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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 Background A thinned anterolateral thigh (ALT flap is often harvested to achieve optimalskin resurfacing. Several techniques have been described to thin an ALT flap including anadipocutaneous flap, an adipofascial flap and delayed debulking.Methods By systematically reviewing all of the available literature in English and French, thepresent manuscript attempts to identify the common surgical indications, complications anddonor site morbidity of the adipofascial variant of the ALT flap. The studies were identifiedby performing a systematic search on Medline, Ovid, EMBASE, the Cochrane Database ofSystematic Reviews, Current Contents, PubMed, Google, and Google Scholar.Results The study selection process was adapted from the Preferred Reporting Items forSystematic Reviews and Meta-Analyses statement, and 15 articles were identified usingthe study inclusion criteria. These articles were then reviewed for author name(s, year ofpublication, flap dimensions and thickness following defatting, perforator type, type of transfer,complications, thinning technique, number of cases with a particular area of application anddonor site morbidity.Conclusions The adipofascial variant of the ALT flap provides tissue to fill large defects andimprove pliability. Its strong and safe blood supply permits adequate immediate or delayeddebulking without vascular complications. The presence of the deep fascia makes it possibleto 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 bereduced through immediate direct closure or liposuction and direct closure. A safe bloodsupply was confirmed by the rate of secondary flap debulking.

  2. The Clinical Application of Anterolateral Thigh Flap

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    Yao-Chou Lee

    2011-01-01

    Furthermore, several modifications widen its clinical applications: the fascia lata can be included for sling or tendon reconstruction, the bulkiness could be created by including vastus lateralis muscle or deepithelization of skin flap, the pliability could be increased by suprafascial dissection or primary thinning, the pedicle length could be lengthening by proximally eccentric placement of the perforator, and so forth. Combined with these technical and conceptual advancements, the anterolateral thigh flap has become the workhorse flap for soft-tissue reconstructions from head to toe.

  3. Functional assessment: Free thin anterolateral thigh flap versus free radial forearm reconstruction for hemiglossectomy defects

    National Research Council Canada - National Science Library

    Lu, Mingxing; Sun, Guowen; Hu, Qingang; Tang, Enyi; Wang, Yujia

    2015-01-01

    To compare free thin anterolateral thigh (ALT) flap with free radial forearm (FRF) flap in the reconstruction of hemiglossectomy defects, and to introduce our methods and experience in the tongue reconstruction with free thin ALT flap...

  4. 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.

  5. Functional outcomes after laryngopharyngectomy with anterolateral thigh flap reconstruction.

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    Lewin, Jan S; Barringer, Denise A; May, Annette H; Gillenwater, Ann M; Arnold, Katherine A; Roberts, Dianna B; Yu, Peirong

    2006-02-01

    We examined speech and swallowing outcomes and complications in patients with anterolateral thigh (ALT) flap reconstruction of cervical esophageal defects. We retrospectively reviewed 29 patients treated with laryngopharyngectomy and ALT flap reconstruction at The University of Texas M. D. Anderson Cancer Center from March 2002 to July 2004. We compared complication rates, nutritional intake, number of tracheoesophageal punctures (TEPs), speech fluency and use, operative defects, and radiotherapy effects. Twenty-two patients had circumferential defects, and seven had partial defects. Twenty-four patients had radiotherapy. Eleven patients underwent TEP. Higher complication rates in patients after TEP compared with those without TEP were not statistically significant (p = .268). Ninety percent of patients with TEP spoke fluently. Ninety percent of all patients returned to oral alimentation without significant effect from TEP (p = 1.00), complications (p = 1.00), radiation therapy (p = 1.00), or surgical defect (p = .56). The ALT flap successfully reconstructs laryngopharyngeal defects with excellent speech and swallowing results. Copyright 2005 Wiley Periodicals, Inc.

  6. Multipaddled anterolateral thigh chimeric flap for reconstruction of complex defects in head and neck.

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    Canhua Jiang

    Full Text Available The anterolateral thigh flap has been the workhouse flap for coverage of soft-tissue defects in head and neck for decades. However, the reconstruction of multiple and complex soft-tissue defects in head and neck with multipaddled anterolateral thigh chimeric flaps is still a challenge for reconstructive surgeries. Here, a clinical series of 12 cases is reported in which multipaddled anterolateral thigh chimeric flaps were used for complex soft-tissue defects with several separately anatomic locations in head and neck. Of the 12 cases, 7 patients presented with trismus were diagnosed as advanced buccal cancer with oral submucous fibrosis, 2 tongue cancer cases were found accompanied with multiple oral mucosa lesions or buccal cancer, and 3 were hypopharyngeal cancer with anterior neck skin invaded. All soft-tissue defects were reconstructed by multipaddled anterolateral thigh chimeric flaps, including 9 tripaddled anterolateral thigh flaps and 3 bipaddled flaps. The mean length of skin paddle was 19.2 (range: 14-23 cm and the mean width was 4.9 (range: 2.5-7 cm. All flaps survived and all donor sites were closed primarily. After a mean follow-up time of 9.1 months, there were no problems with the donor or recipient sites. This study supports that the multipaddled anterolateral thigh chimeric flap is a reliable and good alternative for complex and multiple soft-tissue defects of the head and neck.

  7. Fascia-only anterolateral thigh flap for extremity reconstruction.

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    Fox, Paige; Endress, Ryan; Sen, Subhro; Chang, James

    2014-05-01

    The ability to use the anterolateral thigh (ALT) flap as a vascularized fascial flap, without skin or muscle, was first documented by Koshima et al in 1989. The authors mention the possibility of using the fascia alone for dural reconstruction. Despite its description more than 20 years ago, little literature exists on the application of the ALT flap as a vascularized fascial flap. In our experience, the ALT flap can be used as a fascia-only flap for thin, pliable coverage in extremity reconstruction. After approval from the institutional review board, the medical records and photographs of patients who had undergone fascia-only ALT free flaps for extremity reconstruction were reviewed. Photographic images of patients were then matched to patients who had undergone either a muscle-only or a fasciocutaneous free flap reconstruction of an extremity. Photographs of the final reconstruction were then given to medical and nonmedical personnel for analysis, focusing on aesthetics including color and contour. Review of cases performed over a 2-year period demonstrated similar ease of harvest for fascia-only ALT flaps compared to standard fasciocutaneous ALT flaps. Fascia-only flaps were used for thin, pliable coverage in the upper and lower extremities. There was no need for secondary procedures for debulking or aesthetic flap revision. In contrast to muscle flaps, which require muscle atrophy over time to achieve their final appearance, there was a similar flap contour from approximately 1 month postoperatively throughout the duration of follow-up. When a large flap is required, the fascia-only ALT has the advantage of a single-line donor-site scar. Photograph comparison to muscle flaps with skin grafts and fasciocutaneous flaps demonstrated improved color, contour, and overall aesthetic appearance of the fascia-only ALT over muscle and fasciocutaneous flaps. The fascia-only ALT flap provides reliable, thin, and pliable coverage with improved contour and color over

  8. Functional results of microvascular reconstruction after hemiglossectomy: free anterolateral thigh flap versus free forearm flap.

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    Tarsitano, A; Vietti, M V; Cipriani, R; Marchetti, C

    2013-12-01

    The aim of the present study is to assess functional outcomes after hemiglossectomy and microvascular reconstruction. Twenty-six patients underwent primary tongue microvascular reconstruction after hemiglossectomy. Twelve patients were reconstructed using a free radial forearm flap and 14 with an anterolateral thigh flap. Speech intelligibility, swallowing capacity and quality of life scores were assessed. Factors such as tumour extension, surgical resection and adjuvant radiotherapy appeared to be fundamental to predict post-treatment functional outcomes. The data obtained in the present study indicate that swallowing capacity after hemiglossectomy is better when an anterolateral thigh flap is used. No significant differences were seen for speech intelligibility or quality of life between free radial forearm flap and anterolateral thigh flap.

  9. Reconstruction of Wide-apart Double Defect Using a Branch-based Chimeric Anterolateral Thigh Flap

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    Wei Wei Liu, MD

    2014-01-01

    Full Text Available Summary: Wide-apart double defect in head and neck region is rare and difficult to reconstruct at one time. Double free flaps are normally used for this scenario and often tedious and technically complicated. This study presented a technique using branch-based anterolateral thigh free flap to simultaneously reconstruct the 2 defects separated wide apart. The concept, indications, surgical technique, and anatomical variations are discussed. Branch-based anterolateral thigh flap is a safe technique and the dissection will be easy when the oblique branch is present.

  10. [Resurfacing of a trochanteric pressure sore by a pedicled fasciocutaneous anterolateral thigh flap: a case report].

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    Zeitoun, J; Faghahati, S; Burin Des Roziers, B; Daoud, G; Cartier, S

    2013-06-01

    The anterolateral thigh flap is usually used as a free flap for various kinds of reconstruction and resurfacing of distant areas. Cover of a deep trochanteric pressure sore is commonly made by muscular or musculocutaneous flaps such as tensor of fascia lata or vastus lateralis. We report the case of a trochanteric pressure sore covered by a fasciocutaneous pedicled anterolateral thigh flap after negative pressure therapy in a 58-year-old paraplegic patient. After 6 months, a good quality of coverage was obtained with minimal morbidity of donor site. The pedicled fasciocutaneous anterolateral flap appears as a reliable option for the treatment of trochanteric pressure sore. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  11. Supercharging and Augmenting Venous Drainage of an Anterolateral Thigh Free Flap: Options and Indications

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    Frederic W.-B. Deleyiannis, MD, MPhil, MPH

    2014-04-01

    Full Text Available Summary: This study introduces the options for supercharging and augmenting venous drainage of an anterolateral thigh free flap. Clinical indications and options for additional microvascular anastomoses are reviewed in 5 consecutive patients. The indications were simultaneous mucosal and cutaneous defects, divergent mucosal defects, and extensively wide and long cutaneous defects. Three additional vascular pedicles were anastomosed: the transverse branch of the lateral circumflex (n = 3, a perforator coming directly off the superficial femoral artery (n = 1, and a posterior perforator from the profundus femoral artery (n = 1. The anastomosis of a separate pedicle from the superior, medial, and/or posterior-lateral thigh may be a useful technique when confronted with an extensive defect that may not reliably be reconstructed with a routine anterolateral thigh flap based on a single perforator.

  12. Anterolateral thigh skinfold thickness and the European head and neck cancer patient: a prospective study.

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    Achal, Kulraj S; Farrell, C; Smith, Adam B; Mücke, T; Mitchell, David A; Kanatas, Anastasios N

    2011-03-01

    The purpose of this study was to objectively assess this widely recognised problem of the bulky adipocutaneous Anterolateral thigh flap in the European population that may have implications in the reconstruction of head and neck cancer patients. We report 50 cases that underwent specific prospective thigh skinfold thickness assessment as part of assessment of suitability for ALT flap reconstruction following cancer ablation. The null hypothesis was that thigh skinfold thickness and circumference in an oral cancer population do not differ significantly from published sino-Asian norms. This study confirms anthropometrically the suspicion that European thigh skinfold thickness in a head and neck cancer population is greater than sino-Asian comparators. Copyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  13. Advances in the practice of microsurgery: focusing on free anterolateral thigh perforator flap

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    Theddeus O.H. Prasetyono

    2007-12-01

    Full Text Available The purpose of this paper was to discuss an overview of the current clinical practice of microsurgery with a specific use of free anterolateral flap as one of the commonest flaps used in reconstructive surgery. A systematic review was performed through all English publication that goes to Pubmed during the period of 1997 to 2006 using keywords: “anterolateral thigh perforator flap.” The studies involved were retrospective case reviews on using microsurgical technique and involves free anterolateral thigh flap only without muscle involvement. Evaluation was done to search the indications, contraindications, area or organ to reconstruct, the cause of defects need reconstructive surgery, morbidities, functional and aesthetic results, techniques in regard of suture material, and instruments. Using 7th edition EndNote program, 230 abstracts were successfully retrieved in term of “anterolateral thigh perforator flap” of ANY FIELD and Boolean logic OR. Fifty six abstracts from many journals matched the criteria. Due to our limitation to get all of those articles, finally, 8 articles from Plastic and Reconstructive Surgery became the resources of this paper. The overall success rate in terms of flap viability is 98% (525 from 535 flaps with partial necrosis is as low as 2.2% (12 from 535 flaps. Thinning procedure is commonly applied with regards of the thin flap needed. The recipient sites from 8 articles varies and can be any part of the body includes facial, neck, pharyngoesophagus, breast, upper and lower extremity. Four out of 8 papers mentioned functional evaluation and all stated satisfactory to excellent outcome. There are also 4 papers mentioning the aesthetic evaluation. Overall evaluation was mentioned as good to excellent. It is concluded that free anterolateral thigh perforator flap is a well established choice in most soft tissue reconstruction. It can be indicated to any area needed reconstruction especially head and neck

  14. Functional assessment: free thin anterolateral thigh flap versus free radial forearm reconstruction for hemiglossectomy defects

    OpenAIRE

    Lu, Mingxing; Sun, Guowen; Hu, Qingang; Tang, Enyi; Wang, Yujia

    2015-01-01

    Background To compare free thin anterolateral thigh (ALT) flap with free radial forearm (FRF) flap in the reconstruction of hemiglossectomy defects, and to introduce our methods and experience in the tongue reconstruction with free thin ALT flap. Material and Methods The clinicopathologic data of 46 tongue carcinoma cases hospitalized from December 2009 to April 2014 were obtained from Nangjing Stomatological Hospital, Medical School of Nanjing University. All the subjects were evaluated for ...

  15. Functional results of microvascular reconstruction after hemiglossectomy: free anterolateral thigh flap versus free forearm flap

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    TARSITANO, A.; VIETTI, M.V.; Cipriani, R; MARCHETTI, C.

    2013-01-01

    SUMMARY The aim of the present study is to assess functional outcomes after hemiglossectomy and microvascular reconstruction. Twenty-six patients underwent primary tongue microvascular reconstruction after hemiglossectomy. Twelve patients were reconstructed using a free radial forearm flap and 14 with an anterolateral thigh flap. Speech intelligibility, swallowing capacity and quality of life scores were assessed. Factors such as tumour extension, surgical resection and adjuvant radiotherapy ...

  16. 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.

  17. Inverse relationship of the anterolateral and anteromedial thigh flap perforator anatomy.

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    Yu, Peirong

    2014-09-01

    When anterolateral thigh (ALT) perforators are inadequate, exploration of the contralateral thigh or a new flap may be required. If the anteromedial thigh (AMT) perforators were useable in these instances, harvest could proceed from a single donor site. The purposes of this study were to define the AMT perforator anatomy and examine the relationships between the AMT and ALT perforators. A total of 100 consecutive thighs were explored. The ALT and AMT perforator size and number were documented. The relationship between ALT and AMT size and number was examined using Fisher exact test, logistic regression, and linear regression. The main blood supply to the AMT flap was the rectus femoris branch (RFB) off the descending branch of the lateral circumflex femoris artery. AMT perforators were only present in 51% of the thighs and most likely a single perforator near the midpoint and 3.2 cm medial to the line connecting the anterior superior iliac spine and the patella (perforator B location). Patients with one or fewer ALT perforators had fourfold increased chance of an AMT perforator. Patients with small or no ALT perforators usually had a large AMT perforator. After assigning numeric values to perforators based on size, lower ALT perforator scores were significantly related to higher AMT scores. The RFB is the main vascular pedicle of the AMT flap. There is an inverse relationship between size and number of ALT and AMT perforators: when ALT perforators are inadequate, AMT perforators are typically useable. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  18. Microvascular free tissue transfer for tongue reconstruction after hemiglossectomy: a functional assessment of radial forearm versus anterolateral thigh flap.

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    de Vicente, Juan Carlos; de Villalaín, Lucas; Torre, Aintzane; Peña, Ignacio

    2008-11-01

    The purpose of this study was to evaluate tongue function and donor site morbidity in patients with oral cancer surgically treated and reconstructed with radial or anterolateral thigh free flaps. Twenty patients underwent primary reconstruction after hemiglossectomy between January 2002 and June 2004. Ten patients were reconstructed using a free forearm flap and the remaining with an anterolateral thigh flap. Eight patients on each group underwent postoperative radiotherapy (average, 60 Gy). All of them were followed postoperatively to determine after 6 months their functional outcome as it related to speech, deglutition, tongue mobility, and donor site morbidity. The intelligibility, deglutition, and tongue mobility were each scored on a scale ranging from 1 to 7 by an independent investigator. Data were analyzed by the 2-tail Mann-Whitney U test. No differences in mean speech intelligibility, tongue mobility, or deglutition mean scores were seen between radial forearm flap and anterolateral thigh flap (P > .05). In all anterolateral thigh flap-treated cases, the donor site was closed directly and no complications were seen. However, in all forearm flaps donor site closure was carried out with skin grafts and dorsal forearm splinting was applied for 1 week postoperatively. In 4 cases a partial skin graft failure was observed and donor sites healed for second intention. Anterolateral thigh flap, with its versatility in design, long pedicle with a suitable vessel diameter, and low donor site morbidity, could be the ideal flap for hemiglossectomy defect reconstruction.

  19. Radial forearm versus anterolateral thigh flap reconstruction after hemiglossectomy: functional assessment of swallowing and speech.

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    Hsiao, Hung-Tao; Leu, Yi-Shing; Liu, Chung-Ji; Tung, Kwang-Yi; Lin, Chang-Ching

    2008-02-01

    The authors retrospectively compared the results of postoperative speech and swallowing in patients who had undergone hemiglossectomy for carcinoma of the anterior tongue. Immediate reconstruction in 16 patients was with a free radial forearm flap and in another 16 with an anterolateral thigh flap. Clinical speech pathology evaluation included the Fletcher time-to-time maximum syllable repetition rate, multiple rhyme test, and overall quality and intelligibility of the patients' speech. Evaluation of swallowing included deglutition duration, bolus volume, and ingestion rate. The functional results with both flaps were adequate, and the two groups did not differ significantly between each other for either speech or swallowing.

  20. 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.

  1. Versatility of the Anterolateral Thigh Free Flap: The Four Seasons Flap

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    Di Candia, Michele; Lie, Kwok; Kumiponjera, Devor; Simcock, Jeremy; Cormack, George C.; Malata, Charles M.

    2012-01-01

    Presented at the following academic meetings: ○ 56th Meeting of the Italian Society of Plastic, Reconstructive and Aesthetic Surgery (SICPRE) Fasano (Brindisi), Italy, September 26-29, 2007 ○ 42nd Meeting of the European Society for Surgical Research (ESSR), Warsaw, Poland, May 21-24, 2008 ○ Winter Meeting, British Association of Plastic, Reconstructive and Aesthetic Surgeons, (BAPRAS) London, December 1-3, 2009 Background: The anterolateral free flap has become increasingly popular at our institution year on year. We decided to review our experience with this flap and study the reasons for this trend. Methods: A retrospective review of all anterolateral thigh free flaps performed at Addenbrooke's University Hospital from the available charts was carried out. This chart review included patients' demographics, indications, flap size, recipient vessels used, ischemia time, flap, and donor site outcomes. All flap perforator vessels were located preoperatively using a handheld Doppler ultrasound probe. Results: From October 1999 to December 2008, 55 anterolateral thigh flaps were performed in 55 patients to reconstruct a variety of soft-tissue defects (upper and lower limbs, chest wall, skull base, head and neck). Flap size ranged 12 to 35 cm in length and 4 to 11 cm in width. During flap elevation, the main supply to the flap was found to be a direct septocutaneous perforator in 41% (n = 23) of the cases as opposed to a musculocutaneous perforator, which was found in 59% (n = 32). The mean ischemia time was 82 minutes (range, 62-103). The overall flap success rate was 100%. Two flaps were successfully salvaged after reexploration for venous congestion. The donor site morbidity was minimal. The mean follow-up time was 18 months (range, 2-48). Discussion and Conclusion: The anterolateral thigh free flap was found to be a very reliable flap (100% success) across a wide range of clinical indications. It facilitates microvascular anastomoses as evidenced by the short

  2. A rare case of aberrant quadriceps muscle anatomy preventing anterolateral thigh flap harvest

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    Eugene Omakobia

    2016-03-01

    Full Text Available The anterolateral thigh (ALT flap is now widely established as a versatile flap which can provide ample amounts of skin, muscle and fascia to construct a variety of defects following major head and neck surgery. However, its use remains cautious due to well documented variations in its vascular anatomy for which this flap is notorious. What is less well known is the effect of variations in quadriceps muscle anatomy on the success of flap harvest. Here, we report a unique case in which fusion of the vastus intermedius (V.I and vastus lateralis (V.L muscles precluded ALT flap harvest. We also advise on appropriate management should similar cases be encountered. To our knowledge this is the first reported case of its kind in the English language literature.

  3. Reconstruction of lateral forefoot using reversed medial plantar flap with free anterolateral thigh flap.

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    Fujioka, Masaki; Hayashida, Kenji; Senju, Chikako

    2014-01-01

    Skin defects of the heel have frequently been reconstructed using the medial plantar flap; however, forefoot coverage has remained a challenge, because the alternatives for flap coverage have been very limited. We describe a case of malignant melanoma on the lateral forefoot that was radically removed and reconstructed successfully with a distally based medial plantar flap, together with a free anterolateral thigh flap. The advantages of this flap include that it does not reduce the vascular supply to the foot owing to reconstruction of the medial plantar vascular systems, reduces the risk of flap congestion, minimizes donor site morbidity, and enables the transport of structurally similar tissues to the plantar forefoot. We believe this technique is a reasonable reconstructive option for large lateral plantar forefoot defects.

  4. Combined index finger pollicization with an anterolateral thigh flap for thumb reconstruction

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    Yu Guang; Xu Hongyan; Lei Hongyu; Guo Shuang; Huang Jianhua; Li Dibin

    2014-01-01

    A severe crush injury to the hand is devastating to patients. Under conditions in which the crush force is too great, the digits are not viable candidates for replantation. We present two cases in which the patients suffered from loss of the thumb ray at the first carpometacarpal joint and skin defect at the radial side. The tendons, radial nerve and metacarpal bone of the index finger were injured, and the second metacarpal head was retained. There was a comminuted fracture of the trapezium in both patients. The treatment protocols consisted of the index finger pollicization and the free anterolateral thigh flap transfer. The procedure was performed in a single operation. The new thumb is able to provide a stable post for pinch and grip after six months follow-up. Both patients were satisfied with the function and appearance of the reconstructed thumb.

  5. [Resurfacing of an ischial and trochanteric recurrent pressure sore by a pedicled fasciocutaneous anterolateral thigh flap].

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    Moullot, P; Philandrianos, C; Casanova, D

    2014-10-01

    Ischial pressure sores, common in paraplegic patient, are the most difficult to treat, and poor prognosis associated with a high rate of postoperative recurrence. Many surgical techniques by muscular or myocutaneous flap coverage have been described. We report an original use of a fasciocutaneous pedicled anterolateral thigh (ALTp) flap for coverage of an ischial pressure sore combined with a trochanteric pressure sore, exceeded beyond any conventional therapeutic solution. A 45-year-old paraplegic patient suffered from a trochanteric and ischial pressure sore, which had already received coverage by a muscular flap of biceps femoris and gluteus maximus. At 1 year, the result is satisfactory, with good coverage without recurrence. The fasciocutaneous ALTp flap can be a solution to cover recurrent ischial pressure sores beyond conventional methods. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  6. Functional assessment: Free thin anterolateral thigh flap versus free radial forearm reconstruction for hemiglossectomy defects.

    Science.gov (United States)

    Lu, Mingxing; Sun, Guowen; Hu, Qingang; Tang, Enyi; Wang, Yujia

    2015-11-01

    To compare free thin anterolateral thigh (ALT) flap with free radial forearm (FRF) flap in the reconstruction of hemiglossectomy defects, and to introduce our methods and experience in the tongue reconstruction with free thin ALT flap. The clinicopathologic data of 46 tongue carcinoma cases hospitalized from December 2009 to April 2014 were obtained from Nangjing Stomatological Hospital, Medical School of Nanjing University. All the subjects were evaluated for the articulation and the swallowing function 3 months after the surgery. Among these 46 patients, 12 patients underwent tongue reconstruction after hemiglossectomy with ALT flap; 34 patients underwent tongue reconstruction with FRF flap. The differences in the incidence of vascular crisis, the speech and the swallowing function between two groups were not significant (P > 0.05). Thin ALT flap could be one of the ideal flaps for hemiglossectomy defect reconstruction with its versatility in design, long pedicle with a suitable vessel diameter, and the neglectable donor site morbidity.

  7. Treatment of degloving injury of three fingers with an anterolateral thigh flap

    Institute of Scientific and Technical Information of China (English)

    YU Guang; LEI Hong-yu; GUO Shuang; YU Hao; HUANG Jian-hua

    2011-01-01

    The degloving injuries of the digits and palm remain a persistent challenge. We used an anterolateral thigh flap to treat an 18-year-old, right-handed male worker with degloving injuries of the index, middle and ring fingers. The flap was designated to wrap the entire circumference of three fingers sustaining degloving injury and to form mitten-hand. The total lengths of the distal phalanxes of three fingers were retained almost complete. The donor defect was covered with split-thickness skin graft. Three months after the first operation, roentgenograms revealed terminal phalanxex resorption in three injured fingers, and the surgical syndactyly between the middle and ring finger was separated at the same time. One month later, the syndactyly between the index and middle fingers was also separated. Good coverage of the soft tissue defects with good function and appearance was achieved. Therefore,we considered that the length of the degloved finger could be preserved using free flap.

  8. Reconstruction of Postburn Contracture of the Forefoot Using the Anterolateral Thigh Flap.

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    Lee, Sang Hyun; An, Sung Jin; Kim, Nu Ri; Kim, Um Ji; Kim, Jeung Il

    2016-12-01

    Severe forefoot deformities, particularly those involving the dorsum of the foot, cause inconvenience in daily activities of living including moderate pain on the dorsal aspect of the contracted foot while walking and difficulty in wearing nonsupportive shoes due to toe contractures. This paper presents clinical results of reconstruction of severe forefoot deformity using the anterolateral thigh (ALT) free flap. Severe forefoot deformities were reconstructed using ALT flaps in 7 patients (8 cases) between March 2012 and December 2015. The mean contracture duration was 28.6 years. All the flaps survived completely. The size of the flaps ranged from 8 cm × 5 cm to 19 cm × 8 cm. The mean follow-up period was 10 months (range, 7 to 15 months). There was no specific complication at both the recipient and donor sites. There was one case where the toe contracture could not be completely treated after surgery. All of the patients were able to wear shoes and walk without pain. Also, the patients were highly satisfied with cosmetic results. The ALT flap may be considered ideal for the treatment of severe forefoot deformity.

  9. Lower Extremity Reconstruction Using Vastus Lateralis Myocutaneous Flap versus Anterolateral Thigh Fasciocutaneous Flap

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    Min Jae Lee

    2012-07-01

    Full Text Available BackgroundThe anterolateral thigh (ALT perforator flap has become a popular option for treating soft tissue defects of lower extremity reconstruction and can be combined with a segment of the vastus lateralis muscle. We present a comparison of the use of the ALT fasciocutaneous (ALT-FC and myocutaneous flaps.MethodsWe retrospectively reviewed patients in whom free-tissue transfer was performed between 2005 and 2011 for the reconstruction of lower extremity soft-tissue defects. Twenty-four patients were divided into two groups: reconstruction using an ALT-FC flap (12 cases and reconstruction using a vastus lateralis myocutaneous (VL-MC flap (12 cases. Postoperative complications, functional results, cosmetic results, and donor-site morbidities were studied.ResultsComplete flap survival was 100% in both groups. A flap complication was noted in one case (marginal dehiscence of the ALT-FC group, and no complications were noted in the VL-MC group. In both groups, one case of partial skin graft loss occurred at the donor site, and debulking surgeries were needed for two cases. There were no significant differences in the mean scores for either functional or cosmetic outcomes in either group.ConclusionsThe VL-MC flap is able to fill occasional dead space and has comparable survival rates to ALT-FC with minimal donor-site morbidity. Additionally, the VL-MC flap is easily elevated without myocutaneous perforator injury.

  10. Lower Extremity Reconstruction Using Vastus Lateralis Myocutaneous Flap versus Anterolateral Thigh Fasciocutaneous Flap

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    Min Jae Lee

    2012-07-01

    Full Text Available Background The anterolateral thigh (ALT perforator flap has become a popular option fortreating soft tissue defects of lower extremity reconstruction and can be combined witha segment of the vastus lateralis muscle. We present a comparison of the use of the ALTfasciocutaneous (ALT-FC and myocutaneous flaps.Methods We retrospectively reviewed patients in whom free-tissue transfer was performedbetween 2005 and 2011 for the reconstruction of lower extremity soft-tissue defects. Twentyfourpatients were divided into two groups: reconstruction using an ALT-FC flap (12 cases andreconstruction using a vastus lateralis myocutaneous (VL-MC flap (12 cases. Postoperativecomplications, functional results, cosmetic results, and donor-site morbidities were studied.Results Complete flap survival was 100% in both groups. A flap complication was noted inone case (marginal dehiscence of the ALT-FC group, and no complications were noted in theVL-MC group. In both groups, one case of partial skin graft loss occurred at the donor site,and debulking surgeries were needed for two cases. There were no significant differences inthe mean scores for either functional or cosmetic outcomes in either group.Conclusions The VL-MC flap is able to fill occasional dead space and has comparable survivalrates to ALT-FC with minimal donor-site morbidity. Additionally, the VL-MC flap is easily elevatedwithout myocutaneous perforator injury.

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

    Science.gov (United States)

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

    2016-02-01

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

  12. The Value of the "Papillon" Anterolateral Thigh Flap for Total Pharyngolaryngectomy Reconstruction: A Retrospective Case Series.

    Science.gov (United States)

    Ghazali, Naseem; Hanna, Todd C; Dyalram, Donita; Lubek, Joshua E

    2016-02-01

    The tubed, buried anterolateral thigh (ALT) flap is a popular reconstruction method for total pharyngolaryngectomy defects. The "papillon"-designed ALT flap, described by Hayden et al, offers an alternative method of using the ALT flap in this situation. We report our early experience with the papillon ALT flap in a patient cohort. On retrospective review, all patients who underwent reconstruction of circumferential total pharyngolaryngectomy defects with the papillon ALT flap from February 2012 to February 2015 were identified from our departmental database. Demographic and clinical data, operative details, and complications were analyzed from the records. Seven patients were included in this study. The mean length of hospital stay was 15 days (range, 10 to 32 days). Acute complications occurred in 5 of 7 patients, namely, partial flap loss managed by a pectoralis flap (1 of 7 [14%]); an early pharyngocutaneous fistula (4 of 7 [57%]) managed by simple repair, wound packing, or delayed repair; and a donor-site hematoma (1 of 7 [14%]). At follow-up (range, 2 to 24 months), there was 1 stricture formation, but no chronic fistula. All patients were able to swallow orally. Early results using the papillon ALT flap suggest that this technique is a viable alternative to the standard tubed ALT flap design. The advantages of this design include the following: 1) it offers simultaneous vascularized skin to resurface anterior neck skin deficiency without resorting to additional tissue elsewhere; 2) direct monitoring of the ALT flap is possible; and 3) any pharyngocutaneous fistula is exteriorized to the surface without compromising the internal neck structures and can be easily identified and repaired directly in the office. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  13. An ideal and versatile material for soft-tissue coverage: experiences with most modifications of the anterolateral thigh flap.

    Science.gov (United States)

    Ozkan, Omer; Coşkunfirat, O Koray; Ozgentaş, H Ege

    2004-07-01

    Free anterolateral thigh flaps are a popular flap used for the reconstruction of various soft-tissue defects. From April, 2002 to June, 2003, 32 free anterolateral thigh flaps were used to reconstruct soft-tissue defects. Twenty-three of these flaps were used for lower extremity reconstruction, and nine were used for head and neck reconstruction. There were 24 male and eight female patients, with ages between nine and 82 years. The size of the flaps ranged from 11 to 32 cm in length and 6 to 18 cm in width. Five flaps required reoperation for vascular compromise in four patients and for twisting of the pedicle in another patient. While four of these were salvaged, one flap was lost due to recipient vessel problems. Musculocutaneous perforators were found in 23 cases, and septocutaneous perforators were found in nine cases. In four cases, thinning of the flap was performed. The flap was used as a flow-through type for lower extremity reconstruction in three patients. In two patients, the flap was used as a neurosensory type for foot reconstruction. Eighteen cases underwent split-thickness skin grafting of the donor site and, in the remaining cases, the donor sites were closed primarily. In three patients, the donor areas required a partial skin regrafting procedure. No infections or hematomas were observed. Despite some variations in its vascular anatomy, the anterolateral thigh flap offers the following advantages: 1) it has a long and large-caliber vascular pedicle; 2) it has a wide, reliable skin paddle; 3) it may be harvested as a neurosensory flap; 4) it can be harvested whether its pedicle is septocutaneous or musculocutaneous; 5) it can be designed as a flow-through flap; 6) it can be elevated as a thin or musculocutaneous flap; and 7) the procedure can be performed by two teams working simultaneously, and no positional changes are required.

  14. Anterolateral thigh free flap for simultaneous reconstruction of digital extensor tendon and defect of the dorsal hand: A case report

    Institute of Scientific and Technical Information of China (English)

    Man-Yi Cui; Hui Shen

    2016-01-01

    This paper describes a new technique in the repair of the hand defect with digital extensor tendon injury.The anterolateral thigh flap with the thick femoral fascia has been used in the reconstruction of the composite defect of the dorsal hand,especially the defect of tendon.This technique requires short period of treatment and hence causes less damage to the donor site but shows a better recovery of the hand function.A favorable curative effect has been obtained in this patient.

  15. The combined free partial vastus lateralis with anterolateral thigh perforator flap reconstruction of extensive composite defects.

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    Posch, N A S; Mureau, M A M; Flood, S J; Hofer, S O P

    2005-12-01

    Myocutaneous (MC) free flaps are useful for many reconstructive indications. Perforator flaps have become standard of care. The anterolateral thigh flap (ALT) donor site is popular. With the ALT flap varying sizes of vastus lateralis (VL) muscle can be harvested as a MC flap. The skin islands of these flaps have a great range of freedom when dissected on their perforator. It was hypothesised that the VL-ALT perforator flap would offer adequate tissue volume combining maximal freedom in planning with minimal donor site morbidity. From November 2001 to February 2003 a free partial VL with ALT perforator flap was used in 11 patients to reconstruct large defects. Indications for adding a muscular component were exposed bone, skull base, (artificial) dura, or osteosynthesis material, open sinuses, and lack of muscular bulk. Flaps were planned as standard ALT flaps, after which three types of dissection were performed: I. true MC flap; II. muscle flap with a skin island on one perforator, which could be rotated up to 180 degrees ; III. chimera skin perforator flap with muscle being harvested on a separate branch from the source vessel or on a side branch of the skin perforator. Mean skin size of the MC-ALT flaps was 131 cm2. Mean muscle part size of the MC-ALT flaps was 268 cm3. Muscular parts were custom designed for all defects. No total or partial flap failures were seen. Colour mismatch was seen in 6 of 8 patients, when skin was used in the facial area in this all white population. Excessive flap bulk was found in 8 of 11 patients at 6 weeks, however, only in 2 of 11 patients after 6 months. Patients were satisfied with the functional result (8 of 11 patients) as well as the cosmetic result of their reconstruction (7 of 11 patients). All less satisfied patients had received their flap for external facial skin reconstruction. Donor site morbidity was minimal. The combined free partial VL with ALT perforator flap proved valuable as a (chimera type) MC flap with maximal

  16. 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.

  17. Extended anterolateral thigh pedicled flap for reconstruction of trochanteric and gluteal defects: A new & innovative approach for reconstruction

    Institute of Scientific and Technical Information of China (English)

    G.I.Nambi; Abhijeet Ashok Salunke; Szeryn Chung; K.S.Raj Kumar; Vikram Anil Chaudhari; Anant Dattaray Dhanwate

    2016-01-01

    Descending branch of the lateral circumflex femoral artery (LCFA) is commonly used pedicle for anterolateral thigh (ALT) flap.Oblique branch of LCFA is an alternative pedicle that can be used in microvascular surgery.According to review of literature and to the best of our knowledge we could not find the use of oblique branch of LCFA as a pedicle of the ALT flap in regional soft tissue reconstruction.Here we presented a case of a 55-year-old man sustaining soft tissue injury and wound over the left trochanteric and gluteal region following a road traffic accident,who was treated by the use of extended ALT pedicle flap with oblique branch of LCFA as the pedicle for reconstruction of soft tissue defect in trochanteric and gluteal regions with successful outcome.

  18. 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.

  19. Versatility of the Anterolateral Thigh Free Flap: The Four Seasons Flap

    OpenAIRE

    Di Candia, Michele; Lie, Kwok; Kumiponjera, Devor; Simcock, Jeremy; Cormack, George C.; Charles M. Malata

    2012-01-01

    Presented at the following academic meetings: ○ 56th Meeting of the Italian Society of Plastic, Reconstructive and Aesthetic Surgery (SICPRE) Fasano (Brindisi), Italy, September 26-29, 2007 ○ 42nd Meeting of the European Society for Surgical Research (ESSR), Warsaw, Poland, May 21-24, 2008 ○ Winter Meeting, British Association of Plastic, Reconstructive and Aesthetic Surgeons, (BAPRAS) London, December 1-3, 2009 Background: The anterolateral free flap has become increasingly popular at our in...

  20. Assessment of quality of life of patients with oral cavity cancer who have had defects reconstructed with free anterolateral thigh perforator flaps.

    Science.gov (United States)

    Li, Wenlu; Yang, Yanjie; Xu, Zhongfei; Liu, Fayu; Cheng, Yusheng; Xu, Lei; Sun, Changfu

    2013-09-01

    The aim of this study was to evaluate quality of life (QoL) in patients who have had resections of oral cancer and reconstruction by free anterolateral thigh perforator flaps. QoL was assessed by the 14-item Oral Health Impact Profile (OHIP-14) and the University of Washington Quality of Life (UW-QoL) questionnaires 12 months postoperatively. Fifty-one of the 69 questionnaires were returned (74%). In the UW-QoL the best-scoring domain was pain, whereas the lowest scores were for chewing, saliva, and taste. In the OHIP-14 the lowest-scoring domain was handicap, followed by psychological disability, and social disability. Free anterolateral thigh perforator flaps for reconstruction of defects of the head and neck after resection for cancer significantly influenced the patients' quality of life. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Use of the Fix and Flap Approach to Complex Open Elbow Injury: The Role of the Free Anterolateral Thigh Flap

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    Christopher Hoe-Kong Chui

    2012-03-01

    Full Text Available Background Complex elbow injuries with associated nerve, muscle, or joint injury commonlydevelop post-inury stiffness. In order to preserve function, joint congruency, elbow stabilityand durable wound coverage must be achieved in a timely manner.Methods A retrospective review of patients who underwent orthopaedic fixation followedby free anterolateral thigh (ALT flap soft tissue coverage was performed. Five patients wereidentified and included in this study.Results We present a series of 5 cases managed with this principle. Soft tissue defects rangedin size from 4×9 cm (36 cm2 to 15×30 cm (450 cm2 and were located either posteriorly(n=4 or anteriorly (n=1. Associated injuries included open fractures (n=3 and motor nervetransection (n=2. Wound coverage was achieved in a mean duration of 18.8 days (range, 11to 42 day. There were no flap failures and no major complications. The mean postoperativeactive elbow motion was 102° (range, 45° to 140°.Conclusions In our small series we have highlighted the safety and utility of using the freeALT flap in complex elbow injuries. The ALT flap has many advantages which include abundantskin and subcutaneous tissue; vascularised vastus lateralis muscle that was used in our seriesto obliterate dead space, provide a vascular bed for nerve grafts and combat infection; and,access to fascia lata grafts for reconstruction of the triceps tendon.

  2. Treatment of Radial Nonunion with Corticocancellous Bone Graft and Fascia of Anterolateral Thigh Free Flap: The Wrap Technique

    Science.gov (United States)

    Ronga, Mario; Sallam, Davide; Fagetti, Alessandro; Valdatta, Luigi; Cherubino, Paolo

    2016-01-01

    Summary: The management of nonunion of the forearm bones is a challenging task. Multiple factors have been associated with the establishment of forearm nonunion, such as the fracture position and complexity, general condition of the patient, and the previously utilized surgical technique. The optimal surgical treatment of a bone gap remains a subject of discussion. Autogenous corticocancellous bone grafts and vascularized bone flaps have been used with differing results. The authors describe a technique for the treatment of posttraumatic nonunion of the radius with a 5-cm bone gap using the free anterolateral thigh fascial flap wrapped around a tricortical iliac bone graft. The fracture healed after 5 weeks. The use of a vascularized tissue wrapped around the bone graft resulted in a well-healed bone and no signs of resorption after 2 years of follow-up. A bone graft wrapped by a fascial flap could magnify the restorative effect on the bone defect because of its dual role of constructing vascularization and inducing tissue regeneration.

  3. Vascularized free forearm flap versus free anterolateral thigh perforator flaps for reconstruction in patients with head and neck cancer: assessment of quality of life.

    Science.gov (United States)

    Li, Wenlu; Xu, Zhongfei; Liu, Fayu; Huang, Shaohui; Dai, Wei; Sun, Changfu

    2013-12-01

    This study investigated the quality of life of Chinese patients with malignant tumors who had undergone immediate free flap reconstruction surgery. In addition, we compared 2 groups of patients: those who had received radial forearm free flap surgery and others who had received free anterolateral thigh perforator flap surgery. Quality of life was assessed using the Medical Outcomes Study-Short Form-36 (MOS SF-36) and the University of Washington Quality of Life (UW-QOL) questionnaires 12 months after reconstruction. A total of 121 of 163 questionnaires were returned (74.2%). There were significant differences between the 2 groups in the T classification (p free anterolateral thigh perforator flaps performed better in the appearance and shoulder domains, and the role emotion and social functioning domains. Using either radial forearm free flaps or free anterolateral thigh perforator flaps for reconstruction of head and neck defects after cancer resection significantly influences a patient's quality of life. Copyright © 2013 Wiley Periodicals, Inc., A Wiley Company.

  4. Comparison of morbidity after reconstruction of tongue defects with an anterolateral thigh cutaneous flap compared with a radial forearm free-flap: a meta-analysis.

    Science.gov (United States)

    Chen, H; Zhou, N; Huang, X; Song, S

    2016-12-01

    Currently the radial forearm fasciocutaneous flap and the anterolateral thigh flap are among the most popular free flaps used for reconstruction of oral soft tissue. However, there is controversy about their efficacy after reconstruction of tongue defects because of their respective intrinsic properties, so we have compared them in reconstruction of tongue defects using meta-analysis. We conducted a search in Pubmed, EMBASE, OVID, Science Direct, the Cochrane Library, and Chinese National Knowledge Infrastructure, which covered all papers published before January 2015. Twelve clinical papers, that included 366 patients with 198 radial forearm flaps and 168 anterolateral flaps, met the criteria. Relevant data were extracted and analysed using systematic meta-analyses. The results showed that the incidence of localised numbness at the donor site of the radial forearm flap postoperatively was significantly higher and satisfaction with the appearance of the donor site significantly lower than in the anterolateral thigh group. There were no differences in flap survival, incidence of vascular crises in the flap, complications, satisfaction with the appearance of the tongue, or the postoperative clarity of speech and swallowing ability. Results suggested that the anterolateral thigh flap is the ideal soft tissue flap for reconstructing defects in the tongue, as there was minimal numbness at the donor site and patients were much more satisfied. Further research is needed to address details of the site and the extent of surgical defects as well as the relations between dissection of the radial flap and repair of the skin graft. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Perforator-to-perforator musculocutaneous anterolateral thigh flap for reconstruction of a lumbosacral defect using the lumbar artery perforator as recipient vessel.

    Science.gov (United States)

    Mureau, Marc A M; Hofer, Stefan O P

    2008-05-01

    Reconstruction of large-sized lumbosacral or sacral defects often is not possible using local or regional flaps, making the use of free flaps necessary. However, the difficulty of any microsurgical procedure in this region is complicated by the need to search for potential recipient vessels to revascularize the flap. In the present case, a free musculocutaneous anterolateral thigh flap to cover a large-sized and deep lumbosacral defect was used. Arterial anastomosis was performed, connecting the cutaneous anterolateral thigh (ALT) perforator to the perforator of the second lumbar artery. In this fashion, the arterial circulation through the flap was flowing reversely through the muscle. The concomitant vein of the descending branch of the lateral circumflex femoral artery was hooked up to the thoracodorsal vein using a long interposition vein graft because the perforator of the second lumbar vein was too small. Postoperative healing was uneventful. In conclusion, a successful reconstruction of a lumbar defect has shown that local perforators in the lumbar area may be accessible for easier perforator-to-perforator anastomoses and that the muscular part of the musculocutaneous ALT flap can survive on retrograde arterial perfusion from a perforator of the skin island.

  6. Colgajo anterolateral del muslo: anatomía quirúrgica, técnica de disección y aplicaciones clínicas Anterolateral thigh flap: surgical anatomy, dissection technique and clinical applications

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    J. Masià

    2006-12-01

    Full Text Available El colgajo anterolateral de muslo, basado en perforantes de la rama descendente de la arteria circunfleja femoral lateral, es un colgajo idóneo para la reconstrucción de partes blandas de pequeño y mediano tamaño. En el Hospital de la Santa Creu i Sant Pau de Barcelona (España, éste colgajo ha sido ampliamente utilizado desde el año 2000 para defectos de partes blandas sobre todo en reconstrucción de cabeza y cuello y también en la reconstrucción de extremidad inferior. Este artículo trata de revisar los aspectos más importantes del colgajo, su anatomía, las técnicas de disección quirúrgica, desde su diseño sobre el paciente hasta el proceso de elevación del colgajo, las modificaciones que se le pueden realizar para optimizar sus propiedades y sus diversas aplicaciones, sin olvidar un análisis detallado de sus ventajas e inconvenientes.The anterolateral thigh flap, based on the perfora tors of the descending branch of the lateral femoral circumflex artery, is an ideal soft tissue flap. From 2000 year, in Hospital de la Santa Creu i Sant Pau in Barcelona (Spain, this flap have become the wor khorse in soft tissue reconstruction, it is very useful in head and neck reconstruction and lower limb reconstruction. Its versatility, long and large pedicle, and minimal donor site morbidity are the main advantages. In this paper we are going to review the surgical anatomy and, step by step, all the technique for safe harvesting and transfer.

  7. Aesthetic Multiple-Toe Reconstruction With Combined Iliac Bone Graft and Wraparound Free Anterolateral Thigh Flap-A Case Report and Literature Review.

    Science.gov (United States)

    Kwon, Soo-Ha; Lao, William; Yen, Cheng-I; Lin, Yu-Te; Wu, Katie Pei-Hsuan; Chang, Tommy Nai-Jen

    2017-03-01

    Compared with upper extremity injuries, toe amputations and their replantations are rare because of the difficulty of their relatively thinner soft tissue envelope. Consequently, fewer reconstructive options are available for toes and they are rarely reported in the literature. In this study, we reported a case of right third to fifth toe amputations and their subsequent reconstruction with iliac bone grafts and a free anterolateral thigh flap. After serial debulking and division procedures, 3 toes were divided successfully. Ten months after the initial operation, the patient regained pain-free functional ambulation despite some bone resorption noted on follow-up radiographs. The patient showed high satisfaction on her new toes in terms of aesthetical and functional outcomes. She was able to stand for over 30 minutes without pain. At the 2-year follow-up, the Foot Function Index was 18.3%. Although toe reconstruction is frequently considered unnecessary because of its relative high demand of surgical techniques and little gain on gait; nonetheless, in selected cases, toe reconstruction may still be beneficial if the metatarsophalangeal joints were intact and there is a strong individual desire for aesthetical restoration.

  8. Repair of a soft tissue defect of medial malleolus with cross-leg bridge free transfer of anterolateral thigh muscle flap: a case report

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    ZHANG Gong-lin

    2012-11-01

    Full Text Available 【Abstract】A 38-year-old man sustained a traffic accident injury to his right medial malleolus and leg. It was an open fracture of the right tibia and fibula accompanied by a large soft tissue defect of the right medial malleolus sized 12 cm×4 cm. Doppler examination revealed that the tibialis posterior vessel was occluded due to thrombosis. The anterior tibial artery was patent. Three weeks after injury, the left anterolateral thigh muscle flap was harvested and transplanted to the right medial malleolus defect area for repair of the soft tissue defect, and an end-to-side anasto-mosis was performed between the posterior tibial vessel of the contralateral leg and the muscle flap’s vascular pedicle. A split thickness free skin graft was used to cover the muscle flap and around the flap’s vascular pedicle. The vascular pedicle was cut off after 28 days and the muscle flap sur-vived completely. After 3-year follow-up postoperatively, the right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery of contralateral leg was patent by clinical and Doppler examinations. This tech-nique can be used to preserve the flow and patency of re-cipient arteries. Key words: Surgical flaps; Soft tissue injuries; Leg injuries; Wound healing

  9. [Assessment of life quality of for patients after tongue reconstruction with radial forearm free flap, anterolateral thigh perforator flap or submental island flap].

    Science.gov (United States)

    Zhao, Yang; Xiang, Jing-Zhou; Liu, Fa-Yu

    2017-02-01

    The aim of this study was to evaluate operation-related factors and quality of life (QOL) for patients after tongue reconstruction with radial forearm free flap (RFFF), anterolateral thigh perforator flap (ALT) or submental island flap (SIF). Totally 59 patients, diagnosed as tongue carcinoma, received glossectomy and simultaneous reconstruction with free flaps including RFFF, ALT or SIF in the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, China Medical University from October 2004 to October 2014. All patients were followed up for 6 months and completed the University of Washington Quality of Life scale Version 4 questionnaires. The postoperative QOL was compared among the three groups. The data were analyzed using SPSS 21.0 software package. The operation duration of SIF group was significantly shorter than those of RFFF group or ALT group (Pspeech and postoperative pain among the 3 groups. In summary, there may be functional disability for patients after glossectomy and simultaneous reconstruction. The quality of life would be acceptable after tongue reconstruction with RFFF, ALT and SIF.

  10. The effect of early detection of anterolateral thigh free flap crisis on the salvage success rate, based on 10 years of experience and 1072 flaps.

    Science.gov (United States)

    Yang, Q; Ren, Z H; Chickooree, D; Wu, H J; Tan, H Y; Wang, K; He, Z J; Gong, C J; Ram, V; Zhang, S

    2014-09-01

    The aim of this study was to assess the effectiveness of early exploration of anterolateral thigh (ALT) free flap compromise in head and neck reconstruction and to correlate this with the salvage success rate. The perioperative data of 1051 patients with 1072 ALT flap reconstructions were reviewed retrospectively for the period January 2002 to December 2012. Outcome measures included ethnicity, defect type, incidence and timing of flap compromise, type of flap compromise, causes of vascular occlusion, and salvage rate. The success rate of free flap reconstruction was 97.3% (1043/1072). Of the 29 failures, 21 were complete and eight were partial failures (10-40% of the flap). Venous occlusions occurred in 39 flaps (83.0%) and arterial occlusions in five flaps (17.0%). Six cases were detected within 8h postoperatively, 13 at 8-16 h postoperatively, seven at 16-24h postoperatively, and 18 at 24-48 h postoperatively, with respective salvage rates of 66.7%, 61.5%, 28.6%, and 22.2%; three cases detected after 48 h failed. The salvage rate at ≤16 h (62.2%) was much higher than that at >16 h (21.4%, P=0.0039). Early detection, re-exploration, and effective handling of the flap crisis increases the rate of flap salvage tremendously.

  11. Repair of a soft tissue defect of medial malleolus with cross-leg bridge free transfer of anterolateral thigh muscle flap: a case report

    Institute of Scientific and Technical Information of China (English)

    ZHANG Gong-lin; CHEN Ke-ming; ZHANG Jun-hua; WANG Shi-yong

    2012-01-01

    A 38-year-old man sustained a traffic accident injury to his right medial malleolus and leg.It was an open fracture of the right tibia and fibula accompanied by a large soft tissue defect of the right medial malleolus sized 12 cm×4 cm.Doppler examination revealed that the tibialis posterior vessel was occluded due to thrombosis.The anterior tibial artery was patent.Three weeks after injury,the left anterolateral thigh muscle flap was harvested and transplanted to the right medial malleolus defect area for repair of the soft tissue defect,and an end-to-side anastomosis was performed between the posterior tibial vessel of the contralateral leg and the muscle flap's vascular pedicle.A split thickness free skin graft was used to cover the muscle flap and around the flap's vascular pedicle.The vascular pedicle was cut off after 28 days and the muscle flap survived completely.After 3-year follow-up postoperatively,the right tibia and fibula fractures were confirmed healing radiologically.The posterior tibial artery of contralateral leg was patent by clinical and Doppler examinations.This technique can be used to preserve the flow and patency of recipient arteries.

  12. [Outcome of relaying anterolateral thigh perforator flap in resurfacing the donor site wound following free anteromedial thigh perforator flap transfer for reconstruction of defect after oral tumor radical resection].

    Science.gov (United States)

    Song, D J; Li, Z; Zhou, X; Zhang, Y X; Peng, X W; Zhou, B; Lyu, C L; Yang, L C; Peng, W

    2017-02-20

    Objective: To observe the outcome of relaying anterolateral thigh (ALT) perforator flap in resurfacing the donor site wound following free anteromedial thigh (AMT) perforator flap transfer for reconstruction of defect after oral tumor radical resection. Methods: From January 2013 to January 2016, 28 patients with oral tumor underwent radical resection in our hospital, leaving defects with size ranged from 6.5 cm×3.5 cm to 11.0 cm×7.5 cm which were reconstructed by free AMT perforator flaps with size ranged from 7.0 cm×4.0 cm to 12.0 cm×8.0 cm. All the arteries of AMT perforators were anastomosed with superior thyroid arteries, while the venae comitants were anastomosed with superior thyroid venae or internal jugular venae. The donor site wounds of free AMT perforator flaps were reconstructed by relaying ALT perforator flaps with size ranged from 8.0 cm×3.5 cm to 14.0 cm×7.5 cm. The relaying ALT perforator flap and wound edge were closed directly with layer interrupted suture. Postoperatively, the patients stayed in bed and received diet through nasal feeding tube, and the ordinary diet and lower extremity exercise were carried out from one week after operation. Results: The AMT and ALT perforators existed consistently in all patients. In 16 patients the venae comitants of AMT perforator arteries were anastomosed with superior thyroid venae in end-to-end fashion, while in 12 patients with internal jugular venae in end-to-side fashion. All flaps survived uneventfully about 2 weeks after operation, and the wounds healed smoothly. All patients were followed up for 6 to 30 months after operation. The sites repaired with free AMT perforator flaps were not bulky in appearance, with two-point discrimination distances ranged from 8 to 15 mm. The movement of tongue was not obviously affected, and patients could speak and eat normally. The texture and color of the sites repaired with relaying ALT perforator flaps were close to those of the adjacent tissue, and the two

  13. 数字化股前外侧皮瓣的可视技术在临床中的初步应用%Preliminary application of digital visualization of anterolateral thigh flaps in clinic

    Institute of Scientific and Technical Information of China (English)

    任义军; 任高宏; 金丹; 胡罢生; 魏宽海; 徐凯; 张元智; 裴国献

    2008-01-01

    目的 探讨股前外侧皮瓣的三维重建技术在临床中的初步应用. 方法 对需游离股前外侧皮瓣创面修复的8例患者,术前注射造影剂后采用CT或MRI扫描,应用Amira 4.1软件对股前外侧皮瓣结构进行三维重建,构建患者个性化皮瓣.根据三维构建的个性化皮瓣,于患者股部进行股前外侧皮瓣的点、线、面描记,用以指导手术切取.结果 三维重建患者个性化皮瓣8例,所重建个性化股前外侧皮瓣,能够清晰显示血管、皮肤及其毗邻结构的三维关系.其中5例显示皮瓣主要穿支及主干,与术中检查相符;3例显示皮瓣主干血管,但穿支显示不清,术中探查2例最大穿支血管约0.5mm,1例穿支均小于0.3 mm.术后7例皮瓣全部成活,1例皮瓣边缘出现部分坏死. 结论 通过血管造影下肢CT或MRI扫描,采用数字化三维重建技术可以提供股前外侧皮瓣的三维动态解剖,重建皮瓣能够准确指导术中的皮瓣切取.%Objective To introduce three-dimensional reconstruction technique used in clinic for wound repair with anterolateral thigh flaps. Methods Eight patients who needed wound repair with the anterolateral thigh flap underwent CT or MRI scanning preoperatively after injection of contrast medium. Their anterolateral thigh flaps were reconstructed three-dimensionally with Amira 4. 1 software. The points, lines and surface of the actual anterolateral thigh flaps were designed and marked according to their digital three-dimensional reconstruction of the flaps. Results In each of the 8 cases, an individualized anterolateral thigh flap was reconstructed three-dimensionally. The three-dimensional reconstruction could show thethree-dimensional relations of blood vessels, skin and adjacent tissues clearly. In 5 cases, the main stalks and perforating branches were displayed clearly in accord with intraoperative findings. In 3 cases, the main stalks were clearly displayed, but perforating branches not. In 2

  14. Ablation of advanced tongue cancer and mobile tongue reconstruction by using a sensitive anterolateral thigh and vastus lateralis muscle free flap

    National Research Council Canada - National Science Library

    Tuhar; Zamfirescu, D; Gheorghiță, C; Slăvescu, D; Frunză, A; Lascăr, I

    2015-01-01

    .... The anterior lateral thigh flap sensitive myocutaneous (ALTF) with vastus lateralis muscle was used to reconstruct the oral defect in a patient undergoing total glossectomy with laryngeal preservation for T4 tongue cancer...

  15. 带蒂股前外侧皮瓣阴茎再造术的临床应用%The pedicled anterolateral thigh flap for penile reconstruction

    Institute of Scientific and Technical Information of China (English)

    杨喆; 李养群; 唐勇; 赵穆欣; 陈文; 马宁; 王维新

    2015-01-01

    目的 介绍股前外侧皮瓣带蒂转移再造阴茎的手术方法,探讨其临床应用效果及可行性.方法 2011年5月至2014年5月,对12例阴茎缺损的患者,应用股前外侧皮瓣带蒂转移进行阴茎再造术,皮瓣面积为11 cm×11 cm~12 cm×15 cm.8例患者以"管中管"的形式在皮瓣中央设计皮瓣再造尿道,4例应用阴囊中隔瓣再造尿道.一期进行尿道吻接者4例,于阴茎再造6个月后进行二期尿道吻接者8例.结果 12例皮瓣完全成活10例,皮瓣血运不良致再造阴茎全部坏死1例,术后皮瓣部分坏死继发感染1例,上述2例均采用对侧股前外侧皮瓣带蒂转移完成阴茎再造.术后获随访10例,时间为1~4年,平均1.5年,9例患者对再造阴茎外形满意,其中4例已婚者自述能够完成性生活;8例患者排尿功能正常,2例患者发生再造尿道皮肤瘘,于术后6~12个月行局部皮瓣转移尿瘘修补术.结论 应用旋股外侧动脉降支为蒂的股前外侧皮瓣带蒂转移进行阴茎再造,方法相对简单,无需吻合血管,血运可靠,形态满意,供区隐蔽.%Objective To introduce the application of pedicled anterolateral thigh (ALT) flap for total penile reconstruction and to investigate its feasibility and effect.Methods From May 2011 to May 2015,12 male patients presented with absence of the penis or congenital malformation received phalloplasty with the pedicled ALT flap.Of them, the median age was 35 years old (range, 20-57 years).The size of the flaps ranged from 11 cm× 11 cm to 12 cm × 15 cm.8 patients underwent urethra reconstruction with tube-in-tube flaps and other 4 patients with scrotal septal flaps.In this series, we performed one-stage urethral anastomosis in 4 cases and second-stage urethral anastomosis 6 months after the phalloplasty in 8 cases.Results An acceptable reconstructed phallus was achieved in 10 patients.These flaps were primarily healed with satisfactory functional and cosmetic results

  16. Application of anterolateral thigh perforator flap for repair of soft tissue defect of the hand%股前外侧穿支皮瓣修复手部软组织缺损

    Institute of Scientific and Technical Information of China (English)

    张兴奎; 李虎; 夏勇; 王彬; 张桂红; 唐阳平; 苗峰; 丁桂友; 张亮; 董中洋; 郭彬; 马晓辉

    2012-01-01

    目的 探讨应用游离修薄股前外侧穿支皮瓣修复手部软组织缺损的临床效果.方法 对28例手部软组织缺损创面,采用股前外侧皮瓣游离移植修复.术中切取游离皮瓣至仅剩血管蒂相连时,修薄皮瓣,从外周至血管皮支穿出点附近按次序阶梯样修剪,保留穿出点周围1.5~2.0cm组织不予修剪,同时观察皮瓣血供,防止穿支损伤,皮瓣修薄后游离移植修复手部创面.结果 28例皮瓣全部存活.25例获得3~ 12个月的随访,3例失访.术后皮瓣质地柔软,弹性好,无臃肿,肤色接近正常皮肤,恢复部分感觉功能,手功能及外形恢复良好.结论 修薄股前外侧穿支皮瓣是股前外侧皮瓣的改进,皮瓣存活后疗效满意,是修复手部创面的理想方法之一.%Objective To explore the application of free anterohteral thigh perforator flap in repairing soft tissue defects of the hand and evaluate the clinical results.Methods Free anterolateral thigh perforator flap was transferred to repair soft tissue defects of the hand in 28 cases.During flap harvesting trimming of the flap was carried out when the flap was freed and only connected with its vascular pedicle.A step-wise defatting was done from the periphery of the flap towards the vascular pedicle with 1.5 to 2.0 cm tissue around the perforator preserved.Flap circulation was carefully observed to prevent damage to the perforators.The vascular pedicle was then disconnected and the flap transferred to the hand to cover the defect.Results All the 28 flaps survived.Twenty-five cases were follow-up for 3 to 12 months,while 3 cases were lost to follow-up.The flaps were supple and elastic with near normal color.There was no bulkiness.Partial sensation was restored.The function and appearance of the hand were good.Conclusion The thin anterolateral thigh perforator flap is an improvement of the traditional anterolateral thigh flap.The survived flaps are ideal in terms of covering hand defects and

  17. Perforator-based chimeric anterolateral thigh flap for head and neck reconstruction after en bloc resection%股前外侧穿支嵌合皮瓣修复头颈肿瘤根治术后缺损

    Institute of Scientific and Technical Information of China (English)

    徐中飞; 代炜; 张恩礁; 段维轶; 刘法昱; 谭学新; 黄绍辉; 秦兴军; 孙长伏

    2012-01-01

    PURPOSE; To discuss and report the operative techniques for harvesting perforator-based chimeric flap in anterolateral thigh region and the advantages for head and neck reconstruction after en bloc resection. METHODS: A retrospective review was performed of perforator -based chimeric anterolateral thigh (ALT)flap for head and neck reconstruction since December of 2007 to March of 2011. 66 perforator-based chimeric flaps were harvested including a skin paddle and a muscular flap supplied by one mother pedicle-descending branch of lateral circumflex femoral artery(d- LCFA). 32 flaps were used for the mobile tongue and floor of mouth reconstruction, 30 flaps for base of the tongue and parapharyngeal walls, two for the buccal skin, one for hemimandible and one for parotid. The muscular flap were used to eliminate the dead space of submandibular area. Flaps size ranged from 7cmx4cm to 16cmx7cm and muscular flap was 3cm x4cm approximately. The complications and functions of both donor and recipient sites were recorded and the operative techniques of perforator-based chimeric flap elevation were generalized. RESULTS: All 65 flaps survived completely and the total survival percentage was 98.5%. Only one flap failed and was removed 5 days postoperatively. No complications (fistula, infection, hematoma, seroma et al) were observed in recipient and donor sites. Two anteromedial thigh flaps (AMT) were used for reconstruction due to no sizable perforators in the ALT region. All cases were followed up for 0.5-3 years. The flaps didn't atrophy after six months and the contour was satisfactory. The functions of speech and swallow were recovered well. All the donor sites were closed primarily and the scar was not obvious. The leg's function recovered well. CONCLUSIONS: Using a combination of retrograde and antegrade dissection is a safe and versatile method for harvesting a perforator-based chimeric flap. A chimeric flap including multiple components can meet therequirements of

  18. Ⅰ期移植复合股前外侧穿支皮瓣治疗ⅢC型开放性损伤%Primary composite anterolateral thigh perforator flap transfer for treatment of Gustilo type Ⅲ C open fracture

    Institute of Scientific and Technical Information of China (English)

    王欣; 潘佳栋; 黄耀鹏; 周丹亚; 胡瑞斌; 杨科跃; 陈宏; 章伟文

    2014-01-01

    Objective To investigate the procedure techniques and clinical effects for treatment of cases on the brink of amputation with composite anterolateral thigh perforator flap (ALTP) in primary surgery.Methods From July 2008 to December 2012,9 cases on the verge of amputation received primary composite ALTP transfer to perform limb salvage surgery.All cases were Gustilo type Ⅲ C open injuries resulted from traffic accidents which involved upper extremities in 3 cases and lower extremities in 6 cases.Emergent fracture fixation was done for 5 cases; primary external fixation followed by definitive bone grafting was done for 4 cases combined with bone defects.Types of flaps consisted of flow-through ALTPs in 4 cases,chimeric ALTPs in 2 cases,flow-through + chimeric ALTPs in 2 cases,flow-through + chimeric + polyfoliate ALTP in 1 case.Size of flaps ranged from 10 cm × 6 cm-22 cm × 9 cm.Donor sites were closed primarily.Results Limb salvage succeeded for all the 9 cases.Six flaps survived uneventfully,but another 3 flaps developed tension blisters and survived eventually after stitches removing and blood-letting.Postoperative follow-up was 5-36 months.All cases achieved bone union in 4.5-8 months (mean,6.3 months).Conclusion Emergent composite ALTP transfer can not only save the limb,but also reduce the recovery time and complications and contribute to the early recovery of limb function.%目的 探讨急诊Ⅰ期移植复合股前外侧穿支皮瓣(anterolateral thigh perforator flap,ALTP)挽救濒临截肢患者肢体的手术方法与临床疗效. 方法 2008年7月-2012年12月对9例濒临截肢的患者采用Ⅰ期移植复合ALTP进行保肢手术.所有患者均为交通伤所致的GustiloⅢC型开放性损伤.上肢3例,下肢6例,其中急诊行骨折内固定5例,伴骨缺损Ⅰ期予外固定、Ⅱ期行植骨内固定4例.移植单纯桥接动脉型ALTP 4例,单纯嵌合型AL-TP 2例,桥接动脉+嵌合型ALTP 2例,桥接动脉+嵌合+分叶型ALTP 1

  19. 健侧胫后血管皮瓣桥供血的股前外侧游离皮瓣在小腿开放性骨折治疗中的应用%Clinical applications on anterolateral thigh free flap transfer bridged by posterior tibial vascular flaps from the healthy leg

    Institute of Scientific and Technical Information of China (English)

    张大伟; 祝勇刚; 李军; 赵广跃; 裴国献

    2015-01-01

    目的:探讨小腿软组织缺损合并受区血管损伤无法作为供血血管时游离皮瓣移植的解决办法。方法设计以健侧胫后血管为轴心的舌形皮瓣,卷成皮管,作为血管蒂而携带游离皮瓣移植修复,将双下肢固定于平行位置。结果采用健侧胫后血管形成顺行皮管桥携带游离皮瓣移植修复伤肢创面缺损15例,皮瓣全部成活,创面修复。在双下肢固定于平行位置(并腿)的情况下,术后较易进行皮瓣观察、换药和功能锻炼。结论采用并腿方式固定双下肢,以健侧肢体胫后血管向游离股前外侧皮瓣供血,是解决患侧肢体大面积软组织缺损合并主干血管严重损伤的一种理想修复方法。%Objective To provide a clinical method in the treatment of soft tissue defect in lower extremities by anterolateral thigh free flap transfer in cases without usable blood vessels in receiving areas. Methods Posterior tibial vascular flaps were designed as supplying blood vessel pedicles to carry anterolateral thigh free flaps for soft tissue defect repair. Both lower extremities were fixed in a parallel style. Results Anterograde posterior tibial vascular flap with anterolateral thigh free flap transfer was applied successfully in 15 cases of lower limb defect reconstruction. All combined flaps survived, and defects were reconstructed. Compared to cross-leg flaps, it was more easier to observe blood supply of flaps, change dressing and functional exercise in parallel-leg style. Conclusions Parallel-leg style combined flap is an ideal method in free flap transfer in the cases with large soft tissue defects without usable blood vessels in the receiving area.

