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Sample records for lacerated medial gastrocnemius

  1. ULTRASONOGRAPHIC EVALUATION OF THE RUPTURED MEDIAL HEAD OF GASTROCNEMIUS MUSCLE

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    Damir Lukac

    Full Text Available ABSTRACT Introduction: Tennis leg, a common injury of the medial head of gastrocnemius muscle in the muscle-tendon junction, is usually reported in men during recreational sports. Sudden pain is the main symptom accompanied by the feeling of rupture in the calf. Clinical examination followed by ultrasound is the standard diagnostic procedure. Objective: The main objectives of this study are to compare clinical and ultrasonographic findings in cases of tennis leg, evaluate the location and type of lesion in the medial head of gastrocnemius muscle, and evaluate the edema volume and the presence of deep vein thrombosis (DVT. Second, the healing process was monitored with ultrasound to distinguish the level of recovery and to record the presence of chronic sequelae. Methods: Eighty-one subjects with clinical symptoms of rupture of the medial head of gastrocnemius muscle participated in the study. A linear probe (7-12 MHz was used for ultrasonographic (US and a Doppler was used to verify the presence of DVT. Results: In 78 of 81 subjects examined, we found obvious US changes (96.3% and three of them had no positive findings. In 67 of them, we diagnosed rupture of the medial head of the gastrocnemius muscle. Most of them had partial rupture (73.13% and the remaining had total rupture (26.87%. The edema (30.84% was found in the space between the aponeurosis of the gastrocnemius and soleus muscles. DVT with the clinical signs of tennis leg was observed in 5 of 81 patients (6.17%. Conclusion: Our findings indicate that ultrasound is very important for early diagnosis of muscle-tendon injuries in the leg. In addition, monitoring the healing process and assessing the chosen treatment showed a high efficiency. Ultrasonography is an effective method to identify and differentiate the sequelae of the injured muscles and vascular complications.

  2. Absence of lateral gastrocnemius activity and differential motor unit behavior in soleus and medial gastrocnemius during standing balance.

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    Héroux, Martin E; Dakin, Christopher J; Luu, Billy L; Inglis, John Timothy; Blouin, Jean-Sébastien

    2014-01-15

    In a standing position, the vertical projection of the center of mass passes in front of the ankle, which requires active plantar-flexor torque from the triceps surae to maintain balance. We recorded motor unit (MU) activity in the medial (MG) and lateral (LG) gastrocnemius muscle and the soleus (SOL) in standing balance and voluntary isometric contractions to understand the effect of functional requirements and descending drive from different neural sources on motoneuron behavior. Single MU activity was recorded in seven subjects with wire electrodes in the triceps surae. Two 3-min standing balance trials and several ramp-and-hold contractions were performed. Lateral gastrocnemius MU activity was rarely observed in standing. The lowest thresholds for LG MUs in ramp contractions were 20-35 times higher than SOL and MG MUs (P triceps surae motoneurons.

  3. Diagnosis and Follow-up US Evaluation of Ruptures of the Medial Head of the Gastrocnemius

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    Kwak, Hyo-Sung; Han, Young-Min; Lee, Sang-Yong; Kim, Ki-Nam; Chung, Gyung Ho [Chonbuk National University Medical School, Chonju (Korea, Republic of)

    2006-09-15

    The purpose of this study was to demonstrate the ultrasonographic (US) findings of rupture and the healing process of the medial head of the gastrocnemius ('Tennis Leg'). Twenty-two patients (age range: 30 to 45 years) with clinically suspected ruptures of the medial head of the gastrocnemius were referred to us for US examination. All the patients underwent US of the affected limb and the contralateral asymptomatic limb. Follow-up clinical evaluation and US imaging of all patients were performed at two-week intervals during the month after injury and at one-month intervals during the following six months. Of the 22 patients who had an initial US examination after their injury, partial rupture of the medial head of the gastrocnemius muscle was identified in seven patients (31.8%); the remaining 15 patients were diagnosed with complete rupture. Fluid collection between the medial head of the gastrocnemius and the soleus muscle was identified in 20 patients (90.9%). The thickness of the fluid collection, including the hematoma in the patients with complete rupture (mean: 9.7 mm), was significantly greater than that seen in the patients with partial tear (mean: 6.8 mm) (p < 0.01). The primary union of the medial head of the gastrocnemius with the soleus muscle in all the patients with muscle rupture and fluid collection was recognized via the hypoechoic tissue after four weeks. Ultrasonography is a useful imaging modality for the diagnosis and follow-up examination for the patients suffering with rupture of the medial head of the gastrocnemius.

  4. Application of shear wave elastography for the gastrocnemius medial head to tennis leg.

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    Yoshida, Keiichi; Itoigawa, Yoshiaki; Maruyama, Yuichiro; Saita, Yoshitomo; Takazawa, Yuji; Ikeda, Hiroshi; Kaneko, Kazuo; Sakai, Tatsuo; Okuwaki, Toru

    2017-01-01

    Muscle strain of the gastrocnemius medial head mainly occurs at the musculotendinous junction (MTJ), and stiffness is a risk factor. Shear wave elastography (SWE) measures elasticity by determining the propagation velocity. The aim of this study was to measure the elasticity of the normal muscle and aponeurosis in the MTJ of the gastrocnemius medial head using SWE, thus obtaining information relevant to muscle strain at this point. Forty-one volunteers (82 legs) were recruited and the gastrocnemius medial heads were examined at four points: three on the aponeurosis, namely at the center of the MTJ (Central), 10 mm proximal to it (Proximal) and 10 mm distal to it (Distal); and at one on the muscle belly (Muscle). The measurements were compared among the points, between males and females, and between younger and middle-aged subjects. Correlations between the elastic modulus and age were also examined. The elastic moduli at Proximal, Central, Distal, and Muscle were 2.82 ± 0.53 m/s, 3.43 ± 0.83 m/s, 4.83 ± 1.56 m/s, and 2.25 ± 0.43 m/s, respectively. These values differed significantly among the points of the aponeurosis, Distal having the highest modulus followed by Central. The elastic moduli were significantly greater in males than females at Distal and Muscle and in younger subjects than middle-aged subjects at Muscle. No significant correlations between elastic modulus and age were observed for any point. SWE could be a feasible method for quantifying the elasticity of muscle and aponeurosis in the MTJ of the gastrocnemius medial head. Clin. Anat. 30:114-119, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  5. Efficacy of pedobarographic analysis to evaluate proximal medial gastrocnemius recession in patients with gastrocnemius tightness and metatarsalgia.

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    Vinagre, Gustavo; Alfonso, Matías; Cruz-Morande, Sebastián; Hernández, Miguel; Villas, Carlos

    2017-08-31

    Proximal medial gastrocnemius recession (PMGR) is a surgical procedure performed in patients with gastrocnemius tightness (GT). The purpose of this study is to evaluate the efficacy of pedobarographic analysis on PMGR in patients with GT and metatarsalgia. This prospective study included 52 patients diagnosed with GT treated surgically with PMGR and 49 non-operated upon patients (control group). A total of 55 PMGRs (three bilateral) were performed as an isolated or combined procedure in the treatment group. Passive ankle dorsiflexion with knee flexion and extension was evaluated in all patients. In addition, pedobarographic analysis was performed before and after surgery. Median preoperative ankle dorsiflexion was -10.0° (equinus) with extended knee and 10.0° with flexed knee and postoperative differences in median ankle dorsiflexion was 12.5° (extended knee) (p = 0.000) and 5.0° (flexed knee) (p = 0.002). After the PMGR, the median area of the contact surface (-3.0 cm(2)) (p = 0.009), the maximum (-13,239.0 Pa) (p = 0.019) and mean pressure (-2,942.0 Pa) and the forefoot force (-70.0 N) (p = 0.000) decreased. An increase in hindfoot force (20.0 N), hindfoot bearing time (4.0 ms) (p = 0.005), and forefoot bearing time (1.0 ms) was also observed. Pedobarographic analysis is an efficient tool to evaluate surgical procedures that assess metatarsal overload. PMGR is an effective surgical procedure to improve passive ankle range of motion and decrease forefoot plantar overload.

  6. Force depression decays during shortening in the medial gastrocnemius of the rat.

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    Till, Olaf; Siebert, Tobias; Blickhan, Reinhard

    2014-03-21

    Force depression due to shortening of activated skeletal muscles has previously been described to be long lasting during isometric contractions following the shortening. In the present study, using the medial gastrocnemius of the rat, effects of force depression have been made apparent during shortening by computationally partially compensating for the direct effect of shortening velocity due to the tension-velocity relation. Evidence was found for the decay and complete disappearance of force depression already during continuation of the shortening contraction to short muscle lengths.

  7. Behavior of fascicles and the myotendinous junction of human medial gastrocnemius following eccentric strength training.

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    Duclay, Julien; Martin, Alain; Duclay, Alice; Cometti, Gilles; Pousson, Michel

    2009-06-01

    This study is the first in which measurements of thickness, fascicle angle and length, and tendon elongation were combined to examine the impact of eccentric strength training on both muscle architecture and tendinous structures. Eighteen healthy male subjects were divided into an eccentric strength training group (n = 10) and a control group (n = 8). The training program consisted of 18 sessions of eccentric exercises over a 7-week period. All subjects were tested at baseline and after the last training session. Using ultrasound imaging, the fascicle angle and length and thickness of the medial gastrocnemius (MG) were analyzed at rest (i.e., theta(p), Fl(p), and t(p), respectively), at 50% of maximal voluntary contraction (MVC) (i.e., theta(50), Fl(50), and t(50), respectively), and during MVC (i.e., theta(100), Fl(100), and t(100), respectively). Tendon elongation (TE) was measured by tracking the proximal displacement of the myotendinous junction of the MG during ramp isometric contraction. During ramp isometric contraction, the slope of the load-deformation relationship of the gastrocnemius tendon above 50% MVC was defined as an index of stiffness. After training, muscle thickness and fascicle angle increased significantly at rest and during contraction, whereas fascicle length increased at rest and did not change during contraction. Furthermore, the stiffness of the gastrocnemius tendon increased significantly. The results suggest that the behavior of muscle architecture and tendon mechanical properties are affected differently by strength training.

  8. Gradual mechanics-dependent adaptation of medial gastrocnemius activity during human walking.

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    Wellinghoff, Molly A; Bunchman, Alison M; Dean, Jesse C

    2014-03-01

    While performing a simple bouncing task, humans modify their preferred movement period and pattern of plantarflexor activity in response to changes in system mechanics. Over time, the preferred movement pattern gradually adapts toward the resonant frequency. The purpose of the present experiments was to determine whether humans undergo a similar process of gradually adapting their stride period and plantarflexor activity after a change in mechanical demand while walking. Participants walked on a treadmill while we measured stride period and plantarflexor activity (medial gastrocnemius and soleus). Plantarflexor activity during stance was divided into a storage phase (30-65% stance) and a return phase (65-100% stance) based on when the Achilles tendon has previously been shown to store and return mechanical energy. Participants walked either on constant inclines (0%, 1%, 5%, 9%) or on a variable incline (0-1%) for which they were unaware of the incline changes. For variable-incline trials, participants walked under both single-task and dual-task conditions in order to vary the cognitive load. Both stride period and plantarflexor activity increased at steeper inclines. During single-task walking, small changes in incline were followed by gradual adaptation of storage-phase medial gastrocnemius activity. However, this adaptation was not present during dual-task walking, indicating some level of cognitive involvement. The observed adaptation may be the result of using afferent feedback in order to optimize the contractile conditions of the plantarflexors during the stance phase. Such adaptation could serve to improve metabolic economy but may be limited in clinical populations with disrupted proprioception.

  9. Effective and selective stretching of the medial head of the gastrocnemius.

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    Edama, M; Onishi, H; Kumaki, K; Kageyama, I; Watanabe, H; Nashimoto, S

    2015-04-01

    Muscle injury frequently occurs in the medial head of the gastrocnemius (MG), and stretching is used for treatment. However, there are no studies based on anatomical considerations and biomechanics. This study therefore examined the macroscopic anatomical structure of the triceps surae muscle to design an effective and selective MG stretching method, before quantitatively verifying that method by ultrasonography. The macroscopic anatomy was analyzed in 16 Japanese cadavers (25 legs). Based on the anatomical findings and the arrangement of fascicles in the MG, we concluded that ankle inversion might be advantageous for selective stretching of the tendon fiber bundles into which the MG inserts. We devised a method in which the limb was initially positioned with the knee joint in extension and the ankle joint in plantar flexion. Then, the ankle was dorsiflexed and inverted. The proposed method was compared with standard stretching and verified by ultrasonography in eight healthy adult males. This method effectively and selectively stretched the MG, producing a significantly decreased pennation angle and increased muscle fiber length. This method may be beneficial for preventing future injuries and may enhance the effect of therapy on the MG.

  10. Passive Muscle-Tendon Unit Gearing is Joint Dependent in Human Medial Gastrocnemius

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    Emma F Hodson-Tole

    2016-03-01

    Full Text Available Skeletal muscles change length and develop force both passively and actively. Gearing allows muscle fibre length changes to be uncoupled from those of the whole muscle-tendon unit. During active contractions this process allows muscles to operate at mechanically favorable conditions for power or economical force production. Here we ask whether gearing is constant in passive muscle; determining the relationship between fascicle and muscle-tendon unit length change in the bi-articular medial gastrocnemius and investigating the influence of whether motion occurs at the knee or ankle joint. Specifically, the same muscle-tendon unit length changes were elicited by rotating either the ankle or knee joint whilst simultaneously measuring fascicle lengths in proximal and distal muscle regions using B-mode ultrasound. In both the proximal and distal muscle region, passive gearing values differed depending on whether ankle or knee motion occurred. Fascicle length changes were greater with ankle motion, likely reflecting anatomical differences in proximal and distal passive tendinous tissues, as well as shape changes of the adjacent mono-articular soleus. This suggests that there is joint-dependent dissociation between the mechanical behaviour of muscle fibres and the muscle-tendon unit during passive joint motions that may be important to consider when developing accurate models of bi-articular muscles.

  11. Medial gastrocnemius and soleus muscle-tendon unit, fascicle, and tendon interaction during walking in children with cerebral palsy.

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    Barber, Lee; Carty, Chris; Modenese, Luca; Walsh, John; Boyd, Roslyn; Lichtwark, Glen

    2017-08-01

    This study investigates the in vivo function of the medial gastrocnemius and soleus muscle-tendon units (MTU), fascicles, and tendons during walking in children with cerebral palsy (CP) and an equinus gait pattern. Fourteen children with CP (9 males, 5 females; mean age 10y 6mo, standard deviation [SD] 2y 11mo; GMFCS level I=8, II=6), and 10 typically developing (6 males, 4 females; mean age 10y, SD 2y 1mo) undertook full body 3D gait analysis and simultaneous B-mode ultrasound images of the medial gastrocnemius and soleus fascicles during level walking. Fascicle lengths were analysed using a semi-automated tracking algorithm and MTUs using OpenSim. Statistical parametric mapping (two-sample t-test) was used to compare differences between groups (pwalking is consistent with reduced volume and neuromuscular control of impaired muscle. Reduced ankle push-off power and positive work in the children with CP may be attributed to reduced active medial gastrocnemius fascicle shortening. These findings suggest a reliance on passive force generation for forward propulsion during equinus gait. © 2017 Mac Keith Press.

  12. Within- and between-session reliability of medial gastrocnemius architectural properties

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    JJ McMahon

    2016-05-01

    Full Text Available This study aimed to determine the within- and between-session reliability of medial gastrocnemius (MG architecture (e.g. muscle thickness (MT, fascicle length (FL and pennation angle (PA, as derived via ultrasonography followed by manual digitization. A single rater recorded three ultrasound images of the relaxed MG muscle belly for both legs of 16 resistance trained males, who were positioned in a pronated position with their knees fully extended and the ankles in a neutral (e.g. 90° position. A subset of participants (n = 11 were retested under the same conditions ~48-72 hours after baseline testing. The same rater manually digitized each ultrasound image on three occasions to determine MG MT, FL and PA before pooling the data accordingly to allow for within-image (n = 96, between-image (n = 32 and between-session reliability (n = 22 to be determined. Intraclass correlation coefficients (ICCs demonstrated excellent within-image (ICCs = 0.99-1.00, P < 0.001 and very good between-image (ICCs = 0.83-0.95, P < 0.001 and between-session (ICCs = 0.89- 0.95, P < 0.001 reliability for MT, FL and PA. Between-session coefficient of variation was low (≤ 3.6% for each architectural parameter and smallest detectible difference values of 10.6%, 11.4% and 9.8% were attained for MT, FL and PA, respectively. Manually digitizing ultrasound images of the MG muscle at rest yields highly reliable measurements of its architectural properties. Furthermore, changes in MG MT, FL and PA of ≥ 10.6%, 11.4% and 9.8% respectively, as brought about by any form of intervention, should be considered meaningful.

  13. The effect of temperature on eccentric contraction-induced isometric force loss in isolated perfused rat medial gastrocnemius muscle

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    Vasaghi Gharamaleki B

    2008-09-01

    Full Text Available "nBackground: The typical features of eccentric exercise-induced muscle damage are delayed-onset muscle soreness (DOMS and prolonged loss of muscle strength. It has been shown that passive warmth is effective in reducing muscle injury. Due to the interaction of different systems in vivo, we used isolated perfused medial gastrocnemius skeletal muscle to study the direct effect of temperature on the eccentric contraction-induced force loss. "nMethods: After femoral artery cannulation of a rat, the left medial gastrocnemius muscle was separated and then the entire lower limb was transferred into a prewarmed (35oC chamber. With the chamber temperature at 31, 35 and 39oC before and during eccentric contraction. Isometric force loss was measured after 15 eccentric contractions (N=7-9. "nResults: Maximum contraction force reduction has been used as an index for eccentric contraction-induced force loss. In this study eccentric contraction caused a significant reduction in maximum isometric tension (p<0.01, but no significant difference was seen in isometric force loss at 31oC and 39oC compared with that at 35oC. "nConclusions: Our results suggest that temperature changes before or during eccentric contractions have no effect on eccentric contraction-induced force loss. "nKeywords: Isolated perfused muscle, skeletal muscle, eccentric contractions, isometric force, gastrocnemius muscle, temperature.

  14. PAD patterns of physiologically identified afferent fibres from the medial gastrocnemius muscle.

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    Jiménez, I; Rudomin, P; Solodkin, M

    1988-01-01

    Intracellular recordings were made in the barbiturate-anesthetized cat from single afferent fibres left in continuity with the medial gastrocnemius muscle to document the transmembrane potential changes produced in functionally identified fibres by stimulation of sensory nerves and of the contralateral red nucleus (RN). Fifty five fibres from muscle spindles had conduction velocities above 70 m/s and were considered as from group Ia. Stimulation of group I afferent fibres of the posterior biceps and semitendinosus nerve (PBSt) produced primary afferent depolarization (PAD) in 30 (54%) Ia fibres. Stimulation of the sural (SU) nerve produced no transmembrane potential changes in 39 (71%) group Ia fibres and dorsal root reflex-like activity (DRRs) in 16 (29%) fibres. In 17 out of 28 group Ia fibres (60.7%) SU conditioning inhibited the PAD generated by stimulation of the PBSt nerve. Facilitation of the PBSt-induced PAD by SU conditioning was not seen. Repetitive stimulation of the RN had mixed effects: it produced PAD in 1 out of 8 fibres and inhibited the PAD induced by PBSt stimulation in 2 other fibres. Nine fibres connected to muscle spindles had conduction velocities below 70 m/s and were considered to be group II afferents. No PAD was produced in these fibres by SU stimulation but DRRs were generated in 5 of them. In 23 out of 31 fibres identified as from tendon organs group I PBSt volleys produced PAD. However, stimulation of the SU nerve produced PAD only in 3 out of 34 fibres, no transmembrane potential changes in 30 fibres and DRRs in 1 fibre. The effects of SU conditioning on the PAD produced by PBSt stimulation were tested in 19 Ib fibres and were inhibitory in 12 of them. In 9 of these fibres SU alone produced no transmembrane potential changes. Repetitive stimulation of the RN produced PAD in 3 out of 9 Ib fibres. SU conditioning inhibited the RN-induced PAD. The present findings support the existence of an alternative inhibitory pathway from cutaneous

  15. Correlations and coherence of monopolar EMG-currents of the medial gastrocnemius muscle in proximal and distal compartments

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    Vinzenz eVon Tscharner

    2014-06-01

    Full Text Available The penniform gastrocnemius muscle contains multiple heads in the proximal regions and the aponeuroses are attached to the Achilles tendon. The multiple head structure lead to the assumption that different regions of the muscle must be activated compartment wise. The purpose of this study was to compare the correlation and coherence of EMG-currents within and between proximal and distal compartments of the medial gastrocnemius muscle, which reflect underling synchronization of motor units. It was hypothesized and shown that phase-inverted signals represent a property that discriminates compartments. However, the phase-inverted and non-inverted signals showed values of correlations that were indicative for highly synchronized signals. The correlation increased with the complexity of the task and was higher for the calf-rising movement than while balancing in a tiptoe position. Because the muscle fibers do not span the whole length of the muscles one has to conclude that the MUs were synchronized by synchronizing the various motor nerves. This study shows that it is essential to measure monopolar signals and use non-isometric contractions to observe synchronization of the EMG-signals. One could speculate that compartmental differences can only be observed if more complex movements that generate rotational forces at the knee or ankle are used.

  16. In vivo relationship between pelvis motion and deep fascia displacement of the medial gastrocnemius: anatomical and functional implications.

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    Cruz-Montecinos, Carlos; González Blanche, Alberto; López Sánchez, David; Cerda, Mauricio; Sanzana-Cuche, Rodolfo; Cuesta-Vargas, Antonio

    2015-11-01

    Different authors have modelled myofascial tissue connectivity over a distance using cadaveric models, but in vivo models are scarce. The aim of this study was to evaluate the relationship between pelvic motion and deep fascia displacement in the medial gastrocnemius (MG). Deep fascia displacement of the MG was evaluated through automatic tracking with an ultrasound. Angular variation of the pelvis was determined by 2D kinematic analysis. The average maximum fascia displacement and pelvic motion were 1.501 ± 0.78 mm and 6.55 ± 2.47 °, respectively. The result of a simple linear regression between fascia displacement and pelvic motion for three task executions by 17 individuals was r = 0.791 (P fascia displacement of the MG (r = 0.449, P fasciae in restricting movement in remote zones. © 2015 Anatomical Society.

  17. Characterization of passive elastic properties of the human medial gastrocnemius muscle belly using supersonic shear imaging.

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    Maïsetti, Olivier; Hug, François; Bouillard, Killian; Nordez, Antoine

    2012-04-01

    The passive elastic properties of a muscle-tendon complex are usually estimated from the relationship between the joint angle and the passive resistive torque, although the properties of the different structures crossing the joint cannot be easily assessed. This study aimed to determine the passive mechanical properties of the gastrocnemius medialis muscle (GM) using supersonic shear imaging (SSI) that allows the measurement of localized muscle shear modulus (μ). The SSI of the GM was taken for 7 subjects during passive ankle dorsiflexion at a range of knee positions performed on an isokinetic dynamometer. The relationship between normalized μ and the length of the gastrocnemius muscle-tendon units (GMTU) was very well fitted to an exponential model (0.944knee fully extended was calculated. The μ-length relationship was highly correlated with the force-length (0.964knee extended were similar to that reconstructed from all knee angles and displayed good intra-session reliability (for α, SEM: 9.7 m(-1); CV: 7.5%; ICC: 0.652; for l(0), SEM: 0.002 m; CV: 0.4%; ICC: 0.992). These findings indicate that SSI may provide an indirect estimation of passive muscle force, and highlight its clinical applicability to evaluate the passive properties of mono- and bi-articular muscles.

  18. Corneal Laceration

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    Full Text Available ... Laceration? Corneal Laceration Diagnosis Corneal Laceration Treatment What Is Corneal Laceration? Written By: Daniel Porter Reviewed By: ... A Harrison MD Sep. 01, 2016 The cornea is the clear front window of the eye . A ...

  19. Attenuated Increase in Maximal Force of Rat Medial Gastrocnemius Muscle after Concurrent Peak Power and Endurance Training

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    Furrer, Regula; Jaspers, Richard T.; Baggerman, Hein L.; Bravenboer, Nathalie; Lips, Paul; de Haan, Arnold

    2013-01-01

    Improvement of muscle peak power and oxidative capacity are generally presumed to be mutually exclusive. However, this may not be valid by using fibre type-specific recruitment. Since rat medial gastrocnemius muscle (GM) is composed of high and low oxidative compartments which are recruited task specifically, we hypothesised that the adaptive responses to peak power training were unaffected by additional endurance training. Thirty rats were subjected to either no training (control), peak power training (PT), or both peak power and endurance training (PET), which was performed on a treadmill 5 days per week for 6 weeks. Maximal running velocity increased 13.5% throughout the training and was similar in both training groups. Only after PT, GM maximal force was 10% higher than that of the control group. In the low oxidative compartment, mRNA levels of myostatin and MuRF-1 were higher after PT as compared to those of control and PET groups, respectively. Phospho-S6 ribosomal protein levels remained unchanged, suggesting that the elevated myostatin levels after PT did not inhibit mTOR signalling. In conclusion, even by using task-specific recruitment of the compartmentalized rat GM, additional endurance training interfered with the adaptive response of peak power training and attenuated the increase in maximal force after power training. PMID:23509812

  20. Attenuated Increase in Maximal Force of Rat Medial Gastrocnemius Muscle after Concurrent Peak Power and Endurance Training

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    Regula Furrer

    2013-01-01

    Full Text Available Improvement of muscle peak power and oxidative capacity are generally presumed to be mutually exclusive. However, this may not be valid by using fibre type-specific recruitment. Since rat medial gastrocnemius muscle (GM is composed of high and low oxidative compartments which are recruited task specifically, we hypothesised that the adaptive responses to peak power training were unaffected by additional endurance training. Thirty rats were subjected to either no training (control, peak power training (PT, or both peak power and endurance training (PET, which was performed on a treadmill 5 days per week for 6 weeks. Maximal running velocity increased 13.5% throughout the training and was similar in both training groups. Only after PT, GM maximal force was 10% higher than that of the control group. In the low oxidative compartment, mRNA levels of myostatin and MuRF-1 were higher after PT as compared to those of control and PET groups, respectively. Phospho-S6 ribosomal protein levels remained unchanged, suggesting that the elevated myostatin levels after PT did not inhibit mTOR signalling. In conclusion, even by using task-specific recruitment of the compartmentalized rat GM, additional endurance training interfered with the adaptive response of peak power training and attenuated the increase in maximal force after power training.

  1. Effect of ageing on the force development in tetanic contractions of motor units in rat medial gastrocnemius muscle.

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    Łochyński, Dawid; Kaczmarek, Dominik; Krutki, Piotr; Celichowski, Jan

    2010-09-01

    The purpose of this study was to determine the effect of ageing on the rate of force generation of motor units, and the mechanical efficiency of contraction produced by a doublet discharge. The study was carried out on isolated motor units of rat medial gastrocnemius muscle of young (5-10 mo) and two groups of old (24-25 and 28-30 mo) Wistar rats. Motor units were classified into the fast fatigable (FF), fast resistant (FR) and slow (S) ones. The force output and rate of force development were determined for non-doublet unfused tetanic contractions evoked by a series of a constant-rate trains of pulses and corresponding doublet contractions starting with an initial brief interpulse interval of 5 ms, and for maximal tetanic contraction. In FF motor units the rate of force development and the force produced by the doublet discharge increased transiently at the age of 24-25 mo, while in S and FR motor units this increase was observed at the age of 28-30 mo. Age-related decrease in the rate of force development of skeletal muscle cannot be attributed to a decline in efficiency of force production by functioning motor units.

  2. Contractile behavior of the medial gastrocnemius in children with bilateral spastic cerebral palsy during forward, uphill and backward-downhill gait.

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    Hösl, Matthias; Böhm, Harald; Arampatzis, Adamantios; Keymer, Antonia; Döderlein, Leonhard

    2016-07-01

    Plantarflexor tightness due to muscle degenerations has been frequently documented in children with spastic cerebral palsy but the contractile behavior of muscles during ambulation is largely unclear. Especially the adaptability of gastrocnemius muscle contraction on sloped surface could be relevant during therapy. Medial gastrocnemius contractions were measured during flat-forward, uphill (+12% incline) and backward-downhill (-12% decline) treadmill gait in 15 children with bilateral cerebral palsy, walking in crouch, and 17 typically developing controls (age: 7-16years) by means of ultrasound and motion analysis. Tracked fascicle and calculated series elastic element length during gait were normalized on seated rest length. Additionally electromyography of the medial gastrocnemius, soleus and tibialis anterior was collected. During forward gait spastic gastrocnemii reached 10% shorter relative fascicle length, 5% shorter series elastic element length and showed 37% less concentric fascicle excursion than controls. No difference in eccentric fascicle excursion existed. Uphill gait increased concentric fascicle excursion in children with cerebral palsy and controls (by 23% and 41%) and tibialis anterior activity during swing (by 33% and 48%). Backward downhill gait more than doubled (+112%) eccentric fascicle excursion in cerebral palsy patients. Apart from having innately shorter fascicles at rest, flat-forward walking showed that spastic gastrocnemius fascicles work at shorter relative length than those of controls. Uphill gait may be useful to concentrically train push-off skills and foot lift. During backward-downhill gait the gastrocnemius functions as a brake and displays more eccentric excursion which could potentially stimulate sarcomere-genesis in series with repeated training. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Evidence for restricted central convergence of cutaneous afferents on an excitatory reflex pathway to medial gastrocnemius motoneurons.

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    LaBella, L A; McCrea, D A

    1990-08-01

    1. We previously reported that excitatory postsynaptic potentials (EPSPs) produced by low-threshold electrical stimulation of the caudal cutaneous sural nerve (CCS) occur preferentially and with the shortest central latencies in the medial gastrocnemius (MG) portion of the triceps surae motor nuclei. The present study employs the spatial facilitation technique to assess interneuronal convergence on the short-latency excitatory pathway from CCS to MG by several other ipsilateral hindlimb afferents [the lateral cutaneous sural (LCS), caudal cutaneous femoral (CCF), saphenous (SAPH), superficial peroneal (SP), posterior tibial (TIB), and posterior articular (Joint) nerves]. 2. Spatial facilitation of CCF EPSPs in MG motoneurons was demonstrated with conditioning stimulation of the LCS, CCF, SAPH, SP, and TIB nerves, but was most readily and consistently observed with CCF conditioning. Facilitation of CCS and CCF EPSPs was obtained in individual MG motoneurons with a wide range of condition-test intervals. 3. CCF EPSPs in MG motoneurons produced by twice threshold (2T) afferent stimulation had a mean latency of 4.8 ms and often appeared as slowly rising, asynchronous potentials. On the other hand, 2T CCS EPSPs had a mean latency of 2.8 ms and appeared as sharper rising, less variable depolarizations. The optimum condition-test interval for facilitation of CCS and CCF EPSPs was found to be 5.2 ms on average, with CCS stimulation delayed from that of CCF. The longer latency of CCF EPSPs and the finding that the minimum condition-test interval was on the order of 3.9 ms suggests that convergence occurs late in the excitatory CCF pathway to MG motoneurons. 4. Convergence between excitatory pathways to MG from CCF and CCS afferents is discussed with regard to the original observations of Hagbarth on the location of cutaneous receptive fields and excitation of ankle extensors. In addition, evidence for the segregation of these specialized reflex pathways from those involved

  4. Differential displacement of the human soleus and medial gastrocnemius aponeuroses during isometric plantar flexor contractions in vivo.

    Science.gov (United States)

    Bojsen-Møller, Jens; Hansen, Philip; Aagaard, Per; Svantesson, Ulla; Kjaer, Michael; Magnusson, S Peter

    2004-11-01

    The human triceps surae muscle-tendon complex is a unique structure with three separate muscle compartments that merge via their aponeuroses into the Achilles tendon. The mechanical function and properties of these structures during muscular contraction are not well understood. The purpose of the study was to investigate the extent to which differential displacement occurs between the aponeuroses of the medial gastrocnemius (MG) and soleus (Sol) muscles during plantar flexion. Eight subjects (mean +/- SD; age 30 +/- 7 yr, body mass 76.8 +/- 5.5 kg, height 1.83 +/- 0.06 m) performed maximal isometric ramp contractions with the plantar flexor muscles. The experiment was performed in two positions: position 1, in which the knee joint was maximally extended, and position 2, in which the knee joint was maximally flexed (125 degrees ). Plantarflexion moment was assessed with a strain gauge load cell, and the corresponding displacement of the MG and Sol aponeuroses was measured by ultrasonography. Differential shear displacement of the aponeurosis was quantified by subtracting displacement of Sol from that of MG. Maximal plantar flexion moment was 36% greater in position 1 than in position 2 (132 +/- 20 vs. 97 +/- 11 N.m). In position 1, the displacement of the MG aponeurosis at maximal force exceeded that of the Sol (12.6 +/- 1.7 vs. 8.9 +/- 1.5 mm), whereas in position 2 displacement of the Sol was greater than displacement of the MG (9.6 +/- 1.0 vs. 7.9 +/- 1.2 mm). The amount and "direction" of shear between the aponeuroses differed significantly between the two positions across the entire range of contraction, indicating that the Achilles tendon may be exposed to intratendinous shear and stress gradients during human locomotion.

  5. Medial Gastrocnemius Myotendinous Junction Displacement and Plantar-Flexion Strength in Patients Treated With Immediate Rehabilitation After Achilles Tendon Repair.

    Science.gov (United States)

    De la Fuente, Carlos I; Lillo, Roberto Peña Y; Ramirez-Campillo, Rodrigo; Ortega-Auriol, Pablo; Delgado, Mauricio; Alvarez-Ruf, Joel; Carreño, Gabriel

    2016-12-01

    Pathologic plantar flexion frequently occurs after operative repair of the Achilles tendon (AT) because of immobilization and non-weight bearing in the first weeks of traditional rehabilitation. Novel rehabilitation strategies that apply mobilization and weight bearing have been proposed, but their effects on medial gastrocnemius myotendinous junction displacement (MJD) and isometric plantar-flexion strength (PFS) are unknown. To compare the effects of 12 weeks of immediate versus traditional rehabilitation on MJD and PFS in patients with percutaneous AT repair and to compare AT rupture scores (ATRSs) during follow-up. Controlled laboratory study. Human performance laboratory. A total of 26 amateur soccer players (age = 42.3 ± 9.7 years, body mass index = 29.5 ± 3.9 kg/m(2)) with percutaneous AT repair. Athletes were randomly divided into 2 groups: an immediate group, given physical therapy from day 1 to day 84, and a traditional group, given physical therapy from day 29 to day 84. We used repeated-measures analysis of variance to compare the data. We measured MJD and PFS at days 28 (fourth week), 56 (eighth week), and 84 (12th week) after AT repair. After 12 weeks of rehabilitation, we observed a large clinically meaningful effect and statistical difference between groups. At day 28, the immediate group showed higher values for PFS (P = .002), MJD (P = .02), and ATRS (P = .002) than the traditional group. At day 56, the immediate group presented higher values for MJD (P = .02) and ATRS (P = .009). At day 84, the immediate group registered more MJD (P = .001). Compared with traditional rehabilitation, 12 weeks of immediate rehabilitation after percutaneous AT repair resulted in better MJD, PFS, and ATRS after 4 weeks; better MJD and ATRS after 8 weeks; and better MJD after 12 weeks.

  6. Corneal Laceration

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    Full Text Available ... by something sharp flying into the eye. It can also be caused by something striking the eye ... If the corneal laceration is deep enough it can cause a full thickness laceration. This is when ...

  7. Corneal Laceration

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    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration ... Laceration Treatment What Is Corneal Laceration? Leer en Español: ¿Qué Es una Laceración de la Córnea? Written ...

  8. Measures of ''fastness'' : Force profiles of twitches and partly fused contractions in rat medial gastrocnemius and tibialis anterior muscle units

    NARCIS (Netherlands)

    Bakels, R; Kernell, D

    1995-01-01

    Recordings of isometric force were obtained for twitches and (sub)maximal tetani of gastrocnemius medialis (MG) and tibialis anterior (TA) muscle units in female Wistar rats. We assessed the relationships between unit properties that have all been associated with ''speed''. (1) the relative degree o

  9. Evaluation of elbow flexion following free muscle transfer from the medial gastrocnemius or transfer from the latissimus dorsi, in cases of traumatic injury of the brachial plexus

    Directory of Open Access Journals (Sweden)

    Frederico Barra de Moraes

    2015-12-01

    Full Text Available ABSTRACT OBJECTIVE: To compare the gain in elbow flexion in patients with traumatic injury of the brachial plexus following muscle transfer from latissimus dorsi with the gain following free muscle transfer from the medial belly of the gastrocnemius. METHODS: This was a retrospective study in which the medical files of a convenience sample of 13 patients operated between 2000 and 2010 were reviewed. Group 1 comprised seven patients who underwent transfers from the gastrocnemius and group 2 (controls comprised six patients who underwent transfers from the latissimus dorsi. The following functions were evaluated: (1 range of motion (ROM of elbow flexion, in degrees, using manual goniometry and (2 grade of elbow flexion strength, using a muscle strength scale. Satisfactory results were defined as: (1 elbow flexion ROM ≥ 80° and (2 elbow flexion strength ≥ M3. The Fisher exact and Kruskal-Wallis tests were used (p < 0.05. RESULTS: The patients' mean age was 32 years (range: 17-56 and 72% had been involved in motorcycle accidents. Elbow flexion strength ≥ M3 was observed in seven patients (100% in group 1 and in five patients (83.3% in group 2 (p = 0.462. None of the patients presented M5, and one patient (16.7% in group 2 had a poor result (M2. Elbow flexion ROM with a gain ≥ 80° (daily functions was found in six patients (86% in group 1 and in three patients (50% in group 2 ( p = 0.1. CONCLUSION: The patients in group 1 had greater gains in strength and ROM than did those in group 2, but without statistical significance. Thus, transfers from the gastrocnemius become a new surgical option, if other techniques cannot be used.

  10. Corneal Laceration

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    Full Text Available ... Health Find an Ophthalmologist Academy Store Eye Health A-Z Symptoms Glasses & Contacts Tips & Prevention News Ask ... Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration Sections What Is Corneal Laceration? ...

  11. Corneal Laceration

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    Full Text Available ... Health Find an Ophthalmologist Academy Store Eye Health A-Z Symptoms Glasses & Contacts Tips & Prevention News Ask ... Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration Sections What Is Corneal Laceration? ...

  12. Medial gastrocnemius muscle growth during adolescence is mediated by increased fascicle diameter rather than by longitudinal fascicle growth.

    Science.gov (United States)

    Weide, Guido; Huijing, Peter A; Maas, Josina C; Becher, Jules G; Harlaar, Jaap; Jaspers, Richard T

    2015-06-01

    Using a cross-sectional design, the purpose of this study was to determine how pennate gastrocnemius medialis (GM) muscle geometry changes as a function of adolescent age. Sixteen healthy adolescent males (aged 10-19 years) participated in this study. GM muscle geometry was measured within the mid-longitudinal plane obtained from a 3D voxel-array composed of transverse ultrasound images. Images were taken at footplate angles corresponding to standardised externally applied footplate moments (between 4 Nm plantar flexion and 6 Nm dorsal flexion). Muscle activity was recorded using surface electromyography (EMG), expressed as a percentage of maximal voluntary contraction (%MVC). To minimise the effects of muscle excitation, EMG inclusion criteria were set at muscle (belly) length increased due to an increase in the length component of the physiological cross-sectional area measured within the mid-longitudinal plane. No difference was found between fascicles at different ages, but the aponeurosis length and pennation angle increased by 0.5 cm year(-1) and 0.5° per year, respectively. Footplate angles corresponding to externally applied 0 and 4 Nm plantarflexion moments were not associated with different adolescent ages. In contrast, footplate angles corresponding to externally applied 4 and 6 Nm dorsal flexion moments decreased by 10° between 10 and 19 years. In conclusion, we found that in adolescents' pennate GM muscles, longitudinal muscle growth is mediated predominantly by increased muscle fascicle diameter. © 2015 Anatomical Society.

  13. Corneal Laceration

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    Full Text Available ... Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide ... What Is Corneal Laceration? Leer en Español: ¿Qué ...

  14. Corneal Laceration

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    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... Dangerous for Your Eyes Sep 20, 2017 Eye Injuries from Laundry Packets On the Rise Jun 30, ...

  15. Corneal Laceration

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    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... 27, 2015 Dark Spot in Vision After Blunt Trauma Dec 21, 2014 Pain a Year After Eyelid ...

  16. Corneal Laceration

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    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... and preserving your vision. Privacy Policy Related Eye Injuries from Laundry Packets On the Rise Jun 30, ...

  17. Corneal Laceration

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    Full Text Available ... Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide ... What Is Corneal Laceration? Written By: Daniel Porter ...

  18. Corneal Laceration

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    Full Text Available ... By: Devin A Harrison MD Sep. 01, 2017 The cornea is the clear front window of the eye . A corneal laceration is a cut on the cornea. It is usually caused by something sharp ...

  19. Corneal Laceration

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    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... 27, 2015 Dark Spot in Vision After Blunt Trauma Dec 21, 2014 Pain a Year After Eyelid ...

  20. Estudo anatômico do músculo gastrocnêmio medial visando transferência muscular livre funcional Anatomical study of the medial gastrocnemius muscle for functional free muscle transfer

    Directory of Open Access Journals (Sweden)

    Frederico Barra de Moraes

    2007-08-01

    Full Text Available Poucos são os trabalhos em que o músculo gastrocnêmio medial (MGM foi estudado profundamente em sua anatomia ou foi utilizado a distância como músculo livre para transferência funcional. OBJETIVOS: Os autores apresentam os resultados da dissecção do MGM e seu feixe vasculonervoso, particularmente sua inervação, com o objetivo de contribuir anatomicamente com seu estudo. MÉTODOS: Foram dissecadas 40 peças englobando o joelho e perna (20 à direita e 20 à esquerda, de 40 cadáveres adultos (26 masculinos e 14 femininos, 20 fixados em formaldeído e 20 frescos. Foi realizado estudo anatômico detalhado avaliando o padrão de distribuição, trajeto, número e comprimento da inervação do MGM. RESULTADOS: Foi observado que em 95% dos casos o nervo sural medial é um ramo motor único, de comprimento médio de 3,29cm. Pode-se ganhar em média 1,66cm de extensão ao se dissecar o epineuro, separando-o do nervo poplíteo medial. CONCLUSÃO: O MGM dispõe de um feixe vasculonervoso com irrigação e inervação terminal, o que torna possível a sua transferência muscular livre funcional para membros superiores e não somente como retalho local em membros inferiores.There are not many papers in which the anatomy of the medial gastrocnemius muscle (MGM was studied in depth or in which the medial gastrocnemius muscle was used remotely as free muscle for functional transfer. OBJECTIVES: The authors present the results of dissecting the MGM and its neurovascular bundle, the innervation in particular, with the purpose of making an anatomical contribution to the study. METHODS: 40 specimens were dissected, including knee joint and leg (20 right legs and 20 left legs of 40 adult cadavers (26 male and 14 female, 20 fixated with formaldehyde and 20 fresh cadavers. A detailed anatomical study was performed to evaluate the standard distribution, the pathway, the number, and the length of MGM innervation. RESULTS:In 95% of the cases, the medial sural

  1. 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.

  2. The contractile properties of the medial gastrocnemius motor units innervated by L4 and L5 spinal nerves in the rat.

    Science.gov (United States)

    Celichowski, Jan; Taborowska, Malwina

    2011-01-01

    When a muscle innervation originates from more than one spinal cord segment, the injury of one of the respective ventral roots evokes an overload, and alters the activity and properties of the remaining motor units. However, it is not well documented if the three types of motor units are equally represented within the innervating ventral roots. Single motor units in the rat medial gastrocnemius muscle were studied and their contractile properties as well as distribution of different types of motor units belonging to subpopulations innervated by axons in L4 and L5 ventral roots were analyzed. The composition of the three physiological types of motor units in the two subpopulations was similar. Force parameters were similar for motor units belonging to the two subpopulations. However, the twitch time parameters were slightly longer in L4 in comparison to L5 motor units although the difference was significant only for fast resistant to fatigue motor units. The force-frequency relationships in the two subpopulations of motor units were not different. Concluding, the two subpopulations of motor units in the studied muscle differ in the number of motor units, but contain similar proportions of the three physiological types of these units and their contractile properties are similar. Therefore, the injury of one ventral root evokes various degrees of muscle denervation, but is non-selective in relation to the three types of motor units.

  3. Effect of Transducer Orientation on Errors in Ultrasound Image-Based Measurements of Human Medial Gastrocnemius Muscle Fascicle Length and Pennation.

    Science.gov (United States)

    Bolsterlee, Bart; Gandevia, Simon C; Herbert, Robert D

    2016-01-01

    Ultrasound imaging is often used to measure muscle fascicle lengths and pennation angles in human muscles in vivo. Theoretically the most accurate measurements are made when the transducer is oriented so that the image plane aligns with muscle fascicles and, for measurements of pennation, when the image plane also intersects the aponeuroses perpendicularly. However this orientation is difficult to achieve and usually there is some degree of misalignment. Here, we used simulated ultrasound images based on three-dimensional models of the human medial gastrocnemius, derived from magnetic resonance and diffusion tensor images, to describe the relationship between transducer orientation and measurement errors. With the transducer oriented perpendicular to the surface of the leg, the error in measurement of fascicle lengths was about 0.4 mm per degree of misalignment of the ultrasound image with the muscle fascicles. If the transducer is then tipped by 20°, the error increases to 1.1 mm per degree of misalignment. For a given degree of misalignment of muscle fascicles with the image plane, the smallest absolute error in fascicle length measurements occurs when the transducer is held perpendicular to the surface of the leg. Misalignment of the transducer with the fascicles may cause fascicle length measurements to be underestimated or overestimated. Contrary to widely held beliefs, it is shown that pennation angles are always overestimated if the image is not perpendicular to the aponeurosis, even when the image is perfectly aligned with the fascicles. An analytical explanation is provided for this finding.

  4. Laceration Management.

    Science.gov (United States)

    Mankowitz, Scott L

    2017-08-25

    Traumatic lacerations to the skin represent a fairly common reason for seeking emergency department care. Although the incidence of lacerations has decreased over the past decades, traumatic cutaneous lacerations remain a common reason for patients to seek emergency department care. Innovations in laceration management have the potential to improve patient experience with this common presentation. Studies have confirmed that delays in wound closure rarely confer increased rates of infection, although comorbidities such as diabetes, chronic renal failure, obesity, human immunodeficiency virus, smoking, and cancer should be considered. Antibiotics should be reserved for high-risk wounds, such as those with comorbidities, gross contamination, involvement of deeper structures, stellate wounds, and selected bite wounds. Topical anesthetics, which are painless to apply, have a role in select populations. In most studies, absorbable sutures perform similarly to nonabsorbable sutures and do not require revisit for removal. Novel atraumatic closure devices and expanded use of tissue adhesives for wounds under tension further erode the primacy of regular sutures in wound closure. Maintaining a moist wound environment with occlusive dressings is more important than previously thought. Most topical wound agents are of limited benefit. Recent innovations in wound closure are allowing emergency physicians to shift toward painless, atraumatic, and rapid closure of lacerations. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Estudo anatômico das artérias perfurantes do músculo gastrocnêmio medial Anatomical study of perforator arteries of the medial gastrocnemius muscle

    Directory of Open Access Journals (Sweden)

    Diogo Mesquita Rebouças

    2008-04-01

    Full Text Available OBJETIVOS: Os autores apresentam os resultados da dissecção do feixe vascular do músculo gastrocnêmio medial (MGM e de suas artérias perfurantes, com o objetivo de contribuir anatomicamente para seu estudo. MÉTODOS: Foram dissecadas 13 peças englobando o joelho e perna (oito à direita e cinco à esquerda, de 13 cadáveres adultos (oito masculinos e cinco femininos, todos frescos. Foi realizado estudo anatômico e radiológico detalhado avaliando o padrão de distribuição, trajeto, número e comprimento da irrigação do MGM e de suas artérias perfurantes. RESULTADO: Foi observado que a artéria sural medial (ASM divide-se em dois troncos intramusculares principais (medial e lateral e que em 90% dos casos as perfurantes provêm do tronco lateral. Em 38,5% dos casos, foi identificada uma perfurante, ao passo que duas perfurantes são observadas em 46,1% dos casos. Todas as artérias perfurantes estavam entre 5,7cm e 14,0cm da prega poplítea e entre 16,5cm e 34,0cm do maléolo medial. CONCLUSÃO: A irrigação do MGM pela ASM e suas artérias perfurantes faz-se adequada para sua utilização como retalho miocutâneo no membro inferior.OBJECTIVES: The authors present the results of dissecting the vascular bundle of the medial gastrocnemius muscle (MGM and its perforating arteries with the purpose of giving their contribution to anatomical studies. METHODS: 13 pieces of knee and leg (eight right and five left of 13 fresh adult cadavers (eight male and five female to evaluate the distribution, path, number and length of irrigation of the MGM and its perforating arteries. RESULTS: They observed that the medial sural artery (ASM is divided into two main intramuscular branches (medial and lateral, and in 90% of the cases, the perforating arteries come from the lateral branch. In 38.5% of the cases, they identified one perforating artery, and two perforating arteries were seen in 46.1% of the cases. All of the perforating arteries were at a

  6. Corneal Laceration

    Science.gov (United States)

    ... drugs. These drugs thin the blood and may increase bleeding. After you have finished protecting the eye, see a physician immediately. Next Corneal Laceration Symptoms Related Ask an Ophthalmologist Answers I lost sight from a corneal scar as a child. Now that I’m older, ...

  7. Corneal Laceration

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    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration ... After Eyelid Scratch Jul 28, 2014 Leer en Español: ¿Qué Es una Laceración de la Córnea? Find ...

  8. Estimation of the error between experimental tetanic force curves of MUs of rat medial gastrocnemius muscle and their models by summation of equal successive contractions.

    Science.gov (United States)

    Raikova, Rositsa; Aladjov, Hristo; Krutki, Piotr; Celichowski, Jan

    2016-01-01

    More accurate muscle models require appropriate modelling of individual twitches of motor units (MUs) and their unfused tetanic contractions. It was shown in our previous papers, using a few MUs, that modelling of unfused tetanic force curves by summation of equal twitches is not accurate, especially for slow MUs. The aim of this study was to evaluate this inaccuracy using a statistical number of MUs of the rat medial gastrocnemius muscle (15 of slow, 15 of fast resistant and 15 of fast fatigable type). Tetanic contractions were evoked by trains of 41 stimuli at random interpulse intervals and different mean frequencies, resembling discharge patterns observed during natural muscle activity. The tetanic curves were calculated by the summation of equal twitches according to the respective experimental patterns. The previously described 6-parameter analytical function for twitch modelling was used. Comparisons between the experimental and the modelled curves were made using two coefficients: the fit coefficient and the area coefficient. The errors between modelled and experimental tetanic forces were substantially different between the three MU types. The error was the most significant for slow MUs, which develop much higher forces in real contractions than could be predicted based on the summation of equal twitches, while the smallest error was observed for FF MUs--their recorded tetanic forces were similar to those predicted by modelling. The obtained results indicate the importance of the inclusion of the type-specific non-linearity in the summation of successive twitch-like contractions of MUs in order to increase the reliability of modelling skeletal muscle force.

  9. Intramuscular nerve damage in lacerated skeletal muscles may direct the inflammatory cytokine response during recovery.

    Science.gov (United States)

    Pereira, Barry P; Tan, Bee Leng; Han, Hwan Chour; Zou, Yu; Aung, Khin Zarchi; Leong, David T

    2012-07-01

    The expression of inflammatory cytokines and growth factors in surgically repaired lacerated muscles over a 12-week recovery phase was investigated. We hypothesized that these expression levels are influenced by both neural and muscular damage within lacerated muscles. Microarrays were confirmed with reverse transcription-polymerase chain reaction assays and histology of biopsies at the lesion of three simulated lacerated muscle models in 130 adult rats. The lacerated medial gastrocnemius with the main intramuscular nerve branch either cut (DN), crushed but leaving an intact nerve sheath (RN); or preserved intact (PN) were compared. At 4 weeks, DN had a higher number of interleukins up-regulated. DN and RN also had a set of Bmp genes significantly expressed between 2 and 8 weeks (P ≤ 0.05). By 12 weeks, DN had a poorer and slower myogenic recovery and greater fibrosis formation correlating with an up-regulation of the Tgf-β gene family. DN also showed poorer re-innervation with higher mRNA expression levels of nerve growth factor (Ngf) and brain-derived neurotrophin growth factor (Bdnf) over RN and PN. This study demonstrates that the inflammatory response over 12 weeks in lacerated muscles may be directed by the type of intramuscular nerve damage, which can influence the recovery at the lesion site. Inflammatory-related genes associated to the type of intramuscular nerve damage include Gas-6, Artemin, Fgf10, Gdf8, Cntf, Lif, and Igf-2. qPCR also found up-regulation of Bdnf (1-week), neurotrophin-3 (2w), Lif (4w), and Ngf (4w, 8w) mRNA expressions in DN, making them possible candidates for therapeutic treatment to arrest the poor recovery in muscle lacerations (250).

  10. Self-reinnervated cat medial gastrocnemius muscles. II. analysis of the mechanisms and significance of fiber type grouping in reinnervated muscles.

    Science.gov (United States)

    Rafuse, V F; Gordon, T

    1996-01-01

    1. The technique of glycogen depletion was used to determine whether regenerating motor axons reestablish the normal regionalization of motor units (MUs) in the cat medial gastrocnemius (MG) muscle, 2) whether the extent of clumping between MU fibers and/or type grouping of muscle fibers progressively increases with a decrease in reinnervated MU numbers, and 3) whether the pattern of innervation can explain why MUs fail to increase significantly in size when the cut nerve is sutured directly to the muscle, even when few axons make functional connections. 2. Distributions of MU fibers were analyzed in 5 normal and 14 reinnervated cat MG muscles 4.5-16 mo after sectioning of its nerve and suturing of the proximal end to the distal nerve sheaths (N-N suture) or directly to the muscle fascia (N-M suture). Muscle unit distributions were quantified according to location, territory size, density, and extent of clumping between fibers from the same MU. 3. Normal MU fibers were regionalized within five regions along the muscle's longitudinal and transverse axes. Reinnervated MUs were located within similar regions, indicating that regenerating axons follow the major proximal nerve branches to restore normal compartmentalization. 4. Muscle unit fibers were diffusely scattered within discrete MU territories in normal muscles. Territory size tended to increase with MU size, whereas density of muscle unit fibers within the territory decreased. 5. Territories increased with MU size after N-N suture but were smaller and showed little size variation after N-M suture. The extent of muscle unit fiber clumping was inversely related to the number of reinnervated MUs. On average, the extent of clumping was substantially higher in muscles reinnervated after N-M suture. These results indicate that distal nerve sheaths facilitate proximal axon branching, which establishes MU territory size. Once the territory is established, motor axons branch distally to increase MU size, which in turn

  11. 腓肠肌内侧头肌瓣在胫骨近端骨肉瘤保肢术中的应用%Medial head gastrocnemius muscle flap in the limb-salvage operation for proximal tibial osteosarcoma

    Institute of Scientific and Technical Information of China (English)

    刘傥; 张庆; 张湘生; 黎志宏; 沈奕; 郭晓柠; 凌林

    2012-01-01

    Objective: To evaluate the efficacy of transposition of the medial gastrocnemius muscle flap in the limb-salvage operation for proximal tibial osteosarcoma. Methods: From January 2000 to January 2010, 65 patients [37 males, 28 females; (17.O±6.5) years] suffering from the proximal tibial osteosarcoma had a limb-salvage operation. According to the Enneking staging system, 35 patients were in stage II a, 30 in stage II b. All of the patients underwent resection of the osteosarcomas and reconstruction of the bone defect by prothesis. Among them, there were 35 patients underwent the medial head of the gastrocnemius muscle flap transposition to reconstruct the soft tissues and the other 30 didn't. Results: All the patients were followed-up. In the group with the transposition of medial gastrocnemius muscle flap, the length of tumor bone resection was (13.5±4.2) cm, operation time was (15O±45) min, intraoperative blood loss was (700±135) mL, and drainage volume was (500±200) mL. In the group without the transposition of medial gastrocnemius muscle flap, the length of tumor bone resection was (12.3±5.8) cm, operation time was (13S±37) min, intraoperative blood loss was (6001105) mL, and drainage volume was (450±250) mL. There was significant difference in the operation time (P0.05). In the group with the transposition of medial gastrocnemius muscle flap, local skin necrosis occurred in 2 patients (5.7%), and prosthesis deep infection occurred in 1 (2.9%). In the group without the transposition of medial gastrocnemius muscle flap, subctaneous hematocele, and effusion occurred in 3 (10.0%), wound infection occurred in 4 (13.3%), 1 cured and the other 3 developed prosthesis deep infectioalhere was significant difference in the rate of local complications (P<0.05). According to the function assessment by the Enneking system, in the group with the transposition of medial gastrocnemius muscle flap, 13 patients had excellent results, 17 had good results, 3 had fair

  12. The medial gastrocnemius muscle with an achilles tendon sheath extension flap as a versatile myo-tendon sheath flap for coverage of the upper two-thirds of the tibia and pre-tibial area: a preliminary report.

    Science.gov (United States)

    Elghamry, Ashraf Hussein

    2014-02-01

    The idea of using the leg tendon sheath as a pedicled fascial flap was first described by the author in April 2003. To extend this new idea, the author studied the blood supply and gross features of the outer layer of the Achilles tendon sheath. The findings of that study supported the feasibility of using the medial gastrocnemius muscle with an Achilles tendon sheath extension flap to cover defects over the upper two-thirds of the tibia. Six flaps of the Achilles tendon sheath survived, and the split skin grafts over the tibia took; but, in one flap, the distal 1 cm was lost. The length of follow-up was 3 years for all cases. The results demonstrated safe elevation of up to 8 cm of distal extension.

  13. Colgajo de avance en V-Y de gastrocnemio medial basado en perforante para cierre de defectos del tercio medio de la pierna V-Y advancement gastrocnemius perforant based flap for closure of defects of the medial third of the leg

    Directory of Open Access Journals (Sweden)

    V. Spröhnle

    2010-06-01

    Full Text Available Los colgajos de avance en V-Y han sido una alternativa popular para el cierre de heridas profundas, pero su movilidad es limitada. Los colgajos basados en perforantes son especialmente útiles cuando se necesita un mayor avance y cobertura. Diseñamos un colgajo de gastrocnemio que utiliza ambas técnicas para cubrir los defectos del tercio medio y superior de la pierna en sus caras lateral y posterolateral. Evaluamos en forma retrospectiva 5 pacientes con heridas en el tercio medio y superior de la pierna, tratados entre enero de 2005 y septiembre de 2007 en un solo centro y por un mismo cirujano. Todos fueron varones, con un promedio de edad de 48 años y la etiología fue traumática en todos los casos. El vaso perforante se evaluó preoperatoriamente por medio de doppler color en todos los casos. Valoramos telefónicamente la satisfacción del paciente en el postoperatorio tardío. En todos los casos, encontramos los vasos perforantes identificados en el preoperatorio; el tiempo operatorio promedio fue de 1.8 horas. No hubo complicaciones; la cobertura fue exitosa en todos los casos y los pacientes se mostraron satisfechos en la encuesta realizada. El tiempo medio de seguimiento postoperatorio fue de 19 meses. En conclusión, creemos que el colgajo de avance en V-Y de gastrocnemio basado en perforante se presenta como una alternativa segura para el cierre de defectos del tercio medial y superior de la pierna, en un sólo tiempo quirúrgico y con buenos resultados estéticos y funcionales a largo plazo.Advancement V-Y flaps have been a popular choice for closure of deep wounds but their mobility is limited. Perforant based flaps are specially useful when greater advancement and bigger coverage are needed. We designed a gastrocnemius based flap that uses both techniques for covering the defects of the medial third of the leg. We follow a retrospective evaluation of 5 patients that had their wounds in the medial and superior third of the leg

  14. Curative effects of gastrocnemius medial head muscle flap on tibial osteomyelitis combined with bone exposure%腓肠肌内侧头肌皮瓣治疗胫骨骨髓炎并骨外露的疗效观察

    Institute of Scientific and Technical Information of China (English)

    邢志杰; 曾国庆; 郝钊; 陈爱宝

    2013-01-01

    Objective To observe the clinical curative effects of gastrocnemius medial head muscle flap on tibial traumatic osteomyelitis combined with bone exposure. Methods Thirty two patients with tibial traumatic osteomyelitis combined with bone exposed were treated by muscle flap transplantation of gastrocnemius medial head. Results After the operation, the transplanted flaps all survived. Among the 32 cases, the muscle flaps in 28 cases healed in phase Ⅰ and those in 4 cases healed in phase Ⅱ. There was no recurrence in the follow - up of 1 year to 5 years. Conclusion Gastrocnemius medial head muscle flap in the treatment of tibial traumatic osteomyelitis combined with bone exposed has an obvious curative effect and can shorten the course of treatment and the cost. It is an effective surgical method.%目的 观察腓肠肌内侧头肌皮瓣治疗胫骨创伤性骨髓炎合并骨外露的临床效果.方法 32例胫骨创伤性骨髓炎合并骨外露患者采用腓肠肌内侧头肌皮瓣移植的方法进行治疗.结果 术后移植皮瓣全部成活,32例中,28例肌皮瓣一期愈合,4例二期愈合,术后随访时间1~5年无复发病例.结论 腓肠肌内侧头肌皮瓣治疗胫骨创伤性骨髓炎合并骨外露疗效显著,可以缩短病程,减少治疗费用,是一种有效手术方法.

  15. Investigation of the Expression of Myogenic Transcription Factors, microRNAs and Muscle-Specific E3 Ubiquitin Ligases in the Medial Gastrocnemius and Soleus Muscles following Peripheral Nerve Injury.

    Directory of Open Access Journals (Sweden)

    Rebecca Wiberg

    Full Text Available Despite surgical innovation, the sensory and motor outcome after a peripheral nerve injury remains incomplete. One contributing factor to the poor outcome is prolonged denervation of the target organ, leading to apoptosis of both mature myofibres and satellite cells with subsequent replacement of the muscle tissue with fibrotic scar and adipose tissue. In this study, we investigated the expression of myogenic transcription factors, muscle specific microRNAs and muscle-specific E3 ubiquitin ligases at several time points following denervation in two different muscles, the gastrocnemius (containing predominantly fast type fibres and soleus (slow type muscles, since these molecules may influence the degree of atrophy following denervation. Both muscles exhibited significant atrophy (compared with the contra-lateral sides at 7 days following either a nerve transection or crush injury. In the crush model, the soleus muscle showed significantly increased muscle weights at days 14 and 28 which was not the case for the gastrocnemius muscle which continued to atrophy. There was a significantly more pronounced up-regulation of MyoD expression in the denervated soleus muscle compared with the gastrocnemius muscle. Conversely, myogenin was more markedly elevated in the gastrocnemius versus soleus muscles. The muscles also showed significantly contrasting transcriptional regulation of the microRNAs miR-1 and miR-206. MuRF1 and Atrogin-1 showed the highest levels of expression in the denervated gastrocnemius muscle. This study provides further insights regarding the intracellular regulatory molecules that generate and maintain distinct patterns of gene expression in different fibre types following peripheral nerve injury.

  16. Calcifying tendonitis of the gastrocnemius. A report of three cases.

    Science.gov (United States)

    Iguchi, Y; Ihara, N; Hijioka, A; Uchida, S; Nakamura, T; Kikuta, A; Nakashima, T

    2002-04-01

    We describe the clinical features of calcifying tendonitis in the medial head of gastrocnemius in three elderly female patients. The presenting symptom was chronic pain in the posteromedial area of the knee in two patients and acute pain in the back of the knee in one. All had limitation of movement of the knee and marked tenderness in the region of the tendinous origin of the medial head of gastrocnemius with posterior knee pain induced by stretching the tendon. An injection of 1% lidocaine and steroid into the tendon resulted in temporary relief from pain and improved movement.

  17. Association of gastrocnemius tendon calcification with chondrocalcinosis of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Foldes, K. [Department of Radiology, Veterans Administration Medical Center (VAMC), San Diego, CA (United States)]|[University of California San Diego Medical Center (UCSD), San Diego, CA (United States)]|[National Institute of Rheumatology and Physiotherapy, Budapest (Hungary); Lenchik, L. [Department of Radiology, Veterans Administration Medical Center (VAMC), San Diego, CA (United States)]|[University of California San Diego Medical Center (UCSD), San Diego, CA (United States); Jaovisidha, S. [Department of Radiology, Veterans Administration Medical Center (VAMC), San Diego, CA (United States)]|[University of California San Diego Medical Center (UCSD), San Diego, CA (United States); Clopton, P. [Department of Radiology, Veterans Administration Medical Center (VAMC), San Diego, CA (United States); Sartoris, D.J. [Department of Radiology, Veterans Administration Medical Center (VAMC), San Diego, CA (United States)]|[University of California San Diego Medical Center (UCSD), San Diego, CA (United States); Resnick, D. [Department of Radiology, Veterans Administration Medical Center (VAMC), San Diego, CA (United States)]|[University of California San Diego Medical Center (UCSD), San Diego, CA (United States)

    1996-10-01

    Objective. Chondrocalcinosis of the knee is a common radiological finding in the elderly. However, visualization of chondrocalcinosis may be difficult in patients with advanced cartilage loss.The purpose of this study was to determine sensitivity, specificity, and accuracy of gastrocnemius tendon calcification that might serve as a radiographic marker of chondrocalcinosis in patients with painful knees. Design and patients. We prospectively evaluated 37 knee radiographs in 30 consecutive patients (29 men, 8 women; mean age 67 years, age range 37-90 years) with painful knees who had radiographic evidence of chondrocalcinosis. The frequency of fibrocartilage, hyaline cartilage, and gastrocnemius tendon calcification was determined. For a control group, we evaluated knee radiographs in 65 consecutive patients with knee pain (54 men, 11 women; mean age 59 years, age range 40-93 years) who had no radiological signs of chondrocalcinosis. The frequency of gastrocnemius tendon calcification in the control group was determined. Results. Gastrocnemius tendon calcification was 41% sensitive, 100% specific, and 78% accurate in predicting chondrocalcinosis. The gastrocnemius tendon was calcified on 15 of 37 (41%) radiographs in the experimental group and on 0 of 67 radiographs in the control group. In the chondrocalcinosis group, 23 (62%) had posterior hyaline cartilage calcification, 14 (38%) had anterior hyaline cartilage calcification, 31 (84%) had medial meniscus calcification, and 36 (97%) had lateral meniscus calcification. Conclusions. Our results show that gastrocnemius tendon calcification is an accurate radiographic marker of chondrocalcinosis in patients with knee pain. (orig.). With 2 figs., 2 tabs.

