Radioulnar Synostosis

    Directory of Open Access Journals (Sweden)

    Alessia Pagnotta

    2017-01-01

    Full Text Available Posttraumatic radioulnar synostosis (RUS is a rare event following forearm fractures. Consequences are disabling for patients who suffer from functional limitation in forearm pronosupination. Distal RUS are even more rare and more difficult to treat because of high recurrence rates. The patient we describe in this paper came to our attention with a double distal RUS recurrence and a Darrach procedure already performed. We performed a radical excision of RUS and interposition with a vascularized dorsoulnar artery (DUA adipofascial perforator flap. Four years after surgery, the patient shows the same complete range of motion in pronosupination, and MRI confirms that the flap is still in place with signs of vascularization. Simple synostosis excision has been proven ineffective in many cases. Interposition is recommended after excision, and biological material interposition seems to be more effective than foreign material. Surgeons are increasingly performing vascularized interposition, and the results are very encouraging.

  8. Corrección de cicatrices postraqueostomía mediante doble colgajo adipofascial opuesto Double opposite adipofascial flap for the correction of post-tracheostomy scars

    Directory of Open Access Journals (Sweden)

    S. Llanos

    2012-12-01

    Full Text Available La traqueostomía es un procedimiento frecuentemente para asegurar una vía aérea permeable en casos de intubación prolongada, trauma facial severo y neoplasias de cabeza y cuello. Tras la extubación, el defecto se deja cerrar por segunda intención con el resultado de una cicatriz defectuosa, de pobre resultado estético y con frecuentes alteraciones funcionales asociadas, como por ejemplo disfagia. Se han descrito muchas técnicas para la corrección de estas cicatrices, sin embargo, algunas no corrigen los defectos funcionales y otras requieren una gran disección y movilización de los tejidos. Proponemos una técnica basada en dos colgajos adipofasciales de base opuesta y dependientes de circulación random realizada en 7 pacientes con cicatriz defectuosa postraqueostomía con buenos resultados estéticos y funcionales.Tracheostomy is a frequently used procedure to secure a viable airway in cases such as prolonged intubation, facial trauma and head and neck cancer. After decannulation, the defect is left to heal by secondary intention resulting in a poor aesthetic and functional outcome. Many techniques have been described to correct this defects, however they don´t correct functional defect and some of them require large and complex dissections and manipulation of subdermal tissues. In order to correct these defects we present a technique using a doble opposite adipofascial flap based on random irrigation. This technique has been used in 7 patients with good aesthetical and functional results.

  9. Abdominal- versus thigh-based reconstruction of perineal defects in patients with cancer.

    Science.gov (United States)

    Pang, John; Broyles, Justin M; Berli, Jens; Buretta, Kate; Shridharani, Sachin M; Rochlin, Danielle H; Efron, Jonathan E; Sacks, Justin M

    2014-06-01

    An abdominoperineal resection is an invasive procedure that leaves the patient with vast pelvic dead space. Traditionally, the vertical rectus abdominus myocutaneous flap is used to reconstruct these defects. Oftentimes, this flap cannot be used because of multiple ostomy placements or previous abdominal surgery. The anterolateral thigh flap can be used; however, the efficacy of this flap has been questioned. We report a single surgeon's experience with perineal reconstruction in patients with cancer with the use of either the vertical rectus abdominus myocutaneous flap or the anterolateral thigh flap to demonstrate acceptable outcomes with either repair modality. From 2010 to 2012, 19 consecutive patients with perineal defects secondary to cancer underwent flap reconstruction. A retrospective chart review of prospectively entered data was conducted to determine the frequency of short-term and long-term complications. This study was conducted at an academic, tertiary-care cancer center. Patients in the study were patients with cancer who were receiving perineal reconstruction. Interventions were surgical and included either abdomen- or thigh-based reconstruction. The main outcome measures included infection, flap failure, length of stay, and time to radiotherapy. Of the 19 patients included in our study, 10 underwent anterolateral thigh flaps and 9 underwent vertical rectus abdominus myocutaneous flaps for reconstruction. There were no significant differences in demographics between groups (p > 0.05). Surgical outcomes and complications demonstrated no significant differences in the rate of infection, hematoma, bleeding, or necrosis. The mean length of stay after reconstruction was 9.7 ± 3.4 days (± SD) in the anterolateral thigh flap group and 13.4 ± 7.7 days in the vertical rectus abdominus myocutaneous flap group (p > 0.05). The limitations of this study include a relatively small sample size and retrospective evaluation. This study suggests that the

  10. Anterolateral Ligament (ALL — Myth or Reality?

    Directory of Open Access Journals (Sweden)

    Roman Mihai

    2017-05-01

    Full Text Available Although the anterolateral ligament (ALL was described a long time ago, recent research shows a lot of interest regarding this structure. There is a high variability concerning its anatomy, especially its capsular/extracapsular situation and insertion sites. There is also some controversy about its ligamentous structure. It seems that it has a biomechanical role in restricting anterior tibial translation and internal rotation. The ALL complex seems to have a clinical significance, and a relationship with the pivot shift has been described. Although there are promising results recently, the surgical techniques of ALL reconstruction, in addition to anterior cruciate ligament reconstruction, have to be further investigated. A precise indication algorithm and patient selection criteria need to be established.

  11. Rescate articular con colgajo anterolateral del muslo

    Directory of Open Access Journals (Sweden)

    F.J. García-Bernal

    2015-06-01

    Full Text Available La preservación del nivel de amputación tanto de la extremidad superior como de la inferior, puede mejorar la función residual y el proceso de rehabilitación protésica de la misma. Ambas van a estar condicionadas por la longitud restante de la extremidad, la presencia o no de articulaciones operativas y la calidad de la cobertura del muñón. Presentamos 2 casos de amputaciones. El primero es un caso agudo de amputación traumática de extremidad superior a la altura del tercio proximal de antebrazo, que asocia avulsión cutánea circular desde el tercio medio del brazo y con articulación de codo conservada. El segundo, es la secuela de una amputación infracondílea de extremidad inferior por osteosarcoma que presenta fístulas cutáneas con drenaje supurativo por osteomielitis en el muñón tibial. En ambos pacientes realizamos cobertura con colgajo anterolateral de muslo anastomosado a la arteria radial en el caso de la extremidad superior, y a la arteria genicular descendente en la extremidad inferior. En los dos casos el postoperatorio transcurrió sin complicaciones, logrando preservar las articulaciones del codo y de la rodilla respectivamente, así como la posterior rehabilitación protésica. Consideramos que el colgajo anterolateral del muslo permite aportar tejido de buena calidad como cobertura del muñón de amputación. Dadas las características del tejido aportado y su volumen, es idóneo tanto para cobertura de defectos agudos como de déficits de almohadillado en casos crónicos.

  12. Recurrent gossypiboma in the thigh

    International Nuclear Information System (INIS)

    Puri, Ajay; Anchan, Chetan; Agarwal, Manish G.; Jambhekar, Nirmala A.; Badwe, Rajendra A.

    2007-01-01

    Gossypiboma, an iatrogenic mass lesion caused by a retained surgical sponge is an extremely rare event following musculoskeletal procedures. This entity is therefore a very unusual experience and can create considerable confusion. Unsuspecting surgeons may thus be caught out by this unlikely presentation. We present our experience with a recurrent gossypiboma in the thigh occurring several years after surgical evacuation of a similar gossypiboma from the same anatomic location with interval resolution of symptoms. The purpose of this case report is to highlight the possibility of a ''recurrent'' soft tissue mass occurring for reasons other than a neoplasm. In the absence of a definitive biopsy diagnosis of tumor in patients who have undergone prior surgical procedures in that area, it may be more prudent to adopt a conservative surgical resection rather than a conventional radical resection as warranted by the dramatic clinical presentation mimicking a soft tissue sarcoma. (orig.)

  13. Anterolateral ankle impingement: findings and diagnostic accuracy with ultrasound imaging

    International Nuclear Information System (INIS)

    McCarthy, C.L.; Wilson, D.J.; Coltman, T.P.

    2008-01-01

    The objective was to evaluate the findings and diagnostic accuracy of ultrasound in antero-lateral ankle impingement (ALI) with clinical and arthroscopic correlation. Seventeen elite footballers with chronic ankle pain were referred for ultrasound with a clinical diagnosis of ALI (n = 8) or a control condition (n = 9; lateral mechanical instability, osteochondral defect, intra-articular bodies and osteoarthritis). Ultrasound examination included the antero-lateral gutter for abnormal synovial tissue (synovitic lesion), lateral ligament integrity, tibiotalar joint and osseous spurs of the distal tibia and talus. Ultrasound findings were correlated with subsequent arthroscopic appearance. Ultrasound examination detected a synovitic mass in the antero-lateral gutter in all 8 footballers with clinical ALI (100%) and in 2 patients with a control diagnosis (22%). Arthroscopic correlation of antero-lateral synovitis and fibrosis was present in all 10 cases (100%). The synovitic lesion was seen at ultrasound as a nodular soft tissue mass of mixed echogenicity within the antero-lateral gutter, which extruded anteriorly with manual compression of the distal fibula against the tibia. Increased blood supply was detected using power Doppler imaging in only 1 patient. The synovitic lesion measured >10 mm in its maximum dimension in 7 footballers with clinical ALI and <10 mm in the control group. Additional ultrasound findings in patients with abnormal antero-lateral synovial tissue included an anterior talofibular ligament injury in all patients (n = 10), a tibiotalar joint effusion (n = 6) and osseous spurs (n = 4). Antero-lateral synovitic tissue was accurately identified at ultrasound in the absence of an effusion (n = 4). No synovitic lesion was detected at ultrasound or arthroscopy in the remaining 7 patients with a control diagnosis. Ultrasound is accurate in detecting synovitic lesions within the antero-lateral gutter, demonstrating associated ligamentous injuries and in

  14. Aggressive angiomyxoma of the thigh

    Energy Technology Data Exchange (ETDEWEB)

    Heffernan, E.J.; Alkubaidan, F.O.; Munk, P.L. [Vancouver General Hospital, Department of Radiology, Vancouver, BC (Canada); University of British Columbia, Vancouver, BC (Canada); Hayes, M.M. [BC Cancer Agency, Department of Pathology, Vancouver, BC (Canada); Clarkson, P.W. [BC Cancer Agency, Department of Surgery, Radiation Oncology and Developmental Radiotherapeutics, Vancouver, BC (Canada)

    2008-07-15

    Aggressive angiomyxoma is a rare tumour that typically occurs in the perineum in women of reproductive age. A small number of cases occurring in men have been reported, all of which were located in the low pelvis, perineum or scrotum. While benign, the tumour is locally infiltrative and consequently has a high rate of local recurrence following surgery; therefore, accurate pre-operative diagnosis is important. The characteristic location of these tumours in the low pelvis or perineum has led to speculation that aggressive angiomyxomas arise from a mesenchymal cell that is unique to the perineum. We describe a case of aggressive angiomyxoma arising in the thigh of a 54-year-old man, which we believe is the first reported instance of this rare neoplasm occurring remote from the pelvis or perineum in a male patient. Cross-sectional imaging demonstrated a well-defined mass that had low density on CT and high intensity on fluid-sensitive MR sequences. Biopsy was non-diagnostic and excision was performed. At histological analysis, the tumour exhibited the characteristic features of aggressive angiomyxoma, with bland spindle cells and large, hyalinised blood vessels in a hypocellular myxoid matrix. Extensive immunohistochemical staining further supported the diagnosis. While the imaging features of these tumours are non-specific and suggestive of myxoid neoplasms, the diagnosis should be considered whenever biopsy of a myxoid-appearing mass yields hypocellular, non-diagnostic material, despite adequate sampling. (orig.)

  15. Anatomy and Histology of the Knee Anterolateral Ligament.

    Science.gov (United States)

    Helito, Camilo Partezani; Demange, Marco Kawamura; Bonadio, Marcelo Batista; Tírico, Luis Eduardo Passarelli; Gobbi, Riccardo Gomes; Pécora, José Ricardo; Camanho, Gilberto Luis

    2013-12-01

    Reconstruction of the anterior cruciate ligament (ACL) is one of the most common procedures in orthopaedic surgery. However, even with advances in surgical techniques and implants, some patients still have residual anterolateral rotatory laxity after reconstruction. A thorough study of the anatomy of the anterolateral region of the knee is needed. To study the anterolateral region and determine the measurements and points of attachments of the anterolateral ligament (ALL). Descriptive laboratory study. Dissections of the anterolateral structures of the knee were performed in 20 human cadavers. After isolating the ALL, its length, thickness, width, and points of attachments were determined. The femoral attachment of the ALL was based on the anterior-posterior and proximal-distal distances from the attachment of the lateral collateral ligament (LCL). The tibial attachment point was based on the distance from the Gerdy tubercle to the fibular head and the distance from the lateral tibial plateau. The ligaments from the first 10 dissections were sent for histological analysis. The ALL was found in all 20 knees. The femoral attachment of the ALL at the lateral epicondyle averaged 3.5 mm distal and 2.2 mm anterior to the attachment of the LCL. Two distal attachments were observed: one inserts into the lateral meniscus, the other between the Gerdy tubercle and the fibular head, approximately 4.4 mm distal to the tibial articular cartilage. The mean measurements for the ligament were 37.3 mm (length), 7.4 mm (width), and 2.7 mm (thickness). The histological analysis of the ligaments revealed dense connective tissue. The ALL is consistently present in the anterolateral region of the knee. Its attachment to the femur is anterior and distal to the attachment of the LCL. Moving distally, it bifurcates at close to half of its length. The ALL features 2 distal attachments, one at the lateral meniscus and the other between the Gerdy tubercle and the fibular head. The ALL may be

  16. Morel-Lavallee effusions in the thigh

    International Nuclear Information System (INIS)

    Parra, J.A.; Fernandez, M.A.; Encinas, B.; Rico, M.

    1997-01-01

    Objective. To assess the radiological features of Morel-Lavallee effusion in the thigh. Design and patients. A restrospective study of clinical records and radiological studies was carried out on three patients with Morel-Lavallee effusion. Results and conclusions. Ultrasound and computed tomography (CT) were able to locate the effusion in the three patients. CT demonstrated a capsule around the lesion. A fluid-fluid level was visible with both techniques. Ultrasound and CT are good methods for assessing patients with Morel-Lavallee effusion of the thigh. CT can be used to distinguish patients requiring surgical treatment from those who could be treated by conservative measures. (orig.). With 4 figs

  17. MRI features of the anterolateral ligament of the knee

    International Nuclear Information System (INIS)

    Taneja, Atul K.; Miranda, Frederico C.; Braga, Cesar A.P.; Hartmann, Luiz G.C.; Santos, Durval C.B.; Rosemberg, Laercio A.; Gill, Corey M.

    2015-01-01

    Evaluate the visibility and describe the anatomical features of the anterolateral ligament of the knee using MRI. Magnetic resonance imaging examinations of the knee were independently reviewed by two musculoskeletal radiologists and assessed for the visibility of the anterolateral ligament under direct cross-referencing of axial and coronal images as complete, partial, or non-visible. Distal insertion site (tibial, meniscal), distance to lateral tibial plateau, measurements (length, width, thickness), and associated imaging findings were also tabulated. Clinical and surgical records were also reviewed. Seventy MRI scans from 60 consecutive subjects were included in the study. Mean age was 40 years, body mass 74.9 kg, and height 1.72 m. The subject population was 53 % male, most of the knees were from the left side (51 %), and chronic pain was the main clinical symptom (40 %). Nine knees (13 %) had undergone previous surgery. The anterolateral ligament was identified in 51 % of the knees: completely visible in 11 % and partially visible in 40 %. In all visible cases, the distal insertion site was identified on the tibia, with a mean distance of 5.7 mm to the plateau. A completely visible ligament had a mean length of 33.2 mm, thickness of 5.6 mm, and width of 1.9 mm. Inter-observer agreement for ligament presence was significant (κ = 0.7). Statistical analyses showed a trend to be more visible in men, with a longer length compared with women. Magnetic resonance imaging clearly identifies the anterolateral ligament of the knee in slightly more than half of cases, being partially visible in most of them. In all cases, a tibial insertion is characterized. (orig.)

  18. MRI features of the anterolateral ligament of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Taneja, Atul K. [Hospital Israelita Albert Einstein, Musculoskeletal Radiology Division, Imaging Department, Sao Paulo, SP (Brazil); Hospital do Coracao (HCor), and Teleimagem, Musculoskeletal Imaging, Diagnostic Center, Sao Paulo, SP (Brazil); Miranda, Frederico C.; Braga, Cesar A.P.; Hartmann, Luiz G.C.; Santos, Durval C.B.; Rosemberg, Laercio A. [Hospital Israelita Albert Einstein, Musculoskeletal Radiology Division, Imaging Department, Sao Paulo, SP (Brazil); Gill, Corey M. [Department of Neurology and Cancer Center, Pappas Center for Neuro-Oncology, Boston, MA (United States)

    2014-11-27

    Evaluate the visibility and describe the anatomical features of the anterolateral ligament of the knee using MRI. Magnetic resonance imaging examinations of the knee were independently reviewed by two musculoskeletal radiologists and assessed for the visibility of the anterolateral ligament under direct cross-referencing of axial and coronal images as complete, partial, or non-visible. Distal insertion site (tibial, meniscal), distance to lateral tibial plateau, measurements (length, width, thickness), and associated imaging findings were also tabulated. Clinical and surgical records were also reviewed. Seventy MRI scans from 60 consecutive subjects were included in the study. Mean age was 40 years, body mass 74.9 kg, and height 1.72 m. The subject population was 53 % male, most of the knees were from the left side (51 %), and chronic pain was the main clinical symptom (40 %). Nine knees (13 %) had undergone previous surgery. The anterolateral ligament was identified in 51 % of the knees: completely visible in 11 % and partially visible in 40 %. In all visible cases, the distal insertion site was identified on the tibia, with a mean distance of 5.7 mm to the plateau. A completely visible ligament had a mean length of 33.2 mm, thickness of 5.6 mm, and width of 1.9 mm. Inter-observer agreement for ligament presence was significant (κ = 0.7). Statistical analyses showed a trend to be more visible in men, with a longer length compared with women. Magnetic resonance imaging clearly identifies the anterolateral ligament of the knee in slightly more than half of cases, being partially visible in most of them. In all cases, a tibial insertion is characterized. (orig.)

  19. Magnetic resonance imaging findings in anterolateral impingement of the ankle

    International Nuclear Information System (INIS)

    Jordan, L.K. III.; Cooperman, A.E.; Helms, C.A.; Speer, K.P.

    2000-01-01

    Objective. To demonstrate the MR imaging findings of anterolateral impingement (ALI) of the ankle.Design and patients. Nine patients with a history of ankle inversion injury and chronic lateral ankle pain were imaged with MR imaging, and the findings correlated with the results of arthroscopy. Three additional patients with clinically suspected ALI of the ankle were also included. Ankle MR imaging studies from 20 control patients in whom ALI was not suspected clinically were examined for similar findings to the patient group.Results. MR imaging findings in the patients with ALI included a soft tissue signal mass in the anterolateral gutter of the ankle in 12 of 12 (100%) cases, corresponding to the synovial hypertrophy and soft tissue mass found at arthroscopy in the nine patients who underwent arthroscopy. Disruption, attenuation, or marked thickening of the anterior talofibular ligament was seen in all cases. Additional findings included signs of synovial hypertrophy elsewhere in the tibiotalar joint in seven of 12 patients (58%) and bony and cartilaginous injuries to the tibiotalar joint in five of 12 (42%). None of the control patients demonstrated MR imaging evidence of a soft tissue mass in the anterolateral gutter.Conclusions. ALI of the ankle is a common cause for chronic lateral ankle pain. It has been well described in the orthopedic literature but its imaging findings have not been clearly elucidated. The MR imaging findings, along with the appropriate clinical history, can be used to direct arthroscopic examination and subsequent debridement. (orig.)

  20. Anterolateral Ligament of the Knee Shows Variable Anatomy in Pediatric Specimens.

    Science.gov (United States)

    Shea, Kevin G; Milewski, Matthew D; Cannamela, Peter C; Ganley, Theodore J; Fabricant, Peter D; Terhune, Elizabeth B; Styhl, Alexandra C; Anderson, Allen F; Polousky, John D

    2017-06-01

    Anterior cruciate ligament (ACL) reconstruction failure rates are highest in youth athletes. The role of the anterolateral ligament in rotational knee stability is of increasing interest, and several centers are exploring combined ACL and anterolateral ligament reconstruction for these young patients. Literature on the anterolateral ligament of the knee is sparse in regard to the pediatric population. A single study on specimens younger than age 5 years demonstrated the presence of the anterolateral ligament in only one of eight specimens; therefore, much about the prevalence and anatomy of the anterolateral ligament in pediatric specimens remains unknown. We sought to (1) investigate the presence or absence of the anterolateral ligament in prepubescent anatomic specimens; (2) describe the anatomic relationship of the anterolateral ligament to the lateral collateral ligament; and (3) describe the anatomic relationship between the anterolateral ligament and the physis. Fourteen skeletally immature knee specimens (median age, 8 years; range, 7-11 years) were dissected (12 male, two female specimens). The posterolateral structures were identified in all specimens, including the lateral collateral ligament and popliteus tendon. The presence or absence of the anterolateral ligament was documented in each specimen, along with origin, insertion, and dimensions, when applicable. The relationship of the anterolateral ligament origin to the lateral collateral ligament origin was recorded. The anterolateral ligament was identified in nine of 14 specimens. The tibial attachment point was consistently located in the same region on the proximal tibia, between the fibular head and Gerdy's tubercle; however, the femoral origin of the anterolateral ligament showed considerable variation with respect to the lateral collateral ligament origin. The median femoral origin of the anterolateral ligament was 10 mm (first interquartile 6 mm, third interquartile 13) distal to the distal

  1. Deep soft tissue leiomyoma of the thigh

    International Nuclear Information System (INIS)

    Watson, G.M.T.; Saifuddin, A.; Sandison, A.

    1999-01-01

    A case of ossified leiomyoma of the deep soft tissues of the left thigh is presented. The radiographic appearance suggested a low-grade chondrosarcoma. MRI of the lesion showed signal characteristics similar to muscle on both T1- and T2-weighted spin echo sequences with linear areas of high signal intensity on T1-weighted images consistent with medullary fat in metaplastic bone. Histopathological examination of the resected specimen revealed a benign ossified soft tissue leiomyoma. (orig.)

  2. Recurrent, giant subcutaneous leiomyosarcoma of the thigh

    Directory of Open Access Journals (Sweden)

    Gao Chuanping, MD

    2015-10-01

    Full Text Available We present a case of recurrent, massive subcutaneous leiomyosarcoma involving the left thigh in a 29-year-old male from Madagascar. The patient had earlier undergone local resection of subcutaneous leiomyosarcoma a half year before. After surgical intervention, local recurrence developed at this site and was rapidly growing. The patient was surgically treated with a 2-cm-wide margin local excision in our hospital. The patient has remained recurrence free at 1-year follow-up.

  3. Anterolateral papillary muscle rupture after intervention of the right coronary artery.

    Science.gov (United States)

    Morris, Liam; Desai, Anand; Akkus, Nuri Ilker

    2015-11-01

    Rupture of the anterolateral papillary muscle following a right coronary artery occlusion is extremely rare, and when complicated by a right ventricular infarction, can be fatal. The literature on optimal management of this complication is limited. We present an unusual case of anterolateral papillary muscle rupture following intervention of the right coronary artery. Published by Elsevier España.

  4. Modified Anterolateral Portals in Elbow Arthroscopy: A Cadaveric Study on Safety.

    Science.gov (United States)

    Thon, Stephen; Gold, Peter; Rush, Lane; O'Brien, Michael J; Savoie, Felix H

    2017-11-01

    To evaluate the proximity to the radial nerve on cadaveric specimens of 2 modified anterolateral portals used for elbow arthroscopy. Ten fresh cadaveric elbow specimens were prepared. Four-millimeter Steinman pins were inserted into 3 anterolateral portal sites in relation to the lateral epicondyle: (1) the standard distal anterolateral portal, (2) a modified direct anterolateral portal, and (3) a modified proximal anterolateral portal. These were defined as follows: direct portals 2 cm directly anterior to the lateral epicondyle, and proximal portals 2 cm proximal and 2 cm directly anterior to the lateral epicondyle. Each elbow was then dissected to reveal the course of the radial nerve. Digital photographs were taken of each specimen, and the distance from the Steinman pin to the radial nerve was measured. The modified proximal anterolateral and direct anterolateral portals were found to be a statistically significant distance from the radial nerve compare to the distal portal site (P = .011 and P = .0011, respectively). No significant difference was found in the proximity of the radial nerve between the modified proximal and direct anterolateral portals (P = .25). Inadequate imaging was found at a single portal site for the proximal site; 9 specimens were used for analysis of this portal with 10 complete specimens for the other 2 sites. In cadaveric analysis, both the modified proximal and direct lateral portals provide adequate distance from the radial nerve and may be safe for clinical use. In this study, the distal anterolateral portal was in close proximity of the radial nerve and may result in iatrogenic injury in the clinical setting. This is a cadaveric analysis of 2 modified portal locations at the anterolateral elbow for use in elbow arthroscopy. Further clinical studies are needed prior to determining their absolute safety in comparison to previously identified portal sites. Copyright © 2017 Arthroscopy Association of North America. Published by

  5. Deep soft tissue leiomyoma of the thigh

    Energy Technology Data Exchange (ETDEWEB)

    Watson, G.M.T.; Saifuddin, A. [Department of Radiology, The Royal National Orthopaedic Hospital Trust, Brockley Hill (United Kingdom); Sandison, A. [Department of Pathology, The Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex (United Kingdom)

    1999-07-01

    A case of ossified leiomyoma of the deep soft tissues of the left thigh is presented. The radiographic appearance suggested a low-grade chondrosarcoma. MRI of the lesion showed signal characteristics similar to muscle on both T1- and T2-weighted spin echo sequences with linear areas of high signal intensity on T1-weighted images consistent with medullary fat in metaplastic bone. Histopathological examination of the resected specimen revealed a benign ossified soft tissue leiomyoma. (orig.) With 3 figs., 13 refs.

  6. Giant Epidermoid Cyst of the Thigh

    Directory of Open Access Journals (Sweden)

    NH Mohamed Haflah

    2011-11-01

    Full Text Available Epidermoid cyst is a common benign cutaneous swelling frequently encountered in surgical practice. It usually presents as a painless lump frequently occurring in hairbearing areas of the body particularly the scalp, scrotum, neck, shoulder and back. Giant epidermoid cysts commonly occur in hairy areas such as the scalp. We present here the case of a rare occurrence of a giant epidermoid cyst in the less hairy area of the right upper thigh mimicking a soft tissue sarcoma. Steps are highlighted for the management of this unusual cyst.

  7. Tendon sheath fibroma in the thigh.

    Science.gov (United States)

    Moretti, Vincent M; Ashana, Adedayo O; de la Cruz, Michael; Lackman, Richard D

    2012-04-01

    Tendon sheath fibromas are rare, benign soft tissue tumors that are predominantly found in the fingers, hands, and wrists of young adult men. This article describes a tendon sheath fibroma that developed in the thigh of a 70-year-old man, the only known tendon sheath fibroma to form in this location. Similar to tendon sheath fibromas that develop elsewhere, our patient's lesion presented as a painless, slow-growing soft tissue nodule. Physical examination revealed a firm, nontender mass with no other associated signs or symptoms. Although the imaging appearance of tendon sheath fibromas varies, our patient's lesion appeared dark on T1- and bright on T2-weighted magnetic resonance imaging. It was well marginated and enhanced with contrast.Histologically, tendon sheath fibromas are composed of dense fibrocollagenous stromas with scattered spindle-shaped fibroblasts and narrow slit-like vascular spaces. Most tendon sheath fibromas can be successfully removed by marginal excision, although 24% of lesions recur. No lesions have metastasized. Our patient's tendon sheath fibroma was removed by marginal excision, and the patient remained disease free 35 months postoperatively. Despite its rarity, tendon sheath fibroma should be included in the differential diagnosis of a thigh mass on physical examination or imaging, especially if it is painless, nontender, benign appearing, and present in men. Copyright 2012, SLACK Incorporated.

  8. Scrotal reconstruction with superomedial fasciocutaneous thigh flap

    Directory of Open Access Journals (Sweden)

    DANIEL FRANCISCO MELLO

    2018-02-01

    Full Text Available ABSTRACT Objective: to describe the use of a superomedial fasciocutaneous thigh flap for scrotal reconstruction in open areas secondary to the surgical treatment of perineal necrotizing fasciitis (Fournier’s gangrene. Methods: retrospective analysis of cases treated at the Plastic Surgery Service of Santa Casa de Misericórdia, São Paulo, from 2009 to 2015. Results: fifteen patients underwent scrotal reconstruction using the proposed flap. The mean age was 48.9 years (28 to 66. Skin loss estimates in the scrotal region ranged from 60 to 100%. Definitive reconstruction was performed on average 30.6 days (22 to 44 after the initial surgical treatment. The mean surgical time was 76 minutes (65 to 90 to obtain the flaps, bilateral in all cases. Flap size ranged from 10cm to 13cm in the longitudinal direction and 8cm to 10cm in the cross-sectional direction. The complication rate was 26.6% (four cases, related to the occurrence of segmental and partial dehiscence. Conclusion: the superomedial fasciocutaneous flap of thigh is a reliable and versatile option for the reconstruction of open areas in the scrotal region, showing adequate esthetic and functional results.

  9. Thigh circumference and risk of heart disease and premature death

    DEFF Research Database (Denmark)

    Heitmann, Berit L; Frederiksen, Peder

    2009-01-01

    of follow-up for total death. RESULTS: A small thigh circumference was associated with an increased risk of cardiovascular and coronary heart diseases and total mortality in both men and women. A threshold effect for thigh circumference was evident, with greatly increased risk of premature death below...... circumference seems to be associated with an increased risk of developing heart disease or premature death. The adverse effects of small thighs might be related to too little muscle mass in the region. The measure of thigh circumference might be a relevant anthropometric measure to help general practitioners...... in early identification of individuals at an increased risk of premature morbidity and mortality....

  10. Anterolateral Knee Extra-articular Stabilizers: A Robotic Sectioning Study of the Anterolateral Ligament and Distal Iliotibial Band Kaplan Fibers.

    Science.gov (United States)

    Geeslin, Andrew G; Chahla, Jorge; Moatshe, Gilbert; Muckenhirn, Kyle J; Kruckeberg, Bradley M; Brady, Alex W; Coggins, Ashley; Dornan, Grant J; Getgood, Alan M; Godin, Jonathan A; LaPrade, Robert F

    2018-05-01

    The individual kinematic roles of the anterolateral ligament (ALL) and the distal iliotibial band Kaplan fibers in the setting of anterior cruciate ligament (ACL) deficiency require further clarification. This will improve understanding of their potential contribution to residual anterolateral rotational laxity after ACL reconstruction and may influence selection of an anterolateral extra-articular reconstruction technique, which is currently a matter of debate. Hypothesis/Purpose: To compare the role of the ALL and the Kaplan fibers in stabilizing the knee against tibial internal rotation, anterior tibial translation, and the pivot shift in ACL-deficient knees. We hypothesized that the Kaplan fibers would provide greater tibial internal rotation restraint than the ALL in ACL-deficient knees and that both structures would provide restraint against internal rotation during a simulated pivot-shift test. Controlled laboratory study. Ten paired fresh-frozen cadaveric knees (n = 20) were used to investigate the effect of sectioning the ALL and the Kaplan fibers in ACL-deficient knees with a 6 degrees of freedom robotic testing system. After ACL sectioning, sectioning was randomly performed for the ALL and the Kaplan fibers. An established robotic testing protocol was utilized to assess knee kinematics when the specimens were subjected to a 5-N·m internal rotation torque (0°-90° at 15° increments), a simulated pivot shift with 10-N·m valgus and 5-N·m internal rotation torque (15° and 30°), and an 88-N anterior tibial load (30° and 90°). Sectioning of the ACL led to significantly increased tibial internal rotation (from 0° to 90°) and anterior tibial translation (30° and 90°) as compared with the intact state. Significantly increased internal rotation occurred with further sectioning of the ALL (15°-90°) and Kaplan fibers (15°, 60°-90°). At higher flexion angles (60°-90°), sectioning the Kaplan fibers led to significantly greater internal rotation

  11. Apocrine gland carcinoma on the right thigh

    Directory of Open Access Journals (Sweden)

    Sergio Renato Pais Costa

    2008-12-01

    Full Text Available The authors report a case of cutaneous apocrine ductal carcinomaof the right thigh in a 78-year-old female. Histological examinationrevealed a solid, ductal and glandular tumor with a significantdesmoplastic reaction. The tumor cells showed high-grade cellularatypia, and occasional peritumoral inflammatory infiltration wasalso observed. There were no characteristics of extramammaryPaget´s Disease on the overlying skin. The neoplastic cells wereimmunohistochemically positive for S-100 protein, lysozyme andalpha-chymotrypsin, but negative for CEA, EMA, and HMB-45. On thebasis of these findings, the diagnosis of apocrine ductal carcinomawas confirmed. The patient then underwent wide resection of thetumor plus en-bloc radical inguinal lymphadenectomy. The localreconstruction was done by means of a tensor fascia lata flap, noadjuvant treatment was performed. To date, one year on, the patientremains healthy, there being no evidence of tumor recurrence.

  12. 78 FR 68906 - Agency Information Collection (Hip and Thigh Conditions Disability Benefits Questionnaire) Under...

    Science.gov (United States)

    2013-11-15

    ... Thigh Conditions Disability Benefits Questionnaire) Under OMB Review AGENCY: Veterans Benefits... Control No. 2900-- NEW (Back (Hip and Thigh Conditions Disability Benefits Questionnaire)'' in any... Questionnaire''. SUPPLEMENTARY INFORMATION: Title: Hip and Thigh Conditions Disability Benefits Questionnaire...

  13. Prospective Evaluation of the Effect of Thigh Dissection for Removal of Transobturator Mid Urethral Slings on Refractory Thigh Pain.

    Science.gov (United States)

    King, A B; Tenggardjaja, C; Goldman, H B

    2016-10-01

    Transobturator slings have higher rates of de novo neurologic symptoms than retropubic slings, most commonly related to the thigh. Cases refractory to conservative management may require removal of the thigh portion of the sling. In this series we prospectively examine the effect of thigh dissection with mesh removal on refractory thigh pain. All thigh dissections for refractory neurologic symptoms after transobturator sling placement were followed prospectively from October 2012 to October 2015. Patients were assessed preoperatively, with a pain score using a visual analog scale, and postoperatively with a global response assessment. A total of 12 thigh dissections were performed from October 2012 to October 2015 in 8 patients. Mean (±SD) time from original mesh placement to presentation was 2.7 (±1.5) years. Average preoperative pain score was 7.9 (±1.7) out of 10, with pain in the thigh in all patients. Seven cases involved unilateral thigh dissection and 1 had concomitant bilateral thigh dissection. Five patients underwent concurrent transvaginal excision. On postoperative evaluation the average global response rating was 1.6, with 1 defined as very much better and 2 defined as much better. Of the 8 patients 3 went on to have the contralateral side done with an average global response rating of 1.3 (±0.6). One patient underwent further treatment for stress urinary incontinence with placement of a retropubic mid urethral sling. Our prospective series supports the use of thigh dissection in patients with refractory neurologic symptoms after transobturator sling placement. The procedure can be performed safely with positive outcomes for the patient. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  14. 78 FR 36304 - Proposed Information Collection (Hip and Thigh Conditions Disability Benefits Questionnaire...

    Science.gov (United States)

    2013-06-17

    ... and Thigh Conditions Disability Benefits Questionnaire) Activity: Comment Request AGENCY: Veterans... ``OMB Control No. 2900--NEW (Hip and Thigh Conditions Disability Benefits Questionnaire)'' in any...

  15. Insulin action in human thighs after one-legged immobilization

    DEFF Research Database (Denmark)

    Richter, Erik; Kiens, Bente; Mizuno, M.

    1989-01-01

    Insulin action was assessed in thighs of five healthy young males who had one knee immobilized for 7 days by a splint. The splint was not worn in bed. Subjects also used crutches to prevent weight bearing of the immobilized leg. Immobilization decreased the activity of citrate synthase and 3-OH......-acyl-CoA-dehydrogenase in the vastus lateralis muscle by 9 and 14%, respectively, and thigh volume by 5%. After 7 days of immobilization, a two-step euglycemic hyperinsulinemic clamp procedure combined with arterial and bilateral femoral venous catheterization was performed. Insulin action on glucose uptake and tyrosine release...... of the thighs at mean plasma insulin concentrations of 67 (clamp step I) and 447 microU/ml (clamp step II) was decreased by immobilization, whereas immobilization did not affect insulin action on thigh exchange of free fatty acids, glycerol, O2, or potassium. Before and during the clamp step I, lactate release...

  16. Thigh circumference and risk of heart disease and premature death

    DEFF Research Database (Denmark)

    Heitmann, Berit L; Frederiksen, Peder

    2009-01-01

    OBJECTIVE: To examine associations between thigh circumference and incident cardiovascular disease and coronary heart disease and total mortality. DESIGN: Prospective observational cohort study with Cox proportional hazards model and restricted cubic splines. SETTING: Random subset of adults...... in Denmark. PARTICIPANTS: 1436 men and 1380 women participating in the Danish MONICA project, examined in 1987-8 for height, weight, and thigh, hip, and waist circumference, and body composition by impedance. MAIN OUTCOME MEASURES: 10 year incidence of cardiovascular and coronary heart disease and 12.5 years...... of follow-up for total death. RESULTS: A small thigh circumference was associated with an increased risk of cardiovascular and coronary heart diseases and total mortality in both men and women. A threshold effect for thigh circumference was evident, with greatly increased risk of premature death below...

  17. Interface pressure is affected by slippage of bandages at thigh.

    Science.gov (United States)

    Miyazaki, K; Hirai, M; Koyama, A; Iwata, H; Ohashi, M; Ota, A

    2012-12-01

    Very little is known about how compression bandages lose interface pressure. We hypothesized that the loss of interface pressure is correlated with the slippage of the bandages, and studied the interface pressure and slippage of three bandages over 8 hours. Twenty-Seven legs from 27 healthy volunteers were bandaged with short stretch bandages (SS), cohesive short stretch bandages (CS), and long stretch bandages (LS). Pressure sensors were placed above the ankle (B1), below the knee (D), and mid thigh (F). Interface pressures in a sitting position were recorded at the beginning, and 4 and 8 hours later. In 17 legs, the pressure sensor sites were marked, and their heights were measured on standing upright. SS and CS lost interface pressure quickly, but LS maintained pressure better than SS and CS at all sites. There was no pressure difference between SS and CS at the lower leg. However, CS maintained pressure better than SS at the mid thigh (44.6% vs. 54.4% pressure loss at 8 hours, respectively. P=0.037). There was a tendency toward less slippage with CS than SS at the mid thigh. In CS and LS, there was a linear correlation between the slippage of bandages and the interface pressure at the mid thigh (P pressure may be affected by the slippage of bandages at the thigh, but not at the lower leg. Cohesive short stretch bandages may exert their beneficial impact at the thigh.

  18. Immediate emergency free anterolateral thigh flap after car-tyre friction injury: A case report with eight years follow-up.

    Science.gov (United States)

    Merter, Abdullah; Armangil, Mehmet; Kaya, Burak; Bilgin, Sinan

    2017-01-01

    The car-tyre friction injury has differences from other injuries. The components of injury which are burn, crushing, shearing, and degloving occur. Many treatment options can be performed for coverage of wound which are Vacuum Assisted Closure system (V.A.C), skin grafting, free flaps, local flaps and cross leg flap. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Immediate emergency free anterolateral thigh flap after car-tyre friction injury: A case report with eight years follow-up

    Directory of Open Access Journals (Sweden)

    Abdullah Merter

    2017-01-01

    Full Text Available The car-tyre friction injury has differences from other injuries. The components of injury which are burn, crushing, shearing, and degloving occur. Many treatment options can be performed for coverage of wound which are Vacuum Assisted Closure system (V.A.C, skin grafting, free flaps, local flaps and cross leg flap.

  20. Effect of a novel mobilization with movement procedure on anterolateral ankle impingement - A case report.

    Science.gov (United States)

    Anandkumar, Sudarshan

    2018-07-01

    This case report describes a 50-year-old male who presented with right anterolateral ankle pain managed unsuccessfully with rest, medications, bracing, injection, physical therapy, and massage therapy. Clinical diagnosis of anterolateral ankle impingement was based on concordant symptom reproduction with palpatory tenderness and a positive lateral synovial impingement test. This case report is a potential first time description of the successful management of anterolateral ankle impingement utilizing a novel Mulligan's mobilization with movement procedure (consisting of internal rotation of the distal tibia) and taping with immediate improvements noted in pain, range of motion, and function. The patient was seen twice a week and was discharged after four treatment sessions. A follow-up after 4 months revealed that the patient was pain free and fully functional.

  1. Comparison of complications in transtrochanteric and anterolateral approaches in primary total hip arthroplasty.

    LENUS (Irish Health Repository)

    Cashman, James P

    2008-11-01

    Three surgical approaches to primary total hip arthroplasty (THA) have been in use since Charnley popularized the transtrochanteric approach. This study was designed to examine the difference in morbidity between the transtrochanteric approach and the anterolateral approach in primary THA. Information on 891 patients who underwent primary THA performed by a single surgeon was collected prospectively between 1998 and 2003 using a modified SF-36 form, preoperatively, intraoperatively, and at 3 months postoperatively. The transtrochanteric group had higher morbidity and more patients who were dissatisfied with their THA. There was a greater range of motion in the anterolateral group.

  2. Percutaneous vertebroplasty via anterolateral approach for the treatment of C4 to C7 vertebral tumor

    International Nuclear Information System (INIS)

    Wu Chungen; Cheng Yongde; Gu Yifeng; Zhang Ji; Wang Tao; Li Minghua; Apitzsch, D.E.

    2009-01-01

    Objective To investigate the feasibility and clinical efficacy of percutaneous vertebroplasty via anterolateral approach in treating the middle and lower cervical (C4-C7) vertebral tumor. Methods: During the past four years, percutaneous vertebroplasty via anterolateral approach was performed in 16 patients with middle or lower cervical tumor, including metastases (n=12), myeloma (n=3) and eosinophilic granuloma (n=1). Under fluoroscopic guidance, needle puncture was operated via the anterolateral approach, bone cement was injected into the target cervical body when the needle was in place. A follow-up of three months was made. Results: Twenty-one cervical bodies in the range of C4 to C7 were successfully punctured and injected with bone cement. Marked pain relief was obtained in all 16 patients. The average score of visual analogue scale (VAS) was dramatically decreased from 7 before the procedure to 1.7 after the procedure. The cervical motor function returned to good condition. Conclusion: Percutaneous vertebroplasty via anterolateral approach is a safe, effective and minimally-invasive technique in treating the middle and lower cervical (C4-C7) vertebral tumor. (authors)

  3. Case Report: A man on antiretroviral therapy with painful thighs

    African Journals Online (AJOL)

    A 54 year old man presented with increasing pain in both thighs for three months during a follow up visit at the antiretroviral therapy (ART) clinic of Queen Elizabeth. Central Hospital. He was first seen at the same clinic three years and eight months before the current presentation, when he started. ART with ...

  4. Liposarcoma of the thigh with mixed calcification and ossification

    Directory of Open Access Journals (Sweden)

    Jeremy R. Child, MD

    2016-09-01

    Full Text Available Liposarcoma is one of the most common soft-tissue sarcomas. Calcification and ossification can occur in liposarcoma; however, the presence of both ossification and calcification is a very rare entity. We present a case of a partially calcified and ossified dedifferentiated liposarcoma of the thigh in a 76-year-old woman, which contained heterologous elements of chondrosarcoma and rhabdomyosarcoma.

  5. Perforated appendicitis presenting as a thigh abscess: A lethal ...

    African Journals Online (AJOL)

    Typical cases of acute appendicitis have excellent treatment outcomes, if managed appropriately.1 We discuss an unusual case of perforated retrocaecal appendicitis that presented as a right thigh abscess without prominent abdominal symptoms, which highlights the lethal nature of advanced appendicitis even when ...

  6. Skin injuries on the body and thigh of dairy cows

    DEFF Research Database (Denmark)

    Enevoldsen, Carsten; Gröhn, Y.T.; Thysen, Iver

    1994-01-01

    An epidemiological study was conducted in 18 dairy herds with the objective to characterize those groups of cows where skin injuries to the body and thighs occurred most frequently. Data were analyzed with multivariable logistic regression. The epidemiologic patterns were different in first and l...

  7. acute compartment syndrome of the thigh without associated fracture

    African Journals Online (AJOL)

    FRACTURE: A CASE REPORT. C.K. Lakati, FCS ... fracture leading to failure to appreciate the severity of the injury. ... complaining of pain on the lower part of his right thigh, just above .... reported good recovery after non-operative treatment.

  8. Critical analysis of extra peritoneal antero-lateral approach for lumbar plexus

    Directory of Open Access Journals (Sweden)

    Roberto Sérgio Martins

    2011-08-01

    Full Text Available Lesions of lumbar plexus are uncommon and descriptions of surgical access are derived from vertebral spine approaches. METHOD: The extraperitoneal anterolateral approach to the lumbar plexus was performed in six adult fresh cadavers. The difficulties on dissection were related. RESULTS: An exposure of all distal elements of lumbar plexus was possible, but a cranial extension of the incision was needed to reach the iliohypogastric nerve in all cases. Ligation of vessels derived from common iliac artery was necessary for genitofemoral and obturator nerves exposure in two cases. The most proximal part of the lumbar roots could be identified only after dissection and clipping of most lumbar vessels. CONCLUSION: The extraperitoneal anterolateral approach allows appropriate exposure of terminal nerves of lumbar plexus laterallly to psoas major muscle. Cranial extension of the cutaneous incision may be necessary for exposure of iliohypogastric nerve. Roots exposure increases the risk of vascular damage.

  9. An Accurate Full-flexion Anterolateral Portal for Needle Placement in the Knee Joint With Dry Osteoarthritis.

    Science.gov (United States)

    Hussein, Mohamed

    2017-07-01

    Accurate delivery of an injection into the intra-articular space of the knee is achieved in only two thirds of knees when using the standard anterolateral portal. The use of a modified full-flexion anterolateral portal provides a highly accurate, less painful, and more effective method for reproducible intra-articular injection without the need for ultrasonographic or fluoroscopic guidance in patients with dry osteoarthritis of the knee. The accuracy of needle placement was assessed in a prospective series of 140 consecutive injections in patients with symptomatic degenerative knee arthritis without clinical knee effusion. Procedural pain was determined using the Numerical Rating Scale. The accuracy rates of needle placement were confirmed with fluoroscopic imaging to document the dispersion pattern of injected contrast material. Using the standard anterolateral portal, 52 of 70 injections were confirmed to have been placed in the intra-articular space on the first attempt (accuracy rate, 74.2%). Using the modified full-flexion anterolateral portal, 68 of 70 injections were placed in the intra-articular space on the first attempt (accuracy rate, 97.1%; P = 0.000). This study revealed that using the modified full-flexion anterolateral portal for injections into the knee joint resulted in more accurate and less painful injections than those performed by the same orthopaedic surgeon using the standard anterolateral portal. In addition, the technique offered therapeutic delivery into the joint without the need for fluoroscopic confirmation. Therapeutic Level II.

  10. Minor or occult ankle instability as a cause of anterolateral pain after ankle sprain.

    Science.gov (United States)

    Vega, Jordi; Peña, Fernando; Golanó, Pau

    2016-04-01

    The aim of this study was to determine which intra-articular injuries are associated with chronic anterolateral pain and functional instability after an ankle sprain. From 2008 to 2010, records of all patients who underwent ankle joint arthroscopy with anterolateral pain and functional instability after an ankle sprain were reviewed. A systematic arthroscopic examination of the intra-articular structures of the ankle joint was performed. Location and characteristics of the injuries were identified and recorded. A total of 36 ankle arthroscopic procedures were reviewed. A soft-tissue occupying mass over the lateral recess was present in 18 patients (50%). A partial injury of the anterior talofibular ligament (ATFL) was observed in 24 patients (66.6%). Cartilage abrasion due to the distal fascicle of the anteroinferior tibiofibular ligament coming into contact with the talus was seen in 21 patients (58.3%), but no thickening of the ligament was observed. Injury to the intra-articular posterior structures, including the transverse ligament in 19 patients (52.7%) and the posterior surface of the distal tibia in 21 patients (58.3%), was observed. Intra-articular pathological findings have been observed in patients affected by anterolateral pain after an ankle sprain. Despite no demonstrable abnormal lateral laxity, morphologic ATFL abnormality has been observed on arthroscopic evaluation. An injury of the ATFL is present in patients with chronic anterolateral pain and functional instability after an ankle sprain. A degree of microinstability due to a deficiency of the ATFL could explain the intra-articular pathological findings and the patients' complaints. IV.

  11. Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure?

    Science.gov (United States)

    Guedes, Marco Antonio Vieira; Pomerantzeff, Pablo Maria Alberto; Brandão, Carlos Manuel de Almeida; Vieira, Marcelo Luiz Campos; Grinberg, Max; Stolf, Noedir Antonio Groppo

    2010-01-01

    The right anterolateral thoracotomy is an alternative technique for surgical approach of mitral valve. In these cases, femoral-femoral bypass still has been used, rising occurrence of complications related to femoral cannulation. Describe the technique and results of mitral valve treatment by right anterolateral thoracotomy using aortic cannulation for cardiac pulmonary bypass (CPB). From 1983 e 2008, 100 consecutive female patients, with average age 35 ±13 years, 96 (96%) underwent mitral valve surgical treatment in the Heart Institute of São Paulo. A right anterolateral thoracotomy approach associated with aortic cannulation was used for CPB. Eighty (80%) patients had rheumatic disease and 84 (84%) patients presented functional class III or IV. Were performed 45 (45%) comissurotomies, 38 (38%) valve repairs, 7(7%) mitral valve replacements, seven (7%) recomissurotomies and three (3%) prosthesis replacement. Sparing surgery was performed in 90 (90%) patients. The average CPB and clamp time were 57 ± 27 min e 39 ± 19 min, respectively. There were no in-hospital death, reoperation due to bleeding and convertion to sternotomy. Introperative complications were related to heart harvest (5%), especially in reoperations (3%). The most important complications in postoperative period were related to pulmonary system (11%), followed by atrial fibrilation (10%) but without major systemic repercussions. The mean inhospital length of stay was 8 ± 3 days. Follow-up was 6.038 patients/month. Actuarial survival was 98.0 ± 1.9% and freedom from reoperation was 81.4 ± 7.8% in 180 months. The right anterolateral thoracotomy associated with aortic cannulation in mitral valve surgery is a simple technique, reproducible and safety.

  12. Analysis of right anterolateral impacts: the effect of trunk flexion on the cervical muscle whiplash response

    Directory of Open Access Journals (Sweden)

    Narayan Yogesh

    2006-05-01

    Full Text Available Abstract Background The cervical muscles are considered a potential site of whiplash injury, and there is a need to understand the cervical muscle response under non-conventional whiplash impact scenarios, including variable body position and impact direction. There is no data, however, on the effect of occupant position on the muscle response to frontal impacts. Therefore, the objective of the study was to measure cervical muscle response to graded right anterolateral impacts. Methods Twenty volunteers were subjected to right anterolateral impacts of 4.3, 7.8, 10.6, and 12.8 m/s2 acceleration with their trunk flexed forward 45 degrees and laterally flexed right or left by 45 degrees. Bilateral EMG of the sternocleidomastoids, trapezii, and splenii capitis and acceleration of the sled, torso, and head were measured. Results and discussion With either direction of trunk flexion at impact, the trapezius EMGs increased with increasing acceleration (p Conclusion When the subject sits with trunk flexed out of neutral posture at the time of anterolateral impact, the cervical muscle response is dramatically reduced compared to frontal impacts with the trunk in neutral posture. In the absence of bodily impact, the flexed trunk posture appears to produce a biomechanical response that would decrease the likelihood of cervical muscle injury in low velocity impacts.

  13. Disseminated lymphoma presenting as acute thigh pain and renal failure.

    LENUS (Irish Health Repository)

    Brown, Catherine

    2009-01-01

    A 66-year-old diabetic man presented with severe right thigh swelling and pain together with acute renal failure. At autopsy, this was found to be due to disseminated high grade B cell lymphoma invading the psoas muscle and multiple organs, including the kidneys. The unique presentation of this case emphasizes the need for increased awareness of the variety of ways in which lymphoma can manifest itself.

  14. Hot-boning enhances cook yield of boneless skinless chicken thighs.

    Science.gov (United States)

    Zhuang, H; Bowker, B C; Buhr, R J; Brambila, G Sanchez

    2014-06-01

    Three experiments were conducted to evaluate the effects of postmortem deboning time on cook yield of boneless skinless chicken thighs. In experiment 1, chicken thigh meat was deboned at 0.75 (hot-bone), 2, and 24 h postmortem (PM) and trimmed to obtain mainly iliotibialis muscle. Samples were cooked directly from a frozen state. Cook yield of the muscle was significantly influenced by PM deboning time. Hot-boned thighs exhibited a 7% greater cook yield than the samples deboned at 24 h. In experiment 2, boneless skinless chicken thighs were deboned at 0.3, 2, and 24 h PM and cooked directly from a fresh, never-frozen state at 24 h PM. Cook yield of the hot-boned thighs was significantly higher than those of the 2 and 24 h deboned samples, which did not differ from each other. In experiment 3, whole legs (thigh + drumstick) were cut from the carcass backbone at 0.3 (hot-cut), 2, and 24 h PM. Thighs were separated from the legs (drumsticks) at either the same time the whole legs were removed from the carcasses or at 24 h PM. Intact thighs (bone in) were cooked fresh at 24 h PM. Color of fresh thigh muscles, cook yield, and Warner-Bratzler shear force of cooked samples were measured. Cook yield of the thighs cut from the backbone before chilling was significantly higher than those cut from the carcasses at 2 and 24 h PM, which did not differ from each other. The PM time at which intact thighs were separated from the leg (drumstick) did not influence cook yield. These results demonstrate that postmortem deboning time can significantly affect cook yield of boneless skinless chicken thigh products. Deboning chicken thighs after chilling reduces the cook yield. Differences in the cook yield of thighs may also result from the removal of whole chicken legs from the carcass backbone. Poultry Science Association Inc.

  15. Isolated pediatric hemihyperplasia requiring surgical debulking of the thigh

    Directory of Open Access Journals (Sweden)

    Benjamin D. Schultz

    2015-02-01

    Full Text Available Isolated Hemihyperplasia (IHH is a rare disorder that results in the enlargement of a portion of a limb, a complete limb or an entire half of an individual's body. We describe an 11 year-old girl with isolated hemihyperplasia of her right upper and lower extremities, breast, and vulvar region. A mass consisting of asymmetric enlargement and fatty infiltration of the right adductor compartment was first noticed at approximately 4 years of life and progressed dramatically to severely affect her gait. We surgically debulked the thigh and resected the excess skin to restore symmetry. The patient did well postoperatively, achieved excellent cosmesis, and restoration of gait.

  16. Extraskeletal Osteosarcoma of the Thigh: An Autopsy Case Report

    Directory of Open Access Journals (Sweden)

    Akihito Nagano

    2009-01-01

    Full Text Available We report a case of extraskeletal osteosarcoma (ESOS and autopsy findings. A 35-year-old man presented with an ossified tumor in the right thigh and lung metastasis. The lung tumors continued to develop despite multiagent chemotherapy and caused death within 8 months. Autopsy revealed many secondary lesions in the lungs, especially in the left lung. Histopathologically, the primary tumor and one of the secondary tumors showed proliferation of spindle-shaped tumor cells focally forming lace-like osteoid material. Therefore, we made a definite diagnosis of ESOS.

  17. Focal myositis of the thigh: unusual MR pattern

    International Nuclear Information System (INIS)

    Llauger, Jaume; Palmer, Jaume; San Roman, Luis; Bague, Silvia; Matias-Guiu, Xavier; Doncel, Antonio

    2002-01-01

    Focal myositis is a commonly referenced, infrequently reported and poorly documented benign inflammatory pseudotumor which may be misdiagnosed clinically as a malignant tumor. We report the clinicopathologic features and magnetic resonance imaging findings in a case of focal myositis in the thigh of a 55-year-old woman. A different radiologic presentation of this disorder is described. The gross appearance of the lesion, previously undescribed, appears to be rather specific for such a pseudoneoplastic disorder, and correlates very well with the magnetic resonance imaging features. (orig.)

  18. Focal myositis of the thigh: unusual MR pattern

    Energy Technology Data Exchange (ETDEWEB)

    Llauger, Jaume; Palmer, Jaume; San Roman, Luis [Department of Radiology, Hospital de la Santa Creu i Sant Pau, Barcelona (Spain); Bague, Silvia; Matias-Guiu, Xavier [Department of Pathology, Hospital de la Santa Creu i Sant Pau, Barcelona (Spain); Doncel, Antonio [Department of Orthopedic Surgery, Hospital de la Santa Creu i Sant Pau, Barcelona (Spain)

    2002-05-01

    Focal myositis is a commonly referenced, infrequently reported and poorly documented benign inflammatory pseudotumor which may be misdiagnosed clinically as a malignant tumor. We report the clinicopathologic features and magnetic resonance imaging findings in a case of focal myositis in the thigh of a 55-year-old woman. A different radiologic presentation of this disorder is described. The gross appearance of the lesion, previously undescribed, appears to be rather specific for such a pseudoneoplastic disorder, and correlates very well with the magnetic resonance imaging features. (orig.)

  19. [New anterolateral approach of distal femur for treatment of distal femoral fractures].

    Science.gov (United States)

    Zhang, Bin; Dai, Min; Zou, Fan; Luo, Song; Li, Binhua; Qiu, Ping; Nie, Tao

    2013-11-01

    To assess the effectiveness of the new anterolateral approach of the distal femur for the treatment of distal femoral fractures. Between July 2007 and December 2009, 58 patients with distal femoral fractures were treated by new anterolateral approach of the distal femur in 28 patients (new approach group) and by conventional approach in 30 patients (conventional approach group). There was no significant difference in gender, age, cause of injury, affected side, type of fracture, disease duration, complication, or preoperative intervention (P > 0.05). The operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, hospitalization days, and Hospital for Special Surgery (HSS) score of knee were recorded. Operation was successfully completed in all patients of 2 groups, and healing of incision by first intention was obtained; no vascular and nerves injuries occurred. The operation time and intraoperative fluoroscopy frequency of new approach group were significantly less than those of conventional approach group (P 0.05). All patients were followed up 12-36 months (mean, 19.8 months). Bone union was shown on X-ray films; the fracture healing time was (12.62 +/- 2.34) weeks in the new approach group and was (13.78 +/- 1.94) weeks in the conventional approach group, showing no significant difference (t=2.78, P=0.10). The knee HSS score at last follow-up was 94.4 +/- 4.2 in the new approach group, and was 89.2 +/- 6.0 in the conventional approach group, showing significant difference between 2 groups (t=3.85, P=0.00). New anterolateral approach of the distal femur for distal femoral fractures has the advantages of exposure plenitude, minimal tissue trauma, and early function rehabilitation training so as to enhance the function recovery of knee joint.

  20. Radiological classification of meniscocapsular tears of the anterolateral portion of the lateral meniscus of the knee

    International Nuclear Information System (INIS)

    George, J.; Packya, N.; Tan, A.H.; Paul, G.

    2000-01-01

    In an arthroscopic-MRI correlation study of acute injuries to the knee it was found that anterolateral meniscocapsular separations of the lateral aspect of the knee were missed on MRI reporting. Eighty sports-related injuries of the knee were seen by experienced orthopaedic surgeons at the University of Malaya Medical Centre and at the National Sports Centre, Malaysia from January 1996 to July 1997. Fifty of the patients were suspected to have meniscal tears that were either lateral or medial on clinical examination and they were sent for MRI. Many of these patients were tertiary referrals. Magnetic resonance imaging examinations in 27 of the 50 patients were reported as not showing any intrasubstance or obvious meniscocapsular tears, but arthroscopy performed on them revealed anterolateral meniscocapsular tears of the lateral meniscus of varying degrees in nine of these patients. In retrospect the tears could be seen on MRI, and a pattern to the tears was noted and classified as follows. Type 0, normal; type 1, torn inferior or superior meniscocapsular attachment; type 2, both meniscofemoral and meniscotibial ligaments torn but with minimal separation of meniscus and capsule by fluid or synovitis; and type 3, marked separation of meniscus and capsule by fluid (> 3 mm). Ten patients who did not undergo arthroscopy for various personal and financial reasons underwent MRI which showed type 1 and type 2 tears, and were treated conservatively. These patients were all asymptomatic after 4-6 weeks with regard to clinical signs, suggesting a lateral meniscal tear. Magnetic resonance imaging therefore does reveal minor degrees of meniscocapsular tears anterolaterally when one understands the normal anatomy in this region. Copyright (1999) Blackwell Science Pty Ltd

  1. Arthroscopic Broström repair with Gould augmentation via an accessory anterolateral port for lateral instability of the ankle.

    Science.gov (United States)

    Matsui, Kentaro; Takao, Masato; Miyamoto, Wataru; Innami, Ken; Matsushita, Takashi

    2014-10-01

    Although several arthroscopic surgical techniques for the treatment of lateral instability of the ankle have been introduced recently, some concern remains over their procedural complexity, complications, and unclear clinical outcomes. We have simplified the arthroscopic technique of Broström repair with Gould augmentation. This technique requires only two small skin incisions for two ports (medial midline and accessory anterolateral ports), without needing a percutaneous procedure or extension of the skin incisions. The anterior talofibular ligament is reattached to its anatomical footprint on the fibula with suture anchor, under arthroscopic view. The inferior extensor retinaculum is directly visualized through the accessory anterolateral port and is attached to the fibula with another suture anchor under arthroscopic view via the anterolateral port. The use of two small ports offers a procedure that is simple to perform and less morbid for patients.

  2. Diffuse-type giant cell tumor of the subcutaneous thigh

    International Nuclear Information System (INIS)

    Sanghvi, D.A.; Purandare, N.C.; Jambhekar, N.A.; Agarwal, A.; Agarwal, M.G.

    2007-01-01

    Diffuse-type giant cell tumor is an extra-articular form of pigmented villonodular synovitis. The localized form of this lesion (tenosynovial giant cell tumor) is frequent, representing the most common subset arising from the synovium of a joint, bursa or tendon sheath, with 85% of cases occurring in the fingers. The less frequent diffuse-type giant cell tumors are commonly located in the periarticular soft tissues, but on rare occasions these lesions can be purely intramuscular or subcutaneous We report the case of a 26-year-old female with diffuse-type giant cell tumor of the subcutaneous thigh, remote from a joint, bursa or tendon sheath. A review of the literature did not reveal any similar description of a diffuse-type giant cell tumor completely within the subcutaneous thigh, remote from a joint, bursa or tendon sheath. These lesions were initially regarded as inflammatory or reactive processes, but since the identification of clonal abnormalities in these patients, and in view of their capacity for autonomous growth, they are now widely considered to represent benign neoplasms. (orig.)

  3. Analysis of right anterolateral impacts: the effect of head rotation on the cervical muscle whiplash response

    Directory of Open Access Journals (Sweden)

    Narayan Yogesh

    2005-05-01

    Full Text Available Abstract Background The cervical muscles are considered a potential site of whiplash injury, and there are many impact scenarios for whiplash injury. There is a need to understand the cervical muscle response under non-conventional whiplash impact scenarios, including variable head position and impact direction. Methods Twenty healthy volunteers underwent right anterolateral impacts of 4.0, 7.6, 10.7, and 13.0 m/s2 peak acceleration, each with the head rotated to the left, then the head rotated to the right in a random order of impact severities. Bilateral electromyograms of the sternocleidomastoids, trapezii, and splenii capitis following impact were measured. Results At a peak acceleration of 13.0 m/s2, with the head rotated to the right, the right trapezius generated 61% of its maximal voluntary contraction electromyogram (MVC EMG, while all other muscles generated 31% or less of this variable (31% for the left trapezius, 13% for the right spleinus. capitis, and 16% for the left splenius capitis. The sternocleidomastoids muscles also tended to show an asymmetric EMG response, with the left sternocleidomastoid (the one responsible for head rotation to the right generating a higher percentage (26% of its MVC EMG than the left sternocleidomastoid (4% (p Conclusion The EMG response to a right anterolateral impact is highly dependent on the head position. The sternocleidomastoid responsible for the direction of head rotation and the trapezius ipsilateral to the direction of head rotation generate the most EMG activity.

  4. The role of the anterolateral ligament in ACL insufficient and reconstructed knees on rotary stability

    DEFF Research Database (Denmark)

    Tavlo, Mette; Eljaja, S; Tranum-Jensen, Jørgen

    2016-01-01

    Studies suggest that the anterolateral ligament (ALL) is important for knee stability. The purpose was to clarify ALL's effect on rotatory and anterior-posterior stability in the anterior cruciate ligament (ACL)-insufficient and reconstructed knees and the effect of reconstruction of an insuffici......Studies suggest that the anterolateral ligament (ALL) is important for knee stability. The purpose was to clarify ALL's effect on rotatory and anterior-posterior stability in the anterior cruciate ligament (ACL)-insufficient and reconstructed knees and the effect of reconstruction...... of an insufficient ALL. Eighteen cadaveric knees were included. Stability was tested for intact (+ALL), detached (-ALL) and reconstructed (+ reALL) ALL, with ACL removed (-ACL) and reconstructed (+ACL) in six combinations. All were tested in 0, 30, 60, and 90 °C flexion. Anterior-posterior stability was measured...... with a rolimeter. Rotation with a torque of 8.85 Nm was measured photographically. The ALL was well defined in 78% of knees. ACL reconstruction had a significant effect on anterior-posterior stability. Detaching the ALL had a significant effect on internal rotatory stability and on anterior-posterior stability...

  5. Extranodal diffuse non hodgkin lymphoma in the thigh

    Directory of Open Access Journals (Sweden)

    Bölke E

    2010-08-01

    Full Text Available Abstract Diffuse large B-cell lymphoma usually starts as a rapidly growing mass in an internal lymph node and can grow in other areas such as the bone or intestines. About 1/3 of these lymphomas are confined to one part of the body when they are localized. In the case of a 78-year-old man, an extensive tumour was located on the right thigh. Biopsies of the tumour revealed diffuse proliferation of large lymphoid cells which have totally affected the normal architecture of striated muscle. The patient received multimodality treatment including chemotherapy of the CHOP regimen and adjuvant radiotherapy. Despite this being a fast growing lymphoma, about 3 out of 4 people will have no signs of disease after initial treatment, and about half of all people with this lymphoma are cured with therapy.

  6. Metastasis of Laryngeal Squamous Cell Carcinoma to Bilateral Thigh Muscles

    Directory of Open Access Journals (Sweden)

    Zarah Lucas

    2014-01-01

    Full Text Available Importance. Laryngeal cancer infrequently results in distant metastases, but metastasis to skeletal muscle is extremely uncommon. Observations. A 55-year-old male presenting with progressive dyspnea and hoarseness was found to have Stage IVA T4aN2cM0 laryngeal cancer and eventually underwent total laryngectomy. Before the patient could be started on adjuvant chemoradiation, the patient developed masses on both thighs. Biopsy revealed metastatic squamous cell carcinoma consistent with the primary laryngeal cancer. He was offered palliative chemotherapy; however, he developed new soft tissue masses to the left of his stoma and in the prevertebral area one week later. He also had new cervical and supraclavicular nodes and a pathological compression fracture of L3. Patient died within 4 months of diagnosis. Conclusions. Distant metastasis such as skeletal metastasis portends a poor prognosis. Further studies are required to determine the best course of treatment in these patients.

  7. Giant pyogenic granuloma of the thigh: a case report

    Directory of Open Access Journals (Sweden)

    Nthumba Peter M

    2008-03-01

    Full Text Available Abstract Introduction Pyogenic granuloma or lobular capillary hemangioma remains an etiopathological enigma, with trauma, inflammatory and infectious agents being the commonest suspected causative agents. These lesions affect mucous membranes of the upper aero-digestive tract, and skin. HIV patients diagnosed with pyogenic granuloma present with multiple lesions, caused by Bartonella spp. Case presentation A 28-year-old woman presented with a solitary large tumor on a skin graft donor site on her left thigh. On excision and histological examination the tumor was found to be a lobular capillary hemangioma (pyogenic granuloma. Further investigation in search of a possible explanation for this unusual presentation revealed HIV infection as the underlying cause. Conclusion This report underscores the fact that the full spectrum of presentation of HIV infection is still unknown. Unusual or unexpected presentations should arouse suspicion of underlying immunosuppression, especially in HIV endemic areas.

  8. Incidence and predictors of radial nerve palsy with the anterolateral brachialis splitting approach to the humeral shaft

    Directory of Open Access Journals (Sweden)

    Mohamad Gouse

    2016-08-01

    Conclusion: Contrary to our expectations, secondary procedures and prior multiple surgeries with failed implants and poor soft tissue were not predictive factors of postoperative deficit. From our study, we also conclude that radial nerve recovery can be reasonably expected in all patients with a postoperative palsy following the anterolateral approach.

  9. Supporting the upper body with the hand on the thigh reduces back loading during lifting

    NARCIS (Netherlands)

    Kingma, I.; Faber, G.S.; van Dieen, J.H.

    2016-01-01

    When picking objects from the floor, low back pain patients often tend to support the upper body by leaning with one hand on a thigh. While this strategy may reduce back load, this has not yet been assessed, probably due to the difficulty of measuring the forces between hand and thigh.Ten healthy

  10. The Anterolateral Limit of the Occipital Lobe: An Anatomical and Imaging Study.

    Science.gov (United States)

    Reis, Cassius Vinicius C; Yagmurlu, Kaan; Elhadi, Ali M; Dru, Alexander; Lei, Ting; Gusmão, Sebastião N S; Tazinaffo, Uédson; Zabramski, Joseph M; Spetzler, Robert F; Preul, Mark C

    2016-12-01

    Objectives  The boundaries of the temporal lobe, the parietal lobe, and the anterior portion of the occipital lobe (OL) are poorly defined. Lesions in these areas can be difficult to localize. Therefore, we studied the anterolateral limit of the OL to identify reliable anatomical landmarks. Design  In 10 formalin-fixed cadaveric heads, the boundaries of the OL and relative anatomical landmarks were studied. Main Outcome Measures  Distances between the following structures were measured: (1) preoccipital tentorial plica (POTP) to the junction between lambdoid suture and superior border of the transverse sinus (POTP-SL), (2) POTP to the sinodural angle of Citelli (POTP-PP), (3) lambda to parietooccipital sulcus (L-POS), and (4) preoccipital notch to termination of the vein of Labbé (PON-VL). Landmarks in 559 computed tomography and magnetic resonance images were also studied. Results  The POTP was found on the tentorium of all anatomical specimens, located at the same coronal level as the PON and its attachment to the bony protuberance (BP) at the lateral cranial wall. The mean distances were POTP-SL, 6.5 ± 6.4 mm; POTP-PP, 18.1 ± 7.8 mm; L-POS, 10.8 ± 5.0 mm; and PON-VL, 8.8 ± 10.1 mm. Conclusion  Osseous (asterion, lambda, and BP), dural (POTP), and vascular (VL) landmarks can be used as reference structures to identify the anterolateral limit of the OL.

  11. Delayed presentation of compartment syndrome of the thigh secondary to quadriceps trauma and vascular injury in a soccer athlete

    Directory of Open Access Journals (Sweden)

    Moo Ing How

    2015-01-01

    Conclusion: A high index of suspicion for compartment syndrome is needed in all severe quadriceps contusion. Vascular injury can cause thigh compartment syndrome in sports trauma. MRI findings of deep thigh muscle swelling and “blow-out” tear of the vastus lateralis are strongly suggestive of severe quadriceps injury, and may be a harbinger of delayed thigh compartment syndrome.

  12. Thigh muscle volume predicted by anthropometric measurements and correlated with physical function in the older adults.

    Science.gov (United States)

    Chen, B B; Shih, T T F; Hsu, C Y; Yu, C W; Wei, S Y; Chen, C Y; Wu, C H; Chen, C Y

    2011-06-01

    (1) to correlate thigh muscle volume measured by magnetic resonance image (MRI) with anthropometric measurements and physical function in elderly subjects; (2) to predict MRI-measured thigh muscle volume using anthropometric measurements and physical functional status in elderly subjects. Cross-sectional, nonrandomized study. Outpatient clinic in Taiwan. Sixty-nine elderly subjects (33 men and 36 women) aged 65 and older. The anthropometric data (including body height, body weight, waist size, and thigh circumference), physical activity and function (including grip strength, bilateral quadriceps muscle power, the up and go test, chair rise, and five meters walk time) and bioelectrical impedance analysis data (including total body fat mass, fat-free mass, and predictive muscle size) were measured. MRI-measured muscle volume of both thighs was used as the reference standard. The MRI-measured thigh volume was positively correlated with all anthropometric data, quadriceps muscle power and the up and go test as well as fat-free mass and predictive muscle mass, whereas it was negatively associated with age and walk time. In predicting thigh muscle volume, the variables of age, gender, body weight, and thigh circumference were significant predictors in the linear regression model: Muscle volume (cm3) =4226.3-42.5 × Age (year)-955.7 × gender (male=1, female=2) + 45.9 × body weight(kg) + 60.0 × thigh circumference (cm) (r2 = 0.745, P estimate = 581.6 cm3). The current work provides evidence of a strong relationship between thigh muscle volume and physical function in the elderly. We also developed a prediction equation model using anthropometric measurements. This model is a simple and noninvasive method for everyday clinical practice and follow-up.

  13. A prospective randomized peri- and post-operative comparison of the minimally invasive anterolateral approach versus the lateral approach

    OpenAIRE

    Stefan Landgraeber; Henning Quitmann; Sebastian Güth; Marcel Haversath; Wojciech Kowalczyk; Andrés Kecskeméthy; Hansjörg Heep; Marcus Jäger

    2013-01-01

    There is still controversy as to whether minimally invasive total hip arthroplasty enhances the postoperative outcome. The aim of this study was to compare the outcome of patients who underwent total hip replacement through an anterolateral minimally invasive (MIS) or a conventional lateral approach (CON). We performed a randomized, prospective study of 75 patients with primary hip arthritis, who underwent hip replacement through the MIS (n=36) or CON (n=39) approach. The Western Ontario and ...