  20. 股前外侧皮瓣游离移植一期修复手掌心毁损创面并重建掌浅弓%One-stage repair of mutilated palm and the superficial palmar arch with anterolateral thigh flap transfer

    Institute of Scientific and Technical Information of China (English)

    杨晓东; 杨锦; 刘杨武; 楼旭鹏; 丁建波; 陈逸民; 付尚俊; 周阳

    2010-01-01

    Objective To investigate the clinical results of one-stage coverage of mutilated palm wound and reconstruction of the superficial palmar arch with anterolateral thigh flap transplantation. Methods From March 2005 to December 2009, 6 cases with mutilating palm injury underwent anterolateral thigh flap transfer to resurface the palmar wound and reconstruct the superficial palmar arch at the same time. The flap and vascular pedicle were dissected carefully to form a vascular chain composed of the trunk of the lateral descending branch of lateral circumflex femoral artery and several muscular branches, and the anterolateral thigh flap pedicled on the first perforator. The flap was inset to cover the wound while the vascular chain with its branches was anastomosed to the superficial palmar arch to restore blood circulation to the fingers. Results Postoperatively all free flaps survived. The integrity of the palm and hand was retained. Other than necrosis of the ring finger in 1 case that was amputated and the little finger in 1 case that required revision, all the fingers recovered good blood circulation. Secondary functional reconstruction and flap debulking were carried out in 2 cases. After 6 to 12months of follow-up the results were graded as good in 3 cases, fair in 2 cases, and bad in 1 case according to the provisional functional assessment criterion for upper limbs issued by the Chinese Hand Surgery Society.Conclusion One-stage coverage of mutilated palm wound and reconstruction of the superficial palmar arch with anterolateral thigh flap transplantation leads to satisfactory clinieal results and minimizes the incidence of finger amputation.%目的 探讨应用股前外侧皮瓣游离移植一期修复手掌心毁损创面并重建掌浅弓的临床疗效.方法 2005年3月至2009年12月,对6例手掌心毁损创面应用股前外侧皮瓣游离移植,并重建掌浅弓血管.术中仔细解剖皮瓣及血管蒂,形成以旋股外侧动脉外侧降支为主干

  1. 一期原位修薄的游离股前外侧穿支皮瓣修复足末端创面%Free anterolateral thigh perorator flap: in situ one-stage thinning for the coverage of the distal foot defects.

    Institute of Scientific and Technical Information of China (English)

    朱跃良; 徐永清; 李军; 梅良斌; 王毅

    2011-01-01

    目的 探索一期原位修薄的股前外侧穿支皮瓣游离移植修复足远端创面缺损的可行性.方法2009年1月至2010年8月,应用游离股前外侧穿支皮瓣移植修复足终末端创面9例.术中皮瓣切取根据创面需要,或原位保留深层皮下脂肪和深筋膜于供区(6例),或保留全层脂肪和深筋膜于供区(3例).皮瓣供区直接缝合或中厚皮片植皮.平均手术时间为4.0 h.皮瓣大小为12 cm×8 cm~16 cm×10cm.结果 本组1例术后出现静脉危象,经探查后好转.其余8例愈合顺利,未有无边缘坏死,全部病例皮瓣供区植皮未出现坏死.随访3~16个月,皮瓣质地外观良好,比常规切取的游离穿支皮瓣厚度减少一半,术后双足穿同样尺码的鞋,患者无再次修薄的要求.结论应用一期原位修薄的游离股前外侧穿支皮瓣修复足终末端创面,血供可靠,外形更好,无需二期修薄.%Objective To explore the feasibility of the in situ one-stage thinning of the anterolateral thigh perforator flap for repairing the distal foot defects. Methods From Jun. 2009 to Aug. 2010, 9 cases with distal foot defects were treated with anterolateral thigh perforator flap. During the harvesting of the flap, either the deep layer of the subcutaneous fat and the deep fascia were preserved in situ (6 cases) or the whole layer of the subcutaneous fat and the deep fascia were preserved in situ (3 cases) according to the wound requirements. The donor sites were directly closed or covered with split-thickness skin grafts. The average operating time was 4.0 hours. The flap size ranged from 12x8cm~16cmxl0cm. Results One flap had vein thrombosis postoperatively and the complication was solved after the re-exploration. The other 8 flaps healed uneventfully without any marginal necrosis. There was no skin grafts loss on the donor sites. At a 3~16 months follow up, the flaps took well with good contours. The thickness of these flaps was half of those harvested with

  2. Transplantation of the free anterolateral thigh flap combined with iliotibial band for reconstruction of children's soft tissue defects at foot and ankle%股前外侧皮瓣联合髂胫束移植修复小儿足踝部软组织缺损

    Institute of Scientific and Technical Information of China (English)

    胡锐; 任义军; 严立; 李凡; 韩琼; 程文俊; 勘武生

    2014-01-01

    目的 探讨游离股前外侧皮瓣联合髂胫束移植修复小儿足踝部软组织缺损的临床效果. 方法 2008年1月至2013年1月,采用游离股前外侧皮瓣联合髂胫束移植修复小儿足踝部软组织缺损并重建功能共25例.创面缺损部位足跟部12例,足背部8例,内踝3例,外踝2例;所有患者均伴有不同程度骨折或脱位,且合并有跟腱、足背伸肌腱、内外踝侧副韧带等软组织缺损,软组织缺损髂胫束重建长度3 ~ 16 cm;游离股前外侧皮瓣面积8 cm×5 cm~ 18 cm×12 cm.所有病例术后2周皮瓣成活后在支具保护下行早期康复训练.结果 术后随访6 ~ 24个月,平均14个月;皮瓣全部成活,仅2例皮瓣远端小面积坏死,经换药等治疗愈合;创面愈合时间12~24 d,平均15.1d;术后按Thermann量表功能评定,14例为优,9例为良,可2例,优良率92%.结论 游离股前外侧皮瓣联合髂胫束移植修复小儿足踝部软组织缺损并重建功能,是安全有效的策略,其供区损伤小,缩短治疗周期,能减轻患儿痛苦.%Objective To investigate the clinical effect of transplantation of the free anterolateral thigh flap and iliotibial band for the repair of soft tissue defects at foot and ankle and functional reconstruction.Methods From January,2008 to January,2013,25 pediatric patients with soft tissue defects at foot and ankle were transplantation of the free anterolateral thigh flap and iliotibial band.Of the 25 cases,there were 12 cases at heel,8 cases at dorsum of foot,3 cases at medial malleolus and 2 cases at external malleolus.All the cases were accompanied with different degree of fracture or dislocation,and with soft tissue defect such as achilles tendon,extensor tendon of dorsal,collateral ligament of ankle.The length of soft tissue defect which were reconstructed with iliotibial band were 3 cm to 16 cm.The causes of injury:19 cases were crushed by motorcycle or bicycle,4 cases were crushed machines,2 cases were

  3. 股前外侧游离穿支皮瓣移植修复头面四肢肿瘤切除术后的软组织缺损%Anterolateral thigh perforator free flaps transplantation for repair of head and extremeties soft tissue defects after tumor resection

    Institute of Scientific and Technical Information of China (English)

    李利平; Peter C.Neligan; 姚刚

    2007-01-01

    11 d拆除,四肢创13的缝线术后12~15 d拆除,供瓣区缝线术后15 d以后拆除,引流管在术后3 d拔除.观察所有患者术后愈合情况(Ⅰ期愈合:术后伤口按期愈合;Ⅱ期愈合:术后伤口未按期愈合),同时观察皮瓣是否坏死、伤口是否裂开等.主要观察指标:所有患者皮瓣移植后成活情况、皮瓣供区和受区的外形及功能.结果:纳入需要皮瓣移植的患者16例均进入结果分析.15例患者移植皮瓣全部成活,1例皮瓣大部分成活,皮瓣远端小部分坏死.伤口Ⅰ期愈合14例,Ⅱ期愈合2例(1例皮瓣远端约2.5 cm宽的皮瓣缺血坏死,清除坏死组织后直接缝合愈合,另1例面部上端与皮远瓣区伤口有约3 cm长裂开,经换药、再缝合处理后愈合).所有患者伤口愈合后外形满意.均未见明显疤痕,下肢负重、行走不受影响.结论:股前外侧穿支皮瓣游离移植,对供区损伤小,对受区修复效果好,是一种较理想的修复头面和四肢肿瘤清除术后软组织缺损的方法.%BACKGROUND: Traditional anterolateral thigh flaps transplantation has been widely used in clinics; however, a new generation of perforator free flap transplantation is still in an initial phase at home.OBJECTIVE: To investigate the method, effectiveness and clinical application of anterolateral thigh perforator free flaps transplantation for reconstruction of soft tissue defects of the head and extremeties after tumor resection.DESIGN: Case analysis.SETTING: First Affiliated Hospital of Nanhua University.PARTICIPANTS: A total of 16 patients needing skin flap transplantation were selected from Department of Burns and Plastic Surgery, the First Affiliated Hospital of Nanhua University and Department of Plastic Surgery, General Hospital of Toronto, Toronto University from April 2004 to April of 2006. Soft tissues of all patients could not be directly sutured so as to cause the exposure of tendon, vessel, nerve and sclerotin. There were 13

  4. 带髂胫束的股前外侧皮瓣游离移植修复膝关节周围皮肤软组织合并髌韧带缺损疗效观察%Repair of skin and soft tissue defects around the knee joints combined with patellar ligament defects using free anterolateral thigh flaps with iliotibial tracts

    Institute of Scientific and Technical Information of China (English)

    韩夫; 胡大海; 刘洋; 于洪亮; 马少军; 魏国兴; 郑朝

    2015-01-01

    Objective To observe clinical efficacy of using free anterolateral thigh flaps with iliotibial tracts in repairing skin and soft tissue defects around the knee joints with patellar ligament defects.Methods Twelve patients with skin and soft tissue defects around the knee joints and patellar ligament defects were hospitalized from June 2010 to June 2014.The defects of skin and soft tissue ranged from 7 cm × 6 cm to 16 cm × 12 cm in area, and patellar ligament ranged from 5 to 12 cm in length and 2.5 to 4.0 cm in width.Free anterolateral thigh flaps with iliotibial tracts were used to repair these defects.During reconstruction of patellar ligament, both ends of iliotibial tract were successively folded to form tendon-like threelayer structure at first, and then the newly formed structure was wrapped around the broken ends of patellar ligament and fixed with suture.The flap size ranged from 9 cm ×8 cm to 18 cm × 14 cm.The iliotibial tract ranged from 7 to 14 cm in length and 8 to 12 cm in width.The donor sites were closed by grafting with autologous split-thickness skin harvested from thigh or trunk, and parked with gauze.Immediately after operation, the knee joints were fixed in extension with orthosis for 6 weeks.Weight bearing training of affected limbs being kept in extension position was started from 2 weeks after operation, and flexion and extension exercise of affected knee joints was begun from 6 weeks after operation.Before operation and 12 months after operation, the degree of pain around the knee joints and knee joint function were evaluated with the interna tional knee documentation committee knee uation form, and the ranges of flexion and extension of knee joints were also evaluated.The integrity of reconstructed patellar ligament was assessed by color Doppler ultrasound from 6 to 12 months after operation.The occurrence of surgery-related complications was observed in all patients within 12 months after operation.Results (1) After operation, all

  5. Distal run-off vessel of descending branch of lateral femoral circumflex artery used for reconstruction of extremity defects with free anterolateral thigh flap%旋股外动脉降支远端血管在股前外侧游离皮瓣修复四肢创面中的应用

    Institute of Scientific and Technical Information of China (English)

    何晓清; 朱跃良; 徐永清; 梅良斌; 王毅; 范新宇; 董凯旋

    2015-01-01

    目的 探讨旋股外动脉降支远端血管在股前外侧游离皮瓣修复四肢创面中的应用价值.方法 回顾性分析2009年3月至2013年6月采用带旋股外动脉降支远端血管的股前外侧游离皮瓣修复的14例四肢组织缺损患者资料,男13例,女1例;平均年龄为34.6岁(8~ 57岁).组织缺损部位:足踝部8例,小腿部3例,手部3例.创面缺损面积为5.5cm×4.5cm~25.0cm×14.0 cm.降支远端血管以Flow-through皮瓣方式同时完成血管重建和创面覆盖4例,以Flow-through皮瓣方式保留受区血管连续性6例,以重组嵌合皮瓣方式串联第2足趾同时完成创面覆盖与食指再造1例,以串联横支穿支皮瓣完成足背大创面修复1例,术后血管危象探查中降支远端血管以备用血管发挥作用2例. 结果 14例患者降支远端血管的分离时间为3~7 min,平均4.6 min.降支远端血管平均长度为3.8 cm(1.5 ~6.0 cm).所有患者均未因降支远端血管的切取而出现相关并发症.14例患者术后获2~18个月(平均6.4个月)随访.所有患者皮瓣均完全成活,随访过程中无感染、坏死发生,质地、色泽均良好.8例足踝部缺损及3例小腿部缺损患者均恢复行走功能,足远端血供良好.3例手部缺损患者功能恢复良好. 结论 在股前外侧游离皮瓣修复四肢创面中旋股外动脉降支远端血管分离容易,切取后对供区无额外损伤,且可以根据不同手术目的保留适当长度,以Flow-through皮瓣、重组嵌合皮瓣及备用血管等方式发挥重要作用.%Objective To explore the value of the distal run-off vessel of the descending branch of the lateral circumflex femoral artery in reconstruction of extremity defects with free anterolateral thigh flap.Methods From March 2009 to June 2013,14 patients with extremity defects were repaired with free anterolateral thigh flap that carried the distal run-off vessel of the descending branch of the lateral circumflex femoral artery

  6. Flow-through anterolateral thigh flaps for simultaneous repair of defects of soft tissue and major artery%应用Flow-through股前外侧游离皮瓣同期修复软组织和主干血管缺损

    Institute of Scientific and Technical Information of China (English)

    张大伟; 赵广跃; 裴国献; 李军; 祝勇刚; 王文军

    2012-01-01

    Objective To study the surgical outcomes of simultaneous limb salvage using flow-through anterolateral thigh flaps for severe extremity injuries involving soft tissues and major blood vessels. Methods From May 2003 to February 2012,21 cases of severe extremity injuries were treated in our department.They were 13 men and 8 women,aged from 14 to 53 years (average,37.3 years).There were 4 cases of upper limb injury,17 cases of lower limb injury,14 cases of vascular rupture and defect and 7 cases of massive vascular contusion and thrombosis.In all the injured limbs,severe soft tissue defects were associated with major arterial damages and more or less exposure of the bone,tendon,blood vessel and nerve.Their Mangled Extremity Severity Scores (MESS) ranged from 5 to 8 points (average,5.8 points).The one-stage flow-through flap graft was conducted following thorough debridement in 8 patients with poor or disappeared distal blood supply; of the 13 patients with partial blood supply,6 underwent one-stage flap graft directly and 7 had secondary flap graft according to the wound condition following debridement. Results The 21 patients were followed for 3 to 43 months (average,11.8 months).All the flaps survived and all the injured limbs were salvaged.The blood supply to the distal limb was fine in all cases without any vascular crisis.Necrosis at partial flap margins (3 cases),partial necrosis at the donor site (2 cases),superficial infection (3 cases) and osteomyelitis (one case) were handled until improvement. Conclusion The flow-through anterolateral thigh flap,which can repair soft tissue defects and major vascular injuries simultaneously,is one of the preferable methods in limb salvage for severely damaged extremities.%目的 探讨应用Flow-through股前外侧游离皮瓣同期修复软组织和主干血管缺损的可行性与疗效. 方法 2003年5月至2012年2月共收治21例肢体严重创伤患者,男13例,女8例;年龄14 ~53岁,平均37.3

  7. 个体化设计的股前外侧复合肌皮瓣修复舌癌根治术后舌及口底缺损%Application of individualized free anterolateral thigh combined flap for tongue and mouth floor defects resulted from tongue carcinoma

    Institute of Scientific and Technical Information of China (English)

    胡永杰; 苏彤; 曲行舟; 刘浏; 傅锦业; 张陈平

    2009-01-01

    Objective To investigate the application of individualized free anterolateral thigh combined flap (ALTCF) for tongue and mouth floor defect resulted from tongue carcinoma. Methods From 2006 to 2008, individualized ALTCFs were used in 31 cases of tongue and mouth floor defects resulted from tongue carcinoma. The nutritional perforator vessel was musculocutaneous pattern in 22 cases and septocutaneous pattern in 9 cases. The size of the flaps and the included muscle was (4~8) cm×(5~10) cm and (2~5) cm × (3~ 6) cm, respectively. The length of blood vessel pediclc was (6.81±3.23) cm. Results All the 31 free flaps survived with primary healing and no complication. The appearance and function were both satisfactory. During the follow-up period of 1~3 years, 28 cases survived, 2 cases were reoperated due to the neck lymphatic metastais on the contralateral side. 1 case died of distant metastasis. Conclusions Individualized ALTCF is a reliable flap for the tongue and month floor defects resulted from tongue carcinoma. Both the cosmetic and functional results are satisfactory with less morbidity in donor site and less complication.%目的 探讨应用个体化设计的游离股前外侧复合肌皮瓣,修复舌癌根治术后舌及口底缺损的效果.方法 2006年至2008年应用个体化设计的游离股前外侧复合肌皮瓣,修复31例舌癌根治术后舌及口底缺损,22例皮瓣的穿支血管类型为肌皮穿支,9例为肌间隙穿支;皮瓣大小为(4~8)cm×(5~10)cm,所携带股外侧肌大小为(2~5)cm×(3~6)cm,血管蒂的长度为(6.81±3.23)cm.结果 31例游离股前外侧复合肌皮瓣手术均获成功,舌外形及功能恢复良好,口底及下颌下区饱满;受区及供区伤口一期愈合,未发现口底瘘、下肢运动和感觉功能障碍等并发症,经1~3年的随访,28例无瘤生存,外观及功能满意,2例因术后出现对侧颈淋巴结转移再次手术;1例术后因远处转移死亡.结论 个体化设计

  8. AN ANATOMIC STUDY OF ADIPOFASCIAL FLAP OF THE LEG

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To investigate the vascular anatomy of the subcutaneous tissues and fascias of the leg. Methods Four fresh cadaver legs which had been injected with colored latex were dissected under magnification to identify the origin, course an distribution of vessels from the subfascial level to the skin. The adipofascial flap was harvested from the whole medial side of the leg and fascial flap from other leg of the same cadaver. The posterior tibial artery and its first and second supra-malleolus septal arteries were retained in these flaps. Selective injection of China ink through posterior tibial artery was carried out, and dimension of ink- stained areas was recorded. Results Three main trunk vessels of the leg gave off branches to deep fascia and subcutaneous tissues, forming a large vascular plexus in the subcutaneous tissues on the deep fascia and a deli- cate, but dense and well anastomosed vascular plexus beneath the deep fascia. The vascular plexus in the subcu- taneous tissues ran deeper than the superficial venous system. The areas stained by selective injection in adipo- fascial flaps were larger than those in the fascial flaps. Conclusion Subcutaneous tissues and deep fascia can be considered as an anatomic entity nourished by two very well developed vascular networks which lie on both sides of deep fascia. Incorporation of the deep fascia can not only protect the subcutaneous tissue from being lacerated during raising of the flap, but also enhance vascularity of the adipofascial flap. Leaving superficial veins intact while raising the skin flap does not jeopardize the vascular plexus in the subcutaneous tissues and can preserve the superficial lymnphatic vessels, so that postoperative edema of the flap or the leg could be avoided.

  9. Spontaneous Thigh Compartment Syndrome

    Directory of Open Access Journals (Sweden)

    Khan, Sameer K

    2011-02-01

    Full Text Available A young man presented with a painful and swollen thigh, without any history of trauma, illness, coagulopathic medication or recent exertional exercise. Preliminary imaging delineated a haematoma in the anterior thigh, without any fractures or muscle trauma. Emergent fasciotomies were performed. No pathology could be identified intra-operatively, or on follow-up imaging. A review of thigh compartment syndromes described in literature is presented in a table. Emergency physicians and traumatologists should be cognisant of spontaneous atraumatic presentations of thigh compartment syndrome, to ensure prompt referral and definitive management of this limb-threatening condition. [West J Emerg Med. 2011;12(1:134-138].

  10. Homodigital dorsal adipofascial reverse flap: anatomical study of distal perforators and key points for safe dissection.

    Science.gov (United States)

    Delia, G; Casoli, V; Sommario, M; Risitano, G; D'Alcontres, F Stagno; Colonna, M R

    2010-07-01

    Dorsal adipofascial flaps have been used in the surgical reconstruction of complex injuries distal to the eponychial fold. Such injuries produce nail matrix devascularization/necrosis so that nail bed reconstruction can be a challenging technical problem. Irregular scarring of the nail bed and regrowth anomalies of the nail lamina can result, with both functional and cosmetic impairment of the finger. This study aimed to define the precise vascular anatomy of the dorsal adipofascial flap that has previously been used to reconstruct such complex soft tissue defects. Specifically, the purpose was to identify the key points of safe dissection for these flaps. Anatomical dissections were performed on 32 long fingers. The vascular tree was injected with suitable contrast and the distal dorsal region of the long fingers was studied.

  11. A case report of total breast reconstruction using an inframammary adipofascial flap with an implant.

    Science.gov (United States)

    Ogawa, Tomoko; Yamakawa, Tomomi

    2016-01-01

    Prosthetic-based breast reconstruction can be used in combination with autologous flaps such as a latissimus dorsi (LD) flap or a thoracodorsal artery perforator (TDAP) flap to achieve symmetry. However, the LD and TDAP flaps require a different skin incision from that which is used for the mastectomy. As a new autologous flap for use in combination with prosthetic-based breast reconstruction after nipple-sparing mastectomy (NSM), we used an inframammary adipofascial flap. The patient was a 27-year-old female with moderate ptotic breasts, who had ductal carcinoma in situ in the lower outer quadrant of her left breast. After NSM through the inframammary fold (IMF) incision, the subcutaneous fat of the intended inframammary area was undermined, and the tongue shaped adipofascial flap was pulled up in the intended area. After inserting a tissue expander under the major pectoral muscle, this adipofascial flap was reflected back to the inferior portion of the breast area. After modeling the breast mound with this flap, the inframammary skin incision was sutured. Eleven months later, the patient underwent surgery to replace the expander with a permanent implant. Eight months after the replacement with an implant, the cosmetic result is good. This procedure can be performed through the same skin incision on the IMF as NSM. Total breast reconstruction using the inframammary adipofascial flap with an implant can be an alternative approach to achieving symmetry in some patients. This method is useful for breast reconstruction after NSM for young patients with moderate-ptotic breasts. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Face reconstruction using lateral intercostal artery perforator-based adipofascial free flap.

    Science.gov (United States)

    Jeong, Jae Hoon; Hong, Jin Myung; Imanishi, Nobuaki; Lee, Yoonho; Chang, Hak

    2014-01-01

    The aim of this study was to determine the efficacy of lateral intercostal artery perforator-based adipofascial free flaps for facial reconstruction in patients with facial soft tissue deficiency. We conducted a retrospective study of five consecutive patients diagnosed with facial soft tissue deficiency who underwent operations between July 2006 and November 2011. Flap design included the area containing the perforators. A linear incision was made along the rib, which had the main intercostal pedicle. First, we dissected below Scarpa's fascia as the dorsal limit of the flap. Then, the adipofascial flap was elevated from the medial to the lateral side, including the perforator that pierces the serratus anterior muscle after emerging from the lateral intercostal artery. After confirming the location of the perforator, pedicle dissection was performed dorsally. Dominant perforators were located on the sixth to eighth intercostal space, and more than four perforators were found in fresh-cadaver angiography. In the clinical case series, the seventh or eighth intercostal artery perforators were used for the free flaps. The mean diameter of the pedicle artery was 1.36 mm, and the mean pedicle length was 61.4 mm. There was one case of partial fat necrosis. No severe complications occurred. This is the first study of facial contour reconstruction using lateral intercostal artery perforator-based adipofascial free flaps. The use of this type of flap was effective and can be considered a good alternative for restoring facial symmetry in patients with severe facial soft tissue deficiency.

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

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    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.

  14. Achieving Direct Closure of the Anterolateral Thigh Flap Donor Site—An Algorithmic Approach

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    Jaime Eduardo Pachón Suárez, MD

    2014-10-01

    Conclusions: Direct primary closure of the ALT donor site can be facilitated by the use of our simple algorithm. Certain strategies need to be adopted at the design stage; however, the techniques used are simple and reliable, produce superior cosmetic results at the donor site, save time, and spare the patient the morbidity associated with the harvest of a skin graft.

  15. 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.

  16. Meralgia paresthetica caused by entrapment of the lateral femoral subcutaneous nerve at the fascia lata of the thigh: a case report and literature review.

    Science.gov (United States)

    Omichi, Yasuyuki; Tonogai, Ichiro; Kaji, Shinsuke; Sangawa, Teruaki; Sairyo, Koichi

    2015-01-01

    Meralgia paresthetica (MP) causes tingling, stinging or a burning sensation in the anterolateral part of the thigh, usually as a result of entrapment of the lateral femoral cutaneous nerve (LFCN) at the inguinal ligament (IL) due to mechanical or iatrogenic injury. However, there are few reports on MP caused by entrapment of the LFCN at a more distal site from the IL. We report here a rare case of MP caused by entrapment of the LFCN at the fascia lata of the thigh level. A 23-year-old man felt numbness and sharp pain at the anterolateral aspects of both thighs soon after direct repair surgery for L5 isthmic spondylolisthesis. Although his symptoms were relieved a few days later, numbness and sharp pain in the right thigh recurred 6 months after the surgery. A diagnosis of MP was made, and decompression of the LFCN was performed because conservative treatment for MP was inadequate. Intraoperatively, it was noted that the LFCN was entrapped underneath the fascia lata of the thigh, not at the IL level. His symptoms disappeared after LFCN was released. This case demonstrates that it is necessary to consider the possibility of entrapment of the LFCN at the fascia lata at the thigh level in MP.

  17. Reverse adipofascial flap after resection of a malignant perineurioma of the forearm.

    Science.gov (United States)

    Takahashi, Mitsuhiko; Kasai, Tokio; Nishisho, Toshihiko; Takai, Michihiro; Endo, Hideko; Hirose, Takanori; Sairyo, Koichi

    2014-07-01

    The authors describe a patient with recurrent perineurioma arising in the subcutaneous tissue of the dorsal forearm and extending along the forearm fascia. Soft tissue perineurioma is a rare, originally benign peripheral nerve sheath neoplasm arising from the perineurium, a protective cell barrier surrounding the individual fascicles in peripheral nerves. Perineurioma has only recently been recognized as an entity distinct from other nerve sheath tumors, such as schwannoma and neurofibroma, with unique morphologic, ultrastructural, and immunoreactive features. The recurrent tumor had converted into malignant perineurioma, defined as increased nuclear pleomorphism and cellularity. The ill-marginate feature extending along the fascia required wide resection, leaving a substantial defect on the distal forearm. Surgical repair of large forearm skin defects is challenging because of limited skin extensibility for flap creation, the prominence of the site in terms of aesthetic outcome, and the risk of damage to extrinsic muscles that control delicate hand movements. The reverse forearm adipofascial flap, which was based on distal perforators of the radial artery, was suitable for the current case to cover the exposed myotendinous junctions of the forearm extensor muscles. This flap did not sacrifice skin, a major vessel, or skeletal muscles, and preserved function at both the donor and the recipient sites. The texture of the graft was similar to that of the surrounding skin. The clinical and histopathologic features of this rare tumor are also described to aid in the differential diagnosis and as a reference for surgeons who treat soft tissue neoplasms and may encounter this type of soft tumor.

  18. New Possible Surgical Approaches for the Submammary Adipofascial Flap Based on Its Arterial Supply

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    Ehab M. Elzawawy

    2016-01-01

    Full Text Available Introduction. Submammary adipofascial flap (SMAF is a valuable option for replacement of the inferior portion of the breast. It is particularly useful for reconstruction of partial mastectomy defects. It is also used to cover breast implants. Most surgeons base this flap cranially on the submammary skin crease, reflecting it back onto the breast. The blood vessels supplying this flap are not well defined, and the harvest of the flap may be compromised due to its uncertain vascularity. The aim of the work was to identify perforator vessels supplying SMAF and define their origin, site, diameter, and length. Materials and Methods. The flap was designed and dissected on both sides in 10 female cadavers. SMAF outline was 10 cm in length and 7 cm in width. The flap was raised carefully from below upwards to identify the perforator vessels supplying it from all directions. These vessels were counted and the following measurements were taken using Vernier caliper: diameter, total length, length inside the flap, and distance below the submammary skin crease. Conclusions. The perforators at the lateral part of the flap took origin from the lateral thoracic, thoracodorsal, and intercostal vessels. They were significantly larger, longer, and of multiple origins than those on the medial part of the flap and this suggests that laterally based flaps will have better blood supply, better viability, and more promising prognosis. Both approaches, medially based and laterally based SMAF, carry a better prognosis and lesser chance for future fat necrosis than the classical cranially based flap.

  19. Thigh Injuries in American Football.

    Science.gov (United States)

    Lamplot, Joseph D; Matava, Matthew J

    Quadriceps and hamstring injuries occur frequently in football and are generally treated conservatively. While return to competition following hamstring strains is relatively quick, a high rate of injury recurrence highlights the importance of targeted rehabilitation and conditioning. This review describes the clinical manifestations of thigh-related soft-tissue injuries seen in football players. Two of these-muscle strains and contusions-are relatively common, while a third condition-the Morel-Lavallée lesion-is a rare, yet relevant injury.

  20. Rescate articular con colgajo anterolateral del muslo

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    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.

  1. The localization of the distal perforators of posterior tibial artery: a cadaveric study for the correct planning of medial adipofascial flaps.

    Science.gov (United States)

    Bulla, A; De Luca, L; Campus, G V; Rubino, C; Montella, A; Casoli, V

    2015-01-01

    The adipofascial flap, introduced by Lin in 1994, has many advantages compared to fasciocutaneous or free flaps. Its dissection is relatively easy and fast with low donor-site morbidity, and it does not alter the shape of the leg. The aim of this dissection study is to evaluate the anatomic localization of the most distal perforator of the posterior tibial vessels to provide an anatomical rationale for the safe harvesting of distally based medial adipofascial flaps of the leg. 30 Lower limbs from 15 cadavers were used for this study. The most distal perforator from posterior tibial perforator artery, accompanied by at least one vein, was identified and its distance from the medial malleolus was noted. A distal perforator was found in all specimens; the mean caliber was 0.77 mm. In all cases, the perforator artery passed in the septum between flexor hallucis longus m. and flexor digitorum longus m. and was accompanied by two veins. In our series, the distance between the lowest perforator and the medial malleolus ranged from 3.5 to 8.2 cm. The median was 6.75 cm, the 5th percentile 4 cm and the 95th percentile 8.1 cm. The mean distance of the perforator from the medial tibial border was 1.23 cm. The mean ratio between the distance of perforator from the medial malleolus and the total leg length was 21%. Compared to all previous researches, our study has found more distal perforators from posterior tibial perforator artery. This fact may have important clinical consequences, because the anteromedial adipofascial flap would cover more distal soft tissue defects. Moreover, our data suggest some safety parameters to make the rising of a medial adipofascial leg flap safer in surgical practice.

  2. Acute calcific tendinitis of the gluteus medius: an uncommon source for back, buttock, and thigh pain.

    Science.gov (United States)

    Paik, Nam Chull

    2014-06-01

    This study was conducted to describe the imaging features and clinical manifestations in acute calcific tendinitis (CaT) of the gluteus medius muscle (GMe). A retrospective analysis was conducted, aimed at six patients with acute calcific tendinitis of the gluteus medius muscle (CaT-GMe), who were seen between January 2011 and December 2012. Clinical presentations, radiologic data (radiography, CT, and MRI), and laboratory reports were all subject to review. All patients presented with pain and decreased range of motion (ROM) at the hip. Two of the six patients experienced pain in the anterolateral thigh and groin, with antalgic gait (anterior group). The other four complained of low back, buttock, and posterolateral thigh pain, accompanied by difficulty in standing and antalgic gait (posterior group). Edema within the GMe or effusion surrounding the muscle was regularly identified on MRIs. Calcific deposits were conspicuous in the gluteus medius tendon attachments to the lateral (anterior group) and superoposterior (posterior group) facets of the greater trochanter on radiography, CT, or MRI. Complete resolution of symptoms was uniformly achieved in 5-10 days with conservative management. Acute CaT-GMe should be considered in any patient suffering lateral hip pain (with either groin or low back pain) and ROM limitation. Images of the hip characteristically show edema of the gluteus medius and calcifications lateral or superior to the greater trochanter. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Overview of thigh injuries in dance.

    Science.gov (United States)

    Deleget, Alison

    2010-01-01

    Thigh injuries include musculotendinous strains of the quadriceps, hamstrings, adductors, iliotibial band (ITB), and bony injuries to the shaft of the femur. There is scant information in the literature regarding thigh injuries in dance, which appear to range from 5% to 16% of total injury incidence. Hamstring strains and ITB syndrome are the most commonly reported thigh injuries. Hamstring injuries occur most frequently during slow stretching when the dancer's hip is flexed and knee extended. Uniquely in dancers, adductor injury occurs concurrently with hamstring injuries in approximately one-third of cases. Snapping of the ITB at the lateral hip and knee may result from imbalance of thigh muscle strength and flexibility. To date no quadriceps strain injuries or stress injuries to the shaft of the femur have been reported in the dance medicine literature. As dancers notoriously underestimate time needed to return to dance, it can be suggested that early return to work is a contributing factor to chronic injury. Further research is needed regarding the incidence and nature of injury to the thigh among dancers.

  4. 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

  5. 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.)

  6. Anatomical study on the anterolateral ligament of the knee

    Directory of Open Access Journals (Sweden)

    Camilo Partezani Helito

    2013-08-01

    Full Text Available OBJECTIVE: Describe the knee anterolateral ligament (ALL and establish its anatomical marks of origin and insertion. METHODS: Dissection of the anterolateral aspect of the knee was performed in six cadavers. After isolation of the ALL, its lenght, width and thickness were measured as its places of origin and insertion. The ALL origin was documented in relation to the lateral collateral ligament (LCL origin and the insertion was documented in relation to the Gerdy tubercle, fibullar head and lateral meniscus. After the first two dissections, the ligament was removed and sent to histologycal analysis. RESULTS: The ALL was clearly identified in all knees. Its origin in the lateral epycondile was on average 0.5 mm distal and 2.5 mm anterior to the LCL. In the tibia, two insertions were observed, one in the lateral meniscus and another in the proximal tibia, about 4.5 mm distal to the articular cartilage, between the Gerdy tubercle and the fibullar head. The average measures obtained were: 35.1 mm lenght, 6.8 mm width and 2.6 mm thickness. In the ligament histological analysis, dense connective tissue was observed. CONCLUSION: The ALL is a constant structure in the knee anterolateral region. Its origin is anterior and distal to the LCL origin. In the tibia, it has two insertions, one in the lateral meniscus and another in the proximal tibia between the Gerdy tubercle and the fibullar head.

  7. 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

  8. Thigh-calf contact force measurements in deep knee flexion.

    NARCIS (Netherlands)

    Zelle, J.G.; Barink, M.; Loeffen, R.; Waal Malefijt, M.C. de; Verdonschot, N.J.J.

    2007-01-01

    BACKGROUND: Knee models often do not contain thigh-calf contact which occurs in deep knee flexion. Thigh-calf contact is expected to reduce muscle forces and thereby affects internal stresses in the knee joint. The purpose of this study was to measure thigh-calf contact forces. Two deep knee flexion

  9. 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.

  10. [Impressions on the thighs; semicircular lipoatrophy].

    Science.gov (United States)

    de Rie, M A

    1998-04-01

    An otherwise healthy woman aged 28 had symmetrical band-shaped dents on both thighs. She worked as a secretary; several female colleagues showed identical lesions. An investigation showed that the arrangement of the office equipment combined with sharp-edged desk tops caused these abnormalities. The diagnosis made read 'semicircular lipoatrophy caused by repetitive leaning against a desk'. This is probably a common problem, although it rarely leads to consultation of a dermatologist.

  11. The biomechanical function of the anterolateral ligament of the knee.

    Science.gov (United States)

    Parsons, Erin M; Gee, Albert O; Spiekerman, Charles; Cavanagh, Peter R

    2015-03-01

    Recent anatomic investigations of the lateral structures of the knee have identified a new ligament, called the anterolateral ligament (ALL). To date, the anterolateral ligament has not been biomechanically tested to determine its function. The ALL of the knee will resist internal rotation at high angles of flexion but will not resist anterior drawer forces. Controlled laboratory study. Eleven cadaveric knees were subjected to 134 N of anterior drawer at flexion angles between 0° and 90° and separately to 5 N·m of internal rotation at the same flexion angles. The in situ forces of the ALL, anterior cruciate ligament (ACL), and lateral collateral ligament (LCL) were determined by the principle of superposition. The contribution of the ALL during internal rotation increased significantly with increasing flexion, whereas that of the ACL decreased significantly. At knee flexion angles greater than 30°, the contribution of the ALL exceeded that of the ACL. During anterior drawer, the forces in the ALL were significantly less than the forces in the ACL at all flexion angles (P rotation (P rotation at flexion angles greater than 35°; however, it is minimally loaded during anterior drawer at all flexion angles. The ACL is the primary resister during anterior drawer at all flexion angles and during internal rotation at flexion angles less than 35°. Damage to the ALL of the knee could result in knee instability at high angles of flexion. It is possible that a positive pivot-shift sign may be observed in some patients with an intact ACL but with damage to the ALL. This work may have implications for extra-articular reconstruction in patients with chronic anterolateral instability. © 2015 The Author(s).

  12. 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...... was significantly higher in the immobilized than in the control thigh. Seven days of one-legged immobilization causes local decreased insulin action on thigh glucose uptake and net protein degradation....

  13. 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.

  14. The anterolateral approach for the transcranial resection of pituitary adenomas: technical note.

    Science.gov (United States)

    Agazzi, Siviero; Youssef, Ashraf Sami; van Loveren, Harry R

    2010-05-01

    We sought to quantify the mean surface area of the exposed diaphragma sellae and the mean sellar volume in the subfrontal and anterolateral approaches to pituitary adenomas and to detail our expansion of the superficial and deep window in the anterolateral approach. We performed a retrospective data analysis and cadaveric study in a clinical and skull base laboratory. We studied eight patients who had anterolateral approach for transcranial resection of pituitary macroadenoma and seven cadaveric specimens. Main outcome measures were degree of tumor resection, cerebrospinal fluid (CSF) leak, cranial nerve outcome, and quantification of the exposed sella via the anterior (subfrontal) and anterolateral approach. We observed complete resection in one; visual outcome: stable in three, improved in four, worsened in one; CSF leakage in two; transient CN III palsy in three; mean surface area (mm(2)) of exposed diaphragma sellae,115.3 (subfrontal approach) versus 94.7 (anterolateral approach; p = 0.1); mean sellar volume (mm(3)) exposed, 224.8 (subfrontal approach) versus 569.3 (anterolateral approach; p < 0.0001). Our technical note supports the increased exposure of sellar volume via the anterolateral approach. Despite the relatively high complication rate, complex cranial surgeons should maintain the skills and knowledge of transcranial approaches. Indeed, the rapid expansion of transsphenoidal techniques will continue to decrease the number of cases but will also continue to increase the complexity of those adenomas that are referred for transcranial resection.

  15. 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.

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

    Science.gov (United States)

    Wardi, Gabriel; Görtz, Simon; Snyder, Brian

    2014-05-01

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

  17. Applied anatomy of modified anterolateral approach for type C fractures of the distal femur%改良股前外侧入路治疗股骨远端C型骨折的应用解剖

    Institute of Scientific and Technical Information of China (English)

    骆松; 戴闽; 张斌; 戴江华; 聂涛; 邱平

    2013-01-01

    Objective To provide anatomic basis for treating type C fractures of the distal femur by the modified anterolateral approach of the thigh.Methods Main anterolateral muscles,ligaments were observed on 12 lower limbs of adult cadavers; the modified anterolateral approach was used,and the vessels and nerves related to the posterolateral approach were measured.Results The modified anterolateral approach could fully expose the distal femur without risk of injuring the important nerves and vessels.What's more,it did not affectthe iliotibial band and could attenuate the damage to the quadriceps femoris,which could cffectivelyprotectthe extensor mechanism of the knee joint.Conclusions The treatment of the fracture of the distal femur by the modified anterolateral approach is safe,less traumatic and and greater in exposure.it is worth of further promotion.%目的 为改良股前外侧入路治疗股骨远端C型骨折提供解剖学基础.方法 福尔马林防腐成人下肢标本12例,解剖观察大腿下段前外侧的主要肌肉、韧带的分布;采用改良前外侧手术入路,测量该入路相关的神经、血管走行特点.结果 改良股前外侧入路可充分显露股骨远端,不损伤重要神经血管,不损伤髂胫束并减少了对股四头肌的损伤,有效地保护了伸膝装置.结论 改良股前外侧入路治疗股骨远端C型骨折具有安全,损伤较小,暴露充分等优点,有一定的推广价值.

  18. Acute compartment syndrome of the thigh in a rugby player

    Science.gov (United States)

    Smith, Richard David James; Rust-March, Holly; Kluzek, Stefan

    2015-01-01

    In the absence of obvious trauma, diagnosis of acute compartment syndrome (ACS) of the thigh can easily be delayed, as disproportional pain is not always present. We present a case of ACS of the anterior right thigh compartment in a healthy, semiprofessional rugby player with normal coagulation, who sustained a seemingly innocuous blow during a rugby match. Following early surgical fasciotomy, he returned to his preinjury playing standards within 12 months. Our literature review suggests that high muscle mass, young, athletic males participating in a contact sport are mostly at risk of developing ACS of the thigh. PMID:26250368

  19. Laptop-thighs - laptop-induced erythema ab igne

    DEFF Research Database (Denmark)

    Andersen, Flemming

    2010-01-01

    A 15-year-old boy presented with a livedo reticulares-like eruption on both thighs, but more pronounced on the left. The history revealed the diagnosis: ''Laptop-thighs'' i.e. laptop-induced erythema ab igne, the result of months of daily use of the laptop while placed on the thighs. Erythema ab...... igne is traditionally a disease of the elderly, caused by overuse of heat sources on tender backs etc. The recent popularity of laptop computers and other electronics emitting strong heat has made erythema ab igne a problem also in younger generations. Udgivelsesdato: 2010-Feb-22...

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

    DEFF Research Database (Denmark)

    Heitmann, Berit L; Frederiksen, Peder

    2009-01-01

    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......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...... 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...

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

    Science.gov (United States)

    Gutfraynd, Alexander; Philpott, Sheila

    2016-09-01

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

  2. Acute Compartment Syndrome of the Thigh in Combat Casualties

    Science.gov (United States)

    2013-03-01

    clinical signs and symptoms alone (27, 28). These signs include pain out of proportion, weakness and passive pain on stretch of the muscles in the...spasm/ cramping /weakness). Thirty-three percent (5/15) have pruritis. Twenty-seven percent (4/15) have symptomatic fascial herniations. Twenty...thigh. J. Orthop. Trauma 16:436–438, 2002. 6. Rooser, B., Bengtson, S., Hagglund, G. Acute compartment syndrome from anterior thigh muscle contusion: a

  3. Pelvic Primary Staphylococcal Infection Presenting as a Thigh Abscess

    Directory of Open Access Journals (Sweden)

    T. O. Abbas

    2013-01-01

    Full Text Available Intra-abdominal disease can present as an extra-abdominal abscess and can follow several routes, including the greater sciatic foramen, obturator foramen, femoral canal, pelvic outlet, and inguinal canal. Nerves and vessels can also serve as a route out of the abdomen. The psoas muscle extends from the twelfth thoracic and fifth lower lumbar vertebrae to the lesser trochanter of the femur, which means that disease in this muscle group can migrate along the muscle, out of the abdomen, and present as a thigh abscess. We present a case of a primary pelvic staphylococcal infection presenting as a thigh abscess. The patient was a 60-year-old man who presented with left posterior thigh pain and fever. Physical examination revealed a diffusely swollen left thigh with overlying erythematous, shiny, and tense skin. X-rays revealed no significant soft tissue lesions, ultrasound was suggestive of an inflammatory process, and MRI showed inflammatory changes along the left hemipelvis and thigh involving the iliacus muscle group, left gluteal region, and obturator internus muscle. The abscess was drained passively via two incisions in the posterior left thigh, releasing large amounts of purulent discharge. Subsequent bacterial culture revealed profuse growth of Staphylococcus aureus. The patient recovered uneventfully except for a moderate fever on the third postoperative day.

  4. Pelvic primary staphylococcal infection presenting as a thigh abscess.

    Science.gov (United States)

    Abbas, T O

    2013-01-01

    Intra-abdominal disease can present as an extra-abdominal abscess and can follow several routes, including the greater sciatic foramen, obturator foramen, femoral canal, pelvic outlet, and inguinal canal. Nerves and vessels can also serve as a route out of the abdomen. The psoas muscle extends from the twelfth thoracic and fifth lower lumbar vertebrae to the lesser trochanter of the femur, which means that disease in this muscle group can migrate along the muscle, out of the abdomen, and present as a thigh abscess. We present a case of a primary pelvic staphylococcal infection presenting as a thigh abscess. The patient was a 60-year-old man who presented with left posterior thigh pain and fever. Physical examination revealed a diffusely swollen left thigh with overlying erythematous, shiny, and tense skin. X-rays revealed no significant soft tissue lesions, ultrasound was suggestive of an inflammatory process, and MRI showed inflammatory changes along the left hemipelvis and thigh involving the iliacus muscle group, left gluteal region, and obturator internus muscle. The abscess was drained passively via two incisions in the posterior left thigh, releasing large amounts of purulent discharge. Subsequent bacterial culture revealed profuse growth of Staphylococcus aureus. The patient recovered uneventfully except for a moderate fever on the third postoperative day.

  5. Effectiveness of thigh-to-thigh current path for the measurement of abdominal fat in bioelectrical impedance analysis.

    Science.gov (United States)

    Hong, Ki Hwan; Lim, Yong Gyu; Park, Kwang Suk

    2009-12-01

    We present a new method measuring body impedance using a thigh-to-thigh current path, which can reflect the abdominal fat portion more sensitively and can be conveniently applied during the daily use on a toilet seat. Two pairs of electrodes were installed on a toilet seat to provide current and to permit voltage measurement through a thigh-to-thigh current path. The effectiveness of the method was compared with conventional foot-to-foot and hand-to-foot current paths by simulation and by experiments referenced to computed tomography (CT) image analysis. Body impedance using three different current paths was measured, and abdominal CT images were acquired for eight subjects. Measured body impedances were compared with the visceral to subcutaneous fat ratio (VF/SF) calculated from the CT-determined abdominal fat volume. The thigh-to-thigh current path was about 75% more sensitive in abdominal fat measurement than the conventional current paths in simulation experiments and displayed a higher VF/SF correlation (r = 0.768) than the foot-to-foot (r = 0.425) and hand-to-foot (r = 0.497) current paths.

  6. Three-dimensional visualization of the human face using DICOM data and its application to facial contouring surgery using free anterolateral thigh flap transfer.

    Science.gov (United States)

    Shimizu, Fumiaki; Uehara, Miyuki; Oatari, Miwako; Kusatsu, Manami

    2016-01-01

    One of the main challenges faced by surgeons performing reconstructive surgery in cases of facial asymmetry due to hemifacial atrophy or tumor surgery is the restoration of the natural contour of the face. Soft-tissue augmentation using free-flap transfer is one of the most commonly used methods for facial reconstruction. The most important part of a successful reconstruction is the preoperative assessment of the volume, position, and shape of the flap to be transplanted. This study focuses on three cases of facial deformity due to hemifacial progressive atrophy or tumor excision. For the preoperative assessment, digital imaging and communications in medicine (DICOM) data obtained from computed tomography was used and applied to a three-dimensional (3D) picture software program (ZedView, LEXI, Tokyo, Japan). Using computer simulation, a mirror image of the unaffected side of the face was applied to the affected side, and 3D visualization was performed. Using this procedure, a postoperative image of the face and precise shape, position, and amount of the flap that was going to be transferred was simulated preoperatively. In all cases, the postoperative shape of the face was acceptable, and a natural shape of the face could be obtained. Preoperative 3D visualization using computer simulation was helpful for estimating the reconstructive procedure and postoperative shape of the face. Using free-flap transfer, this procedure facilitates the natural shape after reconstruction of the face in facial contouring surgery.

  7. Anterolateral Versus Medial Plating of Distal Extra-articular Tibia Fractures: A Biomechanical Model.

    Science.gov (United States)

    Pirolo, Joseph M; Behn, Anthony W; Abrams, Geoffrey D; Bishop, Julius A

    2015-09-01

    Both medial and anterolateral plate applications have been described for the treatment of distal tibia fractures, each with distinct advantages and disadvantages. The objective of this study was to compare the biomechanical properties of medial and anterolateral plating constructs used to stabilize simulated varus and valgus fracture patterns of the distal tibia. In 16 synthetic tibia models, a 45° oblique cut was made to model an Orthopedic Trauma Association type 43-A1.2 distal tibia fracture in either a varus or valgus injury pattern. Each fracture was then reduced and plated with a precontoured medial or anterolateral distal tibia plate. The specimens were biomechanically tested in axial and torsional loading, cyclic axial loading, and load to failure. For the varus fracture pattern, medial plating showed less fracture site displacement and rotation and was stiffer in both axial and torsional loading (Ptibia fractures.

  8. 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.

  9. Pericardiectomy: a functional anatomical perspective for the choice of left anterolateral thoracotomy.

    Science.gov (United States)

    Lachman, N; Vanker, E A; Christensen, K N; Satyapal, K S; Fennell, W M Pitt

    2009-01-01

    Although pericardiectomy remains an established method for pericardial resection, the choice of surgical approach is not definitive. Within South Africa, surgical referral for tuberculosis-induced chronic constrictive pericarditis has not declined. Anecdotal reports have indicated good operative results that appear to show an association with choice of surgical technique used. This study aimed to provide a functional anatomical perspective for performance and recovery of the heart during pericardiectomy based on anatomical dissection and surgical notes. En bloc specimens were harvested from 16 fresh cadavers and pericardial segments were measured in terms of percentage cover over surface area of the myocardium. Retrospective analysis of 116 surgical reports of pericardiectomy performed over a period of 20 years was conducted. Surgical notes were compared for median sternotomy and anterolateral left thoracotomy. Results from anatomical study indicated that although the anterior pericardium between the phrenic nerves constitutes about 58% of total selected pericardial area, total pericardium accessible over left ventricle from that approach was only 26%. When orientated in left anterolateral position, total accessible area of left ventricular pericardium was 37%. Standard deviations were found to be comparable. Means were significantly different, indicating that the left anterolateral approach allows wider access to the left ventricle. This paper provides a functional anatomical perspective for the choice of left anterolateral thoracotomy as a surgical approach for pericardiectomy.

  10. 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.

  11. Accessory breast on the posterior thigh of a man.

    Science.gov (United States)

    Camisa, C

    1980-11-01

    An elderly man with a mass that clinically resembles the normal female breast on the posterior portion of his left thigh is presented. We believe this is an unusual case of accessory breast tissue occurring in a location remote from the embryonic mammary line.

  12. 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...

  13. Antipredator strategies in breeding Bristle-thighed Curlews

    Science.gov (United States)

    McCaffery, Brian J.; Gill, Robert E.

    1992-01-01

    Each fall the world’s breeding population of Bristle-thighed Curlews (Numenius tahitiensis) arrives on the central Pacific wintering grounds following a migration that entails a non- stop flight of over 5000 kilometers. Sun-drenched, palm-shrouded atolls will be their home for the ensuing eight months. Even in the avian world, however, such apparant luxury is not without costs. For the Bristle-thighed Curlew these costs are incurred on the breeding grounds. From the time they arrive there in early May until they depart again for the wintering grounds in August and September, curlews are exposed to a host of predators. Gyrfalcons (Falco rusticolus), Golden Eagles (Aquila chrysaetos), Rough-legged Hawks (Buteo lagopus), Northern Harriers (Circus cyaneus), Parasitic Jaegers (Stercorarius parasiticus), Short-eared Owls (Asio flammeus), Common Ravens (Corvus corax) and Red Foxes (Vulpes vulpes) are potential predators of curlews and their offspring. To combat these threats, the Bristle-thighed Curlew has evolved an elaborate suite of antipredator defenses. Depending on the threat and the phase of the breeding cycle, Bristle-thighed Curlews may respond to potential predators by fleeing or flocking, by camouflage or combat. Given the variety of predators on the tundra, a variety of options is critical.

  14. US Diagnosis of Sparganosis Within the Thigh: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chang Yoon; Hong, Suk Joo; Kim, Kyung Min; Myung, Jae Sung; Park, Cheol Min [Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2007-12-15

    Sparganosis is an uncommon infection caused by sparganum, a migrating plerocercoid larva. Currently, various imaging modalities have been actively used for the diagnosis of sparganosis before surgery. We present a case of sparganosis arising in the subcutaneous layer of the thigh that was diagnosed only by an ultrasound examination

  15. 60例游离股前外侧皮瓣术后供区功能恢复及并发症的研究%Study of the complications and functional assessment of 60 free anterolateral myocutaneous flaps donor-site

    Institute of Scientific and Technical Information of China (English)

    胡传宇; 陈卫民; 李文强; 黄平; 邵乐南

    2015-01-01

    Objective:To investigate the complications and functional assessment of donor-site for free anterolateral myocutaneous flaps applicated in the reconstruction of oral-maxillofacial defects. In order to find a better method to redue the complieations in donor-site. Method:analysing the complications and functional assessment through evaluation sheet and questionnairs. Result:The long term complieations in cluded musele weakness(n=7),sensory disturbance(n=50),in an-terolateral thigh upper region Sensory hypoesthesia(n=10),in anterolateral thigh middle region sensory hypoesthesia(n=39) and sensory deprivation(n=l),in anterolateral thigh lower region sensory hypoesthesia(n=40) and sensory deprivation(n=5). Two patients had intolerance of cold. Conclusion: ①.Sensory disturbance occurred in anterolateral thigh region especially concentrated in middle and lower area.It was related to the damage of lateral femoral cutaneous nerve. ②. The risk of sen-sory disturbance was highly related of big size and higher position. 3. Muscle weakness were not significantly related to sac-rifice of the size of vastus lateralis muscle.%目的:评估游离股前外侧肌皮瓣修复口腔颌面部缺损,术后皮瓣供区并发症及功能恢复情况。方法:通过评估表测量加问卷调查的方式描述性分析60例患者术后供区功能恢复情况及相关并发症。结果:远期并发症中患侧股四头肌肌力减弱者7例,皮肤感觉异常者50例。其中供区外上份感觉减退者10例,外中份感觉减退者39例,感觉消失者1例;外下份感觉减退者40例,感觉消失者5例;出现供区寒冷耐受不良者2例。患者认为疤痕严重影响外观者3例。结论:①术后供区的感觉障碍分布于股前外侧区,主要集中在股前外侧的中下区,其主要原因与损伤股外侧皮神经有关;②皮瓣的面积越大,皮瓣位置越靠近股外侧上份,供区出现感觉障碍的概率越大;③股前

  16. 78 FR 36304 - Proposed Information Collection (Hip and Thigh Conditions Disability Benefits Questionnaire...

    Science.gov (United States)

    2013-06-17

    ... AFFAIRS Proposed Information Collection (Hip and Thigh Conditions Disability Benefits Questionnaire... Disability Benefits Questionnaire)'' in any correspondence. During the comment period, comments may be viewed.... SUPPLEMENTARY INFORMATION: ] Title: Hip and Thigh Conditions Disability Benefits Questionnaire, VA Form...

  17. 78 FR 68906 - Agency Information Collection (Hip and Thigh Conditions Disability Benefits Questionnaire) Under...

    Science.gov (United States)

    2013-11-15

    ... AFFAIRS Agency Information Collection (Hip and Thigh Conditions Disability Benefits Questionnaire) Under... Disability Benefits Questionnaire)'' in any correspondence. FOR FURTHER INFORMATION CONTACT: Crystal Rennie... and Thigh Conditions Disability Benefits Questionnaire''. SUPPLEMENTARY INFORMATION: Title: Hip...

  18. 游离腓动脉穿支筋膜瓣修复手部皮肤缺损%Free adipofascial flap from peroneal perforator artery for repair of hand skin defects

    Institute of Scientific and Technical Information of China (English)

    李学渊; 滕晓峰; 黄剑; 陈宏; 章伟文; 陈德松

    2010-01-01

    Objective To explore the surgical technique and clinical outcomes of applying the free adipofascial flap nourished by musculocutaneous perforators of the peroneal artery to repair soft tissue defects of the hand. Methods Six cases of skin defects in the hand were treated from December 2007 to October 2009 with free peroneal artery perforator fascial flap. The size of the raised flaps ranged from 5.0 cm × 4.5 cm to 10 cm × 7 cm. In most cases the musculocutaneous branch was chosen as the vascular pedicle for anastomosis.The blood vessels were anastomosed in an end-to-side fashion. The transferred fascial flap was covered with split thickness skin graft, while the donor site was closed directly. Results All the adipofascial flaps survived uneventfully. The skin graft over the fascial flap showed over 90% survival in 4 cases and 80% survival in 2 cases after 7 days. Follow-up time ranged from 3 to 12 months. Flap bulkiness was seen in one case which underwent debulking procedure 3 months later. The appearance of other 5 cases was satisfactory with only slight flap bulkiness. Only a linear scar was left at the calf donor site. Conclusion The free adipofascial flap was a modification of peroneal perforator flaps to minimize morbidity and improve cosmoses of the donor site. The adipofascial flap can also fill the void caused by soft tissue defects and provide better condition for functional reconstruction.%目的 探讨应用游离腓动脉穿支筋膜瓣修复手部软组织缺损,减少供区损伤的方法和临床效果.方法 2007年12月至2009年10月,对6例手部皮肤缺损患者,应用游离腓动脉肌皮穿支筋膜瓣进行修复,切取面积为5.0 cm×4.5 cm~10.0 cm×7.0 cm,以肌皮穿支为蒂.动脉血管蒂与受区血管采用端侧吻合,受区筋膜瓣行断层植皮覆盖.供区创面直接缝合.结果 术后6例筋膜瓣全部存活;术后7 d,筋膜表面植皮成活大于90%4例,80%2例.随访时间为3~12个月,1例皮瓣臃肿,术后3

  19. 带髂胫束的逆行股前外侧皮瓣修复髌前复合组织缺损并重建髌韧带%The retrograde femoral anterolateral skin flap composited with iliotibial band to repair patellar composite tissue defect and rebuild the patellar ligament

    Institute of Scientific and Technical Information of China (English)

    孙中建; 徐鹏; 孙萌萌; 王晶

    2014-01-01

    目的:探讨带髂胫束的逆行股前外侧皮瓣修复髌前复合组织缺损并重建髌韧带的效果。方法对2007年3月—2011年8月收治的髌前软组织并髌骨缺损的16例患者,采用带髂胫束的逆行股前外侧皮瓣移植修复并重建髌韧带,皮瓣切取范围7.5 cm×10.5 cm~8.5 cm×13.5 cm,髂胫束切取长度7.0~13.0 cm,宽度5.0~7.0 cm,随访时间6个月~3年。结果16例患者皮瓣均成活,优9例,良5例,可2例。结论带髂胫束的逆行股前外侧皮瓣修复髌前复合组织缺损并重建髌韧带的方法是修复髌前软组织并髌骨缺损的一种有效术式。%Objective To discuss the effect of retrograde anterolateral thigh flap with iliotibial band to repaire prepatellar compound tissue defects and reconstruct patellofemaral ligament. Methods From March 2007 to August 2011, 16 patients of prepatellar compound tissue defects were covered in this study. All the patients were repaired and patellofemaral ligament were reconstructed by retrograde anterolateral thigh flap with iliotibial band. The flaps ranged from 7.5 cm×10.5 cm to 8.5 cm×13.5 cm, the length of iliotibial band was from 7 cm to 13 cm and the width was from 5 cm to 7 cm. All patients were followed-up from 0.5 year to 3 years. Results All the flaps survived, 9 cases completely survived, 5 cases mostly survived, 2 cases partly survived. Conclusion Retrograde anterolateral thigh flap with iliotibial band is an effective operation to repair prepatellar compound tissue defects and reconstruct patellofemaral ligament.