  18. Gastrocnemius tendinosis--A frequent finding on MRI knee examination.

    Science.gov (United States)

    Jawahar, Anugayathri; Lu, Yanan; Okur, Gokcan; Kliethermes, Stephanie; Lomasney, Laurie

    2015-12-01

    Gastrocnemius tendinosis (GT) is one potential cause for posterior knee pain, commonly overlooked on clinical examinations and imaging. This study assesses the frequency of GT on MR imaging in a convenience sample based on a database search and associations with other articular pathologies and clinical findings. With IRB approval, retrospective review was completed on 300 randomly selected MR knee exams performed from February 2009 to June 2010. Following de-identification, axial T2 and sagittal PD images, with or without fat suppression, were reviewed by 2 radiologists. The gastrocnemius tendon femoral attachments were graded as normal, mild (few cysts, thickening, intermediate signal) or severe GT (multiple cysts, marrow edema, tear). Select associated MR findings of internal derangement were documented. Clinical charts were reviewed for clinical presentation, physical exam findings, and select demographics. The inter-observer reliability for presence/grading of GT was very high (kappa statistic=0.97). Frequency of GT was 50.33%, most frequently involving medial head of gastrocnemius (63.6%). Grades of GT were 41.7% and 17.2% for mild and severe respectively. Univariate analysis showed statistically significant relationship between grade of GT with arthrosis (p=0.05) and clinical joint effusion (p=0.02). Multivariate analysis showed higher odds of severe GT for individuals with medial plus lateral GT. Statistical significance was noted for presence of both GT and ACL tear (13.9%; p=0.02). Significant findings of our analysis included GT presented with predominant involvement of medial head of gastrocnemius tendon, mild in severity, strong association with ACL tear, presented frequently as posterior knee pain, limited joint motion and clinical joint effusion. However, there was no statistically significant association between demographic features and medical comorbidities in the patients. Increased understanding of frequency of GT allows more accurate reporting of

  19. 腓肠肌内侧头肌腱前移重建髌韧带的解剖及临床应用%Anatomical and clinical study of reconstruction of the pateller ligament with vascularized medial tenden of gastrocnemius muscle

    Institute of Scientific and Technical Information of China (English)

    俞立新; 吴水培

    2008-01-01

    目的 报道腓肠肌内侧头肌腱前移重建髌韧带缺损新的修复方法 . 方法 通过对30侧下肢标本解剖观测腓肠肌内侧头肌腱的形态和血供来源,设计了以腓肠内侧头血管供血带肌蒂的腓肠肌内侧头肌腱前移重建髌腱缺损的术式.临床应用4例. 结果 全部病例随访2~8个月.膝关节伸直功能恢复满意,无再断裂并发症.1例因膝关节骨缺损伸直170°,屈曲120°,有轻度跛行. 结论 带肌蒂的腓肠肌内侧头肌腱前移重建髌腱缺损有术式简单、再造髌腱外形结构接近正常、受区损伤小等优点.腓肠肌内侧头肌腱前移为髌腱缺损修复提供了一种良好的方法 .%Objective To provide a clinical method in the treatment of patellar ligament defect. Methods Based on morphologic observation and blood supply of the medial tenden of gastrocnemius muscle on 30 adult cadaverous lower limp specimens. Then transferring of sural arteries medial tendon of gastrocnemins muscle was designed and used in 4 patients clinically. Results The period of follow-up in all cases was 2-8 months. The knee joint recovered well with satisfactory function. Conclusion The operation is a simple and ideal procedure. The vascularizod adductor magnus tendon is a good donor in the reconstruction of patellar ligament defect. Microsurgical repair of patellar ligament defect is a effective method.

  20. “Tennis leg”: gastrocnemius injury is a far more common cause than plantaris rupture

    Directory of Open Access Journals (Sweden)

    Joelle R. Harwin, BS

    2017-03-01

    Full Text Available We report a typical case of “tennis leg”, in which the main finding was a fluid collection between the medial head of the gastrocnemius and soleus muscles. Since the first clinical description of this entity in 1883, the injury has been attributed to rupture of the plantaris tendon. However, recent studies of this condition with sonography and magnetic resonance imaging have shown that most of these cases are actually due to injury to the gastrocnemius and/or soleus muscles, and up to 10% are due to deep venous thrombosis masquerading as muscle injury. The plantaris muscle and tendon are only rarely involved in this injury.

  1. Muscle fascicle strains in human gastrocnemius during backward downhill walking.

    Science.gov (United States)

    Hoffman, B W; Cresswell, A G; Carroll, T J; Lichtwark, G A

    2014-06-01

    Extensive muscle damage can be induced in isolated muscle preparations by performing a small number of stretches during muscle activation. While typically these fiber strains are large and occur over long lengths, the extent of exercise-induced muscle damage (EIMD) observed in humans is normally less even when multiple high-force lengthening actions are performed. This apparent discrepancy may be due to differences in muscle fiber and tendon dynamics in vivo; however, muscle and tendon strains have not been quantified during muscle-damaging exercise in humans. Ultrasound and an infrared motion analysis system were used to measure medial gastrocnemius fascicle length and lower limb kinematics while humans walked backward, downhill for 1 h (inducing muscle damage), and while they walked briefly forward on the flat (inducing no damage). Supramaximal tibial nerve stimulation, ultrasound, and an isokinetic dynamometer were used to quantify the fascicle length-torque relationship pre- and 2 h postexercise. Torque decreased ~23%, and optimal fascicle length shifted rightward ~10%, indicating that EIMD occurred during the damage protocol even though medial gastrocnemius fascicle stretch amplitude was relatively small (~18% of optimal fascicle length) and occurred predominantly within the ascending limb and plateau region of the length-torque curve. Furthermore, tendon contribution to overall muscle-tendon unit stretch was ~91%. The data suggest the compliant tendon plays a role in attenuating muscle fascicle strain during backward walking in humans, thus minimizing the extent of EIMD. As such, in situ or in vitro mechanisms of muscle damage may not be applicable to EIMD of the human gastrocnemius muscle. Copyright © 2014 the American Physiological Society.

  2. Gastrocnemius tendon length and strain are different when assessed using straight or curved tendon model

    OpenAIRE

    Stosic, Jelena; Finni Juutinen, Taija

    2011-01-01

    The present study investigated the effects of tendon curvature on measurements of tendon length using 3D-kinematic analysis. Curved and straight tendon models were employed for assessing medial gastrocnemius tendon length and strain during hopping (N = 8). Tendon curvature was identified using small reflective markers placed on the skin surface along the length of the tendon and a sum of vectors between the markers from the calcaneous up to the marker at the origin of tendon was calculated. T...

  3. Gastrocnemius tendon length and strain are different when assessed using straight or curved tendon model

    OpenAIRE

    Stosic, Jelena; Finni Juutinen, Taija

    2011-01-01

    The present study investigated the effects of tendon curvature on measurements of tendon length using 3D-kinematic analysis. Curved and straight tendon models were employed for assessing medial gastrocnemius tendon length and strain during hopping (N = 8). Tendon curvature was identified using small reflective markers placed on the skin surface along the length of the tendon and a sum of vectors between the markers from the calcaneous up to the marker at the origin of tendon was calculated. T...

  4. Vaginal Lacerations from Consensual Intercourse in Adolescents

    Science.gov (United States)

    Frioux, Sarah M.; Blinman, Thane; Christian, Cindy W.

    2011-01-01

    Objective: (1) To describe lacerations of the vaginal fornices, an injury known to be associated with consensual sexual intercourse, including known complications and treatment course, (2) to contrast these injuries with injuries sustained during sexual assault, and (3) to discuss the assessment of adolescent patients for sexual injuries. Methods:…

  5. Traumatic parenchymal laceration in a horseshoe kidney.

    LENUS (Irish Health Repository)

    Stunell, H

    2011-03-01

    An 18-year-old man was transferred to the authors\\' institution after a motor vehicle collision in which he was a restrained front seat passenger. The referring hospital performed contrast-enhanced computed tomography which revealed a previously undiagnosed horseshoe kidney with a laceration of the right lower pole moiety. On transfer, he was pale and mildly tachycardic but normotensive.

  6. Role of gastrocnemius activation in knee joint biomechanics: gastrocnemius acts as an ACL antagonist.

    Science.gov (United States)

    Adouni, M; Shirazi-Adl, A; Marouane, H

    2016-01-01

    Gastrocnemius is a premier muscle crossing the knee, but its role in knee biomechanics and on the anterior cruciate ligament (ACL) remains less clear when compared to hamstrings and quadriceps. The effect of changes in gastrocnemius force at late stance when it peaks on the knee joint response and ACL force was initially investigated using a lower extremity musculoskeletal model driven by gait kinematics-kinetics. The tibiofemoral joint under isolated isometric contraction of gastrocnemius was subsequently analyzed at different force levels and flexion angles (0°-90°). Changes in gastrocnemius force at late stance markedly influenced hamstrings forces. Gastrocnemius acted as ACL antagonist by substantially increasing its force. Simulations under isolated contraction of gastrocnemius confirmed this role at all flexion angles, in particular, at extreme knee flexion angles (0° and 90°). Constraint on varus/valgus rotations substantially decreased this effect. Although hamstrings and gastrocnemius are both knee joint flexors, they play opposite roles in respectively protecting or loading ACL. Although the quadriceps is also recognized as antagonist of ACL, at larger joint flexion and in contrast to quadriceps, activity in gastrocnemius substantially increased ACL forces (anteromedial bundle). The fact that gastrocnemius is an antagonist of ACL should help in effective prevention and management of ACL injuries.

  7. Detecting Foreign Bodies in a Head Laceration

    Directory of Open Access Journals (Sweden)

    Thomas R. Fowler

    2015-01-01

    are not identified prior to wound closure. The importance of imaging of lacerations was underscored by a recent case where a 20-year-old male collided with a friend’s mouth on a trampoline sustaining a simple, superficial scalp laceration. The wound was evaluated in typical fashion including irrigation and local exploration and was prepared for closure. The friend was then evaluated and noted to have multiple extensive dental fractures. An increased index of suspicion generated further evaluation of the first patient’s wound. Plain radiography obtained of the first patient’s skull was noted to have bony foreign bodies consistent with teeth, which were then removed after further exploration. Superficial wounds are common and complications arising from retained foreign bodies are a potential source of substantial morbidity and consequently medical litigation. This case serves as a reminder to be vigilant and maintain a high index of suspicion regarding the potential for foreign body.

  8. Therapeutic effects of massage and electrotherapy on muscle tone, stiffness and muscle contraction following gastrocnemius muscle fatigue

    Science.gov (United States)

    Wang, Joong-San

    2017-01-01

    [Purpose] This study aimed to examine the effects of a combined intervention consisting of massage therapy and transcutaneous electrical nerve stimulation on gastrocnemius muscle fatigue, assessing whether the intervention improved muscle tone, stiffness, and muscle contraction. [Subjects and Methods] The subjects were 20 healthy males in their 20s who were equally divided into a transcutaneous electrical nerve stimulation group and a combined therapy group that received a combination of massage therapy and transcutaneous electrical nerve stimulation. Muscle fatigue was triggered on the gastrocnemius muscle, and the effects of intervention method on muscle tone, stiffness, and muscle contraction were examined over time. [Results] Lateral and medial gastrocnemius muscle tone and stiffness significantly increased and gastrocnemius muscle contraction significantly decreased in each group immediately after fatigue was triggered on the gastrocnemius muscle. There was no difference in the effects of the two intervention methods over time. [Conclusion] This study verified that a combined therapy of massage therapy and transcutaneous electrical nerve stimulation was able to be used effectively in improving muscle tone, stiffness, muscle contraction, thereby reducing gastrocnemius muscle fatigue. PMID:28210061

  9. Oral lacerations during motocross: A case report.

    Science.gov (United States)

    Hino, Shunsuke; Takeda, Akio; Kaneko, Takahiro; Horie, Norio; Shimoyama, Tetsuo

    2017-07-21

    Motocross is a high-risk sport that can cause serious injuries including oral injuries. However, mouthguard use is not mandatory in motocross. This report describes a case of an oral laceration with exposure of bilateral inferior alveolar nerves as a result of a motocross accident in which the patient was not wearing a mouthguard. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Posteromedial approach of gastrocnemius for reduction and internal fixation of avulsed tibial attachment of posterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chun-li; XU Hu; LI Ming-quan

    2006-01-01

    Objective:To introduce a posteromedial approach through the medial border of the medial head of gastrocnemius for reduction and reattachment of bony avulsion of the posterior cruciate ligament (PCL) from the tibia.Methods: Eleven patients with avulsed tibial attachment of the PCL underwent an operative reduction and internal fixation through the posteromedial approach of the gastrocnemius in our department from February 1998 to March 2000. The skin incision was reversed L-shaped along the medial border of the medial head of the gastrocnemius and the posterior capsule was exposed by dissecting the medial border and lateral retraction, avoiding the damage of the popliteal neurovascular structures. After that, the posterior capsule was vertically dissected a little medially to the posterior intercondylar sulcus and just on the posterior medial tibial eminence positioned by finger palpation. Then the PCL and its tibial attachment were easily accessible. In the delayed cases, PCL peripheral releasing was necessary to overcome the ligament retraction and to refresh the fracture bed for optimal reduction and bony healing. At last, one or two biodegradable screws were used to fix the avulsed bone segment and 30° flexion knee plaster cast immobilization was regularly applied after the wound was closed. The evaluation included X-ray, posterior sag sign and posterior drawer test compared with the contralateral side. The functional assessment of the low limbs was not available because of concomitant injuries.Results: The posteromedial approach of the gastrocnemius used in repair of tibial attachment avulsed injury of the PCL could provide benefit of clear anatomical exposure, few blood loss (20 ml on average), no need for detachment or reattachment of any structure. The patients were followed up for 11 months on an average (ranging from 6 months to 2 years ). It demonstrated that bony healing was achieved within 4-6 weeks in cases of fresh injury and 7-9 weeks in cases of

  11. Therapeutic Effect of Extracorporeal Shock Wave Therapy According to Treatment Session on Gastrocnemius Muscle Spasticity in Children With Spastic Cerebral Palsy: A Pilot Study.

    Science.gov (United States)

    Park, Dong-Soon; Kwon, Dong Rak; Park, Gi-Young; Lee, Michael Y

    2015-12-01

    To investigate the therapeutic effect of extracorporeal shockwave therapy (ESWT) according to treatment session on gastrocnemius muscle spasticity in children with spastic cerebral palsy (CP). Twelve children with spastic CP underwent 1 ESWT and 2 sham ESWT sessions for gastrocnemius (group 1) or 3 ESWT sessions (group 2) once per week for 3 weeks. Modified Ashworth Scale (MAS) score, passive range of motion (PROM) of the ankle plantar-flexor muscles with knee extension, and median red pixel intensity (RPI) of color histogram of medial gastrocnemius on real-time sonoelastography (RTS) were measured before ESWT, immediately after the first and third ESWT, and at 4 weeks after the third ESWT. Mean ankle PROM was significantly increased whereas as mean ankle MAS and median gastrocnemius RPI were significantly decreased in both groups after the first ESWT. Clinical and RTS parameters before ESWT were not significantly different from those immediately after the third ESWT or at 4 weeks after the third ESWT in group 1. However, they were significantly different from those immediately after the third ESWT or at 4 weeks after the third ESWT in group 2. Mean ankle PROM, mean ankle MAS, and median gastrocnemius RPI in group 2 were significantly different from that in group 1 at 4 weeks or immediately after the third ESWT. The therapeutic effect of ESWT on spastic medial gastrocnemius in children with spastic CP is dependent on the number of ESWT sessions.

  12. Concomitant Contracture of the Knee and Ankle Joint After Gastrocnemius Muscle Rupture: A Case Report.

    Science.gov (United States)

    Ryu, Dong Jin; Kim, Joon Mee; Kim, Bom Soo

    Injury of the medial head of the gastrocnemius, also called "tennis leg," is known to heal uneventfully in most cases with compression and immobilization therapy. Failure to heal or long-term complications, including ongoing pain and pes equinus, have been documented in only a limited number of case reports. To the best of our knowledge, a severe concomitant contracture of the knee and ankle joint as a consequence of a maltreated gastrocnemius muscle rupture has not been previously reported in English-language reports. The purpose of the present study was to report a serious complication of neglected tennis leg with a review of the published data. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Posttraumatic pseudoaneurysm of medial plantar artery in a child: treatment with percutaneous thrombin injection

    Directory of Open Access Journals (Sweden)

    Fabrício Neto Ladeira

    2014-03-01

    Full Text Available Pseudoaneurysms of the medial plantar artery are rare. The authors describe a case of a pseudoaneurysm of the medial plantar artery of a child who had suffered a penetrating laceration injury. Diagnosis can be confirmed using Doppler ultrasound and magnetic resonance angiography. As an alternative to the conventional surgery technique, percutaneous Doppler ultrasound-guided thrombin injection is a safe and effective treatment.

  14. Patellar tendon reconstruction using an extended gastrocnemius flap following cryogenic injury to the knee.

    Science.gov (United States)

    Kim, Raymond H; Randolph, Amanda H; Tirre, Conrad J; Morrey, Matthew; Jennings, Jason M

    2017-06-01

    Cryogenic thermal necrosis after knee surgery is rare. We describe a patient who presented with an anterior knee soft tissue defect in conjunction with an extensor mechanism deficiency secondary to a cold thermal injury after an anterior cruciate ligament reconstruction. We treated the patient with a single stage surgical procedure combining patellar tendon reconstruction and soft tissue coverage utilizing the superficial portion of the patient's vascularized Achilles tendon attached to a medial gastrocnemius flap. The patient returned to unrestricted activities and has demonstrated this through a five year follow-up. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Embolization Therapy for Traumatic Splenic Lacerations

    Energy Technology Data Exchange (ETDEWEB)

    Dasgupta, Niloy; Matsumoto, Alan H., E-mail: ahm4d@virginia.edu; Arslan, Bulent; Turba, Ulku C.; Sabri, Saher; Angle, John F. [University of Virginia Health System, Division of Vascular and Interventional Radiology, Department of Radiology (United States)

    2012-08-15

    Purpose: This study was designed to evaluate the clinical success, complications, and transfusion requirements based on the location of and agents used for splenic artery embolization in patients with splenic trauma. Methods: A retrospective study was performed of patients with splenic trauma who underwent angiography and embolization from September 2000 to January 2010 at a level I trauma center. Electronic medical records were reviewed for demographics, imaging data, technical aspects of the procedure, and clinical outcomes. Results: Fifty patients were identified (34 men and 16 women), with an average age of 48 (range, 16-80) years. Extravasation was seen on initial angiography in 27 (54%) and was absent in 23 (46%). All 27 patients with extravasation were embolized, and 18 of 23 (78.2%) without extravasation were embolized empirically. Primary clinical success was similar (>75%) across all embolization locations, embolic agents, and grades of laceration treated. Of 45 patients treated, 9 patients (20%) were embolized in the main splenic artery, 34 (75.6%) in the splenic hilum, and 2 (4.4%) were embolized in both locations. Partial splenic infarctions developed in 47.3% treated in the splenic hilum compared with 12.5% treated in the main splenic artery. There were four (8.9%) mortalities: two occurred in patients with multiple critical injuries and two from nonbleeding etiologies. Conclusions: Embolization of traumatic splenic artery injuries is safe and effective, regardless of the location of treatment. Embolization in splenic hilar branches may have a higher incidence of infarction. The grade of laceration and agents used for embolotherapy did not impact the outcomes.

  16. Behavior of human gastrocnemius muscle fascicles during ramped submaximal isometric contractions.

    Science.gov (United States)

    Héroux, Martin E; Stubbs, Peter W; Herbert, Robert D

    2016-09-01

    Precise estimates of muscle architecture are necessary to understand and model muscle mechanics. The primary aim of this study was to estimate continuous changes in fascicle length and pennation angle in human gastrocnemius muscles during ramped plantar flexor contractions at two ankle angles. The secondary aim was to determine whether these changes differ between proximal and distal fascicles. Fifteen healthy subjects performed ramped contractions (0-25% MVC) as ultrasound images were recorded from the medial (MG, eight sites) and lateral (LG, six sites) gastrocnemius muscle with the ankle at 90° and 120° (larger angles correspond to shorter muscle lengths). In all subjects, fascicles progressively shortened with increasing torque. MG fascicles shortened 5.8 mm (11.1%) at 90° and 4.5 mm (12.1%) at 120°, whereas LG muscle fascicles shortened 5.1 mm (8.8%) at both ankle angles. MG pennation angle increased 1.4° at 90° and 4.9° at 120°, and LG pennation angle decreased 0.3° at 90° and increased 2.6° at 120°. Muscle architecture changes were similar in proximal and distal fascicles at both ankle angles. This is the first study to describe continuous changes in fascicle length and pennation angle in the human gastrocnemius muscle during ramped isometric contractions. Very similar changes occurred in proximal and distal muscle regions. These findings are relevant to studies modeling active muscle mechanics.

  17. Concurrent deficits of soleus and gastrocnemius muscle fascicles and Achilles tendon post stroke.

    Science.gov (United States)

    Zhao, Heng; Ren, Yupeng; Roth, Elliot J; Harvey, Richard L; Zhang, Li-Qun

    2015-04-01

    Calf muscles and Achilles tendon play important roles in functional activities. However, it is not clear how biomechanical properties of the uniarticular soleus (SOL) and biarticular gastrocnemius muscle and Achilles tendon, including the fascicle length, pennation angle, and stiffness, change concurrently post stroke. Biomechanical properties of the medial gastrocnemius (GM) and soleus muscles were evaluated bilaterally in 10 hemiparetic stroke survivors using combined ultrasonography-biomechanical measurements. Biomechanical properties of the Achilles tendon including the length, cross-sectional area (CSA), stiffness, and Young's modulus were evaluated, together with calf muscle biomechanical properties. Gastrocnemius and SOL contributions were separated using flexed and extended knee positions. The impaired side showed decreased fascicle length (GM: 6%, P = 0.002 and SOL: 9%, P = 0.03, at full knee extension and 0° ankle dorsiflexion) and increased fascicular stiffness (GM: 64%, P = 0.005 and SOL: 19%, P = 0.012, at a common 50 N force level). In contrast, Achilles tendon on the impaired side showed changes in the opposite direction as the muscle fascicles with increased tendon length (5%, P Young's modulus (30%, P muscle fascicles and Achilles tendon biomechanical properties help us better understand concurrent changes of fascicles and tendon as part of the calf muscle-tendon unit and facilitate development of more effective treatments. Copyright © 2015 the American Physiological Society.

  18. The Role of Epimysium in Suturing Skeletal Muscle Lacerations

    Science.gov (United States)

    2005-01-01

    based repair has been reported to be impor- tant for superior stitching of forearm muscle belly lacer- ations.6 A review of the literature found no...Compartmental fascia was removed with care to preserve epimysium. Muscle belly lacerations were made in areas where no tendon was present, and saline was used to...operations can limit muscle sliding under the fascia .8,9 Restoration of the epimysium by re- pair may permit better sliding, and fascia turndown, reported by

  19. Repeated bouts of fast velocity eccentric contractions induce atrophy of gastrocnemius muscle in rats.

    Science.gov (United States)

    Ochi, Eisuke; Nosaka, Kazunori; Tsutaki, Arata; Kouzaki, Karina; Nakazato, Koichi

    2015-10-01

    One bout of exercise consisting of fast velocity eccentric contractions has been shown to increase muscle protein degradation in rats. The present study tested the hypothesis that muscle atrophy would be induced after four bouts of fast velocity eccentric contractions, but not after four bouts of slow velocity eccentric contractions. Male Wistar rats were randomly placed into 3 groups; fast (180°/s) velocity (180EC, n = 7), slow (30°/s) velocity eccentric exercise (30EC, n = 7), or sham-treatment group (control, n = 7). The 180EC and 30EC groups received 4 sessions of 4 sets of 5 eccentric contractions of triceps surae muscles by extending the ankle joint during evoked electrical stimulation of the muscles, and the control group had torque measures, every 2 days, and all rats were sacrificed 1 day after the fourth session. Medial and lateral gastrocnemius wet mass were 4-6 % smaller, cross-sectional area of medial gastrocnemius was 6-7% smaller, and isometric tetanic torque of triceps surae muscles was 36 % smaller (p contractions.

  20. The effect of the gastrocnemius on the plantar fascia.

    Science.gov (United States)

    Pascual Huerta, Javier

    2014-12-01

    Although anatomic and functional relationship has been established between the gastrocnemius muscle, via the Achilles tendon, and the plantar fascia, the exact role of gastrocnemius tightness in foot and plantar fascia problems is not completely understood. This article summarizes past and current literature linking these 2 structures and gives a mechanical explanation based on functional models of the relationship between gastrocnemius tightness and plantar fascia. The effect of gastrocnemius tightness on the sagittal behavior of the foot is also discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Corneal laceration caused by river crab

    Directory of Open Access Journals (Sweden)

    Vinuthinee N

    2015-01-01

    Full Text Available Naidu Vinuthinee,1,2 Anuar Azreen-Redzal,1 Jaafar Juanarita,1 Embong Zunaina2 1Department of Ophthalmology, Hospital Sultanah Bahiyah, Alor Setar, 2Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia Abstract: A 5-year-old boy presented with right eye pain associated with tearing and photophobia of 1-day duration. He gave a history of playing with a river crab when suddenly the crab clamped his fingers. He attempted to fling the crab off, but the crab flew and hit his right eye. Ocular examination revealed a right eye corneal ulcer with clumps of fibrin located beneath the corneal ulcer and 1.6 mm level of hypopyon. At presentation, the Seidel test was negative, with a deep anterior chamber. Culture from the corneal scrapping specimen grew Citrobacter diversus and Proteus vulgaris, and the boy was treated with topical gentamicin and ceftazidime eyedrops. Fibrin clumps beneath the corneal ulcer subsequently dislodged, and revealed a full-thickness corneal laceration wound with a positive Seidel test and shallow anterior chamber. The patient underwent emergency corneal toileting and suturing. Postoperatively, he was treated with oral ciprofloxacin 250 mg 12-hourly for 1 week, topical gentamicin, ceftazidime, and dexamethasone eyedrops for 4 weeks. Right eye vision improved to 6/9 and 6/6 with pinhole at the 2-week follow-up following corneal suture removal. Keywords: corneal ulcer, pediatric trauma, ocular injury

  2. Return to physical activity after gastrocnemius recession

    Science.gov (United States)

    Tang Qian Ying, Camelia; Lai Wei Hong, Sean; Lee, Bing Howe; Thevendran, Gowreeson

    2016-01-01

    AIM To prospectively investigate the time taken and patients’ ability to resume preoperative level of physical activity after gastrocnemius recession. METHODS Endoscopic gastrocnemius recession (EGR) was performed on 48 feet in 46 consecutive sportspersons, with a minimum follow-up of 24 mo. The Halasi Ankle Activity Score was used to quantify the level of physical activity. Time taken to return to work and physical activity was recorded. Functional outcomes were evaluated using the short form 36 (SF-36), American Orthopedic Foot and Ankle Society (AOFAS) Hindfoot score and modified Olerud and Molander (O and M) scores respectively. Patient’s satisfaction and pain experienced were assessed using a modified Likert scale and visual analogue scales. P-value 2 were able to resume their preoperative level of physical activity in mean time of 8.8 mo, as compared to 86% (n = 19) of patients whose activity score was ≤ 2, with mean time of 6.1 mo. Significant improvements were noted in SF-36, AOFAS hindfoot and modified O and M scores. Ninety percent of all patients rated good or very good outcomes on the Likert scale. CONCLUSION The majority of patients were able to return to their pre-operative level of sporting activity after EGR. PMID:27900272

  3. The effect of isolated gastrocnemius contracture and gastrocnemius recession on lower extremity kinematics and kinetics during stance.

    Science.gov (United States)

    Chimera, Nicole J; Castro, Michael; Davis, Irene; Manal, Kurt

    2012-11-01

    Isolated gastrocnemius contracture limits ankle dorsiflexion with full knee extension and is potentially problematic during mid-stance of gait when 10° of dorsiflexion and full knee extension are needed. It is during this time that patients with isolated gastrocnemius contracture may demonstrate altered kinematics and/or kinetics. When conservative management fails to resolve painful foot pathologies associated with non-spastic isolated gastrocnemius contracture, gastrocnemius recession surgery has been suggested to resolve contracture and improve function and strength. However, there are no published reports on lower extremity kinematics/kinetics in the non-spastic isolated gastrocnemius contracture population. Assessment of alterations in gait mechanics is necessary to examine the effects of this potential surgical intervention. Lower extremity kinematics and kinetics were assessed in 6 patients clinically diagnosed with isolated gastrocnemius contracture pre- and post-surgical recession compared with 33 healthy control participants. Pre-operatively, patients with isolated gastrocnemius contracture demonstrated significantly increased peak knee flexion angles and knee flexion moments during mid-stance. There were no differences in peak ankle dorsiflexion angle or peak plantar flexion moment. Gastrocnemius recession did not alter gait kinematics/kinetics following surgery. Joint kinematic strategies utilized to compensate for isolated gastrocnemius contracture varied minimally between participants with IGC; most employed a flexed knee strategy, while one participant utilized a reduced ankle dorsiflexion strategy. Select post-surgical gait mechanics were unaltered; however, gait mechanics were not similar between non-spastic isolated gastrocnemius contracture patients and healthy control participants. Surgical intervention for patients with isolated gastrocnemius contracture does not appear to create any negative gait adaptations; however, patients may benefit

  4. Outcome after repair of concurrent upper and lower canalicular lacerations

    DEFF Research Database (Denmark)

    Ejstrup, Rasmus; Wiencke, Anne K; Toft, Peter B

    2014-01-01

    PURPOSE: To investigate the functional and cosmetic results after primary surgical repair of bicanalicular lacerations. METHODS: We identified patients diagnosed with bicanalicular lacerations at the Eye Clinic of Rigshospitalet, Copenhagen from 2000 through 2009. Patient charts were reviewed......), bicanalicular anular stent (n = 2), bicanalicular stent and dacryocystorhinostomy (n = 1). The surgery was carried out by 6 different surgeons. Eleven patients could be followed up. In these, epiphora was reported after primary surgery by 7 patients, and scarring was graded to more than 1 in 4 patients. However...

  5. Reflex response and control of the human soleus and gastrocnemius muscles during walking and running at increasing velocity

    DEFF Research Database (Denmark)

    Simonsen, Erik B; Alkjær, Tine; Raffalt, Peter C

    2012-01-01

    than the soleus H-reflex. In both muscles the H-reflex increased significantly from walking to running but also with increasing running speed. The peak of EMG activity increased in both muscles with increasing speed. The V-wave of both muscles was absent or rather low during walking, but it increased...... significantly from walking to running with increasing running speed in the soleus but not in the medial gastrocnemius. In both muscles the V-wave was highest just prior to heel strike. It is suggested that this was due to a high firing frequency of the motoneurones in this phase of the movement. It is concluded...

  6. H-reflex excitability is inhibited in soleus, but not gastrocnemius, at the short-latency response of a horizontal jump-landing task.

    Science.gov (United States)

    Thompson, Cassandra S; Schabrun, Siobhan; Marshall, Paul W

    2016-06-01

    Impaired spinal-level neuromuscular control is suggested to contribute to instability and injury during dynamic landing tasks. Despite this suggestion, spinal-level neuromuscular control is yet to be examined during a horizontal jump-landing task. The aim of the current study was to assess changes in H-reflexes and its reliability at the short-latency response of landings from short and long distances. Eight healthy individuals (five male, three female; age, 22±1.2yrs; height, 178±8.1cm; weight, 72±15.7kg) participated in the study. H-reflexes were evoked at the SLR in the soleus and medial gastrocnemius muscles, during two landing conditions: 25% and 50% of maximal broad jump distance. H-reflexes were expressed relative to the background electromyography (EMG) and maximal M-wave responses (M-max). Soleus H-reflexes were inhibited when landing from shorter distance (25%, 13.9±7.6%; 50%, 8.3±6.5%; pH-reflex excitability was observed in medial gastrocnemius. Background EMG was unaltered across landing conditions. Inhibition of soleus H-reflex excitability from 25% to 50% landing condition indicates a reduced contribution of Ia-afferent feedback to the alpha-motor neuron during landings from greater distances, which may contribute to stiffness regulation at the ankle joint. Unaltered H-reflex excitability of medial gastrocnemius is most likely attributed to its functional role during the landing task.

  7. Multiple Heads of Gastrocnemius with Bipennate Fiber Arrangement- A Clinically Significant Variation

    Science.gov (United States)

    Rodrigues, Vincent; Nayak, Shivananda

    2016-01-01

    It is common to have additional muscles or muscle slips in the extremities. Some of them may compress the nerves and vessels or restrict the movements, while others may enhance the muscular activity. However, a small number of them may go unnoticed. Knowledge of such variant muscles becomes important for plastic surgeons while performing various reconstructive surgeries and for clinicians while managing the pain. A case of multiple heads of gastrocnemius muscle was observed during routine dissection of the right lower limb of about 70-year-old male cadaver. It was observed that the medial head of gastrocnemius was attached to the femur with 3 thick heads and lateral head was arising from the lateral condyle of femur by 3 thick heads. All the heads of the muscles remained separate till they formed tendocalcaneus. Some of these heads showed bipinnate fiber arrangement. All the heads were innervated by the branches of tibial nerve. As the muscle heads passed down from their origin, they entrapped the sural nerve and sural nerve was seen emerging at the beginning of tendocalcaneus. Further, detailed literature and the clinical and surgical importance of the case are discussed. PMID:27656426

  8. Safe Zone for Neural Structures in Medial Displacement Calcaneal Osteotomy: A Cadaveric and Radiographic Investigation.

    Science.gov (United States)

    Talusan, Paul G; Cata, Ezequiel; Tan, Eric W; Parks, Brent G; Guyton, Gregory P

    2015-12-01

    We aimed to define reference lines on standard lateral ankle radiographs that could be used intraoperatively to minimize iatrogenic nerve injury risk in medial displacement calcaneal osteotomy. Forty cadaveric specimens were used. In 20 specimens, the sural, medial plantar (MP), and lateral plantar (LP) nerves were sutured to radiopaque wire, and a lateral ankle radiograph was obtained. On the radiograph, a line was drawn from the posterior superior apex of the calcaneal tuberosity to the origin of the plantar fascia and labeled as the "landmark line." A parallel line was drawn 2 mm posterior to the most posterior nerve, and the area between these lines was defined as the safe zone. In 20 additional specimens, an osteotomy was performed 1 cm anterior to the landmark line using a percutaneous or open technique. Dissection was performed to assess for laceration of the sural, MP, LP, medial calcaneal (MC), or lateral calcaneal (LC) nerves. The safe zone was determined to be within the area 11.2 ± 2.7 mm anterior to the landmark line. After open osteotomy, lacerations were found in 3 of 10 MC nerves and 3 of 10 LC nerves. After percutaneous osteotomy, lacerations were found in 2 of 10 MC nerves and 1 of 10 LC nerves. No lacerations of the sural, MP, or LP nerves were found with either osteotomy. The safe zone extended 11.2 ± 2.7 mm anterior to the described landmark line. The MC and LC nerves were always at risk during medial displacement calcaneal osteotomy. Nerve injury to both major and minor sensory nerves is likely underrecognized as a source of morbidity after calcaneal osteotomy. The current study provides a ready intraoperative guideline for minimizing this risk. © The Author(s) 2015.

  9. Mechanical properties of tendon and aponeurosis of human gastrocnemius muscle in vivo.

    Science.gov (United States)

    Muramatsu, T; Muraoka, T; Takeshita, D; Kawakami, Y; Hirano, Y; Fukunaga, T

    2001-05-01

    Load-strain characteristics of tendinous tissues (Achilles tendon and aponeurosis) were determined in vivo for human medial gastrocnemius (MG) muscle. Seven male subjects exerted isometric plantar flexion torque while the elongation of tendinous tissues of MG was determined from the tendinous movements by using ultrasonography. The maximal strain of the Achilles tendon and aponeurosis, estimated separately from the elongation data, was 5.1 +/- 1.1 and 5.9 +/- 1.6%, respectively. There was no significant difference in strain between the Achilles tendon and aponeurosis. In addition, no significant difference in strain was observed between the proximal and distal regions of the aponeurosis. The results indicate that tendinous tissues of the MG are homogeneously stretched along their lengths by muscle contraction, which has functional implications for the operation of the human MG muscle-tendon unit in vivo.

  10. Acute Compartment Syndrome After Gastrocnemius Rupture (Tennis Leg) in a Nonathlete Without Trauma.

    Science.gov (United States)

    Tao, Li; Jun, Huang; Muliang, Ding; Deye, Song; Jiangdong, Ni

    2016-01-01

    Acute compartment syndrome is a serious emergency that warrants urgent decompression, and tennis leg (i.e., rupture of the medial head of the gastrocnemius) is a known clinical condition that is usually treated symptomatically, with good results overall. In rare cases, acute compartment syndrome is associated with tennis leg after severe direct muscle trauma or severe exercise in athletes or physically active individuals. We present an unusual case of acute compartment syndrome secondary to tennis leg after the patient, a nonathlete, had disembarked from a truck without any trauma. Clinicians should have a high index of suspicion for atraumatic compartment syndrome, and timely surgical fasciotomy must be undertaken to avoid complications resulting from delayed diagnosis and treatment.

  11. Medial gastrocnemius architectural properties during isometric contractions in boys and men.

    Science.gov (United States)

    Kannas, Theodoros; Kellis, Eleftherios; Arampatzi, Fotini; de Villarreal, Eduardo Saez Saez

    2010-02-01

    The aim of this study was to examine the differences in muscle architecture during isometric tests between children and adults. Eight boys (age= 11.2 +/- 0.26 years) and eight men (age= 22.3 +/- 2.01 years) performed plantar flexion isometric efforts at angles of -15 degrees, 0 degrees, 15 degrees at 0%, 40%, 60%, 80% of MVC. Analysis of variance tests indicated that adults showed greater fascicle length from rest to 80% of MVC (p MVC (p MVC (p < .05). These differences observed in MG would appear to favor better utilization of the force-length and the force-velocity relationships, of the muscle in adults compared with children.

  12. Lacerations in urban children. A prospective 12-January study.

    Science.gov (United States)

    Baker, M D; Selbst, S M; Lanuti, M

    1990-01-01

    We prospectively investigated the epidemiologic characteristics of all lacerations (N = 2834) repaired at the Children's Hospital of Philadelphia (Pa) during 1987 and identified common hazards and possible avenues of intervention. Two-year-old children incurred most injuries; males outnumbered females 2:1. Almost two thirds (61.8%) of all lacerations occurred from May through September, and 62.2% between 3 and 9 PM. Most injuries occurred indoors (47.0%), on the sidewalk or street (22.5%), or in the residential yard (13.0%). Injuries usually occurred during play (42.3%) or daily activity (32.1%); 1247 (44.0%) involved some sort of fall. Vectors most frequently causing injury were broken glass bottles (15.0%), wooden furniture (12.0%), and asphalt or concrete (11.0%). Broken glass bottles also most frequently inflicted injuries resulting in functional impairment (0.2%), hospitalization (0.9%), or both. Complications were seen in 8% of all lacerations. Our data confirm the importance of injury-prevention strategies aimed at reduction of discarded glass objects (ie, recycling legislation), improved furniture design, and improved municipal services (ie, street repair).

  13. Sonographic evaluation of the immediate effects of eccentric heel drop exercise on Achilles tendon and gastrocnemius muscle stiffness using shear wave elastography.

    Science.gov (United States)

    Leung, Wilson K C; Chu, K L; Lai, Christopher

    2017-01-01

    Mechanical loading is crucial for muscle and tendon tissue remodeling. Eccentric heel drop exercise has been proven to be effective in the management of Achilles tendinopathy, yet its induced change in the mechanical property (i.e., stiffness) of the Achilles tendon (AT), medial and lateral gastrocnemius muscles (MG and LG) was unknown. Given that shear wave elastography has emerged as a powerful tool in assessing soft tissue stiffness with promising intra- and inter-operator reliability, the objective of this study was hence to characterize the stiffness of the AT, MG and LG in response to an acute bout of eccentric heel drop exercise. Forty-five healthy young adults (36 males and nine females) performed 10 sets of 15-repetition heel drop exercise on their dominant leg with fully-extended knee, during which the AT and gastrocnemius muscles, but not soleus, were highly stretched. Before and immediately after the heel drop exercise, elastic moduli of the AT, MG and LG were measured by shear wave elastography. After the heel drop exercise, the stiffness of AT increased significantly by 41.8 + 33.5% (P eccentric heel drop exercise. The findings from this pilot study shed some light on how and to what extent the AT and gastrocnemius muscles mechanically responds to an isolated set of heel drop exercise. Taken together, appropriate eccentric load might potentially benefit mechanical adaptations of the AT and gastrocnemius muscles in the rehabilitation of patients with Achilles tendinopathy.

  14. Evidence-based Comprehensive Approach to Forearm Arterial Laceration

    Directory of Open Access Journals (Sweden)

    Janice N. Thai

    2015-12-01

    Full Text Available Introduction: Penetrating injury to the forearm may cause an isolated radial or ulnar artery injury, or a complex injury involving other structures including veins, tendons and nerves. The management of forearm laceration with arterial injury involves both operative and nonoperative strategies. An evolution in management has emerged especially at urban trauma centers, where the multidisciplinary resource of trauma and hand subspecialties may invoke controversy pertaining to the optimal management of such injuries. The objective of this review was to provide an evidence-based, systematic, operative and nonoperative approach to the management of isolated and complex forearm lacerations. A comprehensive search of MedLine, Cochrane Library, Embase and the National Guideline Clearinghouse did not yield evidence-based management guidelines for forearm arterial laceration injury. No professional or societal consensus guidelines or best practice guidelines exist to our knowledge. Discussion: The optimal methods for achieving hemostasis are by a combination approach utilizing direct digital pressure, temporary tourniquet pressure, compressive dressings followed by wound closure. While surgical hemostasis may provide an expedited route for control of hemorrhage, this aggressive approach is often not needed (with a few exceptions to achieve hemostasis for most forearm lacerations. Conservative methods mentioned above will attain the same result. Further, routine emergent or urgent operative exploration of forearm laceration injuries are not warranted and not cost-beneficial. It has been widely accepted with ample evidence in the literature that neither injury to forearm artery, nerve or tendon requires immediate surgical repair. Attention should be directed instead to control of bleeding, and perform a complete physical examination of the hand to document the presence or absence of other associated injuries. Critical ischemia will require expeditious

  15. The effects of gastrocnemius-soleus muscle forces on ankle biomechanics during triple arthrodesis.

    Science.gov (United States)

    Hejazi, S; Rouhi, G; Rasmussen, J

    2017-02-01

    This paper presents a finite element model of the ankle, taking into account the effects of muscle forces, determined by a musculoskeletal analysis, to investigate the contact stress distribution in the tibio-talar joint in patients with triple arthrodesis and in normal subjects. Forces of major ankle muscles were simulated and corresponded well with the trend of their EMG signals. These forces were applied to the finite element model to obtain stress distributions for patients with triple arthrodesis and normal subjects in three stages of the gait cycle, i.e. heel strike, midstance, and heel rise. The results demonstrated that the stress distribution patterns of the tibio-talar joint in patients with triple arthrodesis differ from those of normal subjects in investigated gait cycle stages. The mean and standard deviations for maximum stresses in the tibo-talar joint in the stance phase for patients and normal subjects were 9.398e7 ± 1.75e7 and 7.372e7 ± 4.43e6 Pa, respectively. The maximum von Mises stresses of the tibio-talar joint for all subjects in the stance phase found to be on the lateral side of the inferior surface of the joint. The results also indicate that, in patients with triple arthrodesis, increasing gastrocnemius-soleus muscle force reduces the stress on the medial malleolus compared with normal subjects. Most of stresses in this area are between 45 and 109 kPa, and will decrease to almost 32 kPa in patients after increasing of 40% in gastrocnemius-soleus muscle force.

  16. Occult lacerations to the epiglottis and pharynx by glass fragments.

    Science.gov (United States)

    Warabi, Ryoko; Tanno, Katsutoshi; Hirayama, Suguru; Warabi, Takehiro; Sakakibara, Noriyuki; Kimura, Yoshinobu

    2008-05-01

    Injury to the epiglottis and pharynx is very rare in neck trauma overall. We experienced such a rare case in which a 43-year-old woman had lacerations to the epiglottis and pharynx. It was difficult to determine the exact site of the damage by observing the cut. We believed there was no damage to the lower respiratory tract because her vital signs were stable and her consciousness was clear. However, initial computed tomography revealed emphysema and showed that fragments from a glass vase had pierced the posterior pharyngeal wall.

  17. A clinical study of emergency room visits for oral and maxillofacial lacerations

    Science.gov (United States)

    Park, Kun-Hyo; Song, Jae-Min; Hwang, Dae-Seok; Kim, Yong-Deok; Shin, Sang-Hun; Kim, Uk-Kyu

    2015-01-01

    Objectives This study investigated patients with oral and maxillofacial lacerations who visited the emergency room over a three-year period in an effort to determine the optimal treatment for these injuries. Materials and Methods This study examined 1,742 patients with oral and maxillofacial lacerations with 2,014 different laceration locations who visited the emergency room of Pusan National University Hospital (Busan, Korea) over three years, from January 2011 to December 2013. Patients were classified by sex, age, visit day, cause of injury, injury site, and the presence or absence of soft tissue and tooth injuries. Results The male to female ratio was 2.50:1. Patients under 10 years old were seen most frequently. Most emergency room visits were on weekends. Among intra-oral lacerations, the lip area was the most vulnerable site; among extra-oral lacerations, the chin area was most frequently injured. The most frequent etiology was a slip down. Most lacerations occurred without bone fracture or tooth damage. Conclusion Laceration may differ in large part as compared with the fracture. Therefore, it is necessary to continue collecting data on oral and maxillofacial lacerations to establish optimal emergency room diagnosis and treatment strategies. PMID:26568926

  18. Time Course Change of IGF1/Akt/mTOR/p70s6k Pathway Activation in Rat Gastrocnemius Muscle During Repeated Bouts of Eccentric Exercise

    OpenAIRE

    Eisuke Ochi; Naokata Ishii; Koichi Nakazato

    2010-01-01

    The purpose of this study was to examine whether insulin-like growth factor (IGF-1) and Akt/mTOR/p70S6K pathway activity is altered by chronic eccentric exercise in rat medial gastrocnemius muscle. Male Wistar rats (n = 24) were randomly assigned to 1 of the 2 groups: eccentric exercise (ECC) group or sham-operated control (CON) group. Rats in the ECC group were trained every second day for 10 days (5 sessions in total) or 20 days (10 sessions in total). After either 5 or 10 exercise sessions...

  19. Gastrocnemius muscle contracture after spinal cord injury: a longitudinal study.

    Science.gov (United States)

    Diong, Joanna; Harvey, Lisa A; Kwah, Li Khim; Clarke, Jillian L; Bilston, Lynne E; Gandevia, Simon C; Herbert, Robert D

    2013-07-01

    The aim of this study was to examine changes in passive length and stiffness of the gastrocnemius muscle-tendon unit in people after spinal cord injury. In a prospective longitudinal study, eight wheelchair-dependent participants with severe paralysis were assessed 3 and 12 mos after spinal cord injury. Passive torque-angle data were obtained as the ankle was slowly rotated through range at six knee angles. Differences in passive ankle torque-angle data recorded at different knee angles were used to derive passive length-tension curves of the gastrocnemius muscle-tendon unit. Ultrasound imaging was used to determine fascicle and tendon contributions to the muscle-tendon unit length-tension curves. The participants had ankle contractures (mean [SD] maximum passive ankle dorsiflexion angle, 88 [9] degrees) 3 mos after spinal cord injury. Ankle range did not worsen significantly during the subsequent 9 mos (mean change, -5 degrees; 95% confidence interval, -16 to 6 degrees). There were no changes in the mean slack length or the stiffness of the gastrocnemius muscle-tendon unit or in the slack lengths of the fascicles or the tendon between 3 and 12 mos after spinal cord injury. There were no consistent patterns of the change in slack length or stiffness with the changes in ankle range in the data from the individual participants. This study, the first longitudinal study of muscle length and stiffness after spinal cord injury, showed that the length and the stiffness of the gastrocnemius did not change substantially between 3 and 12 mos after injury.

  20. Arthroscopic partial medial meniscectomy

    Directory of Open Access Journals (Sweden)

    Dašić Žarko

    2011-01-01

    Full Text Available Background/Aim. Meniscal injuries are common in professional or recreational sports as well as in daily activities. If meniscal lesions lead to physical impairment they usually require surgical treatment. Arthroscopic treatment of meniscal injuries is one of the most often performed orthopedic operative procedures. Methods. The study analyzed the results of arthroscopic partial medial meniscectomy in 213 patients in a 24-month period, from 2006, to 2008. Results. In our series of arthroscopically treated medial meniscus tears we noted 78 (36.62% vertical complete bucket handle lesions, 19 (8.92% vertical incomplete lesions, 18 (8.45% longitudinal tears, 35 (16.43% oblique tears, 18 (8.45% complex degenerative lesions, 17 (7.98% radial lesions and 28 (13.14% horisontal lesions. Mean preoperative International Knee Documentation Committee (IKDC score was 49.81%, 1 month after the arthroscopic partial medial meniscectomy the mean IKDC score was 84.08%, and 6 months after mean IKDC score was 90.36%. Six months after the procedure 197 (92.49% of patients had good or excellent subjective postoperative clinical outcomes, while 14 (6.57% patients subjectively did not notice a significant improvement after the intervention, and 2 (0.93% patients had no subjective improvement after the partial medial meniscectomy at all. Conclusion. Arthroscopic partial medial meniscetomy is minimally invasive diagnostic and therapeutic procedure and in well selected cases is a method of choice for treatment of medial meniscus injuries when repair techniques are not a viable option. It has small rate of complications, low morbidity and fast rehabilitation.

  1. Gastrocnemius Contracture in Patients With and Without Foot Pathology.

    Science.gov (United States)

    Jastifer, James R; Marston, Jessica

    2016-11-01

    Several studies report performing a recession of the gastrocnemius tendon as surgical treatment of foot and ankle pain related to an isolated gastrocnemius contracture. Few report ankle range of motion using a validated measurement device or report a control group. All previous studies reporting measurements using a validated device have been small in number. Using a previously validated device, 66 patients presenting with foot or ankle pain and 66 controls were measured for ankle range of motion and isolated gastrocnemius contractures. Clinical and goniometer measurement of ankle range of motion was also performed. The foot and ankle pain group had a mean dorsiflexion of 11.6 degrees compared with a mean of 17.2 degrees in the control group (P < .0001). No patients in either group had less than 15 degrees of motion with the knee flexed. The difference in dorsiflexion was less using a goniometer than using the validated device, which may be due to measurement technique and external landmarks. Patients with foot and ankle pain had less ankle dorsiflexion than the control group. This is the largest study to date using a validated measurement device as well as a control group and supports the findings of previous authors. Level II, prospective cohort study. © The Author(s) 2016.

  2. Protein synthesis rates in atrophied gastrocnemius muscles after limb immobilization

    Science.gov (United States)

    Tucker, K. R.; Seider, M. J.; Booth, F. W.

    1981-01-01

    Noting that protein synthesis declines in the gastrocnemius 6 hr after immobilization, the study sought to detect an increase of protein synthesis when the limb was freed, and to examine the effects of exercise on the rate of increase. Rats were used as subjects, with their hind legs in plaster of Paris in plantar flexion to eliminate strain on the gastrocnemius. Periods of immobilization were varied and samples of blood from the muscle were taken to track protein synthesis rates for different groups in immobilization and exercise regimens (running and weightlifting). Synthesis rates declined 3.6% during time in the cast, then increased 6.3%/day after the casts were removed. Both running and weightlifting were found to increase the fractional rate of protein formation in the gastrocnemius muscle when compared with contralateral muscles that were not exercised and were used as controls, suggesting that the mechanism controlling protein synthesis in skeletal muscles is rapidly responsive to changes in muscular contractile activity.

  3. Superficial aponeurosis of human gastrocnemius is elongated during contraction: implications for modeling muscle-tendon unit.

    Science.gov (United States)

    Muramatsu, Tadashi; Muraoka, Tetsuro; Kawakami, Yasuo; Fukunaga, Tetsuo

    2002-02-01

    Two questions were addressed in this study: (1) how much strain of the superficial aponeurosis of the human medial gastrocnemius muscle (MG) was obtained during voluntary isometric contractions in vivo, (2) whether there existed inhomogeneity of the strain along the superficial aponeurosis. Seven male subjects, whose knees were extended and ankles were flexed at right angle, performed isometric plantar flexion while elongation of superficial aponeurosis of MG was determined from the movements of the intersections made by the superficial aponeurosis and fascicles using ultrasonography. The strain of the superficial aponeurosis at the maximum voluntary contraction, estimated from the elongation and length data, was 5.6+/-1.2%. There was no significant difference in strain between the proximal and distal parts of the superficial aponeurosis. Based on the present result and that of our previous study for the same subjects (J. Appl. Physiol 90 (2001) 1671), a model was formulated for a contracting uni-pennate muscle-tendon unit. This model, which could be applied to isometric contractions at other angles and therefore of wide use, showed that similar strain between superficial and deep aponeuroses of MG contributed to homogeneous fascicle length change within MG during contractions. These findings would contribute to clarifying the functions of the superficial aponeurosis and the effects of the superficial aponeurosis elongation on the whole muscle behavior.

  4. Labial hair tourniquet: unusual complication of an unrepaired genital laceration.

    Science.gov (United States)

    Dua, Anahita; Jamshidi, Ramin; Lal, Dave R

    2013-07-01

    Hair tourniquet syndrome has been recognized as a medical entity since the 1600 s. Appendages develop acute ischemia from tightening of hair strands circumferentially wrapped around them. Most commonly affected sites are fingers, toes, and penis, but limited reports have described involvement of the female genitalia. Although hair strangulation involving the labia minora or clitoris has been described, it typically occurs in young children. We present a case of an adolescent girl with a labial appendage hair tourniquet resulting from a previous unrepaired genital laceration. This is one of the oldest patients in whom a genital hair tourniquet has been reported, as well as description of a posttraumatic genital appendage. Genital hair tourniquets are medical emergencies that require prompt diagnosis and treatment to avoid tissue necrosis and possible amputation. Genital trauma in general requires surgical evaluation.

  5. Pancreatic laceration and portal vein thrombosis in blunt trauma abdomen

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    Rastogi Rajul

    2008-01-01

    Full Text Available Injuries to the pancreas by blunt trauma are uncommon. The association of pancreatic injury with acute portal vein thrombosis secondary to blunt trauma abdomen is furthermore rare. The early diagnosis of the pancreas with injury to the portal vein is challenging and difficult. These injuries are associated with high morbidity and mortality, particularly if the diagnosis is delayed. Accurate and early diagnosis is therefore imperative and computed tomography plays a key role in detection. We present a case of child with a rare combination of pancreatic laceration and acute portal vein thrombosis following a blunt trauma to the abdomen. With extensive literature search we found no such cases has been described previously.

  6. Anesthesia for Traumatic Diaphragmatic Hernia Associated with Corneal Laceration.

    Science.gov (United States)

    Safaeian, Reza; Hassani, Valiollah; Faiz, Hamid Reza

    2016-09-06

    BACKGROUND Diaphragmatic rupture can be seen in up to 5% of car accidents, and 80%-100% of diaphragmatic hernias are associated with other vital organ injuries. Brain, pelvis, long bones, liver, spleen, and aorta are some other organs that can be severely damaged and need different anesthetic managements. CASE REPORT A 37-year-old male victim of a head-on collision who was suffering diaphragmatic rupture and corneal laceration was prepared for an emergency operation 11 hours after the car accident. Gastric decompression, pre-oxygenation, rapid sequence induction with succinylcholine, immediate use of non-depolarizing muscle relaxant, and mechanical ventilation with low tidal volume after intubation were used in anesthetic management of the patient. CONCLUSIONS Because of the high prevalence of coexisting pathologies with traumatic diaphragmatic hernia, anesthetic management must be tailored to the associated pathologies.

  7. The diagnostic value of oral lacerations and incontinence during convulsive "seizures".

    Science.gov (United States)

    Oliva, Megan; Pattison, Claire; Carino, John; Roten, Annie; Matkovic, Zelko; O'Brien, Terence J

    2008-06-01

    Oral lacerations and urinary incontinence have long been considered useful clinical features for the diagnosis of epileptic seizures; however, both are also reported in patients with psychogenic nonepileptic seizures (PNES). The aims of the study were (1) to investigate whether the presence and nature of oral lacerations or incontinence during convulsive seizures of patients with epilepsy differed from those with PNES, and (2) whether the side of the oral laceration has any correlation with the epilepsy syndrome or lateralization. Eighty-four consecutive patients who experienced at least one convulsive event during video-EEG monitoring (VEM) were questioned and examined for oral lacerations and incontinence. Seizure classification was determined by a team of epileptologists based on the VEM findings and other clinical and investigational data, blinded to the oral laceration and incontinence information. The presence of oral lacerations among patients with epileptic seizures was 26% (17/66), in contrast it was 0% (0/18) with PNES (p = 0.01). Of the oral lacerations sustained by patients during an epileptic seizure, 14 were to the side of the tongue, one to the tip of the tongue, two to the cheek, and three to the lip. No significant relationships were observed between seizure lateralization and oral lacerations. Incontinence occurred in 23% (15/66) of epilepsy patients and 6% (1/18) of PNES patients (p = 0.09). There was no relationship between epilepsy type or lateralization and the prevalence of incontinence. Despite frequent reports of oral lacerations and incontinence by patients with PNES, objective evidence for this is highly specific to convulsive epileptic seizures.

  8. Uniportal endoscopic gastrocnemius recession for treatment of gastrocnemius equinus with a dedicated EGR system with retractable blade.

    Science.gov (United States)

    Schroeder, Stephen M

    2012-01-01

    This study examined the effectiveness and safety of a uniportal endoscopic gastrocnemius recession with a specifically designed uniportal endoscopic system. Fifty-three patients underwent 60 endoscopic gastrocnemius recessions. Their mean range of ankle dorsiflexion changed from a preoperative value of -2.9° ± 1.9° to a postoperative value of 12.8° ± 1.7°, for a total increase of 15.7° ± 1.8° of ankle dorsiflexion (p triceps surae weakness that resolved after physical therapy. Three (5%) cases developed nerve complications, with 2 (3.33%) cases of transient neuritis that spontaneously resolved at 5 and 8 weeks postoperatively, respectively, and 1 (1.67%) that experienced persistent cutaneous anesthesia in the distribution of the sural nerve along the lateral aspect of the foot up to 4 months postoperatively. There were no cases of wound dehiscence or delayed healing, painful scar formation, infection at the surgical site, hematoma, or deep venous thrombosis. Endoscopic gastrocnemius recession with a uniportal system appears to be safe and effective.

  9. MR imaging assessment of the lateral head of the gastrocnemius muscle: prevalence of segmental anomalous origins in children and young adults

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hee Kyung; Laor, Tal; Racadio, Judy M. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2008-12-15

    Variations in the lower extremity musculature have been identified, including an anomalous origin of the medial head of the gastrocnemius muscle. Anomalies of the lateral head of the gastrocnemius muscle (LGN) have been less frequently described, especially in children. To describe the MR imaging appearance, frequency and clinical symptoms associated with anatomic variations of the LGN in children and young adults. A retrospective review of 465 knee MR imaging examinations was performed. The site of origin of the LGN was identified as either normal, lateral segmental anomalous origin (LSAO), or medial accessory anomalous origin (MAAO). The clinical indication for imaging was recorded. An anatomic variation of the LGN was identified in 16 patients (3.4%). Nine patients had LSAO, and five of these had symptoms referable to or abnormalities of the patella. Seven patients had MAAO, and three of these had chronic nontraumatic knee pain. Anatomic variations of the LGN are not rare in young patients, occurring with a frequency of 3.4% in our series. It is unknown whether these anomalies play a role in the etiology of patellofemoral pain or unexplained joint pain in children. (orig.)

  10. Effects of gastrocnemius tightness on forefoot during gait.

    Science.gov (United States)

    Cazeau, Cyrille; Stiglitz, Yves

    2014-12-01

    The gastrocnemius is the main muscle of the posterior compartment of the leg. As a biarticular muscle it has specific biomechanical propertiess. This article discusses these properties combining the major biomechanical topics of anatomy, dynamics, kinetics, and electromyography. This muscle is remarkable in that it has very low energy consumption and very high mechanical efficacy. In addition to the biomechanical features, the consequences of its tightness are discussed. The dysfunction also appears in all the biomechanical topics and clarifies the reasons of the location of symptoms in the midfoot and on the plantar aspect of the forefoot.

  11. Clinical inquiries. How does tissue adhesive compare with suturing for superficial lacerations?

    Science.gov (United States)

    Aukerman, Douglas F; Sebastianelli, Wayne J; Nashelsky, Joan

    2005-04-01

    Tissue adhesives are effective and yield results comparable to those with conventional suturing of superficial, linear, and low-tension lacerations. The cosmetic outcome is similar; wound complications, such as infection and dehiscence, may be lower with tissue adhesives. Wound closure of superficial lacerations by tissue adhesives is quicker and less painful compared with conventional suturing (strength of recommendation: A, systematic reviews of randomized trials).

  12. Iatrogenic Ulnar Nerve Injury post Laceration Suturing – An Unusual Presentation

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    Murali Mothilal

    2013-07-01

    Full Text Available Introduction: Nerve entrapment while suturing a lacerated wound is a complication that is easily avoidable. We report a case low ulnar nerve palsy due to nerve entrapment while suturing a lacerated wound. Case Report: A 48 year old lady came with complaints of pain and a lacerated wound over the dorsomedial aspect of lower third of the left forearm. The lacerated wound was sutured elsewhere one week back. She had fracture of lower third of the ulna which was stabilised with plates and screws using a separate dorsal incision. She developed ulnar claw hand on the third postoperative day. Strength duration curve revealed neurotmesis of ulnar nerve. Ulnar nerve exploration was done and the nerve was found to be ligated at the site of original laceration. The ligature was released and nerve was found to be thinned out at the site. There was no neurological recovery at 5 months follow up and reconstruction procedures in form of tendon tranfer are planned for the patient. Conclusion: This is a case of iatrogenic ulnar nerve palsy which is very rare in our literature. This can be easily avoided if proper care is taken while suturing the primary laceration. A nerve can be mistakenly sutured for a bleeding vein and proper exposure while suturing will be necessary especially at areas where nerves are superficial. Keywords: Iatrogenic, ulnar nerve palsy

  13. A new approach to assess the gastrocnemius muscle volume in rodents using ultrasound; comparison with the gastrocnemius muscle index.

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    Tim H J Nijhuis

    Full Text Available INTRODUCTION: The purpose of this study was to determine the reliability and validity of a new non-invasive ultrasound technique to measure gastrocnemius muscle atrophy after nerve denervation in an animal model. METHODS: In sixteen rodents an eight mm sciatic nerve gap was created. In the following 8 weeks, each week, two rodents were euthanized and the gastrocnemius muscle was examined using two different ultrasound systems and two investigators. The standardized ultrasound measurement protocol consisted of identifying pre-defined anatomical landmarks: 1 the fibula, 2 the fibular nerve, and 3 the junction between the most distal point of the semitendinosus muscle and gastrocnemius muscle. Consequently, we measured the muscle thickness as the length of the line between the fibula and the junction between the two muscles, perpendicular to the fibular nerve. After the ultrasound recording, the muscle mass was determined. RESULTS: A steep decline of muscle weight of 24% was observed after one week. In the following weeks, the weight further decreased and then remained stable from 6 weeks onwards, resulting in a maximal muscle weight decrease of 82%. The correlation coefficient was >0.96 between muscle diameter and weight using both ultrasound systems. The inter-rater reliability was excellent for both devices on the operated side (ICC of 0.99 for both ultrasound systems and good for the non-operated site (ICC's: 0.84 & 0.89. The difference between the muscle mass ratio and the muscle thickness ratio was not more than 5% with two outliers of approximately 13%. DISCUSSION: We have developed an innovative, highly reliable technique for quantifying muscle atrophy after nerve injury. This technique allows serial measurements in the same animal over time. This is a significant advantage compared to the conventional technique for quantifying muscle atrophy, which requires sacrificing the animal.

  14. Anesthesia for Traumatic Diaphragmatic Hernia Associated with Corneal Laceration

    Science.gov (United States)

    Safaeian, Reza; Hassani, Valiollah; Faiz, Hamid Reza

    2016-01-01

    Patient: Male, 37 Final Diagnosis: Diaphragmatic hernia Symptoms: Dyspnea Medication: — Clinical Procedure: CT-scan Specialty: Anesthesiology Objective: Rare co-existance of disease or pathology Background: Diaphragmatic rupture can be seen in up to 5% of car accidents, and 80%–100% of diaphragmatic hernias are associated with other vital organ injuries. Brain, pelvis, long bones, liver, spleen, and aorta are some other organs that can be severely damaged and need different anesthetic managements. Case Report: A 37-year-old male victim of a head-on collision who was suffering diaphragmatic rupture and corneal laceration was prepared for an emergency operation 11 hours after the car accident. Gastric decompression, preoxygenation, rapid sequence induction with succinylcholine, immediate use of non-depolarizing muscle relaxant, and mechanical ventilation with low tidal volume after intubation were used in anesthetic management of the patient. Conclusions: Because of the high prevalence of coexisting pathologies with traumatic diaphragmatic hernia, anesthetic management must be tailored to the associated pathologies. PMID:27595907

  15. Medial canthus retiform hemangioendothelioma

    Directory of Open Access Journals (Sweden)

    Yasser H Al-Faky

    2014-01-01

    Full Text Available Retiform hemangioendothelioma (RH is a distinct entity in the spectrum of vascular tumors with a high local recurrence rate. It is considered a low-grade, well-differentiated cutaneous angiosarcoma with low metastatic potential. We report here for the first time a case of medial canthus recurrent RH. It may be helpful in our practice to include RH as a differential diagnosis of eyelid lesions. It is noteworthy that the progressive course and recurrence tendency of RH might be misdiagnosed as angiosarcoma or basal cell carcinoma (BCC, if not expected and carefully evaluated by the pathologist.

  16. A clinical application of laser direction in anastomosis for inferior canalicular laceration

    Institute of Scientific and Technical Information of China (English)

    LIANG Tao; ZHAO Ke-xiao; ZHANG Ling-yun

    2006-01-01

    Objective:To study the therapeutic efficiency and effecacy of laser-directing approach on searching for the nasal broken end of lacerated lacrimal canaliculus in anastomosis for canalicular laceration.Methods: Forty-nine patients ( 49 eyes ) suffering from traumatic inferior canalicular laceration were divided into control group and laser-directing group. The distance between the lacrimal punctum and the nasal broken end of lacerated lacrimal canaliculus was more than 6 mm. During the course of management of eyelid trauma, the patients were treated by canalicular anastomosis operation with traditional method and laser-directing method in searching for the nasal broken end of lacerated lacrimal canaliculus respectively. The silicone tube of 1 mm diameter was intubated in the lacrimal passage as a stent for 4 to 6months.Results: In the laser-directing group, the mean time in searching for the nasal broken end of lacerated lacrimal canaliculus was (5.75 ± 1.49) minutes and the mean time of operation was (49.21±3.37) minutes; both were significantly shorter than that of the control group(P <0.01). The cure rate of the laser-directing group was96.55 %, higher than that of the control group but without statistical significance (P > 0.05).Conclusions: The laser-directing method is much quicker and more convenient to searching for the nasal broken end of the lacerated lacrimal canaliculus than the traditional approach, and patients suffer less pain and damaging in canalicular anastomosis operation.

  17. Histochemical pattern of gastrocnemius muscle in fluoride toxicity syndrome

    Institute of Scientific and Technical Information of China (English)

    Shashi A; Bhushan B; Bhardwaj M

    2010-01-01

    Objective:To evaluate the effect of sodium fluoride (NaF) on cytochemical distribution of proteins, DNA, and RNA in the gastrocnemius muscle of rat in experimental fluorosis.Methods:Young Sprague Dawley albino rats were administered with NaF at 30, 45, and 75 mg/kg bw/day subcutaneously for 15 and 30 days, respectively. The control animals were given the vehicle (1cc deionized double distilled water/kg bw/day).Results: In the first phase of 15 days experimentation, the gastrocnemius muscle of rats intoxicated with NaF at 30, 45, and 75 mg /kg bw/ day showed decline in proteins includingαamino acids as compared to control. In the second phase of 30 days experimentation, the muscle fibers of rat showed elevation in sarcolemmal and sarcoplasmic proteins in 30 mg NaF dose group, and angulated fibers exhibited increase in sarcolemmal proteins in 45 mg NaF group. The marginal regions of angular and rim fibers showed deeply stained rings of sarcoplasmic proteins whereas the split fibers were faintly stained in rats treated with NaF at 75 mg/kg bw/day for 30 days. In rats treated with NaF at 30 mg/kg bw/day for 15 days, the hypertrophied peripheral muscle fibers contained more DNA, however the atrophied fibers had more RNA. In 45 mg NaF group, RNA was located in sarcolemmal regions, while DNA content decreased as compared to control. In 75 mg NaF group, the muscle fibers had dark and light staining regions of DNA and RNA. In the 30 days of experimentation, the DNA level decreased whereas RNA content increased in the gastrocnemius muscle fibers of the rat treated with NaF at 30 mg/kg bw/day. In treatment group with NaF at 45 mg/kg bw/day, the RNA content slightly declined in comparison to control, in all treatments for 15 days as well as in treatment group with NaF at 30 mg/kg bw/day for 30 days whereas the amount of DNA slightly increased as compared to treatment group with NaF at 75 mg/kg bw/day for 15 days. The highest dose group revealed elevated amount of RNA whereas

  18. A simple method for medial canthal reconstruction

    NARCIS (Netherlands)

    Wittkampf, ARM; Mourits, MP

    2001-01-01

    A simple method for medical canthal wiring reconstruction with the help of a homolaterally fixed osteosynthesis plate and a metal wire is presented. This avoids transnasal wiring and gives superior control when correcting the position of the lacerated Omedial canthus.