  14. Thigh circumference and risk of heart disease and premature death: prospective cohort study

    DEFF Research Database (Denmark)

    Heitmann, Berit; Frederiksen, Peder

    2009-01-01

    OBJECTIVE: To examine associations between thigh circumference and incident cardiovascular disease and coronary heart disease and total mortality. DESIGN: Prospective observational cohort study with Cox proportional hazards model and restricted cubic splines. SETTING: Random subset of adults...... in Denmark. PARTICIPANTS: 1436 men and 1380 women participating in the Danish MONICA project, examined in 1987-8 for height, weight, and thigh, hip, and waist circumference, and body composition by impedance. MAIN OUTCOME MEASURES: 10 year incidence of cardiovascular and coronary heart disease and 12.5 years...... of follow-up for total death. RESULTS: A small thigh circumference was associated with an increased risk of cardiovascular and coronary heart diseases and total mortality in both men and women. A threshold effect for thigh circumference was evident, with greatly increased risk of premature death below...

  15. Effectiveness of Fluoroscopic and US - Guided Percutaneous Catheter Drainage for Iliopsoas Abscess through the Anterolateral Transabdominal Approach

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ho Cheol; Shin, Tae Beom; Park, Mee Jung; Kim, Ji Eun; Choi, Hye Young; Bae, Kyung Soo; Choi, Dae Seob; Na, Jae Boem; Jeong, Seong Hoon [Gyeongsang National University Hospital, College of Medicine, Jinju (Korea, Republic of)

    2011-02-15

    We evaluated the effectiveness of performing fluoroscopic and ultrasonography guided percutaneous catheter drainage (PCD) through the anterolateral transabdominal approach for treating iliopsoas abscess. From January 2008 to December 2009, fluoroscopic and US-guided PCD through the anterolateral transabdominal approach was performed on sixteen iliopsoas abscesses of fourteen patients (7 males and 7 females; mean age: 63 years; age range: 30-87 years). Six abscesses were on the right side and ten abscesses were on the left side. The location of the abscesses were the psoas muscle (n=7), the iliacus muscle (n=7) and the iliopsoas muscle (n=2). All the procedures were performed under fluoroscopy and US guidance in the angiography room. The clinical findings before and after the procedure, the duration of catheter insertion and the procedure-related complications were evaluated. 15 out of the 16 iliopsoas abscesses were effectively treated. The duration of catheter insertion was 5- 27 days (mean: 14.6) days. No patient had significant complications during or after drainage. One patient died of uncontrolled diabetes complications and shock on the 9th day after percutaneous catheter drainage. One recurrence was noted 5 months after removal of the catheter. This patient underwent aspiration and antibiotic treatment for this lesion and the patient improved. Fluoroscopic and US-guided PCD for iliopsoas abscess through the anterolateral transabdominal approach is an effective and safe procedure

  16. FREE ANTEROLATERAL FEMORAL FLAP IS THE FIRST CHOICE IN EMERGENCY RECONSTRUCTIVE SURGERY OF THE LOWER LIMB (ANALYSIS OF CLINICAL CASES

    Directory of Open Access Journals (Sweden)

    A. V. Nevedrov

    2015-01-01

    Full Text Available BACKGROUND. Requirements for the graft used in microsurgery are simple retrieval, minimal anatomic variability, the possibility to operate on one surgical area, great length and diameter of flap vessels.PURPOSE OF STUDY. Evaluation of the results and advantages of revascularized free anterolateral muscle flap usage in emergency surgery.MATERIALS AND METHODS. Free muscle flap of the lateral vastus muscle on a vascular pedicle of the descending branch of the lateral femoral circumflex artery (anterolateral flap was used to replace the defect in 2 patients. In one case, a patient had open fractures of the lower leg, complicated with primary defects of soft tissue, and in the other case a patient had incomplete traumatic amputation of the left foot. All the victims underwent soft tissue defects restoration within the first hours after the injury, next to fixation of the fracture.RESULTS. All grafts have completely healed, total necrosis of muscle flaps hasn’t been observed. All patients had primary wound healing after the transfer. Cases of deep purulent infection after the surgery haven’t been noted.CONCLUSION. The transfer of a free anterolateral muscle flap is the best method for emergency plastic and reconstructive surgery of the lower limbs. The advantages are simple and prompt retreival, no need to turn the patient to the lateral position, large amount of the flap, great length and caliber of vessels. 

  17. Concurrent emphysematous pyelonephritis and thigh necrotizing fasciitis after intramuscular administration of diclofenac

    Directory of Open Access Journals (Sweden)

    Fateme Shamekhi Amiri

    2014-01-01

    Full Text Available Necrotizing fasciitis (NF is a rapidly progressive, life-threatening soft tissue infec-tion. NF may result from any injury to the skin or from hematogenous spread. However, con-current emphysematous pyelonephritis and necrotizing fasciitis of the left thigh has not been reported. We report a case of emphysematous pyelonephritis and necrotizing fasciitis of the left thigh after intramuscular administration of diclofenac that improved with aggressive management including broad-spectrum antibiotics, nephrectomy and surgical intervention.

  18. Characteristic MR image finding of squatting exercise-induced rhabdomyolysis of the thigh muscles.

    Science.gov (United States)

    Yeon, Eung K; Ryu, Kyung N; Kang, Hye J; Yoon, So H; Park, So Y; Park, Ji S; Jin, Wook

    2017-04-01

    To describe the characteristic MRI appearance of squatting-induced rhabdomyolysis involving the thigh muscles. This study consisted of 10 cases obtained at 3 institutions from 2005 to 2015. A retrospective review was performed to obtain clinical information and MR scans for rhabdomyolysis of the thigh muscles. MRI was analyzed according to the distribution and degree of muscle involvement; the degree was assessed and graded as normal, mild or prominent. The mean patient age was 20.2 years (range, 15-24 years), and 7 of the 10 patients were male. All patients had history of excessive squatting action, suffered clinically from bilateral thigh pain and were confirmed to have rhabdomyolysis through analysis of serum creatine kinase (CK) levels. All of the patients (10/10) exhibited diffuse mild to prominent degree involvement of the anterior thigh muscles according to fluid-sensitive MR sequences. Among the anterior thigh muscles, the rectus femoris was spared in 8 patients (8/10) and mild degree involved in 2 patients (2/10). Thus, no cases exhibited prominent degree involvement of the rectus femoris muscle. Preservation of the rectus femoris muscle on MRI in squatting-induced rhabdomyolysis may be useful for differentiating rhabdomyolysis from other aetiologies. Advances in knowledge: Preservation of rectus femoris on MRI is distinguishable finding in squatting-induced rhabdomyolysis and reflects the functional anatomy of anterior thigh muscles.

  19. Electromyography of the thigh muscles during lifting tasks in kneeling and squatting postures

    Energy Technology Data Exchange (ETDEWEB)

    Gallagher, S.; Pollard, J.; Porter, W.L. [NIOSH, Pittsburgh, PA (United States). Pittsburgh Research Laboratory

    2011-07-01

    Underground coal miners who work in low-seam mines frequently handle materials in kneeling or squatting postures. To assess quadriceps and hamstring muscle demands in these postures, nine participants performed lateral load transfers in kneeling and squatting postures, during which electromyographic (EMG) data were collected. EMG activity was obtained at five points throughout the transfer for three quadriceps muscles and two hamstring muscles from each thigh. ANOVA results indicated that EMG data for nine of 10 thigh muscles were affected by an interaction between posture and angular position of the load lifted (p <0.001). Muscles of the right thigh were most active during the lifting portion of the task (lifting a block from the participant's right) and activity decreased as the block was transferred to the left. Left thigh muscles showed the opposite pattern. EMG activity for the majority of thigh muscles was affected by the size of the base of support provided by different postures, with lower EMG activity observed with a larger base of support and increased activity in postures where base of support was reduced (p<0.05). Thigh EMG activity was lowest in postures with fully flexed knees, which may explain worker preference for this posture. However, such postures are also associated with increased risk of meniscal damage.

  20. Anterolateral ligament injuries in knees with an anterior cruciate ligament tear. Contribution of ultrasonography and MRI

    International Nuclear Information System (INIS)

    Faruch Bilfeld, Marie; Constans, Olivia; Lapegue, Franck; Chiavassa Gandois, Helene; Sans, Nicolas; Cavaignac, Etienne; Wytrykowski, Karine; Larbi, Ahmed

    2018-01-01

    To describe the pathological appearance of the anterolateral ligament (ALL) on US and MRI in knees with an anterior cruciate ligament (ACL) tear. This prospective study included 30 patients who had a suspected acute ACL tear. Their injured and contralateral knees were evaluated with radiography, US and MRI. Two radiologists evaluated the ALL on the MRI and US examinations. Agreement between these examiners' findings was evaluated with Cohen's kappa. On US examination, the ALL was found to be injured in 63% of cases (19/30; k = 0.93). The enthesis was found to be torn in 50% of cases (15/30; k = 1), with the tear located at the tibial attachment in all instances. On the MRI exam, the ALL was found to be injured in 53% of cases (16/30; k = 0.93). The enthesis was found to be torn in 13% of cases (4/30; k = 0.76), with the tear located at the tibial attachment in all instances (k = 0.93). ALL injuries that occur with ACL tears are located at the tibial enthesis. They are often associated with bone avulsion at the enthesis and are better viewed on US. (orig.)

  1. Anterolateral ligament injuries in knees with an anterior cruciate ligament tear. Contribution of ultrasonography and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Faruch Bilfeld, Marie; Constans, Olivia; Lapegue, Franck; Chiavassa Gandois, Helene; Sans, Nicolas [CHU Toulouse-Purpan, Service de Radiologie, Toulouse (France); Cavaignac, Etienne; Wytrykowski, Karine [CHU Toulouse-Purpan, Service d' Orthopedie, Toulouse (France); Larbi, Ahmed [Hopital Universitaire Caremeau, Service de Radiologie, Nimes (France)

    2018-01-15

    To describe the pathological appearance of the anterolateral ligament (ALL) on US and MRI in knees with an anterior cruciate ligament (ACL) tear. This prospective study included 30 patients who had a suspected acute ACL tear. Their injured and contralateral knees were evaluated with radiography, US and MRI. Two radiologists evaluated the ALL on the MRI and US examinations. Agreement between these examiners' findings was evaluated with Cohen's kappa. On US examination, the ALL was found to be injured in 63% of cases (19/30; k = 0.93). The enthesis was found to be torn in 50% of cases (15/30; k = 1), with the tear located at the tibial attachment in all instances. On the MRI exam, the ALL was found to be injured in 53% of cases (16/30; k = 0.93). The enthesis was found to be torn in 13% of cases (4/30; k = 0.76), with the tear located at the tibial attachment in all instances (k = 0.93). ALL injuries that occur with ACL tears are located at the tibial enthesis. They are often associated with bone avulsion at the enthesis and are better viewed on US. (orig.)

  2. Anterolateral ankle impingement in adolescents: outcomes of nonoperative and operative treatment.

    Science.gov (United States)

    Edmonds, Eric W; Chambers, Reid; Kaufman, Elizabeth; Chambers, Henry G

    2010-03-01

    Ankle sprains in adolescents usually resolve with conservative management but a few patients may develop ankle impingement syndrome. There have been adult studies addressing surgical treatment of this pathology, but our study evaluated the surgical management of anterolateral ankle impingement in adolescents by comparing their outcomes after nonoperative treatment and subsequent surgical intervention. Thirteen patients (children and adolescents) diagnosed with ankle impingement by history, physical examination, and magnetic resonance imaging during a 9-year period at our institution underwent eventual arthroscopic debridement. A retrospective chart review of these patients was performed and they were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) functional rating scale on 3 separate occasions: (1) initial presentation, (2) termination of nonoperative management, and (3) final postoperative follow-up visit. Thirteen adolescents (11 girls and 2 boys; 14 ankles) with a mean age of 15.6 (11.9-18.3) years met the inclusion criteria; of these, all had arthroscopic surgery. Mean duration of reported symptoms was 9.6 (4-15) months and mean duration of nonoperative management (physical therapy, activity modifications) was 6.9 (2-12) months. The mean AOFAS rating (out of 100 total) at initial presentation was 68.4 (40-84) and after nonoperative management was no better with a mean of 68.2 (63-76). The mean AOFAS rating at final follow-up was 90.6 (52-100), which was statistically significant (Pankle impingement in the adolescent population.

  3. High Interspecimen Variability in Engagement of the Anterolateral Ligament: An In Vitro Cadaveric Study.

    Science.gov (United States)

    Kent, Robert N; Boorman-Padgett, James F; Thein, Ran; van der List, Jelle P; Nawabi, Danyal H; Wickiewicz, Thomas L; Imhauser, Carl W; Pearle, Andrew D

    2017-10-01

    Anterolateral ligament (ALL) reconstruction as an adjunct to anterior cruciate ligament (ACL) reconstruction remains a subject of clinical debate. This uncertainty may be driven in part by a lack of knowledge regarding where, within the range of knee motion, the ALL begins to carry force (engages). (1) Does the ALL engage in the ACL-intact knee; and (2) where within the range of anterior tibial translation occurring in the ACL-sectioned knee does the ALL engage? A robotic manipulator was used to measure anterior tibial translation, ACL forces, and ALL forces in 10 fresh-frozen cadaveric knees (10 donors; mean age, 41 ± 16 years; range, 20-64 years; eight male) in response to applied multiplanar torques. The engagement point of the ALL was defined as the anterior tibial translation at which the ALL began to carry at least 15% of the force carried by the native ACL; a threshold of 15% minimized the sensitivity of the engagement point of the ALL. This engagement point was compared with the maximum anterior tibial translation permitted in the ACL-intact condition using a paired Wilcoxon signed-rank test (p position and tension at which lateral extraarticular grafts and tenodeses are fixed might be able to be tuned to control where within the range of knee motion the graft tissue is engaged to restrain joint motion on a patient-specific basis.

  4. With computed tomography confirmed anterolateral left ventricular pseudoaneurysm in patient with dilatative alcoholic cardiomyopathy

    International Nuclear Information System (INIS)

    Letonja, Mitja; Letonja, Marija Santl

    2011-01-01

    Pseudoaneurysms are rare complications of myocardial infarction with propensity for rupture. There is still a challenge with which diagnostic imaging we performed a final diagnosis of pseudoaneurysm and differentiate it from true aneurysm what is clinically important due to the different treatment. We presented the unusual case of a 56-year-old man with signs of decompensated heart failure which had worsened a few months before hospitalization. We believed that during worsening of symptoms the patient suffered a silent myocardial infarction complicated by subacute free wall rupture which resulted into left ventricular pseudoaneurysm formation without tamponade. Echocardiography showed dilatative cardiomyopathy which was already present years before and a very rare location of the left ventricular pseudoaneurysm on the anterolateral part of the left ventricle. Pseudoaneurysm was confirmed with CT scan. Due to the severity of contractile dysfunction and no response in treatment for congestive heart failure the directive for the resection was tempered and the patient died due to the progressive heart failure and embolic phenomena. This report shows the importance of non-invasive imaging diagnostic evaluation of acute decompensated heart failure where echocardiography and chest X-ray are the first diagnostic steps. Based on those findings further imaging diagnostic steps must be performed such as CT scan in our case which finally confirms left ventricular pseudoaneurysm with dilatative cardiomyopathy

  5. Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis.

    Science.gov (United States)

    Ding, Chao; Jiang, Da-ming; Tao, Kai-yu; Duan, Qun-jun; Li, Jie; Kong, Min-jian; Shen, Zhong-hua; Dong, Ai-qiang

    2014-06-01

    Mitral valve disease tends to be treated with anterolateral minithoracotomy (ALMT) rather than median sternotomy (MS), as ALMT uses progressively smaller incisions to promote better cosmetic outcomes. This meta-analysis quantifies the effects of ALMT on surgical parameters and post-operative outcomes compared with MS. One randomized controlled study and four case-control studies, published in English from January 1996 to January 2013, were identified and evaluated. ALMT showed a significantly longer cardiopulmonary bypass time (P=0.001) and aortic cross-clamp time (P=0.05) compared with MS. However, the benefits of ALMT were evident as demonstrated by a shorter length of hospital stay (PALMT decreased significantly as compared with MS (P=0.05); however, the incidence of peri-operative mortality (P=0.62), re-operation for bleeding (P=0.37), neurologic events (P=0.77), myocardial infarction (P=0.84), gastrointestinal complications (P=0.89), and renal insufficiency (P=0.67) were similar to these of MS. Long-term follow-up data were also examined, and revealed equivalent survival and freedom from mitral valve events. Current clinical data suggest that ALMT is a safe and effective alternative to the conventional approach and is associated with better short-term outcomes and a trend towards longer survival.

  6. Effect of magnesium on reactive oxygen species production in the thigh muscles of broiler chickens.

    Science.gov (United States)

    Liu, Y X; Guo, Y M; Wang, Z

    2007-02-01

    1. The objective of the present study was to investigate the effect of magnesium (Mg) on reactive oxygen species (ROS) production in the thigh muscles of broiler chickens. A total of 96 1-d-old male Arbor Acre broiler chickens were randomly allocated into two groups, fed either on low-Mg or control diets containing about 1.2 g/kg or 2.4 g Mg/kg dry matter. 2. The low-Mg diet significantly increased malondialdehyde (MDA) concentration and decreased glutathione (GSH) in the thigh muscles of broiler chickens. ROS production in the thigh muscle homogenate was significantly higher in the low-Mg group than in the control group. Compared with the control, muscle Mg concentration of broiler chickens from the low-Mg group decreased by 9.5%. 3. Complex II and III activities of the mitochondrial electron transport chain in broilers on low-Mg diet increased by 23 and 35%, respectively. Significant negative correlations between ROS production and the activities of mitochondrial electron transport chain (ETC) complexes were observed. 4. The low-Mg diet did not influence contents of iron (Fe) or calcium (Ca) in the thigh muscles of broiler chickens and did not influence unsaturated fatty acid composition (except C18:2) in the thigh muscles. 5. A low-Mg diet decreased Mg concentration in the thigh muscles of broiler chickens and then induced higher activities of mitochondrial ETC, consequently increasing ROS production. These results suggest that Mg modulates the oxidation-anti-oxidation system of the thigh muscles at least partly through affecting ROS production.

  7. Treatment of Middle Third Humeral Shaft Fractures with Anteromedial Plate Osteosynthesis through an Anterolateral Approach.

    Science.gov (United States)

    Kumar, B S; Soraganvi, P; Satyarup, D

    2016-03-01

    Background: Treatment of humeral shaft fractures has been a subject of debate for many decades. Even though a large majority of humeral shaft fractures can be treated by non operative methods, few conditions like open fractures, polytrauma, ipsilateral humeral shaft and forearm fractures require surgical intervention. The goal of treatment of humeral shaft fractures is to establish union with an acceptable humeral alignment and to restore the patient to pre-injury level of function. The objective was to assess the incidence of radial nerve palsy, non-union and mean time required for in anteromedial plate osteosynthesis with anterolateral approach and also to measure the functional outcome of this procedure. Method: A prospective study was conducted in the Department of Orthopaedics, PESIMSR, Kuppam, Andhra Pradesh, from August 2012 to August 2015 with a total of 54 patients who were operated with anteromedial plate osteosynthesis were included in the study. Rodriguez- Merchan criteria was used to grade the functional outcome. Results: Of the 54 patients, 28 (58.85%) were in the age group of 30-40 years. The most common fracture pattern identified was A3 type (48.14%).The mean (± SD) duration of surgery for anteromedial humeral plating was 53 ± 5.00 minutes. The time taken for the fracture to unite was less than 16 weeks in the majority or 50 patients (92.59%). Four (7.40%) patients had delayed union. There was no incidence of iatrogenic radial nerve palsy. Rodriguez - Merchan criteria showed that 37(68.51%) of the patients had good and 12 (22.22%) had excellent functional outcome.

  8. Treatment of Middle Third Humeral Shaft Fractures with Anteromedial Plate Osteosynthesis through an Anterolateral Approach

    Directory of Open Access Journals (Sweden)

    Kumar BS

    2016-03-01

    Full Text Available Background: Treatment of humeral shaft fractures has been a subject of debate for many decades. Even though a large majority of humeral shaft fractures can be treated by non operative methods, few conditions like open fractures, polytrauma, ipsilateral humeral shaft and forearm fractures require surgical intervention. The goal of treatment of humeral shaft fractures is to establish union with an acceptable humeral alignment and to restore the patient to pre-injury level of function. The objective was to assess the incidence of radial nerve palsy, non-union and mean time required for in anteromedial plate osteosynthesis with anterolateral approach and also to measure the functional outcome of this procedure. Method: A prospective study was conducted in the Department of Orthopaedics, PESIMSR, Kuppam, Andhra Pradesh, from August 2012 to August 2015 with a total of 54 patients who were operated with anteromedial plate osteosynthesis were included in the study. RodriguezMerchan criteria was used to grade the functional outcome. Results: Of the 54 patients, 28 (58.85% were in the age group of 30-40 years. The most common fracture pattern identified was A3 type (48.14%.The mean (+ SD duration of surgery for anteromedial humeral plating was 53 ± 5.00 minutes. The time taken for the fracture to unite was less than 16 weeks in the majority or 50 patients (92.59%. Four (7.40% patients had delayed union. There was no incidence of iatrogenic radial nerve palsy. Rodriguez – Merchan criteria showed that 37(68.51% of the patients had good and 12 (22.22% had excellent functional outcome.

  9. Characterization of the anatomy of the anterolateral ligament of the knee using magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kosy, Jonathan D.; Mandalia, Vipul I.; Anaspure, Rahul [Royal Devon and Exeter Hospital, Princess Elizabeth Orthopaedic Centre, Exeter (United Kingdom)

    2015-11-15

    The anterolateral ligament (ALL) may limit tibial internal rotation and pivot-shift following anterior cruciate ligament reconstruction. Previous studies, using magnetic resonance imaging (MRI) to identify this structure, have been inconsistent. We aimed to further characterize the anatomy of this ligament with reference to previous work. Institutional Review Board approval was gained and a retrospective study of 154 consecutive 1.5-T MRI studies was performed by a consultant musculoskeletal radiologist. Cases with a lateral compartment or cruciate injury and patients under 16 years were excluded. A total of 100 MRIs (98 patients; 63 males: 35 females; mean age, 45.3 years, range, 16-85 years) were included in the study. The ALL was visualized partially in 94 (94.0 %) of the cases and fully with distinct femoral and tibial fibers in 57 (57.0 %) of the cases. Although the femoral origin was discreet in only 57 (57.0 %) of cases, the tibial insertion (7.64 ± 1.26 mm below the joint-line) and meniscal attachment were demonstrated in all cases where the ligament was seen. Where the femoral origin was not seen, a broad expansion of the ligament was noted. We identified four types of meniscal attachment (complete, central, bipolar, and inferior-only). The thickness of the ALL, at the level of the joint-line, was 1.75 ± 0.57 mm. The ALL is a consistent structure with meniscal and tibial portions identifiable in the majority of MRI studies of the uninjured knee. There is an attachment to the lateral meniscus with anatomical variation described by our subclassification. (orig.)

  10. Association between Thigh Muscle Volume and Leg Muscle Power in Older Women.

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    Ulrich Lindemann

    Full Text Available The construct of sarcopenia is still discussed with regard to best appropriate measures of muscle volume and muscle function. The aim of this post-hoc analysis of a cross-sectional experimental study was to investigate and describe the hierarchy of the association between thigh muscle volume and measurements of functional performance in older women. Thigh muscle volume of 68 independently living older women (mean age 77.6 years was measured via magnetic resonance imaging. Isometric strength was assessed for leg extension in a movement laboratory in sitting position with the knee flexed at 90° and for hand grip. Maximum and habitual gait speed was measured on an electronic walk way. Leg muscle power was measured during single leg push and during sit-to-stand performance. Thigh muscle volume was associated with sit-to-stand performance power (r = 0.628, leg push power (r = 0.550, isometric quadriceps strength (r = 0.442, hand grip strength (r = 0.367, fast gait speed (r = 0.291, habitual gait speed (r = 0.256, body mass index (r = 0.411 and age (r = -0.392. Muscle power showed the highest association with thigh muscle volume in healthy older women. Sit-to-stand performance power showed an even higher association with thigh muscle volume compared to single leg push power.

  11. Nutritional value of breast and thigh muscle of chukar partridge (Alectoris chukar under intensive fattening conditions

    Directory of Open Access Journals (Sweden)

    Radovan Jůzl

    2012-01-01

    Full Text Available The aim of our study was to evaluate the nutritional value of the breast and thigh muscle of chukar partridge (Alectoris chukar under intensive fattening conditions. Commercial feeding mixtures for broilers were used. Live weight of 60 partridges (birds were not sexed was controlled during 90 days of fattening. After the fattening was finished, 30 birds were selected to monitor the carcass yield. Breast and thigh muscle were used for chemical analysis of crude protein (Kjeldahl method, total lipids (fat analyser ANKOMXT10, ash (Muffle furnace - 550° C and gross energy (calorimetry. Average values ​​of live weight were increasing in the course of fattening; at the end of fattening the live weight reached 0.452 kg. The carcass yield, breast muscle yield and thigh yield were evaluated (73.72%, 18.09%, 20.80%, respectively. Chemical analysis showed a highly significant difference (P ≤ 0.01 between the breast and thigh muscle for crude protein, fat, ash and gross energy. The ash content demonstrated a significant difference (P ≤ 0.05 between the breast and thigh muscle. This study brings new data on the nutritional value of the meat of chukar partridge that can be used for reccomendation of a suitable feeding mixture.

  12. Comparison of MRI and DXA to measure muscle size and age-related atrophy in thigh muscles.

    Science.gov (United States)

    Maden-Wilkinson, T M; Degens, H; Jones, D A; McPhee, J S

    2013-09-01

    Magnetic resonance imaging (MRI) and dual-energy x-ray absorptiometry (DXA) were used to examine the thigh lean mass in young and old men and women. A whole-body DXA scan was used to estimate thigh lean mass in young (20 men; 22.4±3.1y; 18 women; 22.1±2.0y) and older adults (25 men; 72.3±4.9y; 28 women; 72.0±4.5y). Thigh lean mass determined with a thigh scan on the DXA or full thigh MRI scans were compared. Although the thigh lean mass quantified by DXA and MRI in young and older participants were correlated (R(2)=0.88; polder than young individuals, while the other thigh muscles were only 18% smaller. DXA underestimates the age-related loss of thigh muscle mass in comparison to MRI. The quadriceps muscles were more susceptible to age-related atrophy compared with other thigh muscles.

  13. The anterolateral supra-fibular-head approach for plating posterolateral tibial plateau fractures: A novel surgical technique.

    Science.gov (United States)

    Hu, Sun-Jun; Chang, Shi-Min; Zhang, Ying-Qi; Ma, Zhuo; Du, Shou-Chao; Zhang, Kai

    2016-02-01

    The posterolateral (PL) tibial plateau quadrant is laterally covered by the fibular head and posteriorly covered by a mass of muscle ligament and important neurovascular structures. There are several limitations in exposing and fixing the PL tibial plateau fractures using a posterior approach. The aim of this study is to present a novel anterolateral supra-fibular-head approach for plating PL tibial plateau fractures. Five fresh and ten preserved knee specimens were dissected to measure the following parameters:1) the vertical distance from the apex of the fibular head to the lateral plateau surface, 2) the transverse distance between the PL platform and fibula collateral ligament (FCL), and 3) the tension of the FCL in different knee flexion positions. Clinically, isolated PL quadrant tibial plateau fractures were treated via an anterolateral supra-fibular-head approach and lateral rafting plate fixation. The outcome of the patients was assessed after a short to medium follow-up period. The distance from the apex of the fibular head to the lateral condylar surface was 12.2 ± 1.6 mm on average. With the knee extended and the FCL tensioned, the transverse distance between the PL platform and the FCL was 6.7 ± 1.1 mm. With the knee flexed to 60° and the FCL was in the most relaxed position, the distance increased to 21.1 ± 3.0 mm. Clinically, a series of 7 cases of PL tibial plateau fractures were treated via this anterolateral supra-fibular-head approach. The patient was placed in a lateral decubitus position with the knee flexed to approximately 60 degrees. After the posterior retraction of the FCL, the plate was placed more posteriorly to provide a raft or horizontal belt fixation of the PL tibial plateau fragment. After an average of 14.3 months of follow up, the knee range of motion(ROM) was 121.4° ± 8.8° (range: 105°-135°), the HSS score was 96.7 ± 2.6 (range: 90-100), and the SMFA dysfunction score was 22.4 ± 3.8 (range: 16-28) points. The

  14. Ultrasound assessment of hamstring muscle size using posterior thigh muscle thickness.

    Science.gov (United States)

    Abe, Takashi; Loenneke, Jeremy P; Thiebaud, Robert S

    2016-05-01

    Several studies have investigated the relationship between ultrasound-measured muscle thickness (MT) and individual muscle cross-sectional area (CSA) and muscle volume (MV) in extremity and trunk muscles; however, the hamstring muscle has not been studied. The purpose of this study was to examine the relationship between posterior thigh MT by ultrasound and the muscle CSA and MV of the hamstring obtained by magnetic resonance imaging (MRI). Ten young women aged 20-31 had MT measured by ultrasound at three sites on the medial anterior (50% of thigh length; TL) and posterior (50% and 70% of TL) aspects of the thigh. On the same day, a series of continuous muscle CSA along the thigh was measured by MRI. In each slice, the anatomical CSA of the hamstring (biceps femoris, semitendinosus and semimembranosus) and quadriceps muscle was analysed, and the CSAs at 50% and 70% of TL and maximal CSA of the hamstring (CSAmax ) were determined. MV was calculated by multiplying CSA by slice thickness. A significant correlation was observed between posterior 50% MT and 50% hamstring CSA (r = 0·848, P = 0·002) and between posterior 70% MT and 70% hamstring CSA (r = 0·679, P = 0·031). Posterior 50% MT (r = 0·732, P = 0·016) and 50% MTxTL (r = 0·873, P = 0·001) were also correlated to hamstring MV. Anterior:posterior 50% thigh MT ratio was correlated to MV ratio of quadriceps and hamstring muscles (r = 0·803, P = 0·005). Our results suggest that posterior thigh MT reflects hamstring muscle CSA and MV. The anterior:posterior MT ratio may serve as a surrogate for MV ratio of quadriceps and hamstring. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  15. An analysis of postoperative thigh symptoms after minimally invasive transpsoas lumbar interbody fusion.

    Science.gov (United States)

    Cummock, Matthew D; Vanni, Steven; Levi, Allan D; Yu, Yong; Wang, Michael Y

    2011-07-01

    The minimally invasive transpsoas interbody fusion technique requires dissection through the psoas muscle, which contains the nerves of the lumbosacral plexus posteriorly and genitofemoral nerve anteriorly. Retraction of the psoas is becoming recognized as a cause of transient postoperative thigh pain, numbness, paresthesias, and weakness. However, few reports have described the nature of thigh symptoms after this procedure. The authors performed a review of patients who underwent the transpsoas technique for lumbar spondylotic disease, disc degeneration, and spondylolisthesis treated at a single academic medical center. A review of patient charts, including the use of detailed patient-driven pain diagrams performed at equal preoperative and follow-up intervals, investigated the survival of postoperative thigh pain, numbness, paresthesias, and weakness of the iliopsoas and quadriceps muscles in the follow-up period on the ipsilateral side of the surgical approach. Over a 3.2-year period, 59 patients underwent transpsoas interbody fusion surgery. Of these, 62.7% had thigh symptoms postoperatively. New thigh symptoms at first follow-up visit included the following: burning, aching, stabbing, or other pain (39.0%); numbness (42.4%); paresthesias (11.9%); and weakness (23.7%). At 3 months postoperatively, these percentages decreased to 15.5%, 24.1%, 5.6%, and 11.3%, respectively. Within the patient sample, 44% underwent a 1-level, 41% a 2-level, and 15% a 3-level transpsoas operation. While not statistically significant, thigh pain, numbness, and weakness were most prevalent after L4-5 transpsoas interbody fusion at the first postoperative follow-up. The number of lumbar levels that were surgically treated had no clear association with thigh symptoms but did correlate directly with surgical time, intraoperative blood loss, and length of hospital stay. Transpsoas interbody fusion is associated with high rates of immediate postoperative thigh symptoms. While larger

  16. Oxidative stability of chicken thigh meat after treatment of fennel and savory essential oils

    Directory of Open Access Journals (Sweden)

    Adriana Pavelková

    2016-05-01

    Full Text Available In the present work, the effect of the fennel and savory essential oils on oxidative stability of chicken thigh muscles during chilled storage was investigated. In the experiment were used chickens of hybrid combination Cobb 500 after 42 days of the fattening period. The obtained fresh chicken thigh with skin from left half-carcass were divided into five groups (n = 5: C - control air-packaged group; A1 - vacuum-packaged experimental group; A2 - vacuum-packaged experimental group with EDTA solution 1.50% w/w; A3 - vacuum-packaged experimental group with fennel (Foeniculum vulgare essential oil at concentrations 0.2% v/w and A4 - vacuum-packaged experimental group with savory (Satureja hortensis essential oil at concentration 0.2% v/w. The essential oils were applicate on surface chicken thighs. The chicken thighs were packaged using a vacuum packaging machine and stored in refrigerate at                 4 ±0.5 °C. The value of thiobarbituric acid (TBA expressed as amount of malondialdehyde (MDA in 1 kg sample was measured during storage in 1st, 4th, 8th, 12th and 16th day. The treatments of chicken thighs with fennel and savory essential oils show statistically significant differences between all testing groups and control group, where higher average value of MDA measured in thigh muscle of broiler chickens was in samples of control group                 (0.359 mg.kg-1 compared to experimental groups A1 (0.129 mg.kg-1, A2 (0.091 mg.kg-1, A3 (0.084 mg.kg-1 and A4 (0.089 mg.kg-1 after 16-day of chilled storage. Experiment results show that the treatment of chicken thigh with fennel and savory essential oils had positive influence on the reduction of oxidative processes in thigh muscles during chilling storage and use of essential oil is one of the options increase shelf life of fresh chicken meat.

  17. [Effects of anteriolateral thigh perforator flap and fascia lata transplantation in combination with computed tomography angiography on repair of electrical burn wounds of head with skull exposure and necrosis].

    Science.gov (United States)

    Li, X Q; Wang, X; Han, Y L; Ji, G; Chen, Z H; Zhang, J; Zhu, J P; Duan, J X; He, Y J; Yang, X M; Liu, W J

    2018-05-20

    temporal artery and vein in six patients, while those with facial artery and vein in one patient. All the flaps survived after the operation, and no vascular crisis was observed. Wound healing was satisfactory. One patient was lost to follow up. Six patients were followed up for 6 to 10 months. The patients were bald in the head operation area with acceptable appearance. No psychiatric symptom such as headache or epileptic seizure was reported. The flap donor sites were normal in appearance. The muscle strength of the lower extremities all reached grade V. The sensation and movement of the lower extremities were normal. Conclusions: Anterolateral thigh perforator flap with fascia lata transplantation can effectively repair electrical burn wounds of head with skull exposure and necrosis. The fascia lata can be used to protect the vascular pedicle of flaps, which is beneficial to the survival of the flap. Preoperative head and lower extremities CTA can provide reference for intraoperative vascular exploration in donor site and recipient area, so as to shorten operation time.

  18. Newly designed anterolateral and posterolateral locking anatomic plates for lateral tibial plateau fractures: a finite element study.

    Science.gov (United States)

    Chen, Pengbo; Lu, Hua; Shen, Hao; Wang, Wei; Ni, Binbin; Chen, Jishizhan

    2017-02-23

    Lateral column tibial plateau fracture fixation with a locking screw plate has higher mechanical stability than other fixation methods. The objectives of the present study were to introduce two newly designed locking anatomic plates for lateral tibial plateau fracture and to demonstrate their characteristics of the fixation complexes under the axial loads. Three different 3D finite element models of the lateral tibial plateau fracture with the bone plates were created. Various axial forces (100, 500, 1000, and 1500 N) were applied to simulate the axial compressive load on an adult knee during daily life. The equivalent maps of displacement and stress were output, and relative displacement was calculated along the fracture lines. The displacement and stresses in the fixation complexes increased with the axial force. The equivalent displacement or stress map of each fixation under different axial forces showed similar distributing characteristics. The motion characteristics of the three models differed, and the max-shear stress of trabecula increased with the axial load. These two novel plates could fix lateral tibial plateau fractures involving anterolateral and posterolateral fragments. Motions after open reduction and stable internal fixation should be advised to decrease the risk of trabecular microfracture. The relative displacement of the posterolateral fragments is different when using anterolateral plate and posterolateral plate, which should be considered in choosing the implants for different posterolateral plateau fractures.

  19. Large volume liquid silicone injection in the upper thighs : a never ending story

    NARCIS (Netherlands)

    Hofer, SOP; Damen, A; Nicolai, JPA

    This report concerns a 26-year-old male-to-female transsexual who had received a large volume liquid silicone injection of unknown grade into her upper lateral thighs to gain female contour. She presented at our outpatient clinic 4 years after the silicone injection with complaints of pain and

  20. Retroperitoneal Perforation of the Appendix Presenting as a Right Thigh Abscess

    Directory of Open Access Journals (Sweden)

    Aditya J. Nanavati

    2015-01-01

    Full Text Available A rare case of a retroperitoneal rupture of the appendix is being reported here. A 53-year-old male presented to us with a right sided thigh abscess. There were not any abdominal complaints at presentation. There was continuous discharge after incision and drainage from the thigh. Isolation, in culture, of an enteric bacterium from the pus prompted an evaluation of the gastrointestinal tract as a possible source. An MRI scan revealed fluid tracking from the right paracolic gutter over the psoas sheath and paraspinal muscle into the thigh. A CT scan revealed the perforation at the base of the appendix into the retroperitoneum. At laparotomy the above findings were confirmed. A segmental ileocaecal resection was done. The patient made an uneventful recovery. The absence of abdominal symptoms at presentation leads to delay in diagnosis in such cases. Nonresolving thigh and groin abscesses should lead to the evaluation of the gastrointestinal tract as origin. Diagnostic clues may also be provided by culture reports what as happened in this case.

  1. Neuromuscular properties of the thigh muscles in patients with Ehlers-Danlos syndrome

    NARCIS (Netherlands)

    Gerrits, K.H.; Voermans, N.C.; Haan, A. de; Engelen, B.G.M. van

    2013-01-01

    INTRODUCTION: Ehlers-Danlos syndrome (EDS), a connective tissue disorder, may lead to impaired contractile function of lower limb muscles. METHODS: To test this hypothesis and to understand the possible mechanisms involved, isometric function of the thigh muscles was investigated at different joint

  2. Neuromuscular properties of the thigh muscles in patients with Ehlers-Danlos syndrome

    NARCIS (Netherlands)

    Gerrits, K.H.L.; Voermans, N.C.; de Haan, A.; van Engelen, B.G.

    2013-01-01

    Introduction: Ehlers-Danlos syndrome (EDS), a connective tissue disorder, may lead to impaired contractile function of lower limb muscles. Methods: To test this hypothesis and to understand the possible mechanisms involved, isometric function of the thigh muscles was investigated at different joint

  3. The Internal Pudendal Artery Perforator Thigh Flap: A New Freestyle Pedicle Flap for the Ischial Region

    Directory of Open Access Journals (Sweden)

    Ichiro Hashimoto, MD

    2014-05-01

    Conclusions: The perforator vessels of the internal pudendal artery are very close to the ischial tuberosity. Blood flow to the flap is reliable when careful debridement of the pressure sore is performed. The iPap thigh flap is a new option for soft-tissue defects in the ischial region, including ischial pressure sores.

  4. The appearance of angiolipomatosis after using laptop computer on the thighs: a relationship?

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    Marie Caucanas

    2011-09-01

    Full Text Available A 56-year-old patient developed angiolipomatosis of the anterior part of the thighs after repeated laptop contact localisation. Histological findings exhibit an unusual inflammatory infiltrate. We postulate that the computer could favour lipoma development by a physiopathological mechanism that remains to be clarified.

  5. Thigh infection and subcutaneous emphysema: an emergency, review of literature and case discussion.

    LENUS (Irish Health Repository)

    Thakral, R

    2011-06-01

    Thigh infection associated with local emphysematous signs on presentation to the emergency room should alert the medical staff at once of potential complication associated with it. The infection may be associated with underlying bowel pathology and has a high mortality rate. Hence, emergency treatment should be instituted. We discuss a case with this uncommon presentation, treatment administered and relevant literature.

  6. The adequate rocuronium dose required for complete block of the adductor muscles of the thigh.

    Science.gov (United States)

    Fujimoto, M; Kawano, K; Yamamoto, T

    2018-03-01

    Rocuronium can prevent the obturator jerk during transurethral resection of bladder tumors. We investigated the adequate rocuronium dose required for complete block of the thigh adductor muscles, and its correlation with individual responses of the adductor pollicis muscle to rocuronium. Eleven patients scheduled for transurethral resection of bladder tumors under general anesthesia were investigated. After general anesthesia induction, neuromuscular monitoring of the adductor pollicis muscle and ultrasonography-guided stimulation of the obturator nerve was commenced. Rocuronium, 0.15 mg/kg, was repeatedly administered intravenously. The adequate rocuronium dose required for complete block of the thigh muscles, defined as the cumulative dose of rocuronium administered until that time, and its correlation with the first twitch response of the adductor pollicis muscle on train-of-four stimulation after initial rocuronium administration was analyzed. The rocuronium dose found adequate for complete block of the thigh muscles was 0.30 mg/kg in seven patients and 0.45 mg/kg in the remaining four patients, which did not correlate with the first twitch response. At the time of complete block of the thigh muscles, the neuromuscular blockade level of the adductor pollicis muscle varied greatly, although the level was never more profound than a post-tetanic count of 1. Although the response of the adductor pollicis muscle to rocuronium cannot be used to determine the adequate rocuronium dose required for complete block of the thigh muscles, intense blockade, with maintenance of post-tetanic count at ≤ 1 in the adductor pollicis muscle is essential to prevent the obturator jerk. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  7. Possibility of Undifferentiated Human Thigh Adipose Stem Cells Differentiating into Functional Hepatocytes

    Directory of Open Access Journals (Sweden)

    Jong Hoon Lee

    2012-11-01

    Full Text Available BackgroundThis study aimed to investigate the possibility of isolating mesenchymal stem cells (MSCs from human thigh adipose tissue and the ability of human thigh adipose stem cells (HTASCs to differentiate into hepatocytes.MethodsThe adipose-derived stem cells (ADSCs were isolated from thigh adipose tissue. Growth factors, cytokines, and hormones were added to the collagen coated dishes to induce the undifferentiated HTASCs to differentiate into hepatocyte-like cells. To confirm the experimental results, the expression of hepatocyte-specific markers on undifferentiated and differentiated HTASCs was analyzed using reverse transcription polymerase chain reaction and immunocytochemical staining. Differentiation efficiency was evaluated using functional tests such as periodic acid schiff (PAS staining and detection of the albumin secretion level using enzyme-linked immunosorbent assay (ELISA.ResultsThe majority of the undifferentiated HTASCs were changed into a more polygonal shape showing tight interactions between the cells. The differentiated HTASCs up-regulated mRNA of hepatocyte markers. Immunocytochemical analysis showed that they were intensely stained with anti-albumin antibody compared with undifferentiated HTASCs. PAS staining showed that HTASCs submitted to the hepatocyte differentiation protocol were able to more specifically store glycogen than undifferentiated HTASCs, displaying a purple color in the cytoplasm of the differentiated HTASCs. ELISA analyses showed that differentiated HTASCs could secrete albumin, which is one of the hepatocyte markers.ConclusionsMSCs were islolated from human thigh adipose tissue differentiate to heapatocytes. The source of ADSCs is not only abundant abdominal adipose tissue, but also thigh adipose tissue for cell therapy in liver regeneration and tissue regeneration.

  8. Electromyographic activity of the anterolateral abdominal wall muscles during the vesical filling and evacuation

    Directory of Open Access Journals (Sweden)

    Ahmed Shafik

    2007-06-01

    Full Text Available

    BACKGROUND: The role of the anterolateral abdominal wall muscles (AAWMs during the vesical filling and evacuation has not been sufficiently addressed in the literature. We have investigated the hypothesis that the AAWMs exhibit the increased electromyographic (EMG activity on the vesical distension and contraction which presumably assists vesical evacuation.

    METHODS: The effects of the vesical balloon distension on the vesical pressure (VP, vesical neck (VNP pressures and the AAWMs' EMG activity were studied in 28 healthy volunteers aged 40.7 ± 9.7 years (18 men, 10 women. These effects were tested after the individual anesthetization of the bladder and AAWMs and after saline infiltration.

    RESULTS: The VP and the VNP showed a gradual increase upon the incremental vesical balloon distension which started at a distending volume of 120–140 ml. At a mean volume of 364.6 ± 23.8 ml, the VP increased to a mean of 36.6 ± 3.2 cmH2O, the VNP decreased to 18.4 ± 2.4 cmH2O, and the AAWMs EMG registered a significant increase. This effect disappeared in the individual bladder and in the AAWMs' anesthetization. However, it did not disappear in the saline administration.

    CONCLUSIONS: The AAWMs appear to contract simultaneously with vesical contraction. This action presumably increases the IAP and it

  9. Comparison of femoral neck fracture healing and affected limb pain after anterolateral-approach minimally invasive total hip replacement and hemiarthroplasty

    Directory of Open Access Journals (Sweden)

    Xiao-Dong Cao

    2017-04-01

    Full Text Available Objective: To study the differences in femoral neck fracture healing and affected limb pain after anterolateral-approach minimally invasive total hip replacement and hemiarthroplasty. Methods: A total of 92 patients with femoral neck fracture who received hip replacement in our hospital between May 2013 and December 2015 were selected and randomly divided into total hip and half hip group, total hip group received anterolateral-approach minimally invasive total hip replacement, half hip group received anterolateral-approach minimally invasive hemiarthroplasty, and 1 month after operation, serum was collected to detect the levels of bone metabolism markers, osteocyte cytokines, SP and CGRP. Results: 1 month after operation, serum PINP, PICP, BMP, TGF-β, FGF, IGF-I and IGF-II levels of total hip group were significantly higher than those of half hip group while TRAP5b and CatK levels were significantly lower than those of half hip group; the day after operation, serum pain media SP and CGRP levels were not significantly different between the two groups of patients; 36 h after operation, serum SP and CGRP levels of total hip group were significantly lower than those of half hip group. Conclusion: The bone metabolism after anterolateral-approach minimally invasive total hip replacement is better than that after hemiarthroplasty, and the degree of pain is less than that after hemiarthroplasty.

  10. All-Epiphyseal Anterior Cruciate Ligament Femoral Tunnel Drilling: Avoiding Injury to the Physis, Lateral Collateral Ligament, Anterolateral Ligament, and Popliteus-A 3-Dimensional Computed Tomography Study.

    Science.gov (United States)

    Shea, Kevin G; Cannamela, Peter C; Fabricant, Peter D; Terhune, Elizabeth B; Polousky, John D; Milewski, Matthew D; Anderson, Allen F; Ganley, Theodore J

    2018-01-25

    To investigate the relation of the at-risk structures (distal femoral physis, lateral collateral ligament, anterolateral ligament, popliteus, and articular cartilage) during all-epiphyseal femoral tunnel drilling. A second purpose was 2-fold: (1) to develop recommendations for tunnel placement and orientation that anatomically reconstruct the anterior cruciate ligament (ACL) while minimizing the risk of injury to these at-risk structures, and (2) to allow for maximal tunnel length to increase the amount of graft in the socket to facilitate healing. Three-dimensional models of 6 skeletally immature knees (aged 7-11 years) were reconstructed from computed tomography and used to simulate all-epiphyseal femoral tunnels. Tunnels began within the ACL footprint and were directed laterally or anterolaterally, with the goal of avoiding injury to at-risk structures. The spatial relation between the ideal tunnel and these structures was evaluated. Full-length tunnels and partial length condyle sockets were simulated in the models using the same trajectories. An anterolateral tunnel could be placed to avoid direct injury to lateral structures. The safe zone on the anterolateral aspect of the femur was larger than that of a tunnel with a direct lateral trajectory (median 127 mm 2 vs 83 mm 2 , P = .028). Anterolateral tunnels were longer than direct lateral tunnels (median 30 mm vs 24 mm, P = .041). Safe angles for anterolateral tunnels were 34° to 40° from the posterior condylar axis; direct lateral tunnels were drilled 4° to 9° from the posterior condylar axis. Sockets could be placed without direct injury to structures at risk with either orientation. An all-epiphyseal ACL femoral tunnel can be placed without causing direct injury to at-risk structures. A tunnel angled anterolaterally from the ACL origin is longer and has a larger safe zone compared with the direct lateral tunnel. The largest safe zone for femoral all-epiphyseal ACL drilling was (1) anterior to

  11. Localization and function of the cannabinoid CB1 receptor in the anterolateral bed nucleus of the stria terminalis.

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    Nagore Puente

    Full Text Available BACKGROUND: The bed nucleus of the stria terminalis (BNST is involved in behaviors related to natural reward, drug addiction and stress. In spite of the emerging role of the endogenous cannabinoid (eCB system in these behaviors, little is known about the anatomy and function of this system in the anterolateral BNST (alBNST. The aim of this study was to provide a detailed morphological characterization of the localization of the cannabinoid 1 (CB1 receptor a necessary step toward a better understanding of the physiological roles of the eCB system in this region of the brain. METHODOLOGY/PRINCIPAL FINDINGS: We have combined anatomical approaches at the confocal and electron microscopy level to ex-vivo electrophysiological techniques. Here, we report that CB1 is localized on presynaptic membranes of about 55% of immunopositive synaptic terminals for the vesicular glutamate transporter 1 (vGluT1, which contain abundant spherical, clear synaptic vesicles and make asymmetrical synapses with alBNST neurons. About 64% of vGluT1 immunonegative synaptic terminals show CB1 immunolabeling. Furthermore, 30% and 35% of presynaptic boutons localize CB1 in alBNST of conditional mutant mice lacking CB1 mainly from GABAergic neurons (GABA-CB1-KO mice and mainly from cortical glutamatergic neurons (Glu-CB1-KO mice, respectively. Extracellular field recordings and whole cell patch clamp in the alBNST rat brain slice preparation revealed that activation of CB1 strongly inhibits excitatory and inhibitory synaptic transmission. CONCLUSIONS/SIGNIFICANCE: This study supports the anterolateral BNST as a potential neuronal substrate of the effects of cannabinoids on stress-related behaviors.

  12. Contribution of the bone scintigraphy in unexplained pains of the thigh

    International Nuclear Information System (INIS)

    Oufroukhi, Y.; Ech Charraq, I.; Ben Rais, N.

    2006-01-01

    Mr. R.N. 32 year's old, high level sportsman, without particular pathological antecedents, consults for pains of the area above the knee of the left thigh, of mechanical pace being exacerbated with the effort. The clinical examination notes pains induced by the deep of the left thigh. The biological assessment, in particular blood cell formula and CRP were normal. The standard radiography of the femurs did not find an anomaly of the osseous structure. Because of the persistence of the pains, an osseous scintiscan was carried out and orientated towards pathology of soft tissues. The doppler and the TDM made it possible to pose the diagnosis of intra-tissues muscular hemangioma. The early times of the bone scintigraphy appears important in the approach diagnosis of many osseous disease of the sportsman. (author)

  13. Combined Gluteus and Pudendal Thigh Flap Reconstruction of Vaginal Defects following Robotic Abdominoperineal Resection

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    Kasandra R. Dassoulas, MD

    2017-09-01

    Full Text Available Summary:. Low-lying rectal cancers are being treated more frequently with robotic-assisted abdominoperineal resection, obviating the need for laparotomy and the ability to raise vertical rectus abdominis musculocutaneous flaps. For female patients, posterior vaginectomy often accompanies the resection. Combined pudendal thigh flaps as an extension of bilateral gluteus advancement flaps allow for posterior vaginal resurfacing with thin pliable fasciocutaneous flaps, which rest on the gluteal flap soft-tissue bulk that obliterates the pelvic dead space. For patients with advanced cancers who have had neoadjuvant chemoradiation, the pudendal skin paddle can be planned more laterally to bring in healthier medial thigh skin. The donor incisions lie within the gluteal cleft and crease and groin creases recapitulating normal perineal anatomy and aesthetics.

  14. Simultaneous thigh muscle metastasis from lung cancer and Escherichia coli gas producing myonecrosis

    International Nuclear Information System (INIS)

    Martinez, Gonzalo E.; Coursey, Courtney A.; Martinez, Salutario; Dodd, Leslie

    2008-01-01

    We present the case of a 41-year-old man with known large cell lung cancer who had undergone left pneumonectomy 7 months prior and who presented with a large intramuscular mass involving the posterior left thigh and upper calf. This thigh mass was ultimately surgically explored, and specimens yielded both Escherichia coli organisms and cells reflecting a skeletal muscle metastasis from the patient's known lung cancer. The patient was also found to have a rectal metastasis from his lung cancer. Intramuscular abscesses produced by gastrointestinal tract flora are a well-known presentation of colon cancer. To our knowledge, this is the first case report of the simultaneous occurrence of a skeletal muscle metastasis and an E. coli abscess in the same anatomic location. We believe the patient's rectal metastasis may have been the intermediate step in this process. (orig.)

  15. Simultaneous thigh muscle metastasis from lung cancer and Escherichia coli gas producing myonecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Martinez, Gonzalo E. [Hospital Italiano, Department of Radiology, Cordoba (Argentina); Coursey, Courtney A.; Martinez, Salutario [Duke University Medical Center, Department of Radiology, Durham, NC (United States); Dodd, Leslie [Duke University Medical Center, Department of Pathology, Durham, NC (United States)

    2008-08-15

    We present the case of a 41-year-old man with known large cell lung cancer who had undergone left pneumonectomy 7 months prior and who presented with a large intramuscular mass involving the posterior left thigh and upper calf. This thigh mass was ultimately surgically explored, and specimens yielded both Escherichia coli organisms and cells reflecting a skeletal muscle metastasis from the patient's known lung cancer. The patient was also found to have a rectal metastasis from his lung cancer. Intramuscular abscesses produced by gastrointestinal tract flora are a well-known presentation of colon cancer. To our knowledge, this is the first case report of the simultaneous occurrence of a skeletal muscle metastasis and an E. coli abscess in the same anatomic location. We believe the patient's rectal metastasis may have been the intermediate step in this process. (orig.)

  16. Effects of thigh holster use on kinematics and kinetics of active duty police officers

    OpenAIRE

    Larsen, Louise B.; Tranberg, Roy; Ramstrand, Nerrolyn

    2016-01-01

    Background: Body armour, duty belts and belt mounted holsters are standard equipment used by the Swedish police and have been shown to affect performance of police specific tasks, to decrease mobility and to potentially influence back pain. This study aimed to investigate the effects on gait kinematics and kinetics associated with use of an alternate load carriage system incorporating a thigh holster. Methods: Kinematic, kinetic and temporospatial data were collected using three dimensional g...

  17. Use of mouse thigh as a radiobiological model of radiation-induced skin reactions

    International Nuclear Information System (INIS)

    Smith, A.J.; Hagkyriakou, H.; Martin, R.F.

    2000-01-01

    Full text: The effects of radiation exposure on skin have been widely studied. One of the most useful and relatively easy methods for evaluating radiation-induced skin reactions is the mouse thigh model. This model is non-invasive and has the advantage of not requiring the use of anaesthetic. In the current adaptation of the mouse thigh model, female C3H/HeJ ARC mice (from the Animal Resource Centre, W.A.) were used. The mice were restrained in specially designed jigs where the right leg was held in place by a metal hook. Lead shielding ensured that only the right ventral thigh was exposed to the radiation beam. A 6MeV electron beam from a Varian 2100 Linac (20Gy / minute) was used, thus minimising the time for which the mice were restrained. Eight to twelve days after exposure to the radiation, the first skin reactions can be seen. These are scored according to a scale ranging from 0 (no visible reaction) to 3.5 (breakdown of the entire area with severe exudation). The skin reactions (erythema and moist desquamation) peak approximately 18-22 days after radiation exposure and may remain at peak for only 1-3 days. Therefore, the reactions need to be scored daily and this continues, generally until day 35, or until all moist desquamation has healed. The maximum score in a score versus time profile for each mouse in a group of 5-6 animals are averaged. Radiation-dose response data will be presented. Using the mouse thigh model, hair loss can also be measured (usually on about day 30-35) using a scale from 0-4, where 0 depicts no evident hair loss and 4 represents complete epilation. Leg contraction can also be measured as a late effect by comparison with the length of the unirradiated leg

  18. Bone anatomy of the pelvic girdle, the thigh and the leg of Myrmecophaga tridactyla (Myrmecophagidae: Pilosa

    Directory of Open Access Journals (Sweden)

    Lucas de Assis Ribeiro

    2013-11-01

    Full Text Available The giant anteater (Myrmecophaga tridactyla is the largest anteater species in the world. It is an animal of terrestrial habits, however, it has some ability to climb tall trees and termite mounds. The hard skeletal structures are of crucial importance, since they join and protect the soft organs and help support the body, shape, and get involved in movement. The appendicular skeleton is an important part of the locomotor apparatus, whose anatomical information in wild species is scarce, making it difficult to interpret data on these bones. This paper aims to describe the pelvic girdle, the thigh, and the leg skeleton in the giant anteater. We used two specimens of Myrmecophaga tridactyla Linnaeus (1758, fixed in a 3.7% aqueous formaldehyde solution. At first, the limbs were disjointed and we removed the skin, viscera, and muscles associated to the bones of the pelvic girdle, the thigh, and the leg in the specimens. Then, they were macerated in boiling water, and, subsequently, placed in a hydrogen peroxide solution. Once clean and dry, the bones were identified and described. The pelvic girdle skeleton in the giant anteater consists of the hip bone, formed by the ilium, pubis, and ischium bones; the thigh consists of the femur bone, and the leg consists of the tibia and fibula bones. In the knee joint region there is the patella, a relatively small sesamoid bone, considering the large size of this animal. The giant anteater have osteological features of the pelvic girdle, the thigh, and the leg similar to those in domestic carnivores, however, some morphological differences are made evident, something which may reflect differences in locomotor patterns.

  19. Purulent myositis of the thigh as a presentation of perforated low rectal cancer.

    Science.gov (United States)

    Jenkins, V; Steinke, J; Rajendran, N; Kumar, D

    2018-03-01

    Purulent myositis is an acute, intramuscular bacterial infection involving abscess formation most commonly affecting the quadriceps, hamstring and gluteal muscles. We present a case of extensive purulent myositis of the thigh and lower leg caused by bowel perforation below the peritoneal reflection secondary to rectal cancer. Cases of lower limb and perineal purulent myositis should raise suspicion of rectal perforation and should prompt investigations to exclude rectal malignancy.

  20. Movement anatomy of the gluteal region and thigh of the giant anteater Myrmecophaga tridactyla (Myrmecophagidae: Pilosa)

    OpenAIRE

    Priscilla Rosa Queiroz Ribeiro; André Luiz Quagliatto Santos; Lucas de Assis Ribeiro; Tharlianne Alici Martins de Souza; Daniela Cristina Silva Borges; Rogério Rodrigues de Souza; Saulo Gonçalves Pereira

    2016-01-01

    Abstract: Locomotion reveals the displacement and behavior manner of the species in their daily needs. According to different needs of the several species, different locomotor patterns are adopted. The shapes and attachment points of muscles are important determinants of the movements performed and consequently, the locomotion and motion patterns of living beings. It was aimed to associate anatomical, kinesiology and biomechanics aspects of the gluteal region and thigh of the giant anteater t...

  1. The superomedial thigh flap in scrotal reconstruction: Technical steps to improve cosmetic results

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    Ayat Allah Oufkir

    2013-01-01

    Full Text Available The superomedial thigh flap is a reliable and easy method for scrotal reconstruction described in 1980 and infrequently reported in the literature since its description. We used it for four patients presenting scrotal defects after Fournier′s gangrene with some technical modifications to improve the esthetic results and to facilitate the closure of the donor area. We describe the technical steps and the results.

  2. KNEE-JOINT LOADING IN KNEE OSTEOARTHRITIS: INFLUENCE OF ABDOMINAL AND THIGH FAT

    Science.gov (United States)

    Messier, Stephen P.; Beavers, Daniel P.; Loeser, Richard F.; Carr, J. Jeffery; Khajanchi, Shubham; Legault, Claudine; Nicklas, Barbara J.; Hunter, David J.; DeVita, Paul

    2014-01-01

    Purpose Using three separate models that included total body mass, total lean and total fat mass, and abdominal and thigh fat as independent measures, we determined their association with knee-joint loads in older overweight and obese adults with knee osteoarthritis (OA). Methods Fat depots were quantified using computed tomography and total lean and fat mass determined with dual energy x-ray absorptiometry in 176 adults (age = 66.3 yr., BMI = 33.5 kg·m−2) with radiographic knee OA. Knee moments and joint bone-on-bone forces were calculated using gait analysis and musculoskeletal modeling. Results Higher total body mass was significantly associated (p ≤ 0.0001) with greater knee compressive and shear forces, compressive and shear impulses (p knee extensor moments (p = 0.003). Regression analysis with total lean and total fat mass as independent variables revealed significant positive associations of total fat mass with knee compressive (p = 0.0001), shear (p knee extension moment (p = 0.008). Gastrocnemius and quadriceps forces were positively associated with total fat mass. Total lean mass was associated with knee compressive force (p = 0.002). A regression model that included total thigh and total abdominal fat found both were significantly associated with knee compressive and shear forces (p ≤ 0.04). Thigh fat was associated with the knee abduction (p = 0.03) and knee extension moment (p = 0.02). Conclusions Thigh fat, consisting predominately of subcutaneous fat, had similar significant associations with knee joint forces as abdominal fat despite its much smaller volume and could be an important therapeutic target for people with knee OA. PMID:25133996

  3. Knee joint loading in knee osteoarthritis: influence of abdominal and thigh fat.

    Science.gov (United States)

    Messier, Stephen P; Beavers, Daniel P; Loeser, Richard F; Carr, J Jeffery; Khajanchi, Shubham; Legault, Claudine; Nicklas, Barbara J; Hunter, David J; Devita, Paul

    2014-09-01

    Using three separate models that included total body mass, total lean and total fat mass, and abdominal and thigh fat as independent measures, we determined their association with knee joint loads in older overweight and obese adults with knee osteoarthritis (OA). Fat depots were quantified using computed tomography, and total lean and fat mass were determined with dual energy x-ray absorptiometry in 176 adults (age, 66.3 yr; body mass index, 33.5 kg·m) with radiographic knee OA. Knee moments and joint bone-on-bone forces were calculated using gait analysis and musculoskeletal modeling. Higher total body mass was significantly associated (P ≤ 0.0001) with greater knee compressive and shear forces, compressive and shear impulses (P knee extensor moments (P = 0.003). Regression analysis with total lean and total fat mass as independent variables revealed significant positive associations of total fat mass with knee compressive (P = 0.0001), shear (P knee extension moment (P = 0.008). Gastrocnemius and quadriceps forces were positively associated with total fat mass. Total lean mass was associated with knee compressive force (P = 0.002). A regression model that included total thigh and total abdominal fat found that both were significantly associated with knee compressive and shear forces (P ≤ 0.04). Thigh fat was associated with knee abduction (P = 0.03) and knee extension moment (P = 0.02). Thigh fat, consisting predominately of subcutaneous fat, had similar significant associations with knee joint forces as abdominal fat despite its much smaller volume and could be an important therapeutic target for people with knee OA.

  4. Decreased torque and electromyographic activity in the extensor thigh muscles in chondromalacia patellae.

    Science.gov (United States)

    Väätäinen, U; Airaksinen, O; Jaroma, H; Kiviranta, I

    1995-01-01

    The alterations in thigh muscle properties of chondromalacia patellae patients during isometric and dynamic endurance tests were studied using a variokinetic knee testing system linked to surface EMG. A total of 41 patients (chondromalacia group) with arthroscopically certified chondromalacia of the patella were studied. The control group consisted of 31 healthy adult volunteers with no history of knee pain or trauma. Peak torque values were 21% (p chondromalacia group than in the control group. The decrease in the ratio between integrated EMG (IEMG) and measured force were found in all parts of the quadriceps femoris muscle in patients with chondromalacia of the patella in isometric extension. No change in the normalized IEMG levels of the thigh muscles were found between chondromalacia patients and controls in dynamic endurance test. The severity of the chondromalacia of the patella did not affect the level of electromyographic activation in thigh muscles. The ratio of normalized EMG levels of vastus medialis and vastus lateralis did not differ between the groups. The present study showed that chondromalacia patellae patients have reduced force and electromyographic activation levels of quadriceps femoris muscle. Especially, the explosive strength of the quadriceps femoris muscle is reduced.

  5. The effect of calf neuromuscular electrical stimulation and intermittent pneumatic compression on thigh microcirculation.

    Science.gov (United States)

    Bahadori, Shayan; Immins, Tikki; Wainwright, Thomas W

    2017-05-01

    This study compares the effectiveness of a neuromuscular electrical stimulation (NMES) device and an intermittent pneumatic compression (IPC) device on enhancing microcirculatory blood flow in the thigh of healthy individuals, when stimulation is carried out peripherally at the calf. Blood microcirculation of ten healthy individuals was recorded using laser speckle contrast imaging (LSCI) technique. A region of interest (ROI) was marked on each participant thigh. The mean flux within the ROI was calculated at four states: rest, NMES device with visible muscle actuation (VMA), NMES device with no visible muscle actuation (NVMA) and IPC device. Both NMES and IPC devices increased blood flow in the thigh when stimulation was carried out peripherally at the calf. The NMES device increased mean blood perfusion from baseline by 399.8% at the VMA state and 150.6% at the NVMA state, IPC device increased the mean blood perfusion by 117.3% from baseline. The NMES device at VMA state increased microcirculation by more than a factor of 3 in contrast to the IPC device. Even at the NVMA state, the NMES device increased blood flow by 23% more than the IPC device. Given the association between increased microcirculation and reduced oedema, NMES may be a more effective modality than IPC at reducing oedema, therefore further research is needed to explore this. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Movement anatomy of the gluteal region and thigh of the giant anteater Myrmecophaga tridactyla (Myrmecophagidae: Pilosa

    Directory of Open Access Journals (Sweden)

    Priscilla Rosa Queiroz Ribeiro

    2016-06-01

    Full Text Available Abstract: Locomotion reveals the displacement and behavior manner of the species in their daily needs. According to different needs of the several species, different locomotor patterns are adopted. The shapes and attachment points of muscles are important determinants of the movements performed and consequently, the locomotion and motion patterns of living beings. It was aimed to associate anatomical, kinesiology and biomechanics aspects of the gluteal region and thigh of the giant anteater to its moving characteristics and locomotor habits. It was used three specimens of Myrmecophaga tridactyla, settled in formaldehyde aqueous solution at 10% and subsequently, dissected using usual techniques in gross anatomy. The morphological characteristics of the gluteal region and thigh that influence the patterns of movement and locomotion of animals, were analyzed and discussed in light of literature. All muscles of the gluteal region and thigh of giant anteater show parallel arrangement of the muscular fibers, being flat or fusiform. These muscles are formed in the joint which the interpotent type biolever act. These morphological characteristics indicate a greater predominance of amplitude and movement speed at the expense of strength. On the other hand, features such as osteometric index and the observation of giant anteater motion indicate the opposite, what reflects this animal lack of expertise in locomotor habits and shows the need of future realization of more detailed studies in this subject.

  7. Effects of thigh holster use on kinematics and kinetics of active duty police officers.

    Science.gov (United States)

    Larsen, Louise Bæk; Tranberg, Roy; Ramstrand, Nerrolyn

    2016-08-01

    Body armour, duty belts and belt mounted holsters are standard equipment used by the Swedish police and have been shown to affect performance of police specific tasks, to decrease mobility and to potentially influence back pain. This study aimed to investigate the effects on gait kinematics and kinetics associated with use of an alternate load carriage system incorporating a thigh holster. Kinematic, kinetic and temporospatial data were collected using three dimensional gait analysis. Walking tests were conducted with nineteen active duty police officers under three different load carriage conditions: a) body armour and duty belt, b) load bearing vest, body armour and thigh holster and c) no equipment (control). No significant differences between testing conditions were found for temporospatial parameters. Range of trunk rotation was reduced for both load carriage conditions compared to the control condition (p<0.017). Range of hip rotation was more similar to the control condition when wearing thigh holster rather than the belt mounted hip holster (p<0.017). Moments and powers for both left and right ankles were significantly greater for both of the load carriage conditions compared to the control condition (p<0.017). This study confirms that occupational loads carried by police have a significant effect on gait kinematics and kinetics. Although small differences were observed between the two load carriage conditions investigated in this study, results do not overwhelmingly support selection of one design over the other. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Oxidative stability of cnicken thigh meat after treatment of abies alba essential oil

    Directory of Open Access Journals (Sweden)

    Adriana Pavelková

    2015-12-01

    Full Text Available In the present work, the effect of the Abies alba essential oil in two different concentrations on oxidative stability of chicken thigh muscles during chilled storage was investigated. In the experiment were chickens of hybrid combination Cobb 500 after 42 days of the fattening period slaughtered.  All the broiler chickens were fed with the same feed mixtures and were kept under the same conditions. The feed mixtures were produced without any antibiotic preparations and coccidiostatics. After slaughtering was dissection obtained fresh chicken thigh with skin from left half-carcass which were divided into five groups (n = 5: C - control air-packaged group; A1 - vacuum-packaged experimental group; A2 - vacuum-packaged experimental group with ethylenediaminetetraacetic acid (EDTA solution 1.50% w/w; A3 - vacuum-packaged experimental group with Abies alba oil 0.10% v/w and A4 - vacuum-packaged experimental group with Abies alba oil 0.20% v/w. The Abies alba essential oil was applicate on ground chicken things and immediately after dipping, each sample was packaged using a vacuum packaging machine and storage in refrigerate at 4 ±0.5 °C. Thiobarbituric acid (TBA value expressed in number of malondialdehyde was measured in the process of first storage day of 1st, 4th, 8th, 12th and 16th day after slaughtering and expressed on the amount of malondialdehyde (MDA in 1 kg sample. The treatments of chicken things with Abies alba essential oil show statistically significant differences between all testing groups and control group, where higher average value of MDA measured in thigh muscle of broiler chickens was in samples of control group (0.4380 mg.kg-1 compared to experimental groups A1 (0.124 mg.kg-1, A2 (0.086 mg.kg-1, A3 (0.082 mg.kg-1 and A4 (0.077 mg.kg-1 after 16-day of chilled storage. Experiment results show that the treatment of chicken thigh with Abies alba essential oil positively influenced on the reduction of oxidative processes in thigh

  9. An improved dual approach to post bariatric contouring - Staged liposuction and modified medial thigh lift: A case series

    Directory of Open Access Journals (Sweden)

    Zaher Jandali

    2014-01-01

    Full Text Available Objective: Following massive weight loss (MWL medial contouring of the thigh is frequently requested to improve appearance and function. Thigh lifting can be associated with significant complications. We present a case series of post bariatric patients undergoing thigh lift using staged the liposuction, a modified T incision and a buried de-epithelialised dermal flap. Materials and Methods: From January to December 2012, 21 consecutive patients underwent a modified medial thigh lift. A retrospective review of the case notes was performed to assess complications that occurred. Results: There were no major post-operative complications in terms of reoperation, hematoma, thromboembolism and no seromas. Seven patients, all of which were smokers had minor superficial wound healing complications. Aesthetic outcomes were satisfactory for all patients at a minimum follow-up of 6 months. Conclusions: The modified ′T′ incision with staged liposuction is described. We have found the technique to be useful for a variety of different thighs. It is a reproducible method for contouring the medial thigh in MWL patients. In this series, our overall complications were low, and no seromas occurred.

  10. Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer

    DEFF Research Database (Denmark)

    Bendixen, Morten; Jørgensen, Ole Dan; Kronborg, Christian

    2016-01-01

    (1:1) to lobectomy via four-port VATS or anterolateral thoracotomy. After surgery, we applied identical surgical dressings to ensure masking of patients and staff. Postoperative pain was measured with a numeric rating scale (NRS) six times per day during hospital stay and once at 2, 4, 8, 12, 26......, and 52 weeks, and self-reported quality of life was assessed with the EuroQol 5 Dimensions (EQ5D) and the European Organisation for Research and Treatment of Cancer (EORTC) 30 item Quality of Life Questionnaire (QLQ-C30) during hospital stay and 2, 4, 8, 12, 26, and 52 weeks after discharge. The primary...... died during the follow-up period (three in the VATS group and six in the thoracotomy group). INTERPRETATION: VATS is associated with less postoperative pain and better quality of life than is anterolateral thoracotomy for the first year after surgery, suggesting that VATS should be the preferred...

  11. Triple pelvic osteotomy in Legg-Calve-Perthes disease using a single anterolateral incision: a 4-year review.

    LENUS (Irish Health Repository)

    Conroy, Eimear

    2010-07-01

    Femoral head incongruency at skeletal maturity is associated with the development of osteoarthritis in early adulthood. Containment of the femoral head provides a larger surface area for remodelling of the collapsed femoral head and the development of spherical congruency. Triple pelvic osteotomy has a role to play in Legg-Calve-Perthes\\' disease by improving femoral head containment and preventing subluxation. This is traditionally a two-incision approach with significant associated morbidity. In our unit we perform triple osteotomies through a single anterolateral incision. To retrospectively review the clinical and radiographic outcome of children who had triple osteotomies performed through a single incision over a 4-year period. In our unit from 2003 to 2006 we performed eight triple osteotomies through a single incision in children aged between 6 and 12 years with Legg-Calve-Perthes\\' disease. The procedure was performed through a single anterolateral incision made beneath the middle of the iliac crest and carried forward according to Salter\\'s osteotomy. Image intensification was used to confirm iliac, pubic and ischial cuts. After performing a standard Salter\\'s osteotomy the acetabular fragment was free to rotate anteriorly and laterally. None of the children were casted and all were allowed immediate mobilization nonweight bearing with crutches for 6 weeks. Clinical results and hip function were measured preoperatively and postoperatively using the modified Harris hip score. The average length of hospital stay was 4.7 days. None of the children had a nonunion. The centre edge angle of Wiberg was measured on all preoperative and postoperative anteroposterior pelvic radiographs. In all our patients there was an improvement in the centre edge angle of Wiberg and in the modified Harris hip score. The preoperative modified Harris hip scores ranged from 38 to 60 and postoperatively ranged from 77 to 92. The preoperative centre edge angle of Wiberg ranged

  12. The Effect of Polymethyl Methacrylate Augmentation on the Primary Stability of Cannulated Bone Screws in an Anterolateral Plate in Osteoporotic Vertebrae: A Human Cadaver Study.