  20. 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.

  1. MR imaging of calcifying aponeurotic fibroma of the thigh

    Energy Technology Data Exchange (ETDEWEB)

    Kwak Hyo-Sung [Dept. of Diagnostic Radiology, Univ. MedicalSchool, Chonbuk (Korea); Department of Diagnostic Radiology, The Armed Forces Kyae Ryong Dae District Hospital, Post Office Box No. 37, Bunam-ri, Dooma-myun, Nonsan-city, Chungnam, 320-919 South Korea (Korea); Lee Sang-Yong [Dept. of Diagnostic Radiology, Univ. MedicalSchool, Chonbuk (Korea); Kim Jung-Ryul; Lee Kwang-Bok [Department of Orthopedic Surgery, Chonbuk National University Medical School, South Korea, Chonbuk (Korea)

    2004-05-01

    Calcifying aponeurotic fibroma is a rare, benign soft-tissue proliferation that occurs in the distal extremities in children. Because this lesion has a tendency to recur after surgical resection, MR imaging to determine the extent of the tumor for surgical planning is optimal. We report the MR findings in a 4-year-old boy with a calcifying aponeurotic fibroma of the thigh. (orig.)

  2. Thigh-leg skin tube pedicle and amniotic band syndrome.

    Science.gov (United States)

    Altamirano, Eugenia; Drut, Ricardo; Perelló, Ariel

    2009-01-01

    We are reporting the case of a young infant presenting with a cutaneous tubular bridge running from the dorsal aspect of the middle third of the thigh to the middle third of the leg resulting in a permanent flexion position of the limb. This finding was associated with another related to the amniotic band syndrome. Surgical resection showed a tube formed exclusively by normal skin tissue. The case appears unique although related lesions have been reported in the literature.

  3. Approaches to anterior and anterolateral foramen magnum lesions: A critical review

    Science.gov (United States)

    Komotar, Ricardo J.; Zacharia, Brad E.; McGovern, Robert A.; Sisti, Michael B.; Bruce, Jeffrey N.; D’Ambrosio, Anthony L.

    2010-01-01

    Foramen magnum (FM) lesions represent some of the most complex cases for the modern neurosurgeon because of their location near vital brainstem structures, the vertebral arteries, and lower cranial nerves. In particular, anterior or anterolaterally located FM tumors have traditionally been most difficult to resect with high morbidity and mortality resulting from approaches through the posterior midline or transorally. For many neurosurgeons, the far lateral, extreme lateral approach, and more recently, endoscopic endonasal approaches have become the preferred modern methods for the resection of anterior or anterolateral FM tumors. In this review, we examine both operative and non-operative approaches to FM tumors, including surgical anatomy, surgical technique, and indications for operative intervention in these complex cases. In addition, we compared outcomes from prior series. PMID:21572629

  4. Combined anterolateral ligament and anatomic anterior cruciate ligament reconstruction of the knee.

    Science.gov (United States)

    Smith, James O; Yasen, Sam K; Lord, Breck; Wilson, Adrian J

    2015-11-01

    Although anatomic anterior cruciate ligament (ACL) reconstruction is established for the surgical treatment of anterolateral knee instability, there remains a significant cohort of patients who continue to experience post-operative instability. Recent advances in our understanding of the anatomic, biomechanical and radiological characteristics of the native anterolateral ligament (ALL) of the knee have led to a resurgent interest in reconstruction of this structure as part of the management of knee instability. This technical note describes our readily reproducible combined minimally invasive technique to reconstruct both the ACL and ALL anatomically using autologous semitendinosus and gracilis grafts. This method of ALL reconstruction can be easily integrated with all-inside ACL reconstruction, requiring minimal additional operative time, equipment and expertise. Level of evidence V.

  5. Anterolateral Drawer Versus Anterior Drawer Test for Ankle Instability: A Biomechanical Model.

    Science.gov (United States)

    Miller, Adam G; Myers, Stuart H; Parks, Brent G; Guyton, Gregory P

    2016-04-01

    The addition of unconstrained internal rotation to the physical examination could allow for detection of more subtle degrees of ankle instability. We hypothesized that a simulated anterolateral drawer test allowing unconstrained internal rotation of the ankle would provoke greater displacement of the lateral talus in the mortise versus the anterior drawer test. Ten cadaveric lower extremities were tested in a custom apparatus designed to reproduce the anterior drawer test and the anterolateral drawer test, in which the ankle was allowed to internally rotate about the intact deep deltoid ligament while being subluxed anteriorly. Specimens were tested intact and with anterior tibiofibular ligament sectioned. A differential variable reluctance transducer was used to measure lateral talar displacement with anterior forces of 25 and 50 N. No significant differences in talar displacement or ankle rotation were noted in intact specimens between the groups. Among sectioned specimens, significantly more talar displacement (25 N [6.5 ± 1.7 mm vs 3.8 ± 2.4 mm] and 50 N [8.7 ± 0.9 mm vs 4.5 ± 2.5 mm], P < .001) and ankle rotation (25 N [13.9 ± 8.0 degrees vs 0.0 ± 0.0 degrees] and 50 N [23.7 ± 5.8 degrees vs 0.0 ± 0.0 degrees], P < .001) were found in the anterolateral drawer versus anterior drawer group. In an ankle instability model, the anterolateral drawer test provoked almost twice the lateral talus displacement found with the anterior drawer test. Allowing internal rotation of the ankle while testing for ankle instability may allow the examiner to detect more subtle degrees of ankle instability. © The Author(s) 2015.

  6. Percutaneous anterolateral balloon kyphoplasty for metastatic lytic lesions of the cervical spine.

    Science.gov (United States)

    Lykomitros, Vasilis; Anagnostidis, Kleovoulos S; Alzeer, Ziad; Kapetanos, George A

    2010-11-01

    The purpose of our report is to describe a new application of kyphoplasty, the percutaneous anterolateral balloon kyphoplasty that we performed in two cases of metastatic osteolytic lesions in cervical spine. The first patient, aged 48 years, with primary malignancy in lungs had two metastatic lesions in C2 and C6 vertebrae. Patient's complaints were about pain and restriction of movements (due to the pain) in the cervical spine. The second patient, aged 70 years, with primary malignancy in stomach, had multiple metastatic lesions in thoracolumbar spine and C3, C4 and C5 vertebrae without neurological symptoms. The main symptoms were from cervical spine with severe pain even in bed rest and systematic use of opiate-base analgesic. The preoperative status was evaluated with X-rays, CT scan, MRI scan and with Karnofsky score and visual analogue pain (VAS) scale. Both patients underwent percutaneous anterolateral balloon kyphoplasty via the anterolateral approach in cervical spine under general anaesthesia. No clinical complications occurred during or after the procedure. Both patients experienced pain relief immediately after balloon kyphoplasty and during the following days. The stiffness also resolved rapidly and cervical collars were removed. VAS score significantly improved from 85 and 95 preoperatively to 30 in both patients. Karnofsky score showed also improvement from 40 and 30 preoperatively to 80 and 70, respectively, at the final follow-up (7 months after the procedure). Fluoroscopy-guided percutaneous anterolateral balloon kyphoplasty proved to be safe and effective minimally invasive procedure for metastatic osteolytic lesions of the cervical spine, reducing pain and avoiding vertebral collapse. Experience and attention are necessary in order to avoid complications.

  7. Combined Anterior and Anterolateral Stabilization of the Knee With the Iliotibial Band.

    Science.gov (United States)

    Lutz, Christian; Sonnery-Cottet, Bertrand; Imbert, Pierre; Barbosa, Nuno Camelo; Tuteja, Sanesh; Jaeger, Jean-Henri

    2016-04-01

    Interest and knowledge on the anatomy, function, and biomechanical properties of the anterolateral ligament has led to the recognition of the importance of this structure in rotational control of the knee. This article describes a technique that allows for a combined anterior cruciate ligament (ACL) and anterolateral reconstruction, using an Iliotibial band (ITB) autograft. The graft is detached from the vastus lateralis from proximal to distal, at the center portion from ITB, preserving its distal insertion on the Gerdy tubercle. Its width is 1 cm for the distal part, used for the anterolateral ligament reconstruction, and 3 cm for the proximal part. An outside-in femoral tunnel is drilled respecting both the preferred favorable isometric femoral insertion site and the femoral ACL footprint. An ACL reconstruction combined with a lateral tenodesis with a continuous ITB graft respects the anatomical and isometric rules providing superior internal rotational control of the knee in comparison with a stand-alone ACL reconstruction.

  8. 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.

  9. 游离股前外侧皮瓣修复四肢皮肤软组织缺损12例临床疗效分析%Analysis of Clinical Curative Effect of the Free Anteriolateral Skin Flap of Thigh Repair Soft Tissue Damage of Limbs 12 Cases

    Institute of Scientific and Technical Information of China (English)

    孔靖

    2013-01-01

      目的:探讨游离股前外侧皮瓣修复四肢皮肤软组织缺损的临床疗效。方法:2008年1月~2012年6月,采用吻合血管的游离股前外侧皮瓣修复四肢皮肤软组织缺损12例,皮瓣切取面积8cm×12cm~24cm×14cm。结果:12例皮瓣均成活,术后随访3~18个月,所有患者创面愈合良好,功能恢复满意。结论:游离股前外侧皮瓣存活率高,血运丰富,部位隐蔽,是修复四肢皮肤软组织缺损的理想皮瓣。%Objective:To explore the result of repairing the limbs soft tissue defect of removing anterolateral skin flap of thigh. Methods:From January 2008 to June 2012, the vascular anastomosis of free shares anterolateral skin flap to repair defects of soft tissue limbs in 12 cases, flap chipped area 8 cm × 12 cm~24 cm × 14 cm. Results:12 cases are the flap survival and were followed up for 3 to 18 months, all patients wound healing is good, the function recovered satisfactorily. Conclusion:The survival rate of free anterolateral skin flap is high, the supply of rich blood, location concealed, the free anterolateral skin flap is an ideal flap for repairing defects of soft tissure.

  10. Gluteus medius and thigh muscles electromyography during load carrying walking

    Directory of Open Access Journals (Sweden)

    Petr Šťastný

    2015-11-01

    Full Text Available This study compares the electromyographic (EMG peak amplitude changes of gluteus medius (Gmed, vastus medialis (VMO, vastus lateralis (VL and biceps femoris (BF during load carrying walking due to the increased load. The percentage of maximum isometric voluntary contractions (%MVIC of both limbs and 3D kinematic of lower limbs were detected on eighteen resistance-trained men (mean age ± SD, 31 ± 3.4 years while carrying loads of 25, 50 and 75% of their body mass (BM. The repeated measurement ANOVA was used to evaluate the differences in muscles %MVIC and 3D kinematics at all load conditions. Significant differences were found for Gmed %MVIC (F3,99 = 19.8, p < 0.001. Gmed activity was significantly different between load carrying walking with 25% of BM (mean ± SD, 20 ± 12%MVIC, 50% of BM (32 ± 17%MVIC and 75% of BM (45 ± 26%MVIC condition. Differences were found in hip flexion at Gmed EMG peak (F3,96 = 14, p < 0.001, between 25% of BM (18 ± 11° and 50% of BM (29 ± 7°. No significant differences were found for thigh muscles, when thigh muscle activity did not exceed 30%MVIC even at 75% of BM condition. Load carrying walking is an exercise which activates Gmed more than thigh muscles. This exercise increases the Gmed activity along with increased loads and it should be regarded as a complex Gmed strengthening exercise. This exercise is recommended for strengthening the Gmed with low activation of VL and VMO.

  11. 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.

  12. Thigh Abscess Caused by Yersinia enterocolitica in an Immunocompetent Host

    Directory of Open Access Journals (Sweden)

    Purva Gumaste

    2012-01-01

    Full Text Available Yersinia enterocolitica is primarily a gastrointestinal tract pathogen known to cause gastroenteritis, although it may produce extra-intestinal infections like sepsis and its sequelae. However, primary cutaneous infections are extremely rare. We present a case of Y. enterocolitica thigh abscess in an immunocompetent adult. The portal of entry is unclear in this case. He did many outdoor activities that involved skin injuries and exposure to soil and contaminated water. Hence, direct inoculation as a result of exposure to contaminated water is postulated in the absence of evidence for a gastrointestinal route of infection.

  13. [Hemangiopericytoma of the thigh. Report of a case].

    Science.gov (United States)

    Calvo Cascallo, J; Mundi Salvadó, N; Cardona Fontanet, M; Cañadell Mullerat, A M

    1993-01-01

    A case of Hemangiopericytoma at the thigh is reported. The Hemangiopericytoma is a rare tumour made with pericyties. This neoplasia is usually benign and it is located in the soft tissues. Tumour is profusely irrigated. The most common locations of the Hemangiopericytoma are the lower limbs and the abdominal cavity. The Hemangiopericytoma is difficult to be recognized by histological criteria. The high number of relapses and metastasis involve to an extent surgical ablation of the tumour and its borders. Present literature is reviewed and the different diagnostic and therapeutic options are discussed.

  14. Reconstruction of Temporal Hollowing Defect With Anterior-Lateral Thigh Free Flap Following Resection of Recurrent Ameloblastoma of the Infratemporal Fossa and Right Mandible (a Case Report).

    Science.gov (United States)

    Melville, James C; Hornberger, John C; Young, Simon; Shum, Jonathan W

    2016-09-01

    Recurrent invasive ameloblastoma of the infratemporal fossa is an uncommonly encountered phenomenon in the practice of oral and maxillofacial surgery and presents many surgical challenges for the practitioner. This case report describes a patient who underwent previous resection of a mandibular ameloblastoma with multiple recurrences. The patient was diagnosed with a recurrent ameloblastoma of the infratemporal fossa that was subsequently resected and reconstructed using an anterolateral thigh (ALT) free tissue transfer. There are few reported cases of recurrent ameloblastomas in the infratemporal fossa and none that describe surgical resection and reconstruction of such a lesion. Owing to the uniqueness of the surgical defect, an ALT flap was used to correct the temporal hollowing. There have been multiple reported cases of reconstruction of temporal hollowing defects using autogenous fat or allograft; however, none have described the use of a de-epithelialized ALT microvascular reconstruction of a temporal hollowing defect. This case report describes a unique clinical situation of surgical resection and reconstruction that resulted in a satisfactory outcome for the patient. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Giant Synovial Cyst of Thigh: A Rare Entity

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    Kushagra Sinha

    2013-01-01

    Full Text Available Synovial cyst occurs secondary to traumatic, degenerative, or inflammatory conditions. Synovial cysts represent abnormal distension of bursae, which communicate with the joint. Giant synovial cysts are typically due to rheumatoid arthritis, other causes being trauma and synovial pseudoarthrosis. A 33-year-old male presented to an outpatient clinic with a massive swelling on his posterolateral aspect of right thigh extending from upper one-third to the knee joint which had been increasing in size over the past six months. This was associated with dull aching pain. All laboratory investigations were within normal parameters. Even FNAC was inconclusive. With time, swelling was increasing in size. Ultrasound revealed the cystic nature of swelling. MRI showed large cystic lesion 24 × 10 × 12 cm in posterolateral aspect of thigh extending up to knee joint. Following the MRI, an excision was planned. After excision, histological examination confirmed the synovial nature of the cyst, which had a collagenous wall and dense chronic inflammatory cells. As the disease is extremely rare and asymptomatic, precise diagnosis is difficult and often delayed. We consider that open surgical excision should be reserved for cases of large synovial cysts because it can provide a complete resection of the lesion and minimize the risk of recurrence.

  16. Prognostic factors affecting the surgical outcome of anterolateral benign tumors in the foramen magnum region.

    Science.gov (United States)

    Tao, Chuanyuan; Liu, Xiaowei; Zhang, Yuekang; Liu, Fan; You, Chao

    2016-09-01

    Anterior and anterolateral tumors in foramen magnum region are rare and surgically challenging although most of them are benign. The optimal approach is debatable and prognostic factors affecting surgical outcome remains unclear. We aimed to identify factors including surgical approach determining postoperative outcome. The data of 49 patients diagnosed benign tumors involving the anterior and anterolateral foramen magnum were retrospectively analyzed in our institution from January 2009 to January 2015. The demographic, clinicoradiological, surgical and follow-up information were collected. Primary surgical outcome was new neurological deficits. A multivariate analysis was performed to determine predictors of postoperative neurological deficits. Patients were operated on either via suboccipital (31 cases, 63.3%) or far lateral (18 cases, 36.7%) approach. Newly developed neurological deficits occurred in 11 (22.4%) patients, improved over time in 6 (12.2%) patients. 2 (4.1%) patients died within 3 month after operation and 2 (4.1%) suffered tumor recurrence. 44 (93.6%) out of 47 survivors had good functional outcome (postoperative Karnofsky performance score ≥80) at last follow-up period. Patients with postoperative new neurodeficits harbored tumors which tended to more frequently involve lower third clivus (p = 0.083), to be meningiomas (p = 0.059), were more likely to be removed through far lateral approach (p = 0.010) and have extradural extension (p = 0.024). Multivariate analysis showed that the far lateral approach was the sole predictor independently related to postoperative neurological deficits (p = 0.029). The far lateral approach to benign tumors anterolateral to foramen magnum experienced higher rate of immediate new neurological deficits compared to suboccipital approach. The role of the suboccipital approach may be underestimated and should be further evaluated. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All

  17. Reconstruction of anterior cruciate ligament and anterolateral ligament using interlinked hamstrings - technical note.

    Science.gov (United States)

    Ferreira, Marcio de Castro; Zidan, Flavio Ferreira; Miduati, Francini Belluci; Fortuna, Caio Cesar; Mizutani, Bruno Moreira; Abdalla, Rene Jorge

    2016-01-01

    Recent anatomical and biomechanical studies on the anterolateral ligament (ALL) of the knee have shown that this structure has an important function in relation to joint stability, especially when associated with anterior cruciate ligament (ACL) injury. However, the criteria for its reconstruction have not yet been fully established and the surgical techniques that have been described present variations regarding anatomical points and fixation materials. This study presents a reproducible technique for ALL and ACL reconstruction using hamstring tendons, in which three interference screws are used for fixation.

  18. Complete rupture of the anterolateral papillary muscle caused by coronary spasm.

    Science.gov (United States)

    Yamazaki, Masataka; Fukui, Toshihiro; Mahara, Keitaro; Takanashi, Shuichiro

    2015-12-01

    Papillary muscle rupture usually occurs as a catastrophic complication of acute myocardial infarction in patients with coronary artery stenosis; it is therefore less common in patients without coronary artery stenosis. We report the case of a 67-year old woman without coronary artery stenosis who suffered an acute anterolateral papillary muscle rupture and was successfully treated with mitral valve replacement. Evidence of coronary spasm was found on a coronary vasomotion test, suggesting that a high sensitivity to coronary spasm may explain a mechanism of isolated papillary muscle infarction.

  19. A Case of Pyomyositis and Primary Thigh Abscess in a Systemic Lupus Erythematous Patient MimickingThigh Hematoma

    Directory of Open Access Journals (Sweden)

    Rahele Mehrain

    2011-05-01

    Full Text Available Routes of extension of infection into the thigh can"nbe either direct, through the subcutaneous tissue, or"nthrough naturally occurring defects in the abdominal"nwall. These include: (1 Along the psoas muscle deep"nto the inguinal ligament; (2 Through the femoral"ncanal; (3 By way of the obturator foramen; and (4"nThrough the sacrosciatic notch. Pyomyositis is a"nprimary deep bacterial infection of the skeletal muscle"nwithout contiguous spread from adjacent structures,"nusually accompanied by abscess formation within"nthe skeletal muscle, but may also present as a diffuse"ninflammatory or a rapidly progressing myonecrotic"nprocess. Pyomyositis in patients with SLE has rarely"nbeen reported. Because of its rarity and often vague"nclinical presentation, it is unlikely to be considered"nduring the initial differential diagnosis. Moreover,"nthe diagnosis may be delayed as the affected muscle is"ndeeply situated and local signs are not apparent. This"ndelay in diagnosis may result in increased morbidity"nand sometimes a significant mortality rate. Here,"nwe describe a 57-year-old woman, known case of"nSLE with pyomyositis and primary left thigh abscess"nthat mimicked DVT in physical examination and"nhematoma in MRI. The purpose of this report was to"ndraw attention to this rare occurrence and to highlight"nthe etiology, presentation and the imaging features.

  20. Outcomes of minimally invasive anterolateral THA are not superior to those of minimally invasive direct lateral and posterolateral THA.

    Science.gov (United States)

    Greidanus, Nelson V; Chihab, Samir; Garbuz, Donald S; Masri, Bassam A; Tanzer, Michael; Gross, Allan E; Duncan, Clive P

    2013-02-01

    There has been considerable interest in minimally invasive surgical (MIS) THA in recent years. The MIS anterolateral approach, or the MIS Watson-Jones approach, is a novel intermuscular abductor-sparing technique. Early reports from case series suggest the potential for superior function and reduced complications; however, the available information from clinical reports is inadequate to suggest surgeons should change from their accepted standard approach. We examined the potential superiority of this anterolateral approach, as judged by quality-of-life (QoL) measures, radiographic parameters, and complications, compared to limited-incision MIS direct lateral and MIS posterolateral approaches. We performed a prospective randomized controlled trial involving five surgeons at three centers, recruiting 156 patients undergoing primary THA to receive either the MIS anterolateral or the surgeon's preferred approach (direct lateral or posterolateral). For the 135 patients we report, we collected patient-reported WOMAC, SF-36, Paper Adaptive Test in 5 Domains of Quality of Life in Arthritis Questionnaire [PAT5D], and patient satisfaction scores. We recorded complications and evaluated radiographs for prosthetic component position, subsidence, and fracture. Minimum followup was 24 months (mean, 30 months; range, 24-42 months). QoL and patient-reported satisfaction were similar between groups. Radiographic evaluation demonstrated no differences in acetabular component positioning; however, mean stem subsidence was 4.6 mm for the MIS anterolateral group and 4.1 mm for the alternate group, with differences observed among the three centers for stem subsidence and fracture. One center had increased rate of fracture requiring treatment and need for revision in the MIS anterolateral group. We found no superiority of the MIS anterolateral approach but observed intersite differences in painful stem subsidence and fracture. We have returned to the standard surgical approaches in

  1. Liposuction-assisted medial thigh lift in obese and non obese patients

    Directory of Open Access Journals (Sweden)

    Abdelmohsen Khalaf Aboueldahab

    2013-01-01

    Full Text Available Introduction: The abdomen, thighs and buttocks are often the areas of greatest concern to patients following massive weight loss due to bariatric surgery. The typical appearance of the patient who has lost a massive amount of weight derives from a combination of factors, including gender-dependent body morphology and a change in body mass index, which lead to skin and soft-tissue excess and poor skin tone. Thigh laxity and redundancy represents a great challenge to both patients and surgeons. Not only because of the difficulty to satisfy the patients, but also due to the higher incidence of complications especially, with those obese patients who have not undergone bariatric surgery before. The problems with such patients are due to the heavy thighs that require both debulking and tight anchorage to prevent scar migration or labial distortion. Aim of the Work: The aim of the present study is to improve the aesthetic outcome and avoid the complications of medial thigh lifting with simultaneous liposuction in obese and non-obese. Patients and Methods: A total of 25 female patients presented during the period from January 2007 to July 2011 complaining of moderate to severe thigh laxity with or without lipodystrophy. In 20 patients medial transverse thigh lift was performed, to treat medial thigh friction and laxity particularly in the upper half. Whereas, in the other five patients were suffering from upper and lower medial thigh bulkiness, vertical thigh lift was performed. Results: All patients recovered well in 2 weeks and showed improvement of thigh contour. Scar downward displacement in one patient. No skin necrosis or seroma. No labial distortion or separation encountered. Conclusion: Simultaneous liposuction and thigh lift gave good results provided proper patients selection, appropriate technique to each patient, meticulous, cautious liposuction and handling of the tissues and most importantly is the deep tight anchorage sutures to guard

  2. Cardiac Magnetic Resonance Imaging in the Diagnosis of Anterolateral Left Ventricular Ballooning, a Variant of Classic Takotsubo Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    R. Zbinden

    2012-01-01

    Full Text Available Transient left ventricular apical ballooning syndrome is characterized by transient akinesis of the left ventricular apex with basal wall hyperkinesis; this is also known as Takotsubo cardiomyopathy. There are three distinct contractile LV patterns described in the literature: apical, midventricular, and basal ballooning. The apical ballooning pattern is the most frequent pattern. We describe the case of a transient anterolateral left ventricular ballooning fulfilling the definition of Takotsubo cardiomyopathy except for the contractile LV pattern. The diagnosis was supported by cardiac magnetic resonance imaging and by the fact that the anterolateral ballooning resolved completely after 6 weeks.

  3. 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...

  4. 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.

  5. 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.

  6. Vaginal reconstruction using perineal-thigh flaps with subcutaneous pedicle.

    Science.gov (United States)

    Chen, Z; Chen, C; Chen, M; Zhang, J; Wu, N; Wang, J

    1991-03-01

    A technique of vaginal reconstruction using bilateral, perineal-thigh flaps with subcutaneous pedicle is described. In this procedure, the flaps were raised bilaterally and introduced into an artificial space between the urinary bladder and rectum. The blood supply for the flaps flows from the perineal artery through anastomotic branches to the external pudendal artery. The authors used the technique on four patients, and all the flaps survived entirely. There was no complication. According to a more than two-year follow-up survey, the reconstructed vaginas are expansible and contract little. No stent is needed. There is good sensitivity in the wall of the artificial vagina because sensory nerves run through the flaps.

  7. Do thigh circumference and mass changes alter knee biomechanics during walking?

    Science.gov (United States)

    Westlake, Carolyn G; Milner, Clare E; Zhang, Songning; Fitzhugh, Eugene C

    2013-03-01

    Obese adults walk with different biomechanics compared to healthy weight adults. Previous studies have focused on knee biomechanics because they are associated with development and progression of osteoarthritis. Changes in thigh mass and circumference that occur as body weight increases may influence gait. The purpose of this study was to determine if increases in thigh mass and circumference alter gait biomechanics. For 20 healthy weight young adults (10 male and 10 female) knee kinematic, kinetic and gait temporospatial variables were collected using a three-dimensional motion capture system and a force platform during over ground walking. Data were collected during control, increased thigh mass, increased thigh circumference, and both increased mass and circumference conditions. Increases in thigh segment parameters reflected changes expected with a 10 point increase in body mass index. Step width was wider during the added circumference and combination conditions compared to the control condition. Increases in thigh circumference associated with obesity increase step width. This suggests the greater step width observed in obese adults compared to healthy weight adults is a result of the physical constraints introduced by their wider thigh segments. Peak knee flexion angle, peak knee extension moment, peak knee adduction angle, and peak knee abduction moment were similar in all conditions. Thus, acute changes in thigh segment parameters did not result in knee biomechanics suggestive of an increased risk of knee osteoarthritis.

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

    DEFF Research Database (Denmark)

    Heitmann, Berit; Frederiksen, Peder

    2009-01-01

    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...... 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...

  9. Anatomical variation in the anterolateral ligament of the knee and a new dissection technique for embalmed cadaveric specimens.

    Science.gov (United States)

    Parker, Matthew; Smith, Heather F

    2016-12-18

    Claes et al. recently documented and described the anterolateral ligament (ALL) of the knee, demonstrating its existence in 97% of their samples. Here, we further examined the anatomy of this ligament, documented its morphological variation, and assessed the feasibility of its dissection in preserved cadaveric specimens. To achieve this, we dissected 53 preserved cadaveric knees and documented their morphological variation in the anterolateral ligament. The originally described dissection technique for identifying and following the ALL requires flexion of the knee, a state which is often not possible in stiff, preserved cadavers. Here, we describe and confirm the feasibility of an alternate dissection technique in which the quadriceps femoris tendon is incised, for use on specimens in which flexion of the undissected knee is not possible. We also identify a novel technique for assessing whether the anterolateral ligament is absent from a specimen or has simply been obliterated or overlooked, using the lateral inferior genicular vasculature. These dissection techniques have great potential for the dissection of preserved cadavers used in gross anatomy laboratories, and we discuss the applications of such an approach in student-led dissections. Our dissections also uncovered noticeable variation in the anterolateral ligament course and position. Most notably, it often inserts significantly more laterally than the classical presentation (30.2%), or originates more proximally with superficial fibers extending superiorly and laterally over the distal femur (7.5%).

  10. 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.

  11. Open antero-lateral dislocation of the elbow. A case report

    Directory of Open Access Journals (Sweden)

    Roy Bibas R

    2002-01-01

    Full Text Available Abstract Background Open dislocations are infrequent, often associated with damage to the neuro vascular structures. We present an unusual case of an open antero-lateral dislocation of the elbow, which was not associated with any vascular or neural injury. Case presentation A 34 year female dance instructor sustained an open dislocation of her elbow. Surgical exploration was undertaken. No major neurovascular injury was present. There was almost complete disruption of all the muscular and ligamentous attachments to the distal humerus and the proximal radius and ulna, which were not formally repaired during surgery. The elbow was found to be very unstable, and was placed in a back slab. The functional recovery was complete in about six months, the patient regaining full range of elbow movement. Elbow dislocations without associate fractures are adequately treated by manipulation and reduction, in spite of the almost complete disruption of the soft tissues around the joint.

  12. Bacillus Calmette-Guérin-related cold thigh abscess as an unusual cause of thigh swelling in infants following BCG vaccine administration: a case series

    Directory of Open Access Journals (Sweden)

    Al Shaalan Mohammad

    2011-09-01

    Full Text Available Abstract Introduction Thigh swelling in an infant can be a symptom of a simple benign condition or a life-threatening condition. We observed a cluster of thigh swelling episodes in infants in which the cause was Bacillus Calmette-Guérin-related cold thigh abscess. We report this unusual case series to raise awareness about this diagnosis. Case presentations We performed a retrospective review of five infants (four boys and one girl who presented with Bacillus Calmette-Guérin-related left thigh abscess. The swelling was noticed by the parents at a mean period of three months prior to presentation. The ages at presentation were five, five, eight and nine months for the boys, and six months for the girl. All of the patients were healthy Saudi infants, and received the Bacillus Calmette-Guérin vaccine at birth. Clinically, all of the patients were well and did not demonstrate signs of systemic infection. All patients underwent needle aspiration, with subsequent incision and drainage in four of the five cases. The cultures obtained from the abscess fluids were the key to establishing the diagnosis. Only three patients (60% received antituberculosis drugs. Wound healing lasted for a mean period of approximately seven months. Two-year follow-up was unremarkable for all of our patients. Conclusions Technical errors continue to be significant in the development of vaccine-related complications. Bacillus Calmette-Guérin-related cold thigh abscess is an extremely rare entity.

  13. Bone formation induced in mouse thigh by cultured human cells.

    Science.gov (United States)

    Anderson, H C; Coulter, P R

    1967-04-01

    Cultured FL human amnion cells injected intramuscularly into cortisone-conditioned mice proliferate to form discrete nodules which become surrounded by fibroblasts. Within 12 days, fibroblastic zones differentiate into cartilage which calcifies to form bone. Experiments were conducted to test the hypothesis that FL cells behave as an inductor of bone formation. In the electron microscope, FL cells were readily distinguished from surrounding fibroblasts. Transitional forms between the two cell types were not recognized. Stains for acid mucopolysaccharides emphasized the sharp boundary between metachromatic fibroblastic and cartilaginous zones and nonmetachromatic FL cells. (35)S was taken up preferentially by fibroblasts and chondrocytes and then deposited extracellularly in a manner suggesting active secretion of sulfated mucopolysaccharides. FL cells showed negligible (35)S utilization and secretion. FL cells, labeled in vitro with thymidine-(3)H, were injected and followed radioautographically, during bone formation. Nuclear label of injected FL cells did not appear in adjacent fibroblasts in quantities sufficient to indicate origin of the latter from FL cells. The minimal fibroblast nuclear labeling seen may represent reutilization of label from necrotic FL cells. It is suggested that FL cells injected into the mouse thigh induced cartilage and bone formation by host fibroblasts.

  14. Knee Joint Loading in Knee Osteoarthritis: Influence of Abdominal and Thigh Fat

    National Research Council Canada - National Science Library

    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

    PURPOSEUsing 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...

  15. Evaluation of the inner thigh as site for mantoux test among children ...

    African Journals Online (AJOL)

    2016-07-30

    Jul 30, 2016 ... the volar aspect of the forearm and the inner thigh ... human immunodeficiency virus (HIV) pandemic. Early ... is applied on the volar surface of the forearm (for ease of ... dren, weight and height were measured using a stadi-.

  16. 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.

  17. Microbiological quality of chicken thighs after vacuum packaging, EDTA, Coriandri aetheroleum and Menthae spicata aetheroleum

    OpenAIRE

    Miroslava Kačániová; Jana Petrová; Margarita Terentjeva; Martin Mellen; Attila Kántor; Maciej Kluz; Lukáš Hleba; Peter Haščík; Juraj Čuboň

    2015-01-01

    The aim of the present work was monitoring chicken thighs microbiological quality after treatment by ethylenediaminetetraacetate (EDTA), coriander (Coriandri aetheroleum) and spearmint (Menthae spicata aetheroleum) essential oil, stored under vacuum packaging, at 4±0.5°C for a period of 16 days. The following treatments of chicken thighs were used: Air-packaging control samples, control vacuum-packaging samples, vacuum-packaging with EDTA solution 1.50% w/w, control samples, vacuum-packaging ...

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

    Science.gov (United States)

    Amiri, Fateme Shamekhi; Foroughi, Alireza

    2014-11-01

    Necrotizing fasciitis (NF) is a rapidly progressive, life-threatening soft tissue infection. 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.

  19. Definição do limite anterolateral do lobo occipital em peças anatômicas e exames de imagem Definition of the anterolateral occipital lobe limit in anatomical specimens and with neuroimaging

    Directory of Open Access Journals (Sweden)

    Sebastião Gusmão

    2002-03-01

    Full Text Available Com o objetivo de definir o limite anterolateral do lobo occipital foram estudados sete segmentos cefálicos de cadáveres humanos, 103 exames de tomografia computadorizada e 104 exames de ressonância magnética do encéfalo considerados normais. Foram encontradas uma prega da dura-máter sobre o seio transverso (plica tentorial pré-occipital e uma protuberância óssea relacionadas diretamente com a incisura pré-occipital. Foi calculada, também, a distância média entre o sulco parieto-occipital e a sutura lambdóide. Nos exames de imagem, especialmente na ressonância magnética, foi possível identificar a incisura pré-occipital e/ou a protuberância na parede craniana relacionada a ela, bem como o sulco parieto-occipital e a sutura lambdóide, referências que permitem a definição do limite anterolateral do lobo occipital.The anterolateral limit of the occipital lobe was studied in anatomical specimens and with neuroimaging. Seven human cadaver heads, 103 normal CT-scan and 104 MRJ of the brain were studied. There was a fold of the dura mater on the transverse sinus (preoccipital tentorial plica and a bony protuberance related directly to the preoccipital notch. It was also determined the mean distance between the parieto-occipital sulcus and the lambdoid suture. In the imaging studies, especially magnetic resonance, it was possible to identify the preoccipital notch and/or a protuberance in the cranial vault related to this notch, besides the parieto-occipital sulcus and lambdoid suture, making possible, therefore, the definition of the anterolateral limit of the occipital lobe.

  20. Two Cases of Lower Body Contouring with a Spiral and Vertical Medial Thigh Lift

    Directory of Open Access Journals (Sweden)

    Sang Wha Kim

    2012-01-01

    Full Text Available Massive weight loss results in skin excess, leading to an unsatisfying body contour. Various thigh lift procedures can correct flabby skin in the lower leg. We present a lower body contouring technique with a report on two patients. The procedure is determined by the body contour of the patient. As the skin excess in the thigh area tended to appear mostly on the medial side, a vertical medial thigh lift was considered. Moreover, for patients with a pear/guitar-shaped body contour, we added the spiral thigh lift for skin excess in the buttocks and the lateral thigh area. The extent of tissue to excise was determined by pinching the patient in a standing position. The inferior skin flap was fixed to non-movable tissue, which was helpful for lifting the tissue and preventing the widening of the scar. After the operation, a drain was kept for 3 to 4 days. A compressive garment was used after removing the drain. There were no complications. The patients were discharged 6 to 8 days after the operation. In conclusion, skin excess, especially in the lower body, can be corrected by a thigh lift combining several procedures, varying from person to person.

  1. Abdomen-thigh contact during forward reaching tasks in obese individuals.

    Science.gov (United States)

    Singh, Bhupinder; Brown, Thomas D; Callaghan, John J; Yack, H John

    2013-10-01

    During seated forward reaching tasks in obese individuals, excessive abdominal tissue can come into contact with the anterior thigh. This soft tissue apposition acts as a mechanical restriction, altering functional biomechanics at the hip, and causing difficulty in certain daily activities such as bending down, or picking up objects from the floor. The purpose of the study was to investigate the contact forces and associated moments exerted by the abdomen on the thigh during seated forward-reaching tasks in adult obese individuals. Ten healthy subjects (age 58.1 ± 4.4) with elevated BMI (39.04 ± 5.02) participated in the study. Contact pressures between the abdomen and thigh were measured using a Tekscan Conformat pressure-mapping sensor during forward-reaching tasks. Kinematic and force plate data were obtained using an infrared motion capture system. The mean abdomen-thigh contact force was 10.17 ± 5.18% of body weight, ranging from 57.8 N to 200 N. Net extensor moment at the hip decreased by mean 16.5 ± 6.44% after accounting for the moment generated by abdomen-thigh tissue contact. In obese individuals, abdomen-thigh contact decreases the net moment at the hip joint during seated forward-reaching activities. This phenomenon should be taken into consideration for accurate biomechanical modeling in these individuals.

  2. The antero-lateral approach with corpectomy in the management of the ventral meningioma of the spinal canal.

    Science.gov (United States)

    Radek, Maciej; Grochal, Marek; Tomasik, Bartłomiej; Radek, Andrzej

    2016-01-01

    The authors present the anterior approach to cervical spine, which enabled complete resection of tumor located in the anterior part of the spinal canal. Considering there are not many reports in the literature, the authors present a case of a meningioma at the level C5-C6 resected with good result through anterolateral approach. Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

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

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    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

  4. Comparative study of anterolateral approach versus posterior approach for total hip replacement in the treatment of femoral neck fractures in elderly patients

    Institute of Scientific and Technical Information of China (English)

    WANG Gang; GU Gui-shan; LI Dan; SUN Da-hui; ZHANG Wei; WANG Tie-jun

    2010-01-01

    Objective: To compare the clinical outcome of anterolateral minimally invasive approach versus conventional posterior approach for total hip replacement against femoral neck fractures in elderly patients.Methods: The retrospective study was carried out on 42 patients who suffered from displaced femoral neck fractures (19 cases of Garden type Ⅲ, 23 cases of Garden type Ⅳ) treated by total hip replacement via anterolateral minimally invasive approach or conventional posterior approach by the same experienced surgeon. The average age of the patients was 78.1 years (range: 65-89 years). They were divided into anterolateral mini-invasive group (22 cases) and posterior group (20 cases). The mean time of follow-up was 13 months (range: 6-36 months). The anterolateral approach described by Hardinge goes through between anterior 1/3 and posterior 2/3 of the gluteus medius muscle, reaching the femoral neck from anterior capsule. The traditional posterior approach described by Moore (Southern incision) goes through the insertions of short external rotation muscles,reaching the femoral neck from posterior capsule. The related variables under observation were length of incision,operation time, postoperative limp, length of hospital stay and bed stay and dislolcation rate.Results: The length of the skin incision varied between 7 cm and 12 cm with the anterolateral minimally invasive technique, compared to 15-22 cm in the conventional procedure. It took less time (average 15 minutes) to complete the anterolateral minimally invasive approach (72 min±15 min), compared with the conventional approach (87 min±10 min). The average Harris hip score was 91.23±10.20 inanterolateral approach, 90.03±11.05 in the posterior approach. The average length of hospital stay for patients with the anterolateral approach was (6.4±2.2) days (range:4-9 days), while that in posterior approach was (9.2 ±3.1)days (range: 6-13 days). The average length of bed stay was (3.4±1.1) days (range: 2

  5. Treatment of Thoracolumbar Spinal Infections through Anterolateral Approaches Using Expandable Titanium Mesh Cage for Spine Reconstruction

    Directory of Open Access Journals (Sweden)

    Tarantino Roberto

    2012-01-01

    Full Text Available Pyogenic vertebral osteomyelitis (PVO is still a rare pathology. However, its incidence is on the rise. This is due to an increasing population with predisposing factors. Also, the availability of more effective diagnostic tools has brought it increasingly to the surgeon’s attention. In this study the patients were treated in the Neurosurgery Division of the Department of Neurological Sciences and Psychiatry of the Sapienza University of Rome, between 2001 and 2009. They had thoracolumbar pyogenic spondylitis. This study was undertaken in order to identify the correct diagnostic and therapeutic treatment needed in such cases. From the cases studied here, it is evident that spinal infections can be extremely insidious and that diagnosis tends to be reached late. Surgery, along with the antibiotic treatment, allows for eradication of the causes of the pathology by the reclamation of the affected region. Surgery is also fundamental in helping to recover vital functions and in restoring as much as possible the correct curvature of the rachises. The use of an anterolateral approach is dictated by the necessity of obtaining 360° stability as well as by the need to clear away extensive infections, which are not always reachable using a posterior approach.

  6. Idoneidad del colgajo anterolateral de muslo para reconstrucción de grandes defectos craneofaciales

    Directory of Open Access Journals (Sweden)

    David González-Ballester

    2014-07-01

    Full Text Available La reconstrucción de grandes defectos en la región craneal y del cuero cabelludo constituyen un reto para el cirujano reconstructivo. Diversos factores pueden influir en la selección de un determinado método quirúrgico, tales como: anatomía del defecto, factores dependientes del paciente, preferencias del cirujano, etc. En condiciones desfavorables, tales como grandes defectos, presencia de infección o cirugías previas, los colgajos microvascularizados se presentan superiores al resto de técnicas reconstructivas en la recuperación de la integridad craneofacial. Presentamos un varón de 57 años de edad con defecto estético importante en región frontal e infección crónica activa de más de 20 años de evolución reconstruido con un colgajo libre microvascularizado de la región antero-lateral del muslo de una forma dual, solucionando con ello el cuadro infeccioso al aportar tejido sano vascularizado; y el defecto estético al añadir volumen, consiguiéndose un excelente resultado final.

  7. An unusual form of congenital anterolateral tibial angulation - the delta tibia

    Energy Technology Data Exchange (ETDEWEB)

    Currarino, Guido [Department of Radiology, Texas Scottish Rite Hospital for Children, Dallas, TX (United States); Department of Radiology, University of Texas, Southwestern Medical Center, Dallas, TX (United States); Herring, John A.; Johnston II, Charles E.; Birch, John G. [Department of Orthopaedic Surgery, Texas Scottish Rite Hospital for Children, Dallas, TX (United States)

    2003-05-01

    We report three infants with a poorly known form of congenital anterolateral angulation of the tibia with distinctive features seen on lateral roentgenograms. In these films the affected tibia appears to be divided into two segments, one proximal and the other distal, which taper as they approach each other at the site of the angulation, and end separately at the apex of the curve with an intervening radiolucent gap in the anterior tibial cortex. The two tibial segments are originally bridged and held firmly in that position by a well-defined triangular osseous structure located in the concavity of the tibial bow. It appears from the three cases reported in this paper and a few comparable cases in the literature that this form of tibial bowing is not prone to fracture followed by pseudoarthrosis and that it tends to improve (and resolve) spontaneously, with a resorption of the intramedullary bony structures at the apex of the curve resulting in the formation of a normal medullary cavity. A limb length discrepancy of varying degree is the main residual change of the anomaly. (orig.)

  8. Surgical anatomy of the diaphragm in the anterolateral approach to the spine: a cadaveric study.

    Science.gov (United States)

    Baaj, Ali A; Papadimitriou, Kyriakos; Amin, Anubhav G; Kretzer, Ryan M; Wolinsky, Jean-Paul; Gokaslan, Ziya L

    2014-06-01

    Laboratory cadaveric study. To delineate the pertinent surgical anatomy of the diaphragm during access to the anterolateral thoracolumbar junction. The general anatomy of the thoracic diaphragm is well described. The specific surgical anatomy as it pertains to the lateral and thoracoabdominal approaches to the thoracolumbar junction is not well described. Dissections were performed on adult fresh cadaveric specimens. Special attention was paid to the diaphragmatic attachments to the lower rib cage and to the spinal thoracolumbar junction. The pertinent diaphragmatic attachments to the rib cage are at the 11th and 12th ribs. Whether the diaphragm is incised or mobilized ventrally, the pertinent spinal attachments are the lateral and medial arcuate ligaments. Identifying and sectioning these structures allows for direct access to the thoracolumbar junction, particularly the L1 vertebral body. An understanding of the diaphragmatic-costal and diaphragmatic-spinal attachments is key for the safe and effective implementation of diaphragm mobilization during the lateral and thoracoabdominal approaches to the spine.

  9. Treatment of Thoracolumbar Spinal Infections through Anterolateral Approaches Using Expandable Titanium Mesh Cage for Spine Reconstruction

    Science.gov (United States)

    Roberto, Tarantino; Daniele, Marruzzo; Martina, Cappelletti; Tiziano, De Giacomo; Roberto, Delfini

    2012-01-01

    Pyogenic vertebral osteomyelitis (PVO) is still a rare pathology. However, its incidence is on the rise. This is due to an increasing population with predisposing factors. Also, the availability of more effective diagnostic tools has brought it increasingly to the surgeon's attention. In this study the patients were treated in the Neurosurgery Division of the Department of Neurological Sciences and Psychiatry of the Sapienza University of Rome, between 2001 and 2009. They had thoracolumbar pyogenic spondylitis. This study was undertaken in order to identify the correct diagnostic and therapeutic treatment needed in such cases. From the cases studied here, it is evident that spinal infections can be extremely insidious and that diagnosis tends to be reached late. Surgery, along with the antibiotic treatment, allows for eradication of the causes of the pathology by the reclamation of the affected region. Surgery is also fundamental in helping to recover vital functions and in restoring as much as possible the correct curvature of the rachises. The use of an anterolateral approach is dictated by the necessity of obtaining 360° stability as well as by the need to clear away extensive infections, which are not always reachable using a posterior approach. PMID:23193382

  10. Treatment of compartment syndrome of the thigh associated with acute renal failure after the Wenchuan earthquake.

    Science.gov (United States)

    Duan, Xin; Zhang, Kaiwei; Zhong, Gang; Cen, Shiqiang; Huang, Fuguo; Lv, Jingtong; Xiang, Zhou

    2012-04-01

    Compartment syndrome of the thigh is a rare emergency often treated operatively. The purpose of this study was to evaluate the effects of nonoperative treatment for compartment syndrome of the thigh associated with acute renal failure after the 2008 Wenchuan earthquake. Nonoperative treatment, which primarily involves continuous renal replacement therapy, was performed in 6 patients (3 men and 3 women) who presented with compartment syndrome of the thigh associated with acute renal failure. The mean mangled extremity severity score (MESS) and laboratory data regarding renal function were analyzed before and after treatment, and the clinical outcome was evaluated at 17-month follow-up. Laboratory data regarding renal function showed improvements. All 6 patients survived with the affected lower limbs intact after nonoperative treatment. Follow-up revealed active knee range of motion and increased muscle strength, as well as a recovery of sensation. A positive linear correlation was found between MESS and the time required to achieve a reduction in swelling, as well as the time required for the recovery of sensation and knee range of motion (r>0.8; P<.05). Satisfactory clinical outcomes were obtained in patients with compartment syndrome of the thigh associated with acute renal failure.Urine alkalization, electrolyte and water balance, and continuous renal replacement therapy have played an important role in saving lives and extremities. Nonoperative treatment should be considered in the treatment of compartment syndrome of the thigh associated with acute renal failure.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Lindemann, Ulrich; Mohr, Christian; Machann, Juergen; Blatzonis, Konstantinos; Rapp, Kilian; Becker, Clemens

    2016-01-01

    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.

  13. Perioperative nursing of 6 patients undergoing reconstruction of maxillofacial injuries with anterolateral thigh flap implants%6例股前外侧皮瓣移植修复颌面部缺损手术的护理配合

    Institute of Scientific and Technical Information of China (English)

    刘蕊; 支福娜; 沈蕾; 栗茜

    2008-01-01

    总结6例应用股前外侧皮瓣修复颌骨缺损患者的手术护理经验,分析主要护理问题,实施有效的护理措施.做好手术前、后的护理访视;完成颌面外科、骨科、显徽外科等专科手术特殊用物的准备;合理实施多手术区域术中的无菌布局;掌握显微手术配合技术;做好术中无瘤技术操作.6例股前外侧皮瓣全部成活,颌骨的外形及生理功能恢复良好.

  14. 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; pmuscles in the older 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.

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

    Science.gov (United States)

    How, Moo Ing; Lee, Puah Ken; Wei, Tan See; Chong, Chua Tai

    2015-01-01

    Compartment syndrome isolated to the anterior thigh is a rare complication of soccer injury. Previous reports in the English literature on sports trauma-related compartment syndrome of the thigh are vague in their description of the response of thigh musculature to blunt trauma, magnetic resonance imaging (MRI) findings of high-risk features of compartment syndrome, vascular injury in quadriceps trauma, and the role of vascular study in blunt thigh injury. We present herein the rare case of a 30-year-old man who developed thigh compartment syndrome 8 days after soccer injury due to severe edema of vastus intermedius and large thigh hematoma secondary to rupture of the profunda femoris vein. MRI revealed "blow-out" rupture of the vastus lateralis. Decompressive fasciotomy and vein repair performed with subsequent split-skin grafting of the wound defect resulted in a good functional outcome at 2-years follow-up. 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. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Unusual bilateral origins of the deep artery of thigh and associated variations

    Directory of Open Access Journals (Sweden)

    Shankar N

    2009-08-01

    Full Text Available During routine dissection of a middle aged male cadaver, an unusual origin of the deep artery of thigh was observed bilaterally. It arose from the femoral artery less than 1 cm distal to the inguinal ligament. On both sides, its diameter was greater than that of the femoral artery. An unusually distal origin of the lateral circumflex femoral artery was observed bilaterally. An unnamed branch from the deep artery of thigh on the left side was seen coursing superolaterally towards the anterior superior iliac spine. The deep external pudendal artery arose from the medial circumflex femoral artery on either side. On the right side, the femoral nerve emerged in the femoral triangle by piercing the iliacus muscle. As the deep artery of thigh is often used in vascular reconstructive procedures and is frequently visualized by various radiological imaging techniques, anatomical variations of itself as well as its branches have significant clinical implications.

  17. Anatomic Anterolateral Ligament Reconstruction of the Knee Leads to Overconstraint at any Fixation Angle

    Science.gov (United States)

    Schon, Jason; Brady, Alex; Moatshe, Gilbert; Cruz, Raphael; Chahla, Jorge; Dornan, Grant; Turnbull, Travis L.; Engebretsen, Lars

    2016-01-01

    Objectives: Anterior cruciate ligament (ACL) tears are one of the most common injuries among athletes. However, the ability to fully restore rotational stability with ACL reconstruction (ACLR) remains a challenge because up to 25% of patients may present with a residual pivot shift following surgery. Advocacy for reconstruction of the anterolateral ligament (ALL) is rapidly increasing because biomechanical studies have reported that the ALL is a significant contributor to internal rotational stability of the knee. Although several graft fixation angles for the anatomic ALL reconstruction (ALLR) have been reported in literature, none have been biomechanically validated. Therefore, the purpose of this study was to assess the effect of ALLR graft fixation angle on knee joint kinematics in the clinically relevant setting of a concomitant ACLR. The goal was to find the optimal knee flexion angle for fixation of the ALLR graft that would most accurately restore native knee kinematics without introducing overconstraint to the knee. It was hypothesized that all fixation angles would significantly reduce rotational laxity compared to the sectioned ALL state and that fixation at 30° would best reproduce native joint kinematics. Methods: Eight non-paired fresh-frozen human cadaveric knees with no prior injury, surgical history, or gross anatomic abnormality were evaluated with a 6 degree-of-freedom robotic system. Each specimen underwent a full kinematic assessment in each of the following states: 1) intact, 2) anatomic single-bundle (SB) ACLR with intact ALL, 3) anatomic SB ACLR with sectioned ALL, 4) 7 anatomic SB ACLR and ALLR states utilizing ALL graft fixation knee flexion angles of 0°, 15°, 30°, 45°, 60°, 75° and 90°, and 5) sectioned ACL and ALL. Internal rotation during a 5 N-m internal rotation torque and anterior displacement during an 88 N anterior load were recorded at 15° intervals between 0° and 120° of knee flexion. Axial plane displacement and

  18. The strength and function of hip abductors following anterolateral minimally invasive total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    Tan Jixiang; Chen Hong; Chen Cheng; Liang Xi; Huang Wei

    2014-01-01

    Objective:To analyze the extent of postoperative hip abductor insufficiency in primary total hip arthroplasty (THA) patients undergoing anterolateral minimally invasive (ALMI) approach,and to investigate whether the clinical outcomes are more favorable in femoral neck fracture (FNF) patients than in non-femoral neck fracture (nFNF) patients.Methods:A total of 48 patients were enrolled in this study.Each patient underwent a clinical examination preoperatively and 6,12,24 and 48 weeks postoperatively.The abductor torque,Trendelenburg's sign,gait velocity,Harris hip score,Oxford hip score,Westren Ontario and McMaster Universities (WOMAC) score and visual analog scale pain score were recorded.Statistical evaluation was performed with SPSS software version 18.0.The significance level was set at P<0.05.Results:The abductor torque of the operated hip and the recovery ratio showed a gradual improving tendency from 6 weeks postoperatively until the last follow-up.Gait velocity,Harris hip score,Oxford hip score and WOMAC score improved significantly after the operation until 24 weeks postoperatively.In the FNF group,the abductor torque of the operated side and the recovery ratio were significantly higher than in nFNF group at 6 weeks postoperatively,however,as time passed,this trend tended to disappear.Conclusion:This study demonstrates that patients can obtain good abductor strength and function in the early postoperative period and the hip abductor function of patients who suffer from hip osteoarthritis,rheumatoid arthritis,avascular necrosis of the femoral head could be significantly improved following ALMI THA.

  19. The strength and function of hip abductors following anterolateral minimally invasive total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Tan Jixiang

    2014-04-01

    Full Text Available Objective: To analyze the extent of postoperative hip abductor insufficiency in primary total hip arthroplasty (THA patients undergoing anterolateral minimally invasive (ALMI approach, and to investigate whether the clinical outcomes are more favorable in femoral neck fracture (FNF patients than in non-femoral neck fracture (nFNF patients. Methods:A total of 48 patients were enrolled in this study. Each patient underwent a clinical examination preoperatively and 6, 12, 24 and 48 weeks postoperatively. The abductor torque, Trendelenburg's sign, gait velocity, Harris hip score, Oxford hip score, Westren Ontario and McMaster Universities (WOMAC score and visual analog scale pain score were recorded. Statistical evaluation was performed with SPSS software version 18.0. The significance level was set at P<0.05. Results:The abductor torque of the operated hip and the recovery ratio showed a gradual improving tendency from 6 weeks postoperatively until the last follow-up. Gait velocity, Harris hip score, Oxford hip score and WOMAC score improved significantly after the operation until 24 weeks postoperatively. In the FNF group, the abductor torque of the operated side and the recovery ratio were significantly higher than in nFNF group at 6 weeks postoperatively, however, as time passed, this trend tended to disappear. Conclusion:This study demonstrates that patients can obtain good abductor strength and function in the early postoperative period and the hip abductor function of patients who suffer from hip osteoarthritis, rheumatoid arthritis, avascular necrosis of the femoral head could be significantly improved following ALMI THA. Key words: Arthroplasty, replacement, hip; Surgical procedures, minimally invasive; Recovery of function

  20. 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.)

  1. 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.

  2. Definição do limite anterolateral do lobo occipital em peças anatômicas e exames de imagem Definition of the anterolateral occipital lobe limit in anatomical specimens and with neuroimaging

    OpenAIRE

    Sebastião Gusmão; Cassius Reis; Uedson Tazinaffo; Celso Mendonça; Roberto Leal Silveira

    2002-01-01

    Com o objetivo de definir o limite anterolateral do lobo occipital foram estudados sete segmentos cefálicos de cadáveres humanos, 103 exames de tomografia computadorizada e 104 exames de ressonância magnética do encéfalo considerados normais. Foram encontradas uma prega da dura-máter sobre o seio transverso (plica tentorial pré-occipital) e uma protuberância óssea relacionadas diretamente com a incisura pré-occipital. Foi calculada, também, a distância média entre o sulco parieto-occipital e ...

  3. An unusual presentation of autonomic dysreflexia in a patient with cold abscess of cervical spine for anterolateral decompression

    Science.gov (United States)

    Sarangi, Susmita; Taneja, Dipali; Saxena, Bhavna

    2016-01-01

    A young female having complaints of quadriparesis along with bladder and bowel involvement, diagnosed to have osseous destruction of C4, C6, C7, T2 vertebral bodies with pre- and para-vertebral abscess, was taken up for anterolateral decompression and fusion of cervical spine. She presented with anxiety, agitation, sweating and headache and was in hypertensive crisis which was refractory to antihypertensives, anxiolytics and analgesics but showed a reasonable response to intravenous dexmedetomidine and finally responded dramatically to rectal evacuation. Autonomic dysreflexia was suspected with stimulus arising from distended rectum as all other causes of hypertension were ruled out. PMID:28003699

  4. An unusual presentation of autonomic dysreflexia in a patient with cold abscess of cervical spine for anterolateral decompression

    Directory of Open Access Journals (Sweden)

    Susmita Sarangi

    2016-01-01

    Full Text Available A young female having complaints of quadriparesis along with bladder and bowel involvement, diagnosed to have osseous destruction of C 4 , C 6 , C 7 , T 2 vertebral bodies with pre- and para-vertebral abscess, was taken up for anterolateral decompression and fusion of cervical spine. She presented with anxiety, agitation, sweating and headache and was in hypertensive crisis which was refractory to antihypertensives, anxiolytics and analgesics but showed a reasonable response to intravenous dexmedetomidine and finally responded dramatically to rectal evacuation. Autonomic dysreflexia was suspected with stimulus arising from distended rectum as all other causes of hypertension were ruled out.

  5. Effect of postmortem deboning time on sensory descriptive flavor and texture profiles of cooked boneless skinless chicken thighs

    Science.gov (United States)

    Three replicate trials were conducted to investigate the effect of deboning time on sensory descriptive profiles of cooked boneless skinless thigh meat (iliotibialis, iliofibularis and the femoritibialis). Carcasses (42-d old birds) were obtained from a commercial processing plant. Thighs were hot-b...

  6. 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.

  7. Liposuction-assisted medial thigh lift in non bariatric surgery patients

    Directory of Open Access Journals (Sweden)

    Abdelmohsen K. Aboueldahab

    2014-03-01

    Results: All patients recovered well in two weeks and showed improvement of thigh contour. Scar downward displacement occurred in one patient. No skin necrosis or seroma was encountered. One patient developed superficial thrombophlebitis and required hospital stay for 5 days and anticoagulant treatment. No labial distortion or separation was encountered.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. The relationships of waist and mid-thigh circumference with performance of college golfers.

    Science.gov (United States)

    Son, Seungbum; Han, Kunho; So, Wi-Young

    2016-03-01

    [Purpose] Our aim was to evaluate the relationships between waist and mid-thigh circumference, used as proxy measures of trunk and lower limb strengths, respectively, and selected parameters of driver and putting performance in Korean college golfers. [Subjects and Methods] The participants were 103 college golfers (81 male, 20 to 27 years old). Measurements of body composition, waist and mid-thigh circumference, and grip strength, as well as assessment of golf performance, including driver distance, driver swing speed, putting accuracy, and putting consistency, were performed at the golf performance laboratory at Konkuk University in Chungju-si, Republic of Korea. Average round score was obtained from 10 rounds of golf completed during the study period. The relationships between strength measures and golf performance were evaluated by partial correlation analysis, with adjustment for age, golf experience, and body mass index. [Results] Waist circumference did not correlate with any of the performance variables in both males and females. Mid-thigh circumference correlated with putting consistency (r = 0.364) in males and with putting consistency (r = 0.490) and accuracy (r = 0.547) in females. No other significant correlations between waist and mid-thigh circumference and golf performance were identified. [Conclusion] Lower limb strength may be an important component of putting performance. Further studies are needed to fully characterize the contributions of trunk strength to performance.

  10. Examination of Subcutaneous Tissue Thickness in the Thigh Site for Intramuscular Injection in Obese Individuals.

    Science.gov (United States)

    Zaybak, Ayten; İsmailoğlu, Elif Günay; İsmailoğlu, Eren

    2015-09-01

    The aim of the study was to investigate the thickness of subcutaneous (SC) tissue in the dorsogluteal and thigh sites in obese adults and its suitability for intramuscular injection using a standard-length needle. The sample for this prospective study consisted of 54 obese adults who presented to the ultrasound unit of the radiology clinic of a university hospital in the province of İzmir, Turkey, between June 2012 and August 2013. The study received Institutional Review Board approval, and informed written consent was obtained from all participants. The thickness of the SC tissue in the dorsogluteal and thigh sites was measured by sonography. The sonographic measurements were performed by a radiology specialist. The mean thicknesses of the SC tissue were 61.70 ± 15.73 mm in the dorsogluteal site, 27.05 ± 8.52 mm in the rectus femoris site, and 23.23 ± 8.44 mm in vastus lateralis site. The SC tissue was thicker in the dorsogluteal than the thigh site (P njections to the thigh site would be effective in reaching the muscle in the rectus femoris and vastus lateralis sites in all men and in 77.8% of women, although it is not usually adequate for gluteal injection. © 2015 by the American Institute of Ultrasound in Medicine.

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

    NARCIS (Netherlands)

    Hofer, SOP; Damen, A; Nicolai, JPA

    2000-01-01

    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 silic

  12. Validity and repeatability of a depth camera-based surface imaging system for thigh volume measurement.

    Science.gov (United States)

    Bullas, Alice M; Choppin, Simon; Heller, Ben; Wheat, Jon

    2016-10-01

    Complex anthropometrics such as area and volume, can identify changes in body size and shape that are not detectable with traditional anthropometrics of lengths, breadths, skinfolds and girths. However, taking these complex with manual techniques (tape measurement and water displacement) is often unsuitable. Three-dimensional (3D) surface imaging systems are quick and accurate alternatives to manual techniques but their use is restricted by cost, complexity and limited access. We have developed a novel low-cost, accessible and portable 3D surface imaging system based on consumer depth cameras. The aim of this study was to determine the validity and repeatability of the system in the measurement of thigh volume. The thigh volumes of 36 participants were measured with the depth camera system and a high precision commercially available 3D surface imaging system (3dMD). The depth camera system used within this study is highly repeatable (technical error of measurement (TEM) of <1.0% intra-calibration and ~2.0% inter-calibration) but systematically overestimates (~6%) thigh volume when compared to the 3dMD system. This suggests poor agreement yet a close relationship, which once corrected can yield a usable thigh volume measurement.