  19. Dynamic changes of twitchlike responses to successive stimuli studied by decomposition of motor unit tetanic contractions in rat medial gastrocnemius.

    Science.gov (United States)

    Celichowski, Jan; Raikova, Rositsa; Aladjov, Hristo; Krutki, Piotr

    2014-12-15

    Unfused tetanic contractions evoked by trains of stimuli at variable interpulse intervals (IPIs) were recorded for 10 fast fatigable (FF), 10 fast resistant (FR), and 10 slow (S) motor units (MUs) and subsequently decomposed with a mathematical algorithm into trains of twitch-shape responses to successive stimuli. The mean stimulation frequencies were matched for each MU to evoke tetani of similar fusion degrees, whereas the variability range of IPIs was in each case 50-150% of the mean IPI. Force and time parameters of decomposed twitches were analyzed and related to the first response. Considerable variability of the analyzed twitch parameters was observed in each MU, although the largest range of variability occurred in slow MUs. In general, the decomposed twitch responses had longer duration and higher force than single-twitch contractions, although for nine FF and six FR MUs some of the decomposed responses were slightly weaker (but not faster) than the first twitches of these MUs. Comparison of the strongest decomposed twitch to the first decomposed twitch revealed ratios of forces up to 2.35, 3.33, and 6.89 for FF, FR, and S MUs and ratios of force-time areas up to 3.54, 4.67, and 14.26 for FF, FR, and S MUs, whereas for the contraction times the ratios of the longest decomposed twitch to the first twitch amounted to 2.46, 2.07, and 3.52 for FF, FR, and S MUs, respectively. The results indicate that contractile responses to successive action potentials are considerably variable, especially for slow MUs.

  20. Elevation of myostatin and FOXOs in prolonged muscular impairment induced by eccentric contractions in rat medial gastrocnemius muscle.

    Science.gov (United States)

    Ochi, Eisuke; Hirose, Tatsuro; Hiranuma, Kenji; Min, Seok-Ki; Ishii, Naokata; Nakazato, Koichi

    2010-02-01

    This study aimed to investigate torque deficit and activation of protein synthesis and/or protein degradation signaling pathways during the early and recovery phase after high- and low-velocity eccentric contractions (ECs). Male Wistar rats (n = 36) were randomly divided into fast angular velocity ECs group (FAST; 180 degrees/s; n = 12), slow ECs group (SLOW; 30 degrees/s; n = 12), and control group (control; n = 12). ECs comprised four sets of five forced dorsiflexions combined with electrical stimulation of the plantar flexors. Isometric tetanic torque was measured before and after ECs. Tissue contents of Akt(P) (P, phosphorylated), mammalian target of rapamycin (mTOR)(P), 70-kDa ribosomal protein S6 kinase (P70S6k), P70S6k(P), forkhead transcription factor 1 of the O class (FOXO1), FOXO1(P), FOXO3, FOXO3(P), myostatin, and activin receptor type IIB (ActRIIB) were measured. The isometric tetanic torque after ECs was significantly lower in FAST than in SLOW (days 1, 3, and 5, P muscular function and activation of protein synthesis and/or protein degradation signaling pathways.

  1. Sonographic evaluation of the immediate effects of eccentric heel drop exercise on Achilles tendon and gastrocnemius muscle stiffness using shear wave elastography

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    Wilson K.C. Leung

    2017-07-01

    Full Text Available Background Mechanical loading is crucial for muscle and tendon tissue remodeling. Eccentric heel drop exercise has been proven to be effective in the management of Achilles tendinopathy, yet its induced change in the mechanical property (i.e., stiffness of the Achilles tendon (AT, medial and lateral gastrocnemius muscles (MG and LG was unknown. Given that shear wave elastography has emerged as a powerful tool in assessing soft tissue stiffness with promising intra- and inter-operator reliability, the objective of this study was hence to characterize the stiffness of the AT, MG and LG in response to an acute bout of eccentric heel drop exercise. Methods Forty-five healthy young adults (36 males and nine females performed 10 sets of 15-repetition heel drop exercise on their dominant leg with fully-extended knee, during which the AT and gastrocnemius muscles, but not soleus, were highly stretched. Before and immediately after the heel drop exercise, elastic moduli of the AT, MG and LG were measured by shear wave elastography. Results After the heel drop exercise, the stiffness of AT increased significantly by 41.8 + 33.5% (P < 0.001, whereas the increases in the MG and LG stiffness were found to be more drastic by 75 + 47.7% (P < 0.001 and 71.7 + 51.8% (P < 0.001, respectively. Regarding the AT, MG and LG stiffness measurements, the inter-operator reliability was 0.940, 0.987 and 0.986, and the intra-operator reliability was 0.916 to 0.978, 0.801 to 0.961 and 0.889 to 0.985, respectively. Discussion The gastrocnemius muscles were shown to bear larger mechanical loads than the AT during an acute bout of eccentric heel drop exercise. The findings from this pilot study shed some light on how and to what extent the AT and gastrocnemius muscles mechanically responds to an isolated set of heel drop exercise. Taken together, appropriate eccentric load might potentially benefit mechanical adaptations of the AT and gastrocnemius muscles in the

  2. Hemostasis Plug for an Electromagnetic Thermotherapy and Its Application for Liver Laceration.

    Science.gov (United States)

    Liu, Chung-Hsien; Huang, Sheng-Chieh; Chao, Ying-Jui; Lin, Xi-Zhang; Lee, Gwo-Bin

    2016-04-01

    Accident-induced liver trauma is a significant human health concern, as this organ is readily injured during periods at which the abdominal region is compromised. In this work, electromagnetic thermotherapy was successfully developed and employed in vitro and in vivo to treat livers that had been lacerated. Briefly, a new hemostasis plug was integrated with an electromagnetic thermotherapy system (ETS) to perform surgery on lacerated livers. The high-frequency, alternating electromagnetic field (EMF) was generated by the ETS and was shown to induce a pre-set temperature increase within the hemostasis plug embedded in the target tissue. In order to prevent overheating and maintain a constant hemostasis temperature, a temperature feedback control system was utilized. The effect of the intensity of the EMF on the heating capacity of the ETS-hemostasis system was first explored. Furthermore, the relationship between the coagulation zone and operating temperature were investigated in vitro. By utilizing the temperature feedback control system, the hemostasis plug could be heated to a specific temperature for efficient hemostasis. With this approach, the optimal treatment temperature and time were investigated for liver laceration. Lacerated livers from New Zealand white rabbits were successfully treated with the hemostasis plug and ETS within a short period of time. When compared with the traditional perihepatic packing approach, the volume of blood loss from liver laceration surgeries treated by ETS has been dramatically reduced by 83%, suggesting a high therapeutic potential for this system.

  3. Risk factors associated with forth-degree laceration during vaginal delivery

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    N. Zafarghandi

    2006-08-01

    Full Text Available Background: To identify the risk factors of fourth-degree laceration during vaginal delivery. Methods: This is a retrospective, case control study. We reviewed 131802 records of vaginal deliveries within 14 years period from 1990 to 2004 in two obstetric center. Cases were 93 vaginal deliveries with fourth-degree laceration and 7 cases were delivered at home, control subjects were 200 vaginal deliveries without third- or fourth-degree lacerations and were identified with the use of random selection. We studied the effects of: maternal age, nationality, parity, gestational age, hour of delivery, birth attendants, episiotomy use and duration of second stage of labor, use of oxytocin, use of forceps or vaccum, Infant birth weight, presentation and postion of fetus, previous severe perineal injury, maternal medical illness and place of delivery. Results: We found 93 cases (%0.07 of documented fourth-degree laceration in 131802 deliveries Conclusion: This study identified several factors associated with fourth-degree laceration. Median episiotomy should be avoided. Nulliparity, fetal macrosomia and OP position are significant risk factors that require caution by birth attendants during delivery

  4. Time Course Change of IGF1/Akt/mTOR/p70s6k Pathway Activation in Rat Gastrocnemius Muscle During Repeated Bouts of Eccentric Exercise.

    Science.gov (United States)

    Ochi, Eisuke; Ishii, Naokata; Nakazato, Koichi

    2010-01-01

    The purpose of this study was to examine whether insulin-like growth factor (IGF-1) and Akt/mTOR/p70S6K pathway activity is altered by chronic eccentric exercise in rat medial gastrocnemius muscle. Male Wistar rats (n = 24) were randomly assigned to 1 of the 2 groups: eccentric exercise (ECC) group or sham-operated control (CON) group. Rats in the ECC group were trained every second day for 10 days (5 sessions in total) or 20 days (10 sessions in total). After either 5 or 10 exercise sessions, muscle specimens were dissected and weighed. The mRNA expression of IGF-1 and its variant, mechano growth factor (MGF), was evaluated using real time reverse transcriptase-polymerase chain reaction (RT-PCR). Tissue concentrations of Akt (P), mTOR (P), and p70S6K (P) were measured by using western blot analysis. The medial gastrocnemius muscle mass of the ECC group did not show any significant difference after 5 exercise sessions, whereas the muscle mass increased significantly after 10 exercise sessions with a concomitant increase in the cross-sectional area of muscle fibers (p exercise sessions was significantly higher than those of the age-matched controls and the rats that received 5 exercise sessions. The expression of MGF mRNA in both ECC5S and ECC10S were significantly higher than that in each period-matched control (p exercise, when significant muscular hypertrophy is observed. Key pointsWe confirmed that the rat muscular exercise model using originally-developed equipment increased the wet mass of the medial gastrocnemius muscle and cross-sectional areas of muscle fibres in 10 sessions (20 days) but not in 5 sessions (10days).We clarified that the increases of muscle mass and CSA of muscle fibers were accompanied by IGF-1 mRNA expression, the phosphorylated Akt, mTOR, and p70S6K.These results suggest that muscular hypertrophy in our model was achieved after 10 sessions of exercise and associated with the activation of IGF-1/Akt/mTOR/p70S6K signal pathway.

  5. Delayed liver laceration following transjugular intrahepatic portosystemic shunt for portal hypertension.

    Science.gov (United States)

    Liu, Kai; Fan, Xin-Xin; Wang, Xu-Lin; He, Chang-Sheng; Wu, Xing-Jiang

    2012-12-28

    The transjugular intrahepatic portosystemic shunt (TIPS) is an acceptable procedure that has proven benefits in the treatment of patients who have complications from portal hypertension due to liver cirrhosis. Delayed liver laceration is a rare complication of the TIPS procedure. We describe a patient with portal hypertension due to liver cirrhosis, who suddenly presented with abdominal hemorrhage and liver laceration 8 d after TIPS. Few reports have described complications after TIPS placement. To the best of our knowledge, this is the first report describing delayed liver laceration. This potential and serious complication appears to be specific and fatal for TIPS in portal hypertension. We advocate careful attention to the technique to avoid this complication, and timely treatment is extremely important.

  6. Multiple lacerations in a pregnant woman caused by spontaneously exploding shower screen glass.

    Science.gov (United States)

    Søreide, Kjetil; Søreide, Annbjørg Hegelstad

    2008-11-01

    Injuries caused by glass occur frequently, in particular in children, and make up an estimated 3% to 5% of all emergency visits, most frequently involving lacerations of hands, feet, and face. About 30% to 40% of glass injuries occur at home and often involve so-called architectural glass or bottles and glass containers. Accidents reported in association with showering mostly refer to falls or scalding by hot water. However, an increasing number of shower screens are made of tempered glass, which may potentially brake. Such injuries may be potentially severe, causing laceration of extremity arteries; requiring hospitalization or outpatient treatment for injuries; causing absence from work. These injuries are likely underreported in the medical literature but could have potential medicolegal consequences for the patient. We report a case of multiple lacerations developed in a third-trimester pregnant woman caused by the spontaneous shattering of a shower screen glass and discuss the apparent unawareness to this potential hazard in the scientific literature.

  7. Ultrasound biomicroscopy confirmation of corneal overriding due to improper suturing of full-thickness corneal laceration

    Directory of Open Access Journals (Sweden)

    Murat Kucukevcilioglu

    2014-12-01

    Full Text Available We herein present a case with corneal overriding due to improper suturing of a full-thickness corneal laceration. There was a 2.5-mm difference between horizontal and vertical white-to-white measurements in the cornea. However, slit lamp examination failed to demonstrate the exact architecture of the laceration. Ultrasound biomicroscopy defined the wound edges thoroughly and confirmed the presence of corneal overriding. Six weeks after suture enhancement, the abnormal oval appearance of the cornea was absent and correct apposition of the corneal edges was seen on ultrasound biomicroscopy. Ultrasound biomicroscopy can be used in preoperative surgical planning of cases with complicated corneal lacerations. It can be used to adjust and enhance wound architecture in eyes with penetrating injury.

  8. Pulmonary laceration secondary to a traumatic soccer injury: a case report and review of the literature.

    Science.gov (United States)

    Idriz, Sanjin; Abbas, Ausami; Sadigh, Sufi; Padley, Simon

    2013-11-01

    Pulmonary lacerations are an uncommon injury typically associated with high-impact trauma. Most cases occur as a result of high-speed road traffic collisions. Although chest wall and pleural injuries are commonly associated with sports-related thoracic trauma, pulmonary injuries are far less common. There are only a few reported cases of significant pulmonary trauma associated with sports injuries, the majority of which have described pulmonary contusions occurring as a result of thoracic injury sustained while playing high-impact contact sports such as American football. Pulmonary laceration occurring as result of soccer-related thoracic trauma has never previously been reported.

  9. The "sweet science" of reducing periorbital lacerations in mixed martial arts.

    Science.gov (United States)

    Bastidas, Nicholas; Levine, Jamie P; Stile, Frank L

    2012-01-01

    The popularity of mixed martial arts competitions and televised events has grown exponentially since its inception, and with the growth of the sport, unique facial injury patterns have surfaced. In particular, upper eyelid and brow lacerations are common and are especially troublesome given the effect of hemorrhage from these areas on the fighter's vision and thus ability to continue. We propose that the convexity of the underlying supraorbital rim is responsible for the high frequency of lacerations in this region after blunt trauma and offer a method of reducing subsequent injury by reducing its prominence.

  10. Similarities and Differences of the Soleus and Gastrocnemius H-reflexes during Varied Body Postures, Foot Positions, and Muscle Function: Multifactor Designs for Repeated Measures

    Directory of Open Access Journals (Sweden)

    Sabbahi Mohamed A

    2011-06-01

    Full Text Available Abstract Background Although the soleus (Sol, medial gastrocnemius (MG, and lateral gastrocnemius (LG muscles differ in function, composition, and innervations, it is a common practice is to investigate them as single H-reflex recording. The purpose of this study was to compare H-reflex recordings between these three sections of the triceps surae muscle group of healthy participants while lying and standing during three different ankle positions. Methods The Sol, MG and LG muscles' H-reflexes were recorded from ten participants during prone lying and standing with the ankle in neutral, maximum dorsiflexion, and maximum plantarflexion positions. Four traces were averaged for each combination of conditions. Three-way ANOVAs (posture X ankle position X muscle with planned comparisons were used for statistical comparisons. Results Although the H-reflex in the three muscle sections differed in latency and amplitude, its dependency on posture and ankle position was similar. The H-reflex amplitudes and maximum H-reflex to M-response (H/M ratios were significantly 1 lower during standing compared to lying with the ankle in neutral, 2 greater during standing with the ankle in plantarflexion compared to neutral, and 3 less with the ankle in dorsiflexion compared to neutral during lying and standing for all muscles (p ≤ .05. Conclusion Varying demands are required for muscles activated during distinctly different postures and ankle movement tasks.

  11. Management of tongue and lip laceration due to dystonia in a 1-year-old infant

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    J P Beena

    2017-01-01

    Full Text Available This case report describes the management of tongue and lip lacerations due to dystonia in a 1-year-old infant. A splint was given to raise the bite and prevent repeated trauma and aid in healing of the oral tissue. This paper highlights the importance of pediatric dentist's role in improving quality of patient care in an intensive care unit.

  12. Acute effect of static stretching on passive stiffness of the human gastrocnemius fascicle measured by ultrasound shear wave elastography.

    Science.gov (United States)

    Hirata, Kosuke; Kanehisa, Hiroaki; Miyamoto, Naokazu

    2017-03-01

    Passive muscle stiffness and muscle architecture at a given joint angle, as well as slack angle of the muscle have been shown to change after an acute bout of stretching. However, it remains unclear whether passive muscle stiffness at a given fascicle length is reduced after stretching. We aimed to elucidate the acute effect of static stretching on the passive fascicle stiffness using ultrasound shear wave elastography. Shear modulus, fascicle length, and slack angle of the medial gastrocnemius (MG) as well as passive plantar flexion torque during passive dorsiflexion were measured before and after a 5-min static stretching in 14 healthy males. After stretching, passive torques were significantly reduced at >50% of range of motion (ROM). Shear modulus at a given fascicle length was significantly reduced at >80% of the change in fascicle length during passive dorsiflexion. Slack angle of MG was observed at the middle part of ROM and significantly shifted toward more dorsiflexed position after stretching. The present study showed the significant effectiveness of static stretching on the passive fascicle stiffness. Furthermore, the present results suggest that both the shift in slack angle and the reduction in passive fascicle stiffness contribute to produce the change in passive torque-joint angle relationship during passive dorsiflexion. Notably, the contribution of the reduced passive fascicle stiffness to the decrease in passive torque is substantial over the latter part of ROM.

  13. Effects of knee joint angle on the fascicle behavior of the gastrocnemius muscle during eccentric plantar flexions.

    Science.gov (United States)

    Wakahara, Taku; Kanehisa, Hiroaki; Kawakami, Yasuo; Fukunaga, Tetsuo

    2009-10-01

    The present study aimed to clarify the effects of knee joint angle on the behavior of the medial gastrocnemius muscle (MG) fascicles during eccentric plantar flexions. Eight male subjects performed maximal eccentric plantar flexions at two knee positions [fully extended (K0) and 90 degrees flexed (K90)]. The eccentric actions were preceded by static plantar flexion at a 30 degrees plantar flexed position and then the ankle joint was forcibly dorsiflexed to 15 degrees of dorsiflexion with an isokinetic dynamometer at 30 degrees /s and 150 degrees /s. Tendon force was calculated by dividing the plantar flexion torque by the estimated moment arm of the Achilles tendon. The MG fascicle length was determined with ultrasonography. The tendon forces during eccentric plantar flexions were influenced by the knee joint angle, but not by the angular velocity. The MG fascicle lengths were elongated as the ankle was dorsiflexed in K0, but in K90 they were almost constant despite the identical range of ankle joint motion. These results suggested that MG fascicle behavior during eccentric actions was markedly affected by the knee joint angle. The difference in the fascicle behavior between K0 and K90 could be attributed to the non-linear force-length relations and/or to the slackness of tendinous tissues.

  14. Does ankle joint power reflect type of muscle action of soleus and gastrocnemius during walking in cats and humans?

    Science.gov (United States)

    Cronin, Neil J; Prilutsky, Boris I; Lichtwark, Glen A; Maas, Huub

    2013-04-26

    The main objective of this paper is to highlight the difficulties of identifying shortening and lengthening contractions based on analysis of power produced by resultant joint moments. For that purpose, we present net ankle joint powers and muscle fascicle/muscle-tendon unit (MTU) velocities for medial gastrocnemius (MG) and soleus (SO) muscles during walking in species of different size (humans and cats). For the cat, patterns of ankle joint power and MTU velocity of MG and SO during stance were similar: negative power (ankle moment×angular velocitypower (generation of mechanical energy) was found during MTU shortening. This was also found for the general fascicle velocity pattern in SO. In contrast, substantial differences between ankle joint power and fascicle velocity patterns were observed for MG muscle. In humans, like cats, the patterns of ankle joint power and MTU velocity of SO and MG were similar. Unlike the cat, there were substantial differences between patterns of fascicle velocity and ankle joint power during stance in both muscles. These results indicate that during walking, only a small fraction of mechanical work of the ankle moment is either generated or absorbed by the muscle fascicles, thus confirming the contribution of in-series elastic structures and/or energy transfer via two-joint muscles. We conclude that ankle joint negative power does not necessarily indicate eccentric action of muscle fibers and that positive power cannot be exclusively attributed to muscle concentric action, especially in humans.

  15. Altered Biomechanical Properties of Gastrocnemius Tendons of Turkeys Infected with Turkey Arthritis Reovirus

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    Tamer A. Sharafeldin

    2016-01-01

    Full Text Available Turkey arthritis reovirus (TARV causes lameness and tenosynovitis in commercial turkeys and is often associated with gastrocnemius tendon rupture by the marketing age. This study was undertaken to characterize the biomechanical properties of tendons from reovirus-infected turkeys. One-week-old turkey poults were orally inoculated with O’Neil strain of TARV and observed for up to 16 weeks of age. Lameness was first observed at 8 weeks of age, which continued at 12 and 16 weeks. At 4, 8, 12, and 16 weeks of age, samples were collected from legs. Left intertarsal joint with adjacent gastrocnemius tendon was collected and processed for histological examination. The right gastrocnemius tendon’s tensile strength and elasticity modulus were analyzed by stressing each tendon to the point of rupture. At 16 weeks of age, gastrocnemius tendons of TARV-infected turkeys showed significantly reduced (P<0.05 tensile strength and modulus of elasticity as compared to those of noninfected control turkeys. Gastrocnemius tendons revealed lymphocytic tendinitis/tenosynovitis beginning at 4 weeks of age, continuing through 8 and 12 weeks, and progressing to fibrosis from 12 to 16 weeks of age. We propose that tendon fibrosis is one of the key features contributing to reduction in tensile strength and elasticity of gastrocnemius tendons in TARV-infected turkeys.

  16. GASTROCNEMIUS TUBERCLE IN INDIAN POPULATION: A NEW ANATOMICAL ENTITY?. Tubérculo gastrocnemio en la población india: Una nueva entidad anatómica?

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    Shilpa Gosavi

    2016-03-01

    was named as gastrocnemius tubercle. The medial head of gastrocnemius muscle and posterior oblique ligament were attached close to it. We observed three hundred and ninety six (right-204 and left-192 dry femora belonging to Indian population. The medial condyle was observed for the presence of third bony prominence - gastrocnemius tubercle (GCT along with adductor tubercle and medial epicondyle. The presence or absence of GCT was noted. The size of GCT and AT was compared. The distance between the most prominent point on AT and GCT and between GCT and MEP was measured using digital Vernier caliper accurate up to 0.01 mm. The percentage, mean, range and standard deviation was calculated for the data. Presence of GCT was noted in 207 bones (52.27% (right-109 and left-98. In majority (80.7% of the femora AT was larger than GCT. Mean distance between GCT and AT on right side was 10.8 ± 2.4 mm and on left side it was 10.9 ± 2.3.  Distance between GCT and MEP on right side was observed as 14.8 ± 0.5 mm and on left side 14.9 ± 2.9. The bilateral differences were not significant statistically. It is important for clinicians to identify GCT to avoid non-anatomical repair of medial knee injuries.

  17. Gastrocnemius Recession Leads to Increased Ankle Motion and Improved Patient Satisfaction After 2 Years of Follow-Up

    DEFF Research Database (Denmark)

    Holtmann, Julia Alessandra; Südkamp, Norbert P; Schmal, Hagen

    2017-01-01

    The isolated gastrocnemius contracture present in neurologic healthy patients results in a significant limitation of ankle dorsiflexion causing pathologic gait patterns and a greater risk of further foot disorders. Gastrocnemius recession is an established procedure to increase ankle dorsiflexion....... However, little evidence is available of the use of gastrocnemius recession in these patients. Complication rates, recurrence of gastrocnemius contracture, and the prevalence of additional foot disorders needs further evaluation. A study group of 64 operated limbs undergoing gastrocnemius recession...... had improved significantly from 65.4 ± 26.5 points to 33.4 ± 19.5 points (p contracture seem to have a high prevalence of symptomatic foot disorders. At a mid-term follow-up examination, gastrocnemius recession (Strayer) was shown to be an effective...

  18. Consenso SECOT artrosis femorotibial medial.

    OpenAIRE

    A. Moreno; Silvestre Muñoz, Antonio; Carpintero, P.

    2013-01-01

    Se presenta un consenso elaborado por SECOT sobre la actuación en la artrosis del compartimento medial de la rodilla para establecer criterios y recomendaciones clínicas orientadas a unificar criterios en su manejo, abordando los factores implicados en la patogenia de la artrosis femorotibial medial de rodilla, la utilidad de las técnicas diagnósticas por la imagen y la utilidad de la artroscopia. También se analizarán los tratamientos conservadores y el tratamiento quirúrgico. Los expertos c...

  19. Injerto libre braquial medial Free medial arm graft

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    P. Martos Díaz

    2007-12-01

    Full Text Available Introducción. Entre las reconstrucciones de defectos titulares de cabeza y cuello, el injerto libre microvascularizado braquial medial no ha adquirido mucha popularidad debido a las variaciones anatómicas que se reflejan en la vascularización de éste. Nuestro objetivo es realizar una descripción de la anatomía y técnica quirúrgica, así como una revisión de la literatura describiendo las ventajas y desventajas de este tipo de injerto. Material y método. Presentamos el caso de una paciente con carcinoma epidermoide de mucosa yugal izquierda con afectación ganglionar ipsilateral. Se procedió a su resección con márgenes más disección cervical funcional. La reconstrucción del defecto se llevó a cabo mediante un injerto libre microvascularizado braquial medial de brazo izquierdo. Discusión. Pensamos que el injerto libre braquial medial de brazo se trata de una opción más segura a la hora de la reconstrucción de defectos cervicofaciales, aportando una serie de ventajas entre las que destacan: no sacrificio de una arteria terminal, cierre primario de la zona donante, mínimo defecto estético, y poseer una piel fina, elástica y sin vello.Introduction. Free medial microvascularized arm grafts have not become very popular for the reconstruction of head and neck defects due to anatomic variations in their vascularization. Our objective was to describe the anatomy and surgical technique and to review the literature on the advantages and disadvantages of free medial arm grafts. Material and methods. We report the case of a patient with squamous cell carcinoma of the left jugal mucosa with same-side lymph node involvement. The tumor was resected with margins and a functional cervical dissection was performed. The defect was reconstructed using a free medial microvascularized graft from the left arm. Discussion. We believe that free medial arm grafts are a safer option for the reconstruction of cervicofacial defects and that they offer

  20. Gastrocnemius myotendinous flap for patellar or quadriceps tendon repair, or both.

    Science.gov (United States)

    Rhomberg, M; Schwabegger, A H; Ninkovic, M; Bauer, T; Ninkovic, M

    2000-08-01

    The authors' experience with simultaneous reconstruction of the quadriceps femoris or patellar tendon or both and soft tissue defect using a musculotendinous unit of the gastrocnemius muscle is presented. Five patients with a partial or complete defect of the quadriceps or patellar tendon or both and additional large soft tissue defects underwent reconstruction applying this technique as a one-stage surgical procedure in different variations. In cases with a partial defect of the tendon or loss of tendon thickness, the thick aponeurosis from the deeper aspect of the gastrocnemius was dissected and transferred as a pedicled tendon flap to reconstruct the tendon defect. In cases with a complete defect of the tendon, the superficial layer of the Achilles tendon together with the deep aponeurotic layer of the gastrocnemius muscle served to reconstruct the tendon. In both procedures the gastrocnemius muscle belly provided soft tissue coverage and was covered with a split thickness skin graft. One patient had a marginal deep necrosis develop that had to be covered with the other gastrocnemius muscle in a second operation. One patient with chronic polyarthritis and infection of his knee prosthesis declined additional reconstruction surgery and had the leg amputated. The average followup was 3.5 years. All patients achieved good results in active extension of the knee with an extension deficit of only 5 degrees to 15 degrees. The range of flexion was at least 90 degrees. The surgical technique described in this report provides functional tendon reconstruction and adequate soft tissue repair simultaneously.

  1. Anatomical observation of origins of the gastrocnemius and its significance in total knee arthroplasty%腓肠肌起点解剖观察及其在全膝关节置换术中的意义

    Institute of Scientific and Technical Information of China (English)

    林宇进; 覃健; 黄保华; 侯之启; 周国兴

    2012-01-01

    Objective; To study the anatomical characteristics of origins of the gastrocnemius and explore its significance in total knee arthroplasty for the knee joint with severe flexion deformity. Methods-. Two fresh and 20 embalmed knee joints were dissected to observe the morphological structures of origins of the gastrocnemius and the relationships with their adjacent tissues. Results; The medial and lateral heads of the gastrocnemius consisted of middle muscular part and bilateral tendinous parts. The tendon of biceps femoris and common peroneal nerve crossed behind the fibular back of the beginning part of the lateral head. And. There were tendon of the popliteus and lateral collateral ligament on its fibular side. The tendons of the semitendinosus and semimembranosus were posterior to the tibial side of the beginning part of the medial head. The medial and lateral superior genicular arteries coursed above the origins of the medial and lateral heads of the gastrocnemius. Then, bypassed the medial and lateral condyles and run forwardly. The area surrounding the tendon of gastrocnemius is an anatomical safe zone without important nerves and blood vessels. Conclusion-. In total knee arthroplasty for the knee joints with severe flexion deformity, the conventional release through the collateral ligament only reaches the muscular part,which may be a cause of an incomplete release.%目的:研究腓肠肌起点的解剖学特点,探讨其在严重屈曲挛缩畸形全膝关节置换术(TKA)中的意义.方法:常规解剖20侧防腐及2侧新鲜成人膝关节标本,观测腓肠肌起点的形态结构及其与周围结构的毗邻关系.结果:腓肠肌内、外侧头起点分为中间的肌性部分和两侧的腱性部分.外侧头起始部的腓后侧有股二头肌肌腱及腓总神经斜跨过,腓侧有腘肌腱及外侧副韧带.内侧头起始部的胫后侧有半腱肌和半膜肌肌腱.膝上内、外侧动脉从腓肠肌内、外侧头起点上方贴着骨膜绕

  2. Trigger finger following partial flexor tendon laceration: Magnetic resonance imaging-assisted diagnosis

    Science.gov (United States)

    Couceiro, Jose; Fraga, Javier; Sanmartin, Marcos

    2015-01-01

    Introduction Post-traumatic trigger finger is considerably rarer than normal trigger finger. The diagnosis is usually made on a clinical basis. This can be obscured; however, by concurrent pathological conditions. We report a case of post-traumatic trigger finger in which diagnosis was aided by magnetic resonance imaging (MRI). Presentation of case Our patient is a 32-year-old male who had a previous laceration with a subsequent surgery for infectious tenosynovitis. The MRI showed the impinging tendon tag. Surgical excision of the tag successfully solved the case. Discussion The use of imaging studies for the diagnosis of post-traumatic trigger finger has been previously reported, the authors described a variation on the contour of the pulley system. The full lacerated tendon tag can be seen on our patient's MRI. Conclusion On this case, the use of MRI was a useful aid for the differential diagnosis of post-traumattic trigger finger. PMID:25765739

  3. A serious injury underlying an underestimated small laceration of the hand

    Directory of Open Access Journals (Sweden)

    Burak Kaya

    2015-12-01

    Full Text Available In patients suffering from hand injuries, the most important diagnostic tools include patient history and physical examinations. Injuries of the hand caused by knives or drilling tools require careful attention because serious injuries can occur in the form of small skin incisions, depending on the distance and depth of the advance of the tool. Because stab wounds can appear minor superficially, whereas serious injuries can appear as small-access lacerations, the examining physician should be careful when evaluating wound severity. Here, we present a patient with an injury from a knife attack who was treated with an initial intervention that was insufficient to completely repair the injury. Upon initial examination, the only obvious sign of injury was a small laceration; however, the injury turned out to be much more serious in nature. [Hand Microsurg 2015; 4(3.000: 63-66

  4. Laceration and degloving injury of a child's foot--a case report.

    Science.gov (United States)

    Cáp, R; Lochman, P; Horyna, P; Koudelka, J; Klein, L

    2009-01-01

    Laceration and degloving injury to a child's foot is quite a rare occurence, mostly resulting in persistent consequences. Treatment options for such an injury depend on the specific type of injury and the customary practice of each surgical department. The authors present the interesting case of 4-year-old boy with laceration and degloving injury to his right foot after a collision with a truck, suggesting simple treatment using skin graft which has an excellent functional and cosmetic effect. Several methods have been described in management of this kind of injury, such as microvascular free tissue transfer, free or local flap and skin graft. A full-thickness skin graft was used in this case with good result, and in our opinion this treatment option need not be reserved for plastic surgeons.

  5. Sealing of Corneal Lacerations Using Photo Activated Rose Bengal Dye and Amniotic Membrane

    Science.gov (United States)

    2017-04-22

    corneaJ laceration. The rabbit was placed under anesthesia. then 106 prepped and draped in the normal sterile fashion for eye surgery. A lid speculum was...variables. A score of zero was assigned for no observable characteristics, one was scored 148 for minimal observable characteristics, two for mild, three...of the animals scored over one on the 275 zero to four scale. The neovascularization noted was related to anterior chamber and iris changes 276 that

  6. Pontomedullary lacerations and concomitant injuries: A review of possible underlying mechanisms

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    Živković Vladimir

    2013-01-01

    Full Text Available Anatomically, brainstem is constituted of medulla oblongata, pons and mesencephalon. Traumatic lesions of brainstem most commonly occur on pontomedullary junction. There are several possible mechanisms of pontomedullary lacerations. The first mechanism includes impact to the chin, with or without a skull base fracture, and most often leads to this fatal injury, due to impact force transmission through the jawbone and temporomandibular joint. The second mechanism includes lateral and posterior head impacts with subsequent hinge fractures, where occurrence of pontomedullary lacerations in these cases may depend on the energy of impact, as well as on the exact position of the fracture line, but less so on the head’s movement. The third mechanism includes frontoposterior hyperextension of the head, due to frontal impact, concomitant with fractures or dislocations of upper spine. In the fourth mechanism, there is an absence of direct impact to the head, due to the indirect force of action after feet or buttocks­first impact. Most of these cases are accompanied by ring fractures as well. In situations such as these, the impact force is transmitted up the spinal column and upper vertebrae, and telescopically intruded into the skull, causing brainstem laceration. The jawbone and other facial bones can act as shock absorbers, and their fracture could diminish the energy transfer towards the skull and protect the brain and brainstem from injury. In all the cases with pontomedullary laceration posterior neck dissection should be performed during the autopsy, since upper spine injuries are often associated with this type of injury. [Projekat Ministarstva nauke Republike Srbije, br. 45005

  7. Intercostal Artery Laceration: Rare Complication of Thoracentesis and Role of Ultrasound in Early Detection

    Directory of Open Access Journals (Sweden)

    Wissam Mansour

    2017-01-01

    Full Text Available Hemothorax is a rare but potentially fatal postthoracentesis complication. Early clinical signs may be nonspecific resulting in diagnostic delay. A high index of suspicion is vital for early diagnosis and intervention to avoid further bleeding. Following procedure, early bedside ultrasound findings can be vital for early detection. We report a case of massive hemothorax in a 63-year-old male following therapeutic thoracentesis. Diagnosis was made following highly suggestive sonographic findings prompting thoracotomy and lacerated intercostal artery cauterization.

  8. Therapeutic effects of two anastomoses of lacrimal passage on canalicular laceration

    Institute of Scientific and Technical Information of China (English)

    WANG Zun-jing; KONG Qing-lan; XIE Ying-bin; LI Ting

    2008-01-01

    Objective: To evaluate the therapeutic effects of two anastomoses (canaliculus-to-lacrimal sac anastomosis and end-to-end anastomosis) on nasolacrimal laceration for over 7 mm from the broken end to the dacryon. Methods: A total of 71 patients (44 males and 27 females, aged 16-55 years, mean=34.32 years) with fresh canalicular laceration were treated in our hospital from March 2003 to April 2008. Under a microscope, 37 patients were treated with lacrimal sac anastomosis (the treatment group) and 34 with end-to-end anastomosis (the control group), detaining silicone tubes till 3 months later. Results: The cure rate of the treatment group (89.19%) was significantly higher than that of the control group (55.56%). Class I cure rates were 70.27% in the treatment group and 47.06 % in the control group, and the difference between the two groups was significant (P0.05). Conclusions- When the distance from the broken end to the dacryon is over 7 mm, especially when it is necessary to find the paranasal broken end of the lacrimal canaliculus with dacryocystotomy, canaliculus-to-lacrimal sac anasto-mosis is a better treatment method than end-to-end anasto-mosis for laceration of lacrimal canaliculus.

  9. EMG-normalised kinase activation during exercise is higher in human gastrocnemius compared to soleus muscle.

    Directory of Open Access Journals (Sweden)

    Thomas E Jensen

    Full Text Available In mice, certain proteins show a highly confined expression in specific muscle groups. Also, resting and exercise/contraction-induced phosphorylation responses are higher in rat skeletal muscle with low mitochondrial content compared to muscles with high mitochondrial content, possibly related to differential reactive oxygen species (ROS-scavenging ability or resting glycogen content. To evaluate these parameters in humans, biopsies from soleus, gastrocnemius and vastus lateralis muscles were taken before and after a 45 min inclined (15% walking exercise bout at 69% VO2(max aimed at simultaneously activating soleus and gastrocnemius in a comparable dynamic work-pattern. Hexokinase II and GLUT4 were 46-59% and 26-38% higher (p<0.05 in soleus compared to the two other muscles. The type I muscle fiber percentage was highest in soleus and lowest in vastus lateralis. No differences were found in protein expression of signalling proteins (AMPK subunits, eEF2, ERK1/2, TBC1D1 and 4, mitochondrial markers (F1 ATPase and COX1 or ROS-handling enzymes (SOD2 and catalase. Gastrocnemius was less active than soleus measured as EMG signal and glycogen use yet gastrocnemius displayed larger increases than soleus in phosphorylation of AMPK Thr172, eEF2 Thr56 and ERK 1/2 Thr202/Tyr204 when normalised to the mean relative EMG-signal. In conclusion, proteins with muscle-group restricted expression in mice do not show this pattern in human lower extremity muscle groups. Nonetheless the phosphorylation-response is greater for a number of kinase signalling pathways in human gastrocnemius than soleus at a given activation-intensity. This may be due to the combined subtle effects of a higher type I muscle fiber content and higher training status in soleus compared to gastrocnemius muscle.

  10. Differential diagnosis of isolated calf muscle vein thrombosis and gastrocnemius hematoma by high-frequency ultrasound

    Institute of Scientific and Technical Information of China (English)

    SU Li-ya; GUO Fa-jin; XU Guang; HAN Xiu-jie; SUN Chang-kun; ZHANG Zheng; JING Qing-hong

    2013-01-01

    Background Differential diagnosis of isolated calf muscle vein thrombosis (ICMVT) and gastrocnemius hematoma is essential for early identification of deep vein thrombosis (DVT).This study aimed to investigate the diagnostic value of high-frequency color Doppler ultrasound for differential diagnosis of ICMVT and gastrocnemius hematoma.Methods A retrospective case series of 35 ICMVT (M∶F,21∶14; mean age (64.5±10.6) years) and 23 gastrocnemius hematoma (M∶F,16∶7; mean age (75.4±11.8) years) patients with bilateral/unilateral lower limb pain was conducted between January 2006 and September 2012.Characteristics and the morphology of high-frequency color Doppler ultrasonography of the lower limb deep vein,great saphenous vein,calf muscles,skin,and soft tissue were examined.Results ICMVT hypoechoic signals were characterized by long,tube-like masses on longitudinal sections and oval masses on transverse sections,with apparent muscle thrombosis boundaries,distal and proximal venous connections,and,often,lower limb DVT.Gastrocnemius hematoma hypoechoic signals were characterized by large volumes,enhanced posterior hematoma echo,hyperechoic muscle boundaries,no hematoma blood flow,and no DVT,and clear differences in trauma/exercise-and oral anticoagulant-induced hematomas were readily apparent.According to the measurement,the ratio of long diameter/transverse diameter (D/T) in ICMVT patients was about less than 2.0,whereas in gastrocnemius hematoma patients the ratio was more than 2.0.Early stage isoechoic and hypoechoic signals were detected with gradually increasing ovular anechoic areas.Partial muscle fibers in the hematoma due to muscle fractures were apparent.Conclusion High-frequency color Doppler ultrasound was found to be a sensitive and reliable method for differential diagnosis of ICMVT and gastrocnemius hematoma due to trauma and exercise or prolonged oral anticoagulant use.

  11. Effect of aerobic exercise on the contractile function of gastrocnemius myosin heavy chain

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Objective To study the effect of 4-6 weeks' treadmill training of male SD rats on the contractile function of their gastrocnemius myosin heavy chain (MHC). Methods Forty male SD rats were randomly divided into control group and training group. The treadmill training of the training group rats was incessantly performed for 4-6 weeks at an intensity of about 75% VO2max (18.5-24 m/min,gradient of 0°,each training session lasting 50 minutes,twice a day). The content of gastrocnemius MHC mRNA was tested by rever...

  12. Morphological Alterations in Gastrocnemius and Soleus Muscles in Male and Female Mice in a Fibromyalgia Model.

    Directory of Open Access Journals (Sweden)

    Gabriel Alejandro Bonaterra

    Full Text Available Fibromyalgia (FM is a chronic musculoskeletal pain disorder, characterized by chronic widespread pain and bodily tenderness and is often accompanied by affective disturbances, however often with unknown etiology. According to recent reports, physical and psychological stress trigger FM. To develop new treatments for FM, experimental animal models for FM are needed to be development and characterized. Using a mouse model for FM including intermittent cold stress (ICS, we hypothesized that ICS leads to morphological alterations in skeletal muscles in mice.Male and female ICS mice were kept under alternating temperature (4 °C/room temperature [22 °C]; mice constantly kept at room temperature served as control. After scarification, gastrocnemius and soleus muscles were removed and snap-frozen in liquid nitrogen-cooled isopentane or fixed for electron microscopy.In gastrocnemius/soleus muscles of male ICS mice, we found a 21.6% and 33.2% decrease of fiber cross sectional area (FCSA, which in soleus muscle concerns the loss of type IIa and IIx FCSA. This phenomenon was not seen in muscles of female ICS mice. However, this loss in male ICS mice was associated with an increase in gastrocnemius of the density of MIF+ (8.6%-, MuRF+ (14.7%-, Fbxo32+ (17.8%-cells, a 12.1% loss of capillary contacts/muscle fiber as well as a 30.7% increase of damaged mitochondria in comparison with male control mice. Moreover, significant positive correlations exist among densities (n/mm(2 of MIF+, MuRF+, Fbxo32+-cells in gastrocnemius/ soleus muscles of male ICS mice; these cell densities inversely correlate with FCSA especially in gastrocnemius muscle of male ICS mice.The ICS-induced decrease of FCSA mainly concerns gastrocnemius muscle of male mice due to an increase of inflammatory and atrogenic cells. In soleus muscle of male ICS and soleus/gastrocnemius muscles of female ICS mice morphological alterations seem to occur not at all or delayed. The sex-specificity of

  13. Morphological Alterations in Gastrocnemius and Soleus Muscles in Male and Female Mice in a Fibromyalgia Model

    Science.gov (United States)

    Oezel, Lisa; Schwarzbach, Hans; Ocker, Matthias; Thieme, Kati; Di Fazio, Pietro; Kinscherf, Ralf

    2016-01-01

    Background Fibromyalgia (FM) is a chronic musculoskeletal pain disorder, characterized by chronic widespread pain and bodily tenderness and is often accompanied by affective disturbances, however often with unknown etiology. According to recent reports, physical and psychological stress trigger FM. To develop new treatments for FM, experimental animal models for FM are needed to be development and characterized. Using a mouse model for FM including intermittent cold stress (ICS), we hypothesized that ICS leads to morphological alterations in skeletal muscles in mice. Methods Male and female ICS mice were kept under alternating temperature (4°C/room temperature [22°C]); mice constantly kept at room temperature served as control. After scarification, gastrocnemius and soleus muscles were removed and snap-frozen in liquid nitrogen–cooled isopentane or fixed for electron microscopy. Results In gastrocnemius/soleus muscles of male ICS mice, we found a 21.6% and 33.2% decrease of fiber cross sectional area (FCSA), which in soleus muscle concerns the loss of type IIa and IIx FCSA. This phenomenon was not seen in muscles of female ICS mice. However, this loss in male ICS mice was associated with an increase in gastrocnemius of the density of MIF+ (8.6%)-, MuRF+ (14.7%)-, Fbxo32+ (17.8%)-cells, a 12.1% loss of capillary contacts/muscle fiber as well as a 30.7% increase of damaged mitochondria in comparison with male control mice. Moreover, significant positive correlations exist among densities (n/mm2) of MIF+, MuRF+, Fbxo32+-cells in gastrocnemius/ soleus muscles of male ICS mice; these cell densities inversely correlate with FCSA especially in gastrocnemius muscle of male ICS mice. Conclusion The ICS-induced decrease of FCSA mainly concerns gastrocnemius muscle of male mice due to an increase of inflammatory and atrogenic cells. In soleus muscle of male ICS and soleus/gastrocnemius muscles of female ICS mice morphological alterations seem to occur not at all or

  14. Acute effect of heel-drop exercise with varying ranges of motion on the gastrocnemius aponeurosis-tendon's mechanical properties.

    Science.gov (United States)

    Jeong, Siwoo; Lee, Dae-Yeon; Choi, Dong-Sung; Lee, Hae-Dong

    2014-06-01

    The objectives of this study was to investigate the acute effects of various magnitudes of tendon strain on the mechanical properties of the human medial gastrocnemius (MG) in vivo during controlled heel-drop exercises. Seven male and seven female volunteers performed two different exercises executed one month apart: one was a heel-drop exercise on a block (HDB), and the other was a heel-drop exercise on level floor (HDL). In each regimen, the subjects completed a session of 150 heel-drop exercises (15 repetitions×10 sets; with a 30 s rest following each set). Before and immediately after the heel-drop exercise, the ankle plantar flexor torque and elongation of the MG were measured using a combined measurement system of dynamometry and ultrasonography and then the MG tendon strain and stiffness were evaluated in each subject. The tendon stiffness measured prior to the exercises was not significantly different between the two groups 23.7±10.6N/mm and 24.1±10.0N/mm for the HDB and HDL, respectively (p>.05). During the heel-drop exercise, it was found that the tendon strain during the heel-drop exercise on a block (8.4±3.7%) was significantly higher than the strain measured on the level floor (5.4±3.8%) (p<.05). In addition, the tendon stiffness following the heel-drop exercise on a block (32.3±12.2N/mm) was significantly greater than the tendon stiffness measured following the heel-drop exercise on the level floor (25.4±11.4N/mm) (p<.05). The results of this study suggest that tendon stiffness immediately following a heel-drop exercise depends on the magnitude of tendon strain.

  15. Modeling age-related changes in muscle-tendon dynamics during cyclical contractions in the rat gastrocnemius.

    Science.gov (United States)

    Danos, Nicole; Holt, Natalie C; Sawicki, Gregory S; Azizi, Emanuel

    2016-10-01

    Efficient muscle-tendon performance during cyclical tasks is dependent on both active and passive mechanical tissue properties. Here we examine whether age-related changes in the properties of muscle-tendon units (MTUs) compromise their ability to do work and utilize elastic energy storage. We empirically quantified passive and active properties of the medial gastrocnemius muscle and material properties of the Achilles tendon in young (∼6 mo) and old (∼32 mo) rats. We then used these properties in computer simulations of a Hill-type muscle model operating in series with a Hookean spring. The modeled MTU was driven through sinusoidal length changes and activated at a phase that optimized muscle-tendon tuning to assess the relative contributions of active and passive elements to the force and work in each cycle. In physiologically realistic simulations where young and old MTUs started at similar passive forces and developed similar active forces, the capacity of old MTUs to store elastic energy and produce positive work was compromised. These results suggest that the observed increase in the metabolic cost of locomotion with aging may be in part due to the recruitment of additional muscles to compensate for the reduced work at the primary MTU. Furthermore, the age-related increases in passive stiffness coupled with a reduced active force capacity in the muscle can lead to shifts in the force-length and force-velocity operating range that may significantly impact mechanical and metabolic performance. Our study emphasizes the importance of the interplay between muscle and tendon mechanical properties in shaping MTU performance during cyclical contractions. Copyright © 2016 the American Physiological Society.

  16. ”EMG-Normalised Kinase Activation during Exercise Is Higher in Human Gastrocnemius Compared to Soleus Muscle”

    DEFF Research Database (Denmark)

    Leutert, Robin; Elbenhardt Jensen, Thomas; Rasmussen, Søren Them;

    2012-01-01

    expression of signalling proteins (AMPK subunits, eEF2, ERK1/2, TBC1D1 and 4), mitochondrial markers (F1 ATPase and COX1) or ROS-handling enzymes (SOD2 and catalase). Gastrocnemius was less active than soleus measured as EMG signal and glycogen use yet gastrocnemius displayed larger increases than soleus...

  17. Task-dependent inhibition of slow-twitch soleus and excitation of fast-twitch gastrocnemius do not require high movement speed and velocity-dependent sensory feedback

    Directory of Open Access Journals (Sweden)

    Ricky eMehta

    2014-10-01

    Full Text Available Although individual heads of triceps surae, soleus (SO and medial gastrocnemius (MG muscles, are often considered close functional synergists, previous studies have shown distinct activity patterns between them in some motor behaviors. The goal of this study was to test two hypotheses explaining inhibition of slow SO with respect to fast MG: (1 inhibition occurs at high movement velocities and mediated by velocity-dependent sensory feedback and (2 inhibition depends on the ankle-knee joint moment combination and does not require high movement velocities. The hypotheses were tested by comparing the SO EMG/MG EMG ratio during fast and slow motor behaviors (cat paw shake responses vs. back, straight leg load lifting in humans, which had the same ankle extension-knee flexion moment combination; and during fast and slow behaviors with the ankle extension-knee extension moment combination (human vertical jumping and stance phase of walking in cats and leg load lifting in humans. In addition, SO EMG/MG EMG ratio was determined during cat paw shake responses and walking before and after removal of stretch velocity-dependent sensory feedback by self-reinnervating SO and/or gastrocnemius. We found the ratio SO EMG/MG EMG below 1 (p<0.05 during fast paw shake responses and slow back load lifting, requiring the ankle extension-knee flexion moment combination; whereas the ratio SO EMG/MG EMG was above 1 (p<0.05 during fast vertical jumping and slow tasks of walking and leg load lifting, requiring ankle extension-knee extension moments. Removal of velocity-dependent sensory feedback did not affect the SO EMG/MG EMG ratio in cats. We concluded that the relative inhibition of SO does not require high muscle velocities, depends on ankle-knee moment combinations, and is mechanically advantageous for allowing a greater MG contribution to ankle extension and knee flexion moments.

  18. In vivo human gastrocnemius architecture with changing joint angle at rest and during graded isometric contraction.

    Science.gov (United States)

    Narici, M V; Binzoni, T; Hiltbrand, E; Fasel, J; Terrier, F; Cerretelli, P

    1996-10-01

    1. Human gastrocnemius medialis architecture was analysed in vivo, by ultrasonography, as a function of joint angle at rest and during voluntary isometric contractions up to the maximum force (MCV). maximum force (MVC). 2. At rest, as ankle joint angle increased from 90 to 150 deg, pennation increased from 15.8 to 27.7 deg, fibre length decreased from 57.0 to 34.0 mm and the physiological cross-sectional area (PCSA) increased from 42.1 to 63.5 cm2. 3. From rest to MVC, at a fixed ankle joint angle of 110 deg, pennation angle increased from 15.5 to 33.6 deg and fibre length decreased from 50.8 to 32.9 mm, with no significant change in the distance between the aponeuroses. As a result of these changes the PCSA increased by 34.8%. 4. Measurements of pennation angle, fibre length and distance between the aponeuroses of the gastrocnemius medialis were also performed by ultrasound on a cadaver leg and found to be in good agreement with direct anatomical measurements. 5. It is concluded that human gastrocnemius medialis architecture is significantly affected both by changes of joint angle at rest and by isometric contraction intensity. The remarkable shortening observed during isometric contraction suggests that, at rest, the gastrocnemius muscle and tendon are considerably slack. The extrapolation of muscle architectural data obtained from cadavers to in vivo conditions should be made only for matching muscle lengths.

  19. Passive mechanical properties of gastrocnemius muscles of people with ankle contracture after stroke.

    Science.gov (United States)

    Kwah, Li Khim; Herbert, Robert D; Harvey, Lisa A; Diong, Joanna; Clarke, Jillian L; Martin, Joshua H; Clarke, Elizabeth C; Hoang, Phu D; Bilston, Lynne E; Gandevia, Simon C

    2012-07-01

    To investigate the mechanisms of contracture after stroke by comparing passive mechanical properties of gastrocnemius muscle-tendon units, muscle fascicles, and tendons in people with ankle contracture after stroke with control participants. Cross-sectional study. Laboratory in a research institution. A convenience sample of people with ankle contracture after stroke (n=20) and able-bodied control subjects (n=30). Not applicable. Stiffness and lengths of gastrocnemius muscle-tendon units, lengths of muscle fascicles, and tendons at specific tensions. At a tension of 100N, the gastrocnemius muscle-tendon unit was significantly shorter in participants with stroke (mean, 436mm) than in able-bodied control participants (mean, 444mm; difference, 8mm; 95% confidence interval [CI], 0.2-15mm; P=.04). Muscle fascicles were also shorter in the stroke group (mean, 44mm) than in the control group (mean, 50mm; difference, 6mm; 95% CI, 1-12mm; P=.03). There were no significant differences between groups in the mean stiffness or length of the muscle-tendon units and fascicles at low tension, or in the mean length of the tendons at any tension. People with ankle contracture after stroke have shorter gastrocnemius muscle-tendon units and muscle fascicles than control participants at high tension. This difference is not apparent at low tension. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  20. Glycogen synthesis in human gastrocnemius muscle is not representative of whole-body muscle glycogen synthesis.

    NARCIS (Netherlands)

    Serlie, M.J.; Haan, J.H.A. de; Tack, C.J.J.; Verberne, H.J.; Ackermans, M.T.; Heerschap, A.; Sauerwein, H.P.

    2005-01-01

    The introduction of 13C magnetic resonance spectroscopy (MRS) has enabled noninvasive measurement of muscle glycogen synthesis in humans. Conclusions based on measurements by the MRS technique assume that glucose metabolism in gastrocnemius muscle is representative for all skeletal muscles and thus

  1. EMG-normalised kinase activation during exercise is higher in human gastrocnemius compared to soleus muscle

    DEFF Research Database (Denmark)

    Jensen, Thomas Elbenhardt; Leutert, Robin; Rasmussen, Søren T;

    2012-01-01

    to differential reactive oxygen species (ROS)-scavenging ability or resting glycogen content. To evaluate these parameters in humans, biopsies from soleus, gastrocnemius and vastus lateralis muscles were taken before and after a 45 min inclined (15%) walking exercise bout at 69% VO2(max) aimed at simultaneously...

  2. Fourth-Degree Perineal Laceration in Nonconsenual Fisting: A Case Report, Brief Review of the Literature, and Medicolegal Issues.

    Science.gov (United States)

    Cappelletti, Simone; Fiore, Paola Antonella; Bottoni, Edoardo; Aromatario, Mariarosaria

    2017-09-01

    We present the case of an 18-year-old girl who was sexually assaulted with transanal forearm penetration resulting in a fourth-degree perineal laceration. Fisting is an uncommon sexual practice consisting in the penetration of the vagina, anus, or both of them with fingers, hand (fist) or forearm.Perineal lacerations are a relatively common finding in both consensual and nonconsensual fisting victims. Even though cases of fisting with first-, second-, and third-degree lacerations have been reported in literature, only one previous case of fourth-degree perineal laceration has been described in a woman, who died after anal fisting.The clinical and morphological findings related to this sexual practice have been presented. No previous reports concerning nonfatal cases of fourth-degree perineal laceration, due to anal fisting, exists in literature. We report a case in which the forensic evaluation and the identification of the sexual assault were delayed because of both the atypical and uncommon pattern of injury and the unconsciousness of the patient. The information gathered thanks to this article would support forensic pathologists and sexual assault forensic examiners in recognizing doubtful cases, and this is particularly important when the suspect of sexual assault arise.

  3. One case report:removal of foreign body in ethmoidal sinus-medial orbital wall through nose assisted by endoscope%内镜辅助下经鼻取出筛窦-眶内侧壁异物1例

    Institute of Scientific and Technical Information of China (English)

    杨泽垠; 杨晓红

    2013-01-01

    The patient was male,20 years old,and complained of pain,bleeding and decreased vision after the right eye was injured by nail for an hour.Physical examination:right exophthalmos,conjunctival edema,skin laceration at the lower eyelid of right eye,limitation of eye movement,asymmetric eyes and weak light-reflecting.X-ray showed:metallic foreign body shadow in the right orbit,0.5 cm × 0.4 cm approximately.Orbit and paranasal sinus CT showed:1 hematoma of the right eye and inside.2 high density foreign body embedded in the bone wall of the inside of right orbit and ethmoid.3 medial wall fracture of right eye orbit.4 bilateral maxillary sinus and right ethmoidal sinus effusion.5 slightly left side of nasal septum.The patient was initially diagnosed as foreign body in right ethmoidal sinus,skin laceration of right lower eyelid,retrobulbar hematoma.

  4. Surface electromyographic assessment of the effect of static stretching of the gastrocnemius on vertical jump performance.

    Science.gov (United States)

    Wallmann, Harvey W; Mercer, John A; McWhorter, J Wesley

    2005-08-01

    The purpose of this study was to investigate the effects of static stretching of the gastrocnemius muscle on maximal vertical jump performance using electromyographic activity (EMG) of the gastrocnemius musculature to record muscle activation during vertical jump performance. Fourteen healthy adults (8 men and 6 women) aged 18-34 years, who were familiar with the vertical jumping task and had no lower extremity injuries or any bone or joint disorders within the past year, served as participants for this study. After a brief warm-up, participants performed the following sequence: (a) three baseline maximal vertical jump trials, (b) 15 minutes of quiet sitting and three 30-second bilateral static stretches of the gastrocnemius muscles, and (c) 3 maximal vertical jump trials. Jump height data were collected using the Kistler force plate, while muscle activity was recorded during the jumping and stretching trials using a Noraxon telemetry EMG unit. Vertical jump height data as well as EMG values were averaged for the 3 trials and analyzed using paired t-tests for pre- and poststretching (alpha = 0.05). Vertical jump height was 5.6% lower when poststretch heights were compared with prestretch heights (t = -4.930, p static stretching of the gastrocnemius muscles had a negative effect on maximal jumping performance. The practical importance concerns coaches and athletes, who may want to consider the potential adverse effects of performing static stretching of the gastrocnemius muscles only before a jumping event, as jump height may be negatively affected. Future research is required to identify the mechanisms that affect vertical jump performance.

  5. Isolated Gastrocnemius Recession for Treatment of Insertional Achilles Tendinopathy: A Pilot Study.

    Science.gov (United States)

    Tallerico, Valerie K; Greenhagen, Robert M; Lowery, Clinton

    2015-08-01

    Many surgeries exist for treatment of insertional Achilles tendinopathy. Another surgical option to consider is an isolated gastrocnemius recession. Recent studies have demonstrated the success of a gastrocnemius recession for noninsertional Achilles tendinitis. We hypothesize that an isolated gastrocnemius recession can be a successful, effective, and less invasive surgery for patients with chronic insertional Achilles tendinopathy. This article presents a retrospective review of one surgeon's results of 11 patients (2010-2012), with an average age of 59 years who presented with chronic insertional Achilles tendinopathy. Gastrocnemius recessions, either endoscopic or open, were performed after an average of 6.2 months of conservative treatment. All patients' radiographs were reviewed preoperatively for any calcaneal spurs and divided into groups accordingly. Average follow-up time postoperatively was 13.8 months. Plantarflexion strength, equinus deformity, as well as the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot instrument was assessed. In all, 10/11 (91%) patients had high patient satisfaction, pain relief, no residual equinus deformity, loss in muscle strength and returned to regular activities successfully at 1-year follow up. All patients and groups had significant improvement in AOFAS scores. The median postoperative AOFAS score was 94.8. All patients and patient groups had significant improvement pre- to postoperatively. Patients without spurs appear to do better than patients with spurs. One patient developed recurrence of insertional heel pain and equinus deformity. Other complications included 2 sural nerve parasthesias, which resolved. An isolated gastrocnemius recession for chronic insertional Achilles tendinopathy can provide high satisfaction, pain relief, and a faster recovery period with few or no complications. Therapeutic, Level IV: Case series. © 2014 The Author(s).

  6. Injerto libre braquial medial Free medial arm graft

    OpenAIRE

    2007-01-01

    Introducción. Entre las reconstrucciones de defectos titulares de cabeza y cuello, el injerto libre microvascularizado braquial medial no ha adquirido mucha popularidad debido a las variaciones anatómicas que se reflejan en la vascularización de éste. Nuestro objetivo es realizar una descripción de la anatomía y técnica quirúrgica, así como una revisión de la literatura describiendo las ventajas y desventajas de este tipo de injerto. Material y método. Presentamos el caso de una paciente con ...

  7. TIME COURSE CHANGE OF IGF1/AKT/MTOR/P70S6K PATHWAY ACTIVATION IN RAT GASTROCNEMIUS MUSCLE DURING REPEATED BOUTS OF ECCENTRIC EXERCISE

    Directory of Open Access Journals (Sweden)

    Eisuke Ochi

    2010-06-01

    Full Text Available The purpose of this study was to examine whether insulin-like growth factor (IGF-1 and Akt/mTOR/p70S6K pathway activity is altered by chronic eccentric exercise in rat medial gastrocnemius muscle. Male Wistar rats (n = 24 were randomly assigned to 1 of the 2 groups: eccentric exercise (ECC group or sham-operated control (CON group. Rats in the ECC group were trained every second day for 10 days (5 sessions in total or 20 days (10 sessions in total. After either 5 or 10 exercise sessions, muscle specimens were dissected and weighed. The mRNA expression of IGF-1 and its variant, mechano growth factor (MGF, was evaluated using real time reverse transcriptase-polymerase chain reaction (RT-PCR. Tissue concentrations of Akt (P, mTOR (P, and p70S6K (P were measured by using western blot analysis. The medial gastrocnemius muscle mass of the ECC group did not show any significant difference after 5 exercise sessions, whereas the muscle mass increased significantly after 10 exercise sessions with a concomitant increase in the cross-sectional area of muscle fibers (p < 0.05. The expression of IGF-1 mRNA and the tissue concentrations of Akt (P and p70S6K (P after 10 exercise sessions was significantly higher than those of the age-matched controls and the rats that received 5 exercise sessions. The expression of MGF mRNA in both ECC5S and ECC10S were significantly higher than that in each period-matched control (p < 0.01. The tissue concentration of mTOR (P after 10 sessions showed a significant increase when compared with period-matched controls (p < 0.01. These results suggest that activation of the IGF-1/Akt/mTOR/p70S6K signaling pathway becomes dominant in the later phase of chronic exercise, when significant muscular hypertrophy is observed

  8. Acute Medial Plantar Fascia Tear.

    Science.gov (United States)

    Pascoe, Stephanie C; Mazzola, Timothy J

    2016-06-01

    A 32-year-old man who participated in competitive soccer came to physical therapy via direct access for a chief complaint of plantar foot pain. The clinical examination findings and mechanism of injury raised a concern for a plantar fascia tear, so the patient was referred to the physician and magnetic resonance imaging was obtained. The magnetic resonance image confirmed a high-grade, partial-thickness, proximal plantar fascia tear with localized edema at the location of the medial band. J Orthop Sports Phys Ther 2016;46(6):495. doi:10.2519/jospt.2016.0409.

  9. 腓肠肌羽状角的高频超声测量及其临床意义%Measurement of plume angles of gastrocnemius by high frequency ultrasound and its clinical signiifcance

    Institute of Scientific and Technical Information of China (English)

    叶攀; 胡海涛

    2014-01-01

    Objective To discuss the ultrasonic anatomy of gastrocnemius and its substructures in normal population. Methods Eighty gastrocnemius in 40 volunteers were scanned by real time high frequency ultrasound. Sonograms of medial and lateral heads of gastrocnemius were acquired. Plume angles between medial and lateral heads of gastrocnemius were measured at condition of rest, 5 kg and 10 kg isometric contraction. Both dominant and non-dominant legs were evaluated. Differences of plume angles were compared by ANOVA in different conditions and by t test in different legs. Results At the upper part of the muscle, both medial and lateral heads of gastrocnemius could be divided into muscular compartment, shallow compartment and deep compartment by hyperechoic intra-muscular septa with clear margin. The septa of lateral heads presented as hyperechoic side-lying′T′, while the septa of medial heads presented as hyperechoic side-lying-′T′. Vascular signals could be detected in these hyperechoic septa. The plume angle at the distal part of the lateral head of gastrocnemius was composed of shallow compartment attaching to the Achilles tendon, and that of the medial head was composed of medial muscular compartment attaching to the tendon. At rest, 5 kg and 10 kg isometric contraction, plume angles of lateral heads were (13.36±3.20)°, (13.32±3.30)° and (12.75±3.20)°, and plume angles of medial heads were (8.69±3.30)°, (8.59±2.99)° and (8.65±3.20)°. Under the same condition, plume angles of medial heads were larger than those of lateral heads and the difference was statistically signiifcant (t=9.09, 9.50 and 8.10, all P<0.01). Changes of plume angles between rest and different weight bearing conditions were small, and differences were not statistically signiifcant (F=0.89 and 0.02, P=0.41 and 0.98). Plume angles of medial heads in dominant legs and non-dominant legs were (13.66±3.60)° and (13.30±2.84)°, and those of lateral heads were (8.71±3.48)° and (8.80

  10. Variant position of the medial plantar nerve

    OpenAIRE

    Astik RB; Dave UH; Gajendra KS

    2011-01-01

    Knowledge of variation of position of the medial plantar nerve is important for the forefoot surgeon for plantar reconstruction, local injection therapy and an excision of interdigital neuroma. During routine dissection of 50-year-old female cadaver, we found the medial plantar nerve and vessels variably located between plantar aponeurosis and the muscles of the first layer of the sole of the right foot. Due to this variant position, the medial plantar nerve and vessels lose their protection ...

  11. Corneal Laceration

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  9. Corneal Laceration

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  10. Corneal Laceration

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  11. Corneal Laceration

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  12. Corneal Laceration

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  13. Corneal Laceration

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    Full Text Available ... about eye health and preserving your vision. Privacy Policy Related Really, Toy Guns Are Dangerous for Your ... Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology ...

  14. Corneal Laceration

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    Full Text Available ... lost sight from a corneal scar as a child. Now that I’m older, will a corneal transplant help me? May 15, 2015 Why Do My Eyes Burn After Inserting My Contacts? Feb 27, 2015 Dark ...

  15. Corneal Laceration

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  16. Corneal Laceration

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  17. Snapping Knee Caused by Medial Meniscal Cyst

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Ohishi

    2014-01-01

    Full Text Available Snapping phenomenon around the medial aspect of the knee is rare. We present this case of snapping knee caused by the sartorius muscle over a large medial meniscal cyst in a 66-year-old female. Magnetic resonance images demonstrated a large medial meniscal cyst with a horizontal tear of the medial meniscus. Arthroscopic cyst decompression with limited meniscectomy resulted in the disappearance of snapping, and no recurrence of the cyst was observed during a 2-year follow-up period.

  18. Modelling of gastrocnemius muscle using Hills equation in COMSOL Multiphysics 4.0a

    Directory of Open Access Journals (Sweden)

    S.Vivekanandan

    2012-05-01

    Full Text Available This paper summarizes the force generated by gastrocnemius muscle for the analysis of muscoskeletal simulation in human locomotion using Hills muscle model. Biomechanics of Hills equation describes the study of physical phenomenon by means of mathematical model that relates force and muscle length with the help of a partial differential equation. To calculate maximum fatigue in the muscle and to discriminate strained muscle from the normal one FEM based modelling was done in COMSOL Multiphysics 4.0a. The model parameters were evaluated using similar in vitro experiments performed on frogs gastrocnemius muscle. The biomechanical model was then incorporated into human body for the purpose of predicting force - length response for all the four phases of gait cycle. Evaluating the response for gait cycle will enable the physiotherapist to obtain clues for muscle weakness and fatigue in a rehabilitation program

  19. [Regional differences in the level of ERK1/2 phosphorylation and expression of the myogenic regulatory factors following electrostimulation with different mechanic and metabolic action on the gastrocnemius muscle].