    Science.gov (United States)

    Rüger, Matthias; Sellei, Richard M; Stoffel, Marcus; von Rüden, Christian

    2016-02-01

    Study Design Cohort study. Objective Expandable anterolateral plates facilitate the reduction of posttraumatic deformities of thoracolumbar spine injuries and are commonly used in cases of unstable injuries or compromised bone quality. In this in vitro study, the craniocaudal yield load of the osseous fixation of an anterior angular stable plate fixation system and the effect of polymethyl methacrylate (PMMA) screw augmentation on the primary stability of the screw-bone interface during kyphosis reduction was evaluated in 12 osteoporotic human thoracolumbar vertebrae. Methods The anterolateral stabilization device used for this study is comprised of two swiveling flanges and an expandable midsection. It facilitates the controlled reduction of kyphotic deformities in situ with a geared distractor. Single flanges were attached to 12 thoracolumbar vertebrae. Six specimens were augmented with PMMA by means of cannulated bone screws. The constructs were subjected to static, displacement-controlled craniocaudal loading to failure in a servohydraulic testing machine. Results The uncemented screws cut out at a mean 393 ± 66 N, whereas the cemented screws showed significantly higher yield load of 966 ± 166 N (p augmentation is an effective method to increase two- to threefold the primary stability of the screw-bone interface of an anterolateral spine stabilization system in osteoporotic bone. We recommend it in cases of severely compromised bone quality to reduce the risk of screw loosening during initial kyphosis correction and to increase long-term construct stability.

  13. Noninvasive lifting of arm, thigh, and knee skin with transcutaneous intense focused ultrasound.

    Science.gov (United States)

    Alster, Tina S; Tanzi, Elizabeth L

    2012-05-01

    Transcutaneous intense focused ultrasound is a novel Food and Drug Administration-approved technology for noninvasive skin tightening of the face and neck. No studies have reported on its safety and effectiveness on nonfacial areas. Eighteen paired areas (6 each) on the upper arms, medial thighs, and extensor knees were randomly treated with two different transducers (4.0 MHz, 4.5-mm focal depth and 7.0 MHz, 3.0-mm focal depth). One side was randomly assigned to receive a single pass (single plane) of microthermal coagulation zones over the involved area with the 4.0 MHz, 4.5-mm-depth transducer, and the contralateral side was assigned to receive consecutive single passes (dual plane) using both transducers (4.0 MHz, 4.5-mm depth followed by 7.0 MHz, 3.0-mm depth). Two independent masked assessors determined clinical improvement scores using comparative standardized photographs obtained at baseline and 3 and 6 months after treatment. Subjective assessments of clinical improvement and side effects of treatment were obtained. Global assessment scores revealed significant improvement in all treated areas, with the upper arms and knees demonstrating more skin lifting and tightening than the thighs. Areas receiving dual-plane treatment had slightly better clinical scores than those receiving single-plane treatment in all three sites. Clinical scores from single-plane and dual-plane treated areas continued to improve between 3 and 6 months after treatment. Side effects were mild and transient and included erythema, warmth, and skin tenderness. Rare focal bruising was noted in two patients on the upper arms that resolved within 7 days. No other side effects were reported or observed. Transcutaneous intense focused ultrasound can be safely and effectively used to improve the clinical appearance (texture and contour) of the upper arms, extensor knees, and medial thighs. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  14. EFFECT OF GENOTYPE, SEX AND KEEPING TECHNOLOGY ON THE CHEMICAL COMPOUNDS OF BREAST AND THIGH MEAT

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    SZ. KONRÁD

    2009-10-01

    Full Text Available In the recent decades because of the alternative poultry meat production technologies (free range and organic farming, which are gaining ground in some of the European countries, only special slow growing breeds and hybrids can be used. The end products created by crossing the indigenous Yellow Hungarian hen with different meat type cocks were suitable for alternative keeping technology. The valuable meat parts of the pure bred Yellow Hungarian kept in free range for 84 days and the end product created with crossing (first group as well as the valuable meat parts of Ross 308 broilers fattened for 42 days in intensive keeping technology (second group were thoroughly examined in order to establish whether the genotype, sex and/or keeping technology has any kind of influence on different chemical parameters of the meat. There were no essential differences between the dry matter content of breast meat of the two different keeping technology groups (25.34 and 26.25%. However, dry matter content of thigh was 5.28 to 7.48 percentage points higher in the second group. Protein contents of breast and thigh meat were not affected by the keeping technology. Fat content of thigh meat was two and a half times higher than in the first group (6.03 and 13.73%. Thus, this study have revealed that only the ash content of breast meat affected from the keeping technology, as this parameter was higher in the first group than the second group (0.84 to 1.05 % vs 0.53 %.

  15. Spontaneous Compartment Syndrome of the Thigh in the Absence of Trauma.

    Science.gov (United States)

    Javedani, Parisa P; Ratnabalasuriar, Radhika; Grall, Kristi J H

    2016-07-01

    Compartment syndrome occurs when an increase in pressure results in vascular and functional impairment of the underlying nerve and muscles. Thigh compartment syndrome (TCS) is uncommon, but clinical suspicion warrants emergent surgical consultation and fasciotomy. We present a 42-year-old man evaluated for right lateral thigh pain, without a history of trauma, deep venous thrombosis (DVT), previous surgery, or intravenous drug use. He was febrile, tachycardic, with a mild leukocytosis, an elevated C-reactive protein level, and an elevated creatinine kinase level. Radiographs showed no abnormality and right lower extremity duplex ultrasound showed no DVT. A computed tomography scan of the right lower extremity was concerning for compartment syndrome. Surgical consultation was obtained, and the patient was taken to the operating room for fasciotomy. He was diagnosed with compartment syndrome intraoperatively. The patient was discharged on hospital day 10. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: TCS is exceedingly rare, especially in the absence of underlying traumatic and nontraumatic etiologies. The diagnosis is challenging because more elastic fascia with larger space in the thigh allows for accommodation of acute increases in pressure. Consequently, there may not be the expected acute rise in compartment pressures; increased compartment pressure may only be a late sign, when underlying neurovascular damage has already occurred. TCS is complicated by high morbidity and mortality. Emergent surgical consultation should be obtained when there is a high clinical suspicion for TCS, and limb-saving fasciotomy should not be delayed. This case shows the importance of a high level of suspicion for TCS in patients with no identifiable etiology and no historical risk factors for development of compartment syndrome, because TCS may not present with classic symptoms. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Reliability of computed tomography measurements in assessment of thigh muscle cross-sectional area and attenuation

    International Nuclear Information System (INIS)

    Strandberg, Sören; Wretling, Marie-Louise; Wredmark, Torsten; Shalabi, Adel

    2010-01-01

    Advancement in technology of computer tomography (CT) and introduction of new medical imaging softwares enables easy and rapid assessment of muscle cross-sectional area (CSA) and attenuation. Before using these techniques in clinical studies there is a need for evaluation of the reliability of the measurements. The purpose of the study was to evaluate the inter- and intra-observer reliability of ImageJ in measuring thigh muscles CSA and attenuation in patients with anterior cruciate ligament (ACL) injury by computer tomography. 31 patients from an ongoing study of rehabilitation and muscle atrophy after ACL reconstruction were included in the study. Axial CT images with slice thickness of 10 mm at the level of 150 mm above the knee joint were analyzed by two investigators independently at two times with a minimum of 3 weeks between the two readings using NIH ImageJ. CSA and the mean attenuation of individual thigh muscles were analyzed for both legs. Mean CSA and mean attenuation values were in good agreement both when comparing the two observers and the two replicates. The inter- and intraclass correlation (ICC) was generally very high with values from 0.98 to 1.00 for all comparisons except for the area of semimembranosus. All the ICC values were significant (p < 0,001). Pearson correlation coefficients were also generally very high with values from 0.98 to 1.00 for all comparisons except for the area of semimembranosus (0.95 for intraobserver and 0.92 for interobserver). This study has presented ImageJ as a method to monitor and evaluate CSA and attenuation of different muscles in the thigh using CT-imaging. The method shows an overall excellent reliability with respect to both observer and replicate

  17. Whipple's procedure for an oligometastasis to the pancreas from a leiomyosarcoma of the thigh.

    Science.gov (United States)

    Burke, J P; Maguire, D; Dillon, J; Moriarty, M; O'Toole, G C

    2012-09-01

    Pancreatic tumours are most frequently primary, with lesions secondary to metastasis uncommon. This report describes the case of a 61-year-old man who underwent resection of a right thigh leiomyosarcoma 2 years prior to presentation with obstructive jaundice. Subsequent CT and endoscopic ultrasound (EUS) diagnosed metastatic leiomyosarcoma to the pancreatic head for which he underwent a Whipple's pancreaticoduodenectomy. Metastasis from an extremity leiomyosarcoma to the pancreas is an extremely rare entity, which can be diagnosed by EUS and treated successfully by pancreaticoduodenectomy.

  18. Compartment syndrome of the thigh complicating surgical treatment of ipsilateral femur and ankle fractures

    Science.gov (United States)

    Moore, M. R.; Garfin, S. R.; Hargens, A. R.

    1987-01-01

    A 26-year-old man presented with ipsilateral femur and ankle fractures. The patient was treated with interlocking nail of his femur fracture, followed by open reduction and internal fixation of his ankle fracture under tourniquet control. Postoperatively, the patient developed compartment syndrome of his thigh with elevated pressures, requiring decompressive fasciotomies. This case illustrates the possible complication of treating a femur fracture with intramedullary nailing and then immediately applying a tourniquet to treat an ipsilateral extremity fracture. Because of the complication with this patient, we feel the procedure should be staged, or a tourniquet should be avoided if possible.

  19. Evaluation of [sup 99m]Tc-HM-PAO thigh accumulation in patients with cerebro-vascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Nishigaki, Hiroshi; Adachi, Itaru; Komori, Tsuyoshi; Tatsu, Yoshimitsu; Hisada, Youichi; Sueyoshi, Kouzou; Narabayashi, Isamu (Osaka Medical College, Takatsuki (Japan))

    1993-06-01

    Technetium-99m d,l-hexamethyl-propyleneamine oxime ([sup 99m]Tc-HM-PAO) cerebral SPECT and whole body scintigraphy (WBS) were performed in 5 patients without cerebro-vascular disease (CVD) (Group 1), 31 patients with CVD but not hemiparesis (Group 2) and 18 patients with CVD and hemiparesis (Group 3). Four ROIs were drawn manually around the whole body (WB), brain (Br), right and left thigh (Th). We calculated some ratios: the total counts in the brain over the total counts in the whole body (Br/WB), the total counts in the thigh over the total counts in the whole body (Th/WB) and the mean counts in the thigh over the mean counts in the brain (Th/Br).The Br/WB was 6.9[+-]1.8%, rt-Th/WB was 4.9[+-]2.1%, lt-Th/WB was 5.1[+-]1.3% and Th/Br was 0.46[+-]0.17 in group 1. Whole body scintigraphies in group 1 revealed clear and similar images between right and left thigh. The Br/WB was 6.7[+-]1.4%, Th/WB of paretic side was 4.6[+-]1.0%, Th/WB of non-paretic side was 5.8[+-]1.2% and Th/Br was 0.47[+-]0.18 in group 3. The Th/WB in non paretic side was significantly higher than that in paretic side (p<0.01). The thigh images in group 3 revealed clear differences between paretic and non-paretic thighes. In conclusion we could acquire the clear thigh images with [sup 99m]Tc-HM-PAO. It was possible that we evaluated not only cerebral perfusion but also muscle atrophy and/or perfusion in patients with CVD using [sup 99m]Tc-HM-PAO. (author).

  20. Reconstrucción cervical tras resección de neurofibroma solitario gigante con colgajo anterolateral de muslo

    Directory of Open Access Journals (Sweden)

    Mauricio Mendieta-Espinosa

    Full Text Available Los tumores de cabeza y cuello son un grupo heterogéneo; los neurofibromas pueden originarse de cualquier nervio independientemente de su localización, incluyendo nervios periféricos o intracraneales y se dividen en 4 tipos. Los solitarios son tumores confinados, espontáneos y prácticamente sin ninguna manifestación. Anatómicamente, los neurofibromas del cuello son relativamente raros, con un crecimiento lento e indoloro. Presentamos el caso de un paciente varón de 41 años de edad, remitido a nuestra consulta por presentar neurofibroma solitario gigante en la base del lado izquierdo del cuello, de 10 cm de diámetro, con zona central ulcerada y sangrados intermitentes, adherido a planos profundos, de 30 años de evolución y que había sido tratado en 3 ocasiones con resecciones parciales y cubertura con colgajo acromial. Practicamos resección completa de la tumoración y reconstrucción inmediata con colgajo anterolateral de muslo, logrando la mejoría estético-funcional de la zona cervical y sin complicaciones.

  1. Anterolateral corridor approach to the infratemporal fossa and central skull base in maxillectomy: rationale and technical aspects.

    Science.gov (United States)

    McMahon, Jeremy D; Crowther, John; Taylor, William M; Wong, Ling Siew; Paterson, Tom; Devine, John; Wales, Craig; MacIver, Colin

    2015-11-01

    We describe the technical aspects and report our clinical experience of a surgical approach to the infratemporal fossa that aims to reduce local recurrence after operations for cancer of the posterior maxilla. We tested the technique by operating on 3 cadavers and then used the approach in 16 patients who had posterolateral maxillectomy for disease that arose on the maxillary alveolus or junction of the hard and soft palate (maxillary group), and in 19 who had resection of the masticatory compartment and central skull base for advanced sinonasal cancer (sinonasal group). Early proximal ligation of the maxillary artery was achieved in all but one of the 35 patients. Access to the infratemporal fossa enabled division of the pterygoid muscles and pterygoid processes under direct vision in all cases. No patient in the maxillary group had local recurrence at median follow up of 36 months. Four patients (21%) in the sinonasal group had local recurrence at median follow up of 27 months. Secondary haemorrhage from the cavernous segment of the internal carotid artery resulted in the only perioperative death. The anterolateral corridor approach enables controlled resection of tumours that extend into the masticatory compartment. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. Anterolateral ligament abnormalities in patients with acute anterior cruciate ligament rupture are associated with lateral meniscal and osseous injuries

    Energy Technology Data Exchange (ETDEWEB)

    Dyck, Pieter van; Smet, Eline de; Gielen, Jan L.; Parizel, Paul M. [Antwerp University Hospital and University of Antwerp, Department of Radiology, Antwerp (Belgium); Clockaerts, Stefan [University College Hospitals, Department of Orthopaedics, London (United Kingdom); Vanhoenacker, Filip M. [Antwerp University Hospital and University of Antwerp, Department of Radiology, Antwerp (Belgium); Ghent University Hospital and University of Ghent, Department of Radiology, Ghent (Belgium); AZ St-Maarten, Department of Radiology, Antwerp (Belgium); Lambrecht, Valerie [Ghent University Hospital and University of Ghent, Department of Radiology, Ghent (Belgium); Wouters, Kristien [Antwerp University Hospital and University of Antwerp, Department of Biostatistics, Antwerp (Belgium)

    2016-10-15

    To determine the frequency of anterolateral ligament (ALL) injury in patients with acute anterior cruciate ligament (ACL) rupture and to analyse its associated injury patterns. Ninety patients with acute ACL rupture for which MRI was obtained within 8 weeks after the initial trauma were retrospectively identified. Two radiologists assessed the status of the ALL on MRI by consensus. The presence or absence of an ALL abnormality was compared with the existence of medial and lateral meniscal tears diagnosed during arthroscopy. Associated collateral ligament and osseous injuries were documented with MRI. Forty-one of 90 knees (46 %) demonstrated ALL abnormalities on MRI. Of 49 knees with intact ALL, 15 (31 %) had a torn lateral meniscus as compared to 25 torn lateral menisci in 41 knees (61 %) with abnormal ALL (p = 0.008). Collateral ligament (p ≤ 0.05) and osseous injuries (p = 0.0037) were more frequent and severe in ALL-injured as compared with ALL-intact knees. ALL injuries are fairly common in patients with acute ACL rupture and are statistically significantly associated with lateral meniscal, collateral ligament and osseous injuries. (orig.)

  3. Repair and regeneration of vertebral body after antero-lateral partial vertebrectomy using beta-tricalcium phosphate

    International Nuclear Information System (INIS)

    Momma, Fumiyuki; Amagasa, Masaharu; Nakazawa, Teruo

    2008-01-01

    Antero-lateral partial vertebrectomy (ALPV) was used for decompression in 91 patients with multilevel cervical disorders. The high-speed drill was used to excise about 1/3 of the vertebral body for relief of anterior compression of the cord and nerve roots under the operating microscope. The key point was opening of the medial wall of the foramen of transverse process at the beginning of the ALPV, allowing the determination of the lateral borders of the ALPVs. To repair and regenerate the vertebral body, a beta-tricalcium phosphate (β-TCP) block was trimmed into a cuneiform shape and implanted into the sites of the ALPV excluding the upper and lowermost vertebral bodies. Postoperative computed tomography confirmed that β-TCP was gradually replaced by newly formed bone from the surface towards the center of the block, and that the affected vertebral body was remodeled by 6 to 12 months after the implantation of β-TCP. The cortical bone borders on the bone marrow at the site of the regeneration. The pedicles on the side of the ALPVs were rebuilt during regeneration of the affected vertebrae. Thus, the vertebral foramen of the cervical spine was widened in the anterior direction at the levels of the ALPVs, resulting in restoration of the physiological size of the cervical cord. The cervical curvature remained unchanged and a certain degree of cervical mobility (mean 86%) was preserved in this series. (author)

  4. Anterolateral Approach for Central Thoracic Disc Prolapse-Surgical Strategies Used to Tackle Differing Operative Findings: 3-Dimensional Operative Video.

    Science.gov (United States)

    Patel, Krunal; Budohoski, Karol P; Kenyon, Olivia R P; Barone, Damiano G; Santarius, Thomas; Kirollos, Ramez W; Mannion, Richard J; Trivedi, Rikin A

    2018-04-02

    Thoracic disc prolapses causing cord compression can be challenging. For compressive central disc protrusions, a posterior approach is not suitable due to an unacceptable level of cord manipulation. An anterolateral transthoracic approach provides direct access to the disc prolapse allowing for decompression without disturbing the spinal cord. In this video, we describe 2 cases of thoracic myelopathy from a compressive central thoracic disc prolapse. In both cases, informed consent was obtained. Despite similar radiological appearances of heavy calcification, intraoperatively significant differences can be encountered. We demonstrate different surgical strategies depending on the consistency of the disc and the adherence to the thecal sac. With adequate exposure and detachment from adjacent vertebral bodies, soft discs can be, in most instances, separated from the theca with minimal cord manipulation. On the other hand, largely calcified discs often present a significantly greater challenge and require thinning the disc capsule before removal. In cases with significant adherence to dura, in order to prevent cord injury or cerebrospinal fluid leak a thinned shell can be left, providing total detachment from adjacent vertebrae can be achieved. Postoperatively, the first patient, with a significantly calcified disc, developed a transient left leg weakness which recovered by 3-month follow-up. This video outlines the anatomical considerations and operative steps for a transthoracic approach to a central disc prolapse, whilst demonstrating that computed tomography appearances are not always indicative of potential operative difficulties.

  5. An investigation of the relation between the 30 meter running time and the femoral volume fraction in the thigh

    Directory of Open Access Journals (Sweden)

    MY Tasmektepligil

    2009-12-01

    Full Text Available Leg components are thought to be a related to speed. Only a limited number of studies have, however, examined the interaction between speed and bone size. In this study, we examined the relationship between the time taken by football players to run thirty meters and the fraction which the femur forms compared to the entire thigh region. Data collected from thirty male football players of average age 17.3 (between 16-19 years old were analyzed. First we detected the thirty meter running times and then we estimated the volume fraction of the femur to the entire thigh region using stereological methods on magnetic resonance images. Our data showed that there was a highly negative relationship between the 30 meter running times and the volume fraction of the bone to the thigh region. Thus, 30 meter running time decreases as the fraction of the bone to the thigh region increases. In other words, speed increases as the fraction of bone volume increases. Our data indicate that selecting sportsman whose femoral volume fractions are high will provide a significant benefit to enhancing performance in those branches of sports which require speed. Moreover, we concluded that training which can increase the bone volume fraction should be practiced when an increase in speed is desired and that the changes in the fraction of thigh region components should be monitored during these trainings.

  6. Dietary oxidized poultry offal fat: broiler performance and oxidative stability of thigh meat during chilled storage

    Directory of Open Access Journals (Sweden)

    AMC Racanicci

    2008-03-01

    Full Text Available Two experiments were conducted to evaluate the effects of dietary oxidized poultry offal fat on the performance of broilers and on the oxidative stability of dark chicken meat. One hundred and sixty male chicks were fed a corn-soybean meal diet containing 4% fresh or oxidized poultry fat from 10 to 47 days of age. Fresh fat was stored frozen until diets were produced, and oxidized fat was obtained by electrical heating (110 to 120 ºC. Birds were slaughtered at 47 days of age, and carcass characteristics were measured. Skinless and deboned thigh meat was stored chilled during 12 days, and samples were periodically collected to assess their quality and oxidative stability. Dietary oxidized fat did not affect bird performance or carcass characteristics. During chilled storage, meat color (L*, a* and b* was not affected by dietary treatments; however, TBARS (Thiobarbituric Acid Reactive Substances values were higher (P<0.05 in thigh meat from chickens fed the oxidized fat, indicating that oxidative stability was adversely affected.

  7. Differentiation of fat, muscle, and edema in thigh MRIs using random forest classification

    Science.gov (United States)

    Kovacs, William; Liu, Chia-Ying; Summers, Ronald M.; Yao, Jianhua

    2016-03-01

    There are many diseases that affect the distribution of muscles, including Duchenne and fascioscapulohumeral dystrophy among other myopathies. In these disease cases, it is important to quantify both the muscle and fat volumes to track the disease progression. There has also been evidence that abnormal signal intensity on the MR images, which often is an indication of edema or inflammation can be a good predictor for muscle deterioration. We present a fully-automated method that examines magnetic resonance (MR) images of the thigh and identifies the fat, muscle, and edema using a random forest classifier. First the thigh regions are automatically segmented using the T1 sequence. Then, inhomogeneity artifacts were corrected using the N3 technique. The T1 and STIR (short tau inverse recovery) images are then aligned using landmark based registration with the bone marrow. The normalized T1 and STIR intensity values are used to train the random forest. Once trained, the random forest can accurately classify the aforementioned classes. This method was evaluated on MR images of 9 patients. The precision values are 0.91+/-0.06, 0.98+/-0.01 and 0.50+/-0.29 for muscle, fat, and edema, respectively. The recall values are 0.95+/-0.02, 0.96+/-0.03 and 0.43+/-0.09 for muscle, fat, and edema, respectively. This demonstrates the feasibility of utilizing information from multiple MR sequences for the accurate quantification of fat, muscle and edema.

  8. Differential Proteome Analysis of Breast and Thigh Muscles between Korean Native Chickens and Commercial Broilers

    Directory of Open Access Journals (Sweden)

    Xian De Liu

    2012-06-01

    Full Text Available The Korean native chickens (Woorimotdak™, KNC and commercial broilers (Ross, CB show obvious differences in meat flavor after cooking. To understand the contribution of protein and peptide for meat flavor, 2-dimensional (2-D gel electrophoresis and matrix-assisted laser desorption-ionization time-of-flight (MALDI-TOF mass spectrometry was performed. A total of 16 protein spots were differentially expressed in the breast and thigh meat between the two breeds. A total of seven protein spots were represented by different levels between KNC and CB for breast meat. Among them three protein spots (TU39149, TU40162 and TU39598 showed increases in their expressions in KNC while other four protein spots (BU40125, BU40119, BU40029 and BU39904 showed increases in CB. All nine protein spots that were represented by different levels between KNC and CB for thigh meat showed increases in their expression in KNC. Phosphoglucomutase 1 (PGM 1, myosin heavy chain (MyHC, heat shock protein B1 (HSP27, cytochrome c reductase (Enzyme Q, Glyoxylase 1, DNA methyltransferase 3B (DNA MTase 3 were identified as the main protein spots by MALDI-TOF mass spectrometry. These results can provide valuable basic information for understanding the molecular mechanism responsible for breed specific differences in meat quality, especially the meat flavour.

  9. Modeling of the pliant surfaces of the thigh and leg during gait

    Science.gov (United States)

    Ball, Kevin A.; Pierrynowski, Michael R.

    1998-05-01

    Rigid Body Modeling, a 6 degree of freedom (DOF) method, provides state of the art human movement analysis, but with one critical limitation; it assumes segment rigidity. A non- rigid 12 DOF method, Pliant Surface Modeling (PSM) was developed to model the simultaneous pliant characteristics (scaling and shearing) of the human body's soft tissues. For validation, bone pins were surgically inserted into the tibia and femur of three volunteers. Infrared markers (44) were placed upon the thigh, leg, and bone pin surfaces. Two synchronized OPTOTRAK/3020TM cameras (Northern Digital Inc., Waterloo, ON) were used to record 120 seconds of treadmill gait per subject. In comparison to the 'gold standard' bone pin rotational results, PSM located the tibia, femur and tibiofemoral joint with root mean square (RMS) errors of 2.4 degrees, 4.0 degrees and 4.6 degrees, respectively. These performances met or exceeded (P less than .01) the current state of the art for surface data, Rigid Surface Modeling. The thigh's measured surface experienced uniform repeatable changes in scale: 40% mediolateral, 5% anterioposterior, 5% superioinferior, and planar shears of: 25 degrees transverse, 15 degrees sagittal, 5 degrees frontal. With the brief exception of push-off, the lower leg demonstrated much greater rigidity: less than 5% scaling and less than 5 degrees shearing. Thus, PSM offers superior 'rigid' estimates of knee motion with the ability to quantify 'pliant' surface changes.

  10. A comparison of patency and interventions in thigh versus Hemodialysis Reliable Outflow grafts for chronic hemodialysis vascular access.

    Science.gov (United States)

    Brownie, Evan R; Kensinger, Clark D; Feurer, Irene D; Moore, Derek E; Shaffer, David

    2016-11-01

    With improvements in medical management and survival of patients with end-stage renal disease, maintaining durable vascular access is increasingly challenging. This study compared primary, assisted primary, and secondary patency, and procedure-specific complications, and evaluated whether the number of interventions to maintain or restore patency differed between prosthetic femoral-femoral looped inguinal access (thigh) grafts and Hemodialysis Reliable Outflow (HeRO; Hemosphere Inc, Minneapolis, Minn) grafts. A single-center, retrospective, intention-to-treat analysis was conducted of consecutive thigh and HeRO grafts placed between May 2004 and June 2015. Medical history, interventions to maintain or restore patency, and complications were abstracted from the electronic medical record. Data were analyzed using parametric and nonparametric statistical tests, Kaplan-Meier survival methods, and multivariable proportional hazards regression and logistic regression. Seventy-six (43 thigh, 33 HeRO) grafts were placed in 61 patients (54% male; age 53 [standard deviation, 13] years). Median follow-up time in the intention-to-treat analysis was 21.2 months (min, 0.0; max, 85.3 months) for thigh grafts and 6.7 months (min, 0.0; max, 56.3 months) for HeRO grafts (P = .02). The groups were comparable for sex, age, coronary artery disease, diabetes mellitus, peripheral vascular disease, and smoking history (all P ≥ .12). One thigh graft (2%) and five HeRO (15%) grafts failed primarily. In the intention-to-treat analysis, patency durations were significantly longer in the thigh grafts (all log-rank P ≤ .01). Point estimates of primary patency at 6 months, 1 year, and 3 years were 61%, 46%, and 4% for the thigh grafts and 25%, 15%, and 6% for the HeRO grafts. Point estimates of assisted primary patency at 6 months, 1 year, and 3 years were 75%, 66%, and 54% for the thigh grafts and 41%, 30%, and 10% for the HeRO grafts. Point estimates of secondary patency at 6

  11. HIV Infection Is Associated with Increased Fatty Infiltration of the Thigh Muscle with Aging Independent of Fat Distribution.

    Directory of Open Access Journals (Sweden)

    Javzandulam Natsag

    Full Text Available Lower muscle density on computed tomography (CT provides a measure of fatty infiltration of muscle, an aspect of muscle quality that has been associated with metabolic abnormalities, weakness, decreased mobility, and increased fracture risk in older adults. We assessed the cross-sectional relationship between HIV serostatus, age, thigh muscle attenuation, and thigh muscle cross-sectional area (CSA.Mean CT-quantified Hounsfield units (HU of the thigh muscle bundle and CSA were evaluated in 368 HIV-infected and 145 HIV-uninfected men enrolled in the Multicenter AIDS Cohort Study (MACS Cardiovascular Substudy using multivariable linear regression. Models all were adjusted for HIV serostatus, age, race, and body mass index (BMI; each model was further adjusted for covariates that differed by HIV serostatus, including insulin resistance, hepatitis C, malignancy, smoking, alcohol use, and self-reported limitation in physical activity.HIV-infected men had greater thigh muscle CSA (p<0.001 but lower muscle density (p<0.001 compared to HIV-uninfected men. Muscle density remained lower in HIV-infected men (p = 0.001 when abdominal visceral adiposity, and thigh subcutaneous adipose tissue area were substituted for BMI in a multivariable model. Muscle density decreased by 0.16 HU per year (p<0.001 of increasing age among the HIV-infected men, but not in the HIV-uninfected men (HIV x age interaction -0.20 HU; p = 0.002.HIV-infected men had lower thigh muscle density compared to HIV-uninfected men, and a more pronounced decline with increasing age, indicative of greater fatty infiltration. These findings suggest that lower muscle quality among HIV-infected persons may be a risk factor for impairments in physical function with aging.

  12. Accuracy and precision of flash glucose monitoring sensors inserted into the abdomen and upper thigh compared with the upper arm.

    Science.gov (United States)

    Charleer, Sara; Mathieu, Chantal; Nobels, Frank; Gillard, Pieter

    2018-06-01

    Nowadays, most Belgian patients with type 1 diabetes use flash glucose monitoring (FreeStyle Libre [FSL]; Abbott Diabetes Care, Alameda, California) to check their glucose values, but some patients find the sensor on the upper arm too visible. The aim of the present study was to compare the accuracy and precision of FSL sensors when placed on different sites. A total of 23 adults with type 1 diabetes used three FSL sensors simultaneously for 14 days on the upper arm, abdomen and upper thigh. FSL measurements were compared with capillary blood glucose (BG) measurements obtained with a built-in FSL BG meter. The aggregated mean absolute relative difference was 11.8 ± 12.0%, 18.5 ± 18.4% and 12.3 ± 13.8% for the arm, abdomen (P = .002 vs arm) and thigh (P = .5 vs arm), respectively. Results of Clarke error grid analysis for the arm and thigh were similar (zone A: 84.9% vs 84.5%; P = .6), while less accuracy was seen for the abdomen (zone A: 69.4%; P = .01). Apart from the first day, the accuracy of FSL sensors on the arm and thigh was more stable across the 14-day wear duration than accuracy of sensors on the abdomen, which deteriorated mainly during week 2 (P < .0005). The aggregated precision absolute relative difference was markedly lower for the arm/thigh (10.9 ± 11.9%) compared with the arm/abdomen (20.9 ± 22.8%; P = .002). Our results indicate that the accuracy and precision of FSL sensors placed on the upper thigh are similar to the upper arm, whereas the abdomen performed unacceptably poorly. © 2018 John Wiley & Sons Ltd.

  13. Test-retest reliability of myofascial trigger point detection in hip and thigh areas.

    Science.gov (United States)

    Rozenfeld, E; Finestone, A S; Moran, U; Damri, E; Kalichman, L

    2017-10-01

    Myofascial trigger points (MTrP's) are a primary source of pain in patients with musculoskeletal disorders. Nevertheless, they are frequently underdiagnosed. Reliable MTrP palpation is the necessary for their diagnosis and treatment. The few studies that have looked for intra-tester reliability of MTrPs detection in upper body, provide preliminary evidence that MTrP palpation is reliable. Reliability tests for MTrP palpation on the lower limb have not yet been performed. To evaluate inter- and intra-tester reliability of MTrP recognition in hip and thigh muscles. Reliability study. 21 patients (15 males and 6 females, mean age 21.1 years) referred to the physical therapy clinic, 10 with knee or hip pain and 11 with pain in an upper limb, low back, shin or ankle. Two experienced physical therapists performed the examinations, blinded to the subjects' identity, medical condition and results of the previous MTrP evaluation. Each subject was evaluated four times, twice by each examiner in a random order. Dichotomous findings included a palpable taut band, tenderness, referred pain, and relevance of referred pain to patient's complaint. Based on these, diagnosis of latent MTrP's or active MTrP's was established. The evaluation was performed on both legs and included a total of 16 locations in the following muscles: rectus femoris (proximal), vastus medialis (middle and distal), vastus lateralis (middle and distal) and gluteus medius (anterior, posterior and distal). Inter- and intra-tester reliability (Cohen's kappa (κ)) values for single sites ranged from -0.25 to 0.77. Median intra-tester reliability was 0.45 and 0.46 for latent and active MTrP's, and median inter-tester reliability was 0.51 and 0.64 for latent and active MTrPs, respectively. The examination of the distal vastus medialis was most reliable for latent and active MTrP's (intra-tester k = 0.27-0.77, inter-tester k = 0.77 and intra-tester k = 0.53-0.72, inter-tester k = 0.72, correspondingly

  14. MRI evaluation of the anterolateral ligament of the knee: assessment in routine 1.5-T scans

    International Nuclear Information System (INIS)

    Partezani Helito, Camilo; Pecora, Jose Ricardo; Camanho, Gilberto Luis; Kawamura Demange, Marco; Partezani Helito, Paulo Victor; Pereira Costa, Hugo; Bordalo-Rodrigues, Marcelo

    2014-01-01

    This study evaluated the ability of routine 1.5-T MRI scans to visualize the anterolateral ligament (ALL) and describe its path and anatomic relations with lateral knee structures. Thirty-nine 1.5-T MRI scans of the knee were evaluated. The scans included an MRI knee protocol with T1-weighted sequences, T2-weighted sequences with fat saturation, and proton density (PD)-weighted fast spin-echo sequences. Two radiologists separately reviewed all MRI scans to evaluate interobserver reliability. The ALL was divided into three portions for analyses: femoral, meniscal, and tibial. The path of the ALL was evaluated with regard to known structural parameters previously studied in this region. At least a portion of the ALL was visualized in 38 (97.8 %) cases. The meniscal portion was most visualized (94.8 %), followed by the femoral (89.7 %) and the tibial (79.4 %) portions. The three portions of the ALL were visualized in 28 (71.7 %) patients. The ALL was characterized with greater clarity on the coronal plane and was visualized as a thin, linear structure. The T1-weighted sequences showed a statistically inferior ligament visibility frequency. With regard to the T2 and PD evaluations, although the visualization frequency in PD was higher for the three portions of the ligament, only the femoral portion showed significant values. The ALL can be visualized in routine 1.5-T MRI scans. Although some of the ligament could be depicted in nearly all of the scans (97.4 %), it could only be observed in its entirety in about 71.7 % of the tests. (orig.)

  15. MRI evaluation of the anterolateral ligament of the knee: assessment in routine 1.5-T scans

    Energy Technology Data Exchange (ETDEWEB)

    Partezani Helito, Camilo; Pecora, Jose Ricardo; Camanho, Gilberto Luis; Kawamura Demange, Marco [University of Sao Paulo, Faculty of Medicine, Institute of Orthopedics and Traumatology, Knee Surgery Division, Sao Paulo (Brazil); Partezani Helito, Paulo Victor; Pereira Costa, Hugo; Bordalo-Rodrigues, Marcelo [University of Sao Paulo, Faculty of Medicine, Institute of Orthopedics and Traumatology, Musculoskeletal Radiology Department, Sao Paulo (Brazil)

    2014-10-15

    This study evaluated the ability of routine 1.5-T MRI scans to visualize the anterolateral ligament (ALL) and describe its path and anatomic relations with lateral knee structures. Thirty-nine 1.5-T MRI scans of the knee were evaluated. The scans included an MRI knee protocol with T1-weighted sequences, T2-weighted sequences with fat saturation, and proton density (PD)-weighted fast spin-echo sequences. Two radiologists separately reviewed all MRI scans to evaluate interobserver reliability. The ALL was divided into three portions for analyses: femoral, meniscal, and tibial. The path of the ALL was evaluated with regard to known structural parameters previously studied in this region. At least a portion of the ALL was visualized in 38 (97.8 %) cases. The meniscal portion was most visualized (94.8 %), followed by the femoral (89.7 %) and the tibial (79.4 %) portions. The three portions of the ALL were visualized in 28 (71.7 %) patients. The ALL was characterized with greater clarity on the coronal plane and was visualized as a thin, linear structure. The T1-weighted sequences showed a statistically inferior ligament visibility frequency. With regard to the T2 and PD evaluations, although the visualization frequency in PD was higher for the three portions of the ligament, only the femoral portion showed significant values. The ALL can be visualized in routine 1.5-T MRI scans. Although some of the ligament could be depicted in nearly all of the scans (97.4 %), it could only be observed in its entirety in about 71.7 % of the tests. (orig.)

  16. Segond fracture: involvement of the iliotibial band, anterolateral ligament, and anterior arm of the biceps femoris in knee trauma

    Energy Technology Data Exchange (ETDEWEB)

    Maeseneer, Michel de; Boulet, Cedric; Willekens, Inneke; Mey, Johan de; Shahabpour, Maryam [Universitair Ziekenhuis Brussel, Department of Radiology, Brussels (Belgium); Lenchik, Leon [Wake Forest University, Department of Radiology, Winston Salem, NC (United States); Cattrysse, Erik [Vrije Universiteit Brussel, Department of Experimental Anatomy, Brussels (Belgium)

    2014-12-04

    To evaluate the involvement of the iliotibial band (ITB), the anterolateral ligament (ALL), and the anterior arm of the biceps femoris in MRI-diagnosed Segond fracture and to evaluate other associated findings of Segond fracture. We retrospectively reviewed the MRI of 13 cases of Segond fracture. The studies included proton density-weighted, T2-weighted, and proton density-weighted with fat saturation images in the three planes. We studied 2 cadaveric specimens with emphasis on the ALL. One cadaveric specimen was dissected while the other was sectioned in the sagittal plane. The mean age of the patients was 36 years (range, 17-52). There were 7 men and 6 women. The mean size of the Segond bone fragment was 8 x 10 x 2 mm. The distance from the tibia varied from 2 to 6 mm. Associated findings included anterior cruciate ligament (ACL) tear (n = 13), medial collateral ligament (MCL) tear (n = 8), meniscocapsular tear of the posterior horn of the medial meniscus (n = 5), and posterolateral corner involvement (n = 4). Bone marrow edema involved the mid-lateral femoral condyle and the posterior tibial plateau on both the medial and the lateral side. Edema at the Segond area was seen, but was limited. Fibular head edema was also seen. The ITB (11 out of 13) and ALL (10 out of 13) inserted on the Segond bone fragment. The anterior arm of the biceps tendon did not insert on the Segond fracture. Associated findings of Segond fracture include ACL tear, MCL tear, medial meniscus tear, and posterolateral corner injury. Both the ITB and the ALL may be involved in the Segond avulsion. The anterior arm of the biceps femoris tendon is not involved. (orig.)

  17. The magnetic resonance imaging appearance of the anterolateral ligament of the knee in association with anterior cruciate rupture

    Energy Technology Data Exchange (ETDEWEB)

    Kosy, Jonathan D.; Schranz, Peter J.; Patel, Anish; Anaspure, Rahul; Mandalia, Vipul I. [Royal Devon and Exeter Hospital, Princess Elizabeth Orthopaedic Centre, Exeter (United Kingdom)

    2017-09-15

    The magnetic resonance imaging (MRI) appearance of the anterolateral ligament (ALL) has been described. However, the appearance of this structure and injury, in the presence of anterior cruciate ligament (ACL) injury, is less well defined. We studied the incidence of injury to the ALL and the pattern of this injury on MRI. Following Institutional Review Board approval, a retrospective study of 375 consecutive MRI studies was performed. Cases were identified from a prospective database of ACL reconstruction patients. Following exclusions, 280 MRIs (277 patients; 197 males: 80 females; mean age 30.2 years, range, 16-54) were evaluated. Injury was defined as full thickness, partial thickness, or an avulsion fracture. Each study was independently assessed by two consultant musculoskeletal radiologists. Injury to the ALL was identified (by at least one observer) in only 10.7% of cases (2.50% full thickness, 7.50% partial thickness, and 0.71% avulsion fracture). There was an almost perfect level of interobserver agreement for both the identification of an injury (κ = 0.854) and grading of injury (κ = 0.858). The MRI incidence of ALL injury was significantly greater within 6 weeks of the knee injury (18.5 vs. 8.37%; p < 0.05). ALL injury was identified in only one-tenth of cases of ACL rupture. MRI changes can be reliably identified with strong agreement between observers. ALL injury is found more frequently on MRI within 6 weeks of the knee injury (compared to scans performed after this time period) suggesting that some injuries may resolve or become less visible. (orig.)

  18. Segond fracture: involvement of the iliotibial band, anterolateral ligament, and anterior arm of the biceps femoris in knee trauma

    International Nuclear Information System (INIS)

    Maeseneer, Michel de; Boulet, Cedric; Willekens, Inneke; Mey, Johan de; Shahabpour, Maryam; Lenchik, Leon; Cattrysse, Erik

    2015-01-01

    To evaluate the involvement of the iliotibial band (ITB), the anterolateral ligament (ALL), and the anterior arm of the biceps femoris in MRI-diagnosed Segond fracture and to evaluate other associated findings of Segond fracture. We retrospectively reviewed the MRI of 13 cases of Segond fracture. The studies included proton density-weighted, T2-weighted, and proton density-weighted with fat saturation images in the three planes. We studied 2 cadaveric specimens with emphasis on the ALL. One cadaveric specimen was dissected while the other was sectioned in the sagittal plane. The mean age of the patients was 36 years (range, 17-52). There were 7 men and 6 women. The mean size of the Segond bone fragment was 8 x 10 x 2 mm. The distance from the tibia varied from 2 to 6 mm. Associated findings included anterior cruciate ligament (ACL) tear (n = 13), medial collateral ligament (MCL) tear (n = 8), meniscocapsular tear of the posterior horn of the medial meniscus (n = 5), and posterolateral corner involvement (n = 4). Bone marrow edema involved the mid-lateral femoral condyle and the posterior tibial plateau on both the medial and the lateral side. Edema at the Segond area was seen, but was limited. Fibular head edema was also seen. The ITB (11 out of 13) and ALL (10 out of 13) inserted on the Segond bone fragment. The anterior arm of the biceps tendon did not insert on the Segond fracture. Associated findings of Segond fracture include ACL tear, MCL tear, medial meniscus tear, and posterolateral corner injury. Both the ITB and the ALL may be involved in the Segond avulsion. The anterior arm of the biceps femoris tendon is not involved. (orig.)

  19. A Prospective Randomized Peri- and Post-Operative Comparison of the Minimally Invasive Anterolateral Approach Versus the Lateral Approach

    Science.gov (United States)

    Landgraeber, Stefan; Quitmann, Henning; Güth, Sebastian; Haversath, Marcel; Kowalczyk, Wojciech; Kecskeméthy, Andrés; Heep, Hansjörg; Jäger, Marcus

    2013-01-01

    There is still controversy as to whether minimally invasive total hip arthroplasty enhances the postoperative outcome. The aim of this study was to compare the outcome of patients who underwent total hip replacement through an anterolateral minimally invasive (MIS) or a conventional lateral approach (CON). We performed a randomized, prospective study of 75 patients with primary hip arthritis, who underwent hip replacement through the MIS (n=36) or CON (n=39) approach. The Western Ontario and McMaster Universities Osteoarthritis Index and Harris Hip score (HHS) were evaluated at frequent intervals during the early postoperative follow-up period and then after 3.5 years. Pain sensations were recorded. Serological and radiological analyses were performed. In the MIS group the patients had smaller skin incisions and there was a significantly lower rate of patients with a positive Trendelenburg sign after six weeks postoperatively. After six weeks the HHS was 6.85 points higher in the MIS group (P=0.045). But calculating the mean difference between the baseline and the six weeks HHS we evaluated no significant differences. Blood loss was greater and the duration of surgery was longer in the MIS group. The other parameters, especially after the twelfth week, did not differ significantly. Radiographs showed the inclination of the acetabular component to be significantly higher in the MIS group, but on average it was within the same permitted tolerance range as in the CON group. Both approaches are adequate for hip replacement. Given the data, there appears to be no significant long term advantage to the MIS approach, as described in this study. PMID:24191179

  20. A prospective randomized peri- and post-operative comparison of the minimally invasive anterolateral approach versus the lateral approach

    Directory of Open Access Journals (Sweden)

    Stefan Landgraeber

    2013-07-01

    Full Text Available There is still controversy as to whether minimally invasive total hip arthroplasty enhances the postoperative outcome. The aim of this study was to compare the outcome of patients who underwent total hip replacement through an anterolateral minimally invasive (MIS or a conventional lateral approach (CON. We performed a randomized, prospective study of 75 patients with primary hip arthritis, who underwent hip replacement through the MIS (n=36 or CON (n=39 approach. The Western Ontario\tand\tMcMaster\tUniversities Osteoarthritis Index and Harris Hip score (HHS were evaluated at frequent intervals during the early postoperative follow-up period and then after 3.5 years. Pain sensations were recorded. Serological and radiological analyses were performed. In the MIS group the patients had smaller skin incisions and there was a significantly lower rate of patients with a positive Trendelenburg sign after six weeks postoperatively. After six weeks the HHS was 6.85 points higher in the MIS group (P=0.045. But calculating the mean difference between the baseline and the six weeks HHS we evaluated no significant differences. Blood loss was greater and the duration of surgery was longer in the MIS group. The other parameters, especially after the twelfth week, did not differ significantly. Radiographs showed the inclination of the acetabular component to be significantly higher in the MIS group, but on average it was within the same permitted tolerance range as in the CON group. Both approaches are adequate for hip replacement. Given the data, there appears to be no significant long term advantage to the MIS approach, as described in this study.

  1. Anterolateral minithoracotomy versus median sternotomy for the treatment of congenital heart defects: a meta-analysis and systematic review.

    Science.gov (United States)

    Ding, Chao; Wang, Chunmao; Dong, Aiqiang; Kong, Minjian; Jiang, Daming; Tao, Kaiyu; Shen, Zhonghua

    2012-05-04

    Anterolateral Minithoracotomy (ALMT) for the radical correction of Congenital Heart Defects is an alternative to Median Sternotomy (MS) due to reduce operative trauma accelerating recovery and yield a better cosmetic outcome after surgery. Our purpose is to conduct whether ALMT would bring more short-term benefits to patients than conventional Median Sternotomy by using a meta-analysis of case-control study in the published English Journal. 6 case control studies published in English from 1997 to 2011 were identified and synthesized to compare the short-term postoperative outcomes between ALMT and MS. These outcomes were cardiopulmonary bypass time, aortic cross-clamp time, intubation time, intensive care unit stay time, and postoperative hospital stay time. ALMT had significantly longer cardiopulmonary bypass times (8.00 min more, 95% CI 0.36 to 15.64 min, p = 0.04). Some evidence proved that aortic cross-clamp time of ALMT was longer, yet not significantly (2.38 min more, 95% CI -0.15 to 4.91 min, p = 0.06). In addition, ALMT had significantly shorter intubation time (1.66 hrs less, 95% CI -3.05 to -0.27 hrs, p = 0.02). Postoperative hospital stay time was significantly shorter with ALMT (1.52 days less, 95% CI -2.71 to -0.33 days, p = 0.01). Some evidence suggested a reduction in ICU stay time in the ALMT group. However, this did not prove to be statistically significant (0.88 days less, 95% CI -0.81 to 0.04 days, p = 0.08). ALMT can bring more benefits to patients with Congenital Heart Defects by reducing intubation time and postoperative hospital stay time, though ALMT has longer CPB time and aortic cross-clamp time.

  2. Demography and conservation of an isolated Spur-thighed tortoise Testudo graeca population in Dobrogea (Romania

    Directory of Open Access Journals (Sweden)

    Gabriel Buică

    2013-06-01

    Full Text Available Spur-thighed tortoise is a vulnerable species. The local declines of populations led to an imperative need for conservation. Testudo graeca reaches its northern range limit in Dobrogea region, Romania. We studied a population from this region, which occupies an enclosed area of 32 ha within Histria Archaeological Complex. Based on a capture-mark-recapture study we estimated the population size of 221 ± 12.2 individuals. The observed density was 5.1 individuals/ha. The predicted population size suggests a relatively high density in relation to the area thus raising attention for a future conservation strategy. The population structure shows reduced sexual dimorphism and an unbiased sex ratio, implying a young population structure. We suggest correlating the future archaeological studies with conservation requirements of tortoises.

  3. Comparative anatomy of the thigh nerves of Cebus libidinosus (Rylands et al., 2000

    Directory of Open Access Journals (Sweden)

    R.A.G.M.F. Aversi-Ferreira

    2011-03-01

    Full Text Available Non-human primates have constituted an important group among animals subjected to various studies. Ethological, evolutionary and paleontological studies have revealed changes in anatomical structures linked to the evolution of primates, considered in studies on the comparative anatomy between Cebus libidinosus and other neotropical monkeys or those from the Old World, and the detailed knowledge on their anatomy may represent an important factor for their preservation and protection when the animals are brought to veterinary clinics after accidents or illnesses. In terms of veterinary importance, sometimes these animals arrive in the veterinary medical clinics after accidents, needing surgery or clinical treatment, but the little data available on anatomy has impaired the correct proceedings. The main justification for studies on C. libidinosus, is due to little information about the anatomy related to C. libidinosus in Brazilian and worldwide scientific literature. In this study, the distribution, enervation and path of the femoral and sciatic nerves of the pelvic limb (thigh of C. libidinosus were studied and these results were compared with literature on the anatomy of humans, chimpanzees and baboons. In general, the enervation model of the four primates is identical, but in specific terms, the differences in enervations indicate evolution convergence closer to the branch of baboons in the evolutionary tree, and these data corroborate other comparative studies in relation to the same primates to vessels, muscles and nerves. In conclusion, the nerve organization in the thigh of C. libidinosus is identical to baboon, chimpanzee and homo, but more similar to baboon. The specific differences found indicate an ancient phylogenic origin to C. libidinosus and baboons (data corroborated by other studies.

  4. Finite element analysis to investigate variability of MR elastography in the human thigh.

    Science.gov (United States)

    Hollis, L; Barnhill, E; Perrins, M; Kennedy, P; Conlisk, N; Brown, C; Hoskins, P R; Pankaj, P; Roberts, N

    2017-11-01

    To develop finite element analysis (FEA) of magnetic resonance elastography (MRE) in the human thigh and investigate inter-individual variability of measurement of muscle mechanical properties. Segmentation was performed on MRI datasets of the human thigh from 5 individuals and FEA models consisting of 12 muscles and surrounding tissue created. The same material properties were applied to each tissue type and a previously developed transient FEA method of simulating MRE using Abaqus was performed at 4 frequencies. Synthetic noise was applied to the simulated data at various levels before inversion was performed using the Elastography Software Pipeline. Maps of material properties were created and visually assessed to determine key features. The coefficient of variation (CoV) was used to assess the variability of measurements in each individual muscle and in the groups of muscles across the subjects. Mean measurements for the set of muscles were ranked in size order and compared with the expected ranking. At noise levels of 2% the CoV in measurements of |G * | ranged from 5.3 to 21.9% and from 7.1 to 36.1% for measurements of ϕ in the individual muscles. A positive correlation (R 2 value 0.80) was attained when the expected and measured |G * | ranking were compared, whilst a negative correlation (R 2 value 0.43) was found for ϕ. Created elastograms demonstrated good definition of muscle structure and were robust to noise. Variability of measurements across the 5 subjects was dramatically lower for |G * | than it was for ϕ. This large variability in ϕ measurements was attributed to artefacts. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Combined Anterolateral, Anterior, and Anteromedial Ankle Impingement in an Adolescent Soccer Player-A Case Report and Review of the Literature.

    Science.gov (United States)

    Cosma, Dan I; Vasilescu, Dana E; Corbu, Andrei; Todor, Adrian; Valeanu, Madalina; Ulici, Alexandru

    2018-01-24

    A unique case of combined anterolateral, anterior, and anteromedial ankle impingement in an adolescent soccer player is presented in this article. To the best of our knowledge, this is the only report of circumferential, massive, anterior ankle impingement in children described in the literature. The importance of proper diagnosis and treatment of such a lesion is illustrated in this case report. We also emphasize that clinical examination combined with 3D computed tomography scan reconstruction is an excellent and cost-effective imaging modality that can help with the diagnosis of anterior ankle impingement. Finally, open surgical treatment showed excellent results in an elite athlete.

  6. [Forensic medical diagnostics of the extent of the thigh skin injury inflicted by motor vehicles of different weight].

    Science.gov (United States)

    Sashko, S Iu; Isakov, V D; Droblenkov, A V

    2011-01-01

    The authors report the results of an experimental study designed to characterize microstructural changes in the thigh skin caused by the impacts simulating the car wheel loads of different intensity. It was shown that histological methods can be used to discriminate between the intensities of traumatic loading on biological tissues.

  7. Long-term outcome of using posterior-thigh fasciocutaneous flaps for the treatment of ischial pressure sores.

    Science.gov (United States)

    Lin, Haodong; Hou, Chunlin; Chen, Aimin; Xu, Zhen

    2010-08-01

    Among the many difficult problems presented by patients with spinal cord injuries, management of ischial pressure ulcers remains challenging for reconstructive surgeons. This study describes the long-term outcome of using posterior-thigh fasciocutaneous flaps for the treatment of ischial pressure sores. Between January 1999 and June 2003, 12 patients with ischial sores were enrolled in this study. All the patients underwent early aggressive surgical debridement followed by surgical reconstruction with a laterally based posterior-thigh fasciocutaneous flap. The follow-up period ranged from 24 months to 97 months (mean, 62 months). All the flaps survived, and there were no partial flap losses. Primary-wound healing occurred in all the cases. In two patients, Grade II ischial pressure sores recurred 24 months and 27 months after the operation. There was no recurrence in the other 10 patients. The posterior-thigh fasciocutaneous pedicled flap was a good method for treating ischial bed sores. This flap could be used to treat recurrences observed after primary bed-sore treatment with other methods. The flap was easy to raise, and it did not cause any donor-site morbidity. The long-term outcome of using posterior-thigh fasciocutaneous flaps for the treatment of ischial pressure sores was generally good. (c) Thieme Medical Publishers.

  8. Can the anterior-posterior thigh diameter be used as an indicator for fetal age using two-dimensional sonography?

    International Nuclear Information System (INIS)

    Ismail, Saad Ramzi

    2008-01-01

    This study evaluated the usefulness and direct correlation of a simple new method of predicting fetal age by measurement of the anterior-posterior thigh diameter (APTD) in a normal 18 to 28 week pregnancies using two-dimensional sonography. Little published research exists in the area of fetal thigh biometry, specifically in the use of the anterior-posterior fetal thigh diameter (APTD). The only study I found was that of fetal thigh circumference. Continuing review of existing practices needs to be coupled with evaluation of alternate or additional methodology. Materials and methods: This was a quantitative prospective study of 55 patients in High Level General Hospital, Alberta, Canada. Anterior-posterior thigh diameters (APTD) were sonographically measured. The normal range for each week of pregnancy was determined five times for reliability. Results: Significant correlation was found between (APTD) and fetal age from simple line regression analysis, with 99.993% confidence intervals at each week from 18 to 28 weeks gestation. There was a correlation of 1 mm APTD per 1 week of fetal age. In addition R > 0.93, P < 0.001. The residual scatter plots confirmed the APTD validity. Conclusion: APTD is a reliable and valid method for assessing fetal age in a normal pregnancy and may be particularly useful when other parameters are unable to accurately predict fetal age. An accurate linear measurement of multiple fetal parameters allows a more complete profile of fetal growth and estimated date of delivery (EDD). APTD may also be useful in identifying fetal growth problems. All of the values of fetal age lie directly on the 'best-fit' regression line. Since the coefficient of determination (Rsq) is very high, this model is very effective

  9. Acute Effects of Lateral Thigh Foam Rolling on Arterial Tissue Perfusion Determined by Spectral Doppler and Power Doppler Ultrasound.

    Science.gov (United States)

    Hotfiel, Thilo; Swoboda, Bernd; Krinner, Sebastian; Grim, Casper; Engelhardt, Martin; Uder, Michael; Heiss, Rafael U

    2017-04-01

    Hotfiel, T, Swoboda, B, Krinner, S, Grim, C, Engelhardt, M, Uder, M, and Heiss, R. Acute effects of lateral thigh foam rolling on arterial tissue perfusion determined by spectral Doppler and power Doppler ultrasound. J Strength Cond Res 31(4): 893-900, 2017-Foam rolling has been developed as a popular intervention in training and rehabilitation. However, evidence on its effects on the cellular and physiological level is lacking. The aim of this study was to assess the effect of foam rolling on arterial blood flow of the lateral thigh. Twenty-one healthy participants (age, 25 ± 2 years; height, 177 ± 9 cm; body weight, 74 ± 9 kg) were recruited from the medical and sports faculty. Arterial tissue perfusion was determined by spectral Doppler and power Doppler ultrasound, represented as peak flow (Vmax), time average velocity maximum (TAMx), time average velocity mean (TAMn), and resistive index (RI), and with semiquantitative grading that was assessed by 4 blindfolded investigators. Measurement values were assessed under resting conditions and twice after foam rolling exercises of the lateral thigh (0 and 30 minutes after intervention). The trochanteric region, mid portion, and distal tibial insertion of the lateral thigh were representative for data analysis. Arterial blood flow of the lateral thigh increased significantly after foam rolling exercises compared with baseline (p ≤ 0.05). We detected a relative increase in Vmax of 73.6% (0 minutes) and 52.7% (30 minutes) (p power Doppler scores at all portions revealed increased average grading of 1.96 after intervention and 2.04 after 30 minutes compared with 0.75 at baseline. Our results may contribute to the understanding of local physiological reactions to self-myofascial release.

  10. Anterolateral minithoracotomy versus median sternotomy for the treatment of congenital heart defects: a meta-analysis and systematic review

    Directory of Open Access Journals (Sweden)

    Ding Chao

    2012-05-01

    Full Text Available Abstract Background Anterolateral Minithoracotomy (ALMT for the radical correction of Congenital Heart Defects is an alternative to Median Sternotomy (MS due to reduce operative trauma accelerating recovery and yield a better cosmetic outcome after surgery. Our purpose is to conduct whether ALMT would bring more short-term benefits to patients than conventional Median Sternotomy by using a meta-analysis of case–control study in the published English Journal. Methods 6 case control studies published in English from 1997 to 2011 were identified and synthesized to compare the short-term postoperative outcomes between ALMT and MS. These outcomes were cardiopulmonary bypass time, aortic cross-clamp time, intubation time, intensive care unit stay time, and postoperative hospital stay time. Results ALMT had significantly longer cardiopulmonary bypass times (8.00 min more, 95% CI 0.36 to 15.64 min, p = 0.04. Some evidence proved that aortic cross-clamp time of ALMT was longer, yet not significantly (2.38 min more, 95% CI −0.15 to 4.91 min, p = 0.06. In addition, ALMT had significantly shorter intubation time (1.66 hrs less, 95% CI −3.05 to −0.27 hrs, p = 0.02. Postoperative hospital stay time was significantly shorter with ALMT (1.52 days less, 95% CI −2.71 to −0.33 days, p = 0.01. Some evidence suggested a reduction in ICU stay time in the ALMT group. However, this did not prove to be statistically significant (0.88 days less, 95% CI −0.81 to 0.04 days, p = 0.08. Conclusion ALMT can bring more benefits to patients with Congenital Heart Defects by reducing intubation time and postoperative hospital stay time, though ALMT has longer CPB time and aortic cross-clamp time.

  11. Measures of Functional Performance and Their Association With Hip and Thigh Strength

    Science.gov (United States)

    Kollock, Roger; Van Lunen, Bonnie L.; Ringleb, Stacie I.; Oñate, James A.

    2015-01-01

    Context: Insufficient hip and thigh strength may increase an athlete's susceptibility to injury. However, screening for strength deficits using isometric and isokinetic instrumentation may not be practical in all clinical scenarios. Objective: To determine if functional performance tests are valid indicators of hip and thigh strength. Design: Descriptive laboratory study. Setting: Research laboratory. Patients or Other Participants: Sixty-two recreationally athletic men (n = 30, age = 21.07 years, height = 173.84 cm, mass = 81.47 kg) and women (n = 32, age = 21.03 years, height = 168.77 cm, mass = 68.22 kg) participants were recruited. Intervention(s): During session 1, we measured isometric peak force and rate of force development for 8 lower extremity muscle groups, followed by an isometric endurance test. During session 2, participants performed functional performance tests. Main Outcome Measure(s): Peak force, rate of force development, fatigue index, hop distance (or height), work (joules), and number of hops performed during the 30-second lateral-hop test were assessed. The r values were squared to calculate r 2. We used Pearson correlations to evaluate the associations between functional performance and strength. Results: In men, the strongest relationship was observed between triple-hop work and hip-adductor peak force (r2 = 50, P ≤ .001). Triple-hop work also was related to hip-adductor (r2 = 38, P ≤ .01) and hip-flexor (r2 = 37, P ≤ .01) rate of force development. For women, the strongest relationships were between single-legged vertical-jump work and knee-flexor peak force (r2 = 0.44, P ≤ .01) and single-legged vertical-jump height and knee-flexor peak force (r2 = 0.42, P ≤ .01). Single-legged vertical-jump height also was related to knee-flexor rate of force development (r2 = 0.49, P ≤ .001). The 30-second lateral-hop test did not account for a significant portion of the variance in strength endurance. Conclusions: Hop tests alone did not

  12. Quantifying the Elastic Property of Nine Thigh Muscles Using Magnetic Resonance Elastography.

    Science.gov (United States)

    Chakouch, Mashhour K; Charleux, Fabrice; Bensamoun, Sabine F

    2015-01-01

    Pathologies of the muscles can manifest different physiological and functional changes. To adapt treatment, it is necessary to characterize the elastic property (shear modulus) of single muscles. Previous studies have used magnetic resonance elastography (MRE), a technique based on MRI technology, to analyze the mechanical behavior of healthy and pathological muscles. The purpose of this study was to develop protocols using MRE to determine the shear modulus of nine thigh muscles at rest. Twenty-nine healthy volunteers (mean age = 26 ± 3.41 years) with no muscle abnormalities underwent MRE tests (1.5 T MRI). Five MRE protocols were developed to quantify the shear moduli of the nine following thigh muscles at rest: rectus femoris (RF), vastus medialis (VM), vastus intermedius (VI), vastus lateralis (VL), sartorius (Sr), gracilis (Gr), semimembranosus (SM), semitendinosus (ST), and biceps (BC). In addition, the shear modulus of the subcutaneous adipose tissue was analyzed. The gracilis, sartorius, and semitendinosus muscles revealed a significantly higher shear modulus (μ_Gr = 6.15 ± 0.45 kPa, μ_ Sr = 5.15 ± 0.19 kPa, and μ_ ST = 5.32 ± 0.10 kPa, respectively) compared to other tissues (from μ_ RF = 3.91 ± 0.16 kPa to μ_VI = 4.23 ± 0.25 kPa). Subcutaneous adipose tissue had the lowest value (μ_adipose tissue = 3.04 ± 0.12 kPa) of all the tissues tested. The different elasticities measured between the tissues may be due to variations in the muscles' physiological and architectural compositions. Thus, the present protocol could be applied to injured muscles to identify their behavior of elastic property. Previous studies on muscle pathology found that quantification of the shear modulus could be used as a clinical protocol to identify pathological muscles and to follow-up effects of treatments and therapies. These data could also be used for modelling purposes.

  13. Quantitative ultrasound tissue characterization in shoulder and thigh muscles – a new approach

    Directory of Open Access Journals (Sweden)

    Jørgensen Kurt

    2006-01-01

    Full Text Available Abstract Background The echogenicity patterns of ultrasound scans contain information of tissue composition in muscles. The aim was: (1 to develop a quantitative ultrasound image analysis to characterize tissue composition in terms of intensity and structure of the ultrasound images, and (2 to use the method for characterization of ultrasound images of the supraspinatus muscle, and the vastus lateralis muscle. Methods Computerized texture analyses employing first-order and higher-order grey-scale statistics were developed to objectively characterize ultrasound images of m. supraspinatus and m. vastus lateralis from 9 healthy participants. Results The mean grey-scale intensity was higher in the vastus lateralis muscle (p -2 and for m. supraspinatus: 0.016 mm-2. Conclusion The higher intensity and the higher number of blobs in the vastus lateralis muscle indicates that the thigh muscle contained more non-contractile components than the supraspinatus muscle, and that the muscle was coarser. The image analyses supplemented each other and gave a more complete description of the tissue composition in the muscle than the mean grey-scale value alone.

  14. The muscle CT of thigh in chronic Werdnig-Hoffmann disease

    International Nuclear Information System (INIS)

    Horikawa, Hirosei; Konagaya, Masaaki; Takayanagi, Tetsuya; Otsuji, Hideaki

    1986-01-01

    In this paper, the muscle CT of thigh in chronic Werdnig-Hoffmann disease (chronic WH) was evaluated. The subjects were five cases of chronic WH (3 males and 2 females, ages ranging from 6 to 22 years) and four control males. All cases showed symmetrical muscular weakness. The proximal muscle were more affected than the distal in the upper limbs. But the muscle strength of hip adduction was relatively spared as compared with other strength of lower limbs. The CT scan was carried out at the upper quarter level between lesser trochanter and medial condyle of the femur. The muscle CT of cases aged 6 and 7 years showed the severely decreased cross-sectional area of muscle without significant decrease in density. The atrophic muscles were surrounded by a large amount of low density area. The hamstring muscles and the adductor muscles, especially adductor longus muscle (ALM), were less affected than the quadriceps femoris muscles. Spotty and moth-eaten low density areas were observed dominantly in the severely affected muscles. In the advanced cases, only ALM could be identified on the CT image. The other muscles were unable to be identified because of severe atrophy with extremely low density. These CT findings suggest the process of muscular wastings of chronic WH as follows; at first muscle fibers are atrophied due to denervation and sooner or later replaced with fat tissue. Moreover, the preservation of ALM suggests that loss of anterior horn cells does not always go on homogeneously. (author)

  15. Evaluation for computerized axial tomography to three anthropomorphic methods to estimate the thigh muscle area

    International Nuclear Information System (INIS)

    Fernandez Vieitez, Jorge Alberto; Alvarez Cuesta, Jose Alberto; Williams Wilson, Luis

    2001-01-01

    Three anthropometric methods to estimate the thigh muscle area (TMA, cm) were evaluated. Seventeen young males were taken as a sample. The TMA was estimated by using the formulas of Gurney-Jellife, Jones-Pearson, Housh, and others. In the same place where the measurements of circumferences and skinfolds were made, the TAM was determined by computerized axial tomography. It was used as a reference criterion with which the anthropometric values were compared. The methods of Gurney-Jellife and Jones-Pearson significantly overestimated the TAM obtained by CAT (9.0 + - 12.8 cm 2 [4.4 %]; p = 0.01 and 22.0 + - 14.9 cm 2 [10.9 %]; p = 1.6 . 10-5, respectively), whereas that of Housh and others underestimated the values of CAT (-48.8 + - 11.7 cm 2 [24.1 %]; p = 9.4 . 10-12). The Gurney-Jellife equation was the only one that proved to be interchangeable with CAT, on obtaining a coefficient of correlation (r) and a slope of regression (b) for the difference and the average between both methods that were not statistically significant (r 0,421; b = 0,21 + - 0.12, p = 0.09). It was concluded that of the 3 studied anthropometric methods, the Gurney-Jellife method offers the most accurate TAM values

  16. Hygienic quality control of chicken (thighs) by means of ionizing radiations

    International Nuclear Information System (INIS)

    Lescano, G.; Kairiyama, E.; Narvaiz, P.; Kaupert, N.L.

    1990-01-01

    High quality chicken thighs, packed in polystyrene trays covered with PVC films, were treated with ionizing energy provided by a semiindustrial 60 Co facility, with a dose of 2.5 kGy, at the temperature of melting ice. Control and irradiated samples were stored at 2 deg C ± 2 deg C and RH: 89 % ± 6 %. Microbiological, chemical and sensory evaluations were performed. This treatment improved significantly the hygienic quality of the product, and reduced in two log cycles the initial number of aerobic bacteria, which led to a 2.5 times extension of the commercialization period. A diminished water content was observed after irradiation. Decreasing values were also found in every sample as storage time went by; the irradiated sample, on day 23, had values 9 % lower than that of the control sample on day 2. Rancidity, measured as peroxide number, increased their values after irradiation, but in such extent that was not noticed organoleptically. It was never higher than 10 meg/kg of fat (specification of the Argentine Alimentary Codex for oils). The commercial quality of the irradiated samples was acceptable until day 22. (Author) [es

  17. Hyalomma aegyptium on Spur-thighed Tortoise (Testudo graeca in Urmia Region West Azerbaijan, Iran

    Directory of Open Access Journals (Sweden)

    M Tavassoli

    2007-05-01

    Full Text Available Background: Ticks are obligate blood feeders that parasitize a wide variety of animals. Hyalomma aegyptium, parasitize tortoises and other small wild life and livestock. This study was carried out to determine spur-thighed tortoise (Testudo graeca infestation to H. ageyptium in Urmia region West Azerbaijan of Iran. Methods: The study was carried out over a 16 month period from the spring of 2004 to the fall of 2005. A total of 32 tor¬toises were sampled. Results: The results indicated that 14 tortoises infected with ticks. A total of 117 ticks were collected from infested animals, the minimum and maximum tick infestation was 1-60. Ticks were attached to the axilla of fore and hind legs of tortoises. All ticks were determined to be H. aegyptium. Conclusion: H. aegyptium was the most common tick species in the study area. Due to tendency of some people to keeping tortoise as pet animal, more attention must be done to tortoise’s tick infestation. Due to existence of H. aegyptium on tor¬toises in this region more study will need to evaluate presence of this tick on other animal species and its role on transmis¬sion of diseases.

  18. Automated assessment of thigh composition using machine learning for Dixon magnetic resonance images.

    Science.gov (United States)

    Yang, Yu Xin; Chong, Mei Sian; Tay, Laura; Yew, Suzanne; Yeo, Audrey; Tan, Cher Heng

    2016-10-01

    To develop and validate a machine learning based automated segmentation method that jointly analyzes the four contrasts provided by Dixon MRI technique for improved thigh composition segmentation accuracy. The automatic detection of body composition is formulized as a three-class classification issue. Each image voxel in the training dataset is assigned with a correct label. A voxel classifier is trained and subsequently used to predict unseen data. Morphological operations are finally applied to generate volumetric segmented images for different structures. We applied this algorithm on datasets of (1) four contrast images, (2) water and fat images, and (3) unsuppressed images acquired from 190 subjects. The proposed method using four contrasts achieved most accurate and robust segmentation compared to the use of combined fat and water images and the use of unsuppressed image, average Dice coefficients of 0.94 ± 0.03, 0.96 ± 0.03, 0.80 ± 0.03, and 0.97 ± 0.01 has been achieved to bone region, subcutaneous adipose tissue (SAT), inter-muscular adipose tissue (IMAT), and muscle respectively. Our proposed method based on machine learning produces accurate tissue quantification and showed an effective use of large information provided by the four contrast images from Dixon MRI.

  19. Lower limb gigantism, lymphedema, and painful varicosities following a thigh vascular access graft.

    Science.gov (United States)

    Thompson, Michael; Mathuram Thiyagarajan, Umasankar; Akoh, Jacob A

    2014-07-01

    Prosthetic arteriovenous grafts (AVGs) are associated with greater morbidity than autogenous arteriovenous fistulas (AVFs), but their use is indicated when AVF formation is not possible. This report adds to the literature a case of lower limb gigantism, painful varicosities, and lymphedema following long-term use of AVG in the upper thigh. The patient's past medical history included renal transplantation on the same side well before the AVG was inserted and right leg deep vein thrombosis. Suspicion of AVG thrombosis was excluded by Doppler ultrasound, which demonstrated an access flow of 1700 mL/min. A computed tomography (CT) scan of the abdomen and pelvis did not identify the cause of her symptoms. Whereas functional incompetence of the iliac vein valve might be responsible for the varicosities, the extent of hypertrophy in this case raises the suspicion of lymphatic blockage possibly secondary to groin dissection undertaken at the time of graft insertion, in addition to the previous dissection at the time of transplantation. This case highlights the need for minimal groin dissection during AVG insertion, particularly in patients with a history of previous abdominopelvic surgery. © 2014 International Society for Hemodialysis.

  20. Scaling and the frequency dependence of Nyquist plot maxima of the electrical impedance of the human thigh.

    Science.gov (United States)

    Shiffman, Carl

    2017-11-30

    To define and elucidate the properties of reduced-variable Nyquist plots. Non-invasive measurements of the electrical impedance of the human thigh. A retrospective analysis of the electrical impedances of 154 normal subjects measured over the past decade shows that 'scaling' of the Nyquist plots for human thigh muscles is a property shared by healthy thigh musculature, irrespective of subject and the length of muscle segment. Here the term scaling signifies the near and sometimes 'perfect' coalescence of the separate X versus R plots into one 'reduced' Nyquist plot by the simple expedient of dividing R and X by X m , the value of X at the reactance maximum. To the extent allowed by noise levels one can say that there is one 'universal' reduced Nyquist plot for the thigh musculature of healthy subjects. There is one feature of the Nyquist curves which is not 'universal', however, namely the frequency f m at which the maximum in X is observed. That is found to vary from 10 to 100 kHz. depending on subject and segment length. Analysis shows, however, that the mean value of 1/f m is an accurately linear function of segment length, though there is a small subject-to-subject random element as well. Also, following the recovery of an otherwise healthy victim of ankle fracture demonstrates the clear superiority of measurements above about 800 kHz, where scaling is not observed, in contrast to measurements below about 400 kHz, where scaling is accurately obeyed. The ubiquity of 'scaling' casts new light on the interpretation of impedance results as they are used in electrical impedance myography and bioelectric impedance analysis.

  1. Managing Knee Osteoarthritis: The Effects of Body Weight Supported Physical Activity on Joint Pain, Function, and Thigh Muscle Strength.