  13. Influence of exercise loading on magnetic resonance image texture of thigh soft tissues.

    Science.gov (United States)

    Sikiö, Minna; Harrison, Lara C V; Nikander, Riku; Ryymin, Pertti; Dastidar, Prasun; Eskola, Hannu J; Sievänen, Harri

    2014-09-01

    Adaptation to exercise training can affect bone marrow adiposity; muscle-fat distribution; and muscle volume, strength and architecture. The objective of this study was to identify exercise-load-associated differences in magnetic resonance image textures of thigh soft tissues between various athlete groups and non-athletes. Ninety female athletes representing five differently loading sport types (high impact, odd impact, high magnitude, repetitive low impact and repetitive non-impact), and 20 non-athletic clinically healthy female controls underwent magnetic resonance imaging. Five thigh muscles, subcutaneous fat and femoral bone marrow were analysed with co-occurrence matrix-based quantitative texture analysis at two anatomical levels of the dominant leg. Compared with the controls thigh muscle textures differed especially in high-impact and odd-impact exercise-loading groups. However, all sports appeared to modulate muscle textures to some extent. Fat tissue was found different among the low-impact group, and bone marrow was different in the high-impact group when compared to the controls. Exercise loading was associated with textural variation in magnetic resonance images of thigh soft tissues. Texture analysis proved a potential method for detecting apparent structural differences in the muscle, fat and bone marrow.

  14. [A 35-year-old woman with fever, dyspnea, and pain in the left thigh].

    Science.gov (United States)

    Picardi, A; Navajas, F; De Iorio, F; Amicarelli, M; Spoto, S; De Galasso, L; Vespaciani Gentilucci, U; Scarlata, S; Zardi, E; Di Cuonzo, G

    2001-01-01

    A thirty-five years old woman during her twelfth pregnancy presented fever and pain at the left thigh. After cesarean delivery dyspnea added to the first two symptoms and pulmonary embolism was suspected. A clinical history revaluation suggested a diagnosis of infectious endocarditis and femoural osteomielitis due to a septic embolus.

  15. 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. 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

  16. 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.

  17. Correlation between waist and mid-thigh circumference and cardiovascular fitness in Korean college students: a case study.

    Science.gov (United States)

    Ko, Sung-Sik; Chung, Jae-Soon; So, Wi-Young

    2015-09-01

    [Purpose] We investigated whether waist and mid-thigh circumference correlated with cardiovascular fitness (VO2max) in a selected sample of Korean college students. [Subjects and Methods] The subjects were 41 college students (25 males, 16 females; age, > 19 years) who visited the sports medicine laboratory at the Korea National University of Transportation in Chungju-si, Republic of Korea, to undergo measurements of body composition, cardiovascular fitness, and waist and mid-thigh circumference. [Results] VO2max did not correlate with waist circumference or mid-thigh circumference in males, whereas VO2max was negatively correlated with mid-thigh circumference, but not waist circumference, in females. [Conclusion] Mid-thigh circumference was not associated with cardiovascular fitness or waist in male college students. However, it was associated with cardiovascular fitness in female college students. Well-designed studies are needed to investigate this further.

  18. Body vectoring technique with Radiesse® for tightening of the abdomen, thighs, and brachial zone

    Directory of Open Access Journals (Sweden)

    Cogorno Wasylkowski V

    2015-05-01

    Full Text Available Valeria Cogorno Wasylkowski Médico Estético Cosmetic Medicine, Clinic Novosalud, Madrid, Spain Background: The objective of this study was to investigate the efficacy, safety, and subject satisfaction of the calcium hydroxylapatite-based dermal filler Radiesse® in a novel body vectoring technique to correct skin flaccidity in the thighs, abdomen, and brachial zones.Methods: Female subjects with self-evaluated flaccidity scores ≥3 on a 6-point scale (0, no flaccidity; 5, very severe flaccidity in the zones of interest were included. Radiesse was injected according to predesigned vector maps (3 mL per thigh, 1.5 mL per hemiabdomen or brachial zone. Clinical assessments (skin density and thickness were made by an independent reviewer at an exact position before and 5 weeks after treatment using a cutometer and an ultrascan. Subjects rated skin flaccidity before and 5 weeks after treatment on the 6-point scale and performed a pinch test to self-assess changes in skin thickness. All adverse events were recorded.Results: Twenty females (aged 28–67 years were enrolled, contributing 36 treatment zones. Across all zones, 78% of flaccidity measurements improved after treatment. Improvements in skin flaccidity were most common in the thighs (82% of cases. An improvement in skin density versus baseline was observed in the majority across all zones, most frequently in the abdomen (88% of cases. Skin thickness in each zone also improved versus baseline for the majority, most frequently in the thighs (88% of cases. Mean self-assessed flaccidity scores at baseline were 3.6 (thighs, 3.7 (abdomen, and 3.8 (brachial zone, and 2.6, 2.7, and 3.0, respectively, posttreatment. All subjects reported a positive pinch test. In total, 47.0% of subjects had bruising after treatment, which resolved within a week. No serious adverse events were reported.Conclusion: Using this novel technique, Radiesse had notable results on skin flaccidity, density and thickness in

  19. Radiological results of treatment using an extensive anterolateral approach for developmental dysplasia of the hip: minimum 5-year follow-up.

    Science.gov (United States)

    Sugawara, Ryo; Watanabe, Hideaki; Hagiwara, Kayo; Inoue, Hirokazu; Takeshita, Katsushi; Kikkawa, Ichiro

    2016-11-01

    To investigate the radiological results using the extensive anterolateral approach in patients with developmental dysplasia of the hip. A total of 16 hips with developmental dysplasia of the hip treated by the extensive anterolateral approach were retrospectively reviewed after a minimum follow-up of 5 years. For evaluation, we considered the Severin classification and postoperative complications. At the final follow-up (mean 75.6 months), 14 hips (87.5%) were satisfactory in the Severin classification. Reoperation was performed in only one hip (6.3%) because of redislocation. No femoral head necrosis was observed. Our results were more favorable than those using conventional surgical methods.

  20. Overlap Between Anterior Cruciate Ligament and Anterolateral Meniscal Root Insertions: A Scanning Electron Microscopy Study.

    Science.gov (United States)

    Steineman, Brett D; Moulton, Samuel G; Haut Donahue, Tammy L; Fontboté, Cristián A; LaPrade, Christopher M; Cram, Tyler R; Dean, Chase S; LaPrade, Robert F

    2017-02-01

    The anterolateral meniscal root (ALMR) has been reported to intricately insert underneath the tibial insertion of the anterior cruciate ligament (ACL). Previous studies have begun to evaluate the relationship between the insertion areas and the risk of iatrogenic injuries; however, the overlap of the insertions has yet to be quantified in the sagittal and coronal planes. To investigate the insertions of the human tibial ACL and ALMR using scanning electron microscopy (SEM) and to quantify the overlap of the ALMR insertion in the coronal and sagittal planes. Descriptive laboratory study. Ten cadaveric knees were dissected to isolate the tibial ACL and ALMR insertions. Specimens were prepared and imaged in the coronal and sagittal planes. After imaging, fiber directions were examined to identify the insertions and used to calculate the percentage of the ACL that overlaps with the ALMR instead of inserting into bone. Four-phase insertion fibers of the tibial ACL were identified directly medial to the ALMR insertion as they attached onto the tibial plateau. The mean percentage of ACL fibers overlapping the ALMR insertion instead of inserting into subchondral bone in the coronal and sagittal planes was 41.0% ± 8.9% and 53.9% ± 4.3%, respectively. The percentage of insertion overlap in the sagittal plane was significantly higher than in the coronal plane ( P = .02). This study is the first to quantify the ACL insertion overlap of the ALMR insertion in the coronal and sagittal planes, which supplements previous literature on the insertion area overlap and iatrogenic injuries of the ALMR insertion. Future studies should determine how much damage to the ALMR insertion is acceptable to properly restore ACL function without increasing the risk for tears of the ALMR. Overlap of the insertion areas on the tibial plateau has been previously reported; however, the results of this study demonstrate significant overlap of the insertions superior to the insertion sites on the

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

    Science.gov (United States)

    Kingma, Idsart; Faber, Gert S; van Dieën, Jaap H

    2016-04-11

    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 male subjects lifted a pencil and a crate from the floor, with four lifting techniques (free, squat, stoop and a Weight Lifters Technique (WLT)), each of which was performed with and without supporting with one hand on the thigh. A six Degrees of Freedom force transducer, with a comfortable surface to support the hand on, was mounted just above the subject׳s left knee. Hand forces, ground reaction forces, full body kinematics, and trunk EMG were measured. Using inverse dynamics and taking the forces between hand and thigh into account, we calculated 3D L5S1 joint moments, and subsequently estimated spine forces using an EMG-assisted trunk model. For lifting a pencil, hand support reduced average peak total moments by 17-25%, dependent on lifting technique. For crate lifting, hand support reduced total moments by 13-19% compared with one-handed lifting and by 14-26% compared to two-handed lifting. Hand support slightly increased asymmetric motions and caused a substantial increase in asymmetric moments in crate lifting. For compression forces, reductions (up to 28%) were seen in all techniques except in stoop lifts. It is concluded that leaning with a hand on the thigh can lead to substantial reductions of low back loading during lifting.

  2. 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.

  3. A review of the anterolateral ligament of the knee: current knowledge regarding its incidence, anatomy, biomechanics, and surgical dissection.

    Science.gov (United States)

    Pomajzl, Ryan; Maerz, Tristan; Shams, Christienne; Guettler, Joseph; Bicos, James

    2015-03-01

    To systematically review current literature on the anterolateral ligament (ALL) of the knee. We searched the PubMed/Medline database for publications specifically addressing the ALL. We excluded studies not written in English, studies not using human cadavers or subjects, and studies not specifically addressing the ALL. Data extraction related to the incidence, anatomy, morphometry, biomechanics, and histology of the ALL and its relation to the Segond fracture was performed. The incidence of the ALL ranged from 83% to 100%, and this range occurs because of small discrepancies in the definition of the ALL's bony insertions. The ALL originates anterior and distal to the femoral attachment of the lateral collateral ligament. It spans the joint in an oblique fashion and inserts between the fibular head and Gerdy tubercle on the tibia. Exact anatomic and morphometric descriptions vary in the literature, and there are discrepancies regarding the ALL's attachment to the capsule and lateral meniscus. The ALL is a contributor to tibial internal rotation stability, and histologically, it exhibits parallel, crimped fibers consistent with a ligamentous microstructure. The footprint of the ALL has been shown to be at the exact location of the Segond fracture. The ALL is a distinct ligamentous structure at the anterolateral aspect of the knee, and it is likely involved in tibial internal rotation stability and the Segond fracture. Level IV, systematic review of anatomic and imaging studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  4. 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

  5. Sciatica due to malignant nerve sheath tumour of sciatic nerve in the thigh.

    Directory of Open Access Journals (Sweden)

    Sharma R

    2001-04-01

    Full Text Available Malignant peripheral nerve sheath tumour (MPNST is a rare malignant neoplasm arising from the supportive non-neural component of the peripheral nerves. An unusual case of pain and weakness of the foot and calf muscles due to a giant MPNST of the sciatic nerve in the posterior compartment of the thigh is presented. The patient was already investigated as a case of sciatica due to a lumbar disc disease with a negative magnetic resonance imaging and then unsuccessfully operated elsewhere twice, with a misdiagnosis of tarsal tunnel syndrome. Neurosurgical referral prompted a diagnostic magnetic resonance study of the thigh, revealing the lesion, which was completely excised microsurgically with total relief in the pain and partial improvement in the weakness and sensations in the sole of the foot.

  6. Three-dimensional Superficial Liposculpture of the Hips, Flank, and Thighs

    Directory of Open Access Journals (Sweden)

    Yi Xin Zhang, MD

    2015-01-01

    Conclusions: If performed correctly, 3-dimensional superficial liposuction of the trunk, hips, and thighs can yield very satisfying outcomes because of the excellent contour and the enhanced skin retraction provided by the thin cutaneous adipose flap. Three-dimensional liposuction is a reliable method with proven results. A careful application of the technique combined with accurate surgical planning, a thorough preoperative explanation of real expectations, and postoperative care is crucial.

  7. Broiler chicken thigh and breast muscle responses to cold stress during simulated transport before slaughter.

    Science.gov (United States)

    Dadgar, S; Crowe, T G; Classen, H L; Watts, J M; Shand, P J

    2012-06-01

    The effect of acute cold exposure was assessed on broiler physiology, breast and thigh muscle metabolites, and meat quality. In total, 160 male birds at ages of 5 and 6 wk were exposed to temperatures of -9 to -15°C (cold stressed) and +20°C (control) in a simulated transport chamber for 3 h before slaughter followed by 0 or 2 h of lairage. Bird physiology parameters, including core body temperature, live shrink, blood glucose, and muscle temperature, were assessed. Core body temperature was monitored every minute using i-Button data loggers, and live shrink and blood glucose were assessed. Total glucose and lactate concentrations at 30 h postmortem, as well as ultimate pH (pH(u)), color, and water-holding attributes were evaluated on pectoralis major muscle of breast and iliotibialis muscle of thigh. Birds were grouped based on their microclimate temperature to control and cold-stressed groups (0 to -8, -8 to -11, and -11 to -14°C). Significant (P muscle temperatures were observed at simulated transport temperatures below 0°C. In addition, higher (P muscle was almost depleted of glycogen reserve compared with a significant but small reduction in breast muscle glycogen when exposure temperature was below -8°C. Similarly, much greater effects were observed on thigh pH(u) and quality attributes compared with breast. In addition, 84% incidence of the dark, firm, dry quality defect was observed in thigh meat (pH(u) > 6.4, L* 6.1, L* muscle was affected more severely than breast muscle by exposure to cold temperatures before slaughter.

  8. Assessment of Intraocular and Systemic Vasculature Pressure Parameters in Simulated Microgravity with Thigh Cuff Countermeasure

    Science.gov (United States)

    Huang, Alex S.; Balasubramanian, Siva; Tepelus, Tudor; Sadda, Jaya; Sadda, Srinivas; Stenger, Michael B.; Lee, Stuart M. C.; Laurie, Steve S.; Liu, John; Macias, Brandon R.

    2017-01-01

    Changes in vision have been well documented among astronauts during and after long-duration space flight. One hypothesis is that the space flight induced headward fluid alters posterior ocular pressure and volume and may contribute to visual acuity decrements. Therefore, we evaluated venoconstrictive thigh cuffs as a potential countermeasure to the headward fluid shift-induced effects on intraocular pressure (IOP) and cephalic vascular pressure and volumes.

  9. 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 < 0.0001), patellofemoral forces (p< 0.006), and 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 < 0.001), and patellofemoral forces (p = 0.01) and 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

  10. Sentinel Node Mapping of VX2 Carcinoma in Rabbit Thigh with CT Lymphography Using Ethiodized Oil

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yoon Jin; Kim, Young Hoon; Lee, Kyoung Ho; Park, Ji Hoon [Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Lee, Hye Seung [Department of Pathology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Jung, Seung Chai [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744 (Korea, Republic of); Joo, Seung-Moon [Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720 (Korea, Republic of)

    2014-07-01

    To assess the feasibility of computed tomography (CT) lymphography using ethiodized oil for sentinel node mapping in experimentally induced VX2 carcinoma in the rabbit thigh. This experiment received approval from the institutional animal use and care administrative advisory committee. Twenty-three rabbits with VX2 carcinoma in the thigh underwent CT before and after (1 hour, 2 hour) peritumoral injection of 2 mL ethiodized oil. After the CT examination, sentinel nodes were identified by peritumoral injection of methylene blue and subsequently removed. The retrieved sentinel and non-sentinel lymph nodes were investigated with radiographic and pathologic examinations. Based on the comparison of CT findings with those of radiographic and pathologic examinations, the diagnostic performance of CT for sentinel node identification was assessed. All 23 rabbits showed 53 ethiodized oil retention nodes on post-injection CT and specimen radiography, and 52 methylene blue-stained nodes at the right femoroiliac area. Of the 52 blue-stained sentinel nodes, 50 nodes demonstrated ethiodized oil retention. Thus, the sentinel node detection rate of CT was 96% (50 of 52). On pathologic examination, 28 sentinel nodes in 17 rabbits (nodes/rabbit, mean ± standard deviation, 1.7 ± 0.6) harbored metastasis. Twenty seven of the 28 metastatic sentinel nodes were found to have ethiodized oil retention. Computed tomography lymphography using ethiodized oil may be feasible for sentinel node mapping in experimentally induced VX2 carcinoma in the rabbit thigh.

  11. 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.

  12. The use of MRI to evaluate posterior thigh muscle activity and damage during nordic hamstring exercise.

    Science.gov (United States)

    Mendiguchia, Jurdan; Arcos, Asier L; Garrues, Mirian A; Myer, Gregory D; Yanci, Javier; Idoate, Fernando

    2013-12-01

    The aim of this study was to investigate the effects of the Nordic hamstring exercise on the biceps femoris long head (BFlh), biceps femoris short head (BFsh), semitendinosus (SMT), and semimembranosus (SMM) muscles. The Nordic hamstring strengthening exercise has been widely used in injury prevention, yet not much is known about the site-specific activation of this exercise on different muscles of the thigh. Eight male national-level referees were assigned to a Nordic hamstring exercise protocol (5 sets of 8 repetitions). Magnetic resonance imaging (MRI) of the subjects' thighs was performed before, within 3 minutes after, and repeated again 72 hours after the exercise intervention. Fifteen axial scans of the thigh interspaced by a distance of 1 of 15 right femur length were obtained from the level of 1 of 15 Lf to 15 of 15 Lf. The MRI data were analyzed for signal intensity changes. After 72 hours, significant changes in transverse (spin-spin) relaxation time signal intensity and cross-sectional area were maintained distally at BFsh cranial portion and concretely at the nondominant limb, whereas no significant changes were observed in transverse (spin-spin) relaxation time signal intensity at BFlh, SMM, or SMT. This study demonstrated that the Nordic hamstring exercise did not result in a uniform response (training stimulus) neither interhamstring (dominant vs. nondominant) nor intrahamstring muscles (same leg) and was better suited for loading proximal BFsh.

  13. Influence of exercise training with thigh compression on heat-loss responses.

    Science.gov (United States)

    Amano, T; Inoue, Y; Koga, S; Nishiyasu, T; Kondo, N

    2015-06-01

    We investigated the effect of thigh compression, which accelerates activation of central command and muscle metabo- and mechanoreceptors, on the adaptation of sweating and cutaneous vascular responses during exercise heat acclimation. Nine non-heat-acclimated male subjects were acclimated to heat (32 °C and 50% RH) while cycling [50% of maximum oxygen uptake ( V ˙ O 2 m a x )] 60 min/day for 7 days (control group). The experimental group (n = 9) conducted the same training while the proximal thighs were compressed by a cuff at 60 mmHg. V ˙ O 2 m a x , acetylcholine-induced forearm sweating rate (iontophoresis), and mean sweating and cutaneous vascular responses on the forehead, chest, and forearm (SRmean and CVCmean ) during passive heating were evaluated before and after training. Training significantly increased V ˙ O 2 m a x while did not affect acetylcholine-induced sweating rates in either group. Training significantly decreased Tb thresholds for SRmean and CVCmean during passive heating without the alternations of sensitivities in both groups. Although SRmean during passive heating at a given ΔTb was not improved in either group, CVCmean was significantly (P training only in experimental group. Our results indicate that thigh cuff compression during exercise heat acclimation does not influence adaptation of the sweating response but attenuate cutaneous vasodilation.

  14. MORPHOLOGICAL CHANGES IN LUNGS, HEART AND LIVER CAUSED BY EXPERIMENTAL ASSOCIATED CHEST AND THIGHS TRAUMA

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    M. M. Khudobiak

    2017-07-01

    Full Text Available Background. According to preliminary results obtained, the development of hypoxemia caused by chest trauma affected lipid peroxidation stimulation leading to disruption of cell membranes structure and consequently cell death closing the ‘vicious’ circle, which in our opinion and according to the literature cause multiple organ failure. Objective. The aim of our study was to determine the features of morphological changes in cases of heart, lungs, liver injury after associated chest and both thighs trauma in rats. Methods. For histological examination the pieces of left ventricle tissues of heart, lungs and liver were used, which were fixed in 10% neutral formalin solution, dehydrated and embedded in paraffin blocks. Results. It was established that associated trauma of chest and both thighs in 1 day after the injury is accompanied by disturbances of hemodynamics in parenchymal organs due to venous congestion that occurs during the development of cardiovascular disease caused by traumatic shock. In the most severe period of maximum likelihood of complications, within 3 days, respiratory hypoxia, cardiovascular disorders, metabolic acidosis, and induced programmed cell death may develop. Conclusions. On the background of increasing pulmonary oedema (thickening of inter air sac membranes caused by associated trauma of chest and both thighs in rats after only one day of the experiment hemodynamic changes in heart (low-blood supply of vessels in epicardium and isolated blood vessels of venous type and liver (mainly plethora of blood vessels were observed, which lead to morphological changes of myocardium within 3 days.

  15. 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.

  16. Reduction in thigh circumference and improvement in the appearance of cellulite with dual-wavelength, low-level laser energy and massage.

    Science.gov (United States)

    Gold, Michael H; Khatri, Khalil A; Hails, Kelley; Weiss, Robert A; Fournier, Nathalie

    2011-02-01

    This study evaluated the efficacy and safety of a low-level, dual-wavelength laser energy and massage device for improving the appearance of cellulite and reducing thigh circumference. Subjects (n = 83) with mild to moderate cellulite enrolled in this IRB-approved, open-label, multicenter study. Their right or left thighs received eight treatments with a low-level, dual-wavelength laser and massage device. The untreated contralateral thigh served as a control. Circumferences of the upper, middle, and lower thighs (treated and untreated) were measured before the fifth and eighth treatments and 1 month after the final treatment. Reduction in thigh circumference of the treated areas exceeded those of the control areas for the upper, middle, and lower thigh in most subjects. The maximum reduction (-0.82 cm) occurred in the upper thigh at 1 month. The mean reduction of the upper, middle, and lower thigh circumferences was -0.64 cm for the treated thighs compared to -0.20 cm for untreated thighs. The difference was significant (p cellulite while reducing thigh circumference.

  17. 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.

  18. Bristle-thighed Curlew Capture Data from James Campbell National Wildlife Refuge, O'ahu, Hawaii, 2012-2014

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This data set contains banding, morphology, and satellite telemetry information for Bristle-thighed curlews (Numenius tahitiensis) that were captured between 2012...

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

    Science.gov (United States)

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

    2016-12-24

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

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

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    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.

  1. Long-term outcomes of arteriovenous thigh grafts in hemodialysis patients: a comparison with tunneled dialysis catheters.

    Science.gov (United States)

    Ong, Song; Barker-Finkel, Jill; Allon, Michael

    2013-05-01

    Arteriovenous thigh grafts are a potential vascular access option in hemodialysis patients who have exhausted all upper-limb sites. This study compared the outcomes of thigh grafts with outcomes obtained with dialysis catheters. A prospective vascular access database was queried to identify 209 thigh grafts placed from January 1, 2003, to June 30, 2011. The following were calculated: secondary graft survival (from graft creation to permanent failure), assisted primary graft survival (from graft creation to first thrombosis), and infection-free graft survival (from graft creation to first graft infection). Graft outcomes were compared with those observed with 472 tunneled internal jugular dialysis catheters. The median duration of patient follow-up was 340 days for grafts and 91 days for catheters. The surgical technical failure rate of thigh grafts was 8.1% and was higher in patients with vascular disease (hazard ratio [HR], 2.94; 95% confidence interval [CI], 1.07-8.04; P=0.03). Secondary and assisted primary graft survival rates at 1, 2, and 5 years were 62%, 54%, and 38% and 38%, 27%, and 17%, respectively. Infection-free graft survival rates at 1, 2, and 5 years were 79%, 73%, and 61%. Secondary survival was much worse for dialysis catheters than thigh grafts (HR, 4.44; 95% CI, 3.65-5.22; Pcatheters than for thigh grafts (HR, 3.77; 95% CI, 2.80-4.82; Pdialysis catheters.

  2. Variações da extensão anterolateral do acesso suboccipital lateral: estudo anatômico Anterolateral extension of the lateral suboccipital approach: an anatomical study

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    Roberto Leal Silveira

    2002-06-01

    Full Text Available Estudamos, em laboratório de microcirurgia, as extensões do acesso suboccipital lateral (ASOL em sete peças anatômicas, com o objetivo de definir as extensões deste acesso necessárias à abordagem das lesões da região anterolateral do forame magno e do forame jugular. As extensões (ressecção óssea foram realizadas em cinco estágios progressivos: 1 craniectomia suboccipital retrossigmóidea (ASOL retrocondilar; 2 ampliação da craniectomia com remoção da metade posterior do côndilo occipital (ASOL transcondilar parcial; 3extensão lateral da blocagem do côndilo occipital até abrir o canal do hipoglosso, seguida de ressecção do processo jugular e abertura do forame jugular (ASOL transcondilar parcial-transjugular; 4 brocagem completa do côndilo occipital (ASOL transcondilar completo; 5 ASOL completo acrescido de retirada da massa lateral do atlas até identificação do processo odontóide. Concluimos que as extensões do ASOL devem ser adaptadas à topografia da lesão: o ASOL retrocondilar para as lesões laterais ao forame magno, o ASOL transcondilar parcial para as anterolaterais, o ASOL transcondilar-transjugular para as lesões da região do forame jugular, o ASOL transcondilar completo para as anteriores ao forame magno, e o transcondilar completo/trans-massa lateral do atlas para as lesões extradurais da região anterior ao forame magno.We studied the extensions of the lateral suboccipital approach (LSOA in seven cadaver heads, in the microsurgical laboratory, in order to stablish the extensions necessary to approach the anterolateral area of the foramen magnum and the jugular foramen. The extensions (bone resection were accomplished in five progressive steps: 1 suboccipital retrossigmoid craniectomy (LSOA retrocondylar; 2 extending the craniectomy with removal of half the occipital condyle (LSOA partial transcondylar; 3 extending the drilling of the occipital condyle to open the hypoglossal foramen, followed by

  3. Pharmacokinetics/pharmacodynamics of antofloxacin hydrochloride in a neutropenic murine thigh model of Staphylococcus aureus infection

    Institute of Scientific and Technical Information of China (English)

    Xiu-mei XIAO; Yong-hong XIAO

    2008-01-01

    Aim:Antofloxacin hydrochloride is a new fluoroquinolone antibiotic with broad-spectrum in vitro activity.Using the neutropenic murine thigh infection model,we defined the pharmacodynamic profile and property of antofloxacin hydroehloride against Staphylococcus aureus.Methods:Single-dose pharmacokinetic studies of antofloxacin hydrochloride were carried out in thigh infected mice.Therapy was initiated at 2 h postinoculation with 5-640 mg/kg per d fractionated for different dosing regimens.The thighs were removed for bacterial measurement after 24 h of therapy,the best pharmacokinetic/ pharmacodynamic (PK/PD) index correlated with the efficacy was determined by nonlinear regression analysis.A sigmoid Emax dose-response model was used to estimate the daily dose and AUC24 h/MIC (minimal inhibitory concentration) required to achieve a static effect.Results:The PK was linear with similar elimination half-life over the dose range studied.The AUC24 h/MIC ratio was the PK/PD parameter that best correlated with efficacy (R2=92.3%,90.8% for the two organisms,compared with Cmax/MIC and T>MIC [%],respectively).The 24 h static dose ranged from 34.3 to 153.7 mg/kg per d for all S aureus strains,the total AUC24h/MIC ratio to achieve bacteriostatic effect varied from 31.7 to 122.5 (mean,65.7±30.6).Conclusion:Antofloxacin hydrochloride showed powerful antibacterial activity against the S aureus isolates used in our neutropenic infected mice model.Our data suggested that the AUC/MIC ratio appeared to be most closely linked to the bacterial outcome (R290%),and a total AUC24/MIC ratio of 65.7 appears to be the target value to achieve a net bactericidal activity against S aureus,similar to the results of other fluoroquinolones.

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

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    SZ. KONRÁD

    2013-07-01

    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 %.

  5. 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.

  6. Acute morbidity and complications of thigh compartment syndrome: A report of 26 cases

    Science.gov (United States)

    2010-01-01

    Background To describe the patient population, etiology, and complications associated with thigh compartment syndrome (TCS). TCS is a rare condition, affecting less than 0.3% of trauma patients, caused by elevated pressure within a constrained fascial space which can result in tissue necrosis, fibrosis, and physical impairment in addition to other complications. Compartment releases performed after irreversible tissue ischemia has developed can lead to severe infection, amputation, and systemic complications including renal insufficiency and death. Methods This study examines the course of treatment of 23 consecutive patients with 26 thigh compartment syndromes sustained during an eight-year period at two Level 1 trauma centers, each admitting more than 2,000 trauma patients yearly. Results Patients developing TCS were young (average 35.4 years) and likely to have a vascular injury on presentation (57.7%). A tense and edematous thigh was the most consistent clinical exam finding leading to compartment release (69.5%). Average time from admission to the operating room was 18 +/- 4.3 hours and 8/23 (34.8%) were noted to have ischemic muscle changes at the time of release. Half of those patients (4/8) developed local complications requiring limb amputations. Conclusion TCS is often associated with high energy trauma and is difficult to diagnose in uncooperative, obtunded and multiply injured patients. Vascular injuries are a common underlying cause and require prompt recognition and a multidisciplinary approach including the trauma and orthopaedic surgeons, intensive care team, vascular surgery and interventional radiology. Prompt recognition and treatment of TCS are paramount to avoid the catastrophic acute and long term morbidities. PMID:20723263

  7. Segmentation of magnetic resonance images of the thighs for a new National Institutes of Health initiative

    Science.gov (United States)

    Monzon, A.; Hemler, P. F.; Nalls, M.; Manini, T.; Clark, B. C.; Harris, T. B.; McAuliffe, M. J.

    2007-03-01

    This paper describes a new system for semi-automatically segmenting the background, subcutaneous fat, interstitial fat, muscle, bone, and bone marrow from magnetic resonance images (MRI's) of volunteers for a new osteoarthritis study. Our system first creates separate right and left thigh images from a single MR image containing both legs. The subcutaneous fat boundary is very difficult to detect in these images and is therefore interactively defined with a single boundary. The volume within the boundary is then automatically processed with a series of clustering and morphological operations designed to identify and classify the different tissue types required for this study. Once the tissues have been identified, the volume of each tissue is determined and a single, false colored, segmented image results. We quantitatively compare the segmentation in three different ways. In our first method we simply compare the tissue volumes of the resulting segmentations performed independently on both the left and right thigh. A second quantification method compares our results temporally with three image sets of the same volunteer made one month apart including a month of leg disuse. Our final quantification methodology compares the volumes of different tissues detected with our system to the results of a manual segmentation performed by a trained expert. The segmented image results of four different volunteers using images acquired at three different times suggests that the system described in this paper provides more consistent results than the manually segmented set. Furthermore, measurements of the left and right thigh and temporal results for both segmentation methods follow the anticipated trend of increasing fat and decreasing muscle over the period of disuse.

  8. 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).

  9. PET/CT and MRI Imaging of a Eumycetoma of the Right Thigh.

    Science.gov (United States)

    Besson, Florent L; Blanc-Durand, Paul; Meyer, Céline; Grimon, Gilles; Durand, Emmanuel

    2017-01-01

    Eumycetoma is a chronic tropical fungal disease that infiltrates subcutaneous tissues, mainly in the feet and legs. Standard antifungal drugs are ineffective, and mutilating surgery is common. Morphological imaging is useful for assessing the local extent of the disease before surgery. FDG PET/CT may be of potential interest for the general extent, but PET descriptions remain scarce and mostly relate to the feet. Here, the authors present FDG PET/CT and MRI study of a very rare case of an extensive, biopsy-proven eumycetoma of the right thigh that was performed to guide potential surgery.

  10. 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.

  11. Inhibition of lung metastasis of osteosarcoma cell line POS-1 transplanted into mice by thigh ligation.

    Science.gov (United States)

    Kamijo, Akira; Koshino, Tomihisa; Uesugi, Masaaki; Nitto, Hironori; Saito, Tomoyuki

    2002-12-15

    Using a model with external ligation of the thigh, the effect of ischemia-reperfusion injury on tumor growth and the activity of lung metastasis was investigated in mice inoculated a spontaneous murine osteosarcoma cell line (POS-1) in vivo. POS-1 cell suspension was inoculated into the right hind footpad of 70 mice. Four weeks after inoculation, the ipsilateral thigh was ligated for 3 h in 15 mice and the contralateral thigh in 15 mice. Another ten mice were inoculated with POS-1 without ligating the thigh. The number of metastatic foci on the lung surface 6 weeks after inoculation was 2.29+/-0.98 (mean+/-SE) foci/lungs in mice with ipsilateral ligation and 6.25+/-2.41 in mice with contralateral ligation, which were significantly lower than control (13.40+/-1.42 in mice no ligation) (P<0.01). The number of metastatic foci on the lung surface in mice with intraperitoneal injection of superoxide dismutase (SOD) and catalase was 3.25+/-0.65 (mean+/-SE) foci/lungs in mice with ligation which was significantly greater than that in mice without SOD and catalase injection 1.29+/-0.97 (P=0.04). Cell viability was 9.12+/-4.07% with 100 microM H(2)O(2) in 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay. It revealed that at concentrations of 100 microM H(2)O(2) or higher was cytotoxic to POS-1. In cell invasion assay, the number of invading cells with 10 microM H(2)O(2) was 2.80+/-0.53 cells/field, which was significantly lower than control (5.93+/-0.18) (mean+/-SE), indicating that low-dose H(2)O(2) suppressed invasion of POS-1. These results suggested that reperfusion injury had selective cytotoxicity to POS-1 through producing reactive oxygen species. Activated oxygen was considered to inhibit the regional growth and the ability of lung metastasis of POS-1 cells.

  12. 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...... 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......BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is used increasingly as an alternative to thoracotomy for lobectomy in the treatment of early-stage non-small-cell lung cancer, but remains controversial and worldwide adoption rates are low. Non-randomised studies have suggested that VATS...

  13. 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

  14. Return to play after thigh muscle injury in elite football players: implementation and validation of the Munich muscle injury classification

    Science.gov (United States)

    Ekstrand, Jan; Askling, Carl; Magnusson, Henrik; Mithoefer, Kai

    2013-01-01

    Background Owing to the complexity and heterogeneity of muscle injuries, a generally accepted classification system is still lacking. Aims To prospectively implement and validate a novel muscle injury classification and to evaluate its predictive value for return to professional football. Methods The recently described Munich muscle injury classification was prospectively evaluated in 31 European professional male football teams during the 2011/2012 season. Thigh muscle injury types were recorded by team medical staff and correlated to individual player exposure and resultant time-loss. Results In total, 393 thigh muscle injuries occurred. The muscle classification system was well received with a 100% response rate. Two-thirds of thigh muscle injuries were classified as structural and were associated with longer lay-off times compared to functional muscle disorders (pinjuries) with increasing lay-off time associated with more severe structural injury. Median lay-off time of functional disorders was 5–8 days without significant differences between subgroups. There was no significant difference in the absence time between anterior and posterior thigh injuries. Conclusions The Munich muscle classification demonstrates a positive prognostic validity for return to play after thigh muscle injury in professional male football players. Structural injuries are associated with longer average lay-off times than functional muscle disorders. Subclassification of structural injuries correlates with return to play, while subgrouping of functional disorders shows less prognostic relevance. Functional disorders are often underestimated clinically and require further systematic study. PMID:23645834

  15. Higher incidence of injection site reactions after subcutaneous bortezomib administration on the thigh compared with the abdomen.

    Science.gov (United States)

    Kamimura, Tomohiko; Miyamoto, Toshihiro; Yokota, Noriko; Takashima, Shuichiro; Chong, Yong; Ito, Yoshikiyo; Akashi, Koichi

    2013-02-01

    Subcutaneous (sc) rather than intravenous administration of bortezomib (Bor) is becoming more common for treating multiple myeloma (MM) because scBor results in lower incidence and severity of peripheral neuropathy and has equivalent efficacy. Bor is an irritant cytotoxic agent when it leaks out; therefore, it is recommended that injections of scBor should be rotated among eight different sites on the abdomen and thigh. However, detailed information about injection site reaction (ISR) has not been sufficiently documented. We retrospectively analyzed the incidence and severity of ISR following scBor administration in 15 Japanese patients with MM. Grade 1 ISR occurred following 40 of 158 (25.3%) scBor injections in ten patients, whereas grade 2 ISRs occurred following seven injections (4.4%) in five patients. Five patients did not develop ISR. Of note, grade 2 ISR was documented in 6 of 65 (9.2%) thigh injections but only in 1 of 93 (1.1%) abdominal injections. These data show that grade 2 ISRs were more common in the thigh compared with the abdomen possibly because the thigh contains lesser adipose tissue than the abdomen. Grade 2 ISRs resolved without any sequela within a median of 7 d. scBor administration on the abdomen instead of the thigh should be considered, especially for emaciated patients, because ISR rapidly resolves within the interval before the next injection even if it occurs. © 2012 John Wiley & Sons A/S.

  16. 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.

  17. 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.

  18. Microbiological quality of chicken thighs after vacuum packaging, EDTA, Coriandri aetheroleum and Menthae spicata aetheroleum

    Directory of Open Access Journals (Sweden)

    Miroslava Kačániová

    2015-05-01

    Full Text Available The aim of the present work was monitoring chicken thighs microbiological quality after treatment by ethylenediaminetetraacetate (EDTA, coriander (Coriandri aetheroleum and spearmint (Menthae spicata aetheroleum essential oil, stored under vacuum packaging, at 4±0.5°C for a period of 16 days. The following treatments of chicken thighs were used: Air-packaging control samples, control vacuum-packaging samples, vacuum-packaging with EDTA solution 1.50% w/w, control samples, vacuum-packaging with Menthae crispae aetheroleum essential oil at concentrations 0.2% v/w and vacuum-packaging with Coriandri aetheroleum essential oil at concentration 0.2% v/w. The quality assessment of all samples was established by microbiological analysis. The microbiological parameters as the total viable count, Enterobacteraceae genera counts, lactic acid bacteria and Pseudomonas spp. were detected. The results of this present study suggest the possibility of application the essential oil of Coriandri aetheroleum and Menthae spicata aetheroleum as natural food preservatives and potential sources of antimicrobial ingredients for food industry.

  19. Electromyographic analysis of thigh muscles during track cycling on a velodrome.

    Science.gov (United States)

    Watanabe, Kohei; Sato, Takayuki; Mukaimoto, Takahiro; Takashima, Wataru; Yamagishi, Michio; Nishiyama, Tetsunari

    2016-08-01

    We aimed to investigate neuromuscular activation of thigh muscles during track cycling at various speeds. Eight male competitive cyclists volunteered to participate in this study. Surface electromyography of the vastus lateralis, biceps femoris and adductor magnus muscles of the bilateral legs was recorded during track cycling on velodromes with a 250-m track. The participants were instructed to maintain three different lap times: 20, 18 and 16 s. The average rectified value (ARV) was calculated from the sampled surface electromyography. Significantly higher ARVs were observed in the right compared to left leg for the biceps femoris muscle during both straight and curved sections at 18- and 16-s lap times (P muscle, significant changes in ARVs during the recovery phase with an increase in speed were seen in the right leg only (P muscles (P > 0.05). From our findings, it was suggested that during track cycling on a velodrome the laterality of the biceps femoris muscle activity is a key strategy to regulate the speed, and fixed neuromuscular strategies are adopted between straight and curved sections for thigh muscles.

  20. Pelvic and thigh musculature in frogs (Anura) and origin of anuran jumping locomotion.

    Science.gov (United States)

    Prikryl, Tomás; Aerts, Peter; Havelková, Pavla; Herrel, Anthony; Rocek, Zbynek

    2009-01-01

    Comparative analysis of the anuran pelvic and thigh musculoskeletal system revealed that the thigh extensors, responsible for the initial phase of jump, the propulsive stroke in swimming and, if used asynchronously, also for walking, are least affected by the transformations observed between anurans and their temnospondyl ancestors (as reflected in contemporary caudates). The iliac shaft and urostyle, two of the most important anuran apomorphies, represent skeletal support for muscles that are mostly protractors of the femur or are important in attaining a crouching position, a necessary prerequisite for rapid escape. All of these muscles originate or insert on the iliac shaft. As the orientation of the pubis, ischium and ilium is the same in anurans, caudates and by inference also in their temnospondyl ancestors, it is probable that the pelvis was shifted from the sacral vertebra posteriorly along the reduced and stiffened tail (urostyle) by the elongation of the illiac shaft. Thus, the original vertical orientation of the ilium was maintained (which is also demonstrated by stable origins of the glutaeus maximus, iliofemoralis and iliofibularis on the tuber superius) and the shaft itself is a new structure. A review of functional analysis of anuran locomotion suggests some clear differences from that in caudates, suggesting that terrestrial jumping may have been a primary locomotor activity, from which other types of anuran locomotion are derived.

  1. Determination of optimal placements of markers on the thigh during walking and landing

    Directory of Open Access Journals (Sweden)

    Pain M.T.G.

    2010-06-01

    Full Text Available Kinematics of skin markers are affected by skin tissue artefact with respect to the bone during sports activities or locomotion. The purpose of this study is to determine the less disturbed marker’s location for walking and landing. Twenty-six markers were put on the thigh of nine male subjects. Each subject performed a static trial, a setup movement for determining a functional hip joint centre and five walking and landing trials. The marker displacements were obtained by comparing recorded marker positions and solidified marker positions based on the geometry of the static acquisition. The markers were subsequently ranked from the worst to the least deformed. The ranking of each trial for each subject was analyzed with the concordance coefficient of Kendall and descriptive statistics were used to determine the most and the least disturbed markers. The results show reproducibility between trials for each subject for the two movements. Statistical analysis shows that the most deformed markers during walking were located close to the hip and knee joints whereas the least disturbed were on the mid-thigh. The landing analysis does not permit to determine the best markers from the worst.

  2. Determination of optimal placements of markers on the thigh during walking and landing

    Science.gov (United States)

    Thouzé, A.; Monnet, T.; Begon, M.; Pain, M. T. G.

    2010-06-01

    Kinematics of skin markers are affected by skin tissue artefact with respect to the bone during sports activities or locomotion. The purpose of this study is to determine the less disturbed marker’s location for walking and landing. Twenty-six markers were put on the thigh of nine male subjects. Each subject performed a static trial, a setup movement for determining a functional hip joint centre and five walking and landing trials. The marker displacements were obtained by comparing recorded marker positions and solidified marker positions based on the geometry of the static acquisition. The markers were subsequently ranked from the worst to the least deformed. The ranking of each trial for each subject was analyzed with the concordance coefficient of Kendall and descriptive statistics were used to determine the most and the least disturbed markers. The results show reproducibility between trials for each subject for the two movements. Statistical analysis shows that the most deformed markers during walking were located close to the hip and knee joints whereas the least disturbed were on the mid-thigh. The landing analysis does not permit to determine the best markers from the worst.

  3. Incidence of Heterotopic Ossification after Surface and Conventional Total Hip Arthroplasty: A Comparative Study Using Anterolateral Approach and Indomethacin Prophylaxis

    Directory of Open Access Journals (Sweden)

    Dario Regis

    2013-01-01

    Full Text Available The incidence and severity of heterotopic ossification (HO in two homogeneous groups of patients that received surface replacement arthroplasty (SRA and conventional total hip arthroplasty (THA were evaluated retrospectively. Thirty-nine patients undergoing 42 hip resurfacing procedures and 41 primary cementless THAs through an anterolateral approach received a 10-day course of 150 mg/die of indomethacin postoperatively. The median surgical time was 190 minutes and 156 minutes, respectively (. At a minimum 1-year followup, the development of HO was assessed on standard X-ray using Brooker grading. Ectopic bone formation was detected in five cases (11.9%, two Brooker grade I and three grade II in the SRA group and in 14 hips (34.1%, 12 grade I and two grade II treated with conventional THA, but the difference was not significant (. No clinically relevant periprosthetic ossification (Brooker III or IV occurred in both groups. Although the difference was not statistically significant, the incidence of HO after SRA was lower than conventional THA. More extensive soft tissue trauma, bone debris, and longer operative time in hip resurfacing are not likely to be absolute risk factors for HO. Further investigations including larger patient populations are needed to confirm these findings.

  4. 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.)

  5. 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.

  6. Thigh abscess as an extension of psoas abscess: the first manifestation of perforated appendiceal adenocarcinoma: case report.

    Science.gov (United States)

    Petrovic, Igor; Pecin, Ivan; Prutki, Maja; Augustin, Goran; Nedic, Ana; Gojevic, Ante; Potocki, Kristina; Reiner, Zeljko

    2015-08-01

    A 65-year-old woman presented with a painful, swollen, red right thigh and the mild pain in the right abdomen without nausea, vomiting or diarrhoea that lasted for 1 week. Laboratory findings revealed elevated inflammatory markers. Computed tomography of the right thigh, abdomen and pelvis showed an abscess formation in the adductor muscles draining from the abscess that completely occupied the right retroperitoneum up to the diaphragm, dissecting downward through the inguinal canal. Appendix was enlarged with an appendicolith. Emergent exploratory laparotomy revealed a perforated appendix with psoas abscess. Pathohistological diagnosis revealed adenocarcinoma of the appendix. Thigh abscess is an uncommon condition with insidious clinical presentation. Therefore, early recognition and setting of the correct diagnosis enables adequate treatment avoiding additional complications and in some cases potential life-threatening conditions. When upper leg abscess is suspected or proven abdominal examination is mandatory.

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

    Science.gov (United States)

    Natsag, Javzandulam; Erlandson, Kristine M; Sellmeyer, Deborah E; Haberlen, Sabina A; Margolick, Joseph; Jacobson, Lisa P; Palella, Frank J; Koletar, Susan L; Lake, Jordan E; Post, Wendy S; Brown, Todd T

    2017-01-01

    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 (pmuscle density (pMuscle 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 (pincreasing 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.

  8. 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

    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...... (MOD; 29+/-4 W) and with thigh OCC, and moderate exercise followed by 90-s of intense exercise (HI; 65+/-8 W). Temperatures were continuously measured in m. vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) and successive muscle biopsies were obtained from VL. During MOD, muscle...

  9. Physical rehabilitation of patients with amputation stump of thigh because of trauma

    Directory of Open Access Journals (Sweden)

    Efremova O.V.

    2009-10-01

    Full Text Available The article is exposition essence of problem of renewal of ability to work of a problem of restoration after amputation at the hip. The analysis of the standard program of the standard in traumatology programs of physical rehabilitation of patients after amputation and presents the results of the developed physical rehabilitation of patients with amputating the thigh stumps due to injury. The authors propose to use the means of physical rehabilitation in accordance with the flow dynamics of the reparative processes after amputation and clinical features of injury. All this contributes to the development of compensatory own human capabilities, resulting in remission. Since these funds most physiological, their correct application does not cause complications.

  10. [Mirror therapy for the treatment of phantom limb pain after bilateral thigh amputation. A case report].

    Science.gov (United States)

    Wosnitzka, M; Papenhoff, M; Reinersmann, A; Maier, C

    2014-12-01

    This case study is the first to report successful treatment of bilateral phantom limb pain (PLP) in a patient with bilateral thigh amputation and inefficacious medical treatment using a protocol of graded interventions including mirror therapy (MT). MT is a common treatment for PLP but requires the induction of a visual illusion of an intact limb in the mirror, usually achieved by mirroring the healthy extremity. Here, we illustrate how application of a unilateral prosthesis sufficed to induce the necessary illusion. After sequential imagery, then lateralization training, which alleviated pain attacks, the patient received a further 3-week treatment of mirror treatment. Pain intensity was reduced by more than 85 %; the number of attacks were decreased by more than 90% per day. The analgesic efficacy lasted until the unexpected death of the patient several months later. This case illustrates the mechanisms of MT through overcoming the sensory incongruences underlying the distorted body schema and its efficacy in patients with bilateral amputation.

  11. Giant Sporadic Low Grade Malignant Peripheral Nerve Sheath (MPNST) of Left Thigh.

    Science.gov (United States)

    Nikumbh, Dhiraj B; Suryawanshi, K H; Dravid, N V; Patil, T B; Rokade, C M

    2013-06-01

    Malignant Peripheral Nerve Sheath Tumours (MPNST) are rare spindle- cell sarcomas which are derived from the schwann cells or the pleuripotent cells of the neural crest. MPNSTs are usually located in the peripheral nerve trunk roots, extremities and in the head and neck region. These tumours may arise as sporadic variants or in patients with neurofibromatosis1 (NF1). The estimated incidence of MPNSTs in the patients with NF1is 2-5% as compared to a 0.001% incidence in the general population. Herein, we are reporting a case of a giant sporadic (NF1 independent) low grade MPNST of the left thigh in 65 year female patient, which had a good prognosis.

  12. Hypoxia affects tissue oxygenation differently in the thigh and calf muscles during incremental running.

    Science.gov (United States)

    Osawa, Takuya; Arimitsu, Takuma; Takahashi, Hideyuki

    2017-08-17

    The present study was performed to determine the impact of hypoxia on working muscle oxygenation during incremental running, and to compare tissue oxygenation between the thigh and calf muscles. Nine distance runners and triathletes performed incremental running tests to exhaustion under normoxic and hypoxic conditions (fraction of inspired oxygen = 0.15). Peak pulmonary oxygen uptake ([Formula: see text]) and tissue oxygen saturation (StO2) were measured simultaneously in both the vastus lateralis and medial gastrocnemius. Hypoxia significantly decreased peak running speed and [Formula: see text] (p incremental running, StO2 in the vastus lateralis decreased almost linearly, and the rate of decrease from warm-up (180 m min(-1)) to [Formula: see text] was significantly greater than in the medial gastrocnemius under both normoxic and hypoxic conditions (p incremental running.

  13. De-epithelialised fasciocutaneous turnover flap: An alternative for defects in lower thigh and knee joint

    Directory of Open Access Journals (Sweden)

    Sharma R

    2004-01-01

    Full Text Available We describe the use of proximally based de-epithelialised fasciocutaneous flap for coverage of defects in the lower thigh and knee joint. These flaps are based on a number of perforators around the knee joint and can be based either posteriorly, posteromedially or posterolaterally depending upon the location of the defect. The whole of the flap including the bridge segment is de-epithelialised and turned over by 180 degrees and a split thickness graft is placed over the flap and the donor site. The flaps can be raised quickly, have minimum morbidity and are reliable even in the presence of extensive injuries. These flaps have remained stable and trouble free during a follow up period of 2-4 years.

  14. Anatomy of anterolateral portals of elbow arthroscopy%肘关节镜前外侧入路的解剖学研究

    Institute of Scientific and Technical Information of China (English)

    吴关; 鲁谊

    2016-01-01

    目的:初步探讨肘关节镜前外侧入路向前方的变化范围。方法选用10具新鲜上肢标本,在肘关节屈曲90°下,测量近端前外侧入路、前外侧入路、外侧入路与桡神经的距离;测量改良后3个入路前方5 mm 与桡神经的距离。结果标准入路的近端前外侧入路、前外侧入路、外侧入路与桡神经的距离平均值分别为:12.8 mm、8.5 mm、3.8 mm,改良后的近端前外侧入路、前外侧入路、外侧入路与桡神经的距离平均值分别为4.1 mm、2.2 mm、-0.5 mm。结论肘关节近端前外侧入路与前外侧入路之间的连线区可向前方5 mm 进行操作,越靠远端距离桡神经越近;前外侧入路与外侧入路距离桡神经较近,不建议向前方改变入路。%[Abstract ] Background From the 1 980s, elbow arthroscopic surgery has been rapidly developing and widely applied.Indications for elbow arthroscopic surgery include:loose bodies,stiff elbow,elbow synovitis,and elbow cartilage injury etc.In recent years,more and more scholars try to apply elbow arthroscopy in more complex operations,such as ligament repair,reconstruction,and fracture fixation and so on.Currently,there are quite a few reports on reduction and fixation of radial head fracture, humerus capitellum fracture, ulna coronoid fracture under elbow arthroscopy. Recently,we started to conduct elbow arthroscopic fracture reduction and internal fixation,and found that due to the varying types of fracture morphologies and locations,the conventional lateral elbow approach sometimes cannot access satisfactory fixation angles.Due to the narrow space in the elbow joint and complex anatomical relationship of the peripheral nerves,nerve injury is common in elbow surgery and consequences are often serious.Therefore,we aim to explore better approaches to protect the radial nerve based on study of anatomical specimens. Here we used either an improved anterolateral elbow approach that entered at a more

  15. 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.

  16. 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

    2017-06-29

    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.

  17. Reduced Adipogenic Gene Expression in Thigh Adipose Tissue Precedes Human Immunodeficiency Virus-Associated Lipoatrophy

    Science.gov (United States)

    Kratz, Mario; Purnell, Jonathan Q.; Breen, Patricia A.; Thomas, Katherine K.; Utzschneider, Kristina M.; Carr, Darcy B.; Kahn, Steven E.; Hughes, James P.; Rutledge, Elizabeth A.; Van Yserloo, Brian; Yukawa, Michi; Weigle, David S.

    2008-01-01

    Context: The expression of adipogenic genes in sc adipose tissue has been reported to be lower among patients with HIV-associated lipoatrophy than HIV-uninfected controls. It is unclear whether this is a result or cause of lipoatrophy. Objective: The objective of the study was to investigate the temporal relationships among changes in adipogenic gene expression in sc adipose tissue and changes in body fat distribution and metabolic complications in HIV-infected subjects on antiretroviral therapy. Design: This was a prospective longitudinal study. Setting: The study was conducted at HIV clinics in Seattle, Washington. Participants: The study population included 31 HIV-infected and 12 control subjects. Interventions: Subjects were followed up for 12 months after they initiated or modified their existing antiretroviral regimen. Main Outcome Measures: Changes in body composition, plasma lipids, insulin sensitivity, and gene expression in sc abdominal and thigh adipose tissue. Results: Subjects who developed lipoatrophy (n = 10) had elevated fasting triglycerides [3.16 (sd 2.79) mmol/liter] and reduced insulin sensitivity as measured by frequently sampled iv glucose tolerance test [1.89 (sd 1.27) × 10−4 min−1/μU·ml] after 12 months, whereas those without lipoatrophy (n = 21) did not show any metabolic complications [triglycerides 1.32 (sd 0.58) mmol/liter, P = 0.01 vs. lipoatrophy; insulin sensitivity 3.52 (sd 1.91) × 10−4 min−1/μU·ml, P = 0.01 vs. lipoatrophy]. In subjects developing lipoatrophy, the expression of genes involved in adipocyte differentiation, lipid uptake, and local cortisol production in thigh adipose tissue was significantly reduced already at the 2-month visit, several months before any loss of extremity fat mass was evident. Conclusions: In HIV-infected subjects, lipoatrophy is associated with elevated fasting triglycerides and insulin resistance and might be caused by a direct or indirect effect of antiretroviral drugs on sc adipocyte

  18. Reduced adipogenic gene expression in thigh adipose tissue precedes human immunodeficiency virus-associated lipoatrophy.

    Science.gov (United States)

    Kratz, Mario; Purnell, Jonathan Q; Breen, Patricia A; Thomas, Katherine K; Utzschneider, Kristina M; Carr, Darcy B; Kahn, Steven E; Hughes, James P; Rutledge, Elizabeth A; Van Yserloo, Brian; Yukawa, Michi; Weigle, David S

    2008-03-01

    The expression of adipogenic genes in sc adipose tissue has been reported to be lower among patients with HIV-associated lipoatrophy than HIV-uninfected controls. It is unclear whether this is a result or cause of lipoatrophy. The objective of the study was to investigate the temporal relationships among changes in adipogenic gene expression in sc adipose tissue and changes in body fat distribution and metabolic complications in HIV-infected subjects on antiretroviral therapy. This was a prospective longitudinal study. The study was conducted at HIV clinics in Seattle, Washington. The study population included 31 HIV-infected and 12 control subjects. Subjects were followed up for 12 months after they initiated or modified their existing antiretroviral regimen. Changes in body composition, plasma lipids, insulin sensitivity, and gene expression in sc abdominal and thigh adipose tissue. Subjects who developed lipoatrophy (n=10) had elevated fasting triglycerides [3.16 (sd 2.79) mmol/liter] and reduced insulin sensitivity as measured by frequently sampled iv glucose tolerance test [1.89 (sd 1.27)x10(-4) min(-1)/microU.ml] after 12 months, whereas those without lipoatrophy (n=21) did not show any metabolic complications [triglycerides 1.32 (sd 0.58) mmol/liter, P=0.01 vs. lipoatrophy; insulin sensitivity 3.52 (sd 1.91)x10(-4) min(-1)/microU.ml, P=0.01 vs. lipoatrophy]. In subjects developing lipoatrophy, the expression of genes involved in adipocyte differentiation, lipid uptake, and local cortisol production in thigh adipose tissue was significantly reduced already at the 2-month visit, several months before any loss of extremity fat mass was evident. In HIV-infected subjects, lipoatrophy is associated with elevated fasting triglycerides and insulin resistance and might be caused by a direct or indirect effect of antiretroviral drugs on sc adipocyte differentiation.

  19. 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.)

  20. 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.)

  1. Elderly oarsmen have larger trunk and thigh muscles and greater strength than age-matched untrained men.

    Science.gov (United States)

    Asaka, Meiko; Usui, Chiyoko; Ohta, Megumi; Takai, Yohei; Fukunaga, Tetsuo; Higuchi, Mitsuru

    2010-04-01

    To evaluate whether regularly performed rowing exercise affects the trunk muscles size and function, and to examine the effect of rowing exercise on thigh muscle size and function in elderly rowers, we compared the cross-sectional area (CSA) and strength of these muscles in elderly male rowers and in age-matched untrained men. Participants were 16 elderly rowing-trained men (ROW age, 67.8 +/- 2.3 years) and 18 elderly untrained men (CON 66.2 +/- 3.0 years). CSA was measured by MRI in the trunk and thigh muscles. Isometric trunk flexion force and leg extension power were measured. ROW had a 20% larger total trunk muscle CSA than CON (P muscles did not differ significantly between CON and ROW. In ROW, the CSA was 13% larger in the total thigh muscles (P leg extension power was 43% higher than in CON (P muscles, especially psoas major and that it improves thigh muscle size and function in elderly men.

  2. Definição do limite anterolateral do lobo occipital em peças anatômicas e exames de imagem

    OpenAIRE

    Gusmão Sebastião; Reis Cassius; Tazinaffo Uedson; Mendonça Celso; Silveira Roberto Leal

    2002-01-01

    Com o objetivo de definir o limite anterolateral do lobo occipital foram estudados sete segmentos cefálicos de cadáveres humanos, 103 exames de tomografia computadorizada e 104 exames de ressonância magnética do encéfalo considerados normais. Foram encontradas uma prega da dura-máter sobre o seio transverso (plica tentorial pré-occipital) e uma protuberância óssea relacionadas diretamente com a incisura pré-occipital. Foi calculada, também, a distância média entre o sulco parieto-occipital e ...

  3. Fatty acids profile of breast and thigh muscles of broiler chickens fed diets with propolis and probiotics

    Directory of Open Access Journals (Sweden)

    Lenka TREMBECKÁ

    2016-12-01

    Full Text Available The aim of the study was to assess the effect of supplying propolis extract separately and propolis extract together with probiotics based on Lactobacillus fermentum on fatty acids (FA composition of the most valuable parts of chicken carcass. Diets enriched with 400 mg propolis extract per 1 kg of feed mixture and 400 mg propolis extract per 1 kg of feed mixture plus 3.3 g probiotic preparation added to drinking water (E1 and E2 groups, respectively were given to broiler chickens throughout a 42-d growth period. After slaughter, the FA profiles of breast and thigh samples were determined. Both supplemented diets decreased the total amount of saturated FA (SFA, mainly because of the myristic (C14:0 and stearic (C18:0 acid contents in both breast and thigh muscles. However, a significant decrease (P ≤ 0.05 in SFA was confirmed only in thigh muscle. Supplementation with propolis together with probiotics (E2 significantly increased (P ≤ 0.05 monounsaturated FA (MUFA contents in breast muscle. Particularly oleic acid (C18:1 cis contributed to an overall increase in MUFA. A rise (P ≤ 0.05 in polyunsaturated FA (PUFA in breast muscle was, however, associated with the dietary supplementation of propolis extract separately (E1. A similar trend (P  0.05 for MUFA and PUFA levels was also observed in thigh muscle. Of all PUFAs detected in breast and thigh muscles, linoleic acid (C18:2 cis was found at the highest levels. Its levels varied from 11.34 to 12.02 g*100 g-1 and from 11.05 to 11.82 g*100 g-1 in breast and thigh muscles, respectively. The highest level (P ≤ 0.05 of linoleic acid was observed in group E1. Comparing breast with thigh muscle, the breast was demonstrated to contain more SFA and PUFA, but less MUFA proportions. Although the n-3 PUFA:n-6 PUFA ratio was similar among the treatments in both breast and thigh muscles, n-6 PUFA:n-3 PUFA ratio has been showed to be a significantly lower (P ≤ 0.05 in thigh muscle, with the lowest

  4. Mutability of bifunctional thigh muscle activity in pedaling due to contralateral leg force generation.

    Science.gov (United States)

    Kautz, S A; Brown, D A; Van der Loos, H F M; Zajac, F E

    2002-09-01

    Locomotion requires uninterrupted transitions between limb extension and flexion. The role of contralateral sensorimotor signals in executing smooth transitions is little understood even though their participation is crucial to bipedal walking. However, elucidating neural interlimb coordinating mechanisms in human walking is difficult because changes to contralateral sensorimotor activity also affect the ipsilateral mechanics. Pedaling, conversely, is ideal for studying bilateral coordination because ipsilateral mechanics can be independently controlled. In pedaling, the anterior and posterior bifunctional thigh muscles develop needed anterior and posterior crank forces, respectively, to dominate the flexion-to-extension and extension-to-flexion transitions. We hypothesized that contralateral sensorimotor activity substantially contributes to the appropriate activation of these bifunctional muscles during the limb transitions. Bilateral pedal forces and surface electromyograms (EMGs) from four thigh muscles were collected from 15 subjects who pedaled with their right leg against a right-crank servomotor, which emulated the mechanical load experienced in conventional two-legged coupled-crank pedaling. In one pedaling session, the contralateral (left) leg pseudo-pedaled (i.e., EMG activity and pedal forces were pedaling-like, but pedal force was not allowed to affect crank rotation). In other sessions, the mechanically decoupled contralateral leg was first relaxed and then produced rhythmic isometric force trajectories during either leg flexion or one of the two limb transitions of the pedaling leg. With contralateral force production in the extension-to-flexion transition (predominantly by the hamstrings), rectus femoris activity and work output increased in the pedaling leg during its flexion-to-extension transition, which occurs simultaneously with contralateral extension-to-flexion in conventional pedaling. Similarly, with contralateral force production in the

  5. Subcutaneous Thigh Fat Assessment: A Comparison of Skinfold Calipers and Ultrasound Imaging

    Science.gov (United States)

    Selkow, Noelle M.; Pietrosimone, Brian G.; Saliba, Susan A.