    Science.gov (United States)

    Borzykh, A A; Kuz'min, I V; Lysenko, E A; Vinogradova, O L

    2014-01-01

    Effect of high-frequency electrical stimulation of the sciatic nerve on ERK1/2 kinase phosphorylation and mRNA expression in MyoD (myogenic regulation factor) and myogenin in the red (RGM) and white (WGM) parts of the medial head in rat's m. gastrocnemius was studied. Two stimulation regimes were equalized both lengthwise and in total effort but differed in duration and number of contractions and, therefore, in mechanic and metabolic effects on the muscle. It was shown that growth of the number of phosphorylated ERK1/2 was particularly high in WCM due to application of the protocol for multiple short-time contractions. Whatever the stimulation regime, MyoD mRNA expression in RGM and WGM increases to the same extent, whereas myogenin mRNA expression does not change. Consequently, the regime with the predominantly mechanic effect is favorable to activation of the ERK signaling pathway in glycolytic myofibers.

  20. Temperature Changes During Therapeutic Ultrasound in the Precooled Human Gastrocnemius Muscle

    OpenAIRE

    1994-01-01

    Therapeutic ultrasound is frequently employed as a deep heating rehabilitation modality. It is administered in one of three ways: a) ultrasound with no preceding treatment, b) ultrasound on preheated tissues, or c) ultrasound on precooled tissues. The purpose of this study was to investigate the effect of ultrasound treatments on the tissue temperature rise of precooled human gastrocnemius muscle. Sixteen male subjects had a 23-gauge hypodermic needle microprobe inserted 3 cm deep into the me...

  1. Gastrocnemius mitochondrial respiration: are there any differences between men and women?

    Science.gov (United States)

    Thompson, Jonathan R; Swanson, Stanley A; Casale, George P; Johanning, Jason M; Papoutsi, Evlampia; Koutakis, Panagiotis; Miserlis, Dimitrios; Zhu, Zhen; Pipinos, Iraklis I

    2013-11-01

    Work on human and mouse skeletal muscle by our group and others has demonstrated that aging and age-related degenerative diseases are associated with mitochondrial dysfunction, which may be more prevalent in males. There have been, however, no studies that specifically examine the influence of male or female sex on human skeletal muscle mitochondrial respiration. The purpose of this study was to compare mitochondrial respiration in the gastrocnemius of adult men and women. Gastrocnemius muscle was obtained from male (n = 19) and female (n = 11) human subjects with healthy lower-extremity musculoskeletal and arterial systems and normal ambulatory function. All patients were undergoing operations for the treatment of varicose veins in their legs. Mitochondrial respiration was determined with a Clark electrode in an oxygraph cell containing saponin-skinned muscle bundles. Complex I-, II-, III-, and IV-dependent respiration was measured individually and normalized to muscle weight, total protein content, and citrate synthase (CS, index of mitochondrial content). Male and female patients had no evidence of musculoskeletal or arterial disease and did not differ with regard to age, race, body mass index, or other clinical characteristics. Complex I-, II-, III-, and IV-dependent respiration normalized to muscle weight, total protein content, and CS did not statistically differ for males compared with females. Our study evaluates, for the first time, gastrocnemius mitochondrial respiration of adult men and women who have healthy musculoskeletal and arterial systems and normal ambulatory function. Our data demonstrate there are no differences in the respiration of gastrocnemius mitochondria between men and women. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Cut-laceration injuries and related career groups in New Jersey career, vocational, and technical education courses and programs.

    Science.gov (United States)

    Shendell, Derek G; Mizan, Samina S; Marshall, Elizabeth G; Kelly, Sarah W; Therkorn, Jennifer H; Campbell, Jennifer K; Miller, Ashley E

    2012-09-01

    Investigations of young workers, including limited surveys in supervised school settings, suggested their elevated injury risk. This study identified factors contributing to cuts-lacerations among adolescents in New Jersey secondary school career, technical, and vocational education programs. Of 1,772 injuries reported between December 1, 1998, and September 1, 2010, 777 (44%) were cuts-lacerations; analyses focused on 224 reports (n = 182 post-exclusions) submitted after fall 2005 in three career groups-Food, Hospitality & Tourism (FH&T) (n = 71), Manufacturing & Construction (M&C) (n = 84), and Automotive & Transportation (A&T) (n = 27). Most students were "struck by" tools or hard surfaces (n = 93, 51%); 63 cuts were from knives in FH&T. In M&C, most cuts-lacerations were caused by hand-held tools (n = 18) and being "struck against/by" or "caught between hard surfaces" (n = 19). Males reported more cuts-lacerations (n = 145), most commonly among 11th graders (n = 54) and ages 16 to 17 years (n = 79). Fingers (n = 117) were most often injured, usually by cutting tools (n = 83). Training, supervision, and appropriate equipment, and further assessments of "struck by" and "pinch point" hazards, are needed. Copyright 2012, SLACK Incorporated.

  3. Medial Patella Subluxation: Diagnosis and Treatment

    Science.gov (United States)

    McCarthy, Mark A.; Bollier, Mathew J.

    2015-01-01

    Medial patella subluxation is a disabling condition typically associated with previous patellofemoral instability surgery. Patients often describe achy pain with painful popping episodes. They often report that the patella shifts laterally, which occurs as the medial subluxed patella dramatically shifts into the trochlear groove during early knee flexion. Physical examination is diagnostic with a positive medial subluxation test. Nonoperative treatment, such as focused physical therapy and patellofemoral stabilizing brace, is often unsuccessful. Primary surgical options include lateral retinacular repair/imbrication or lateral reconstruction. Prevention is key to avoid medial patella subluxation. When considering patellofemoral surgery, important factors include appropriate lateral release indications, consideration of lateral retinacular lengthening vs release, correct MPFL graft placement and tension, and avoiding excessive medialization during tubercle transfer. This review article will analyze patient symptoms, diagnostic exam findings and appropriate treatment options, as well as pearls to avoid this painful clinical entity. PMID:26361441

  4. Clinical study on application of gastrocnemius blood vessles in transplatation of free flaps for repairing infected skin defects of seriously injured legs%腓肠肌血管在小腿严重创伤感染性皮肤缺损游离皮瓣移植中的应用研究

    Institute of Scientific and Technical Information of China (English)

    任志勇; 张维彬; 王辉; 黄现峰; 魏长月

    2012-01-01

    defects of skin and soft tissues where the gastrocnemius blood vessles were anastomosed with the flaps to supply artery blood and receive vein blood. Results The main blood vessles of the gastrocnemius muscles were medial and lateral gastrocnemius blood vessles. They both origined from the popliteal arteries and communicated with other blood vessles. The pedicles of the medial gastrocnemius blood vessles were 8.0 -13.8 cm in length which averaged 11.1 cm and their outer diameters were (1.8 ± 0.3) mm when they entered the muscles. The pedicles of the medial gastrocnemius blood vessles were 5.4 - 12.3 cm in length which averaged 8.8 cm.The outer diameters of the two accompanying veins were (1.8 ± 0.3)mm when they entered the muscles.When one gastrocnemius blood vessle were obstructed,the gastrocnemius muscles could got enough blood supply by co mmunicating branches between the obstructed vessle and other blood vessles.All the 52 free flaps survived. Through one to two-years follow-up, the defects cured with no infection and the knees' motions were normal. Conclusions With a long pedicle and wide diameter,the medial or lateral gastrocnemius blood vessle can be a reliable alternative used in free flap transplautation for repairing large defects of skin and soft tissues of seriously injured legs with no other choice of blood vessles, which causes unobvious effects to the blood supply of the legs and can simplify the free flap transplantation.

  5. Anxiety and self-consciousness in patients with facial lacerations one week and six months later.

    Science.gov (United States)

    Tebble, Nicola J; Adams, Robert; Thomas, David W; Price, Patricia

    2006-12-01

    We explored the psychological impact of disfigurement resulting from facial lacerations in patients who presented at an accident and emergency department in the UK. Patients participated in relevant sections of the Derriford Appearance Scale and State Trait Anxiety Inventory at one week and six months after injury. In all patients self-consciousness and anxiety scores were higher than in the general population. The extent of the scar, the patient's living arrangements, and the cause of the injury were significantly related to self-consciousness and anxiety. General self-consciousness improved at six months but not social self-consciousness and anxiety. These injuries may have a considerable impact on the lives of the affected people.

  6. 三维步态分析评定腓肠肌长度的初步研究%Pilot study of 3-D gait analysis for measurement of gastrocnemius length

    Institute of Scientific and Technical Information of China (English)

    孟殿怀; 许光旭; 朱奕; 励建安

    2012-01-01

    Objective: To explore the application of 3-D gait analysis for dynamic measurement of gastrocnemius length. Method: The pathology models of footdrop with ankle plantar flexion were established in 12 victims of poliomyelitis sequela. Ten age-matched normal juveniles were included as the control. The 3-D motion analysis system was employed to obtain the data of dynamic segmental motion on walking. Mathematic modeling was established to calculate the length of gastrocnemius. The angle of ankle dorsiflexion(passive motion) was measured by goniometer. Result: ①There was no significant difference of body height between patients with poliomyelitis sequela foot drop and the normal controls(P>0.05), but there were significant differences between the length of medial head and lateral head of gastrocnemius(P<0.05). ②The length of gastrocnemius was significant correlated with the cosine value of ankle dorsiflexion angle(P < 0.05). ③The equation of linear regression between the relative gastrocnemius length and the cosine value of ankle dorsiflexion angle was significant (P<0.01).Conclusion: Ankle dorsiflexion angle during walking by 3-D motion analysis may estimate the length of gastrocnemius of normal persons and patients with poliomyelitis sequela footdrop, judge the contraction of achillotendon, and provide an important reference of orthopedic surgery and rehabilitation for patients with poliomyelitis sequela footdrop.%目的:研究三维步态分析评定腓肠肌长度的可行性.方法:采用脊髓灰质炎后遗症患者作为足下垂病理模型12例;正常青少年10例作为对照组.采用三维动作分析系统采集步行时的动态运动数据,经建模分析求出腓肠肌长度;用量角器测量出测试对象踝背屈(被动活动)的角度值进行相关同归分析.结果:①脊髓灰质炎后遗症患者组与正常对照组身高差异无显著性(P>0.05),腓肠肌内/外侧头长度差异有显著性(P< 0.05);②腓肠肌长度与踝

  7. Variant position of the medial plantar nerve

    Directory of Open Access Journals (Sweden)

    Astik RB

    2011-01-01

    Full Text Available Knowledge of variation of position of the medial plantar nerve is important for the forefoot surgeon for plantar reconstruction, local injection therapy and an excision of interdigital neuroma. During routine dissection of 50-year-old female cadaver, we found the medial plantar nerve and vessels variably located between plantar aponeurosis and the muscles of the first layer of the sole of the right foot. Due to this variant position, the medial plantar nerve and vessels lose their protection from the muscles of the first layer of the sole of the foot and became vulnerable for compression.

  8. Medial talo-calcaneal coalition. Case report

    Energy Technology Data Exchange (ETDEWEB)

    Daly, B.D.; Towers, M.J.; Hamilton, S.

    1988-11-01

    Medial talo-calcaneal coalition is an uncommon developmental anomaly consisting of a bony projection arising from the postero-medial aspect of the sustentaculum tali, which may articulate with another bony projection from the medial aspect of the talus. Fibrous, cartilaginous or bony ankylosis may occur. It usually presents in adolescents, and causes pain following exercise. It may cause a lump, and can predispose to flat foot and early osteoarthrosis. This condition is easily overlooked on routine views of the ankle, and may require oblique views and tomography for its detection and clarification.

  9. Diaphragm arterioles are less responsive to alpha1- adrenergic constriction than gastrocnemius arterioles.

    Science.gov (United States)

    Aaker, Aaron; Laughlin, M H

    2002-05-01

    The sympathetic nervous system has greater influence on vascular resistance in low-oxidative, fast-twitch skeletal muscle than in high-oxidative skeletal muscle (17). The purpose of this study was to test the hypothesis that arterioles isolated from low-oxidative, fast-twitch skeletal muscle [the white portion of gastrocnemius (WG)] possess greater responsiveness to adrenergic constriction than arterioles isolated from high-oxidative skeletal muscle [red portion of the gastrocnemius muscle (RG) and diaphragm (Dia)]. Second-order arterioles (2As) were isolated from WG, RG, and Dia of rats and reactivity examined in vitro. Results reveal that Dia 2As constrict less to norepinephrine (NE) (10(-9) to 10 (-4) M) than 2As from RG and WG, which exhibited similar NE-induced constrictions. This difference was not endothelium dependent, because responses of denuded 2As were similar to those of intact arterioles. The blunted NE-induced constrictor response of Dia 2As appears to be the result of differences in alpha1-receptor effects because 1) arterioles from Dia also responded less to selective alpha1-receptor stimulation with phenylephrine than RG and WG arterioles; 2) arterioles from Dia, RG, and WG dilated similarly to isoproterenol (10(-9) to 10(-4) M) and did not respond to selective alpha2-receptor stimulation with UK-14304; and 3) endothelin-1 produced similar constriction in 2As from Dia, RG, and WG. We conclude that differences in oxidative capacity and/or fiber type composition of muscle tissue do not explain different NE responsiveness of Dia 2As compared with 2As from gastrocnemius muscle. Differences in alpha1-adrenergic constrictor responsiveness among arterioles in skeletal muscle may contribute to nonuniform muscle blood flow responses observed during exercise and serve to maintain blood flow to Dia during exercise-induced increases in sympathetic nerve activity.

  10. 腓肠肌内侧头挛缩致马蹄足1例%One case of strephopodia of contracture of medials head of gastrocnemius musculus

    Institute of Scientific and Technical Information of China (English)

    窦建; 牛其昌; 毛瑞君

    2002-01-01

    @@ 1 临床资料 患者,女,10岁,出生时为双胞胎,足月顺产,四肢无畸形,活动自如.一周岁时可自己行走,二周岁时其家长发现患儿快走时左足跟部不能着地,随着年龄的增长症状愈加明显.三周岁时来我院就诊,被诊断为跟腱挛缩,行跟腱延长术,畸形被矫正完全,效果好.一年后症状渐复发,三年后以跟腱挛缩第二次收住院治疗,再次行跟腱延长术,效果满意.一年后症状再次复发,三年后因症状明显加重而第三次就诊.查:左足呈马蹄畸形,小腿肌萎缩.膝关节伸直位时,足呈马蹄畸形,被动使足背伸受限,同时小腿后内侧可触及上至股骨内髁下达跟腱的条索状物.膝关节屈曲位时,足马蹄畸形消失,同时小腿后内侧的条索状物不能触及.

  11. [Tibial periostitis ("medial tibial stress syndrome")].

    Science.gov (United States)

    Fournier, Pierre-Etienne

    2003-06-01

    Medial tibial stress syndrome is characterised by complaints along the posteromedial tibia. Runners and athletes involved in jumping activities may develop this syndrome. Increased stress to stabilize the foot especially when excessive pronation is present explain the occurrence this lesion.

  12. Medial and Lateral Plantar Nerve Entrapment

    Science.gov (United States)

    ... Foot Problems Overview of Foot Problems Achilles Tendon Bursitis Achilles Tendon Enthesopathy Bunion Corns and Calluses Damage ... the Foot Freiberg Disease Hammer Toe Inferior Calcaneal Bursitis Medial and Lateral Plantar Nerve Entrapment Metatarsal Joint ...

  13. UMAPRM: Uniformly sampling the medial axis

    KAUST Repository

    Yeh, Hsin-Yi Cindy

    2014-05-01

    © 2014 IEEE. Maintaining clearance, or distance from obstacles, is a vital component of successful motion planning algorithms. Maintaining high clearance often creates safer paths for robots. Contemporary sampling-based planning algorithms That utilize The medial axis, or The set of all points equidistant To Two or more obstacles, produce higher clearance paths. However, They are biased heavily Toward certain portions of The medial axis, sometimes ignoring parts critical To planning, e.g., specific Types of narrow passages. We introduce Uniform Medial Axis Probabilistic RoadMap (UMAPRM), a novel planning variant That generates samples uniformly on The medial axis of The free portion of Cspace. We Theoretically analyze The distribution generated by UMAPRM and show its uniformity. Our results show That UMAPRM\\'s distribution of samples along The medial axis is not only uniform but also preferable To other medial axis samplers in certain planning problems. We demonstrate That UMAPRM has negligible computational overhead over other sampling Techniques and can solve problems The others could not, e.g., a bug Trap. Finally, we demonstrate UMAPRM successfully generates higher clearance paths in The examples.

  14. Effect of a 5-week static stretching program on hardness of the gastrocnemius muscle.

    Science.gov (United States)

    Akagi, R; Takahashi, H

    2014-12-01

    This study investigated the effects of a static stretching (SS) program on muscle hardnesses of the gastrocnemius medialis (MG) and gastrocnemius lateralis (LG). Nineteen young men participated in this study. Either the right or left leg was randomly selected to conduct three bouts of 2-min SS of the plantar flexors 6 days a week for 5 weeks in each subject (the SS group), and the other leg was assigned to a control group. Before (pretest) and after (posttest) conducting the SS program, MG and LG hardnesses were measured using shear wave ultrasound elastography. The SS program was found to decrease muscle hardnesses, but not to change the ratio of MG hardness to LG hardness. There were no significant differences between the relative changes in the MG and LG hardnesses from pretest to posttest in both the SS and control groups. Significant correlations between the muscle hardness ratios at pretest and posttest were found in both groups. The results of this study suggest that the current SS program is useful for improving muscle condition in the plantar flexors, and that its long-term effects on the MG and LG hardnesses are of the same degree. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Functional properties of slow and fast gastrocnemius muscle fibers after a 17-day spaceflight

    Science.gov (United States)

    Widrick, J. J.; Romatowski, J. G.; Norenberg, K. M.; Knuth, S. T.; Bain, J. L.; Riley, D. A.; Trappe, S. W.; Trappe, T. A.; Costill, D. L.; Fitts, R. H.

    2001-01-01

    The purpose of this investigation was to study the effects of a 17-day spaceflight on the contractile properties of individual fast- and slow-twitch fibers isolated from biopsies of the fast-twitch gastrocnemius muscle of four male astronauts. Single chemically skinned fibers were studied during maximal Ca2+-activated contractions with fiber myosin heavy chain (MHC) isoform expression subsequently determined by SDS gel electrophoresis. Spaceflight had no significant effect on the mean diameter or specific force of single fibers expressing type I, IIa, or IIa/IIx MHC, although a small reduction in average absolute force (P(o)) was observed for the type I fibers (0.68 +/- 0.02 vs. 0.64 +/- 0.02 mN, P twitch gastrocnemius muscle compared with slow and fast fibers obtained from the slow antigravity soleus [J. J. Widrick, S. K. Knuth, K. M. Norenberg, J. G. Romatowski, J. L. W. Bain, D. A. Riley, M. Karhanek, S. W. Trappe, T. A. Trappe, D. L. Costill, and R. H. Fitts. J Physiol (Lond) 516: 915-930, 1999].

  16. Redox proteomic analysis of the gastrocnemius muscle from adult and old mice

    Directory of Open Access Journals (Sweden)

    Brian McDonagh

    2015-09-01

    Full Text Available The data provides information in support of the research article, “Differential Cysteine Labeling and Global Label-Free Proteomics Reveals an Altered Metabolic State in Skeletal Muscle Aging”, Journal of Proteome Research, 2014, 13 (11, 2008–21 [1]. Raw data is available from ProteomeXchange [2] with identifier PDX001054. The proteome of gastrocnemius muscle from adult and old mice was analyzed by global label-free proteomics and the relative quantification of specific reduced and reversibly oxidized Cysteine (Cys residues was performed using Skyline [3]. Briefly, reduced Cysteine (Cys containing peptides was alkylated using N-ethylmalemide (d0-NEM. Samples were desalted and reversibly oxidized Cys residues were reduced using tris(2-carboxyethylphosphine (TCEP and the newly formed reduced Cys residues were labeled with heavy NEM( d5-NEM. Label-free analysis of the global proteome of adult (n=5 and old (n=4 gastrocnemius muscles was performed using Peaks7™ mass spectrometry data analysis software [4]. Relative quantification of Cys containing peptides that were identified as reduced (d(0 NEM labeled and reversibly oxidized d(5–NEM labeled was performed using the intensity of their precursor ions in Skyline. Results indicate that muscles from old mice show reduced redox flexibility particularly in proteins involved in the generation of precursor metabolites and energy metabolism, indicating a loss in the flexibility of the redox energy response.

  17. Intentional Laceration of the Anterior Mitral Valve Leaflet to Prevent Left Ventricular Outflow Tract Obstruction During Transcatheter Mitral Valve Replacement

    Science.gov (United States)

    Khan, Jaffar M.; Rogers, Toby; Schenke, William H.; Mazal, Jonathan R.; Faranesh, Anthony Z.; Greenbaum, Adam B.; Babaliaros, Vasilis C.; Chen, Marcus Y.; Lederman, Robert J.

    2017-01-01

    OBJECTIVES The authors propose a novel transcatheter transection of the anterior mitral leaflet to prevent iatrogenic left ventricular outflow tract (LVOT) obstruction during transcatheter mitral valve replacement (TMVR). BACKGROUND LVOT obstruction is a life-threatening complication of TMVR caused by septal displacement of the anterior mitral leaflet. METHODS In vivo procedures in swine were guided by biplane x-ray fluoroscopy and intracardiac echocardiography. Retrograde transaortic 6-F guiding catheters straddled the anterior mitral leaflet. A stiff 0.014-inch guidewire with polymer jacket insulation was electrified and advanced from the LVOT, through the A2 leaflet base, into the left atrium. The wire was snared and externalized, forming a loop that was energized and withdrawn to lacerate the anterior mitral leaflet. RESULTS The anterior mitral leaflet was successfully lacerated in 7 live and 1 post-mortem swine under heparinization. Lacerations extended to 89 ± 19% of leaflet length and were located within 0.5 ± 0.4 mm of leaflet centerline. The chordae were preserved and retracted the leaflet halves away from the LVOT. LVOT narrowing after benchtop TMVR was significantly reduced with intentional laceration of the anterior mitral leaflet to prevent LVOT obstruction than without (65 ± 10% vs. 31 ± 18% of pre-implantation diameter, p < 0.01). The technique caused mean blood pressure to fall (from 54 ± 6 mm Hg to 30 ± 4 mm Hg, p < 0.01), but blood pressure remained steady until planned euthanasia. No collateral tissue injury was identified on necropsy. CONCLUSIONS Using simple catheter techniques, the anterior mitral valve leaflet was transected. Cautiously applied in patients, this strategy can prevent anterior mitral leaflet displacement and LVOT obstruction caused by TMVR. PMID:27609260

  18. Term Neonate With Liver Laceration, Obstructive Uropathy, and Ascites—Secondary to Extravasation of Total Parenteral Nutrition

    Science.gov (United States)

    Adesanya, Olubukunola; Naqvi, Mubariz

    2016-01-01

    We report a rare, but serious, complication of a malpositioned umbilical venous catheter in a term male infant who developed laceration, hematoma, and necrosis of liver, ascites, and left-sided obstructive uropathy secondary to extravasation of total parenteral nutrition. Abdominal paracentesis confirmed the presence of parenteral nutrition in the peritoneal cavity. Although, the umbilical venous catheterization is a common intravenous access used in neonatal intensive care units, judicious continued monitoring of its use should be practiced to avoid serious complications. PMID:27766283

  19. An unusual salvage technique for posterior tracheal membranous laceration associated with transhiatal esophagectomy: A transcervical–transsternal approach

    Directory of Open Access Journals (Sweden)

    Seyed Ziaeddin Rasihashemi

    2017-09-01

    Full Text Available Various surgical approaches may be employed for esophageal resection. Major airway injuries due to transhiatal esophagectomy include vertical tears in the membranous trachea. Tracheal injury is an uncommon but potentially fatal complication. This article describes the technique to repair the posterior membranous tracheal tear, extended just over the carina through a transcervical–transsternal approach, thereby avoiding a second thoracotomy. Six patients with posterior membranous tracheal injury underwent this procedure. The laceration ranged from 3 cm to 5 cm in length. Four patients had received neoadjuvant chemoradiation. The management of tracheal laceration added approximately 60 minutes to the total operation time. There was no mortality related to tracheal injury. Patients were followed up for 6 months after surgery, and both posterior tracheal wall and transverse tracheotomy remained intact without stenosis. The transcervical–transsternal approach decreases the need of thoracotomy and its complications in patients with tracheal laceration in any stage, even in cases of an extended tear down to the carina.

  20. Severe primary postpartum hemorrhage due to genital tract laceration after operative vaginal delivery: successful treatment with transcatheter arterial embolization

    Energy Technology Data Exchange (ETDEWEB)

    Fargeaudou, Yann; Soyer, Philippe; Sirol, Marc; Dref, Olivier le; Boudiaf, Mourad; Dahan, Henri; Rymer, Roland [Hopital Lariboisiere-APHP-GHU Nord et Universite Diderot-Paris 7, Department of Abdominal and Interventional Imaging, Paris (France); Morel, Olivier [Hopital Lariboisiere-APHP-GHU Nord et Universite Diderot-Paris 7, Department of Obstetrics, Paris (France)

    2009-09-15

    The purpose of this study was to report our experience in the management of severe primary postpartum hemorrhage due to genital tract laceration following operative vaginal delivery with forceps using pelvic transcatheter arterial embolization (TAE). Ten women (mean age, 31.9 years) with severe primary postpartum hemorrhage due to genital tract laceration after operative delivery with forceps were treated with TAE. TAE was indicated because of intractable bleeding that could not be controlled with uterotonic drugs, blood transfusion, attempted suturing and packing in all patients. Postdelivery perineal examination showed cervical or vaginal tears in all women and associated paravaginal hematoma in four. Angiography revealed extravasation of contrast material in six patients. TAE performed with gelatin sponge allowed to control the bleeding in all patients. Cervical and vaginal suturing was made possible and successfully achieved in the six women who had failed suturing attempts before TAE. Paravaginal hematoma was successfully evacuated in four patients in whom it was present after TAE. No complications related to TAE were noted. We conclude that in women with severe primary postpartum hemorrhage due to genital tract laceration after operative delivery with forceps, TAE is effective and safe for stopping the bleeding and helps genital tract suturing and evacuation of hematoma. (orig.)

  1. Blunt abdominal injury with rupture of giant hepatic cavernous hemangioma and laceration of the spleen.

    Science.gov (United States)

    Kang, Lung-Yun; Huang, Fong-Dee; Liu, Yuan-Yuarn

    2015-02-01

    A 41-year-old woman with blunt abdominal trauma due to a motor vehicle accident presented to our emergency department. The patient had a history of a giant hepatic cavernous hemangioma. Emergency exploratory laparotomy was performed for suspected intra-abdominal bleeding with abdominal compartment syndrome, and more than 4 liters of blood and blood clots were removed. An active bleeding laceration (5 cm) of a hepatic cavernous hemangioma was detected in segment III of the liver. The bleeding was controlled by sutures, Teflon patches and tamponade. The abdomen was closed temporarily using the vacuum-assisted method. Because of the presence of persistent fresh blood through abdominal drainage at a rate of >1 L/h, splenectomy was performed to control the bleeding again by sutures and Teflon patches. Finally, the abdomen was closed using a biologic mesh. The patient was discharged home 30 days after trauma. Bleeding of trauma-caused hepatic hemangioma is rare, but splenic injury due to blunt abdominal trauma is common. An in-depth investigation is necessary to avoid second intervention.

  2. Acute Gastrocnemius-Soleus Complex Injuries in National Football League Athletes

    Science.gov (United States)

    Werner, Brian C.; Belkin, Nicole S.; Kennelly, Steve; Weiss, Leigh; Barnes, Ronnie P.; Potter, Hollis G.; Warren, Russell F.; Rodeo, Scott A.

    2017-01-01

    Background: Lower extremity muscle injuries are common in professional football. Although less common than hamstring or quadriceps injuries in National Football League (NFL) athletes, calf injuries occur with relative frequency and have not previously been studied. Purpose: To evaluate gastrocnemius-soleus complex muscle injuries over the past 13 years from a single NFL team to determine the incidence of such injuries, their imaging characteristics, and return to play after such injuries and any correlation between imaging findings and prolonged return to play. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of all acute calf muscle injuries on a single NFL team from 2003 to 2015 was performed. Player demographics and return-to-play data were obtained from the medical records. All available magnetic resonance images (MRIs) were reviewed by a musculoskeletal radiologist for specific imaging findings that correlated with return to play. Results: A total of 27 calf injuries in 24 NFL players were reviewed, yielding an incidence of 2.3 acute calf injuries per year on a single NFL team. Of these 27 injuries, 20 (74%) were isolated injuries to the gastrocnemius muscle, 4 (15%) were isolated injuries to the soleus muscle, and the remaining 3 injuries (11%) involved both. Defensive players were more likely to sustain injuries (P = .043). The mean time to return to play for all 27 players was 17.4 ± 14.6 days (range, 3-62 days). MRIs were available in 14 of the 27 injuries. The average size of the fascial defect (P = .032) and the presence of a fluid collection (P = .031) both correlated with return to play of longer than 2 weeks. Conclusion: Although less common than hamstring or quadriceps muscle injuries, calf muscle injuries occur with relative frequency in the NFL, and more so in defensive players. The majority of these injuries occur in the gastrocnemius and result in significant disability, with at least 2 weeks of missed playing

  3. Medial meniscal cyst: a case report.

    Science.gov (United States)

    Spina, Mauro; Sabbioni, Giacomo; Tigani, Domenico

    2008-12-01

    Meniscal cysts are a rare disease constantly combined with a horizontal meniscal lesion. Currently, nuclear magnetic resonance (MRI) is the main diagnostic tool, because of its high sensitivity and specificity, and decompression arthroscopy combined with selective meniscectomy is the treatment of choice. The Authors report a case of a voluminous medial meniscal cyst where instrumental examination, MRI, was fundamental for the preoperative diagnosis of the horizontal meniscal lesion causing the cystic degeneration of the meniscus. The treatment performed was selective meniscectomy of the body and posterior horn of the medial meniscus and decompression of the voluminous cyst by arthroscopy. Physical examination after six months showed the complete resolution of swelling at the medial hemirima, no walking pain and normal range of motion.

  4. Effects of muscle activation on shear between human soleus and gastrocnemius muscles.

    Science.gov (United States)

    Finni, T; Cronin, N J; Mayfield, D; Lichtwark, G A; Cresswell, A G

    2017-01-01

    Lateral connections between muscles provide pathways for myofascial force transmission. To elucidate whether these pathways have functional roles in vivo, we examined whether activation could alter the shear between the soleus (SOL) and lateral gastrocnemius (LG) muscles. We hypothesized that selective activation of LG would decrease the stretch-induced shear between LG and SOL. Eleven volunteers underwent a series of knee joint manipulations where plantar flexion force, LG, and SOL muscle fascicle lengths and relative displacement of aponeuroses between the muscles were obtained. Data during a passive full range of motion were recorded, followed by 20° knee extension stretches in both passive conditions and with selective electrical stimulation of LG. During active stretch, plantar flexion force was 22% greater (P muscles, at least at flexed knee joint angles, which may serve to facilitate myofascial force transmission. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Changes in nitric oxide and free radical levels in rat gastrocnemius muscle during contraction and fatigue.

    Science.gov (United States)

    Ibrahim, Mariam Y; Ashour, Osama M

    2011-12-01

    1. The ratio of nitric oxide (NO) to free radicals is critical during skeletal muscle contraction. Changes in this ratio have been suggested to play a role in muscle fatigue. 2. The aim of the present study was to investigate the changes in NO and free radicals during tetanic and subtetanic contraction and fatigue in the gastrocnemius muscle of adult male Wistar rats. 3. Rats were subjected to either low- or high-frequency stimulation (10 and 100 Hz, respectively) of the right gastrocnemius muscle. Both groups were further subdivided into untreated (0.9% NaCl solution), N(G) -nitro-L-arginine methyl ester (L-NAME)-treated and reduced glutathione (GSH)-treated groups. Rats were administered their treatments intraperitoneally 30 min prior to electrical stimulation. 4. Levels of both NO and lipid peroxides increased significantly during peak force contraction for either type of contractions, with a more significant response during subtetanic contraction. Treatment with L-NAME significantly reduced the maximal force and this effect was more marked in the low frequency-stimulated group. Although peroxides levels were reduced by GSH, it had no significant effect on force production. In L-NAME-treated rats, the onset of 50% fatigue was accelerated with a significant increase in peroxides levels, whereas the opposite effects were observed after GSH treatment. 5. Current results reflect the importance of endogenous NO, as an anti-oxidant, in aiding muscle performance by overcoming oxidative stress during fatigue. They provide a possible explanation as to why patients with myopathies like Duchenne muscular dystrophy, in which dystrophin is lacking suffer from muscle weakness and fatigue easily.

  6. Calpain 3 Expression Pattern during Gastrocnemius Muscle Atrophy and Regeneration Following Sciatic Nerve Injury in Rats

    Directory of Open Access Journals (Sweden)

    Ronghua Wu

    2015-11-01

    Full Text Available Calpain 3 (CAPN3, also known as p94, is a skeletal muscle-specific member of the calpain family that is involved in muscular dystrophy; however, the roles of CAPN3 in muscular atrophy and regeneration are yet to be understood. In the present study, we attempted to explain the effect of CAPN3 in muscle atrophy by evaluating CAPN3 expression in rat gastrocnemius muscle following reversible sciatic nerve injury. After nerve injury, the wet weight ratio and cross sectional area (CSA of gastrocnemius muscle were decreased gradually from 1–14 days and then recovery from 14–28 days. The active form of CAPN3 (~62 kDa protein decreased slightly on day 3 and then increased from day 7 to 14 before a decrease from day 14 to 28. The result of linear correlation analysis showed that expression of the active CAPN3 protein level was negatively correlated with muscle wet weight ratio. CAPN3 knockdown by short interfering RNA (siRNA injection improved muscle recovery on days 7 and 14 after injury as compared to that observed with control siRNA treatment. Depletion of CAPN3 gene expression could promote myoblast differentiation in L6 cells. Based on these findings, we conclude that the expression pattern of the active CAPN3 protein is linked to muscle atrophy and regeneration following denervation: its upregulation during early stages may promote satellite cell renewal by inhibiting differentiation, whereas in later stages, CAPN3 expression may be downregulated to stimulate myogenic differentiation and enhance recovery. These results provide a novel mechanistic insight into the role of CAPN3 protein in muscle regeneration after peripheral nerve injury.

  7. On high heels and short muscles: a multiscale model for sarcomere loss in the gastrocnemius muscle.

    Science.gov (United States)

    Zöllner, Alexander M; Pok, Jacquelynn M; McWalter, Emily J; Gold, Garry E; Kuhl, Ellen

    2015-01-21

    High heels are a major source of chronic lower limb pain. Yet, more than one third of all women compromise health for looks and wear high heels on a daily basis. Changing from flat footwear to high heels induces chronic muscle shortening associated with discomfort, fatigue, reduced shock absorption, and increased injury risk. However, the long-term effects of high-heeled footwear on the musculoskeletal kinematics of the lower extremities remain poorly understood. Here we create a multiscale computational model for chronic muscle adaptation to characterize the acute and chronic effects of global muscle shortening on local sarcomere lengths. We perform a case study of a healthy female subject and show that raising the heel by 13cm shortens the gastrocnemius muscle by 5% while the Achilles tendon remains virtually unaffected. Our computational simulation indicates that muscle shortening displays significant regional variations with extreme values of 22% in the central gastrocnemius. Our model suggests that the muscle gradually adjusts to its new functional length by a chronic loss of sarcomeres in series. Sarcomere loss varies significantly across the muscle with an average loss of 9%, virtually no loss at the proximal and distal ends, and a maximum loss of 39% in the central region. These changes reposition the remaining sarcomeres back into their optimal operating regime. Computational modeling of chronic muscle shortening provides a valuable tool to shape our understanding of the underlying mechanisms of muscle adaptation. Our study could open new avenues in orthopedic surgery and enhance treatment for patients with muscle contracture caused by other conditions than high heel wear such as paralysis, muscular atrophy, and muscular dystrophy.

  8. Combined flexor hallucis longus tendon transfer and gastrocnemius recession for reconstruction of gapped chronic achilles tendon ruptures.

    Science.gov (United States)

    Elgohary, Hatem Elsayed Ahmed; Elmoghazy, Nabil A; Abd Ellatif, Mohammed Serry

    2016-12-01

    The aim of this study was to assess the functional outcomes after a combined FHL transfer and a gastrocnemius recession for treatment of chronic ruptures of Achilles tendon with a gap and to investigate the patient's satisfaction about the great toe function after transfer. 19 patients with chronic rupture of the Achilles tendon with a gap were treated with a flexor halluces longus tendon transfer combined with a gastrocnemius recession, Clinical diagnosis depends on the presence of gap in the tendon on examination, inability of tip toe walking on the affected side and positive calf-squeeze test, MRI was used to confirm the clinical diagnosis. American Orthopedic Foot & Ankle Society hind foot score was used for assessment of the results. The AOFAS score improved significantly from a mean of 65 preoperatively to 94 at the last follow up (ptendon weaved through the stump of the Achilles tendon and those with trans osseous tunnels, the mean AOFAS score at the last follow up was 94.2, 93.8 respectively, no patient complained of big toe dysfunction. Management of chronic rupture of the Achilles tendon with a gap with flexor halluces longus tendon transfer combined with a gastrocnemius recession is a safe and reliable method with a significantly improved functional outcome, muscle advancement through gastrocnemius recession decreases the length of the gap without affecting the muscle function, flexor halluces longus tendon transfer doesn't harm the big toe function. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. RELATIVE DEGREE OF STIMULATION-EVOKED GLYCOGEN DEGRADATION IN MUSCLE-FIBERS OF DIFFERENT TYPE IN RAT GASTROCNEMIUS

    NARCIS (Netherlands)

    KERNELL, D; LIND, A; VANDIEMEN, ABJP; DEHAAN, A

    1995-01-01

    1. The relative degree of glycogen degradation, caused in different fibre types by supramaximal electrical activation of the muscle nerve, was investigated in m. gastrocnemius medialis of young adult rats under general pentobarbitone anaesthesia. Pour different protocols of intermittent maximal teta

  10. Spiral CT Diagnosis of Pulmonary Laceration%肺撕裂伤的螺旋CT诊断

    Institute of Scientific and Technical Information of China (English)

    王之平; 许永明

    2011-01-01

    Objective To analyze the spiral CT features of lung laceration. Methods 29 patients with lung laceration were examined by spiral CT in 1-4 hours after injury. 16 cases of them were followed-up in 1-3 days,4 days-3 weeks and 3 weeks later respectively after injury. Results There were 38 focuses among 29 cases,including solitary lesions ( n=12) and multiple lesions ( n=3) in right lung, solitary lesions (n=l0) and multiple lesions (n=l) in left lung, and multiple lesions ( n= 3) in bilateral lungs.The first cmergency CT findings included 5 types: (1) single cavities (n=3) and cavity lesions with air-fluid levels (n=l0) ; (2)multiple cavity lesions with air-fluid levels (n=7) ; (3) single or multiple air cavities in patchy hemorrhage or wet lung (n=12) ;(4) simplex pulmonary hematomas (n=3) ; (5) hematomas with bubbles inside ( n= 3). There were patchy, cloudy or halo-like ground glass opacity (GGO) around all of the focuses. CT findings in 16 cases followed-up included: (1) in 1-3 days, the air cavity appeared air-fluid levels, the fluid in the cavity lesions with air-fluid levels increased, the cope of hemorrhage diminished and there became hematomas, with definite margins, the GGO around the lesions gradually absorbed; (2)in 4 days-3 weeks, 8 lesions be came hematomas, with definife margins(8/16) , 3 cavity with air-fluid levels lesions diminished, the air-fluid levels disappeared and became thick wall cavity( 3/16) , 5 lesions didn't changed much( 5/16) , the GGO around all the focuses became diminished or disappeared; (3) 3 weeks later, the cavity and the cavity with air-fluid levels diminished or disappcared, the cavity in hemorrhage entirely disappeared, pulmonary hemotomas diminished, small hematoma absorbed, leaving stripe-like shadows, 3 pulmonary hemotomas were not absorbed after half-year repeated CT examination, which appeared as masses. Conclusion cavity lesion,cavity with airfluid levels, pulmonary hematoma and GGO around of the focuses are the

  11. Medial branch neurotomy in low back pain

    Energy Technology Data Exchange (ETDEWEB)

    Masala, Salvatore; Mammucari, Matteo; Simonetti, Giovanni [Interventional Radiology and Radiotherapy University ' ' Tor Vergata' ' , Department of Diagnostic and Molecular Imaging, Rome (Italy); Nano, Giovanni [Interventional Radiology and Radiotherapy University ' ' Tor Vergata' ' , Department of Diagnostic and Molecular Imaging, Rome (Italy); University ' ' Tor Vergata' ' , Department of Radiology, Rome (Italy); Marcia, Stefano [S. Giovanni di Dio Hospital, Department of Diagnostic and Molecular Imaging, Cagliari (Italy)

    2012-07-15

    This study aimed to assess the effectiveness of pulsed radiofrequency medial branch dorsal ramus neurotomy in patients with facet joint syndrome. From January 2008 to April 2010, 92 patients with facet joint syndrome diagnosed by strict inclusion criteria and controlled diagnostic blocks undergone medial branch neurotomy. We did not exclude patients with failed back surgery syndrome (FBSS). Electrodes (20G) with 5-mm active tip were placed under fluoroscopy guide parallel to medial branch. Patients were followed up by physical examination and by Visual Analog Scale and Oswestry Disability Index at 1, 6, and 12 months. In all cases, pain improvement was statistically significant and so quality of life. Three non-FBSS patients had to undergo a second neurotomy because of non-satisfactory pain decrease. Complications were reported in no case. Medial branch radiofrequency neurotomy has confirmed its well-established effectiveness in pain and quality of life improvement as long as strict inclusion criteria be fulfilled and nerve ablation be accomplished by parallel electrode positioning. This statement can be extended also to FBSS patients. (orig.)

  12. Hierarchical error representation in medial prefrontal cortex.

    Science.gov (United States)

    Zarr, Noah; Brown, Joshua W

    2016-01-01

    The medial prefrontal cortex (mPFC) is reliably activated by both performance and prediction errors. Error signals have typically been treated as a scalar, and it is unknown to what extent multiple error signals may co-exist within mPFC. Previous studies have shown that lateral frontal cortex (LFC) is arranged in a hierarchy of abstraction, such that more abstract concepts and rules are represented in more anterior cortical regions. Given the close interaction between lateral and medial prefrontal cortex, we explored the hypothesis that mPFC would be organized along a similar rostro-caudal gradient of abstraction, such that more abstract prediction errors are represented further anterior and more concrete errors further posterior. We show that multiple prediction error signals can be found in mPFC, and furthermore, these are arranged in a rostro-caudal gradient of abstraction which parallels that found in LFC. We used a task that requires a three-level hierarchy of rules to be followed, in which the rules changed without warning at each level of the hierarchy. Task feedback indicated which level of the rule hierarchy changed and led to corresponding prediction error signals in mPFC. Moreover, each identified region of mPFC was preferentially functionally connected to correspondingly anterior regions of LFC. These results suggest the presence of a parallel structure between lateral and medial prefrontal cortex, with the medial regions monitoring and evaluating performance based on rules maintained in the corresponding lateral regions.

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

    Science.gov (United States)

    Matziolis, G; Röhner, E

    2015-10-01

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

  14. Rheo: Japanese Sound Art Interrogating Digital Mediality

    DEFF Research Database (Denmark)

    Vandsø, Anette

    2014-01-01

    THe article asks in what way the Japanese sound artist Ryoichi Kurokawa's audiovisual installation Rheo 5 Horisonz (2010) is 'digital'. Using Professor Lars Elleströms concept of 'mediality, the main claim in this article is that Rheo no only uses digital tehcnology, but also interrogates digital...

  15. Closed medial total subtalar joint dislocation without ankle fracture: a case report

    Science.gov (United States)

    2014-01-01

    Introduction Total subtalar dislocation without fracture of the ankle is a rare clinical entity; it is usually due to a traumatic high-energy mechanism. Standard treatment is successful closed reduction under general anesthesia followed by non-weight bearing and ankle immobilization with a below-knee cast for 6 weeks. Case presentation We present the case of a 30-year-old Moroccan woman who was involved in a road traffic accident. She subsequently received a radiological assessment that objectified a total subtalar dislocation without fracture of her ankle. She was immediately admitted to the operating theater where an immediate reduction was performed under sedation, and immobilization in a plaster boot was adopted for 8 weeks. The management of this traumatic lesion is discussed in the light of the literature. Conclusions Medial subtalar dislocation is a rare dislocation and is not commonly seen as a sports injury because it requires transfer of a large amount of kinetic energy. The weaker talocalcaneal and talonavicular ligaments often bear the brunt of the energy and are more commonly disrupted, compared to the relatively stronger calcaneonavicular ligament. Urgent reduction is important, and closed reduction under general anesthesia is usually successful, often facilitated by keeping the knee in flexion to relax the gastrocnemius muscle. Long-term sequelae include talar avascular necrosis and osteochondral fracture, as well as chronic instability and pain. PMID:25240955

  16. 面部挫裂伤的急诊美容修复%The aesthetic repair of facial lacerating wound

    Institute of Scientific and Technical Information of China (English)

    王量; 杨东运; 陶灵; 刘剑毅; 陈亮; 李世荣

    2012-01-01

    Objective To analyzed the experience in the aesthetic repair of facial lacerating wound. Methods To observed the healing effects of 87 emergency facial lacerating wound cases with aesthetic repair from 2009 to 2012. Results All the cases were primary healed, there was no obvious hypertrophic scar and no disfunction,the secondary repair was not required. The results were satisfactory. Conclusion Early stage aesthetic repair with plastic surgical principles and techniques of facial trauma could prevent the secondary treatment and relieve the pain of the patients.lt should be emphasized that tissue preserving could lessen deformity postoperative in the repairment of facial lacerating wound.%目的:总结面部挫裂伤的急诊整形美容外科修复经验,为临床工作提供指导.方法:对2009年至2012年间我科急诊整形美容修复的87例面部挫裂伤患者术后效果进行观察.结果:87例患者随访均Ⅰ期愈合,均无明显瘢痕增生,无功能障碍,无需进行Ⅱ期修复,效果满意.结论:面部挫裂伤后遵循整形外科基本原则的急诊整形美容精细修复,可达到无需或减少后续治疗,为患者减少痛苦,减轻负担.特别要提出在挫裂伤修复中对组织的保留,可减轻术后畸形.

  17. Hyperglycemia decreased medial amygdala projections to medial preoptic area in experimental model of Diabetes Mellitus.

    OpenAIRE

    Yousef Mohamadi; Seyed Behnam-edin Jameie; Mohammad Akbari; Masumeh Staji; Fatemeh Moradi; Tahmineh Mokhtari; Maryam Khanehzad; Gholamreza Hassanzadeh

    2015-01-01

    In Wistar rats, reproductive behavior is controlled in a neural circuit of ventral forebrain including the medial amygdala (Me), bed nucleus of the stria terminalis (BNST) and medial preoptic area (MPOA) via perception of social odors. Diabetes Mellitus (DM) is a widespread metabolic disease that affects many organs in a variety of levels. DM can cause central neuropathies such as neuronal apoptosis, dendritic atrophy, neurochemical alterations and also causes reproductive dysfunctions. So we...

  18. GENE RESPONSE OF THE GASTROCNEMIUS AND SOLEUS MUSCLES TO AN ACUTE AEROBIC RUN IN RATS

    Directory of Open Access Journals (Sweden)

    Michael J. McKenzie

    2011-06-01

    Full Text Available Genes can be activated or inhibited by signals within the tissues in response to an acute bout of exercise. It is unclear how a particular aerobic exercise bout may influence two muscles with similar actions to the activity. Therefore, the purposes of this investigation was to determine the gene response of selected genes involved in the "stress" response of the gastrocnemius (fast-twitch and soleus (slow-twitch muscles to a single two hour aerobic exercise bout in female Sprague-Dawley Rats at the 1 hour time point after the exercise. Exercised rats were run (n=8 for 2 hours at 20 m.min-1 and one hour after the completion of the bout had their soleus (S and gastrocnemius (G muscles removed. Age and timed matched sedentary control rats had both S and G muscles removed also. RNA was isolated from all muscles. Real-time PCR analysis was performed on the following genes: NFκB, TNFα, and Atf3. GAPDH was used as the housekeeping gene for both muscles. S muscle showed more genes altered (n = 52 vs G (n = 26. NFκB gene expression was 0.83 ± 0.14 in the exercised S but was + 1.36 ± 0.58 in the exercised G and was not significantly different between the muscles. TNFα was altered 1.30 ± 0. 34 in the exercised S and 1.36 ± 0.71 in the exercised G and was not significantly different between the muscles. The gene Atf3 was significantly altered at 4.97 ± 1.01 in the exercised S, while it was not significantly altered in the exercised G (0.70 ± 0.55. This study demonstrates that an acute bout of aerobic exercise can alter gene expression to a different extent in both the S and G muscles. It is highly likely that muscle recruitment was a factor which influenced the gene expression in theses muscles. It is interesting to note that some genes were similarly activated in these two muscles but other genes may demonstrate a varied response to the same exercise bout depending on the type of muscle

  19. Effects of photobiomodulation therapy on Bothrops moojeni snake-envenomed gastrocnemius of mice using enzymatic biomarkers.

    Science.gov (United States)

    Dourado, Doroty Mesquita; Matias, Rosemary; Barbosa-Ferreira, Marcos; da Silva, Baldomero Antonio Kato; de Araujo Isaias Muller, Jéssica; Vieira, Willians Fernando; da Cruz-Höfling, Maria Alice

    2017-08-01

    Bothropic venom contains a range of biologically active substances capable of causing severe local and systemic envenoming symptomatology within its victims. The snake anti-venom is effective against systemic effects but has no neutralizing effect against the fast developing local effects. Herein, mice gastrocnemius injected with Bothrops moojeni venom (40 μg/kg) or saline solution were irradiated with HeNe (632.8 nm) and GaAs (904 nm) lasers (daily energy density of 4 J/cm(2); 0.03/0.21 power density; 0.07/0.16 spot size; 1.2/0.04 total energy, 1 cm off contact, for HeNe and GaAs lasers, respectively) and euthanized in periods ranging from 3 h to 21 days. Blood biochemistry for creatine kinase (CK), alkaline phosphatase (ALP), acid phosphatase (AP), lactate dehydrogenase (LDH), aspartate transaminase (AST), and myoglobin and histopathological analysis, for assessing the degree of myonecrosis and regeneration of gastrocnemius, were done at every time interval. GaAs laser promoted faster photobiomodulation therapy (PBMT) effects, and the GaAs group exhibited a better clinical outcome than the HeNe group. Within the GaAs group, the serum levels of CK, LDH, AP, AST, and myoglobin, which were increased by the physiological effects of the venom, were reduced to initial baseline before snake envenomation in less time than those irradiated by the HeNe laser. However, the group receiving irradiation from the HeNe laser returned the levels of ALP activity to baseline faster than those of the GaAs group. Histopathological analysis revealed enhanced muscle regeneration in mice groups treated with both lasers. PBM promoted by GaAs and HeNe showed well-developed centrally nucleate regenerating cells and an increased number of newly formed blood vessels when compared to unirradiated muscle. We therefore suggest that GaAs had the best outcomes likely derived from a deeper penetrating longer wavelength. We conclude that PMBT is a promising, non-invasive approach to be

  20. Foot medial longitudinal-arch deformation during quiet standing and gait in subjects with medial tibial stress syndrome

    DEFF Research Database (Denmark)

    Bandholm, Thomas Quaade; Boysen, Lisbeth; Haugaard, Stine

    2008-01-01

    ). There was no correlation between medial longitudinal-arch deformation during quiet standing and gait in either of the 2 groups (r .653). The subjects with medial tibial stress syndrome in this study demonstrated increased navicular drop and medial longitudinal-arch deformation during quiet standing......The objective of this study was to investigate (1) if subjects with medial tibial stress syndrome demonstrate increased navicular drop and medial longitudinal-arch deformation during quiet standing and gait compared with healthy subjects, and (2) the relationship between medial longitudinal......-arch deformation during quiet standing and gait. Thirty subjects aged 20 to 32 years were included (15 with medial tibial stress syndrome and 15 controls). Navicular drop and medial longitudinal-arch deformation were measured during quiet standing with neutral and loaded foot using a ruler and digital photography...

  1. Comparison of topical tetracaine, adrenaline, and cocaine anesthesia with lidocaine infiltration for repair of lacerations in children.

    Science.gov (United States)

    Hegenbarth, M A; Altieri, M F; Hawk, W H; Greene, A; Ochsenschlager, D W; O'Donnell, R

    1990-01-01

    Local anesthetic infiltration is painful and frightening for children. We prospectively compared a topical alternative, TAC solution (tetracaine 0.5%, adrenaline 1:2,000, cocaine 11.8%), with 1% lidocaine infiltration for use in laceration repair in 467 children. Adequate anesthesia of facial and scalp wounds was achieved for 81% of TAC-treated wounds versus 87% of lidocaine-treated wounds (P = .005). TAC was less effective on extremity wounds; 43% had effective anesthesia compared with 89% of lidocaine-treated extremity wounds (P less than .0001). No systemic toxicity was observed. The incidence of wound infection was 2.2% for both TAC and lidocaine. Wound dehiscence occurred in seven TAC- and two lidocaine-treated facial or scalp wounds (4.5% vs 1.8%, NS) and in five TAC- and four lidocaine-treated extremity wounds (20% vs 17.4%, NS). The unusually high rate of dehiscence was due partially to recurrent trauma or coincident infection. TAC was well accepted by patients and parents. We encourage the careful use of TAC as a less painful alternative to lidocaine infiltration for selected scalp and facial lacerations in children.

  2. Medial Cochlear Efferent Function: A Theoretical Analysis

    Science.gov (United States)

    Mountain, David C.

    2011-11-01

    Since the discovery of the cochlear efferent system, many hypotheses have been put forth for its function. These hypotheses for its function range from protecting the cochlea from over stimulation to improving the detection of sounds in noise. It is known that the medial efferent system innervates the outer hair cells and that stimulation of this system reduces basilar membrane and auditory nerve sensitivity which suggests that this system acts to decrease the gain of the cochlear amplifier. Here I present modeling results as well as analysis of published experimental data that suggest that the function of the medial efferent reflex is to decrease the cochlear amplifier gain by just the right amount so that the nonlinearity in the basilar membrane response lines up perfectly with the inner hair cell nonlinear transduction process to produce a hair cell receptor potential that is proportional to the logarithm of the sound pressure level.

  3. [SECOT consensus on medial femorotibial osteoarthritis].

    Science.gov (United States)

    Moreno, A; Silvestre, A; Carpintero, P

    2013-01-01

    A consensus, prepared by SECOT, is presented on the management of medial knee compartment osteoarthritis, in order to establish clinical criteria and recommendations directed at unifying the criteria in its management, dealing with the factors involved in the pathogenesis of medial femorotibial knee osteoarthritis, the usefulness of diagnostic imaging techniques, and the usefulness of arthroscopy. Conservative and surgical treatments are also analysed. The experts consulted showed a consensus (agreed or disagreed) in 65.8% of the items considered, leaving 14items where no consensus was found, which included the aetiopathogenesis of the osteoarthritis, the value of NMR in degenerative disease, the usefulness of COX-2 and the chondroprotective drugs, as well as on the ideal valgus tibial osteotomy technique. © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  4. Masseter and medial pterygoid muscle hypertrophy.

    Science.gov (United States)

    Guruprasad, R; Rishi, Sudhirkumar; Nair, Preeti P; Thomas, Shaji

    2011-09-26

    Hypertrophy refers to an enlargement caused by an increase in the size but not in the number of cells. Generalised masticatory muscle hypertrophy may affect the temporalis muscle, masseters and medial pterygoids in a variety of combinations. Masseteric hypertrophy may present as either unilateral or bilateral painless swelling of unknown origin in the region of angle of mandible. It is a relatively rare condition and presents a diagnostic dilemma. While the history and clinical examination are important in differentiating this benign condition from parotid or dental pathology, they cannot necessarily exclude rare malignant lesion within the muscle. Advanced imaging modalities like CT and MRI are essential to confirm the diagnosis. Here the authors are reporting a unique case of masseter muscle hypertrophy along with medial pterygoid hypertrophy which was missed clinically but confirmed using CT and MRI.

  5. Masseter and medial pterygoid muscle hypertrophy

    OpenAIRE

    R, Guruprasad; Rishi, Sudhirkumar; Nair, Preeti P; Thomas, Shaji

    2011-01-01

    Hypertrophy refers to an enlargement caused by an increase in the size but not in the number of cells. Generalised masticatory muscle hypertrophy may affect the temporalis muscle, masseters and medial pterygoids in a variety of combinations. Masseteric hypertrophy may present as either unilateral or bilateral painless swelling of unknown origin in the region of angle of mandible. It is a relatively rare condition and presents a diagnostic dilemma. While the history and clinical examination ar...

  6. Functional bundles of the medial patellofemoral ligament.

    Science.gov (United States)

    Kang, Hui Jun; Wang, Fei; Chen, Bai Cheng; Su, Yan Ling; Zhang, Zhan Chi; Yan, Chang Bao

    2010-11-01

    The purpose of this study was to explore the anatomy and evaluate the function of the medial patellofemoral ligament (MPFL). Anatomical dissection was performed on 12 fresh-frozen knee specimens. The MPFL is a condensation of capsular fibers, which originates at the medial femoral condyle. It runs transversely and inserts to the medial edge of the patella. With the landmark of the medial femur epicondyle (MFE), the femoral origination was located: just 8.90 ± 3.27 mm proximally and 13.47 ± 3.68 mm posteriorly to the MFE. The most interesting finding in present study was functional bundles of its patellar insertion. Approximately from the femoral origination point, fibers of the MPFL form two relatively concentrated fiber bundles: the inferior-straight bundle and the superior-oblique bundle. The whole length of each was 71.78 ± 5.51 and 73.67 ± 5.40 mm, respectively. The included angle between bundles was 15.1° ± 2.1°. Although the superior-oblique bundle and the inferior-straight bundle run on the patellar MPFL inferiorly and superiorly, respectively, as their name indicates, the two bundles are not entirely separated, which make MPFL one intact structure. The inferior-straight bundle is the main static soft tissue restraints where the superior-oblique bundle associated with vastus medialis obliquus (VMO) is to serve as the main dynamic soft tissue restraints. So this finding may provide the theoretical foundation for the anatomical reconstruction of the MPFL and shed lights on the future researchers.

  7. Effects of botulinum toxin A injection and exercise on the growth of juvenile rat gastrocnemius muscle.

    Science.gov (United States)

    Chen, Chen-Ming; Stott, N Susan; Smith, Heather K

    2002-10-01

    Botulinum toxin A (Btx) injections and supervised exercise are often used concurrently to treat calf muscle spasticity in children. This study has analyzed the early effects of Btx-induced paralysis and increased activity by voluntary wheel running on cell growth-related processes in juvenile rat gastrocnemius muscle. Btx injection at 29 days of age prevented the normal increases in wet mass (50%) and fiber cross-sectional area (34%) seen by 36 days of age in control rats. Btx-injected vs. contralateral muscles had 22% fewer myonuclei per fiber length but greater than twofold the number of MyoD-positive nuclei at 36 days of age. The accretion of 5-bromo-2'-deoxyuridine-labeled newly produced myonuclei did not differ between limbs. Voluntary exercise during the 7 days increased the mass (18%) and fiber size (23%) of Btx-injected and contralateral muscles but did not affect any other variable. Thus Btx injection and exercise had early effects on muscle and fiber size without consistently associated changes in myonuclear production or number. This suggests the presence of noncontractile activity-dependent, growth-promoting cytoplasmic events in juvenile muscle.

  8. Homogeneity of fascicle architecture following repeated contractions in the human gastrocnemius medialis.

    Science.gov (United States)

    Thomas, Neil M; Dewhurst, Susan; Bampouras, Theodoros M

    2015-12-01

    This investigation sought to determine the effects of fatigue on fascicle architecture across the length of the human gastrocnemius medialis (GM). With institutional ethical approval, fifteen healthy males performed repeated isometric plantar flexion maximal voluntary contractions (MVC) until peak force fell 30% below baseline. Brightness-mode ultrasound was used to determine fascicle length and pennation angle at rest and during MVC prior to and following the fatiguing contractions. The results show a significant increase in fascicle length during MVC in the distal (2.8 mm, 8.1%) middle, (4.9 mm, 14.1%), and proximal (5.2 mm, 14.7%) regions post-fatigue compared to pre-fatigue (p MVC in the distal (3.3°, 8.8%), middle (3.9°, 9.4%), and proximal (2.9°, 6.9%) regions post-fatigue compared to pre-fatigue (p < 0.05). These changes, however, were not region specific. These are the first results to show that fascicle shortening within the GM remains homogeneous following fatigue, suggesting that the fascicles were fatigued in a similar pattern throughout the muscle. The significant reduction of fascicle shortening may reflect an additional strategy to maintain an optimal force output in fatigued conditions, although future work is needed to confirm this notion.

  9. Ankle Power and Endurance Outcomes Following Isolated Gastrocnemius Recession for Achilles Tendinopathy.

    Science.gov (United States)

    Nawoczenski, Deborah A; DiLiberto, Frank E; Cantor, Maxwell S; Tome, Josh M; DiGiovanni, Benedict F

    2016-07-01

    Studies have demonstrated improved ankle dorsiflexion and pain reduction following a gastrocnemius recession (GR) procedure. However, changes in muscle performance during functional activities are not known. The purpose of this study was to determine the effect of an isolated GR on ankle power and endurance in patients with Achilles tendinopathy. Fourteen patients with chronic unilateral Achilles tendinopathy and 10 healthy controls participated in this study. Patient group data were collected 18 months following GR. Pain was compared to preoperative values using a 10-cm visual analog scale (VAS). Patient-reported outcomes for activities of daily living (ADL) and sports were assessed using the Foot and Ankle Ability Measure (FAAM). Kinematic and kinetic data were collected during gait, stair ascent (standard and high step), and repetitive single-limb heel raises. Between-group and side-to-side differences in ankle plantarflexor muscle power and endurance were evaluated with appropriate t tests. Compared with preoperative data, VAS pain scores were reduced (pre 6.8, post 1.6, P tendinopathy who failed nonoperative interventions. There were good patient-reported outcomes for activities of daily living. However, compared to controls, ankle plantarflexion power and endurance deficits in the GR group were noted. The functional implications of the muscle performance deficits are unclear, but may be reflective of patients' self-reported difficulty during more challenging activities. Level III, comparative study. © The Author(s) 2016.

  10. Bio-energetic changes in human gastrocnemius muscle 1-2 days after strenuous exercise.

    Science.gov (United States)

    Kemp, G J; Taylor, D J; Radda, G K; Rajagopalan, B

    1992-09-01

    [31P]magnetic resonance spectroscopy was used to study the metabolic sequelae of intense muscular activity in gastrocnemius of seven subjects 1-2 days after a 67-mile bicycle ride. The muscle was examined at rest, during a test exercise and during recovery from test exercise. Post-ride and pre-ride results were compared. At rest, the ratio of phosphocreatine to ATP (PCr/ATP) was increased post-ride; during test exercise PCr/(PCr+Pi) was lower post-ride; and the recoveries of PCr, Pi and PCr/(PCr+Pi) after test exercise were delayed, with decreased 'overshoot' of PCr/(PCr+Pi) (which is due to recovery of Pi to below its resting value). Mild mitochondrial damage (perhaps due to exposure to high cytosolic [Pi] during the bicycle ride) may explain some of these results. In contrast to reports of largely eccentric exercise there was no increase in resting Pi/ATP. We have thus demonstrated perturbations of muscle bio-energetics 1-2 days after strenuous exercise, in the absence of convincing enzymological evidence of muscle damage.

  11. Piper rhythm in the activation of the gastrocnemius medialis during running.

    Science.gov (United States)

    Stirling, Lisa M; von Tscharner, Vinzenz; Kugler, Patrick; Nigg, Benno M

    2011-02-01

    The presence of temporal rhythmicity in electromyographic (EMG) signals at frequencies of 35-60 Hz was initially noted by Piper (1907). This modulation and synchronization of motor unit activity is generally accepted to represent a centrally generated coding of motor commands. The purpose of this study was to resolve and quantify the Piper rhythm in the gastrocnemius medialis (GM) muscle during running. EMG was recorded from the GM of 14 female runners during 1-h treadmill runs. The average wavelet transform was computed for EMG from series of steps taken at 2 min intervals throughout the run. The total intensity across three wavelets (center frequencies: 170, 218 and 271 Hz) was computed and a histogram indicating the incidence peaks in this signal was generated for each subject. In order to rule out effects of the analysis process, the process was repeated using simulated EMG data. Autocorrelations of the histograms were used to extract the frequency of the peaks resulting in rhythmicity at 25-55 Hz. The ability to measure superimposed rhythmicity in EMG signals during dynamic tasks allows investigation of the role of aspects of central drive during movement. In particular, the changes in central control during dynamic activities can be examined with this approach.

  12. Influence of step-height and body mass on gastrocnemius muscle fascicle behavior during stair ascent.

    Science.gov (United States)

    Spanjaard, M; Reeves, N D; van Dieën, J H; Baltzopoulos, V; Maganaris, C N

    2008-01-01

    To better understand the role of the ankle plantar flexor muscles in stair negotiation, we examined the effects of manipulation of kinematic and kinetic constraints on the behavior of the gastrocnemius medialis (GM) muscle during stair ascent. Ten subjects ascended a four-step staircase at four different step-heights (changing the kinematic constraints): standard (17 cm), 50% decreased, 50% increased and 75% increased. At the standard height, subjects also ascended the stairs wearing a weighted jacket, adding 20% of their body mass (changing the kinetic constraints). During stair ascent, kinematics and kinetics of the lower legs were determined using motion capture and ground reaction force measurements. The GM muscle fascicle length was measured during the task with ultrasonography. The amount of GM muscle fascicle shortening increased with step-height, coinciding with an increase in ankle joint moment. The increase in body mass resulted in an increased ankle joint moment, but the amount of GM muscle fascicle shortening during the lift-off phase did not increase, instead, the fascicles were shorter over the whole stride cycle. Increasing demands of stair ascent, by increasing step-height or body mass, requires higher joint moments. The increased ankle joint moment with increasing demands is, at least in part, produced by the increase in GM muscle fascicle shortening.

  13. Reliability of ultrasound texture measures of Biceps Brachialis and Gastrocnemius Lateralis muscles' images.

    Science.gov (United States)

    da Silva Pereira Júnior, Newton; da Matta, Thiago Torres; Alvarenga, André Victor; de Albuquerque Pereira, Wagner Coelho; de Oliveira, Liliam Fernandes

    2017-01-01

    Ultrasound (US) is an important tool for diagnosing of many musculoskeletal tissue conditions. Image texture analysis can be used to characterize this tissue. The complexity curve (CC) is a technique commonly used to characterize the number of grey-level transitions in an image. Variability and reliability of US texture measures in the muscle tissue are unavailable in the literature. The aim of this study was to determine the variability and reliability of five CC texture parameters from US images of healthy Biceps Brachialis and Gastrocnemius Lateralis (GL) muscles, with longitudinal and transversal orientations of the probe. Eight images per subject were obtained for 30 men in 2 days. Mean, standard deviation, coefficient of variation and intraclass correlation coefficient for the five parameters were calculated for regions of interest. Results showed that the variability was similar for both muscles and most of the parameters showed satisfactory reliability (r > 0·7) for the Biceps Brachialis with the transverse scan and for the GL with the longitudinal scan. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  14. Vascularity of myocardium and gastrocnemius muscle in rats selectively bred for endurance running capacity.