    Science.gov (United States)

    Peeler, Jason; Christian, Mathew; Cooper, Juliette; Leiter, Jeffrey; MacDonald, Peter

    2015-11-01

    To determine the effect of a 12-week lower body positive pressure (LBPP)-supported low-load treadmill walking program on knee joint pain, function, and thigh muscle strength in overweight patients with knee osteoarthritis (OA). Prospective, observational, repeated measures investigation. Community-based, multidisciplinary sports medicine clinic. Thirty-one patients aged between 55 and 75 years, with a body mass index ≥25 kg/m and mild-to-moderate knee OA. Twelve-week LBPP-supported low-load treadmill walking regimen. Acute knee joint pain (visual analog scale) during full weight bearing treadmill walking, chronic knee pain, and joint function [Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire] during normal activities of daily living, and thigh muscle strength (isokinetic testing). Appropriate methods of statistical analysis were used to compare data from baseline and follow-up evaluation. Participants reported significant improvements in knee joint pain and function and demonstrated significant increases in thigh muscle strength about the degenerative knee. Participants also experienced significant reductions in acute knee pain during full weight bearing treadmill walking and required dramatically less LBPP support to walk pain free on the treadmill. Data suggest that an LBPP-supported low-load exercise regimen can be used to significantly diminish knee pain, enhance joint function, and increase thigh muscle strength, while safely promoting pain-free walking exercise in overweight patients with knee OA. These findings have important implications for the development of nonoperative treatment strategies that can be used in the management of joint symptoms associated with progressive knee OA in at-risk patient populations. This research suggests that LBPP-supported low-load walking is a safe user-friendly mode of exercise that can be successfully used in the management of day-to-day joint symptoms associated with knee OA, helping to improve the

  2. Estimation of thigh muscle mass with magnetic resonance imaging in older adults and people with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Mathur, Sunita; Takai, Karen Pr; Macintyre, Donna L; Reid, Darlene

    2008-02-01

    Quantifying muscle mass is an essential part of physical therapy assessment, particularly in older adults and in people with chronic conditions associated with muscle atrophy. The purposes of this study were to examine the relationship between muscle cross-sectional area (CSA) and volume by use of magnetic resonance imaging (MRI) and to compare anthropometric estimations of midthigh CSA with measurements obtained from MRI. Twenty older adults who were healthy and 20 people with chronic obstructive pulmonary disease (COPD), matched for age, sex, and body mass index, underwent MRI to obtain measurements of thigh muscle CSA and volume. Anthropometric measurements (skinfold thickness and thigh circumference) were used to estimate midthigh CSA. Muscle volumes were significantly lower in the people with COPD than in the older adults who were healthy. Moderate to high correlations were found between midthigh CSA and volume in both groups (r=.61-.94). Anthropometric measurements tended to overestimate midthigh CSA in both the people with COPD (estimated CSA=64.9+/-17.8; actual CSA=48.3+/-10.2 cm(2)) and the older adults who were healthy (estimated quadriceps femoris muscle CSA=65.0+/-14.0; actual CSA=56.8+/-13.5 cm(2)). Furthermore, the estimated quadriceps femoris muscle CSAs were not sensitive enough to detect a difference in muscle size between people with COPD and controls. Thigh circumference alone was not different between groups and showed only low to moderate correlations with muscle volume (r=.19-.47). Muscle CSA measured from a single slice provides a good indication of volume, but the most representative slice should be chosen on the basis of the muscle group of interest. Thigh circumference is not correlated with muscle volume and, therefore, should not be used as an indicator of muscle size. The development of population-specific reference equations for estimating muscle CSA from anthropometric measurements is warranted.

  3. Evaluation of 99mTc-HM-PAO thigh accumulation in patients with cerebro-vascular disease

    International Nuclear Information System (INIS)

    Nishigaki, Hiroshi; Adachi, Itaru; Komori, Tsuyoshi; Tatsu, Yoshimitsu; Hisada, Youichi; Sueyoshi, Kouzou; Narabayashi, Isamu

    1993-01-01

    Technetium-99m d,l-hexamethyl-propyleneamine oxime ( 99m Tc-HM-PAO) cerebral SPECT and whole body scintigraphy (WBS) were performed in 5 patients without cerebro-vascular disease (CVD) (Group 1), 31 patients with CVD but not hemiparesis (Group 2) and 18 patients with CVD and hemiparesis (Group 3). Four ROIs were drawn manually around the whole body (WB), brain (Br), right and left thigh (Th). We calculated some ratios: the total counts in the brain over the total counts in the whole body (Br/WB), the total counts in the thigh over the total counts in the whole body (Th/WB) and the mean counts in the thigh over the mean counts in the brain (Th/Br). The Br/WB was 6.9±1.8%, rt-Th/WB was 4.9±2.1%, lt-Th/WB was 5.1±1.3% and Th/Br was 0.46±0.17 in group 1. Whole body scintigraphies in group 1 revealed clear and similar images between right and left thigh. The Br/WB was 6.7±1.4%, Th/WB of paretic side was 4.6±1.0%, Th/WB of non-paretic side was 5.8±1.2% and Th/Br was 0.47±0.18 in group 3. The Th/WB in non paretic side was significantly higher than that in paretic side (p 99m Tc-HM-PAO. It was possible that we evaluated not only cerebral perfusion but also muscle atrophy and/or perfusion in patients with CVD using 99m Tc-HM-PAO. (author)

  4. Biochemical signaling by remote ischemic conditioning of the arm versus thigh: Is one raise of the cuff enough?

    Directory of Open Access Journals (Sweden)

    Cameron Dezfulian

    2017-08-01

    Full Text Available Remote Ischemic Conditioning (RIC, induced by brief cycles of ischemia and reperfusion, protects vital organs from a prolonged ischemic insult. While several biochemical mediators have been implicated in RIC's mechanism of action, it remains unclear whether the localization or “dose” of RIC affects the extent of protective signaling. In this randomized crossover study of healthy individuals, we tested whether the number of cycles of RIC and its localization (arm versus thigh determines biochemical signaling and cytoprotection. Subjects received either arm or thigh RIC and then were crossed over to receive RIC in the other extremity. Blood flow, tissue perfusion, concentrations of the circulating protective mediator nitrite, and platelet mitochondrial function were measured after each RIC cycle. We found that plasma nitrite concentration peaked after the first RIC cycle and remained elevated throughout RIC. This plasma nitrite conferred cytoprotection in an in vitro myocyte model of hypoxia/reoxygenation. Notably, though plasma nitrite returned to baseline at 24 h, RIC conditioned plasma still mediated protection. Additionally, no difference in endpoints between RIC in thigh versus arm was found. These data demonstrate that localization and “dose” of RIC does not affect cytoprotection and further elucidate the mechanisms by which nitrite contributes to RIC-dependent protection.

  5. Progression and variation of fatty infiltration of the thigh muscles in Duchenne muscular dystrophy, a muscle magnetic resonance imaging study.

    Science.gov (United States)

    Li, Wenzhu; Zheng, Yiming; Zhang, Wei; Wang, Zhaoxia; Xiao, Jiangxi; Yuan, Yun

    2015-05-01

    The purpose of this study was to assess the progression and variation of fatty infiltration of the thigh muscles of Duchenne muscular dystrophy patients. Muscle magnetic resonance imaging was used to measure the degree of fatty infiltration of the thigh muscles of 171 boys with Duchenne muscular dystrophy (mean age, 6.09 ± 2.30 years). Fatty infiltration was assigned using a modified Mercuri's scale 0-5 (normal-severe). The gluteus maximus and adductor magnus were affected in patients less than two years old, followed by the biceps femoris. Quadriceps and semimembranosus were first affected at the age of five to six years; the sartorius, gracilis and adductor longus remained apparently unaffected until seven years of age. Fatty infiltration of all the thigh muscles developed rapidly after seven years of age. The standard deviation of the fatty infiltration scores ranged from 2.41 to 4.87 before five years old, and from 6.84 to 11.66 between six and ten years old. This study provides evidence of highly variable degrees of fatty infiltration in children of different ages with Duchenne muscular dystrophy, and indicates that fatty infiltration progresses more quickly after seven years of age. These findings may be beneficial for the selection of therapeutic regimens and the analysis of future clinical trials. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Thigh and knee circumference, knee-extension strength, and functional performance after fast-track total hip arthroplasty

    DEFF Research Database (Denmark)

    Holm, Bente; Kristensen, Morten Tange; Husted, Henrik

    2011-01-01

    OBJECTIVE: To (1) quantify changes in knee-extension strength and functional-performance at discharge after fast-track total hip arthroplasty (THA) and (2) investigate whether these changes correlate to changes in thigh and knee circumference (ie, swelling) or pain. DESIGN: A prospective, descrip......OBJECTIVE: To (1) quantify changes in knee-extension strength and functional-performance at discharge after fast-track total hip arthroplasty (THA) and (2) investigate whether these changes correlate to changes in thigh and knee circumference (ie, swelling) or pain. DESIGN: A prospective......, descriptive, hypothesis-generating study. SETTING: A special unit for fast-track hip and knee arthroplasty operations at a university hospital. PARTICIPANTS: Twenty-four patients (20 women and 4 men; ages 69 ± 6.1 years) scheduled for primary unilateral THA. METHODS: All patients were evaluated before surgery......, except for hip pain. The average loss in knee-extension strength after surgery (32%, P = .01) did not correlate with increased thigh circumference (6%, P

  7. The posterior thigh flap for defect coverage of ischial pressure sores - a critical single-centre analysis.

    Science.gov (United States)

    Djedovic, Gabriel; Morandi, Evi M; Metzler, Julia; Wirthmann, Anna; Matiasek, Johannes; Bauer, Thomas; Rieger, Ulrich M

    2017-12-01

    The development of pressure sores is still not only an enormous economical but also a medical burden. Especially in the ischial region, the local defect coverage remains demanding as it is the main weight-bearing area in wheelchair-mobilised patients and is prone to high mobility. The purpose of our study was to report our long-time experience with the reconstruction of ischial pressure ulcers with the medially based posterior thigh flap. A retrospective analysis of all primary pressure sores grade III-IV in the ischial area, which were covered with a medially based posterior thigh flap between January 2008 and December 2014, at our department was conducted. A total of 28 patients underwent defect coverage of an ischial pressure sore with the aforementioned flap. The subgroup with complications showed a statistically significant longer hospital stay. A statistically significant correlation between age and the coincidence of comorbidities could be seen. Older patients showed significantly higher grades of pressure sores. The medially based posterior thigh flap is a safe and reliable flap design. Complication rates are comparable to other flaps. Nevertheless, in case of complications, a significantly longer duration of hospitalisation has to be taken into account. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  8. The physicochemical properties and antioxidative potential of raw thigh meat from broilers fed a dietary medicinal herb extract mixture

    Directory of Open Access Journals (Sweden)

    K. Shirzadegan

    2014-07-01

    Full Text Available A 6-wk feeding study was conducted to evaluate the antioxidative potential, indices such as quality of the thigh meat and liver of broiler chickens fed with a dietary medicinal herb extract mixture (HEM, consisting: Iranian green tea, cinnamon, garlic and chicory at a ratio of 25:15:45:15. A total of 320, one-d-old Ross (male broiler chickens were used to investigate the effects of 0.0, 2.5, 5.0 and 7.5 g/kg HEM in the diet, on aforementioned factors. The HEM supplementation did not influence the composition of raw thigh meat except for the total phenols and crude ash (P<0.05. Furthermore, pH, water-holding capacity (WHC and acceptability of thigh meat were affecting by administration of HEM in diets (P<0.05. Meat flavor increased in the supplemented groups (P<0.05. According to our data, HEM supplementation decreased the amount of thiobarbituric acid reactive substance (TBARS in various times of storage and improved the liver lipid peroxides and superoxide dismutase (SOD activities at week 6 (P<0.05, but did not influence the catalase activity. Our results reveal that the addition of 7.5 g/kg or higher HEM in diet could be sufficient to increase the antioxidative activity and 2.5 g/kg for meat taste of broilers in maximum levels.

  9. Injury risk curves for the skeletal knee-thigh-hip complex for knee-impact loading.

    Science.gov (United States)

    Rupp, Jonathan D; Flannagan, Carol A C; Kuppa, Shashi M

    2010-01-01

    Injury risk curves for the skeletal knee-thigh-hip (KTH) relate peak force applied to the anterior aspect of the flexed knee, the primary source of KTH injury in frontal motor-vehicle crashes, to the probability of skeletal KTH injury. Previous KTH injury risk curves have been developed from analyses of peak knee-impact force data from studies where knees of whole cadavers were impacted. However, these risk curves either neglect the effects of occupant gender, stature, and mass on KTH fracture force, or account for them using scaling factors derived from dimensional analysis without empirical support. A large amount of experimental data on the knee-impact forces associated with KTH fracture are now available, making it possible to estimate the effects of subject characteristics on skeletal KTH injury risk by statistically analyzing empirical data. Eleven studies were identified in the biomechanical literature in which the flexed knees of whole cadavers were impacted. From these, peak knee-impact force data and the associated subject characteristics were reanalyzed using survival analysis with a lognormal distribution. Results of this analysis indicate that the relationship between peak knee-impact force and the probability of KTH fracture is a function of age, total body mass, and whether the surface that loads the knee is rigid. Comparisons between injury risk curves for the midsize adult male and small adult female crash test dummies defined in previous studies and new risk curves for these sizes of occupants developed in this study suggest that previous injury risk curves generally overestimate the likelihood of KTH fracture at a given peak knee-impact force. Future work should focus on defining the relationships between impact force at the human knee and peak axial compressive forces measured by load cells in the crash test dummy KTH complex so that these new risk curves can be used with ATDs.

  10. Microvascular anastomosis simulation using a chicken thigh model: Interval versus massed training.

    Science.gov (United States)

    Schoeff, Stephen; Hernandez, Brian; Robinson, Derek J; Jameson, Mark J; Shonka, David C

    2017-11-01

    To compare the effectiveness of massed versus interval training when teaching otolaryngology residents microvascular suturing on a validated microsurgical model. Otolaryngology residents were placed into interval (n = 7) or massed (n = 7) training groups. The interval group performed three separate 30-minute practice sessions separated by at least 1 week, and the massed group performed a single 90-minute practice session. Both groups viewed a video demonstration and recorded a pretest prior to the first training session. A post-test was administered following the last practice session. At an academic medical center, 14 otolaryngology residents were assigned using stratified randomization to interval or massed training. Blinded evaluators graded performance using a validated microvascular Objective Structured Assessment of Technical Skill tool. The tool is comprised of two major components: task-specific score (TSS) and global rating scale (GRS). Participants also received pre- and poststudy surveys to compare subjective confidence in multiple aspects of microvascular skill acquisition. Overall, all residents showed increased TSS and GRS on post- versus pretest. After completion of training, the interval group had a statistically significant increase in both TSS and GRS, whereas the massed group's increase was not significant. Residents in both groups reported significantly increased levels of confidence after completion of the study. Self-directed learning using a chicken thigh artery model may benefit microsurgical skills, competence, and confidence for resident surgeons. Interval training results in significant improvement in early development of microvascular anastomosis skills, whereas massed training does not. NA. Laryngoscope, 127:2490-2494, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  11. Experimental abscess in the thigh of rabbit : magnetic resonance imaging and pathologic correlation

    International Nuclear Information System (INIS)

    Kang, Heung Sik; Chung, Yoong Ki; Jang, Ja June

    1996-01-01

    To understand MR imaging characteristics, of abscesses by correlation with pathologic findings, with emphasis on the hypointense rim of the abscess wall on T2-weighted images. We experimentally induced twenty abscesses on both thighs of ten New Zealand white rabbits by innoculation of E. coli. Spin-echo axial T1-weighted images(T1WI), proton density weighted images(PDWI), T2-weighted images(T2WI) and gadolinium enhanced T1WI of two rabbits were each obtained at 1 and 3 days, and at 1, 2 and 4 weeks following innoculation of pathogens. Rabbits were sacrificed after MR imaging, and freezing, sectioning along MR imaging planes and histopathologic examination were subsequently carried out. MR-pathologic correlation was performed, with emphasis on the MR signal characteristics of the abscess wall. In 19 abscesses, necrotic portions except gas showed hypointensity or hyperintensity on T1WI and hyperintensity on T2WI. Peripheral inflammatory reaction showed hypointensity on T1WI, hyperintensity on PDWI and T2WI, and contrast enhancement. Abscess wall showed slightly increased signal intensity on T1WI. A hypointense rim on PDWI and T2WI appeared from 3 days after pathogen innoculation. The rim was thickest at 1 week, and showed multilayers at 2 weeks and double layers at 4 weeks after pathogen innoculation. Cellular and necrotic debris was accumulated at the inner portion of the abscess wall. Inflammatory cells were mainly polymorphonuclear leukocytes and lymphocytes. Macrophages, which appeared at 3 days, suggested active phagocytosis at 1 week after innoculation. Thereafter, inflammatory reactions decreased and fibrosis progressed. The hypointense rim of the abscess wall on T2WI reflects the accumulation of cellular debris, the paramagnetic effect of free radicals due to active phagocytosing macrophages during the abscess forming stage, and fibrosis during the maturation stage

  12. Effect of antioxidants on the quality of irradiated sausages prepared with turkey thigh meat.

    Science.gov (United States)

    Du, M; Ahn, D U

    2002-08-01

    The effects of antioxidants on the flavor and color of electron-beam-irradiated turkey sausages were studied. Sausages were prepared from turkey thigh meat, NaCl (2.0%), phosphate (0.5%), water (10%), and one of five antioxidant treatments (none, vitamin E, sesamol, rosemary extract, or gallic acid at 0.02%). Sausages were stuffed and cooked in an 85 C smokehouse to an internal temperature of 74 C, then chilled and sliced to 1.5-cm thickness, and vacuum-packaged. Packaged sausages were randomly divided into three groups and irradiated at 0, 1.5 or 3.0 kGy, using an electron beam. Volatiles, color, 2-TBA-reactive substances values, and sensory characteristics were analyzed. The antioxidant effect of sesamol was the highest, followed by vitamin E and gallic acid; rosemary extract had the weakest antioxidant effect. Irradiation induced red color in sausages, but addition of gallic acid, rosemary extract, or sesamol reduced it. Gallic acid was very effective in lowering the redness of irradiated and nonirradiated sausages. The redness (a*) values of sausages with added gallic acid that were irradiated at 0, 1.5, and 3.0 kGy were 1.49,2.03, and 2.29, respectively, whereas those of control sausages under the same irradiation conditions were 2.58, 2.81, and 3.25, respectively. The reduction of redness in irradiated sausages by antioxidants was not related to CO, because antioxidants had no effect on CO production by irradiation. The amount of total volatiles was decreased significantly by antioxidants, but antioxidants had minimal effect on the off-flavor of turkey sausages induced by irradiation.

  13. Improvement of Reliability of Diffusion Tensor Metrics in Thigh Skeletal Muscles.

    Science.gov (United States)

    Keller, Sarah; Chhabra, Avneesh; Ahmed, Shaheen; Kim, Anne C; Chia, Jonathan M; Yamamura, Jin; Wang, Zhiyue J

    2018-05-01

    Quantitative diffusion tensor imaging (DTI) of skeletal muscles is challenging due to the bias in DTI metrics, such as fractional anisotropy (FA) and mean diffusivity (MD), related to insufficient signal-to-noise ratio (SNR). This study compares the bias of DTI metrics in skeletal muscles via pixel-based and region-of-interest (ROI)-based analysis. DTI of the thigh muscles was conducted on a 3.0-T system in N = 11 volunteers using a fat-suppressed single-shot spin-echo echo planar imaging (SS SE-EPI) sequence with eight repetitions (number of signal averages (NSA) = 4 or 8 for each repeat). The SNR was calculated for different NSAs and estimated for the composite images combining all data (effective NSA = 48) as standard reference. The bias of MD and FA derived by pixel-based and ROI-based quantification were compared at different NSAs. An "intra-ROI diffusion direction dispersion angle (IRDDDA)" was calculated to assess the uniformity of diffusion within the ROI. Using our standard reference image with NSA = 48, the ROI-based and pixel-based measurements agreed for FA and MD. Larger disagreements were observed for the pixel-based quantification at NSA = 4. MD was less sensitive than FA to the noise level. The IRDDDA decreased with higher NSA. At NSA = 4, ROI-based FA showed a lower average bias (0.9% vs. 37.4%) and narrower 95% limits of agreement compared to the pixel-based method. The ROI-based estimation of FA is less prone to bias than the pixel-based estimations when SNR is low. The IRDDDA can be applied as a quantitative quality measure to assess reliability of ROI-based DTI metrics. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Anterolateral Ankle Impingement Syndrome (review)%踝关节前外侧撞击综合征的研究进展

    Institute of Scientific and Technical Information of China (English)

    闵红巍; 刘克敏

    2014-01-01

    临床将踝关节扭伤后无骨折脱位,反复出现踝关节前外侧肿痛称为踝关节前外侧撞击综合征,为慢性踝关节疼痛的主要病因之一,受到广泛关注。本文就其发病机制、临床表现、诊断及治疗进行综述。%Ankle sprain without fracture or dislocation, accompanied by repeated ankle swelling is called as Anterolateral Ankle Im-pingement Syndrome. It is a major reason of chronic ankle pain and received extensive attention. This paper summarized its pathogenesis, clinical manifestations, diagnosis and treatment.

  15. Effect of Vegetable Oil Fortified Feeds on the Content of Fatty Acids in Breast and Thigh Muscles in Broiler Chickens

    Directory of Open Access Journals (Sweden)

    Tereza Krejčí-Treu

    2010-01-01

    Full Text Available The main objective of this work was to compare the effect of six vegetable oils added to feeding mixtures that were administered to broiler chickens on the content of major fatty acids in chicken meat. The experiment started with 90 one-day-old Ross 308 meat hybrid male chickens that were divided into six groups. Chickens were fed complete feeding mixtures for the prefattening (BR1, fattening (BR2, and post-fattening (BR3 of broiler chickens. The BR1 feeding mixture was administered to chickens aged 1-10 days, the BR2 feeding mixture was given from Day 11 to Day 30, and the BR3 feeding mixture was then administered until Day 42. The BR1 feeding mixture that was administered to all six groups during the first ten days of the experiment was supplemented with soybean oil. BR2 and BR3 feeding mixtures used to feed chickens aged 11-42 days were fortified with soybean oil (SO Group, rapeseed oil (RO Group, sunflower oil (SFO Group, flaxseed oil (FO Group, olive oil (OO Group, and evening primrose oil (EPO Group. The vegetable oils used differed by the composition of fatty acids, particularly by the content of oleic acid, linoleic acid, α-linolenic acid. The use of the above-described experimental diets in young broilers from Day 11 to 42 had a significant effect on the content of fatty acids in the fat from breast and thigh muscles. The content of α-linolenic acid in breast and thigh muscles of broilers that received the feed containing flaxseed oil (21.16 g/100 g of oil and 17.13 g/100 g of oil, respectively significantly increased (p ⪬ 0.01. The highest content of linoleic acid (p ⪬ 0.01 in breast and thigh muscles was found in chickens that were fed the feed containing primrose oil (59.13 g/100 g and 51.71 g/100 g. A significant increase (p ⪬ 0.01 in the level of oleic acid was detected in both breast and thigh muscles of broilers that received olive oil fortified feed (52.44 g/100 g and 43.70 g/100 g of oil. No significant variation was

  16. Anterolateral meningioma of the foramen magnum and high cervical spine presenting intradural and extradural growth in a child: case report and literature review.

    Science.gov (United States)

    Athanasiou, Alkinoos; Magras, Ioannis; Sarlis, Panagiotis; Spyridopoulos, Evangelos; Polyzoidis, Konstantinos

    2015-12-01

    We report a rare case of anterolateral meningioma of the foramen magnum (FMM) and high cervical spine presenting both intradural and extradural growth in a 7.5-year-old boy. We also performed a review of the relevant peer-reviewed literature. The patient presented with progressive tetraparesis and gait instability. Neuroimaging revealed an anterolateral tumor of the foramen magnum, C1 and C2 cervical spine level. The patient was treated in two stages: During the first operation, the extradural part was resected while the intradural part was removed in a second operation. Following the second operation, the patient showed almost complete neurological recovery as a result of cervical spinal cord and brainstem decompression but was complicated with cerebrospinal fluid leakage and infection by Acinetobacter. He sustained two further operations for dural sealing and external ventricular drainage and was treated with intraventricular administration of antibiotics. Histopathology of the tumor confirmed a meningotheliomatous meningioma. At the 6-month post-op follow-up examination, the patient exhibited complete neurological recovery and no radiological tumor recurrence. To the authors' best knowledge, we report the third case of sporadic pediatric meningioma of the foramen magnum and high cervical compartments with an extradural growth. Accurate pre-operative estimation of possible extradural growth is crucial towards surgical planning and sufficient treatment. Treatment of choice is total resection in a single operating session to avoid re-operations and increased risk of complications. If not possible, a re-operation should always attempt to secure the desired result.

  17. Use of inferior gluteal artery and posterior thigh perforators in management of ischial pressure sores with limited donor sites for flap coverage.

    Science.gov (United States)

    Unal, Cigdem; Ozdemir, Jale; Yirmibesoglu, Oktay; Yucel, Ergin; Agir, Hakan

    2012-07-01

    Reconstructive surgery for ischial pressure sore defects presents a challenge because of high rates of recurrence. The aim of this study was to describe the use of inferior gluteal artery (IGA) and posterior thigh perforators in management of ischial pressure sores with limited donor sites. Between September 2005 and 2009, 11 patients (9 male, 2 female) with ischial sores were operated by using IGA and posterior thigh perforator flaps. The data of patients included age, sex, cause of paraplegia, flap size, perforator of flap, previous surgeries, recurrences, complications, and postoperative follow-up. Nine IGA and 5 posterior thigh perforator flaps were used. Six patients presented with recurrent lesions, 5 patients were operated for sacral and contralateral ischial pressure sores previously. In 2 patients, IGA and posterior thigh perforator flaps were used in combination. Patients were followed for an average of 34.3 months. In 2 recurrent cases, readvancement of IGA perforator flap and gluteus maximus myocutaneous flap were treatment of choice. Treatment of patients with recurrent lesions or multiple pressure sores is challenging because of limited available flap donor sites. In this study, posterior thigh perforator flaps were preferred in patients in whom the previous donor site was the gluteal region. IGA perforator flaps were the treatment of choice in patients for whom posterior thigh region was previously used. Alternately, preserved perforators of previous conventional myocutaneous flaps enabled us to use these perforators in recurrences.

  18. Face resurfacing using a cervicothoracic skin flap prefabricated by lateral thigh fascial flap and tissue expander.

    Science.gov (United States)

    Li, Qingfeng; Zan, Tao; Gu, Bin; Liu, Kai; Shen, Guoxiong; Xie, Yun; Weng, Rui

    2009-01-01

    Resurfacing of facial massive soft tissue defect is a formidable challenge because of the unique character of the region and the limitation of well-matched donor site. In this report, we introduce a technique for using the prefabricated cervicothoracic skin flap for facial resurfacing, in an attempt to meet the principle of flap selection in face reconstructive surgery for matching the color and texture, large dimension, and thinner thickness (MLT) of the recipient. Eleven patients with massive facial scars underwent resurfacing procedures with prefabricated cervicothoracic flaps. The vasculature of the lateral thigh fascial flap, including the descending branch of the lateral femoral circumflex vessels and the surrounding muscle fascia, was used as the vascular carrier, and the pedicles of the fascial flap were anastomosed to either the superior thyroid or facial vessels in flap prefabrication. A tissue expander was placed beneath the fascial flap to enlarge the size and reduce the thickness of the flap. The average size of the harvested fascia flap was 6.5 x 11.7 cm. After a mean interval of 21.5 weeks, the expanders were filled to a mean volume of 1,685 ml. The sizes of the prefabricated skin flaps ranged from 12 x 15 cm to 15 x 32 cm. The prefabricated skin flaps were then transferred to the recipient site as pedicled flaps for facial resurfacing. All facial soft tissue defects were successfully covered by the flaps. The donor sites were primarily closed and healed without complications. Although varied degrees of venous congestion were developed after flap transfers, the marginal necrosis only occurred in two cases. The results in follow-up showed most resurfaced faces restored natural contour and regained emotional expression. MLT is the principle for flap selection in resurfacing of the massive facial soft tissue defect. Our experience in this series of patients demonstrated that the prefabricated cervicothoracic skin flap could be a reliable alternative

  19. MRI-guided gas bubble enhanced ultrasound heating in in vivo rabbit thigh

    International Nuclear Information System (INIS)

    Sokka, S D; King, R; Hynynen, K

    2003-01-01

    In this study, we propose a focused ultrasound surgery protocol that induces and then uses gas bubbles at the focus to enhance the ultrasound absorption and ultimately create larger lesions in vivo. MRI and ultrasound visualization and monitoring methods for this heating method are also investigated. Larger lesions created with a carefully monitored single ultrasound exposure could greatly improve the speed of tumour coagulation with focused ultrasound. All experiments were performed under MRI (clinical, 1.5 T) guidance with one of two eight-sector, spherically curved piezoelectric transducers. The transducer, either a 1.1 or 1.7 MHz array, was driven by a multi-channel RF driving system. The transducer was mounted in an MRI-compatible manual positioning system and the rabbit was situated on top of the system. An ultrasound detector ring was fixed with the therapy transducer to monitor gas bubble activity during treatment. Focused ultrasound surgery exposures were delivered to the thighs of seven New Zealand white rabbits. The experimental, gas-bubble-enhanced heating exposures consisted of a high amplitude 300 acoustic watt, half second pulse followed by a 7 W, 14 W or 21 W continuous wave exposure for 19.5 s. The respective control sonications were 20 s exposures of 14 W, 21 W and 28 W. During the exposures, MR thermometry was obtained from the temperature dependency of the proton resonance frequency shift. MR T2-enhanced imaging was used to evaluate the resulting lesions. Specific metrics were used to evaluate the differences between the gas-bubble-enhanced exposures and their respective control sonications: temperatures with respect to time and space, lesion size and shape, and their agreement with thermal dose predictions. The bubble-enhanced exposures showed a faster temperature rise within the first 4 s and higher overall temperatures than the sonications without bubble formation. The spatial temperature maps and the thermal dose maps derived from the MRI

  20. Heterogeneous recruitment of quadriceps muscle portions and fibre types during moderate intensity knee-extensor exercise: effect of thigh occlusion

    DEFF Research Database (Denmark)

    Krustrup, Peter; Söderlund, Karin; Relu, Mihai U.

    2009-01-01

    temperature increase (DeltaT(m)) in RF was 0.52+/-0.09 degrees C, which was 57% and 73% higher (Pmuscle CP in slow twitch (ST) and fast......The involvement of quadriceps femoris muscle portions and fibre type recruitment was studied during submaximal knee-extensor exercise without and with thigh occlusion (OCC) and compared with responses during intense exercise. Six healthy male subjects performed 90-s of moderate exercise without...... twitch (FT) fibres was 81% and 91% of resting levels, respectively, with lower (Pfibres had CP levels below mean-1 SD, respectively, with corresponding values for FT fibres being 41...

  1. Long-standing morel-lavallee lesion in the proximal thigh: ultrasound and MR findings with surgical and histopathological correlation

    International Nuclear Information System (INIS)

    Puig, J.; Pelaez, I.; Banos, J.; Balliu, E.; Maroto, A.; Pedraza, S.; Casas, M.

    2006-01-01

    A 65-year-old man presented with a soft mass in his proximal right thigh. Ultrasonography showed a well-defined anechoic lesion with slightly internal echoes. On MRI, the mass was hypointense and minimally hyperintense compared with muscle at T 1 and hyperintense at T 2 , with a hypointense peripheral rim on both sequences. No signal loss was observed on T 1 -weighted fat-suppression MRI. The clinical setting, imaging findings and histopathological features were consistent with a long-standing Morel-Lavallee lesion

  2. Performance of thigh-mounted triaxial accelerometer algorithms in objective quantification of sedentary behaviour and physical activity in older adults.

    Directory of Open Access Journals (Sweden)

    Jorgen A Wullems

    Full Text Available Accurate monitoring of sedentary behaviour and physical activity is key to investigate their exact role in healthy ageing. To date, accelerometers using cut-off point models are most preferred for this, however, machine learning seems a highly promising future alternative. Hence, the current study compared between cut-off point and machine learning algorithms, for optimal quantification of sedentary behaviour and physical activity intensities in the elderly. Thus, in a heterogeneous sample of forty participants (aged ≥60 years, 50% female energy expenditure during laboratory-based activities (ranging from sedentary behaviour through to moderate-to-vigorous physical activity was estimated by indirect calorimetry, whilst wearing triaxial thigh-mounted accelerometers. Three cut-off point algorithms and a Random Forest machine learning model were developed and cross-validated using the collected data. Detailed analyses were performed to check algorithm robustness, and examine and benchmark both overall and participant-specific balanced accuracies. This revealed that the four models can at least be used to confidently monitor sedentary behaviour and moderate-to-vigorous physical activity. Nevertheless, the machine learning algorithm outperformed the cut-off point models by being robust for all individual's physiological and non-physiological characteristics and showing more performance of an acceptable level over the whole range of physical activity intensities. Therefore, we propose that Random Forest machine learning may be optimal for objective assessment of sedentary behaviour and physical activity in older adults using thigh-mounted triaxial accelerometry.

  3. Performance of thigh-mounted triaxial accelerometer algorithms in objective quantification of sedentary behaviour and physical activity in older adults

    Science.gov (United States)

    Verschueren, Sabine M. P.; Degens, Hans; Morse, Christopher I.; Onambélé, Gladys L.

    2017-01-01

    Accurate monitoring of sedentary behaviour and physical activity is key to investigate their exact role in healthy ageing. To date, accelerometers using cut-off point models are most preferred for this, however, machine learning seems a highly promising future alternative. Hence, the current study compared between cut-off point and machine learning algorithms, for optimal quantification of sedentary behaviour and physical activity intensities in the elderly. Thus, in a heterogeneous sample of forty participants (aged ≥60 years, 50% female) energy expenditure during laboratory-based activities (ranging from sedentary behaviour through to moderate-to-vigorous physical activity) was estimated by indirect calorimetry, whilst wearing triaxial thigh-mounted accelerometers. Three cut-off point algorithms and a Random Forest machine learning model were developed and cross-validated using the collected data. Detailed analyses were performed to check algorithm robustness, and examine and benchmark both overall and participant-specific balanced accuracies. This revealed that the four models can at least be used to confidently monitor sedentary behaviour and moderate-to-vigorous physical activity. Nevertheless, the machine learning algorithm outperformed the cut-off point models by being robust for all individual’s physiological and non-physiological characteristics and showing more performance of an acceptable level over the whole range of physical activity intensities. Therefore, we propose that Random Forest machine learning may be optimal for objective assessment of sedentary behaviour and physical activity in older adults using thigh-mounted triaxial accelerometry. PMID:29155839

  4. Passive radiofrequency shimming in the thighs at 3 Tesla using high permittivity materials and body coil receive uniformity correction.

    Science.gov (United States)

    Brink, Wyger M; Versluis, Maarten J; Peeters, Johannes M; Börnert, Peter; Webb, Andrew G

    2016-12-01

    To explore the effects of high permittivity dielectric pads on the transmit and receive characteristics of a 3 Tesla body coil centered at the thighs, and their implications on image uniformity in receive array applications. Transmit and receive profiles of the body coil with and without dielectric pads were simulated and measured in healthy volunteers. Parallel imaging was performed using sensitivity encoding (SENSE) with and without pads. An intensity correction filter was constructed from the measured receive profile of the body coil. Measured and simulated data show that the dielectric pads improve the transmit homogeneity of the body coil in the thighs, but decrease its receive homogeneity, which propagates into reconstruction algorithms in which the body coil is used as a reference. However, by correcting for the body coil reception profile this effect can be mitigated. Combining high permittivity dielectric pads with an appropriate body coil receive sensitivity filter improves the image uniformity substantially compared with the situation without pads. Magn Reson Med 76:1951-1956, 2016. © 2015 International Society for Magnetic Resonance in Medicine. © 2015 International Society for Magnetic Resonance in Medicine.

  5. The clinical and radiological importance of extraarticular contrast material leakage into adjacent synovial compartments on ankle MR arthrography in patients with OCD and anterolateral impingement

    Energy Technology Data Exchange (ETDEWEB)

    Ogul, Hayri, E-mail: drhogul@gmail.com [Department of Radiology, Medical Faculty, Ataturk University, Erzurum (Turkey); Guzel, Yunus [Department of Orthopaedics and Traumatology, Medical Faculty, Ordu University, Ordu (Turkey); Pirimoglu, Berhan [Department of Radiology, Medical Faculty, Ataturk University, Erzurum (Turkey); Tuncer, Kutsi [Department of Orthopedic, Medical Faculty, Ataturk University, Erzurum (Turkey); Polat, Gokhan; Ergun, Fatih; Sade, Recep; Bayraktutan, Ummugulsum; Yuce, Ihsan; Kantarci, Mecit [Department of Radiology, Medical Faculty, Ataturk University, Erzurum (Turkey)

    2016-10-15

    Purpose: To evaluate the tibiotalar joint capacity and the localisation, frequency and amount of extravasation in patients with extraarticular contrast material leakage into adjacent synovial compartments on ankle magnetic resonance (MR) arthrography. Materials and methods: Sites of extravasation were determined in the ankle MR arthrograms of 69 patients. Thirty-four patients without extraarticular contrast material leakage into locations unrelated to the injection path were included as a control group. Volumetric measurements of extraarticular contrast material leakage and the tibiotalar joint capacity were performed on a three dimensional (3D) volume measurement workstation. Results: Extravasation of contrast material occurred through the anterior, posterior, and anterolateral recesses of the tibiotalar joint. The most common site of extravasation was along the flexor hallucis longus tendon synovium (24.6%). The amount of extravasation was significantly higher in patients with ankle osteochondritis dissecans (OCD) than in patients with a different diagnosis (p = 0.039). Loose bodies were detected in all OCD’s patients with insufficient tibiotalar joint distention. Conclusions: Connections between the ankle joint and neighboring synovial compartments can decrease the diagnostic value of ankle MR arthrography examinations due to inadequate joint distention. Large injection volumes should be used for ankle MR arthrography of patients with OCD (especially OCD’s patients with loose body) and impingement syndrome.

  6. Combined reconstruction of the anterior cruciate ligament associated with anterolateral tenodesis effectively controls the acceleration of the tibia during the pivot shift.

    Science.gov (United States)

    Hardy, Alexandre; Casabianca, Laurent; Hardy, Edouard; Grimaud, Olivier; Meyer, Alain

    2017-04-01

    The pivot shift test is quantified subjectively during assessment of patients presenting with suspected Anterior Cruciate Ligament (ACL) tears and has a low interobserver reproducibility. The Kinematic Rapid Assessment (KiRA) is a triaxial accelerometer that makes it possible to non-invasively quantify tibial acceleration during the pivot shift test. Abolishing pivot shift is considered to be a key element in surgical reconstruction but is incomplete in 25-38% of patients. Patients were included prospectively. Inclusion criteria were patients requiring ACL reconstruction associated with at least one of the following factors corresponding to the patient who have a high risk of rupture either by their sports activity, a failure case, or the notion of important rotational laxity: the patient practiced a competitive pivot-contact sport, revision ACL reconstruction (besides STG (semitendinosus-gracilis graft) repair), subjective explosive rotational laxity, Segond fracture, and TELOS value of >10 mm. Standardized pre- and postoperative pivot shift tests were immediately performed under anesthesia in both knees. Forty-three patients were included. Mean preoperative variations in tibial acceleration in the healthy and injured knees were 1.2 ± 0.1 and 2.7 ± 0.3 m/s 2 , respectively, p operated knees (n.s). Combined ACL reconstruction associated with anterolateral tenodesis suppress acute pathologic tibial acceleration in the pivot shift. III.

  7. Percutaneous ultrasound-guided renal biopsy in supine antero-lateral position: a new approach for obese and non-obese patients.

    Science.gov (United States)

    Gesualdo, Loreto; Cormio, Luigi; Stallone, Giovanni; Infante, Barbara; Di Palma, Anna Maria; Delli Carri, Paolo; Cignarelli, Mauro; Lamacchia, Olga; Iannaccone, Salvatore; Di Paolo, Salvatore; Morrone, Luigi; Aucella, Filippo; Carrieri, Giuseppe

    2008-03-01

    Percutaneous ultrasound (US)-guided renal biopsy is the gold standard in the evaluation of renal diseases, but some patients, such as the obese, may not be eligible for this procedure. Aim of this study was to determine the feasibility, efficacy and safety of US-guided percutaneous renal biopsy in supine antero-lateral position (SALP) in high-risk patients (BMI > 30 and/or respiratory difficulty), as well as to compare the overall outcome of SALP with that of traditional prone position (PP) in low-risk patients (BMI SALP (Group 2), whereas 20 high-risk patients received US-guided renal biopsy in SALP (Group 3) and were our observational cohort study. Comfort compliance and breathing difficulty in each group were evaluated by the Visual Analogue Scale (VAS). Bleeding complications were evaluated through US renal scanning. Mean operating time was 7 min. Comfort compliance and breathing difficulty were significantly better for SALP in both low- and high-risk patients; there were no significant differences in pain after biopsy among the three groups. Bleeding complications were slightly higher in Group 1. Diagnostic yield was similar in all groups. SALP is reliable, minimally invasive, easy, highly successful, timesaving and almost free from severe side-effects. A better VAS score for breathing difficulty and comfort compliance characterizes this procedure, making it particularly suitable for obese patients.

  8. The clinical and radiological importance of extraarticular contrast material leakage into adjacent synovial compartments on ankle MR arthrography in patients with OCD and anterolateral impingement

    International Nuclear Information System (INIS)

    Ogul, Hayri; Guzel, Yunus; Pirimoglu, Berhan; Tuncer, Kutsi; Polat, Gokhan; Ergun, Fatih; Sade, Recep; Bayraktutan, Ummugulsum; Yuce, Ihsan; Kantarci, Mecit

    2016-01-01

    Purpose: To evaluate the tibiotalar joint capacity and the localisation, frequency and amount of extravasation in patients with extraarticular contrast material leakage into adjacent synovial compartments on ankle magnetic resonance (MR) arthrography. Materials and methods: Sites of extravasation were determined in the ankle MR arthrograms of 69 patients. Thirty-four patients without extraarticular contrast material leakage into locations unrelated to the injection path were included as a control group. Volumetric measurements of extraarticular contrast material leakage and the tibiotalar joint capacity were performed on a three dimensional (3D) volume measurement workstation. Results: Extravasation of contrast material occurred through the anterior, posterior, and anterolateral recesses of the tibiotalar joint. The most common site of extravasation was along the flexor hallucis longus tendon synovium (24.6%). The amount of extravasation was significantly higher in patients with ankle osteochondritis dissecans (OCD) than in patients with a different diagnosis (p = 0.039). Loose bodies were detected in all OCD’s patients with insufficient tibiotalar joint distention. Conclusions: Connections between the ankle joint and neighboring synovial compartments can decrease the diagnostic value of ankle MR arthrography examinations due to inadequate joint distention. Large injection volumes should be used for ankle MR arthrography of patients with OCD (especially OCD’s patients with loose body) and impingement syndrome.

  9. Thigh-calf contact parameters for six high knee flexion postures: Onset, maximum angle, total force, contact area, and center of force.

    Science.gov (United States)

    Kingston, David C; Acker, Stacey M

    2018-01-23

    In high knee flexion, contact between the posterior thigh and calf is expected to decrease forces on tibiofemoral contact surfaces, therefore, thigh-calf contact needs to be thoroughly characterized to model its effect. This study measured knee angles and intersegmental contact parameters in fifty-eight young healthy participants for six common high flexion postures using motion tracking and a pressure sensor attached to the right thigh. Additionally, we introduced and assessed the reliability of a method for reducing noise in pressure sensor output. Five repetitions of two squatting, two kneeling, and two unilateral kneeling movements were completed. Interactions of posture by sex occurred for thigh-calf and heel-gluteal center of force, and thigh-calf contact area. Center of force in thigh-calf regions was farther from the knee joint center in females, compared to males, during unilateral kneeling (82 and 67 mm respectively) with an inverted relationship in the heel-gluteal region (331 and 345 mm respectively), although caution is advised when generalizing these findings from a young, relatively fit sample to a population level. Contact area was larger in females when compared to males (mean of 155.61 and 137.33 cm 2 across postures). A posture main effect was observed in contact force and sex main effects were present in onset and max angle. Males had earlier onset (121.0°) and lower max angle (147.4°) with onset and max angles having a range between movements of 8° and 3° respectively. There was a substantial total force difference of 139 N between the largest and smallest activity means. Force parameters measured in this study suggest that knee joint contact models need to incorporate activity-specific parameters when estimating loading. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Effects of diet, packaging, and irradiation on protein oxidation, lipid oxidation, and color of raw broiler thigh meat during refrigerated storage.

    Science.gov (United States)

    Xiao, S; Zhang, W G; Lee, E J; Ma, C W; Ahn, D U

    2011-06-01

    This study was designed to evaluate the effects of dietary treatment, packaging, and irradiation singly or in combination on the oxidative stability of broiler chicken thigh meat. A total of 120 four-week-old chickens were divided into 12 pens (10 birds/pen), and 4 pens of broilers were randomly assigned to a control oxidized diet (5% oxidized oil) or an antioxidant-added diet [500 IU of vitamin E + 200 mg/kg of butylated hydroxyanisole (BHA)] and fed for 2 wk. After slaughter, thigh meats were separated, ground, packaged in either oxygen-permeable or oxygen-impermeable vacuum bags, and irradiated at 0 or 3 kGy. Lipid oxidation (TBA-reactive substances), protein oxidation (carbonyl), and color of the meat were measured at 1, 4, and 7 d of refrigerated storage. The lipid and protein oxidation of thigh meats from birds fed the diet supplemented with antioxidants (vitamin E + BHA) was significantly lower than the lipid and protein oxidation of birds fed the control diet, whereas the lipid and protein oxidation of broilers fed the oxidized oil diet was higher than that of birds fed the control diet. Vacuum packaging slowed, but irradiation accelerated, the lipid and protein oxidation of thigh meat during storage. Dietary antioxidants (vitamin E + BHA) and irradiation treatments showed a stronger effect on lipid oxidation than on protein oxidation. A significant correlation between lipid and protein oxidation in meat was found during storage. Dietary supplementation of vitamin E + BHA and the irradiation treatment increased the lightness and redness of thigh meat, respectively. It is suggested that appropriate use of dietary antioxidants in combination with packaging could be effective in minimizing oxidative changes in irradiated raw chicken thigh meat.

  11. Long-term follow-up of MRI changes in thigh muscles of patients with Facioscapulohumeral dystrophy: A quantitative study.

    Science.gov (United States)

    Fatehi, Farzad; Salort-Campana, Emmanuelle; Le Troter, Arnaud; Lareau-Trudel, Emilie; Bydder, Mark; Fouré, Alexandre; Guye, Maxime; Bendahan, David; Attarian, Shahram

    2017-01-01

    Facioscapulohumeral muscular dystrophy (FSHD) is one of the most common hereditary muscular disorders. Currently FSHD has no known effective treatment and detailed data on the natural history are lacking. Determination of the efficacy of a given therapeutic approach might be difficult in FSHD given the slow and highly variable disease progression. Magnetic resonance imaging (MRI) has been widely used to qualitatively and quantitatively evaluate in vivo the muscle alterations in various neuromuscular disorders. The main aim of the present study was to investigate longitudinally the time-dependent changes occurring in thigh muscles of FSHD patients using quantitative MRI and to assess the potential relationships with the clinical findings. Thirty-five FSHD1 patients (17 females) were enrolled. Clinical assessment tools including manual muscle testing using medical research council score (MRC), and motor function measure (MFM) were recorded each year for a period ranging from 1 to 2 years. For the MRI measurements, we used a new quantitative index, i.e., the mean pixel intensity (MPI) calculated from the pixel-intensity distribution in T1 weighted images. The corresponding MPI scores were calculated for each thigh, for each compartment and for both thighs totally (MPItotal). The total mean pixel intensity (MPItotal) refers to the sum of each pixel signal intensity divided by the corresponding number of pixels. An increased MPItotal indicates both a raised fat infiltration together with a reduced muscle volume thereby illustrating disease progression. Clinical scores did not change significantly over time whereas MPItotal increased significantly from an initial averaged value of 39.6 to 41.1 with a corresponding rate of 0.62/year. While clinical scores and MPItotal measured at the start of the study were significantly related, no correlation was found between the rate of MPItotal and MRC sum score changes, MFMtotal and MFM subscores. The relative rate of MPItotal

  12. Long-term follow-up of MRI changes in thigh muscles of patients with Facioscapulohumeral dystrophy: A quantitative study.

    Directory of Open Access Journals (Sweden)

    Farzad Fatehi

    Full Text Available Facioscapulohumeral muscular dystrophy (FSHD is one of the most common hereditary muscular disorders. Currently FSHD has no known effective treatment and detailed data on the natural history are lacking. Determination of the efficacy of a given therapeutic approach might be difficult in FSHD given the slow and highly variable disease progression. Magnetic resonance imaging (MRI has been widely used to qualitatively and quantitatively evaluate in vivo the muscle alterations in various neuromuscular disorders. The main aim of the present study was to investigate longitudinally the time-dependent changes occurring in thigh muscles of FSHD patients using quantitative MRI and to assess the potential relationships with the clinical findings. Thirty-five FSHD1 patients (17 females were enrolled. Clinical assessment tools including manual muscle testing using medical research council score (MRC, and motor function measure (MFM were recorded each year for a period ranging from 1 to 2 years. For the MRI measurements, we used a new quantitative index, i.e., the mean pixel intensity (MPI calculated from the pixel-intensity distribution in T1 weighted images. The corresponding MPI scores were calculated for each thigh, for each compartment and for both thighs totally (MPItotal. The total mean pixel intensity (MPItotal refers to the sum of each pixel signal intensity divided by the corresponding number of pixels. An increased MPItotal indicates both a raised fat infiltration together with a reduced muscle volume thereby illustrating disease progression. Clinical scores did not change significantly over time whereas MPItotal increased significantly from an initial averaged value of 39.6 to 41.1 with a corresponding rate of 0.62/year. While clinical scores and MPItotal measured at the start of the study were significantly related, no correlation was found between the rate of MPItotal and MRC sum score changes, MFMtotal and MFM subscores. The relative rate of

  13. Observations on habitat use, breeding chronology and parental care in Bristle-thighed Curlews on the Seward Peninsula, Alaska

    Science.gov (United States)

    Gill, R.E.; Lanctot, Richard B.; Mason, J.D.; Handel, Colleen M.

    1991-01-01

    Results from an intensive survey in 1989 of one of the two known breeding localities of Bristle-thighed Curlews Numenius tahitiensis are reported. During the pre-nesting period birds confined most of their activity to two vegetation communities: shrub meadow tundra and low shrub/tussock tundra. During nesting more than half the Curlews seen were observed on shrub meadow tundra, whilst during brood rearing, use of low shrub/tussock tundra continued to decline in importance as birds attending young increased their use of sedge wet meadows. Despite extensive searches no nests were located; however, observations of broods indicated that nest initiation began around 25 May and that hatching occurred during the last week of June. Detailed observations are presented on the formation of four brood-groups, some of which held different combinations of unrelated adults or young. The adaptive significance of this unusual wader behaviour is discussed.

  14. Cross-reacting Material-positive Hemophilia A Diagnosed in a Patient with a Spontaneous Thigh Hemorrhage.

    Science.gov (United States)

    Saito, Tatsuya; Mukae, Jyunichi; Nakamura, Yosuke; Inaba, Hiroshi; Nogami, Keiji; Koyama, Takatoshi; Fukutake, Katsuyuki; Yamamoto, Koh

    2017-01-01

    A 53-year-old man, who had been diagnosed with mild hemophilia A (HA) at 35 years of age, was hospitalized with a thigh hematoma. His bleeding continued despite the administration of recombinant factor VIII (FVIII). The results of an FVIII/von Willebrand factor binding assay were normal. The patient's FVIII coagulant activity (FVIII:C) was low, but his FVIII antigen levels were within the normal limits, suggesting FVIII protein dysfunction. The FVIII:C measurements obtained by one-stage clotting and chromogenic assays were different. An FVIII gene analysis revealed a missense mutation p.Ser308Leu, which is rare in Japan. This case highlights that gene analyses and chromogenic assays are necessary to interpret the discrepancies between FVIII:C and the bleeding phenotype of patients with mild HA.

  15. [Acute mild hypoxia impairment of dynamic cerebral autoregulation assessed by spectral analysis and thigh-cuff deflation].

    Science.gov (United States)

    Katsukawa, Hajime; Ogawa, Yojiro; Aoki, Ken; Yanagida, Ryo; Iwasaki, Kenichi

    2012-01-01

    Acute hypoxia may impair dynamic cerebral autoregulation. However, previous studies have been controversial. The difference in methods of estimation of dynamic cerebral autoregulation is reported to be responsible for conflicting reports. We, therefore, conducted this study using two representative methods of estimation of dynamic cerebral autoregulation to test our hypothesis that dynamic cerebral autoregulation is impaired during acute exposure to mild hypoxia. Eleven healthy men were exposed to 15% oxygen concentration for two hours. They were examined under normoxia (21% O(2)) and hypoxia (15% O(2)). The mean arterial pressure (MAP) in the radial artery was measured by tonometry, and cerebral blood flow velocity (CBFv) in the middle cerebral artery was measured by transcranial Doppler ultrasonography. Dynamic cerebral autoregulation was assessed by spectral and transfer function analyses of beat-by-beat changes in MAP and CBFv. Moreover, the dynamic rate of regulation and percentage restoration of CBFv were estimated when a temporal decrease in arterial pressure was induced by thigh-cuff deflation. Arterial oxygen saturation decreased significantly during hypoxia (97±0% to 88±1%), whereas respiratory rate was unchanged, as was steady-state CBFv. With 15% O(2), the very-low-frequency power of CBFv variability increased significantly. Transfer function coherence (0.40±0.02 to 0.53±0.05) and gain (0.51±0.07 cm/s/mmHg to 0.79±0.11 cm/s/mmHg) in the very-low-frequency range increased significantly. Moreover, the percentage restoration of CBF velocity determined by thigh-cuff deflation decreased significantly during hypoxia (125±25% to 65±8%). Taken together, these results obtained using two representative methods consistently indicate that mild hypoxia impairs dynamic cerebral autoregulation.

  16. Differences in Physicochemical and Nutritional Properties of Breast and Thigh Meat from Crossbred Chickens, Commercial Broilers, and Spent Hens

    Directory of Open Access Journals (Sweden)

    Yulian Chen

    2016-06-01

    Full Text Available The objective of this study was to compare the physicochemical and nutritional properties of breast and thigh meat from commercial Chinese crossbred chickens (817 Crossbred chicken, 817C, imported commercial broilers (Arbor Acres broiler, AAB, and commercial spent hens (Hyline Brown, HLB. The crossbred chickens, commercial broilers and spent hens were slaughtered at their typical market ages of 45 d, 40 d, and 560 d, respectively. The results revealed that several different characteristic features for the three breeds. The meat of the 817C was darker than that of the other two genotypes. The 817C were also characterized by higher protein, lower intramuscular fat, and better texture attributes (cooking loss, pressing loss and Warner-Bratzler shear force [WBSF] compared with AAB and HLB. The meat of the spent hens (i.e. HLB was higher in WBSF and total collagen content than meat of the crossbred chickens and imported broilers. Furthermore, correlation analysis and principal component analysis revealed that there was a clear relationship among physicochemical properties of chicken meats. With regard to nutritional properties, it was found that 817C and HLB exhibited higher contents of essential amino acids and essential/non-essential amino acid ratios. In addition, 817C were noted to have highest content of microelements whereas AAB have highest content of potassium. Besides, 817C birds had particularly higher proportions of desirable fatty acids, essential fatty acids, polyunsaturated/saturated and (18:0+18:1/16:0 ratios. The present study also revealed that there were significant differences on breast meat and thigh meat for the physicochemical and nutritional properties, regardless of chicken breeds. In conclusion, meat of crossbred chickens has some unique features and exhibited more advantages over commercial broilers and spent hens. Therefore, the current investigation would provide valuable information for the chicken meat product processing

  17. Differences in Physicochemical and Nutritional Properties of Breast and Thigh Meat from Crossbred Chickens, Commercial Broilers, and Spent Hens

    Science.gov (United States)

    Chen, Yulian; Qiao, Yan; Xiao, Yu; Chen, Haochun; Zhao, Liang; Huang, Ming; Zhou, Guanghong

    2016-01-01

    The objective of this study was to compare the physicochemical and nutritional properties of breast and thigh meat from commercial Chinese crossbred chickens (817 Crossbred chicken, 817C), imported commercial broilers (Arbor Acres broiler, AAB), and commercial spent hens (Hyline Brown, HLB). The crossbred chickens, commercial broilers and spent hens were slaughtered at their typical market ages of 45 d, 40 d, and 560 d, respectively. The results revealed that several different characteristic features for the three breeds. The meat of the 817C was darker than that of the other two genotypes. The 817C were also characterized by higher protein, lower intramuscular fat, and better texture attributes (cooking loss, pressing loss and Warner-Bratzler shear force [WBSF]) compared with AAB and HLB. The meat of the spent hens (i.e. HLB) was higher in WBSF and total collagen content than meat of the crossbred chickens and imported broilers. Furthermore, correlation analysis and principal component analysis revealed that there was a clear relationship among physicochemical properties of chicken meats. With regard to nutritional properties, it was found that 817C and HLB exhibited higher contents of essential amino acids and essential/non-essential amino acid ratios. In addition, 817C were noted to have highest content of microelements whereas AAB have highest content of potassium. Besides, 817C birds had particularly higher proportions of desirable fatty acids, essential fatty acids, polyunsaturated/saturated and (18:0+18:1)/16:0 ratios. The present study also revealed that there were significant differences on breast meat and thigh meat for the physicochemical and nutritional properties, regardless of chicken breeds. In conclusion, meat of crossbred chickens has some unique features and exhibited more advantages over commercial broilers and spent hens. Therefore, the current investigation would provide valuable information for the chicken meat product processing, and

  18. The neuromechanical functional contractile properties of the thigh muscles measured using tensiomyography in male athletes and non-athletes

    Directory of Open Access Journals (Sweden)

    Toskić Lazar

    2016-01-01

    Full Text Available Involuntary neuromechanical muscle contractile properties, especially of the extensor muscles and knee joint flexors as the largest muscle groups of the caudal part of the body, play an important role in both everyday movement and sport. Based on these data we can obtain important information on the functional properties of muscles. The basic means of evaluation of the functional involuntary neuromechanical muscles contractile properties is the non-invasive tensiomyographic method (TMG. The aim of this study was to determine the differences between the involuntary neuromechanical contractile properties of the thigh muscles measured using the TMG method on a sample of male athletes and non-athletes. The sample of participants was made up of 17 athletes and 10 non-athletes. By applying the multivariate analysis of variance (MANOVA and the t-test, we achieved results which indicate that of the overall 30 variables, a difference was determined among 13 of them. Most of the differences were determined for the extensor muscles of the right knee, especially of the rectus femoris muscle. It was also shown that in addition to the main knee joint extensor muscle (rectus femoris the main knee joint flexor muscle (biceps femoris also takes part in the definition of the difference between athletes and non-athletes. The results have shown that the following variables: contraction time (Tc and delay contraction time (Td are the functional parameters for which the highest difference between athletes and non-athletes were determined (from t = -2.284, p < 0.05 for the vastus lateralis of the right leg to t = -4.018, p < 0.01 for the rectus femoris of the left leg. These results have shown that it is possible to determine the differences in the functional involuntary neuromechanical contractile properties of the thigh muscles among trained and untrained individuals using the tensiomyographic method, but at the same time indicated that these differences were very

  19. The Impact of Chocolate Goat's and Cow's Milk on Postresistance Exercise Endocrine Responses and Isometric Mid-Thigh Pull Performance.

    Science.gov (United States)

    Bellar, David; LeBlanc, Nina R; Murphy, Kellie; Moody, Kaitlyn M; Buquet, Gina

    2016-01-01

    The present investigation examined the effects of chocolate cow's and goat's milk on endocrine responses and isometric mid-thigh pull performance post back squat exercise. Twelve college-aged males volunteered to participate and reported to the lab on four occasions. The first visit included anthropometric measurement, one-repetition back squat (1RM), and familiarization with the isometric mid-thigh pull assessment (IMTP). During the subsequent three visits, five sets of eight repetitions of the back squat exercise at 80% of 1RM were performed. For these trials, the participants performed an IMTP and gave a saliva sample prior to, immediately after, 1 hr and 2 hr post exercise. After exercise, a treatment of low-fat chocolate goat's milk (355 ml, 225 kcal), low-fat chocolate cow's milk (355 ml, 225 kcal), or control (water 355 ml, 0 kcal) was given in a counterbalanced order. Saliva samples were analyzed for testosterone, cortisol, and dehydroepiandrosterone (DHEA). Cortisol and DHEA hormone were unaffected by exercise; however, testosterone values did increase significantly post exercise. For IMTP, there was a significant main effect for time (F = 8.41, p = .007) but no treatment or interactions effects. N changes were noted post supplementation for cortisol or DHEA, but testosterone was found to be significantly reduced in both diary treatments compared to control (F = 4.27, p = .022). Based upon these data, it appears that a single treatment of chocolate goat's or cow's milk results in similar endocrine alterations but both fail to enhance postexercise isometric strength following resistance exercise.

  20. The Effect of Utilization of Sweet Potato Flour as Energy Source of Broiler Feed at Finisher Period to Carcass Weight, Chest Weight, Thigh Weight and Abdominal Fat

    Directory of Open Access Journals (Sweden)

    Nonok Supartini

    2012-02-01

    Full Text Available The objective of current research is was to know the effect of feeding sweet potato flour as a source of energy to carcass weight, chest weight, thigh weight, and abdominal fat.The material of the research were 80 finisher male broiler with initial weight of 963.37 ± 31.23 g. Completely Randomized Design (CRD used for research method which consisted of 4 treatment, namely feeding without sweet potato flour (P0, with concentration of sweet potato flour of 10% (P1, 20% (P2 and 30% (P3.The parameter of research were carcass weight, chest weight,thigh weight and abdominal fat. The results showed that the gift effect of sweet potato flour to carcass weight were P0 1199.4%; P1 1138.98%; P2 1076.6; P3 1038.2; chest weight of P0 358.08; P1 366.6; P2 337.8; and P3 323.4%; thigh weight of P0 479.8; P1 472.94; P2 468.4; and P3 442; and abdominal fat of P0 33.2; P1 35.6; P2 25.4; P3 27.8. It could be concluded that the concentration of 10% sweet potato flour from total feeding gave the best treatment.   Keywords : sweet potato flour, carcass weight, chest weight, thigh weight, abdominal fat

  1. Application of thiopropyl sepharose 6B for removal of PCR inhibitors from DNA extracts of a thigh bone recovered from the sea

    DEFF Research Database (Denmark)

    Sørensen, Erik; Hansen, Steen Holger; Eriksen, Birthe

    2003-01-01

    for the removal of PCR inhibitors in DNA extracts originating from stains on clothing. Here we show that TS is efficient also for the removal of inhibitors from PCR extracts from a highly decomposed human thigh bone. TS treatment, however, leads to a substantial loss of DNA making the technique best suited when...

  2. Visibility of Anterolateral Ligament Tears in Anterior Cruciate Ligament-Deficient Knees With Standard 1.5-Tesla Magnetic Resonance Imaging.

    Science.gov (United States)

    Hartigan, David E; Carroll, Kevin W; Kosarek, Frank J; Piasecki, Dana P; Fleischli, James F; D'Alessandro, Donald F

    2016-10-01

    To attempt to visualize the ligament with standard 1.5-tesla magnetic resonance imaging (MRI) in the acute anterior cruciate ligament (ACL)-torn knee, and if it is visible, attempt to characterize it as torn or intact at its femoral, meniscal, and tibial attachment sites. This was a retrospective MRI study based on arthroscopic findings of a known ACL tear in 72 patients between the years 2006 and 2010. Patients all had hamstring ACL reconstructions, no concomitant lateral collateral ligament, or posterolateral corner injury based on imaging and physical examination, and had a preoperative 1.5-tesla MRI scan with standard sequences performed within 3 weeks of the injury. Two fellowship-trained musculoskeletal radiologists retrospectively reviewed the preoperative MRI for visualization of the anterolateral ligament (ALL) for concomitant tears. Inter- and intraobserver reliability was calculated. Learning effect was analyzed to determine if radiologists' agreement improved as reads progressed. Both radiologists were able to visualize the ALL in 100% of the scans. Overall, ALL tears were noted in 26% by radiologist 1 and in 62% by radiologist 2. The agreement between the ligament being torn or not had a kappa of 0.54 between radiologists. The agreements in torn or not torn between radiologists in the femoral, meniscal, and tibial sites were 0.14, 0.15, and 0.31. The intraobserver reliability by radiologist 1 for femoral, meniscal, and tibial tears was 0.04, 0.57, and 0.54 respectively. For radiologist 2, they were 0.75, 0.61, and 0.55. There was no learning effect noted. ALL tears are currently unable to be reliably identified as torn or intact on standard 1.5-tesla MRI sequences. Proper imaging sequences are of crucial importance to reliably follow these tears to determine their clinical significance. Level IV, therapeutic case series study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  3. Isometric Mid-Thigh Pull Correlates With Strength, Sprint, and Agility Performance in Collegiate Rugby Union Players.

    Science.gov (United States)

    Wang, Ran; Hoffman, Jay R; Tanigawa, Satoru; Miramonti, Amelia A; La Monica, Michael B; Beyer, Kyle S; Church, David D; Fukuda, David H; Stout, Jeffrey R

    2016-11-01

    Wang, R, Hoffman, JR, Tanigawa, S, Miramonti, AA, La Monica, MB, Beyer, KS, Church, DD, Fukuda, DH, and Stout, JR. Isometric mid-thigh pull correlates with strength, sprint, and agility performance in collegiate rugby union players. J Strength Cond Res 30(11): 3051-3056, 2016-The purpose of this investigation was to examine the relationships between isometric mid-thigh pull (IMTP) force and strength, sprint, and agility performance in collegiate rugby union players. Fifteen members of a champion-level university's club rugby union team (mean ± SD: 20.67 ± 1.23 years, 1.78 ± 0.06 m, and 86.51 ± 14.18 kg) participated in this investigation. One repetition maximum (1RM) squat, IMTP, speed (40 m sprint), and agility (proagility test and T-test) were performed during 3 separate testing sessions. Rate of force development (RFD) and force output at 30, 50, 90, 100, 150, 200, and 250 milliseconds of IMTP, as well as the peak value were determined. Pearson product-moment correlation analysis was used to examine the relationships between these measures. Performance in the 1RM squat was significantly correlated to the RFD between 90 and 250 milliseconds from the start of contraction (r's ranging from 0.595 to 0.748), and peak force (r = 0.866, p ≤ 0.05). One repetition maximum squat was also correlated to force outputs between 90 and 250 milliseconds (r's ranging from 0.757 to 0.816, p ≤ 0.05). Sprint time over the first 5 m in the 40 m sprint was significantly (p ≤ 0.05) correlated with peak RFD (r = -0.539) and RFD between 30 and 50 milliseconds (r's = -0.570 and -0.527, respectively). Time for the proagility test was correlated with peak RFD (r = -0.523, p ≤ 0.05) and RFD between 30 and 100 milliseconds (r's ranging from -0.518 to -0.528, p's strength, agility, and sprint performance. Future studies should examine IMTP as a potential tool to monitor athletic performance during the daily training of rugby union players.

  4. Effect of pre-cooling, with and without thigh cooling, on strain and endurance exercise performance in the heat.

    Science.gov (United States)

    Cotter, J D; Sleivert, G G; Roberts, W S; Febbraio, M A

    2001-04-01

    Body cooling before exercise (i.e. pre-cooling) reduces physiological strain in humans during endurance exercise in temperate and warm environments, usually improving performance. This study examined the effectiveness of pre-cooling humans by ice-vest and cold (3 degrees C) air, with (LC) and without (LW) leg cooling, in reducing heat strain and improving endurance performance in the heat (35 degrees C, 60% RH). Nine habitually-active males completed three trials, involving pre-cooling (LC and LW) or no pre-cooling (CON: 34 degrees C air) before 35-min cycle exercise: 20 min at approximately 65% VO2peak then a 15-min work-performance trial. At exercise onset, mean core (Tc, from oesophagus and rectum) and skin temperatures, forearm blood flow (FBF), heart rate (HR), and ratings of exertion, body temperature and thermal discomfort were lower in LW and LC than CON (Pcooling by ice-vest and cold air effectively reduced physiological and psychophysical strain and improved endurance performance in the heat, irrespective of whether thighs were warmed or cooled.

  5. Home Range of the Spur-Thighed Tortoise, Testudo graeca (Testudines, Testudinidae, in the National Park of El Kala, Algeria

    Directory of Open Access Journals (Sweden)

    Rouag R.

    2017-02-01

    Full Text Available Spur-thighed tortoise is a vulnerable species, the local declines of populations require an imperative need for conservation. Research on habitat use is essential for understanding population ecology. To investigate the home range and movement patterns we studied a population which occupies an enclosed area of 30 ha in northeastern Algeria. Studies of movement showed that home ranges were substantially smaller than in Spain. This difference was due to the high trophic availability with significant richness in plants which make part of the diet of the tortoise. The home range varied from 0.287 ha in males to 0.354 ha for females; there was no sexual difference. The males are the most active with a distance of 3.79 m/d. Females and juveniles are respectively about 2.25 m/d and 2.11 m/d. The distance moved each day do not vary significantly by sex and ages. Results from this study are important for establishing conservation strategies for this vulnerable species.

  6. Use of anteromedial thigh perforator flap and immunological implications of Gorlin-Goltz syndrome: a case study.

    Science.gov (United States)

    Scalise, A; Calamita, R; Tartaglione, C; Bolletta, E; Di Benedetto, G; Pierangeli, M

    2016-12-02

    Gorlin-Goltz syndrome is mainly characterised by the development of numerous multicentric and relapsing cutaneous basal cell carcinomas (BCCs). A major problem for patients with Gorlin-Goltz syndrome is the large amount of BCCs that can invade the deep underlying structures, especially the face. Here, we describe the case of a 23-year-old male affected by Gorlin-Goltz syndrome. He had recurrent BCCs on a hairless scalp and dorsum since he was 17 years old and underwent four surgical procedures to excise BCCs, including a reconstruction with anteromedial thigh perforator flap. For each of the surgical procedures, a phenotypic study on peripheral blood mononuclear cells using flow cytometry was performed on the same day of surgery, and on days 7, 14 and 21 after surgery. The role of the tumour-specific cytolytic immune response as a potential future treatment of syndromic BCCs and its trend in relation to surgical ablation of large portions of tumour tissue was examined, and the cosmetic and therapeutic results are shown.

  7. Influence of Anterior Cruciate Ligament Tear on Thigh Muscle Strength and Hamstring-to-Quadriceps Ratio: A Meta-Analysis

    Science.gov (United States)

    Ahn, Sung-Eun; Park, Min-Ji; Lee, Dae-Hee

    2016-01-01

    Theoretical compensation after anterior cruciate ligament (ACL) tear could cause quadriceps weakness and hamstring activation, preventing anterior tibial subluxation and affecting the expected hamstring-to-quadriceps ratio. Although quadriceps weakness often occurs after ACL tears, it remains unclear whether hamstring strength and hamstring-to-quadriceps ratio increase in ACL deficient knees. This meta-analysis compared the isokinetic muscle strength of quadriceps and hamstring muscles, and the hamstring-to-quadriceps ratio, of the injured and injured limbs of patients with ACL tears. This meta-analysis included all studies comparing isokinetic thigh muscle strengths and hamstring-to-quadriceps ratio in the injured and uninjured legs of patients with ACL tear, without or before surgery. Thirteen studies were included in the meta-analysis. Quadriceps and hamstring strengths were 22.3 N∙m (95% CI: 15.2 to 29.3 N∙m; Phamstring-to-quadriceps ratio was 4% greater in ACL deficient than in uninjured limbs (95% CI: 1.7% to 6.3%; Phamstring muscles of patients with ACL tear, with the decrease in quadriceps strength being 3-fold greater. These uneven reductions slightly increase the hamstring-to-quadriceps ratio in ACL deficient knees. PMID:26745808

  8. Influence of Anterior Cruciate Ligament Tear on Thigh Muscle Strength and Hamstring-to-Quadriceps Ratio: A Meta-Analysis.

    Science.gov (United States)

    Kim, Hyun-Jung; Lee, Jin-Hyuck; Ahn, Sung-Eun; Park, Min-Ji; Lee, Dae-Hee

    2016-01-01

    Theoretical compensation after anterior cruciate ligament (ACL) tear could cause quadriceps weakness and hamstring activation, preventing anterior tibial subluxation and affecting the expected hamstring-to-quadriceps ratio. Although quadriceps weakness often occurs after ACL tears, it remains unclear whether hamstring strength and hamstring-to-quadriceps ratio increase in ACL deficient knees. This meta-analysis compared the isokinetic muscle strength of quadriceps and hamstring muscles, and the hamstring-to-quadriceps ratio, of the injured and injured limbs of patients with ACL tears. This meta-analysis included all studies comparing isokinetic thigh muscle strengths and hamstring-to-quadriceps ratio in the injured and uninjured legs of patients with ACL tear, without or before surgery. Thirteen studies were included in the meta-analysis. Quadriceps and hamstring strengths were 22.3 N∙m (95% CI: 15.2 to 29.3 N∙m; Pratio was 4% greater in ACL deficient than in uninjured limbs (95% CI: 1.7% to 6.3%; Pratio in ACL deficient knees.

  9. Aflatoxin B1 residues in imported and local broiler, s breast and thigh muscle in Kurdistan region

    Directory of Open Access Journals (Sweden)

    E.P. Candlan

    2015-06-01

    Full Text Available Residues of Aflatoxins and their metabolites might be present in meat and other products of animals receiving Aflatoxin contaminated feeds which could subsequently create health problems in man. Eighty nine imported (Iran/Khosh pokht; (Turkey/Yam-tapilic, Lades, Senplic, Kapidac, Kozoa, Oznesilpilic and (Brazil, hilal, Sadia, and 90 locally produced (Hoshiar poultry farm, Nihad poultry farm, Hokar poultry farm, Mansoor poultry farm, AL-Shimal poultry house, Mardin poultry house and AL-Eetimad poultry slaughterhouse broiler breast and thigh muscle samples were examined for residual Aflatoxin B1 using ELIZA test. Results revealed that out of 89 imported samples only 21 (23.59% were positive, but only 2 (2.24% were rejected, while the remaining 87 samples (97.75% were acceptable. Concerning the local samples, results showed that 19 samples (21.11% were positive, but 10 (11.11% were rejected, while the remaining 80 samples (88.88% were accepted. The public health importance of residual AFB1 in broiler meat samples was discussed.