    2011-01-01

    Abstract Context: Skinfold calipers (SC) typically are used to determine subcutaneous fat thicknesses. Identifying the exact separation of muscle and fat can complicate measurements. Ultrasound imaging (USI) might provide a better technique for analyzing subcutaneous fat thicknesses. Objective: To compare measurements from SC and USI in assessing subcutaneous thigh fat thickness. Design: Descriptive laboratory study. Setting: Laboratory. Patients and Other Participants: Twenty healthy adults (13 men, 7 women; age  =  26.9 ± 5.4 years, height  =  173.9 ± 7.3 cm, mass  =  77.4 ± 16.1 kg) participated. Intervention(s): Participants were seated in 90° of knee flexion and 85° of trunk extension. A standardized template was used to identify measurement sites over the vastus medialis obliquus (VMO), distal rectus femoris (dRF), proximal rectus femoris (pRF), and vastus lateralis (VL). Three measurements at each of the 4 sites were made in random order and were averaged for each measurement tool by the same investigator. Main Outcome Measure(s): Fat thickness was measured in millimeters with SC and USI. Measurements at each site were compared using Pearson product moment correlations and Bland-Altman plots. Results: Strong correlations between measures were found at the VMO (r  =  .90, P thicknesses compared with USI. Limits of agreement, as illustrated by the Bland-Altman plots, were fairly wide at each site: from −3.38 mm to 7.74 mm at the VMO, from −3.04 mm to 6.52 mm at the dRF, from −1.53 mm to 8.87 mm at the pRF, and from −3.73 mm to 8.15 mm at the VL. All plots except for the VL demonstrated increasing overestimation via the SC as fat thicknesses increased. Conclusions: We found strong correlations between the SC and USI; however, the large limits of agreement and increasing mean differences with larger fat thicknesses were a concern in terms of using this tool. When measuring subcutaneous fat thickness of the thigh, SC tended

  6. Neuromuscular electrical stimulation attenuates thigh skeletal muscles atrophy but not trunk muscles after spinal cord injury.

    Science.gov (United States)

    Gorgey, Ashraf S; Dolbow, David R; Cifu, David X; Gater, David R

    2013-08-01

    The current study examined the effects of 12weeks of surface neuromuscular electrical stimulation (NMES) and ankle weights on the cross-sectional areas (CSAs) of three thigh [Gracilis (Gra), Sartorious (Sar) and Adductor (Add)] as well as two trunk [hip flexor (HF) and back extensor (BE)] muscle groups in men with spinal cord injury (SCI). Seven individuals with chronic motor complete SCI were randomly assigned into a resistance training +diet (RT+diet; n=4) or diet control (n=3) groups. The RT+diet group underwent twice weekly training with surface NMES and ankle weights for 12weeks. Training composed of four sets of 10 repetitions of leg extension exercise while sitting in their wheelchairs. Both groups were asked to monitor their dietary intake. Magnetic resonance images were captured before and after 12weeks of interventions. Gra muscle CSA showed no change before and after interventions. A significant interaction (P=0.001) was noted between both groups as result of 9% increase and 10% decrease in the Gra muscle CSA of the RT+diet and diet groups, respectively. Sar muscle CSA increased [1.7±0.4-2.5±0.5cm(2); P=0.029] in the RT+diet group with no change [2.9±1.4-2.6±1.3cm(2)] in the diet group; with interaction noted between both groups (P=0.002). Analysis of covariance indicated that Add muscle CSA was 38% greater in the RT+diet compared to the diet group (P=0.025) after 12weeks; a trend of interaction was also noted between both groups (P=0.06). HF and BE muscle groups showed no apparent changes in CSA in both groups. The results suggested that surface NMES can delay the process of progressive skeletal muscle atrophy after chronic SCI. However, the effects are localized to the trained thigh muscles and do not extend to the proximal trunk muscles.

  7. In vivo pharmacodynamics of ceftobiprole against multiple bacterial pathogens in murine thigh and lung infection models.

    Science.gov (United States)

    Craig, W A; Andes, D R

    2008-10-01

    Ceftobiprole medocaril is the parenteral prodrug of ceftobiprole, a novel pyrrolidinone broad-spectrum cephalosporin with in vitro and in vivo bactericidal activities against methicillin-resistant Staphylococcus aureus (MRSA) and penicillin-resistant Streptococcus pneumoniae (PRSP). We have used murine thigh and lung infection models in neutropenic and normal mice to characterize the in vivo pharmacokinetic (PK)-pharmacodynamic (PD) activities of ceftobiprole against multiple strains of S. aureus (including MRSA), S. pneumoniae (including PRSP), and gram-negative bacilli. Serum levels of ceftobiprole following the administration of multiple doses were determined by a microbiological assay. In vivo bactericidal activities and postantibiotic effects (PAEs) of ceftobiprole against MRSA and PRSP strains were determined from serial CFU/thigh values following single doses of ceftobiprole (40 and 160 mg/kg of body weight). Dose fractionation studies were used to determine which PK-PD index correlated best with activity. Magnitudes of the PK-PD indices were calculated from MICs and PK parameters. A sigmoid dose-response model was used to estimate the dose (mg/kg/24 h) required to achieve a static and 2-log(10) kill effects over 24 h. PK results showed area under the concentration-time curve/dose values of 1.8 to 2.8 and half-lives of 0.29 to 0.51 h. MICs ranged from 0.015 to 2 microg/ml. Ceftobiprole demonstrated time-dependent killing; its in vivo PAEs varied from 3.8 h to 4.8 h for MRSA and from 0 to 0.8 h for PRSP. The time above MIC (T > MIC) correlated best with efficacy for both MRSA and PRSP. The T > MIC values required for the static doses were significantly longer (P ceftobiprole against S. pneumoniae but only slightly against Klebsiella pneumoniae. Based on its PD profile, ceftobiprole is a promising new beta-lactam agent with activity against gram-negative and gram-positive organisms including MRSA and PRSP.

  8. Comparative analysis of skin surface lipids of the labia majora, inner thigh, and forearm.

    Science.gov (United States)

    Warren, R; Wertz, P W; Kirkbride, T; Brunner, M; Gross, M C

    2011-01-01

    The purpose of this study was to develop a procedure for the collection of skin surface corneocyte lipids from the semioccluded and intimate regions of the labia majora and inner thigh of women, to evaluate the polar and nonpolar composition, and to compare the distribution of the lipid classes relative to a collection of lipids from the forearm. The solvent system of ethanol-cyclohexane was well tolerated across all sites. While the yield of polar lipids was similar across all 3 sites, there were only marginal differences in the relative abundance of ceramides, a class of lipids closely associated with skin barrier activity. The yield of neutral lipids was significantly less for the labia majora and was associated with a reduced yield of wax esters, triglycerides and free fatty acids, likely associated with reduced sebaceous gland activity. Factors that may contribute to an inferior skin barrier activity for the labia majora are discussed and suggest a possible deficiency of ω-6 fatty acid linked to the sphingosine base of ceramide EOS. Copyright © 2011 S. Karger AG, Basel.

  9. 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.

  10. Synovial fluid from an African spur-thighed tortoise (Geochelone sulcata).

    Science.gov (United States)

    Casimire-Etzioni, Athema L; Wellehan, James F X; Embury, Jennifer E; Terrell, Scott P; Raskin, Rose E

    2004-01-01

    A 4.5-year old, male African spur-thighed tortoise (Geochelone sulcata) was presented to the University of Florida Veterinary Teaching Hospital with a 2-week history of lethargy, anorexia, constipation, dyspnea, and coughing up fluid or vomiting. Laboratory results included an inflammatory leukogram and a marked increase in plasma uric acid concentration. Synovial fluid from multiple joints was thick, chalky white, and opaque, with a grainy consistency. Microscopically, the fluid contained numerous brown, needle-like crystals consistent with urates (gout). Gross necropsy findings and histopathology confirmed a diagnosis of systemic gout, with urate deposition, gout tophi, and underlying necrosis in multiple organs, including kidneys, lung, and liver. Dehydration with concurrent renal insufficiency may have impaired urate excretion and led to a build-up of urates in the blood and tissues of this tortoise. A high protein diet also may have contributed to the development of gout. Cytologic evaluation of synovial fluid can be used as a quick and definitive tool to diagnose gout in tortoises.

  11. Relationships of isometric mid-thigh pull variables to weightlifting performance.

    Science.gov (United States)

    Beckham, G; Mizuguchi, S; Carter, C; Sato, K; Ramsey, M; Lamont, H; Hornsby, G; Haff, G; Stone, M

    2013-10-01

    The purpose of this study was to evaluate the relationship between weightlifting performance (snatch, clean and jerk, and total) and variables obtained from the isometric mid-thigh pull (IMTP). Twelve weightlifters, ranging from novice to advanced, performed the IMTP 10 days after a competition. Correlations were used to evaluate relationships between variables of the IMTP and absolute and scaled competition results. Unscaled competition results correlated strongly with IRFD (0-200ms: r=0.567-0.645, 0-250ms: r=0.722-0.781) while results correlated weakly with Peak IRFD (5ms window, r=0.360-0.426). Absolute peak force values correlated very strongly with absolute values for the competition performance (r=0.830-0.838). Force at 100ms, 150ms, 200ms and 250ms also correlated strongly with competition results (r=0.643-0.647, r=0.605-0.636, r=0.714-0.732, r=0.801-0.804). Similar findings were noted for allometrically scaled values. Measures of average IRFD probably represent a more relevant variable to dynamic performance than does Peak IRFD (5ms). Maximum isometric strength also is likely to have a strong role in weightlifting performance.

  12. 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.

  13. Aquacel Surgical Dressing after Thigh Lift: A Case–Control Study

    Science.gov (United States)

    Bocchiotti, Maria A.; Baglioni, Elisabetta A.; Spaziante, Luca; Frenello, Ambra

    2016-01-01

    Background: The postoperative dressing in patients undergoing thigh lift is often difficult, not very resistant to movement, and uncomfortable for the patient, and often exposes surgical site to infection, maceration, or delay in wound healing. Methods: We included 40 patients in a case–control crossover study with no period effects, who were treated both by Aquacel Surgical and a traditional wound dressing. Surveys with a 10-point scale evaluation were used to assess nontraumatic removal level, ease of application, adhesion, and strength of the 2 treatments. We reported the number of days necessary for wound healing, the number of infection cases, and wound-related complications. Costs of the 2 medications were also considered. Ten days after surgery, patients answered a questionnaire with 6 multiple-choice questions to assess comfort, pain at dressing change, pruritus, strength, and number of dressing changes. Results: Compared with controls, surveys revealed Aquacel Surgical to be less traumatic to remove, easier to apply, and to be more adherent and stronger. Significant acceleration of the wound healing was also evident with Aquacel Surgical compared with the traditional dressing. Nonsignificant differences were reported about the risk of infection and wound-related complications between the 2 treatments. A statistical analysis of costs revealed that Aquacel Surgical is significantly more expensive than the traditional medication. Conclusion: We recommend the use of Aquacel Surgical in all the surgery procedures where the risk of wound dehiscence and maceration is high.

  14. 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......, 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...... and on the day of hospital discharge. MAIN OUTCOME MEASURES: Knee-extension strength, thigh and knee joint circumference, hip pain, and functional performance (Timed Up & Go, 30-Second Chair Stand, and 10-Meter Walk tests). RESULTS: All investigated variables changed significantly from before to after surgery...

  15. Pancreatic Fistula Extending into the Thigh Caused by the Rupture of an Intraductal Papillary Mucinous Adenoma of the Pancreas.

    Science.gov (United States)

    Shimizu, Yuki; Imaizumi, Hiroshi; Yamauchi, Hiroshi; Okuwaki, Kosuke; Miyazawa, Shiro; Iwai, Tomohisa; Takezawa, Miyoko; Kida, Mitsuhiro; Suzuki, Erina; Saegusa, Makoto; Koizumi, Wasaburo

    2017-01-01

    We herein report the first case of a pancreatic fistula extending into the thigh caused by the rupture of an intraductal papillary mucinous neoplasm (IPMN) of the pancreas. An 80-year-old man was suspected to have necrotizing fasciitis because of right femoral pain. Computed tomography showed fluid retention from the pancreatic head to the right iliopsoas muscle and an IPMN at the pancreatic head. The findings of endoscopic retrograde pancreatography led to the suspicion of a minor leak and a pancreatic stent was placed. The patient died due to an uncontrollable infection. A pathological autopsy showed a pancreatic fistula extending into the thigh that had been caused by the rupture of the IPMN.

  16. 'Serious thigh muscle strains': beware the intramuscular tendon which plays an important role in difficult hamstring and quadriceps muscle strains.

    Science.gov (United States)

    Brukner, Peter; Connell, David

    2016-02-01

    Why do some hamstring and quadriceps strains take much longer to repair than others? Which injuries are more prone to recurrence? Intramuscular tendon injuries have received little attention as an element in 'muscle strain'. In thigh muscles, such as rectus femoris and biceps femoris, the attached tendon extends for a significant distance within the muscle belly. While the pathology of most muscle injures occurs at a musculotendinous junction, at first glance the athlete appears to report pain within a muscle belly. In addition to the musculotendinous injury being a site of pathology, the intramuscular tendon itself is occasionally injured. These injuries have a variety of appearances on MRIs. There is some evidence that these injuries require a prolonged rehabilitation time and may have higher recurrence rates. Therefore, it is important to recognise the tendon component of a thigh 'muscle strain'.

  17. Pancreatic Fistula Extending into the Thigh Caused by the Rupture of an Intraductal Papillary Mucinous Adenoma of the Pancreas

    Science.gov (United States)

    Shimizu, Yuki; Imaizumi, Hiroshi; Yamauchi, Hiroshi; Okuwaki, Kosuke; Miyazawa, Shiro; Iwai, Tomohisa; Takezawa, Miyoko; Kida, Mitsuhiro; Suzuki, Erina; Saegusa, Makoto; Koizumi, Wasaburo

    2017-01-01

    We herein report the first case of a pancreatic fistula extending into the thigh caused by the rupture of an intraductal papillary mucinous neoplasm (IPMN) of the pancreas. An 80-year-old man was suspected to have necrotizing fasciitis because of right femoral pain. Computed tomography showed fluid retention from the pancreatic head to the right iliopsoas muscle and an IPMN at the pancreatic head. The findings of endoscopic retrograde pancreatography led to the suspicion of a minor leak and a pancreatic stent was placed. The patient died due to an uncontrollable infection. A pathological autopsy showed a pancreatic fistula extending into the thigh that had been caused by the rupture of the IPMN. PMID:28154275

  18. Pharmacokinetic/pharmacodynamic evaluation of sulbactam against Acinetobacter baumannii in in vitro and murine thigh and lung infection models.

    Science.gov (United States)

    Yokoyama, Yuta; Matsumoto, Kazuaki; Ikawa, Kazuro; Watanabe, Erika; Shigemi, Akari; Umezaki, Yasuhiro; Nakamura, Koyo; Ueno, Keiichiro; Morikawa, Norifumi; Takeda, Yasuo

    2014-06-01

    Acinetobacter baumannii is a pathogen that has become globally associated with nosocomial infections. Sulbactam, a potent inhibitor of β-lactamases, was previously shown to be active against A. baumannii strains in vitro and effective against A. baumannii infections. However, a pharmacokinetic/pharmacodynamic (PK/PD) analysis of sulbactam against A. baumannii infections has not yet been performed. This is necessary because optimisation of dosing regimens should be based on PK/PD analysis. Therefore, in vitro and in vivo PK/PD analyses of sulbactam were performed using murine thigh and lung infection models of A. baumannii to evaluate the pharmacokinetics and pharmacodynamics of sulbactam. Sulbactam showed time-dependent bactericidal activity in vitro against A. baumannii. The PK/PD index that best correlated with its in vivo effects was the time that the free drug concentration remained above the minimum inhibitory concentration (fT>MIC) both in the thigh (R(2)=0.95) and lung (R(2)=0.96) infection models. Values of fT>MIC for a static effect and 1, 2 and 3log10 kill, respectively, were 21.0%, 32.9%, 43.6% and 57.3% in the thigh infection model and 20.4%, 24.5%, 29.3% and 37.3% in the lung infection model. Here we report the in vitro and in vivo time-dependent activities of sulbactam against A. baumannii infection and demonstrate that sulbactam was sufficiently bactericidal when an fT>MIC of >60% against A. baumannii thigh infection and >40% against A. baumannii lung infection was achieved.

  19. Evaluation of the relation between triceps surae H-reflex, M-response latencies and thigh length in normal population

    Directory of Open Access Journals (Sweden)

    Saeid Khosrawi

    2013-01-01

    Full Text Available Background: The H-reflex is a useful electrophysiological procedure for evaluating the status of the peripheral nervous system, especially at the proximal segment of the peripheral nerve. The purpose of this study is to investigate the relation between triceps surae H-reflex and M- response latencies and thigh length in normal population, in order to determine if there is any regression equation between them. Materials and Methods: After screening 75 volunteers by considering inclusion and exclusion criteria, 72 of them were selected to enroll into our study (34 men and 38 women with the mean age of 36.04 ± 7.7 years. In all of the subjects H-reflex and M-response latencies were recorded by standard electrophysiological techniques and thigh length was measured. Finally, our data was analyzed for its relations with respect to ages in both sexes by appropriate statistical and mathematical methods. Results: Mean ± SD for H-reflex latency was 27.94 ± 1.6 ms. We found a significant correlation between H-reflex latency and M-latency (r = 0.28, no significant correlation was found between H-reflex latency and thigh length (r = -0.051. Finally based on our findings we introduce a new formula in this paper.Conclusion: We found a significant correlation among of M-response latency and other variables (H-reflex latency and thigh length. Despite this it was eliminated from our formula. The relationship between H-reflex latency and age was significant. Further studies are required to delineate the clinical usage and interpretation of the formula, which we found in this study.

  20. Acute effects of lateral thigh foam rolling on arterial tissue perfusion determined by spectral Doppler and Power Doppler ultrasound.

    Science.gov (United States)

    T, Hotfiel; B, Swoboda; S, Krinner; C, Grim; M, Engelhardt; M, Uder; R, Hei

    2016-09-23

    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 four blind-folded investigators. Measurement values were assessed under resting conditions and twice after foam rolling exercises of the lateral thigh (0 min and 30 min post 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 following foam rolling exercises compared to baseline (p<0.05). We detected a relative increase in Vmax of 73.6% (0 min) and 52.7 % (30 min) (p<0.001), in TAMx of 53.2% (p<0.001) and 38.3 % (p=0.002), and in TAMn of 84.4% (p<0.001) and 68.2 % (p<0.001). Semiquantitative Power Doppler scores at all portions revealed increased average grading of 1.96 after intervention and 2.04 after 30 min compared to 0.75 at baseline. Our results may contribute to the understanding of local physiological reactions to self-myofascial release.

  1. “Emergency” definitive reconstruction of a necrotising fasciitis thigh debridement defect with a pedicled TRAM flap

    Science.gov (United States)

    Hughes, Tom; Yu, Jonathan T.S.; Wong, Kai Yuen; Malata, Charles M.

    2013-01-01

    INTRODUCTION Necrotising fasciitis (NF) is a rare, severe, rapidly progressing and life-threatening synergistic infection primarily affecting the superficial fascia. A novel method of definitive and aesthetic reconstruction of NF thigh defects by using a pedicled transverse rectus abdominis myocutaneous (TRAM) flap without recourse to temporising skin grafts is presented. PRESENTATION OF CASE A 30-year-old parous woman presented in extremis with fulminant NF of her left anteromedial thigh. Following emergency radical debridement and intensive care stabilisation she was reconstructed 48 h later in a single stage with a pedicled TRAM flap islanded on the ipsilateral deep inferior epigastric vessels. There was excellent contour restoration of her thigh and coverage of the exposed femoral vessels. DISCUSSION Pedicled flaps based on the rectus abdominis muscle provide a large, readily available reconstructive option for correction of substantial regional defects as herein illustrated. They are robust when based on dominant inferior vascular pedicle with a long reach and wide arc of rotation when designed transversely (as a TRAM flap). CONCLUSION This case also illustrates that definitive flap reconstruction of NF can be successfully undertaken in the emergent setting, thereby negating the need for large areas of skin grafting which can lead to contractures with consequent functional impairment and suboptimal aesthetic results. PMID:23548707

  2. 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.

  3. Thigh muscle size and vascular function after blood flow-restricted elastic band training in older women

    Science.gov (United States)

    Yasuda, Tomohiro; Fukumura, Kazuya; Tomaru, Takanobu; Nakajima, Toshiaki

    2016-01-01

    We examined the effect of elastic band training with blood flow restriction (BFR) on thigh muscle size and vascular function in older women. Older women were divided into three groups: low-intensity elastic band BFR training (BFR-Tr, n = 10), middleto high-intensity elastic band training (MH-Tr, n = 10), and no training (Ctrl, n = 10) groups. BFR-Tr and MH-Tr groups performed squat and knee extension exercises using elastic band, 2 days/week for 12 weeks. During BFR-Tr exercise session, subjects wore pressure cuffs around the most proximal region of both thighs. The following measurements were taken before (pre) and 3-5 days after (post) the final training session: MRI-measured muscle cross-sectional area (CSA) at mid-thigh, maximum voluntary isometric contraction (MVIC) of knee extension, central systolic blood pressure (c-SBP), central-augmentation index (c-AIx), cardio-ankle vascular index testing (CAVI), ankle-brachial pressure index (ABI). Quadriceps muscle CSA (6.9%) and knee extension MVIC (13.7%) were increased (p muscle CSA as well as maximal muscle strength, but does not decrease vascular function in older women. PMID:27244884

  4. Serotypes and antibiotic susceptibility patterns of Salmonella spp. isolates from spur-thighed tortoise, Testudo graeca illegally introduced in Italy

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    Cristina Giacopello

    2012-09-01

    Full Text Available The prevalence of Salmonella carriage and distribution of serotypes in spur-thighed tortoises, Testudo graeca Linnaeus, 1758 illegallyintroduced in Italy was studied to assess the risk of disease exposure for humans once these specimens were traded as pets. Antibiotic susceptibilitypatterns were also analyzed to estimate the emergence of antibiotic-resistant Salmonella strains. One hundred forty-six cloacal swabs ofspur-thighed tortoises were tested by standard bacteriological methods. Antimicrobial susceptibility tests on Salmonella strains isolated werealso performed. Ninety-one Salmonella spp. strains were isolated in 74 of 146 turtles examined and a total of 20 different serotypes were found.Out of the 91 isolates, 67 were grouped in the Salmonella enterica subspecies I. Salmonella isolates were susceptible to most of the antibioticstested. Resistance was most commonly observed against tetracycline (57.1% followed by ampicillin (33.0%, streptomycin (13.2% andamoxicillin-clavulanic acid (11.0%. Our findings confirm that wild-caught spur-thighed tortoises can carry different serotypes of Salmonella .Accordingly, strict preventive sanitation measures should be adopted when handling reptiles.

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

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    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.

  6. Relationship of electrical resistance end morphological changes thigh rats after modeling of open fracture (experimental study

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    Pavlova T.M.

    2016-06-01

    Full Text Available Background. Due to the development of industry, increasing number of vehicles on the roads rate of traumatic injuries among adult population causing disability and mortality is still high in all countries of the world. Among all fractures of long bones open diaphyseal fractures ranges from 28% to 53%. Objective. To study the relationship of electrical resistance and morphological features of the femur of white male rats after modeling the open fracture. Methods. Studies were conducted on white male rats aged about 3 months. Digital multimeter UT70B was used to measure the electrical resistance of bones in experimental animals after 1 and 3 hours of experimental modeling of opened bone fracture. Histological and electron microscopic studies were performed to evaluate bone structure. Results. 1 hour after modeling an open bone fracture it was detected the presence of empty lacunae or gaps filled with detritus. 3 hours after the experiment cellular density in the first studied area was reduced 4.1 times, in the second area - 3.2 times comparing with the control. Conclusion. These histological examination and study of the electrical resistance of bone fragments after re-fracture (with or without coagulation fragments indicate similar changes in direction of the bone. Electrical resistance after testing in the clinical setting can be used for testing the bone fragments after an open fracture to assess viability. We have developed a technique for evaluation the electrical resistance making it possible to predict the viability of bone tissue with opened diaphyseal fractures of extremities on early stages. Citation: Pavlova TM, Berezka MI. [Relationship of electrical resistance end morphological changes thigh rats after mod-eling of open fracture (experimental study]. Morphologia. 2016;10(2:31-9. Ukrainian.

  7. Validation and Comparison of Accelerometers Worn on the Hip, Thigh, and Wrists for Measuring Physical Activity and Sedentary Behavior

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    Alexander H.K. Montoye

    2016-05-01

    Full Text Available Background: Recent evidence suggests that physical activity (PA and sedentary behavior (SB exert independent effects on health. Therefore, measurement methods that can accurately assess both constructs are needed. Objective: To compare the accuracy of accelerometers placed on the hip, thigh, and wrists, coupled with machine learning models, for measurement of PA intensity category (SB, light-intensity PA [LPA], and moderate- to vigorous-intensity PA [MVPA] and breaks in SB. Methods: Forty young adults (21 female; age 22.0 ± 4.2 years participated in a 90-minute semi-structured protocol, performing 13 activities (three sedentary, 10 non-sedentary for 3–10 minutes each. Participants chose activity order, duration, and intensity. Direct observation (DO was used as a criterion measure of PA intensity category, and transitions from SB to a non-sedentary activity were breaks in SB. Participants wore four accelerometers (right hip, right thigh, and both wrists, and a machine learning model was created for each accelerometer to predict PA intensity category. Sensitivity and specificity for PA intensity category classification were calculated and compared across accelerometers using repeated measures analysis of variance, and the number of breaks in SB was compared using repeated measures analysis of variance. Results: Sensitivity and specificity values for the thigh-worn accelerometer were higher than for wrist- or hip-worn accelerometers, > 99% for all PA intensity categories. Sensitivity and specificity for the hip-worn accelerometer were 87–95% and 93–97%. The left wrist-worn accelerometer had sensitivities and specificities of > 97% for SB and LPA and 91–95% for MVPA, whereas the right wrist-worn accelerometer had sensitivities and specificities of 93–99% for SB and LPA but 67–84% for MVPA. The thigh-worn accelerometer had high accuracy for breaks in SB; all other accelerometers overestimated breaks in SB. Conclusion: Coupled with

  8. The use of dry needling for a subject with chronic lateral hip and thigh pain: a case report.

    Science.gov (United States)

    Pavkovich, Ron

    2015-04-01

    Lateral thigh pain, commonly referred to as greater trochanteric pain syndrome (GTPS) and/ or iliotibial band syndrome (ITBS) is commonly treated by the physical therapist. Lateral thigh pain is commonly treated by the physical therapist. The sources of lateral thigh pain are commonly attributed to GTPS and/ or ITBS though various pathologies may contribute to this pain, of which trigger points (TrPs) may be an etiology. Dry needling (DN) is an intervention utilized by physical therapists where a monofilament needle is inserted into soft tissue in order to reduce pain to improve range of motion/ motor control dysfunction. This can assist with facilitation of return to prior level of function. The purpose of this case report is to report the outcomes of a patient with lateral hip and thigh pain treated with DN as a primary intervention strategy. The subject was an active 78-year-old female recreational walker who was referred to physical therapy for chronic left lateral hip and thigh pain of greater than one-year duration without a clear mechanism of injury. She had a history of previous physical therapy treatment for the same condition, and previous therapeutic intervention strategies were effective for approximately two to three months duration prior to return of pain symptoms. Physical examination supported a diagnosis of GTPS/ ITBS. Subjective reports denoted sleep deficit due to pain lying on the left side at night and difficulty walking more than five minutes. Objective findings included decreased strength of the hip musculature and reproduction of pain symptoms upon flat palpation in specific locations throughout the lateral hip and thigh regions. She was treated for eight weeks using only DN to determine the effectiveness of DN as a primary intervention strategy, as previous physical therapy interventions were inconsistent and were only beneficial in the short-term. Clinically meaningful improvements were noted in disability and pain, as measured by the

  9. 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.

  10. In vivo activity of cefquinome against Escherichia coli in the thighs of neutropenic mice.

    Science.gov (United States)

    Shan, Qi; Liang, Chaoping; Wang, Jing; Li, Jufeng; Zeng, Zhenling

    2014-10-01

    Cefquinome is a cephalosporin with broad-spectrum antibacterial activity, including activity against enteric Gram-negative bacilli such as Escherichia coli. We utilized a neutropenic mouse model of colibacillosis to examine the pharmacodynamic (PD) characteristics of cefquinome, as measured by organism number in homogenized thigh cultures after 24 h of therapy. Serum drug levels following 4-fold-escalating single doses of cefquinome were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The pharmacokinetic (PK) properties of cefquinome were linear over a dose range of 10 to 640 mg/kg of body weight. Serum half-lives ranged from 0.29 to 0.32 h. Dose fractionation studies over a 24-h dose range of 2.5 to 320 mg/kg were conducted every 3, 6, 12, or 24 h. Nonlinear regression analysis was used to determine which pharmacodynamic parameter best correlated with efficacy. The free percentage of the dosing interval that the serum levels exceed the MIC (fT>MIC) was the PK-PD index that best correlated with efficacy (R(2) = 73% for E. coli, compared with 13% for the maximum concentration of the free drug in serum [fCmax]/MIC and 45% for the free-drug area under the concentration-time curve from 0 to 24 h [fAUC0-24]/MIC). Subsequently, we employed a similar dosing strategy by using 4-fold-increasing total cefquinome doses administered every 4 h to treat animals infected with four additional E. coli isolates. A sigmoid maximum-effect (Emax) model was used to estimate the magnitudes of the %fT>MIC associated with net bacterial stasis, a 1-log10 CFU reduction from baseline, and a 2-log10 CFU reduction from baseline; the corresponding values were 28.01% ± 2.27%, 37.23% ± 4.05%, and 51.69% ± 9.72%. The potent bactericidal activity makes cefquinome an attractive option for the treatment of infections caused by E. coli.

  11. Competitive athletic participation, thigh muscle strength, and bone density in elite senior athletes and controls.

    Science.gov (United States)

    McCrory, Jean L; Salacinski, Amanda J; Hunt Sellhorst, Sarah E; Greenspan, Susan L

    2013-11-01

    The relationship between participation in highly competitive exercise, thigh muscle strength, and regional and total body bone mineral density (BMD) in elite senior athletes and healthy elderly controls was investigated. One hundred and four elite senior athletes (age: 72.6 ± 6.4 years, height: 168.7 ± 8.6 cm, mass: 72.6 ± 13.5 kg, 57 male:47 female) and 79 healthy controls (age: 75.4 ± 5.6 years, height: 170.8 ± 25.5 cm, mass: 79.5 ± 11.7 kg, 46 male:33 female) participated in this cross-sectional study. Vitamin D and calcium intake were assessed via a recall survey. Isometric knee extension and flexion peak torque were measured via a custom strength measurement device. Total body and regional BMD of the hip, radius, and spine were assessed with a dual-energy x-ray absorptiometer. For each BMD site assessed, multivariate linear regression analysis was performed in 4 steps (α = 0.10) to examine the contribution of (a) age, sex, bodyweight, and calcium and vitamin D intake; (b) group (elite senior athlete, control); (c) knee extension peak torque; and (d) knee flexion peak torque on BMD. Sex, age, bodyweight, and calcium and vitamin D intake explained a significant amount of variance in BMD in each site. Group was not significant. Knee extension peak torque explained an additional 3.8% of the variance in hip BMD (p = 0.06). Knee flexion peak torque was not correlated to BMD at any of the sites assessed. In conclusion, participation in highly competitive athletics was not related to total body or regional BMD. Age, sex, bodyweight, and vitamin D and calcium intake were significantly related to BMD at all the sites assessed. Quadriceps strength contributed slightly to hip BMD. Our results imply that participation in highly competitive senior athletics does not have a protective effect on BMD, perhaps because of a lower bodyweight or other confounding factors.

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

    Science.gov (United States)

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

    2003-01-21

    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 while 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. MRT2-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

  13. Numerical Investigations of Interactions between the Knee-Thigh-Hip Complex with Vehicle Interior Structures.

    Science.gov (United States)

    Kim, Yong Sun; Choi, Hyeong Ho; Cho, Young Nam; Park, Yong Jae; Lee, Jong B; Yang, King H; King, Albert I

    2005-11-01

    Although biomechanical studies on the knee-thigh-hip (KTH) complex have been extensive, interactions between the KTH and various vehicular interior design parameters in frontal automotive crashes for newer models have not been reported in the open literature to the best of our knowledge. A 3D finite element (FE) model of a 50(th) percentile male KTH complex, which includes explicit representations of the iliac wing, acetabulum, pubic rami, sacrum, articular cartilage, femoral head, femoral neck, femoral condyles, patella, and patella tendon, has been developed to simulate injuries such as fracture of the patella, femoral neck, acetabulum, and pubic rami of the KTH complex. Model results compared favorably against regional component test data including a three-point bending test of the femur, axial loading of the isolated knee-patella, axial loading of the KTH complex, axial loading of the femoral head, and lateral loading of the isolated pelvis. The model was further integrated into a Wayne State University upper torso model and validated against data obtained from whole body sled tests. The model was validated against these experimental data over a range of impact speeds, impactor masses and boundary conditions. Using Design Of Experiment (DOE) methods based on Taguchi's approach and the developed FE model of the whole body, including the KTH complex, eight vehicular interior design parameters, namely the load limiter force, seat belt elongation, pretensioner inlet amount, knee-knee bolster distance, knee bolster angle, knee bolster stiffness, toe board angle and impact speed, each with either two or three design levels, were simulated to predict their respective effects on the potential of KTH injury in frontal impacts. Simulation results proposed best design levels for vehicular interior design parameters to reduce the injury potential of the KTH complex due to frontal automotive crashes. This study is limited by the fact that prediction of bony fracture was

  14. Development and Validation of a High Anatomical Fidelity FE Model for the Buttock and Thigh of a Seated Individual.

    Science.gov (United States)

    Al-Dirini, Rami M A; Reed, Matthew P; Hu, Jingwen; Thewlis, Dominic

    2016-09-01

    Current practices for designing new cushions for seats depend on superficial measurements, such as pressure mapping, which do not provide sufficient information about the condition of sub-dermal tissues. Finite element (FE) modelling offers a unique alternative to integrate assessment of sub-dermal tissue condition into seat/cushion design and development processes. However, the development and validation of such FE models for seated humans requires accurate representation of the anatomy and material properties, which remain challenges that are yet to be addressed. This paper presents the development and validation of a detailed 3D FE model with high anatomical fidelity of the buttock and thigh, for a specific seated subject. The developed model consisted of 28 muscles, the pelvis, sacrum, femur, and one layer of inter-muscular fat, subcutaneous fat and skin. Validation against in vivo measurements from MRI data confirmed that the FE model can simulate the deformation of soft tissues under sitting loads with an accuracy of (mean ± SD) 4.7 ± 4.4 mm. Simulation results showed that the maximum strains (compressive, shear and von-Mises) on muscles (41, 110, 79%) were higher than fat tissues (21, 62, 41%). The muscles that experienced the highest mechanical loads were the gluteus maximus, adductor magnus and muscles in the posterior aspect of the thighs (biceps femoris, semitendinosus and semimembranosus muscles). The developed FE model contributes to the progression towards bio-fidelity in modelling the human body in seated postures by providing insight into the distribution of stresses/strains in individual muscles and inter-muscular fat in the buttock and thigh of seated individuals. Industrial applications for the developed FE model include improving the design of office and household furniture, automotive and airplane seats and wheelchairs as well as customisation and assessment of sporting and medical equipment to meet individual requirements.

  15. Morphometric analysis of high-intensity focused ultrasound-induced lipolysis on cadaveric abdominal and thigh skin.

    Science.gov (United States)

    Lee, Sugun; Kim, Hee-Jin; Park, Hyun Jun; Kim, Hyoung Moon; Lee, So Hyun; Cho, Sung Bin

    2017-07-01

    Non-focused ultrasound and high-intensity focused ultrasound (HIFU) devices induce lipolysis by generating acoustic cavitation and coagulation necrosis in targeted tissues. We aimed to investigate the morphometric characteristics of immediate tissue reactions induced by 2 MHz, 13-mm focused HIFU via two-dimensional ultrasound images and histologic evaluation of cadaveric skin from the abdomen and thigh. Acoustic fields of a 2 MHz, 38-mm HIFU transducer were characterized by reconstruction of the fields using acoustic intensity measurement. Additionally, abdominal and thigh tissues from a fresh cadaver were treated with a HIFU device for a single, two, and three pulses at the pulse energy of 130 J/cm(2) and a penetration depth of 13 mm. Acoustic intensity measurement revealed characteristic focal zones of significant thermal injury at the depth of 38 mm. In both the abdomen and thigh tissue, round to oval ablative thermal injury zones (TIZs) were visualized in subcutaneous fat layers upon treatment with a single pulse of HIFU treatment. Two to three HIFU pulses generated larger and more remarkable ablative zones throughout subcutaneous fat layers. Finally, experimental treatment in a tumescent infiltration-like setting induced larger HIFU-induced TIZs of an oval or columnar shape, compared to non-tumescent settings. Although neither acoustic intensity measurement nor cadaveric tissue exactly reflects in vivo HIFU-induced reactions in human tissue, we believe that our data will help guide further in vivo studies in investigating the therapeutic efficacy and safety of HIFU-induced lipolysis.

  16. Characterizing in vivo pharmacodynamics of carbapenems against Acinetobacter baumannii in a murine thigh infection model to support breakpoint determinations.

    Science.gov (United States)

    Macvane, Shawn H; Crandon, Jared L; Nicolau, David P

    2014-01-01

    Pharmacodynamic profiling data of carbapenems for Acinetobacter spp. are sparse. This study aimed to determine the pharmacodynamic targets of carbapenems for Acinetobacter baumannii based on a range of percentages of the dosing interval in which free drug concentrations remained above the MIC (fT>MIC) in the neutropenic murine thigh infection model. fT>MIC values of 23.7%, 32.8%, and 47.5% resulted in stasis, 1-log reductions, and 2-log reductions in bacterial density after 24 h, respectively. The pharmacodynamic targets of carbapenems for A. baumannii demonstrated in vivo are similar to those of other Gram-negative bacteria.

  17. The Classic: Case of Osteo-Sarcoma of Tibia, Recurring in Stump of Thigh, and Probably Affecting the Lung

    OpenAIRE

    Ewens, John

    2012-01-01

    This Classic article is a reprint of the original work by Mr. John Ewens, “Case of Osteo-Sarcoma of Tibia, Recurring in Stump of Thigh, and Probably Affecting the Lung.” The case is of interest, because the findings contradicted an existing idea, “that large malignant growths, springing from the long bones, do not, after amputation, if the whole of the diseased structures be removed, return in the stump, but at some distant part; and, therefore, it is not necessary to amputate above the knee ...

  18. Multiple level arterial occlusions of the leg. Reliability of indirect thigh pressures in the assessment of proximal arterial obstruction

    DEFF Research Database (Denmark)

    Noer, Ivan; Tønnesen, K H; Lassen, N A

    1981-01-01

    19 patients with obstructive arterial disease both proximal and distal to the inguinal ligament were studied with segmental blood pressure recordings because reconstruction of the proximal lesion was considered. The common femoral pressure was measured intraarterially as well as with a 12 cm cuff...... placed as proximally as possible on the thigh. The proximal pressures measured by the two techniques were found to correlate well. Thus, the atraumatic cuff pressure technique is validated which can be of use in evaluating multilevel occlusions and the associated run off problem involved in partial...

  19. Twenty-eight Cases of Neuritis of Lateral Cutaneous Nerve of Thigh Treated by Acupuncture and Point-Injection

    Institute of Scientific and Technical Information of China (English)

    廖明扬

    2001-01-01

    @@Neuritis of lateral cutaneous nerve of thigh, also called meralgia paresthetica, is a commonly encountered disease in clinical practice. The author has treated 28 cases of meralgia paresthetica since 1996 by acupuncture plus point-injection with satisfactory results. A report follows. Clinical Data Among the 28 cases, 13 were male and 15 female. Their age ranged from 24 to 72 years, most of the patients being 35 to 50 years; the duration of illness varied from one month to ten years and 6 cases were affected on left side, 8 cases on right side and 14 cases on both sides.

  20. Compartment syndrome of thigh and lower leg with disruption of the popliteal vascular bundle after being run over by a 25-ton truck

    Directory of Open Access Journals (Sweden)

    Burghardt Rolf D

    2013-10-01

    Full Text Available 【Abstract】Compartment syndrome of the thigh is a rare condition, potentially resulting in devastating functional outcome. Increasing intracompartmental pressure which suppresses microcirculation and capillary perfusion may lead to cellular anoxia and muscle ischemia. The muscle compartments in the thigh have a more compliant fascia and blend anatomically into the open compartments of the pelvis, thus compensating higher volumes than the compartments in the lower leg. We present a previously unreported case in which the limb of a 36-year-old man was run over by a 25-ton truck. He presented with a sensomotor deficit in his left lower leg with full paralysis of the shank muscles and absence of all foot pulses. CT scan showed a huge haematoma in the thigh with active bleeding out of the popliteal artery into the haematoma which has already expanded into the muscle compartments of the lower leg. The limb had a disastrous compartment syndrome of the thigh and lower leg with disruption of the popliteal neurovascular bundle; however, no bones in the limb were fractured. A complete fasciotomy of all the lower limb muscle compartments was immediately performed. The artery was reconstructed with interposition of the smaller saphenous vein, which was already interrupted through the initial trauma. Key words: Compartment syndromes; Thigh; Hemorrhage; Popliteal artery; Peroneal nerve

  1. Combined use of waist and thigh circumference to identify high-risk, abdominally obese HIV+ patients

    Directory of Open Access Journals (Sweden)

    T O'Neil

    2012-11-01

    Full Text Available Background We examined whether the combination of waist (WC and thigh (ThC circumference improves the prediction of visceral adipose tissue (VAT over WC and ThC independently in HIV-infected men and women after correction for age. We also examined the independent associations between VAT, and the combination of WC and ThC with metabolic risk factors, metabolic syndrome, type 2 diabetes mellitus (T2DM and prior cardiovascular events in HIV-infected individuals. Methods Consecutive patients attending the metabolic clinic of the University of Modena in Italy between 2005 and 2009 were recruited in this cross-sectional study. Total and regional fat mass and lean mass were quantified using DEXA. A single CT image was taken for quantification of VAT and CAC. Prior cardiovascular events which occurred within a 5-year period of the clinical evaluation were analysed. A cross-fold test was used to explore different models in the ability to predict VAT in order to build an algorithm for VAT estimation (e-VAT. Regression analysis were performed to determine the univariate and multivariate relations between WC, ThC, and age with VAT. A comparison of beta coefficients for VAT and e-VAT to predict cardio-metabolic risk and events were performed using multivariable regression models after correction for BMI and age. Results 2322 HIV-infected patients were recruited: median duration of HIV infection was 182 months (IQR 126–236; median nadir and current CD4 were 172 (IQR 68–262 and 515.5 (IQR 369–700 and 75% of them had undetectable HIV1-VL. In this abstract only the results of men will be presented. Men (n=1481 had a mean age of 45.9±7.3 years, a BMI of 24.1 ± 3.8 kg/m2, a WC of 88.0±10.1 cm and a ThC of 47.8±4.3 cm. e-VAT algorithm for men was: (5.44*WC−(1.35*ThC−(1.70*age−348.1 In men, at multivariable regression models after correction for BMI and age, e-VAT was concordant to VAT in predicting HOMA, MetS Risk, prior cardiovascular events (OR=1

  2. The Classic: Case of osteo-sarcoma of tibia, recurring in stump of thigh, and probably affecting the lung. 1878.

    Science.gov (United States)

    Ewens, John

    2013-03-01

    This Classic article is a reprint of the original work by Mr. John Ewens, "Case of Osteo-Sarcoma of Tibia, Recurring in Stump of Thigh, and Probably Affecting the Lung." The case is of interest, because the findings contradicted an existing idea, "that large malignant growths, springing from the long bones, do not, after amputation, if the whole of the diseased structures be removed, return in the stump, but at some distant part; and, therefore, it is not necessary to amputate above the knee in the case of the tibia, or at the hip-joint in the case of the femur." In Mr. Ewen's case, an osteosarcoma of the tibia was treated with above-the-knee amputation, but, in fact, it recurred in the stump. The mechanism was unclear but could have arisen from the presence of a multifocal lesion in the femur, seeding at the time of amputation (details of the amputation were not provided, although the site of the tumor was apparently not involved), or perhaps subsequent metastasis from elsewhere to the stump. Mr. Ewens was a surgeon at the Hospital for Sick Children in Bristol, England. (No other information on Mr. Ewens could be located, and we have no accompanying biographical sketch.) The Classic Article is © (1878) and is reprinted from Ewens J. Case of Osteo-Sarcoma of Tibia, Recurring in Stump of Thigh, and Probably Affecting the Lung. Brit Med J. 1878; Feb 9;1(893):192-193.

  3. Discrepancies between Skinned Single Muscle Fibres and Whole Thigh Muscle Function Characteristics in Young and Elderly Human Subjects

    Directory of Open Access Journals (Sweden)

    Hyunseok Jee

    2016-01-01

    Full Text Available We aimed to analyse the mechanical properties of skinned single muscle fibres derived from the vastus lateralis (VL muscle in relation to those of the whole intact thigh muscle and to compare any difference between young and older adults. Sixteen young men (29.25±4.65 years, 11 older men (71.45±2.94 years, 11 young women (29.64±4.88 years, and 7 older women (67.29±1.70 years were recruited. In vivo analyses were performed for mechanical properties such as isokinetic performance, isometric torque, and power. Specific force and maximum shortening velocity (Vo were measured with single muscle fibres. Sex difference showed greater impact on the functional properties of both the whole muscle (p<0.01 and single muscle fibres than aging (p<0.05. Sex difference, rather than aging, yielded more remarkable differences in gross mechanical properties in the single muscle fibre study in which significant differences between young men and young women were found only in the cross-sectional area and Vo (p<0.05. Age and sex differences reflect the mechanical properties of both single muscle fibres and whole thigh muscle, with the whole muscle yielding more prominent functional properties.

  4. Cardiac and Vascular Responses to Thigh Cuffs and Respiratory Maneuvers on Crewmembers of the International Space Station

    Science.gov (United States)

    Hamilton, Douglas; Sargsyan, Ashot E.; Garcia, Kathleen; Ebert, Douglas; Whitson, Peggy A.; Feiveson, Alan; Alferova, Irina V.; Dulchavsky, Scott A.; Matveev, Vladimir P.; Bogomolov, Valery V.; hide

    2011-01-01

    The transition to microgravity eliminates the hydrostatic gradients in the vascular system. The resulting fluid redistribution commonly manifests as facial edema, engorgement of the external neck veins, and a decrease in leg diameter. This experiment examined the responses to modified Valsalva and Mueller maneuvers measured by cardiac and vascular ultrasound (ECHO) in a baseline steady state and during preload reduction introduced with thigh occlusion cuffs used as a counter-measure device (Braslet cuffs) measured by cardiac and vascular ultrasound examinations. Methods: Nine International Space Station crewmember subjects (Expeditions 16 - 20) were examined in 15 experiment sessions 101 +/- 46.days after launch (mean +/- SD; 33 - 185). Twenty Seven cardiac and vascular parameters were obtained with/without respiratory maneuvers before and after tightening of the Braslet cuffs. Results: Non-physicians performed diagnostic-quality cardiac and vascular ultrasound examinations using remote guidance. Three of 27 combinations of maneuvers and Braslet or Braslet alone were identified as being significant changed when compared to baseline. Eleven of 81 differences between combinations of Mueller, Valsalva or baseline were significant and related to cardiac preload reduction or increase in lower extremity venous volume. Conclusions: Acute application of Braslet occlusion cuffs causes lower extremity fluid sequestration and exerts commensurate measurable effects on cardiac performance in microgravity. Ultrasound techniques to measure the hemodynamic effects of thigh cuffs in combination with respiratory maneuvers may serve as an invaluable tool in determining the volume status of the cardiac patient at the 'microgravity bedside'.

  5. Mitral Valve Replacement via Anterolateral Right Thoracotomy without Cross-Clamping in a Patient with Fungal Infective Endocarditis and Functioning Internal Mammary Artery after Previous Coronary Artery Bypass Grafting and Mitral Valve Repair.

    Science.gov (United States)

    Taguchi, Takahiro; Dillon, Jeswant; Yakub, Mohd Azhari

    2016-02-24

    A 55-year-old man developed severe mitral regurgitation with persistent fungal infective endocarditis 8 months after coronary artery bypass grafting with a left internal mammary artery and 2 saphenous veins, as well as mitral valve repair with a prosthetic ring. Echocardiography demonstrated severe mitral regurgitation and a valvular vegetation. Computed tomography coronary arteriography indicated that all grafts were patent and located intimately close to the sternum. Median resternotomy was not attempted due to the risk of injury to the bypass grafts, and therefore, a right anterolateral thoracotomy approach was utilized. Mitral valve replacement was performed with the patient under deep hypothermia and ventricular fibrillation without aortic cross-clamping. The patient`s postoperative course was uneventful. Thus, right anterolateral thoracotomy may be a superior approach to mitral valve surgery in patients who have undergone prior coronary artery bypass grafting.

  6. Regional Anesthesia Did Not Delay Diagnosis of Compartment Syndrome: A Case Report of Anterior Compartment Syndrome in the Thigh Not Masked by an Adductor Canal Catheter.

    Science.gov (United States)

    Torrie, Arissa; Sharma, Jyoti; Mason, Mark; Cruz Eng, Hillenn

    2017-04-24

    BACKGROUND Acute compartment syndrome (ACS) of the thigh after elective primary total knee arthroplasty is rare. If not recognized and treated promptly, devastating consequences may result. Certain regional anesthesia techniques are thought to mask the symptoms of acute compartment syndrome, but there are no cases reported of adductor canal catheters masking the symptoms of thigh compartment syndrome. We report a case where symptoms and diagnosis of acute anterior thigh compartment syndrome were not masked by a functioning adductor canal catheter. CASE REPORT A 56-year-old male developed anterior thigh compartment syndrome after an elective primary total knee arthroplasty. Surgery was performed under spinal anesthesia with periarticular local infiltration analgesia. Postoperatively, an adductor canal catheter was placed, atraumatically, under ultrasound guidance in the recovery room with a plan to begin a continuous infusion of 0.2% ropivacaine 10 hours after the periarticular injection. Six hours after surgery, the patient complained of tightness and 10/10 pain in his right thigh, which was initially managed with parenteral opioids with moderate success. Continuous infusion through the adductor canal catheter was started and pain improved to 6/10 aching pain. Nonetheless, two hours after starting the continuous infusion, the patient reported tightness, swelling, and 10/10 pressure-like pain that was not relieved by the peripheral catheter infusion or PRN boluses of additional opioids. Due to the patient's symptomatology compartment pressures were measured. The anterior compartment pressure was 47 mm Hg and emergent anterior compartment fasciotomy was performed. CONCLUSIONS In this case, a functioning adductor canal catheter did not mask symptoms of, or delay diagnosis of, acute compartment syndrome in the thigh.

  7. Carbon fibre reinforced plastic knee-ankle-foot orthosis with a partially flexible thigh cuff: a modification for comfort while sitting on a toilet seat.

    Science.gov (United States)

    Hachisuka, K; Arai, K; Arai, M

    2007-06-01

    At the request of a polio survivor, a partially flexible thigh cuff made of leather and canvas for a carbon KAFO was devised to allow the wearer to feel more comfortable while sitting on a toilet seat. The original, acrylic resin, thigh cuff was partially excised to make an opening (15x10 cm), which was stuffed with rubber sponge, and was sealed with leather and canvas. The opening's surround was vertically and horizontally reinforced with carbon fibres. This modification provided relief to the polio survivor from the discomfort previously experienced while sitting on a toilet seat, and satisfied her needs in daily life.

  8. 带神经削薄的游离股前外侧穿支分叶皮瓣修复足踝部软组织缺损%Clinical application of free super-thin anterolateral femoral perforator lobulated skin flap with nerve for repair of tissue defect of the foot and ankle

    Institute of Scientific and Technical Information of China (English)

    董玉金; 张铁慧; 钟声; 任远飞

    2016-01-01

    upper limb function evaluation of upper limb, the results were excellent in 22 cases, good in 9, fair in 1, with 97%(31/32) overall excellent and good rate. Conclusion The free super⁃thin anterolateral femoral perfo⁃rator lobulated skin flap with nerve is an improvement of the traditional anterolateral thigh flap. The survived flaps are ideal in terms of covering foot and ankle defects and restore function.%目的:探讨应用带神经削薄的游离股前外侧穿支分叶皮瓣修复足踝部软组织缺损的临床效果。方法回顾性分析2011年1月至2014年12月,采用带神经削薄的游离股前外侧穿支分叶皮瓣修复32例足踝部软组织缺损患者资料,男20例,女12例;年龄21~50岁,平均35.5岁;均为足踝背侧合并足底皮肤缺损,创面均伴有肌腱、骨或内固定外露,缺损面积12 cm×10 cm~20 cm×15 cm。采用超声多普勒确定皮瓣穿支血管部位,并以此为中心,根据缺损创面的形状及大小,设计携带股前外侧皮神经皮瓣,切取该皮瓣,保留大部分阔筋膜,游离皮瓣至仅血管蒂相连时,修薄皮瓣,从外周至血管皮支穿出点附近按次序阶梯样修剪并削除皮下脂肪,皮瓣四周皮下脂肪可完全削去,仅保留真皮层,穿出点周围1.0~2.0 cm组织不予修剪;观察皮瓣血供,防止穿支血管损伤,皮瓣修薄后,形成分叶皮瓣,移植修复足踝部创面。结果32例患者术后无一例发生血管危象,皮瓣均成活,其中1例在术后第5天出现皮瓣远端约1.5 cm×1.0 cm浅表坏死,经换药后愈合。32例患者均获得随访,随访时间6~24个月,平均13个月;术后皮瓣质地柔软,弹性好,无臃肿,肤色接近正常皮肤,感觉功能恢复良好,两点辨别觉为3.0~5.0 mm,足踝功能及外形恢复良好。根据中华医学会手外科学会上肢部分功能评定试用标准,评分为55~100分,平均90分,其中优22例,良9

  9. Noninvasive quantification of postocclusive reactive hyperemia in mouse thigh muscle by near-infrared diffuse correlation spectroscopy.

    Science.gov (United States)

    Cheng, Ran; Zhang, Xiaoyan; Daugherty, Alan; Shin, Hainsworth; Yu, Guoqiang

    2013-10-20

    Many vasculature-related diseases affecting skeletal muscle function have been studied in mouse models. Noninvasive quantification of muscle blood flow responses during postocclusive reactive hyperemia (PORH) is often used to evaluate vascular function in human skeletal muscles. However, blood flow measurements during PORH in small skeletal muscles of mice are rare due to the lack of appropriate technologies coupled with the challenge of measurement setup resulting from the lack of large enough test sites. In this study, we explored adapting diffuse correlation spectroscopy (DCS) for noninvasive measurement of the relative changes of blood flow (rBF) in mouse thigh muscles during PORH. A small fiber-optic probe was designed and glued on the mouse thigh to reduce the motion artifact induced by the occlusion procedure. Arterial occlusion was created by tying a polyvinyl chloride (PVC) tube around the mouse thigh while the muscle rBF was continuously monitored by DCS to ensure the success of the occlusion. After 5 min, the occlusion was rapidly released by severing the PVC tube using a cautery pen. Typical rBF responses during PORH were observed in all mice (n=7), which are consistent with those observed by arterial-spin-labeled magnetic resonance imaging (ASL-MRI) as reported in the literature. On average, rBF values from DCS during occlusion were lower than 10% (3.1±2.2%) of the baseline values (assigning 100%), indicating the success of arterial occlusion in all mice. Peak values of rBF during PORH measured by the DCS (357.6±36.3%) and ASL-MRI (387.5±150.0%) were also similar whereas the values of time-to-peak (the time duration from the end of occlusion to the peak rBF) were quite different (112.6±35.0  s versus 48.0±27.0  s). Simultaneous measurements by these two techniques are needed to identify the factors that may cause such discrepancy. This study highlights the utility of DCS technology to quantitatively evaluate tissue blood flow responses

  10. "Target" and "Sandwich" Signs in Thigh Muscles have High Diagnostic Values for Collagen Ⅵ-related Myopathies

    Institute of Scientific and Technical Information of China (English)

    Jun Fu; Yi-Ming Zheng; Su-Qin Jin; Jun-Fei Yi; Xiu-Juan Liu; He Lyn; Zhao-Xia Wang

    2016-01-01

    Background:Collagen Ⅵ-related myopathies are autosomal dominant and recessive hereditary myopathies,mainly including Ullrich congenital muscular dystrophy (UCMD) and Bethlem myopathy (BM).Muscle magnetic resonance imaging (MRI) has been widely used to diagnosis muscular disorders.The purpose of this study was to evaluate the diagnostic value of thigh muscles MRI for collagen Ⅵ-related myopathies.Methods:Eleven patients with collagen Ⅵ gene mutation-related myopathies were enrolled in this study.MRI of the thigh muscles was performed in all patients with collagen Ⅵ gene mutation-related myopathies and in 361 patients with other neuromuscular disorders (disease controls).Tl-weighted images were used to assess fatty infiltration of the muscles using a modified Mercuri's scale.We assessed the sensitivity and specificity of the MRI features of collagen Ⅵ-related myopathies.The relationship between fatty infiltration of muscles and specific collagen Ⅵ gene mutations was also investigated.Results:Eleven patients with collagen Ⅵ gene mutation-related myopathies included six UCMD patients and five BM patients.There was no significant difference between UCMD and BM patients in the fatty infiltration of each thigh muscle except sartorius (P =0.033);therefore,we combined the UCMD and BM data.Mean fatty infiltration scores were 3.1 and 3.0 in adductor magnus and gluteus maximus,while the scores were 1.3,1.3,and 1.5 in gracilis,adductor longus,and sartorius,respectively.A "target" sign in rectus femoris (RF) was present in seven cases,and a "sandwich" sign in vastus lateralis (VL) was present in ten cases.The "target" and "sandwich" signs had sensitivities of 63.6% and 90.9% and specificities of 97.3% and 96.9% for the diagnosis of collagen Ⅵ-related myopathies,respectively.Fatty infiltration scores were 2.0-3.0 in seven patients with mutations in the triple-helical domain,and 1.0-1.5 in three of four patients with mutations in the N-or C-domain of the

  11. ¹³C MRS reveals a small diurnal variation in the glycogen content of human thigh muscle.

    Science.gov (United States)

    Takahashi, Hideyuki; Kamei, Akiko; Osawa, Takuya; Kawahara, Takashi; Takizawa, Osamu; Maruyama, Katsuya

    2015-06-01

    There is marked diurnal variation in the glycogen content of skeletal muscles of animals, but few studies have addressed such variations in human muscles. (13)C MRS can be used to noninvasively measure the glycogen content of human skeletal muscle, but no study has explored the diurnal variations in this parameter. This study aimed to investigate whether a diurnal variation in glycogen content occurs in human muscles and, if so, to what extent it can be identified using (13)C MRS. Six male volunteers were instructed to maintain their normal diet and not to perform strenuous exercise for at least 3 days before and during the experiment. Muscle glycogen and blood glucose concentrations were measured six times in 24 h under normal conditions in these subjects. The glycogen content in the thigh muscle was determined noninvasively by natural abundance (13)C MRS using a clinical MR system at 3 T. Nutritional analysis revealed that the subjects' mean carbohydrate intake was 463 ± 137 g, being approximately 6.8 ± 2.4 g/kg body weight. The average sleeping time was 5.9 ± 1.0 h. The glycogen content in the thigh muscle at the starting point was 64.8 ± 20.6 mM. Although absolute and relative individual variations in muscle glycogen content were 7.0 ± 2.1 mM and 11.3 ± 4.6%, respectively, no significant difference in glycogen content was observed among the different time points. This study demonstrates that normal food intake (not fat and/or carbohydrate rich), sleep and other daily activities have a negligible influence on thigh muscle glycogen content, and that the diurnal variation of the glycogen content in human muscles is markedly smaller than that in animal muscles. Moreover, the present results also support the reproducibility and availability of (13)C MRS for the evaluation of the glycogen content in human muscles. Copyright © 2015 John Wiley & Sons, Ltd.

  12. The reparation of flyback avulsion injury of skin in foot by anterolateral thigh flap and sural neurovascular flap with their neural anastomosis%股前外侧皮瓣和腓肠神经营养血管皮瓣联合修复足部套状撕脱伤

    Institute of Scientific and Technical Information of China (English)

    刘勇; 裴国献; 张成进; 王成琪; 李忠; 姚旺祥; 梅良斌

    2006-01-01

    目的 探讨吻合神经的股前外侧皮瓣和腓肠神经营养血管皮瓣联合修复足部套状逆行撕脱伤的临床效果.方法 足部套状逆行撕脱伤患者14例,男10例,女4例;年龄16~58岁,平均31岁.切取带股前外侧皮神经的股前外侧皮瓣移植至足部,将股前外侧皮神经与足底内侧神经吻合,并将足底外侧神经植入股前外侧皮瓣的足底修复区;转移腓肠神经营养血管皮瓣修复足外侧部.将腓浅神经及其分支分别与腓肠内、外侧皮神经吻合.按照Swanson等制定的周围神经损伤临床疗效评定方法,将感觉分成S1~S5 5级,将感觉恢复范围分为R1(<25%)、R2(25%~50%)、R3(50%~75%)与R4(75%~100%)4级.结果 14例移植皮瓣均成活,术后外形良好.术后6个月足部感觉恢复分级:足内侧,S2 6足,S3 8足;足底,S2 9足,S3 5足;足外侧,S2 3足,S3 11足.足部感觉恢复范围:足内侧,R1 4足,R210足;足底,R1 8足、R2 6足;足外侧,R1 4足、R2 10足.术后9个月足部感觉恢复分级:足内侧,S3 7足,S4 7足;足底,S2 2足,S3 6足,S4 6足;足外侧,S3 8足,S4 6足.足部感觉恢复范围:足内侧,R2 5足,R3 8足,R4 1足;足底,R2 8足,R3 4足,R4 2足;足外侧,R2 5足,R3 7足,R4 2足.结论 吻合神经的股前外侧皮瓣和腓肠神经营养血管皮瓣联合修复足部套状逆行撕脱伤具有供区隐蔽、实用,受区感觉恢复理想的特点.

  13. Assessment of the quality of life of oral cancer patients after reconstruction with free anterolateral thigh perforator flaps%股前外侧穿支皮瓣修复口腔癌术后缺损患者的生活质量评估

    Institute of Scientific and Technical Information of China (English)

    邓娜; 何巍; 李锐; 李文鹿; 高宁; 张文

    2015-01-01

    ObjectiveThis study aims to evaluate the quality of life (QOL) of patients who underwent resection of oral cancer and reconstruction by free anterolateral thigh perforator flaps (ALTF). Methods   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 pro-file (OHIP-14) and the medical outcome study short form-36 (SF-36) questionnaires. Results   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. Conclusion   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, deglu-tition, and speech can be restored in varying degrees. Thus, ALTF can improve the patients’ QOL.%目的:评估应用游离股前外侧穿支皮瓣(ALTF)修复口腔颌面部恶性肿瘤切除术后组织缺损患者的生活质量(QOL)。方法以2012年1月—2013年7月应用ALTF修复口腔颌面部恶性肿瘤切除术后组织缺损的32例患者为研究对象,应用口腔健康影响程度量表(OHIP-14)和简明健康状况调查问卷(SF-36)对患者术后12个月的QOL进行调查和评估。结果 SF-36问卷得分位于前3的项目是躯体疼痛、生理功能和躯体角色,得分分别是78.58±14.82、72.08±27.86和60.00±42.63;得分较低的是情感角色(41.67±39.62)、心理健康(50.75±13.07)和健康变化(54.17±21.75)。分析OHIP-14量表得分,恢复较好的项目是社交障碍和残障,得分分别为34.50±11.32和36.04±12.05;恢复较差的项目是生理性疼痛和心理不适,得分分别为73.50±18.96和60.17±25.66。结论采用ALTF修复口腔颌面部恶性肿瘤切除术后组织缺损,能够恢复患者外形、语言和咀嚼功能的基本需求,提高患者的QOL。

  14. [TREATMENT OF POST-SPONDYLODESIS, ADJACENT-SEGMENT DISEASE WITH MINIMALLY INVASIVE, ANTEROLATERAL SURGERY ON THE LUMBAR SPINE: IS THERE IS NO NEED FOR DORSAL OPERATION?].