    Science.gov (United States)

    Beighley, Patricia E; Zamir, Mair; Wentz, Robert J; Koch, Lauren G; Britton, Steven L; Ritman, Erik L

    2013-02-04

    We tested the hypothesis that changes in the arteriolar branching architecture contributed to increased running capacity of rats subjected to two-way artificial selection for intrinsic aerobic endurance treadmill running capacity resulting in strains of low-capacity and high-capacity endurance rats. Hearts and gastrocnemius muscles were harvested from each strain, and the microvasculature's branching geometry measured from micro-CT images. The vascular branching geometry of the hearts and skeletal muscle from the high capacity was indistinguishable from low-capacity rats. Our hypothesis was not supported. Neither remodeling nor an increase in arteriolar microvasculature branching appears to play a role in the enhanced performance of the high capacity rats. We are led to speculate that endothelial tolerance for shear stress and/or increased coupling of myocardial muscle fiber metabolic-to-contractile function is increased in the high-capacity runner strain to the effect of allowing either higher flow rate per unit volume of muscle or more efficient use of oxygen and nutrients in the high-capacity endurance rats.

  15. [Reduction of dielectric properties of rat gastrocnemius induced by loss of weight].

    Science.gov (United States)

    Tang, Zhiynan; Zhao, Weihong; Wang, Lin; Ma, Qing

    2009-10-01

    In this experimental study, the AC impedance of isolated gastrocnemius was measured with an impendance analyzer of Agilent 4294A, and the effect of simulated weightlessness on the dielectric properties of the cells in isolated rat sural muscle was investigated by analyzing the dielectric numerical characters with the use of dielectric spectroscopy, the Cole-Cole plots, the spectrum of loss factor and loss tangent, as well as the spectrum of conductivity imaginary part. The results demonstrated that 10 weeks' simulated weightlessness caused some changes; for example, both permittivity at low frequency (epsilonL) and permittivity increment (deltaepsilon) were reduced, and conductivity at high frequency (kappa(h)) was also reduced; at the same time, conductivity increment (deltakappa) was reduced, too. The first characteristic frequency (f(C1)) decreased, while the second characteristic frequency(f(C2)) increased. All of the peak of loss factor, the peak of loss tangent, and the maximum of conductivity imaginary part were reduced. These data indicated that the reduction of dielectric properties of skeletal muscles was induced by weightlessness.

  16. PPM1B and P-IKKβ expression levels correlated inversely with rat gastrocnemius atrophy after denervation

    Energy Technology Data Exchange (ETDEWEB)

    Wei, Jian; Liang, Bing-Sheng [Department of Orthopedics, the Second Hospital, Shanxi Medical University, Taiyuan (China)

    2012-05-18

    Activated inhibitor of nuclear factor-κB kinase β (IKKβ) is necessary and sufficient for denervated skeletal muscle atrophy. Although several studies have shown that Mg{sup 2+}/Mn{sup 2+}-dependent protein phosphatase 1B (PPM1B) inactivated IKKβ, few studies have investigated the role of PPM1B in denervated skeletal muscle. In this study, we aim to explore the expression and significance of PPM1B and phosphorylated IKKβ (P-IKKβ) during atrophy of the denervated gastrocnemius. Thirty young adult female Wistar rats were subjected to right sciatic nerve transection and were sacrificed at 0 (control), 2, 7, 14, and 28 days after denervation surgery. The gastrocnemius was removed from both the denervated and the contralateral limb. The muscle wet weight ratio was calculated as the ratio of the wet weight of the denervated gastrocnemius to that of the contralateral gastrocnemius. RT-PCR and Western blot analysis showed that mRNA and protein levels of PPM1B were significantly lower than those of the control group at different times after the initiation of denervation, while P-IKKβ showed the opposite trends. PPM1B protein expression persistently decreased while P-IKKβ expression persistently increased for 28 days after denervation. PPM1B expression correlated negatively with P-IKKβ expression by the Spearman test, whereas decreasing PPM1B expression correlated positively with the muscle wet weight ratio. The expression levels of PPM1B and P-IKKβ were closely associated with atrophy in skeletal denervated muscle. These results suggest that PPM1B and P-IKKβ could be markers in skeletal muscle atrophy.

  17. Oedema and fatty degeneration of the soleus and gastrocnemius muscles on MR images in patients with achilles tendon abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, Adrienne [University Hospital Balgrist Zuerich, Radiology Department, Zuerich (Switzerland); Hirslanden Klinik Aarau, Radiology Department, Aarau (Switzerland); Mamisch, Nadja; Buck, Florian M.; Pfirrmann, Christian W.A.; Zanetti, Marco [University Hospital Balgrist Zuerich, Radiology Department, Zuerich (Switzerland); Espinosa, Norman [University Hospital Balgrist Zuerich, Orthopedic Surgery Department, Zuerich (Switzerland)

    2011-09-15

    The purpose of this study was to evaluate the frequency of oedema and fatty degeneration of the soleus and gastrocnemius muscles in patients with Achilles tendon abnormalities. Forty-five consecutive patients (mean 51 years; range 14-84 years) with achillodynia were examined with magnetic resonance (MR) images of the calf. The frequency of oedema and fatty degeneration in the soleus and gastrocnemius muscles was determined in patients with normal tendons, tendinopathy and in patients with a partial tear or a complete tear of the Achilles tendon. Oedema was encountered in 35% (7/20) of the patients with tendinopathy (n = 20; range 13-81 years), and in 47% (9/19) of the patients with partial tears or complete tears (n = 19; 28-78 years). Fatty degeneration was encountered in 10% (2/20) of the patients with tendinopathy, and in 32% (6/19) of the patients with tears. The prevalence of fatty degeneration was significantly more common in patients with a partial or complete tear compared with the patients with a normal Achilles tendon (p = 0.032 and p = 0.021, respectively). Oedema and fatty degeneration of the soleus and gastrocnemius muscles are common in patients with Achilles tendon abnormalities. (orig.)

  18. Post-ablative reconstruction of the medial canthus and medial orbital wall using conchal cartilage graft with three illustrative cases.

    Science.gov (United States)

    Dagregorio, G; Darsonval, V

    2005-12-01

    When the medial third of the upper or lower eyelid has to be reconstructed after full-thickness tumour excision, we usually use Hübner tarsomarginal grafts, but when medial canthal lesions spread to the medial orbital wall without invading the orbital margin, conchal graft becomes our first surgical option. Previously reported solutions to this difficult problem are few and concern more directly medial orbital wall fractures. We found no article dealing specifically with the use of conchal graft in post-ablative reconstruction of the medial orbital wall. Nevertheless the concha presents great advantages over bone grafting or rib cartilage, because it is more flexible and malleable. And it is less prone to extrusion or infection as may be allografts implants. It is a very effective way to repair medial orbital defects, but graft reorientation must be perfect to match exactly the medial orbital wall concavity.

  19. The Effects of Ligustrazine on the Ca2+ Concentration of Soleus and Gastrocnemius Muscle Fibers in Hindlimb Unloaded Rat

    Science.gov (United States)

    Gao, Yunfang; Goswami, Nandu; Du, Bei; Hu, Huanxin; Wu, Xue

    Background:Spaceflight or inactivity (bed rest, limb immobilization, hindlimb unloading) causes skeletal muscle atrophy. Recent studies show that an increase in protein degradation is an important mechanism for disuse atrophy. Furthermore, the calcium overload of disuse-atrophied muscle fiber has been shown to initiate the skeletal muscle proteolysis in disuse atrophy. Ligustrazine (tetramethylpyrazine, TMP), one of the important active ingredient extracted from Chuanxiong, has been shown by our group to increase muscle fiber cross-sectional area in atrophied soleus induced by 14 days hindlimb unloading. However, the underlying mechanisms of ligustrazine effects on disuse-atrophied muscle fibers remain unknown. Objective: We investigated the effects of ligustrazine on the cytoplasmic calcium overloading in soleus and gastrocnemius in 14 days hindlimb unloaded (HU) rats. Methods: Adult female Sprague-Dawley rats were matched for body mass and randomly assigned to three groups (n=8, each group): 1) synchronous control (CON); HU + intragastric water instillation (HU+W); HU + intragastric 60.0 mg kg-1 ligustrazine instillation (HU+Tmp). Laser scanning confocal microscope assessed the concentrations of cytoplasmic calcium ions. Spaceflight disuse atrophy was simulated by hindlimb unloading, provided by tail suspension. Results: 1) Compared with CON, the concentration of soleus intracellular calcium ion in HU+W and HU+Tmp increased 330% and 86% respectively(P<0.01). Compared with HU+W, the concentration of soleus intracellular calcium ion in HU+Tmp decreased by 130%(P<0.01). 2) Compared with CON, the concentration of gastrocnemius intracellular calcium ion in HU+W and HU+Tmp increased 189.8% and 32.1% respectively(P<0.01). Compared with HU+W, the concentration of gastrocnemius intracellular calcium ion in HU+Tmp decreased by 119.3% (P<0.01). Conclusion: After 14 days of hindlimb unloading, cytoplasmic calcium of soleus (slow-twitch muscle) and gastrocnemius (fast

  20. Pattern of paediatric corneal laceration injuries in the University of port Harcourt teaching hospital, Rivers state, Nigeria

    Directory of Open Access Journals (Sweden)

    Omobolanle Adio

    2012-12-01

    Full Text Available Abstract Background Corneal lacerations mostly affect younger children, commonly males, who will constitute the majority of the workforce. Clinical outcomes are reviewed and compared so that measures to reduce their occurrence and improve outcome can be proffered. Methods Records of all children between the ages of 1-18 yrs, who presented with penetrating eye injuries at the eye clinic of the University of Port Harcourt teaching Hospital, Rivers state, Nigeria between January 2002 and December 2009 were included. Information retrieved -patient’s Bio data, presenting symptoms, presenting visual acuity (VA, source of injury, surgical intervention and outcome using VA. All data analysed with EPI Info version 6 with the aid of a statistician. Results Folders of thirty-six children (36 eyes between the ages of 0–18 years diagnosed with corneal laceration over a period of 8 years out of 65 cases managed within that period available. Other folders reported as missing. Male female ratio 3:1, the mean age is 8.7 years (SD ± 3.67. Only one presented within 24 hours. Objects causing injury mainly missiles with stones/catapult injuries (n = 8, 22.2%. Presenting VAs in those that could be measured, ranged from 6/24 to 6/60 (n = 4, 11% to no light perception (NLP (n = 5, 13.9%. Associated injuries include lid laceration, cataract, vitreous haemorrhage and retinal detachment. Twenty one patients had primary corneal repair (58.3% carried out within 7 days of presentation. Four had endophthalmitis. After 3 months follow up, VA of 6/60 and better was achieved in 11 of 18 eyes left in follow up (6/60-6/24 in 8 eyes (22.2%, 6/18 and better in 3 eyes (8.3%. Conclusion Most eye injuries in children are preventable. In this study, the prognosis was better in those whose injuries were confined to a peripheral part of the cornea, with no other associated injury, who presented within 5 days and who did not have any intraocular

  1. Clinical Exploration on 90 Cases with Soft Birth Canal Laceration%软产道裂伤90例临床探究

    Institute of Scientific and Technical Information of China (English)

    韩荣荣

    2014-01-01

    Objective:The specific causes and treatment methods of post-partum hemorrhage caused by soft birth canal laceration were analyzed. Method:A total of 90 cases with post-partum hemorrhage caused by soft birth canal laceration in our hospital from January 2011 to January 2013 were chosen as study objects,and the causes and treatment methods of patients were m retrospectively analyzed.Result:The incidence rate of soft birth canal laceration in patients whose first stage of labor was shorter than 1 hour or the second stage of labor was shorter than 0.5 hour was the highest.The incidence rate of soft birth canal laceration in patients whose first stage of labor was from 8 to 16 h or whose second stage of labor was from 1 to 2 h was the middle one.The incidence rate of soft birth canal laceration was lowest in patients whose stage of labor was not higher than the warning line and dispose line.Conclusion:Soft birth canal laceration is correlated with the stage of labor,fetal size and other factors,and mastering the reasons of soft birth canal laceration has a significance for doing a good job in preventing post-partum hemorrhage work.%目的:分析因软产道裂伤导致的产后出血的具体原因及处理方法。方法:将2011年1月-2013年1月笔者所在医院产科收治的因软产道裂伤引起的90例产后出血病患作为研究对象,回顾性分析病患出现软产道裂伤的原因及处理方法。结果:第一产程<1 h者及第二产程<0.5 h者产道裂伤发生率最高;第一产程8~16 h及第二产程1~2 h者产道裂伤发生率次之,而未超过产程警戒线及处理线者产道裂伤发生率最低。结论:软产道裂伤和产程、胎儿大小等因素有关,全面掌握软产道裂伤的原因,对做好预防产后出血工作具有重要意义。

  2. Behaviour of the human gastrocnemius muscle architecture during submaximal isometric fatigue.

    Science.gov (United States)

    Mademli, Lida; Arampatzis, Adamantios

    2005-08-01

    The purpose of this study was to examine whether the human gastrocnemius medialis (GM) fascicle length and pennation angle alter during a sustained submaximal isometric plantar flexion. Fourteen male subjects performed maximal voluntary plantar flexions (MVC) on a dynamometer before and after a fatiguing task. This task consisted of a sustained submaximal isometric fatiguing contraction (40% MVC) until failure to hold the defined moment. Ultrasonography was used to visualise the muscle belly of the GM. Leg kinematics were recorded (120 Hz) to calculate the joint moment using inverse dynamics. The exerted moments and the EMG signals from GM and lateralis, soleus and tibialis anterior were measured at 1,080 Hz. The root mean square (RMS) of the EMG signal of the three triceps surae muscles increased significantly (P < or = 0.05) between 17% and 28% with fatigue. Further, the fascicle length of the GM significantly decreased from 47.1 +/- 8.0 mm at the beginning to 41.8 +/- 6.7 mm at the end of fatigue and the pennation angle increased from 23.5 +/- 4.1 degrees to 26.3 +/- 2.2 degrees (P < or = 0.05). The changes in fascicle length and pennation angle of the GM during the contraction can influence the force potential of the muscle due to the force-length relationship and the force transmission to the tendon. This provides evidence on that an additional mechanical mechanism, namely tendon creep, can contribute to the increase in the EMG activity of the GM during submaximal isometric sustained contractions.

  3. Effects of estrogen on gastrocnemius muscle strain injury and regeneration in female rats

    Institute of Scientific and Technical Information of China (English)

    XinFENG; Guo-zhenLI; ShengWANG

    2004-01-01

    AIM: To study the effects of estrogen on muscle damage and regeneration after acute passive gastrocnemius muscle strain injury in female Sprague-Dawley rats. METHODS: Rats were divided into 5 groups: ovariectomized, strained and treated with low-dosage estradiol (20μg/d) (Elow), treated with high-dosage estradiol (200 lag/d) (Ehigh), treated with oil placebo (Oil), strained with no ovariectomy (Strain), and sham operated with no strain and no ovariectomy (Con). Muscle damage index [plasma creatine kinase (CK)], antioxidant indexes [glutathione (GSH), Vitamin E (Vit E), total antioxidant capability (TAC)], and muscle regeneration index (desmin) were investigated at 7d. RESULTS: The plasma CK activity increased but GSH, Vit E, and TAC levels decreased after muscle strain injury (Strain vs Con P<0.05). Plasma CK activity was the greatest while GSH, Vit E, and TAC were the lowest in the Oil group among the five groups (P<0.01). Plasma CK in the Ehigh and Strain groups was lower than that in the Elow group. Plasma GSH, Vit E, and TAC were higher in the Ehigh and Strain groups compared with the Elow group (P<0.05). The expression of desmin in the Ehigh and Strain groups was higher than that in the Elow group (P<0.01) while that in the Oil group was the lowest in all the five groups (P<0.01). CONCLUSION: Endogenous estrogen in normal female rats or exogenous estrogen in ovariectomized rats could improve antioxidant capability in vivo, so that reduced muscle damage and accelerated muscle regeneration post gastronemius muscle strain injury.

  4. Effects of estrogen on gastrocnemius muscle strain injury and regeneration in female rats

    Institute of Scientific and Technical Information of China (English)

    Xin FENG; Guo-zhen LI; Sheng WANG

    2004-01-01

    AIM: To study the effects of estrogen on muscle damage and regeneration after acute passive gastrocnemius muscle strain injury in female Sprague-Dawley rats. METHODS: Rats were divided into 5 groups: ovariectomized,strained and treated with low-dosage estradiol (20 μg/d) (Elow), treated with high-dosage estradiol (200 μg/d) (Ehigh),treated with oil placebo (Oil), strained with no ovariectomy (Strain), and sham operated with no strain and no ovariectomy (Con). Muscle damage index [plasma creatine kinase (CK)], antioxidant indexes [glutathione (GSH),Vitamin E (Vit E), total antioxidant capability (TAC)], and muscle regeneration index (desmin) were investigated at7 d. RESULTS: The plasma CK activity increased but GSH, Vit E, and TAC levels decreased after muscle strain injury (Strain vs Con P<0.05). Plasma CK activity was the greatest while GSH, Vit E, and TAC were the lowest in the Oil group among the five groups (P<0.01). Plasma CK in the Ehigh and Strain groups was lower than that in the Elow group. Plasma GSH, Vit E, and TAC were higher in the Ehigh and Strain groups compared with the Elow group(P <0.05). The expression of desmin in the Ehigh and Strain groups was higher than that in the Elow group (P<0.01)while that in the Oil group was the lowest in all the five groups (P<0.01). CONCLUSION: Endogenous estrogen in normal female rats or exogenous estrogen in ovariectomized rats could improve antioxidant capability in vivo, so that reduced muscle damage and accelerated muscle regeneration post gastronemius muscle strain injury.

  5. Effect of joint rotation correction when measuring elongation of the gastrocnemius medialis tendon and aponeurosis.

    Science.gov (United States)

    Arampatzis, Adamantios; Monte, Gianpiero De; Karamanidis, Kiros

    2008-06-01

    It is well known that during maximal plantar flexion contractions the ankle joint rotation overestimates the actual elongation of the tendon and aponeurosis. The aim of this study was to examine the influence of the curve length changes of the Achilles tendon on the joint rotation corrected elongation and strain of the gastrocnemius medialis (GM) tendon and aponeurosis. Nine subjects (age: 29.4+/-5.7 years, body mass: 78.8+/-6.8 kg, body height: 178+/-4 cm) participated in the study. The subjects performed maximal voluntary isometric plantarflexion contractions in the prone position on a Biodex-dynamometer. Ultrasonography (Aloka SSD 4000) was used to visualize the muscle belly of the GM muscle-tendon unit. To calculate the curve length changes of the Achilles tendon its surface contour was reconstructed using a series of small reflective skin markers having a diameter of 2.5mm. The elongation of the GM tendon and aponeurosis was calculated (a) as the difference of the measured and the passive (due to joint rotation) displacement of the tendon and aponeurosis and (b) as the difference of the measured displacement and the length changes of the reconstructed Achilles tendon surface contour. The absolute difference between the elongation obtained by both methods were 1.2+/-0.4mm. These differences were due to the higher changes in length obtained by the reconstruction of the tendon curved surface contour as compared to the changes observed in the passive displacement of the digitised point at the aponeurosis. Without correcting for angle joint rotation, the measured elongation clearly overestimates the actual elongation of the GM tendon and aponeurosis. After the passive displacement correction the calculated elongation still overestimates the actual elongation of the GM tendon and aponeurosis. However, this overestimation has a negligible effect on the examined in vivo strain ( approximately 0.3%) of the tendon and aponeurosis.

  6. Characteristics of myogenic response and ankle torque recovery after lengthening contraction-induced rat gastrocnemius injury

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    Song Hongsun

    2012-10-01

    Full Text Available Abstract Background Although muscle dysfunction caused by unfamiliar lengthening contraction is one of most important issues in sports medicine, there is little known about the molecular events on regeneration process. The purpose of this study was to investigate the temporal and spatial expression patterns of myogenin, myoD, pax7, and myostatin after acute lengthening contraction (LC-induced injury in the rat hindlimb. Methods We employed our originally developed device with LC in rat gastrocnemius muscle (n = 24. Male Wistar rats were anesthetized with isoflurane (aspiration rate, 450 ml/min, concentration, 2.0%. The triceps surae muscle of the right hindlimb was then electrically stimulated with forced isokinetic dorsi-flexion (180°/sec and from 0 to 45°. Tissue contents of myoD, myogenin, pax7, myostatin were measured by western blotting and localizations of myoD and pax7 was measured by immunohistochemistry. After measuring isometric tetanic torque, a single bout of LC was performed in vivo. Results The torque was significantly decreased on days 2 and 5 as compared to the pre-treatment value, and recovered by day 7. The content of myoD and pax7 showed significant increases on day 2. Myogenin showed an increase from day 2 to 5. Myostatin on days 5 and 7 were significantly increased. Immunohistochemical analysis showed that myoD-positive/pax7-positive cells increased on day 2, suggesting that activated satellite cells play a role in the destruction and the early recovery phases. Conclusion We, thus, conclude that myogenic events associate with torque recovery after LC-induced injury.

  7. Human postural sway results from frequent, ballistic bias impulses by soleus and gastrocnemius.

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    Loram, Ian D; Maganaris, Constantinos N; Lakie, Martin

    2005-04-01

    It has been widely assumed for nearly a century, that postural muscles operate in a spring-like manner and that muscle length signals joint angle (the mechano-reflex mechanism). Here we employ automated analysis of ultrasound images to resolve calf muscle (soleus and gastrocnemius) length changes as small as 10 mum in standing subjects. Previously, we have used balancing of a real inverted pendulum to make predictions about human standing. Here we test and confirm these predictions on 10 subjects standing quietly. We show that on average the calf muscles are actively adjusted 2.6 times per second and 2.8 times per unidirectional sway of the body centre of mass (CoM). These alternating, small (30-300 microm) movements provide impulsive, ballistic regulation of CoM movement. The timing and pattern of these adjustments are consistent with multisensory integration of all information regarding motion of the CoM, pattern recognition, prediction and planning using internal models and are not consistent with control solely by local reflexes. Because the system is unstable, errors in stabilization provide a perturbation which grows into a sway which has to be reacted to and corrected. Sagittal sway results from this impulsive control of calf muscle activity rather than internal sources (e.g. the heart, breathing). This process is quite unlike the mechano-reflex paradigm. We suggest that standing is a skilled, trial and error activity that improves with experience and is automated (possibly by the cerebellum). These results complement and extend our recent demonstration that paradoxical muscle movements are the norm in human standing.

  8. Effect of aerobic exercise on the contractile function of gastrocnemius myosin heavy chain

    Institute of Scientific and Technical Information of China (English)

    Wen-jun Ren

    2009-01-01

    Objective To study the effect of 4- 6 weeks' treadmill training of male SD rats on the contractile function of their gnstroenemius myosin heavy chain (MHC). Methods Forty male SD rats were randomly divided into control group and training group. The treadmill training of the training group rats was incessantly performed for 4- 6 weeks at an intensity of about 75% VO2max (18. 5- 24 m/min, gradient of 0°, each training session lasting 50 minutes, twice a day). The content of gastrocnemlas MHC mRNA was tested by reverse transcription polymernse chain reaction (RT-PCR), and the changes of muscle fibre and its cross-section area (CSA) were measured using immunohistochemistry. Electric stimulation tests were used to determine the maximal tension of isometric contraction of the post-training gastrocnemius. Results ① After continuous treadmill training for 4 - 6 weeks, we found that the content of the total MHC, MHC Ⅰ , MHC Ⅱ x, MHC Ⅱ a mRNAs was 105%, 105%, 109% and 108% of that in the resting control group, respectively, and the MHC Ⅱ b mRNA content did not change significantly. The percentage of MHC Ⅰ mRNA in the total MHC mRNA increased while that of MHC Ⅱ mRNA decreased after aerobic training. ② The slow type of fibre type Ⅰ was the main part of the MHC after training and the CSA of the muscle fibres increased simultaneously. ③ The maximal tension of isometric contraction by pulse stimulation of square wave in the training group increased significantly compared with that in the control group (P<0. 01). Conclusion The findings indicate that aerobic exercise may promote an increase in the contractile function of MHC.

  9. Microsurgical treatment of medial sphenoid ridge meningioma

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    Wei-qi HE

    2011-02-01

    Full Text Available Objective To explore the microsurgical technique of medial sphenoid ridge meningioma resectional therapy.Methods The clinical data were retrospectively analyzed of 29 patients(13 males and 16 females;aged 18-68 years with average of 42 years;duration of disease was 5 months to 8 years,averaged 28 months with medial sphenoidal ridge meningioma and admitted from Jan.2005 to Jan.2010.The anatomical relationship of the tumor to surrounding structures was assessed intraoperatively,the tumor was then completely resected through cutting off the tumor supplying vessels,shrinking the tumor volume and separating the tumors from adjacent vessels and nerves.All the patients were followed up for 4 months to 4 years.Results Of the 29 cases,20 got total tumor removal,7 got subtotal and 2 got partial tumor removal.Of the 20 patients with obviously preoperative visual impairment,12 were obviously relieved,6 showed no improvement and 2 got symptoms aggravation.Hemiplegia occurred in 2 cases and oculomoter nerve palsy in 6 cases.There was no death after surgery.A 6 months to 4 years follow-up showed that no recurrence was found in 27 patients with tumor resection level of Simpson I and II,2 patients with tumor resection level of Simpson III received postoperative radiotherapy or gamma knife surgery,and 1 recurred and received reoperation.Conclusions Fine intraoperative assessment of the anatomical relationship of the tumor to surrounding structures,separating and excising tumor according to the assessed result is the key of medial sphenoid ridge meningioma resection,and the tumor resection is favorable to visual rehabilitation and tumor control.

  10. OPTIMAL SURGICAL MANAGEMENT OF HIGH VELOCITY POSTERIOR TIBIAL PLATEAU FRACTURE SUBLUXATIONS (DUPARC, REVISED CLASSIFICATION, GROUP – V: POSTERO - MEDIAL FRACTURE BY DIRECT, DORSAL APPROACH – A CHANGING TREND: A PROSPECTIVE STUDY

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    Pardhasaradhi

    2015-10-01

    Full Text Available INTRODUCTION : High - energy tibial plateau fractures are infrequent and technically demanding to treat especially if those are shearing type, coronal plane, displaced fractures. The most widely used the Schatzker system of classification , [1] ( B ased on the AP radiograph is more than likely to miss postero - medial and postero - lateral shear fractures, best visible on the lateral, than the AP radiograph. These fractures have recently been characterised by two studies, highlighti ng their clinical relevance [ 2,3] and showing that less invasive surgery and indirect reduction techniques are often inadequate. Hohl described unicondylar c oronal plane splitting fractures of the medial tibial plateau, noted that these injuries be considered as fracture - dislocations. Connolly and others have suggested that the mechanism involved in this fracture pattern is one of knee flexion, varus, and inter nal rotation of the medial femoral condyle . [4,5,6 ] Consistent among these and other authors is that the occurrence of this fragment is relatively unusual and that the use of a posteriorly based exposure with direct fracture visualization, anatomic reductio n and absolute stability appears to result in satisfactory outcomes. Though variations of a postero - medial approach been previously described ( by Trickey et al and also by Burks et al.,, more recently, Lobenhoffer et al described direct posterior exposure , Wang et al described postero - medial approach and Luo et al. described the approach for the management of posterior bicondylar tibial plateau fractures . [7,8] These approaches have been used in isolation or as a dual - incision approach for treating tibial plateau fractures . [9,10,11,12,13,14, 15] PURPOSE : The purpose of this study is to describe this unfamiliar direct posterior surgical (Medial Gastrocnemius approach to a general orthopod, highlighting the relevant anatomy and presenting our experience using this approach in treating a

  11. 20G silicone rod as monocanalicular stent in repair of canalicular lacerations: Experience from a tertiary eye care centre

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    Susanta Chatterjee

    2013-01-01

    Full Text Available To evaluate the outcome of 20G silicone rod as monocanalicular stent in canalicular lacerations. Retrospective case series involving patients between July 2006 and June 2010. Fourteen canalicular repairs in 12 consecutive patients were done in the study period. Eleven were male and mean age was 30.5 years. A single canaliculus was involved in 10 patients and associated injury to the globe was noted in 3 patients. The median lag time between injury and repair was 3 (range 1-9 days. The mean duration of stenting was 6.9 (SD 3.2 weeks. Spontaneous extrusion of monocanalicular stent occurred in 3 patients. Patency on syringing was noted in 10 (70% canaliculi over a median follow up of 7 (range 2-17 months. 20G silicone rod may be used as an effective and economical alternative in canalicular lacration repairs.

  12. Carotid-cavernous fistula caused by laceration of persistent fetal trigeminal artery treated with single catheter coil embolization

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    Benjamin L Brown

    2012-01-01

    Full Text Available We present the endovascular treatment of traumatic carotid-cavernous fistula from persistent fetal trigeminal artery (PFTA laceration. To date, there are six such cases of traumatic PFTA-cavernous fistulas reported in the literature. These injuries can pose a unique challenge in that rupture of a PFTA in its course through the cavernous sinus may produce a fistula feeding from both anterior and posterior circulations. Previously, these have been treated with dual catheter coil embolization from the carotid and basilar systems. We utilize a single catheter technique accessing the cavernous sinus through the origin of the PFTA on the internal carotid. Both anterior and posterior fistula components may be embolized through this single access. This represents a simple yet safe treatment option.

  13. Musculus gastrocnemius tetanus kinetics in alcohol-intoxicated rats with experimentally-induced hindlimb vascular ischemia under conditions of low-frequence muscle fatigue

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    O. A. Melnychuk

    2014-04-01

    Full Text Available Alcohol intoxication and ischemic injury of skeletal muscles often accompany each other. It is shown that patients hospitalized with chronic alcoholism develop muscle fatigue. Skeletal muscle dysfunction in alcohol-dependent patients is caused by ethanol-associated myofibrillar atrophy and metabolic disbalance, while compression-ischemic lesions result from unconsciousness of the patient, in case of taking the critical alcohol dose. Therefore, the aim of this study is to discover typical m. gastrocnemius (cap. med. tetanic kinetics changes in alcohol intoxicated rats with experimentally induced vascular ischemia of hindlimb muscles under conditions of low-frequency progressive muscle fatigue. Experiments were carried out on 10 young male Wistar rats (149.5 ± 5.8 g kept under standard vivarium conditions and diet. The investigation was conducted in two phases: chronic (30 days and acute (3 hours experiment. All surgical procedures were carried out aseptically under general anesthesia. Ishemic m. gastrocnemius (cap. med. tetanic kinetic changes and force productivity in alcohol intoxicated rats were investigated in the isometric mode, with direct electrical stimulation. The fatigue of m. gastrocnemius (cap. med. was evaluated by three characteristic criteria: the first sag effect, the secondary force rise, the second sag effect. There have been 10 similar experiments: 5 series in each study group with 10 tetanic runs in each series. The highest amplitude of the native m. gastrocnemius (cap. med. tetanus relative to isoline was taken as 100% force response. The same pattern of m. gastrocnemius (cap. med. low-frequency fatigue development was found in both rat groups under study. It is evidenced by the absence of substantial m. gastrocnemius (cap. med. tetanus kinetics differences in alcohol intoxicated rats, compared with non-alcohol intoxicated rats during fatigue test. However, the appreciable m. gastrocnemius (cap. med. tetanic force reduction

  14. Biomechanical consequences of patellar component medialization in total knee arthroplasty.

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    Anglin, Carolyn; Brimacombe, Jill M; Wilson, David R; Masri, Bassam A; Greidanus, Nelson V; Tonetti, Jérôme; Hodgson, Antony J

    2010-08-01

    The optimal amount of patellar component medialization in knee arthroplasty is unknown. We measured the impact, on patellofemoral kinematics and contact force distribution, of 0.0-, 2.5-, and 5.0-mm patellar component medialization in 7 cadaveric specimens implanted with knee arthroplasty components. The knees were flexed dynamically in a weight-bearing rig. Medialization led to lateral shift of the patellar bone, slight medial shift of the patellar component in the femoral groove, lateral tilt of the patella, reduced patellofemoral contact force in later flexion, and lateral shift of the center of pressure in early flexion. Effects on shift and tilt were proportional to the amount of medialization. As a result of this investigation, we recommend medializing the patellar component slightly-on the order of 2.5 mm. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  15. The medial tibial stress syndrome. A cause of shin splints.

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    Mubarak, S J; Gould, R N; Lee, Y F; Schmidt, D A; Hargens, A R

    1982-01-01

    The medial tibial stress syndrome is a symptom complex seen in athletes who complain of exercise-induced pain along the distal posterior-medial aspect of the tibia. Intramuscular pressures within the posterior compartments of the leg were measured in 12 patients with this disorder. These pressures were not elevated and therefore this syndrome is a not a compartment syndrome. Available information suggests that the medial tibial stress syndrome most likely represents a periostitis at this location of the leg.

  16. Influence of different degrees of bilateral emulated contractures at the triceps surae on gait kinematics: The difference between gastrocnemius and soleus.

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    Attias, M; Bonnefoy-Mazure, A; De Coulon, G; Cheze, L; Armand, S

    2017-07-31

    Ankle plantarflexion contracture results from a permanent shortening of the muscle-tendon complex. It often leads to gait alterations. The objective of this study was to compare the kinematic adaptations of different degrees of contractures and between isolated bilateral gastrocnemius and soleus emulated contractures using an exoskeleton. Eight combinations of contractures were emulated bilaterally on 10 asymptomatic participants using an exoskeleton that was able to emulate different degrees of contracture of gastrocnemius (biarticular muscle) and soleus (monoarticular muscle), corresponding at 0°, 10°, 20°, and 30° ankle plantarflexion contracture (knee-flexed and knee-extended). Range of motion was limited by ropes attached for soleus on heel and below the knee and for gastrocnemius on heel and above the knee. A gait analysis session was performed to evaluate the effect of these different emulated contractures on the Gait Profile Score, walking speed and gait kinematics. Gastrocnemius and soleus contractures influence gait kinematics, with an increase of the Gait Profile Score. Significant differences were found in the kinematics of the ankles, knees and hips. Contractures of soleus cause a more important decrease in the range of motion at the ankle than the same degree of gastrocnemius contractures. Gastrocnemius contractures cause greater knee flexion (during the stance phase) and hip flexion (during all the gait cycle) than the same level of soleus contractures. These results can support the interpretation of the Clinical Gait Analysis data by providing a better understanding of the effect of isolate contracture of soleus and gastrocnemius on gait kinematics. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Gastrocnemius Stretching Program: More Effective in Increasing Ankle/Rear-Foot Dorsiflexion When Subtalar Joint Positioned in Pronation Than in Supination.

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    Johanson, Marie A; Armstrong, Megan; Hopkins, Chris; Keen, Meghan L; Robinson, Michael; Stephenson, Scott

    2015-08-01

    Stretching exercises are commonly prescribed for patients and healthy individuals with limited extensibility of the gastrocnemius muscle. To determine if individuals demonstrate more dorsiflexion at the ankle/rear foot and less at the midfoot after a gastrocnemius-stretching program with the subtalar joint (STJ) positioned in supination compared with pronation. Randomized controlled trial. Biomechanical laboratory. 22 volunteers with current or recent history of lower-extremity cumulative trauma and gastrocnemius tightness (10 women and 4 men, mean age 28 y) randomly assigned to stretching groups with the STJ positioned in either pronation (n = 11) or supination (n = 11). 3-wk home gastrocnemius-stretching program using a template to place the subtalar joint in either a pronated or a supinated position. A 7-camera Vicon motion-analysis system measured ankle/ rear-foot dorsiflexion and midfoot dorsiflexion of all participants during stretching with the STJ positioned in both pronation and supination before and after the 3-wk gastrocnemius-stretching program. A 2-way mixed-model ANOVA revealed a significant interaction (P = .019). At posttest, the group who performed the 3-week stretching program with the STJ positioned in pronation demonstrated more increased ankle/rear-foot dorsiflexion when measured with the STJ in pronation than the group who performed the 3-wk stretching program with the STJ positioned in supination. No significant main effect of stretching group or interaction for dorsiflexion at the midfoot was detected (P = .755 and P = .820, respectively). After a 3-wk gastrocnemius-stretching program, when measuring dorsiflexion with the STJ positioned in supination, the participants who completed a 3-wk gastrocnemius stretching program with the STJ positioned in pronation showed more increased dorsiflexion at the ankle/rear foot than participants who completed the stretching program with the STJ positioned in supination.

  18. Ligament balancing in total knee arthroplasty—Medial stabilizing technique

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    Shuichi Matsuda

    2015-10-01

    Full Text Available Ligament balancing is one of the most important surgical techniques for successful total knee arthroplasty. It has traditionally been recommended that medial and lateral as well as flexion and extension gaps are equal. This article reviews the relevant literature and discusses the clinical importance of the aforementioned gaps. Current evidence indicates that achieving medial stability throughout the range of motion should be a high priority in ligament balancing in total knee arthroplasty. Finally, the medial stabilising surgical technique, which aims to achieve good medial stability in posterior cruciate-retaining total knee arthroplasty, is introduced.

  19. Generation of 3D ultrasound biomicroscopic images: technique validation and in vivo volumetric imaging of rat lateral gastrocnemius

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    Natália Santos da Fonseca Martins

    Full Text Available Introduction Ultrasound biomicroscopy (UBM is a technique for generating high-resolution images, with frequencies from 20 MHz to 100 MHz. For example, it has been used in animal research related to models of injury and diseases that mimic human conditions. With a three-dimensional ultrasound (3D image system, an organ can be viewed at various angles and the volume estimated, contributing to an accurate diagnosis. This work refers to the generation of 3D-UBM images, employing a 35 MHz ultrasound system, from multiple two-dimensional (2D images. Phantoms were used to validate the technique and to determine its reliability of volume measurements. Additionally, the technique was used to obtain 3D images of the rat gastrocnemius muscle. Methods Four different phantoms were used and ten acquisition sequences of 2D-images acquired for each one. Thereafter, 5 volume segmentations were performed for each acquisition sequence, resulting in 50 measured volumes for each phantom. The physical volumes of all phantoms were used to validate the technique based on the coefficient of variation (CV and the intraclass correlation coefficient (ICC. Images of the gastrocnemius muscle were acquired and the partial volume quantified. Results The CV and ICC confirmed the reliability of volume measurements obtained by segmentation. Moreover, cross-sectional 2D images of rat hindlimb were obtained, allowing to identify the gastrocnemius muscle and to partially quantify the muscle volume from 3D images. Conclusion The results indicated that the technique is valid to generate 3D images and quantify the volume of a muscle compatible with the dimensions of a small animal.

  20. In vivo passive mechanical behaviour of muscle fascicles and tendons in human gastrocnemius muscle-tendon units.

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    Herbert, Robert D; Clarke, Jillian; Kwah, Li Khim; Diong, Joanna; Martin, Josh; Clarke, Elizabeth C; Bilston, Lynne E; Gandevia, Simon C

    2011-11-01

    Ultrasound imaging was used to measure the length of muscle fascicles in human gastrocnemius muscles while the muscle was passively lengthened and shortened by moving the ankle. In some subjects the muscle belly 'buckled' at short lengths. When the gastrocnemius muscle-tendon unit was passively lengthened from its shortest in vivo length by dorsiflexing the ankle, increases in muscle-tendon length were not initially accompanied by increases in muscle fascicle lengths (fascicle length remained constant), indicating muscle fascicles were slack at short muscle-tendon lengths. The muscle-tendon length at which slack is taken up differs among fascicles: some fascicles begin to lengthen at very short muscle-tendon lengths whereas other fascicles remain slack over a large range of muscle-tendon lengths. This suggests muscle fascicles are progressively 'recruited' and contribute sequentially to muscle-tendon stiffness during passive lengthening of the muscle-tendon unit. Even above their slack lengths muscle fascicles contribute only a small part (tendon length. The contribution of muscle fascicles to muscle-tendon length increases with muscle length. The novelty of this work is that it reveals a previously unrecognised phenomenon (buckling at short lengths), posits a new mechanism of passive mechanical properties of muscle (recruitment of muscle fascicles), and confirms with high-resolution measurements that the passive compliance of human gastrocnemius muscle-tendon units is due largely to the tendon. It would be interesting to investigate if adaptations of passive properties of muscles are associated with changes in the distribution of muscle lengths at which fascicles fall slack.

  1. Reconstruction of neglected achilles tendon ruptures with gastrocnemius flaps: excellent results in long-term follow-up.

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    Seker, Ali; Kara, Adnan; Armagan, Raffi; Oc, Yunus; Varol, Ali; Sezer, Hasan Basri

    2016-10-01

    Repair of the neglected achilles tendon ruptures can be challenging due to retraction of tendon stumps. Different repair and augmentation techniques were described. This study aims to investigate long-term results of neglected achilles tendon rupture repair with gastrocnemius flaps. Between 1995 and 2005, 21 neglected achilles tendon rupture reconstructions were performed with using gastrocnemius fascial flaps. Mean age was 32.1 years. Mean period between rupture and operation was 8.4 weeks. Ankle range of motion, calf circumference, heel raise test, Visual Analog Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) hindfoot and Foot and Ankle Disability Index (FADI) scores were checked. The average gap length was 6.4 cm. Mean follow-up was 145.3 months. Median dorsiflexion/plantar flexion values for operated and uneffected sides were 18°/30° and 19°/30°, respectively. The mean values for AOFAS and FADI scores were 98.5 points and 98.9 %, respectively. VAS score was 0 point for all patients. With the numbers available, no significant difference could be detected in terms of ankle range of motion, calf circumference measures and dynamometric analysis. Mean time for return to daily activities was 11.1 (8-16) weeks after surgery. Prerupture activity level was achieved 14.1 months postoperatively. All patients were able to perform heel raise test. Repair of neglected achilles tendon ruptures with gastrocnemius flaps has satisfactory long-term results.

  2. Time-Course of Muscle Mass Loss, Damage, and Proteolysis in Gastrocnemius following Unloading and Reloading: Implications in Chronic Diseases

    Science.gov (United States)

    Chacon-Cabrera, Alba; Lund-Palau, Helena; Gea, Joaquim; Barreiro, Esther

    2016-01-01

    Background Disuse muscle atrophy is a major comorbidity in patients with chronic diseases including cancer. We sought to explore the kinetics of molecular mechanisms shown to be involved in muscle mass loss throughout time in a mouse model of disuse muscle atrophy and recovery following immobilization. Methods Body and muscle weights, grip strength, muscle phenotype (fiber type composition and morphometry and muscle structural alterations), proteolysis, contractile proteins, systemic troponin I, and mitochondrial content were assessed in gastrocnemius of mice exposed to periods (1, 2, 3, 7, 15 and 30 days) of non-invasive hindlimb immobilization (plastic splint, I cohorts) and in those exposed to reloading for different time-points (1, 3, 7, 15, and 30 days, R cohorts) following a seven-day period of immobilization. Groups of control animals were also used. Results Compared to non-exposed controls, muscle weight, limb strength, slow- and fast-twitch cross-sectional areas, mtDNA/nDNA, and myosin content were decreased in mice of I cohorts, whereas tyrosine release, ubiquitin-proteasome activity, muscle injury and systemic troponin I levels were increased. Gastrocnemius reloading following splint removal improved muscle mass loss, strength, fiber atrophy, injury, myosin content, and mtDNA/nDNA, while reducing ubiquitin-proteasome activity and proteolysis. Conclusions A consistent program of molecular and cellular events leading to reduced gastrocnemius muscle mass and mitochondrial content and reduced strength, enhanced proteolysis, and injury, was seen in this non-invasive mouse model of disuse muscle atrophy. Unloading of the muscle following removal of the splint significantly improved the alterations seen during unloading, characterized by a specific kinetic profile of molecular events involved in muscle regeneration. These findings have implications in patients with chronic diseases including cancer in whom physical activity may be severely compromised. PMID

  3. Three-Dimensional Muscle Architecture and Comprehensive Dynamic Properties of Rabbit Gastrocnemius, Plantaris and Soleus: Input for Simulation Studies.

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    Tobias Siebert

    Full Text Available The vastly increasing number of neuro-muscular simulation studies (with increasing numbers of muscles used per simulation is in sharp contrast to a narrow database of necessary muscle parameters. Simulation results depend heavily on rough parameter estimates often obtained by scaling of one muscle parameter set. However, in vivo muscles differ in their individual properties and architecture. Here we provide a comprehensive dataset of dynamic (n = 6 per muscle and geometric (three-dimensional architecture, n = 3 per muscle muscle properties of the rabbit calf muscles gastrocnemius, plantaris, and soleus. For completeness we provide the dynamic muscle properties for further important shank muscles (flexor digitorum longus, extensor digitorum longus, and tibialis anterior; n = 1 per muscle. Maximum shortening velocity (normalized to optimal fiber length of the gastrocnemius is about twice that of soleus, while plantaris showed an intermediate value. The force-velocity relation is similar for gastrocnemius and plantaris but is much more bent for the soleus. Although the muscles vary greatly in their three-dimensional architecture their mean pennation angle and normalized force-length relationships are almost similar. Forces of the muscles were enhanced in the isometric phase following stretching and were depressed following shortening compared to the corresponding isometric forces. While the enhancement was independent of the ramp velocity, the depression was inversely related to the ramp velocity. The lowest effect strength for soleus supports the idea that these effects adapt to muscle function. The careful acquisition of typical dynamical parameters (e.g. force-length and force-velocity relations, force elongation relations of passive components, enhancement and depression effects, and 3D muscle architecture of calf muscles provides valuable comprehensive datasets for e.g. simulations with neuro-muscular models, development of more realistic

  4. Effects of growth on geometry of gastrocnemius muscle in children: a three-dimensional ultrasound analysis

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    Bénard, Menno R; Harlaar, Jaap; Becher, Jules G; Huijing, Peter A; Jaspers, Richard T

    2011-01-01

    During development, muscle growth is usually finely adapted to meet functional demands in daily activities. However, how muscle geometry changes in typically developing children and how these changes are related to functional and mechanical properties is largely unknown. In rodents, longitudinal growth of the pennate m. gastrocnemius medialis (GM) has been shown to occur mainly by an increase in physiological cross-sectional area and less by an increase in fibre length. Therefore, we aimed to: (i) determine how geometry of GM changes in healthy children between the ages of 5 and 12 years, (ii) test whether GM geometry in these children is affected by gender, (iii) compare normalized growth of GM geometry in children with that in rats at similar normalized ages, and (iv) investigate how GM geometry in children relates to range of motion of angular foot movement at a given moment. Thirty children (16 females, 14 males) participated in the study. Moment-angle data were collected over a range of angles by rotating the foot from plantar flexion to dorsal flexion at standardized moments. GM geometry in the mid-longitudinal plane was measured using three-dimensional ultrasound imaging. This geometry was compared with that of GM geometry in rats. During growth from 5 to 12 years of age, the mean neutral footplate angle (0 Nm) occurred at −5° (SD 7°) and was not a function of age. Measured at standardized moments (4 Nm), footplate angles towards plantar flexion and dorsal flexion decreased by 25 and 40%, respectively. In both rats and children, GM muscle length increased proportionally with tibia length. In children, the length component of the physiological cross-sectional area and fascicle length increased by 7 and 5% per year, respectively. Fascicle angle did not change over the age range measured. In children, the Achilles tendon length increased by 6% per year. GM geometry was not affected by gender. We conclude that, whereas the length of GM in rat develops mainly

  5. Medialized repair for retracted rotator cuff tears.

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    Kim, Young-Kyu; Jung, Kyu-Hak; Won, Jun-Sung; Cho, Seung-Hyun

    2017-08-01

    The purpose of this study was to evaluate the functional outcomes of medialized rotator cuff repair and the continuity of repaired tendon in chronic retracted rotator cuff tears. Thirty-five consecutive patients were selected from 153 cases that underwent arthroscopic rotator cuff repair for more than medium-sized posterosuperior rotator cuff tears between July 2009 and July 2012 performed with the medialized repair. All cases were available for at least 2 years of postoperative follow-up. The visual analog scale of pain, muscle strength, Constant score, American Shoulder and Elbow Surgeons (ASES) score, and University of California-Los Angeles score were evaluated. At the final follow-up, all clinical outcomes were significantly improved. The visual analog scale score for pain improved from 6 ± 1 preoperatively to 2 ± 1 postoperatively. The range of motion increased from preoperatively to postoperatively: active forward elevation, from 134° ± 49° to 150° ± 16°; active external rotation at the side, from 47° ± 15° to 55° ± 10°; and active internal rotation, from L3 to L1. The shoulder score also improved: Constant score, from 53.5 ± 16.7 to 79 ± 10; American Shoulder and Elbow Surgeons score, from 51 ± 15 to 82 ± 8; and University of California-Los Angeles score, from 14 ± 4 to 28 ± 4. The retear cases at the final follow-up were 6 (17%). Medialized repair may be useful in cases in which anatomic bone-to-tendon repair would be difficult because of the excessive tension of the repaired tendon and a torn tendon that does not reach the anatomic insertion. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  6. Comparison of the Effects of Ultrasound-Guided Interfascial Pulsed Radiofrequency and Ultrasound-Guided Interfascial Injection on Myofascial Pain Syndrome of the Gastrocnemius.

    Science.gov (United States)

    Park, So Min; Cho, Yun Woo; Ahn, Sang Ho; Lee, Dong Gyu; Cho, Hee Kyung; Kim, Sung Yup

    2016-10-01

    To investigate the comparative treatment effects of ultrasound-guided pulsed radiofrequency treatment (UG-PRF) in the gastrocnemius interfascial space and ultrasound-guided interfascial injection (UG-INJ) on myofascial pain syndrome. Forty consecutive patients with myofascial pain syndrome of the gastrocnemius were enrolled and were allocated to one of the two groups. Twenty patients were treated by UG-PRF delivered to the gastrocnemius interfascial space (UG-PRF group) and the other 20 patients were treated by interfascial injection (UG-INJ group). The primary outcome measure was the numeric rating score (NRS) for pain on pressing the tender point in the gastrocnemius, and the secondary outcome measure was health-related quality of life as determined by the Short Form-36 questionnaire (SF-36). NRSs were obtained at the first visit, immediately after treatment, and at 2 and 4 weeks post-treatment, and physical component summary scores (PCS) and mental component summary scores (MCS) of the SF-36 questionnaire were measured at the first visit and at 4 weeks post-treatment. Immediately after treatments, mean NRS in the UG-PRF group was significantly higher than that in the UG-INJ group (pmyofascial pain syndrome of the gastrocnemius.

  7. Bi-pedicled V-Y gastrocnemius myocutaneous flap for repairing Achilles tendon and overlying skin defect: the anatomic basis and clinical application

    Institute of Scientific and Technical Information of China (English)

    XU Yong-qing; ZHU Yue-liang; YANG Jun; LI Jun; DING Jing; LU Sheng

    2007-01-01

    Objective: To study the anatomic basis of the bi-pedicled V-Y gastrocnemius myocutaneous flap for repairing the composite Achilles tendon defect. Methods: The pedicle anatomy of the bi-pedicled V-Y gastrocnemius myocutaneous flap was examined on 30 cadaver specimens. The sliding distances of the flap were measured at different knee flexion degrees. The bi-pedicled V-Y gastrocnemius myocutaneous flap was applied in 12 cases of Achilles tendon defect with simultaneous skin and soft tissue defect. Results: The sural arteries could be classified into four types. After cutting off the gastrocnemius origin with a "Z-shaped" incision, the sliding distance of the flap reached (3.7±0.5)cm when the knee flexed 0°,(4.9±0.7)cm when the knee flexed 30°,(6.7±0.7)cm when the knee flexed 60°and (9.2±0.9)cm when the knee flexed 90°. All the defects healed. The patients recovered ambulation with satisfactory knee and ankle function.The follow-up was 4 months -12 years. Conclusions: Different sural artery types should be noticed during the harvest of the bi-pedicled V-Y gastrocnemius myocutaneous flap. With 90°knee flexion,this flap is suitable for one-stage repair of composite Achilles tendon defect within 9.2 cm±0.9 cm.

  8. 腓肠肌前方腱膜松解治疗非痉挛性腓肠肌挛缩%Anterior aponeurotic recession of gastrocnemius for non-spastic gastrocnemius contraction

    Institute of Scientific and Technical Information of China (English)

    荣凯; 朱渊; 刘津浩; 徐向阳

    2014-01-01

    目的:介绍及评价腓肠肌前方腱膜松解治疗非痉挛性腓肠肌挛缩的手术方法及术后疗效。方法回顾性研究2006年7月至2013年7月期间,本组采用腓肠肌前方腱膜松解治疗非痉挛性腓肠肌挛缩的患者。患者术前体检Silfverskiöld试验(+),采用Baumann入路在腓肠肌与比目鱼肌间隙之间,松解腓肠肌前方腱膜,背伸踝关节至角度满意。术前和末次随访时测量踝关节的最大被动背伸角度(膝关节伸直位和屈曲90°时),进行美国足踝医师协会后足-踝关节(AOFAS-AH)评分,并记录术后并发症情况。结果29例(35足)患者获得随访,平均年龄36.5岁(8~69岁),平均随访32.6个月(7~54个月)。其中成人扁平足11例13足,儿童扁平足4例5足,踇外翻6例8足,跖筋膜炎5例6足,创伤性马蹄足3例3足。术前和末次随访时伸膝位踝关节最大被动背伸角度分别为(-5.7°±3.2°)(-15°~3°)和(8.2°±3.7°)(-6°~17°)(P<0.01),背伸角度平均增加13.9°。 AOFAS-AH评分由术前平均46.7分提高到末次随访的75.1分(P<0.01)。术后马蹄足畸形复发2例(2足),无过度延长、神经血管损伤及伤口并发症发生。结论腓肠肌前方腱膜松解操作方便,术后踝关节背伸角度恢复满意,跖屈肌力良好,未见明显并发症,是治疗非痉挛性腓肠肌挛缩安全、有效的手术方法。%Objective To investigate the surgical method and the clinical results of the anterior aponeurotic recession of gastrocnemius for non-spastic gastrocnemius contraction .Methods The patients with non-spastic gastrocnemius contraction treated by the anterior aponeurotic recession of gastrocnemius during July 2007 to July 2013, were retrospectively studied .All the patients were preoperatively identified by Silfverskiold test , and received the anterior aponeurotic recession of gastrocnemius in the

  9. Revision Gore-Tex medialization laryngoplasty.

    Science.gov (United States)

    Cohen, Jacob T; Bates, Dwight D; Postma, Gregory N

    2004-09-01

    To evaluate the indications, results, and safety of revision Gore-Tex medialization laryngoplasty (GML). A retrospective chart review of 156 patients that underwent GML procedures between the years 1998-2002. Study population consisted of those patients who required revision surgery for any reason. Sixteen patients required 22 revision procedures. Indications for revision were divided into 2 groups, complications and glottal closure problems. Complications included extruded or displaced implants (n = 4). The most common glottal closure problem was undercorrection (n = 9). Others included anterior overcorrection (n = 1) and persistent posterior glottal gap (n = 2). Revision procedures included GML (n = 9), injection augmentation (n = 9), endoscopic implant removal (n = 2), and arytenoid adduction (n = 2). In patients with glottal closure problems, the GCI improved in all 10 and the voice rating scale improved in 9. Reasons for revision of GML are variable, the most common being undercorrection. A variety of safe, effective revision techniques are available with a high success rate.

  10. Neuromuscular Exercise Post Partial Medial Meniscectomy

    DEFF Research Database (Denmark)

    Hall, Michelle; Hinman, Rana S; Wrigley, Tim V

    2015-01-01

    outcomes included additional measures of knee joint load distribution, patient-reported outcomes, maximal knee and hip muscle strength, and physical function measures. RESULTS: 60 out of 62 randomized participants (97%) completed the trial. There were no significant between-group differences in the change......PURPOSE: To evaluate the effects of a 12-week, home-based, physiotherapist-guided neuromuscular exercise program on the knee adduction moment (an indicator of mediolateral knee load distribution) in people with a medial arthroscopic partial meniscectomy within the past 3-12 months. METHODS...... or a control group with no exercise. The exercise program included eight individual sessions with one of seven physiotherapists in private clinics, together with home exercises. Primary outcomes were the peak external knee adduction moment during normal pace walking and during a one-leg sit-to-stand. Secondary...

  11. Medial humeral epicondylitis in clinically affected cats.

    Science.gov (United States)

    Streubel, Ronny; Bilzer, Thomas; Grest, Paula; Damur, Daniel; Montavon, Pierre M

    2015-10-01

    To describe the clinical signs and histologic changes in cats clinically affected with medial humeral epicondylitis (MHE) and evaluate long-term outcome after either conservative or surgical treatment. Prospective cohort study. Client-owned cats (n = 17) with MHE. Cats diagnosed with MHE, based on clinical signs, radiographs and computed tomography (CT), were prospectively recruited. Cats were treated conservatively for an initial 4 weeks, followed by either surgery or continued conservative treatment. Followup examinations were performed at 6 and 12 weeks and at 6-49 months. Cats had a mean age of 10.3 years and presented for chronic lameness. Examination revealed pain on palpation caudodistal to the medial epicondyle and by exerting antebrachial supination/pronation with elbow and carpal flexion. Lameness was restricted to 1 limb although CT revealed bilateral disease in 11/17 cats. Free mineralized joint bodies were identified in 9/17 cats. Nine cats were treated surgically and 8 cats were treated conservatively. Intraoperative findings included new bone formation at the origin of the humeral head of the flexor carpi ulnaris muscle with displacement and adhesions of the ulnar nerve. Microscopic examination revealed neurogenic myopathy in 4/9 cats treated surgically. Seven of 9 cats treated surgically were free from lameness by 12 weeks. Seven of 8 cats treated conservatively were chronically lame throughout the study. Cats with forelimb lameness should be evaluated for MHE. This condition is associated with free joint bodies and neurogenic myopathy. Surgical treatment is associated with excellent outcome in the majority of cats. © Copyright 2015 by The American College of Veterinary Surgeons.

  12. Medial patellofemoral ligament and medial patellotibial ligament reconstruction in children: preliminary results.

    Science.gov (United States)

    Sadigursky, David; Garcia, Lucas Cortizo; Armede, Maurício; Oliveira, Lucas Rodrigues de; Carneiro, Rogério Jamil Fernandes; Colavolpe, Paulo Oliveira

    2017-01-01

    The aim of this study was to evaluate the reconstruction of the medial patellofemoral ligament associated with the medial patellotibial ligament in skeletally immature patients. This is a case series study in patients with patellar instability with open physis. In total, seven patients were evaluated: four males and three females were operated using the proposed technique. Patients with open physis who had more than two episodes of recurring patellar dislocation were included. No patients underwent additional procedures. The distance from the anterior tibial tuberosity to the trochlea grove (TT-TG) was measured in all patients. On physical examination, the inverted J-sign, the apprehension sign, and the knee range of motion parameters were used in the pre- and post-operative period. In addition, the Kujala and Lysholm scores were applied before and 12 months after surgery. The results were analyzed with the Wilcoxon test. The mean age of the patients was 11.28 in both genders. Comparing the data of the pre- and post-operative period, the inverted J-sign was present in six patients (85.7%) vs. absent in one (14.3%). The apprehension sign was absent in cases in the postoperative period; the range of motion was 117.85 ± 8.09 vs. 148.57 ± 3.77. The Kujala score was 42.57 ± 8.9 vs. 88.57 ± 5.09 and the Lysholm scores were classified as excellent or good in 28.6% and 71.4%, respectively. The combined reconstruction of the medial patellofemoral ligament combined with the medial patellotibial ligament in skeletally immature patients with predisposing factors, presents satisfactory results without episodes of recurrence or residual subluxation; according to these preliminary results, it should be considered as a treatment option.

  13. The pediculated gastrocnemius muscle flap as a treatment for soft tissue problems of the knee – indication, placement and results

    Directory of Open Access Journals (Sweden)

    Moebius, Boris

    2012-01-01

    Full Text Available With the increase of endoprosthetic knee replacements, there is also an increase of critical wounds to the knee due to a high incidence of soft tissue problems (ranging from wound healing defects to severe wound infections. The literature describes a general rate of soft tissue complications of up to 20% [1], [2], with 5% [3] involving exposed bone. These complications are an increasingly important problem for surgeons. Since sufficient coverage of bones, tendons and prosthetic material with soft tissue is a necessity, the use of a pediculated muscle flap is the only solution in some cases. The gastrocnemius muscle is very useful for this purpose. It is an elaborate procedure which is associated with a high rate of complications. However, this procedure can establish a secure coverage with soft tissue, and the function of the prosthesis and the patient’s extremity can be saved. We have treated 23 patients with a gastrocnemius rotation flap after knee prosthesis or knee arthrodesis infection with consecutive soft tissue damage at our hospital from 8/2004 through 3/2011. The overall rate of healing of the knee infections with stable soft tissue status is almost 87%. The revision rate with lifting of the flap and revision of the sutures at the point of insertion as well as the point of extraction was about 35% with long-term conservative or additional surgical treatments.

  14. Effects of hip and head position on ankle range of motion, ankle passive torque, and passive gastrocnemius tension.

    Science.gov (United States)

    Andrade, R J; Lacourpaille, L; Freitas, S R; McNair, P J; Nordez, A

    2016-01-01

    Ankle joint range of motion (ROM) is notably influenced by the position of the hip joint. However, this result remains unexplained. Thus, the aim of this study was to test if the ankle passive torque and gastrocnemius muscle tension are affected by the hip and the head positions. The torque and the muscle shear elastic modulus (measured by elastography to estimate muscle tension) were collected in nine participants during passive ankle dorsiflexions performed in four conditions (by combining hip flexion at 90 or 150°, and head flexed or neutral). Ankle maximum dorsiflexion angle significantly decreased by flexing the hip from 150 to 90° (P  0.05). Maximal passive torque and shear elastic modulus were higher with the hip flexed at 90° (P  0.05) were found for both torque and shear elastic modulus at a given common ankle angle among conditions. Shifts in maximal ankle angle due to hip angle manipulation are not related neither to changes in passive torque nor tension of the gastrocnemius. Further studies should be addressed to better understand the functional role of peripheral nerves and fasciae in the ankle ROM limits.

  15. Gait Analysis before and after Gastrocnemius Fascia Lengthening for Spastic Equinus Foot Deformity in a 10-Year-Old Diplegic Child

    Directory of Open Access Journals (Sweden)

    Manuela Galli

    2010-01-01

    Full Text Available Purpose. This case study quantified kinematic and kinetic effects of gastrocnemius lengthening on gait in a Cerebral Palsy child with equinus foot. Methods. A 10-year-old diplegic child with Cerebral Palsy was evaluated with Gait Analysis (GA before and after gastrocnemius fascia lengthening, investigating the lower limb joints kinematics and kinetics. Results. Kinematics improved at the level of distal joints, which are directly associated to gastrocnemius, and also at the proximal joint (like hip; improvements were found in ankle kinetics, too. Conclusions. This case study highlighted that GA was effective not only to quantify the results of the treatment but also to help preoperative decision making in dealing with CP child.

  16. Peritonitis secondary to traumatic duodenal laceration in the presence of a large pancreatic pseudocyst: a case report

    Directory of Open Access Journals (Sweden)

    Seenath Marlon M

    2011-10-01

    Full Text Available Abstract Introduction A pancreatic pseudocyst is a common sequela of severe acute pancreatitis. Commonly, it presents with abdominal pain and a mass in the epigastrium several weeks after the acute episode and can be managed conservatively, endoscopically or surgically. We report a patient with a pancreatic pseudocyst awaiting endoscopic therapy who developed a life-threatening complication following a rather innocuous trauma to the abdomen. Case presentation A 23-year-old Asian male student presented as an emergency with an acute abdomen a week after a minor trauma to his upper abdomen. The injury occurred when he was innocently punched in the abdomen by a friend. He experienced only moderate discomfort briefly at the time. His past medical history included coeliac disease and an admission four months previously with severe acute pancreatitis. He was hospitalized for 15 days; his pancreatitis was thought to be due to alcohol binge drinking on weekends. Ultrasound scanning showed no evidence of gallstone disease. Five days after the trauma, he became anorexic, lethargic and feverish and started vomiting bilious content. Seven days post-trauma, he presented to our emergency department with severe abdominal pain. An emergency laparotomy was performed where a transverse linear duodenal laceration was found at the junction of the first and second part of his duodenum, with generalized peritonitis. His stomach and duodenum were stretched over a large pancreatic pseudocyst posterior to his stomach. It was postulated that an incomplete duodenal injury (possibly a serosal tear occurred following the initial minor trauma, which was followed by local tissue necrosis at the injury site resulting in a delayed presentation of generalized peritonitis. Conclusion This is the first reported case of a traumatic duodenal laceration following minor blunt trauma in the presence of a large pancreatic pseudocyst. Minor blunt abdominal trauma in a normal healthy adult

  17. CT Findings and Dynamic Analysis of Pulmonary Laceration%肺撕裂伤的CT表现和动态观察

    Institute of Scientific and Technical Information of China (English)

    黄耀渠; 李均洪; 梁振华

    2013-01-01

    To investigate the CT findings of pulmonary laceration. Methods: The CT imagings of 51 cases with pulmonary laceration were analyzed retrospectively. Results: 249 lesions in total were found in the 51 patients. The CT findings included traumatic gas cyst (22 lesions), gas-fluid cyst (182 lesions) and fluid cyst (45 lesions). Various degree of pulmonary contusion around the lung laceration could be assessed. On dynamic follow-up observation of 20 patients, the gas cyst lesions could change to gas-fluid cyst or fluid cyst, and the gas-fluid cyst lesions could change to fluid cyst, but reversed variation was not found. Conclusion: The gas cyst, gas-fluid cyst and fluid cyst were the characteristic CT findings and dynamic morphology changes of pulmonary laceration.%目的:探讨肺撕裂伤的CT表现.方法:回顾性分析51例肺撕裂伤患者的首次检查和治疗后复查的CT资料.结果:51例患者共249个病灶,CT表现为气囊(22个)、气液囊(182个)和液囊(45个),周围伴不同程度肺挫伤.20例患者进行CT动态观察,气囊可以演变为气液囊或液囊,气液囊可以演变为液囊,但未有逆向演变者.结论:气囊、气液囊和液囊是肺撕裂伤的典型CT表现和动态演变过程.

  18. Corkscrew Seals: Grey Seal (Halichoerus grypus) Infanticide and Cannibalism May Indicate the Cause of Spiral Lacerations in Seals

    Science.gov (United States)

    2016-01-01

    Large numbers of dead seals with characteristic spiral lesions have been washing ashore around the North Atlantic over the past two decades. Interactions with ship propellers and shark predation have been suggested as the likely causal mechanisms. However, new evidence points towards a more likely candidate: grey seal predation. An adult male grey seal was observed and recorded catching, killing and eating five weaned grey seal pups over a period of one week on the Isle of May, Scotland. A further 9 carcasses found in the same area exhibited similar injuries. Post mortem analysis of lesions indicated the wound characteristics were similar to each other and in 12 of the 14 carcasses analysed, were indistinguishable from carcasses previously attributed to propeller interaction. We therefore propose that most of the seal carcasses displaying spiral lacerations in the UK are caused by grey seal predation. Cases in other locations should be re-evaluated using the scoring system presented here to identify whether grey seal predation is a major cause of mortality in phocid seals. PMID:27254025

  19. Corkscrew Seals: Grey Seal (Halichoerus grypus Infanticide and Cannibalism May Indicate the Cause of Spiral Lacerations in Seals.

    Directory of Open Access Journals (Sweden)

    Andrew Brownlow

    Full Text Available Large numbers of dead seals with characteristic spiral lesions have been washing ashore around the North Atlantic over the past two decades. Interactions with ship propellers and shark predation have been suggested as the likely causal mechanisms. However, new evidence points towards a more likely candidate: grey seal predation. An adult male grey seal was observed and recorded catching, killing and eating five weaned grey seal pups over a period of one week on the Isle of May, Scotland. A further 9 carcasses found in the same area exhibited similar injuries. Post mortem analysis of lesions indicated the wound characteristics were similar to each other and in 12 of the 14 carcasses analysed, were indistinguishable from carcasses previously attributed to propeller interaction. We therefore propose that most of the seal carcasses displaying spiral lacerations in the UK are caused by grey seal predation. Cases in other locations should be re-evaluated using the scoring system presented here to identify whether grey seal predation is a major cause of mortality in phocid seals.

  20. Saltwater nectotizing fasciitis following coral reef laceration possibly exacerbated by a long-haul flight: a case report.