  10. Muscle tension increases impact force but decreases energy absorption and pain during visco-elastic impacts to human thighs.

    Science.gov (United States)

    Tsui, Felix; Pain, Matthew T G

    2018-01-23

    Despite uncertainty of its exact role, muscle tension has shown an ability to alter human biomechanical response and may have the ability to reduce impact injury severity. The aim of this study was to examine the effects of muscle tension on human impact response in terms of force and energy absorbed and the subjects' perceptions of pain. Seven male martial artists had a 3.9 kg medicine ball dropped vertically from seven different heights, 1.0-1.6 m in equal increments, onto their right thigh. Subjects were instructed to either relax or tense the quadriceps via knee extension (≥60% MVC) prior to each impact. F-scan pressure insoles sampling at 500 Hz recorded impact force and video was recorded at 1000 Hz to determine energy loss from the medicine ball during impact. Across all impacts force was 11% higher, energy absorption was 15% lower and time to peak force was 11% lower whilst perceived impact intensity was significantly lower when tensed. Whether muscle is tensed or not had a significant and meaningful effect on perceived discomfort. However, it did not relate to impact force between conditions and so tensing may alter localised injury risk during human on human type impacts. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Magnetic resonance imaging, ultrasound and real-time ultrasound elastography of the thigh muscles in congenital muscle dystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Drakonaki, Eleni E. [University of Crete, Radiology Department, Heraklion (Greece); Allen, Gina M. [Green Templeton College, Oxford (United Kingdom)

    2010-04-15

    Congenital muscle dystrophy includes a range of genetic disorders characterized by muscle weakness and contractures. We report the magnetic resonance (MR), ultrasound (US) and real-time sonoelastography (RTE) imaging findings of the thigh muscles of a 15-year-old boy with Bethlem myopathy diagnosed with clinical, electromyographic and histopathological criteria. Ultrasound and MR showed hyperechoic appearance and high signal intensity on T1- and T2-weighted sequences respectively at the periphery of the vastus lateralis and the long head of the biceps femoris muscles, and at a central area within the rectus femoris muscles. RTE was employed to examine the elastic properties of the muscle. The elastograms were presented as colour-coded maps superimposed on the B-mode images and revealed that the elastographic pattern correlated with the MR and US pattern of involvement. The abnormal muscle areas were stiffer (blue) than the normal-appearing areas (green), a finding that probably correlates with the presence of dystrophic collagen at the affected areas. This report suggests that RTE could be used as an additional imaging tool to evaluate the pattern of muscle changes in congenital myopathy. Further studies are needed to investigate the specificity and clinical value of RTE in the diagnosis and monitoring of neuromuscular disease. (orig.)

  12. Magnetic resonance imaging, ultrasound and real-time ultrasound elastography of the thigh muscles in congenital muscle dystrophy

    International Nuclear Information System (INIS)

    Drakonaki, Eleni E.; Allen, Gina M.

    2010-01-01

    Congenital muscle dystrophy includes a range of genetic disorders characterized by muscle weakness and contractures. We report the magnetic resonance (MR), ultrasound (US) and real-time sonoelastography (RTE) imaging findings of the thigh muscles of a 15-year-old boy with Bethlem myopathy diagnosed with clinical, electromyographic and histopathological criteria. Ultrasound and MR showed hyperechoic appearance and high signal intensity on T1- and T2-weighted sequences respectively at the periphery of the vastus lateralis and the long head of the biceps femoris muscles, and at a central area within the rectus femoris muscles. RTE was employed to examine the elastic properties of the muscle. The elastograms were presented as colour-coded maps superimposed on the B-mode images and revealed that the elastographic pattern correlated with the MR and US pattern of involvement. The abnormal muscle areas were stiffer (blue) than the normal-appearing areas (green), a finding that probably correlates with the presence of dystrophic collagen at the affected areas. This report suggests that RTE could be used as an additional imaging tool to evaluate the pattern of muscle changes in congenital myopathy. Further studies are needed to investigate the specificity and clinical value of RTE in the diagnosis and monitoring of neuromuscular disease. (orig.)

  13. Knee-extension strength, postural control and function are related to fracture type and thigh edema in patients with hip fracture

    DEFF Research Database (Denmark)

    Kristensen, Morten T; Bandholm, Thomas; Bencke, Jesper

    2008-01-01

    BACKGROUND: Post-surgery thigh edema, loss of knee-extension strength, and reduced physical performance are common following a hip fracture. It is not known if knee-extension strength and physical performance are related to the edema and fracture type. The aim of this study was to examine...... the influence of fracture type and post-surgery edema on physical performances in patients with hip fracture. METHODS: Fifteen women and five men admitted from their own home to an acute orthopedic hip fracture unit were examined. Ten had cervical and ten had intertrochanteric fractures. Correlations between...... fracture type and thigh edema in the fractured limb (% non-fractured) to physical performances of basic mobility, postural control (sway), and isometric knee-extension strength were examined. All measures, except those of basic mobility, were conducted at the time of discharge, 8.5 days post...

  14. The 6-minute walk test, motor function measure and quantitative thigh muscle MRI in Becker muscular dystrophy: A cross-sectional study.

    Science.gov (United States)

    Fischer, Dirk; Hafner, Patricia; Rubino, Daniela; Schmid, Maurice; Neuhaus, Cornelia; Jung, Hans; Bieri, Oliver; Haas, Tanja; Gloor, Monika; Fischmann, Arne; Bonati, Ulrike

    2016-07-01

    Becker muscular dystrophy (BMD) has an incidence of 1 in 16 000 male births. This cross-sectional study investigated the relation between validated functional scores and quantitative MRI (qMRI) of thigh muscles in 20 ambulatory BMD patients, aged 18.3-60 years (mean 31.2; SD 11.1). Clinical assessments included the motor function measure (MFM) and its subscales, as well as timed function tests such as the 6-minute walk test (6MWT) and the timed 10-m run/walk test. Quantitative MRI of the thigh muscles included the mean fat fraction (MFF) using a 2-point Dixon (2-PD) technique, and transverse relaxation time (T2) measurements. The mean MFM value was 80.4%, SD 9.44 and the D1 subscore 54.5%, SD 19.9. The median 6MWT was 195m, IQR 160-330.2. The median 10-m run/walk test was 7.4 seconds, IQR 6.1-9.3. The mean fat fraction of the thigh muscles was 55.6%, SD 17.4%, mean T2 relaxation times of all muscles: 69.9 ms, SD 14.4. The flexors had the highest MFF and T2 relaxation times, followed by the extensors and the adductors. MFF and global T2 relaxation times were highly negatively correlated with the MFM total, D1-subscore and 6MWT, and positively correlated with the 10 m run/walk test time (p < 0.01). Age was not correlated with MFF, global T2 relaxation time or clinical assessments. Both MFF and T2 measures in the thigh muscle were well correlated with clinical function in BMD and may serve as a surrogate outcome measure in clinical trials. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Effects of the Dietary Supplementation of Sucupira (Pterodon Emarginatus Vog. and Copaiba (Copaifera Langsdorffii Resinoils on Chicken Breast and Thigh Meat Quality and Oxidative Stability

    Directory of Open Access Journals (Sweden)

    CB de Lima

    2015-12-01

    Full Text Available ABSTRACT An experiment was conducted to evaluate the addition of the oil resins ofsucupira (Pterodon emarginatus Vog. and copaiba (Copaifera langsdorffii to broiler diets on chicken meat composition, quality, and lipid peroxidation. 350 one-d-old broiler chicks were submitted to seven treatments, consisting of the diets supplemented with copaiba (COP or sucupira (SUC resin oils at three different concentrations (500, 900, and 1300 ppm plus a negative control diet (CONT. At 37 days of age, 10 birds per treatment were selected according to the average weight of the experimental unit and slaughtered to collect breast and thigh meat, which was stored at 4°C for 24 hours to evaluate pH, color (L*, a*, b*, cooking weight loss (CWL, and shear force (SF. Raw meat was vacuum packed and stored frozen until lipid peroxidation analysis. Meat samples were pooled to prepare pre-cooked meatballs (30 ± 0.5g, stored under refrigeration (eight days, and analyzed every two days for TBARS concentration. Results were analyzed using the PROC GLM and MIXED procedures (SAS statistical software. Plant oils increased (p<0.05 breast meat humidity (HU and crude protein (CP levels and reduced (p<0.05 total lipid (TLC and ash (AS levels when compared with the CONT treatment. Plant oils increased (p<0.05 thigh meat HU when compared with the CONT. High COP dietary levels reduced (p<0.05 breast meat CWL, and increased (p<0.05 thigh meat L* values when compared to CONT, except for SUC500 and SUC900. The dietary inclusion of plant oil resins showed a pro-oxidant effect (p<0.01 on breast meat when compared with the CONT. Low SUC dietary supplementation levels significantly reduced (p<0.01 the concentration of secondary oxidation products in thigh meat.

  16. Diffusion-Tensor Imaging of Thigh Muscles in Duchenne Muscular Dystrophy: Correlation of Apparent Diffusion Coefficient and Fractional Anisotropy Values With Fatty Infiltration.

    Science.gov (United States)

    Li, Gui Dian; Liang, Ying Yin; Xu, Ping; Ling, Jian; Chen, Ying Ming

    2016-04-01

    The purpose of this study is to investigate the correlation of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values with fatty infiltration in the thigh muscles of patients with Duchenne muscular dystrophy (DMD) using diffusion-tensor imaging (DTI). Twenty-one boys with DMD were recruited. The grade of fatty infiltration and the ADC and FA values of four thigh muscles (rectus femoris, semitendinosus, sartorius, and gracilis) were measured, and the FA and ADC values were compared with the grade of fatty infiltration. Twenty age-matched healthy boys were enrolled as the control group. The differences in the ADC and FA values of the thigh muscles between patients with DMD and the control group were compared. The patients with DMD showed lower FA values and higher ADC values in all measured muscles when compared with the control group. The FA and ADC values were correlated with the grade of fatty infiltration. For the rectus femoris muscle, r = -0.753 and p = 0.007 for FA, and r = 0.685 and p = 0.001 for ADC. For the semitendinosus muscle, r = -0.621 and p = 0.041 for FA, and r = 0.705 and p = 0.021 for ADC. For the sartorius muscle, r = -0.662 and p = 0.027 for FA, and r = 0.701 and p = 0.017 for ADC. For the gracilis muscle, r = -0.618 and p = 0.043 for FA, and r = 0.695 and p = 0.022 for ADC. Damage to the thigh muscles in patients with DMD can be detected by ADC and FA values using DTI. DTI can be used to assess the severity of the disease.

  17. The use of the greater trochanter marker in the thigh segment model: Implications for hip and knee frontal and transverse plane motion

    Directory of Open Access Journals (Sweden)

    Valentina Graci

    2016-03-01

    Conclusion: Hip and knee kinematics differed across different segment definitions including or excluding the greater trochanter marker, especially in the transverse plane. Therefore when considering whether to include the greater trochanter in the thigh segment model when using a surface markers to calculate 3D kinematics for movement assessment, it is important to have a clear understanding of the effect of different marker sets and segment models in use.

  18. Influence of Whole Body Vibration and Specific Warm-ups on Force during an Isometric Mid-Thigh Pull

    Directory of Open Access Journals (Sweden)

    Vanessa L. Cazás-Moreno

    2015-10-01

    Full Text Available Purpose: The purpose of this study was to investigate the effects of general and specific warm-up protocols on rate of force development (RFD, relative RFD (rRFD, ground reaction force (GRF and relative ground reaction force (rGRF during an isometric mid-thigh pull (IMTP, after WBV exposure. Methods: Fifteen healthy recreationally trained males  (age: 24.1 ± 2.3 yrs, height: 72.9 ± 7.8 cm; mass: 86.9 ± 8.3 completed five protocols: baseline, isometric vibration (iVib, isometric no vibration (iNV, dynamic vibration (dVib and dynamic no vibration (dNV. The baseline was completed without any warm-up prior to the IMTP. The intervention protocols had the same prescription of 4 sets of 30-second bouts of quarter squats (dynamic [DQS] and isometric [IQS] on the WBV platform with or without vibration. Following a one-minute rest period after each protocol, participants completed three maximal IMTPs. Results: Repeated measures ANOVA with a Bonferroni post hoc demonstrated that RFD in dNV (7657.8 ± 2292.5 N/s was significantly greater than iVib (7156.4 ± 2170.0 N/s. However, the other experimental trials for RFD demonstrated no significant differences (p>0.05. There were also no significant differences for rRFD, GRF or rGRF between protocols. Conclusion: These results demonstrate that a dynamic warm-up without WBV elicits greater RFD than an isometric warm-up with WBV prior to a maximal isometric exercise. Further research needs to be investigated utilizing dynamic and isometric warm-ups in conjunction with WBV and power output. Keywords: males, recreationally trained, power

  19. Muscle-skeletal model of the thigh: a tool for understanding the biomechanics of gait in patients with cerebral palsy

    Science.gov (United States)

    Ravera, Emiliano Pablo; Catalfamo Formento, Paola Andrea; José Crespo, Marcos; Andrés Braidot, Ariel

    2011-12-01

    Cerebral Palsy represents the most common cause of physical disability in modern world and within the pediatrics orthopedics units. The gait analysis provides great contributions to the understanding of gait disorders in CP. Giving a more comprehensive treatment plan, including or excluding surgical procedures that can potentially decrease the number of surgical interventions in the life of these patients. Recommendations for orthopedic surgery may be based on a quantitative description of how to alter the properties probably muscle force generation, and how this affects the action of the muscle to determine how these muscles, impaired by disease or surgery, contributing to the movement of the segments of the limb during crouch gait. So the causes and appropriate treatment of gait abnormalities are difficult to determine because the movements generated by the muscular forces of these patients are not clearly understood. A correct determination of the etiology of abnormal patterns of the knee is the key to select the appropriate therapy, presenting a major challenge at present since there is no theoretical basis to determine the biomechanical causes of abnormal gait of these patients. The potential and necessity of using correct biomechanical models that consistently study the abnormalities becomes clear. Reinforcing and correcting a simple gait analysis and eliminating the unknowns when selecting the appropriate treatment is crucial in clinical settings. In this paper a computer muscle-skeletal model is proposed. The model represents a person's thigh simulating the six most representative muscles and joints of the hip and knee. In this way you can have a better understanding of gait abnormalities present in these patients. So the quality of these estimates of individual muscle dynamics facilitate better understanding of the biomechanics of gait pathologies helping to reach better diagnosis prior to surgery and rehabilitation treatments.

  20. Muscle-skeletal model of the thigh: a tool for understanding the biomechanics of gait in patients with cerebral palsy

    International Nuclear Information System (INIS)

    Ravera, Emiliano Pablo; Catalfamo Formento, Paola Andrea; Crespo, Marcos José; Braidot, Ariel Andrés

    2011-01-01

    Cerebral Palsy represents the most common cause of physical disability in modern world and within the pediatrics orthopedics units. The gait analysis provides great contributions to the understanding of gait disorders in CP. Giving a more comprehensive treatment plan, including or excluding surgical procedures that can potentially decrease the number of surgical interventions in the life of these patients. Recommendations for orthopedic surgery may be based on a quantitative description of how to alter the properties probably muscle force generation, and how this affects the action of the muscle to determine how these muscles, impaired by disease or surgery, contributing to the movement of the segments of the limb during crouch gait. So the causes and appropriate treatment of gait abnormalities are difficult to determine because the movements generated by the muscular forces of these patients are not clearly understood. A correct determination of the etiology of abnormal patterns of the knee is the key to select the appropriate therapy, presenting a major challenge at present since there is no theoretical basis to determine the biomechanical causes of abnormal gait of these patients. The potential and necessity of using correct biomechanical models that consistently study the abnormalities becomes clear. Reinforcing and correcting a simple gait analysis and eliminating the unknowns when selecting the appropriate treatment is crucial in clinical settings. In this paper a computer muscle-skeletal model is proposed. The model represents a person's thigh simulating the six most representative muscles and joints of the hip and knee. In this way you can have a better understanding of gait abnormalities present in these patients. So the quality of these estimates of individual muscle dynamics facilitate better understanding of the biomechanics of gait pathologies helping to reach better diagnosis prior to surgery and rehabilitation treatments.

  1. Influence of Anterior Cruciate Ligament Tear on Thigh Muscle Strength and Hamstring-to-Quadriceps Ratio: A Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Hyun-Jung Kim

    Full Text Available Theoretical compensation after anterior cruciate ligament (ACL tear could cause quadriceps weakness and hamstring activation, preventing anterior tibial subluxation and affecting the expected hamstring-to-quadriceps ratio. Although quadriceps weakness often occurs after ACL tears, it remains unclear whether hamstring strength and hamstring-to-quadriceps ratio increase in ACL deficient knees. This meta-analysis compared the isokinetic muscle strength of quadriceps and hamstring muscles, and the hamstring-to-quadriceps ratio, of the injured and injured limbs of patients with ACL tears. This meta-analysis included all studies comparing isokinetic thigh muscle strengths and hamstring-to-quadriceps ratio in the injured and uninjured legs of patients with ACL tear, without or before surgery. Thirteen studies were included in the meta-analysis. Quadriceps and hamstring strengths were 22.3 N∙m (95% CI: 15.2 to 29.3 N∙m; P<0.001 and 7.4 N∙m (95% CI: 4.3 to 10.5 N∙m; P<0.001 lower, respectively, on the injured than on the uninjured side. The mean hamstring-to-quadriceps ratio was 4% greater in ACL deficient than in uninjured limbs (95% CI: 1.7% to 6.3%; P<0.001. Conclusively, Decreases were observed in both the quadriceps and hamstring muscles of patients with ACL tear, with the decrease in quadriceps strength being 3-fold greater. These uneven reductions slightly increase the hamstring-to-quadriceps ratio in ACL deficient knees.

  2. Lower Mitochondrial Energy Production of the Thigh Muscles in Patients With Low-Normal Ankle-Brachial Index.

    Science.gov (United States)

    AlGhatrif, Majd; Zane, Ariel; Oberdier, Matt; Canepa, Marco; Studenski, Stephanie; Simonsick, Eleanor; Spencer, Richard G; Fishbein, Kenneth; Reiter, David; Lakatta, Edward G; McDermott, Mary M; Ferrucci, Luigi

    2017-08-30

    Lower muscle mitochondrial energy production may contribute to impaired walking endurance in patients with peripheral arterial disease. A borderline ankle-brachial index (ABI) of 0.91 to 1.10 is associated with poorer walking endurance compared with higher ABI. We hypothesized that in the absence of peripheral arterial disease, lower ABI is associated with lower mitochondrial energy production. We examined 363 men and women participating in the Baltimore Longitudinal Study of Aging with an ABI between 0.90 and 1.40. Muscle mitochondrial energy production was assessed by post-exercise phosphocreatine recovery rate constant ( k PCr) measured by phosphorus magnetic resonance spectroscopy of the left thigh. A lower post-exercise phosphocreatine recovery rate constant reflects decreased mitochondria energy production.The mean age of the participants was 71±12 years. A total of 18.4% had diabetes mellitus and 4% were current and 40% were former smokers. Compared with participants with an ABI of 1.11 to 1.40, those with an ABI of 0.90 to 1.10 had significantly lower post-exercise phosphocreatine recovery rate constant (19.3 versus 20.8 ms -1 , P =0.015). This difference remained significant after adjusting for age, sex, race, smoking status, diabetes mellitus, body mass index, and cholesterol levels ( P =0.028). Similarly, post-exercise phosphocreatine recovery rate constant was linearly associated with ABI as a continuous variable, both in the ABI ranges of 0.90 to 1.40 (standardized coefficient=0.15, P =0.003) and 1.1 to 1.4 (standardized coefficient=0.12, P =0.0405). An ABI of 0.90 to 1.10 is associated with lower mitochondrial energy production compared with an ABI of 1.11 to 1.40. These data demonstrate adverse associations of lower ABI values with impaired mitochondrial activity even within the range of a clinically accepted definition of a normal ABI. Further study is needed to determine whether interventions in persons with ABIs of 0.90 to 1.10 can prevent

  3. Diagnosis of extraskeletal myxoid chondrosarcoma in the thigh using EWSR1-NR4A3 gene fusion: a case report.

    Science.gov (United States)

    Kobayashi, Hiroki; Kikuta, Kazutaka; Sekita, Tetsuya; Susa, Michiro; Nishimoto, Kazumasa; Sasaki, Aya; Kameyama, Kaori; Sugita, Shintaro; Hasegawa, Tadashi; Nakamura, Masaya; Matsumoto, Morio; Morioka, Hideo

    2016-11-10

    Extraskeletal myxoid chondrosarcoma is a rare soft tissue sarcoma that has unusual ultrastructural and molecular features. However, unlike other soft tissue sarcomas, it does not have specific clinical symptoms or radiological features, which can make its diagnosis difficult. Nevertheless, extraskeletal myxoid chondrosarcoma has a rare gene fusion (EWSR1-NR4A3) that is useful for making a differential diagnosis. A 43-year-old Japanese man presented with a soft tissue mass in his right thigh. A physical examination and radiography revealed a large soft tissue mass. During magnetic resonance imaging, the mass exhibited isointensity on T1-weighted images and high intensity on T2-weighted images, as well as gadolinium enhancement at the side edge of the partition structure. Thus, we considered a possible diagnosis of a malignant myxoid soft tissue tumor, such as myxoid liposarcoma, myxofibrosarcoma, or metastatic carcinomas, including myoepithelial tumor and neuroendocrine tumor, and performed an incisional biopsy to make a definitive diagnosis. The pathological findings revealed a lobulated tumor with a myxoid structure and atypical spindle-shaped cells that created eosinophilic cord-like forms. Immunohistochemistry revealed that the tumor was positive for S-100 and negative for synaptophysin, chromogranin A, and pan keratin (AE1/AE3). The percentage of Ki-67 was 10 % in the hot spot area. Based on these clinicopathological findings, we initially considered the possibility of a myxoid liposarcoma, although we did not observe any lipoblasts. Therefore, we considered the possibility of an extraskeletal myxoid chondrosarcoma. As this tumor is very rare, we searched for the EWSR1-NR4A3 gene fusion using fluorescence in situ hybridization, which confirmed the diagnosis of extraskeletal myxoid chondrosarcoma. Positron emission tomography-computed tomography did not identify any obvious metastases, and we performed radical resection of our patient's vastus medialis and

  4. Pharmacodynamics of Imipenem in Combination with β-Lactamase Inhibitor MK7655 in a Murine Thigh Model

    Science.gov (United States)

    Mavridou, Eleftheria; Melchers, Ria J. B.; van Mil, Anita C. H. A. M.; Mangin, E.; Motyl, Mary R.

    2014-01-01

    MK7655 is a newly developed beta-lactamase inhibitor of class A and class C carbapenemases. Pharmacokinetics (PK) of imipenem-cilastatin (IMP/C) and MK7655 were determined for intraperitoneal doses of 4 mg/kg to 128 mg/kg of body weight. MIC and pharmacodynamics (PD) studies of MK7655 were performed against several beta-lactamase producing Pseudomonas aeruginosa and Klebsiella pneumoniae strains to determine its effect in vitro and in vivo. Neutropenic mice were infected in each thigh 2 h before treatment with an inoculum of approximately 5 × 106 CFU. They were treated with IMP/C alone (every 2 hours [q2h], various doses) or in combination with MK7655 in either a dose fractionation study or q2h for 24 h and sacrificed for CFU determinations. IMP/MK7655 decreased MICs regarding IMP MIC. The PK profiles of IMP/C and MK7655 were linear over the dosing range studied and comparable with volumes of distribution (V) of 0.434 and 0.544 liter/kg and half-lives (t1/2) of 0.24 and 0.25 h, respectively. Protein binding of MK7655 was 20%. A sigmoidal maximum effect (Emax) model was fit to the PK/PD index responses. The effect of the inhibitor was not related to the maximum concentration of drug in serum (Cmax)/MIC, and model fits for T>MIC and area under the concentration-time curve (AUC)/MIC were comparable (R2 of 0.7 and 0.75), but there appeared to be no significant relationship of effect with dose frequency. Escalating doses of MK7655 and IMP/C showed that the AUC of MK7655 required for a static effect was dependent on the dose of IMP/C and the MIC of the strain, with a mean area under the concentration-time curve for the free, unbound fraction of the drug (fAUC) of 26.0 mg · h/liter. MK7655 shows significant activity in vivo and results in efficacy of IMP/C in otherwise resistant strains. The exposure-response relationships found can serve as a basis for establishing dosing regimens in humans. PMID:25403667

  5. Tumor vascularity of experimentally induced VX2 carcinoma in the rabbit thigh: evaluation with enhanced power doppler sonography and DSA correlated with histopathologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Hoon; Han, Joon Koo; Chung, Jin Wook; Lee, Kyoung Ho; Kim, Se Hyung; Kim, Seog Joon; Choi, Byung Ihn; Chang, Kee Hyun [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2002-05-01

    To describe findings of enhanced power Doppler sonography and DSA in experimentally induced VX2 carcinomas in rabbit thigh and to correlate the imaging findings with the histopathologic features. A total of 30 VX2 carcinomas were implanted in rabbit thigh, and after conventional and enhanced power Doppler sonography and DSA, histopathologic examination was performed. Enhanced power Doppler sonography and DSA, were used to determine the distribution pattern of tumor vascularity; to assess its grade and the percentage of a tumor area occupied by vessels, conventional and enhanced power Doppler sonography, as well as DSA, were used. The grade of necrosis and the development of fibrovascular stroma and capsule were histopathologically determined. The findings of power Doppler sonography were compared with those of DSA and the imaging features were correlated with the histopathologic features. At enhanced power Doppler sonography, the signal was either avascular (n=9), peripheral (n=15) or diffuse (n=6), while at DSA, the corresponding totals were eight, fourteen and eight. There was statistically significant corelation between enhanced power Doppler sonogrpahy and DSA, both in their depiction of the distribution of patterns of tumor vascularity and as regards their findings of grade and percentage of vascular area. As determined by both conventional and enhanced power Doppler sonogrpahy, and by DSA, grade of necrosis and the development of fibrovascular stroma and a capsule correlated with grade and the percentage of vascular area. Experimentally induced VX2 carcinomas in rabbit thigh demonstrated various patterns of tumor vascularity, and the findings of enhanced power Doppler sonography correlated with those of DSA. Tumor vascularity, as demonstrated by two imaging modalities, correlated closely with grade of necrosis and the development of fibrovascular stroma and a capsule, as revealed by histopathologic examination.

  6. Tumor vascularity of experimentally induced VX2 carcinoma in the rabbit thigh: evaluation with enhanced power doppler sonography and DSA correlated with histopathologic findings

    International Nuclear Information System (INIS)

    Kim, Young Hoon; Han, Joon Koo; Chung, Jin Wook; Lee, Kyoung Ho; Kim, Se Hyung; Kim, Seog Joon; Choi, Byung Ihn; Chang, Kee Hyun

    2002-01-01

    To describe findings of enhanced power Doppler sonography and DSA in experimentally induced VX2 carcinomas in rabbit thigh and to correlate the imaging findings with the histopathologic features. A total of 30 VX2 carcinomas were implanted in rabbit thigh, and after conventional and enhanced power Doppler sonography and DSA, histopathologic examination was performed. Enhanced power Doppler sonography and DSA, were used to determine the distribution pattern of tumor vascularity; to assess its grade and the percentage of a tumor area occupied by vessels, conventional and enhanced power Doppler sonography, as well as DSA, were used. The grade of necrosis and the development of fibrovascular stroma and capsule were histopathologically determined. The findings of power Doppler sonography were compared with those of DSA and the imaging features were correlated with the histopathologic features. At enhanced power Doppler sonography, the signal was either avascular (n=9), peripheral (n=15) or diffuse (n=6), while at DSA, the corresponding totals were eight, fourteen and eight. There was statistically significant corelation between enhanced power Doppler sonogrpahy and DSA, both in their depiction of the distribution of patterns of tumor vascularity and as regards their findings of grade and percentage of vascular area. As determined by both conventional and enhanced power Doppler sonogrpahy, and by DSA, grade of necrosis and the development of fibrovascular stroma and a capsule correlated with grade and the percentage of vascular area. Experimentally induced VX2 carcinomas in rabbit thigh demonstrated various patterns of tumor vascularity, and the findings of enhanced power Doppler sonography correlated with those of DSA. Tumor vascularity, as demonstrated by two imaging modalities, correlated closely with grade of necrosis and the development of fibrovascular stroma and a capsule, as revealed by histopathologic examination

  7. Lean muscle volume of the thigh has a stronger relationship with muscle power than muscle strength in women with knee osteoarthritis.

    Science.gov (United States)

    Davison, Michael J; Maly, Monica R; Keir, Peter J; Hapuhennedige, Sandani M; Kron, Amie T; Adachi, Jonathan D; Beattie, Karen A

    2017-01-01

    Thigh lean muscle and intramuscular fat have been implicated in the impairment of physical function observed in people with knee osteoarthritis. We investigated the relationships of quadriceps and hamstrings intramuscular fat fraction and lean muscle volume with muscle power and strength, controlling for neuromuscular activation, and physical performance in women with knee OA. Women (n=20) 55years or older with symptomatic, radiographic knee osteoarthritis underwent a 3.0T magnetic resonance imaging scan of the thigh of their most symptomatic knee. Axial fat-separated images were analyzed using software to quantify intramuscular fat and lean muscle volumes of the quadriceps and hamstrings. To quantify strength and power of the knee extensors and flexors, participants performed maximum voluntary isometric contraction and isotonic knee extensions and flexions, respectively. Electromyography of the quadriceps and hamstrings was measured. Participants also completed five physical performance tests. Quadriceps and hamstrings lean muscle volumes were related to isotonic knee extensor (B=0.624; p=0.017) and flexor (B=1.518; p=0.032) power, but not knee extensor (B=0.001; p=0.615) or flexor (B=0.001; p=0.564) isometric strength. Intramuscular fat fractions were not related to isotonic knee extensor or flexor power, nor isometric strength. No relationships were found between intramuscular fat or lean muscle volume and physical performance. Muscle power may be more sensitive than strength to lean muscle mass in women with knee osteoarthritis. Thigh lean muscle mass, but neither intramuscular nor intermuscular fat, is related to knee extensor and flexor power in women with knee osteoarthritis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Semi-automated segmentation and quantification of adipose tissue in calf and thigh by MRI: a preliminary study in patients with monogenic metabolic syndrome

    International Nuclear Information System (INIS)

    Al-Attar, Salam A; Pollex, Rebecca L; Robinson, John F; Miskie, Brooke A; Walcarius, Rhonda; Rutt, Brian K; Hegele, Robert A

    2006-01-01

    With the growing prevalence of obesity and metabolic syndrome, reliable quantitative imaging methods for adipose tissue are required. Monogenic forms of the metabolic syndrome include Dunnigan-variety familial partial lipodystrophy subtypes 2 and 3 (FPLD2 and FPLD3), which are characterized by the loss of subcutaneous fat in the extremities. Through magnetic resonance imaging (MRI) of FPLD patients, we have developed a method of quantifying the core FPLD anthropometric phenotype, namely adipose tissue in the mid-calf and mid-thigh regions. Four female subjects, including an FPLD2 subject (LMNA R482Q), an FPLD3 subject (PPARG F388L), and two control subjects were selected for MRI and analysis. MRI scans of subjects were performed on a 1.5T GE MR Medical system, with 17 transaxial slices comprising a 51 mm section obtained in both the mid-calf and mid-thigh regions. Using ImageJ 1.34 n software, analysis of raw MR images involved the creation of a connectedness map of the subcutaneous adipose tissue contours within the lower limb segment from a user-defined seed point. Quantification of the adipose tissue was then obtained after thresholding the connected map and counting the voxels (volumetric pixels) present within the specified region. MR images revealed significant differences in the amounts of subcutaneous adipose tissue in lower limb segments of FPLD3 and FPLD2 subjects: respectively, mid-calf, 15.5% and 0%, and mid-thigh, 25.0% and 13.3%. In comparison, old and young healthy controls had values, respectively, of mid-calf, 32.5% and 26.2%, and mid-thigh, 52.2% and 36.1%. The FPLD2 patient had significantly reduced subcutaneous adipose tissue compared to FPLD3 patient. Thus, semi-automated quantification of adipose tissue of the lower extremity can detect differences between individuals of various lipodystrophy genotypes and represents a potentially useful tool for extended quantitative phenotypic analysis of other genetic metabolic disorders

  9. Hemodynamic Instability after Low-Energy Thigh Contusion Caused by Injury to the Femoral Artery: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Juan Miguel Rodríguez-Roiz

    2016-01-01

    Full Text Available Acute vascular injuries have been described in relation to high-energy trauma accidents or in patients undergoing surgery in the femoral area. We describe a healthy patient who sustained a direct, low-energy contusion in the thigh and presented haemodynamic instability. Arteriography was used to locate the point of bleeding, and embolisation and vessel occlusion were carried out to stop the haemorrhage. The genetic study identified the COL3A1 gene mutation; accordingly, the patient was diagnosed with the Ehlers-Danlos syndrome type IV (vascular type.

  10. Haemodynamic responses to exercise, ATP infusion and thigh compression in humans: insight into the role of muscle mechanisms on cardiovascular function

    DEFF Research Database (Denmark)

    Gonzalez-Alonso, J.; Mortensen, S.P.; Jeppesen, Tina Dysgaard

    2008-01-01

    on cardiovascular function during exercise, we determined leg and systemic haemodynamic responses in healthy men during (1) incremental one-legged knee-extensor exercise, (2) step-wise femoral artery ATP infusion at rest, (3) passive exercise (n=10), (4)femoral vein or artery ATP infusion (n=6), and (5) cyclic...... exercise also increased blood flow (DeltaLBF 0.7 +/- 0.1 l min(-1)), yet the increase in muscle and systemic perfusion, unrelated to elevations in aerobic metabolism, accounted only for approximately 5% of peak exercise hyperaemia.Likewise, thigh compressions alone or in combination with passive exercise...

  11. Anterior thigh composition measured using ultrasound imaging to quantify relative thickness of muscle and non-contractile tissue: a potential biomarker for musculoskeletal health

    International Nuclear Information System (INIS)

    Agyapong-Badu, Sandra; Warner, Martin; Samuel, Dinesh; Stokes, Maria; Narici, Marco; Cooper, Cyrus

    2014-01-01

    This study aimed to use ultrasound imaging to provide objective data on the effects of ageing and gender on relative thickness of quadriceps muscle and non-contractile tissue thickness (subcutaneous fat, SF, combined with perimuscular fascia). In 136 healthy males and females (aged 18–90 years n = 63 aged 18–35 years; n = 73 aged 65–90) images of the anterior thigh (dominant) were taken in relaxed supine using B-mode ultrasound imaging. Thickness of muscle, SF and perimuscular fascia were measured, and percentage thickness of total anterior thigh thickness calculated. Independent t-tests compared groups. Correlation between tissue thickness and BMI was examined using Pearson’s coefficient. Muscle thickness was: 39  ±  8 mm in young males, 29  ±  6 mm in females, 25  ±  4 mm in older males and 20  ±  5 mm in females. Percentage muscle to thigh thickness was greater in young participants (p = 0.001). Percentage SF and fascia was 17  ±  6% in young and 26  ±  8% in older males, 32  ±  7% in young and 44  ±  7% in older females. BMI was similar for age and correlated moderately with non-contractile tissue (r = 0.54; p < 0.001) and poorly with muscle (r = −0.01; p = 0.93). In conclusion, this novel application of ultrasound imaging as a simple and rapid means of assessing thigh composition (relative thickness of muscle and non-contractile tissue) may help inform health status, e.g. in older people at risk of frailty and loss of mobility, and aid monitoring effects of weight loss or gain, deconditioning and exercise. (paper)

  12. Effect of nicotine and preventive role of camellia sinensis on the histomorphology of developing epiphyseal plate of thigh bone of chick

    International Nuclear Information System (INIS)

    Shan, M.; Butt, S.A.

    2014-01-01

    Objective: To determine the effect of nicotine and camellia sinensis (green tea) on the developing epiphyseal plate of thigh bone of chick. Design: Randomized controlled trial. Place and Duration of Study: Army medical college, Rawalpindi, Pakistan from April 2012 to May 2012. Material and Method: Freshly laid fertilized eggs of Fayoumi breed chick eggs were selected at zero hour of incubation. Four groups were made, group G1 was control group treated with normal saline. Experimental group G2 was treated with camellia sinensis extract (green tea), group G3 was given nicotine whereas group G4 was injected with working solution nicotine and camellia sinensis (green tea), in 0.1 ml quantity. Double exposure one at 48 hour of incubation and other at 48 hours after hatching of chicks. SPSS version 15 was used to analyze the data. Results: It was observed that the weight of chick at one month of age and weight of femur of chicks of nicotine treated groups G3 and group G4 were reduced in comparison to control group G1. Mean number of cells in hypertrophy zone of developing epiphyseal plate of thigh bone were reduced of nicotine treated groups in comparison to control group. Conclusion: Camellia sinensis (green tea) helped to reduce the harmful effects of nicotine treated group but cannot reverse the oxidative injury. (author)

  13. Mid-thigh cortical bone structural parameters, muscle mass and strength, and association with lower limb fractures in older men and women (AGES-Reykjavik Study).

    Science.gov (United States)

    Johannesdottir, Fjola; Aspelund, Thor; Siggeirsdottir, Kristin; Jonsson, Brynjolfur Y; Mogensen, Brynjolfur; Sigurdsson, Sigurdur; Harris, Tamara B; Gudnason, Vilmundur G; Lang, Thomas F; Sigurdsson, Gunnar

    2012-05-01

    In a cross-sectional study we investigated the relationship between muscle and bone parameters in the mid-thigh in older people using data from a single axial computed tomographic section through the mid-thigh. Additionally, we studied the association of these variables with incident low-trauma lower limb fractures. A total of 3,762 older individuals (1,838 men and 1,924 women), aged 66-96 years, participants in the AGES-Reykjavik study, were studied. The total cross-sectional muscular area and knee extensor strength declined with age similarly in both sexes. Muscle parameters correlated most strongly with cortical area and total shaft area (adjusted for age, height, and weight) but explained lower limb fractures. Small muscular area, low knee extensor strength, large MA, low cortical thickness, and high BR were significantly associated with fractures in both sexes. Our results show that bone and muscle loss proceed at different rates and with different gender patterns.

  14. [Repair of pressure sores over ischial tuberosity with long head of biceps femoris muscle flap combined with semi-V posterior thigh fasciocutaneous flap].

    Science.gov (United States)

    Hai, Heng-lin; Shen, Chuan-an; Chai, Jia-ke; Li, Hua-tao

    2012-02-01

    To explore the clinical effect of transplantation of the long head of biceps femoris muscle flap in combination with semi-V posterior thigh fasciocutaneous flap for repair of pressure sores over ischial tuberosity. Eight patients with 10 deep pressure sores over ischial tuberosity were admitted to the First Affiliated Hospital to the PLA General Hospital and the 98th Hospital of PLA from April 2004 to June 2010. The wounds measured from 2 cm × 2 cm to 6 cm × 4 cm were covered with the long head of biceps femoris muscle flap and semi-V posterior thigh fasciocutaneous flap (ranged from 10 cm × 6 cm to 13 cm × 8 cm). The condition of flaps was observed and followed up for a long time. All flaps survived. Nine wounds healed by first intention. Subcutaneous accumulation of fluids occurred in one wound with formation of a sinus at drainage site, and it healed after dressing change for 25 days. Patients were followed up for 7 to 34 months. Sore recurred in one patient 9 months after surgery, and it was successfully repaired with the same flap for the second time. Flaps in the other 7 patients appeared satisfactory with soft texture and without ulceration. This combined flap is easy in formation and transfer, and it causes little side injury with good resistance against pressure. It is a new method for repair of pressure sore over sacral region.

  15. Effects of organic selenium in broiler feed on the content of selenium and fatty acid profile in lipids of thigh muscle tissue

    Directory of Open Access Journals (Sweden)

    Zlata Kralik

    2013-01-01

    Full Text Available The aim of our study was to determine the effects of selenium supplementation to broiler feed on the content of selenium, total fatty acids in lipids and on the oxidative stability of broiler thigh muscle tissue. The experiment involved 40 broilers fattened for 42 days. During the first three weeks, all broilers consumed starter diet containing 22% crude protein. After three weeks, broilers were divided into two groups and fed finisher diets containing 18% crude protein and supplemented with 3% sunflower oil and 3% linseed oil. Group 1 was not administered artificial selenium; Group 2 was supplemented with organic selenium at the amount of 0.5 mg Se/kg of feed. Significantly higher (P P P > 0.05 and increase of linolenic acid and total n-3 polyunsaturated fatty acids (P < 0.05 in thigh muscle tissue of broilers. Since selenium and n-3 polyunsaturated fatty acids are nutricines, our results show that the produced broiler meat may be considered as functional food.

  16. Real-time monitoring of bacterial infection in vivo: development of bioluminescent staphylococcal foreign-body and deep-thigh-wound mouse infection models.

    Science.gov (United States)

    Kuklin, Nelly A; Pancari, Gregory D; Tobery, Timothy W; Cope, Leslie; Jackson, Jesse; Gill, Charles; Overbye, Karen; Francis, Kevin P; Yu, Jun; Montgomery, Donna; Anderson, Annaliesa S; McClements, William; Jansen, Kathrin U

    2003-09-01

    Staphylococcal infections associated with catheter and prosthetic implants are difficult to eradicate and often lead to chronic infections. Development of novel antibacterial therapies requires simple, reliable, and relevant models for infection. Using bioluminescent Staphylococcus aureus, we have adapted the existing foreign-body and deep-wound mouse models of staphylococcal infection to allow real-time monitoring of the bacterial colonization of catheters or tissues. This approach also enables kinetic measurements of bacterial growth and clearance in each infected animal. Persistence of infection was observed throughout the course of the study until termination of the experiment at day 16 in a deep-wound model and day 21 in the foreign-body model, providing sufficient time to test the effects of antibacterial compounds. The usefulness of both animal models was assessed by using linezolid as a test compound and comparing bioluminescent measurements to bacterial counts. In the foreign-body model, a three-dose antibiotic regimen (2, 5, and 24 h after infection) resulted in a decrease in both luminescence and bacterial counts recovered from the implant compared to those of the mock-treated infected mice. In addition, linezolid treatment prevented the formation of subcutaneous abscesses, although it did not completely resolve the infection. In the thigh model, the same treatment regimen resulted in complete resolution of the luminescent signal, which correlated with clearance of the bacteria from the thighs.

  17. Effect of protein-xanthophylls (PX) concentrate of alfalfa supplementation on physico-chemical properties of turkey breast and thigh muscles during ageing.

    Science.gov (United States)

    Karwowska, M; Stadnik, J; Dolatowski, Z J; Grela, E R

    2010-10-01

    The objective was to evaluate the effects of a dietary protein-xanthophylls (PX) concentrate of alfalfa to turkey diets (at 15 and 30 g kg(-1) feed) on the physico-chemical properties of breast and thigh muscles during ageing. The experiment involved 120 turkeys (Big-6 type) allotted to 3 groups (group I-control group; group II--with 1.5% supplementation of the protein-xanthophylls (PX) concentrate; group III--with 3% supplementation of the protein-xanthophylls (PX) concentrate). Measurements of pH, water holding capacity, color, oxymyoglobin content, TBARS and oxidation-reduction potential showed that the addition of protein-xanthophylls (PX) concentrate of alfalfa to a turkey diet did not cause deterioration of breast and thigh meat quality. In addition, changes in color, oxymyoglobin content, TBARS and oxidation-reduction potential values suggested that the inclusion of the concentrate to turkey diets acts as an antioxidant in the raw meat. Copyright (c) 2010 The American Meat Science Association. Published by Elsevier Ltd. All rights reserved.

  18. Isometric Mid-Thigh Pull Performance Is Associated With Athletic Performance And Sprinting Kinetics In Division I Men And Women's Basketball Players.

    Science.gov (United States)

    Townsend, Jeremy R; Bender, David; Vantrease, William; Hudy, John; Huet, Kevin; Williamson, Cassie; Bechke, Emily; Serafini, Paul; Mangine, Gerald T

    2017-07-31

    To examine the relationships between isometric mid-thigh pull (IMTP) force, athletic performance measures, and sprint kinetics in Division I men's and women's basketball players. Twenty-three (male = 8, female = 15) division 1 basketball players completed a maximal 20-m sprint trial while tethered to a device which provided kinetic feedback (peak and average sprinting power, velocity and force). Additionally, one repetition-maximal (1RM) front squat, 1RM hang clean, vertical jump height, and agility (pro-agility and lane agility) tests were performed. Rate of force development (RFD) at 50ms, 100ms, 150ms, 200ms and 250ms of IMTP, as well as peak force (PF) were also collected. Pearson product-moment correlation analysis was used to examine the relationships between these measures. Significant (p training.

  19. Activity of Colistin in Combination with Meropenem, Tigecycline, Fosfomycin, Fusidic Acid, Rifampin or Sulbactam against Extensively Drug-Resistant Acinetobacter baumannii in a Murine Thigh-Infection Model.

    Directory of Open Access Journals (Sweden)

    Bing Fan

    Full Text Available Few effective therapeutic options are available for treating severe infections caused by extensively drug-resistant Acinetobacter baumannii (XDR-AB. Using a murine thigh-infection model, we examined the in vivo efficacy of colistin in combination with meropenem, tigecycline, fosfomycin, fusidic acid, rifampin, or sulbactam against 12 XDR-AB strains. Colistin, tigecycline, rifampin, and sulbactam monotherapy significantly decreased bacterial counts in murine thigh infections compared with those observed in control mice receiving no treatment. Colistin was the most effective agent tested, displaying bactericidal activity against 91.7% of strains at 48 h post-treatment. With strains showing a relatively low minimum inhibitory concentration (MIC for meropenem (MIC ≤ 32 mg/L, combination therapy with colistin plus meropenem caused synergistic inhibition at both 24 h and 48 h post-treatment. However, when the meropenem MIC was ≥64 mg/L, meropenem did not significantly alter the efficacy of colistin. The addition of rifampin and fusidic acid significantly improved the efficacy of colistin, showing a synergistic effect in 100% and 58.3% of strains after 24 h of treatment, respectively, while the addition of tigecycline, fosfomycin, or sulbactam did not show obvious synergistic activity. No clear differences in activities were observed between colistin-rifampin and colistin-fusidic acid combination therapy with most strains. Overall, our in vivo study showed that administering colistin in combination with rifampin or fusidic acid is more efficacious in treating XDR-AB infections than other combinations. The colistin-meropenem combination may be another appropriate option if the MIC is ≤32 mg/L. Further clinical studies are urgently needed to confirm the relevance of these findings.

  20. Thigh muscle segmentation of chemical shift encoding-based water-fat magnetic resonance images: The reference database MyoSegmenTUM.

    Directory of Open Access Journals (Sweden)

    Sarah Schlaeger

    Full Text Available Magnetic resonance imaging (MRI can non-invasively assess muscle anatomy, exercise effects and pathologies with different underlying causes such as neuromuscular diseases (NMD. Quantitative MRI including fat fraction mapping using chemical shift encoding-based water-fat MRI has emerged for reliable determination of muscle volume and fat composition. The data analysis of water-fat images requires segmentation of the different muscles which has been mainly performed manually in the past and is a very time consuming process, currently limiting the clinical applicability. An automatization of the segmentation process would lead to a more time-efficient analysis. In the present work, the manually segmented thigh magnetic resonance imaging database MyoSegmenTUM is presented. It hosts water-fat MR images of both thighs of 15 healthy subjects and 4 patients with NMD with a voxel size of 3.2x2x4 mm3 with the corresponding segmentation masks for four functional muscle groups: quadriceps femoris, sartorius, gracilis, hamstrings. The database is freely accessible online at https://osf.io/svwa7/?view_only=c2c980c17b3a40fca35d088a3cdd83e2. The database is mainly meant as ground truth which can be used as training and test dataset for automatic muscle segmentation algorithms. The segmentation allows extraction of muscle cross sectional area (CSA and volume. Proton density fat fraction (PDFF of the defined muscle groups from the corresponding images and quadriceps muscle strength measurements/neurological muscle strength rating can be used for benchmarking purposes.

  1. ASSOCIATION OF KNEE PAIN WITH A REDUCTION IN THIGH MUSCLE STRENGTH – A CROSS-SECTIONAL ANALYSIS INCLUDING 4553 OSTEOARTHRITIS INITIATIVE PARTICIPANTS

    Science.gov (United States)

    Ruhdorfer, Anja; Wirth, Wolfgang; Eckstein, Felix

    2016-01-01

    Objective To cross-sectionally determine the quantitative relationship of age-adjusted, sex-specific isometric knee extensor and flexor strength to patient-reported knee pain. Methods Difference of thigh muscle strength by age, and that of age-adjusted strength per unit increase on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee pain scale, was estimated from linear regression analysis of 4553 Osteoarthritis Initiative participants (58% women). Strata encompassing the minimal clinically important difference (MCID) in knee pain were compared to evaluate a potentially non-linear relationship between WOMAC pain levels and muscle strength. Results In Osteoarthritis Initiative participants without pain, the age-related difference in isometric knee extensor strength was −9.0%/−8.2% (women/men) per decade, and that of flexor strength was −11%/−6.9%. Differences in age-adjusted strength values for each unit of WOMAC pain (1/20) amounted to −1.9%/−1.6% for extensor and −2.5%/−1.7% for flexor strength. Differences in torque/weight for each unit of WOMAC pain ranged from −3.3 to − 2.1%. There was no indication of a non-linear relationship between pain and strength across the range of observed WOMAC values, and similar results were observed in women and men. Conclusion Each increase by 1/20 units in WOMAC pain was associated with a ~2% lower age-adjusted isometric extensor and flexor strength in either sex. As a reduction in muscle strength is known to prospectively increase symptoms in knee osteoarthritis and as pain appears to reduce thigh muscle strength, adequate therapy of pain and muscle strength is required in knee osteoarthritis patients to avoid a vicious circle of self-sustaining clinical deterioration. PMID:27836675

  2. MRI assessment of the thigh musculature in dermatomyositis and healthy subjects using diffusion tensor imaging, intravoxel incoherent motion and dynamic DTI.

    Science.gov (United States)

    Sigmund, E E; Baete, S H; Luo, T; Patel, K; Wang, D; Rossi, I; Duarte, A; Bruno, M; Mossa, D; Femia, A; Ramachandran, S; Stoffel, D; Babb, J S; Franks, A; Bencardino, J

    2018-06-04

    Dermatomyositis (DM) is an idiopathic inflammatory myopathy involving severe debilitation in need of diagnostics. We evaluated the proximal lower extremity musculature with diffusion tensor imaging (DTI), intravoxel incoherent motion (IVIM) and dynamic DTI in DM patients and controls and compared with standard clinical workup.  METHODS: In this IRB-approved, HIPAA-compliant study with written informed consent, anatomical, Dixon fat/water and diffusion imaging were collected in bilateral thigh MRI of 22 controls and 27 DM patients in a 3T scanner. Compartments were scored on T1/T2 scales. Single voxel dynamic DTI metrics in quadriceps before and after 3-min leg exercise were measured. Spearman rank correlation and mixed model analysis of variance/covariance (ANOVA/ANCOVA) were used to correlate with T1 and T2 scores and to compare patients with controls. DM patients showed significantly lower pseudo-diffusion and volume in quadriceps than controls. All subjects showed significant correlation between T1 score and signal-weighted fat fraction; tissue diffusion and pseudo-diffusion varied significantly with T1 and T2 score in patients. Radial and mean diffusion exercise response in patients was significantly higher than controls. Static and dynamic diffusion imaging metrics show correlation with conventional imaging scores, reveal spatial heterogeneity, and provide means to differentiate dermatomyositis patients from controls. • Diffusion imaging shows regional differences between thigh muscles of dermatomyositis patients and controls. • Signal-weighted fat fraction and diffusion metrics correlate with T1/T2 scores of disease severity. • Dermatomyositis patients show significantly higher radial diffusion exercise response than controls.

  3. Mitral valve surgery using right anterolateral thoracotomy: is the aortic cannulation a safety procedure? Cirurgia valvar mitral via toracotomia ântero-lateral direita: a canulação aórtica é segura?

    Directory of Open Access Journals (Sweden)

    Marco Antonio Vieira Guedes

    2010-09-01

    Full Text Available INTRODUCTION: The right anterolateral thoracotomy is an alternative technique for surgical approach of mitral valve. In these cases, femoral-femoral bypass still has been used, rising occurrence of complications related to femoral cannulation. Objective: Describe the technique and results of mitral valve treatment by right anterolateral thoracotomy using aortic cannulation for cardiac pulmonary bypass (CPB. METHODS: From 1983 e 2008, 100 consecutive female patients, with average age 35 ±13 years, 96 (96% underwent mitral valve surgical treatment in the Heart Institute of São Paulo. A right anterolateral thoracotomy approach associated with aortic cannulation was used for CPB. Eighty (80% patients had rheumatic disease and 84 (84% patients presented functional class III or IV. RESULTS: Were performed 45 (45% comissurotomies, 38 (38% valve repairs, 7(7% mitral valve replacements, seven (7% recomissurotomies and three (3% prosthesis replacement. Sparing surgery was performed in 90 (90% patients. The average CPB and clamp time were 57 ± 27 min e 39 ± 19 min, respectively. There were no in-hospital death, reoperation due to bleeding and convertion to sternotomy. Introperative complications were related to heart harvest (5%, especially in reoperations (3%. The most important complications in postoperative period were related to pulmonary system (11%, followed by atrial fibrilation (10% but without major systemic repercussions. The mean inhospital length of stay was 8 ± 3 days. Follow-up was 6.038 patients/month. Actuarial survival was 98.0 ± 1.9% and freedom from reoperation was 81.4 ± 7.8% in 180 months. CONCLUSION: The right anterolateral thoracotomy associated with aortic cannulation in mitral valve surgery is a simple technique, reproducible and safety.INTRODUÇÃO: A toracotomia ântero-lateral direita tem sido utilizada como uma alternativa para a abordagem cirúrgica da valva mitral. Nestes casos, a canulação femoral continua sendo

  4. A higher protein intake is not associated with 5-year change in mid-thigh muscle cross-sectional area by computed tomography in older adults : the health, aging, and body composition (Health ABC) study

    NARCIS (Netherlands)

    Verreijen, A.M.; Engberink, M.F.; Brouwer, I.A.; Cawthon, P.M.; Newman, A.B.; Tylavsky, F.A.; Harris, T.B.; Weijs, P.J.M.; Visser, M.

    2017-01-01

    Rationale: A higher protein intake is suggested to preserve muscle mass during aging, and may therefore reduce the risk for sarcopenia. We explored whether the amount, type (animal/vegetable) and essential amino acid (EAA) composition of protein intake were associated with 5-year change in mid-thigh

  5. 0.125 mm(3) spatial resolution steady-state MR angiography of the thighs with a blood pool contrast agent using the quadrature body coil only at 1.5 Tesla.

    Science.gov (United States)

    Boschewitz, Jack M; Hadizadeh, Dariusch R; Kukuk, Guido M; Meyer, Carsten; Wilhelm, Kai; Koscielny, Arne; Verrel, Frauke; Gieseke, Jürgen; Schild, Hans H; Willinek, Winfried A

    2014-10-01

    To implement and evaluate high spatial resolution three-dimensional MR contrast-enhanced angiography (3D-CEMRA) of the thighs using a blood pool contrast agent (BPCA) using the quadrature body coil only in patients with peripheral arterial occlusive disease (PAOD) in cases receiver coils cannot be used at 1.5 Tesla (T). Nineteen patients (mean age: 68.7 ± 11.2 years; range, 38-83 years) with known PAOD (Fontaine stages; III: 16, IV: 3) prospectively underwent 3D-CEMRA at 1.5T with a noninterpolated voxel size of 0.49 × 0.49 × 0.48 mm(3) . Digital subtraction angiography (DSA) was available for comparison in all patients. Two readers independently evaluated movement artifacts, overall image quality of 3D-CEMRA, and grade of stenosis as compared to DSA. SNR and CNR levels were quantified. The 3D-CEMRA was successfully completed in all patients. Patient movement artifacts that affected stenosis grading occurred in 3/38 thighs. Overall image quality was rated excellent in 15/38, good in 12/38, and diagnostic in 8/38 thighs. Stenosis grading matched with that in DSA in 35/38 thighs. High SNR and CNR were measured in all vessels. The 0.125 mm(3) spatial resolution 3D-CEMRA of the thighs with a BPCA is feasible using a quadrature body coil exclusively with excellent image quality despite long acquisition times. J. Magn. Reson. Imaging 2014;40:996-1001. © 2014 Wiley Periodicals, Inc. © 2014 Wiley Periodicals, Inc.

  6. The Effect of a Vegetarian vs Conventional Hypocaloric Diabetic Diet on Thigh Adipose Tissue Distribution in Subjects with Type 2 Diabetes: A Randomized Study.

    Science.gov (United States)

    Kahleova, Hana; Klementova, Marta; Herynek, Vit; Skoch, Antonin; Herynek, Stepan; Hill, Martin; Mari, Andrea; Pelikanova, Terezie

    2017-07-01

    The aim of our study was to compare the effects of a vegetarian and a conventional diet on thigh adipose tissue distribution in subjects with type 2 diabetes (T2D). Seventy-four subjects with T2D were randomly assigned to either follow a vegetarian diet (V, n = 37) or a control group who followed an isocaloric conventional anti-diabetic diet (C, n = 37). Both diets were calorie restricted (-500 kcal/day). To measure insulin sensitivity, the hyperinsulinemic (1 mU.kg -1 .min -1 ) isoglycemic clamp was conducted. β-Cell function was assessed using a mathematical model after a test meal. Magnetic resonance imaging of the thigh was performed. All subjects were examined at 0, 3, and 6 months. Statistical analyses were performed using repeated measures analysis of variance and a multivariate regression model. Greater reduction was observed in total leg area in V (-13.6 cm 2 [95% confidence interval [CI], -14.2 to -12.9] in V vs -9.9 cm 2 [95% CI, -10.6 to -9.2] in C; Gxt p diets (Gxt, p = 0.64). Subfascial fat was reduced only in response to a vegetarian diet (-0.82 [95% CI, -1.13 to -0.55] cm 2 in V vs -0.44 [95% CI, -0.78 to +0.02] cm 2 in C; Gxt, p = 0.04). The reduction in intramuscular fat tended to be greater in response to a vegetarian diet (-1.78 [95% CI, -2.26 to -1.27] cm 2 in V vs -0.57 [95% CI, -1.06 to -0.09] cm 2 in C; Gxt, p = 0.12). Changes in subcutaneous and subfascial fat correlated with changes in glycated hemoglobin (HbA1c), fasting plasma glucose, and β-cell insulin sensitivity. After adjustment for changes in body mass index (BMI), correlations remained significant for changes in fasting plasma glucose and β-cell insulin sensitivity and with changes in triglycerides. Our data indicate the importance of both subcutaneous and subfascial fat in relationship to glucose and lipid metabolism. BMI , body mass index; C , control group; FPG , fasting plasma glucose; Gxt , interaction between group and time; HbA1c , glycated hemoglobin; MCR

  7. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    Directory of Open Access Journals (Sweden)

    Andrew D. Vigotsky

    2015-09-01

    Full Text Available Background. Foam rolling has been shown to acutely increase range of motion (ROM during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test.Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated.Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61; z(22 = 2.08; p = 0.0372; Pearson’s r = 0.43 (0.02, 0.72 was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = −1.39° (−5.53, +2.75; t(22 = −0.70; p = 0.4933; Cohen’s d = − 0.15 (−0.58, 0.29 or rectus femoris length (change = −0.005 (−0.013, +0.003; t(22 = −1.30; p = 0.2070; Cohen’s d = − 0.27 (−0.70, 0.16 were not due to chance alone.Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol.

  8. [Thigh and leg musculo-cutaneous island flap for giant bilateral trochanteric and perineal pressure sores coverage: Extreme treatment in spinal cord injury].

    Science.gov (United States)

    André, A; Crouzet, C; De Boissezon, X; Grolleau, J-L

    2015-06-01

    Surgical treatment of perineal pressure sores could be done with various fascio-cutaneous or musculo-cutaneous flaps, which provide cover and filling of most of pressure sores after spinal cord injuries. In rare cases, classical solutions are overtaken, then it is necessary to use more complex techniques. We report a case of a made-to-measure lower limb flap for coverage of confluent perineal pressure sores. A 49-year-old paraplegic patient developed multiple pressure sores on left and right ischial tuberosity, inferior pubic bone and bilateral trochanters with hips dislocation. Surgical treatment involved a whole right thigh flap to cover and fill right side lesions, associated to a posterior right leg musculo-cutaneous island flap to cover and fill the left trochanteric pressure sore. The surgical procedure lasted 6.5 hours and required massive blood transfusion. Antibiotics were adapted to bacteriological samples. There were no postoperative complications; complete wound healing occurred after three weeks. A lower limb sacrifice for coverage of a giant perineal pressure sores is an extreme surgical solution, reserved to patients understanding the issues of this last chance procedure. A good knowledge of vascular anatomy is an essential prerequisite, and allows to shape made-to-measure flaps. The success of such a procedure is closely linked to the collaboration with the rehabilitation team (appropriate therapeutic education concerning transfers and positioning). Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  9. Colgajo póstero-medial de muslo (adductor: a propósito de un caso Postero-medial thigh flap (adductor flap: case report

    Directory of Open Access Journals (Sweden)

    L. Gómez-Escolar Larrañaga

    2008-12-01

    Full Text Available En pacientes con úlceras masivas o confluentes en la región glútea, puede ser necesaria la amputación de la extremidad inferior y la reconstrucción mediante colgajos totales de muslo para la cobertura del defecto. Esta técnica es muy agresiva y además de las evidentes secuelas físicas que crea puede generar importantes trastornos psíquicos para el paciente. Presentamos el caso de una paciente con una gran úlcera por decúbito en la región isquio-trocantéreosacra en la que se empleó el colgajo Adductor como alternativa a la amputación de la extremidad inferior.Amputation of the lower extremity and total thigh flaps may be necessary for coverage in patients with massive multiple or confluent sores in the buttock region. This is an aggressive technique with important physical and psychological consequences for the patient. The Adductor flap was used as an alternative of the amputation in a patient with a big ischial-trocantericsacral pressure sore.

  10. Timed function tests, motor function measure, and quantitative thigh muscle MRI in ambulant children with Duchenne muscular dystrophy: A cross-sectional analysis.

    Science.gov (United States)

    Schmidt, Simone; Hafner, Patricia; Klein, Andrea; Rubino-Nacht, Daniela; Gocheva, Vanya; Schroeder, Jonas; Naduvilekoot Devasia, Arjith; Zuesli, Stephanie; Bernert, Guenther; Laugel, Vincent; Bloetzer, Clemens; Steinlin, Maja; Capone, Andrea; Gloor, Monika; Tobler, Patrick; Haas, Tanja; Bieri, Oliver; Zumbrunn, Thomas; Fischer, Dirk; Bonati, Ulrike

    2018-01-01

    The development of new therapeutic agents for the treatment of Duchenne muscular dystrophy has put a focus on defining outcome measures most sensitive to capture treatment effects. This cross-sectional analysis investigates the relation between validated clinical assessments such as the 6-minute walk test, motor function measure and quantitative muscle MRI of thigh muscles in ambulant Duchenne muscular dystrophy patients, aged 6.5 to 10.8 years (mean 8.2, SD 1.1). Quantitative muscle MRI included the mean fat fraction using a 2-point Dixon technique, and transverse relaxation time (T2) measurements. All clinical assessments were highly significantly inter-correlated with p muscle MRI values significantly correlated with all clinical assessments with the extensors showing the strongest correlation. In contrast to the clinical assessments, quantitative muscle MRI values were highly significantly correlated with age. In conclusion, the motor function measure and timed function tests measure disease severity in a highly comparable fashion and all tests correlated with quantitative muscle MRI values quantifying fatty muscle degeneration. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. The relationship between maternal body composition in early pregnancy and foetal mid-thigh soft-tissue thickness in the third trimester in a high-risk obstetric population.

    Science.gov (United States)

    Anglim, Breffini; Farah, Nadine; O'Connor, Clare; Daly, Niamh; Kennelly, Mairead M; Turner, Michael J

    2017-07-01

    Maternal obesity is an emerging challenge in contemporary obstetrics. To date there has been no study analysing the relationship between specific maternal body composition measurements and foetal soft-tissue measurements. The aim of this study was to determine whether measurement of maternal body composition at booking predicts foetal soft-tissue trajectories in the third trimester. We analysed the relationship between foetal thigh in the third trimester and both maternal BMI and body composition using the Tanita digital scales in the first trimester. Foetal subcutaneous thigh tissue measurements were obtained at intervals of 28, 32 and 36 weeks of gestation. A total of 160 women were identified. There was a direct correlation between MTST at 36 weeks and BMI (p = .002). There was a positive correlation between MTST at 36 weeks and leg fat mass (p = .13) and leg fat free mass (p = .013). There was a positive correlation between arm fat free mass and MTST at 36 weeks. We showed there is an association between maternal fat distribution and foetal subcutaneous thigh tissue measurements. MTST may be more useful in determining if a child is at risk of macrosomia. Impact statement Previous studies have suggested that maternal obesity programmes intrauterine foetal adiposity and growth. The aim of this study was to examine the relationship in a high-risk obstetric population between measurements of maternal body composition in early pregnancy and the assessment of foetal adiposity in the third trimester using serial ultrasound measurements of mid-thigh soft-tissue thickness. BMI is only a surrogate measurement of fat and does not measure fat distribution. Our study shows the distribution of both maternal fat and fat-free mass in early pregnancy may be positively associated with foetal soft-tissue measurements in the third trimester. Maternal arthropometric measurements other than BMI may help predict babies at risk of macrosomia and neonatal adiposity.

  12. Effect of addition of pollen and propolis to feeding mixtures during the production of broiler chickens ROSS 308 to the colour of thigh and breast muscle and pH determination

    Directory of Open Access Journals (Sweden)

    Hana Šulcerová

    2011-01-01

    Full Text Available The aim of this study was to verify influence of pollen and propolis added to the feeding mixture in the diet of broiler chickens Ross 308 to colour breast and thigh muscles in relation to pH values. A total of 198 units 1 day-old Ross 308 hybrid combinations divided into 6 groups according to the feeding mixtures were investigated on meat quality characteristics changes. Muscle colour of breasts and thighs was measured and compared with pH in three times, pH1, pH2 and pHult. Feeding with various additions to feeding mixtures for chicken showed small impact of low content (200 or 300 mg.kg−1 propolis to meat quality characteristics. Higher effect on breast quality was found in group with 400 mg.kg−1 pollen addition to feed, there was faster and deeper postmortal process level found, although without negative impact on meat quality. Meat colour and muscle pH of chicken in this experiment was pale and had low ultimate pH. In these parameters were found correlation. Chicken meat of this experimental animals was paler and had the lowest ultimate pH, altough in group with higher addition it wasn’t confirmed. Raw meat breast pH was significantly lower than thigh muscles in all measurement time. Various feeding especially pollen had significant impact on breast colour which was paler although without negative displays attended of pH decline. Significant relationships are between breast and thigh L*a*b* values and pH1 respectively.

  13. Concurrent agreement between an anthropometric model to predict thigh volume and dual-energy X-Ray absorptiometry assessment in female volleyball players aged 14-18 years.

    Science.gov (United States)

    Tavares, Óscar M; Valente-Dos-Santos, João; Duarte, João P; Póvoas, Susana C; Gobbo, Luís A; Fernandes, Rômulo A; Marinho, Daniel A; Casanova, José M; Sherar, Lauren B; Courteix, Daniel; Coelho-E-Silva, Manuel J

    2016-11-24

    A variety of performance outputs are strongly determined by lower limbs volume and composition in children and adolescents. The current study aimed to examine the validity of thigh volume (TV) estimated by anthropometry in late adolescent female volleyball players. Dual-energy X-ray absorptiometry (DXA) measures were used as the reference method. Total and regional body composition was assessed with a Lunar DPX NT/Pro/MD+/Duo/Bravo scanner in a cross-sectional sample of 42 Portuguese female volleyball players aged 14-18 years (165.2 ± 0.9 cm; 61.1 ± 1.4 kg). TV was estimated with the reference method (TV-DXA) and with the anthropometric method (TV-ANTH). Agreement between procedures was assessed with Deming regression. The analysis also considered a calibration of the anthropometric approach. The equation that best predicted TV-DXA was: -0.899 + 0.876 × log 10 (body mass) + 0.113 × log 10 (TV-ANTH). This new model (NM) was validated using the predicted residual sum of squares (PRESS) method (R 2 PRESS  = 0.838). Correlation between the reference method and the NM was 0.934 (95%CI: 0.880-0.964, S y∙x  = 0.325 L). A new and accurate anthropometric method to estimate TV in adolescent female volleyball players was obtained from the equation of Jones and Pearson alongside with adjustments for body mass.

  14. Coelomic implantation of satellite transmitters in the bar-tailed godwit (Limosa lapponica) and the bristle-thighed curlew (Numenius tahitiensis) using propofol, bupivacaine, and lidocaine

    Science.gov (United States)

    Mulcahy, Daniel M.; Gartrell, Brett D.; Gill, Robert E.; Tibbitts, T. Lee; Ruthrauff, Daniel R.

    2011-01-01

    Intravenous propofol was used as a general anesthetic with a 2∶1 (mg∶mg) adjunctive mixture of lidocaine and bupivacaine as local anesthetics infiltrated into the surgical sites for implantation of satellite transmitters into the right abdominal air sac of 39 female and 4 male bar-tailed godwits (Limosa lapponica baueri and Limosa lapponica menzbeiri) and 11 female and 12 male bristle-thighed curlews (Numenius tahitiensis). The birds were captured on nesting grounds in Alaska, USA, and on overwintering areas in New Zealand and Australia from 2005 through 2008. As it was developed, the mass of the transmitter used changed yearly from a low of 22.4 ± 0.2 g to a high of 27.1 ± 0.2 g and weighed 25.1 ± 0.2 g in the final year. The mean load ratios ranged from 5.2% to 7.7% for godwits and from 5.7% to 7.5% for curlews and exceeded 5% for all years, locations, and genders of both species. The maximum load ratio was 8.3% for a female bar-tailed godwit implanted in Australia in 2008. Three godwits and no curlews died during surgery. Most birds were hyperthermic upon induction but improved during surgery. Two godwits (one in New Zealand and one in Australia) could not stand upon release, likely due to capture myopathy. These birds failed to respond to treatment and were euthanized. The implanted transmitters were used to follow godwits through their southern and northern migrations, and curlews were followed on their southern migration.

  15. RELATIONSHIP BETWEEN ISOMETRIC THIGH MUSCLE STRENGTH AND MINIMAL CLINICALLY IMPORTANT DIFFERENCES (MCIDS) IN KNEE FUNCTION IN OSTEOARTHRITIS – DATA FROM THE OSTEOARTHRITIS INITIATIVE

    Science.gov (United States)

    Ruhdorfer, Anja; Wirth, Wolfgang; Eckstein, Felix

    2014-01-01

    Objective To determine the relationship between thigh muscle strength and clinically relevant differences in self-assessed lower limb function. Methods Isometric knee extensor and flexor strength of 4553 Osteoarthritis Initiative participants (2651 women/1902 men) was related to Western Ontario McMasters Universities (WOMAC) physical function scores by linear regression. Further, groups of Male and female participant strata with minimal clinically important differences (MCIDs) in WOMAC function scores (6/68) were compared across the full range of observed values, and to participants without functional deficits (WOMAC=0). The effect of WOMAC knee pain and body mass index on the above relationships was explored using stepwise regression. Results Per regression equations, a 3.7% reduction in extensor and a 4.0% reduction in flexor strength were associated with an MCID in WOMAC function in women, and a 3.6%/4.8% reduction in men. For strength divided by body weight, reductions were 5.2%/6.7% in women and 5.8%/6.7% in men. Comparing MCID strata across the full observed range of WOMAC function confirmed the above estimates and did not suggest non-linear relationships across the spectrum of observed values. WOMAC pain correlated strongly with WOMAC function, but extensor (and flexor) muscle strength contributed significant independent information. Conclusion Reductions of approximately 4% in isometric muscle strength and of 6% in strength/weight were related to a clinically relevant difference in WOMAC functional disability. Longitudinal studies will need to confirm these relationships within persons. Muscle extensor (and flexor) strength (per body weight) provided significant independent information in addition to pain in explaining variability in lower limb function. PMID:25303012

  16. Relationship between isometric thigh muscle strength and minimum clinically important differences in knee function in osteoarthritis: data from the osteoarthritis initiative.

    Science.gov (United States)

    Ruhdorfer, Anja; Wirth, Wolfgang; Eckstein, Felix

    2015-04-01

    To determine the relationship between thigh muscle strength and clinically relevant differences in self-assessed lower leg function. Isometric knee extensor and flexor strength of 4,553 Osteoarthritis Initiative participants (2,651 women and 1,902 men) was related to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function scores by linear regression. Further, groups of male and female participant strata with minimum clinically important differences (MCIDs) in WOMAC function scores (6 of 68 units) were compared across the full range of observed values and to participants without functional deficits (WOMAC score 0). The effect of WOMAC knee pain and body mass index on the above relationships was explored using stepwise regression. Per regression equations, a 3.7% reduction in extensor strength and a 4.0% reduction in flexor strength were associated with an MCID in WOMAC function in women, and, respectively, a 3.6% and 4.8% reduction in men. For strength divided by body weight, reductions were 5.2% and 6.7%, respectively, in women and 5.8% and 6.7%, respectively, in men. Comparing MCID strata across the full observed range of WOMAC function confirmed the above estimates and did not suggest nonlinear relationships across the spectrum of observed values. WOMAC pain correlated strongly with WOMAC function, but extensor (and flexor) muscle strength contributed significant independent information. Reductions of approximately 4% in isometric muscle strength and of 6% in strength per body weight were related to a clinically relevant difference in WOMAC functional disability. Longitudinal studies will need to confirm these relationships within persons. Muscle extensor (and flexor) strength (per body weight) provided significant independent information in addition to pain in explaining variability in lower leg function. Copyright © 2015 by the American College of Rheumatology.