    Science.gov (United States)

    Schwarcz, Attila; Szakály, Péter; Büki, András; Dóczi, Tamás

    2015-07-30

    Adjacent segment disease (ASD) occurs with a probability of 30% in the lumbar spine following spinal fusion surgery. Usually advanced degenerative changes happen cranially to the fused lumbar segment. Thus, secondary spinal instability, stenosis, spodylolisthesis, foraminal stenosis can lead to the recurrence of the pain not always amenable to conservative measures. A typical surgical solution to treat ASD consists of posterior revision surgery including decompression, change or extension of the instrumentation and fusion to the rostral level. It results in a larger operation with considerable risk of complications. We present a typical case of ASD treated surgically with a new minimally invasive method not yet performed in Hungary. We use anterolateral abdominal muscle splitting approach to reach the lumbar spine through the retroperitoneum. A discectomy is performed by retracting the psoas muscle dorsally. The intervertebral bony fusion is achieved by implanting a cage with large volume that is stuffed with autologous bone or tricalcium phosphate. A cage with large volume results in excellent annulus fibrosus tension, immediate stability and provides large surface for bony fusion. A stand-alone cage construct can be supplemented with lateral screw/rod/plate fixation. The advantage of the new technique for the treatment of ASD includes minimal blood loss, short operation time, significantly less postoperative pain and much lower complication rate.

  15. The role of the anterolateral ligament in ACL insufficient and reconstructed knees on rotatory stability: A biomechanical study on human cadavers.

    Science.gov (United States)

    Tavlo, M; Eljaja, S; Jensen, J T; Siersma, V D; Krogsgaard, M R

    2016-08-01

    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 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 in ACL-insufficient knees. Reconstruction of ACL and ALL reestablished knee stability. The appearance of the ALL was not uniform. The ALL was an internal rotational stabilizer. Anatomical ALL reconstruction in combination with ACL reconstruction could reestablish stability. ALL reconstruction might be considered in patients with combined ACL and ALL tears, but the clinical effect should be established in a controlled clinical study.

  16. 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.

  17. B1-insensitive T2 mapping of healthy thigh muscles using a T2-prepared 3D TSE sequence.

    Science.gov (United States)

    Klupp, Elisabeth; Weidlich, Dominik; Schlaeger, Sarah; Baum, Thomas; Cervantes, Barbara; Deschauer, Marcus; Kooijman, Hendrik; Rummeny, Ernst J; Zimmer, Claus; Kirschke, Jan S; Karampinos, Dimitrios C

    2017-01-01

    To propose a T2-prepared 3D turbo spin echo (T2prep 3D TSE) sequence for B1-insensitive skeletal muscle T2 mapping and compare its performance with 2D and 3D multi-echo spin echo (MESE) for T2 mapping in thigh muscles of healthy subjects. The performance of 2D MESE, 3D MESE and the proposed T2prep 3D TSE in the presence of transmit B1 and B0 inhomogeneities was first simulated. The thigh muscles of ten young and healthy subjects were then scanned on a 3 T system and T2 mapping was performed using the three sequences. Transmit B1-maps and proton density fat fraction (PDFF) maps were also acquired. The subjects were scanned three times to assess reproducibility. T2 values were compared among sequences and their sensitivity to B1 inhomogeneities was compared to simulation results. Correlations were also determined between T2 values, PDFF and B1. The left rectus femoris muscle showed the largest B1 deviations from the nominal value (from 54.2% to 92.9%). Significant negative correlations between T2 values and B1 values were found in the left rectus femoris muscle for 3D MESE (r = -0.72, pvariation (RMSCVs) were equal to 3.5% in T2prep 3D TSE, 2.6% in 3D MESE and 2.4% in 2D MESE. Significant differences between T2 values of 3D sequences (T2prep 3D TSE and 3D MESE) and 2D MESE were found in all muscles with the highest values for 2D MESE (pmuscle T2 mapping.

  18. 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

    2016-06-01

    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

  19. NMR imaging estimates of muscle volume and intramuscular fat infiltration in the thigh: variations with muscle, gender, and age.

    Science.gov (United States)

    Hogrel, Jean-Yves; Barnouin, Yoann; Azzabou, Noura; Butler-Browne, Gillian; Voit, Thomas; Moraux, Amélie; Leroux, Gaëlle; Behin, Anthony; McPhee, Jamie S; Carlier, Pierre G

    2015-06-01

    Muscle mass is particularly relevant to follow during aging, owing to its link with physical performance and autonomy. The objectives of this work were to assess muscle volume (MV) and intramuscular fat (IMF) for all the muscles of the thigh in a large population of young and elderly healthy individuals using magnetic resonance imaging (MRI) to test the effect of gender and age on MV and IMF and to determine the best representative slice for the estimation of MV and IMF. The study enrolled 105 healthy young (range 20-30 years) and older (range 70-80 years) subjects. MRI scans were acquired along the femur length using a three-dimension three-point Dixon proton density-weighted gradient echo sequence. MV and IMF were estimated from all the slices. The effects of age and gender on MV and IMF were assessed. Predictive equations for MV and IMF were established using a single slice at various femur levels for each muscle in order to reduce the analysis process. MV was decreased with aging in both genders, particularly in the quadriceps femoris. IMF was largely increased with aging in men and, to a lesser extent, in women. Percentages of MV decrease and IMF increase with aging varied according to the muscle. Predictive equations to predict MV and IMF from single slices are provided and were validated. This study is the first one to provide muscle volume and intramuscular fat infiltration in all the muscles of the thigh in a large population of young and elderly healthy subjects.

  20. Compartment syndrome of thigh and lower leg with disruption of the popliteal vascular bundle after being run over by a 25-ton truck

    Institute of Scientific and Technical Information of China (English)

    Rolf D Burghardt; Thorsten Gehrke; Daniel Kendoff; Ulrich St(o)ckle; Sebastian Siebenlist

    2013-01-01

    Compartment syndrome of the thigh is a rare condition,potentially resulting in devastating functional outcome.Increasing intracompartmental pressure which suppresses micmcirculation and capillary perfusion may lead to cellular anoxia and muscle ischemia.The muscle compartments in the thigh have a more compliant fascia and blend anatomically into the open compartments of the pelvis,thus compensating higher volumes than the compartments in the lower leg.We present a previously unreported case in which the limb of a 36-year-old man was run over by a 25-ton truck.He presented with a sensomotor deficit in his left lower leg with full paralysis of the shank muscles and absence of all foot pulses.CT scan showed a huge haematoma in the thigh with active bleeding out of the popliteal artery into the haematoma which has already expanded into the muscle compartments of the lower leg.The limb had a disastrous compartment syndrome of the thigh and lower leg with disruption of the popliteal neurovascular bundle; however,no bones in the limb were fractured.A complete fasciotomy of all the lower limb muscle compartments was immediately performed.The artery was reconstructed with interposition of the smaller saphenous vein,which was already interrupted through the initial trauma.

  1. Chicken thigh, chicken liver, and iron-fortified wheat flour increase iron uptake in an in vitro digestion/Caco-2 cell model.

    Science.gov (United States)

    Pachón, Helena; Stoltzfus, Rebecca J; Glahn, Raymond P

    2008-12-01

    The objective of this study was to test meat and fortified-food combinations to identify those that optimize iron uptake in an in vitro digestion/Caco-2 cell model, a proxy for iron bioavailability. Four experiments tested combinations of meats such as chicken (blood, spleen, liver, thigh), beef (cube steak), and fish (whole-fish meal) with iron-fortified foods (rice cereal, maize-soy flour, wheat flour). Chicken liver, thigh, spleen, blood, or fish meal increased the Caco-2 cell iron uptake from these combined with rice cereal (Pflour (Pmeats did not increase the Caco-2 cell iron uptake (P >or= .05). Adding either meat to the 3 fortified foods increased the Caco-2 cell iron uptake of the fortified foods (Pflour were selected for an infant porridge because the combinations with the highest Caco-2 cell iron uptake were chicken thigh + wheat flour, chicken liver + wheat flour, and chicken liver + maize-soy flour, and wheat flour was the least expensive fortified food sold in the target population. Per unit of iron, the chicken thigh + wheat flour and chicken liver + wheat flour combinations resulted in the highest bioavailable iron. In the proportion of 3:1 fortified food:meat examined, meat increases the bioavailability of iron-fortified foods, but iron-fortified foods do not enhance total iron bioavailability when added to meat.

  2. Thigh oxygen uptake at the onset of intense exercise is not affected by a reduction in oxygen delivery caused by hypoxia

    DEFF Research Database (Denmark)

    Christensen, Peter Møller; Nordsborg, Nikolai Baastrup; Nybo, Lars;

    2012-01-01

    In response to hypoxic breathing most studies report slower pulmonary oxygen uptake (Vo(2)) kinetics at the onset of exercise, but it is not known if this relates to an actual slowing of the Vo(2) in the active muscles(.) The aim of the present study was to evaluate whether thigh Vo(2) is slowed ...

  3. A Unique Case of Increased 18F-FDG Metabolic Activity in the Soft Tissues of the Bilateral Upper Thighs Due to Immunizations in a Pediatric Patient

    Science.gov (United States)

    Galloway, Terrel L.; Johnston, Mickaila J.; Starsiak, Michael D.; Silverman, Eugene D.

    2017-01-01

    A case of a 7-month-old white female who was referred for 18F-fluorodeoxyglucose (FDG) Positron emission tomography/computed tomography (PET/CT) initial evaluation of a lytic skull lesion with presumed diagnosis of Langerhans cell histiocytosis is described. Incidentally, she was found to have hypermetabolic nodules in the soft tissues of her anterior thighs. PMID:28217022

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

    Institute of Scientific and Technical Information of China (English)

    Valentina Graci; Gretchen B. Salsich

    2016-01-01

    Background: The greater trochanter marker is commonly used in 3-dimensional (3D) models; however, its influence on hip and knee kinematics during gait is unclear. Understanding the influence of the greater trochanter marker is important when quantifying frontal and transverse plane hip and knee kinematics, parameters which are particularly relevant to investigate in individuals with conditions such as patellofemoral pain, knee osteoarthritis, anterior cruciate ligament (ACL) injury, and hip pain. The aim of this study was to evaluate the effect of including the greater trochanter in the construction of the thigh segment on hip and knee kinematics during gait. Methods: 3D kinematics were collected in 19 healthy subjects during walking using a surface marker system. Hip and knee angles were compared across two thigh segment definitions (with and without greater trochanter) at two time points during stance:peak knee flexion (PKF) and minimum knee flexion (MinKF). Results: Hip and knee angles differed in magnitude and direction in the transverse plane at both time points. In the thigh model with the greater trochanter the hip was more externally rotated than in the thigh model without the greater trochanter (PKF:−9.34° ± 5.21° vs. 1.40° ± 5.22°, MinKF:−5.68° ± 4.24° vs. 5.01° ± 4.86°;p<0.001). In the thigh model with the greater trochanter, the knee angle was more internally rotated compared to the knee angle calculated using the thigh definition without the greater trochanter (PKF:14.67° ± 6.78° vs. 4.33° ± 4.18°, MinKF:10.54° ± 6.71° vs.−0.01° ± 2.69°;p<0.001). Small but significant differences were detected in the sagittal and frontal plane angles at both time points (p<0.001). 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

  5. Anatomical study of the anterolateral and posteromedial bundles of the posterior cruciate ligament for double-bundle reconstruction using the quadruple bone-tunnel technique

    Institute of Scientific and Technical Information of China (English)

    LUO Hao; AO Ying-fang; ZHANG Wei-guang; LIU Sheng-yong; ZHANG Ji-ying; YU Jia-kuo

    2012-01-01

    Background Several techniques have been described for posterior cruciate ligament(PCL)reconstruction.However,double-bundle PCL reconstruction using the quadruple bone-tunnel technique has been seldom reported.The current study investigated this technique,focusing on the anatomy of the femoral and tibial insertions of the anterolateral(AL)and posteromedial(PM)bundles of the PCL.Methods Twenty-two fresh,healthy adult cadaveric knees were dissected and measured.The PCL was divided into the AL bundle and PM bundle at the insertion footprint.The insertion footprints of the AL and PM bundles,their location,size,and the clock positions were measured and described.Results On the femur,the clock position of the footprint of the AL bundle was 11:21±0:23(left)or 0:39±0:23(right),and the PM bundle was 9:50±0:18(left)or 2:10±0:18(right),with the knee flexed at 90 degrees.The distances from the center of the femoral insertions of the AL and PM bundles to the anterior cartilage margins of the medial femoral condyle were(7.79±1.22)mm and(8.36±1.63)mm,respectively.On the tibia,the vertical distances from the center of the tibial insertions of the AL and PM bundles to the tibial articular surface were(3.25±1.20)mm and(6.91±1.57)mm,respectively.Conclusions These results have led to a better definition of the anatomy of the AL and PM bundle footprint of the PCL.The technique of double-bundle PCL reconstruction using quadruple bone-tunnel is feasible.Application of these data during PCL reconstruction using the quadruple bone-tunnel technique may help optimize knee stability.

  6. 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.

  7. [A comparison of operative invasiveness in minimally invasive anterolateral hip replacement (MIS-AL) and standard hip procedure, using biochemical markers].

    Science.gov (United States)

    Musil, D; Stehlík, J; Verner, M

    2008-02-01

    The aim of this prospective randomized study was to compare, by means of biochemical markers, the operative invasiveness of the standard total hip replacement with that of the minimally invasive anterolateral (MIS-AL) approach. Twenty-six randomly assigned patients with standard and 22 patients with MIS-AL total hip replacement were included in the study. Patients with elevated pre-operative levels of the markers evaluated or patients taking medication that might affect marker levels were not included. Creatine phosphokinase (CPK) and C-reactive protein (CRP) were chosen as markers of muscle damage and post-operative inflammatory changes, respectively. Blood samples were drawn before surgery (less than 24 hours) and after surgery at 24, 48 and 96 hours, which respected biological half-lives of the markers and permitted us to study their dynamics. The results were evaluated and statistically analyzed at the department of biochemistry, using the two sample t-test. Statistically significant differences between the two groups of patients were found for both markers. The average CRP values differed significantly (p MIS-AL total hip replacement by 28% and 44%, respectively. The average CPK values showed the most marked difference at 48 hours after surgery, when the level was higher by 62.5% in the standard than MIS-AL total hip replacement (p MIS-AL results in minimal damage to muscle tissue and, consequently, a lower degree of post-operative inflammation than is recorded in traditional hip replacement surgery. In the patients undergoing MIS-AL total hip replacement, post-operative levels of CPK and CRP were significantly lower than in the patients with standard total hip replacement. The MIS-AL technique evidently provides a more sparing approach to soft tissues.

  8. Luxação aguda isolada da articulação tibiofibular proximal Acute isolated anterolateral dislocation of the proximal tibiofibular joint

    Directory of Open Access Journals (Sweden)

    Paulo Roberto de Almeida Silvares

    2010-01-01

    Full Text Available A luxação traumática isolada da articulação tibiofibular proximal é rara. Esta lesão pode não ser reconhecida ou diagnosticada no atendimento inicial. A ausência de suspeita clínica pode causar problemas para o diagnóstico. O diagnóstico necessita de história precisa do mecanismo e sintomas da lesão, avaliação clínica e radiográfica adequada de ambos joelhos. Casos não reconhecidos são fonte de alterações crônicas. O tratamento é feito por redução fechada e imobilização ou, em casos irredutíveis ou instáveis, redução aberta com fixação interna temporária. Um caso raro de luxação tibiofibular proximal isolada em um jogador de basquetebol é relatado para ilustrar essa lesão.The isolated traumatic dislocation of the proximal tibiofibular joint is rare. The injury could go unrecognized or be misdiagnosed at the initial presentation. Lack of clinical suspicion can cause diagnostic problems. The diagnosis requires accurate history of the mechanism and symptoms of the injury, and adequate clinical and radiographic evaluation of the both knees. Overlooked injuries are a source of potentially chronic changes. The treatment is closed reduction and immobilization or, in case of a failed or unstable reduction, open reduction with temporary internal fixation. A rare case of acute isolated anterolateral dislocation of the proximal tibiofibular joint in a basketball player was described to illustrate this injury.

  9. Non-Instrumental Movement Inhibition (NIMI differentially suppresses head and thigh movements during screenic engagement: dependence on interaction

    Directory of Open Access Journals (Sweden)

    Harry J Witchel

    2016-02-01

    Full Text Available Background: Estimating engagement levels from postural micromovements has been summarized by some researchers as: increased proximity to the screen is a marker for engagement, while increased postural movement is a signal for disengagement or negative affect. However, these findings are inconclusive: the movement hypothesis challenges other findings of dyadic interaction in humans, and experiments on the positional hypothesis diverge from it.Hypotheses: 1 Under controlled conditions, adding a relevant visual stimulus to an auditory stimulus will preferentially result in Non-Instrumental Movement Inhibition (NIMI of the head. 2 When instrumental movements are eliminated and computer-interaction rate is held constant, for two identically-structured stimuli, cognitive engagement (i.e. interest will result in measurable NIMI of the body generally. Methods: Twenty-seven healthy participants were seated in front of a computer monitor and speakers. Discrete three-minute stimuli were presented with interactions mediated via a handheld trackball without any keyboard, to minimize instrumental movements of the participant's body. Music videos and audio-only music were used to test hypothesis 1. Time-sensitive, highly interactive stimuli were used to test hypothesis 2. Subjective responses were assessed via visual analogue scales. The computer users' movements were quantified using video motion tracking from the lateral aspect. Repeated measures ANOVAs with Tukey post hoc comparisons were performed.Results: For two equivalently-engaging music videos, eliminating the visual content elicited significantly increased non-instrumental movements of the head (while also decreasing subjective engagement; a highly engaging user-selected piece of favorite music led to further increased non-instrumental movement. For two comparable reading tasks, the more engaging reading significantly inhibited (42% movement of the head and thigh; however, when a highly engaging

  10. The Influence of Different Vegetable Oils on Some ω-3 Polyunsaturated Fatty Acids from Thigh and Abdominal Fat of Broilers

    Directory of Open Access Journals (Sweden)

    Dragoş Sorin Fota

    2011-05-01

    Full Text Available Energy sources, especialy vegetable oils, added to the combined fodder can segnificantly modefy the fatty acids profile of the chicken feed, thus through its control the fatty acids profile of the carcases can be modefied, through enrichment in some fatty acids. In this respect an experiment was coduced on broilers, made up of three experimental groups, fed with a combined base fodder (corn and soybean meal in which 2% of different energy sources were added (sunflower oil, soybean oil, linseed oil. At the end of the 42 days growing period, using gaz cromatography, the fatty acids profile, % of fatty acids in 100 g product (EPA,DPA, DHA, Σ SFA, Σ MUFA, Σ PUFA from the studied cut pieces, were determined. The results obtained after statistc processing and interpretation of the data, showed the fact that regarding the fatty acids profile in chicken thigh and abdominal fat we can observe variations, what denotes that the fatty acids profile can be influenced by dietary factors, the quantity being yet determined by the participation % of the energy sources (vegetable oils, but also by the fatty acids content of the participating raw materials.

  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. 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.

  13. Simulating Non-Specific Influences of Body Posture and Temperature on Thigh-Bioimpedance Spectroscopy during Continuous Monitoring Applications

    Science.gov (United States)

    Ismail, A. H.; Leonhardt, S.

    2013-04-01

    Application of bioimpedance spectroscopy (BIS) for continuous monitoring of body fluid volumes is gaining considerable importance in personal health care. Unless laboratory conditions are applied, both whole-body or segmental BIS configurations are subject to nonspecific influences (e.g. temperature and change in body position) reducing the method's accuracy and reproducibility. In this work, a two-compartment mathematical model, which describes the thigh segment, has been adapted to simulate fluid and solute kinetics during change in body position or variation in skin temperature. The model is an improved version of our previous one offering a good tradeoff between accuracy and simplicity. It represents the kinetics of fluid redistribution, sodium-, potassium-, and protein-concentrations based on simple equations to predict the time course of BIS variations. Validity of the model was verified in five subjects (following a sequence of 7 min supine, 20 min standing, and 40 min supine). The output of the model may reduce possible influences on BIS by up to 80%.

  14. Giant malignant peripheral nerve sheath tumor of thigh in an adolescent with neurofibromatosis type 1: a case report

    Directory of Open Access Journals (Sweden)

    Tosun HB

    2015-10-01

    Full Text Available Haci Bayram Tosun,1 Sancar Serbest,2 Bilge Aydin Turk,3 Seyit Ali Gumustas,1 Abuzer Uludag1 1Department of Orthopaedics and Traumatology, Faculty of Medicine, Adiyaman University, Adiyaman, 2Department of Orthopaedics and Traumatology, Faculty of Medicine, Kirikkale University, Kirikkale, 3Department of Pathology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey Abstract: Malignant peripheral nerve sheath tumors (MPNSTs are rare sarcomas of children and adolescents, and they are aggressive tumors with a high rate of local recurrence. We present a 15-year-old boy with neurofibromatosis type 1 (NF1, who had a giant MPNST on the right thigh taking into account the available literature. Diagnosis of MPNST may be delayed in NF1 patients due to confusion with a neurofibroma and/or a plexiform neurofibroma. Malignancy should be considered, especially in cases with big masses, with heterogeneous involvement, or in the presence of cysts or necrotic nodules. The aim of surgical treatment is complete surgical excision. Keywords: nerve sheath neoplasm, sarcoma, adolescent, neurofibromatosis, lower extremity

  15. 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; Pmuscles 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.

  16. Multiple muscular variations including tenuissimus and tensor fasciae suralis muscles in the posterior thigh of a human case.

    Science.gov (United States)

    Arakawa, Takamitsu; Kondo, Takahiro; Tsutsumi, Masahiro; Watanabe, Yuko; Terashima, Toshio; Miki, Akinori

    2017-09-01

    The posterior thigh muscles on the right side of an 81-year-old male cadaver had multiple variations, denoted muscles I-IV. Muscle I originated from the posteromedial surface of the greater trochanter and divided into two muscle bellies. These muscle bellies fused with the long head of the biceps femoris and were innervated by two branches from muscular branches of the semitendinosus and the long head of the biceps. Muscle II separated from the medial surface of the long head of the biceps in the proximal third and fused with the semitendinosus in the distal fourth. Muscle III was a biventer muscle. Its superior belly separated from the medial surface of the long head of the biceps in the distal third. The inferior belly of this muscle fused with the posterior surface of the crural fascia and was innervated by the tibial nerve. Muscle IV separated from the adductor magnus muscle, passed between the long and short heads of the biceps, fused with the inferior belly of muscle III, and was innervated by the muscular branch of the common fibular nerve to the short head of the biceps. Peeling off the epineurium of the muscular branches to the inferior belly of muscle III showed that this nerve fascicle divided from the common trunk with branches to the gastrocnemius and soleus muscles. The inferior bellies of muscle III and muscle IV were thought to be equivalent to the tensor fasciae suralis and tenuissimus muscles, respectively.

  17. 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.

  18. Sciatic nerve entrapment in the upper thigh caused by an injury sustained during World War II at the battle of Anzio. Case report.

    Science.gov (United States)

    Oldershaw, John B; Salem, Ayman; Storrs, Bruce B; Milner, Brenton; Omer, George E

    2004-03-01

    The authors present an unusual case of sciatic nerve entrapment due to a World War II shrapnel injury to the left thigh suffered during the battle of Anzio in 1943. The patient presented for evaluation of left lower-extremity pain in the sciatic nerve distribution. Magnetic resonance imaging of the lumbosacral spine revealed a disc bulge at L5-S1 that would not explain severe sciatica. A positive Tinel sign was present in the posterior aspect of the upper thigh at the site of a scar resulting from a World War II shrapnel injury. The patient underwent exploratory external neurolysis of the area, and the sciatic nerve was released from fibrous adhesive entrapment. The patient improved dramatically following surgery. During a 3-year follow-up period, no recurrence of symptoms was noted.

  19. 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...

  20. 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.

  1. 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.

  2. Spatial genetic structure of bristle-thighed curlews (Numenius tahitiensis): breeding area differentiation not reflected on the non-breeding grounds

    Science.gov (United States)

    Sonsthagen, Sarah A.; Tibbitts, T. Lee; Gill, Robert E.; Williams, Ian S.; Talbot, Sandra L.

    2015-01-01

    Migratory birds occupy geographically and ecologically disparate areas during their annual cycle with conditions on breeding and non-breeding grounds playing separate and important roles in population dynamics. We used data from nuclear microsatellite and mitochondrial DNA control region loci to assess the breeding and non-breeding spatial genetic structure of a transoceanic migrant shorebird, the bristle-thighed curlew. We found spatial variance in the distribution of allelic and haplotypic frequencies between the curlew's two breeding areas in Alaska but did not observe this spatial structure throughout its non-breeding range on low-lying tropical and subtropical islands in the Central Pacific (Oceania). This suggests that the two breeding populations do not spatially segregate during the non-breeding season. Lack of migratory connectivity is likely attributable to the species' behavior, as bristle-thighed curlews exhibit differential timing of migration and some individuals move among islands during non-breeding months. Given the detrimental impact of many past and current human activities on island ecosystems, admixture of breeding populations in Oceania may render the bristle-thighed curlew less vulnerable to perturbations there, as neither breeding population will be disproportionally affected by local habitat losses or by stochastic events. Furthermore, lack of migratory connectivity may enable bristle-thighed curlews to respond to changing island ecosystems by altering their non-breeding distribution. However, availability of suitable non-breeding habitat for curlews in Oceania is increasingly limited on both low-lying and high islands by habitat loss, sea level rise, and invasive mammalian predators that pose a threat to flightless and flight-compromised curlews during the molting period.

  3. Extensive retroperitoneal and right thigh abscess in a patient with ruptured retrocecal appendicitis: An extremely fulminant form of a common disease

    Institute of Scientific and Technical Information of China (English)

    Chi-Hsun Hsieh; Yu-Chun Wang; Horng-Ren Yang; Ping-Kuei Chung; Long-Bin Jeng; Ray-Jade Chen

    2006-01-01

    As a disease commonly encountered in daily practice,acute appendicitis is usually diagnosed and managed easily with a low mortality and morbidity rate.However, acute appendicitis may occasionally become extraordinarily complicated and life threatening. A56-year-old man, healthy prior to this admission, was brought to the hospital due to spiking high fever, poor appetite, dysuria, progressive right flank and painful swelling of the thigh for 3 d. Significant inflammatory change of soft tissue was noted, involving the entire right trunk from the subcostal margin to the knee joint. Painful disability of the right lower extremity and apparent signs of peritonitis at the right lower abdomen were disclosed. Laboratory results revealed leukocytosis and an elevated C-reactive protein level. Abdominal CT revealed several communicated gas-containing abscesses at the right retroperitoneal region with mass effect, pushing the duodenum and the pancreatic head upward, compressing and encasing inferior vena cava,destroying psoas muscle and dissecting downward into the right thigh. Laparotomy and right thigh exploration were performed immediately and about 500 mL of frank pus was drained. A ruptured retrocecal appendix was the cause of the abscess. The patient fully recovered at the end of the third post-operation week. This case reminds us that acute appendicitis should be treated carefully on an emergency basis to avoid serious complications.CT scan is the diagnostic tool of choice, with rapid evaluation followed by adequate drainage as the key to the survival of the patient.

  4. Isolation and identification of Nocardia asteroids complex isolated from thigh abscess in a patient with Behçet\\\\\\'s syndrome: the first report from Iran

    Directory of Open Access Journals (Sweden)

    Seyyed Saeed Eshraghi

    2013-10-01

    Full Text Available Background: Nocardia species are Gram-positive, partially acid fast, non-motile, catalase positive, aerobic and saprophytic actinomycetes found all around the world. They invade the human body from the environment via trauma and respiratory tract and cause cutaneous, pulmonary and systemic diseases. They are able to grow in various media.The organisms opportunistically infect both immunocompromised and immunocompetent individuals. Behcet's disease is an autoimmune disease and immunocompromised patient which may suitable host for Nocardia bacterium. The present study is the first case report of isolation of Nocardia from the thigh abscess in a patient with behcet’s disease from Iran.Case Presentation: A 39-year-old man with Behcet’s disease in August 2011 was admitted to Shariati hospital Tehran, with swelling and pain in the left flank and left thigh. Microscopic identification from direct microbiological slide of thigh abscess discharge demonstrated number of lymphocytes, neutrophils and macrophages foamy and white blood cells together with filamentous bacteria. Further microbiological characterization using phenotypic and antibiogram tests with disk diffusion method, demonstrated that the isolated bacterium is Nocardia asteroides complex. The bacteria were sensitive to ampicillin, vancomycin, ceftriaxone, amikacin and cotrimoxazole but it was resistant to clindamycin, erythromycin, penicillin G, cephalothin and gentamicin. The patient was treated with cotrimoxazole.Conclusion: Because of the high incidence and high mortality of Nocardia infection in immunocompromised cases, rapid detection and timely treatment for these patients is necessary.

  5. A pilot study comparison of a new method for aortic pulse wave velocity measurements using transthoracic bioimpedance and thigh cuff oscillometry with the standard tonometric method.

    Science.gov (United States)

    Brinkmann, Julia; Jordan, Jens; Tank, Jens

    2015-04-01

    Aortic pulse wave velocity (aPWV) can be measured with different methodologies, including applanation tonometry. These pilot study findings suggest that impedance cardiography combined with thigh oscillometry provides comparable results. Intra- and inter-observer variability was tested by two observers in two subjects. We instrumented 41 patients and 12 healthy normotensive controls for impedance cardiography and consecutive applanation tonometry and compared methods using the Bland-Altman method. Observer variability for the impedance-thigh cuff method (range, 3.61%-7.77%) was comparable with the tonometric method (range, 2.93%-7.37%). Comparison of the two methods based on the Bland-Altman plot revealed a good agreement between methods. The bias between impedance and tonometric measurements was -0.28 ± 0.37 m/s. Both measurements were significantly correlated (r(2) = 0.94; P < .0001; slope = 1.038).Impedance cardiography combined with thigh oscillometry is an easy to use approach which, in addition to providing hemodynamic information, yields aPWV measurements comparable to applanation tonometry. Following full validation according to current guidelines, the methodology could prove useful in cardiovascular risk stratification. Copyright © 2015 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  6. Anatomic and clinical significance of the anterolateral hip joint capsule and iliofemoral ligament%髋前外侧关节囊与髂股韧带的应用解剖及临床意义

    Institute of Scientific and Technical Information of China (English)

    林佳杰; 唐毓金; 黄秀峰; 谢克恭; 黄可; 乔宁宁

    2016-01-01

    背景:全髋关节置换后关节囊及其周围韧带的修补与重建是预防置换后脱位的有效手段之一。近年来前外侧入路全髋关节置换被广泛应用,但髋前外侧关节囊及髂股韧带的应用解剖学研究国内外鲜有报道。目的:观测髋关节前外侧关节囊及髂股韧带的解剖学特点,为全髋关节置换入路及优化提供解剖参考数据。方法:使用30例经甲醛固定的成人髋关节标本,解剖出前外侧关节囊及髂股韧带,将其分为3区9部,分别测量每部的厚度、在转子间线附着点的宽度及到交汇点的距离。观测关节囊的起止、走行、分支及其组织学特点。结果与结论:髋前外侧关节囊与髂股韧带紧密愈合无法分开,形成关节囊髂股韧带复合体,其各部厚薄不一,其中BⅠ、BⅡ部最薄。此外,各区在转子间线的附着点的宽度和到交汇区的高度也不完全一样。关节囊起源于髂前下棘、髋臼缘向下走行分为3支止与转子间线。对髋前外侧关节囊及髂股韧带的了解有助于临床全髋关节置换过程中置换入路的选择及置换方式的设计与优化。%BACKGROUND:To repair and reconstruct the joint capsule and surrounding ligaments is one of effective methods against displacement and dislocation after total hip arthroplasty. In recent years, anterolateral total hip arthroplasty has been widely used, but little is reported on the anatomic features of the anterolateral hip joint capsule and iliofemoral ligament. OBJECTIVE:To investigate the anatomic features of the anterolateral hip joint capsule and iliofemoral ligaments, thereby providing anatomic evidence for selecting and optimizing the approach for total hip arthroplasty and for clinical practice. METHODS:Thirty adult cadaver hips fixed with formalin were used for this study. The anterolateral hip joint capsule and the iliofemoral ligaments were dissected and anterolateral hip joint

  7. The effectiveness and safety of topical PhotoActif phosphatidylcholine-based anti-cellulite gel and LED (red and near-infrared) light on Grade II-III thigh cellulite: a randomized, double-blinded study.

    Science.gov (United States)

    Sasaki, Gordon H; Oberg, Kerby; Tucker, Barbara; Gaston, Margaret

    2007-06-01

    Cellulite of the upper lateral and posterior thighs and lower buttocks represents a common, physiological and unwanted condition whose etiologies and effective management are subjects of continued debate. The purpose of this controlled, double-blinded study is to evaluate the efficacy and safety of a novel phosphatidylcholine-based, cosmeceutical anti-cellulite gel combined with a light-emitting diode (LED) array at the wavelengths of red (660 nm) and near-infrared (950 nm), designed to counter the possible mechanisms that purportedly accentuate the presence of thigh cellulite. Nine healthy female volunteers with Grade II-III thigh cellulite were randomly treated twice daily with an active gel on one thigh and a placebo gel on the control thigh for 3 months. Twice weekly, each thigh was exposed for a 15-minute treatment with LED light for a total of 24 treatments. At 0, 6, and 12 weeks of the study the following clinical determinants were obtained: standardized digital photography, height and weight measurements, standardized thigh circumference tape measurements, pinch testing, body mass index (kg/m2), body fat analysis (Futrex-5500/XL near-infrared analyzer), and digital high-resolution ultrasound imaging of the dermal-adiposal border. In selected patients, full-thickness biopsies of the placebo and active-treated sites were obtained. At 18 months, repeat standardized digital photography, height and weight measurements, and body mass index measurements were obtained. At the end of 3 months, eight of nine thighs treated with the phosphatidylcholine-based, anti-cellulite gel and LED treatments were downgraded to a lower cellulite grade by clinical examination, digital photography, and pinch test assessment. Digital ultrasound at the dermal-adiposal interface demonstrated not only a statistically significant reduction of immediate hypodermal depth, but also less echo-like intrusions into the dermal layer. Three of six biopsies from thighs treated for 3 months with

  8. 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.

  9. 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

  10. 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.

  11. Kinesiology Tape or Compression Sleeve Applied to the Thigh Does Not Improve Balance or Muscle Activation Before or Following Fatigue.

    Science.gov (United States)

    Cavanaugh, M Tyler; Quigley, Patrick J; Hodgson, Daniel D; Reid, Jonathan C; Behm, David G

    2016-07-01

    Cavanaugh, MT, Quigley, PJ, Hodgson, DD, Reid, JC, and Behm, DG. Kinesiology tape or compression sleeve applied to the thigh does not improve balance or muscle activation before or following fatigue. J Strength Cond Res 30(7): 1992-2000, 2016-Compression sleeves (CS) and kinesiology tape (KT) are purported to enhance proprioception, however, there is substantial conflict in the literature. Because the beneficial effects of CS and KT are more evident in the literature with recovery, the objective of this study was to examine the effects of CS and KT on balance under acute nonfatigued and postfatigued conditions. Using a within-subject, repeated-measures design, 12 university participants (5 females and 7 males) performed in a random order CS, KT, and Control conditions. Two trials of each test were conducted before the application of CS or KT (pretest 1), immediately after the application (pretest 2), with posttests at 1 and 10 minutes after 4 sets of unilateral Bulgarian squats to failure (1 minute rest between sets). Tests included a Y balance test (measures: distance reached by nondominant foot in anterior, posterior lateral, and posterior medial directions) and drop jump landing balance test from a 50-cm platform (measures: ground reaction force, electromyography, and center of pressure). The fatigue protocol induced 25.3% decrease in unilateral squat repetitions from set 1 to set 4. There were no significant condition main effects or interactions for any balance measure or EMG before or after fatigue. In conclusion, independent of fatigue, there was no significant effect of CS or KT on balance outcomes immediately and up to 10 minutes following the fatiguing intervention. Thus, nonfatigued or muscles weakened by fatigue did not benefit from CS and KT application.

  12. EFFECTIVENESS OF DRY NEEDLING, STRETCHING, AND STRENGTHENING TO REDUCE PAIN AND IMPROVE FUNCTION IN SUBJECTS WITH CHRONIC LATERAL HIP AND THIGH PAIN: A RETROSPECTIVE CASE SERIES.

    Science.gov (United States)

    Pavkovich, Ron

    2015-08-01

    Chronic lateral hip and thigh pain is regularly treated by the physical therapist. Many issues can cause pain in this region, and trigger points may contribute to pain. Dry Needling (DN) is an intervention used by physical therapists where a monofilament needle is inserted into soft tissue to reduce pain thereby facilitating return to prior level of function. The purpose of this case series is to report the outcomes of DN and conventional physical therapy as a treatment intervention for subjects with chronic lateral hip and thigh pain. Four subjects with chronic lateral hip and thigh pain attended between four and eight sixty-minute sessions of dry needling and stretching/ strengthening activities over a four to eight week intervention course. Outcomes were tested at baseline and upon completion of therapy. A long-term follow up averaging 12.25 months (range 3 to 20 months) was also performed. The outcome measures included the Visual Analog Scale (VAS) and the Lower Extremity Functional Scale (LEFS). The LEFS and VAS indicated clinically meaningful improvements in disability and pain in the short term and upon long term follow up for each subject. The LEFS(mean) for the four subjects improved from 50.75 at baseline to 66.75 at the completion of treatment. At long-term follow-up, the LEFS(mean) was 65.50. Each subject met the minimal clinically important difference (MCID) and minimal detectable change (MDC) for the LEFS and the VAS. The VAS was broken down into best (VAS(B)), current (VAS(C)), and worst (VAS(W)) rated pain levels and averaged between the four subjects. The VAS(B) improved from 20 mm at the initial assessment to 0 mm upon completion of the intervention duration. The VAS(C) improved from 25.75 mm to 11.75 mm, and the VAS(W) improved from 85 mm to 32.5 mm. At the long-term follow up (average 12.25 months), the VAS(B), VAS(C), and VAS(W) scores were 0 mm, 14.58 mm, and 43.75 mm respectively. Clinically meaningful improvements in pain and disability were

  13. The free femoral anterolateral flap combined with iliotibial band to repair dorsalis pedis composite tissue defects%带髂胫束的游离股前外侧皮瓣修复足背复合组织缺损

    Institute of Scientific and Technical Information of China (English)

    孙灵通; 陈瑜; 陈娟; 朱英箭; 王曦; 朱文龙

    2015-01-01

    Objective To assess the effect on free femoral anterolateral skin flap with the iliotibial band to repair the curative effect of dorsalis pedis composite tissue defects. Methods From September 2008 to June 2011, femoral anterolateral flap transplantation with the iliotibial band to repair and toe tendon concurrent instep area skin defect in 16 cases, skin flap ranged from 6.5 cm × 9.0 cm~6.5 cm × 10.5 cm, the length of the iliotibial band was cut 7.0~11.0 cm, 6.0~9.0 cm width. According to the Chinese medical association in to the upper extremity function evaluation standard to assess efficacy. Follow-up for 6 months to 2 years. Results All flaps survived after operation. Excellent in 9 cases, good in 5 cases, fair in 2 cases. Conclusion With femoral anterolateral flap transplantation iliotibial band is an effective method to repair dorsalis pedis composite tissue defect and rebuild toe tendon surgery method.%目的:探讨带髂胫束的游离股前外侧皮瓣修复足背复合组织缺损的疗效。方法对2008年9月—2011年6月收治的16例足背复合组织缺损,采用带髂胫束的股前外侧皮瓣游离移植修复,皮瓣切取范围6.5 cm×9.0 cm~12.0 cm×22.0 cm,髂胫束的切取长度7.0~25.0 cm,宽度6.0~9.0 cm。结果术后所有皮瓣均成活。优9例,良5例,可2例,优良率87.5%。结论带髂胫束的股前外侧皮瓣游离移植修复足背复合组织缺损并重建趾伸肌腱是一种有效的手术方法。

  14. Journal of Tissue Engineering and Reconstructive Surgery%The Clinical Comparison Study of Two Different Methods for Repairing Facial Soft Tissue Defect in Severe Progressive Facial Hemiatrophy

    Institute of Scientific and Technical Information of China (English)

    陈军宝; 李澍源; 曹谊林; 李秉航; 滕利; 卢建建; 徐家杰; 张超; 解芳; 杨莉亚; 杨璐

    2016-01-01

    Objective To evaluate clinical effect of free anterolateral thigh adipofascial flap transplantation and autologous fat graft to repair facial soft tissue defection in severe progressive facial hemiatrophy. Methods From September 2013 to December 2015, 16 patients with progressive facial hemiatrophy were selected according to enter criterion. The patients were divided into two groups according to different surgical methods, autologous fat graft group (Group A, n=8) and free anterolateral thigh adipofascial flap group (Group B, n=8). The facial three-dimensional data were acquired via 3-D scanner preoperatively. Using Mimics 17.0 and Geomagic studio 12.0 software, facial 3-D model of patient was reconstructed, facial symmetry was analyzed, the volume of facial tissue defect was calculated and the reconstruction scope of facial soft tissue was designed. All the patients were operated and clinical indexes were analysed after 6 months. Results The facial symmetry and soft tissue defect in Group A and Group B 6 months post-operation were both significantly improved compared with pre-operation (P0.05). The patients′clinical indexes: total operation time, postoperative hospital stay in Group B were greater than in Group A, times of hospitalization of Group B surpassed Group A with statistical significance (P0.05). Satisfaction score: patients postoperative satisfaction in Group A was better than in Group B (P0.05). Conclusion The clinical effect of autologous fat graft in repairing facial soft tissue defect of severe PFHA patients is non-inferior to free anterolateral thigh adipofascial flap transplantation with good clinical effects and high satisfactory, and is worthy of clinical application.%目的:比较吻合血管的股前外侧筋膜脂肪瓣移植与自体脂肪移植两种方法,修复重度半侧颜面萎缩(PFHA)患者面部软组织缺损的临床效果。方法自2013年09月至2015年12月,根据入组标准选取PFHA患者16例,分为自

  15. Associations of anterior accessory or thigh posterior tributary and great saphenous reflux patterns in early stages of chronic venous valvular insufficiency

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Engelhorn

    2014-07-01

    Full Text Available Varicose veins are a common disorder. Extensive ultrasound (US mapping of lower extremity chronic venous valvular insufficiency includes the great saphenous vein (GSV, anterior accessory saphenous vein (AASV and thigh posterior tributary to GSV such as the posterior accessory saphenous vein (PTSV, PASV. The aim of this study was to determine associations between GSV-AASV-PTSV (including PASV reflux in a specific sample population of Southern Brazilian women, mostly euro descendents, with telangiectasias, reticular veins, varices and/or intermittent edema. US performed in 1016 extremities of 513 women, 43±18 (18-81 years old were included. Women with previous venous thrombosis, surgery, suspicion of pelvic congestion syndrome, and men were excluded. Small saphenous vein and related thigh veins were excluded from analysis. GSV-AASV-PTSV reflux patterns were analyzed; prevalence was compared using χ2 statistics. Reflux prevalence in AASV and/or thigh PTSV was 5.8% (59/1016: 1.3% at PTSV (n=13 and 4.5% at AASV (n=46, significantly lower than GSV reflux: 72% (n=727 (P<0.001. AASV and/or PTSV reflux was associated with GSV reflux (81%, n=48/59; common pattern was diffuse reflux, starting at AASV/PTSV saphenous junctions (56%, n=33/59; otherwise, short, non-diffuse reflux was noted in part of the AASV/PTSV evaluated. Isolated AASV or PTSV reflux was rare (1%, n=11/1016: 9 at the AASV, and 2 at the PTSV. US mapping of AASV/PTSV in early stages of disease, in women without pelvic congestion syndrome, increased reflux detection by 1%, and improved definition of reflux patterns in about 6% of the extremities.

  16. Effect of Dietary Protein and Energy Level on Proximate Composition of Breast and Thigh Meat in White Leghorn Layers at Molt and Post Molt Production Stages

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    S. Javaid*, M. I. Anjum1 and M. Akram2

    2012-10-01

    Full Text Available An experiment was conducted to explore the effects of varying protein and energy levels in molt diets on meat composition of White Leghorn layers. One hundred and fifty four, 70 weeks old, layers were randomly divided into 18 experimental units of 8 hens each in addition to 10 birds that were slaughtered at pre molt and post fast stages. After 10 days of fasting during molting, 6 experimental diets having 3 levels of crude protein (CP i.e. 14, 16 and 18% and 2 levels of metabolizable energy (ME i.e. 2700 and 2900 kcal/kg were given to the birds at the rate of 45 g/bird for 25 day. There after the birds were offered ad-libitum layer ration during production phase. Two birds per replicate at post molt, at 50% egg production and at the end of experiment were slaughtered and then breast and thigh meat samples were analyzed for proximate composition. Moisture (71.7 and 70.0% content was significantly (P<0.05 higher while, ether extract (2.13 and 3.49% was significantly (P<0.05 lower in both breast and thigh meat, respectively, with 18% CP diet as compared to 14 and 16% CP diets. Medium Protein-High Energy (MPHE molt diet having 16% CP with 2900 kcal/kg ME produced more dry matter and protein content in meat at the expense of ether extract. Results regarding proximate composition of layer meat determined at different stages of molting and post molt production revealed that moisture and protein contents of both breast and thigh meat were significantly increased where as, ether extract and ash contents were significantly decreased at post fast stage with respect to other stages.

  17. An imaging analysis of {sup 99m}Tc-UBI (29-41) uptake in S. aureus infected thighs of rabbits on ciprofloxacin treatment

    Energy Technology Data Exchange (ETDEWEB)

    Akhtar, Muhammad S. [Punjab Institute of Nuclear Medicine (PINUM), P.O. Box-2019, Faisalabad (Pakistan); Pakistan Institute of Engineering and Applied Sciences (PIEAS) University, Islamabad (Pakistan); Khan, Muhammad E.; Irfanullah, Javaid; Afzal, Muhammad S.; Khan, Muhammad A.; Nadeem, Muhammad A.; Imran, Muhammad B. [Punjab Institute of Nuclear Medicine (PINUM), P.O. Box-2019, Faisalabad (Pakistan); Khan, Bashar; Jehangir, Mustansar [Pakistan Institute of Nuclear Science and Technology (PINSTECH), Islamabad (Pakistan)

    2008-06-15

    The uptake of {sup 99m}Tc-UBI (29-41) was evaluated at sites of bacterial infections in rabbits before and after treatment with ciprofloxacin. Staphylococcus aureus susceptible to ciprofloxacin was used to induce a focal infection in each rabbit of group 1 (G1), group 2 (G2), and group 3 (G3) with 2 x 10{sup 4}, 2 x 10{sup 6}, and 2 x 10{sup 8} colony forming units (CFU), respectively. After 24 h, images of infected thighs (target: T) and contralateral thighs (nontarget: NT) were acquired. Animals then received ciprofloxacin intramuscularly for 5 days followed by imaging on the third and fifth days. The control group 4 (G4) was imaged at days 1, 3, and 5 under the same acquisition parameters. Group 5 (G5) was employed to study biodistribution of the peptide. Increases in (T/NT) ratios in G1, G2, and G3 were observed from 5 min onwards with maximum values at 60 min. G3 revealed the highest accumulation of the peptide. Growth of the same strain of S. aureus on blood agar medium was visualized after fine needle aspiration. After ciprofloxacin treatment, the images for G1-G3 resulted in significantly decreased (P < 0.05) T/NT values on the third and fifth days that correlated with reduction in number of viable bacteria. No significant difference (P < 0.05) in left to right thigh ratios in the control group (G4) was observed. Biodistribution of the peptide showed rapid removal of tracer from circulation through the kidneys. {sup 99m} Tc-UBI (29-41) accumulation directly correlates with the number of viable bacteria. This infection localization agent can be utilized for monitoring efficacy and duration of antibiotic treatment. (orig.)

  18. Evaluation of enzymatically treated Artemisia annua L. on growth performance, meat quality, and oxidative stability of breast and thigh muscles in broilers.

    Science.gov (United States)

    Wan, X L; Song, Z H; Niu, Y; Cheng, K; Zhang, J F; Ahmad, H; Zhang, L L; Wang, T

    2017-04-01

    An experiment was conducted to evaluate the effects of including enzymatically treated Artemisia annua L. (EA) in broiler diets on growth performance, meat quality, and oxidative stability of breast and thigh muscles. A total of 256 one-d-old Arbor Acres broiler chicks were randomly allotted into four groups with eight replicates of eight birds each. Broilers in the four groups were offered basal diet supplemented with 0.0, 0.5, 1.0, and 1.5 g/kg EA during the 42-d experiment, respectively. The ADG, ADFI, and feed/gain ratio (F:G) were measured at 42 d of age. Breast and thigh muscle samples from eight birds per treatment were obtained at 42 d to determine meat quality, free radical scavenging activity, and lipid peroxidation. All treatment groups had similar ADG, ADFI, and F:G during the 42 d experiment (P > 0.05). Drip loss at 24 h and shearing force of breast muscle were linearly (P muscle followed the same fashion. The supplementation of EA quadratically increased 2, 2-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) diammonium salt (ABTS) (P = 0.004) and 2, 2-diphenyl-1-picrylhydrazyl (DPPH) (P = 0.035) free radical scavenging activities in breast muscle, and linearly (P muscle. Increasing levels of EA linearly (P muscle samples during 15 d of storage at 4°C. The results indicated that EA supplementation improved meat quality and oxidative stability of breast and thigh muscles in broilers. The inclusion level of 1.0 g/kg EA in broiler diet was recommended. © 2016 Poultry Science Association Inc.

  19. Effect of supplemental fermented Ginkgo biloba leaves at different levels on growth performance, meat quality, and antioxidant status of breast and thigh muscles in broiler chickens.

    Science.gov (United States)

    Niu, Y; Wan, X L; Zhang, X H; Zhao, L G; He, J T; Zhang, J F; Zhang, L L; Wang, T

    2017-04-01

    The present study was conducted to investigate the influence of dietary supplementation with different levels of fermented Ginkgo biloba leaves (FGBL) on growth performance, slaughter performance, meat quality, antioxidant enzyme capacity, and free radical scavenging activities of muscles in broiler chickens. A total of 648 one-d-old broiler chickens were randomly allocated into six dietary treatments, including control group (CON group: basal diet), FGBL1, FGBL2, FGBL3, FGBL4, and FGBL5 groups (basal diet containing 1.5, 2.5, 3.5, 4.5, and 5.5 g/kg FGBL, respectively). Body weight gain and feed intake were recorded at 1, 21, and 42 d. At 42 d, 2 birds from each replicate were slaughtered. The results indicated that 3.5 g/kg FGBL diet significantly increased (P muscle, cooking loss in thigh muscle and lower 24 h and 48 h drip loss in both breast and thigh muscles than those of other groups. Furthermore, birds in the FGBL3 and FGBL4 groups increased (P muscles, and the scavenging activities of 2,2΄-azino-bis (3-ethylbenzothiazoline-6-sulfonic) acid radical, OH•, and O2•- in thigh muscle, decreased (P muscle, as compared to the CON group. In conclusion, FGBL had the potential to improve the growth performance, meat quality and antioxidant status of broiler chickens. The optimal dose in the present study of FGBL in broiler diets was from 3.5 to 4.5 g/kg. © 2016 Poultry Science Association Inc.

  20. Effects of intermittent pneumatic compression of the thigh on blood flow velocity in the femoral and popliteal veins: developing a new physical prophylaxis for deep vein thrombosis in patients with plaster-cast immobilization of the leg.

    Science.gov (United States)

    Nakanishi, Keisuke; Takahira, Naonobu; Sakamoto, Miki; Yamaoka-Tojo, Minako; Katagiri, Masato; Kitagawa, Jun

    2016-11-01

    Patients with plaster-cast immobilization of the lower limb have an estimated venous thromboembolism rate of 2.5 % without prophylaxis, which includes many fatal cases. However, there is no practical physical prophylaxis for deep-vein thrombosis (DVT) in these patients. The aim of this study was to examine the effects of intermittent pneumatic compression on the thigh alone (IPC to the thigh) on peak blood velocity (PBV) in the legs and to consider the possibility that IPC of the thigh could be used as physical prophylaxis for DVT in patients with plaster-cast immobilization of the lower leg. Nine healthy male volunteers and eighteen elderly males were recruited. We immobilized each subject's right lower leg and ankle with a plaster splint, and applied the ActiveCare+S.F.T.(®) (Medical Compression Systems, Inc.) device to each subject's right thigh. The PBV in the superficial femoral vein (PBVFV) and the popliteal vein (PBVPV) were measured using duplex Doppler ultrasonography. IPC to the thigh resulted in a 2.3-fold increase in PBVFV and a 3.0-fold increase in PBVPV compared with resting at supine in the elderly group. Although IPC to the thigh also increased PBVFV and PBVPV significantly in the sitting position, the change ratios of PBV in the supine and sitting positions were equal (2.6-fold increase in PBVFV and 2.9-fold increase in PBVPV). IPC to the thigh in supine and sitting positions significantly increased PBVFV and PBVPV, and could be a useful prophylaxis for DVT in patients with plaster-cast immobilization of the lower leg.

  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

    PCR amplification of DNA from forensic samples often proves difficult due to the presence of inhibitors of the polymerase chain reaction. One possible way to remove PCR inhibitors from a DNA extract is the use of the affinity resin thiopropyl sepharose 6B (TS), which has been used previously...... 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...... substantial amounts of DNA are present....

  2. Neural Network Model for Survival and Growth of Salmonella enterica Serotype 8,20:-:z6 in Ground Chicken Thigh Meat during Cold Storage: Extrapolation to Other Serotypes.

    Science.gov (United States)

    Oscar, T P

    2015-10-01

    Mathematical models that predict the 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 the behavior of Salmonella enterica serotype 8,20:-:z6 in chicken meat during cold storage and to determine how well the model would predict the behavior of other serotypes of Salmonella stored under the same conditions. To develop the model, ground chicken thigh meat (0.75 cm(3)) was inoculated with 1.7 log Salmonella 8,20:-:z6 and then stored for 0 to 8 -8 to 16°C. An automated miniaturized most-probable-number (MPN) method was developed and used for the enumeration of Salmonella. Commercial software (Excel and the add-in program NeuralTools) was used to develop a multilayer feedforward neural network model with one hidden layer of two nodes. The performance of the model was evaluated using the acceptable prediction zone (APZ) method. The number of Salmonella in ground chicken thigh meat stayed the same (P > 0.05) during 8 days of storage at -8 to 8°C but increased (P < 0.05) during storage at 9°C (+0.6 log) to 16°C (+5.1 log). The proportion of residual values (observed minus predicted values) in an APZ (pAPZ) from -1 log (fail-safe) to 0.5 log (fail-dangerous) was 0.939 for the data (n = 426 log MPN values) used in the development of the model. The model had a pAPZ of 0.944 or 0.954 when it was extrapolated to test data (n = 108 log MPN per serotype) for other serotypes (S. enterica serotype Typhimurium var 5-, Kentucky, Typhimurium, and Thompson) of Salmonella in ground chicken thigh meat stored for 0 to 8 days at -4, 4, 12, or 16°C under the same experimental conditions. A pAPZ of ≥0.7 indicates that a model provides predictions with acceptable bias and accuracy. Thus, the results indicated that the model provided valid predictions of the survival and growth of Salmonella 8,20:-:z6 in ground chicken thigh meat stored for 0 to 8 days at -8 to

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

    Directory of Open Access Journals (Sweden)

    Walcarius Rhonda

    2006-08-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusion 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

  4. 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.

  5. Visualization of abscess formation in a murine thigh infection model of Staphylococcus aureus by 19F-magnetic resonance imaging (MRI.

    Directory of Open Access Journals (Sweden)

    Tobias Hertlein

    Full Text Available BACKGROUND: During the last years, (19F-MRI and perfluorocarbon nanoemulsion (PFC emerged as a powerful contrast agent based MRI methodology to track cells and to visualize inflammation. We applied this new modality to visualize deep tissue abscesses during acute and chronic phase of inflammation caused by Staphylococcus aureus infection. METHODOLOGY AND PRINCIPAL FINDINGS: In this study, a murine thigh infection model was used to induce abscess formation and PFC or CLIO (cross linked ironoxides was administered during acute or chronic phase of inflammation. 24 h after inoculation, the contrast agent accumulation was imaged at the site of infection by MRI. Measurements revealed a strong accumulation of PFC at the abscess rim at acute and chronic phase of infection. The pattern was similar to CLIO accumulation at chronic phase and formed a hollow sphere around the edema area. Histology revealed strong influx of neutrophils at the site of infection and to a smaller extend macrophages during acute phase and strong influx of macrophages at chronic phase of inflammation. CONCLUSION AND SIGNIFICANCE: We introduce (19F-MRI in combination with PFC nanoemulsions as a new platform to visualize abscess formation in a murine thigh infection model of S. aureus. The possibility to track immune cells in vivo by this modality offers new opportunities to investigate host immune response, the efficacy of antibacterial therapies and the influence of virulence factors for pathogenesis.

  6. Acute Effects of Constant-Angle and Constant-Torque Static Stretching on Passive Stiffness of the Posterior Hip and Thigh Muscles in Healthy, Young and Old Men.

    Science.gov (United States)

    Palmer, Ty B

    2017-07-24

    The purpose of this study was to examine the acute effects of constant-angle (CA) and constant-torque (CT) static stretching on passive stiffness of the posterior hip and thigh muscles in healthy, young and old men. Fifteen young (25±3 years) and 15 old (71±4 years) men underwent 2 passive straight-leg raise (SLR) assessments before and after 8 min of CA and CT stretching using an isokinetic dynamometer. Passive stiffness was calculated during each SLR as the slope of the final 10% of the angle-torque curve. The results indicated that passive stiffness decreased from pre- to post-stretching for both treatments (P≤0.001-0.002) and age groups (P≤0.001-0.046); however, greater decreases were observed for the CT than the CA stretching (P=0.045) and for the old than the young men (Pstretching. These findings suggest that holding stretches at a constant tension may be a more effective strategy for altering passive stiffness of the posterior hip and thigh muscles. The greater stretch-induced stiffness decreases observed for the older men provide support that acute static stretching may be particularly effective for reducing stiffness in the elderly. As a result, it may be advantageous to prescribe static stretching prior to exercise for older adults, as this may be used to elicit substantial declines in passive stiffness, which could help reduce the risk of subsequent injury events in this population.

  7. The efficacy of capacitive radio-frequency diathermy in reducing buttock and posterior thigh cellulite measured through the cellulite severity scale.

    Science.gov (United States)

    De La Casa Almeida, Maria; Suarez Serrano, Carmen; Medrano Sánchez, Ester Maria; Diaz Mohedo, Esther; Chamorro Moriana, Gema; Rebollo Salas, Manuel

    2014-10-01

    Cellulite, despite its high prevalence in women, has been subjected to very little research, while the majority has been carried out using unvalidated evaluation tools. To determine the efficacy of capacitive radio-frequency diathermy (CRFD) in reducing buttock and posterior thigh cellulite and to verify its relationship with the reduction of body weight. Design: Experimental clinical study consists of two parallel groups. Totally 54 lower limbs of 27 women (26.41 ± 6.16 years) were considered with each patient's two limbs being assigned one to each group via simple random distribution. First group received local application of CRFD (30 min) and the second received the same treatment followed by a supplementary whole-segment application of CRFD (20 min). Each limb received 20 sessions, twice a week. Cellulite Severity Scale dimensions score, weight and Body Mass Index (BMI) were taken for the evaluation of the study. A significance of p less than 0.01 was observed for all the variables in both groups, thereby demonstrating the effectiveness of both the treatments; no significant differences were observed between groups (p > 0.05). Monopolar static application of CRFD is effective in reducing buttock and posterior thigh cellulite. It appears that there is not necessarily any relationship between weight loss, decreased BMI and reduction in cellulite.

  8. Impact of injection speed and volume on perceived pain during subcutaneous injections into the abdomen and thigh: a single-centre, randomized controlled trial.

    Science.gov (United States)

    Heise, T; Nosek, L; Dellweg, S; Zijlstra, E; Præstmark, K A; Kildegaard, J; Nielsen, G; Sparre, T

    2014-10-01

    The aim of this study was to assess pain associated with subcutaneous injection into the abdomen and thigh of different combinations of injection speeds and volumes. The study was a single-centre, one-visit, double-blinded, randomized controlled trial in 82 adults with type 1 or type 2 diabetes receiving daily injections of insulin or glucagon-like peptide-1 (GLP-1) agonists. Participants received 17 subcutaneous injections (12 in abdomen, 5 in thigh) of saline at different injection speeds (150, 300 and 450 µl/s), with different volumes (400, 800, 1200 and 1600 µl), and two needle insertions without any injection. Pain was evaluated on a 100-mm visual analogue scale (VAS) (0 mm no pain, 100 mm worst pain) and on a yes/no scale for pain acceptability. Injection speed had no impact on injection pain (p = 0.833). Injection of larger volumes caused significantly more pain [VAS least square mean differences 1600 vs. 400 µl, 7 · 2 mm (95% confidence interval - CI; 4.6-9.7; p Injection speed had no effect on injection pain, whereas higher injection volumes caused more pain. The results of this study may be of value for guiding patients to use the appropriate injection site and technique to reduce their injection pain. Furthermore, these findings may have important implications for the development of new injection devices and drug formulations for clinical practice. © 2014 John Wiley & Sons Ltd.

  9. 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.

  10. An imaging analysis of (99m)Tc-UBI (29-41) uptake in S. aureus infected thighs of rabbits on ciprofloxacin treatment.

    Science.gov (United States)

    Akhtar, Muhammad Saeed; Khan, Muhammad Ejaz; Khan, Bashar; Irfanullah, Javaid; Afzal, Muhammad Shahzad; Khan, Muhammad Aleem; Nadeem, Muhammad Afzal; Jehangir, Mustansar; Imran, Muhammad Babar

    2008-06-01

    The uptake of (99m)Tc-UBI (29-41) was evaluated at sites of bacterial infections in rabbits before and after treatment with ciprofloxacin. Staphylococcus aureus susceptible to ciprofloxacin was used to induce a focal infection in each rabbit of group 1 (G1), group 2 (G2), and group 3 (G3) with 2 x 10(4), 2 x 10(6), and 2 x 10(8) colony forming units (CFU), respectively. After 24 h, images of infected thighs (target: T) and contralateral thighs (nontarget: NT) were acquired. Animals then received ciprofloxacin intramuscularly for 5 days followed by imaging on the third and fifth days. The control group 4 (G4) was imaged at days 1, 3, and 5 under the same acquisition parameters. Group 5 (G5) was employed to study biodistribution of the peptide. Increases in (T/NT) ratios in G1, G2, and G3 were observed from 5 min onwards with maximum values at 60 min. G3 revealed the highest accumulation of the peptide. Growth of the same strain of S. aureus on blood agar medium was visualized after fine needle aspiration. After ciprofloxacin treatment, the images for G1-G3 resulted in significantly decreased (P removal of tracer from circulation through the kidneys. ( 99m ) Tc-UBI (29-41) accumulation directly correlates with the number of viable bacteria. This infection localization agent can be utilized for monitoring efficacy and duration of antibiotic treatment.

  11. Automatic Fat Segmentation Method on Thigh MRI%腿部磁共振图像自动分割算法研究

    Institute of Scientific and Technical Information of China (English)

    吴水才; 姜佩杰; 杨春兰; 阮祥燕

    2012-01-01

    提出利用期望最大值分割算法的结果对水平集算法进行改进,实现腿部磁共振图像脂肪和其他组织的自动分割.实验结果表明,该方法能较好地分割出腿部皮下脂肪组织、肌肉间脂肪组织及其他组织.%Fat research of thigh is very valuable in the diagnosis of metabolic syndrome and metabolic dysfunction.However,it is more difficult to segment the subcutaneous fat and intermuscular fat in MRI images because of connected regions.The result of expectation maximization algorithm is used to improve level-set algorithm and realize automatic MRI image segmentation.Results show that the subcutaneous fat tissue,intermuscular fat tissue,and other tissues of thigh can be successfully segmented with the method.