    LENUS (Irish Health Repository)

    Byrne, Ann-Maria

    2009-01-01

    INTRODUCTION: Necrotising fasciits is a rapidly progressive disease characterised by extensive necrosis of the fascia, skin, and subcutaneous tissue, with relative sparing of the underlying muscle. CASE PRESENTATION: We present the case of a 24-year old Irish male student who sustained a laceration to his right shin from contact with a coral reef while swimming in the Phuket region, off the west coast of Thailand. The following day, he returned to Ireland and presented with an aggressive and destructive variant of group A beta-hemolytic streptococcal necrotising fasciitis originating at the site of the coral reef injury, and exacerbated by the long-haul flight. He was successfully treated with aggressive surgical debridement, vacuum-assisted dressings, split skin grafting and broad spectrum antibiotics. CONCLUSION: Necrotising fasciitis can progress rapidly to systemic toxicity and even death without expedient diagnosis and aggressive treatment. Long-haul flights induce significant fluid accumulation in the lower extremity. These physiological fluid shifts may have contributed to the severity of our patient\\'s necrotizing condition following his flight from Thailand.

  1. Corkscrew Seals: Grey Seal (Halichoerus grypus) Infanticide and Cannibalism May Indicate the Cause of Spiral Lacerations in Seals.

    Science.gov (United States)

    Brownlow, Andrew; Onoufriou, Joseph; Bishop, Amanda; Davison, Nicholas; Thompson, Dave

    2016-01-01

    Large numbers of dead seals with characteristic spiral lesions have been washing ashore around the North Atlantic over the past two decades. Interactions with ship propellers and shark predation have been suggested as the likely causal mechanisms. However, new evidence points towards a more likely candidate: grey seal predation. An adult male grey seal was observed and recorded catching, killing and eating five weaned grey seal pups over a period of one week on the Isle of May, Scotland. A further 9 carcasses found in the same area exhibited similar injuries. Post mortem analysis of lesions indicated the wound characteristics were similar to each other and in 12 of the 14 carcasses analysed, were indistinguishable from carcasses previously attributed to propeller interaction. We therefore propose that most of the seal carcasses displaying spiral lacerations in the UK are caused by grey seal predation. Cases in other locations should be re-evaluated using the scoring system presented here to identify whether grey seal predation is a major cause of mortality in phocid seals.

  2. Laceração canalicular: uma técnica simplificada de sutura Canalicular laceration: a simplified suture technique

    Directory of Open Access Journals (Sweden)

    Juliana Vendramini Rossi

    2003-06-01

    Full Text Available Os autores descrevem a utilização do cateter de teflon como molde intracanalicular visando tornar a sutura do canalículo lacrimal mais simples e acessível a todo oftalmologista. A técnica consiste em identificar os cotos canaliculares e, após introdução de cateter de teflon (número 22 ou 24 no lúmem canalicular, realizam-se três pontos cardinais transfixantes de sutura do canalículo com o fio nylon monofilamento (Mononylon® ou poliglactina trançada (Vicryl® 8-0. Esta técnica está indicada em casos de lacerações regulares, que possibilitem a cateterização do canalículo.The authors describe the use of a teflon catheter as an intracanalicular stent in order to increase its accessability to ophthalmologists.The technique is based on the identification of the canalicular borders followed by the introduction of a teflon catheter (22 or 24 into the canalicular lumen. Three full-thickness sutures are placed at the canaliculum using a 8-0 mononylon or a 8-0 vicryl. This technique can be used in cases of non-complicated lacerations, in which catheterization is still possible.

  3. Las encuadernaciones mudéjares de lacerías con motivos centrales en la Catedral de Toledo

    Directory of Open Access Journals (Sweden)

    Antonio Carpallo Bautista

    2012-02-01

    Full Text Available Dentro de la historia de la encuadernación española destaca el florecimiento del estilo mudéjar entre los siglos XIII y XVI, sobre todo en la península ibérica, sobresaliendo los trabajos realizados en algunas ciudades como Toledo. La Biblioteca Capitular de la Catedral de Toledo dispone uno de los grupos más importantes de España, cuantitativa y cualitativamente, aunque su estado de conservación no es el más adecuado en muchos de los ejemplares. El presente trabajo pretende estudiar y analizar los diferentes tipos de encuadernaciones mudéjares con lacerías, tipo de decoración muy propio de ciudades como Toledo, Salamanca y Barcelona. Se han estudiado las estructuras decorativas y los elementos artísticos empleados, las técnicas de decoración y de construcción, así como los materiales utilizados en la elaboración, con lo que hemos podido establecer el origen o procedencia de cada encuadernación en función de la estructura decorativa, de los motivos decorativos individuales, de las filigranas de las guardas originales y del tipo de cabezadas.

  4. The medial scaffold of 3D unorganized point clouds.

    Science.gov (United States)

    Leymarie, Frederic F; Kimia, Benjamin B

    2007-02-01

    We introduce the notion of the medial scaffold, a hierarchical organization of the medial axis of a 3D shape in the form of a graph constructed from special medial curves connecting special medial points. A key advantage of the scaffold is that it captures the qualitative aspects of shape in a hierarchical and tightly condensed representation. We propose an efficient and exact method for computing the medial scaffold based on a notion of propagation along the scaffold itself, starting from initial sources of the flow and constructing the scaffold during the propagation. We examine this method specifically in the context of an unorganized cloud of points in 3D, e.g., as obtained from laser range finders, which typically involve hundreds of thousands of points, but the ideas are generalizable to data arising from geometrically described surface patches. The computational bottleneck in the propagation-based scheme is in finding the initial sources of the flow. We thus present several ideas to avoid the unnecessary consideration of pairs of points which cannot possibly form a medial point source, such as the "visibility" of a point from another given a third point and the interaction of clusters of points. An application of using the medial scaffold for the representation of point samplings of real-life objects is also illustrated.

  5. Optogenetic dissection of medial prefrontal cortex circuitry

    Directory of Open Access Journals (Sweden)

    Danai eRiga

    2014-12-01

    Full Text Available The medial prefrontal cortex (mPFC is critically involved in numerous cognitive functions, including attention, inhibitory control, habit formation, working memory and long-term memory. Moreover, through its dense interconnectivity with subcortical regions (e.g. thalamus, striatum, amygdala and hippocampus, the mPFC is thought to exert top-down executive control over the processing of aversive and appetitive stimuli. Because the mPFC has been implicated in the processing of a wide range of cognitive and emotional stimuli, it is thought to function as a central hub in the brain circuitry mediating symptoms of psychiatric disorders. New optogenetics technology enables anatomical and functional dissection of mPFC circuitry with unprecedented spatial and temporal resolution. This provides important novel insights in the contribution of specific neuronal subpopulations and their connectivity to mPFC function in health and disease states. In this review, we present the current knowledge obtained with optogenetic methods concerning mPFC function and dysfunction and integrate this with findings from traditional intervention approaches used to investigate the mPFC circuitry in animal models of cognitive processing and psychiatric disorders.

  6. Optogenetic dissection of medial prefrontal cortex circuitry.

    Science.gov (United States)

    Riga, Danai; Matos, Mariana R; Glas, Annet; Smit, August B; Spijker, Sabine; Van den Oever, Michel C

    2014-01-01

    The medial prefrontal cortex (mPFC) is critically involved in numerous cognitive functions, including attention, inhibitory control, habit formation, working memory and long-term memory. Moreover, through its dense interconnectivity with subcortical regions (e.g., thalamus, striatum, amygdala and hippocampus), the mPFC is thought to exert top-down executive control over the processing of aversive and appetitive stimuli. Because the mPFC has been implicated in the processing of a wide range of cognitive and emotional stimuli, it is thought to function as a central hub in the brain circuitry mediating symptoms of psychiatric disorders. New optogenetics technology enables anatomical and functional dissection of mPFC circuitry with unprecedented spatial and temporal resolution. This provides important novel insights in the contribution of specific neuronal subpopulations and their connectivity to mPFC function in health and disease states. In this review, we present the current knowledge obtained with optogenetic methods concerning mPFC function and dysfunction and integrate this with findings from traditional intervention approaches used to investigate the mPFC circuitry in animal models of cognitive processing and psychiatric disorders.

  7. Medial plica after reconstruction of anterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    YIN Yu; WANG Jian-quan; HE Zhen-ming

    2009-01-01

    Background The medial plica may be caused by direct trauma or joint degeneration,which also could be iatrogenic.There have been few reports in the literature discussing incidence of the medial plica caused by an operation on the knee joint,specifically after the reconstruction of anterior cruciate ligament (ACL).In this study,we aimed to evaluate and analyze the relationship between the incidence of the medial plica and reconstruction of the ACL.Methods A retrospective case series study was conducted to review the findings of 1085 patients between 2003 and 2007,who underwent second-look arthroscopy after reconstruction of the ACL (between 2002 and 2006).The correlation of the incidence of medial plica with the stability of the knee joint,the time from onset of injury to reconstruction surgery,the associated injuries,and the rate of progress during postoperative rehabilitation were analyzed.Results We found that 722 patients had the structure of a medial plica.The incidence after reconstruction of the anterior cruciate ligament (66.5%) was significantly higher than usually reported.All these medial plica had avascular fibrotic and thickened edges.An excision of pathologic medial plica and fat pad synovial fringes were done.The incidences were significantly different between the two groups with their reconstruction operation time,from onset of injury to surgery (less than one month or over 2 years),and the progress rate of postoperative rehabilitation (knee flexion could not be over 90° in four weeks).The incidence was not different between the groups with knee stable conditions.Conclusions Medial plica is more common in patients after reconstruction of ACL.More associated injuries and more rehabilitation difficulties can increase the medial plica incidence.

  8. Operant conditioning of the soleus H-reflex does not induce long-term changes in the gastrocnemius H-reflexes and does not disturb normal locomotion in humans.

    Science.gov (United States)

    Makihara, Yukiko; Segal, Richard L; Wolpaw, Jonathan R; Thompson, Aiko K

    2014-09-15

    In normal animals, operant conditioning of the spinal stretch reflex or the H-reflex has lesser effects on synergist muscle reflexes. In rats and people with incomplete spinal cord injury (SCI), soleus H-reflex operant conditioning can improve locomotion. We studied in normal humans the impact of soleus H-reflex down-conditioning on medial (MG) and lateral gastrocnemius (LG) H-reflexes and on locomotion. Subjects completed 6 baseline and 30 conditioning sessions. During conditioning trials, the subject was encouraged to decrease soleus H-reflex size with the aid of visual feedback. Every sixth session, MG and LG H-reflexes were measured. Locomotion was assessed before and after conditioning. In successfully conditioned subjects, the soleus H-reflex decreased 27.2%. This was the sum of within-session (task dependent) adaptation (13.2%) and across-session (long term) change (14%). The MG H-reflex decreased 14.5%, due mainly to task-dependent adaptation (13.4%). The LG H-reflex showed no task-dependent adaptation or long-term change. No consistent changes were detected across subjects in locomotor H-reflexes, EMG activity, joint angles, or step symmetry. Thus, in normal humans, soleus H-reflex down-conditioning does not induce long-term changes in MG/LG H-reflexes and does not change locomotion. In these subjects, task-dependent adaptation of the soleus H-reflex is greater than it is in people with SCI, whereas long-term change is less. This difference from results in people with SCI is consistent with the fact that long-term change is beneficial in people with SCI, since it improves locomotion. In contrast, in normal subjects, long-term change is not beneficial and may necessitate compensatory plasticity to preserve satisfactory locomotion. Copyright © 2014 the American Physiological Society.

  9. Medial Femoral Condyle Degeneration Associated with a Mediopatellar Plica

    Directory of Open Access Journals (Sweden)

    Mehmet Balik

    2014-03-01

    Full Text Available Sixty-years-old female patient complaining from knee pain since 15 years. The patient could not localize the pain at first. Since 10 years, she experiences a temporary pain localized at the medial side of tibiofemoral joint during twisting her knee. Also, pain persists at the medial patellar region at semi-flexed position of her knee. The patient did not benefit from conversative treatment with the diagnosis of gonarthrosis. We performed knee artrhroplasty. During arthroplasty, we observed that the medial femoral condyle was damaged due to long term mediopatellar plica impingement.

  10. The effect of the oral contraceptive pill on the passive stiffness of the human gastrocnemius muscle in vivo.

    Science.gov (United States)

    Morse, C I; Spencer, J; Hussain, A W; Onambele, G L

    2013-03-01

    The aim of this investigation was to determine the effect of sustained monophasic oral contraceptive pill (MOCP) use on the in vivo passive stiffness of the gastrocnemius medialis (GM) muscle-tendon unit. Twenty four females volunteered for this study (age range 20-25 yrs); twelve participants had been taking the combined MOCP for a minimum of 12 months, and twelve participants, who had never taken the MOCP, formed a control group. Distal displacement of the GM myotendinous junction (MTJ) was measured during passive dorsiflexion at 2 Nm increments to 20 Nm, and at end range of motion using ultrasonography. In addition, GM MTJ displacement was measured at passive torques equivalent to 5, 10 and 15% of plantarflexion maximal voluntary contraction (MVC) torque, and relative to GM length. MOCP users had significantly greater GM MTJ displacement at all passive torques (PMTJ displacement, passive muscle stiffness is less in MOCP using females, compared to non-pill users.

  11. Quantitative Effects on Proximal Joints of Botulinum Toxin Treatment for Gastrocnemius Spasticity: A 4-Year-Old Case Study

    Directory of Open Access Journals (Sweden)

    Veronica Cimolin

    2009-01-01

    Full Text Available Botulinum toxin A (BTA is a recognized treatment for the early management of spasticity in children with Cerebral Palsy. This study quantified with Gait Analysis (GA the gait pattern of a 4-year-old diplegic child with calf contracture before, 5 days, and 3 months after BTA injections into gastrocnemius. Kinematic and kinetic data of main lower limb joints were investigated. After only 5 days, ankle dorsi-plantarflexion and knee flex-extension improved, but hip joint worsened, increasing its excessive flexion, to compensate the improvement in knee position of the treated limb and to obtain better stability. A worsening of hip power happened. After 3 months, all joints generally improved their position during gait cycle. Hip and knee joints increased their range of movement and improvements occurred at ankle kinematics and kinetisc, too; a better ankle position and an increase of its capacity of propulsion during terminal stance were evident.

  12. Effects of high-intensity intermittent training on carnitine palmitoyl transferase activity in the gastrocnemius muscle of rats

    Energy Technology Data Exchange (ETDEWEB)

    Carnevali, L.C. Jr. [Grupo de Biologia Molecular da Célula, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo SP (Brazil); Centro Universitário Ítalo-Brasileiro (Unítalo), São Paulo SP (Brazil); Eder, R.; Lira, F.S. [Grupo de Biologia Molecular da Célula, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo SP (Brazil); Lima, W.P. [Grupo de Biologia Molecular da Célula, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo SP (Brazil); Instituto Federal de Educação,Ciência e Tecnologia de São Paulo, São Paulo SP (Brazil); Gonçalves, D.C. [Grupo de Biologia Molecular da Célula, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo SP (Brazil); Zanchi, N.E. [Laboratorio de Nutrição e Metabolismo Aplicado à Atividade Motora, Escola de Educação Física e Esporte, Universidade de São Paulo, São Paulo SP (Brazil); Centro de Pesquisa do Genoma Humano, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo SP (Brazil); Nicastro, H. [Laboratorio de Nutrição e Metabolismo Aplicado à Atividade Motora, Escola de Educação Física e Esporte, Universidade de São Paulo, São Paulo SP (Brazil); Lavoie, J.M. [Department of Kinesiology, University of Montreal, Montreal (Canada); Seelaender, M.C.L. [Grupo de Biologia Molecular da Célula, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo SP (Brazil)

    2012-06-29

    We examined the capacity of high-intensity intermittent training (HI-IT) to facilitate the delivery of lipids to enzymes responsible for oxidation, a task performed by the carnitine palmitoyl transferase (CPT) system in the rat gastrocnemius muscle. Male adult Wistar rats (160-250 g) were randomly distributed into 3 groups: sedentary (Sed, N = 5), HI-IT (N = 10), and moderate-intensity continuous training (MI-CT, N = 10). The trained groups were exercised for 8 weeks with a 10% (HI-IT) and a 5% (MI-CT) overload. The HI-IT group presented 11.8% decreased weight gain compared to the Sed group. The maximal activities of CPT-I, CPT-II, and citrate synthase were all increased in the HI-IT group compared to the Sed group (P < 0.01), as also was gene expression, measured by RT-PCR, of fatty acid binding protein (FABP; P < 0.01) and lipoprotein lipase (LPL; P < 0.05). Lactate dehydrogenase also presented a higher maximal activity (nmol·min{sup −1}·mg protein{sup −1}) in HI-IT (around 83%). We suggest that 8 weeks of HI-IT enhance mitochondrial lipid transport capacity thus facilitating the oxidation process in the gastrocnemius muscle. This adaptation may also be associated with the decrease in weight gain observed in the animals and was concomitant to a higher gene expression of both FABP and LPL in HI-IT, suggesting that intermittent exercise is a “time-efficient” strategy inducing metabolic adaptation.

  13. Effects of high-intensity intermittent training on carnitine palmitoyl transferase activity in the gastrocnemius muscle of rats

    Directory of Open Access Journals (Sweden)

    L.C. Carnevali Jr

    2012-08-01

    Full Text Available We examined the capacity of high-intensity intermittent training (HI-IT to facilitate the delivery of lipids to enzymes responsible for oxidation, a task performed by the carnitine palmitoyl transferase (CPT system in the rat gastrocnemius muscle. Male adult Wistar rats (160-250 g were randomly distributed into 3 groups: sedentary (Sed, N = 5, HI-IT (N = 10, and moderate-intensity continuous training (MI-CT, N = 10. The trained groups were exercised for 8 weeks with a 10% (HI-IT and a 5% (MI-CT overload. The HI-IT group presented 11.8% decreased weight gain compared to the Sed group. The maximal activities of CPT-I, CPT-II, and citrate synthase were all increased in the HI-IT group compared to the Sed group (P < 0.01, as also was gene expression, measured by RT-PCR, of fatty acid binding protein (FABP; P < 0.01 and lipoprotein lipase (LPL; P < 0.05. Lactate dehydrogenase also presented a higher maximal activity (nmol·min-1·mg protein-1 in HI-IT (around 83%. We suggest that 8 weeks of HI-IT enhance mitochondrial lipid transport capacity thus facilitating the oxidation process in the gastrocnemius muscle. This adaptation may also be associated with the decrease in weight gain observed in the animals and was concomitant to a higher gene expression of both FABP and LPL in HI-IT, suggesting that intermittent exercise is a "time-efficient" strategy inducing metabolic adaptation.

  14. Feasibility and preliminary effectiveness of ice therapy in patients with an acute tear in the gastrocnemius muscle: A pilot randomized controlled trial

    NARCIS (Netherlands)

    Prins, J.C.M.; Stubbe, J.H.; Meeteren, N.L.U. van; Scheffers, F.A.; Dongen, M.C.J.M. van

    2011-01-01

    Objective: To investigate the feasibility of a randomized controlled trial and the preliminary effectiveness of ice therapy in the acute phase of a gastrocnemius tear for the quality of functional recovery. Design: A pilot version of an intended prospective randomized controlled clinical trial was

  15. Medial tibial stress syndrome: a critical review.

    Science.gov (United States)

    Moen, Maarten H; Tol, Johannes L; Weir, Adam; Steunebrink, Miriam; De Winter, Theodorus C

    2009-01-01

    Medial tibial stress syndrome (MTSS) is one of the most common leg injuries in athletes and soldiers. The incidence of MTSS is reported as being between 4% and 35% in military personnel and athletes. The name given to this condition refers to pain on the posteromedial tibial border during exercise, with pain on palpation of the tibia over a length of at least 5 cm. Histological studies fail to provide evidence that MTSS is caused by periostitis as a result of traction. It is caused by bony resorption that outpaces bone formation of the tibial cortex. Evidence for this overloaded adaptation of the cortex is found in several studies describing MTSS findings on bone scan, magnetic resonance imaging (MRI), high-resolution computed tomography (CT) scan and dual energy x-ray absorptiometry. The diagnosis is made based on physical examination, although only one study has been conducted on this subject. Additional imaging such as bone, CT and MRI scans has been well studied but is of limited value. The prevalence of abnormal findings in asymptomatic subjects means that results should be interpreted with caution. Excessive pronation of the foot while standing and female sex were found to be intrinsic risk factors in multiple prospective studies. Other intrinsic risk factors found in single prospective studies are higher body mass index, greater internal and external ranges of hip motion, and calf girth. Previous history of MTSS was shown to be an extrinsic risk factor. The treatment of MTSS has been examined in three randomized controlled studies. In these studies rest is equal to any intervention. The use of neoprene or semi-rigid orthotics may help prevent MTSS, as evidenced by two large prospective studies.

  16. Medial temporal lobe and topographical memory.

    Science.gov (United States)

    Urgolites, Zhisen J; Hopkins, Ramona O; Squire, Larry R

    2017-08-08

    There has been interest in the idea that medial temporal lobe (MTL) structures might be especially important for spatial processing and spatial memory. We tested the proposal that the MTL has a specific role in topographical memory as assessed in tasks of scene memory where the viewpoint shifts from study to test. Building on materials used previously for such studies, we administered three different tasks in a total of nine conditions. Participants studied a scene depicting four hills of different shapes and sizes and made a choice among four test images. In the Rotation task, the correct choice depicted the study scene from a shifted perspective. MTL patients succeeded when the study and test images were presented together but failed the moment the study scene was removed (even at a 0-s delay). In the No-Rotation task, the correct choice was a duplicate of the study scene. Patients were impaired to the same extent in the No-Rotation and Rotation tasks after matching for difficulty. Thus, an inability to accommodate changes in viewpoint does not account for patient impairment. In the Nonspatial-Perceptual task, the correct choice depicted the same overall coloring as the study scene. Patients were intact at a 2-s delay but failed at longer, distraction-filled delays. The different results for the spatial and nonspatial tasks are discussed in terms of differences in demand on working memory. We suggest that the difficulty of the spatial tasks rests on the neocortex and on the limitations of working memory, not on the MTL.

  17. Variant attachments of the anterior horn of the medial meniscus.

    Science.gov (United States)

    Jakubowicz, Marian; Ratajczak, Wojciech; Pytel, Andrzej

    2003-01-01

    The purpose of this study was to analyse the occurrence of variants of anomalous insertions of the anterior horn of the medial meniscus in human knee joints. The study was carried out on 78 human lower limbs of both sexes (42 males and 36 females). Out of 78 knee joints, 10 knee joints (12.82%) presented atypical attachments of the anterior horn of the medial meniscus. In 9 cases we found that the anterior horn of the medial meniscus was attached to the transverse ligament of the knee and in 1 case it was attached to the coronary ligament. In the remaining cases the anterior horn of the medial meniscus was attached to the anterior intercondylar area of the tibia.

  18. Medial Meniscus Posterior Root Tear: A Comprehensive Review

    National Research Council Canada - National Science Library

    Lee, Dhong Won; Ha, Jeong Ku; Kim, Jin Goo

    2014-01-01

    Damage to the medial meniscus root, for example by a complete radial tear, destroys the ability of the knee to withstand hoop strain, resulting in contact pressure increases and kinematic alterations...

  19. Hyperglycemia decreased medial amygdala projections to medial preoptic area in experimental model of Diabetes Mellitus.

    Directory of Open Access Journals (Sweden)

    Yousef Mohamadi

    2015-01-01

    Full Text Available In Wistar rats, reproductive behavior is controlled in a neural circuit of ventral forebrain including the medial amygdala (Me, bed nucleus of the stria terminalis (BNST and medial preoptic area (MPOA via perception of social odors. Diabetes Mellitus (DM is a widespread metabolic disease that affects many organs in a variety of levels. DM can cause central neuropathies such as neuronal apoptosis, dendritic atrophy, neurochemical alterations and also causes reproductive dysfunctions. So we hypothesized damage to the nuclei of this circuit can cause reproductive dysfunctions. Therefore in this project we assessed diabetic effect on these nuclei. For this purpose neuron tracing technique and TUNEL assay were used. We injected HRP in the MPOA and counted labeled cells in the Me and BNST to evaluate the reduction of neurons in diabetic animals. Also, coronal sections were analyzed with the TMB histochemistry method. Animals in this study were adult male Wistar rats (230 ± 8g divided to control and 10-week streptozotocin-induced diabetic groups. After data analysis by SPSS 16 software, a significant reduction of HRP-labeled neurons was shown in both Me and BNST nuclei in the diabetic group. Moreover, apoptotic cells were significantly observed in diabetic animals in contrast to control the group. In conclusion, these alterations of the circuit as a result of diabetes might be one of the reasons for reproductive dysfunctions.

  20. GABAergic Projections from the Medial Septum Selectively Inhibit Interneurons in the Medial Entorhinal Cortex

    Science.gov (United States)

    Gonzalez-Sulser, Alfredo; Parthier, Daniel; Candela, Antonio; McClure, Christina; Pastoll, Hugh; Garden, Derek; Sürmeli, Gülşen

    2014-01-01

    The medial septum (MS) is required for theta rhythmic oscillations and grid cell firing in the medial entorhinal cortex (MEC). While GABAergic, glutamatergic, and cholinergic neurons project from the MS to the MEC, their synaptic targets are unknown. To investigate whether MS neurons innervate specific layers and cell types in the MEC, we expressed channelrhodopsin-2 in mouse MS neurons and used patch-clamp recording in brain slices to determine the response to light activation of identified cells in the MEC. Following activation of MS axons, we observed fast monosynaptic GABAergic IPSPs in the majority (>60%) of fast-spiking (FS) and low-threshold-spiking (LTS) interneurons in all layers of the MEC, but in only 1.5% of nonstellate principal cells (NSPCs) and in no stellate cells. We also observed fast glutamatergic responses to MS activation in a minority (<5%) of NSPCs, FS, and LTS interneurons. During stimulation of MS inputs at theta frequency (10 Hz), the amplitude of GABAergic IPSPs was maintained, and spike output from LTS and FS interneurons was entrained at low (25–60 Hz) and high (60–180 Hz) gamma frequencies, respectively. By demonstrating cell type-specific targeting of the GABAergic projection from the MS to the MEC, our results support the idea that the MS controls theta frequency activity in the MEC through coordination of inhibitory circuits. PMID:25505326

  1. Medial rectus muscle anchoring in complete oculomotor nerve palsy.

    Science.gov (United States)

    Lee, Si Hyung; Chang, Jee Ho

    2015-10-01

    The management of exotropia resulting from complete oculomotor nerve palsy is challenging. Conventional therapeutic interventions, including supramaximal resection and recession, superior oblique tendon resection and transposition, and several ocular anchoring procedures have yielded less-than-adequate results. Here we describe a novel surgical technique of anchoring the medial rectus muscle to the medial orbital wall in combination with lateral rectus disinsertion and reattachment to the lateral orbital wall.

  2. Cytoarchitecture and probability maps of the human medial orbitofrontal cortex.

    Science.gov (United States)

    Henssen, Anton; Zilles, Karl; Palomero-Gallagher, Nicola; Schleicher, Axel; Mohlberg, Hartmut; Gerboga, Fatma; Eickhoff, Simon B; Bludau, Sebastian; Amunts, Katrin

    2016-02-01

    Previous architectonical studies of human orbitofrontal cortex (OFC) provided divergent maps regarding number, location, and extent of areas. To solve this controversy, an observer-independent cytoarchitectonical mapping of medial OFC (mOFC) was performed. Borders of cortical areas were detected in histological sections of ten human post-mortem brains using a quantitative, statistically testable method, and their stereotaxic localization and intersubject variability were determined. Three areas were identified: granular Fo1 mainly on the rostral Gyrus rectus and medial of the olfactory sulcus; granular to dysgranular Fo2, mainly on the posterior part of the ventromedial Gyrus rectus and the medial and lateral banks of the olfactory sulcus; granular Fo3 between the olfactory and medial or intermediate orbital sulci. Fo3 was bordered medially by Fo1 and Fo2 and laterally by the lateral OFC (lOFC). A cluster analysis of the cytoarchitectonical features of Fo1-Fo3, subgenual cingulate areas, BA12, lateral and medial areas of the frontopolar cortex, lOFC and areas of Broca's region demonstrated the cytoarchitectonical similarity between the mOFC areas in contrast to all other frontal areas. Probabilistic maps of mOFC areas show a considerable intersubject variability in extent and position in stereotaxic space, and provide spatial templates for anatomical localization of in vivo neuroimaging data via the JuBrain atlas and the Anatomy Toolbox.

  3. Lateral-Medial Dissociation in Orbitofrontal Cortex-Hypothalamus Connectivity.

    Science.gov (United States)

    Hirose, Satoshi; Osada, Takahiro; Ogawa, Akitoshi; Tanaka, Masaki; Wada, Hiroyuki; Yoshizawa, Yasunori; Imai, Yoshio; Machida, Toru; Akahane, Masaaki; Shirouzu, Ichiro; Konishi, Seiki

    2016-01-01

    The orbitofrontal cortex (OFC) is involved in cognitive functions, and is also closely related to autonomic functions. The OFC is densely connected with the hypothalamus, a heterogeneous structure controlling autonomic functions that can be divided into two major parts: the lateral and the medial. Resting-state functional connectivity has allowed us to parcellate the cerebral cortex into putative functional areas based on the changes in the spatial pattern of connectivity in the cerebral cortex when a seed point is moved from one voxel to another. In the present high spatial-resolution fMRI study, we investigate the connectivity-based organization of the OFC with reference to the hypothalamus. The OFC was parcellated using resting-state functional connectivity in an individual subject approach, and then the functional connectivity was examined between the parcellated areas in the OFC and the lateral/medial hypothalamus. We found a functional double dissociation in the OFC: the lateral OFC (the lateral orbital gyrus) was more likely connected with the lateral hypothalamus, whereas the medial OFC (the medial orbital and rectal gyri) was more likely connected with the medial hypothalamus. These results demonstrate the fundamental heterogeneity of the OFC, and suggest a potential neural basis of the OFC-hypothalamic functional interaction.

  4. Lateral–Medial Dissociation in Orbitofrontal Cortex–Hypothalamus Connectivity

    Science.gov (United States)

    Hirose, Satoshi; Osada, Takahiro; Ogawa, Akitoshi; Tanaka, Masaki; Wada, Hiroyuki; Yoshizawa, Yasunori; Imai, Yoshio; Machida, Toru; Akahane, Masaaki; Shirouzu, Ichiro; Konishi, Seiki

    2016-01-01

    The orbitofrontal cortex (OFC) is involved in cognitive functions, and is also closely related to autonomic functions. The OFC is densely connected with the hypothalamus, a heterogeneous structure controlling autonomic functions that can be divided into two major parts: the lateral and the medial. Resting-state functional connectivity has allowed us to parcellate the cerebral cortex into putative functional areas based on the changes in the spatial pattern of connectivity in the cerebral cortex when a seed point is moved from one voxel to another. In the present high spatial-resolution fMRI study, we investigate the connectivity-based organization of the OFC with reference to the hypothalamus. The OFC was parcellated using resting-state functional connectivity in an individual subject approach, and then the functional connectivity was examined between the parcellated areas in the OFC and the lateral/medial hypothalamus. We found a functional double dissociation in the OFC: the lateral OFC (the lateral orbital gyrus) was more likely connected with the lateral hypothalamus, whereas the medial OFC (the medial orbital and rectal gyri) was more likely connected with the medial hypothalamus. These results demonstrate the fundamental heterogeneity of the OFC, and suggest a potential neural basis of the OFC–hypothalamic functional interaction. PMID:27303281

  5. Medial collateral ligament reconstruction in the baseball Pitcher's elbow.

    Science.gov (United States)

    Erne, Holger C; Zouzias, Ioannis C; Rosenwasser, Melvin P

    2009-08-01

    Pitchers are prone to elbow injuries because of high and repetitive valgus stresses on the elbow. The anterior bundle of the medial ulnar collateral ligament (MCL) of the elbow is the primary restraint and is often attenuated with time, leading to functional incompetence and ultimate failure. Pitchers with a history of medial elbow pain, reduced velocity, and loss of command may have an MCL injury in evolution. Physical examination and imaging can confirm the diagnosis. Treatment begins with rest and activity modification. All medial elbow pain is not MCL injury. Surgery is considered only for talented athletes who wish to return to competitive play and may include elite scholastic and other collegiates and professionals. The technique for MCL reconstruction was first described in 1986. Many variations have been offered since then, which can result in predictable outcomes, allowing many to return to the same level of competitive play.

  6. Isolated medial foot compartment syndrome after ankle sprain.

    Science.gov (United States)

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

    2014-03-01

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

  7. Traumatic fragmented medial coronoid process in a Chihuahua.

    Science.gov (United States)

    Hadley, H S; Wheeler, J L; Manley, P A

    2009-01-01

    Fragmented medial coronoid process (FMCP) is a disease process that has not previously been reported in toy-breed dogs. This report describes a presumptive case of FMCP in a 14-month-old Chihuahua that was presented for evaluation approximately four weeks following acute onset of moderate lameness in the left forelimb. Definitive diagnosis of a fragmented medial coronoid process was based upon computed tomography (CT) scan. A CT scan also demonstrated moderate joint incongruity in the affected elbow. Surgical removal of the fragment and subtotal coronoidectomy were performed via a medial arthrotomy. An ulnar ostectomy was also performed to address joint incongruity. Histology of specimens removed at surgery did not demonstrate evidence of microdamage as characteristic of FMCP in large breed dogs, and instead, suggested that the fracture was acute and traumatic in nature. Rapid return to function was observed following surgery.

  8. Gore-Tex medialization laryngoplasty for treatment of dysphagia.

    Science.gov (United States)

    Hendricker, Ryan M; deSilva, Brad W; Forrest, L Arick

    2010-04-01

    Gore-Tex medialization laryngoplasty is a well described procedure for the management of glottal incompetence with associated phonatory disturbance. Limited literature exists describing the use of this procedure in the management of dysphagia. We describe our experience with Gore-Tex medialization laryngoplasty and the treatment of dysphagia. Case series with chart review. Tertiary referral center. Between April 2000 and September 2008, 189 Gore-Tex medialization laryngoplasties were performed on 180 patients by the senior author. Complete records and analysis were available for and performed on 121 procedures for 113 patients. The main outcome measures were discontinuation of gastrostomy tube (g-tube) use or avoidance of g-tube, as well as clinical subjective improvement in swallowing function. Fifty-seven of 113 (50%) patients had complaints of dysphagia at presentation, with 47 of 57 (82%) having an objective swallowing evaluation. Thirty-two of 47 (68%) had documented penetration and/or aspiration. Twenty of 57 (35%) patients with dysphagia required g-tubes for alimentation. Eleven of 20 (55%) patients were able to discontinue g-tube use after Gore-Tex medialization laryngoplasty, and an additional five patients with aspiration were able to avoid need for g-tubes with Gore-Tex medialization laryngoplasty and swallowing therapy. Gore-Tex medialization laryngoplasty is a well tolerated and well described treatment for the management of glottal incompetence. The procedure is an appropriate adjunct in dysphagia management for the appropriate patient population. Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

  9. Efficiency of Medial Rectus Advancement Surgery in Consecutive Exotropia

    Directory of Open Access Journals (Sweden)

    Kemal Yar

    2015-12-01

    Full Text Available Purpose: To evaluate the efficiency of medial rectus advancement surgery in consecutive exotropia. Material and Methods: The study group consisted of 20 cases, 10 male, 10 female, who were diagnosed as consecutive exotropia and underwent surgery between 2008-2013 at Cukurova University Medical Faculty Ophthalmology Department. Records of the patients were investigated retrospectively. We evaluated best corrected visual acuity, existence of ambliopia, postoperative duration following the first surgery and applied surgical procedures. Postoperative deviation lower than 10 PD were assesed as successful. Mean follow up period was 29,8 +/- 21,36 (8-80 months, patients with inadequate follow up period were dismissed from the study group. Results: We only applied bilateral medial rectus advancement surgery to 6 and unilateral medial rectus advancement surgery to 5 patients and obtained intended surgical result in these 11 cases. The other patients underwent lateral rectus recession or/and medial rectus resection operations inorder to reach projected deviation degrees. Deviation was found to be 46,4+/-9,24 (40-70 PD in cases who only underwent advancement surgery and was 65,56 +/- 18,78 (40-90 PD in cases who underwent additional surgical procedure. 16 (%80 of the cases had hypermetropi various dioptries and 7 (%35 had ambliopia. Discussion: Consecutive exotropia can appear years after surgery and is an important late period complication. In this study achievement of %55 success with medial rectus advancement surgery indicates that this is a preferable procedure. But in wide angle deviations additional lateral rectus recession or/and medial rectus resection operations can be applied inorder to reach intended adjustment. Accurrate prediction of the propotion of advancement surgery and adjustment is not always possible because of intensive fybrosis in operated muscles and enviroment tissue. [Cukurova Med J 2015; 40(4.000: 707-713

  10. MORPHOLOGICAL STUDY OF MEDIAL CIRCUMFLEX FEMORAL ARTERY IN HUMAN CADAVERS

    Directory of Open Access Journals (Sweden)

    Brijesh R. Aghera

    2014-10-01

    Full Text Available Background: Medial circumflex femoral artery is an important branch of Profunda femoris artery. It is an important artery in supplying blood to the head and neck of the femur, the adductor muscles and form anastomosis around head of femur. So study of variation of medial circumflex femoral artery great value for surgeon and orthopaedic surgeries. Materials and Methods: The present study includes 102 lower limbs of adult formalin fixed human cadavers used for the routine dissection procedure for under graduate and post graduate students in the department of Anatomy, M.R. Medical College, KBN Medical college and H K E Homeopathic College, Gulbarga (India during 2011-2014.The study was done by dissection method as per Cunningham’s manual of practical Anatomy. Result: In present study, we found that 25 extremities (25.49% medial circumflex femoral artery was originated directly from femoral artery. In 10 extremities (9.80% a common trunk was observed form medial circumflex femoral with femoral artery. Normal study was observed in 66 extremities (64.70%. Conclusion: In present study and other past studies we conclude that knowledge of variation in this artery is very important to preventing injury to vessels during surgical procedures around hip joint and also has important value in plastic surgery operations as the vascular pedicle of grafts such as the transverse upper gracilis (TUG flap, medial thigh flap and medial circumflex femoral (gracilis perforator free flap. During case of selective arteriography in ischaemic necrosis of the femoral head to know the arterial supply of the femoral head it is used.

  11. Treating32 cases of gastrocnemius muscle spasm by moxa-moxibustion at ankle tips%艾灸踝尖治疗腓肠肌痉挛32例

    Institute of Scientific and Technical Information of China (English)

    张家玉

    2016-01-01

    目的:观察艾灸治疗腓肠肌痉挛的临床疗效。方法:32例患者均给予艾灸患肢内外踝尖治疗。结果:32例患者经过1个疗程的治疗,治愈28例,经过2个疗程又治愈4例,有效率为100%,疗效显著。%Objective: To observe the clinical eifcacy of moxa-moxibustion at ankle tips on gastrocnemius muscle spasm. Methods: 32 patients were given moxibustion. Results: All patients were cured (28 cases within 1 course, the last within 2 courses); the efifciency was 100%. Moxibustion at ankle tips has conifrmed effects for gastrocnemius muscle spasm.

  12. Treating60 cases of gastrocnemius muscle spasm with Shaoyao Gancao decoction%加味芍药甘草汤治疗腓肠肌痉挛60例

    Institute of Scientific and Technical Information of China (English)

    李春红

    2014-01-01

    观察加味芍药甘草汤治疗腓肠肌痉挛的临床疗效。60例患者均给予加味芍药甘草汤治疗。60例患者均被治愈,有效率为100%。加味芍药甘草汤治疗腓肠肌痉挛疗效显著。%To observe the clinical efficacy of Shaoyao Gancao decoction on treating gastrocnemius muscle spasm. 60 patients were given Shaoyao Gancao decoction, all patients were cured, the efficiency was 100%. Shaoyao Gancao decoction has confirmed effects for gastrocnemius muscle spasm.

  13. Diagnosis and treatment of 16 cases of pulmonary laceration%肺撕裂伤16例的诊治分析

    Institute of Scientific and Technical Information of China (English)

    毕伟; 刘旭军; 江曙光; 丁长青; 刘德海; 刘文

    2015-01-01

    Objective:To investigate the CT diagnosis and treatment of pulmonary laceration.Methods:16 patients with traumatic lung injury were selected,the clinical data were retrospectively analyzed.Results:CT performance were pulmonary contusion combined with balloon or gas liquid capsule(n=9),pulmonary contusion combined with hematoma(n=6),simple hematoma(n=1). Patients were treated with symptomatic treatment,they were followed up for 1 week to 4 months,the lesions were essentially disappeared.Conclusion:CT was of great value in the diagnosis and treatment of pulmonary laceration.%目的:探讨肺撕裂伤的CT诊断和治疗。方法:收治创伤性肺撕裂伤患者16例,回顾性分析其临床资料。结果:CT表现为肺挫伤合并气囊或气液囊(n=9)、肺挫伤合并血肿(n=6)、单纯血肿(n=1)。临床采取对症处理,随访1周~4个月,病灶基本消失。结论:CT在创伤肺撕裂伤诊断及治疗、随访中具有重要价值。

  14. Effects of sildenafil on the gastrocnemius and cardiac muscles of rats in a model of prolonged moderate exercise training.

    Directory of Open Access Journals (Sweden)

    Barbara Rinaldi

    Full Text Available Moderate exercise training improves energetic metabolism, tissue perfusion and induces cardiac and skeletal muscle remodeling. Sildenafil, a potent phosphodiesterase-5 inhibitor used to treat erectile dysfunction, reduces infarct size and increases tissue oxygenation in experimental models of cardiovascular disease. We have evaluated the effects of prolonged moderate exercise training and a repeat administration of sildenafil on the rat gastrocnemius and cardiac muscles. Animals were divided into two groups: sedentary and trained. Each group was subdivided into animals treated with vehicle or with two doses of sildenafil (10 or 15 mg/kg/day during the last week of training. Physical exercise did not induce cardiac hypertrophy, whereas it increased mRNA levels of the PGC-1α, HIF-1α and VEGF genes, which are involved in mitochondrial biogenesis and angiogenesis, and reduced mRNA levels of FoxO3a, MuRF-1 and Atrogin-1. Sildenafil dose-dependently promoted both angiogenesis, as shown by increased capillary density, and muscle atrophy, as shown by muscle fibre size. These effects were more pronounced in trained animals. Our data confirm the beneficial effects of a moderate and prolonged training on cardiovascular and skeletal systems and document the positive and negative effects of sildenafil on these tissues at doses higher than those used in clinical practice. This report may impact on the use of sildenafil as a substance able to influence sports performance.

  15. Forced use as a potential cause of gastrocnemius tears during neurologic rehabilitation: a report of 2 cases.

    Science.gov (United States)

    Fisher, Steve R; Wiggs, Laura L; Ivanhoe, Cindy B

    2007-03-01

    Broadly defined, forced-use therapy uses specific techniques designed to engage the patient with brain injury in activities that disallow overcompensation with the noninvolved or less involved body segments while forcing the use of the more involved segments. Some applications may involve placing the patient's hemiparetic extremity in a closed-chain weight-bearing activity with therapist support. We describe 2 cases of gastrocnemius muscle tears that occurred during inpatient neurologic rehabilitation that may be attributed to forced use of the hemiplegic lower extremity. Each presented with signs and symptoms indicative of deep vein thrombosis of the calf but was later confirmed with magnetic resonance imaging to be muscle tears. Some closed-chain, forced-use activities may be ill advised in the early stages of rehabilitation or if force generation of the muscle is inadequate to provide a protective response to overstretching. Gastroc-soleus tears should also be considered in the differential diagnosis of unilateral or even bilateral lower-extremity swelling and pain in neurologically impaired patients who are undergoing forced-use therapy.

  16. Proprioceptive acuity predicts muscle co-contraction of the tibialis anterior and gastrocnemius medialis in older adults' dynamic postural control.

    Science.gov (United States)

    Craig, C E; Goble, D J; Doumas, M

    2016-05-13

    Older adults use a different muscle strategy to cope with postural instability, in which they 'co-contract' the muscles around the ankle joint. It has been suggested that this is a compensatory response to age-related proprioceptive decline however this view has never been assessed directly. The current study investigated the association between proprioceptive acuity and muscle co-contraction in older adults. We compared muscle activity, by recording surface electromyography (EMG) from the bilateral tibialis anterior (TA) and gastrocnemius medialis (GM) muscles, in young (aged 18-34) and older adults (aged 65-82) during postural assessment on a fixed and sway-referenced surface at age-equivalent levels of sway. We performed correlations between muscle activity and proprioceptive acuity, which was assessed using an active contralateral matching task. Despite successfully inducing similar levels of sway in the two age groups, older adults still showed higher muscle co-contraction. A stepwise regression analysis showed that proprioceptive acuity measured using variable error was the best predictor of muscle co-contraction in older adults. However, despite suggestions from previous research, proprioceptive error and muscle co-contraction were negatively correlated in older adults, suggesting that better proprioceptive acuity predicts more co-contraction. Overall, these results suggest that although muscle co-contraction may be an age-specific strategy used by older adults, it is not to compensate for age-related proprioceptive deficits.

  17. Time course of changes in passive properties of the gastrocnemius muscle-tendon unit during 5 min of static stretching.

    Science.gov (United States)

    Nakamura, Masatoshi; Ikezoe, Tome; Takeno, Yohei; Ichihashi, Noriaki

    2013-06-01

    The minimum time required for Static stretching (SS) to change the passive properties of the muscle-tendon unit (MTU), as well as the association between these passive properties, remains unclear. This study investigated the time course of changes in the passive properties of gastrocnemius MTU during 5 min of SS. The subjects comprised 20 healthy males (22.0 ± 1.8 years). Passive torque as an index of MTU resistance and myotendinous junction (MTJ) displacement as an index of muscle extensibility were assessed using ultrasonography and dynamometer during 5 min of SS. Significant differences before and every 1 min during SS were determined using Scheffé's post hoc test. Relationships between passive torque and MTJ displacement for each subject were determined using Pearson's product-moment correlation coefficient. Although gradual changes in both passive torque and MTJ displacement were demonstrated over every minute, these changes became statistically significant after 2, 3, 4, and 5 min of SS compared with the values before SS. In addition, passive torque after 5 min SS was significantly lower than that after 2 min SS. Similarly, MTJ displacement after 5 min SS was significantly higher than that after 2 min SS. A strong correlation was observed between passive torque and MTJ displacement for each subject (r = -0.886 to -0.991). These results suggest that SS for more than 2 min effectively increases muscle extensibility, which in turn decreases MTU resistance. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Changes in Muscular Lipids in Unilateral Isolated Hypertrophy of Gastrocnemius Muscle Can Be Revealed by 1H MR Spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Brechtel, Klaus; Machann, Juergen; Pick, Margarete; Schaefer, Juergen F.; Claussen, Claus D.; Schick, Fritz [University of Tuebingen, Tuebingen (Germany)

    2009-12-15

    To test whether proton magnetic resonance spectroscopy ({sup 1}H-MRS) reveals changes in the lipid content of the gastrocnemius muscle (GM) and soleus muscle (SOL) of a patient with unilateral isolated hypertrophy of the right GM. {sup 1}H-MRS was performed on a 1.5 Tesla (T) wholebody unit. Muscular lipids inside SOL and GM were assessed in both calves of the patient by a STEAM (stimulated echo acquisition mode) localization sequence. Results were compared to a control group of four healthy volunteers. Total amount of muscular lipids in the hypertrophic GM of the patient was clearly increased compared to the controls (38.7 versus 21.8{+-}3.5 a.u.) while intramyocellular lipids of the adjacent SOL were lower compared to the contralateral healthy leg. Muscular lipids are substrates for metabolism and can be assessed non-invasively by {sup 1}H-MRS. {sup 1}H-MRS is considered to be a helpful tool in clinical assessment of muscle metabolism in cases with muscular hypo- or hypertrophy.

  19. Medial circumflex femoral artery flap for ischial pressure sore

    Science.gov (United States)

    Palanivelu, S.

    2009-01-01

    A new axial pattern flap based on the terminal branches of the medial circumflex femoral artery is described for coverage of ischial pressure sore. Based on the terminal branches of the transverse branch of medial circumflex femoral artery, which exit through the gap between the quadratus femoris muscle above and the upper border of adductor magnus muscle below, this fascio cutaneous flap is much smaller than the posterior thigh flap but extremely useful to cover ischeal pressure sores. The skin redundancy below the gluteal fold allows a primary closure of the donor defect. It can also be used in combination with biceps femoris muscle flap. PMID:19881020

  20. 腓肠肌内侧头肌瓣在胫骨上端恶性骨肿瘤保肢术中的应用%Musculo-Flap of Medial Gastrocnemius For Limb Salvage of Proximal Tibial Malignant Bone Tumor

    Institute of Scientific and Technical Information of China (English)

    于秀淳; 刘晓平; 周银; 李开华; 马胜忠; 刘亚; 宋若先

    2003-01-01

    目的:探讨腓肠肌内侧头前移术在预防胫骨上端恶性骨肿瘤保肢术后切口愈合问题中的价值.方法:在对20例胫骨上端恶性骨肿瘤患者行保肢术的同时行腓肠肌内侧头前移术.骨肉瘤12例,骨巨细胞瘤6例,尤文肉瘤和恶性纤维组织细胞瘤各1例.瘤段切除特制人工关节置换术14例,瘤段切除灭活骨再植术6例.结果:本组患者除1例患者术后胫骨前部皮肤坏死,经清创后行游离植皮而愈合外,余19例患者术后切口均1期愈合,3例出现后期切口渗出及裂开.18例获得随访,2例骨肉瘤死亡;术后肢体功能优4例,良7例,可2例,差5例.结论:腓肠肌内侧头前移术应成为胫骨上端恶性骨肿瘤保肢术的一个重要组成部分,对于预防切口问题的发生具有重要的意义.

  1. Effect of frozen storage duration and cooking on physical and oxidative changes in M.Gastrocnemius pars interna and M.Iliofibularis of rhea americana

    OpenAIRE

    Schmidt Filgueras, Renata; Gatellier, Philippe; ZAMBIAZI,Rui C.; Sante-Lhoutellier, Veronique

    2010-01-01

    This study was conducted to evaluate the effect of frozen storage time (30, 60, 90 or 180 days) and cooking (100 °C, 30 min) on the physical characteristics and oxidative stability of M. Gastrocnemius pars interna (GN) and M. Iliofiburalis (IF) of rhea americana. Physical parameters measured included thawing and cooking loss, colour parameters (L*a*b*), while oxidation was assessed by determining the TBA-RS, carbonyl and aromatic amino acid content. Prolonged frozen storage of rhea meat decre...

  2. Lacerations - liquid bandage

    Science.gov (United States)

    ... be found at your local pharmacy. Applying and Caring for a Liquid Bandage With clean hands or ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  3. The Application of Gastrocnemius Flap in Severe Electrical Burns of the Knees%腓肠肌肌瓣在修复严重膝部电烧伤中的应用

    Institute of Scientific and Technical Information of China (English)

    朱维平; 陈国华; 赵琳

    2003-01-01

    Objective To investigate the repairing methods of severe electrical burns of the knees. Methods 10pateints with severe electrical burns of the knees were enrolled in this study. After local debridement, gastrocnemius flap and netskin graft immediately. Results The entire flap survived very well with satisfactory results. Conclusion Early debridementfollowed by gastrocnemius flap and net skin graft could be simple, safe and reliable treatment strategies in the patients withsevere electrical burns of the knees.

  4. Stiffness of the healing medial collateral ligament of the mouse.

    NARCIS (Netherlands)

    Gijssen, Y.; Sierevelt, I.N.; Kooloos, J.G.M.; Blankevoort, L.

    2004-01-01

    The knee joints of mice can serve as a model for studying knee ligament properties. The goal of our study was to measure the structural stiffness of the medial collateral ligament (MCL) of the murine knee. A tensile test was developed for this purpose. First 84 femur-MCL-tibia complexes of

  5. Aetiology, imaging and treatment of medial tibial stress syndrome

    NARCIS (Netherlands)

    Moen, M.H.

    2012-01-01

    The work contained is this thesis discusses aetiology, imaging and treatment of a common leg injury: medial tibial stress syndrome (MTSS). Although a common injury, the number of scientific articles on this topic is relatively low as is explained in chapter 1. This chapter also highlights that the m

  6. Robust Segmentation of Voxel Shapes using Medial Surfaces

    NARCIS (Netherlands)

    Reniers, Dennie; Telea, Alexandru

    2008-01-01

    We present a new patch-type segmentation method for 3D voxel shapes based on the medial surface, also called surface skeleton. The boundaries of the simplified fore- and background skeletons map one-to-one to increasingly fuzzy, soft convex, respectively concave, edges of the shape. Using this prope

  7. Anatomical segmentation of the human medial prefrontal cortex

    NARCIS (Netherlands)

    Corcoles-Parada, M.; Muller, N.C.J.; Ubero, M.; Serrano-Del-Pueblo, V.M.; Mansilla, F.; Marcos-Rabal, P.; Artacho-Perula, E.; Dresler, M.; Insausti, R.; Fernandez, G.; Munoz-Lopez, M.

    2017-01-01

    The medial prefrontal areas 32, 24, 14, and 25 (mPFC) form part of the limbic memory system, but little is known about their functional specialization in humans. To add anatomical precision to structural and functional magnetic resonance imaging (MRI) data, we aimed to identify these mPFC subareas i

  8. Downregulation of the posterior medial frontal cortex prevents social conformity

    NARCIS (Netherlands)

    Klucharev, V.; Munneke, M.; Smidts, A.; Fernandez, G.S.E.

    2011-01-01

    We often change our behavior to conform to real or imagined group pressure. Social influence on our behavior has been extensively studied in social psychology, but its neural mechanisms have remained largely unknown. Here we demonstrate that the transient downregulation of the posterior medial front

  9. Internal Mammary and Medial Supraclavicular Irradiation in Breast Cancer

    NARCIS (Netherlands)

    Poortmans, P.M.P.; Collette, S.; Kirkove, C.; Limbergen, E. van; Budach, V.; Struikmans, H.; Collette, L.; Fourquet, A.; Maingon, P.; Valli, M.; Winter, K. De; Marnitz, S.; Barillot, I.; Scandolaro, L.; Vonk, E.; Rodenhuis, C.; Marsiglia, H.; Weidner, N.; Tienhoven, G. van; Glanzmann, C.; Kuten, A.; Arriagada, R.; Bartelink, H.; Bogaert, W. Van den

    2015-01-01

    BACKGROUND: The effect of internal mammary and medial supraclavicular lymph-node irradiation (regional nodal irradiation) added to whole-breast or thoracic-wall irradiation after surgery on survival among women with early-stage breast cancer is unknown. METHODS: We randomly assigned women who had a

  10. Temporary Medial Upper Eyelid Lagophthalmos after External Dacryocystorhinostomy.

    Science.gov (United States)

    Haefliger, I O; Meienberg, O; Pimentel de Figueiredo, A R

    2016-04-01

    Background. Report of three cases of medial upper eyelid lagophthalmos as complication of external dacryocystorhinostomy. History and Signs. Shortly after dacryocystorhinostomy (skin incision on the side of the nose), three of ten consecutive patients (28 ± 4 years; mean ± standard deviation), presented with an ipsilateral lagophthalmos of 4 ± 1 mm in voluntary eyelid closure and 6 ± 1 mm in spontaneous blink. The lagophthalmos was due to a selective paresis of the medial part of the orbicularis oculi muscle of the upper eyelid. Patient 1 complained bitterly of dry eye symptoms and of her lagophthalmos. Patient 2 had mild symptoms but became very concerned after peers made her aware of her asymmetric blink. Patient 3 was asymptomatic and did not notice anything particular. Therapy and Outcome. Lagophthalmos resolved spontaneously within three months after surgery, first by improvement of voluntary eyelid closure and then of spontaneous blinking. Conclusions. Temporary lagophthalmos can occur as a complication of external dacryocystorhinostomy, most likely due to damage of the (only recently described) superficial buccal and/or zygomatic branches of the facial nerve that run upward to cross over the medial ligament and innervate the medial part of the orbicularis oculi muscle. Georg Thieme Verlag KG Stuttgart · New York.

  11. Proactive and Reactive Control by the Medial Frontal Cortex

    Directory of Open Access Journals (Sweden)

    Veit eStuphorn

    2012-06-01

    Full Text Available Adaptive behavior requires the ability to flexibly control actions. This can occur either proactively to anticipate task requirements, or reactively in response to sudden changes. In this article, we describe the behavioral and physiological evidence for dual mechanisms of control in response inhibition in the medial frontal cortex in the context of the stop signal or countermanding task.

  12. Tendon sheath fibroma of the medial canthal tendon.

    Science.gov (United States)

    Andrew, Nicholas; Dodd, Tom; Selva, Dinesh; Davis, Garry

    2013-01-01

    Fibromas of the tendon sheath are slow-growing, benign tumors most commonly found on the hands and wrist. A fibroma of the tendon sheath arising from the medial canthal tendon presented as an enlarging nodule that had been present for 40 years. The fibroma was identified by microscopy and immunohistochemistry, and surgical resection appears to have been curative.

  13. [Medial unicompartmental knee prosthesis for patients with unicompartmental gonarthrosis

    NARCIS (Netherlands)

    Kort, N.P.; Deutman, R.; Raay, J.J. van; Horn, J.R. van

    2004-01-01

    The function and survival time of unicompartmental knee prostheses for patients with severe gonarthrosis have been improved the past few years by developments in their design, the instrumentarium and the surgical technique. A medial unicompartmental knee prosthesis may be indicated in patients with

  14. Medial Patellofemoral Ligament Reconstruction in a Below-Knee Amputee

    Directory of Open Access Journals (Sweden)

    Sherif El-Tawil

    2015-01-01

    Full Text Available Patellar instability is a common finding in patients with below-knee amputation and yet management options are not commonly described in the literature. We describe the first reported case of a medial patellofemoral ligament reconstruction using allograft in a patient with a below-knee amputation. Clinical outcome at two-year follow-up remains very good.

  15. Arthroscopic Treatment of Medial Femoral Condylar Coronal Fractures and Nonunions

    Science.gov (United States)

    Ercin, Ersin; Bilgili, M. Gokhan; Basaran, S. Hakan; Baca, Emre; Kural, Cemal; Avkan, M. Cevdet

    2013-01-01

    Nonunion of medial femoral condylar coronal fractures are uncommon. In neglected Hoffa fractures despite nonunion, there is a risk of missing accompanying ligamentous and intra-articular injuries. Neither preoperative clinical examination nor magnetic resonance imaging showed these injuries before arthroscopy. Arthroscopy before internal fixation gives additional information and changes the surgical protocol for these fractures and nonunions. PMID:24400191

  16. MR imaging findings of medial tibial crest friction

    Energy Technology Data Exchange (ETDEWEB)

    Klontzas, Michail E., E-mail: miklontzas@gmail.com; Akoumianakis, Ioannis D., E-mail: ioannis.akoumianakis@gmail.com; Vagios, Ilias, E-mail: iliasvagios@gmail.com; Karantanas, Apostolos H., E-mail: akarantanas@gmail.com

    2013-11-01

    Objective: Medial tibial condyle bone marrow edema (BME), associated with soft tissue edema (STe) surrounding the medial collateral ligament, was incidentally observed in MRI examinations of young and athletic individuals. The aim of the present study was to 1. Prospectively investigate the association between these findings and coexistence of localized pain, and 2. Explore the possible contribution of the tibial morphology to its pathogenesis. Methods: The medial tibial condyle crest was evaluated in 632 knee MRI examinations. The angle and depth were measured by two separate evaluators. The presence of STe and BME was recorded. A third evaluator blindly assessed the presence of pain at this site. Results: BME associated with STe was found in 24 patients (with no history of previous trauma, osteoarthritis, tumor or pes anserine bursitis). The mean crest angle was 151.3° (95%CI 147.4–155.3°) compared to 159.4° (95%CI 158.8–160°) in controls (Mann–Whitney test, P < 0.0001). MRI findings were highly predictive of localized pain (sensitivity 92% specificity 99%, Fisher's exact test, P < 0.0001). Conclusion: Friction at the medial tibial condyle crest is a painful syndrome. MRI is a highly specific and sensitive imaging modality for its diagnosis.

  17. Medial supracondylar stress fracture in an adolescent pitcher

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Eric Y.; Chung, Christine B. [VA San Diego Healthcare System, San Diego, CA (United States); University of California, San Diego Medical Center, San Diego, CA (United States); Fronek, Jan [Scripps Healthcare, La Jolla, CA (United States)

    2014-01-15

    We report the occurrence of a medial supracondylar stress fracture in an adolescent pitcher. To our knowledge, this fracture has not been described in the literature, and awareness of this entity allows initiation of therapy and precludes further unnecessary work-up. The radiographic, computed tomography, and magnetic resonance imaging appearances are reviewed and the mechanism of injury is discussed. (orig.)

  18. Scene-Selectivity and Retinotopy in Medial Parietal Cortex

    Science.gov (United States)

    Silson, Edward H.; Steel, Adam D.; Baker, Chris I.

    2016-01-01

    Functional imaging studies in human reliably identify a trio of scene-selective regions, one on each of the lateral [occipital place area (OPA)], ventral [parahippocampal place area (PPA)], and medial [retrosplenial complex (RSC)] cortical surfaces. Recently, we demonstrated differential retinotopic biases for the contralateral lower and upper visual fields within OPA and PPA, respectively. Here, using functional magnetic resonance imaging, we combine detailed mapping of both population receptive fields (pRF) and category-selectivity, with independently acquired resting-state functional connectivity analyses, to examine scene and retinotopic processing within medial parietal cortex. We identified a medial scene-selective region, which was contained largely within the posterior and ventral bank of the parieto-occipital sulcus (POS). While this region is typically referred to as RSC, the spatial extent of our scene-selective region typically did not extend into retrosplenial cortex, and thus we adopt the term medial place area (MPA) to refer to this visually defined scene-selective region. Intriguingly MPA co-localized with a region identified solely on the basis of retinotopic sensitivity using pRF analyses. We found that MPA demonstrates a significant contralateral visual field bias, coupled with large pRF sizes. Unlike OPA and PPA, MPA did not show a consistent bias to a single visual quadrant. MPA also co-localized with a region identified by strong differential functional connectivity with PPA and the human face-selective fusiform face area (FFA), commensurate with its functional selectivity. Functional connectivity with OPA was much weaker than with PPA, and similar to that with face-selective occipital face area (OFA), suggesting a closer link with ventral than lateral cortex. Consistent with prior research, we also observed differential functional connectivity in medial parietal cortex for anterior over posterior PPA, as well as a region on the lateral

  19. Interaction between gastrocnemius medialis fascicle and Achilles tendon compliance: a new insight on the quick-release method.

    Science.gov (United States)

    Farcy, Stevy; Nordez, Antoine; Dorel, Sylvain; Hauraix, Hugo; Portero, Pierre; Rabita, Giuseppe

    2014-02-01

    The insufficient temporal resolution of imaging devices has made the analysis of very fast movements, such as those required to measure active muscle-tendon unit stiffness, difficult. Thus the relative contributions of tendon, aponeurosis, and fascicle to muscle-tendon unit compliance remain to be determined. The present study analyzed the dynamic interactions of fascicle, tendon, and aponeurosis in human gastrocnemius medialis during the first milliseconds of an ankle quick-release movement, using high-frame-rate ultrasonography (2,000 frames/s). Nine subjects performed the tests in random order at six levels of maximal voluntary contraction (MVC) (30% to 80% of MVC). These tests were carried out with the ultrasound probe placed on the muscle belly and on the myotendinous junction. Tendon, muscle fascicle, and aponeurosis length changes were quantified in relation to shortening of the muscle-tendon unit during the first few milliseconds following the release. The tendon was the main contributor (around 72%) to the shortening of the muscle-tendon unit, whereas the muscle fascicle and aponeurosis contributions were 18% and 10%, respectively. Because these structures can be considered in series, the quantified contributions can be regarded as relative contributions to muscle-tendon compliance. These contributions were not modified with the level of MVC or the time range used for the analysis between 10 and 25 ms. The constant contribution of tendon, muscle fascicle, and aponeurosis to muscle-tendon unit compliance may help to simplify the mechanism of compliance regulation and to maintain the important role of tendons in enhancing work output and movement efficiency.

  20. Regional differences in expression of VEGF mRNA in rat gastrocnemius following 1 hr exercise or electrical stimulation

    Directory of Open Access Journals (Sweden)

    Tang Kechun

    2002-06-01

    Full Text Available Abstract Background Vascular endothelial growth factor (VEGF mRNA levels increase in rat skeletal muscle after a single bout of acute exercise. We assessed regional differences in VEGF165 mRNA levels in rat gastrocnemius muscle using in situ hybridization after inducing upregulation of VEGF by treadmill running (1 hr or electrical stimulation (1 hr. Muscle functional regions were defined as oxidative (primarily oxidative fibers, I and IIa, or glycolytic (entirely IIb or IId/x fibers. Functional regions were visualized on muscle cross sections that were matched in series to slides processed through in situ hybridization with a VEGF165 probe. A greater upregulation in oxidative regions was hypothesized. Results Total muscle VEGF mRNA (via Northern blot was upregulated 3.5-fold with both exercise and with electrical stimulation (P = 0.015. Quantitative densitometry of the VEGF mRNA signal via in situ hybridization reveals significant regional differences (P ≤ 0.01 and protocol differences (treadmill, electrical stimulation, and control, P ≤ 0.05. Mean VEGF mRNA signal was higher in the oxidative region in both treadmill run (~7%, N = 4 muscles, P ≤ 0.05 and electrically stimulated muscles (~60%, N = 4, P ≤ 0.05. These regional differences were not significantly different from control muscle (non-exercised, non-stimulated, N = 2 muscles, although nearly so for electrically stimulated muscle (P = 0.056. Conclusions Moderately higher VEGF mRNA signal in oxidative muscle regions is consistent with regional differences in capillary density. However, it is not possible to determine if the VEGF mRNA signal difference is important in either the maintenance of regional capillarity differences or exercise induced angiogenesis.

  1. Contributions of the soleus and gastrocnemius muscles to the anterior cruciate ligament loading during single-leg landing.

    Science.gov (United States)

    Mokhtarzadeh, Hossein; Yeow, Chen Hua; Hong Goh, James Cho; Oetomo, Denny; Malekipour, Fatemeh; Lee, Peter Vee-Sin

    2013-07-26

    The aim of this study was to identify the contribution of the Soleus and Gastrocnemius (Gastroc) muscles' forces to anterior cruciate ligament (ACL) loading during single-leg landing. Although Quadriceps (Quads) and Hamstrings (Hams) muscles were recognized as the main contributors to the ACL loading, less is known regarding the role of ankle joint plantarflexors during landing. Eight healthy subjects performed single-landing tasks from 30 and 60cm heights. Scaled generic musculoskeletal models were developed in OpenSim to calculate lower limb muscle forces. The model consisted of 10 segments with 23 degrees of freedom and 92 lower body muscle-tendon units. Knee joint reaction forces were calculated based on the estimated muscle forces and used to predict ACL forces. We hypothesized that Soleus and Gastrocs muscle forces have opposite effects on tibial loading in the anterior/posterior directions. In situations where greater landing height would lead to an increase in GRF and risk of ACL injury, we further hypothesized that posterior forces of the Soleus and Hams would increase correspondingly to help protect the ACL during a safe landing maneuver. Our results demonstrated the antagonistic and agonistic roles of Gastrocs and Soleus respectively in ACL loading. The posterior force of Soleus reached 28-32% of Ham's posterior force for both landing heights at peak GRF while the posterior force of Gastrocs on femur was negligible. ACL injury risk during single-leg landing is not only dependent on knee musculature but also influenced by muscles that do not span the knee joint, such as the Soleus. In conclusion, the role of the ankle plantarflexors should be considered when developing training strategies for ACL injury prevention.

  2. Formation of median nerve without the medial root of medial cord and associated variations of the brachial plexus

    Directory of Open Access Journals (Sweden)

    Bhanu SP

    2010-02-01

    Full Text Available The anatomical variations in the formation, course and termination of brachial plexus are well documented and have clinical significance to surgeons, neurologists and anatomists. The present case report describes the unusual origin of median nerve, arising directly from the lateral cord without the union of lateral and medial roots of brachial plexus. A communicating branch existed between the ulnar nerve and anterior division of middle trunk. The lateral pectoral nerve was arising from anterior divisions of upper and middle trunks as two separate branches instead from lateral cord. The branches then joined together to form the lateral pectoral nerve. The medial cord instead of its five terminal branches, had only three branches, the ulnar nerve, medial pectoral nerve and a single trunk for the medial cutaneous nerve of arm and forearm which got separated at the middle of the arm. The variations of the lateral cord and its branches make it a complicated clinical and surgical approach which is discussed with the developmental background.