  17. Cirurgia de revascularização do miocárdio através de minitoracotomia ântero-lateral esquerda Myocardial revascularization surgery through left anterolateral minithoracotomy

    Directory of Open Access Journals (Sweden)

    J. Glauco Lobo Filho

    1996-09-01

    Full Text Available No período de outubro de 1995 a fevereiro de 1996, 16 pacientes selecionados foram submetidos a cirurgia de revascularização do miocárdio através de minitoracotomia ântero-lateral esquerda. Em todos os casos a artéria torácica interna esquerda foi dissecada, para posterior anastomose com o ramo interventricular anterior (RIA sem a utilização de circulação extracorpórea. A idade variou de 43 a 77, com média de 60 anos. Sessenta e dois por cento dos pacientes eram do sexo masculino. Não houve complicações tais como: hemorragias, acidente vascular cerebral, insuficiência renal aguda, mediastinite ou infarto agudo do miocárdio. Não houve mortalidade no grupo em questão. Em 4 (25% pacientes foi realizado estudo hemodinâmico, que demostrou uma normalidade da anastomose da artéria torácica interna para o ramo interventricular anterior. Devido aos excelentes resultados iniciais, acreditamos que este procedimento possa ser empregado com maior freqüência e com a familiarização dos grupos cirúrgicos, e que as artérias diagonais e marginais da circunflexa possam ser beneficiadas com este tipo de procedimento.Between October 1995 and February 1996, sixteen patients were selected to undergo to surgical myocardial revascularization through left anterolateral minithoracotomy. The left internal thoracic artery was dissected in all patients, for consecutive anastomosis with interventricular anterior artery, without using extracorporeal circulation. Patients age ranged from 43 to 77, average 60 years. Sixty-two percent of them were men. There were no complications such as: acute myocardial infarction, mediastinitis, acute renal failure, hemorrhagy or stroke. There were no deaths. Four (25% patients were submitted to cardiac catheterization that showed patency of grafts and grafted native arteries. Due to excellent initial results, the authors believe that this technique can be employed with greater frequency and that its use can be

  18. Suprafascial versus traditional harvesting technique for free antero lateral thigh flap: A case-control study to assess the best functional and aesthetic result in extremity reconstruction.

    Science.gov (United States)

    Maruccia, Michele; Fallico, Nefer; Cigna, Emanuele; Ciudad, Pedro; Nicoli, Fabio; Trignano, Emilio; Nacchiero, Eleonora; Giudice, Giuseppe; Ribuffo, Diego; Chen, Hung-Chi

    2017-11-01

    Clinical applications of ALT flap have currently extended to extremity (hand and foot) as well as oral cavity reconstruction. In these anatomical areas, the traditional harvesting technique presents a few disadvantages such as bulkiness of the recipient site and potential donor site morbidity including damage to the deep fascia and skin graft adhesions. The purpose of the present study was to compare the functional and aesthetic outcomes of upper and lower extremity reconstruction with either suprafascial or subfascial harvested anterolateral (ALT) flaps. Sixty patients who underwent hand or foot reconstruction with an ALT flap between January 2013 and January 2015 were included in the study (34 flaps elevated on a subfascial plane and 26 on a suprafascial plane). Group 1 (subfascial harvested ALT flap) was composed of 23 male and 11 female patients with an average age of 53.4 years (range, 36-72 years). Group 2 (suprafascial harvested ALT flap) was composed of 18 male and 8 female patients with an average age of 48.7 years (range, 32-69 years). Surgical indication was tumor resection for 20 patients in group 1 and 16 patients in group 2, chronic ulcer for 8 patients in group 1 and 6 patients in group 2, and trauma for 6 patients in group 1 and 4 patients in group 2. Complications were documented. Aesthetic outcomes were considered in terms of bulkiness of the recipient site, subsequent request for a debulking procedure, and donor site morbidity. Donor site scars were evaluated for cosmesis using a modified Hollander Wound Evaluation Scale (HWES). Skin grafts outcomes were assessed according to the modified Vancouver Scar Scale (VSS). Functional outcome at the recipient site was measured using the Enneking functional outcome score (ESS). Total range of motion (ROM) was recorded. All flaps were successfully elevated with at least one viable perforator with both approaches. The survival rates of suprafascial and subfascial harvested ALT flaps were 96.2 and 97

  19. Effect of bee pollen extract as a supplemental diet on broilers´s ross 308 breast and thigh meat muscles fatty acids

    Directory of Open Access Journals (Sweden)

    Peter Haščík

    2014-02-01

    Full Text Available The present study was aimed to study the effect of the bee pollen extract on the broiler Ross 308 breast and thigh meat fatty acids. The experiment enrolled 90 chicks in one day old, which were divided into 3 groups (control, E1 and E2. The broiler has been bred in a cage condition for 42 days. To the experimental groups were added bee pollen extract in the amount (400, 800  Normal 0 false false false SK JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:Calibri;} mg.kg-1. The chickens have been bred in a cage conditions, each cage was equipped with feed dispenser and water intake was ensured ad libitum through a self feed-pump. The temperature was controlled during the fattening period and it was 33 °C at the first day and every week was reduced about 2 °C the end temperature was 23 °C. At the end of the experiment the fatty acids have beenevaluatedby using Agilent 7890A Gas Chromatograph apparatus (USA. The findings have been shown that the myristoleic acid, linoleic acid, linoelaidic acid, arachidonic acid, and archaic acid were decreased after using the bee pollen into broiler feed mixture otherwise, the bee pollen has been increased the polemic acids and oleic acid and there were found no significant differences (P ≥0.05 among all the experimental groups.From the recent experiment, we conclude that bee pollen extract has decreasedthe fattyacids except palmitoleic acid acid and oleic acid, whichwere higher compared to control groupand there were no significant differences (P ≥0.05 between experimental groups.

  20. Temporary Relocation of the Testes in Anteromedial Thigh Pouches Facilitates Delayed Primary Scrotal Wound Closure in Fournier Gangrene With Extensive Loss of Scrotal Skin-Experience With 12 Cases.

    Science.gov (United States)

    Okwudili, Obi Anselm

    2016-03-01

    To share our experience on the use of temporary testicular thigh pouches to facilitate scrotal wound closure in Fournier gangrene with extensive loss of scrotal skin. Patients seen over a 10-year period who had extensive (>50%) loss of scrotal skin precluding delayed primary closure of the residual scrotal skin over the testes were documented. Patients had serial debridement as required with scrotal wound dressing until healthy granulation tissue was achieved. The testes were placed temporarily in anteromedial thigh pouches to allow for scrotal wound closure. In the postoperative period, the testes were gradually massaged back into the residual scrotal pouch, thus acting as natural tissue expanders. Mean patient age was 38.1 ± 10.0 years. Mean duration of admission was 24.4 ± 4.7 days. Identified predisposing factors were ischiorectal fossa abscess in 2 patients and urethral stricture in 1 patient. The rest were idiopathic. Mean Fournier gangrene severity index was 6.0 ± 1.3. Mean number of debridements was 2.3 ± 0.5. There was no mortality. The residual scrotal pouches expanded sufficiently over time (3-8 months) to accommodate the testes. Normal testicular volume was maintained in all patients. Mean testicular volume was 19.0 ± 3.2 cm. Follow-up was for 14.8 ± 9.7 months. Temporarily relocating the testes in anteromedial thigh pouches facilitates scrotal wound closure in Fournier gangrene with extensive loss of scrotal skin and obviates the need for specialized reconstructive surgery.

  1. In Vivo Activities of Ceftolozane, a New Cephalosporin, with and without Tazobactam against Pseudomonas aeruginosa and Enterobacteriaceae, Including Strains with Extended-Spectrum β-Lactamases, in the Thighs of Neutropenic Mice

    Science.gov (United States)

    Andes, D. R.

    2013-01-01

    Ceftolozane is a new cephalosporin with potent activity against Pseudomonas aeruginosa and Enterobacteriaceae. A neutropenic murine thigh infection model was used to determine which pharmacokinetic/pharmacodynamic index and magnitude drives the efficacy of ceftolozane with Gram-negative bacilli, to compare the rates of in vivo killing of P. aeruginosa by ceftolozane and ceftazidime, and to determine the impact of different ratios of ceftolozane plus tazobactam on Enterobacteriaceae containing extended-spectrum β-lactamases (ESBLs). Neutropenic mice had 106.2-7.1 CFU/thigh when treated with ceftolozane for 24 h with (i) various doses (3.12 to 1,600 mg/kg) and dosage intervals (3, 6, 12, and 24 h) against two Enterobacteriaceae strains, (ii) 0.39 to 800 mg/kg every 6 h for four Enterobacteriaceae and four P. aeruginosa strains, and (iii) 400 or 800 mg/kg with 2:1. 4:1, and 8:1 ratios of tazobactam against five Enterobacteriaceae strains with ESBLs. The pharmacokinetics of ceftolozane at 25, 100, and 400 mg/kg were linear with peak/dose values of 1.0 to 1.4 and half-lives of 12 to 14 min. T>MIC was the primary index driving efficacy. For stasis (1 log kill), T>MIC was 26.3% ± 2.1% (31.6% ± 1.6%) for wild-type Enterobacteriaceae, 31.1% ± 4.9% (34.8% ± 4.4%) for Enterobacteriaceae with ESBLs, and 24.0% ± 3.3% (31.5% ± 3.9%) for P. aeruginosa. At 200 mg/kg every 3 h, the rate of in vivo killing of P. aeruginosa was faster with ceftolozane than with ceftazidime (−0.34 to −0.41 log10 CFU/thigh/h versus −0.21 to −0.24 log10 CFU/thigh/h). The 2:1 ratio of ceftolozane with tazobactam was the most potent combination studied. The T>MIC required for ceftolozane is less than with other cephalosporins and may be due to more rapid killing. PMID:23274659

  2. 99mTc-HDP Bone Scan Findings of Acute Rhabdomyolysis of Lumbar Multifidus and Thigh Muscles and Bone Scan and US Signs of Acute Tubular Necrosis in Excessive Rabbit's Leaping: A Case Report

    International Nuclear Information System (INIS)

    Bahk, Yong Whee; Kim, Jang Min

    2008-01-01

    Marked rhabdomyolysis (RML) complicated by acute tubular necrosis is not a rare disease. It is characterized by disintegration of skeletal muscle fibers due to a variety of causes including excessive physical exercise, trauma, operation, infection, bed-ridden life, alcohol, drugs, toxins, exhaustion and others. We report a case of RML with acute renal failure studied using magnification bone scan which specifically identified the muscles injured by excessive rabbit's leap. The injured muscles recognized were the multifidus of the lumbar spine and the anterior and posterior muscle groups of the thigh. In addition, 99 mTc-HDP bone scan findings of acute tubular necrosis correlated with that of the sonographic signs are described. Patient was treated simply with normal saline hydration and bed rest and uneventfully recovered to be discharged on the fourth hospital day. Lab data on the final hospital day: LDH=20 IU/L (normalized) and CPK=600 IU/L (still higher than normal), BUN=14.2 mg/dl (normalized) and creatinin=1.5 mg/dl (normalized) GOT=20 mg/dl (normalized) and GPT=72 mg/dl (higher than normal), respectively

  3. {sup 99m}Tc-HDP Bone Scan Findings of Acute Rhabdomyolysis of Lumbar Multifidus and Thigh Muscles and Bone Scan and US Signs of Acute Tubular Necrosis in Excessive Rabbit's Leaping: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Yong Whee; Kim, Jang Min [Sung Ae Hospital, Seoul (Korea, Republic of)

    2008-06-15

    Marked rhabdomyolysis (RML) complicated by acute tubular necrosis is not a rare disease. It is characterized by disintegration of skeletal muscle fibers due to a variety of causes including excessive physical exercise, trauma, operation, infection, bed-ridden life, alcohol, drugs, toxins, exhaustion and others. We report a case of RML with acute renal failure studied using magnification bone scan which specifically identified the muscles injured by excessive rabbit's leap. The injured muscles recognized were the multifidus of the lumbar spine and the anterior and posterior muscle groups of the thigh. In addition, {sup 99}mTc-HDP bone scan findings of acute tubular necrosis correlated with that of the sonographic signs are described. Patient was treated simply with normal saline hydration and bed rest and uneventfully recovered to be discharged on the fourth hospital day. Lab data on the final hospital day: LDH=20 IU/L (normalized) and CPK=600 IU/L (still higher than normal), BUN=14.2 mg/dl (normalized) and creatinin=1.5 mg/dl (normalized) GOT=20 mg/dl (normalized) and GPT=72 mg/dl (higher than normal), respectively.

  4. Aplicação clínica do retalho fáscio-cutâneo da região posterior da coxa em V-Y Clinical application of the VY posterior thigh fasciocutaneous flap

    Directory of Open Access Journals (Sweden)

    J. A. CALIL

    2001-12-01

    -stage treatment of single or multiple sores using the V-Y posterior thigh fasciocutaneous flap. METHODS: Twenty patients were treated, having 25 ulcers in the gluteal and perineal regions, being 23 pressure ulcers, 1 perianal abscess and 1 perineal trauma. In all of the patients the repair was carried out with a fasciocutaneous flap from the posterior region of the thigh. The flap was made with a superior and lateral base, preserving the fasciocutaneous branches of the inferior gluteal arteries, first and second perforating, in the treatment of ischial ulcers. In the associations of the same with sacral ulcer, a fasciocutaneous extension from the gluteal region was added to the flap for a one and only surgical procedure. A superior and medial based flap was made, preserving the fasciocutaneous branch of the inferior gluteal artery in the treatment of the trochanteric ulcers. In the associations with sacral ulcer a fasciocutaneous extension from the gluteal region was added to the posterior thigh flap which permitted the closure of all ulcers in only one surgical procedure. In the associations of trochanteric and ischial ulcers a flap with a superior base was made, preserving the fasciocutaneous branch of the inferior gluteal artery. RESULTS: There was no necrosis of the flap. The immediate complications were 3 infections, 1 dehiscences and 1 hematoma. In a follow-up period of 6 months to 29 months, with one patient being lost to follow up, there were 6 recurrences 6/24 (25.0% in 5 patients 5/19 (26.32%. CONCLUSION: We conclude that the posterior fasciocutaneous thigh flap, in V-Y, can be used with safety in the treatment of isolated or multiple ulcers in the gluteal and perineal regions.

  5. An alternative method for facial resurfacing: supraclavicular skin prefabrication by perforator fascia flap.

    Science.gov (United States)

    Hocaoğlu, Emre

    2014-01-01

    Prefabrication of supraclavicular skin provides a useful source for flaps congruent with the face skin. Among various vascular sources that have been used for this purpose, anterolateral thigh fascia seems to represent a greater value because of having a long and strong vascular pedicle and negligible donor-site morbidity. In this regard, we present a technical report on using the lateral circumflex femoral artery perforator flap harvest technique in preparing an anterolateral thigh fascia flap for the prefabrication of the supraclavicular skin. The technique proved successful in resurfacing the facial skin of a young female patient with a giant congenital melanocytic hairy nevus on the left side of her face.

  6. Evaluation of the Combined Application of Neuromuscular Electrical Stimulation and Volitional Contractions on Thigh Muscle Strength, Knee Pain and Physical Performance in Women at Risk for Knee Osteoarthritis: A Randomized Controlled Trial.

    Science.gov (United States)

    Rabe, Kaitlin G; Matsuse, Hiroo; Jackson, Anthony; Segal, Neil A

    2018-05-28

    Knee osteoarthritis (OA) is a leading cause of disability that is associated with quadriceps weakness. However, strengthening in people with or with risk factors for knee OA can be poorly tolerated. To assess the efficacy of a twelve-week low-load exercise program, using a hybrid training system (HTS) that utilizes the combination of neuromuscular electrical stimulation and volitional contractions, for improving thigh muscle strength, knee pain and physical performance in women with or with risk factors for knee OA. Randomized, single-blind, controlled trial SETTING: Exercise training laboratory PARTICIPANTS: Forty-two women, age 44-85 years, with risk factors for knee OA INTERVENTIONS: Participants randomized to 12 weeks of biweekly low-load resistance training either with HTS or on an isokinetic dynamometer (control). Maximum isokinetic knee extensor torque. Secondary measures included: maximum isokinetic knee flexor torque, knee pain (KOOS), and timed 20-meter walk and chair-stand tests. HTS and control both resulted in muscle strengthening, reduced knee pain and improved physical performance. HTS group quadriceps and hamstring strength increased by 0.06±0.04 Nm/kg (p>.05) and 0.05±0.02 Nm/kg (p=.02), respectively. Control group quadriceps and hamstring strength increased by 0.03±0.04 Nm/kg (p>.05) and 0.06±0.02 Nm/kg (p=.009), respectively. Knee pain improved by 11.9±11.5 points (pmeter walk time decreased by 1.60±2.04 seconds (p=.005) and 0.95±1.2 seconds (p=.004), and chair stand time decreased by 4.8±10.0 seconds (p>.05) and 1.9±4.7 seconds (p>.05) in the HTS and control groups, respectively. These results did not differ statistically between HTS and control groups. These results suggest HTS is effective for improving pain and physical performance in women with risk factors for knee OA. However, HTS does not appear to be superior to low-load resistance training for improving muscle strength, pain or physical function. Copyright © 2018 American

  7. Acute Compartment Syndrome of the Thigh in Combat Casualties

    Science.gov (United States)

    2013-03-01

    Orthopaedic Association VOLUME 22, NUMBER 1, SPRING 2013 45 incisions were closed primarily, six with skin graft , and one by secondary intention. Discussion...With skin graft (skin from another part of your body) Y / N comment _________________ By Secondary intention (daily dressing changes to

  8. An asymptomatic needle in the left ventricular anterolateral wall: a prison inmate's strange radio antenna.

    Science.gov (United States)

    Akpinar, Ibrahim; Sayin, Muhammet Rasit; Karabag, Turgut; Dogan, Sait Mesut; Aydin, Mustafa

    2012-09-01

    A foreign body such as a needle in the heart can be life-threatening. While this may occur accidentally, needles may be inserted into the body by psychiatric patients or in cases involving domestic violence. A needle can migrate through the thorax toward the heart. In drug users, needles may also reach the right ventricle via the peripheral veins. Cardiac injury can occur via the esophagus after swallowing a needle. The clinical outcome may vary from an asymptomatic situation to tamponade or shock, depending on how severely the cardiac structures are affected. In injuries involving the thorax, pneumothorax may cause sudden shortness of breath. Here, we report the case of a 34-year-old male prison inmate who accidentally lodged a pin in his left ventricle while asleep. As he has refused surgery, it was decided to follow the patient carefully. © 2012, Wiley Periodicals, Inc.

  9. Improved method for direct coronary grafting without CPB via anterolateral small thoracotomy

    NARCIS (Netherlands)

    Boonstra, PW; Grandjean, JG; Mariani, MA

    We describe an improved method of minimally invasive coronary artery bypass grafting that facilitates the anastomosis on the beating heart by means of a rigid and simple coronary stabilizer This technique permits anastomosis of the left internal mammary artery to the left anterior descending

  10. The iliotibial band and anterolateral capsule have a combined attachment to the Segond fracture.

    Science.gov (United States)

    Albers, Marcio; Shaikh, Humza; Herbst, Elmar; Onishi, Kentaro; Nagai, Kanto; Musahl, Volker; Fu, Freddie H

    2018-05-01

    The purpose of this report was to describe the injury mechanism, surgical findings, and outcomes in a 21-year-old professional female football player who presented with a complete anterior cruciate ligament (ACL) rupture and Segond fracture. Interview and video analysis were performed to elicit the injury mechanism. Clinical examination and imaging revealed a complete ACL tear, Segond fracture, lateral meniscus tear, MCL sprain, and posterolateral corner sprain. Examination under anaesthesia revealed Grade 2 pivot shift and varus/valgus instability. Surgical examination revealed attachment of the posterior fibres of the iliotibial band and the lateral capsule to the Segond fragment. The fracture was reduced with suture fixation, and an anatomic ACL reconstruction was performed. Follow-up demonstrated rotatory and anterior tibial translation stability, and imaging at 7 months post-operatively revealed no movement and continued osseous integration of the Segond fragment. Level of evidence V.

  11. Dermatofibrosarcoma protuberans diagnosed by a single biopsy

    Directory of Open Access Journals (Sweden)

    Kristian Bakke Arvesen

    2012-07-01

    Full Text Available This brief report is about a 9 year old girl presenting with a 2.5 cm circular blue to violet discoloration on the anterolateral upper left thigh. The first biopsy taken revealed the diagnosis dermatofibrosarcoma protuberans. The patient underwent surgery at a specialized sarcoma center with post operative histology showing free wide resection margin. Preoperative chest x-ray showed no sign of metastasis. This brief report emphasizes the significance of the use of biopsy when cutaneous elements look suspicious and diagnosis is unclear.

  12. Migration of a Broken Steinman Pin into the Posterior Compartment of the Leg 12 Years after Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Ali Birjandi Nejad

    2013-09-01

    Full Text Available This report is on a migration of a Steinman pin into the posterior com Department of the calf. It was used to fix a greater trochanteric osteotomy in a total hip arthroplasty. The puzzling note is how this metal piece passed through the anterolateral compartment of the thigh to the posterior compartment of the calf. Accord ing to our literature review, migration of fixation pins through the knee joint is an extremely rare occurrence and could be missed by an inattentive physician.  

  13. Free temporal fascia flap to cover soft tissue defects of the foot: a case report

    Directory of Open Access Journals (Sweden)

    Schreiber, Martin

    2015-01-01

    Full Text Available Severe soft tissue defects as a result of lye contamination remain a huge challenge in the interdisciplinary approach of trauma surgeons and plastic surgeons. Free tissue transfer is a suitable surgical option for successful reconstruction of form and function of defects in the distal parts of the lower extremities. We report the successful two-stage reconstruction of a full thickness lye contamination at the dorsum of the foot with a free temporoparietal fascia flap covered with a split-thickness skin graft from the thigh. The described method is a suitable operative alternative to anterolateral thigh flaps or other thin fascia flaps regarding flap harvest and donor site morbidity and should be considered in the portfolio of the plastic surgeon.

  14. Anaphylaxis: lack of hospital doctors' knowledge of adrenaline (epinephrine) administration in adults could endanger patients' safety.

    Science.gov (United States)

    Droste, J; Narayan, N

    2012-06-01

    Adrenaline (epinephrine) is the first line drug to be given in anaphylaxis and can save patients' lives. Conversely, incorrect administration of adrenaline in anaphylaxis has caused patients serious harm, including death. We compared the survey results of doctors' knowledge of adrenaline administration in adults of two District General Hospitals Trusts in England and found, that from 284 Hospital Doctors, 14.4% (n = 41) would administer adrenaline as recommended by published anaphylaxis guidelines. This survey comparison shows that a significant number of hospital doctors, regardless of seniority and specialty, have an educational deficit regarding correct administration of adrenaline (epinephrine) administration in adults with anaphylaxis. Multilevel strategies to educate doctors and prevent patient harm are needed. We propose a mnemonic for remembering the recommended treatment for anaphylaxis in the adult: "A Thigh 500" forAdrenaline into the antero-lateral thigh, 500 micrograms.

  15. Partial rupture of the quadriceps muscle in a child

    Directory of Open Access Journals (Sweden)

    Aydemir Gokhan

    2010-09-01

    Full Text Available Abstract Background The quadriceps femoris muscle ruptures usually occur in the middle-aged population. We present a 4-year-old patient with partial rupture of the quadriceps femoris muscle. To our knowledge, this is the youngest patient reported with a quadriceps femoris muscle rupture. Case Presentation A 4-year-old girl admitted to our clinic with left knee pain and limitation in knee movements. Her father reported that she felt pain while jumping on sofa. There was no direct trauma to thigh or knee. We located a palpable soft tissue swelling at distal anterolateral side of thigh. The history revealed that 10 days ago the patient was treated for upper tract respiratory infection with intramuscular Clindamycin for 7 days. When we consulted the patient with her previous doctor and nurse, we learnt that multiple daily injections might be injected to same side of left thigh. MRI showed a partial tear of vastus lateralis muscle matching with the injection sites. The patient treated with long leg half-casting for three weeks. Clinical examination and knee flexion had good results with conservative treatment. Conclusions Multiple intramuscular injections may contribute to damage muscles and make prone to tears with muscle contractions. Doctors and nurses must be cautious to inject from different parts of both thighs.

  16. Free Vastus Intermedius Muscle Flap: A Successful Alternative for Complex Reconstruction of the Neurocranium in Preoperated Patients.

    Science.gov (United States)

    Horn, Dominik; Freudlsperger, Christian; Berger, Moritz; Freier, Kolja; Ristow, Oliver; Hoffmann, Jürgen; Sakowitz, Oliver; Engel, Michael

    2017-07-01

    The reconstruction of large cranial and scalp defects is a surgical and esthetic challenge. Single autologous tissue transfer can be insufficient due to the defect size and the anatomic complexity of the recipient site. Alloplastic patient-specific preformed implants can be used to recover hard tissue defects of the neurocranium. Nevertheless, for long-term success adequate soft tissue support is required. In this brief clinical study, the authors describe calvarian reconstruction in a 33-year-old patient with wound healing disorder after an initial resection of ependymoma. The patient suffered from osteonecrosis and wound breakdown in the fronto-parietal region. An alloplastic polymethylmethacrylate implant for hard tissue support was manufactured based on 3-dimensional visualization of a computed tomography scan. After the resection of remaining pathologic bone from earlier surgical procedures, the alloplastic implant was inserted to achieve functional coverage of the brain. Due to anatomic variation of donor site vessels during anterolateral thigh flap preparation, the authors performed a vastus intermedius free flap as a new muscular flap for craniofacial reconstruction. The authors achieved excellent functional and esthetic results. The muscular vastus intermedius free flap in combination with a split skin graft proves to be a new alternative to the anterolateral thigh flap for soft tissue reconstruction of the neurocranium.

  17. Free-style puzzle flap: the concept of recycling a perforator flap.

    Science.gov (United States)

    Feng, Kuan-Ming; Hsieh, Ching-Hua; Jeng, Seng-Feng

    2013-02-01

    Theoretically, a flap can be supplied by any perforator based on the angiosome theory. In this study, the technique of free-style perforator flap dissection was used to harvest a pedicled or free skin flap from a previous free flap for a second difficult reconstruction. The authors call this a free-style puzzle flap. For the past 3 years, the authors treated 13 patients in whom 12 pedicled free-style puzzle flaps were harvested from previous redundant free flaps and recycled to reconstruct soft-tissue defects at various anatomical locations. One free-style free puzzle flap was harvested from a previous anterolateral thigh flap for buccal cancer to reconstruct a foot defect. Total flap survival was attained in 12 of 13 flaps. One transferred flap failed completely. This patient had received postoperative radiotherapy after the initial cancer ablation and free anterolateral thigh flap reconstruction. Another free flap was used to close and reconstruct the wound. All the donor sites could be closed primarily. The free-style puzzle flap, harvested from a previous redundant free flap and used as a perforator flap to reconstruct a new defect, has proven to be versatile and reliable. When indicated, it is an alternative donor site for further reconstruction of soft-tissue defects.

  18. Release of hand burn contracture: comparing the ALT perforator flap with the gracilis free flap with split skin graft.

    Science.gov (United States)

    Misani, M; Zirak, C; Hau, Lê Thua Trung; De Mey, A; Boeckx, W

    2013-08-01

    The use of microsurgery in the management of burn sequelae is not a new idea. According to the properties of various types of free flaps different goals can be achieved or various additional procedures have to be combined. We report the comparison of two different free flaps on a single patient for reconstruction of both upper extremities for burn sequelae. A 1-year-old child sustained severe burns on both hands, arms and thorax and was initially only treated conservatively. This resulted in severe contractures. At the age of 4-years a free gracilis flap was selected for reconstruction of his left hand and a free anterolateral thigh flap for the right hand. We noticed a better functional and esthetic result for the gracilis flap associated with a shorter operative time and a minor donor site morbidity. The intraoperative technique and time, postoperative complications, functional and esthetic results and donor site morbidities were studied in the two types of flaps chosen. A review of literature was also performed. Our experience reported a better success of the gracilis muscle flap covered with a split skin graft compared to the anterolateral thigh flap in the reconstruction of hand function after severe burn sequelae. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  19. Reliable site for suction blister induction and harvesting

    Directory of Open Access Journals (Sweden)

    Laxmisha Chandrashekar

    2005-01-01

    Full Text Available Background: Suction blister grafting is a useful modality of treatment of patients with resistant and stable vitiligo. However, there have been no detailed studies to find out the best donor site for blister formation. Methods: The study was conducted between the period of October 2004 and February 2005 in the dermatology department at a tertiary care center. Nine patients with vitiligo (focal vitiligo, 3; mucosal vitiligo, 2; acrofacial vitiligo, 2; vitiligo vulgaris, 1; and segmental vitiligo, 1 were selected for blister harvesting and grafting. The blisters were raised using the method described by Gupta et al. Results: Suction blisters were attempted to be raised at 52 sites, but only 38 blisters could be raised, 24 complete and 14 incomplete. Blisters were raised in all the three cases on the flexor aspect of the arm (100%, 15 of 17 cases (88.2% on the flexor aspect of the forearm, 4 of 5 cases (80% on the abdomen, 11 of 16 cases (68.7% on the anterolateral thigh, and less frequently over leg or foot. Complete blisters were formed in 13/15 cases (86.6% on the flexor aspect of the forearm, 6/11 cases (54.5% on the anterolateral thigh, and in all cases over leg. Conclusion: The flexor aspect of the forearm is a good site for suction blister harvesting.

  20. Pharmacodynamics of Cefepime Combined with Tazobactam against Clinically Relevant Enterobacteriaceae in a Neutropenic Mouse Thigh Model

    NARCIS (Netherlands)

    Melchers, M.J.; Mil, A.C van; Lagarde, C.M.; Hartigh, J. den; Mouton, J.W.

    2017-01-01

    The lack of new antibiotics has prompted investigation of the combination of two existing agents-cefepime, a broad-spectrum cephalosporin, and tazobactam-to broaden their efficacy against extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae We determined the pharmacokinetic (PK) and

  1. Quantitative ultrasound tissue characterization in shoulder and thigh muscles – a new approach

    DEFF Research Database (Denmark)

    Nielsen, P.K.; Jensen, B.R.; Darvann, Tron Andre

    2006-01-01

    Background: The echogenicity patterns of ultrasound scans contain information of tissue composition in muscles. The aim was: ( 1) to develop a quantitative ultrasound image analysis to characterize tissue composition in terms of intensity and structure of the ultrasound images, and ( 2) to use th...

  2. Schwannoma extending from the umbilical region to the mid-thigh ...

    African Journals Online (AJOL)

    ... originating from the cells of peripheral nerve sheaths; the diagnosis was a schwannoma. Abdominal schwannomas are rare neoplasms that can be misdiagnosed. Laparoscopy is a safe and efficient option for approaching benign pelvic tumours and may offer the advantage of better visualisation of structures owing to the ...

  3. Schwannoma extending from the umbilical region to the mid-thigh ...

    African Journals Online (AJOL)

    We report the case of a 23yearold woman with a mass extending from the ... in our case laparoscopy was not considered owing to the size and anatomical location of the tumour. ... bladder, uterus, distal inferior vena cava .... cyst in pregnancy.

  4. Asymmetry and Thigh Muscle Coactivity in Fatigued Anterior Cruciate Ligament-Reconstructed Elite Skiers

    DEFF Research Database (Denmark)

    Jordan, Matthew J; Aagaard, Per; Herzog, Walter

    2017-01-01

    PURPOSE: The acute effects of fatigue on functional interlimb asymmetry and quadriceps/hamstring muscle activity levels, including preparatory coactivation during squat jump takeoff and landing, were evaluated in elite alpine ski racers with/without anterior cruciate ligament reconstruction (ACLR......). METHODS: Twenty-two elite ski racers (ACLR, n = 11; control, n = 11) performed an 80-s repeated squat jump test (jump test) on a dual force plate system with simultaneous EMG recordings in vastus lateralis, vastus medialis, semitendinosus, and biceps femoris. Asymmetry index (AI) and jump height of body...

  5. Evaluation of the inner thigh as site for mantoux test among children ...

    African Journals Online (AJOL)

    2016-07-30

    Jul 30, 2016 ... mary attending Physicians re- quested a Mantoux test. Methods: This was a cross sec- .... the help of an assistant. Elimination of zero error was done before each weight was obtained. ... using a 27 gauge needle by the principal investigator with an assistant after training and standardization of the process.

  6. Pelvic and thigh musculature in frogs (Anura) and origin of anuran jumping locomotion

    Czech Academy of Sciences Publication Activity Database

    Přikryl, Tomáš; Aerts, C.; Havelková, P.; Herrel, A.; Roček, Zbyněk

    2009-01-01

    Roč. 214, č. 1 (2009), s. 100-139 ISSN 0021-8782 Grant - others:GA MŠk(CZ) KONTAKT 1-06-05 (2006-2007) Institutional research plan: CEZ:AV0Z30130516 Keywords : Anura * anuran jumping * Caudata * comparative myology * evolution Subject RIV: EG - Zoology Impact factor: 2.134, year: 2009

  7. Instrumental evaluation of colour changes in broiler breast and thigh muscles after irradiation treatment

    International Nuclear Information System (INIS)

    Zabielski, J.; Jaworska-Piasecka, A.; Stangierski, J.

    2004-01-01

    Colour changes in Biceps femoris, Rectus femoris and Pectoralis major broiler chicken muscles were determined with a reflectance colorimeter after irradiation with gamma 60Co rays. The muscles were irradiated with doses of 2, 3, 5, 7 and 10 kGy. The colour parameters L*, a* and b* were measured after 2, 5, 7 and 9 days of refrigerated storage of muscles at 1 deg C using a MINOLTA CR-200b reflectance colorimeter. The saturation of colour C* was also calculated and the significance of redness and yellowness effect on saturation was estimated by a linear regression analysis. Only in the Biceps femoris muscle were all the examined colour parameters found to be dependent both on storage time and irradiation treatment, however, the relationship between the dose and the measured effect demonstrated no linear characteristics. It was noted that the difference between the irradiated and control Biceps femoris muscles resulted from different trends of L*, b* and C* changes during storage

  8. Experimental characterization of the BSD MAPA for heating of the human thigh

    International Nuclear Information System (INIS)

    Guerquin-Kern, J.L.; Hagmann, M.J.; Levin, R.L.; Glatstein, E.J.

    1985-01-01

    The authors began a series of experiments in order to characterize a Mini-Annular Phased Array (MAPA) applicator from the BSD Medical Corp. prior to possible clinical implementation at NIH. Heating patterns have been measured in simple cylindrical phantoms as well as a full-sized phantom-filled half-mannequin which is representative of the part of the human body that is below the waist. Implantable electric field probes have been used as well as non-perturbing temperature probes in these tests. The authors describe the relationship of measurements of the external electric field to changes in the heating pattern caused by lateral displacement of the phantom relative to the MAPA. The dependence of usable bandwidth upon phantom size and position, as well as upon the degree of bolus filling, is also described. Several recent tests made using two different types of helical coil applicators with the phantom-filled half-mannequin are also described for comparison

  9. Massive de-gloving thigh injury treated by vacuum therapy, dermal regeneration matrix and lipografting

    Directory of Open Access Journals (Sweden)

    Mario Cherubino

    2013-01-01

    Full Text Available Frequently lower limb injuries are caused by road and work accidents. The young age of those affected coupled with the anatomical and functional peculiarities of this part of the body with regards to social life during adolescence make the treatment of the leg wound complex and challenging. We present two cases of young girls, victims of serious road accidents who were treated initially with frequent wound washings, vacuum therapy to stimulate granulation tissue, then dermal regeneration matrix (INTEGRA ® and split-thickness skin grafts. After one year, both patients treated with lipofilling have shown improved cosmetic results allowing a new social life.

  10. EMG changes in thigh and calf muscles in fin swimming exercise.

    Science.gov (United States)

    Jammes, Y; Delliaux, S; Coulange, M; Jammes, C; Kipson, N; Brerro-Saby, C; Bregeon, F

    2010-08-01

    Because previous researchers have reported a reduced lactic acid production that accompanies a delayed or an absent ventilatory threshold (VTh) in water-based exercise, we hypothesized that the metaboreflex, activated by muscle acidosis, might be absent in fin swimming. This motor response, delaying the occurrence of fatigue, is characterized by a decreased median frequency (MF) of electromyographic (EMG) power spectrum. Seven healthy subjects performed a maximal fin swimming exercise protocol with simultaneous recordings of surface EMGs in VASTUS MEDIALIS (VM), TIBIALIS ANTERIOR (TA) and GASTROCNEMIUS MEDIALIS (GM). We computed the root mean square (RMS) and MF and recorded the compound evoked muscle potential (M-wave) in VM. We also measured the propulsive force and oxygen uptake (VO (2)), and determined VTh. VTh was absent in 4/7 subjects and measured at 70-90% of VO (2max) in the other three. In the three studied muscles, the global EMG activity (RMS) increased while the MF decreased in proportion of VO (2), the MF changes being significantly higher in VM (-29%) and GM (-39%) than in TA (-19%). Because no M-wave changes were noted, the MF decline was attributed to the recruitment of low-frequency, fatigue-resistant motor units. Our most important finding is the persistence of the metaboreflex even in a situation of reduced muscle acidosis. (c) Georg Thieme Verlag KG Stuttgart . New York.

  11. Giant trochanteric pressure sore: Use of a pedicled chimeric perforator flap for cover

    Directory of Open Access Journals (Sweden)

    Mehrotra Sandeep

    2009-01-01

    Full Text Available Pressure sores are increasing in frequency commensurate with an ageing population with multi-system disorders and trauma. Numerous classic options are described for providing stable wound cover. With the burgeoning knowledge on perforator anatomy, recent approaches focus on the use of perforator-based flaps in bedsore surgery. A giant neglected trochanteric pressure sore in a paraplegic is presented. Since conventional options of reconstruction appeared remote, the massive ulcer was successfully managed by a chimeric perforator-based flap. The combined muscle and fasciocutaneous flaps were raised as separate paddles based on the anterolateral thigh perforator branches and provided stable cover without complications. Perforators allow versatility in managing complex wounds without compromising on established principles.

  12. Malign retroperitoneal schwannoma

    International Nuclear Information System (INIS)

    Pinilla Gonzalez, Rafael; Hadi Al-Bahlooli, Saeed; Lopez Lazo, Sarah; Quintana Diaz, Juan Carlos; Gonzales Rivera, Armando

    2009-01-01

    The retroperitoneal tumors are infrequent and are classified according to the original tissue. This is a case presentation of a patient presenting with pain in right hypochondrium and a tumor in this zone, weight loss and painful discomfort in the anterolateral face of right thigh. In physical examination we found cutaneousmucous paleness and painless tumor in hypochondrium and right flank. Abdominal ultrasound (US) showed a homogenous mass of 14,11 cm and abdominal computed tomography allows to see a right retroperitoneal tumor rejecting the kidney. Excretory urogram showed a anteromedial rejection of right kidney. An encapsulated tumor with a few peritumoral adherences was removed. By histological study it was possible to confirm a fusiform cells tumor with hyperchromatism and nuclear pleomorphism, numerous mitosis and areas of necrosis and in the diagnosis of malign tumor of the sheath of a peripheral nerve.(author)

  13. Free flap transfer reconstruction in managing tongue carcinoma during pregnancy.

    Science.gov (United States)

    Miyazaki, Yuko; Fukuda, Kenji; Fujita, Kazutoshi; Nishimoto, Soh; Terada, Tomonori; Wada, Ryu; Sotsuka, Yohei; Kawai, Kenichiro; Kakibuchi, Masao

    2017-08-01

    Malignant oral cancers do not commonly occur in pregnant women. But when they do, the presence of a foetus and maternal physiological changes complicate and limit the treatment options. Risk benefit assessment and balancing of them are always important. A 33-year-old woman, who was 25 weeks pregnant, presented with a squamous cell carcinoma on her tongue. She was clinically staged II (T2, N0 and M0). Discussions between the patient, surgical teams and obstetricians agreed to continue her pregnancy while managing the tumour. Hemi-glossectomy and ipsilateral neck dissection was performed. Free antero-lateral thigh flap was transferred to reconstruct the tongue defect, successfully. The patient gave birth to a healthy baby afterward. She is tumour free for 6 years. Free flap reconstruction can be an option, even if the patient is pregnant.

  14. A delayed presentation of ameloblastic fibrosarcoma in an African patient.

    Science.gov (United States)

    Chauke, Nkhensani Yvonne; Sofianos, Chrysis; Liakos, Dimitri; Ndobe, Elias

    2017-08-01

    A 24-year-old womanpresented with ameloblastic fibrosarcoma arising from ameloblastic fibroma. The delayed presentation accounted for the extensive destruction of the mandible and complete occlusion of her oral cavity. This resulted in an inability to eat and maintain oral hygiene. A multidisciplinary team management approach involved nutritional optimisation, segmental mandibulectomy, reconstruction with a reconstructive plate and a free anterolateral thigh flap to line the the floor of mouth. Functional and aesthetic outcome was acceptable, and the patient is planned for secondary free fibular flap bony reconstruction. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Development of a phantom mimicking the functional and structural behaviors of the thigh muscles characterized with magnetic resonance elastography technique.

    Science.gov (United States)

    Chakouch, Mashhour K; Charleux, Fabrice; Bensamoun, Sabine F

    2015-01-01

    Magnetic Resonance Elastography (MRE) is a non invasive technique based on the propagation of shear waves in soft tissues providing the quantification of the mechanical properties [1]. MRE was successfully applied to healthy and pathological muscles. However, the MRE muscle methods must be further improved to characterize the deep muscles. A way will be to develop phantom mimicking the muscle behavior in order to set up new MRE protocol. Thus, the purpose of this study is to create a phantom composed of a similar skeletal muscle architecture (fiber, aponorosis) and equivalent elastic properties as a function of the muscle state (passive or active). Two homogeneous phantoms were manufactured with different concentrations of plastisol to simulate the elastic properties in relaxed (50% of plastisol) and contracted (70% of plastisol) muscle conditions. Moreover, teflon tubing pipes (D = 0.9 mm) were thread in the upper part of the phantom (50%) to represent the muscle fibers and a plastic sheet (8 × 15 cm) was also included in the middle of the phantom to mimic the aponeurosis structure. Subsequently, MRE tests were performed with two different pneumatic drivers, tube and round, (f = 90Hz) to analyze the effect of the type of driver on the wave propagation. Then, the wavelength was measured from the phase images to obtain the elastic properties (shear modulus). Both phantoms revealed elastic properties which were in the same range as in vivo muscle in passive (μ(50%) = 2.40 ± 0.18 kPa ) and active (6.24 ± 0.21 kPa) states. The impact of the type of driver showed higher values (about 1.2kPa) with the tube. The analysis of the wave behavior revealed a sliding along the plastic sheet as it was observed for in vivo muscle study. The wave was also sensitive to the presence of the fibers where gaps were identified. The present study demonstrates the ability of the phantom to mimic the structural and functional properties of the muscle.

  16. One session of strength exercise does not promote negative changes in the structure venous leg and thigh in men

    Directory of Open Access Journals (Sweden)

    Adenilson de Araújo Júnior

    2014-09-01

    Full Text Available The increase of the venous diameter is associated with the incompetence of the venous system of lower limb. In order to analyze the acute effects of one session of strength exercise (SE on superficial venous diameter (VD of the lower limbs (LL. Twenty-two men (22 ± 2 years old, 81.2 ± 13.4kg weight, 173.0 ± 4.0 cm height and 18.6 ± 3.3% estimated body fat performed a circuit of  three SE, with 3 sets of 6 repetitions, controlled by metronome, with a load of 85% (1-RM and 3 minutes rest. The VDs of the internal saphenous vein (ISV, in right and left LL, were measured at baseline and immediately after each set with color eco-Doppler. Data were analyzed by means of a one-way ANOVA for repeated measures. There was a significant effect of time for the right and left VSI (p= 0.001, the VDs at baseline were higher than in series for both. Furthermore, between sets, there was a significant decrease between the first and second (p= 0.009 and an increase between the second and third series (p= 0.027 for the right ISV. For the left ISV, only measured after the first and second are different (p= 0.001. There was a trend toward reduction in VD after the acute bout of strength exercise, indicating that their practice is efficient for the performance of this structure.

  17. Hip abductors and thigh muscles strength ratios and their relation to electromyography amplitude during split squat and walking lunge exercises

    Directory of Open Access Journals (Sweden)

    Petr Stastny

    2015-06-01

    Full Text Available Background: The hip abductors (HAB, quadriceps (Q and hamstrings (H reciprocal strength ratios are predictors of electromyography (EMG amplitude during load carrying walking at moderate intensity. Therefore, these strength ratios might predict also the EMG during the exercises as walking lunge (WL or split squat (SSq at submaximal intensity. Objective: To determine whether the EMG amplitude of vastus mediali (VM, vastus laterali (VL, biceps femoris (BF and gluteus medius (Gmed is associated with muscle strength ratio during SSqs and WLs. To determine whether the EMG amplitude differs between individuals with HAB/H ratio above and below one and between individuals with H/Q or HAB/Q ratio above and below 0.5 during SSqs and WLs. Methods: 17 resistance-trained men (age 29.6 ± 4.6 years with at least 3 years of strength training performed in cross-sectional design 5 s maximal voluntary isometric contractions (MVIC on an isokinetic dynamometer for knee extension, knee flexion, and hip abduction. The MVIC was used to normalize the EMG signal and estimate the individual strength ratios. Than participants performed WL and SSq for a 5 repetition maximum, to find out muscle activity at submaximal intensity of exercise. Results: The H/Q ratio was associated by Kendall's tau (τ with VM (τ = .33 and BF (τ = -.71 amplitude, HAB/Q ratio was associated with BF (τ = -.43 and Gmed (τ = .38 amplitude, as well as HAB/H was associated with VM (τ = -.41 and Gmed (τ = .74 amplitude. ANOVA results showed significant differences between SSq and WL (F(4, 79 = 10, p < .001, ηp2 = .34 in Gmed amplitude, where WL resulted in higher Gmed amplitude compared to SSq. Other significant differences were found between H/Q groups (F(4, 29 = 3, p = .04, ηp2 = .28 in VM and Gmed amplitude, where group with H/Q > 0.5 showed higher VMO amplitude and lower Gmed amplitude. Furthermore, significant difference was found for HAB/H groups (F(4, 29 = 4, p = .02, ηp2 = .34 in VM amplitude, where group with HAB/H < 1 showed higher VM amplitude. Conclusions: The ratios of HAB, H and Q are able to predict Gmed, VM and BF activity during WL and SSq. WL resulted in higher activity level of Gmed than SSq, because WL includes the impact forces as part of lunge movement. WL should be used in resistance-training programme, if the strengthening of Gmed or VM is the aim.

  18. The effects of alternative electrical and mechanical stunning methods on hemorrhaging and meat quality of broiler breast and thigh muscles

    NARCIS (Netherlands)

    Hillebrand, S.J.W.; Lambooij, E.; Veerkamp, C.H.

    1996-01-01

    Five trials were conducted to determine the effects of various alternative stunning and restraining methods on the quality of chicken broiler meat. The stunning methods used were electrical whole-body and head-only stunning with different voltages (25 vs 100 V) and frequencies (50 vs 200 Hz), and

  19. VARIATIONS IN NEUROMUSCULAR ACTIVITY OF THIGH MUSCLES DURING WHOLE-BODY VIBRATION IN CONSIDERATION OF DIFFERENT BIOMECHANICAL VARIABLES

    Directory of Open Access Journals (Sweden)

    Dennis Perchthaler

    2013-09-01

    Full Text Available The intention of this study was to systematically analyze the impact of biomechanical variables in terms of different vibration frequencies, amplitudes and knee angles on quadriceps femoris and hamstring activity during exposure to whole-body vibration (WBV. 51 healthy men and women (age 55 ± 8 years voluntary participated in the study and were randomly allocated to five different vibration-frequency groups. Each subject performed 9 static squat positions (3 amplitudes x 3 knee angles on a side alternating vibration platform. Surface electromyography (EMG was used to record the neuromuscular activity of the quadriceps femoris and hamstring muscles. Maximal voluntary contractions (MVCs were performed prior to the measurements to normalize the EMG signals. A three-way mixed ANOVA was performed to analyze the different effects of the biomechanical variables on muscle activity. Depending on the biomechanical variables, EMG muscle activity ranged between 18.2 and 74.1 % MVC in the quadriceps femoris and between 5.2 and 27. 3 % MVC in the hamstrings during WBV. The highest levels of muscle activation were found at high frequencies and large amplitudes. Especially in the quadriceps femoris muscle, a WBV frequency of 30 Hz led to a significant increase in muscle activity compared to the other tested frequencies. However, it seems that knee angle is only relevant for the quadriceps femoris muscle. The results of this study should give more information for developing individual training protocols for WBV treatment in different practical applications

  20. Comparison of drug delivery with autoinjector versus manual prefilled syringe and between three different autoinjector devices administered in pig thigh

    Directory of Open Access Journals (Sweden)

    Hill RL

    2016-08-01

    Full Text Available Robert L Hill,1,* John G Wilmot,1,* Beth A Belluscio,1 Kevin Cleary,2 David Lindisch,3 Robin Tucker,4 Emmanuel Wilson,2 Rajesh B Shukla11Meridian Medical Technologies Inc., Columbia, MD, 2Children’s National Medical Center, 3Washington DC VA Medical Center, 4Georgetown University Medical Center, Washington, DC, USA *These authors have contributed equally to this work Abstract: Parenteral routes of drug administration are often selected to optimize actual dose of drug delivered, assure high bioavailability, bypass first-pass metabolism or harsh gastrointestinal environments, as well as maximize the speed of onset. Intramuscular (IM delivery can be preferred to intravenous delivery when initiating intravenous access is difficult or impossible. Drugs can be injected intramuscularly using a syringe or an automated delivery device (autoinjector. Investigation into the IM delivery dynamics of these methods may guide further improvements in the performance of injection technologies. Two porcine model studies were conducted to compare differences in dispersion of injectate volume for different methods of IM drug administration. The first study compared the differences in the degree of dispersion and uptake of injectate following the use of a manual syringe and an autoinjector. The second study compared the spatial spread of the injected formulation, or dispersion volume, and uptake of injectate following the use of five different autoinjectors (EpiPen® [0.3 mL], EpiPen® Jr [0.3 mL], Twinject® [0.15 mL, 0.3 mL], and Anapen® 300 [0.3 mL] with varying needle length, needle gauge, and force applied to the plunger. In the first study, the autoinjector provided higher peak volumes of injectate, indicating a greater degree of dispersion, compared with manual syringe delivery. In the second study, EpiPen autoinjectors resulted in larger dispersion volumes and higher initial dispersion ratios, which decreased rapidly over time, suggesting a greater rate of uptake of injectate than the other autoinjectors. The differences in dispersion and uptake of injectate are likely the result of different functional characteristics of the delivery systems. Both studies demonstrate that the functional characteristics of the method for delivering IM injections impact the dispersion and uptake of the material injected, which could significantly affect the pharmacokinetics and, ultimately, the effectiveness of the drug. Keywords: anaphylaxis, autoinjector device, injector pen, intramuscular drug administration, dispersion volume

  1. Statistical mapping of the effect of knee extension on thigh muscle viscoelastic properties using magnetic resonance elastography

    International Nuclear Information System (INIS)

    Barnhill, Eric; Kennedy, Paul; Van Beek, Edwin J R; Roberts, Neil; Hammer, Steven; Brown, Colin

    2013-01-01

    Skeletal muscle viscoelastic properties reflect muscle microstructure and neuromuscular activation. Elastographic methods, including magnetic resonance elastography, have been used to characterize muscle viscoelastic properties in terms of region of interest (ROI) measurements. The present study extended this approach to create thresholded pixel-by-pixel maps of viscoelastic properties of skeletal muscle during rest and knee extension in eleven subjects. ROI measurements were taken for individual quadricep muscles and the quadriceps region as a whole, and the viscoelastic parameter map pixels were statistically tested at positive false discovery rate q ⩽ 0.25. ROI measurements showed significant (p ⩽ 0.05) increase in storage modulus (G′) and loss modulus (G″), with G″ increasing more than G′, in agreement with previous findings. The q-value maps further identified the vastus intermedius as the primary driver of this change, with greater G″/G′ increase than surrounding regions. Additionally, a cluster of significant decrease in G″/G′ was found in the region of vastus lateralis below the fulcrum point of the lift. Viscoelastic parameter mapping of contracted muscle allows new insight into the relationship between physiology, neuromuscular activation, and human performance. (paper)

  2. Pharmacodynamics of Imipenem in Combination with beta-Lactamase Inhibitor MK7655 in a Murine Thigh Model

    NARCIS (Netherlands)

    Mavridou, E.; Melchers, M.J.B.; Mil, A.C. van; Mangin, E.; Motyl, M.R.; Mouton, J.W.

    2015-01-01

    MK7655 is a newly developed beta-lactamase inhibitor of class A and class C carbapenemases. Pharmacokinetics (PK) of imipenem-cilastatin (IMP/C) and MK7655 were determined for intraperitoneal doses of 4 mg/kg to 128 mg/kg of body weight. MIC and pharmacodynamics (PD) studies of MK7655 were performed

  3. Gonad doses in radiotherapy. Phantom measurement in mammary carcinomas, Morbus Hodgkin, seminomas, hypernephromas, and rhabdomyosarcomas of the thigh

    International Nuclear Information System (INIS)

    Liebstueckel, L.

    1979-01-01

    The gonad doses in the therapy of malignant diseases were determined under defined conditions with the aid of a 60 Co and a 137 Cs irradiation appliance using an Alderson and paraffin phantom each. The measurements were carried out with a condiometer by Physikalisch-Technische Werkstaetten, Freiburg. Two different types of condensator chambers with a measuring range 15 mR to 8 R were used. In the irradiation of mammary carcinoma using the Alderson phantom with two tangential stationary fields the ovarian dose was 0.49 to 1.05 per mille, the testicular dose 0.3 to 0.47 per mille of the maximum irradiated dose. If mammary carcinomas are irradiated using a Caesa-Gammatron, the ovarian dose varies from 0.04 to 0.78 per mille within the five fields, the testicular dose from 0.01 to 0.13 per mille. For these measurements the paraffin phantom was used. If the radiation technique was somewhat modified, the ovaries (testes) of the Alderson phantom irradiated for Hodgkin's disease received 7 (4.7) per mille from irradiation of the thoracal field and 4.6 (3.2) per mille from irradiation of the mediastinal field. Irradiation of the abdominal field produced doses for the female and male gonads of 520 resp. 47.2 per mille. On irradiation of the para-aortic field, the ovaries and testes received doses of 8 resp. 4.6 per mille. Irradiation of the Alderson phantom for seminoma involved testicular doses between 29.1 and 3.1 per mille, depending on the size of the field and its distance from the gonads. Hypernephroma irradiation was carried out on the Alderson phantom with two pendular fields. The ovaries received between 3.7 and 14 per mille and the testes between 2.3 and 3.3 per mille of the focal dose. In irradiation for rhabdomyosarcoma, simulated with the paraffin phantom, the ovarian doses ranged between 5.5 and 11.9 per mille. The male gonad dose rose to values between 36.5 and 458 per mille of the focal dose. (orig./MG) [de

  4. Cleft, crevice, or the inner thigh: 'another place' for the establishment of the invasive barnacle Austrominius modestus (Darwin, 1854.

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    Sally A Bracewell

    Full Text Available The proliferation of anthropogenic infrastructure in the marine environment has aided the establishment and spread of invasive species. These structures can create novel habitats in areas normally characterised as void of suitable settlement sites. The habitat requirements of the invasive acorn barnacle Austrominius modestus (Darwin, 1854 were assessed using a novel sampling site at Crosby Beach, Liverpool. Austrominius modestus has spread rapidly around the UK since its initial introduction, becoming locally dominant in many estuarine areas including the Antony Gormley art installation, 'Another Place', at Crosby Beach. The installation consists of 100 replicate solid cast-iron life-size human figures, located at a range of heights on the shore. We recorded the distribution and abundance of A. modestus present on all of the statues at various positions during the summer of 2006. The positions varied in location, exposure, direction, and rugosity. Although parameters such as rugosity and exposure did influence patterns of recruitment, they were less important than interactions between shore height and direction, and specific location on the beach. The addition of a suitable substrate to a sheltered and estuarine region of Liverpool Bay has facilitated the establishment of A. modestus. Understanding the habitat requirements of invasive species is important if we are to make predictions about their spread and the likelihood of invasion success. Austrominius modestus has already become locally dominant in some regions of the UK and, with projections of favourable warming conditions and the global expansion of artificial structures, the continued spread of this species can be expected. The implications of this on the balance between native and invasive species dominance should be considered.

  5. Thigh muscle activity, knee motion, and impact force during side-step pivoting in agility-trained female basketball players.

    Science.gov (United States)

    Wilderman, Danielle R; Ross, Scott E; Padua, Darin A

    2009-01-01

    Improving neuromuscular control of hamstrings muscles might have implications for decreasing anterior cruciate ligament injuries in females. To examine the effects of a 6-week agility training program on quadriceps and hamstrings muscle activation, knee flexion angles, and peak vertical ground reaction force. Prospective, randomized clinical research trial. Sports medicine research laboratory. Thirty female intramural basketball players with no history of knee injury (age = 21.07 +/- 2.82 years, height = 171.27 +/- 4.66 cm, mass = 66.36 +/- 7.41 kg). Participants were assigned to an agility training group or a control group that did not participate in agility training. Participants in the agility training group trained 4 times per week for 6 weeks. We used surface electromyography to assess muscle activation for the rectus femoris, vastus medialis oblique, medial hamstrings, and lateral hamstrings for 50 milliseconds before initial ground contact and while the foot was in contact with the ground during a side-step pivot maneuver. Knee flexion angles (at initial ground contact, maximum knee flexion, knee flexion displacement) and peak vertical ground reaction force also were assessed during this maneuver. Participants in the training group increased medial hamstrings activation during ground contact after the 6-week agility training program. Both groups decreased their vastus medialis oblique muscle activation during ground contact. Knee flexion angles and peak vertical ground reaction force did not change for either group. Agility training improved medial hamstrings activity in female intramural basketball players during a side-step pivot maneuver. Agility training that improves hamstrings activity might have implications for reducing anterior cruciate ligament sprain injury associated with side-step pivots.

  6. Surface dosimetry in phototherapy: comparison of three ultraviolet B lamps used in the treatment of psoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Snow, J.L.; Muller, S.A. [Mayo Clinic, Rochester, MN (United States)

    1996-12-01

    The quantitation (dosimetry) of ultraviolet B irradiation (UVB) administered during phototherapy for psoriasis is fundamental to this modality of treatment because only absorbed irradiation can cause a photochemical reaction and, hence, a phototherapeutic effect. Significant differences may exist in surface dosimetry achieved with different UVB irradiators, and this could have important consequences for the observed clinical efficacy of phototherapy as well as practical implications for avoiding burning when transferring patients between systems. Multiple anatomically referenced polysulphone photodosimeters were applied to the skin of five subjects receiving treatment for severe psoriasis. Three subjects were irradiated with both a free-standing hot quartz lamp and a fluorescent cabinet. Two others were irradiated with a flat bank of fluorescent tubes. Topographical maps of surface irradiation were constructed. `Cold` areas (< 50% of stated dose) included the neck, upper chest, shoulders, and anterolateral thighs for the hot quartz lamp; the medial arms, medial legs, and feet for the cabinet; and the lateral arms, forearms, lower legs, and feet for the bank of tubes. `Hot` areas (> 100% of stated dose) included the forearms and posterior thighs for the hot quartz lamp; the lateral arms, dorsal forearm, and abdomen for the cabinet; and the central trunk (anterior and posterior) for the bank of tubes. Thus, striking differences in surface irradiation exist among the three UVB irradiators studied, and this has an impact on the results of phototherapy for psoriasis. (author).

  7. Using perforators as recipient vessels (supermicrosurgery) for free flap reconstruction of the knee region.

    Science.gov (United States)

    Hong, Joon Pio; Koshima, Isao

    2010-03-01

    The purpose of this article is to evaluate the feasibility of a perforator as a recipient vessel to reconstruct soft tissue defects of the knee region.From December of 2006 to August of 2008, total of 25 patients underwent reconstructive procedure using either an anterolateral thigh or an upper medial thigh perforator flap. The flaps were anastomosed in a perforator to perforator manner using supermicrosurgery technique.Minimum of 3 perforators were traced around the knee defect. All flaps survived attached to a recipient perforator with artery diameter ranging from 0.4 to 0.9 mm and accompanying veins ranging from 0.4 to 1.2 mm. This approach allowed reduction in time for pedicle and recipient vessel dissection and minimized the trauma involved during isolation of the vessels.Using the perforator as recipient vessel allows an increase in selection for choice of recipient. By using a perforator as recipient, less time is consumed to secure the vessel, does not need long pedicles for flap, is not bound by the condition of major arteries, and minimizes any risk for major vessel injury while having acceptable flap survival.

  8. Lipoatrofia semicircular: una revisión sistemática de la literatura Semicircular lipoatrophy: a sistematic review of the literature

    Directory of Open Access Journals (Sweden)

    Rafael Díaz Sarmiento

    2011-03-01

    unkvown cause. It is characterized by unilateral o bilateral semicircular depressions in the anterolateral side of the thighs. It is related to environmental labor conditions, repeated microtraumas and personal factors. We conducted this systematic review of the scientific literature to characterize the existing knowledge. Methods: Systematic Review. Databases: IBECS, IBSST, LILACS, IME, OSH-UPDATE, ISI-WOK, PubMed, CIS-DOC and Cochrane. We included articles about semicircular lipoatrophy related to working and environmental conditions. We used the levels of scientific evidence of the Scottish Intercollegiate Guidelines Network. Results: 66 articles were recovered. Only 22 fulfilled the inclusion criteria: Fifteen with evidence level 3 and 7 with evidence level 4. Seven studies were series of cases and 8 were unique case reports. All of them added 838 cases, informed between 1982-2010. The principal risk factors for LS are repetitive microtrauma, low relative humidity and electricity in modern office buildings. The semicircular depressions occur in the anterolateral side of thighs, without alteration of the skin and muscles, mostly in women (85%, without inflammatory signs and with unspecific histopathology. The magnetic resonance, x rays and the antinuclear antibodies are negative. The diagnosis is clinical, supported by ultrasonography. Psychological treatment and physical therapy can be useful. The preventive measures of greater impact are controlling risk factors. Conclusions: Insufficient scientific evidence exists about the causes of LS. It is a prevalent disorder that generates alarm, related to workplace conditions. It is necessary to continue investigating about causative agents.

  9. The Gluteus Medius Vs. Thigh Muscles Strength Ratio and Their Relation to Electromyography Amplitude During a Farmer’s Walk Exercise

    Directory of Open Access Journals (Sweden)

    Stastny Petr

    2015-03-01

    Full Text Available The strength ratio between hamstrings and quadriceps (H/Q is associated with knee injuries as well as hip abductor muscle (HAB weakness. Sixteen resistance trained men (age, 32.5 ± 4.2 years performed 5 s maximal isometric contractions at 75° of knee flexion/extension and 15° of hip abduction on a dynamometer. After this isometric test they performed a Farmer´s walk exercise to find out if the muscle strength ratio predicted the electromyography amplitude expressed as a percentage of maximum voluntary isometric contraction (%MVIC. The carried load represented a moderate intensity of 75% of the exercise six repetitions maximum (6RM. Electromyography data from the vastus medialis (VM, vastus lateralis (VL, biceps femoris (BF and gluteus medius (Gmed on each leg were collected during the procedure. The groups selected were participants with H/Q ≥ 0.5, HQ < 0.5, HAB/H ≥ 1, HAB/H < 1, HAB/Q ≥ 0.5 and HAB/Q < 0.5. One way ANOVA showed that Gmed activity was significantly greater in the group with HAB/H < 1 (42 ± 14 %MVIC as compared to HAB/H ≥ 1 (26 ± 10 %MVIC and HAB/Q < 0.5 (47 ± 19 %MVIC compared to HAB/Q ≥ 0.5 (26 ± 12 %MVIC. The individuals with HAB/H < 1 were found to have greater activation of their Gmed during the Farmer’s walk exercise. Individuals with HAB/Q < 0.5 had greater activation of the Gmed. Gmed strength ratios predict the muscle involvement when a moderate amount of the external load is used. The Farmer’s walk is recommended as an exercise which can strengthen the gluteus medius, especially for individuals with a HAB/H ratio < 1 and HAB/Q < 0.5.

  10. Neural network model for survival and growth of Salmonella 8,20:-:z6 in ground chicken thigh meat during cold storage: extrapolation to other serotypes

    Science.gov (United States)

    Mathematical models that predict behavior of human bacterial pathogens in food are valuable tools for assessing and managing this risk to public health. A study was undertaken to develop a model for predicting behavior of Salmonella 8,20:-:z6 in chicken meat during cold storage and to determine how...

  11. A manual therapy and exercise approach to meralgia paresthetica in pregnancy: a case report

    Science.gov (United States)

    Skaggs, Clayton D.; Winchester, Brett A.; Vianin, Michael; Prather, Heidi

    2006-01-01

    Abstract Objective To present a case of a pregnant patient with meralgia paresthetica who improved using manual therapy and exercise procedures. Clinical Features A 22-year-old patient in the sixteenth week of pregnancy had low back pain, bilateral anterolateral thigh paresthesia and groin pain for a duration of 1 month. She had no motor deficits in either lower extremity and her reflexes were intact. As a standard clinic procedure, a battery of functional tests were performed including: active straight leg raise, long dorsal ligament test, and the pelvic pain provocation procedure. Based on her clinical history and physical responses to the aforementioned functional tests, the diagnosis of meralgia paresthetica was deduced. Intervention and Outcome Treatment was provided at 6 visits over a 6-week period where the patient underwent evaluation, manual intervention, and exercise prescription. Active Release Technique (ART) was performed to the restricted right sacroiliac (SIJ) complex and quadratus lumborum muscles. ART and post-isometric relaxation were applied to the illiopsoas muscles. The home exercise program consisted of pelvic/low back mobility, stabilization and relaxation exercises. After 6 treatments, the patient reported complete resolution of low back pain and left lower extremity symptoms and a 90% improvement in the right thigh symptoms. At her one-year follow-up, the patient reported no further complications and the absence of pain. Conclusions Manual therapy and exercises may serve as an effective treatment protocol for pregnant patients experiencing low back pain complicated by paresthesia. Because these conservative procedures offer a low-risk intervention, additional clinical studies are warranted to further study this treatment. PMID:19674679

  12. Overcoming the Obstacles of the Ilizarov Device in Extremity Reconstruction: Usefulness of the Perforator as the Recipient Vessel.

    Science.gov (United States)

    Kim, Kyu Nam; Hong, Joon Pio; Park, Sung Woo; Kim, Sang Woo; Yoon, Chi Sun

    2015-07-01

    When patients using the Ilizarov device need a free-flap procedure for their thigh and leg, it is difficult to isolate the major vessels as the recipient vessel due to the limited working space around the Ilizarov rings and pins. The usefulness of a perforator as the recipient vessel to allow minimally invasive surgery was investigated in this study. Between October 2011 and December 2013, 77 patients using the Ilizarov device needed free flap reconstruction using an anterolateral thigh perforator flap or superficial circumflex iliac artery perforator flap. The perforator was used as a recipient vessel in 50 cases, with which end-to-end anastomosis was performed using a perforator-to-perforator approach, and major vessels were used as a recipient vessel in 27 cases (n = 20, anterior tibial vessel; n = 7, posterior vessel). When the perforator was used as the recipient vessel, total loss developed in one case and marginal necrosis in four cases. When the major vessel was used as the recipient vessel, whole necrosis developed in one case and marginal necrosis in two cases. The procedure increased the freedom of hand movement, decreased the recipient vessel dissection time, and reduced the recipient dissection scar. The use of perforators as recipients overcomes the obstacles associated with the Ilizarov device and allows convenient and rapid reconstruction, with similar success as microsurgery using major vessels. Further studies are needed to address the limitations of this approach, which include perfusion physiology and the viable limit of the flap dimension. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  13. A Case of Urethral Reconstruction Using a Superficial Circumflex Iliac Artery

    Directory of Open Access Journals (Sweden)

    Kun-Woon Yoo

    2012-05-01

    Full Text Available A radial forearm free flap has been conventionally used for urethral reconstruction. However, aesthetic and functional complications occur frequently at the donor site. The use of a superficial circumflex iliac artery perforator (SCIP flap can resolve these disadvantages. Here, we report our case with a review of literature. A 69-year-old man visited our hospital with multiple contusions of the abdomen and genital amputation. After necrotic tissue debridement, the length of the residual corpus carvernosum was 1.5 cm and that of the corpus spongiosum and urethra was 1 cm. For the reconstruction of the penis, a SCIP flap and anterolateral thigh free flap was performed. The primary closure was performed at the donor site. Three weeks postoperatively, the patient had a urethral foley catheter removed. The neourethra was functioning well without stricture. Four months postoperatively, the patient had no complications such as urethral stricture. A good recovery was also achieved with no aesthetic deficits at the donor site. SCIP flap is appropriate for urethral reconstruction. Because of its proximity to the recipient sites, it makes surgical preparation easier and the primary closure at the donor site available. It is also advantageous in that its location is almost unnoticeable.

  14. Ophthalmic Artery Embolization as Pretreatment of Orbital Exenteration for Conjunctival Squamous Cell Carcinoma

    International Nuclear Information System (INIS)

    Matsuo, Toshihiko; Ohara, Nobuya; Namba, Yuzaburo; Koshima, Isao; Ida, Kentaro; Kanazawa, Susumu

    2009-01-01

    The aim of this study is to describe the effect of transarterial embolization from the ophthalmic artery as a pretreatment for orbital exenteration. A 75-year-old Chinese man with a 7-year history of gradual increase of the left eye swelling showed a massive conjunctival tumor growing outwardly from the interpalpebral fissure and had no light perception in the left eye. Magnetic resonance imaging showed orbital invasion of the tumor around the left eyeglobe. The initial surgery for the planned orbital exenteration was discontinued after skin incision around the orbital margin due to massive hemorrhage. The patient underwent transarterial embolization with gelatin sponge (Spongel) of the feeding arteries from the left ophthalmic artery and, the next day, had orbital exenteration with well-controllable bleeding and reconstruction with free vascularized anterolateral thigh cutaneous flap transfer. Pathologically, well-differentiated squamous cell carcinoma proliferated in exophytic, papillary, and nested fashions, arising from the bulbar conjunctiva. Tumor cells were also found in the conjunctival stroma around the vessels. The sclera at the equator had a perforated site with tumor cell invasion, but no intraocular invasion was found. Hematoxylin-positive gelatin sponges were found inside the orbital vessels and large choroidal vessels. In conclusion, transarterial embolization of feeding arteries arising from the ophthalmic artery is a useful pretreatment to control bleeding at orbital exenteration for malignancy.

  15. Free-flap surgical correction of facial deformity after anteromedial maxillectomy.

    Science.gov (United States)

    Sarukawa, Shunji; Kamochi, Hideaki; Noguchi, Tadahide; Sunaga, Ataru; Uda, Hirokazu; Mori, Yoshiyuki; Nishino, Hiroshi; Yoshimura, Kotaro

    2017-09-01

    Anteromedial maxillectomy is typically performed in conjunction with low-dose radiotherapy and intraarterial chemotherapy. In doing so, the extent of surgical defects is reduced. However, nasal deviation and oral incompetence may ensue, due to cicatricial contracture of wounds, and may be distressing to these patients. Herein, we report a series of eight free perforator flap procedures (anterolateral thigh [ALT] flap, 6; thoracodorsal artery perforator [TAP] flap, 2) used to correct such deformities. The TAP flap was combined with scapular tip [ST] osseous flap in patients with added zygomatic prominence defects. Three adipocutaneous parts developed from each perforator flap were applied as follows: two to reconstruct nasal lining and oral vestibule, and one to augment cheek volume. All aesthetic results proved satisfactory, although orbital dystopia and contracture of mimic muscles were not resolved completely. These secondary interventions are suitable for sequelae of simple anteromedial maxillectomy. Immediate reconstruction should be considered if orbital floor and mimic muscles are involved. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  16. Reconstruction after complex facial trauma: achieving optimal outcome through multiple contemporary surgeries.

    Science.gov (United States)

    Jaiswal, Rohit; Pu, Lee L Q

    2013-04-01

    Major facial trauma injuries often require complex repair. Traditionally, the reconstruction of such injuries has primarily utilized only free tissue transfer. However, the advent of newer, contemporary procedures may lead to potential reconstructive improvement through the use of complementary procedures after free flap reconstruction. An 18-year-old male patient suffered a major left facial degloving injury resulting in soft-tissue defect with exposed zygoma, and parietal bone. Multiple operations were undertaken in a staged manner for reconstruction. A state-of-the-art free anterolateral thigh (ALT) perforator flap and Medpor implant reconstruction of the midface were initially performed, followed by flap debulking, lateral canthopexy, midface lift with redo canthopexy, scalp tissue expansion for hairline reconstruction, and epidermal skin grafting for optimal skin color matching. Over a follow-up period of 2 years, a good and impressive reconstructive result was achieved through the use of multiple contemporary reconstructive procedures following an excellent free ALT flap reconstruction. Multiple staged reconstructions are essential in producing an optimal outcome in this complex facial injury that would likely not have been produced through a 1-stage traditional free flap reconstruction. Utilizing multiple, sequential contemporary surgeries may substantially improve outcome through the enhancement and refinement of results based on possibly the best initial soft-tissue reconstruction.

  17. Reconstruction of soft tissue after complicated calcaneal fractures.

    Science.gov (United States)

    Koski, E Antti; Kuokkanen, Hannu O M; Koskinen, Seppo K; Tukiainen, Erkki J

    2004-01-01

    A total of 35 flap reconstructions were done to cover exposed calcaneal bones in 31 patients. All patients had calcaneal fractures, 19 of which were primarily open. Soft tissue reconstruction for the closed fractures was indicated by a postoperative wound complication. A microvascular flap was used for reconstruction in 21 operations (gracilis, n = 11; anterolateral thigh, n = 5; rectus abdominis, n = 3; and latissimus dorsi, n = 2). A suralis neurocutaneous flap was used in eight, local muscle flaps in three, and local skin flaps in three cases. The mean follow-up time was 14 months (range 3 months-4 years). One suralis flap failed and was replaced by a latissimus dorsi flap. Necrosis of the edges that required revision affected three flaps. Deep infection developed in two patients and delayed wound healing in another four. During the follow-up the soft tissues healed in all patients and there were no signs of calcaneal osteitis. Flaps were considered too bulky in five patients. Soft tissues heal most rapidly with microvascular flaps. In the long term, gracilis muscle covered with free skin grafts gives a good contour to the foot. The suralis flap is reliable and gives a good final aesthetic outcome. Local muscles can be transposed for reconstruction in small defects.