  12. New anterolateral LCP for internal fixation of pilon fractures%新型胫骨远端前外侧锁定加压钢板用于Pilon骨折内固定

    Institute of Scientific and Technical Information of China (English)

    史德海; 卢华定; 李东会; 蔡道章

    2010-01-01

    Objective To introduce experience of using the new AO anterolateral distal tibia locking com-pression plate (LCP) for treatment of Pilon fractures. Methods Between February and August of 2009,8 closed Pi-lon fractures were treated by open reduction and internal fixation. The distal fibula was fixed with a one-third tubular plate or an recontruction plate via a straight incision posterior to the fibular crest. The distal tibia was approched by a straight incision over the ankle joint, and the fracture was stabilized using an anterolateral distal tibia LCP. Regular follow up was made to observe and evaluate the preliminary clinical outcomes. Results Seven of the 8 patients were availabe for follow up for 3 ~ 6 months (average 4.5 months). All incisions obtained primary healing, though one ex-perienced mild superficial inflammation,and none developed deep infections. Based on the Burwell and Charnley radi-ographic criteria,anatomical reduction was obtained in 5 cases,good in 1 ,and fair in 1. Among the 5 cases exceeding 5 months postsurgery,4 were evaluated as excellent and 1 us good according to Tometta' s clinically based criteria for Pilon fractures. Conclusion With good surgical timing,internal fixation with anterolateral LCP for Pilon fractures is reliable and warrants less complications.%目的 介绍新型AO胫骨远端前外侧锁定加压钢板(IEP)治疗胫骨远端骨折(Pilon骨折)的初步经验.方法 手术治疗8例闭合性Pilon骨折,腓骨作外踝后方纵切口,复位后用1/3管形或重建钢板固定;胫骨远端骨折采用踝关节前方中点纵向直切口,复位后采用胫骨远端前外侧LCP内固定,术后进行定期临床随访.观察初步疗效.结果 术后7例患者获得随访3~6个月(平均4.5个月).虽有1例切口出现短暂的表浅轻微炎症,最终所有切口均一期愈合,无深部感染发生.按照Burwell-Charnley骨折复位放射学评价标准,解剖复位5例,1例复位好,1例可;采用Tometta治

  13. 单一前外侧切口治疗Pilon骨折的初步报告%The Use of A Aingle Anterolateral Approach for the Treatment of Pilon Fracture Preliminary Report

    Institute of Scientific and Technical Information of China (English)

    相大勇; 林景波; 郭刚; 林昂如

    2012-01-01

    Objectives To introduce the indications and operative procedure of a single anterolateral approach for the treatment of Pilon fracture and report its preliminary results. Methods 12 cases with closed unilateral tibial pilon fracture were treated with a single anterolateral approach between March 2008 and March 2010. There were 8 males and 4 femals. The average age was 28 years(range 18 to 48 years). According to the AO/OTA classification,there were type 43-B in 4 cases and type 43-C in 8 cases. A lateral skin incision is made along the anterial border of the fibula to the end of fibula then toward the base of the fourth metatarsal. The anterior perforating peroneal artery can be I-dentified and preserved. Be care of protecting the superficial peroneal nerve. Further blunt dissection is used to expose the distal parts of the tibia and fibula. Then the anterior ankle joint capsule is released to assist the reduction. Patients began to do exercise when the wound were completely healed. Standard postoperative weightbearing restrictions were maintained until evidence of healing was present. Results Partial skin necrosis curing without any treatment was found in 1 case,the others were all healed completely. Accoding to the Mazur critical,the results was evaluated as ex-erllent in 8 cases,good in 3 cases and fair in 1 cases. Conclusion A single anterolateral approach is not suitable for all patients to these difficult fractures. But this approach preduce soft-tissue complications and is helpful to reconstruction of the articular surface of the distal tibia.%目的 介绍一种单一前外侧切口治疗Pilon骨折的适应证、方法及初期随访结果.方法 2008年3月至2010年3月,应用单一前外侧切口治疗12例闭合性胫骨Pilon骨折患者.男性8例,女性4例;年龄18~48岁,平均28岁.采用分期治疗方法,伤后至手术时间5~14 d,平均7.1d.按AO/OTA分型,43-B型4例,43-C型8例,切口位于腓骨前缘,至腓骨远端后斜向第四

  14. [Fasciocutaneous flap of the posterior surface of the thigh with distal pedicle. Anatomical study and surgical value. A propos of 3 cases].

    Science.gov (United States)

    Lambert, F; Cariou, J L; Couturaud, B; Bellavoir, A

    1996-04-01

    In the light of previous studies, the authors conducted an anatomical study on 21 cadaveric dissections with injection in order to define the characteristics of the distally based fasciocutaneous flap of the posterior surface of the thigh, described for the first time in 1988 by Maruyama. This leaf-shaped flap extends from the popliteal region to the gluteal sulcus. It possesses an axial arterial network derived from the popliteal artery, reinforced by the perforating arteries derived from the vessel or the profunda femoris artery. The venous return is ensured by venae comitantes and the communicating saphenous vein. The flap raising technique is described. From 1991 to 1994, 3 patients were operated in order to cover a defect of the knee (1 case) and amputation stumps (2 cases). The postoperative course was uneventful and the results were considered to be stable and of excellent quality with a follow-up of 2 to 4 years.

  15. 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

    The muscle pump and muscle vasodilatory mechanism are thought to play important roles in increasing and maintaining muscle perfusion and cardiac output ((.)Q) during exercise, but their actual contributions remain uncertain. To evaluate the role of the skeletal muscle pump and vasodilatation...... thigh compressions at rest and during passive and voluntary exercise (n=7). Incremental exercise resulted in progressive increases in leg blood flow (DeltaLBF 7.4 +/- 0.7 l min(-1)), cardiac output (Delta (.)Q 8.7 +/- 0.7 l min(-1)), mean arterial pressure (DeltaMAP 51 +/- 5 mmHg), and leg and systemic.......Further, its contribution to muscle and systemic peak exercise hyperaemia appears to be minimal in comparison to the effects of muscle vasodilatation Udgivelsesdato: 2008/5/1...

  16. Treatment of elderly patients with advanced lipedema: a combination of laser-assisted liposuction, medial thigh lift, and lower partial abdominoplasty

    Directory of Open Access Journals (Sweden)

    Wollina U

    2014-01-01

    Full Text Available Uwe Wollina,1 Birgit Heinig,2 Andreas Nowak31Department of Dermatology and Allergology, 2Centre of Physical Therapy and Rehabilitative Medicine, 3Department of Anaesthesiology and Intensive Medical Care, Emergency Medicine and Pain Management, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, GermanyBackground: Lipedema is a rare female disorder with a characteristic distribution of adipose tissue hypertrophy on the extremities, with pain and bruising. In advanced stages, reduction of adipose tissue is the only available effective treatment. In elderly patients with advanced lipedema, correction of increased skin laxity has to be considered for an optimal outcome.Methods: We report on a tailored combined approach to improve advanced lipedema in elderly females with multiple comorbidities. Microcannular laser-assisted liposuction of the upper legs and knees is performed under tumescent anesthesia. Medial thigh lift and partial lower abdominoplasty with minimal undermining are used to correct skin laxity and prevent intertrigo. Postsurgical care with nonelastic flat knitted compression garments and manual lymph drainage are used.Results: We report on three women aged 55–77 years with advanced lipedema of the legs and multiple comorbidities. Using this step-by-step approach, a short operation time and early mobilization were possible. Minor adverse effects were temporary methemoglobinemia after tumescent anesthesia and postsurgical pain. No severe adverse effects were seen. Patient satisfaction was high.Conclusion: A tailored approach may be useful in advanced lipedema and is applicable even in elderly patients with multiple comorbidities.Keywords: lipedema, tumescent anesthesia, liposuction, subdermal diode laser, medial thigh lift, lower abdominoplasty

  17. 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.

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

    Science.gov (United States)

    Vigotsky, Andrew D; Lehman, Gregory J; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H

    2015-01-01

    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.

  19. Effects of Aerobic Exercise Intensity on Abdominal and Thigh Adipose Tissue and Skeletal Muscle Attenuation in Overweight Women with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Ji Yeon Jung

    2012-06-01

    Full Text Available BackgroundWe investigated the effects of exercise intensity on abdominal and mid-thigh adipose tissue, attenuation of skeletal muscle, and insulin sensitivity in overweight women with type 2 diabetes mellitus (T2DM.MethodsTwenty-eight patients were randomly assigned to control (CG, n=12, moderate intensity exercise (MEG, n=8, or vigorous intensity exercise (VEG, n=8 group. Subjects in both exercise groups completed a 12-week exercise program (MEG, 3.6 to 5.2 METs; VEG, ≥5.2 METs that was monitored by accelerometers. We assessed body mass index (BMI, total fat area (TFA, visceral fat area (VFA, subcutaneous fat area (SFA, mid-thigh intramuscular adipose tissue (TIMAT, total skeletal muscle (TTM, low density skeletal muscle (TLDM, and normal density skeletal muscle (TNDM using computed tomography, and measured insulin sensitivity with an insulin tolerance test (KITT, before and after the intervention.ResultsAt baseline, the mean age was 53.8±7.9 years, duration of diabetes was 3.8±2.3 years, and BMI was 26.6±2.6 kg/m2. After 12 weeks, the percent change (%C in BMI, TIMAT, and TLDM were not different among three groups. However, %C in TFA and VFA were significantly reduced in MEG compared to CG (P=0.026 and P=0.008, respectively. %C SFA was significantly reduced in VEG compared to CG (P=0.038 and %C TTM, TNDM, and KITT were significantly increased in VEG compared to the CG (P=0.044, P=0.007, and P=0.016, respectively.ConclusionAlthough there was no difference in the change in BMI among groups, TFA and VFA were more reduced in MEG, and only VEG increased TTM, TNDM, and insulin sensitivity compared to CG.

  20. Posterior hip approach yields better functional results vis-à-vis anterolateral approach in total hip arthroplasty for patients with severe hip dysplasia: A prospective randomized controlled clinical study.

    Science.gov (United States)

    Çatma, Faruk Mehmet; Öztürk, Alper; Ünlü, Serhan; Ersan, Önder; Altay, Murat

    2017-01-01

    We aimed to compare functional outcomes of two common hip approaches for patients with severe hip dysplasia in total hip replacement (THR) surgery. Seventy hips of 68 patients randomized into two groups with regard to hip approach as posterior (group I) and anterolateral (group II). All patients underwent THR surgery with femoral shortening osteotomy. The groups were compared for operation time, preoperative and 6 months after abductor muscle strengths (AMSs), gait disorders, union time of the osteotomied site and dislocation rates. There were two early dislocations in group I, and two early and one late dislocations in group II. No significant difference was observed regarding hip dislocations. Mean union time of the osteotomied site was 113.9 ± 51 days in group I while 111.1 ± 29.3 days in group II ( p = 0.774). Six months after surgery, group I had higher AMS than group II ( p dysplasia of hip is a challenging procedure, and posterior approach provides better functional outcomes regarding gait and AMSs.

  1. Anatomic basis and application experience of the puncture technique through anterolateral cervical approach%颈椎前外侧入路穿刺技术的解剖学基础及应用体会

    Institute of Scientific and Technical Information of China (English)

    单建林; 姜恒; 王崇伟; 张阳; 王飞; 李放

    2013-01-01

    Objective To explore the anatomical basis,safty and manipuility of the puncture technique through anterolateral cervical approach.Methods Twenty two embalmed cadavers and 50 patients who underwent operation through anterolateral cervical approach were used to observe the cervical anatomical characteristics.During the cadaver dissection and operation,the following information was observed:the movement of the carotid sheath while the visceral sheath was pushed left,the features of interspace between the two sheaths at each cervical level,the movement of the esophagus and the interfascial space in which the esophagus moved while the trachea was pushed medially,and the movement of the carotid sheath while it was pushed medially and laterally.From January 2007 to December 2011,206 patients diagnosed as cervical discogenic pain or cervical vertigo were treated by radiofrequency using puncture technique through anterolateral cervical approach,including 93 males and 113 females,aged from 22 to 71 years (average,48years).A total of 434 discs were involved.Results Both in cadaver dissection and in operation,the following results were observed:there was no natural interspace between the carotid sheath and visceral sheath below the C4 level,as a result,manual separation was needed to create a interspace between the two sheaths for the puncture; the two layers of the prevertebral fascia could be separated easily; keeping the visceral sheath intact,the esophagus moved following the trachea when the latter was pushed medially,and the movement of the visceral sheath relative to the cervical vertebra occurred between the two layers of prevertebral fascia; the carotid sheath was primarily constituted by continuation of the prevertebral fascia,as a result,the movement of the carotid sheath was limited by its own tension and the prevertebral fascia.A total of 434 cases of puncture to cervical disc were performed smoothly with no complications related to the carotid artery

  2. 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.

  3. Laser cellulite treatment and laser-assisted lipoplasty of the thighs and buttocks: Combined modalities for single stage contouring of the lower body.

    Science.gov (United States)

    Petti, Christine; Stoneburner, Jacqueline; McLaughlin, Laura

    2016-01-01

    Cellulite and lipodystrophy are often found together, especially in areas of the buttocks and thighs, causing skin surface irregularities. Each of these conditions is currently treated independently as two separate surgical procedures. In our practice, we developed a novel combined approach for the simultaneous treatment of cellulite and lipodystrophy, as a single stage procedure in the same anatomic area. For the treatment of cellulite, we used the Nd:YAG laser at a wavelength of 1,440-nm, along with an innovative 1,000-micron directional side-firing fiber optic laser system. For the treatment of lipodystrophy, the Nd:YAG laser with a 1,440 nm wavelength, along with a fiber optic laser system was used. The objective of this study is to determine the efficacy and safety of a combined approach for the simultaneous treatment of cellulite and lipodystrophy. In 2012, 16 subjects with noticeable cellulite, Grade II and Grade III, accompanied by mild-to-moderate lipodystrophy of the lower body received single treatments of the Nd:YAG laser at a wavelength of 1,440-nm along with the 1,000-micron side-firing fiber optic laser system for simultaneous treatments of both cellulite and lipodystrophy. Patients were assessed at baseline and 3-6 months post-treatment by a modified Nurnberger-Muller scale utilized to quantify the cellulite severity. Additionally, patient satisfaction and a global aesthetic improvement scale were used to measure the improvement in lipodystrophy. Blinded reviewers identified the correct baseline photographs 97% of the time when presented with a set of photographs. The median modified Nurnberger-Muller scale score at baseline was 4.75 ± 1.2 and the average improvement was 2.0 ± 1.2. Global aesthetic improvement scores ranged from 1 to 3 with an average of 1.58 indicating a much-improved overall appearance. Satisfaction was high for both physicians and patients with scores corresponding to extremely satisfied/satisfied. Precise, effective

  4. 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 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 , metabolic clearance rate of glucose; OPLS , orthogonal projections to

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

    Science.gov (United States)

    González-Alonso, José; Mortensen, Stefan P; Jeppesen, Tina D; Ali, Leena; Barker, Horace; Damsgaard, Rasmus; Secher, Niels H; Dawson, Ellen A; Dufour, Stéphane P

    2008-05-01

    The muscle pump and muscle vasodilatory mechanism are thought to play important roles in increasing and maintaining muscle perfusion and cardiac output ((.)Q) during exercise, but their actual contributions remain uncertain. To evaluate the role of the skeletal muscle pump and vasodilatation 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 thigh compressions at rest and during passive and voluntary exercise (n=7). Incremental exercise resulted in progressive increases in leg blood flow (DeltaLBF 7.4 +/- 0.7 l min(-1)), cardiac output (Delta (.)Q 8.7 +/- 0.7 l min(-1)), mean arterial pressure (DeltaMAP 51 +/- 5 mmHg), and leg and systemic oxygen delivery and (.)VO2 . Arterial ATP infusion resulted in similar increases in (.)Q , LBF, and systemic and leg oxygen delivery, but central venous pressure and muscle metabolism remained unchanged and MAP was reduced. In contrast,femoral vein ATP infusion did not alter LBF, (.)Q or MAP. Passive 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 increased blood flow (DeltaLBF 0.5-0.7 l min(-1)) without altering (.)Q, MAP or (.)VO2. These findings suggest that the skeletal muscle pump is not obligatory for sustaining venous return, central venous pressure,stroke volume and (.)Q or maintaining muscle blood flow during one-legged exercise in humans.Further, its contribution to muscle and systemic peak exercise hyperaemia appears to be minimal in comparison to the effects of muscle vasodilatation.

  6. A Case Report on Bilateral Knee Coverage Following Septic Arthritis: Lateral Distal Thigh Island Flap and Medial Head Gastrocnemius Flap Methods

    Directory of Open Access Journals (Sweden)

    Abdolrazaghi

    2016-03-01

    Full Text Available Introduction Septic arthritis is the rheumatological and orthopedic emergency that causes the most difficulties with joints–especially knee and hip joints. The clinical symptoms include pain, swelling, inflammation, stiffness, and a limited range of motion in both active and passive joints. Debridement of the necrotic tissue is one beneficial method for septic arthritis treatment, although soft tissue defects around joints are a challenging issue for surgeons. Our purpose was to investigate the consequences of two flap surgery methods undertaken to repair soft tissue damaged during knee joint debridement caused by septic arthritis. Case Presentation This is a case report concerning a patient who had septic arthritis in the knee area and so underwent soft tissue surgery. The reconstruction methods were not the same for both knees as the lateral distal thigh island flap reparation method was used on the left knee and the medial head gastrocnemius flap method was utilized on the right. We then investigated the results and outcomes of the surgery three months later. Conclusions Lower extremity movement extent was carefully evaluated and, in respect to muscle strength, the patient was able to walk independently three months after the surgery. The patient’s balance was studied and the results showed moderate levels of stability.

  7. 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.

  8. Mullerian-Type Ciliated Cyst of the Thigh with PAX-8 and WT1 Positivity: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Corinthia Fabien-Dupuis

    2016-01-01

    Full Text Available Mullerian-type ciliated cysts are uncommon lesions usually found in the lower extremities and perineal region of young females. They have however been reported in males and in other anatomic sites. The cyst lining is typically positive for estrogen receptor (ER, progesterone receptor (PR, PAX-8, and WT1 immunohistochemical stains. This staining pattern has led to the notion that these cysts are of Müllerian origin. The vast majority of cases are located in the dermis where the preferred nomenclature is cutaneous ciliated cyst (CCC. We report a case of Müllerian-type ciliated cyst in the thigh of a 16-year-old girl. Unlike most of the cases reported in the English literature, this cyst was not centered in the dermis. Only a few other cases of Müllerian-type ciliated cysts with no cutaneous connection have been reported. We propose the term ectopic Müllerian cyst for this rare subset of lesions that are not skin based as is the current case.

  9. [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.

  10. Chromium levels in insulin-sensitive tissues and the thigh bone are modulated by prednisolone and high-fat diets in mice.

    Science.gov (United States)

    Chen, Po-Wen; Lin, Chang; Chen, Chung-De; Chen, Wen-Ying; Mao, Frank Chiahung

    2013-04-01

    Glucocorticoids (GCs) are often prescribed in clinics but many adverse effects are also attributed to GCs. It is important to determine the role of GCs in the development of those adverse effects. Here, we investigated the impact of GCs on trivalent chromium (Cr) distribution in animals. Cr has been proposed to be important for proper insulin sensitivity, and deficits may lead to disruption of metabolism. For comparison, the effect of a high-fat diet on Cr modulation was also evaluated. C57BL/6JNarl mice were fed regular or high-fat diets for 12 weeks and further grouped for treatment with prednisolone or saline. Cr levels in tissues were determined 12 h after the treatments. Interestingly, prednisolone treatment led to significantly reduced Cr levels in fat tissue in mice fed regular diets; compared to the high-fat diet alone, prednisolone plus the high-fat diet led to a further reduction in Cr levels in the liver, muscle, and fat. Notably, a single dose of prednisolone was linked with elevated Cr levels in the thigh bones of mice fed by either regular or high-fat diets. In conclusion, this report has provided evidence that prednisolone in combination with a high-fat diet effects modulation of Cr levels in selected tissues.

  11. Using PHILOS plate through anterolateral acromial approach for treating proximal humerus fractures in elderly patients%经肩峰前外侧入路PHILOS钢板治疗老年人肱骨近端骨折

    Institute of Scientific and Technical Information of China (English)

    陈孝均; 贺智榆; 邹永根; 罗成; 吴健

    2016-01-01

    Objective To investigate the clinical significance of using proximal humeral internal locking system ( PHILOS) plate through anterolateral acromial approach for treatment of proximal humerus fractures in eld -erly patients with minimally invasive plate osteosynthesis (MIPO) technique.Methods From Apr.2012 to Apr. 2014,26 cases of proximal humerus fractures were treated with PHILOS plate through anterolateral acromial ap -proach with MIPO technique.There were 11 males and 15 females with an average age of 67.8 years (range,60-82 years) and with an average time of 4.1 days after injury(range,2-14 days) between injury and operation,including 6 cases of Neer Ⅱ,11 cases of Neer Ⅲ,and 9 cases of Neer Ⅳ.The operation time ,operative blood loss ,length of follow-up,healing time and Neer score were recorded .Results All cases experienced a primary wound healing ,a mean operation time of 85 min (range,50-115 min),and a mean intraoperative blood loss of 90mL (range,60-140mL).All the 26 cases were followed up for 6 to 18 months with an average of 9.5 months.The bone healing time was 15.8 weeks(range,11-29 weeks).According to Neer scores,the functional results of the shoulder were e-valuated within 1 year after operation ,were classified as excellent in 10 cases,good in 13 cases,fair in 2 cases,and poor in 1 case.The excellent and good rate was 88.5%.Conclusion Using PHILOS plate through anterolateral acromial approach for treatment of proximal humerus fractures in elderly patients with MIPO technique has advanta -ges of less trauma , less blood loss , shorter operative time , rapid recovery of shoulder joint function and fracture . When the procedure is performed with the lateral double incision , preservation of the axillary nerve is necessary . This approach can be the first choice for closed proximal humerus fracture but more extensive studies are needed ,es-pecially to elderly patients with osteoporosis .%目的:评价应用肱骨近端内锁定系统( proximal

  12. Clinical modification of the anterolateral approach for burst fractures of thoracolumbar spine%改进的侧前方手术径路在胸腰椎爆裂性骨折中的应用

    Institute of Scientific and Technical Information of China (English)

    樊健; 俞光荣; 刘璠; 赵剑; 张烽; 周家钤; 赵宏谋

    2010-01-01

    Objective To discuss the modified anterolateral approach for the treatment of burst fractures of the thoracolumbar spine. Methods From April 2003 to September 2006, we treated 27 patients with burst fractures of the thoracolumbar spine. Sixteen of them were operated on through the "L" anterolateral approach modified out of the conventional thoraco-extraperitoneal approach using the space be-tween the erector spine muscles and quadratus lumborum muscles according to the anatomic relation of the thoracolumbar spine. The other 11 cases were treated through the conventional approach. The average blood loss for vertebral exposure, operation time and the total operation blood loss, as well as intraoperative and postoperative complications were compared between the 2 approaches. Results All the 27 cases had successful surgery. There were significant differences between the 2 approaches (P 0.05) in Cobb angle, height ratio of anterior borders of injured and normal vertebrae and neurological recovery. No serious complications were found in operation. After an average follow-up of 13 months, none of the patients had neurological deterioration, the spine recovered normal curvature and no implant failure happened. Conclusion The modified antero-lateral approach for the treatment of thoracolumbar spine burst fractures have the advantages of less invasion,less blood loss, effective decompression and maintenance of the spinal stability, and fewer complications.%目的 探讨改进的侧前方手术径路减压内固定治疗胸腰椎爆裂性骨折的疗效. 方法 2003年4月至2006年9月利用胸腰段的解剖关系,改进成"L"形肌间隙经椎间孔入路行骨折减压内固定治疗胸腰椎爆裂性骨折,临床应用16例(改进径路组),并将11例经传统胸腹膜外入路(传统径路组)作为对照组,比较两组住皮肤切口到完全显露椎体出血量、手术时间及总出血量、疗效等方面的差异,并观察术中、术后并发症情况.

  13. 胫骨远端前外侧锁定钢板延期治疗复杂Pilon骨折%LCP Anterolateral Distal Tibia Plate for Treatment of Complex Pilon Fractures at a Delayed-stage

    Institute of Scientific and Technical Information of China (English)

    李宇; 黄涛; 葛俊波; 洪焕玉; 张海光

    2013-01-01

    目的:探讨延期切开复位结合胫骨远端前外侧“L”形锁定钢板治疗复杂Pilon骨折.方法:30例Pilon骨折患者,按AO分类方式,所有患者均为C型:C1型7例,C2型15例,C3型8例.6例为开放性骨折,24例为闭合性骨折,延迟手术时间为7~14d(平均10.5d),待肿胀消退后行切开复位结合胫骨远端前外侧“L”形锁定钢板内固定治疗.结果:30例均获术后随访,随访时间14~28个月(平均18.5个月).骨折临床愈合时间为12~23个月(平均14.3个月).术后有2例伤口感染;3例皮肤坏死;5例出现骨折延迟愈合,其中2例再次行植骨手术;1例过早负重,导致骨折端畸形愈合.临床疗效根据AOFAS评分系统进行评定:优18例,良9,可3例,优良率为90%.结论:严重Pilon骨折根据不同的骨折类型、软组织损伤程度选择不同的手术方式和手术时机非常重要.延期切开复位结合胫骨远端前外侧“L”形锁定钢板是临床治疗复杂Pilon骨折的理想方法.%Objective:To detect the curative effect of delayed open reduction and "L"-shaped LCP anterolateral distal tibia plate for treating of complex Pilon fractures.Methods:A total of 30 cases of Pilon fractures were treated by open reduction and "L"-shaped LCP anterolateral distal tibia plate after improvement of soft tissue conditions.All the cases were type C fracture according to AO classification,7 cases of which were type C1,15 cases were type C2,and 8 cases were type C3.There were 6 cases of open Pilon fractures and 24 cases of closed fractures.Operations were performed on average 10.5days after the injuries (range 7 to 14 days).Results:All the patients were followed-up for 14 months to 28 months (18.5months averagely).The average healing times was 12 to 23 months (14.3 months averagely).There were 2 cases of wound infection,3 cases of cutaneous necrosis,and 5 cases of delayed bone healing,including two cases of bone grafting surgery again.There was also one case of

  14. 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.

  15. 改良前外侧入路胫骨近端锁定加压钢板固定治疗胫骨平台后外侧骨折%CLINICAL EFFECT OF IMPROVED ANTEROLATERAL PROXIMAL TIBIA AFTER LOCKING COM- PRESSION PLATE FIXATION IN THE TREATMENT OF LATERAL TIBIA PLATEAU FRACTURE

    Institute of Scientific and Technical Information of China (English)

    何建华

    2015-01-01

    Objective To analyze the clinical effect of modified anterolateral proximal tibia locking compres‐sion plate fixation in patients with lateral tibia plateau fracture .Methods Totally 80 cases of tibia plateau lateral fracture patients were treated in author's hospital from March 2011 to March 2013 were randomly di‐vided into observation group and control group .The control group received conventional treatment methods anterolateral approach ,while the observation group received an improved anterolateral approach proximal tibia compression plate fixation ,and then the clinical effect were compared between the two groups .Results There were significant difference (P The modified anterolateral proximal tibia locking compression plate fixation is worthy of clinical use for patients of the poster lateral tibia plateau fractures with a significant effect ,simple and safe operation .%目的:分析改良前外侧入路胫骨近端锁定加压钢板固定治疗胫骨平台后外侧骨折的临床效果。方法将收治的80例胫骨平台后外侧骨折患者随机分为观察组和对照组,对照组给予传统前外侧入路的治疗方法,观察组给予改良前外侧入路胫骨近端加压钢板固定治疗,分析和比较二组患者的治疗效果。结果二组患者平均手术时间、手术出血量、并发症发生率等各手术参数、随访结果及膝关节功能评分的比较差异有统计学意义(P<0.05)。结论改良前外侧入路胫骨近端锁定加压钢板固定治疗胫骨平台后外侧骨折疗效显著、操作简便、安全性高,值得临床推广使用。

  16. A new formula for estimating fetal weight: The impression of biparietal diameter, abdominal circumference, mid-thigh soft tissue thickness and femoral length on birth weight.

    Science.gov (United States)

    Kalantari, Mojgan; Negahdari, Arezou; Roknsharifi, Shima; Qorbani, Mostafa

    2013-11-01

    Abdominal circumference (AC), biparietal diameters (BPD) and femoral length (FL) are now the main parameters used to obtain estimated fetal weight (EFW). Although the role of soft tissue parameters in determining fetal weight was proved but clinical attention to mid-thigh soft tissue thickness (STT) is limited. To find the impression of STT on birth weight (BW) and represent a new predictive formula. One hundred and fourteen normal singleton term (36-42w) pregnancies with delivery within 72 hours were randomly selected to participate in this prospective cohort study. Variables measured by ultrasonography before birth included: AC, BPD, FL and STT. The actual neonatal BW was also measured after birth. Linear regression model was used and R square and p-value were reported. The mean (SD) of BW was 3406 (405) gr. R square was best fit for the model that STT was added to AC, BPD, FL (r(2): 0.77). R square for the model using BPD, AC, FL and model using BPD, STT, FL was the same (r(2): 0.7). Best fit formula was Log (BW)= 2.461+0.003BPD+0.001AC+0.007STT+0.005FL. 0.67, pSTT (R: 0.50, pSTT (p=0.001) CONCLUSION: This study showed adding STT to other variables in predictive models of fetal weight would provide a nice estimation (r(2)=0.77) and in cases that measuring AC is suboptimal STT may be a good replacement.

  17. Is 2-deoxy-2-[18F]fluoro-D-glucose PET/CT acquisition from the upper thigh to the vertex of skull useful in oncological patients?

    Science.gov (United States)

    Salvatore, B.; Caprio, M.G.; Fonti, R.; D’Amico, D.; Fraioli, F.; Salvatore, M.; Pace, L.

    2015-01-01

    Aim To assess whether performing routinely 2-deoxy-2-[18F]fluoro-D-glucose PET/CT (18FDG PET/CT) scan from the upper thigh to the vertex of skull is clinically relevant. Materials and Methods: 3502 (1634 female; mean-age 60+16) consecutive patients undergoing 18FDG PET/CT were retrospectively analyzed. Patients were divided in 10 groups according to primary malignancy. Chi-square analysis was used to assess differences among proportions. A p value < 0.05 was considered significant. Results: 18FDG PET/CT was positive in head district in 130/3502 (3,7%) patients. In all patients lesions were unknown before PET/CT examination. PET/CT showed 158 positive brain/head uptake in the 130 patients. The 158 lesions were localized in: brain (43/158; 27%), bone (52/158; 33%), lymph node (1/158; 0,6%), soft tissue (55/158; 35%) and other sites (7/158; 4,4%). According to each group, patients were positive in the head district in 1.0% for Gastrointestinal Cancer (7/690), 3.0 % for Genitourinary Cancer (3/101), 3.7 % for Haemathologic Cancer (59/1590), 2.7 % for Gynaecologic Cancer (3/112), 7.8% for Head-Neck-Thyroid and Parathyroid Cancer (26/331), 3.5% for Breast Cancer (7/200), 2.6% for Lung Cancer (7/271), 3.4% for Melanoma (2/59), 7.4% for Sarcoma (2/27), 11.6% for Unknown Primary Tumour (14/121). Conclusion: Our data show a relatively high incidence of brain/head lesion in patients with Unknown Primary Tumour. PMID:25674547

  18. 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.

  19. Inoculum effects of ceftobiprole, daptomycin, linezolid, and vancomycin with Staphylococcus aureus and Streptococcus pneumoniae at inocula of 10(5) and 10(7) CFU injected into opposite thighs of neutropenic mice.

    Science.gov (United States)

    Lee, Dong-Gun; Murakami, Yoichi; Andes, David R; Craig, William A

    2013-03-01

    Reduced bactericidal efficacy at a high inoculum is known as the inoculum effect (IE). We used neutropenic mice to compare the IEs of ceftobiprole (CFB), daptomycin (DAP), linezolid (LZD), and vancomycin (VAN) against 6 to 9 strains of Staphylococcus aureus and 4 strains of Streptococcus pneumoniae at 2 inocula in opposite thighs of the same mice. Neutropenic mice had 10(4.5) to 10(5.7) CFU/thigh (low inoculum [LI]) in one thigh and 10(6.4) to 10(7.2) CFU/thigh (high inoculum [HI]) in the opposite thigh when treated for 24 h with subcutaneous (s.c.) doses every 12 h of DAP at 0.024 to 100 mg/kg of body weight and LZD at 0.313 to 320 mg/kg and s.c. doses every 6 h of CFB at 0.003 to 160 mg/kg and VAN at 0.049 to 800 mg/kg. Dose-response data were analyzed by a maximum effect (E(max)) model using nonlinear regression. Static doses for each drug and at each inoculum were calculated, and the difference between HI and LI (IE index) gave the magnitude of IE for each drug-organism combination. Mean (range) IE indexes of S. aureus were 2.9 (1.7 to 4.6) for CFB, 4.1 (2.6 to 9.3) for DAP, 4.6 (1.7 to 7.1) for LZD, and 10.1 (6.3 to 20.3) for VAN. In S. pneumoniae, the IE indexes were 2.5 (1.3 to 3.3) for CFB, 2.0 (1.6 to 2.8) for DAP, 1.9 (1.7 to 2.2) for LZD, and 1.5 (0.8 to 3.2) for VAN; these values were similar for all drugs. In S. aureus, the IE was much larger with VAN than with CFB, DAM, and LZD (P < 0.05). An in vivo time course of vancomycin activity showed initiation of killing at 4- to 16-fold-higher doses at HI than at LI despite similar initial growth of controls.

  20. 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

  1. Study of the Dextran-DTPA-Gd at rabbit popliteal fossa lymph node metastasis from thigh transplanted tumor with interstitial magnetic resonance lymphography

    Institute of Scientific and Technical Information of China (English)

    Zhenpeng Zhao; Yuanyong Feng; Wei Li; Shengbiao Wan; Tao Jiang; Wei Shang

    2014-01-01

    Objective:The aim of the study was to investigate the developing situation of the interstitial magnetic resonance (MR) lymphoid contrast agent Dextran-DTPA-Gd through the rabbit popliteal fossa lymph node metastasis from thigh VX2 transplanted tumor injection to show targeting enhanced metastatic lymph nodes and lymphatics. Methods:VX2 tumor was transplanted to the right hind limb quadriceps of 12 healthy New Zealand rabbits and the left side as a contrast. Eight rabbits had homonymy popliteal lymph node metastasis after 1 month through 3.0 GE MRI and they were later injected with lym-phatic targeting contrast agent Dextran-DTPA-Gd 0.4 mL (3.96 × 10-3 mol/L) through bilateral hindlimb toe web respectively. Enhanced MR images were obtained with interval 10 min, 15 min, 20 min, 25 min, 30 min, 35 min, 40 min, 45 min, 50 min, 55 min, 60 min, 2 h, 4 h, and 24 h. The signal intensities before and after enhancing were measured to calculate the enhanc-ing rates (E%) of popliteal lymph node and the popliteal lymph node signal intensity-time curves were drawn to observe the development of cancer metastasis lymph nodes and lymphatics and to compare the dif erences of interval sides. Results:Ten minutes after injected into the rabbit’s bilateral hindlimb toe web, we could see hind lymphatic and popliteal lymph nodes were strengthened significantly and evenly without blood vessels developing. The signal reached a peak after 35 min with E%to 315%, which decreased to 205%after 4 h and would be undif erentiated with the surrounding tissues after 24 h. Sta-tistical analysis was made to popliteal lymph node enhancement rate. It was considered statistical y significant as long as P<0.05. The tumor-side popliteal lymph node manifested as coarse and irregular shape, lymphatic vessels tortuous dilated and lymphatic chain incomplete as a result of tumor infection. Conclusion:Dextran-DTPA-Gd is specific to lymphoid tissue development. It can targeting display regional lymphatic

  2. Anatomic study and clinical application of perforator free flap in posterior region of thigh%游离股后侧穿支动脉皮瓣的解剖学研究及临床应用

    Institute of Scientific and Technical Information of China (English)

    王剑利; 王根; 赵刚; 郭永强; 王五洲

    2013-01-01

    Objective To study how design and harvest perforating artery free flaps in posterior region of thigh based on research of the anatomical features and distribution regularities of those perforating artery.Methods Using 8 fresh bodies specimen with latex leaded perfusion of inferior gluteal area to study perforator artery anatomy structure and distribution of rear thigh.Screen the fitting perforator arteries for perforator free flap both in caliber and length.Total 7 cases were performed with perforator free flap in posterior thigh,the flap size:from 3 cm × 8 cm-8 cm × 16 cm,and the first perforating artery flap carried out in 4 cases,the second perforating artery flap in 2 cases,the third perforating artery flap in Ⅰ case.Results Anatomic study showed that perforating artery suitable for free flap in this area were in teams of 4 to 5,the average diameter were in range of 0.4 to 2.8 mm,the average length was 2.2-9.0 cm.Seven cases had been applied with perforator flap and all survived.Followed-up from 5 to 11 months,the wounds repaired by the perforator flap of posterior thigh presented fine elasticity,thin flap,beautiful appearance.Conclusion The distribution,length and diameter of perforating artery in posterior region of thigh are suitable for perforator free flap.Being hidden,direct close the posterior region of thigh expected to acchive satisfactory clinical effects.%目的 通过研究股后侧区的穿支动脉解剖特点和分布规律,设计切取以该区域穿支血管为蒂的游离皮瓣. 方法 利用新鲜尸体8具乳胶加铅灌注标本对股后侧区域内血管解剖结构尤其是穿支血管走行及分布进行研究,筛选口径、长度及走行适合做吻合血管蒂的穿支.临床上实际应用7例,均为穿支游离皮瓣,皮瓣大小:3 cm×8 cm~8 cm×16 cm,第一穿动脉皮瓣3例,第二穿动脉皮瓣2例,第三穿动脉皮瓣1例,第一穿动脉上无名穿支皮瓣1例. 结果 解剖研究发现,该区域适

  3. Spinal hydatid with meralgia paresthetica in a female: A rare case report.

    Science.gov (United States)

    Lonkar, Yeshwant; Amale, Amar; Acharya, Sourya; Banode, Pankaj; Yeola, Meenakshi

    2012-07-01

    Meralgia paresthetica presents as tingling sensation in the antero-lateral aspect of thigh. It occurs due to compression of the lateral cutaneous nerve of thigh. Proximal spinal lesions may present as meralgia paresthetica due to radiculopathy. We present a rare case of spinal hydatid with meralgia paresthetica.

  4. Spinal hydatid with meralgia paresthetica in a female: A rare case report

    Directory of Open Access Journals (Sweden)

    Yeshwant Lonkar

    2012-01-01

    Full Text Available Meralgia paresthetica presents as tingling sensation in the antero-lateral aspect of thigh. It occurs due to compression of the lateral cutaneous nerve of thigh. Proximal spinal lesions may present as meralgia paresthetica due to radiculopathy. We present a rare case of spinal hydatid with meralgia paresthetica.

  5. Rescate articular con colgajo anterolateral del muslo

    OpenAIRE

    F.J. García-Bernal; P. Zayas-Pinedo; J. Regalado-Bilbao; C. Jul-Vázquez; R. Fuentes-Gastañaga

    2015-01-01

    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 antebr...

  6. Rescate articular con colgajo anterolateral del muslo

    OpenAIRE

    F.J. García-Bernal; P. Zayas-Pinedo; J. Regalado-Bilbao; C. Jul-Vázquez; R. Fuentes-Gastañaga

    2015-01-01

    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 antebr...

  7. 颈椎钩突形态特点及其在前外侧入路减压术中的意义%Clinical significance of the morphometry of cervical uncinate process in the anterolateral decompression of cervical spine

    Institute of Scientific and Technical Information of China (English)

    初国良; 彭映基; 冯正巩; 徐朝任

    2001-01-01

    目的:确定钩突的大小,为钩突切除提供形态学基础。方法:50套颈椎C3~C7,共250块颈椎,测量钩突高度、宽度、前后径和钩间距及椎体上矢径和椎体下横径。结果:钩突高从C3~C7逐渐减小,C3为(6.0±1.1) mm,C7为(4.9±1.3) mm;钩突宽在C3~C6小于C7,C3为(4.8±1.0) mm,C6为(4.8±1.0) mm,C7为 (5.1±0.9) mm;钩突前后径从C4~C7逐渐减少,C4为(11.6±1.7) mm,C7为(9.6±1.7) mm;钩突间距、椎体上矢径和椎体下横径从C3~C7逐渐增大,分别为(19.1±2.0)~(25.6±1.9) mm、(19.3±2.4)~(26.9±2.2) mm、(14.4±1.4)~(16.1±1.9) mm。结论:钩突形态学资料有助于经前外侧入路钩突切除术、钩突椎间孔切开术和减少并发症的发生。%Objective:To provide morphologic basis for surgical excision of cervical uncinate process by measuring it.Methods: Totally 250 C3~C7 cervical vertebrae of 50 dried cervical spines were measured with caliper to get the following parameter:the height,width,anteroposterior diameter,interuncinate distance of the uncinate process;upper anteroposterior diameter and lower transverse diameter of the vertebral body.Results: The height of the uncinate process decreased gradually from the C3(6.0±1.0 mm) to C7(4.9±1.3 mm); the width of it at C3~C6(4.8±1.0~4.8±0.8 mm) was smaller than that at C7(5.1±0.9 mm);the anteroposterior diameter decreased gradually from C4(11.6±1.7 mm) to C7(9.6±1.7 mm);the interuncinate distance,upper anteroposterior and lower transverse diameter of the vertebral body increased gradually from C3 to C7,and their measured values were 19.1±2.0~25.6±1.9 mm,19.3±2.4~26.9±2.2 mm and 14.4±1.4~16.1±1.9 mm respectively.Conclusion:The morphology of the cervical uncinate process may be helpful during anterolateral cervical uncosectomy or uncoforaminotomy and reduce the risk of possible complications.

  8. Effectiveness of Anterolateral Minimally Invasive and Traditional Posterolateral Approach in Total Hip Arthroplasty:a Systematic Review%微创前外侧与常规后外侧入路对全髋置换术的系统评价

    Institute of Scientific and Technical Information of China (English)

    夏韶襁; 刘世清; 周炎; 张锐; 熊菡萏

    2016-01-01

    Objective To evaluate the effectiveness of anterolateral minimally invasive versus traditional posterolateral ap-proach in total hip arthroplasty. Methods The Cochrane central register of controlled trials,MEDLINE,EMBASE,CINAHL, ISI Web of Science,CNKI,vIP,Wan fang Data,CBM were searched from inception to August 2015,searching randomized con-trolled trials(RCTs)about effectiveness of anterolateral minimally invasive versus traditional posterolateral approach in total hip arthroplasty. According to the Cochrane Handbook 5. 1. 0 treatment evaluation standard,Review Manager 5. 2 software Me-ta-analysis of the data. Results A total of six randomized controlled clinical trials,including 376 cases of patients. Conclusion Anterolateral minimally invasive is better than traditional posterolateral aproach in total hip arthroplasty,and it can be used in clinical treatment as one of the first therapies.%目的:系统评价微创前外侧与常规后外侧入路对全髋置换术的临床效果。方法计算机检索 Cochrane Central Register of Controlled Trials,MEDLINE,EMBASE,CINAHL,CNKI,vIP,万方数据库和中国生物医学文献数据库,辅以手工检索其他杂志,全面检索关于前外侧微创与常规后外侧入路对全髋置换术效果的随机对照试验,检索时限均为从建库至2015年8月。按照 Cochrane 系统评价手册5.1.0版本偏倚风险评估标准评估文献质量,采用 Review Manager 5.2软件对数据进行 Meta 分析。结果共纳入6篇文献。包括376例患者,结果显示:前外侧微创较常规后外侧入路的切口长度小、出血少、术后各随访时期 Harris 评分高,并发症发生率较少,而手术时间及髋臼外展角度无差异。结论前外侧微创较常规后外侧入路的临床效果更有优势,可作为髋关节置换术的首选切口之一。

  9. Case of semicircular lipoatrophy: relation between its characteristic distribution and anatomical muscle structure.

    Science.gov (United States)

    Hinogami, Haruna; Sakai, Hiroshi; Shirabe, Hirotsugu

    2014-08-01

    Semicircular lipoatrophy is characterized by one or more partial, horizontal, band-like depressions, usually on the anterolateral thigh or thighs. We report the case of a 47-year-old woman who presented with a 1-month history of bilateral, parallel, symmetrical depressions on the anterolateral aspects of her thighs. She had been wearing a tight girdle, and the girdle's folds matched the cutaneous bands. Ultrasound examination of the affected areas showed that the muscle tensor fasciae latae became its tendon at this level, and the muscle rectus femoris originated at the same level in the deeper layer. Although semicircular lipoatrophy has a predisposition for the anterolateral aspect of the thigh, and has often been considered to be caused by repetitive mild trauma to the site, we speculate that it is also attributed to the vulnerability of the site, as explained by the muscle structure.

  10. Efficacy observation on treating thigh hamstring injury by electro-acupuncture combined with muscle stretching exercises%电针配合肌肉伸展练习治疗大腿后肌拉伤疗效观察

    Institute of Scientific and Technical Information of China (English)

    舒育芳

    2013-01-01

    Objective: To observe the effect on treating thigh hamstring injury by electro-acupuncture combined with muscle stretching exercises. Methods:Give priority to Ashi point, and treated by electro-acupuncture for 20 minutes once per day, cooperating with muscle stretching exercises. Results: 29 out of 50 patients were recovered (accounting for 58%) and 21 were improved (accounting for 42%). The total efficiency was 100%. Conclusion: Satisfied with the efficacy of treating thigh hamstring injury by electro-acupuncture combined with muscle stretching exercises.%  目的:观察电针配合肌肉伸展练习治疗大腿后肌拉伤的疗效。方法:阿是穴为主,用电针治疗20min,1次/d,配合肌肉伸展练习。结果:50例中治愈29例(58%),好转21例(42%),总有效率100%。结论:电针配合肌肉伸展练习治疗大腿后肌拉伤的疗效满意。

  11. Investigation and analysis on intervention effects of thigh venous catheterization infection to patients of hemodialysis%血液透析患者股静脉置管感染调查与干预效果分析

    Institute of Scientific and Technical Information of China (English)

    杨莉梅; 刘彩霞; 朱庆伟; 李素

    2012-01-01

    Objective To explore the dangerous factors of thigh venous catheterization infection to patients of hemodialysis,and seek the effective methods to prevent and control femoral venepuncture infection.Methods A retrospective survey was carried out to investigate the data of patients of hemodialysis suffering thigh venous catheterization infection,and to analyze the risk factors of thigh venous catheterization infection.Then we took intervention measures to make prospective observation to the effects of infection controls.Results After taking measures,rates of infections declined from 8.8% in 2010 to 2.9% in 2011.Conclusions Risk factors of thigh venous catheterization infection are as below:long-time ( >3 weeks ) of femoral venepuncture;catheters are polluted by wrongful deals; patients often go to public places; diabetes mellitus complication; too long time intervals of medicine dressing change; non-rigorous aseptic technique (self dressing change by patients).Effective measures of controlling thigh venous catheterization inffection are as below:rigorous aseptic technique; emphasizing indwelling catheters and observing; proper catheters nursing; shortening time for catheters indwelling strengthening propaganda and education to patients.%目的 探讨血液透析患者股静脉置管感染的危险因素,寻找预防和控制股静脉置管感染的有效方法.方法 对血液透析股静脉置管患者相关资料进行回顾性调查,分析股静脉置管患者感染危险因素,并采取干预措施,前瞻性观察感染控制效果.结果 采取控制措施后,血液透析患者股静脉置管感染率从2010年的8.8%下降至2011年的2.9%.结论 股静脉置管时间超过3周,局部护理不当、置管处被污染,患者常去公共场所,合并糖尿病,换药时间间隔过长,无菌技术不严格(患者自行换药)是血液透析患者股静脉置管感染的危险因素.严格无菌技术操作、重视留置导管的观察、正确进行导

  12. 使用运动监视传感网络对行走过程中腿部屈伸角的跟踪%Tracking of Thigh Flexion Angle during Gait Cycles in an Ambulatory Activity Monitoring Sensor Network

    Institute of Scientific and Technical Information of China (English)

    董梁; 吴健康; 包晓明; 肖文栋

    2006-01-01

    An accelerometry-based gait analysis approach via the platform of sensor network is reported in this paper. The hardware units of the sensor network are wearable accelerometers that are attached at the limbs of human body. For the specific task of gait analysis, flexion angles of the thighs during gait cycles are computed. A Kalman filter is designed to estimate the flexionextension angle, angular velocity of the thigh using the output of the wearable accelerometers. The proposed approach has been applied to four subjects and the performance is compared with videobased approach. Comparative results indicate that with the proposed Kalman filter, the sensor network is able to track the movement of the thighs during gait cycles with good accuracy and simultaneously detect major gait event of foot contact from the waveform of the angular velocity.

  13. 不同滚揉腌制工艺对野鸭腿肉品质的影响%Effects of different tumbling marination crafts on quality of thigh meat of wild duck

    Institute of Scientific and Technical Information of China (English)

    姜英杰; 贡汉坤

    2016-01-01

    Using the thigh meat of wild duck as materials , effects of five different crafts ( nor-mal marination , tumbling marination under atmospheric pressure , tumbling marination under compression , tumbling marination under vacuum , marination under pressure -transform) on the quality of thigh meat of wild duck were researched .The results indicated that tumbling marination under compression changed the color of thigh meat of wild duck significantly . Tumbling crafts improved the production rate of marination and reduced the rate of cooking lose .Tumbling marination under compression obtained the highest production rate of marina-tion, tumbling marination under vacuum of obtained the lowest rates of cooking lose , and tumbling marination under compression and vacuum obtained the same rate of final produc-tion.The sensory evaluations of different marination crafts were almost same .Tumbling mari-nation under compression ob1tained the maximum sensory evaluation at 8 hours, that reduced the time of marination effectively , reduced 75%compared to normal marination .%以野鸭腿肉为原料,对其分别进行常规腌制、常压滚揉腌制、加压滚揉腌制、真空滚揉腌制以及呼吸滚揉腌制五种方式进行处理,对比研究五种腌制工艺对野鸭腿肉品质的影响。结果表明,加压滚揉腌制对野鸭腿肉肉色改变最为明显。不同滚揉工艺处理的野鸭腿肉腌制出品率均明显高于常规腌制的腌制出品率,而蒸煮损失率明显低于常规腌制。加压滚揉的野鸭腿肉腌制出品率最高,真空滚揉的野鸭腿肉蒸煮损失率最小,加压滚揉和真空滚揉的最终产品得率基本相同。不同腌制处理的野鸭腿肉最终产品感官评定值基本相同,加压滚揉腌制8h产品感官评定值达到最大,可有效缩短野鸭腿肉的腌制时间,比常规腌制可缩短时间75%。

  14. 股前内侧穿支皮瓣游离移植修复手部创面%Clinical application of anteromedial thigh perforator flap transplantation for repairing wounds in the hand

    Institute of Scientific and Technical Information of China (English)

    杨晓东; 刘杨武; 杨锦; 陈逸民; 付尚俊; 周阳; 丁建波; 楼旭鹏

    2012-01-01

    Objective To investigate the clinical effects of repairing wounds in the hand with free anteromedial thigh perforator flap transplantation. Methods From June 2008 to June 2011,15 cases were treated with free anteromedial thigh perforator flap transplantation for repairing the wound in the hand.There were 5 cases of volar defects,4 cases of defects on the ulnar aspect of the hand,1case of first web space wound and 5 cases of dorsal defects.Wound sizes ranged from 6 cm × 4 cm to 13 cm × 9 cm.Flap pedicles were anastomosed to the radial artery and cephalic vein of the recipient site in 11cases,and to the ulnar artery and basilic vein in 4 cases.Direct closure of the donor rite was possible in 9 cases,while skin graft was necessary in 6 cases. Results All the transplants survived.There was no vascular crisis.Postoperative follow-up ranged from 3 to 12 months.Satisfactory clinical results were recorded. Conclusion Anteromedial thigh perforator flap transfer is an effective method of repairing wounds in the hand.%目的 探讨应用股前内侧穿支皮瓣游离移植修复手部创面的临床疗效.方法 2008年6月至2011年6月,应用股前内侧穿支皮瓣游离移植修复手部创面共15例,其中手掌侧创面5例,尺侧创面4例,虎口区创面1例,手背创面5例;缺损面积:6 cm×4cm~13cm×9 cm;其中11例与受区桡动脉、头静脉吻合,4例与尺动脉、贵要静脉吻合.供区直接缝合9例,部分植皮6例.结果 本组15例皮瓣全部存活,未出现血管危象.随访3~ 12个月,临床效果满意.结论 应用股前内侧穿支皮瓣游离移植修复手部(正)面,临床效果满意,值得推广应用.

  15. 经胸病灶清除兼椎管前外侧减压术治疗儿童胸椎结核并发截瘫(附42例报告)%Transthoracic Focal Debridement and Anterolateral Decompression of Spinal Cord for Thoracic TB Spine Complicated with Paraplegia in Children

    Institute of Scientific and Technical Information of China (English)

    林羽; 田武昌; 吴启秋; 程宏; 袁士琴; 田士和; 王兰

    1986-01-01

    @@ 截瘫是脊椎结核的严重并发症,在儿童常见.我科1959~1983年共收治儿童(2~14岁)脊椎结核253例,其中并发截瘫者60例(23.7%).60例中颈椎1例,颈胸椎4例,胸椎最多共55例(91.7%).对儿童胸椎结核并发截瘫的手术治疗,以往多采用传统的肋骨、横突切除术,由胸膜外施行病灶清除和椎管侧前方减压,此种手术虽有较多优点,但还不够理想~((1)).近年来经胸病灶清除兼椎管前外侧减压术(以下简称经胸清除减压术)对成年人胸椎结核并发截瘫的手术治疗国内外已有较多报道.对儿童胸椎结核并发截瘫的治疗,能否也可采用此种手术方法,是值得商榷的问题.%Paraplegia is one of the serious complications of TB spine in children.At present,most orthopaedists still adopted traditional anterolateral decompression of spinal cord through costotransversectomy on such patients and the results have been satisfactory.42 patients with thoracic TB spine complicated with paraplegia were treated in the period from 1959 to 1983 by transthoracic focal debridement and anterolateral decompression and 88% of them recovered from paraplegia.An analysis of the clinical findings showed that paraplegia in children was characterized not only by disturbances in motion and feeling but also by dysfunction of sphincter muscle.Postoperative recovery from paraplegia depends on the changes in the spinal cord and is also related to the characteristics of compressive mass on dura.If the operation is,indicated with adeq a te preoperative preparation and proper intensivecare of respiratory passage after operation,the transthoracic approach is well acceptable and tolerable.

  16. Science.gov (United States)

    TARSITANO, A.; VIETTI, M.V.; CIPRIANI, R.; MARCHETTI, C.

    2013-01-01

    SUMMARY The aim of the present study is to assess functional outcomes after hemiglossectomy and microvascular reconstruction. Twenty-six patients underwent primary tongue microvascular reconstruction after hemiglossectomy. Twelve patients were reconstructed using a free radial forearm flap and 14 with an anterolateral thigh flap. Speech intelligibility, swallowing capacity and quality of life scores were assessed. Factors such as tumour extension, surgical resection and adjuvant radiotherapy appeared to be fundamental to predict post-treatment functional outcomes. The data obtained in the present study indicate that swallowing capacity after hemiglossectomy is better when an anterolateral thigh flap is used. No significant differences were seen for speech intelligibility or quality of life between free radial forearm flap and anterolateral thigh flap. PMID:24376292

  17. Efeitos dos corticoesteroides nas lesões por radiofrequência na coxa de ratos em diferentes faixas etárias Effects of the corticosteroids in the lesions by radiofrequency on rats' thigh in different age groups

    Directory of Open Access Journals (Sweden)

    Mieko Okada

    2010-08-01

    Full Text Available FUNDAMENTO: Os corticosteroides limitam o crescimento tardio das lesões por radiofrequência (RF no músculo da coxa de ratos filhotes, mas seus efeitos em ratos púberes e adultos são desconhecidos. OBJETIVO: Avaliar os efeitos dos corticoesteroides na cicatrização das lesões por RF no músculo da coxa de ratos em diferentes faixas etárias. MÉTODOS: Realizou-se ablação no músculo da coxa de 30 ratos (1 lesão por animal: infantis (30 dias de idade, peso 73 g, n = 10, púberes (60 dias de idade, peso 230 g, n = 10 e 10 adultos (90 dias de idade, 310 g, n = 10, subdivididos em controles e tratados, que receberam Hidrocortisona (10 mg/kg IM pós-RF e Betametasona (3,5 mg/kg IM, duas vezes por semana, por 29 dias. Os ratos foram sacrificados 60 dias após a ablação para análise histopatológica e planimétrica com software específico (ImageJ®. RESULTADOS: Nos infantis, púberes e adultos o ganho de peso no seguimento não diferiu entre controles e tratados. Nos controles, as lesões dos infantis e púberes eram maiores (p = 0,01 que as dos adultos. O tratamento reduziu o tamanho da lesão nos infantis (5,58+0,61 mm² vs 4,02+0,23 mm²; p BACKGROUND: The corticosteroids limit the late growth of the lesions by radiofrequency (RF on the rats' infants' thighs, but the effects on the pubescent and adult rats are unknown. OBJECTIVE: Evaluate the effects of the corticosteroids in the healing of the lesions by RF on the rats' thighs muscles in different age groups. METHODS: Ablation was performed on the thigh muscle of 30 rats (1 lesion per animal: infants (30 days old, weight 73 g, n = 10, pubescents (60 days old, weight 230 g, n = 10 and 10 adults (90 days old, 310 g, n = 10, subdivided in control and treated groups, that received Hydrocortisone (10 mg/kg IM post-RF and Betametasone (3.5 mg/kg IM, twice a week, for 29 days. The rats were sacrificed 60 days after the ablation for hystopathological and planimetric analysis with specified

  18. 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.

  19. 腹部和大腿皮下脂肪组织抵抗素蛋白的表达%Expression of resistin protein in abdominal and thigh subcutaneous adipose tissues

    Institute of Scientific and Technical Information of China (English)

    朱欢丽; 周咏明; 张木勋

    2006-01-01

    BACKGROUND: Resistin is an adipocyte-derived polypeptides. While central obesity can result in insulin resistance and type 2 diabetes mellitus.OBJECTIVE: To compare the expression of resistin protein in subcutaneous adipose tissue of normal human abdominal and thigh, and to investigate the role of resistin in central obesity bringing insulin resistance.DESIGN: Controlled observational experiment.SETTING: Department of Endocrinology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology.PARTICIPANTS: Totally 20 patients hospitalized between January and April 2003 at the Department of Surgery of Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology were selected. All cases were divided into abdominal fat group with 12 cases and thigh fat group with 8 cases based on the site of fat tissue.METHODS: ①Blood pressure, height, body mass were measured and body mass index (BMI), percentage of body fat (BF%) in vivo (according to formulas induced by data from white people) were calculated: Male=1.2×body mass (kg)+height-2 (M-2)+0.23×age-16.2; Female =1.2× body mass (kg)×height-2 (m-2)+0.23×age-5.4. ②Fasting blood glucose was measured with glucose oxidase assay. ③Protein was isolated with lysis buffer and protein concentration was identified with Bradford method; The expression of resistin protein was measured with Western-blot method.MAIN OUTCOME MEASURES: Blood pressure, BMI, BF%; fasting blood glucose and expression of resistin protein of all cases of the two groups.RESULTS: Totally 20 patients were involved the result analysis. ①There were no significant difference in fast blood glucose, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI) and BF%between two groups (P > 0.05). ②Expression levels (A) of resistin protein in abdominal subcutaneous adipose tissues was (14 942±6 076), which was more higher than that in thigh subcutaneous

  20. Reduction and fixation via posteromedial and anterolateral approaches for complex tibial fractures associated with collapse of posterolateral articular surface%后内侧联合前外侧入路复位固定治疗后外侧关节面塌陷的复杂胫骨平台骨折

    Institute of Scientific and Technical Information of China (English)

    丁浩亮; 薛子超; 胡传真; 秦晖; 安智全

    2015-01-01

    Objective To explore the treatment of complex tibial fractures associated with collapse of posterolateral articular surface (Schatzker types Ⅵ and Ⅴ) using reduction via posteromedial and anterolateral approaches.Methods From July 2010 to September 2012,19 patients with complex tibial fracture were treated and followed up by our department.They were 11 males and 8 females,with an average age of 49.5 years (range,from 30 to 65 years).Their fractures were classified as Schatzker type Ⅴ in 14 cases and Schatzker type Ⅵ in 5.All fractures involved the posterolateral tibial plateau.They were all reduced via the posteromedial and anterolateral approaches.The posterolateral cortical fragments were pushed anteriorly and a curved reconstruction plate was used to maintain the reduction via the posteromedial approach.An anatomically designed plate was lastly placed on the anterolateral side of the proximal tibia to fix the lateral articular surface of the proximal tibia.The knee function was evaluated by The Hospital fou Special Surgery Score(HSS) at the last follow-ups.Results The mean operation time was 164.7 min (range,from 120 to 280 min).All fractures united clinically and radiographically after an average time of 15.2 weeks (range,from 12 to 18 weeks).No nonunion,injury to the common peroneal nerve,varus deformity,implant failure,or no deep wound infection occurred.At immediate postoperation and one year postoperation,the mean tibial plateau angle (TPA) was 87.2°± 1.0° and 87.1°± 1.1°,and the mean posterior slope angle (PSA) was 7.0° ± 1.1° and 7.0° ± 1.0°,respectively,showing no significant difference between the 2 time points (P > 0.05).At one year postoperation,the average motion of the affected knee was 128.7° (range,from 0 to 135°).The posterolateral tibial articular malreduction (≤2 mm step-off) was seen in 2 patients.The mean HSS score at the last follow-ups was 92.6 (range,from 88 to 97).Conclusions Posterolateral fragments in complex

  1. 应用MIPO技术经肩峰前外侧入路治疗肱骨近端骨折的疗效观察%Curative effect Observation of Using Minimal Invasive Plate Osteosynthesis Technique through Anterolateral ;Acromial Approach for the Treatment of Proximal Humeral Fractures

    Institute of Scientific and Technical Information of China (English)

    陈孝均; 肖继冲; 邹永根; 张箭; 杨杰翔; 陶源

    2015-01-01

    目的:评价应用微创钢板接骨(minimally invasive plate osteosynthesis,MIPO)技术肱骨近端内锁定系统(Proximal Humeral Internal Locking System,PHILOS)钢板经肩峰前外侧入路治疗肱骨近端骨折的临床疗效。方法:选取2012年4月-2014年3月应用MIPO技术PHILOS钢板经肩峰前外侧入路治疗的38例肱骨近端骨折患者,其中男20例,女18例;年龄27~82岁,平均62.2岁;伤后手术时间2~17 d,平均4.7 d;Neer二部分骨折12例,三部分骨折19例,四部分骨折7例。自肩峰前0.5 cm处向下切开皮肤,长约6 cm,沿肌纤维方向劈开三角肌,显露骨折,直视下间接复位骨折,用克氏针临时固定,在肌层深面向远端插入PHILOS钢板,近端软组织手术窗用5~6枚锁定螺钉固定肱骨头,下方软组织手术窗植入3~4枚螺钉固定肱骨干。结果:本组病例手术时间45~110 min,平均75 min;术中出血60~155 mL,平均95 mL;切口均一期愈合。38例得到平均9.3个月(6~18个月)的随访,骨折均愈合,愈合时间15.2周(11~29周)。术后一年内,肩关节Neer评分优(>90分)19例,良(80~89分)15例,可(71~79分)3例,差(≤70分)1例,优良率为89.5%。结论:应用MIPO技术PHILOS钢板经肩峰前外侧入路治疗肱骨近端骨折具有创伤小、术中出血少、手术时间短、骨折愈合快、肩关节功能恢复好等优点。手术过程中必须对腋神经加以保护。该术式是治疗肱骨近端骨折的一种较好的方法,但与常规的经胸大肌三角肌间隙入路相比,如要明确哪种入路更为优良,则需要进一步增加患者数量来进行比较研究。%Objective:To investigate the curative effect of using minimally invasive plate osteosynthesis(MIPO) technique through anterolateral acromial approach for the treatment of proximal humerus fractures with proximal humeral internal locking system

  2. Posterior single segment anterolateral decompression and anterior column reconstruction for type Denis B thoracolumbar burst fractures%后路单节段侧前方减压前柱重建术治疗Denis B型胸腰椎爆裂骨折

    Institute of Scientific and Technical Information of China (English)

    高志朝; 王梅; 张妙林; 孟永俊; 祝卫民; 张春

    2011-01-01

    Objective To investigate the feasibility and clinical effect of the posterior single segment anterolateral decompression and anterior column reconstruction in the treatment of thoracolumbar burst fractures. Methods A retrospective study was done on 21 patients with type Denis B thorocalumbar burst fractures who were treated by posterior approach minimal incision pedicle SCreW fixation,single segment anterolateral decompression and titanium mesh and bone graft from August 2007 to August 2009.There were 15 males and six males at mean age of 35.6 years(range,23-50 years).The involved segments included T12 in six patients,L1 in 11,L2 in three,and L3 in one.The preoperative spinal canal enemachment rate was 62.5%and the anterior-middle vertebral compression of all patients was less than 50%.CT scanning showed normal vertebral body and inferior endplate structure.The fracture reduction,graft fusion,neurological function recovery,correction loss,lumbar activities and adjacent lumbar disc degeneration were observed through preoperative,immediate postoperative and final follow up X-ray,CT and neurological examinations. Results The operation duration was 1.5-3.2 hours(average 2.1hours),with the bleeding of 350-1 000 ml(average 580 ml).All the patients were followed up for 4-26months(average 10.3 months),which showed that the vertebral fusion time was 4-6 months,with no loss of the vertebral height,implant breakage,loosening or extrusion.The nerve function was improved for 1-2 grades. Conclusions With correct selection of the indications,the posterior single segment anterolateral decompression and anterior column reconstruction is a reliable fixation,for it takes advantages of simple operation,minor trauma,less fusion segments and fast recovery.%目的 探讨后路小切口单节段侧前方减压前柱重建术治疗Denis B犁胸腰椎爆裂骨折的可行性及临床疗效.方法 回顾性分析2007年8月-2009年8月采用经后路小切口椎弓根钉内同定、单间

  3. Limited open reduction and internal fixation with anterolateral L-shape locking compression plate for treatment of distal metaphyseal tibial fractures%有限切开复位结合前外侧 L 形锁定加压接骨板内固定治疗胫骨远端干骺端骨折

    Institute of Scientific and Technical Information of China (English)

    周炎; 杨越; 刘世清; 余铃; 廖琦; 赵奇; 张春; 黄涛; 张锐; 夏韶强

    2015-01-01

    目的:探讨胫骨远端干骺端骨折应用有限切开复位结合前外侧L形锁定加压接骨板( locking compression plate, LCP)内固定治疗的临床疗效。方法2011年6月~2013年1月共收治15例胫骨远端干骺端骨折患者。骨折按照国际内固定研究协会( AO/ASIF)分型:43A2型3例,43A3型10例,43B1型2例,均合并腓骨下端骨折;胫骨远端干骺端骨折线距踝关节面1.6~4.5cm,平均2.8cm;闭合性骨折8例,开放性骨折7例( GustiloⅠ型2例,Ⅱ型3例,ⅢA型2例)。 GustiloⅢA型2例急诊行清创、腓骨内固定及外固定支架固定,余患者术前行跟骨骨牵引。运用有限切开复位结合前外侧L形LCP内固定治疗,术中酌情植骨,术后早期功能锻炼。结果所有患者术后获12~18个月(平均16个月)随访,术后2例切口表皮坏死,经换药处理后愈合,余切口均一期愈合。骨折于术后16~24周(平均20周)获骨性愈合。末次随访时根据美国骨科协会足踝外科分会( American Orthopedic Foot Ankle Society,AOFAS)评分标准:评分为73~95分,平均89.5分,其中优10例,良3例,可2例,优良率86.7%。随访期间无感染、骨不连及内固定松动断裂等并发症发生。结论采用有限切开复位结合前外侧L形LCP内固定治疗胫骨远端干骺端骨折,术中利用微创置板技术,并酌情植骨,术后早期功能锻炼,可获得良好疗效。%Objective To investigate the clinical effects of limited open reduction and internal fixation with anterolateral L-shape locking compression plate for treatment of distal metaphyseal tibial fractures.Methods Fifteen patients with distal metaphyseal tibial fractures were treated in our department between Jun.2011 and Jan.2013.According to AO/ASIF classification,3 patients were with Type 43A2 fracture,10 patients with Type 43A3 fracture, 2 patients with Type 43B1 fracture and all were combined

  4. Vascular anatomy of the anteromedial thigh flap

    Directory of Open Access Journals (Sweden)

    Jeremy Mingfa Sun

    2017-09-01

    Conclusion: The anatomy of the RFB, which is critical in the blood supply of the AMT flap, is constant and predictable. The location of the perforators is predictable, which aids preoperative planning.