  3. The Prevalence of Medial Epicondylitis Among Patients With C6 and C7 Radiculopathy

    OpenAIRE

    2010-01-01

    Background: Medial epicondylitis, or golfer’s/pitcher’s elbow, develops as a result of medial stress overload on the flexor muscles at the elbow and presents as pain at the medial epicondyle. Cervical radiculopathy has been associated with lateral epicondylitis, but few associations between the cervical spine and medial epicondylitis have been made. Researchers propose that there is an association, suggesting that the weakness and imbalance in the elbow flexor and extensor muscles from C6 and...

  4. Posterior horn medial meniscal root tear: the prequel

    Energy Technology Data Exchange (ETDEWEB)

    Umans, H. [Albert Einstein College of Medicine, Bronx, NY (United States); Lenox Hill Radiology and Imaging Associates, New York, NY (United States); Morrison, W. [Thomas Jefferson University Hospital, Philadelphia, PA (United States); DiFelice, G.S. [Hospital for Special Surgery, New York, NY (United States); Vaidya, N. [Crystal Run Healthcare, Middletown, NY (United States); Winalski, C.S. [Cleveland Clinic, Imaging Institute, Department of Biomedical Engineering, Lerner Research Institute, Cleveland, OH (United States)

    2014-06-15

    To determine whether subarticular marrow changes deep to the posterior horn medial meniscal root anchor might predict subsequent medial meniscal root tear. Fifteen patients with MR-diagnosed posterior horn medial meniscal root (PHMMR) tear and a knee MRI antecedent to the tear were identified at three imaging centers over a 7-year period. The pre- and post-tear MR images were evaluated for marrow signal changes deep to the root anchor, meniscal root signal intensity, medial compartment articular cartilage thinning, and meniscal body extrusion. Images of 29 age- and gender-matched individuals with two MRIs of the same knee were reviewed as a control group. MRI in 11 of 15 (73 %) cases with subsequent PHMMR tear demonstrated linear subcortical marrow edema deep to the meniscal root anchor on the antecedent MRI compared to only 1 of 29 (3 %) non-tear controls (p < 0.0001). The abnormal signal resolved on post-tear MRI in all but two patients. Cyst-like changes deep to the PHMMR were present on initial MRI in three of 15 (23 %) cases and three of 29 (10 %) controls, persisting in all but one case on follow-up imaging. The PHMMR was gray on the initial MRI in seven of 15 (47 %) of cases that developed tears compared to four of 29 (14 %) controls (p < 0.0001). There was medial meniscal extrusion (MME) prior to tear in two of 15 (13 %) patients and in ten of 15 (67 %) patients after PHMMR failure. In the control group, MME was present in one (3 %) and three (10 %) of 29 subjects on the initial and follow-up MRIs, respectively. Articular cartilage loss was noted in two of 15 (15 %) cases before tear and nine of 15 (69 %) on follow-up imaging, as compared to one (3 %) and four (14 %) of 29 subjects in the control group. Subcortical marrow edema deep to the PHMMR may result from abnormal stresses and thus be a harbinger of meniscal root failure. This hypothesis is supported by resolution of these marrow signal changes after root tear. Following tear, extrusion of the

  5. An extensive posterior approach of the elbow with osteotomy of the medial epicondyle

    NARCIS (Netherlands)

    Vos, de M.J.; Wagener, M.L.; Verdonschot, N.J.J.; Eygendaal, D.

    2014-01-01

    Background This study describes a posterior approach to the elbow for placement of a total elbow prosthesis. Methods Release of the medial collateral ligament is achieved by performing an osteotomy of the medial epicondyle. This allows anatomic refixation of the origin of the medial collateral liga

  6. An extensive posterior approach of the elbow with osteotomy of the medial epicondyle

    NARCIS (Netherlands)

    Vos, M.J. de; Wagener, M.L.; Verdonschot, N.J.J.; Eygendaal, D.

    2014-01-01

    BACKGROUND: This study describes a posterior approach to the elbow for placement of a total elbow prosthesis. METHODS: Release of the medial collateral ligament is achieved by performing an osteotomy of the medial epicondyle. This allows anatomic refixation of the origin of the medial collateral lig

  7. Dynamic Changes in Acetylcholine Output in the Medial Striatum during Place Reversal Learning

    Science.gov (United States)

    Ragozzino, Michael E.; Choi, Daniel

    2004-01-01

    The present studies explored the role of the medial striatum in learning when task contingencies change. Experiment 1 examined whether the medial striatum is involved in place reversal learning. Testing occurred in a modified cross-maze across two consecutive sessions. Injections of the local anesthetic, bupivacaine, into the medial striatum, did…

  8. The Caring and Consideration of Two Cases of Vaginal Laceration%阴道撕裂伤2例的护理与思考

    Institute of Scientific and Technical Information of China (English)

    马晓燕; 朱红

    2015-01-01

    Objective:Summarize the two cases of vaginal laceration nursing care of patients and hope to ponder sex education for adolescents. Methods:According to the psychological problems and clinical symptoms of two cases of vaginal laceration patients, we develop feasible and effective plan of care and implement. Results:After a positive health guidance and nursing intervention symptomatic, two patients peace of mind, good recovery, discharged. Conclusion:Correct guidance of young people on sexual and universal knowledge, learning and understanding of sexual morality are necessary to reduce adolescent variety of injuries in the growth process, and promote their personal physical and mental health.%目的:报道2例阴道撕裂伤患者的护理体会并由此对青少年性教育的思考。方法:根据2例阴道撕裂伤患者的心理问题及临床症状,制定可行有效的护理计划并实施。结果:经过积极的护理干预及对症的健康指导,2例患者心态平和、恢复良好、痊愈出院。结论:正确普及青少年的性知识、性道德的教育,以此减少青少年在成长过程中受到的各种伤害,促进其个人身心健康发展。

  9. Dopaminergic Activity in the Medial Prefrontal Cortex Modulates Fear Conditioning

    Directory of Open Access Journals (Sweden)

    Parvin Babaei

    2011-07-01

    Full Text Available "nThe purpose of the present study was to determine the role of medial prefrontal cortex (mPFC dopaminergic system in fear conditioning response considering individual differences. Animals were initially counterbalanced and classified based on open field test, and then were given a single infusion of the dopamine agonist, amphetamine (AMPH and antagonist, clozapine (CLZ into the medial prefrontal cortex. Rats received tone-shock pairing in a classical fear conditioning test and then exposed to the tone alone. Freezing responses were measured as conditioned fear index. The results showed that both AMPH and CLZ infusion in mPFC reduced the expression of conditioned fear. This finding indicates that elevation or reduction in the dopaminergic activity is associated with the decrease of fear responses, despite preexisting individual-typological differences.

  10. Risk Factors of Medial Tibial Stress Syndrome(MTSS)

    Institute of Scientific and Technical Information of China (English)

    Sae Yong Lee

    2009-01-01

    @@ Background According to Mubarak[1,2],who first coined the term medial tibial stress syndrome (MTSS)in 1982,the definition of MTSS is " a symptom complex in athletes who experience exercise-induced pain along thedistalposteromedialaspectofthetibia."Previous studies have shown that MTSS accounts for 6 to 15 percent of running related injuries [3-9] and has an incidence among certain populations (ie,military recruits) of up to 35 percent [10].The etiology of MTSS is not well known,but it is commonly believed that the cause is inflammation and possibly an avulsion of the origins of the posterior tibialis and/or the soleus from the periosteum of the posteromedial tibia [10].Traction at the periosteal interface is thought to lead to inflammation and pain at the periosteal-fascial junction.The location of the pain is usually localized over the posterior medial edge of the distal third of the tibia.

  11. Downregulation of the posterior medial frontal cortex prevents social conformity.

    Science.gov (United States)

    Klucharev, Vasily; Munneke, Moniek A M; Smidts, Ale; Fernández, Guillén

    2011-08-17

    We often change our behavior to conform to real or imagined group pressure. Social influence on our behavior has been extensively studied in social psychology, but its neural mechanisms have remained largely unknown. Here we demonstrate that the transient downregulation of the posterior medial frontal cortex by theta-burst transcranial magnetic stimulation reduces conformity, as indicated by reduced conformal adjustments in line with group opinion. Both the extent and probability of conformal behavioral adjustments decreased significantly relative to a sham and a control stimulation over another brain area. The posterior part of the medial frontal cortex has previously been implicated in behavioral and attitudinal adjustments. Here, we provide the first interventional evidence of its critical role in social influence on human behavior.

  12. Medial shoe-ground pressure and specific running injuries

    DEFF Research Database (Denmark)

    Brund, René Korsgaard; Rasmussen, Sten; Nielsen, Rasmus O.

    2017-01-01

    Objectives Achilles tendinitis, plantar fasciopathy and medial tibial stress syndrome injuries (APM-injuries) account for approximately 25% of the total number of running injuries amongst recreational runners. Reports on the association between static foot pronation and APM-injuries...... are contradictory. Possibly, dynamic measures of pronation may display a stronger relationship with the risk of APM-injuries. Therefore, the purpose of the present study was to investigate if running distance until the first APM-injury was dependent on the foot balance during stance phase in recreational male...... foot balance groups. Results Compared with the LP-group (n = 59), the proportion of APM-injuries was greater in the MP-group (n = 99) after 1500 km of running, resulting in a cumulative risk difference of 16%-points (95% CI = 3%-point; 28%-point, p = 0.011). Conclusions Runners displaying a more medial...

  13. Medial patellofemoral ligament reconstruction: patient selection and perspectives

    Directory of Open Access Journals (Sweden)

    Baer MR

    2017-09-01

    Full Text Available Michael R. Baer, Jeffrey A. Macalena Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA Abstract: Patellofemoral instability is a painful and often recurring disorder with many negative long-term consequences. After a period of failed nonoperative management, surgical intervention has been used to reduce the incidence of patellar subluxation and dislocations. Medial patellofemoral ligament (MPFL reconstruction successfully addresses patellofemoral instability by restoring the deficient primary medial patellar soft tissue restraint. When planning MPFL reconstruction for instability, it is imperative to consider the patient’s unique anatomy including the tibial tuberosity–trochlear groove (TT–TG distance, trochlear dysplasia, and patella alta. Additionally, it is important to individualize surgical treatment in the skeletally immature, hypermobile, and athletic populations. Keywords: MPFL, indications, considerations, contraindications

  14. Medial prefrontal D1 dopamine neurons control food intake.

    Science.gov (United States)

    Land, Benjamin B; Narayanan, Nandakumar S; Liu, Rong-Jian; Gianessi, Carol A; Brayton, Catherine E; Grimaldi, David M; Sarhan, Maysa; Guarnieri, Douglas J; Deisseroth, Karl; Aghajanian, George K; DiLeone, Ralph J

    2014-02-01

    Although the prefrontal cortex influences motivated behavior, its role in food intake remains unclear. Here, we demonstrate a role for D1-type dopamine receptor-expressing neurons in the medial prefrontal cortex (mPFC) in the regulation of feeding. Food intake increases activity in D1 neurons of the mPFC in mice, and optogenetic photostimulation of D1 neurons increases feeding. Conversely, inhibition of D1 neurons decreases intake. Stimulation-based mapping of prefrontal D1 neuron projections implicates the medial basolateral amygdala (mBLA) as a downstream target of these afferents. mBLA neurons activated by prefrontal D1 stimulation are CaMKII positive and closely juxtaposed to prefrontal D1 axon terminals. Finally, photostimulating these axons in the mBLA is sufficient to increase feeding, recapitulating the effects of mPFC D1 stimulation. These data describe a new circuit for top-down control of food intake.

  15. Aetiology, imaging and treatment of medial tibial stress syndrome

    OpenAIRE

    Moen, M.H.

    2012-01-01

    The work contained is this thesis discusses aetiology, imaging and treatment of a common leg injury: medial tibial stress syndrome (MTSS). Although a common injury, the number of scientific articles on this topic is relatively low as is explained in chapter 1. This chapter also highlights that the most probable cause of MTSS is bone overload and not traction induced periostitis. In chapter 2 a review of the literature on MTSS is provided until 2009. Chapters 3 and 4 discuss different common a...

  16. Acutely calcified hematoma mimicking a displaced medial epicondyle fracture

    Directory of Open Access Journals (Sweden)

    Majed Addie

    2009-01-01

    Full Text Available We present an interesting and unusual case of an acutely calcified pin-site infection hematoma mimicking a displaced cartilaginous medial epicondyle, in a child with a Gartland type III fracture. The treatment of such pathology could be confusing and may interfere with the correct clinical decision-making process. To our knowledge, this is the first presentation of such a case.

  17. Bilateral Medial Medullary Stroke: A Challenge in Early Diagnosis

    Directory of Open Access Journals (Sweden)

    Amir M. Torabi

    2013-01-01

    Full Text Available Bilateral medial medullary stroke is a very rare type of stroke, with catastrophic consequences. Early diagnosis is crucial. Here, I present a young patient with acute vertigo, progressive generalized weakness, dysarthria, and respiratory failure, who initially was misdiagnosed with acute vestibular syndrome. Initial brain magnetic resonance imaging (MRI that was done in the acute phase was read as normal. Other possibilities were excluded by lumbar puncture and MRI of cervical spine. MR of C-spine showed lesion at medial medulla; therefore a second MRI of brain was requested, showed characteristic “heart appearance” shape at diffusion weighted (DWI, and confirmed bilateral medial medullary stroke. Retrospectively, a vague-defined hyperintense linear DWI signal at midline was noted in the first brain MRI. Because of the symmetric and midline pattern of this abnormal signal and similarity to an artifact, some radiologists or neurologists may miss this type of stroke. Radiologists and neurologists must recognize clinical and MRI findings of this rare type of stroke, which early treatment could make a difference in patient outcome. The abnormal DWI signal in early stages of this type of stroke may not be a typical “heart appearance” shape, and other variants such as small dot or linear DWI signal at midline must be recognized as early signs of stroke. Also, MRI of cervical spine may be helpful if there is attention to brainstem as well.

  18. Medial blepharosynechioplasty: a new surgical concept for severe dry eye

    Directory of Open Access Journals (Sweden)

    Sasaki T

    2012-06-01

    Full Text Available Tsugihisa Sasaki,1,2 Taeko Ota,3 Youko Ookura,4 Kazuhisa Sugiyama11Department of Ophthalmology, Kanazawa University School of Medicine, Kanazawa, Ishikawa; 2Department of Ophthalmology, Fukui Prefectural Hospital, Fukui; 3Department of Ophthalmology, Tonami General Hospital, Tonami-city, Toyama; 4Department of Ophthamology, Saiseikai Kanazawa Hospital, Kanazawa, Ishikawa, JapanBackground: The purpose of this work was to report on the performance of medial blepharosynechioplasty (MBSP, a newly devised technique for treating severe dry eye.Methods: In this retrospective, nonrandomized clinical trial, three cases with severe dry eye (Sjögren’s syndrome associated with repeated punctal plug loss were treated using MBSP to create a synechia between the upper and lower lid medial borders of the puncta to suppress the lacrimal pump.Results: Postoperative follow-up showed improvement in the corneal condition in all three cases that persisted for 12–35 months. None of the patients had visual impairment.Conclusion: MBSP is a promising treatment for severe dry eye and merits further study.Keywords: dry eye, lacrimal pump suppression, medial blepharosynechioplasty

  19. MARRT: Medial Axis biased rapidly-exploring random trees

    KAUST Repository

    Denny, Jory

    2014-05-01

    © 2014 IEEE. Motion planning is a difficult and widely studied problem in robotics. Current research aims not only to find feasible paths, but to ensure paths have certain properties, e.g., shortest or safest paths. This is difficult for current state-of-the-art sampling-based techniques as they typically focus on simply finding any path. Despite this difficulty, sampling-based techniques have shown great success in planning for a wide range of applications. Among such planners, Rapidly-Exploring Random Trees (RRTs) search the planning space by biasing exploration toward unexplored regions. This paper introduces a novel RRT variant, Medial Axis RRT (MARRT), which biases tree exploration to the medial axis of free space by pushing all configurations from expansion steps towards the medial axis. We prove that this biasing increases the tree\\'s clearance from obstacles. Improving obstacle clearance is useful where path safety is important, e.g., path planning for robots performing tasks in close proximity to the elderly. Finally, we experimentally analyze MARRT, emphasizing its ability to effectively map difficult passages while increasing obstacle clearance, and compare it to contemporary RRT techniques.

  20. Dopamine in the medial amygdala network mediates human bonding

    Science.gov (United States)

    Touroutoglou, Alexandra; Rudy, Tali; Salcedo, Stephanie; Feldman, Ruth; Hooker, Jacob M.; Dickerson, Bradford C.; Catana, Ciprian; Barrett, Lisa Feldman

    2017-01-01

    Research in humans and nonhuman animals indicates that social affiliation, and particularly maternal bonding, depends on reward circuitry. Although numerous mechanistic studies in rodents demonstrated that maternal bonding depends on striatal dopamine transmission, the neurochemistry supporting maternal behavior in humans has not been described so far. In this study, we tested the role of central dopamine in human bonding. We applied a combined functional MRI-PET scanner to simultaneously probe mothers’ dopamine responses to their infants and the connectivity between the nucleus accumbens (NAcc), the amygdala, and the medial prefrontal cortex (mPFC), which form an intrinsic network (referred to as the “medial amygdala network”) that supports social functioning. We also measured the mothers’ behavioral synchrony with their infants and plasma oxytocin. The results of this study suggest that synchronous maternal behavior is associated with increased dopamine responses to the mother’s infant and stronger intrinsic connectivity within the medial amygdala network. Moreover, stronger network connectivity is associated with increased dopamine responses within the network and decreased plasma oxytocin. Together, these data indicate that dopamine is involved in human bonding. Compared with other mammals, humans have an unusually complex social life. The complexity of human bonding cannot be fully captured in nonhuman animal models, particularly in pathological bonding, such as that in autistic spectrum disorder or postpartum depression. Thus, investigations of the neurochemistry of social bonding in humans, for which this study provides initial evidence, are warranted. PMID:28193868

  1. Voice Outcome after Gore-Tex Medialization Thyroplasty.

    Science.gov (United States)

    Elnashar, Ismail; El-Anwar, Mohammad; Amer, Hazem; Quriba, Amal

    2015-07-01

    Introduction Although medialization thyroplasty utilizing Gore-Tex (Gore and Associates, Newark, Delaware, United States) has been discussed in the literature, few reports have assessed voice quality afterward, and they did not use a full assessment protocol. Objective To assess the improvement in voice quality after medialization thyroplasty utilizing Gore-Tex in patients with glottic insufficiency of variable etiology. Methods Eleven patients with glottic insufficiency of different etiologies that failed compensation were operated by type 1 thyroplasty utilizing Gore-Tex. Pre- and postoperative (1 week, 3 months, and 6 months) voice assessment was done and statistical analysis was performed on the results. Results In all postoperative assessments, there was significant improvement in the grade of dysphonia (p Gore-Tex medialization provides reliable results for both subjective and objective voice parameters. It leads to a satisfactory restoration of voice whatever the etiology of glottic incompetence is. This technique is relatively easy and does not lead to major complications. Further studies with larger number of patients and more extended periods of follow-up are still required to assess the long-term results of the technique regarding voice quality and implant extrusion.

  2. Medial Epicondyle Fractures in the Pediatric Overhead Athlete.

    Science.gov (United States)

    Cruz, Aristides I; Steere, Joshua T; Lawrence, J Todd R

    2016-06-01

    The medial epicondyle serves as the proximal attachment of the medial ulnar collateral ligament and the origin of the flexor pronator musculature and as such it is responsible for resisting the main static and dynamic restraints to valgus force at the elbow. Fractures through the physis in the developing elbow are common and treatment remains controversial. Biomechanical modeling predicts that anterior should be the direction of greatest displacement. Anatomic considerations predict that anterior displacement should have the greatest effect on elbow stability and range of motion making the ulnar collateral ligament too loose in flexion and too tight in extension and potentially leading to valgus laxity in flexion and a block to full extension. In the elite overhead athlete, where elbow stability is critical both for sports performance and the long-term health of the elbow, assessment of anterior displacement is thus theoretically an important consideration. Standard radiographic views cannot adequately assess anterior displacement. Specialized radiographs and 3-dimensional modalities such as computerized tomography and magnetic resonance imaging can adequately assess anterior displacement and in the overhead athlete can sometimes aid in the decision-making process. Here, we present a review of the current literature and the rationale for a treatment algorithm for medial epicondyle fractures in the skeletally immature overhead athlete.

  3. The Fate of Old Memories after Medial Temporal Lobe Damage

    Science.gov (United States)

    Bayley, Peter J.; Hopkins, Ramona O.; Squire, Larry R.

    2008-01-01

    Damage to the hippocampal region and related medial temporal lobe structures (perirhinal, entorhinal, and parahippocampal cortices) impairs new learning (anterograde amnesia) as well as memory for information that was acquired before the damage occurred (retrograde amnesia). We assessed retrograde amnesia with the Autobiographical Memory Interview (AMI) and with a news events test in six patients with damage limited primarily to the hippocampal region (H group) and two patients with large medial temporal lobe lesions (MTL group). On the news event test, the H group exhibited temporally limited retrograde amnesia covering ∼5 years. On the same test, the MTL group exhibited an extensive retrograde amnesia covering decades. Nevertheless, performance was relatively spared for very remote time periods. On the AMI, all patients had intact remote autobiographical memory. Because our patients with hippocampal lesions, as well as our patients with large MTL lesions, performed normally on the AMI, patients who perform poorly on the same test presumably have damage beyond the hippocampus and related structures in the medial temporal lobe. The findings emphasize the difference in the extent of retrograde amnesia associated with hippocampal lesions and large MTL lesions. PMID:17182781

  4. Biomechanics of medial unicondylar in combination with patellofemoral knee arthroplasty.

    Science.gov (United States)

    Heyse, Thomas J; El-Zayat, Bilal F; De Corte, Ronny; Scheys, Lennart; Chevalier, Yan; Fuchs-Winkelmann, Susanne; Labey, Luc

    2014-01-01

    Modular bicompartmental knee arthroplasty (BKA) for treatment of medio-patellofemoral osteoarthritis (OA) should allow for close to normal kinematics in comparison with unicondylar knee arthroplasty (UKA) and the native knee. There is so far no data to support this. Six fresh frozen full leg cadaver specimens were prepared and mounted in a kinematic rig with six degrees of freedom for the knee joint. Three motion patterns were applied with the native knee and after sequential implantation of medial UKA and patellofemoral joint replacement (PFJ): passive flexion-extension, open chain extension, and squatting. During the loaded motions, quadriceps and hamstrings muscle forces were applied. Infrared cameras continuously recorded the trajectories of marker frames rigidly attached to femur, tibia and patella. Prior computer tomography allowed identification of coordinate frames of the bones. Strains in the collateral ligaments were calculated from insertion site distances. UKA led to a less adducted and internally rotated tibia and a more strained medial collateral ligament (MCL). Addition of a patellofemoral replacement led to a more posterior position of both femoral condyles, a more dorsally located tibiofemoral contact point and higher MCL strain with squatting. In comparison to UKA modular BKA leads to a more dorsal tibial contact point, a medial femoral condyle being located more posteriorly, and more MCL strain. Mainly the changes to the trochlear anatomy as introduced by PFJ may account for these differences. © 2014 Elsevier B.V. All rights reserved.

  5. An Isolated Medial Patellofemoral Ligament Reconstruction with Patellar Tendon Autograft

    Directory of Open Access Journals (Sweden)

    Dariusz Witoński

    2013-01-01

    Full Text Available The aim of the study was to evaluate the results of the medial patellofemoral ligament reconstruction with a medial strip of patellar tendon autograft after a minimum 2-year followup. Ten patients (10 knees were operated on by one surgeon, according to the modified technique, described by Camanho, without any bone plug at free graft end. The mean age of the patients was 27.2 years (ranging from 18 to 42 years. The mean follow-up period was 3 years and 7 months. All patients were reviewed prospectively. At the last follow-up visit, all the patients demonstrated a significant improvement in terms of patellofemoral joint stability, all aspects of the KOOS questionnaire, and Kujala et al.’s score (59.7 points preoperatively and 84.4 points at the last followup. No patient revealed recurrent dislocation. The SF-36 score revealed a significant improvement in bodily pain, general health, physical role functioning, social role functioning, and physical functioning domains. The described MPFL reconstruction with the use of the medial 1/3rd of patella tendon is an effective procedure that gives satisfactorily patellofemoral joint functions, improves the quality of life, and provides much pain relief. It is relatively simple, surgically not extensive, and economically cost-effective procedure.

  6. Bottom-up Visual Integration in the Medial Parietal Lobe.

    Science.gov (United States)

    Pflugshaupt, Tobias; Nösberger, Myriam; Gutbrod, Klemens; Weber, Konrad P; Linnebank, Michael; Brugger, Peter

    2016-03-01

    Largely based on findings from functional neuroimaging studies, the medial parietal lobe is known to contribute to internally directed cognitive processes such as visual imagery or episodic memory. Here, we present 2 patients with behavioral impairments that extend this view. Both had chronic unilateral lesions of nearly the entire medial parietal lobe, but in opposite hemispheres. Routine neuropsychological examination conducted >4 years after the onset of brain damage showed little deficits of minor severity. In contrast, both patients reported persistent unusual visual impairment. A comprehensive series of tachistoscopic experiments with lateralized stimulus presentation and comparison with healthy participants revealed partial visual hemiagnosia for stimuli presented to their contralesional hemifield, applying inferential single-case statistics to evaluate deficits and dissociations. Double dissociations were found in 4 experiments during which participants had to integrate more than one visual element, either through comparison or formation of a global gestalt. Against the background of recent neuroimaging findings, we conclude that of all medial parietal structures, the precuneus is the most likely candidate for a crucial involvement in such bottom-up visual integration. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  7. Medial vestibular connections with the hypocretin (orexin) system

    Science.gov (United States)

    Horowitz, Seth S.; Blanchard, Jane; Morin, Lawrence P.

    2005-01-01

    The mammalian medial vestibular nucleus (MVe) receives input from all vestibular endorgans and provides extensive projections to the central nervous system. Recent studies have demonstrated projections from the MVe to the circadian rhythm system. In addition, there are known projections from the MVe to regions considered to be involved in sleep and arousal. In this study, afferent and efferent subcortical connectivity of the medial vestibular nucleus of the golden hamster (Mesocricetus auratus) was evaluated using cholera toxin subunit-B (retrograde), Phaseolus vulgaris leucoagglutinin (anterograde), and pseudorabies virus (transneuronal retrograde) tract-tracing techniques. The results demonstrate MVe connections with regions mediating visuomotor and postural control, as previously observed in other mammals. The data also identify extensive projections from the MVe to regions mediating arousal and sleep-related functions, most of which receive immunohistochemically identified projections from the lateral hypothalamic hypocretin (orexin) neurons. These include the locus coeruleus, dorsal and pedunculopontine tegmental nuclei, dorsal raphe, and lateral preoptic area. The MVe itself receives a projection from hypocretin cells. CTB tracing demonstrated reciprocal connections between the MVe and most brain areas receiving MVe efferents. Virus tracing confirmed and extended the MVe afferent connections identified with CTB and additionally demonstrated transneuronal connectivity with the suprachiasmatic nucleus and the medial habenular nucleus. These anatomical data indicate that the vestibular system has access to a broad array of neural functions not typically associated with visuomotor, balance, or equilibrium, and that the MVe is likely to receive information from many of the same regions to which it projects.

  8. Bipartite Medial Cuneiform: Case Report and Retrospective Review of 1000 Magnetic Resonance (MR Imaging Studies

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    Geraldine H. Chang

    2014-01-01

    Full Text Available Objective. To present a unique case report of a Lisfranc fracture in a patient with a bipartite medial cuneiform and to evaluate the prevalence of the bipartite medial cuneiform in a retrospective review of 1000 magnetic resonance (MR imaging studies of the foot. Materials and Methods. Case report followed by a retrospective review of 1000 MR imaging studies of the foot for the presence or absence of a bipartite medial cuneiform. Results. The incidence of the bipartite medial cuneiform is 0.1%. Conclusion. A bipartite medial cuneiform is a rare finding but one with both clinical and surgical implications.

  9. Role of gastrocnemius-soleus muscle in forefoot force transmission at heel rise - A 3D finite element analysis.

    Science.gov (United States)

    Chen, Wen-Ming; Park, Jaeyoung; Park, Seung-Bum; Shim, Victor Phyau-Wui; Lee, Taeyong

    2012-06-26

    The functions of the gastrocnemius-soleus (G-S) complex and other plantar flexor muscles are to stabilize and control major bony joints, as well as to provide primary coordination of the foot during the stance phase of gait. Geometric positioning of the foot and transferring of plantar loads can be adversely affected when muscular control is abnormal (e.g., equinus contracture). Although manipulation of the G-S muscle complex by surgical intervention (e.g., tendo-Achilles lengthening) is believed to be effective in restoring normal plantar load transfer in the foot, there is lack of quantitative data supporting that notion. Thus, the objective of this study is to formulate a three-dimensional musculoskeletal finite element model of the foot to quantify the precise role of the G-S complex in terms of biomechanical response of the foot. The model established corresponds to a muscle-demanding posture during heel rise, with simulated activation of major extrinsic plantar flexors. In the baseline (reference) case, required muscle forces were determined from what would be necessary to generate the targeted resultant ground reaction forces. The predicted plantar load transfer through the forefoot plantar surface, as indicated by plantar pressure distribution, was verified by comparison with experimental observations. This baseline model served as a reference for subsequent parametric analysis, where muscle forces applied by the G-S complex were decreased in a step-wise manner. Adaptive changes of the foot mechanism, in terms of internal joint configurations and plantar stress distributions, in response to altered muscular loads were analyzed. Movements of the ankle and metatarsophalangeal joints, as well as forefoot plantar pressure peaks and pressure distribution under the metatarsal heads (MTHs), were all found to be extremely sensitive to reduction in the muscle load in the G-S complex. A 40% reduction in G-S muscle stabilization can result in dorsal-directed rotations

  10. Arthroscopic trans-portal deep medial collateral ligament pie-crusting release.

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    Atoun, Ehud; Debbi, Ronen; Lubovsky, Omri; Weiler, Andreas; Debbi, Eytan; Rath, Ehud

    2013-02-01

    Arthroscopic treatments of meniscal injuries of the knee are among the most common orthopaedic procedures performed. Adequate visualization of the posterior horn of the medial meniscus might be challenging, especially in patients with tight medial compartments. In these cases instrument manipulation in an attempt to reach the posterior horn of the meniscus can cause an iatrogenic chondral injury because of the narrow medial joint space. A transcutaneous medial collateral ligament (MCL) pie-crusting release facilitates expansion of the medial joint space in a case of a tight medial compartment. Nevertheless, it might cause injury to the superficial MCL, infection, and pain and injury to the saphenous nerve because of multiple needle punctures of the skin. We describe an inside-out, arthroscopic deep MCL pie-crusting release, which allows access to the medial meniscus through the anterior approach to provide good visualization of the footprint and sufficient working space.

  11. Multimodal intervention in older adults improves resting-state functional connectivity between the medial prefrontal cortex and medial temporal lobe.

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    Li, Rui; Zhu, Xinyi; Yin, Shufei; Niu, Yanan; Zheng, Zhiwei; Huang, Xin; Wang, Baoxi; Li, Juan

    2014-01-01

    The prefrontal cortex and medial temporal lobe are particularly vulnerable to the effects of aging. The disconnection between them is suggested to be an important cause of cognitive decline in normal aging. Here, using multimodal intervention training, we investigated the functional plasticity in resting-state connectivity of these two regions in older adults. The multimodal intervention, comprised of cognitive training, Tai Chi exercise, and group counseling, was conducted to explore the regional connectivity changes in the default-mode network, as well as changes in prefrontal-based voxel-wise connectivity in the whole brain. Results showed that the intervention selectively affected resting-state functional connectivity between the medial prefrontal cortex and medial temporal lobe. Moreover, the strength of resting-state functional connectivity between these regions correlated with individual cognitive performance. Our results suggest that multimodal intervention could postpone the effects of aging and improve the function of the regions that are most heavily influenced by aging, as well as play an important role in preserving the brain and cognition during old age.

  12. Multimodal intervention in older adults improves resting-state functional connectivity between the medial prefrontal cortex and medial temporal lobe

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    Rui eLi

    2014-03-01

    Full Text Available The prefrontal cortex and medial temporal lobe are particularly vulnerable to the effects of aging. The disconnection between them is suggested to be an important cause of cognitive decline in normal aging. Here, using multimodal intervention training, we investigated the functional plasticity in resting-state connectivity of these two regions in older adults. The multimodal intervention, comprised of cognitive training, Tai Chi exercise, and group counseling, was conducted to explore the regional connectivity changes in the default-mode network, as well as changes in prefrontal-based voxel-wise connectivity in the whole brain. Results showed that the intervention selectively affected resting-state functional connectivity between the medial prefrontal cortex and medial temporal lobe. Moreover, the strength of resting-state functional connectivity between these regions correlated with individual cognitive performance. Our results suggest that multimodal intervention could postpone the effects of aging and improve the function of the regions that are most heavily influenced by aging, as well as play an important role in preserving the brain and cognition during old age.Clinical Trial Registration: This trial was registered in the Chinese Clinical Trial Registry (ChiCTR (http://www.chictr.org: ChiCTR-PNRC-13003813.

  13. Neglected Achilles Tendon Rupture Treated with Flexor Hallucis Longus transfer with two turndown gastrocnemius fascia flap and reinforced with plantaris tendon.

    Science.gov (United States)

    Mao, Haijiao; Shi, Zengyuan; Xu, Dachuan; Liu, Zhenxin

    2015-09-01

    Neglected Achilles Tendon Ruptures are commonly seen by orthopaedic surgeons. In cases resistant to conservative treatment, a variety of surgical procedures have been utilized in the past. The senior -surgeon at our institution has utilized a technique -employing two turndown fascia flaps fashioned from the proximal Achilles tendon augmented by a tenomyodesis of the flexor hallucis longus and plantaris tendon. The purpose of this study was to assess the clinical outcome of all patients who underwent this procedure. The medical records of 10 cases that underwent this procedure were retrospectively reviewed. We completed data collection sets using the American Orthopaedic Foot and Ankle Society ankle-hind foot scores, isokinetic evaluation, and postoperative magnetic resonance imaging (MRI) at 1 year of follow-up. The mean American Orthopaedic Foot and Ankle Society ankle-hind foot scores improved from 64.4±3.54. Isokinetic testing at 30º/sec and 120º/sec revealed an mean deficits of 24.5%, respectively, in the plantar flexion peak torque of the involved ankle than non-involved ankle. The flexor hallucis longus tendon, gastrocnemius fascia flap and plantaris were well -integrated into the Achilles tendon forming a homogenous tendon, which was confirmed in MRI. Our subjective and objective data indicate that the reconstructive technique using flexor hallucis longus transfer with two turndown gastrocnemius fascia flaps and plantaris tendon is a good option for repairing large gap defect of Achilles tendon.

  14. Fracture of an unossified humeral medial epicondyle: use of magnetic resonance imaging for diagnosis

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    Tanabe, Katsuhisa; Miyamoto, Nao [Nishinomiya Municipal Central Hospital, Department of Orthopaedic Surgery, Nishinomiya (Japan)

    2016-10-15

    Fracture of the humeral medial epicondyle is a relatively common injury in children. Surgery is a good option for treatment, but correct diagnosis is important. Most fractures occur after the ossification of the medial epicondylar apophysis. If a fracture occurs before the ossification of the medial epicondyle, it is undetectable by radiographs. Here we report a case of an unossified medial epicondyle fracture of the humerus. A 9-year-old boy had persistent pain in the medial side of the right elbow after a fall. Despite his pain, he could move his injured elbow with a range from 60 to 90 . Radiographs and computed tomography showed neither fracture nor dislocation in the injured elbow, and soft tissue swelling was the only finding. Neither the trochlea nor the medial epicondyle was ossified. Magnetic resonance imaging showed that the medial epicondyle was separated from the medial metaphysis and displaced. This clear finding led us to surgical fixation. Under general anesthesia, valgus stress showed gross instability of the injured elbow. Two years after the operation, he had no complaints and could play sports with the same range of motion as the left elbow. It is important to keep in mind that medial epicondylar fractures may be hidden in a normal radiograph before the ossification of the medial epicondylar apophysis. (orig.)

  15. Arthroscopic decompressive medial release of the varus arthritic knee: Expanding the functional envelope.

    Science.gov (United States)

    Leon, H O; Blanco, C E; Guthrie, T B

    2001-05-01

    We present the rationale and technique for treating medial knee osteoarthritis by dynamically unloading the medial compartment of the knee. Recent advances in kinematic studies indicate a dynamic linkage between differing degrees of freedom in the knee joint. Both the adduction moment and the foot progression angle are important determinants of medial compartment loading. The medially osteoarthritic knee has progressive compromise of free motion in more than 1 plane. Arthroscopic decompressive medial release unloads the medial compartment by release of the medial capsule and medial collateral ligament in the presence of intact cruciate ligaments, which may allow a decreased adduction moment and decrease of the external rotation restraint in extension found in more severely osteoarthritic knees. A case series of 38 patients with medial gonarthrosis was treated by this technique at the Hermanos Ameijeiras Hospital in Havana, Cuba. All patients had good results without postoperative valgus instability or significant complications. We feel that this technique warrants further clinical and biomechanical study for its use in isolation or in combination with high tibial osteotomy or minimally invasive selective osteotomy for the treatment of medial gonarthrosis of the knee. A minimally invasive, selective approach to biomechanical factors in osteoarthritis may be combined with other modulating techniques in efforts to forestall or prevent the need for total joint replacement.

  16. Medial patellar ossification after patellar instability: a radiographic finding indicative of prior patella subluxation/dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Jerabek, Seth A. [Harvard Combined Orthopaedic Surgery Residency Program, Boston, MA (United States); Asnis, Peter D.; Poon, Steven K.; Gill, Thomas J. [Massachusetts General Hospital, Department of Orthopaedic Surgery, Boston, MA (United States); Bredella, Miriam A.; Ouellette, Hugue A. [Massachusetts General Hospital, Department of Radiology, Boston, MA (United States)

    2009-08-15

    To describe the correlation between medial patellar ossification and prior patella subluxation and/or dislocation. A retrospective billing database search identified 544 patients who had been diagnosed with patellar instability over a 13-year period. One hundred twenty-eight patients met the inclusion criteria. After review by a staff orthopedic surgeon and two musculoskeletal radiologists, 28 patients were found to have medial patellar ossification. The size and location of medial patellar ossification was recorded. Of the 28 patients (20 males, eight females, age 13-66 years, mean 28 years) who were found to have medial patellar ossification, 22 had radiographs, 16 had magnetic resonance imaging, and ten had both. The medial patellar ossification ranged in size from 2 to 18 mm with an average of 6.8 mm. Twelve were located in the medial patellofemoral ligament (MPFL), 14 in the medial joint capsule, and two in both the MPFL and joint capsule. Twenty-seven of 28 patients had a single ossification, and one patient had two ossifications. The timing from injury to first imaging of the lesion ranged from 10 days to a chronic history ({>=}35 years) of patellar instability. Medial patellar ossification correlates with a history of prior patella subluxation and/or dislocation. The medial ossification can be seen within the MPFL or the medial joint capsule, suggesting remote injury to these structures. The presence of this lesion will prompt physicians to evaluate for patellar instability. (orig.)

  17. The effect of different depths of medial heel skive on plantar pressures

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    Bonanno Daniel R

    2012-08-01

    Full Text Available Abstract Background Foot orthoses are often used to treat lower limb injuries associated with excessive pronation. There are many orthotic modifications available for this purpose, with one being the medial heel skive. However, empirical evidence for the mechanical effects of the medial heel skive modification is limited. This study aimed to evaluate the effect that different depths of medial heel skive have on plantar pressures. Methods Thirty healthy adults (mean age 24 years, range 18–46 with a flat-arched or pronated foot posture and no current foot pain or deformity participated in this study. Using the in-shoe pedar-X® system, plantar pressure data were collected for the rearfoot, midfoot and forefoot while participants walked along an 8 metre walkway wearing a standardised shoe. Experimental conditions included a customised foot orthosis with the following 4 orthotic modifications: (i no medial heel skive, (ii a 2 mm medial heel skive, (iii a 4 mm medial heel skive and (iv a 6 mm medial heel skive. Results Compared to the foot orthosis with no medial heel skive, statistically significant increases in peak pressure were observed at the medial rearfoot – there was a 15% increase (p = 0.001 with the 4 mm skive and a 29% increase (p  Conclusions This study found that a medial heel skive of 4 mm or 6 mm increases peak pressure under the medial rearfoot in asymptomatic adults with a flat-arched or pronated foot posture. Plantar pressures at the midfoot and forefoot were not altered by a medial heel skive of 2, 4 or 6 mm. These findings provide some evidence for the effects of the medial heel skive orthotic modification.

  18. Medial tibial pain: a dynamic contrast-enhanced MRI study.

    Science.gov (United States)

    Mattila, K T; Komu, M E; Dahlström, S; Koskinen, S K; Heikkilä, J

    1999-09-01

    The purpose of this study was to compare the sensitivity of different magnetic resonance imaging (MRI) sequences to depict periosteal edema in patients with medial tibial pain. Additionally, we evaluated the ability of dynamic contrast-enhanced imaging (DCES) to depict possible temporal alterations in muscular perfusion within compartments of the leg. Fifteen patients with medial tibial pain were examined with MRI. T1-, T2-weighted, proton density axial images and dynamic and static phase post-contrast images were compared in ability to depict periosteal edema. STIR was used in seven cases to depict bone marrow edema. Images were analyzed to detect signs of compartment edema. Region-of-interest measurements in compartments were performed during DCES and compared with controls. In detecting periosteal edema, post-contrast T1-weighted images were better than spin echo T2-weighted and proton density images or STIR images, but STIR depicted the bone marrow edema best. DCES best demonstrated the gradually enhancing periostitis. Four subjects with severe periosteal edema had visually detectable pathologic enhancement during DCES in the deep posterior compartment of the leg. Percentage enhancement in the deep posterior compartment of the leg was greater in patients than in controls. The fast enhancement phase in the deep posterior compartment began slightly slower in patients than in controls, but it continued longer. We believe that periosteal edema in bone stress reaction can cause impairment of venous flow in the deep posterior compartment. MRI can depict both these conditions. In patients with medial tibial pain, MR imaging protocol should include axial STIR images (to depict bone pathology) with T1-weighted axial pre and post-contrast images, and dynamic contrast enhanced imaging to show periosteal edema and abnormal contrast enhancement within a compartment.

  19. Voice Outcome after Gore-Tex Medialization Thyroplasty

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    Elnashar, Ismail

    2015-02-01

    Full Text Available Introduction Although medialization thyroplasty utilizing Gore-Tex (Gore and Associates, Newark, Delaware, United States has been discussed in the literature, few reports have assessed voice quality afterward, and they did not use a full assessment protocol. Objective To assess the improvement in voice quality after medialization thyroplasty utilizing Gore-Tex in patients with glottic insufficiency of variable etiology. Methods Eleven patients with glottic insufficiency of different etiologies that failed compensation were operated by type 1 thyroplasty utilizing Gore-Tex. Pre- and postoperative (1 week, 3 months, and 6 months voice assessment was done and statistical analysis was performed on the results. Results In all postoperative assessments, there was significant improvement in the grade of dysphonia (p < 0.004 and highly significant reduction in the size of glottic gap and prolongation of maximum phonation time (p < 0.0001. The difference in voice parameters in the early (1 week and the late (3 and 6 months postoperative period was not significant. None of the patients developed stridor or shortness of breath necessitating tracheotomy, and there was no implant extrusion in any patient during the study period. Conclusion Gore-Tex medialization provides reliable results for both subjective and objective voice parameters. It leads to a satisfactory restoration of voice whatever the etiology of glottic incompetence is. This technique is relatively easy and does not lead to major complications. Further studies with larger number of patients and more extended periods of follow-up are still required to assess the long-term results of the technique regarding voice quality and implant extrusion.

  20. Clinical Outcomes After Suture Anchor Repair of Recalcitrant Medial Epicondylitis.

    Science.gov (United States)

    Grawe, Brian M; Fabricant, Peter D; Chin, Christopher S; Allen, Answorth A; DePalma, Brian J; Dines, David M; Altchek, David W; Dines, Joshua S

    2016-01-01

    This study evaluated clinical and patient-reported outcomes and return to sport after surgical treatment of medial epicondylitis with suture anchor fixation. Consecutive patients were evaluated after undergoing debridement and suture anchor repair of the flexor-pronator mass for the treatment of medial epicondylitis. Demographic variables, a short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, Oxford Elbow Score (OES), and 10-point pain and satisfaction scales were collected. Ability and time to return to sport after surgery were evaluated, and the relationship between predictor variables and both elbow function and return to sport was investigated. Median age at the time of surgery was 55 years (range, 29-65 years), with median follow-up of 40 months (range, 12-67 months). Median QuickDASH score and OES at final follow-up were 2.3 (range, 0-38.6) and 45 (range, 22-48), respectively. Most patients returned to premorbid sporting activities at a median of 4.5 months (range, 2.5-12 months), whereas 4 patients (14%) reported significant limitations at final follow-up. Older age at the time of surgery was predictive of better QuickDASH score and OES (P=.05 and P=.02, respectively). Patients who underwent surgery after a shorter duration of symptoms had better outcomes, but the difference did not reach statistical significance (QuickDASH, P=.09; OES, P=.10). Surgical treatment of recalcitrant medial epicondylitis with suture anchor fixation offers good pain relief and patient satisfaction, with little residual disability. Older age at the time of surgery predicts a better outcome.

  1. Isolated medial incisional approach to subtalar and talonavicular arthrodesis.

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    Weinraub, Glenn M; Schuberth, John M; Lee, Michael; Rush, Shannon; Ford, Lawrence; Neufeld, Jason; Yu, Jenny

    2010-01-01

    Triple arthrodesis is commonly used to correct complex deformity with hindfoot valgus. The authors use an isolated medial incisional approach for subtalar and talonavicular joint arthrodesis to correct hindfoot deformity, including high degrees of hindfoot valgus. To assess outcomes achieved with this approach, we reviewed the records of 45 patients from the practices of 5 surgeons. Independent variables evaluated included patient age, primary pathology, use of biologic agents, operative time, time to union, and complications. The median patient age was 57 years (range, 14-78 years). Pathology leading to fusion included 27 (60%) posterior tibial tendon dysfunction, 6 (13.3%) tarsal coalition, 7 (5.5%) degenerative joint disease, 2 (4.4%) rheumatoid arthritis, and 1 (2.2%) each, with Charcot neuroarthropathy, multiple sclerosis, and poliomyelitis. Orthobiological materials were used in 27 (60.0%) of the patients. The median duration of surgery was 87 minutes (range, 65-164 minutes), and the median time to successful arthrodesis was 8 weeks (range, 6-20 weeks). A complication was observed in 6 (13.3%) of the patients, including 1 each of the following: painful calcaneal-cuboid joint, talar fracture, incision dehiscence, poor exposure that required abandonment of the procedure, elevated first ray, and painful fixation. None of the patients experienced a nonunion or an adverse event related to the medial neurovascular structures. Based on our experience with the procedure, the single medial-incision subtalar and talonavicular joint arthrodesis is a useful alternative to triple arthrodesis for the correction of hindfoot valgus deformity. Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  2. [Chondropathy of the patella. Experiences with 100 medializations].

    Science.gov (United States)

    Villiger, K J

    1976-10-01

    After a brief reference to the biomechanics of the patellofemoral joint, the anamnesis and the clinical and the radiologic symptomatology of chondropathia and the possibilities of its therapy are described. Patellofemoral arthrography is very helpful for the diagnosis. The technique of our operation is also described. After close study of current available literature and careful control of our 100 medialization cases, the results after 6, 12, 24, and 36 months are shown in tabular form. The operation is recommended for primary chondropathia patellae with lateroposition or lateral-tipped patella.

  3. Visualization of the medial forebrain bundle using diffusion tensor imaging

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    Ardian eHana

    2015-10-01

    Full Text Available Diffusion tensor imaging is a technique that enables physicians the portrayal of white matter tracts in vivo. We used this technique in order to depict the medial forebrain bundle in 15 consecutive patients between 2012 and 2015. Men and women of all ages were included. There were 6 women and 9 men. The mean age was 58,6 years (39-77. Nine patients were candidates for an eventual deep brain stimulation. Eight of them suffered from Parkinson`s disease and one had multiple sclerosis. The remaining 6 patients suffered from different lesions which were situated in the frontal lobe. These were 2 metastasis, 2 meningiomas, 1 cerebral bleeding and 1 glioblastoma. We used a 3DT1-sequence for the navigation. Furthermore T2- and DTI- sequences were performed. The FOV was 200 x 200 mm², slice thickness 2 mm, and an acquisition matrix of 96 x 96 yielding nearly isotropic voxels of 2 x 2 x 2 mm. 3-Tesla-MRI was carried out strictly axial using 32 gradient directions and one b0-image. We used Echo-Planar-Imaging (EPI and ASSET parallel imaging with an acceleration factor of 2. b-value was 800 s/mm². The maximal angle was 50°. Additional scanning time was less than 9 minutes. We were able to visualize the medial forebrain bundle in 12 of our patients bilaterally and in the remaining 3 patients we depicted the medial forebrain bundle on one side. It was the contralateral side of the lesion. These were 2 meningiomas and one metastasis. Portrayal of the medial forebrain bundle is possible for everyday routine for neurosurgical interventions. As part of the reward circuitry it might be of substantial importance for neurosurgeons during deep brain stimulation in patients with psychiatric disorders. Furthermore it might explain at a certain extent character changes in patients with lesions in the frontal lobe. Surgery in this part of the brain should always take the preservation of this white matter tract into account.

  4. Foot posture in people with medial compartment knee osteoarthritis

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    Feller Julian A

    2010-12-01

    Full Text Available Abstract Background Foot posture has long been considered to contribute to the development of lower limb musculoskeletal conditions as it may alter the mechanical alignment and dynamic function of the lower limb. This study compared foot posture in people with and without medial compartment knee osteoarthritis (OA using a range of clinical foot measures. The reliability of the foot measures was also assessed. Methods The foot posture of 32 patients with clinically and radiographically-confirmed OA predominantly in the medial compartment of the knee and 28 asymptomatic age-matched healthy controls was investigated using the foot posture index (FPI, vertical navicular height and drop, and the arch index. Independent t tests and effect size (Cohen's d were used to investigate the differences between the groups in the foot posture measurements. Results Significant differences were found between the control and the knee OA groups in relation to the FPI (1.35 ± 1.43 vs. 2.46 ± 2.18, p = 0.02; d = 0.61, medium effect size, navicular drop (0.02 ± 0.01 vs. 0.03 ± 0.01, p = 0.01; d = 1.02, large effect size and the arch index (0.22 ± 0.04 vs. 0.26 ± 0.04, p = 0.04; d = 1.02, large effect size. No significant difference was found for vertical navicular height (0.24 ± 0.03 vs. 0.23 ± 0.03, p = 0.54; d = 0.04, negligible effect size. Conclusion People with medial compartment knee OA exhibit a more pronated foot type compared to controls. It is therefore recommended that the assessment of patients with knee OA in clinical practice should include simple foot measures, and that the potential influence of foot structure and function on the efficacy of foot orthoses in the management of medial compartment knee OA be further investigated.

  5. Considerations for the Management of Medial Orbital Wall Blowout Fracture

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    Park, Youngsoo; Chung, Kyu Jin

    2016-01-01

    Recently, diagnoses of and operations for medial orbital blowout fracture have increased because of the development of imaging technology. In this article, the authors review the literature, and overview the accumulated knowledge about the orbital anatomy, fracture mechanisms, surgical approaches, reconstruction materials, and surgical methods. In terms of surgical approaches, transcaruncular, transcutaneous, and transnasal endoscopic approaches are discussed. Reconstruction methods including onlay covering, inlay implantation, and repositioning methods are also discussed. Consideration and understanding of these should lead to more optimal outcomes. PMID:27218019

  6. Open Wedge High Tibial Osteotomy and Combined Arthroscopic Surgery in Severe Medial Osteoarthritis and Varus Malalignment: Minimum 5-Year Results

    OpenAIRE

    Yoo, Moon-Jib; Shin, Yong-Eun

    2016-01-01

    Purpose To evaluate the radiologic and functional outcomes of medial open wedge high tibial osteotomy (HTO) combined with arthroscopic procedure in patients with medial osteoarthritis. Materials and Methods From June 1996 to March 2010, 26 patients (32 knees) who underwent medial open wedge osteotomy and arthroscopic operation for medial osteoarthritis were retrospectively reviewed. Measurements included hip-knee-ankle (HKA) angle, femorotibial angle, medial proximal tibial angle, posterior t...

  7. Reconstruction of medial patellofemoral ligament using quadriceps tendon combined with reconstruction of medial patellotibial ligament using patellar tendon: initial experience☆

    Science.gov (United States)

    Hinckel, Betina Bremer; Gobbi, Riccardo Gomes; Bonadio, Marcelo Batista; Demange, Marco Kawamura; Pécora, José Ricardo; Camanho, Gilberto Luis

    2016-01-01

    Objective To describe a surgical technique for anatomical reconstruction of the medial patellofemoral ligament using the quadriceps tendon, combined with reconstruction of the medial patellotibial ligament using the patellar tendon; and to present the initial results from a case series. Method The proposed technique was used on a series of cases of patients with diagnoses of patellofemoral instability and indications for surgical treatment, who were attended by the Knee Group of HC-IOT, University of São Paulo. The following were evaluated before and after the operation: range of motion (ROM), apprehension test, lateral translation test, patellar inclination test, inverted J sign, subluxation upon extension, pain from compression of the patella and pain from contraction of the quadriceps. After the operation, the patients were asked whether any new episode of dislocation had occurred, what their degree of satisfaction with the surgery was (on a scale from 0 to 10) and whether they would be prepared to go through this operation again. Results Seven knees were operated, in seven patients, with a mean follow-up of 5.46 months (±2.07). Four patients who presented apprehension before the operation did not show this after the operation. The lateral translation test became normal for all the patients, while the patellar inclination test remained positive for two patients. The patients with an inverted J sign continued to be positive for this sign. Five patients were positive for subluxation upon extension before the operation, but all patients were negative for this after the operation. None of the patients presented any new episode of dislocation of the patella. All of them stated that they were satisfied: five gave a satisfaction score of 9 and two, a score of 10. All of them said that they would undergo the operation again. Only one patient presented a postoperative complication: dehiscence of the wound. Conclusion Reconstruction of the medial patellofemoral ligament

  8. Reconstruction of medial patellofemoral ligament using quadriceps tendon combined with reconstruction of medial patellotibial ligament using patellar tendon: initial experience

    Directory of Open Access Journals (Sweden)

    Betina Bremer Hinckel

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To describe a surgical technique for anatomical reconstruction of the medial patellofemoral ligament using the quadriceps tendon, combined with reconstruction of the medial patellotibial ligament using the patellar tendon; and to present the initial results from a case series. METHOD: The proposed technique was used on a series of cases of patients with diagnoses of patellofemoral instability and indications for surgical treatment, who were attended by the Knee Group of HC-IOT, University of São Paulo. The following were evaluated before and after the operation: range of motion (ROM, apprehension test, lateral translation test, patellar inclination test, inverted J sign, subluxation upon extension, pain from compression of the patella and pain from contraction of the quadriceps. After the operation, the patients were asked whether any new episode of dislocation had occurred, what their degree of satisfaction with the surgery was (on a scale from 0 to 10 and whether they would be prepared to go through this operation again. RESULTS: Seven knees were operated, in seven patients, with a mean follow-up of 5.46 months (±2.07. Four patients who presented apprehension before the operation did not show this after the operation. The lateral translation test became normal for all the patients, while the patellar inclination test remained positive for two patients. The patients with an inverted J sign continued to be positive for this sign. Five patients were positive for subluxation upon extension before the operation, but all patients were negative for this after the operation. None of the patients presented any new episode of dislocation of the patella. All of them stated that they were satisfied: five gave a satisfaction score of 9 and two, a score of 10. All of them said that they would undergo the operation again. Only one patient presented a postoperative complication: dehiscence of the wound. CONCLUSION: Reconstruction of the

  9. Modified endoscopic medial maxillectomy for zygomatic implant salvage

    Science.gov (United States)

    Tajudeen, Bobby A.; Adappa, Nithin D.; Palmer, James N.

    2016-01-01

    Objectives: Odontogenic chronic rhinosinusitis (CRS) is an epidemiologically important disease process due, in part, to the increasingly commonplace use of dental restorative procedures such as zygomatic implantation. Traditional management of this clinical entity typically entails extraction of the infected hardware via an open or endoscopic approach. We describe a novel management strategy of odontogenic CRS following bilateral zygomatic implantation for oral rehabilitation that we surgically salvaged via a modified endoscopic medial maxillectomy. Methods: We describe the presentation and management of a case of metachronous development of bilateral CRS subsequent to zygomatic implantation. Results: The patient's postoperative course was characterized by marked endoscopic, radiologic, and symptomatic improvement as measured by the 22-item Sino-Nasal Outcome Test. Conclusion: We describe a novel treatment strategy for the management of odontogenic sinusitis resulting from erroneous zygomatic implant placement. Modified endoscopic medial maxillectomy in this clinical context facilitates mucosal normalization of the affected sinus, while permitting preservation of oral function through salvage of the displaced implant. PMID:28107147

  10. MRI parcellation of ex vivo medial temporal lobe.

    Science.gov (United States)

    Augustinack, Jean C; Magnain, Caroline; Reuter, Martin; van der Kouwe, André J W; Boas, David; Fischl, Bruce

    2014-06-01

    Recent advancements in radio frequency coils, field strength and sophisticated pulse sequences have propelled modern brain mapping and have made validation to biological standards - histology and pathology - possible. The medial temporal lobe has long been established as a pivotal brain region for connectivity, function and unique structure in the human brain, and reveals disconnection in mild Alzheimer's disease. Specific brain mapping of mesocortical areas affected with neurofibrillary tangle pathology early in disease progression provides not only an accurate description for location of these areas but also supplies spherical coordinates that allow comparison between other ex vivo cases and larger in vivo datasets. We have identified several cytoarchitectonic features in the medial temporal lobe with high resolution ex vivo MRI, including gray matter structures such as the entorhinal layer II 'islands', perirhinal layer II-III columns, presubicular 'clouds', granule cell layer of the dentate gyrus as well as lamina of the hippocampus. Localization of Brodmann areas 28 and 35 (entorhinal and perirhinal, respectively) demonstrates MRI based area boundaries validated with multiple methods and histological stains. Based on our findings, both myelin and Nissl staining relate to contrast in ex vivo MRI. Precise brain mapping serves to create modern atlases for cortical areas, allowing accurate localization with important applications to detecting early disease processes. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Medial Orbitofrontal Cortex Is Associated with Fatigue Sensation

    Directory of Open Access Journals (Sweden)

    Seiki Tajima

    2010-01-01

    Full Text Available Fatigue is an indispensable bioalarm to avoid exhaustive state caused by overwork or stresses. It is necessary to elucidate the neural mechanism of fatigue sensation for managing fatigue properly. We performed H2O  15 positron emission tomography scans to indicate neural activations while subjects were performing 35-min fatigue-inducing task trials twice. During the positron emission tomography experiment, subjects performed advanced trail-making tests, touching the target circles in sequence located on the display of a touch-panel screen. In order to identify the brain regions associated with fatigue sensation, correlation analysis was performed using statistical parametric mapping method. The brain region exhibiting a positive correlation in activity with subjective sensation of fatigue, measured immediately after each positron emission tomography scan, was located in medial orbitofrontal cortex (Brodmann's area 10/11. Hence, the medial orbitofrontal cortex is a brain region associated with mental fatigue sensation. Our findings provide a new perspective on the neural basis of fatigue.

  12. Function of the medial meniscus in force transmission and stability.

    Science.gov (United States)

    Walker, Peter S; Arno, Sally; Bell, Christopher; Salvadore, Gaia; Borukhov, Ilya; Oh, Cheongeun

    2015-06-01

    We studied the combined role of the medial meniscus in distributing load and providing stability. Ten normal knees were loaded in combinations of compressive and shear loading as the knee was flexed over a full range. A digital camera tracked the motion, from which femoral-tibial contacts were determined by computer modelling. Load transmission was determined from the Tekscan for the anterior horn, central body, posterior horn, and the uncovered cartilage in the centre of the meniscus. For the three types of loading; compression only, compression and anterior shear, compression and posterior shear; between 40% and 80% of the total load was transmitted through the meniscus. The overall average was 58%, the remaining 42% being transmitted through the uncovered cartilage. The anterior horn was loaded only up to 30 degrees flexion, but played a role in controlling anterior femoral displacement. The central body was loaded 10-20% which would provide some restraint to medial femoral subluxation. Overall the posterior horn carried the highest percentage of the shear load, especially after 30 degrees flexion when a posterior shear force was applied, where the meniscus was estimated to carry 50% of the shear force. This study added new insights into meniscal function during weight bearing conditions, particularly its role in early flexion, and in transmitting shear forces.

  13. Increased Intrinsic Activity of Medial-Temporal Lobe Subregions is Associated with Decreased Cortical Thickness of Medial-Parietal Areas in Patients with Alzheimer's Disease Dementia.

    Science.gov (United States)

    Pasquini, Lorenzo; Scherr, Martin; Tahmasian, Masoud; Myers, Nicholas E; Ortner, Marion; Kurz, Alexander; Förstl, Hans; Zimmer, Claus; Grimmer, Timo; Akhrif, Atae; Wohlschläger, Afra M; Riedl, Valentin; Sorg, Christian

    2016-01-01

    In Alzheimer's disease (AD), disrupted connectivity between medial-parietal cortices and medial-temporal lobes (MTL) is linked with increased MTL local functional connectivity, and parietal atrophy is associated with increased MTL memory activation. We hypothesized that intrinsic activity in MTL subregions is increased and associated with medial-parietal degeneration and impaired memory in AD. To test this hypothesis, resting-state-functional and structural-MRI was assessed in 22 healthy controls, 22 mild cognitive impairment patients, and 21 AD-dementia patients. Intrinsic activity was measured by power-spectrum density of blood-oxygenation-level-dependent signal, medial-parietal degeneration by cortical thinning. In AD-dementia patients, intrinsic activity was increased for several right MTL subregions. Raised intrinsic activity in dentate gyrus and cornu ammonis 1 was associated with cortical thinning in posterior cingulate cortices, and at-trend with impaired delayed recall. Critically, increased intrinsic activity in the right entorhinal cortex was associated with ipsilateral posterior cingulate degeneration. Our results provide evidence that in AD, intrinsic activity in MTL subregions is increased and associated with medial-parietal atrophy. Results fit a model in which medial-parietal degeneration contributes to MTL dysconnectivity from medial-parietal cortices, potentially underpinning disinhibition-like changes in MTL activity.

  14. Medial Elbow Exposure for Coronoid Fractures: FCU-Split Versus Over-the-Top

    Science.gov (United States)

    2013-12-01

    margin of the mass anteriorly) was split and the pronator teres was released from the medial epicondyle and reflected off the anterior elbow capsule and...ORIGINAL ARTICLE Medial Elbow Exposure for Coronoid Fractures: FCU-Split Versus Over-the-Top Jeannie Huh, MD,* Chad A. Krueger, MD,* Michael J...fractures is unknown. The purpose of this study was to quantitatively compare the osseous and ligamentous exposure of the medial elbow using the flexor

  15. Comparison Of Medial Arch-Supporting Insoles And Heel Pads In The Treatment Of Plantar Fasciitis

    Directory of Open Access Journals (Sweden)

    Malkoc Melih

    2015-03-01

    Full Text Available Plantar fasciitis is a disorder caused by inflammation of the insertion point of the plantar fascia over the medial tubercle of the calcaneus. Foot orthotics are used to treat plantar fasciitis. Heel pads medialise the centre of force, whereas medial arch supporting insoles lateralise the force. We assessed the clinical results of the treatment of plantar fasciitis with silicone heel pads and medial arch-supported silicone insoles.

  16. The mechanical benefit of medial support screws in locking plating of proximal humerus fractures.

    Directory of Open Access Journals (Sweden)

    Wen Zhang

    Full Text Available BACKGROUND: The purpose of this study was to evaluate the biomechanical advantages of medial support screws (MSSs in the locking proximal humeral plate for treating proximal humerus fractures. METHODS: Thirty synthetic left humeri were randomly divided into 3 subgroups to establish two-part surgical neck fracture models of proximal humerus. All fractures were fixed with a locking proximal humerus plate. Group A was fixed with medial cortical support and no MSSs; Group B was fixed with 3 MSSs but without medial cortical support; Group C was fixed with neither medial cortical support nor MSSs. Axial compression, torsional stiffness, shear stiffness, and failure tests were performed. RESULTS: Constructs with medial support from cortical bone showed statistically higher axial and shear stiffness than other subgroups examined (P<0.0001. When the proximal humerus was not supported by medial cortical bone, locking plating with medial support screws exhibited higher axial and torsional stiffness than locking plating without medial support screws (P ≤ 0.0207. Specimens with medial cortical bone failed primarily by fracture of the humeral shaft or humeral head. Specimens without medial cortical bone support failed primarily by significant plate bending at the fracture site followed by humeral head collapse or humeral head fracture. CONCLUSIONS: Anatomic reduction with medial cortical support was the stiffest construct after a simulated two-part fracture. Significant biomechanical benefits of MSSs in locking plating of proximal humerus fractures were identified. The reconstruction of the medial column support for proximal humerus fractures helps to enhance mechanical stability of the humeral head and prevent implant failure.

  17. Estudo anatômico das válvulas do tronco gastrocnêmio em cadáveres humanos Anatomical study of valves in the gastrocnemius trunk in human cadavers

    Directory of Open Access Journals (Sweden)

    José Aderval Aragão

    2007-06-01

    Full Text Available CONTEXTO: As válvulas são estruturas características das veias, importantes na orientação do fluxo sangüíneo. Sua presença no sistema venoso superficial dos membros inferiores tem sido bastante estudada. No entanto, nas veias profundas, como a veia gastrocnêmia, a literatura é escassa. OBJETIVO: Realizar um estudo anatômico das válvulas do tronco gastrocnêmio principal em cadáveres humanos adultos. MÉTODOS: Foram dissecados os troncos gastrocnêmios principais de 80 cabeças de músculos gastrocnêmios de 20 cadáveres adultos do sexo masculino, com idade entre 40 e 68 anos, após fixados e mantidos em solução de formol a 10%. Os troncos e tipos de redes foram classificados de acordo com o proposto por Aragão et al. As válvulas foram estudadas quanto ao número, distribuição, localização e tipo com relação ao tronco, perna, cabeça do músculo e tipo de rede gastrocnêmia. RESULTADO: Em 80 cabeças de músculos gastrocnêmios, foram encontrados 95 troncos gastrocnêmios principais, sendo que 17 deles eram duplicados. Foram encontradas 65 válvulas em 60 troncos gastrocnêmios principais, todas elas do tipo bicúspide, sendo 35 na rede tipo I, 23 na do tipo II e sete na rede tipo III. Em 74% dos casos, as válvulas estavam localizadas no terço proximal do tronco gastrocnêmio principal. CONCLUSÃO: As válvulas foram encontradas em todos os tipos de redes que possuíam tronco gastrocnêmio principal, eram todas do tipo bicúspide e se localizaram predominantemente no terço proximal dos troncos gastrocnêmios principais.BACKGROUND: Valves are characteristic structures of veins and are important to guide blood flow. Their presence in the superficial venous system of lower limbs has been well studied. However, there is a lack of published literature on deep veins, such as the gastrocnemius vein. OBJECTIVE: To carry out an anatomical study of the veins in the main gastrocnemius trunk in adult human cadavers. METHODS: The

  18. Anaphylaxis, Intra-Abdominal Infections, Skin Lacerations, and Behavioral Emergencies: A Literature Review of Austere Analogs for a near Earth Asteroid Mission

    Science.gov (United States)

    Chough, Natacha G.; Watkins, Sharmi; Menon, Anil S.