  18. Necrotizing streptococcal myositis of the upper extremity: a case report.

    Science.gov (United States)

    Reichert, Johannes C; Habild, Götz; Simon, Paul; Nöth, Ulrich; Krümpelmann, Jan B

    2017-08-15

    Necrotizing myositis is a rare but life-threatening soft-tissue infection characterized by rapidly spreading inflammation and subsequent necrosis of the affected tissue. The myositis is often caused by toxin-producing, virulent bacteria such as group A β-hemolytic streptococcus and associated with severe systemic toxicity. It is rapidly fatal unless diagnosed promptly and treated aggressively. However, necrotizing myositis is often initially misdiagnosed as a more benign soft-tissue infection as such fulminant, invasive muscle infections are rare with no more than 30 cases reported over the last century. We illustrate the case of a 74-year-old male Caucasian initially presenting with a progressing swelling and gradually oncoming pain of the upper right extremity. Rapidly, livid discolorations of the skin, blisters, hypoesthesia and severe pain resistant to analgesics treatment developed accompanied by disruption of the arterial blood flow. Due to a manifest compartment syndrome the patient was admitted to theater for fasciotomy of the arm. After multiple revision surgeries wound closure was achieved using a pedicled, fasciocutaneous parascapular flap and a free, ipsilateral anterolateral thigh flap. Microbiological analysis revealed group A β-hemolytic streptococcus, histology a bacterial interstitial myositis with necrotic muscular fibers. A high degree of clinical suspicion is necessary to avert potentially disastrous consequences of necrotizing myositis. Timely diagnosis, broad-spectrum antibiotic therapy, and aggressive surgical debridement of affected tissue are keys to the treatment of this serious, often life-threatening infection.

  19. Síndrome do nevo de Becker: relato de caso Becker's nevus syndrome: case report

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    Isabela Guimarães Ribeiro Baeta

    2010-10-01

    Full Text Available O nevo de Becker se manifesta como uma mácula hipercrômica, localizada predominantemente no tronco anterior ou região escapular, e frequentemente associada à hipertricose. A coexistência do nevo de Becker e anormalidades cutâneas, músculo-esqueléticas ou maxilo-faciais corresponde à síndrome do nevo de Becker. Relata-se o caso de uma paciente de 16 anos, portadora desde os sete anos de mácula hipercrômica, localizada no tronco ântero-lateral direito, estendendo-se até a face medial da coxa direita, acompanhada de hipoplasia mamária ipsilateral. O exame anatomopatológico confirmou a hipótese clínica de nevo de Becker.Becker's nevus is a hyperpigmented macula that is predominantly located on the anterior trunk or on the scapular region, frequently associated with hypertrichosis. The association of Becker's nevus with other cutaneous, musculoskeletal or maxillofacial anomalies has been called Becker's nevus syndrome. We report a case of a 16-year-old girl with a hyperpigmented macula which spread from her right anterolateral trunk to the inner part of her right thigh accompanied by ipsilateral mammary hypoplasia. The skin lesion started when the patient was seven years old when it was also noticed ipsilateral mammary hypoplasia. The histological exam confirmed the clinical hypothesis of Becker's nevus.

  20. Free flap reconstruction for diabetic foot limb salvage.

    Science.gov (United States)

    Sato, Tomoya; Yana, Yuichiro; Ichioka, Shigeru

    2017-12-01

    Although free flap is gaining popularity for the reconstruction of diabetic foot ulcers, it is unclear whether free flap reconstruction increases the chances of postoperative independent ambulation. The aim of this study is to evaluate the relationship between free flap success and postoperative ambulation. This study reviewed 23 cases of free flap reconstruction for diabetic foot ulcers between January 2007 and March 2014. Free rectus abdominis, latissimus dorsi, and anterolateral thigh flaps were used in ten, eight, and five patients, respectively. A comparison was made between free flap success and postoperative independent ambulation using Fisher's exact test. Two patients developed congestive heart failure with fatal consequences within 14 days postoperatively, resulting in an in-hospital mortality rate of 8.7%. Five patients lost their flaps (21.7%). Of the 16 patients who had flap success, 12 achieved independent ambulation. Five patients with flap loss did not achieve independent ambulation, except one patient who underwent secondary flap reconstruction using a distally based sural flap. Fisher's exact test revealed that independent ambulation was associated with free flap success (p = 0.047). The present study indicates that free flap reconstruction may increase the possibility of independent ambulation for patients with extensive tissue defects due to diabetic ulcers. Intermediate limb salvage rates and independent ambulation rates were favourable in patients with successful reconstruction. The use of foot orthoses and a team approach with pedorthists were effective to prevent recurrence.

  1. Robot-Assisted Free Flap in Head and Neck Reconstruction

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    Han Gyeol Song

    2013-07-01

    Full Text Available Background  Robots have allowed head and neck surgeons to extirpate oropharyngealtumors safely without the need for lip-split incision or mandibulotomy. Using robots inoropharyngealreconstruction is newbut essentialfor oropharyngeal defectsthatresultfromrobotic tumor excision. We report our experience with robotic free-flap reconstruction ofhead and neck defectsto exemplify the necessity forrobotic reconstruction.Methods  We investigated head and neck cancer patients who underwent ablation surgeryand free-flap reconstruction by robot. Between July 1, 2011 andMarch 31, 2012, 5 caseswereperformed and patient demographics, location of tumor, pathologic stage, reconstructionmethods, flap size, recipient vessel, necessary pedicle length, and operation time wereinvestigated.Results  Among five free-flap reconstructions, four were radial forearm free flaps and onewas an anterolateral thigh free-flap. Four flaps used the superior thyroid artery and oneflap used a facial artery as the recipient vessel. The average pedicle length was 8.8 cm. Flapinsetting and microanastomosis were achieved using a specially manufactured roboticinstrument. The total operation timewas 1,041.0 minutes(range, 814 to 1,132 minutes, andcomplicationsincluding flap necrosis, hematoma, andwound dehiscence did not occur.Conclusions  Thisstudy demonstratesthe clinically applicable use ofrobotsin oropharyngealreconstruction, especially using a free flap. A robot can assist the operator in insettingthe flap at a deep portion of the oropharynx without the need to perform a traditionalmandibulotomy. Robot-assisted reconstruction may substitute for existing surgical methodsand is accepted asthemost up-to-datemethod.

  2. Epinephrine (adrenaline) in anaphylaxis.

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    Simons, F Estelle R; Simons, Keith J

    2010-01-01

    Epinephrine (adrenaline) is universally recommended as the initial drug of choice for the treatment of anaphylaxis. No other medication has similar life-saving pharmacologic effects in multiple organ systems, including prevention and relief of both upper and lower airway obstruction, and of shock. Failure to inject epinephrine promptly contributes to anaphylaxis fatalities. It is most effective when given immediately after the onset of anaphylaxis symptoms. The initial recommended adult dose is 0.3-0.5 mg, injected intramuscularly in the anterolateral aspect of the mid-thigh. Injected by other routes, epinephrine appears to have a less satisfactory therapeutic window; for example, onset of action is potentially delayed when it is injected subcutaneously, and risk of adverse effects potentially increases when it is injected intravenously. The possibility of randomized, controlled trials of epinephrine in anaphylaxis should be considered. For ethical reasons, these trials will not be placebo-controlled. They might involve comparison of one epinephrine dose versus another, or one route of epinephrine administration versus another. For first-aid treatment of people with anaphylaxis in the community, novel epinephrine formulations are being developed. These include epinephrine autoinjectors that are safer and easier to use, and epinephrine formulations that can be administered through non-invasive routes. Copyright 2010 S. Karger AG, Basel.

  3. Schwannoma retroperitoneal maligno Malign retroperitoneal schwannoma

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    Rafael Pinilla González

    2009-12-01

    Full Text Available Los tumores del retroperitoneo son poco frecuentes y se clasifican según el tejido del que se originan. Se presenta el caso de una paciente con dolor en el hipocondrio derecho y tumor en esta zona, pérdida de peso y molestia dolorosa en la cara anterolateral del muslo derecho. En el examen físico se halló palidez cutáneo-mucosa y tumoración indolora en el hipocondrio y flanco derecho. El ultrasonido abdominal mostró una masa homogénea de 14,11 cm y la tomografía computarizada de abdomen permitió observar un tumor retroperitoneal derecho que rechazaba el riñón. El urograma excretor mostró rechazamiento anteromedial del riñón derecho. Se extirpó un tumor encapsulado con pocas adherencias peritumorales. Mediante estudio histológico se confirmó un tumor de células fusiformes con hipercromatismo y pleomorfismo nuclear, numerosas mitosis y áreas de necrosis y el diagnóstico de tumor maligno de la vaina de un nervio periférico.The retroperitoneal tumors are infrequent and are classified according to the original tissue. This is a case presentation of a patient presenting with pain in right hypochondrium and a tumor in this zone, weight loss and painful discomfort in the anterolateral face of right thigh. In physical examination we found cutaneous-mucous paleness and painless tumor in hypochondrium and right flank. Abdominal ultrasound (US showed a homogenous mass of 14,11 cm and abdominal computed tomography allows to see a right retroperitoneal tumor rejecting the kidney. Excretory urogram showed a anteromedial rejection of right kidney. An encapsulated tumor with a few peritumoral adherences was removed. By histological study it was possible to confirm a fusiform cells tumor with hyperchromatism and nuclear pleomorphism, numerous mitosis and areas of necrosis and in the diagnosis of malign tumor of the sheath of a peripheral nerve.

  4. Muscle cramps

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    ... the lower leg/calf Back of the thigh (hamstrings) Front of the thigh (quadriceps) Cramps in the ... Names Cramps - muscle Images Chest stretch Groin stretch Hamstring stretch Hip stretch Thigh stretch Triceps stretch References ...

  5. [Reconstruction of ankle and foot with combination of free perforator flaps and skin graft].

    Science.gov (United States)

    Yin, Lu; Gong, Ketong; Yin, Zhonggang; Zhang, Bo; Xu, Jianhua

    2017-03-01

    To evaluate the clinical outcomes of free perforator flaps combined with skin graft for reconstruction of ankle and foot soft tissue defects. Between June 2014 and October 2015, 20 cases of ankle and foot soft tissue defects were treated. There were 16 males and 4 females, aged from 19 to 61 years (mean, 43.3 years). Injury was caused by traffic accident in 7 cases, by crashing in 9 cases, and machine twist in 4 cases. The locations were the ankle in 6 cases, the heel in 3 cases, the dorsum pedis in 4 cases, and the plantar forefoot in 7 cases of avulsion injury after toes amputation. The size of wound ranged from 15 cm×10 cm to 27 cm×18 cm. The time from injury to treatment was from 11 to 52 days (mean, 27 days). The anterolateral thigh perforator flap was used in 11 cases, thoracodorsal antery perforator flap in 3 cases, medial sural artery perforator flap in 4 cases, deep inferior epigastric perforator flap in 1 case, and anteromedial thigh perforator flap in 1 case, including 5 chimeric perforator flaps, 5 polyfoliate perforator flaps, 3 flow-through perforator flaps, and 3 conjoined perforator flaps. The size of the perforator flap ranged from 10.0 cm×6.5 cm to 36.0 cm×8.0 cm, the size of skin graft from 5 cm×3 cm to 18 cm×12 cm. Venous crisis occurred in 2 flaps which survived after symptomatic treatment; 18 flaps survived successfully and skin grafting healed well. The follow-up time ranged 4-18 months (mean, 8.3 months). The flaps had good appearance, texture and color, without infection. The patients could walk normally and do daily activities. Only linear scars were observed at the donor sites. Free perforator flap can be used to reconstruct defects in the ankle and foot, especially in the weight-bearing area of the plantar forefoot. A combination of free perforator flap and skin graft is ideal in reconstruction of great soft tissue defects in the ankle and foot.

  6. Microsurgical free flap reconstructions of head and neck region in 406 cases: a 13-year experience.

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    Gerressen, Marcus; Pastaschek, Claudia Inge; Riediger, Dieter; Hilgers, Ralf-Dieter; Hölzle, Frank; Noroozi, Nelson; Ghassemi, Alireza

    2013-03-01

    The reconstruction of extended soft tissue and bony defects in the maxillofacial region with microsurgical flaps is considered to be the therapy of first choice. The aim of this retrospective study was to detect different influencing factors concerning flap survival. We examined the data of 406 patient cases (121 female and 285 male cases; mean age, 57 years) undergoing reconstruction with a microsurgical flap in our facility between 1998 and 2010. In these cases 326 soft tissue flaps (radial forearm flap, scapula flap, latissimus dorsi flap, anterolateral thigh flap, lateral arm flap, and jejunum flap) and 80 bony flaps (fibula flap and deep circumflex iliac artery flap) were examined. Evaluated parameters were, among others, the timing of reconstruction, defect localization, and recipient vessels used (external vs internal jugular system), as well as anticoagulative management. We statistically analyzed data by means of a χ(2) test, taking account of the odds ratio with P < .05, which was deemed significant. The overall flap survival rate was approximately 92%, without any gender- or age-specific differences. Primary reconstructions proceeded distinctly more successfully than secondary reconstructions (P < .01). Likewise, the defect localization exerted a significant effect on the survival rate (P = .01), with a more caudal localization affecting flap survival positively. Finally, neither the anticoagulation regimen nor the choice of recipient vein system exercised an influence on the survival rate. Microsurgical tissue transfer is a convenient and reliable method in maxillofacial surgery, provided that one is aware of the determining factors for success. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Clampless anastomosis with an intraluminal thermosensitive gel: first application in reconstructive microsurgery and literature review.

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    Giessler, G A; Fischborn, G T; Schmidt, A B

    2012-01-01

    Microvascular clamps of various designs provide a bloodless field for a safe anastomosis but can cause intimal lesions, occupy space in confined sites and have a risk of backwalling due to vessel flattening. They are often insufficient in their haemostatic effect in plaque-filled atherosclerotic vessels. A new, CE-certified thermosensitive gel (LeGoo™) clinically proven in cardiovascular surgery allows a clampless microanastomosis technique. We operated on a series of five consecutive patients aged 24-71 years with six flaps for lower-extremity reconstruction using a clampless anastomosis technique with LeGoo™. We transplanted one fabricated chimaeric fibula plus gracilis, three gracilis muscle and one anterolateral thigh (ALT) flap. Pre- and postoperative protocols were similar to a 'standard' procedure with micro-clamps. All flaps survived completely except for a small area on fibula skin island, which was unrelated to gel use. The gel-assisted technique has a quick learning curve, according to this case series. The veins should be sutured first to prevent stasis in the flap. The gel provides circular stenting and gentle distension of the vessels for a safe and blood-free anastomotic site. It is completely dissolved after completion of the anastomosis with cold saline irrigation. Repolymerisation in the periphery will not occur, making it safe for microvascular flap surgery. From the experiences from this series and other specialities, the use of the thermosensitive gel LeGoo™ permits a safe clampless microanastomosis technique minimising mechanical vessel manipulation and compression. This makes it an attractive alternative to micro-clamps, especially for atherosclerotic arteries and confined anastomosis sites. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. [Management of vascular crisis of free flaps after reconstruction of head and neck defects caused by tumor resection].

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    Ni, Song; Zhu, Yiming; Li, Dezhi; Liu, Jie; An, Changming; Zhang, Bin; Liu, Shaoyan

    2015-11-01

    To discuss the management of vascular crisis of free flaps after reconstruction of head and neck defects caused by tumor resection. A total of 259 cases of free flap reconstruction performed in the Cancer Hospital of Chinese Academy of Medical Sciences from 2010 to 2013 were retrospectively analyzed, including 89 cases of anterolateral thigh flaps, 48 cases of radial forearm flaps, 46 free fibula flaps, 5 cases of inferior epigastric artery perforator flaps, 5 cases of free latissimus dorsi flaps, one case of lateral arm flap, and one case of medial femoral flap. The surveillance frequency of free flaps was q1h on post-operative day (POD) 1, q2h on POD 2 and 3, and q4h after POD 3. Vascular crises were reviewed for analysis. The incidence rate of vascular crisis was 8.1% (21/259), with 15 males and 6 females. The average age was 54.8 years old (17-68), and the average time of vascular crisis was 100.8 h post-operation (3-432). There were 7 cases of free jejunum flaps and 14 dermal free flaps. Seven of these 21 cases with vascular crisis were rescued by surgery. The success rate of salvage surgery within 72 hours from the primary operation was 54.5% (6/11), significantly higher than that of salvage surgery performed later than 72 hours from primary operation (10.0%, 1/10, P=0.043). There were 14 cases of flap necrosis, two of which died of local infection. Early detection of vascular crisis can effectively improve the success rate of salvage, so as to avoid the serious consequences caused by free flap necrosis.

  9. Reconstruction of the Lower Extremity Using Free Flaps

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    Min Jo Kang

    2013-09-01

    Full Text Available Background The aim of lower-extremity reconstruction has focused on wound coverage andfunctional recovery. However, there are limitations in the use of a local flap in cases of extensivedefects of the lower-extremities. Therefore, free flap is a useful option in lower-extremityreconstruction.Methods We performed a retrospective review of 49 patients (52 cases who underwentlower-extremity reconstruction at our institution during a 10-year period. In these patients,we evaluated causes and sites of defects, types of flaps, recipient vessels, types of anastomosis,survival rate, and complications.Results There were 42 men and 10 women with a mean age of 32.7 years (range, 3-72years. The sites of defects included the dorsum of the foot (19, pretibial area (17, ankle(7, heel (5 and other sites (4. The types of free flap included latissimus dorsi muscle flap(10, scapular fascial flap (6, anterolateral thigh flap (6, and other flaps (30. There werefour cases of vascular complications, out of which two flaps survived after intervention. Theoverall survival of the flaps was 96.2% (50/52. There were 19 cases of other complications atrecipient sites such as partial graft loss (8, partial flap necrosis (6 and infection (5. However,these complications were not notable and were resolved with skin grafts.Conclusions The free flap is an effective method of lower-extremity reconstruction. Goodoutcomes can be achieved with complete debridement and the selection of appropriaterecipient vessels and flaps according to the recipient site.

  10. Secondary free-flap reconstruction following ablation for acute invasive fungal sinusitis.

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    Allensworth, Jordan J; Troob, Scott H; Weaver, Tyler S; Gonzalez, Javier D; Petrisor, Daniel; Wax, Mark K

    2017-04-01

    Acute invasive fungal sinusitis (AIFS) is a frequently fatal infection for which extensive and debilitating surgical debridement is a mainstay of therapy. Resulting defects are often composite in nature, mandating free tissue-transfer reconstruction. Outcomes data for free flap reconstruction are limited. The purpose of this study was to examine surgical outcomes and survival in patients undergoing free flap transfer following invasive fungal sinusitis. Retrospective case series. Between 1995 and 2015, patients undergoing operative debridement for AIFS were identified. Surgical records were used to identify survivors of acute infection who subsequently underwent free flap reconstructive surgery. Patient demographics, cause of immune compromise, defect description, flap type, perioperative complications, indications for revision surgery, functional outcomes, and long-term survival were reviewed. Forty-four patients were treated for AIFS, of those, 30 (68%) survived acute infection. Ten patients underwent maxillectomy, six with orbital exenteration, and were designated candidates for reconstruction. Eight patients underwent reconstruction. Median time from debridement to reconstruction was 67.5 days. Flap types included latissimus dorsi, scapula, anterolateral thigh, rectus, radial forearm, and fibula. Median follow-up was 7.7 months. No perioperative complications were encountered, and all subjects remained disease-free, able to speak and eat normally without prosthetic supplementation. Seven patients (87%) are currently alive. Reconstruction of defects left by invasive fungal sinusitis using free-tissue transfer resulted in successful flap survival, with no disease recurrence for all defects and flap types reviewed. Survivors of AIFS are able to tolerate midface reconstruction, with favorable functional outcomes and survival rates. 4. Laryngoscope, 127:815-819, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  11. Reconstruction of the Lower Extremity Using Free Flaps

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    Min Jo Kang

    2013-09-01

    Full Text Available BackgroundThe aim of lower-extremity reconstruction has focused on wound coverage and functional recovery. However, there are limitations in the use of a local flap in cases of extensive defects of the lower-extremities. Therefore, free flap is a useful option in lower-extremity reconstruction.MethodsWe performed a retrospective review of 49 patients (52 cases who underwent lower-extremity reconstruction at our institution during a 10-year period. In these patients, we evaluated causes and sites of defects, types of flaps, recipient vessels, types of anastomosis, survival rate, and complications.ResultsThere were 42 men and 10 women with a mean age of 32.7 years (range, 3-72 years. The sites of defects included the dorsum of the foot (19, pretibial area (17, ankle (7, heel (5 and other sites (4. The types of free flap included latissimus dorsi muscle flap (10, scapular fascial flap (6, anterolateral thigh flap (6, and other flaps (30. There were four cases of vascular complications, out of which two flaps survived after intervention. The overall survival of the flaps was 96.2% (50/52. There were 19 cases of other complications at recipient sites such as partial graft loss (8, partial flap necrosis (6 and infection (5. However, these complications were not notable and were resolved with skin grafts.ConclusionsThe free flap is an effective method of lower-extremity reconstruction. Good outcomes can be achieved with complete debridement and the selection of appropriate recipient vessels and flaps according to the recipient site.

  12. Free Boomerang-shaped Extended Rectus Abdominis Myocutaneous flap: The longest possible skin/myocutaneous free flap for soft tissue reconstruction of extremities

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    Ashok R Koul

    2011-01-01

    Full Text Available Background: A soft tissue defect requiring flap cover which is longer than that provided by the conventional "long" free flaps like latissimus dorsi (LD and anterolateral thigh (ALT flap is a challenging problem. Often, in such a situation, a combination of flaps is required. Over the last 3 years, we have managed nine such defects successfully with a free "Boomerang-shaped" Extended Rectus Abdominis Myocutaneous (BERAM flap. This flap is the slightly modified and "free" version of a similar flap described by Ian Taylor in 1983. Materials and Methods: This is a retrospective study of patients who underwent free BERAM flap reconstruction of soft tissue defects of extremity over the last 3 years. We also did a clinical study on 30 volunteers to compare the length of flap available using our design of BERAM flap with the maximum available flap length of LD and ALT flaps, using standard markings. Results: Our clinical experience of nine cases combined with the results of our clinical study has confirmed that our design of BERAM flap consistently provides a flap length which is 32.6% longer than the standard LD flap and 42.2% longer than the standard ALT flap in adults. The difference is even more marked in children. The BERAM flap is consistently reliable as long as the distal end is not extended beyond the mid-axillary line. Conclusion: BERAM flap is simple in design, easy to harvest, reliable and provides the longest possible free skin/myocutaneous flap in the body. It is a useful new alternative for covering long soft tissue defects in the limbs.

  13. Free Boomerang-shaped Extended Rectus Abdominis Myocutaneous flap: The longest possible skin/myocutaneous free flap for soft tissue reconstruction of extremities.

    Science.gov (United States)

    Koul, Ashok R; Nahar, Sushil; Prabhu, Jagdish; Kale, Subhash M; Kumar, Praveen H P

    2011-09-01

    A soft tissue defect requiring flap cover which is longer than that provided by the conventional "long" free flaps like latissimus dorsi (LD) and anterolateral thigh (ALT) flap is a challenging problem. Often, in such a situation, a combination of flaps is required. Over the last 3 years, we have managed nine such defects successfully with a free "Boomerang-shaped" Extended Rectus Abdominis Myocutaneous (BERAM) flap. This flap is the slightly modified and "free" version of a similar flap described by Ian Taylor in 1983. This is a retrospective study of patients who underwent free BERAM flap reconstruction of soft tissue defects of extremity over the last 3 years. We also did a clinical study on 30 volunteers to compare the length of flap available using our design of BERAM flap with the maximum available flap length of LD and ALT flaps, using standard markings. Our clinical experience of nine cases combined with the results of our clinical study has confirmed that our design of BERAM flap consistently provides a flap length which is 32.6% longer than the standard LD flap and 42.2% longer than the standard ALT flap in adults. The difference is even more marked in children. The BERAM flap is consistently reliable as long as the distal end is not extended beyond the mid-axillary line. BERAM flap is simple in design, easy to harvest, reliable and provides the longest possible free skin/myocutaneous flap in the body. It is a useful new alternative for covering long soft tissue defects in the limbs.

  14. Facial contour deformity correction with microvascular flaps based on the 3-dimentional template and facial moulage

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    Dinesh Kadam

    2013-01-01

    Full Text Available Introduction: Facial contour deformities presents with varied aetiology and degrees severity. Accurate assessment, selecting a suitable tissue and sculpturing it to fill the defect is challenging and largely subjective. Objective assessment with imaging and software is not always feasible and preparing a template is complicated. A three-dimensional (3D wax template pre-fabricated over the facial moulage aids surgeons to fulfil these tasks. Severe deformities demand a stable vascular tissue for an acceptable outcome. Materials and Methods: We present review of eight consecutive patients who underwent augmentation of facial contour defects with free flaps between June 2005 and January 2011. De-epithelialised free anterolateral thigh (ALT flap in three, radial artery forearm flap and fibula osteocutaneous flap in two each and groin flap was used in one patient. A 3D wax template was fabricated by augmenting the deformity on facial moulage. It was utilised to select the flap, to determine the exact dimensions and to sculpture intraoperatively. Ancillary procedures such as genioplasty, rhinoplasty and coloboma correction were performed. Results: The average age at the presentation was 25 years and average disease free interval was 5.5 years and all flaps survived. Mean follow-up period was 21.75 months. The correction was aesthetically acceptable and was maintained without any recurrence or atrophy. Conclusion: The 3D wax template on facial moulage is simple, inexpensive and precise objective tool. It provides accurate guide for the planning and execution of the flap reconstruction. The selection of the flap is based on the type and extent of the defect. Superiority of vascularised free tissue is well-known and the ALT flap offers a versatile option for correcting varying degrees of the deformities. Ancillary procedures improve the overall aesthetic outcomes and minor flap touch-up procedures are generally required.

  15. The retrograde transverse cervical artery as a recipient vessel for free tissue transfer in complex head and neck reconstruction with a vessel-depleted neck.

    Science.gov (United States)

    Ciudad, Pedro; Agko, Mouchammed; Manrique, Oscar J; Date, Shivprasad; Kiranantawat, Kidakorn; Chang, Wei Ling; Nicoli, Fabio; Lo Torto, Federico; Maruccia, Michele; Orfaniotis, Georgios; Chen, Hung-Chi

    2017-11-01

    Reconstruction in a vessel-depleted neck is challenging. The success rates can be markedly decreased because of unavailability of suitable recipient vessels. In order to obtain a reliable flow, recipient vessels away from the zone of fibrosis, radiation, or infection need to be explored. The aim of this report is to present our experience and clinical outcomes using the retrograde flow coming from the distal transverse cervical artery (TCA) as a source for arterial inflow for complex head and neck reconstruction in patients with a vessel-depleted neck. Between July 2010 and June 2016, nine patients with a vessel-depleted neck underwent secondary head and neck reconstruction using the retrograde TCA as recipient vessel for microanastomosis. The mean age was 49.6 years (range, 36 to 68 years). All patients had previous bilateral neck dissections and all, except one, had also received radiotherapy. Indications included neck contracture release (n = 3), oral (n = 1), mandibular (n = 3) and pharyngoesophageal (n = 2) reconstruction necessitating free anterolateral thigh (n = 3) and medial sural artery (n = 1) perforator flaps, fibula (n = 3) and ileocolon (n = 2) flaps respectively. There was 100% flap survival rate with no re-exploration or any partial flap loss. One case of intra-operative arterial vasospasm at the anastomotic suture line was managed intra-operatively with vein graft interposition. There were no other complications or donor site morbidity during the follow-up period. In a vessel-depleted neck, the reverse flow of the TCA may be a reliable option for complex secondary head and neck reconstruction in selected patients. © 2017 Wiley Periodicals, Inc.

  16. Robot-Assisted Free Flap in Head and Neck Reconstruction

    Directory of Open Access Journals (Sweden)

    Han Gyeol Song

    2013-07-01

    Full Text Available BackgroundRobots have allowed head and neck surgeons to extirpate oropharyngeal tumors safely without the need for lip-split incision or mandibulotomy. Using robots in oropharyngeal reconstruction is new but essential for oropharyngeal defects that result from robotic tumor excision. We report our experience with robotic free-flap reconstruction of head and neck defects to exemplify the necessity for robotic reconstruction.MethodsWe investigated head and neck cancer patients who underwent ablation surgery and free-flap reconstruction by robot. Between July 1, 2011 and March 31, 2012, 5 cases were performed and patient demographics, location of tumor, pathologic stage, reconstruction methods, flap size, recipient vessel, necessary pedicle length, and operation time were investigated.ResultsAmong five free-flap reconstructions, four were radial forearm free flaps and one was an anterolateral thigh free-flap. Four flaps used the superior thyroid artery and one flap used a facial artery as the recipient vessel. The average pedicle length was 8.8 cm. Flap insetting and microanastomosis were achieved using a specially manufactured robotic instrument. The total operation time was 1,041.0 minutes (range, 814 to 1,132 minutes, and complications including flap necrosis, hematoma, and wound dehiscence did not occur.ConclusionsThis study demonstrates the clinically applicable use of robots in oropharyngeal reconstruction, especially using a free flap. A robot can assist the operator in insetting the flap at a deep portion of the oropharynx without the need to perform a traditional mandibulotomy. Robot-assisted reconstruction may substitute for existing surgical methods and is accepted as the most up-to-date method.

  17. Acute effects of remote ischemic preconditioning on cutaneous microcirculation - a controlled prospective cohort study

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    Kraemer Robert

    2011-11-01

    Full Text Available Abstract Background Therapeutic strategies aiming to reduce ischemia/reperfusion injury by conditioning tissue tolerance against ischemia appear attractive not only from a scientific perspective, but also in clinics. Although previous studies indicate that remote ischemic intermittent preconditioning (RIPC is a systemic phenomenon, only a few studies have focused on the elucidation of its mechanisms of action especially in the clinical setting. Therefore, the aim of this study is to evaluate the acute microcirculatory effects of remote ischemic preconditioning on a distinct cutaneous location at the lower extremity which is typically used as a harvesting site for free flap reconstructive surgery in a human in-vivo setting. Methods Microcirculatory data of 27 healthy subjects (25 males, age 24 ± 4 years, BMI 23.3 were evaluated continuously at the anterolateral aspect of the left thigh during RIPC using combined Laser-Doppler and photospectrometry (Oxygen-to-see, Lea Medizintechnik, Germany. After baseline microcirculatory measurement, remote ischemia was induced using a tourniquet on the contralateral upper arm for three cycles of 5 min. Results After RIPC, tissue oxygen saturation and capillary blood flow increased up to 29% and 35% during the third reperfusion phase versus baseline measurement, respectively (both p = 0.001. Postcapillary venous filling pressure decreased statistically significant by 16% during second reperfusion phase (p = 0.028. Conclusion Remote intermittent ischemic preconditioning affects cutaneous tissue oxygen saturation, arterial capillary blood flow and postcapillary venous filling pressure at a remote cutaneous location of the lower extremity. To what extent remote preconditioning might ameliorate reperfusion injury in soft tissue trauma or free flap transplantation further clinical trials have to evaluate. Trial registration ClinicalTrials.gov: NCT01235286

  18. Customizing anaphylaxis guidelines for emergency medicine.

    Science.gov (United States)

    Nowak, Richard; Farrar, Judith Rosen; Brenner, Barry E; Lewis, Lawrence; Silverman, Robert A; Emerman, Charles; Hays, Daniel P; Russell, W Scott; Schmitz, Natalie; Miller, Judi; Singer, Ethan; Camargo, Carlos A; Wood, Joseph

    2013-08-01

    Most episodes of anaphylaxis are managed in emergency medical settings, where the cardinal signs and symptoms often differ from those observed in the allergy clinic. Data suggest that low recognition of anaphylaxis in the emergency setting may relate to inaccurate coding and lack of a standard, practical definition. Develop a simple, consistent definition of anaphylaxis for emergency medicine providers, supported by clinically relevant consensus statements. Definitions of anaphylaxis and criteria for diagnosis from current anaphylaxis guidelines were reviewed with regard to their utilization in emergency medical settings. The agreed-upon working definition is: Anaphylaxis is a serious reaction causing a combination of characteristic findings, and which is rapid in onset and may cause death. It is usually due to an allergic reaction but can be non-allergic. The definition is supported by Consensus Statements, each with referenced discussion. For a positive outcome, quick diagnosis and treatment of anaphylaxis are critical. However, even in the emergency setting, the patient may not present with life-threatening symptoms. Because mild initial symptoms can quickly progress to a severe, even fatal, reaction, the first-line treatment for any anaphylaxis episode--regardless of severity--is intramuscular injection of epinephrine into the anterolateral thigh; delaying its administration increases the potential for morbidity and mortality. When a reaction appears as "possible anaphylaxis," it is generally better to err on the side of caution and administer epinephrine. We believe that this working definition and the supporting Consensus Statements are a first step to better management of anaphylaxis in the emergency medical setting. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Analysis of fatty infiltration and inflammation of the pelvic and thigh muscles in boys with Duchenne muscular dystrophy (DMD): grading of disease involvement on MR imaging and correlation with clinical assessments.

    Science.gov (United States)

    Kim, Hee Kyung; Merrow, Arnold C; Shiraj, Sahar; Wong, Brenda L; Horn, Paul S; Laor, Tal

    2013-10-01

    Prior reports focus primarily on muscle fatty infiltration in Duchenne muscular dystrophy (DMD). However, the significance of muscle edema is uncertain. To evaluate the frequency and degree of muscle fat and edema, and correlate these with clinical function. Forty-two boys (ages 5-19 years) with DMD underwent pelvic MRI. Axial T1- and fat-suppressed T2-weighted images were evaluated to grade muscle fatty infiltration (0-4) and edema (0-3), respectively. Degree and frequency of disease involvement were compared to clinical evaluations. Gluteus maximus had the greatest mean fatty infiltration score, followed by adductor magnus and gluteus medius muscles, and had the most frequent and greatest degree of fatty infiltration. Gluteus maximus also had the greatest mean edema score, followed by vastus lateralis and gluteus medius muscles. These muscles had the most frequent edema, although the greatest degree of edema was seen in other muscles. There was correlation between cumulative scores of fatty infiltration and all clinical evaluations (P muscles with the most frequent fatty infiltration had the greatest degree of fatty infiltration and correlated with patient function. However, the muscles with the most frequent edema were different from those with the greatest degree of edema. Thus, edema may not predict patient functional status.

  20. Comparação entre dois testes clínicos para avaliar a flexibilidade dos músculos posteriores da coxa Comparison between two clinical tests for evaluating the flexibility of the posterior muscles of the thigh

    Directory of Open Access Journals (Sweden)

    RL Carregaro

    2007-04-01

    Full Text Available OBJETIVOS: Comparar os resultados dos testes de Dedos ao Chão e Elevação dos MMII em Extensão por meio da fotogrametria, verificar a concordância entre os achados do ângulo do quadril entre os dois testes e avaliar a confiabilidade intra e interavaliadores do procedimento de análise fotogramétrica. MÉTODO: Os testes foram aplicados em 35 sujeitos saudáveis do sexo masculino (média de 23 anos de idade ± 3, 170 cm de altura ± 4 e 68 Kg ± 11, que foram divididos em dois grupos com base na classificação dos testes. Marcadores superficiais foram colocados em referências ósseas para traçar os ângulos do quadril, tóraco-lombar, perna, joelho e tíbio-társico. Testou-se a confiabilidade do procedimento de análise fotogramétrica dos ângulos mensurados por dois avaliadores. RESULTADOS: Para o ângulo do quadril houve diferenças significativas entre os grupos de flexibilidade, nos dois testes, sendo que o ângulo foi menor nos sujeitos com flexibilidade reduzida. Houve uma diferença significativa de 22,8% entre a classificação designada pelos dois testes. Entretanto, o ângulo do quadril obteve altos índices de concordância entre os testes (ICC: 0,89 e diferença média de -0,85º. Os procedimentos de fotogrametria apresentaram altos índices de confiabilidade tanto intra quanto interavaliadores (ICC variando de 0,94 a 0,99. CONCLUSÃO: Os testes apresentaram diferenças na classificação de flexibilidade dos sujeitos. Entretanto, quando o ângulo do quadril foi considerado, houve alta concordância entre os resultados dos testes. Os procedimentos de análise fotogramétrica foram reprodutíveis tanto intra quanto interavaliadores, constituindo uma ferramenta útil de análise para os testes em questão.OBJECTIVE: To compare the results from fingertip-to-floor and straight leg raise tests by means of photogrammetry, investigate the concordance of hip angle findings between the two tests and evaluate the intra and inter-examiner reliability of the photogrammetric analysis procedure. METHOD: The tests were applied to 35 healthy male subjects (mean age 23 ± 3.4 years, height 170 ± 4 cm and weight 68 ± 11 kg. The subjects were divided into two groups on the basis of the test classifications. Surface markers were placed on bone references in order to calculate the hip, thoracolumbar, leg, knee and tibiotarsal angles. The reliability of the photogrammetric analysis procedure on the angles measured by two examiners was tested. RESULTS: For the hip angle, there were significant differences between the flexibility groups in both tests, and subjects with reduced flexibility had lower angles. There was a significant difference (22.8% between the classifications designated by the two tests. However, the hip angle showed high levels of concordance between the tests (ICC: 0.89 and mean difference of -0.85º. The photogrammetric procedures presented high reliability rates, both for intra and inter-examiner (ICC ranging from 0.94 to 0.99. CONCLUSION: The tests presented differences in the classification of the subjects' flexibility. However, considering the hip angle, there was high concordance between the test results. The photogrammetric analysis procedures were reproducible, both for intra and for inter-examiner measurements, thus making this a useful analysis tool for the tests in question.

  1. Perforator plus flaps: Optimizing results while preserving function and esthesis

    Directory of Open Access Journals (Sweden)

    Mehrotra Sandeep

    2010-01-01

    Full Text Available Background: The tenuous blood supply of traditional flaps for wound cover combined with collateral damage by sacrifice of functional muscle, truncal vessels, or nerves has been the bane of reconstructive procedures. The concept of perforator plus flaps employs dual vascular supply to flaps. By safeguarding perforators along with supply from its base, robust flaps can be raised in diverse situations. This is achieved while limiting collateral damage and preserving nerves, vessels, and functioning muscle with better function and aesthesis. Materials and Methods: The perforator plus concept was applied in seven different clinical situations. Functional muscle and fasciocutaneous flaps were employed in five and adipofascial flaps in two cases, primarily involving lower extremity defects and back. Adipofascial perforator plus flaps were employed to provide cover for tibial fracture in one patients and chronic venous ulcer in another. Results: All flaps survived without any loss and provided long-term stable cover, both over soft tissue and bone. Functional preservation was achieved in all cases where muscle flaps were employed with no clinical evidence of loss of power. There was no sensory loss or significant oedema in or distal to the flap in both cases where neurovascular continuity was preserved during flap elevation. Fracture union and consolidation were satisfactory. One patient had minimal graft loss over fascia which required application of stored grafts with subsequent take. No patient required re-operation. Conclusions: Perforator plus concept is holistic and applicable to most flap types in varied situations. It permits the exercise of many locoregional flap options while limiting collateral functional damage. Aesthetic considerations are also addressed while raising adipofascial flaps because of no appreciable donor defects. With quick operating times and low failure risk, these flaps can be a better substitute to traditional flaps and at

  2. A comparison of surgical exposures for posterolateral osteochondral lesions of the talar dome.

    Science.gov (United States)

    Mayne, Alistair I W; Lawton, Robert; Reidy, Michael J; Harrold, Fraser; Chami, George

    2018-04-01

    Perpendicular access to the posterolateral talar dome for the management of osteochondral defects is difficult. We examined exposure available from each of four surgical approaches. Four surgical approaches were performed on 9 Thiel-embalmed cadavers: anterolateral approach with arthrotomy; anterolateral approach with anterior talo-fibular ligament (ATFL) release; anterolateral approach with antero-lateral tibial osteotomy; and anterolateral approach with lateral malleolus osteotomy. The furthest distance posteriorly allowing perpendicular access with a 2mm k-wire was measured. An anterolateral approach with arthrotomy provided a mean exposure of the anterior third of the lateral talar dome. A lateral malleolus osteotomy provided superior exposure (81.5% vs 58.8%) compared to an anterolateral tibial osteotomy. Only the anterior half of the lateral border of the talar dome could be accessed with an anterolateral approach without osteotomy. A fibular osteotomy provided best exposure to the posterolateral aspect of the talar dome. Copyright © 2016 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  3. Effectiveness of Acellular Dermal Matrix on Autologous Split-Thickness Skin Graft in Treatment of Deep Tissue Defect: Esthetic Subjective and Objective Evaluation.

    Science.gov (United States)

    Lee, Yoo Jung; Park, Myong Chul; Park, Dong Ha; Hahn, Hyung Min; Kim, Sue Min; Lee, Il Jae

    2017-10-01

    A split-thickness skin graft (STSG) is performed to cover a large full-thickness skin defect. Esthetic and functional deficits can result, and many studies have sought to overcome them. This study compared the effectiveness of the acellular dermal matrix (ADM) graft and STSG concerning esthetic and functional effectiveness of ADM on scar quality. Of the patients who underwent anterolateral thigh free flap from 2011 to 2015, patients who received skin graft only (n = 10) or skin graft with ADM (n = 20) for coverage of the donor site were enrolled. In all cases, autologous STSG was performed with 1:1.5 meshed 0.008-0.010-inch-thick skin. In the skin graft with ADM group, 0.008-0.013-inch-thick meshed ADM (CGderm ® ; CGBio, Inc., Seungnam, Korea) was co-grafted. Negative-pressure wound therapy (CuraVAC ® ; CGBio, Inc., Seungnam, Korea) was applied to both groups in continuous mode at -120 mmHg. We investigate early outcomes (skin loss rate, duration of negative-pressure wound therapy, days to removal of stitches, days to achieve complete healing, and complications) and late outcomes in terms of scar quality (vascularity, pigmentation, pliability and height) and graft-related symptoms (itching sensation and pain). Assessments used the Vancouver Scar Scale and the Patient and Observer Scar Assessment Scale. Skin fold was measured to evaluate the elasticity of scar tissue. In the Vancouver Scar Scale, vascularity subscore (p = 0.003) and total score (p = 0.016) were significantly lower in the skin graft with ADM group. In Patient and Observer Scar Assessment Scale, the pain (p = 0.037) and stiffness subscores (p = 0.002), and total score (p = 0.017) were significantly lower in the skin graft with ADM group. Skin graft with ADM results in better scar quality in objective and subjective aspects. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to

  4. Effects of 16-week high-intensity interval training using upper and lower body ergometers on aerobic fitness and morphological changes in healthy men: a preliminary study

    Directory of Open Access Journals (Sweden)

    Osawa Y

    2014-11-01

    Full Text Available Yusuke Osawa,1,2,* Koichiro Azuma,3,* Shogo Tabata,3 Fuminori Katsukawa,2 Hiroyuki Ishida,2 Yuko Oguma,2 Toshihide Kawai,4 Hiroshi Itoh,4 Shigeo Okuda,5 Hideo Matsumoto3 1Japan Society for the Promotion of Science, Graduate School of Arts and Sciences, University of Tokyo, Tokyo, Japan; 2Sports Medicine Research Center, Keio University, Kanagawa, Japan; 3Institute for Integrated Sports Medicine, School of Medicine, Keio University, Tokyo, Japan; 4Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan; 5Department of Radiology, School of Medicine, Keio University, Tokyo, Japan *Yusuke Osawa and Koichiro Azuma are co-first authors of this article Abstract: It is unclear whether combined leg and arm high-intensity interval training (HIIT improves fitness and morphological characteristics equal to those of leg-based HIIT programs. The aim of this study was to compare the effects of HIIT using leg-cycling (LC and arm-cranking (AC ergometers with an HIIT program using only LC. Effects on aerobic capacity and skeletal muscle were analyzed. Twelve healthy male subjects were assigned into two groups. One performed LC-HIIT (n=7 and the other LC- and AC-HIIT (n=5 twice weekly for 16 weeks. The training programs consisted of eight to 12 sets of >90% VO2 (the oxygen uptake that can be utilized in one minute peak for 60 seconds with a 60-second active rest period. VO2 peak, watt peak, and heart rate were measured during an LC incremental exercise test. The cross-sectional area (CSA of trunk and thigh muscles as well as bone-free lean body mass were measured using magnetic resonance imaging and dual-energy X-ray absorptiometry. The watt peak increased from baseline in both the LC (23%±38%; P<0.05 and the LC–AC groups (11%±9%; P<0.05. The CSA of the quadriceps femoris muscles also increased from baseline in both the LC (11%±4%; P<0.05 and the LC–AC groups (5%±5%; P<0.05. In contrast, increases were observed in the CSA of

  5. The Effects of Prototype Helicopter Seat Cushion Concepts on Human Body Vibration Response

    National Research Council Canada - National Science Library

    Smith, Suzanne

    1998-01-01

    ...), and thigh, and the input at the seat. Seating configurations included the rigid seat, a current inventory seat cushion, and a prototype cushion with an inflatable thigh support in both the deflated and inflated positions...

  6. 38 CFR 4.73 - Schedule of ratings-muscle injuries.

    Science.gov (United States)

    2010-07-01

    ... by belt-over-pulley action at knee joint. Posterior thigh group, Hamstring complex of 2-joint muscles... postural support of body (6); acting with hamstrings in synchronizing hip and knee (1, 2). Anterior thigh...

  7. Research Article Special Issue

    African Journals Online (AJOL)

    pc

    2017-10-17

    Oct 17, 2017 ... range without feeling the pain about the joints and muscles [11]. Flexibility referred to ... of body back, thighs and hip (lower back andposterior thighs) ultrasonic ... the flexibility of hamstring muscle on both legs. 10 to 17 years.

  8. ~~v~:r~r:~

    African Journals Online (AJOL)

    1974-09-07

    Sep 7, 1974 ... On physical examination the patient was not distressed, the pulse was 88/min and ... ponade, showing recent diaphragmatic infarction with anterolateral ... therapy with digitalis, diuretics and bedrest. Right heart pressures ...

  9. Review article: Surgical approaches for correction of post-tubercular kyphosis.

    Science.gov (United States)

    Panchmatia, Jaykar R; Lenke, Lawrence G; Molloy, Sean; Cheung, Kenneth M C; Kebaish, Khaled M

    2015-12-01

    This study reviewed the literature regarding the pros and cons of various surgical approaches (anterior, anterolateral, combined, and posterior) for correction of post-tubercular kyphosis. The anterior and anterolateral approaches are effective in improving neurological deficit but not in correcting kyphosis. The combined anterior and posterior approach and the posterior approach combined with 3-column osteotomy achieve good neurological improvement and kyphosis correction. The latter is superior when expertise and facilities are available.

  10. Cutaneous flaps in the treatment of 338 pressure sores: a better choice.

    Science.gov (United States)

    Greco, Manfredi; Marchetti, Francesco; Tempesta, Massimo; Ruggiero, Marco; Marcasciano, Marco; Carlesimo, Bruno

    2013-01-01

    Muscular flaps are considered by many surgeons as a treatment of choice for pressure sores. Nevertheless fasciocutaneous and adipofascial flaps are less sensitive to ischemia, more resistant to pressure and have higher mechanical resistance. The aim of this study is to evaluate the results of our integrated rehabilitative and surgical protocol in pressure sore management based on the use of cutaneous flaps. Since 1998, we treated 338 pressure sores (PS) in 195 patients (120 males; 75 females), 189 patients were affected by paraplegia and tetraplegia and 6 of them by neurological disorders. Ninety sacral, 156 ischiatic, 75 trochanteric, 9 calcanean and 8 sores of the iliac-crest were succesfully treated. All showed an involvement of the bone element, with osteitis and/or periosteitis. 14 cases of trocanteric sores showed a deeper bone involvement, with evidences of osteomyelitis. Follow up ranges from 7 years to 2 months. Median time for wound healing was 18 days. The use of fasciocutaneous flaps, as an alternative to the traditional muscolocutaneous flaps in the treatment of pressure sores leads to good and statistically comparable, healing rate, time and incidence of complications. Reconstructive plastic surgery as is a decisive factor to reach a good rehabilitative outcome, minimizing the time of rehabilitation with a following decrease of hospitalization costs. In spinal cord injured patients, surgical treatment of pressure sores is not proposed as the main procedure, but it is an important stage during the natural history of pressure sores. Cutaneous, adipofascial and fasciocutaneous flaps are less invasive, of a relatively easy execution, provided by a reliable vascular pedicle and they could be "re-used" in case of recurrences.

  11. Characterization of lower-limbs inter-segment coordination during the take-off extension in ski jumping.

    Science.gov (United States)

    Chardonnens, Julien; Favre, Julien; Cuendet, Florian; Gremion, Gérald; Aminian, Kamiar

    2013-08-01

    Take-off, the most important phase in ski jumping, has been primarily studied in terms of spatio-temporal parameters; little is known about its motor control aspects. This study aims to assess the inter-segment coordination of the shank-thigh and thigh-sacrum pairs using the continuous relative phase (CRP). In total 87 jumps were recorded from 33 athletes with an inertial sensor-based system. The CRP curves indicated that the thighs lead the shanks during the first part of take-off extension and that the shanks rotated faster at the take-off extension end. The thighs and sacrum first rotated synchronously, with the sacrum then taking lead, with finally the thighs rotating faster. Five characteristic features were extracted from the CRP and their relationship with jump length was tested. Three features of the shank-thigh pair and one of the thigh-sacrum pair reported a significant association with jump length. It was observed that athletes who achieved longer jumps had their thighs leading their shanks during a longer time, with these athletes also having a more symmetric movement between thighs and sacrum. This study shows that inter-segment coordination during the take-off extension is related to performance and further studies are necessary to contrast its importance with other ski jumping aspects. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Lipoatrofia semicircular: Nuestra experiencia dos años después (2007-2009 Semicircular Lipoatrophy: Our experience two years later (2007-2009

    Directory of Open Access Journals (Sweden)

    Antonio Ortega Díaz de Cevallos

    2009-12-01

    publicados en los que no se modificaba el entorno, en una gran proporción de los casos. Además estas correcciones han demostrado una gran eficacia frenando la aparición de nuevos casos. No se han apreciado otras manifestaciones patológicas que las estrictamente propias de lipoatrofia segmentaria.Background and objectives: To describe and to analyze the clinical presentation and the evolution after variation of certain environmental factors, of our series of cases of semicircular lipoatrophy in job environment, with special attention to the resolution of the injury and to value the possible association with other patologies from the ethiologic point of view or if it could be part of a more complex syndrome. Patients and method: Workers attended between spring of 2007 and summer of 2009. In the first visit, we made a standardized history performing physical examination with measurement and location of the injury, laboratory parameters tests and ultrasonographic study of the presumptively affected zone. Subsequently, after having been taken the measurements recommended in companies to eliminate the static electricity, quarterly controls are included with anamnesis, physical exploration and ultrasonographic comparatives. Results: 96,7 % are women, without predominance of any age. They all work at desks with informatic material and abundant electric wired up. The locations, except for 3 cases (2 in arm and one in bottom region, were at the level of the anterolateral face of thighs and with average values of 69x20x73 cm. (heightxwidthxlength. Evolvely 6 months later 93 % of cases was showing clinical remiss (62 % complete, 3l % partial; after one year only 2 cases have not showed any variation having a 69 % of complete resolutions. None of the cases has presented any other related pathology. In the first year of control there were 36 new cases, in the second one 22 and in what takes of the third one 4. Conclusions: The clinical characteristics are superimposable on those of

  13. Early outcome of minimally invasive mitral valve surgery

    Directory of Open Access Journals (Sweden)

    Shawky Fareed

    2016-08-01

    Conclusion: Right anterolateral mini-thoracotomy minimally invasive technique provides excellent exposure of the mitral valve, even with a small atrium and offers a better cosmetic lateral scar which is less prone to keloid formation. In addition, minimally invasive right anterolateral mini-thoracotomy is as safe as median sternotomy for mitral valve surgery, with fewer complications and postoperative pain, less ICU and hospital stay, fast recovery to work with no movement restriction after surgery. It should be used as an initial approach for mitral valve surgery. Furthermore, it was believed that less spreading of the incision, no interference with the diaphragm and less tissue dissection might improve outcomes, particularly respiratory function.

  14. Type and intensity of activity and risk of mobility limitation: the mediating role of muscle parameters

    NARCIS (Netherlands)

    Visser, M.; Simonsick, E.M.; Colbert, L.H.; Brach, J.S.; Rubin, S.M.; Kritchevsky, S.B.; Newman, A.B.; Harris, T.B.

    2005-01-01

    2,719 kcal/wk of total physical activity). The study outcome, incident mobility limitation, was defined as two consecutive, semiannual self-reports of any difficulty walking one quarter of a mile or climbing 10 steps. Thigh muscle area, thigh muscle attenuation (a marker of fat infiltration in

  15. Diet-induced changes in subcutaneous adipose tissue blood flow in man: effect of beta-adrenoceptor inhibition

    DEFF Research Database (Denmark)

    Simonsen, L; Bülow, J; Astrup, A

    1990-01-01

    : the forearm, the thigh and the abdomen. The subjects were given a meal consisting of white bread, jam, honey and apple juice (about 2300 kJ). The meal induced a twofold increase in blood flow in the examined tissues. Propranolol abolished the flow increase in the thigh and the abdomen and reduced...

  16. Blood lipid metabolites and meat lipid peroxidation responses of ...

    African Journals Online (AJOL)

    Blood samples were collected from broilers to evaluate serum biochemical metabolites on day 41. Thigh meat samples were provided and analysed after 1, 5 and 10 days' storage to evaluate lipid peroxidation at the end of the experiment. Fat and protein contents of thigh muscle and abdominal fat weight were measured ...

  17. Myositis ossificans with Ga-67 citrate positivity

    International Nuclear Information System (INIS)

    Moreno, A.J.; Yedinak, M.A.; Spicer, M.J.; Turnbull, G.L.; Byrd, B.F.; Brown, T.J.

    1985-01-01

    A 16 year-old boy presented with a firm mass within the left thigh. Ga-67 citrate and bone scintigraphy revealed soft tissue radiotracer accumulation within the mass lesion. Radiographs and xerography of the left thigh revealed calcification within the soft tissue mass typical of myositis ossificans. The patient's clinical course was uneventful

  18. Levels of Bifurcation of the Sciatic Nerve among Ugandans at ...

    African Journals Online (AJOL)

    Background: The sciatic nerve is derived from the lumbo-sacral plexus, It is the thickest nerve in the whole body, it exits the gluteal region through the lower part of the greater sciatic foramen, it is the main innervator of the posterior thigh, the leg and foot, it usually ends halfway down the back of the thigh by dividing into the ...

  19. Ward Round - Late Presentation of Acute Compartment Syndrome in ...

    African Journals Online (AJOL)

    following the course of ibuprofen mentioned. Twelve days after admission he started to complain of increasing pain and tightness in his left thigh. Sensation and motor function. Ward Round - Late Presentation of Acute. Compartment Syndrome in the Thigh. University of Malawi, College of Medicine, Department of Surgery,.

  20. Evaluation of the Function and Quality of Life after Total Hip Arthroplasty by Different Approaches

    Directory of Open Access Journals (Sweden)

    Paulo Araújo

    2017-09-01

    Conclusion: After 24 months post total hip arthroplasty there are no differences between the two approaches with regard to function or quality of life. However, the patients operated by the anterolateral approach had greater muscle strength deficits and higher percentage of positive Trendelenburg test.

  1. Case Report: CT diagnosis of thymic remnant cyst/thymopharyngeal duct cyst

    International Nuclear Information System (INIS)

    Daga, Bipin V; Chaudhary, VA; Dhamangaokar, VB

    2009-01-01

    A 4-year-old boy presented with history of left anterolateral neck swelling since birth. He was clinically diagnosed to have a branchial cleft cyst. A CT scan revealed findings suggestive of a thymic remnant cyst. The lesion was excised and the diagnosis was confirmed by histopathology

  2. Local immobilization of the left anterior descending artery for minimally invasive coronary bypass grafting

    NARCIS (Netherlands)

    Boonstra, PW; Grandjean, JG; Mariani, MA

    We describe a device for coronary artery stabilization during minimally invasive coronary artery bypass grafting performed without cardiopulmonary bypass via a small (8 to 10 cm) left anterolateral thoracotomy. This device facilitates the anastomosis of the left internal mammary artery to the left

  3. Understanding the surgical pitfalls in total mesorectal excision : Investigating the histology of the perirectal fascia and the pelvic autonomic nerves

    NARCIS (Netherlands)

    Kraima, A. C.; West, N. P.; Treanor, D.; Magee, D. R.; Bleys, R. L A W; Rutten, H. J T; Van De Velde, C. J H; Quirke, P.; Deruiter, M. C.

    2015-01-01

    Aim Excellent understanding of fasciae and nerves surrounding the rectum is necessary for total mesorectal excision (TME). However, fasciae anterolateral to the rectum and surrounding the low rectum are still poorly understood. We studied the perirectal fascia enfolding the extraperitoneally located

  4. Early post-operative pulmonary function tests after mitral valve replacement: Minimally invasive versus conventional approach. Which is better?

    Directory of Open Access Journals (Sweden)

    Magdy Gomaa

    2016-12-01

    Conclusion: Minimally invasive right anterolateral mini-thoracotomy is as safe as median sternotomy for mitral valve surgery, with fewer complications and postoperative pain, less ICU and hospital stay, fast recovery to work with no movement restriction after surgery. There was a highly significant difference denoting better post operative pulmonary function of the minimally invasive approach.

  5. Accuracy of double-contrast arthrography and arthroscopy of the knee joint

    International Nuclear Information System (INIS)

    Thijn, C.J.P.

    1982-01-01

    Only in the diagnosis of medial meniscal lesions is double contrast arthrography superior to arthroscopy, provided that arthroscopy is carried out only from the anterolateral side (94% against 81% positive correlations). The rates in diagnosing lateral meniscal lesions are respectively 90% and 94.5%, in patellar chondropathy 55% and 99.5% respectively, and in diagnosting cruciate ligament lesions 69% and 97% respectively

  6. osmoregulation by means of a hitherto unsuspected osmoregulatory ...

    African Journals Online (AJOL)

    and may be concerned with the maintenance of a constant haemolymph osmotic pressure in the antero-lateral regions of the haemocoel, but tpis requires more critical study. There is considerable difference between the abilities of C. punctatus and· P. chabrus to tolerate hypotonic external media. C. punctatus can survive ...

  7. [Evaluation of the Function and Quality of Life after Total Hip Arthroplasty by Different Approaches].

    Science.gov (United States)

    Araújo, Paulo; Machado, Luís; Cadavez, Duarte; Mónaco, Lisete; Januário, Filipa; Luís, Lisete; Bártolo, Mafalda

    2017-09-29

    To assess the function and quality of life in patients undergoing total hip arthroplasty distinguishing two surgical approaches (posterior / anterolateral) used by the Orthopedics department of Centro Hospitalar de Leiria. Retrospective study of 94 patients subject to unilateral hip replacement surgery, using the 'Hip Osteoarthritis Outcome Score' (HOOS LK 2.0) questionnaire, the Trendelenburg test and evaluation of muscle strength of the hip abductor muscles with dynamometer. Patients were evaluated at six months, 12 months, 18 months and 24 months after surgery. The study revealed that 97.9% patients completed the rehabilitation program. The postoperative evolution (six to 24 months) does not appear to have any differences in results when comparing both approaches. At six months the patient operated by the anterolateral approach showed worse results when compared with the posterior approach, in particular in Hip Osteoarthritis Outcome Score pain, in Hip Osteoarthritis Outcome Score symptoms and Hip Osteoarthritis Outcome Score activities of daily living. After 24 months, no differences between the two surgical approaches were found. Of the 94 patients evaluated, the Trendelenburg test was positive in 31% of patients of which 81.9% corresponds to patients operated by the anterolateral approach. Muscle strength of the abductors of the operated hip was clearly lower in the anterolateral approach at six months, 12 months, and 24 months. This study showed that, in the first six months after total hip arthroplasty, the patients operated by the posterior approach were, according to the HOOS questionnaire, less symptomatic, and presented with better quality of life and less impact on activities of daily living and in sport and leisure when compared with the patients operated by the anterolateral approach. However, these differences were matched over the 24 months. Moreover, the results of muscle strength of the abductor muscles of the hip were clearly superior in

  8. Severe Hand Injuries Caused by a Mole Gun

    Directory of Open Access Journals (Sweden)

    Serdar Düzgün

    2017-10-01

    Full Text Available Objective: Injuries by mole guns differ from other firearm injuries primarily because they are close-range, low-energy injuries that are highly contaminated owing to contact with contaminated surfaces and the presence of numerous residual foreign bodies within the wound. The aim of this article is to share our surgical experience regarding the repair of severe hand injuries caused by mole guns. Material and Methods: This retrospective study included 11 patients with hand injuries. Data obtained about the patients, including age, gender, dominant or non-dominant hand, injuries to all vital structures, and reconstructive procedures were assessed, categorized, and recorded. Results: Ten patients had defects in one or several common digital branches of the median nerve in areas ranging from the distal part of the carpal tunnel to the distal palmar crease. All patients had flexor and extensor tendon injuries in all fingers except for the first finger. Reconstruction of soft tissue and skin defects was carried out with an interpolation flap planned from a random-based subpectoral- paraumbilical region in five patients, a SCIA-based groin flap in four patients, a reverse-radial forearm flap in one patient, and an adipofascial flap planned from the forearm in one patient. Conclusion: Mole gun injuries typically include all structures of the hand, and repair procedures involve every anatomic structure of the hand. An early and effective surgical operation followed by prolonged and effective physical therapy protocols is vital for regaining the full spectrum of hand functions.

  9. EXTENDED REVERSE SURAL FLAP FOR LOWER LIMB COVERAGE

    Directory of Open Access Journals (Sweden)

    Biswajit Mishra

    2018-12-01

    Full Text Available BACKGROUND The reverse sural artery flap has been a workhorse for the reconstruction of distal third of leg, ankle, sole and foot. Major limitation of reverse sural flap has been venous congestion particularly when harvested from proximal third of the leg. Objective- To evaluate the efficacy, safety of the extended reverse sural flap from proximal third of the leg. MATERIALS AND METHODS A prospective study was conducted at the department of plastic surgery on twenty patients who needed soft tissue reconstruction in the distal third of the leg, ankle, heel, forefoot and midfoot due to various cause. In all cases flap was extended proximally to the upper third of the calf and neurovenoadipo fascial pedicled sural fasciocutaneous flap was harvested. RESULTS There were only two cases of marginal necrosis. None of the patients had complete necrosis. Two patients developed hypertrophy of the flap margin. CONCLUSION Distally based neuroveno adipofascial pedicled sural fasciocutaneous flap can be safely extended to proximal third of the leg and is a reliable option for reconstruction of the defects in the foot, ankle and sole.

  10. Surgical Management of Localized Scleroderma.

    Science.gov (United States)

    Lee, Jae Hyun; Lim, Soo Yeon; Lee, Jang Hyun; Ahn, Hee Chang

    2017-09-01

    Localized scleroderma is characterized by a thickening of the skin from excessive collagen deposits. It is not a fatal disease, but quality of life can be adversely affected due to changes in skin appearance, joint contractures, and, rarely, serious deformities of the face and extremities. We present six cases of localized scleroderma in face from our surgical practice. We reviewed six localized scleroderma cases that were initially treated with medication and then received follow-up surgery between April 2003 and February 2015. Six patients had facial lesions. These cases presented with linear dermal sclerosis on the forehead, oval subcutaneous and dermal depression in the cheek. En coup de sabre (n=4), and oval-shaped lesion of the face (n=2) were successfully treated. Surgical methods included resection with or without Z-plasty (n=3), fat graft (n=1), dermofat graft (n=1), and adipofascial free flap (n=1). Deformities of the affected parts were surgically corrected without reoccurrence. We retrospectively reviewed six cases of localized scleroderma that were successfully treated with surgery. And we propose an algorithm for selecting the best surgical approach for individual localized scleroderma cases. Although our cases were limited in number and long-term follow-up will be necessary, we suggest that surgical management should be considered as an option for treating scleroderma patients.

  11. Effect of Free-range Rearing on Meat Composition, Physical Properties and Sensory Evaluation in Taiwan Game Hens

    Science.gov (United States)

    Lin, Cheng-Yung; Kuo, Hsiao-Yun; Wan, Tien-Chun

    2014-01-01

    Experiments were conducted to evaluate the effect of an outdoor-grazed raising model on meat composition, physical properties and sensory attributes of Taiwan game hens. Six hundred 1-d old female chicks were raised on a floor for 8 weeks. On day 57, 600 healthy birds, with similar body weight, were selected and randomly assigned to three treatment groups (cage, floor-pen and free-range). The results showed that different feeding models had no effect on drip loss, cooking loss, moisture, crude protein, crude fat, crude ash, zinc and calorie contents in breast meat and moisture content in thigh meat. The free-range group had the lowest fat content in both breast and thigh meat, and the lowest calorie content in thigh meat. The firmness and toughness in both thigh and breast of the free-range group were the highest values (pmeat and total collagen content in breast meat of the free-range group were significantly higher than those of the cage-feeding group (pmeat sensory scores of flavor, chewiness and overall acceptability of both thigh and breast meat of the free-range group were significantly (pmeat quality, with higher scores for flavor, chewiness and overall acceptability for greater sensory satisfaction in both breast and thigh meat. In addition, the thigh meat contained high protein and total collage but low fat, offering a healthier diet choice. PMID:25050027

  12. Amino Acid Levels in Muscle Tissue of Six Wild Feathered Species

    Directory of Open Access Journals (Sweden)

    Eva Straková

    2016-01-01

    Full Text Available The objective of this study was to determine and compare the levels of amino acids (AAs in breast and thigh muscles of six species of feathered game of the same age. The experiment involved the following species: wild turkey (Meleagris gallopavo, guinea fowl (Numida meleagris, chukar partridge (Alectoris chucar, Japanese quail (Coturnix coturnix japonica, common pheasant (Phasianus colchicus and grey partridge (Perdix perdix. The highest content of AAs was found in the chukar partridge (breast: 815.7 ± 47.71 g/kg; thigh: 771.4 ± 107.0 g/kg, on a dry matter basis, the lowest levels of AAs were found in Japanese quail (breast: 734.2 ± 45.07 g/kg and grey partridge (thigh: 614.9 ± 49.66 g/kg. In all examined species, the level of histidine in breast muscles differed (P ≤ 0.01 from that in thigh muscles. In all investigated species, the levels of essential AAs in breast muscles were higher (P ≤ 0.01 than those in thigh muscles, whereas the levels of non-essential AAs in breast muscles were lower (P ≤ 0.01 than those in thigh muscles. Breast muscles are therefore more valuable than thigh muscles because of the content of essential AAs.

  13. Effect of Free-range Rearing on Meat Composition, Physical Properties and Sensory Evaluation in Taiwan Game Hens.

    Science.gov (United States)

    Lin, Cheng-Yung; Kuo, Hsiao-Yun; Wan, Tien-Chun

    2014-06-01

    Experiments were conducted to evaluate the effect of an outdoor-grazed raising model on meat composition, physical properties and sensory attributes of Taiwan game hens. Six hundred 1-d old female chicks were raised on a floor for 8 weeks. On day 57, 600 healthy birds, with similar body weight, were selected and randomly assigned to three treatment groups (cage, floor-pen and free-range). The results showed that different feeding models had no effect on drip loss, cooking loss, moisture, crude protein, crude fat, crude ash, zinc and calorie contents in breast meat and moisture content in thigh meat. The free-range group had the lowest fat content in both breast and thigh meat, and the lowest calorie content in thigh meat. The firmness and toughness in both thigh and breast of the free-range group were the highest values (pmeat and total collagen content in breast meat of the free-range group were significantly higher than those of the cage-feeding group (pmeat sensory scores of flavor, chewiness and overall acceptability of both thigh and breast meat of the free-range group were significantly (pgame hens of the free-range feeding model displayed well-received carcass traits and meat quality, with higher scores for flavor, chewiness and overall acceptability for greater sensory satisfaction in both breast and thigh meat. In addition, the thigh meat contained high protein and total collage but low fat, offering a healthier diet choice.

  14. Anthropometric changes in adolescents with anorexia nervosa in response to resistance training

    OpenAIRE

    Fernández del Valle, María; Larumbe Zabala, Eneko; Graell Berna, Montserrat; Pérez Ruiz, Margarita

    2015-01-01

    The follow-up of anthropometric percentiles such as triceps and mid-thigh skinfold thickness (TSF, MTSF), mid-upper arm and mid-thigh circumferences (MUAC, MTC), and arm and mid-thigh muscle areas (AMA, MTMA) after a resistance training might allow for detecting nutritional progress of fat and muscular tissue during the treatment of anorexia nervosa restricting (AN-R) type patients. A total of 44 AN-R patients were randomized for control (CG 13.0 ± 0.6 years) and intervention (IG 12.7 ± 0....

  15. 82 East and Central African Journal of Surgery Volume 12 Number 2 ...

    African Journals Online (AJOL)

    Josephine Nakato

    Background: Pressure ulcer management is difficult for the patient, relatives, doctor, and nursing staff ... school. Conclusion: Bilateral hip disarticulation with bilateral thigh flap utilization for the coverage ... (The classical incision goes below the.

  16. The effect of a topically-applied cosmetic oil formulation on striae ...

    African Journals Online (AJOL)

    underarms, thighs, hips and buttocks.1 The prevalence of striae is high ... Conclusions: The test product (Bio-Oil™) significantly improved the appearance of striae on the treated side of ... with the involvement of private medical practitioners.

  17. Lateral collateral ligament (image)

    Science.gov (United States)

    The lateral collateral ligament connects the end of the femur (thigh) to the top of the fibula (the thin bone that runs next to the shin bone). The lateral collateral ligament provides stability against varus stress. Varus stress ...

  18. Early Onset Squamous Cell Carcinoma In A Case Of Lichen Planus

    Directory of Open Access Journals (Sweden)

    Singh Shri Nath

    1998-01-01

    Full Text Available Lichen planus, which is a very common condition, is being presented. However, the uncommon feature in this cases is its early onset and equally early development of squamous cell carcinoma on a lesion on the right thigh.

  19. Hip Injuries and Disorders

    Science.gov (United States)

    Your hip is the joint where your femur (thigh bone) meets your pelvis (hip bone). There are two main parts: a ball ... fits in a socket in the pelvis. Your hip is known as a ball-and-socket joint. ...

  20. Bone X-Ray (Radiography)

    Medline Plus

    Full Text Available ... the hand, wrist, arm, elbow, shoulder, spine, pelvis, hip, thigh, knee, leg (shin), ankle or foot. top ... dislocations. In elderly or patients with osteoporosis, a hip fracture may be clearly seen on a CT ...

  1. Principles of management of vascular problems in the diabetic foot

    African Journals Online (AJOL)

    2011-01-01

    Jan 1, 2011 ... ischaemia, several factors must be taken into account prior to any ... abscesses as well as the necessary toe, ray or .... the risk of wound complications in the thigh .... to clear the mess and instead attacked lung tissue.

  2. Research Article Special Issue

    African Journals Online (AJOL)

    pc

    2018-02-24

    Feb 24, 2018 ... during an exercise has been shown to be associated with long-term ... participants were asked to extend the knee without rotating the thigh while an assistant ..... greater in the dominant site that was stronger and faster.

  3. Download this PDF file

    African Journals Online (AJOL)

    erbeyli incir araştırma

    2014-11-19

    Nov 19, 2014 ... outdoor access (Fanatico et al., 2005; Owens et al., 2006; Wang et al., 2009; ... intestinal health in organically reared chickens. ..... There were no meat yield benefits, except for thigh meat, in the spring season with a diet.

  4. Managing Adrenal Insufficiency

    Science.gov (United States)

    ... a child, use the dose prescribed by the health care provider 8. Replace the needle cap 9. Select your injection site. To inject yourself safely, become familiar with your body. Undress your thigh, and look ...

  5. Evaluation of Early and Prolonged Effects of Acute Neurotoxicity and Neuroprotection Using Novel Functional Imaging Techniques

    National Research Council Canada - National Science Library

    Brownell, Anna-Liisa

    2002-01-01

    ... glutamate receptor agonist. We have conducted studies using a superThigh resolution positron tomograph to explore acute and long-term excitotoxicity mediated mechanisms in rats exposed to 3-nitroproptiomc acid (3-NP...

  6. Research

    African Journals Online (AJOL)

    ebutamanya

    2015-01-15

    1, thigh -28, ... Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, ... clinical information and a definitive final cytologic diagnosis were.

  7. Keep the Beat Recipes - Chicken and Mushroom Fricassee | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... good for your heart and taste great, too. Chicken and Mushroom Fricassee Serves 4 Ingredients: 1 Tbsp ... onions, raw or frozen 3 Cup low-sodium chicken broth 1 lb skinless chicken legs or thighs ( ...

  8. Bone X-Ray (Radiography)

    Medline Plus

    Full Text Available ... of any bone in the body, including the hand, wrist, arm, elbow, shoulder, spine, pelvis, hip, thigh, knee, leg ( ... Image Gallery Radiological technologist preparing to take an arm x-ray on a ... Images related ...

  9. Diagnosis and Management of Closed Internal Degloving Injuries: The Morel-Lavallée Lesion.

    Science.gov (United States)

    Jalota, Leena; Ukaigwe, Anene; Jain, Shashank

    2015-07-01

    Morel-Lavallée (ML) lesions are closed degloving injuries described as posttraumatic subcutaneous fluid collections. They are most commonly seen in the proximal thigh. They can present several days to months after the inciting event. A 55-year-old woman with a recent admission for trauma presented to the Emergency Department with increasing swelling and pain in the right thigh for the previous 3 days. Ultrasound of the thigh was negative. Magnetic resonance imaging performed to further evaluate for leg swelling revealed a "Morel-Lavallée lesion" of the thigh that required drainage. The patient recovered completely after the surgery. WHY SHOULD THE EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be aware of these rare lesions because they are often mistaken for tumors or hematomas. Early recognition may avoid subsequent complications and help in obtaining prompt specialist care. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Effects of high-energy electron irradiation of chicken meat on Salmonella and aerobic plate count

    International Nuclear Information System (INIS)

    Heath, J.L.; Owens, S.L.; Tesch, S.; Hannah, K.W.