  5. Recurrent squamous cell carcinoma of the scalp treated with serial free flaps

    DEFF Research Database (Denmark)

    Ikander, Peder; Sørensen, Jens Ahm

    2015-01-01

    dorsi flaps and one anterolateral thigh flap. No total flap loss was seen, but partial flap necrosis called for secondarily reconstruction. The final result was cosmetically acceptable and the patient is of good health. In conclusion, serial free microvascular flaps may be used with good results when...

  6. Removal of intraosseous cartilaginous node originated from thoracic vertebrae via anterolateral ex-trapleural approach%经侧前方肋间隙胸膜外入路切除胸椎椎体后缘骨内软骨结节的胸椎管减压

    Institute of Scientific and Technical Information of China (English)

    黑龙; 袁海峰; 赵浩宁; 乔永东; 王自立; 丁惠强

    2014-01-01

    目的:探讨侧前方经肋间隙胸膜外入路手术切除胸椎椎体后缘骨内软骨结节治疗胸椎管狭窄症的方法和疗效。方法:2002年4月~2012年9月,对18例明确诊断为胸椎椎体后缘骨内软骨结节所致椎管狭窄症患者采用经侧前方肋间隙胸膜外入路减压内固定融合术治疗,男12例,女6例;年龄33~61岁,平均46岁。影像学证实均为单一节段椎体后缘骨内软骨结节,且不合并胸椎黄韧带骨化及后纵韧带骨化。病变节段:T7/82例,T8/94例,T9/105例,T10/117例。术前神经功能Frankel 分级:C 级6例,D级12例;JOA 评分6.6±1.3分。观察术后疗效和并发症发生情况。结果:18例患者均顺利完成手术,平均用时3.5h,平均出血量420ml (350~620ml),术后无气胸、胸腔积液等并发症发生;1例术后1周发生肺炎,5例术后第2天复查胸片时发现邻近肋骨骨折,均经保守治疗后痊愈。所有患者均获得随访,随访时间2~12年,平均6年。疗效参照Epstein标准评价,优15例,良2例,差1例,优良率94%(17/18)。术前Frankel分级为C级的患者1例无明显改善,1例改善至D级,4例改善为E级;12例D级患者均改善为E级。 JOA评分改善到9.4±1.6分,与术前比较有显著性差异(P<0.05)。术后1年复查CT见椎间植骨区表面有连续性骨小梁通过,末次随访时影像学检查未发现内固定断裂、松动和植骨不融合现象。结论:对于胸椎椎体后缘骨内软骨结节所致胸椎管狭窄症患者,采用经侧前方肋间隙胸膜外入路胸椎椎体后缘骨内软骨结节切除减压可取得较好的临床疗效,是一种安全有效的手术方式。%Objectives: To investigate the surgical method and its outcome of the removal of intraosseous cartilaginous node originated from thoracic vertebrae via anterolateral extrapleural approach. Methods: From April 2002 to September 2012, 18 cases

  7. Acute Anterolateral Myocardial Infarction Due to Aluminum Phosphide Poisoning

    Directory of Open Access Journals (Sweden)

    Bita Dadpour

    2013-08-01

    Full Text Available Aluminum phosphide (AlP is a highly effective rodenticide which is used as a suicide poison. Herein, a 24 year-old man who’d intentionally ingested about 1liter of alcohol and one tablet of AlP is reported. Acute myocardial infarction due to AlP poisoning has been occurred secondary to AIP poisoning. Cardiovascular complications are poor prognostic factors in AlP poisoning

  8. 日粮中添加共轭亚油酸对肉仔鸡胸肌和腿肌脂质过氧化状态的影响%Effect of dietary conjugated linoleic acid on the lipid peroxidation of the breast muscle and the thigh muscle of broiler chickens

    Institute of Scientific and Technical Information of China (English)

    刘永祥; 徐秋良; 刘艳丽; 姜东风; 杨建平

    2012-01-01

    【目的】研究日粮中添加共轭亚油酸(Conjugated linoleic acid,CLA)对肉仔鸡胸肌和腿肌脂质过氧化状态的影响及原因。【方法】将96只1日龄AA(Arbor Acre)雄性肉仔鸡用玉米-豆粕日粮饲喂至3周龄,在3周龄末,将其随机分为对照组和CLA组,分别饲喂基础日粮和CLA日粮,每处理8个重复,每重复6只鸡。42日龄时屠宰,剥离胸肌和腿肌,检测其中的脂肪酸组成和脂质过氧化相关指标。【结果】日粮中添加CLA降低了肉仔鸡胸肌和腿肌的丙二醛(MDA)(P〈0.01)和活性氧含量(P〈0.05)。2组肉仔鸡腿肌和胸肌中各种抗氧化酶活性无显著差异(P〉0.05)。与对照组相比,CLA组肉仔鸡胸肌和腿肌的谷胱甘肽含量分别提高了21.89%和21.56%(P〈0.01),γ-谷氨酰半胱氨酸合成酶的活性分别提高了28.57%和25.80%(P〈0.01)。日粮中添加CLA提高了肉仔鸡胸肌和腿肌总CLA(P〈0.01)及饱和脂肪酸(SFA)含量(P〈0.05),极显著降低了单不饱和脂肪酸含量(P〈0.01)。【结论】日粮中添加CLA改变了肉仔鸡胸肌和腿肌脂肪酸的组成,提高了脂质稳定性,同时增加了GSH含量,淬灭了更多的自由基,从而降低了脂质过氧化水平。%[Objective] The present study was conducted to investigate effect of conjugated linoleic acid (CLA) on the lipid peroxidation of the breast muscle and the thigh muscle of broiler chickens and cress- ponding mechanism. [Method] Ninety six 1-day-old male AA (Abor Acre) broiler chickens were suple- mented with the same maize-soyabean meal diet until the end of the third week,and then were randomly al- located into control group and 1.5% CLA supplementation group, suplemented with control diet and CLA suplementation diet respectively, each treatment with elght replicates of 6 chickens. The brolier chickens were excuted at 42 days old,and the breast muscle and the thigh muscle were excised. The fatty

  9. 股外侧筋膜及前臂游离带蒂皮瓣联合即刻修复下唇全层缺损的临床研究%Clinical application of forearm free flap and lateral thigh fascia in the reconstruction of whole lower lip defect

    Institute of Scientific and Technical Information of China (English)

    阿不都克力木江·买买提; 买买提吐逊; 胡尔曼·巴合提别克; 阿迪力江·赛买提; 居来提·吐尔逊

    2015-01-01

    Objective To investigate the clinical application of forearm free flap and lateral thigh fascia in the reconstruction whole lower lip defect. Methods Combination of forearm free flap and lateral thigh fascia were used in 13 patients to reconstruct the whole lower lip defect which was caused by trauma.Microsurgery techniques was applied to vascular anastomosis,radial artery anastomized to facial artery and cephalic vein to external jugular vein. Results 13 patients with lower soft tissue defects were reconstructed with forearm arm free flap combination with lateral thigh fascia,and flaps were alive without severe complication.Only one flap showed mild distal part necrosis,and healed completely.All patients were followed up for 1-36 months,the flaps presented good quality and attachment.Patients were well satisfied with the appearance and function. Conclusion Vastus lateralis fascia and forearm free joint immediate pedicle flap to repair lower lip full-thickness defects, the appearance of repair and functional recovery is superior to other treatments.%目的:探讨前臂游离带蒂血管皮瓣及股外侧筋膜组织联合应用即刻修复下唇部软组织全层缺损的临床效果.方法:对因外伤后的下唇部软组织全层缺损的创面用前臂桡侧游离皮瓣及股外侧筋膜联合修复13例,应用显微外科技术将桡动脉与面动脉吻合,头静脉与颈外静脉吻合.结果:联合即刻修复下唇部各类全层软组织缺损13例,全部存活;1例皮瓣远端少许坏死,经换药治疗后完全愈合.术后随访1~36个月,成活的皮瓣质地优良,与基底附着良好,外观比较满意,未见塌陷下垂,功能及口角恢复良好.结论:股外侧筋膜及前臂游离带蒂皮瓣联合即刻修复下唇全层缺损(尤其双侧口角缺损),对外观修复及功能恢复优越于其他治疗方法.

  10. 手法配合常规理疗早期干预专业运动员股内收肌急性损伤的临床疗效观察%Clinical Observation of Manual Therapy Early Intervention on Professional Athletes Thigh Adductor Acute Injury

    Institute of Scientific and Technical Information of China (English)

    王琼; 朱国苗; 王爱斌; 张鲁申

    2014-01-01

    [目的]观察手法配合常规理疗早期干预专业运动员股内收肌急性损伤的临床效果。[方法]采取前瞻性临床随机对照研究方法,将134名符合纳入标准的专业运动员随机分成观察组和对照组,观察组采用手法和常规理疗干预,对照组采用单纯常规理疗干预。采用简化McGil 疼痛量表(short-form McGil pain questionnaire,SF-MPQ)评估运动员治疗前、第1次治疗后及疗程结束后疼痛改善情况。[结果]第1次手法干预后,观察组SF-MPQ指数显著降低,与对照组相比差异有统计学意义(P<0.01),疗程结束后观察组SF-MPQ 中疼痛分级量表(pain rating index,PRI)和疼痛视觉模拟评分量表(visual analogue scale,VAS)指数显著降低,与对照组相比差异有统计学意义(P<0.01),但疼痛强度PPI指数(present pain index, PPI)与对照组相比无显著性差异(P=0.26)。[结论]手法配合常规理疗早期专业运动员股内收肌急性损伤具有显著的即刻镇痛效果,与常规理疗相比,手法配合常规理疗早期干预急性软组织损伤具有一定的优势。%[Objective]To observe the clinical effect of manual therapy early intervention on professional athletes thigh adductor acute injury. [Methods]A prospective randomized control ed clinical 134 cases met the inclusion criteria, at the same time did not meet the exclusion criteria of profession athletes, who were randomly divided into two groups, treatment and control groups, the manipulation group receiving manual therapy plus rountine physiotherapy intervention while the control one just routine physiotherapy intervention. Short-form McGil pain questionnaire(SF-MPQ) is used to evaluate pain be-fore and after the first treatment and the last treatment. [Results] After first intervention, the treatment group could statistical y significantly reduce the pain index(P<0.01). At the end of the treatment, compared with the control group

  11. 游离股外侧肌瓣联合封闭式负压吸引技术修复四肢软组织缺损%Clinical Observation of Sequential Vacuum-assisted Closure and Free Lateral Thigh Muscle Flaps for Soft Tissue Defects in Extremities

    Institute of Scientific and Technical Information of China (English)

    张定伟; 王军; 唐诗添; 王陶; 石波; 康斌

    2013-01-01

    Objective To investigate the clinical effect of sequential vacuum-sealing drainage (VSD) and free lateral thigh muscle flaps on soft tissue defects in extremities. Methods A total of 25 cases of soft tissue defects in extremities treated between June 2009 and June 2011. After careful debridement, the wound was covered with VSD according to the condition of the soft tissue defect. The VSD negative pressure membrane wag removed after 5-9 days, then the free lateral thigh muscle flaps were transferred to cover the defects. The vascular crisis of the muscle flaps were treated after transfer, and grafting skin in the late. Results All cases were followed up for 6-12 months. After treated by VSD, no obvious infection was seen in 25 patient with soft tissue defect complicated by infection, and granulation tissue surrounding tendons and bone exposure area grew well. Three muscle flaps restored blood circulation in three cases vascular crisis. The result was satisfactory, and all muscle flaps were survived. The infection was well controlled, and no fistula tract was found. Conclusions For patients with soft tissue defect complicated by underlying tissue exposure, after strict debridement, the treatment circle will be obviously shortened by the application of sequential drainage and free lateral thigh muscle flaps, and the success rate of the operation is improved. Therefore, the function of affected limbs will be recovered as far as possible.%目的 探讨游离股外侧肌瓣联合封闭式负压吸引技术(VSD)修复四肢软组织缺损的临床效果.方法 2009年6月-2011年6月,对25例四肢软组织缺损患者采用游离股外侧肌瓣联合VSD治疗对创面经彻底清创后,先行VSD覆盖,5~9d后去除VSD负压膜.再次清创受区,切取股外侧肌瓣修复创面,处理血管危象,二期植皮.结果 25例均获得随访,时间6~12个月.经负压封闭引流后,局部创面无明显感染,肌腱及骨外露区周围肉芽组织

  12. Clinical Efficacy of the Lower Leg Section Reserved thigh Saphenous Vein Stripping Segment Surgical for Elderly Patients with Varicose Veins of Lower Extremity%老年人下肢静脉曲张患者保留小腿段大隐静脉大腿段剥脱术的临床效果

    Institute of Scientific and Technical Information of China (English)

    王兵

    2016-01-01

    目的:观察老年人下肢静脉曲张应用保留小腿段大隐静脉大腿段剥脱术的效果。方法选取2014年3月~2015年3月本院接收的86例下肢静脉曲张患者,随机分作研究组与传统组,每组43例,分别行大隐静脉大腿段剥脱术联合小腿曲张静脉剥脱术、传统大隐静脉高位结扎及全段剥脱术治疗,比较两组手术效果。结果研究组患者平均术中失血量、术程、住院时间分别为(30.52±4.23)ml、(45.40±5.65) min、(4.25±0.36)d;传统组分别为(75.23±5.12)ml、(65.55±6.24) min、(12.36±0.42)d,研究组平均术中失血量、术程、住院时间均较传统组少,差异具统计学意义(P<0.01);研究组并发症发生率与术后1年复发率分别为6.98%与0,传统组分别为23.26%与13.95%,研究组并发症发生率更低,差异具统计学意义(P<0.05)。结论老年下肢静脉曲张应用保留小腿段大隐静脉大腿段剥脱术治疗效果理想,值得应用。%Objective To discuss the clinical efficacy of the lower leg section reserved thigh saphenous vein stripping segment surgical for elderly patients with varicose veins of lower extremity.Methods Selected 86 cases with varicose veins from Mar 2013 to Mar 2014 were randomly divided into study group and the conventional group, each of 43 cases. Study group was treated with the great saphenous vein stripping surgery combined with calf thigh section stripping of varicose veins, and conventional group was treated with the traditional great saphenous vein high ligation and stripping of intact. Clinical efifcacy of two groups was compared.Results Study patients mean intraoperative blood loss, surgery process, duration of hospitalization was (30.52 ± 4.23)ml, (45.40 ± 5.65)min, (4.25 ± 0.36) d; conventional group were (75.23 ± 5.12)ml, (65.55 ± 6.24)min, (12.36 ± 0.42)d, and study group mean intraoperative blood loss, surgery process, length of stay

  13. The surface-electromyographic characteristics of the anterior and posterior thigh muscles in patients recovering from cerebral infarction%脑梗死恢复期患者大腿前后肌群表面肌电特征的研究

    Institute of Scientific and Technical Information of China (English)

    窦祖林; 姜丽; 何萃; 温红梅

    2011-01-01

    Objective To assess the contraction and coordination changes in the anterior and posterior thigh muscles of patients recovering from cerebral infarction,and to provide objective references for targeted rehabilitation programs. Methods Eighteen cerebral infarction patients with mild hemiparesis (the patient group) and eighteen age- and sex-matched healthy volunteers (the healthy group) were investigated. The surface-electromyographic (sEMG) signals of their vastus medialis,rectus femoris,vastus lateralis,biceps femoris,semitendinosus and semimembranosus were recorded during knee joint flexion and extension in the prone position.The sEMG signals from both legs were recorded for the patient group,but only from the left leg in the healthy group.The standardized root mean square (stRMS) signals and the co-contraction ratios (CRs) were compared and analysed, Results The stRMSs of the rectus femoris,vastus lateralis and vastus medialis on the patients' affected side during knee extension were significantly higher than those in the healthy group at baseline and follow-up.The stRMSs of the biceps femoris and semitendinosus-semimembranous on the patients' unaffected side were significantly higher than those of the affected side and the healthy group during knee flexion at baseline.The CRs during knee flexion on the patientsˊ affected side at baseline and follow-up were significantly higher than those of the unaffected side at baseline. Conclusions After cerebral infarction,the functioning of both the anterior and posterior thigh muscles on the affected side are impaired.The rectus femoris are the most severely impaired knee extensors,and the biceps femoris,semitendinosus and semimembranous are impaired equally in knee flexion.The thigh flexors and extensors lose their normal antagonist-agonist contraction modes.The functions of both the anterior and posterior thigh muscles should be emphasized during rehabilitation to improve abnormal contraction.%目的 探讨脑梗死偏

  14. Perfil lipídico e maciez da carne de coxa e sobrecoxa de frangos de corte alimentados com rações contendo diferentes fontes lipídicas Lipidic profile and tenderness of thigh and drumstick meat of broilers fed diets supplemented with different lipid sources

    Directory of Open Access Journals (Sweden)

    Potença Alexandra

    2010-08-01

    Full Text Available Foram conduzidos dois experimentos com o objetivo de avaliar a qualidade e o perfil de ácidos graxos da carne de coxa e sobrecoxa em frangos de corte, no período de 1 a 42 dias de idade. No experimento 1, foi adotado delineamento experimental inteiramente casualizado, com quatro dietas, oito repetições e 49 aves por unidade experimental. Na fase inicial, as aves receberam rações formuladas com óleo de soja; óleo de algodão; óleo de vísceras ou sebo bovino e, na fase de crescimento, cada uma dessas dietas foi desmembrada em duas, de modo que um grupo de aves continuou a receber a mesma fonte de óleo utilizada na fase anterior, enquanto o outro grupo passou a receber óleo de soja na dieta. Nessa fase, foi utilizado um delineamento inteiramente casualizado, com sete dietas, cada uma com quatro repetições. Houve influência das dietas no perfil de ácidos graxos da coxa. No experimento 2, durante a fase inicial (1 a 21 dias, as aves receberam a mesma ração, contendo 3% de óleo de soja e, na fase de crescimento (22 a 42 dias, em um delineamento inteiramente casualizado, com cinco dietas, cada uma com uma com uma fonte lipídica (óleo de soja, óleo de canola, óleo de girassol, óleo de vísceras ou sebo bovino seis repetições e 30 aves/unidade experimental, fontes lipídicas. Não foi verificado efeito das dietas sobre o pH e a força de cisalhamento. As dietas influenciaram, no entanto, o perfil de ácidos graxos da coxa, pois, de acordo com os resultados, o enriquecimento das rações com fontes de óleo promoveu modificações na composição lipídica na carne da coxa dos frangos, de modo que o melhor perfil de ácidos graxos foi observado na carne dos animais alimentados com a ração contendo óleo de soja.Two experiments were carried out to evaluate the quality and profile of fatty acids in the thigh and drumstick of broiler chickens, from one to 42 days of age. In the experiment 1, a complete randomized design, with four

  15. Alcohol neurolysis of lateral femoral cutaneous nerve for recurrent meralgia paresthetica.

    Science.gov (United States)

    Chen, Chee Kean; Phui, Vui Eng; Saman, Mat Ariffin

    2012-01-01

    Meralgia paresthetica is an entrapment mononeuropathy of lateral femoral cutaneous nerve, which results in localized area of paresthesia and numbness on the anterolateral aspect of the thigh. We describe the use of alcohol neurolysis of lateral femoral cutaneous nerve in a 74-year-old female who presented with paresthesia over antero-lateral aspect of her left thigh, which was consistent with meralgia paresthetica. Diagnostic block with local anaesthetic confirmed the diagnosis but only archieved temporary pain relief. Alcohol neurolysis was then offered and patient responded well with no complication. The patient experienced prolonged pain relief at 6-month follow-up, with return of ability to ambulate and perform daily activity. Alcohol neurolysis of lateral femoral cutaneous nerve is safe, effective and able to provide sustained pain relief for recurrent meralgia paresthetica.

  16. [Lipoatrophia semicircularis in the male. Coincidence of arterial variations and micro-traumas as a possible disease cause].

    Science.gov (United States)

    Bloch, P H; Runne, U

    1978-05-01

    Semicircular lipoatrophy is a new entity with horizontal depressions involving half the circumference of thigh, on the antero-lateral aspect. After seven female patients we observed this condition for the first time in the male. Therefore semicircular lipoatrophy is not specific to the female. The cause could not be determined clinically, nor by biochemical, immunological or histological methods. In our opinion semicircular lipoatrophy represents an ischemic atrophy of the fatty tissue, manifested by repeated microtraumata (corners of wash-basins, dressing tables or desks). The perfusion on the antero-lateral aspect of the thighs is tenous, especially when the course of the lateral femoral circumflex artery varies from the normal. In this case semicircular anastomotic areas become ischemic and horizontal bands of lipoatrophy result.

  17. Lipoatrophia semicircularis: a case report and review of the literature.

    Science.gov (United States)

    Presta, Fabrizio; Del Giglio, Micol; Girolomoni, Giampiero

    2016-08-01

    The case of a 45 years old woman with lipoatrophia semicircularis is presented showing a typical semicircular depressions of the anterolateral aspects of the thighs. The lesion regressed after avoiding the pressing of the thighs against the desk edge. A PubMed search disclosed 125 cases of lipoatrophia semicircularis reported in details. More then 90% were middle aged women. Repeated external microtraumatisms was the most common cause. The few cases biopsied revealed a localized lipoatrophy. Avoiding microtraumatisms resulted in a complete remission of lipoatrophia semicircularis in most cases.

  18. Meralgia paresthetica and femoral acetabular impingement: a possible association.

    Science.gov (United States)

    Ahmed, Aiesha

    2010-12-11

    Meralgia paresthetica consists of pain and dysesthesia in the anterolateral thigh. Etiology is divided into spontaneous and iatrogenic causes. To my knowledge this has never been attributed to femoral acetabular impingement. This case highlights the presence of lateral femoral cutaneous neuropathy in the setting of femoral acetabular impingement syndrome thus raising the possibility of an association. Femoral acetabular impingement; Lateral femoral cutaneous nerve; Dysesthesia; Nerve conduction studies.

  19. [Unilateral temporary meralgia paresthetica after caesarean section: report of a case].

    Science.gov (United States)

    Yanaru, Tomoaki; Katori, Kiyoshi; Higa, Kazuo; Miyako, Yuka; Nitahara, Keiichi

    2012-10-01

    We report a patient who developed unilateral temporary meralgia paresthetica after caesarean section. A 28-year-old morbidly obese woman underwent caesarean section under combined spinal and epidural anesthesia. Intraoperative position was 5-degree head down lithotomy position. She noted pain and hypesthesia along the anterolateral aspect of the right thigh on the second postoperative day, when postoperative continuous epidural analgesia was stopped. The pain and sensory impairment resolved 8 days after surgery without medications.

  20. Clinical Features of Primary Vein Grafts in Free Tissue Transfers

    OpenAIRE

    Mitsuru Nemoto; Kenichi Kumazawa; Eiju Uchinuma; Natsuko Kounoike; Akira Takeda

    2015-01-01

    The outcomes of free tissue transfers combined with vein grafts have been inconsistent, and discussions continue regarding their appropriate use. Of the 142 free tissue transfers that we performed from January 2004 to December 2011, we retrospectively analyzed 15 consecutive patients who underwent free tissue transfers in combination with vein grafts. Etiologies included trauma (8 patients), infection (4), and tumor (3). Types of free tissue transfers were fibula (4), anterolateral thigh (3),...

  1. Utility of Indocyanine Green Angiography in Arterial Selection during Free Flap Harvest in Patients with Severe Peripheral Vascular Disease

    OpenAIRE

    Maxwell, Anne K.; Deleyiannis, Frederic W.-B.

    2016-01-01

    Summary: Indocyanine green angiography (SPY) was used to guide arterial selection for an anterolateral thigh free flap in the setting of severe peripheral vascular disease. SPY technology serves as a novel and sensitive intraoperative tool to predict decreased tissue perfusion from vessel sacrifice for flap harvest. Change in SPY time parameters measuring superficial blood flow distal to the donor site while temporarily intraoperatively clamping different possible arterial pedicles can optimi...

  2. Foot and ankle reconstruction: an experience on the use of 14 different flaps in 226 cases.

    Science.gov (United States)

    Zhu, Yue-Liang; Wang, Yi; He, Xiao-Qing; Zhu, Min; Li, Fu-Bin; Xu, Yong-Qing

    2013-11-01

    The aim of this report was to present our experience on the use of different flaps for soft tissue reconstruction of the foot and ankle. From 2007 to 2012, the soft tissue defects of traumatic injuries of the foot and ankle were reconstructed using 14 different flaps in 226 cases (162 male and 64 female). There were 62 pedicled flaps and 164 free flaps used in reconstruction. The pedicled flaps included sural flap, saphenous flap, dorsal pedal neurocutaneous flap, pedicled peroneal artery perforator flap, pedicled tibial artery perforator flap, and medial plantar flap. The free flaps were latissimus musculocutaneous flap, anterolateral thigh musculocutaneous flap, groin flap, lateral arm flap, anterolateral thigh perforator flap, peroneal artery perforator flap, thoracdorsal artery perforator flap, medial arm perforator flap. The sensory nerve coaptation was not performed for all of flaps. One hundred and ninety-four cases were combined with open fractures. One hundred and sixty-two cases had tendon. Among 164 free flaps, 8 flaps were completely lost, in which the defects were managed by the secondary procedures. Among the 57 flaps for plantar foot coverage (25 pedicled flaps and 32 free flaps), ulcers were developed in 5 pedicled flaps and 6 free flaps after weight bearing, and infection was found in 14 flaps. The donor site complications were seen in 3 cases with the free anterolateral thigh perforator flap transfer. All of limbs were preserved and the patients regained walking and daily activities. All of patients except for one regained protective sensation from 3 to 12 months postoperatively. Our experience showed that the sural flap and saphenous flap could be good options for the coverage of the defects at malleolus, dorsal hindfoot and midfoot. Plantar foot, forefoot and large size defects could be reconstructed with free anterolateral thigh perforator flap. For the infected wounds with dead spce, the free latissimus dorsi musculocutaneous flap remained to

  3. Repair of pressure sores over ischial tuberosity with long head of biceps femoris muscle flap combined with semi-V posterior thigh fasciocutaneous flap%股二头肌长头肌瓣联合半V形股后筋膜皮瓣修复坐骨结节压疮

    Institute of Scientific and Technical Information of China (English)

    海恒林; 申传安; 柴家科; 李华涛

    2012-01-01

    Objective 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. Methods 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. Results 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. Conclusions 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.%目的 观察应用股二头肌长头肌瓣联合半V形股后筋膜皮瓣修复坐骨结节压疮的临床疗效. 方法 选择2004年4月-2010年6月2家笔者单位收治的坐骨结节深度压疮患者8例共10处创面,压疮范围2cm×2 cm~6 cm ×4cm.设计股二头肌长头肌瓣和半V形股后筋膜皮瓣进行修复,其中股后筋膜皮瓣大小为10 cm ×6 cm ~13 cm×8 cm.统计术后皮瓣成活情况,并进行远期随访. 结果 术后皮瓣全部成活,其中9处压疮切口术后顺利愈合;1处因皮瓣下积液引流部位形成窦道,经换药治疗于术后25 d愈合.随访7

  4. 饲喂不同配比油脂饲料对肉鸡肉品质及肌肉中脂肪酸组成的影响%Effect of Feeding Diets Containing Different Oils to Broilers on Meat Quality and Fatty Acid Composition in Breast and Thigh Muscles

    Institute of Scientific and Technical Information of China (English)

    安文俊; 张丽; 庄苏; 王恬

    2011-01-01

    研究日粮中添加不同配比油脂对肉鸡肉品质、肌肉胆固醇含量及脂肪酸组成的影响。选取648只1日龄AA肉鸡,随机分成6组,CON为对照组(饲喂基础日粮),SO为正对照组(日粮中添加豆油),LO为负对照组(日粮中添加猪油),COP、COC、COV组分别在日粮中添加以棕榈油为主的配比油脂、以椰子油为主的配比油脂、多种植物油组成的配比油脂,实验期为42d。结果表明:COP组胸肌24h的滴水损失显著升高(P〈0.05);COC组腿肌烹饪损失显著降低(P〈0.05)。LO组胸肌不饱和脂肪酸/饱和脂肪酸得到提高(P〈0.0%The purpose of this study was to investigate the effect of adding different vegetable oils or fat to basal diet on the meat quality,cholesterol content and fatty acid composition of breast and thigh muscles of Arbor Acre(AA) broilers.Totally 648 one-day-old chickens were randomly divided into 6 groups: CON(fed basal diet mainly consisting of corn meal and soybean meal as normal control),SO(fed basal diet added with soybean oil as positive control),LO(fed basal diet added with lard as negative control),COP(fed basal diet added with commercial complex vegetable oil sample mainly containing palm oil),COC(fed basal diet added with commercial complex vegetable oil sample mainly containing coconut oil) and COV(fed basal diet added with commercial complex vegetable oil sample containing multiple vegetable oils).Each chicken was fed for 42 days.The results showed that:(1) Drip loss(24 h postmortem) of breast muscle in COP group was significantly increased(P 0.05) and cooking loss of thigh muscle in COC group was significantly decreased(P 0.05).(2) Breast ratio of unsaturated to saturated fatty acids in LO group was improved(P 0.05);more n-3 PUFAs were determined in SO,LO,COP and COC groups(P 0.05);compared with CON group,the contents of n-6 PUFAs in SO and COC groups were

  5. Functional Reconstruction of a Combined Tendocutaneous Defect of the Achilles Using a Segmental Rectus Femoris Myofascial Construct: A Viable Alternative

    Directory of Open Access Journals (Sweden)

    Michael Vincent DeFazio

    2014-05-01

    Full Text Available The composite anterolateral thigh flap with vascularized fascia lata has emerged as a workhorse at our institution for complex Achilles defects requiring both tendon and soft tissue reconstruction. Safe elevation of this flap, however, is occasionally challenged by absent or inadequate perforators supplying the anterolateral thigh. When discovered intraoperatively, alternative options derived from the same vascular network can be pursued. We present the case of a 74-year-old male who underwent composite Achilles defect reconstruction using a segmental rectus femoris myofascial free flap. Following graduated rehabilitation, postoperatively, the patient resumed full activity and was able to ambulate on his tip-toes. At 1-year follow-up, active total range of motion of the reconstructed ankle exceeded 85% of the unaffected side, and donor site morbidity was negligible. American Orthopaedic Foot and Ankle Society and Short Form-36 scores improved by 78.8% and 28.8%, respectively, compared to preoperative baseline assessments. Based on our findings, we advocate for use of the combined rectus femoris myofascial free flap as a rescue option for reconstructing composite Achilles tendon/posterior leg defects in the setting of inadequate anterolateral thigh perforators. To our knowledge, this is the first report to describe use of this flap for such an indication.

  6. Clinical Study of Electroacupuncture on Acupoints Located Along Anterior and Posterior Thigh Muscles Plus Isokinetic Muscle Strength Training in Treating Poststroke Lower Limb Dysfunction%电针大腿前后肌群穴位配合等速训练治疗中风后下肢功能障碍的临床研究

    Institute of Scientific and Technical Information of China (English)

    张涧; 何铭锋; 赵书恒; 陈红霞

    2015-01-01

    Objective To observe the therapeutic effect of electroacupuncture (EA) on acupoints located along anterior and posterior thigh muscles plus isokinetic muscle strength training for poststroke lower limb dysfunction. Methods Fifty-two qualified mild hemiplegia cases were randomized into control group A ( N=17) , control group B (N=17), and observation group (N=18 ). Control group A was given conventional rehabilitation training, control group B was given conventional rehabilitation training and task-targeting knee strength-coordination isokinetic muscle strength training based on visual feedback, and observation group was given EA on acupoints located along anterior and posterior thigh muscles plus the treatment for control group B. The treatment for the three groups was performed once a day, five days a week, lasting 3 weeks. Before and after treatment, the lower limb motor function, peak torque ( PT) of knee flexion and extension muscles, and gait speed and gait symmetry were monitored. Results After treatment for 3 weeks, the lower limb motor function, PT and gait symmetry were much improved in the three groups (P0.05) , the improvement of observation indexes of control group B was superior to that of control group A, and the improvement of observation indexes of observation group was more obvious than that of the two control groups ( P<0.05) . Conclusion EA on acupoints located along anterior and posterior thigh muscles plus isokinetic muscle strength training is more effective for improving lower limb motor function of poststroke lower limb dysfunction patients than conventional isokinetic training.%【目的】观察电针大腿前后肌群穴位配合等速训练治疗中风后下肢功能障碍的临床疗效。【方法】将52例符合纳入标准的轻度偏瘫患者随机分为对照A组17例、对照B组17例和试验组18例。对照A组给予常规康复训练治疗,对照B组在常规康复训练中增加带有视觉反馈和任务导向的膝关

  7. [Foot defect with vascular and neural injury due to freshwater stingray sting: reconstruction with a lesser saphenous vein adipo-fascial flap].

    Science.gov (United States)

    Moutran, M; Mojallal, A; Chekaroua, K; Martin, E; Braye, F

    2009-04-01

    The emergency care to stingrays envenomation permits, in the majority of cases, to limit the damage caused. In the case of delayed medical care, we can meet deep and extensive lesions that need to be thoroughly explored in order to better address their reconstruction. We report the case of a patient injured by freshwater stingray. He presented a necrotic defect of 6 cm in diameter under the right medial malleolus with bone exposure and neurovascular injury. We opted for a therapeutic strategy in two steps. The first step consisted in a large debridement of the necrotic defect, under appropriate antibiotics and negative pressure therapy. Three weeks later, we covered the defect with a distally based lesser saphenous vein veno-fascia-subcutaneous flap, covered with a split-thickness graft. The coverage of the defect was satisfactory. The infection was controlled with antibiotics, which we prolonged for one month. The patient presented, initially, hypoesthesia of the upper lateral foot in relation with a neurapraxis of the sural nerve. The symptoms resolved at two months. The foot edema due to venous stasis also resolved at two months. The donor site healed without complications. The ability to wear normal shoes was preserved. The patient resumed his daily activities promptly.

  8. A cause of severe thigh injury: Battery explosion

    Directory of Open Access Journals (Sweden)

    Tahsin Görgülü

    2016-02-01

    Discussion: Battery explosion causing lower extremity tissue defect is a type of injury that is rarely seen in the literature. Regardless of battery size and energy level, they should be considered as potential explosive material and protector masks, clothing should be worn during contact with this type of material.

  9. acute compartment syndrome of the thigh without associated fracture

    African Journals Online (AJOL)

    C.K. Lakati, FCS (Ortho) ECSA, Orthopaedic Surgeon and Lecturer, Egerton University, B.M. Ndeleva, MMed. (Ortho -Mak), FCS ... damage to the nerves and muscles in that compartment. Early diagnosis ... Quadriceps exercises were started ...

  10. Pelvic Primary Staphylococcal Infection Presenting as a Thigh Abscess

    OpenAIRE

    T. O. Abbas

    2013-01-01

    Intra-abdominal disease can present as an extra-abdominal abscess and can follow several routes, including the greater sciatic foramen, obturator foramen, femoral canal, pelvic outlet, and inguinal canal. Nerves and vessels can also serve as a route out of the abdomen. The psoas muscle extends from the twelfth thoracic and fifth lower lumbar vertebrae to the lesser trochanter of the femur, which means that disease in this muscle group can migrate along the muscle, out of the abdomen, and pres...

  11. Effect of muscle strength exercise on surface electromyography over thigh in stroke patients with hemiplegia during convalescence%肌力训练对脑卒中恢复期偏瘫患者大腿表面肌电的影响

    Institute of Scientific and Technical Information of China (English)

    姜丽; 窦祖林; 温红梅; 兰月; 李奎; 丘卫红; 胡昔权

    2010-01-01

    目的 探讨脑卒中恢复期偏瘫患者肌力训练对大腿肌群表面肌电(sEMG)信号特征的影响,为脑卒中患者的康复治疗提供客观依据.方法 共选取35例脑卒中恢复期偏瘫患者,分为治疗组(n=19)和对照组(n=16),治疗组给予6周的肌力训练,并在治疗前后在患侧膝关节屈伸最大等长收缩(MIVC)时记录股内侧肌、股直肌、股外侧肌、股二头肌、半腱半膜肌的sEMG信号,计算膝关节屈伸力矩值、均方根值(RMS)及其相应协同收缩率;对照组不给予康复训练,仅与治疗组同时进行上述指标测量.结果 治疗组治疗后患者患侧屈膝及伸膝MIVC力矩均较治疗前明显改善[屈膝:(18.02±6.52)nm比(13.12±5.79)nm,伸膝:(45.72±17.21)nm比(34.76±17.19)nm,均P<0.05],而伸屈膝协同收缩率较治疗前无明显变化.对照组伸屈膝MIVC力矩和协同收缩率治疗前后差异则无统计学意义(均P>0.05).治疗组治疗后患者患侧大腿股直肌、股外侧肌、半腱半膜肌作为主动肌时的RMS值均较治疗前明显改善[(146.60±60.85)μV比(97.02±57.17)μV,(172.65±60.73)μV比(131.46±52.15)μV,(188.69±89.60)μV比(130.57±73.76)μV,均P<0.05],而股内侧肌、股二头肌的RMS值在治疗前后无明显变化,对照组治疗前后各肌的RMS值则无变化(均P>0.05).结论 肌力训练可改善脑卒中恢复期偏瘫患者下肢屈伸肌力,但并不会增强下肢伸屈肌的异常收缩.sEMG结合力矩测量能更全面评估偏瘫肢体功能状态.%Objective To explore the effect of muscle strength exercise on surface electromyography (sEMG) over thigh in stroke patients with hemiplegia during convalescence so as to gain objective evidence for rehabilitation therapy of stroke patients. Methods Thirty-five stroke patients with hemiplegia during convalescence were enrolled in this study, and were divided into two groups, treatment group (n=19) and control group (n=16). The treatment group underwent muscle

  12. Lipoatrophia semicircularis: a compressive lipoatrophy consecutive to persistent mechanical pressure.

    Science.gov (United States)

    Herane, María Isabel; Urbina, Francisco; Sudy, Emilio

    2007-06-01

    Lipoatrophia semicircularis is an infrequent condition characterized by semicircular depressions of the anterolateral aspects of the thighs. The origin of this peculiar variant of lipoatrophy is unknown, although repeated mechanical trauma on the affected thighs has been advocated in many cases. A 57-year-old woman presented with a 1-year history of two bilateral, parallel, symmetric, asymptomatic depressions on the anterolateral aspect of her thighs. The patient worked as a cashier, permanently seated and almost always wearing trousers. The localization of lesions and their linear artifactual appearance perfectly matched with the strangling folds formed by trousers while being sat. Echotomographic examination revealed a loss of the normal echogenic pattern in the subcutaneous tissue of the affected areas. We believe that the anatomical adipose constitution of women's thighs predisposes that a persistent mechanical pressure induced by wearing trousers while being sat for long periods of time, originates a relative impaired circulation on a tenuous perfused tissue, and induces the development of lipoatrophia semicircularis.

  13. Efeito do uso de óleo de vísceras de aves oxidado na ração de frangos de corte sobre o desempenho, a composição da carcaça e a estabilidade oxidativa da carne da sobrecoxa Dietary oxidized poultry offal fat: performance, carcass and meat composition, and oxidative stability of frozen thigh meat of broiler chickens

    Directory of Open Access Journals (Sweden)

    Aline Mondini Calil Racanicci

    2008-03-01

    Full Text Available Foi conduzido um experimento utilizando-se 200 pintos de corte da linhagem Ross de 10 a 40 dias de idade alimentados com ração à base de milho e farelo de soja e suplementada com 4% de óleo de vísceras de aves fresco ou oxidado, com o objetivo de avaliar os efeitos da qualidade do óleo utilizado nas rações sobre o desempenho de frangos de corte e a estabilidade oxidativa da carne de sobrecoxa congelada. Óleo de vísceras recém produzido com absorbâncias específicas de 5,80 a 232 nm e 0,690 a 532 nm, indicando a presença de quantidades mínimas de compostos de oxidação, foi congelado (-18ºC até o momento da produção das rações. O óleo oxidado foi produzido a partir deste mesmo lote, que foi aquecido em uma fritadeira elétrica com temperatura em torno de 110 a 120ºC até atingir absorbâncias específicas de 11,33 (232 nm e 2,31 (532 nm, caracterizando o acúmulo de compostos de ranço. Aos 41 dias de idade, 136 animais foram abatidos para avaliação das características de rendimento da carcaça e das partes e as sobrecoxas desossadas e sem pele foram embaladas e mantidas sob congelamento (-20ºC. O acompanhamento do processo de oxidação lipídica da carne congelada foi avaliado mensalmente pela determinação dos compostos secundários da oxidação (TBARS. O uso do óleo de vísceras oxidado não afetou o desempenho das aves, nem as características principais da carcaça. A partir do sexto mês de armazenamento, a estabilidade oxidativa da carne de sobrecoxa congelada foi comprometida pelo consumo de rações contendo o óleo oxidado, evidenciado pelo maior valor de TBARS.Two hundred male Ross broiler chicks were raised from 10 to 40 days of age and fed a corn-soy diet with 4% of fresh or oxidized poultry offal fat to evaluate the effects of dietary fat quality on broiler performance and on oxidative stability of frozen thigh meat during storage. Fresh poultry fat, characterized by low concentration of oxidation

  14. Clinical anatomic study of the lower lumbar anterolateral vein: with respect to retroperitoneal endoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    LU Sheng; XU Yong-qing; DING Zi-hai; WANG Yue-li; SHI Ji-hong; ZHONG Shi-zhen

    2008-01-01

    To study the anatomy of veins of the lower lumbar spine and provide the anatomic basement for laparoscopic lumbar surgery.Methods:A total of 15 formaldehyde-preserved cadavers were studied with special attention to the variety and surrounding structure of ascending lumbar vein(ALV)and iliolumbar veins(ILV),and their relationship with lumbar plexus.Results:ALV and ILV can be found on every sides,which have four variants including separate entry and common entry. The ascending vein and iliolumbar vein separately enter common iliac vein in 18 cases, and as a common stem enter the common iliac vein in 12 cases. Retracting common iliac vein medially both the ascending lumbar and the iliolumbar veins are always at risk of avulsion on exposure of the disc space. The injury of obturator nerve and lumbosacral trunk of lumbar plexus should be avoided.Conclusion:Awareness of these anatomic variation can prevent the hemorrhage and be helpful for the surgeon in performing a careful ligation of these veins before medial retraction of the common iliac vein. Our findings emphasize the need for proper dissection of ALV and ILV before ligature during exposure of the lower lumbar spine.

  15. Less known non-infectious and neuromusculoskeletal system-originated anterolateral neck and craniofacial pain disorders.

    Science.gov (United States)

    Aydil, Utku; Kizil, Yusuf; Köybaşioğlu, Ahmet

    2012-01-01

    Pain syndromes of neuromusculoskeletal origin are not well-known by most of the clinicians working on head and neck area. As a result, most of the patients with these syndromes are either overlooked without having any treatment or they inappropriately have antibiotic treatments or surgical interventions such as dental extractions and tonsillectomies. Better recognition of the pain syndromes of the neck and face region or entities related to neuromusculoskeletal system may result in more appropriate and effective management of such conditions while avoiding unnecessary medical and surgical treatments. In this review, causes, clinical characteristics, diagnostic and treatment modalities of relatively less known craniofacial and neck pain entities including Eagle syndrome, carotidynia, glossopharyngeal neuralgia, superior laryngeal neuralgia, hyoid bone syndrome, acute calcific retropharyngeal tendinitis, temporal tendinitis, thyroid and cricoid cartilage syndromes, and mastoid process syndrome are summarized.

  16. latrogenic brachial artery injury during anterolateral plating of humeral shaft fracture

    Institute of Scientific and Technical Information of China (English)

    Vishal Kumar; Prateek Behera; Sameer Aggarwal; Umesh Kumar Meena

    2013-01-01

    There are several well defined indications for surgical management of humeral shaft fractures.Operative procedures on the humerus are associated with their own complications.Iatrogenic brachial artery injury as a complication of humeral shaft plating has not been reported previously.We report a case of a 48 years old femalewho received operation at a district hospital and was referred to us when the surgeon could not palpate the pulse.CT angiogram showed that there was segmental non-opacification of the brachial artery.There was distal reformation and the thrombosis was decided to be managed conservatively.We believe that the arterial injury was a result ofimproper surgical technique and the segmental block might be due to improper use of plate holding forceps.This case report makes us aware of a rare complication of operative management of humeral shaft fractures and that basic principles of surgery must be always followed to prevent such injuries.

  17. Ultrasound-guided alcohol neurolysis of lateral femoral cutaneous nerve for intractable meralgia paresthetica: a case series.

    Science.gov (United States)

    Ahmed, Arif; Arora, Divesh; Kochhar, Amit Kumar

    2016-11-01

    Meralgia paresthetica is a rare sensory entrapment neuropathy which leads to burning, tingling and numbness in the antero-lateral aspect of thigh. Mostly it runs a benign course, and responds to conservative measures. We present a case series of six patients with intractable meralgia paresthetica with severe pain over antero-lateral thigh along the distribution of lateral cutaneous nerve of thigh which was further confirmed by nerve conduction study. These patients did not respond to the oral anti-neuropathic medications. The two successive diagnostic lateral femoral cutaneous nerve block not only had confirmed the diagnosis but also provided pain relief for a few days. Then the ultrasound-guided lateral femoral cutaneous nerve neurolysis was done using 50% alcohol. In all the patients, there were more than 50% decrease in pain intensity and improvement in quality of life after the procedure, and the relief and improvement were maintained for up to 12 weeks. This case series shows ultrasound-guided lateral femoral cutaneous nerve neurolysis is a safe and effective treatment for intractable meralgia paresthetica and also provides prolonged pain relief and is a good option in avoiding the surgery. Summary points The literature on neurolysis is rare, with only few case reports. This is the first case series on this topic, and it will greatly improve the evidence that ultrasound-guided neurolysis can also be used for intractable meralgia paresthetica patients who do not respond to conservative measures before proceeding to surgery.

  18. Primary reconstruction of skin avulsion injury on both feet%双足皮肤脱套伤的一期修复

    Institute of Scientific and Technical Information of China (English)

    刘勇; 张成进; 付兴茂; 王剑利; 张雪涛; 王蕾; 隋志强

    2014-01-01

    目的 探讨利用双侧股前外侧皮瓣联合胸脐皮瓣或背阔肌肌皮瓣一期修复双足皮肤脱套伤的临床效果.方法 2005年6月至2011年8月共利用双侧股前外侧皮瓣联合胸脐皮瓣或背阔肌肌皮瓣一期修复双足皮肤脱套伤4例.其中切取带股前外侧皮神经的股前外侧皮瓣修复足底,胸脐皮瓣或背阔肌肌皮瓣修复足背.结果 4例双足脱套伤均一期修复,皮瓣存活,术后功能外形良好,随访6个月至2年,足底感觉恢复良好,两点辨距觉为14~18 mm,行走正常.结论 利用双侧股前外侧皮瓣联合胸脐皮瓣或背阔肌肌皮瓣一期修复双足皮肤脱套伤,是一种较好的修复方法.%Objective To investigate the therapeutic effect of primary reconstruction of skin avulsion injury with bilateral anterolateral thigh flaps combined with thorax umbilicus flap or latissimus dorsi flap.Methods From June 2005 to Aug.2011,4 cases with skin avulsion injury on both feet were treated.The bilateral anterolateral thigh flaps,including with anterolateral thigh cutaneous nerves,were transferred to cover the feet plantar.The thorax umbilicus flap or latissimus dorsi flap were used to cover the feet dorsum.Results All the skin avulsion injury were reconstructed primarily.All the flaps survived completely with good cosmetic and functional results.The patients were followed up for 6 months to 2 years with good sensory recovery(two point discrimination:14-18 mm).Conclusion The skin avulsion injury on both feet can be primarily reconstructed by bilateral anterolateral thigh flaps combined with thorax umbilicus flap or latissimus dorsi flap.

  19. 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.  

  20. Meralgia Paresthetica after Prone Positioning Ventilation in the Intensive Care Unit

    DEFF Research Database (Denmark)

    Svendsen Juhl, Christian; Ballegaard, Martin; Bestle, Morten H

    2016-01-01

    Meralgia paresthetica (MP) is a mononeuropathy of the lateral femoral cutaneous nerve (LFCN) caused by external compression of the nerve during its course close to the anterior superior iliac spine. We present a case of a patient with acute respiratory distress induced by Legionella pneumonia who...... was admitted to the intensive care unit (ICU) for mechanical ventilation. In the ICU, the patient received one session of prone position ventilation for 8.5 consecutive hours. At evaluation six months later, the patient reported persistent bilateral numbness of the anterolateral thigh, which he complained had...

  1. L1 radiculopathy mimicking meralgia paresthetica: a case report.

    Science.gov (United States)

    Yang, Seung Nam; Kim, Dong Hwee

    2010-04-01

    L1 radiculopathy is very rare and difficult to diagnose with needle electromyography. A patient presented with pain and hypesthesia on the anterolateral aspect of the left thigh. Nerve conduction studies and needle electromyography were normal, except for the quadratus lumborum and iliopsoas muscles, which showed abnormal spontaneous activity and polyphasic motor unit potentials with reduced recruitment patterns. Magnetic resonance imaging of the lumbar spine showed disc extrusion of the L1-2 intervertebral space with upward migration. This case demonstrates the usefulness of examination of the quadratus lumborum in the diagnosis of L1 radiculopathy.

  2. Thoraco dorsal artery perforator flap for trismus release in a young girl.

    Science.gov (United States)

    Deneuve, Sophie; Qassemyar, Quentin; Blancal, Jean-Philippe; Couloignier, Vincent; Sainte-Rose, Christian; Janot, François; Kolb, Frederic

    2015-11-01

    Trismus is a frequent complication occurring after treatment of tumors of the pterygomaxillary fossa. Local flaps and full-thickness skin grafts fail to release it because they usually lead to scar contracture in previously irradiated tissues. We propose to release it with a thoracodorsal artery perforator flap, which is feasible in children like other perforator flaps. It is interesting because it is thinner than the anterolateral thigh flap and its scar may be less disgraceful and easier to hide. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Reusing of the Failing Free Flap “Nutrient Flap” as Salvage Procedure

    OpenAIRE

    Koji Takahashi, MD; Ching-Hua Hsieh, MD, PhD; Seng-Feng Jeng, MD

    2014-01-01

    Summary: A 26-year-old woman sustained a traffic accident injury to her left medial malleolus. A soft-tissue defect 15 × 7 cm with exposure of bone was found and underwent free anterolateral thigh flap to cover it. On the second postoperative day, venous congestion occurred and re-exploration was performed. Re-anastomosis of the vein was done after the thrombectomy; unfortunately, the flap did not recover. We found there was a good granulation bed under the failing flap and thinned the failin...

  4. Lateral femoral cutaneous nerve transposition: Renaissance of an old concept in the light of new anatomy.

    Science.gov (United States)

    Hanna, Amgad S

    2017-04-01

    Meralgia paresthetica causes pain in the anterolateral thigh. Most surgical procedures involve nerve transection or decompression. We conducted a cadaveric study to determine the feasibility of lateral femoral cutaneous nerve (LFCN) transposition. In three cadavers, the LFCN was exposed in the thigh and retroperitoneum. The two layers of the LFCN canal superficial and deep to the nerve were opened. The nerve was then mobilized medially away from the ASIS, by cutting the septum medial to sartorius. It was possible to mobilize the nerve for 2 cm medial to the ASIS. The nerve acquired a much straighter course with less tension. A new technique of LFCN transposition is presented here as an anatomical feasibility study. The surgical technique is based on the new understanding of the LFCN canal. Clin. Anat. 30:409-412, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  5. Meralgia paresthetica: a result of tight new trendy low cut trousers ('taille basse').

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    Moucharafieh, Ramzi; Wehbe, Joseph; Maalouf, Ghassan

    2008-04-01

    Meralgia paresthetica is an entrapment neuropathy involving the lateral femoral cutaneous nerve of the thigh. Patients complain of a persistent burning sensation, tingling and aching pain, and hypersensitivity or hyposensitivity in the anterolateral aspect of the thigh. Numerous direct and indirect causes for the disease have been suggested in the literature. We present 12 cases that were diagnosed to have meralgia paresthetica due to tight new fashion low cut trousers ('taille basse'). The diagnosis was confirmed by injecting a small amount of a short acting local anesthetic around the lateral femoral cutaneous nerve which alleviated the symptoms for several hours. Electrophysiologic studies were sensitive in 83.3% of the cases. All cases were treated successfully using conservative methods, namely avoiding tight trousers, local steroid infiltration and weight reduction.

  6. Meralgia paresthetica: diagnosis and management strategies.

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    Harney, Donal; Patijn, Jacob

    2007-01-01

    Meralgia paresthetica (MP), coined from the Greek words meros (thigh and algos), meaning pain, is a neurological disorder characterized by a localized area of paresthesia and numbness on the anterolateral aspect of the thigh. The incidence of MP is more common than often reported in the literature. The etiology of MP includes mechanical factors such as obesity, pregnancy, and other conditions associated with increased intrabdominal pressure, surgery of the spine, and pelvic osteotomy. A coherent history and pertinent physical examination is essential in making the diagnosis; however, red flags such as tumor and lumbar disk herniations must be recognized and appropriately treated. While the diagnosis of MP is essentially a clinical diagnosis, sensory nerve conduction velocity studies are a useful adjunctive diagnostic tool. The management of MP includes treating the underlying cause (if any) and conservative management. Surgery should only be adopted when all nonoperative therapies have failed to manage the condition in an effective manner.

  7. Chiropractic management of chronic idiopathic meralgia paresthetica: a case study.

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    Houle, Sébastien

    2012-03-01

    This report describes the case of a patient with chronic idiopathic meralgia paresthetica associated with bilateral sacroiliac joint dysfunction who was managed with chiropractic care. A 35-year-old white woman presented to a private chiropractic clinic with a complaint of numbness in the right anterolateral thigh region. Neurological assessment revealed a diminution of sensibility and discrimination on the right lateral femoral cutaneous nerve territory. Pain was rated as 8.5 on a numeric pain scale of 0 to 10. Musculoskeletal examination of the pelvic region disclosed bilateral sacroiliac joint dysfunction. Chiropractic management included pelvic mobilizations, myofascial therapy, transverse friction massage, and stretching exercises. After 3 visits (2 weeks later), result of neurological evaluation was normal, with no residual numbness over the lateral thigh. In the present case, chiropractic management with standard and applied kinesiology techniques resulted in recovery of meralgia paresthetica symptoms for this patient.

  8. Meralgia paresthetica: what an anesthesiologist needs to know.

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    Hui, Grace K M; Peng, Philip W H

    2011-01-01

    Meralgia paresthetica (MP) is an entrapment pain syndrome of the lateral femoral cutaneous nerve (LFCN) of thigh. Diagnosis is principally made on clinical ground with pain and paresthesia of the anterolateral thigh. Electrophysiological test and nerve block play important roles when the diagnosis is uncertain. Clinicians should be aware of the various etiological factors that can be potentially modified or treated. Most of the patients respond to conservative management including nerve block. Surgical options should be considered in patients refractory to those treatment options. Anesthesiologists are commonly involved in the management of MP because of their expertise in pain management and performance of the LFCN block. Blockade of the LFCN with local anesthetics and steroid serves both the diagnostic and therapeutic role. Copyright © 2011 by American Society of Regional Anesthesia and Pain Medicine

  9. Meralgia paresthetica affecting parturient women who underwent cesarean section -A case report-.

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    Chung, Kum Hee; Lee, Jong Yeon; Ko, Tong Kyun; Park, Chung Hyun; Chun, Duk Hee; Yang, Hyeon Jeong; Gill, Hyun Jue; Kim, Min Ku

    2010-12-01

    Meralgia paresthetica is commonly caused by a focal entrapment of lateral femoral cuteneous nerve while it passes the inguinal ligament. Common symptoms are paresthesias and numbness of the upper lateral thigh area. Pregnancy, tight cloths, obesity, position of surgery and the tumor in the retroperitoneal space could be causes of meralgia paresthetica. A 29-year-old female patient underwent an emergency cesarean section under spinal anesthesia without any problems. But two days after surgery, the patient complained numbness and paresthesia in anterolateral thigh area. Various neurological examinations and L-spine MRI images were all normal, but the symptoms persisted for a few days. Then, electromyogram and nerve conduction velocity test of the trunk and both legs were performed. Test results showed left lateral cutaneous nerve injury and meralgia paresthetica was diagnosed. Conservative treatment was implemented and the patient was free of symptoms after 1 month follow-up.

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

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    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.

  11. Partial rupture of the quadriceps muscle in a child

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    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.

  12. Reliable site for suction blister induction and harvesting

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    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.

  13. Meralgia paresthetica-like symptoms following epidural analgesia after total knee arthroplasty.

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    Shin, H J; Kim, Y H; Lee, H W

    2014-11-01

    Meralgia paresthetica (MP) is generally caused by entrapment of the lateral femoral cutaneous nerve (LFCN), and presents with pain and paresthesia in the anterolateral thigh. This paper describes a patient who had MP-like symptoms as a result of continuous epidural analgesia after total knee arthroplasty. The patient with pre-existing left foraminal stenosis at L3-L4 and disc herniations at L4-5 did not complain of paresthesia or pain during the combined spinal-epidural anesthetic procedure. However, during epidural analgesia on the second post-operative day, he complained of paresthesia and pain in the anterolateral thigh of the contralateral leg. Electromyography showed a neurogenic lesion at the level of L3. Although an ultrasound-guided diagnostic block of the LFCN was performed twice post-operatively, the patient's symptoms persisted. The symptoms gradually resolved 12 months after the surgery. In our case, we suggest that the continuous epidural infusate caused neural ischemia of the L3 nerve root by a compressive effect. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  14. Spinal cord stimulation for treatment of meralgia paresthetica.

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    Barna, Steven A; Hu, M Melvin; Buxo, Carlos; Trella, Jason; Cosgrove, G Rees

    2005-07-01

    Meralgia paresthetica is a clinical syndrome of pain, dysesthesia or both, in the anterolateral thigh. It is associated with an entrapment mononeuropathy of the lateral femoral cutaneous nerve. Diagnosis of meralgia paresthetica is typically made clinically and is based on the characteristic location of pain or dysesthesia, sensory abnormality on exam, and absence of any other neurological abnormality in the leg. The majority of patients with meralgia paresthetica respond well to conservative treatment. To present a case of intractable meralgia paresthetica in which conservative treatment options failed but which was successfully treated with a spinal cord stimulator. A 44-year-old woman presented to the pain clinic with a one-year history of bilateral anterolateral thigh pain. History, physical exam, and diagnostic work-up were consistent with meralgia paresthetica. Multiple medications, physical therapy, and chiropractic therapy were not successful for this patient. In addition, local anesthetic/steroid injection of the lateral femoral cutaneous nerve provided only short-term relief. Ultimately, a spinal cord stimulator was implanted after a successful temporary percutaneous trial. Two months after the implantation, sh