    1990-01-01

    Four experiments were used to determine the effects of high-energy irradiation on the number of aerobic microorganisms and Salmonella on broiler breasts and thighs. Irradiation ranging from 100 to 700 kilorads (krads) was provided by a commercial-scale, electron-beam accelerator. Irradiation of broiler breast and thigh pieces with electron beams at levels of 100, 200, 300, 400, 500, and 600 krads showed that levels as low as 100 krads would eliminate Salmonella. When 33 thighs were tested after irradiation at 200 krads, only one thigh tested presumptive positive. The total number of aerobic organisms was reduced by 2 to 3 log10 cycles at irradiation levels of 100, 200, 300, 400, 500, 600, and 700 krads. Increasing the dose above 100 krads gave little if any additional benefit

  11. Bone X-Ray (Radiography)

    Medline Plus

    Full Text Available ... body, including the hand, wrist, arm, elbow, shoulder, spine, pelvis, hip, thigh, knee, leg (shin), ankle or ... of a fracture. guide orthopedic surgery, such as spine repair/fusion, joint replacement and fracture reductions. look ...

  12. 21 CFR 358.650 - Labeling of pediculicide drug products.

    Science.gov (United States)

    2010-04-01

    ... act against the introduction or delivery for introduction into interstate commerce of unapproved new... to the skin surface [bullet] may be present on the short hairs of groin, thighs, trunk, and underarms...

  13. metabolic disturbances associated with antiretroviral therapy and hn

    African Journals Online (AJOL)

    CT scans for visceral fat and mid-thigh measures. Therapy has been ... confusion relating to metabolic disturbances is the absence of universally .... Neuronal growth hormone and gammapentone have ... triglycerides and fatty acids. Note that ...

  14. Flare up of Nickel Contact Dermatits Following Oral Challenge

    Directory of Open Access Journals (Sweden)

    C R Srinivas

    1988-01-01

    Full Text Available A patient having contact dermatitis due to nickel on the wrist, sides of neck, thighs and legs, confirmed by patch tests with nickel sulphate, showed aggravation of the dermatitis following oral provocation with 25 mg nickel sulphate.

  15. Effects of an eccentric training programme on hamstring strain injuries in women football players

    Directory of Open Access Journals (Sweden)

    del Ama Espinosa Gurutze

    2015-09-01

    Full Text Available Study aim: to test the hypothesis that an eccentric training programme applied on women football players would reduce the hamstring injury rate by improving thigh muscle balance and, particularly, hamstring strength.

  16. Biochemical, nutritional and haematological implications of Telfairia ...

    African Journals Online (AJOL)

    GREGO

    2007-04-16

    Apr 16, 2007 ... rich sources of iron and essential fatty acids making it desirable as cooking oil. The essential ... commercial feed milling machine (Artec, model 20). The proximate ..... thigh muscle (Iliotibialis) were all similar in their treatment.

  17. Bone X-Ray (Radiography)

    Medline Plus

    Full Text Available ... wrist, arm, elbow, shoulder, spine, pelvis, hip, thigh, knee, leg (shin), ankle or foot. top of page ... the patient standing upright, as in cases of knee x-rays. A portable x-ray machine is ...

  18. 1888-IJBCS-Article-Youssao Issaka

    African Journals Online (AJOL)

    hp

    chickens were characterized by greater protein content, organic matter content, moisture, thigh cooking loss, ... MATERIALS AND METHODS ... energetic elements (kitchen waste, bran ...), vitamins ... shavings litter in buildings of california type.

  19. Skeletal Muscle Magnetic Resonance Imaging of the Lower Limbs in Late-onset Lipid Storage Myopathy with Electron Transfer Flavoprotein Dehydrogenase Gene Mutations

    Institute of Scientific and Technical Information of China (English)

    Xin-Yi Liu; Ming Jin; Zhi-Qiang Wang; Dan-Ni Wang; Jun-Jie He; Min-Ting Lin; Hong-Xia Fu

    2016-01-01

    Background:Lipid storage myopathy (LSM) is a genetically heterogeneous group with variable clinical phenotypes.Late-onset multiple acyl-coenzyme A dehydrogenation deficiency (MADD) is a rather common form of LSM in China.Diagnosis and clinical management of it remain challenging,especially without robust muscle biopsy result and genetic detection.As the noninvasion and convenience,muscle magnetic resonance imaging (MRI) is a helpful assistant,diagnostic tool for neuromuscular disorders.However,the disease-specific MRI patterns of muscle involved and its diagnostic value in late-onset MADD have not been systematic analyzed.Methods:We assessed the MRI pattern and fat infiltration degree of the lower limb muscles in 28 late-onset MADD patients,combined with detailed clinical features and gene spectrum.Fat infiltration degree of the thigh muscle was scored while that ofgluteus was described as obvious or not.Associated muscular atrophy was defined as obvious muscle bulk reduction.Results:The mean scores were significantly different among the anterior,medial,and posterior thigh muscle groups.The mean of fat infiltration scores on posterior thigh muscle group was significantly higher than either anterior or medial thigh muscle group (P < 0.001).Moreover,the mean score on medial thigh muscle group was significantly higher than that of anterior thigh muscle group (P < 0.01).About half of the patients displayed fat infiltration and atrophy in gluteus muscles.Of 28 patients,12 exhibited atrophy in medial and/or posterior thigh muscle groups,especially in posterior thigh muscle group.Muscle edema pattern was not found in all the patients.Conclusions:Late-onset MADD patients show a typical muscular imaging pattern of fat infiltration and atrophy on anterior,posterior,and medial thigh muscle groups,with major involvement of posterior thigh muscle group and gluteus muscles and a sparing involvement of anterior thigh compartment.Our findings also suggest that muscle MRI of

  20. Adductor muscle pyo-myositis simulating appendicitis: CT and MR imaging findings; Pyomyosite des mulcles adducteurs mimant une appendicite aigue: aspects tomodensitometriques et IRM

    Energy Technology Data Exchange (ETDEWEB)

    Coumbaras, M.; Le Hir, P.; Jomaah, N.; Arrive, L.; Tubiana, J.M. [Hopital Saint Antoine, 75 - Paris (France)

    2001-04-01

    Pyo-myositis is a primary bacterial infection of skeletal muscle. This infection tends to occur in the large muscles of the lower extremity. Pyo-myositis of the proximal muscles of the thigh can simulate acute abdominal disease. Early diagnosis improves the outcome. Delayed diagnosis may lead to septicemia and shock. We report the CT and MRI findings in a patient with pyo-myositis of the proximal muscles of the thigh. (authors)

  1. Adductor muscle pyo-myositis simulating appendicitis: CT and MR imaging findings

    International Nuclear Information System (INIS)

    Coumbaras, M.; Le Hir, P.; Jomaah, N.; Arrive, L.; Tubiana, J.M.

    2001-01-01

    Pyo-myositis is a primary bacterial infection of skeletal muscle. This infection tends to occur in the large muscles of the lower extremity. Pyo-myositis of the proximal muscles of the thigh can simulate acute abdominal disease. Early diagnosis improves the outcome. Delayed diagnosis may lead to septicemia and shock. We report the CT and MRI findings in a patient with pyo-myositis of the proximal muscles of the thigh. (authors)

  2. Skin perfusion pressure on the legs measured as the external pressure required for skin reddening after blanching

    DEFF Research Database (Denmark)

    Holstein, P; Nielsen, P.E.; Lund, P

    1980-01-01

    -187) compared to 80.8 mmHg (range 18-158) (P > 0.1). A normal material was obtained from twenty-four subjects measured on the thigh, calf and ankle; the average gradients between the auscultatory brachial mean blood pressure and the BTEP were: thigh 10.7 mmHg (SD 12.7); calf 4.0 mmHg (SD 12.1); ankle 5.1 mm...

  3. Effect of Free-range Rearing on Meat Composition, Physical Properties and Sensory Evaluation in Taiwan Game Hens

    Directory of Open Access Journals (Sweden)

    Cheng-Yung Lin

    2014-06-01

    Full Text Available Experiments were conducted to evaluate the effect of an outdoor-grazed raising model on meat composition, physical properties and sensory attributes of Taiwan game hens. Six hundred 1-d old female chicks were raised on a floor for 8 weeks. On day 57, 600 healthy birds, with similar body weight, were selected and randomly assigned to three treatment groups (cage, floor-pen and free-range. The results showed that different feeding models had no effect on drip loss, cooking loss, moisture, crude protein, crude fat, crude ash, zinc and calorie contents in breast meat and moisture content in thigh meat. The free-range group had the lowest fat content in both breast and thigh meat, and the lowest calorie content in thigh meat. The firmness and toughness in both thigh and breast of the free-range group were the highest values (p<0.05. The crude protein, total collagen, zinc and iron contents in thigh meat and total collagen content in breast meat of the free-range group were significantly higher than those of the cage-feeding group (p<0.05. The meat sensory scores of flavor, chewiness and overall acceptability of both thigh and breast meat of the free-range group were significantly (p<0.05 better than those of the other two groups. Moreover, the current findings also indicate that the Taiwan game hens of the free-range feeding model displayed well-received carcass traits and meat quality, with higher scores for flavor, chewiness and overall acceptability for greater sensory satisfaction in both breast and thigh meat. In addition, the thigh meat contained high protein and total collage but low fat, offering a healthier diet choice.

  4. Effect of some factors used to the chicken meat preservation and processing on the protease activity

    International Nuclear Information System (INIS)

    Przysiezna, E.; Skrabka-Blotnicka, T.

    1996-01-01

    The obtained results indicated that the cathepsin activity was higher by about 60% in the extract from thigh than from breast muscles. Freezing and defrosting (not stored) of chicken meat did not influence the breast muscle cathepsin activity while they caused a decrease of activity of about 20% in the case of thigh muscles. The increase in cathepsin activity was noticed in both kinds of muscles during storage at -20 °C up to 4 months (45.6% and 19.4% for thigh and breast muscles respectively). The activity of cathepsin in extract from 5 months stored meat reached 80% in case of breast muscles and 83% in case of thigh muscles in relation to control sample respectively. The cathepsin activity significantly increased during heating of breast muscles up to 60 °C, but in case of thigh muscles it was slightly higher than at 50°C. The heating of cured chicken breast muscles up to 60°C caused a non significant growth in cathepsin activity opposite to raw muscles. The cathepsin activity from all cured samples heated up to 70°C were several times lower in relation to control samples. The cathepsin activity of both thigh and breast muscles were resistant to gamma radiation. The investigated factors caused changes in the activity of cathepsin but none of them caused its total inactivation. The changes of cathepsin activity depended on the kind of muscles and the kind and the value of acting factors

  5. Xanthogranulomatous Cystitis: A Challenging Imitator of Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Sinan Ekici

    2010-01-01

    Full Text Available Xanthogranulomatous cystitis is a rare, benign, chronic inflammatory disease of the bladder, mimicking malignancy with unknown etiology. Herein, we report a 57-year-old man who presented with pollakiuria, nocturia, dysuria, left flank pain, and a palpable mass on the right lower abdomen. Computerized tomography demonstrated an obstructing 10-mm stone in the lower third of the left ureter and a 6-cm solid mass on the right at the anterolateral wall of the bladder. The mass presented local perivesical invasion at the anterolateral side. Cystouretroscopy revealed a mass protruding into the bladder cavity with edematous smooth surface. Frozen section analysis of the partial cystectomy specimen could not rule out malignancy. Therefore, radical cystoprostatectomy and ureterolithotomy were performed. Histologically, fibrosis, numerous plasma cells, eosinophils, and, immunohistochemically, CD68-positive epithelioid and foamy macrophages were detected. Localized prostatic adenocarcinoma was also found. The present case of xanthogranulomatous cystitis is the 23rd to be reported in the world literature.

  6. Tuberculous osteomyelitis/arthritis of the first costo-clavicular joint and sternum.

    Science.gov (United States)

    Patel, Prasan; Gray, Robin R

    2014-12-28

    A young Somali immigrant presents with a two-year history of a large, firm, painful right anterolateral chest wall sternal mass. The patient denied any history of trauma or infection at the site and did not have a fever, erythematous lesion at the site, clubbing, or lymphadenopathy. A lateral chest radiograph demonstrated a low density mass isolated to the subcutaneous soft tissue overlying the sternum, ribs and clavicle. Computed tomography (CT) with contrast demonstrated a cystic lesion in the right anterolateral chest wall deep to the pectoralis muscle. Enhanced CT of the chest demonstrated sclerosis and destruction of the rib and costochondral joint and manubrio-sternal joint narrowing. Ultrasound-guided biopsy and aspiration returned 500 cc of purulent, cloudy yellow, foul-smelling fluid. Acid-fact bacilli stain and the nucleic acid amplification test identified and confirmed Mycobacterium tuberculosis. A diagnosis of tuberculous osteomyelitis/septic arthritis was made and antibiotic coverage for tuberculosis was initiated.

  7. Arthroscopy of the Nondistractable Hip: A Novel Extracapsular Approach

    Science.gov (United States)

    Doron, Ran; Amar, Eyal; Rath, Ehud; Sampson, Thomas; Ochiai, Derek; Matsuda, Dean K.

    2014-01-01

    Adequate traction to achieve hip joint distraction is essential for avoiding iatrogenic injury to the joint during hip arthroscopy. An inability to distract the joint is a relative contraindication for hip arthroscopy. This report describes a novel technique involving an extracapsular approach to gain safe access to a hip joint that fails a trial of traction during positioning for hip arthroscopy. The anterolateral portal is established under fluoroscopic guidance. The arthroscope is positioned on the lateral rim of the acetabulum. A shaver, introduced through a modified anterior portal, is used to facilitate capsular exposure. An arthroscopic capsular incision is made proximal to the lateral acetabular rim and extended anteriorly with a radiofrequency probe. Osteoplasty of the anterolateral acetabular rim is carried out with a burr while protecting the labrum. Distraction of the hip is then possible, allowing safe central-compartment access and subsequent chondrolabral procedures. PMID:25685682

  8. Anatomical relations of anterior and posterior ankle arthroscopy portals: a cadaveric study.

    Science.gov (United States)

    Oliva, Xavier Martin; Méndez López, José Manuel; Monzo Planella, Mariano; Bravo, Alex; Rodrigues-Pinto, Ricardo

    2015-04-01

    Ankle arthroscopy is an increasingly used technique. Knowledge of the anatomical structures in relation to its portals is paramount to avoid complications. Twenty cadaveric ankles were analysed to assess the distance between relevant neurovascular structures to the anteromedial, anterolateral, posteromedial, and posterolateral arthroscopy portals. The intermediate dorsal branch of the superficial peroneal nerve was the closest structure to any of the portals (4.8 mm from the anterolateral portal), followed by the posterior tibial nerve (7.3 mm from the posteromedial portal). All structures analysed but one (posterior tibial artery) were, at least in one specimen, portals. This study provides information on the anatomical relations of ankle arthroscopy portals and relevant neurovascular structures, confirming previous studies identifying the superficial peroneal nerve as the structure at highest risk of injury, but also highlighting some important variations. Techniques to minimise the injury to these structures are discussed.

  9. Portal placement in elbow arthroscopy by novice surgeons: cadaver study.

    Science.gov (United States)

    Claessen, Femke M A P; Kachooei, Amir R; Kolovich, Gregory P; Buijze, Geert A; Oh, Luke S; van den Bekerom, Michel P J; Doornberg, Job N

    2017-07-01

    In this anatomical cadaver study, the distance between major nerves and ligaments at risk for injury and portal sites created by trainees was measured. Trainees, inexperienced in elbow arthroscopy, have received a didactic lecture and cadaver instruction prior to portal placement. The incidence of iatrogenic injury from novice portal placement was also determined. Anterolateral, direct lateral, and anteromedial arthroscopic portals were created in ten cadavers by ten inexperienced trainees in elbow arthroscopy. After creating each portal, the trajectory of the portal was marked with a guide pin. Subsequently, the cadavers were dissected and the distances between the guide pin in the anterolateral, direct lateral, and anteromedial portals and important ligaments and nerves were measured. The difference between the distance of the direct lateral portal and the posterior antebrachial cutaneous nerve (PABCN) (22 mm, p cadaver instruction session alone. Level of evidence V.

  10. The role of the reversed oblique radiograph in trauma of the foot and ankle

    International Nuclear Information System (INIS)

    Geusens, E.; Geyskens, W.; Brys, P.; Janzing, H.

    2000-01-01

    The objective of this study was to demonstrate the statistical significance of a reversed oblique radiograph of the foot in patients with ankle or foot trauma. In 100 consecutive patients a reversed oblique radiograph of the foot was taken in addition to the conventional plain films. Ten of 29 fractures were not visualised on the conventional films of foot and ankle and could only be diagnosed on the reversed oblique film. In 7 of these 10 cases an avulsion fracture at the anterolateral aspect of the calcaneus was present. This additional reversed oblique film of the foot seems to be of considerable importance, especially when an anterolateral avulsion fracture of the calcaneus is clinically suspected. (orig.)

  11. The role of the reversed oblique radiograph in trauma of the foot and ankle

    Energy Technology Data Exchange (ETDEWEB)

    Geusens, E.; Geyskens, W.; Brys, P. [Dept. of Radiology, University Hospitals, Leuven (Belgium); Janzing, H. [Dept. of Traumatology, University Hospitals, Leuven (Belgium)

    2000-03-01

    The objective of this study was to demonstrate the statistical significance of a reversed oblique radiograph of the foot in patients with ankle or foot trauma. In 100 consecutive patients a reversed oblique radiograph of the foot was taken in addition to the conventional plain films. Ten of 29 fractures were not visualised on the conventional films of foot and ankle and could only be diagnosed on the reversed oblique film. In 7 of these 10 cases an avulsion fracture at the anterolateral aspect of the calcaneus was present. This additional reversed oblique film of the foot seems to be of considerable importance, especially when an anterolateral avulsion fracture of the calcaneus is clinically suspected. (orig.)

  12. Neolasioptera pantaneira, a new species of Cecidomyiidae (Diptera) associated with Aeschynomene denticulata (Fabaceae) from Brazil.

    Science.gov (United States)

    Maia, V C; Catian, G; Leme, F M

    2017-03-01

    A new species of gall midge that induces stem galls on Aeschynomene denticulata (Fabaceae) is described based on material collected in Pantanal (Mato Grosso do Sul, Brazil). This species is unique among the Brazilian congeners in having spatula with three convex teeth, cruciate, with defined anterolateral extensions, four lateral papillae on each side of the spatula, and three pairs of terminal papillae (larva), four-segmented palpi (adult), 17 flagellomeres (female), ovipositor about 11 times length of seventh tergite.

  13. Occult lawn mower projectile injury presenting with hemoptysis

    Directory of Open Access Journals (Sweden)

    Patric J. Darvie, BS

    2017-12-01

    Full Text Available We present the case of a 72-year-old man with hemoptysis after a thoracic projectile injury, which occurred while mowing the lawn. Chest radiograph followed by a computed tomography angiogram revealed a metallic foreign body in the right middle lobe of the lung. The patient underwent a right anterolateral thoracotomy where the object was successfully retrieved. The patient had an uneventful postoperative recovery.

  14. Occult lawn mower projectile injury presenting with hemoptysis.

    Science.gov (United States)

    Darvie, Patric J; Ballard, David H; Harris, Nicholas; Bhargava, Peeyush; Rao, Vyas R; Samra, Navdeep S

    2017-12-01

    We present the case of a 72-year-old man with hemoptysis after a thoracic projectile injury, which occurred while mowing the lawn. Chest radiograph followed by a computed tomography angiogram revealed a metallic foreign body in the right middle lobe of the lung. The patient underwent a right anterolateral thoracotomy where the object was successfully retrieved. The patient had an uneventful postoperative recovery.

  15. Occult lawn mower projectile injury presenting with hemoptysis

    OpenAIRE

    Patric J. Darvie, BS; David H. Ballard, MD; Nicholas Harris, MD; Peeyush Bhargava, MD, MBA; Vyas R. Rao, MD; Navdeep S. Samra, MD

    2017-01-01

    We present the case of a 72-year-old man with hemoptysis after a thoracic projectile injury, which occurred while mowing the lawn. Chest radiograph followed by a computed tomography angiogram revealed a metallic foreign body in the right middle lobe of the lung. The patient underwent a right anterolateral thoracotomy where the object was successfully retrieved. The patient had an uneventful postoperative recovery.

  16. Lower extremity thrust and non-thrust joint mobilization for patellofemoral pain syndrome: a case report

    OpenAIRE

    Simpson, Brad G; Simon, Corey B

    2014-01-01

    A 40-year old female presented to physical therapy with a one-year history of insidious right anteromedial and anterolateral knee pain. Additionally, the patient had a history of multiple lateral ankle sprains bilaterally, the last sprain occurring on the right ankle 1 year prior to the onset of knee pain. The patient was evaluated and given a physical therapy diagnosis of patellofemoral pain syndrome (PFPS), with associated talocrural and tibiofemoral joint hypomobility limiting ankle dorsif...

  17. Nasopharyngeal cancer through maxillary swing

    International Nuclear Information System (INIS)

    Pacheco Ojeda, Luis; Chicaiza Acosta, Jorge; Ulloa Miranda, Darwin

    2006-01-01

    Nasopharyngeal cancer is very rare in Ecuador. Radiotherapy associated to concurrent chemotherapy is currently the standard treatment. In case of tumor recurrence, these two treatment modalities are usually not effective. For this reason, several studies about the satisfactory results of salvage surgery in terms of locoregional control of the disease, have appeared recently in the literature. We report our first experience of surgical salvage resection of a recurrent tumor through an anterolateral approach (maxillary swing) with an initial satisfactory result. (The author)

  18. Functional results after chest wall stabilization with a new screwless fixation device

    OpenAIRE

    Wiese, Mark Nikolaj; Kawel-Boehm, Nadine; Moreno de la Santa, Pablo; Al-Shahrabani, Feras; Toffel, Melanie; Rosenthal, Rachel; Schäfer, Juliane; Tamm, Michael; Bremerich, Jens; Lardinois, Didier

    2017-01-01

    OBJECTIVES This is the experience with the Stratos system in two surgical centres for the management of two types of rib fractures: flail chest and multiple dislocated rib fractures with significant chest wall deformity. METHODS From January 2009 to May 2012, 94 consecutive patients were included. Selected indications were extended anterolateral flail chest (n = 68) and dislocated painful rib fractures (n = 26). The open reduction internal fixation (ORIF) system consists of flexible titanium ...

  19. Echocardiographic appearance of a hydatid cyst of the papillary muscle and chordae tendineae.

    Science.gov (United States)

    Fabijanić, Damir; Bulat, Cristijan; Letica, Dalibor; Nenadić, Denis; Pešutić-Pisac, Valdi; Carević, Vedran

    2011-09-01

    A 24-year-old woman with a history of hydatid disease of the lung and brain, which was treated surgically and medically with albendazole, was admitted because of syncope. Echocardiography demonstrated a mass in the anterolateral papillary muscle and chordae tendineae. Despite negative serologic tests for Echinococcus granulosus, cytology and histology of the surgically removed mass confirmed hydatid disease. The patient was discharged and treated further with albendazole and praziquantel. Copyright © 2011 Wiley Periodicals, Inc.

  20. Influence of Surgical Approach on Pelvic Lift in Hip Arthroplasty During Cup Insertion.

    Science.gov (United States)

    Brodt, Steffen; Windisch, Christoph; Krakow, Linda; Nowack, Dimitri; Matziolis, Georg

    2017-07-01

    The position of the acetabular cup is a major factor in the long-term outcome of total hip arthroplasty (THA). Malpositioning of the acetabular cup frequently has been reported with the use of a minimally invasive implantation technique. It remains unclear whether the limited visibility or the increased retractor traction and thus tilting of the pelvis during cup implantation is the cause. This study investigated the influence of iatrogenically related pelvic lift using an anterolateral minimally invasive THA technique. In a group of 30 consecutive patients who underwent THA via a minimally invasive anterolateral approach, iatrogenic lifting of the pelvis was measured with a smartphone using a 3-axis accelerometer and compared with patients in a historical age- and sex-matched control group who underwent THA using a transgluteal approach. Postoperatively, the inclination and anteversion of the cup was determined on pelvic radiographs. In the anterolateral group, the pelvis was lifted by a maximum of 6.3° and by an average of 3.9° when the acetabular cup was impacted; no difference was noted compared with the transgluteal group. In contrast, the cups in the anterolateral group showed significantly increased inclination and reduced anteversion. In both techniques, the iatrogenic tilting of the pelvis at the time of cup implantation occurred to a comparable extent. Therefore, the significant differences in postoperative radiographs cannot be attributed to increased retractor traction on exposure of the acetabulum, which means that the limited visibility must be responsible. [Orthopedics. 2017; 40(4):e589-e593.]. Copyright 2017, SLACK Incorporated.

  1. Lateral Augmentation Procedures in Anterior Cruciate Ligament Reconstruction: Anatomic, Biomechanical, Imaging, and Clinical Evidence.

    Science.gov (United States)

    Weber, Alexander E; Zuke, William; Mayer, Erik N; Forsythe, Brian; Getgood, Alan; Verma, Nikhil N; Bach, Bernard R; Bedi, Asheesh; Cole, Brian J

    2018-02-01

    There has been an increasing interest in lateral-based soft tissue reconstructive techniques as augments to anterior cruciate ligament reconstruction (ACLR). The objective of these procedures is to minimize anterolateral rotational instability of the knee after surgery. Despite the relatively rapid increase in surgical application of these techniques, many clinical questions remain. To provide a comprehensive update on the current state of these lateral-based augmentation procedures by reviewing the origins of the surgical techniques, the biomechanical data to support their use, and the clinical results to date. Systematic review. A systematic search of the literature was conducted via the Medline, EMBASE, Scopus, SportDiscus, and CINAHL databases. The search was designed to encompass the literature on lateral extra-articular tenodesis (LET) procedures and the anterolateral ligament (ALL) reconstruction. Titles and abstracts were reviewed for relevance and sorted into the following categories: anatomy, biomechanics, imaging/diagnostics, surgical techniques, and clinical outcomes. The search identified 4016 articles. After review for relevance, 31, 53, 27, 35, 45, and 78 articles described the anatomy, biomechanics, imaging/diagnostics, surgical techniques, and clinical outcomes of either LET procedures or the ALL reconstruction, respectively. A multitude of investigations were available, revealing controversy in addition to consensus in several categories. The level of evidence obtained from this search was not adequate for systematic review or meta-analysis; thus, a current concepts review of the anatomy, biomechanics, imaging, surgical techniques, and clinical outcomes was performed. Histologically, the ALL appears to be a distinct structure that can be identified with advanced imaging techniques. Biomechanical evidence suggests that the anterolateral structures of the knee, including the ALL, contribute to minimizing anterolateral rotational instability

  2. The recurrent branch of the lateral cutaneous nerve of the forearm.

    OpenAIRE

    Horiguchi, M

    1981-01-01

    Cutaneous nerves of the upper arm were observed in 31 Japanese cadavers dissected in a student course of gross anatomy dissection and in cadaver selected randomly for intensive dissection. Contrary to the descriptions in current textbooks of human anatomy, the lateral cutaneous nerve of the forearm supplies also the skin over the distal region of the anterolateral surface of the upper arm. A branch to the upper arm (the recurrent branch) arises from the proper trunk of the lateral cutaneous n...

  3. Accuracy of double-contrast arthrography and arthroscopy of the knee joint

    International Nuclear Information System (INIS)

    Thijn, C.J.P.

    1982-01-01

    Only in the diagnosis of medial meniscal lesions is double contrast arthrography superior to arthroscopy, provided that arthroscopy is carried out only from the anterolateral side (94% against 81% positive correlations). The rates in diagnosing lateral meniscal lesions are respectively 90% and 94.5%, in patellar chondropathy 55% and 99.5% respectively, and in diagnosting cruciate ligament lesions 69% and 97% respectively. (orig.)

  4. Sensory Loss Mimicking Cauda Equina Syndrome due to Cervical Spinal Lesion in a Patient with Clinically Isolated Syndrome

    OpenAIRE

    Vinceti, Giulia; Zini, Andrea; Nichelli, Paolo; Mandrioli, Jessica

    2012-01-01

    We describe the case of a 39-year-old woman with signs and symptoms suggesting cauda equina syndrome. Lumbosacral magnetic resonance imaging (MRI) demonstrated no lesion at this level, while cervical MRI showed a T2-hyperintense lesion in the middle-right anterolateral region of the cervical spinal cord, which may explain the symptoms by involving the anterior spinothalamic tract. We suggest that in cases with cauda equina syndrome presentation and normal lumbosacral MRI, a cervicodorsal lesi...

  5. Anatomical study of the posterior cruciate ligament with the knee flexed at 90°,

    Directory of Open Access Journals (Sweden)

    Daniel Kyubin Cho

    2014-10-01

    Full Text Available Objective:To study the anatomy of the posterior cruciate ligament (PCL and define anatomical parameters with the knee flexed at 90°.Methods:Eight knees from cadavers were dissected in order to make measurements from the center of the anterolateral band to the roof (AL1, from the center of the anterolateral band to the anterior cartilage (AL2, from the center of the posteromedial band to the roof (PM1, from the center of the posteromedial band to the anterior cartilage (PM2, from the center of the tibial insertion to the medial region of the tibia (TIM, from the center of the tibial insertion to the lateral region of the tibia (TIL, from the center of the medial insertion to the medial meniscus (IMM and the width of the origin of the PCL (WO. To obtain the results from each anatomical structure, the means and standard deviations of the measurements were calculated.Results:The measurements in millimeters that were found were AL1, 6.2; AL2, 4.9; PM1, 11.7; PM2, 5.5; TIM, 32.5; TIL, 40.6; IMM, 9.4; and WO, 32.5.Conclusions:The PCL has an extensive origin. The center of the anterolateral band is 6 mm from the roof and 5 mm from the anterior cartilage of the knee. The tibial insertion is slightly medial and 10 mm distal to the posterior cornu of the medial meniscus.

  6. Oblique radiograph for the detection of bone spurs in anterior ankle impingement

    International Nuclear Information System (INIS)

    Dijk, Niek C. van; Wessel, Ronald N.; Tol, Johannes L.; Maas, M.

    2002-01-01

    Objective: The aim of this study was to develop a radiographic view to detect anteromedial talotibial osteophytes that remain undetected on standard radiographs. Design and patients: In 10 cadaver specimens the maximal size was measured of anteromedial tibial osteophytes that remain undetected on a standard lateral radiograph projection, due to the presence of the anteromedial tibial rim. The average projection of the most prominent anterolateral tibial rim over the anteromedial rim was found to be 7.3 mm. A 7 mm barium-clay osteophyte was attached to this anteromedial rim of the distal tibia. Anteromedial osteophytes become most prominent on an oblique view, in which the radiographic beam is tilted into a 45 craniocaudal direction with the leg in 30 external rotation. This oblique view was compared with the findings of arthroscopic surgery in 25 consecutive patients with anterior ankle impingement syndrome. Results: Medially located tibial and talar osteophytes remained undetected on a standard lateral projection and became visible on the oblique anteromedial impingement (AMI) radiograph. Anterolateral tibial and talar osteophytes were well detected on a standard lateral radiograph projection but were invisible on the AMI view. There was a high correlation between the location of the osteophyte and the location of symptoms and the findings at arthroscopy. Conclusion: A combination of lateral and oblique radiographs can be used to differentiate between anteromedial and anterolateral bony ankle impingement. (orig.)

  7. Assessment of paramedian thalamic infarcts: MR imaging, clinical features and prognosis

    International Nuclear Information System (INIS)

    Weidauer, Stefan; Zanella, Friedhelm E.; Lanfermann, Heinrich; Nichtweiss, Michael

    2004-01-01

    Considering the highly variable vascular supply of the thalamic nuclei, MRI and clinical syndromes can be heterogeneous in ischemic diseases. We attempt to determine MRI pattern and to analyse neurological features and prognosis of paramedian infarcts. In a prospective case series within 5 years from 1999 to 2003, MRI, MRA and clinical symptoms of 38 consecutive patients were analysed. The inferomedial (posterior thalamoperforating artery) territory was affected in 89%, and lesions in the anterolateral (tuberothalamic artery) territory occurred in 42%. However, definite attribution to anterolateral or inferomedial territories was not possible in 13%. Neurological manifestations were somnolence (87%), hemisyndromes (79%), cognitive deficits (58%), oculomotor nerve palsies (53%) and vertical gaze palsies (39%). The most common aetiologies were cardiac embolism (42%), intraarterial embolism (16%), small vessel disease (13%) and large artery arteriosclerosis (13%). Pathological MRA findings were encountered in 55%, and in 18%, lesions were only visible on diffusion-weighted imaging. Correlation of MRI pattern and neurological symptoms points out anterolateral thalamic lesions as the cause of amnestic deficits. Intracranial MRA allows a non-invasive prediction of basilar tip occlusion. Our results underline the necessity of additional diffusion-weighted imaging in detecting small thalamic and midbrain lesions. (orig.)

  8. Post biopsy pneumothorax: Risk factors and course

    International Nuclear Information System (INIS)

    Sanchez, J.A.; Retamar, J.A.; Blazquez, J.; Castano, J.C.

    1996-01-01

    The was to study the natural course of pneumothorax produced after aspiration biopsy in the attempt to differentiate those cases that will resolve spontaneously from those that will require drainage, and to assess the possible risk factors associated with the development of this entity. Eighty-nine CT-guided aspiration biopsies were performed in 80 patients. Control CT was done immediately after the procedure and 24 hours later. When pneumothorax persisted, CT was repeated at 48 h, 72 h, day 5 and day 7 or until a drainage tube was introduced. The cases of pneumothorax were classified as minimal, anterior or anterolateral. Seven variables were assessed as possible risk factors for its occurrence. Pneumothorax developed on 29 occasions (32.5%), requiring drainage in 12 cases (13.5%). In 20 patients (22%), pneumothorax occurred immediately, while in the remaining 9 (10%) it was detected in the 24 h CT scan. When studied according to type, drainage was required in 3 of the 19 cases of minimal or anterior pneumothorax (15%) and in 9 or the 10 cases of anterolateral location (90%) (p<0.0005). The mean thickness of the parenchyma punctured was 3.4 cm +- 2.2. cm when pneumothorax developed and 1.3 cm+- 2 cm when it did not (p<0.0001). There is a statistically significant association between the development of anterolateral pneumothorax and the need for chest drainage. The thickness of the punctured parenchyma is associated with the production of pneumothorax. 16 refs

  9. Prevalence of electrocardiographic changes in patients with acute aneurysmal subarachnoid hemorrhage and their relationship with outcome

    Directory of Open Access Journals (Sweden)

    Saktheeswaran Mahesh Kumar

    2013-01-01

    Full Text Available Background: Electrocardiographic (ECG alterations occurring after subarachnoid hemorrhage (SAH have been described frequently, but the prognostic significance of these changes has not been well characterized. Aim and Objectives: To report the prevalence and patterns of ECG alterations in patients with acute aneurysmal SAH and to study the relationship between ECG alterations and the neurological outcome, if any. Materials and Methods: Records of consecutive patients admitted to the neurosurgical intensive care unit of the SCTIMST, Trivandrum between January 1999 and January 2011 with acute aneurysmal SAH were retrospectively analyzed. Results: Of the 321 patients with SAH, 190 (59.2% had abnormal ECGs. Repolarization abnormalities were the most common, with T wave inversion in the anterolateral leads occurring in 155 (48.3% patients. By univariate analysis, female sex, Glasgow Coma Score (GCS at admission of I, ST segment depression or T inversion in anterolateral leads, prolonged corrected QT interval, and sinus bradycardia were associated with increased risk of death. By multivariate analysis, only GCS and WFNS grade independently predicted mortality and none of the ECG changes predicted the same. Presence of tall T waves in anterior leads, T inversion in anterolateral leads, sinus bradycardia, and WFNS grade >1 were independently associated with GCS <15 and poor outcome at discharge. Conclusions: In patients with acute aneurysmal SAH, repolarization abnormalities are the commonest ECG alterations. ECG alterations do not independently predict death, but independently predict poor discharge neurological status.

  10. [Saphenous perforator flap].

    Science.gov (United States)

    Winkel, R; Tajsic, N; Husum, H; Schlageter, M; Hanebuth, G; Hoffmann, R

    2013-04-01

    Replacement of full thickness soft tissue defects in the lower leg and ankle, appropriate to the defect and following the course of blood vessels feeding the skin of a distally hinged fasciocutaneous flap most reliably based on the individual anatomy of distal perforators of the posterior tibial artery. Full thickness soft tissue defects, up to 12 cm in length and up to 8 cm in width. Sufficient vascularization of the foot required, in osteomyelitis, and when joints, fractures, implants and tendons are exposed and when a split skin graft, a local flap, a suralis perforator flap or a free flap is not indicated. For patients, in whom a 1-2 h operation is not possible; necessity of angioplasty; decollement or scars around the distal perforators of the posterior tibial artery; local infection or necrosis of soft tissues and/or bone, which cannot be totally excised. Radical debridement; flap dissection without tourniquet; microdissection; design of the flap on the skin: pivot point ~ 10 cm (6-14 cm) proximal of the tip of the medial malleolus; base ~ 5 cm in width, between the course of the saphenous nerve and of the great saphenous vein and the Achilles tendon; adipofascial pedicle up to 15 cm in length sited over the septum between soleus and flexor digitorum muscles, following the course of the saphenous nerve, with a central skin stripe, which expands into a proximal skin island; skin island is outlined similar to the defect, but larger by 1 to 2 cm, surrounded by an adipofascial border: adjustment of the planning as well as of the elevation of these flaps according to the individual position and the caliber of perforators requires in each case the search for a perforator at the estimated pivot point. Delay of transposition, if the division of more than one perforator proximal to the pivot point obviously diminishes circulation. No "tunnelling "of the pedicle; defects of skin due to the elevation of the flap are replaced by split and meshed skin grafts or temporary

  11. Drenaje suplementario del sistema venoso superficial en colgajos pediculados Supplementary drainage of superficial venous system in pedicled flaps

    Directory of Open Access Journals (Sweden)

    A. Fernández García

    2012-06-01

    Full Text Available Los colgajos pediculados pueden sufrir edema y congestión debido a que su drenaje a trevés del sistema venoso superfical es imposible y el flujo hacia el sistema profundo a nivel del pedículo es precario. Esta situación suele evolucionar hacia la necrosis parcial o la pérdida total del colgajo en pocas horas. La apertura del sistema venoso superficial permite el drenaje adecuado de los tejidos transferidos y evita estas complicaciones. Este artículo analiza el papel de las anastomosis microquirúrgicas en el sistema venoso superficial de los colgajos pediculados. Esta técnica permite comunicar el sistema venoso superfical de los tejidos transferidos con el sistema venoso superficial del territorio que rodea al defecto. Presentamos los resultados obtenidos con esta técnica en colgajos de perforante en hélice, colgajos miocutáneos, colgajos neurocutáneos y colgajos fasciograsos volteados.The pedicled flaps can suffer edema and congestion due to the impossibility of drainage toward the superficial venous system and the precarious flow via the deep system at the level of the pedicle. The evolution of this situation is usually partial necrosis or total loss of the flap in a few hours. The opening of the venous superficial system achieves an appropriate drainage of the transfered tissues and avoids these complications. In this article we analyze the role of the microsurgical anastomosis at the level of the superficial venous system of pedicled flaps. This technique allows to communicate the superficial venous system of the transfered tissues with the superficial venous system of the territory around the defect. We report the results with this method in propeller perforator flaps, miocutaneous flaps, neurocutaneous flaps and adipofascial turn over flaps.

  12. Distally based sural neuro-fasciocutaneous perforator flap for foot and ankle reconstruction: Surgical modifications for flap pedicle and donor site closure without skin graft.

    Science.gov (United States)

    Chi, Zhenglin; Chen, Yiheng; Chu, Tinggang; Gao, Weiyang; Li, Zhijie; Yan, Hede; Song, Yonghuan

    2018-02-01

    The conventional procedure of the sural neuro-fasciocutaneous flap enables the supply of blood and venous drainage by increasing the width of the adipofascial tissue and preserving tiny venous return routes. Moreover, skin graft is a common method for donor site closure, which may lead to some complications and influence the aesthetic appearance. We report modifications for a distally based sural neuro-fasciocutaneous perforator flap and a relaying flap for donor site closure without skin graft. Twelve patients undergoing the modified flap for foot and ankle reconstruction were included in this study between 2014 and 2016. A peroneal-based perforator, a superficial vein, and the vascular axis of the sural nerve were included in the pedicle. A Z-shape skin incision was performed to explore the perforator vessels and a relaying island perforator flap was used to close the donor site. All flaps survived completely without necrosis. The area of the flaps ranged from 16 × 8 cm to 30 × 15 cm. The diameter width of the pedicle ranged from 1.0 to 2.0 cm. A relaying perforator island flap was used in 10 cases for donor site closure and no skin graft was performed. There were no serious donor site complications. All patients were satisfied with the aesthetic outcome postoperatively at the final follow-up. The distally based sural neuro-fasciocutaneous perforator flap is considered a reliable method for foot and ankle reconstruction. The modification for flap pedicle and donor site closure method without skin graft should be recommended. Copyright © 2017. Published by Elsevier Ltd.

  13. Validation of a Cephalad Fluid Shift Countermeasure

    Science.gov (United States)

    Macias, B.; Cole, C.; Kesari, S.; Hargens, A.; Stenger, M.; Ebert, D.; Lee, S. M. C.; Sargsyan, A.; Liu, J.

    2016-01-01

    INTRODUCTION: This project will provide critical data required to objectively determine how an optimized thigh cuff could be incorporated into the NASA integrated physiological countermeasure suite. This project will determine if thigh cuffs used during simulated spaceflight impact intracranial pressure (ICP), ocular structure and function, and intraocular pressure (IOP) using state of-the-art techniques. Additionally, some of the same methods, hardware, and protocols will be employed in the present investigation to enable direct comparisons to the International Space Station (ISS) "Fluid Shifts" experiment with Chibis-Lower Body Negative Pressure (LBNP). This study will determine the temporal physiological responses of thigh cuff application and removal on ocular and cerebral variables (including invasive ICP) in a microgravity analog. Furthermore, this proposed study will determine tissue pressure distribution applied by thigh cuffs in order to improve comfort, mobility, and efficacy of the countermeasure. Our specific aim is to determine the efficacy of a novel thigh cuff device to mitigate cephalad fluid shifts. We hypothesize that a thigh cuff countermeasure employed in a microgravity analog will temporarily reverse or attenuate ocular and cerebral-volume-pressure variables, approaching normal Earth-based seated posture, the most frequent posture assumed in daily life. In addition, we hypothesize that the magnitude of fluid and pressure redistribution using a thigh cuff countermeasure may require a longer exposure time than that of Chibis-LBNP (using ground-based data from our "Fluid Shifts" project). This project directly addresses Critical Path Roadmap Risks and Questions regarding "Risk of Spaceflight-Induced Intracranial Hypertension/Vision Alterations," and IRP Gap VIIP13: We need to identify preventative and treatment countermeasures to mitigate changes in ocular structure and function and intracranial pressure during spaceflight. METHODS: Noninvasive

  14. A comparison of intermittent pneumatic compression of the calf and whole leg in preventing deep venous thrombosis in urological surgery.

    Science.gov (United States)

    Soderdahl, D W; Henderson, S R; Hansberry, K L

    1997-05-01

    Intermittent pneumatic compression of the calf and/or thigh effectively decreases the incidence of deep venous thrombosis and other thrombotic sequelae but clinical data comparing these modalities are currently lacking. A total of 90 patients undergoing major urological surgery was randomly assigned to receive calf length or thigh length pneumatic compression for antithrombotic prophylaxis. Duplex ultrasound of the lower extremities was performed preoperatively and twice postoperatively to evaluate for deep venous thrombosis. Health care providers in the operating room, recovery room and ward were asked to compare the compression systems, and a cost analysis was performed. A total of 47 patients wore the thigh length sequential pneumatic sleeves and 43 wore calf length uniform compression systems. A pulmonary embolus without evidence of deep venous thrombosis was detected in 1 patient (2%) using the thigh length system. A thrombus was detected in the common femoral vein by duplex ultrasonography in 1 patient (2%) with the calf length system. Nursing personnel found the calf length sleeves easier to apply and more comfortable by patient account but they were satisfied with both systems. There was a significant cost savings with the calf length pneumatic compression system. Calf and thigh length pneumatic compression systems similarly decrease the risk of deep venous thrombosis in patients undergoing urological surgery. The calf length system has the added advantage of being less expensive and easier to use.

  15. Muscle areas of lower limbs were determined by anthropometric and computed tomography in the adult of the masculine sex

    International Nuclear Information System (INIS)

    Fernandez Vieitez, Jorge Alberto; Alvarez Cuesta, Jose Alberto; Williams Wilson, Luis

    2000-01-01

    In a sample of 17 males (age 26 + - 5 years; weight 76.3 + - 7.1 kg and height 177.2 + - 3.9 cm) the differences, ratios and interchangeability among muscle areas (cm 2 ) of lower limbs (medial thigh and maximum leg) were determined by anthropometric (muscle area= [limb circumference (cm)- 0.31416 skinfold (mm)]2 /12.5664 and computed tomography. The anthropometric method overestimated muscle areas in both regions (thigh + 9.0 + - 12.8; p= 0.01 and leg: +8.5 + - 11.2; p=0.006). Relation between the two procedures was statistically significant (thigh r=0.9; p= 8.8 .10-7 and leg r=0.52; p=0.03). Both methods were interchangeable since neither the correlation coefficient (thigh r=0.42; leg r=0.38) nor the regression gradient (thigh b 0 .21 + - 0.12; leg b = -0.44 + - 0.28) between the differences (anthropometric ? TAC) and the averages (anthropometric + TAC/ 2) in both methods were statistically significant (p>0.05). It was concluded that the anthropometric method requires certain adjustments to be able to estimate more accurately the muscle areas of lower limbs

  16. Energy value of meat in selected species of feathered game

    Directory of Open Access Journals (Sweden)

    František Vitula

    2011-01-01

    Full Text Available The aim of this work was to compare gross energy (GE in breast and thigh muscles in the following six species of feathered game reared in Europe: guineafowl (Numida meleagris, common pheasant (Phasianus colchicus, Japanese quail (Coturnix coturnix japonica, chukar (Alectoris chucar, grey partridge (Perdix perdix and wild turkey (Meleagris gallopavo. Calorimetric analysis revealed significant (P ≤ 0.05 and highly significant (P ≤ 0.01 differences between individual species in the content of energy in breast and thigh muscles. The highest content of energy (recalculated to dry matter was found in breast muscles from wild turkey (24.75 MJ·kg-1 and Japanese quail (24.57 MJ·kg-1 whereas the highest content of energy (recalculated to dry matter in thigh muscles was found in Japanese quail and grey partridge. Highly significant (P ≤ 0.01 differences in the energy content were also found between breast and thigh muscles in all studied game species except for wild turkey. Differences in the content of energy in muscles between individual species occur mainly due to different contents of fat in muscles. This is also confirmed by high correlation coefficients between the content of energy and the content of fat in breast (r = 0.912 and thigh muscles (r = 0.878. Our study provides more specific data on the amount of energy in muscles of major species of feathered game reared in Europe and significantly extends current knowledge in this field.

  17. Improving the nutritional quality and shelf life of broiler meat by feeding diets supplemented with fermented pomegranate (Punica granatum L.) by-products.

    Science.gov (United States)

    Ahmed, S T; Ko, S-Y; Yang, C-J

    2017-12-01

    1. Four experimental diets containing 0, 0.5, 1.0 and 2.0% fermented pomegranate by-products (FPB) were supplied to 320d-old broilers to evaluate the effects of FPB on growth performance, nutritional composition, fatty acid profile and oxidative stability of meat. 2. Dietary supplementation of FPB linearly increased the weight gain and feed intake of broilers with linear reduction in feed conversion ratio. 3. The crude protein, iron, magnesium, and sodium content were linearly higher, whereas cholesterol was linearly lower in the breast meat of FPB-supplemented broilers. In thigh meat, linearly lower ether extract and cholesterol with higher moisture was noted in response to increasing levels of FPB. 4. The proportion of saturated fatty acids was both linearly and quadratically lower in breast and thigh meat, whereas those of monounsaturated fatty acids of breast (linear and quadratic) and n-3 fatty acids of breast and thigh (linear) meat was higher in the FPB-supplemented broilers. The n-6/n-3 ratio of breast meat was linearly lower in response to FPB supplementation. The hypocholesterolaemic to hypercholesterolaemic ratio of thigh meat was higher in the FPB-supplemented groups. 5. The thiobarbituric acid reactive substances and pH value were lower in the breast and thigh meat of FPB-supplemented broilers. 6. Thus, additive supplementation of the diet with up to 2% FPB improved the nutritional quality, fatty acid profile and shelf life of broiler meat.

  18. Muscle areas of lower limbs were determined by anthropometric and computed tomography in the adult of the masculine sex; Areas musculares del muslo y la pierna estimadas por antropometria y tomografia axial computadorizada en varones adultos

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez Vieitez, Jorge Alberto; Alvarez Cuesta, Jose Alberto; Williams Wilson, Luis [Centro Provincial de Medicina del Deporte, Holguin (Cuba)

    2000-07-01

    In a sample of 17 males (age 26 {sup +}{sub -} 5 years; weight 76.3 {sup +}{sub -} 7.1 kg and height 177.2 {sup +}{sub -} 3.9 cm) the differences, ratios and interchangeability among muscle areas (cm{sup 2}) of lower limbs (medial thigh and maximum leg) were determined by anthropometric (muscle area= [limb circumference (cm)- 0.31416 skinfold (mm)]2 /12.5664 and computed tomography. The anthropometric method overestimated muscle areas in both regions (thigh + 9.0 {sup +}{sub -} 12.8; p= 0.01 and leg: +8.5 {sup +}{sub -} 11.2; p=0.006). Relation between the two procedures was statistically significant (thigh r=0.9; p= 8.8 .10-7 and leg r=0.52; p=0.03). Both methods were interchangeable since neither the correlation coefficient (thigh r=0.42; leg r=0.38) nor the regression gradient (thigh b {sub {sub 0.21}} {sup +}{sub -} 0.12; leg b = -0.44{sup +}{sub -} 0.28) between the differences (anthropometric ? TAC) and the averages (anthropometric + TAC/ 2) in both methods were statistically significant (p>0.05). It was concluded that the anthropometric method requires certain adjustments to be able to estimate more accurately the muscle areas of lower limbs.

  19. Influence of cold-water immersion on limb blood flow after resistance exercise.

    Science.gov (United States)

    Mawhinney, Chris; Jones, Helen; Low, David A; Green, Daniel J; Howatson, Glyn; Gregson, Warren

    2017-06-01

    This study determined the influence of cold (8°C) and cool (22°C) water immersion on lower limb and cutaneous blood flow following resistance exercise. Twelve males completed 4 sets of 10-repetition maximum squat exercise and were then immersed, semi-reclined, into 8°C or 22°C water for 10-min, or rested in a seated position (control) in a randomized order on different days. Rectal and thigh skin temperature, muscle temperature, thigh and calf skin blood flow and superficial femoral artery blood flow were measured before and after immersion. Indices of vascular conductance were calculated (flux and blood flow/mean arterial pressure). The colder water reduced thigh skin temperature and deep muscle temperature to the greatest extent (P lower (55%) than the control post-immersion (P water similarly reduce femoral artery and cutaneous blood flow responses but not muscle temperature following resistance exercise.

  20. Common recessive limb girdle muscular dystrophies differential diagnosis: why and how?

    Directory of Open Access Journals (Sweden)

    Ana Cotta

    2014-09-01

    Full Text Available Limb girdle muscular dystrophies are heterogeneous autosomal hereditary neuromuscular disorders. They produce dystrophic changes on muscle biopsy and they are associated with mutations in several genes involved in muscular structure and function. Detailed clinical, laboratorial, imaging, diagnostic flowchart, photographs, tables, and illustrated diagrams are presented for the differential diagnosis of common autosomal recessive limb girdle muscular dystrophy subtypes diagnosed nowadays at one reference center in Brazil. Preoperative image studies guide muscle biopsy site selection. Muscle involvement image pattern differs depending on the limb girdle muscular dystrophy subtype. Muscle involvement is conspicuous at the posterior thigh in calpainopathy and fukutin-related proteinopathy; anterior thigh in sarcoglycanopathy; whole thigh in dysferlinopathy, and telethoninopathy. The precise differential diagnosis of limb girdle muscular dystrophies is important for genetic counseling, prognostic orientation, cardiac and respiratory management. Besides that, it may probably, in the future, provide specific genetic therapies for each subtype.

  1. Effect of dietary garlic bulb and husk on the physicochemical properties of chicken meat.

    Science.gov (United States)

    Kim, Y J; Jin, S K; Yang, H S

    2009-02-01

    This study was carried out to compare the physicochemical and sensory properties of chicken thigh muscles from broilers fed different levels of garlic bulb (GB) and garlic husk (GH). Two hundred male Arbor Acre broiler chickens were fed either a control diet (based on corn and soybean meal) or the control diet supplemented with 2 and 4% of GB and GH powder for 5 wk. There were no differences among diets in moisture and ash contents. However, dietary supplementation with GB and GH resulted in significantly greater protein content and lower fat content in chicken thigh muscle compared with muscle from birds fed nonsupplemented diets (Pchicken diets with garlic can produce chicken meat with favorable lipid profiles and can enhance eating quality because sensory panels found that thigh meat from chickens fed a garlic-supplemented diet had better texture and flavor. Therefore, the treatment with the most significant effects in this study was that with the high level of garlic husk.

  2. Glutamate availability is important in intramuscular amino acid metabolism and TCA cycle intermediates but does not affect peak oxidative metabolism

    DEFF Research Database (Denmark)

    Mourtzakis, M.; Graham, T.E.; Gonzalez-Alonso, J.

    2008-01-01

    Muscle glutamate is central to reactions producing 2-oxoglutarate, a tricarboxylic acid (TCA) cycle intermediate that essentially expands the TCA cycle intermediate pool during exercise. Paradoxically, muscle glutamate drops approximately 40-80% with the onset of exercise and 2-oxoglutarate...... declines in early exercise. To investigate the physiological relationship between glutamate, oxidative metabolism, and TCA cycle intermediates (i.e., fumarate, malate, 2-oxoglutarate), healthy subjects trained (T) the quadriceps of one thigh on the single-legged knee extensor ergometer (1 h/day at 70......% maximum workload for 5 days/wk), while their contralateral quadriceps remained untrained (UT). After 5 wk of training, peak oxygen consumption (VO2peak) in the T thigh was greater than that in the UT thigh (Pglutamate infusion. Peak...

  3. Effect of sex and genotype on carcase composition and nutritional characteristics of chicken meat.

    Science.gov (United States)

    Baeza, E; Chartrin, P; Meteau, K; Bordeau, T; Juin, H; Le Bihan-Duval, E; Lessire, M; Berri, C

    2010-06-01

    1. The aim of this study was to examine the effect of sex and genotype on carcase composition and nutritional and sensory characteristics of chicken meat. The "Geline de Touraine" (GT) characterised by high carcase fatness was compared with an experimental crossbreed (EC) and "Label rouge" (LR) genotype. 2. Females compared with males, and GT chickens compared with LR and EC chickens were characterised by increased carcase fatness and an increased lipid level in thigh meat. 3. In both breast and thigh meat, the percentage of monounsaturated fatty acids was increased and the percentage of polyunsaturated fatty acids was decreased. However, these effects did not affect sensory characteristics of meat particularly those of roasted breast fillets containing very low lipid level by comparison with thigh meat. 4. Finally, in our study, high carcase fatness was related to high intermuscular fatness affecting the nutritional characteristics of meat but not its sensory attributes.

  4. Vertical jump fatigue does not affect intersegmental coordination and segmental contribution

    Directory of Open Access Journals (Sweden)

    Gleber Pereira

    2014-09-01

    Full Text Available The aim of this study was to describe the intersegmental coordination and segmental contribution during intermittent vertical jumps performed until fatigue. Seven male visited the laboratory on two occasions: 1 the maximum vertical jump height was determined followed by vertical jumps habituation; 2 participants performed intermittent countermovement jumps until fatigue. Kinematic and kinetic variables were recorded. The overall reduction in vertical jump height was 5,5%, while the movement duration increased 10% during the test. The thigh segment angle at movement reversal significantly increased as the exercise progressed. Non-significant effect of fatigue on movement synergy was found for the intersegmental coordination pattern. More than 90% of the intersegmental coordination was explained by one coordination pattern. Thigh rotation contributed the most to the intersegmental coordination pattern, with the trunk second and the shank the least. Therefore, one intersegmental coordination pattern is followed throughout the vertical jumps until fatigue and thigh rotation contributes the most to jump height.

  5. Abdominal implantation of testicles in the management of intractable testicular pain in Fournier gangrene.

    Science.gov (United States)

    Chan, Cyrus C; Shahrour, Khaled; Collier, Ronald D; Welch, Marlene; Chang, Shiliang; Williams, Mallory

    2013-01-01

    Fournier gangrene (FG) is a necrotizing soft tissue infection involving the superficial and fascial planes of the perineum. In many cases of FG, debridement of the scrotum is necessary, leaving definitive management of the exposed testicles a significant surgical challenge. Frequent incidental trauma to the testicles can cause severe pain, especially in laborers. Practical surgical solutions are few and not well detailed. Various options exist, including creating a neoscrotum with adjacent thigh tissue, split-thickness skin grafts (STSGs), or even creating a subcutaneous thigh pocket. We describe a case of abdominal implantation of bilateral testicles for persistent testicular pain in a case where STSGs did not provide adequate protection, adjacent thigh skin was not available for creation of a neoscrotum, and significant cord contracture occurred. We detail the advantages and disadvantages of the commonly described techniques, including this approach, and how in select individuals this may be a suitable alternative.

  6. Influence of basal ganglia on upper limb locomotor synergies. Evidence from deep brain stimulation and L-DOPA treatment in Parkinson's disease.

    Science.gov (United States)

    Crenna, P; Carpinella, I; Lopiano, L; Marzegan, A; Rabuffetti, M; Rizzone, M; Lanotte, M; Ferrarin, M

    2008-12-01

    Clinical evidence of impaired arm swing while walking in patients with Parkinson's disease suggests that basal ganglia and related systems play an important part in the control of upper limb locomotor automatism. To gain more information on this supraspinal influence, we measured arm and thigh kinematics during walking in 10 Parkinson's disease patients, under four conditions: (i) baseline (no treatment), (ii) therapeutic stimulation of the subthalamic nucleus (STN), (iii)L-DOPA medication and (iv) combined STN stimulation and L-DOPA. Ten age-matched controls provided reference data. Under baseline conditions the range of patients' arm motion was severely restricted, with no correlation with the excursion of the thigh. In addition, the arm swing was abnormally coupled in time with oscillation of the ipsilateral thigh. STN stimulation significantly increased the gait speed and improved the spatio-temporal parameters of arm and thigh motion. The kinematic changes as a function of gait speed changes, however, were significantly smaller for the upper than the lower limb, in contrast to healthy controls. Arm motion was also less responsive after L-DOPA. Simultaneous deep brain stimulation and L-DOPA had additive effects on thigh motion, but not on arm motion and arm-thigh coupling. The evidence that locomotor automatisms of the upper and lower limbs display uncorrelated impairment upon dysfunction of the basal ganglia, as well as different susceptibility to electrophysiological and pharmacological interventions, points to the presence of heterogeneously distributed, possibly partially independent, supraspinal control channels, whereby STN and dopaminergic systems have relatively weaker influence on the executive structures involved in the arm swing and preferential action on those for lower limb movements. These findings might be considered in the light of phylogenetic changes in supraspinal control of limb motion related to primate bipedalism.

  7. The Influence of Protein Supplementation on Muscle Hypertrophy

    Science.gov (United States)

    Fardi, A.; Welis, W.

    2018-04-01

    The problem of this study was the lack of knowledge about nutrition, so the use of protein supplements to support the occurrence of muscle hypertrophy is not optimal. The use of natural supplements is a substitute of the manufacturer's supplements. The purpose of this study was to determine the effect of natural protein supplementation to muscle hypertrophy.The method of the research was a quasi experiment. There are 26 subject and were divided two group. Instrument of this research is to use tape measure and skinfold to measure muscle rim and thickness of fat in arm and thigh muscle. Then to calculate the circumference of the arm and thigh muscles used the formula MTC - (3.14 x TSF). MTC is the arm muscle or thigh muscle and TSF is the thickness of the muscles of the arm or thigh muscles. Data analysis technique used was t test at 5% significant level. The result of the research showed that average score of arm muscle hypertrophy at pretest control group was 255.61 + 17.69 mm and posttest average score was 263.48.58 + 17.21 mm and average score of thigh muscle hypertrophy at pretest control group was 458.32 + 8.72 mm and posttest average score was 468.78 + 11.54 mm. Average score of arm muscle hypertrophy at pretest experiment group was 252.67 + 16.05 mm and posttest average score was 274.58 ± 16.89 mm and average score of thigh muscle hypertrophy at pretest experiment group was 459.49 ± 6.99 mm and posttest average score was 478.70 + 9.05 mm. It can be concluded that there was a significant effect of natural protein supplementation on muscle hypertrophy.

  8. Antioxidant Enzyme Activity, Iron Content and Lipid Oxidation of Raw and Cooked Meat of Korean Native Chickens and Other Poultry

    Directory of Open Access Journals (Sweden)

    Muhlisin

    2016-05-01

    Full Text Available This study was conducted to observe antioxidant enzyme activity, iron content and lipid oxidation of Korean native chickens and other poultry. The breast and thigh meat of three Korean native chicken breeds including Woorimatdak, Hyunin black and Yeonsan ogye, and three commercial poultry breeds including the broiler, White Leghorn and Pekin duck (Anasplatyrhyncos domesticus were studied. The analyses of the antioxidant enzymes activity, iron content and lipid oxidation were performed in raw and cooked samples. The activity of catalase (CAT in the thigh meat was higher than that of the breast meat of three Korean native chickens and the broiler, respectively. The activity of glutathione peroxidase (GPx in the uncooked thigh meat of three Korean native chickens was higher than that of the breasts. The breast meat of Woorimatdak and Pekin duck had higher superoxide dismutase (SOD activity than the others, while only the thigh meat of Pekin duck had the highest activity. Cooking inactivated CAT and decreased the activity of GPx and SOD. The thigh meat of Woorimatdak, White Leghorn, Yeonsan ogye and Hyunin black contained more total iron than the breast meat of those breeds. The heme-iron lost during cooking ranged from 3.2% to 14.8%. It is noted that the thigh meat had higher thiobarbituric acid reactive substances values than the breast in all chicken breeds. Though Woorimatdak showed higher antioxidant enzyme activity and lower released-iron percentage among Korean native chickens, no differences were found on lipid oxidation. We confirm that the dark meat of poultry exhibited higher antioxidant enzyme activity and contained more iron than the white meat.

  9. Psoas muscle cross-sectional area as a measure of whole body lean muscle mass in maintenance hemodialysis patients

    Science.gov (United States)

    Morrell, Glen R.; Ikizler, Talat A.; Chen, Xiaorui; Heilbrun, Marta E.; Wei, Guo; Boucher, Robert; Beddhu, Srinivasan

    2016-01-01

    Objective We investigate whether psoas or paraspinous muscle area measured on a single L4–5 image is a useful measure of whole lean body mass compared to dedicated mid-thigh magnetic resonance imaging (MRI). Design Observational study. Setting Outpatient dialysis units and a research clinic. Subjects 105 adult participants on maintenance hemodialysis. No control group was used. Exposure variables Psoas muscle area, paraspinous muscle area, and mid-thigh muscle area (MTMA) were measured by MRI. Main outcome measure Lean body mass was measured by dual-energy absorptiometry (DEXA) scan. Results In separate multivariable linear regression models, psoas, paraspinous, and mid-thigh muscle area were associated with increase in lean body mass. In separate multivariate logistic regression models, c-statistics for diagnosis of sarcopenia (defined as lean body mass) were 0.69 for paraspinous muscle area, 0.81 for psoas muscle area, and 0.89 for mid-thigh muscle area. With sarcopenia defined as lean body mass, the corresponding c-statistics were 0.71, 0.92, and 0.94. Conclusions We conclude that psoas muscle area provides a good measure of whole body muscle mass, better than paraspinous muscle area but slightly inferior to mid thigh measurement. Hence, in body composition studies a single axial MR image at the L4–L5 level can be used to provide information on both fat and muscle and may eliminate the need for time-consuming measurement of muscle area in the thigh. PMID:26994780

  10. Effects of storage temperature on biogenic amine concentrations in meat of uneviscerated pheasants (Phasianus colchicus

    Directory of Open Access Journals (Sweden)

    Zdeňka Hutařová

    2013-01-01

    Full Text Available The aim of this study was to determine the hygienic quality of the pheasants reared for high-quality meat production by the biogenic amine concentrations in their meat. The content of biogenic amines was measured in the meat of sixty male pheasants killed by pithing and stored uneviscerated for 21 days under different storage temperatures (0 °C, 7 °C and 15 °C. The samples of breast and thigh muscles of pheasant were tested at weekly intervals. Biogenic amines were analysed by reverse phase liquid chromatography and detected by tandem mass spectrometry. Concentrations of biogenic amines (except spermin and spermidin in thigh muscle were higher than in breast muscle. Highly significant difference (P < 0.01 was found in tyramine (5.80 mg/kg and 1.38 mg/kg for thigh and breast muscle, respectively, cadaverine (40.80 mg/kg and 14.43 mg/kg for thigh and breast muscle, respectively, putrescine (13.42 mg/kg and 3.16 mg/kg for thigh and breast muscle, respectively and histamine (5.51 mg/kg and 1.70 mg/kg for thigh and breast muscle, respectively concentrations after 21 days of storage at 15 °C. This study provides information on the dynamics of biogenic amine formation in pheasant meat during 21 days of storage at different temperatures. Based on our results, we can recommend storing pithed uneviscerated pheasants at 0–7°C for up to 21 days, or at 15 °C for up to 7 days. Concentrations of biogenic amines gained in our study can be helpful in evaluating freshness and hygienic quality of the pheasant game meat.

  11. Effect of Low Dose Radiation Upon Antioxidant Parameters in Skeletal Muscle of Chick Embryo

    International Nuclear Information System (INIS)

    Vilic, M.; Pirsljin, J.; Beer Ljubic, B.; Miljanic, S.; Kraljevic, P.

    2008-01-01

    In this paper an attempt was made to determine the effect of irradiation of eggs with low dose ionizing radiation upon lipid peroxide (TBARS) level, glutathione (GSH) level, activity of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and catalase (CAT) in skeletal muscle of chick embryo and newly hatched chicks. The eggs of a heavy breeding chickens were irradiated with a dose of 0.3 Gy gamma radiation (60Co source) on the 19th day of incubation. Along with the irradiated chick embryos, there was a control group of non-irradiated chick embryos. The antioxidant parameters were measured in breast muscle (m. pectoralis superficialis) and thigh muscle (m. biceps femoris) of chick embryos on 1, 3, 6, 24 and 72 h after egg irradiation. All parameters were determined spectrophotometrically. Lipid peroxidation, GSH level and CAT activity decreased in the breast and thigh muscle of chick embryos on the first hour after irradiation, while the activity of GSH-Px increased in the thigh muscle on the 1st hour after irradiation. CAT activity decreased in the breast muscle of chick embryos on the hour 24 after irradiation. The GSH level increased in the breast and thigh muscle of chick embryos on the hour 72 after irradiation while the activity of GSH-Px increased in the breast muscle. At the same time CAT activity decreased in breast muscle while lipid peroxidation decreased in thigh muscle. The obtained results showed that acute irradiation of chicken eggs on the 19th day of incubation with the dose of 0.3 Gy gamma radiation could be an oxidative stress in both types of muscles immediately after irradiation. However, at the one-day old chicks (72 hours after irradiation) this dose could have a stimulating effect upon GSH level in both breast and thigh muscle.(author)

  12. Unilateral mid-femoral periosteal newbone of varying aetiology in children. Radiographic analysis of 25 cases

    Energy Technology Data Exchange (ETDEWEB)

    Kozlowski, K.; Diard, F.; Padovani, J.; Sprague, P.; Pietron, K.

    1986-09-01

    Thigh pain is a serious condition in childhood and should be promptly and thoroughly investigated. Twenty-five cases of thigh pain lasting between 1 day and 7 months with mid-femoral periosteal thickening were analysed. There were 10 patients with Ewing's sarcoma, 7 with eosinophilic granuloma, 1 with osteoid osteoma, 1 with leukaemia, 3 with osteomyelitis, 1 with myositis and 2 with post-traumatic periosteal reaction. It was shown that patients with Ewing's sarcoma and eosinophilic granuloma have certain patterns of X-ray changes in high diagnostic value, which allow a proper diagnosis in most cases.

  13. Simulation of Adaptive Seat Energy Absorber for Military Rotorcraft Crash Safety Enhancement

    Science.gov (United States)

    2014-04-01

    extracted from anthropometric specifications for dummy family (5) for the 5th percentile female (small female), 50th percentile male (average male), and...the thorax (m2); the abdomen (m3); the pelvis (m4); the thighs (m5); and the calf and foot (m6). The estimated segment mass properties (5) are...Thigh (m5) 11.83 17.23 21.65 Calf and foot (m6) 6.00 11.66 18.24 Total 48.22 76.56 102.46 5 Table 2. Stiffness and damping coefficients of

  14. [The speed of nerve-conduction after micro-surgical suture of the tibial nerve of the rabbit (author's transl)].

    Science.gov (United States)

    Weigert, M; Mellerowicz, H; Werhahn, C

    1975-10-01

    Isolated division of the tibial nerve in the thigh preserving the peroneal and sural nerves does not cause loss of normal position of the animal, in particular of sitting. Nor does it lead to pressure sores. The animals are fitter then after division of the sciatic nerve. Microsurgical suture of the isolated tibial nerve in the thigh of the rabbit with 1 or 2 simple sutures with 10 x 0 thread show that an average recovery can be achieved in over 80 per cent. As few sutures as possible should be used. Otherwise there with be scarring and no return of function.

  15. Comparison of soft tissue effects of conventional ionic, low osmolar ionic and nonionic iodine containing contrast material in experimental animals

    International Nuclear Information System (INIS)

    McAlister, W.H.; Kissane, J.M.

    1990-01-01

    Conventional, low osmolar, and non-ionic iodine containing contrast media and saline controls were placed in the paws, muscles, and subcutaneous tissues of Sprague-Dawley rat thighs. The paw injections were observed and photographed, while the thighs were examined histologically. Results showed that although the low osmolar and non-ionic agents did produce inflammatory reactions and focal necrosis in the soft tissues, they were much better tolerated than were the conventional ionic agents. A non-ionic or low osmolar ionic contrast agent should be strongly considered when a possibility for extravasation exists. (orig.)

  16. Imaging features in calcinosis circumscripta, a rare type of subcutaneous calcification in localized scleroderma

    Directory of Open Access Journals (Sweden)

    Pratiksha Yadav

    2013-01-01

    Full Text Available Calcinosis cutis circumscripta is a rare condition in which abnormal deposition of calcium seen in the dermis and subcutaneous tissue, it is associated with localized scleroderma. A 30-year-old female presented with an area of extensive calcification involving the right gluteal region, lateral aspect of right thigh and a small area on left thigh detected on radiograph with atrophy of subcutaneous tissue. Magnetic resonance imaging and computed tomography were done for further evaluation and the findings were of calcification and atrophy involving the skin and subcutaneous tissue.

  17. Diet-induced changes in subcutaneous adipose tissue blood flow in man

    DEFF Research Database (Denmark)

    Simonsen, L; Bülow, J; Astrup, A

    1990-01-01

    The effect of a carbohydrate-rich meal on subcutaneous adipose tissue blood flow was studied with and without continuous i.v. infusion of propranolol in healthy volunteers. The subcutaneous adipose tissue blood flow was measured with the 133Xe washout method in three different locations......: the forearm, the thigh and the abdomen. The subjects were given a meal consisting of white bread, jam, honey and apple juice (about 2300 kJ). The meal induced a twofold increase in blood flow in the examined tissues. Propranolol abolished the flow increase in the thigh and the abdomen and reduced...

  18. Actinomycetoma Due To Nocardia Brasiliensis in Tamil Nadu

    Directory of Open Access Journals (Sweden)

    V V Pankajalakshmi

    1982-01-01

    Full Text Available Two cases of actinomycetoma caused by Nocardia Brasiliensis in Tamilians are reported. Both presented with multiple sinuses discharging serosanguinous material without any granules. In the first case, the lesion was located in the thigh and leg and the specific diagnosis was made by histopathology and isolation of N. brasiliensis. In the other, in addition to thigh and leg, the foot was also affected and the causative agent was isolated in pure culture. The geographic distribution of the organism and its incidence and prevalence are discussed.

  19. Effect of Particular Breed on the Chemical Composition, Texture, Color, and Sensorial Characteristics of Dry-cured Ham

    OpenAIRE

    Seong, Pil Nam; Park, Kuyng Mi; Kang, Sun Moon; Kang, Geun Ho; Cho, Soo Hyun; Park, Beom Young; Van Ba, Hoa

    2014-01-01

    The present study demonstrates the impact of specific breed on the characteristics of dry-cured ham. Eighty thighs from Korean native pig (KNP), crossbreed (Landrace×Yorkshire)♀×Duroc♂ (LYD), Berkshire (Ber), and Duroc (Du) pig breeds (n = 10 for each breed) were used for processing of dry-cured ham. The thighs were salted with 6% NaCl (w/w) and 100 ppm NaNO2, and total processing time was 413 days. The effects of breed on the physicochemical composition, texture, color and sensory characteri...

  20. Hyper-Immunoglobulin E Syndrome

    Directory of Open Access Journals (Sweden)

    Gnanraj Pushpa

    2004-01-01

    Full Text Available A case of hyper-IgE syndrome in a 6 year old boy with bronchial asthma is reported here with the various manifestations of multiple tender abscesses of the scalp, recurrent dermatophyte infections of his face and right thigh, eczematous lesions of his neck, shoulders and antecubital fossae, candidiasis of the tongue, angular cheilitis and total dystrophy of his right bit toe nail. Laboratory investigations revealed staphylococcus aureus infection of the scalp, Trichophyton rubrum infection of the face and the thigh and candidal onychomycosis. Immunological survey revealed markedly elevated serum lgE level.