    2012-01-01

    As space exploration is directed towards destinations beyond low-Earth orbit, the consequent new set of medical risks will drive requirements for new capabilities and more resources to ensure crew health. The Space Medicine Exploration Medical Conditions List (SMEMCL), developed by the Exploration Medical Capability element of the Human Research Program, addresses the risk of "unacceptable health and mission outcomes due to limitations of in-flight medical capabilities". It itemizes 85 evidence-based clinical requirements for eight different mission profiles and identifies conditions warranting further research and technology development. Each condition is given a clinical priority for each mission profile. Four conditions -- intra-abdominal infections, skin lacerations, anaphylaxis, and behavioral emergencies -- were selected as a starting point for analysis. A systematic literature review was performed to understand how these conditions are treated in austere, limited-resource, space-analog environments (i.e., high-altitude and mountain environments, submarines, military deployments, Antarctica, isolated wilderness environments, in-flight environments, and remote, resource-poor, rural environments). These environments serve as analogs to spaceflight because of their shared characteristics (limited medical resources, delay in communication, confined living quarters, difficulty with resupply, variable time to evacuation). Treatment of these four medical conditions in austere environments provides insight into medical equipment and training requirements for exploration-class missions.

  19. Treatment of open pelvic fractures with perineal laceration infection%开放性骨盆骨折会阴撕裂感染的治疗

    Institute of Scientific and Technical Information of China (English)

    陈戈; 李滔; 陈仲; 赵航; 吴照祥; 杨洪昌

    2011-01-01

    Objective To evaluate the effect of external fixator,colostomy,repeated debridement and vacuum-assisted closure (VAC) to treat open pelvic fractures concomitant with perineal laceration and infection.Methods A retrospective analysis was made about 8 cases of open pelvic fractures concomitant with perineal laceration and infection from February 2004 to January 2011.It includes 7 men and 1 woman,with the average age of 36.3 years (ranged from 22 to 59 years).Five cases were injured by traffic accident,2 cases were fall-down from height,and 1 case was crushed by weight.Fractures type according to Tile:3 cases were type B,5 cases were type C.All cases were type I according to Faringer classification.All patients were treated with external fixator according to the displacement of pelvic fractures,early colostomy,repeated debridement,and after infection be controlled,VAC was used to close wound and drainage.Results The eight cases of open pelvic fractures concomitant with perineal laceration and infection were followed up from 6 to 36 months,with the average of 16 months.The infection was healed in all patients,and the body temperature and blood routine got normal.The period from injury to wound closing was from 8 to 43 days,with the average time of 17 days.According to the Majeed evaluation system,the pelvic fractures healing was evaluated after treatment:2 cases were excellent; 3 cases were good; 2 cases were fair;,1 case was poor;,the good to excellent rate was 62.5%.Conclusion The method of applying external fixator,colostomy,repeated debridement and VAC to treat open pelvic fractures concomitant with perineal laceration and infection is useful.The methods played an active role in controlling infection,reducing infection rates and mortality rates,and shortening the healing time.%目的 探讨应用骨盆外固定支架复位固定、结肠造瘘、反复清刨、创口封闭负压引流等措施治疗开放性骨盆骨折会阴撕裂感染的疗效.方法 2004年2

  20. Simultaneous MPFL and LPFL reconstruction for recurrent lateral patellar dislocation with medial patellofemoral instability

    Directory of Open Access Journals (Sweden)

    Masashi Kusano

    2014-01-01

    Full Text Available We report an extremely rare case of both recurrent lateral patella dislocation and medial patellofemoral instability, following prior operations to correct patella maltracking. Manual translation of the patella revealed medial and lateral instability with a positive apprehension sign. 3-D computer modelling of kinematics based on MRI data demonstrated that the patella deviated laterally at full extension and translated medially with knee flexion. The medial and lateral patellofemoral ligaments were reconstructed simultaneously with hamstring tendons, alleviating peripatellar pain and patellar instability in both directions.

  1. Medial tibial pain. A prospective study of its cause among military recruits.

    Science.gov (United States)

    Milgrom, C; Giladi, M; Stein, M; Kashtan, H; Margulies, J; Chisin, R; Steinberg, R; Swissa, A; Aharonson, Z

    1986-12-01

    In a prospective study of 295 infantry recruits during 14 weeks of basic training, 41% had medial tibial pain. Routine scintigraphic evaluation in cases of medial tibial bone pain showed that 63% had abnormalities. A stress fracture was found in 46%. Only two patients had periostitis. None had ischemic medial compartment syndrome. Physical examination could not differentiate between cases with medial tibial bone pain secondary to stress fractures and those with scintigraphically normal tibias. When both pain and swelling were localized in the middle one-third of the tibia, the lesion most likely proved to be a stress fracture.

  2. Missed Medial Malleolar Fracture Associated With Achilles Tendon Rupture: A Case Report and Literature Review.

    Science.gov (United States)

    Nakajima, Koji; Taketomi, Shuji; Inui, Hiroshi; Nakamura, Kensuke; Sanada, Takaki; Tanaka, Sakae

    2016-01-01

    A 45-year-old man sustained an Achilles tendon rupture while playing futsal. A concomitant medial malleolar fracture was not diagnosed until the patient underwent an operation for Achilles tendon repair. A routine postoperative radiograph showed a minimally displaced medial malleolar fracture. Conservative treatment was chosen for the fracture. The function of the Achilles tendon recovered well, and the fracture was united. A medial malleolar fracture can be missed when an Achilles tendon rupture occurs simultaneously. Thus, surgeons should consider the possibility of medial malleolar fracture associated with an Achilles tendon rupture. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  3. The effects of neuromuscular exercise on medial knee joint load post-arthroscopic partial medial meniscectomy: 'SCOPEX', a randomised control trial protocol

    DEFF Research Database (Denmark)

    Hall, Michelle; Hinman, Rana S; Wrigley, Tim V

    2012-01-01

    Meniscectomy is a risk factor for knee osteoarthritis, with increased medial joint loading a likely contributor to the development and progression of knee osteoarthritis in this group. Therefore, post-surgical rehabilitation or interventions that reduce medial knee joint loading have the potential...... to reduce the risk of developing or progressing osteoarthritis. The primary purpose of this randomised, assessor-blind controlled trial is to determine the effects of a home-based, physiotherapist-supervised neuromuscular exercise program on medial knee joint load during functional tasks in people who have...

  4. 肺挫裂伤31例CT与X线片诊断分析比较%31 Cases of CT with Pulmonary Contusion and Laceration in Comparison of Diagnosis and Analysis

    Institute of Scientific and Technical Information of China (English)

    李春洞

    2015-01-01

    目的:探讨多层螺旋CT及X线片对于肺挫裂伤的诊断价值。方法对31例临床怀疑肺挫裂伤的伤者进行临床随访、多层螺旋CT扫描、X线平片检查。并对多层螺旋CT扫描结果及X线平片检查结果进行分析。结果多层螺旋CT显示肺挫伤26例,裂伤5例。X线平片漏诊6例、误诊2例。结论多层螺旋CT能够明确诊断肺挫裂伤的部位、范围、性质、程度、合并症及进行鉴别诊断,为临床提供较X线平片更多的诊断信息、治疗依据。多层螺旋CT是目前诊断肺挫裂伤的最重要的检查方法。%Objective To explore diagnostic value of Multi-slice spiral CT (MSCT) and X-ray film on the pulmonary contusion and laceration.Methods MSCT scan and X-ray imaging were performed in 31 cases with suspected pulmonary contusion and laceration after clinical follow-up. The two sets of data were comparatively analysed.Results MSCT diagnosed 26 cases of pulmonary contusion, 5cases of laceration. X-ray missed 6 cases and misdiagnosed 2 cases.Conclusion The MSCT scan technology could definitely display the location, extent, nature, degree, complications and differential diagnosis of pulmonary contusion and laceration, providing more valuable diagnostic information and therapeutic basis than X-ray film. So MSCT is the most important method of the diagnosis of pulmonary laceration and contusion.

  5. 经外侧裂脑池开放减压治疗额颞对冲性脑挫裂伤%Opening cistern combined decompression by transsylvian surgical approach in treatment of severe bump contusion and laceration of brain

    Institute of Scientific and Technical Information of China (English)

    曾昭明; 郭予大; 邵强; 陈秋明; 冯志铁; 吴分浪

    2008-01-01

    Objective To summarize the clinical effects of opening cistern combined decompression of severe bump contusion and laceration of brain by transsylvian surgical approach. Methods Clinical data from 31 cases with severe bump contusion and laceration of brain in the decompression treatment combined with open-ing parasellar and basal cisterns by transsylvian surgical approach was analyzed retrospectively. Results Post- operative did not show visible brain edema in severe bump contusion and laceration of brain,2 cases died of brain exhaustion,2 cases died of severe complications. The Glasgow Outcome Score (COS) was determined at 3-6 months of follow-up for other 27 cases:20 cases had a good recovery,5 cases had moderate disability,2 cases were in a vegetative state. Conclusion Opening cistern combined decompression of severe bump contusion and laceration of brain by transsylvian surgical approach could alleviate secondary brain edema and improve the clin- ical effect for severe bump contusion and laceration of brain.%目的 总结经外侧裂脑池开放在对冲性脑挫裂伤减压术中的应用效果.方法 对31例额颞对冲性脑挫裂伤术中经外侧裂入路施行鞍旁脑池和基底池开放的患者进行临床资料的进行回顾性分析.结果 术后动态复查头颅CT,全部患者额颞脑挫裂伤区域未见明显脑水肿现象,2例死于脑功能衰竭,2例死于严重并发症.其余随访3~6个月,按GOS评分,良好20例,中残5例,植物状生存2例.结论 额颞对冲性脑挫裂伤术中经外侧裂施行鞍旁脑池和基底池开放减压可减轻继发性脑水肿,提高临床效果.

  6. Familial Discoid Medial Meniscus Tear in Three Members of a Family: A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Raheel Ahmed Ali

    2014-01-01

    Full Text Available Background. A discoid meniscus is a thickened variant of the normal C-shaped meniscus prone to injury. Discoid medial meniscal tears have rarely been reported within families and may suggest familial or developmental origins. Methods. We report the cases of two Caucasian brothers with symptomatic discoid medial meniscus tears. A literature review was conducted addressing discoid medial meniscus and cases of familial meniscus tears. Case Presentation. Physically active brothers presented with progressively worsening knee pain. MRI revealed medial meniscus tears in both brothers. The family history of medial meniscus tears in their mother and the discoid medial meniscus injuries found on arthroscopy suggested evidence for familial discoid medial meniscus tears. Conclusions. Discoid medial meniscus tears within a family have not been previously reported. Two cases of families with discoid lateral meniscus tears have been reported. Discoid medial meniscus is rare relative to the discoid lateral meniscus and predisposes children to symptomatic tears.

  7. Comparison of Medial and Lateral Meniscus Root Tears.

    Directory of Open Access Journals (Sweden)

    Ji Hyun Koo

    Full Text Available The meniscus root plays an essential role in maintaining the circumferential hoop tension and preventing meniscal displacement. Studies on meniscus root tears have investigated the relationship of osteoarthritis and an anterior cruciate ligament tear. However, few studies have directly compared the medial and lateral root tears. To assess the prevalence of meniscal extrusion and its relationship with clinical features in medial and lateral meniscus root tears, we performed a retrospective review of the magnetic resonance imaging (MRI results of 42 knee patients who had meniscus posterior horn root tears and who had undergone arthroscopic operations. The presence of meniscal extrusion was evaluated and the exact extent was measured from the tibial margin. The results were correlated with arthroscopic findings. Clinical features including patients' ages, joint abnormalities, and previous trauma histories were evaluated. Twenty-two patients had medial meniscus root tears (MMRTs and twenty patients had lateral meniscus root tears (LMRTs. Meniscal extrusion was present in 18 MMRT patients and one LMRT patient. The mean extent of extrusion was 4.2mm (range, 0.6 to 7.8 in the MMRT group and 0.9mm (range, -1.9 to 3.4 in the LMRT group. Five patients with MMRT had a history of trauma, while 19 patients with LMRT had a history of trauma. Three patients with MMRT had anterior cruciate ligament (ACL tears, while 19 patients with LMRT had ACL tears. The mean age of the patients was 52 years (range: 29-71 years and 30 years (range: 14-62 years in the MMRT and LMRT group, respectively. There was a significant correlation between a MMRT and meniscal extrusion (p<0.0001, and between an ACL tear and LMRT (p<0.0001. A history of trauma was significantly common in LMRT (p<0.0001. LMRT patients were significantly younger than MMRT patients (p<0.0001. Kellgren-Lawrence (K-L grade differed significantly between MMRT and LMRT group (p<0.0001. Meniscal extrusion is

  8. 胎头娩出速度控制助产防护产妇会阴裂伤的价值%Value of speed control midwifery fetal head protection for maternal perineal laceration

    Institute of Scientific and Technical Information of China (English)

    刘彩玲

    2015-01-01

    目的:探讨控制胎头娩出速度助产法在减少产妇会阴裂伤中的价值。方法选择2012年1月至2014年10月行阴道分娩的120例产妇为研究对象,随机将其分为对照组与研究组,每组60例,对照组产妇给予常规阴道助产保护,研究组产妇给予胎头娩出速度控制助产,比较两组会阴裂伤发生率及其裂伤程度、第二产程时间、产后出血量、住院时间。结果研究组会阴裂伤发生率、Ⅱ度裂伤率分别为18.33%、3.33%,对照组分别为40.00%、24.33%,两组比较比较差异有统计学意义(P <0.05)。产后出血量、住院时间研究组分别为(127.60±47.28)ml、(2.40±0.33)d,对照组分别为(179.52±89.35)ml、(3.43±0.62)d,两组比较差异均有统计学意义(P <0.05)。结论控制胎头娩出速度助产能明显减少产妇会阴裂伤发生率,减轻裂伤程度,缩短住院时间,值得临床推广。%Objective To investigate the valye of speed control midwifery fetal head protection for maternal perineal lacera-tion. Methods From Janyary 2012 to October 2014,one hyndrad and twenty patients with vaginal delivery were selected as the research objects,and they were randomly divided into control groyp and stydy groyp with 60 cases in each groyp. The control groyp was given the midwifery of roytine vaginal maternal protection,and the stydy groyp was given the midwifery of controlling the speed of fetal head. The incidence of perineal laceration,the degree of laceration,the second delivery process,the postpar-tym blood loss and the length of hospital stay were compared between the two groyps. Results The incidence of perineal lacera-tion and degree Ⅱ laceration rate of the observation groyp were 18. 33% and 3. 33% respectively,and 40. 00% and 24. 33% in the control groyp,the differences had statistically significant between the two groyps(P < 0. 05). In addition,the postpartym blood loss and the length of hospital

  9. Bucket handle tears of the medial meniscus: meniscal intrusion rather than meniscal extrusion

    Energy Technology Data Exchange (ETDEWEB)

    Schlossberg, S. [Jacobi Medical Center, Department of Radiology, Bronx, NY (United States); Umans, H. [Jacobi Medical Center, Department of Radiology, Bronx, NY (United States); Jacobi Medical Center, Department of Surgery Division of Orthopedic Surgery, Bronx, NY (United States); Flusser, G. [Tel Aviv Sourasky Medical Center, Department of Radiology, Tel Aviv (Israel); DiFelice, G.S. [Jacobi Medical Center, Department of Surgery Division of Orthopedic Surgery, Bronx, NY (United States); Lerer, D.B. [Montefiore Medical Center, Department of Radiology, Bronx, NY (United States)

    2007-01-15

    To determine the frequency of medial meniscal extrusion (MME) versus ''medial meniscal intrusion'' in the setting of bucket handle tears. Images were evaluated for previously reported risk factors for MME, including: medial meniscal root tear, radial tear, degenerative joint disease and joint effusion. Forty-one consecutive cases of bucket handle tear of the medial meniscus were reviewed by consensus by two musculoskeletal radiologists. Imaging was performed using a 1.5 GE Signa MR unit. Patient age, gender, medial meniscal root integrity, MME, medial meniscal intrusion, degenerative joint disease, effusion and anterior cruciate ligament (ACL) tear were recorded. Thirteen females and 27 males (age 12-62 years, median=30 years) were affected; one had bucket handle tear of each knee. Effusion was small in 13, moderate in 9 and large in 18. Degenerative joint disease was mild in three, moderate in two and severe in one. 26 ACL tears included three partial and three chronic. Medial meniscal root tear was complete in one case and partial thickness in two. None of the 40 cases with an intact or partially torn medial meniscal root demonstrated MME. MME of 3.1 mm was seen in the only full-thickness medial meniscal root tear, along with chronic ACL tear, moderate degenerative joint disease and large effusion. Medial meniscal intrusion of the central bucket handle fragment into the intercondylar notch was present in all 41 cases. Given an intact medial meniscal root in the setting of a ''pure'' bucket handle tear, there is no MME. (orig.)

  10. Effect of troxerutin on insulin signaling molecules in the gastrocnemius muscle of high fat and sucrose-induced type-2 diabetic adult male rat.

    Science.gov (United States)

    Sampath, Sathish; Karundevi, Balasubramanian

    2014-10-01

    Troxerutin is a trihydroxyethylated derivative of the flavonoid, rutin. It has been reported to possess the hepatoprotective, nephroprotective, antioxidant, anti-inflammatory, and antihyperlipidemic activities. Troxerutin treatment reduced the blood glucose and glycosylated hemoglobin levels in high-cholesterol-induced insulin-resistant mice and in type-2 diabetic patients. However, the mechanism by which it exhibits antidiabetic property was unknown. Therefore, the present study was designed to evaluate the effect of troxerutin on insulin signaling molecules in gastrocnemius muscle of high fat and sucrose-induced type-2 diabetic rats. Wistar male albino rats were selected and divided into five groups. Group I: Control. Group II: High fat and sucrose-induced type-2 diabetic rats. Group III: Type-2 diabetic rats treated with troxerutin (150 mg/kg body weight/day orally). Group IV: Type-2 diabetic rats treated with metformin (50 mg/kg body weight/day orally). Group V: Normal rats treated with troxerutin (150 mg/kg body weight/day orally). After 30 days of treatment, fasting blood glucose, oral glucose tolerance, serum lipid profile, and the levels of insulin signaling molecules, glycogen, glucose uptake, and oxidation in gastrocnemius muscle were assessed. Diabetic rats showed impairment in insulin signaling molecules (IR, p-IRS-1(Tyr632), p-Akt(Ser473), β-arrestin-2, c-Src, p-AS160(Thr642), and GLUT4 proteins), glycogen concentration, glucose uptake, and oxidation. Oral administration of troxerutin showed near normal levels of blood glucose, serum insulin, lipid profile, and insulin signaling molecules as well as GLUT4 proteins in type-2 diabetic rats. It is concluded from the present study that troxerutin may play a significant role in the management of type-2 diabetes mellitus, by improving the insulin signaling molecules and glucose utilization in the skeletal muscle.

  11. A new linearly-combined bi-exponential model for kinetic analysis of the isometric relaxation process of Bufo gastrocnemius under electric stimulation in vitro

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    There was a slow-relaxing tail of skeletal muscles in vitro upon the inhibition of Ca2+-pump by cyclopiazonic acid (CPA). Herein, a new linearly-combined bi-exponential model to resolve this slow-relaxing tail from the fast-relaxing phase was investigated for kinetic analysis of the isometric relaxation process of Bufo gastrocnemius in vitro, in comparison to the single exponential model and the classical bi-exponential model. During repetitive stimulations at a 2-s interval by square pulses of a 2-ms duration at 12 V direct currency (DC), the isometric tension of Bufo gastrocnemius was recorded at 100 Hz. The relaxation curve with tensions falling from 90% of the peak to the 15th datum before next stimulation was analyzed by three exponential models using a program in MATLAB 6.5. Both the goodness of fit and the distribution of the residuals for the best fitting supported the comparable validity of this new bi-exponential model for kinetic analysis of the relaxation process of the control muscles. After CPA treatment, however, this new bi-exponential model showed an obvious statistical superiority for kinetic analysis of the muscle relaxation process, and it gave the estimated rest tension consistent to that by experimentation, whereas both the classical bi-exponential model and the single exponential model gave biased rest tensions. Moreover, after the treatment of muscles by CPA, both the single exponential model and the classical bi-exponential model yielded lowered relaxation rates,nevertheless, this new bi-exponential model had relaxation rates of negligible changes except much higher rest tensions. These results suggest that this novel linearly-combined bi-exponential model is desirable for kinetic analysis of the relaxation process of muscles with altered Ca2+-pumping activity.

  12. The acute effects of unilateral ankle plantar flexors static- stretching on postural sway and gastrocnemius muscle activity during single-leg balance tasks.

    Science.gov (United States)

    Lima, Bráulio N; Lucareli, Paulo R G; Gomes, Willy A; Silva, Josinaldo J; Bley, Andre S; Hartigan, Erin H; Marchetti, Paulo H

    2014-09-01

    The aim of this study was to investigate the acute effects of unilateral ankle plantar flexors static- stretching on surface electromyography (sEMG) and the center of pressure (COP) during a single-leg balance task in both lower limbs. Fourteen young healthy, non-athletic individuals performed unipodal quiet standing for 30s before and after (stretched limb: immediately post-stretch, 10 and 20 minutes and non-stretched limb: immediately post-stretch) a unilateral ankle plantar flexor static- stretching protocol [6 sets of 45s/15s, 70-90% point of discomfort (POD)]. Postural sway was described using the COP area, COP speed (antero-posterior and medio-lateral directions) and COP frequency (antero-posterior and medio-lateral directions). Surface EMG (EMG integral [IEMG] and Median frequency[FM]) was used to describe the muscular activity of gastrocnemius lateralis. Ankle dorsiflexion passive range of motion increased in the stretched limb before and after the static-stretching protocol (mean ± SD: 15.0° ± 6.0 and 21.5° ± 7.0 [p stretch limb between pre-stretching and immediately post-stretching (p = 0.015 and p = 0.036, respectively). In conclusion, our static- stretching protocol effectively increased passive ankle ROM. The increased ROM appears to increase postural sway and muscle activity; however these finding were only a temporary or transient effect. Key PointsThe postural control can be affected by static- stretching protocol.The lateral gastrocnemius muscle action was increased after the static- stretching protocol.The static- stretching effects remain for less than 10 minutes.

  13. Using gastrocnemius sEMG and plasma α-synuclein for the prediction of freezing of gait in Parkinson's disease patients.

    Directory of Open Access Journals (Sweden)

    Xiao-Ying Wang

    Full Text Available Freezing of gait (FOG is a complicated gait disturbance in Parkinson's disease (PD and a relevant subclinical predictor algorithm is lacking. The main purpose of this study is to explore the potential value of surface electromyograph (sEMG and plasma α-synuclein levels as predictors of the FOG seen in PD. 21 PD patients and 15 normal controls were recruited. Motor function was evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS and Freezing of gait questionnaire (FOG-Q. Simultaneously, gait analysis was also performed using VICON capture system in PD patients and sEMG data was recorded as well. Total plasma α-synuclein was quantitatively assessed by Luminex assay in all participants. Recruited PD patients were classified into two groups: PD patients with FOG (PD+FOG and without FOG (PD-FOG, based on clinical manifestation, the results of the FOG-Q and VICON capture system. PD+FOG patients displayed higher FOG-Q scores, decreased walking speed, smaller step length, smaller stride length and prolonged double support time compared to the PD-FOG in the gait trial. sEMG data indicated that gastrocnemius activity in PD+FOG patients was significantly reduced compared to PD-FOG patients. In addition, plasma α-synuclein levels were significantly decreased in the PD+FOG group compared to control group; however, no significant difference was found between the PD+FOG and PD-FOG groups. Our study revealed that gastrocnemius sEMG could be used to evaluate freezing gait in PD patients, while plasma α-synuclein might discriminate freezing of gait in PD patients from normal control, though no difference was found between the PD+FOG and PD-FOG groups.

  14. Isolated cystic tuberculosis of medial cuneiform: a case report

    Directory of Open Access Journals (Sweden)

    Nadeem Ali

    2013-08-01

    Full Text Available Isolated tuberculosis of foot is a rare entity. Plenty of literature is available on osteoarticular tuberculosis but literature on tuberculosis of foot is limited. Additionally the condition mimics variety of other foot pathologies which can delay diagnosis and add to morbidity. We present a twelve year old boy who presented clinically with swelling, pain and discharging sinus of foot with a cystic lesion in medial cuneiform on radiography. Though histopathology and Ziehl Nielsen staining later on established the diagnosis, but initially it was mistaken as a case of mycotic osteomyelitis. Tuberculosis of foot, though rare, should always be one of the differential diagnoses in a patient presenting with bony lesion on radiography irrespective of absence of constitutional symptoms and negative tests for tuberculosis. If battery of tests fails to establish diagnosis, open biopsy with curettage and histopathology should be considered to work out the final diagnosis. [Int J Res Med Sci 2013; 1(4.000: 592-595

  15. Watching cartoons activates the medial prefrontal cortex in children

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The medial prefrontal cortex (MPFC) of human adults is involved in attributing mental states to real human agents but not to virtual artificial characters. This study examined whether such differential MPFC activity can be observed in children who are more fascinated by cartoons than adults. We measured brain activity using functional magnetic resonance imaging (fMRI) while 10-year-old children watched movie and cartoon clips, simulating real and virtual visual worlds, respectively. We showed neuroimaging evidence that, in contrast to adults, the MPFC of children was activated when perceiving both human agents and artificial characters in coherent visual events. Our findings suggest that, around the age of 10 years, the MPFC activity in children is different from that in adults in that it can be spontaneously activated by non-human agents in a virtual visual world.

  16. MORPHOMETRIC STUDY OF MEDIAL COLLATERAL LIGAMENTS OF ANKLE

    Directory of Open Access Journals (Sweden)

    Neelu Prasad

    2016-06-01

    Full Text Available BACKGROUND The ankle joint is one of the most frequently injured joint. A sprained ankle results due to tear of anterior talofibular and calcaneofibular ligaments when the foot is twisted in lateral direction. In forcible eversion of the foot, the deltoid ligament may be torn. At times, the deltoid ligament pulls the medial malleolus thereby causing avulsion fracture of the malleolus. The strong eversion pull on the deltoid ligament causes transverse fracture of medial malleolus. If the tibia is carried anteriorly, the posterior margin of the distal end of the tibia is also broken by the talus producing a trimalleolar fracture. The talocrural joint is a major weight bearing joint of the body. The weight of the body is transmitted from the tibia and fibula to the talus which distributes the weight anteriorly and posteriorly within the foot. One sixth of the static load of the leg is carried by the fibula at the tibiofibular joint. These require a high degree of stability which is determined by the passive and dynamic factors. A sprained ankle results due to tear of anterior talofibular and calcaneofibular ligaments when the foot is twisted in lateral direction. In forcible eversion of the foot, the deltoid ligament may be torn. At times, the deltoid ligament pulls the medial malleolus thereby causing avulsion fracture of the malleolus. The strong eversion pull on the deltoid ligament causes transverse fracture of medial malleolus. If the tibia is carried anteriorly, the posterior margin of the distal end of the tibia is also broken by the talus producing a trimalleolar fracture. Conventionally, X-ray techniques have been used to diagnose ligament injuries. Magnetic resonance (MR imaging has opened new horizons in the diagnosis and treatment of many musculoskeletal diseases of the ankle and foot. It demonstrates abnormalities in the bones and soft tissues before they become evident at other imaging modalities. The anatomy of the deltoid ligament

  17. Sports injury to a bipartite medial cuneiform in a child.

    Science.gov (United States)

    Eves, Timothy B; Ahmad, Mudussar A; Oddy, Michael J

    2014-01-01

    We report the case of an 11-year-old boy who had sustained a soccer injury to his mid-foot. Plain radiography did not reveal any fracture to account for the severity of his symptoms or his inability to bear weight. Magnetic resonance imaging was undertaken and demonstrated the medial cuneiform to be a bipartite bone consisting of 2 ossicles connected by a synchondrosis. No acute fracture or diastasis of the bipartite bone was demonstrated; however, significant bone marrow edema was noted, corresponding to the site of the injury and his clinical point bony tenderness. This anatomic variant should be considered as a rare differential diagnosis in the skeletally immature foot. The injury was treated nonoperatively with a non-weightbearing cast and pneumatic walker immobilization, with successful resolution of his symptoms and a return to sports activity by 4 months after injury.

  18. The Vascularized Medial Femoral Corticoperiosteal Flap for Thumb Reconstruction

    Science.gov (United States)

    Amin, Kavit; Darhouse, Nagham; Sivakumar, Bran; Floyd, David

    2015-01-01

    Summary: We present an interesting method of shaping a vascularized medial femoral condyle (MFC) flap into a “neophalanx” for phalangeal reconstruction. Our patient presented with limited strength and function secondary to fracture nonunion of the proximal phalanx of the dominant thumb. Following excision of the pseudarthrosis, an MFC corticoperiosteal flap was harvested, sculpted into a prism shape and inset. The superomedial genicular pedicle was anastomosed to the princeps pollicis artery and a cephalic tributary. On follow-up, new bone growth was seen on radiographs and the patient had substantially improved function, with full metacarpophalangeal extension, a Kapandji score of 9, and a markedly reduced Disabilities of the Arm, Shoulder and Hand score of 2.68. The MFC flap is useful for reconstruction of bony defects, with minimal donor morbidity. This versatile vascularized flap can be crafted to requisite shapes and is useful for small defects in the hand, including phalangeal reconstruction. PMID:26495205

  19. Lateral and medial epicondylitis: role of occupational factors.

    Science.gov (United States)

    Shiri, Rahman; Viikari-Juntura, Eira

    2011-02-01

    Epicondylitis is a common upper-extremity musculoskeletal disorder. It is most common at the age of 40-60 years. Epicondylitis seems to affect women more frequently than men. Diagnosis of epicondylitis is clinical and based on symptoms and findings of physical examination. The prevalence of lateral epicondylitis in the general populations is approximately 1.0-1.3% in men and 1.1-4.0% in women and that of medial epicondylitis is nearly 0.3-0.6% in men and 0.3-1.1% in women. The incidence rate of medical consultations has been estimated at 0.3-1.1 for lateral and 0.1 for medial epicondylitis per year per 100 subjects of general practice populations. Of occupational risk factors, forceful activities, high force combined with high repetition or awkward posture and awkward postures are associated with epicondylitis. The number of studies is limited to work-related psychosocial factors and the effects are not as consistent as those of physical load factors. Topical non-steroidal anti-inflammatory drugs, corticosteroid injections and acupuncture provide short-term beneficial effects. Workload modification should be considered, especially in manually strenuous jobs. According to clinical case series, surgical treatment has shown fair to good results; however, the efficacy of surgical treatment has not been evaluated in randomised controlled trials. Poorer prognosis of epicondylitis has been reported for individuals with high level of physical strain at work, non-neutral wrist postures during work activity and for those with the condition on the dominant elbow. Modification of physical factors could reduce the risk or improve the prognosis of epicondylitis.

  20. Perfusion network shift during seizures in medial temporal lobe epilepsy.

    Directory of Open Access Journals (Sweden)

    Karen M Sequeira

    Full Text Available BACKGROUND: Medial temporal lobe epilepsy (MTLE is associated with limbic atrophy involving the hippocampus, peri-hippocampal and extra-temporal structures. While MTLE is related to static structural limbic compromise, it is unknown whether the limbic system undergoes dynamic regional perfusion network alterations during seizures. In this study, we aimed to investigate state specific (i.e. ictal versus interictal perfusional limbic networks in patients with MTLE. METHODS: We studied clinical information and single photon emission computed tomography (SPECT images obtained with intravenous infusion of the radioactive tracer Technetium- Tc 99 m Hexamethylpropyleneamine Oxime (Tc-99 m HMPAO during ictal and interictal state confirmed by video-electroencephalography (VEEG in 20 patients with unilateral MTLE (12 left and 8 right MTLE. Pair-wise voxel-based analyses were used to define global changes in tracer between states. Regional tracer uptake was calculated and state specific adjacency matrices were constructed based on regional correlation of uptake across subjects. Graph theoretical measures were applied to investigate global and regional state specific network reconfigurations. RESULTS: A significant increase in tracer uptake was observed during the ictal state in the medial temporal region, cerebellum, thalamus, insula and putamen. From network analyses, we observed a relative decreased correlation between the epileptogenic temporal region and remaining cortex during the interictal state, followed by a surge of cross-correlated perfusion in epileptogenic temporal-limbic structures during a seizure, corresponding to local network integration. CONCLUSIONS: These results suggest that MTLE is associated with a state specific perfusion and possibly functional organization consisting of a surge of limbic cross-correlated tracer uptake during a seizure, with a relative disconnection of the epileptogenic temporal lobe in the interictal period. This

  1. Functional connectivity based parcellation of the human medial temporal lobe.

    Science.gov (United States)

    Wang, Shao-Fang; Ritchey, Maureen; Libby, Laura A; Ranganath, Charan

    2016-10-01

    Regional differences in large-scale connectivity have been proposed to underlie functional specialization along the anterior-posterior axis of the medial temporal lobe (MTL), including the hippocampus (HC) and the parahippocampal gyrus (PHG). However, it is unknown whether functional connectivity (FC) can be used reliably to parcellate the human MTL. The current study aimed to differentiate subregions of the HC and the PHG based on patterns of whole-brain intrinsic FC. FC maps were calculated for each slice along the longitudinal axis of the PHG and the HC. A hierarchical clustering algorithm was then applied to these data in order to group slices according to the similarity of their connectivity patterns. Surprisingly, three discrete clusters were identified in the PHG. Two clusters corresponded to the parahippocampal cortex (PHC) and the perirhinal cortex (PRC), and these regions showed preferential connectivity with previously described posterior-medial and anterior-temporal networks, respectively. The third cluster corresponded to an anterior PRC region previously described as area 36d, and this region exhibited preferential connectivity with auditory cortical areas and with a network involved in visceral processing. The three PHG clusters showed different profiles of activation during a memory-encoding task, demonstrating that the FC-based parcellation identified functionally dissociable sub-regions of the PHG. In the hippocampus, no sub-regions were identified via the parcellation procedure. These results indicate that connectivity-based methods can be used to parcellate functional regions within the MTL, and they suggest that studies of memory and high-level cognition need to differentiate between PHC, posterior PRC, and anterior PRC.

  2. Anatomical study and clinical application of the medial sural artery perforator flap%吻合腓肠内侧血管穿支皮瓣的应用解剖和临床应用

    Institute of Scientific and Technical Information of China (English)

    程天庆; 柴益民; 曾炳芳

    2008-01-01

    of 2.1 perforators was noted over the medial gastrocnemius muscle. The perforating vessels from the medial sural artery clustered about 9 to 18 cm from the popliteal crease, 1 to 5 cm from the posterior medial line. Their diameter was (1.03±0.22)mm at the deep fascial level. The average vascular territory on the sural area was (107.5±23.9)cm2, and the average supplying area of single perforator was (58.3±17.0)cm2. All the transferred free flaps taken in the 5 clinical cases survived uneventfully. All the patients were followed-up from 6 months to 12 months. The appearance of flaps and the function of the limbs were satisfied. Conclusion The standard method for the study of perforator flap is the lead oxide-gelatin technique. It is the anatomic basis that there are perforating musculocutaneous vessels on the medial gastrocnemius muscles constantly. The free medial sural perforator flap has the advantage of good appearance. It is the safe and suitable choice in the cases when a medium or small-sized flap is required for resurfacing hand injuries.

  3. Fractures of the Medial Column of the Distal Humerus in Adults

    NARCIS (Netherlands)

    K.M. Brouwer; T.G. Guitton; J.N. Doornberg; P. Kloen; J.B. Jupiter; D. Ring

    2009-01-01

    Purpose Medial column fractures of the distal humerus are uncommon in adults. Among 26 patients identified in the English language literature, only 2 had articular fragmentation. We reviewed the experience of 2 trauma centers with isolated medial column fractures to evaluate our impression that thes

  4. Case report - curved femoral osteotomy for management of medial patellar luxation

    DEFF Research Database (Denmark)

    Allpass, Maja; Miles, James Edward

    2015-01-01

    Medial patellaluxation kan forårsages af femoral varus hos hund. Førhen har patienter med excessiv femoralvarus været korrigeret ved en lateralt placeret femoral kile-ostektomi. Her præsenteres en case, hvor en buet osteotomi blev anvendt til behandling af medial patellaluxation....

  5. Analysis of medial deviation of center of pressure after initial heel contact in forefoot varus

    Directory of Open Access Journals (Sweden)

    Wei-Li Hsi

    2016-03-01

    Conclusion: The most medial CoP of the row and CoP% detected increased medial CoP deviation in FV ≥ 8°, and may be applied to other clinical conditions where rearfoot angle and CoP of the array after initial heel contact cannot detect significant differences.

  6. Releasing the circumferential fixation of the medial meniscus does not affect its kinematics

    NARCIS (Netherlands)

    Vrancken, A.C.T.; Tienen, van T.G.; Hannink, G.; Janssen, D.; Verdonschot, N.J.J.; Buma, P.

    2014-01-01

    Background Meniscal functioning depends on the fixation between the meniscal horns and the surrounding tissues. It is unknown, however, whether the integration between the outer circumference of the medial meniscus and the knee capsule/medial collateral ligament also influences the biomechanical beh

  7. Correlation between the knee adduction torque and medial contact force for a variety of gait patterns.

    Science.gov (United States)

    Zhao, Dong; Banks, Scott A; Mitchell, Kim H; D'Lima, Darryl D; Colwell, Clifford W; Fregly, Benjamin J

    2007-06-01

    The external knee adduction torque has been proposed as a surrogate measure for medial compartment load during gait. However, a direct link between these two quantities has not been demonstrated using in vivo measurement of medial compartment load. This study uses in vivo data collected from a single subject with an instrumented knee implant to evaluate this link. The subject performed five different overground gait motions (normal, fast, slow, wide, and toe-out) with simultaneous collection of instrumented implant, video motion, and ground reaction data. For each trial, the knee adduction torque was measured externally while the total axial force applied to the tibial insert was measured internally. Based on data collected from the same subject performing treadmill gait under fluoroscopic motion analysis, a regression equation was developed to calculate medial contact force from the implant load cell measurements. Correlation analyses were performed for the stance phase and entire gait cycle to quantify the relationship between the knee adduction torque and both the medial contact force and the medial to total contact force ratio. When the entire gait cycle was analyzed, R(2) for medial contact force was 0.77 when all gait trials were analyzed together and between 0.69 and 0.93 when each gait trial was analyzed separately (p knee adduction torque is highly correlated with medial compartment contact force and medial to total force ratio during gait.

  8. Increased medial foot loading during drop jump in subjects with patellofemoral pain

    DEFF Research Database (Denmark)

    Rathleff, Michael S; Richter, Camilla; Brushøj, Christoffer

    2014-01-01

    pressure distribution was collected during drop jump and single leg squat using pressure-sensitive Pedar insoles, inserted into a standard flat shoe. The primary outcome was the medial-to-lateral force, quantified as the peak force under the medial forefoot as the percentage of force under the total...

  9. Impact of occupational mechanical exposures on risk of lateral and medial inguinal hernia requiring surgical repair

    DEFF Research Database (Denmark)

    Vad, Marie Vestergaard; Frost, Poul; Bay-Nielsen, Morten;

    2012-01-01

    We undertook a register-based cohort study to evaluate exposure-response relations between cumulative occupational mechanical exposures, and risk of lateral and medial inguinal hernia repair.......We undertook a register-based cohort study to evaluate exposure-response relations between cumulative occupational mechanical exposures, and risk of lateral and medial inguinal hernia repair....

  10. Increased medial foot loading during drop jump in subjects with patellofemoral pain.

    Science.gov (United States)

    Rathleff, Michael S; Richter, Camilla; Brushøj, Christoffer; Bencke, Jesper; Bandholm, Thomas; Hölmich, Per; Thorborg, Kristian

    2014-10-01

    To compare medial-to-lateral plantar forces during drop jump and single leg squat in individuals with and without patellofemoral pain. This cross-sectional study compared 23 young adults with patellofemoral pain to 20 age- and sex-matched controls without knee pain. The plantar pressure distribution was collected during drop jump and single leg squat using pressure-sensitive Pedar insoles, inserted into a standard flat shoe. The primary outcome was the medial-to-lateral force, quantified as the peak force under the medial forefoot as the percentage of force under the total forefoot during drop jump. Secondary outcomes included peak medial-to-lateral force during single leg squat and mean forces during drop jump and single leg squat. The primary outcome showed that individuals with patellofemoral pain had a 22% higher medial-to-lateral peak force during drop jump, (p=0.03). Secondary outcomes showed 32% higher medial-to-lateral peak force during single leg squat (p=0.01) and 19-23% higher medial-to-lateral mean force during drop jump and single leg squat (p=0.02-0.04). These findings indicate that individuals with patellofemoral pain display a more medially oriented loading pattern of the forefoot compared to individuals without knee pain. This loading pattern may be associated with the distribution of forces acting on the patellofemoral joint and suggest treatment of PFP should consider interventions that target normalisation of foot loading. III.

  11. Multiple unilateral variations in medial and lateral cords of brachial plexus and their branches.

    Science.gov (United States)

    Goel, Shivi; Rustagi, Shaifaly Madan; Kumar, Ashwani; Mehta, Vandana; Suri, Rajesh Kumar

    2014-03-01

    During routine dissection of the upper extremity of an adult male cadaver, multiple variations in branches of medial and lateral cords of brachial plexus were encountered. Three unique findings were observed. First, intercordal neural communications between the lateral and medial cords were observed. Second, two lateral pectoral nerves and one medial pectoral nerve were seen to arise from the lateral and medial cord respectively. The musculocutaneous nerve did not pierce the coracobrachialis. Finally, the ulnar nerve arose by two roots from the medial cord. Knowledge of such variations is of interest to anatomists, radiologists, neurologists, anesthesiologists, and surgeons. The aim of our study is to provide additional information about abnormal brachial plexus and its clinical implications.

  12. Reverse Evans peroneus brevis medial ankle stabilization for balancing valgus ankle contracture during total ankle replacement.

    Science.gov (United States)

    Roukis, Thomas S; Prissel, Mark A

    2014-01-01

    Medial ankle instability secondary to deltoid ligament insufficiency is frequently encountered when performing total ankle replacement and remains a challenge. In the present techniques report, we describe a "reverse" Evans peroneus brevis tendon nonanatomic deltoid ligament reconstruction for medial ankle stabilization harvested through limited incisions using simple topographic anatomic landmarks. The harvested peroneus brevis tendon is brought through a drill hole in the talus from laterally to medially, aiming for the junction of the talar neck and body plantar to the midline. The tendon is the brought superiorly and obliquely to the anterior medial aspect of the distal tibia where it is secured under a plate and screw construct. This modified Evans peroneus brevis tendon nonanatomic deltoid ligament reconstruction is useful in providing medial ankle stability during or after primary and revision total ankle replacement.

  13. Differential effects of unilateral lesions in the medial amygdala on spontaneous and induced ovulation.

    Science.gov (United States)

    Sanchez, M A; Dominguez, R

    1995-01-01

    The possible existence of asymmetry in the control of ovulation by the medial amygdala was explored. Unilateral lesions of the medial amygdala were performed on each day of the estrous cycle. The estral index diminished in almost all animals with a lesion in the right side of medial amygdala. Lesions of the right medial amygdala, when performed on diestrus-1, resulted in a significant decrease in the number of rats ovulating compared to controls (4/8 vs. 8/8, p rats with lesions of the right medial amygdala. However, sequential injections of PMSG-hCG did result in ovulation by all members of a group of lesioned animals. In this last condition a significant decrease in the number of ova shed by the right ovary was found compared to animals in the lesion-only condition (1.5 +/- 0.5 vs. 6.0 +/- 1.5, p cycle.

  14. Neurochemical metabolites in the medial prefrontal cortex in bipolar disorder A proton magnetic resonance spectroscopy study

    Institute of Scientific and Technical Information of China (English)

    Osman (O)zdel; Demet Kalayci; Gülfizar S(o)zeri-Varma; Yilmaz Kiro(g)lu; Selim Tümkaya; Tu(g)(c)e Toker-U(g)urlu

    2012-01-01

    The aim of this study was to investigate proton magnetic resonance spectroscopy metabolite values in the medial prefrontal cortex of individuals with euthymic bipolar disorder. The subjects consisted of 15 patients with euthymic bipolar disorder type I and 15 healthy controls. We performed proton magnetic resonance spectroscopy of the bilateral medial prefrontal cortex and measured levels of N-acetyl aspartate, choline and creatine. Levels of these three metabolites in the medial prefrontal cortex were found to be lower in patients with bipolar disorder compared with healthy controls. A positive correlation was found between illness duration and choline levels in the right medial prefrontal cortex. Our study suggests that during the euthymic period, there are abnormalities in cellular energy and membrane phospholipid metabolism in the medial prefrontal cortex, and that this may impair neuronal activity and integrity.

  15. Coding Odorant Concentration through Activation Timing between the Medial and Lateral Olfactory Bulb

    Directory of Open Access Journals (Sweden)

    Zhishang Zhou

    2012-11-01

    Full Text Available In mammals, each olfactory bulb (OB contains a pair of mirror-symmetric glomerular maps organized to reflect odorant receptor identity. The functional implication of maintaining these symmetric medial-lateral maps within each OB remains unclear. Here, using in vivo multielectrode recordings to simultaneously detect odorant-induced activity across the entire OB, we reveal a timing difference in the odorant-evoked onset latencies between the medial and lateral halves. Interestingly, the latencies in the medial and lateral OB decreased at different rates as odorant concentration increased, causing the timing difference between them to also diminish. As a result, output neurons in the medial and lateral OB fired with greater synchrony at higher odorant concentrations. Thus, we propose that temporal differences in activity between the medial and lateral OB can dynamically code odorant concentration, which is subsequently decoded in the olfactory cortex through the integration of synchronous action potentials.

  16. Feasibility of the Medial Temporal lobe Atrophy index (MTAi and derived methods for measuring atrophy of the medial temporal lobe

    Directory of Open Access Journals (Sweden)

    Francisco eConejo Bayón

    2014-11-01

    Full Text Available Introduction: the Medial Temporal-lobe Atrophy index (MTAi, 2D-Medial Temporal Atrophy (2D-MTA, yearly rate of MTA (yrRMTA and yearly rate of relative MTA (yrRMTA are simple protocols for measuring the relative extent of atrophy in the MTL in relation to the global brain atrophy. Albeit preliminary studies showed interest of these methods in the diagnosis of AD, FTLD and correlation with cognitive impairment in PD, formal feasibility and validity studies remained pending. As a first step, we aimed to assess the feasibility. Mainly, we aimed to assess the reproducibility of measuring the areas needed to compute these indices. We also aimed to assess the efforts needed to start using these methods correctly. Methods: a series of 290 1.5T-MRI studies from 230 subjects ranging 65-85 years old who had been studied for cognitive impairment were used in this study. Six inexperienced tracers (IT plus one experienced tracer (ET traced the three areas needed to compute the indices. Finally, tracers underwent a short survey on their experience learning to compute the MTAi and experience of usage, including items relative to training time needed to understand and apply the MTAi, time to perform a study after training and overall satisfaction. Results: learning to trace the areas needed to compute the MTAi and derived methods is quick and easy. Results indicate very good intrarater ICC for the MTAi, good intrarater ICC for the 2D-MTA, yrMTA and yrRMTA and also good interrater ICC for the MTAi, 2D-MTA, yrMTA and yrRMTA.Conclusion: our data support that MTAi and derived methods (2D-MTA, yrMTA and yrRTMA have good to very good intrarater and interrater reproducibility and may be easily implemented in clinical practice even if new users have no experience tracing the area of regions of interest.

  17. Location and tension of the medial palpebral ligament.

    Science.gov (United States)

    Hwang, Kun; Huan, Fan; Nam, Yong Seok; Han, Seung Ho; Kim, Dae Joong

    2013-11-01

    The aim of this study was to elucidate the precise anatomic location and tension of the medial palpebral ligament (MPL). Eleven hemifaces of 10 fresh Korean adult cadavers were used in this study. Nine specimens were used for measurement of dissection and tension, and 2 were used for histologic study. Measurements of tensile strength of each part of the MPL and Horner muscle were performed using a force gauge.The MPL consisted of 2 layers in all specimens dissected. The superficial layer of the palpebral ligament (SMPL) was observed from the anterior lacrimal crest to the upper and lower tarsal plates. The deep layer of the palpebral ligament (DMPL) lay from the anterior lacrimal crest to the posterior lacrimal crest, covering the lacrimal sac. The Horner muscle was observed at the posterior lacrimal crest just lateral to the attachment of the DMPL and ran laterally to the tarsal plate deep to the SMPL. The SMPL began at 4.5 ± 2.3 mm lateral to the nasomaxillary suture line to the upper and lower tarsal plates. Its transverse length was 9.6 ± 1.5 mm, and vertical width was 2.4 ± 0.7 mm, and its thickness was 4.5 ± 2.3 mm. The transverse length of the DMPL was 3.7 ± 0.4 mm, and its vertical width was 2.9 ± 1.3 mm, with a thickness of 0.3 ± 0.1 mm. The transverse length of the Horner muscle was 7.6 ± 1.9 mm, and its vertical width was 4.06 ± 1.5 mm, with a thickness of 0.4 ± 0.1 mm. The tensile strength of the SMPL was 13.4 ± 3.2 N, that of the DMPL was 4.1 ± 1.7 N, and that for Horner muscle was 9.0 ± 3.1 N. The tensile strength of the SMPL was significantly higher than that of the DMPL (P = 0.003).We reconfirmed that the MPL consisted of 2 layers: superficial layer and deep layer. Our results might be of use in surgeries of the medial canthi.

  18. Effects of different medial arch support heights on rearfoot kinematics

    Science.gov (United States)

    Mayer, Frank; Baur, Heiner

    2017-01-01

    Background Foot orthoses are usually assumed to be effective by optimizing mechanically dynamic rearfoot configuration. However, the effect from a foot orthosis on kinematics that has been demonstrated scientifically has only been marginal. The aim of this study was to examine the effect of different heights in medial arch-supported foot orthoses on rear foot motion during gait. Methods Nineteen asymptomatic runners (36±11years, 180±5cm, 79±10kg; 41±22km/week) participated in the study. Trials were recorded at 3.1 mph (5 km/h) on a treadmill. Athletes walked barefoot and with 4 different not customized medial arch-supported foot orthoses of various arch heights (N:0 mm, M:30 mm, H:35 mm, E:40mm). Six infrared cameras and the `Oxford Foot Model´ were used to capture motion. The average stride in each condition was calculated from 50 gait cycles per condition. Eversion excursion and internal tibia rotation were analyzed. Descriptive statistics included calculating the mean ± SD and 95% CIs. Group differences by condition were analyzed by one factor (foot orthoses) repeated measures ANOVA (α = 0.05). Results Eversion excursion revealed the lowest values for N and highest for H (B:4.6°±2.2°; 95% CI [3.1;6.2]/N:4.0°±1.7°; [2.9;5.2]/M:5.2°±2.6°; [3.6;6.8]/H:6.2°±3.3°; [4.0;8.5]/E:5.1°±3.5°; [2.8;7.5]) (p>0.05). Range of internal tibia rotation was lowest with orthosis H and highest with E (B:13.3°±3.2°; 95% CI [11.0;15.6]/N:14.5°±7.2°; [9.2;19.6]/M:13.8°±5.0°; [10.8;16.8]/H:12.3°±4.3°; [9.0;15.6]/E:14.9°±5.0°; [11.5;18.3]) (p>0.05). Differences between conditions were small and the intrasubject variation high. Conclusion Our results indicate that different arch support heights have no systematic effect on eversion excursion or the range of internal tibia rotation and therefore might not exert a crucial influence on rear foot alignment during gait. PMID:28257426

  19. Application of Rigid gas permeable contact lens for irregular astigmatism caused by corneal laceration%硬性透气性角膜接触镜矫正角膜裂伤愈合后的不规则散光

    Institute of Scientific and Technical Information of China (English)

    杨吟; 吴峥峥

    2015-01-01

    目的 研究硬性透气性角膜接触镜(RGP)对矫正角膜裂伤愈合后的不规则散光的作用.方法 角膜裂伤愈合后继发不规则散光20例(20眼),分别验配框架眼镜及RGP,记录其矫正视力,并在配戴RGP后随访观察3个月.结果 所有试验眼在配戴RGP后,较配戴框架眼镜视力平均提高(4.40±0.88)行(标准对数视力表).对比配戴框架眼镜,配戴RGP后的矫正视力明显提高,差异具有统计学意义(t =13.58,P=O.00).结论 配戴RGP能提高角膜裂伤愈合后不规则散光的患眼的视力.%Objective To study the effect of rigid gas permeable contact lens (RGP) on irregular astigmatism caused by corneal laceration.Methods twenty eyes of 20 patients with irregular astigmatism caused by corneal laceration were collected.The fram glasses and RGP fitting were performed,and the corrected visual acuity was recorded.The follow-up time was 3 months.Results Compared with wearing frame glasses,the corrected visual acuity of all the eyes had an average increase of (4..40 ±0.88)lines when wearing RGP.And the difference was statistically significant (t =13.58,P =0.00).Conclusion Wearing RGP could improve the visual acuity of eyes with irregular astigmatism caused by corneal laceration.

  20. Analysis of 51 cases with uterine laceration caused by caesarean transverse incision%剖宫产术子宫下段横切口撕裂51例临床分析

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    沈霞

    2012-01-01

    Objective To investigate the relevant factors of lower uterine segment laceration of transverse incision during caesarean section. Methods The clinical data of 1 795 patients with transverse incision during caesarean section from January 2007 to December 2010 were reviewed retrospectively. Results About 2. 84% ( 51 patients ) of 1 795 patients suffered from lower uterine segment laceration. After labor (χ2 = 110. 90 ,P < 0. 01 ), occiput transverse position or occiput posterior position (χ2 = 121. 24,P < 0. 01 ), fetal presentation ≥ + 2cm (χ2 =290. 52,P<0.01 ), the poor formation of lower uterine segment (χ2 = 109. 87,P <0. 01 ) and high fetal weight ( ≥4 000g) (χ2 = 36.46 ,P < 0. 01 ) were the high risk factors of lower uterine segment laceration of transverse incision during caesarean section. Conclusion Birth process, fetal position, fetal presentation, the formation of lower uterine segment and fetal weight are closely related with the occurrence of lower uterine segment laceration of transverse incision.%目的 探讨剖宫产术子宫下段横切口撕裂伤的相关因素.方法 回顾性分析响水县人民医院2007年1月至2010年12月1 795例子宫下段横切口剖宫产患者的病历资料.结果 接受子宫下段横切口剖宫产术的1 795例患者中,约51例(2.84%)发生子宫下段横切口撕裂伤.临产后(χ2=110.90,P<0.01)、枕横位或枕后位(χ2=121.24,P<0.01)、胎先露≥+2cm (χ2=290.52,P<0.01)、子宫下段形成差(χ2=109.87,P<0.01)及胎儿体重≥4 000g(χ2=36.46,P<0.01)时子宫下段横切口撕裂率较高.结论 产程阶段、胎方位、胎先露、子宫下段形成情况及胎儿体重与子宫下段横切口撕裂的发生关系紧密.

  1. Clinical Observation of Maternal Perineal Laceration Reduction Control of Fetal Head Delivery Speed Midwifery Law%控制胎头娩出速度助产法减少产妇会阴裂伤的临床观察

    Institute of Scientific and Technical Information of China (English)

    陈瑞

    2015-01-01

    目的:探讨应用控制胎头娩出速度助产法减少产妇会阴裂伤的临床效果。方法将2013年5月~2014年6月我院收治的68例阴道分娩产妇随机分为研究组和常规组,均为34例;常规组采取阴道保护法实施助产;研究组则采取控制胎头娩出速度法实施助产,对比两组的临床效果。结果研究组的产妇会阴裂伤发生率、裂伤程度均低于常规组,差异有统计意义(P<0.05);另外,研究组的平均住院时间、平均住院费用及满意度均优于常规组,差异显著,有统计意义(P<0.05)。结论为实现人性化分娩,可采取控制胎头娩出速度助产法,能有效降低产妇会阴裂伤发生率,减少住院时间和医疗费用,提高满意度,临床实践意义深远。%Objective To investigate the application of fetal head delivery speed control method to reduce the effect of midwifery clinical maternal perineal laceration. Methods 68 cases of vaginal delivery mothers in our hospital were randomly divided into study group and routine group, were 34 cases; conventional group take the implementation of the law on the protection of vagina midwifery;research group is to take control of fetal head delivery speed method implementation of midwifery, compared the clinical effects of two groups. Results The incidence of maternal perineal laceration, laceration degree were lower than the conventional group, the difference was signiifcant, with statistical signiifcance (P<0.05. Conclusion In order to realize the humanization of childbirth, can take control of fetal head delivery speed midwifery method, can effectively reduce the incidence of maternal perineal laceration, clinical practical signiifcance.

  2. Fratura avulsão do planalto tibial medial (Segond reverso Avulsion fracture of the medial tibial plateau (reverse Segond injury

    Directory of Open Access Journals (Sweden)

    Fabio Janson Angelini

    2007-01-01

    Full Text Available Descreve-se neste artigo um padrão de lesão descrito na literatura apenas duas vezes, num total de quatro casos, denominado Segond reverso por apresentar achados clínicos e radiológicos exatamente opostos aos da clássica lesão de Segond. Semelhantemente aos casos previamente descritos, apresentou fratura avulsão do planalto tibial medial, na inserção do ligamento colateral medial profundo, associada a lesão do ligamento cruzado posterior. Assim como em um dos casos prévios, foi constatada lesão do ligamento cruzado anterior. Entretanto, diferiu dos anteriormente relatados por não apresentar lesão do menisco medial.This article reports an injury pattern described only twice in literature, totaling four cases, and referred to as reverse Segond injury for its clinical and radiological findings are precisely opposite to those observed in the classical Segond injury. Similarly to the previously described cases, our case reported avulsion fracture of the medial tibial plateau at the insertion of the deep tibial collateral ligament, associated to posterior cruciate ligament injury. Similarly to one of the previous cases, anterior cruciate ligament injury was found in our case, although it differs from the previous ones because it does not show medial meniscal injury.

  3. The effect of different types of insoles or shoe modifications on medial loading of the knee in persons with medial knee osteoarthritis: a randomised trial.

    Science.gov (United States)

    Jones, Richard K; Chapman, Graham J; Parkes, Matthew J; Forsythe, Laura; Felson, David T

    2015-11-01

    Many conservative treatments exist for medial knee osteoarthritis (OA) which aims to reduce the external knee adduction moment (EKAM). The objective of this study was to determine the difference between different shoes and lateral wedge insoles on EKAM, knee adduction angular impulse (KAAI), external knee flexion moment, pain, and comfort when walking in individuals with medial knee OA. Seventy individuals with medial knee OA underwent three-dimensional walking gait analysis in five conditions (barefoot, control shoe, typical wedge, supported wedge, and mobility shoe) with pain and comfort recorded concurrently. The change in EKAM, KAAI, external knee flexion moment, pain, and comfort were assessed using multiple linear regressions and pairwise comparisons. Compared with the control shoe, lateral wedge insoles and barefoot walking significantly reduced early stance EKAM and KAAI. The mobility shoe showed no effect. A significant reduction in latter stance EKAM was seen in the lateral wedge insoles compared to the other conditions, with only the barefoot condition reducing the external knee flexion moment. However, the mobility shoe showed significant immediate knee pain reduction and improved comfort scores. Different lateral wedge insoles show comparable reductions in medial knee loading and in our study, the mobility shoe did not affect medial loading.

  4. Autonoetic Consciousness in Autobiographical Memories after Medial Temporal Lobe Resection

    Science.gov (United States)

    Noulhiane, M.; Piolino, P.; Hasboun, D.; Clemenceau, S.; Baulac, M.; Samson, S.

    2008-01-01

    This study aims to investigate autonoetic consciousness associated with episodic autobiographical memory in patients who had undergone unilateral medial temporal lobe resection for intractable epilepsy. Autonoetic consciousness, defined as the conscious feeling of mentally travelling back in time to relive a specific event, was assessed using the Remember/Know (R/K) paradigm across different time periods as proposed in the autobiographical memory task developed by Piolino et al. (TEMPau task). Results revealed that the two patient groups (left and right temporal resection) gave reduced sense of reliving (R) responses and more familiarity (K) responses than healthy controls. This poor autonoetic consciousness was highlighted when patients were asked to justify their Remember responses by recalling sensory-perceptive, affective or spatiotemporal specific details across all life periods. These results support the bilateral MTL contribution to episodic autobiographical memory covering the entire lifespan, which is consistent with the multiple trace theory of MTL function [7,9]. This study also demonstrates the bilateral involvement of MTL structures in recalling specific details of personal events characterized by autonoetic consciousness. PMID:18413911

  5. A general role for medial prefrontal cortex in event prediction

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    William H Alexander

    2014-07-01

    Full Text Available A recent computational neural model of medial prefrontal cortex (mPFC, namely the PRO model (Alexander & Brown, 2011, suggests that mPFC learns to predict the outcomes of actions. The model accounted for a wide range of data on the mPFC. Nevertheless, numerous recent findings suggest that mPFC may signal predictions and prediction errors even when the predicted outcomes are not contingent on prior actions. Here we show that the existing PRO model can learn to predict outcomes in a general sense, and not only when the outcomes are contingent on actions. A series of simulations show how this generalized PRO model can account for an even broader range of findings in the mPFC, including human ERP, fMRI, and macaque single-unit data. The results suggest that the mPFC learns to predict salient events in general and provides a theoretical framework that links mPFC function to model-based reinforcement learning, Bayesian learning, and theories of cognitive control.

  6. Medial Amygdalar Aromatase Neurons Regulate Aggression in Both Sexes

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    Elizabeth K. Unger

    2015-02-01

    Full Text Available Aromatase-expressing neuroendocrine neurons in the vertebrate male brain synthesize estradiol from circulating testosterone. This locally produced estradiol controls neural circuits underlying courtship vocalization, mating, aggression, and territory marking in male mice. How aromatase-expressing neuronal populations control these diverse estrogen-dependent male behaviors is poorly understood, and the function, if any, of aromatase-expressing neurons in females is unclear. Using targeted genetic approaches, we show that aromatase-expressing neurons within the male posterodorsal medial amygdala (MeApd regulate components of aggression, but not other estrogen-dependent male-typical behaviors. Remarkably, aromatase-expressing MeApd neurons in females are specifically required for components of maternal aggression, which we show is distinct from intermale aggression in pattern and execution. Thus, aromatase-expressing MeApd neurons control distinct forms of aggression in the two sexes. Moreover, our findings indicate that complex social behaviors are separable in a modular manner at the level of genetically identified neuronal populations.

  7. Medial amygdalar aromatase neurons regulate aggression in both sexes.

    Science.gov (United States)

    Unger, Elizabeth K; Burke, Kenneth J; Yang, Cindy F; Bender, Kevin J; Fuller, Patrick M; Shah, Nirao M

    2015-02-03

    Aromatase-expressing neuroendocrine neurons in the vertebrate male brain synthesize estradiol from circulating testosterone. This locally produced estradiol controls neural circuits underlying courtship vocalization, mating, aggression, and territory marking in male mice. How aromatase-expressing neuronal populations control these diverse estrogen-dependent male behaviors is poorly understood, and the function, if any, of aromatase-expressing neurons in females is unclear. Using targeted genetic approaches, we show that aromatase-expressing neurons within the male posterodorsal medial amygdala (MeApd) regulate components of aggression, but not other estrogen-dependent male-typical behaviors. Remarkably, aromatase-expressing MeApd neurons in females are specifically required for components of maternal aggression, which we show is distinct from intermale aggression in pattern and execution. Thus, aromatase-expressing MeApd neurons control distinct forms of aggression in the two sexes. Moreover, our findings indicate that complex social behaviors are separable in a modular manner at the level of genetically identified neuronal populations.

  8. Diffusion tensor imaging in medial temporal lobe epilepsy

    Institute of Scientific and Technical Information of China (English)

    YU Ai-hong; LI Kun-cheng; YU Chun-shui; WANG Yu-ping; XUE Su-fang

    2006-01-01

    Background Diffusion tensor imaging (DTI) is a noninvasive imaging technique for the assessment of theintegrity of cerebral tissues. This study was undertaken to assess the changes of diffusion indices of hippocampalformation (HF) in patients with medial temporal lobe epilepsy (MTLE).Methods Fourteen patients with MTLE and 14 healthy subjects were evaluated. Mean diffusivity (MD) andfractional anisotropy (FA) from the symmetrical-voxel sampling regions of the anterior HF were calculated in allsubjects. The MD and FA values were compared across the groups.Results No significant differences of MD and FA values were noted between right and left HF in the controls.In the patient group, MD significantly increased in the HF ipsilateral to the lesioned side [(9.27±1.09)×10-4mm2/s], compared with the values in the contralateral HF [(8.20±0.59)×10-4 mm2/s] (t = 4.479, P = 0.001) andhealthy subjects [(7.58±0.51)×10-4 mm2/s] (P<0.001), but no significant differences were found in FA. Whencompared with the controls, patients had a significantly higher MD inthe contralateral HF (P<0.05), but thedifference in FA was not statistically significant.Conclusions DTI could detect hippocampal abnormality in patients with MTLE. This technique may be helpfulfor preoperative evaluation of such patients.

  9. Medial displacement calcaneal osteotomy using minimally invasive technique.

    Science.gov (United States)

    Kheir, Ehab; Borse, Vishal; Sharpe, Jon; Lavalette, David; Farndon, Mark

    2015-03-01

    Medial displacement calcaneal osteotomy is a common procedure often used as part of pes planovalgus deformity correction. Traditionally the osteotomy is performed using a direct lateral or extended lateral approach, which may carry the risk of wound problems, infection and neurovascular injury. The authors describe a minimally invasive technique to perform the osteotomy and achieve the desired correction. The article illustrates our experience and learning curve with the use of this technique as an option for calcaneal osteotomy. We retrospectively reviewed the records of a sequential series of patients since 2011 whose calcaneal osteotomies were performed by 2 surgeons, after cadaveric training using a minimally invasive operative approach. Prior to 2011, similar surgeries, performed by the senior authors, were undertaken using a direct lateral approach. Thirty cases were identified; 29 had tibialis posterior reconstruction coupled with calcaneal osteotomy for acquired flexible planovalgus deformity and 1 patient had surgery for a malunited calcaneal fracture. Radiological and clinical union occurred in all 30 cases (100%). The radiographs of all cases were reviewed by a specialist musculoskeletal radiologist. There were no neurovascular or wound complications. All patients had restoration of neutral hindfoot alignment. One patient required screw removal after union, resolving all symptoms. This series suggests that minimally invasive calcaneal osteotomy surgery can achieve excellent union rates aiding correction of deformity with no observed neurovascular or soft tissue complications. For surgeons experienced in open surgery, there is a short learning curve after appropriate training. © The Author(s) 2014.

  10. Correlating Function and Imaging Measures of the Medial Longitudinal Fasciculus.

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    Ken Sakaie

    Full Text Available To test the validity of diffusion tensor imaging (DTI measures of tissue injury by examining such measures in a white matter structure with well-defined function, the medial longitudinal fasciculus (MLF. Injury to the MLF underlies internuclear ophthalmoparesis (INO.40 MS patients with chronic INO and 15 healthy controls were examined under an IRB-approved protocol. Tissue integrity of the MLF was characterized by DTI parameters: longitudinal diffusivity (LD, transverse diffusivity (TD, mean diffusivity (MD and fractional anisotropy (FA. Severity of INO was quantified by infrared oculography to measure versional disconjugacy index (VDI.LD was significantly lower in patients than in controls in the medulla-pons region of the MLF (p < 0.03. FA was also lower in patients in the same region (p < 0.0004. LD of the medulla-pons region correlated with VDI (R = -0.28, p < 0.05 as did FA in the midbrain section (R = 0.31, p < 0.02.This study demonstrates that DTI measures of brain tissue injury can detect injury to a functionally relevant white matter pathway, and that such measures correlate with clinically accepted evaluation indices for INO. The results validate DTI as a useful imaging measure of tissue integrity.

  11. Autobiographical memory, future imagining, and the medial temporal lobe.

    Science.gov (United States)

    Dede, Adam J O; Wixted, John T; Hopkins, Ramona O; Squire, Larry R

    2016-11-22

    In two experiments, patients with damage to the medial temporal lobe (MTL) and healthy controls produced detailed autobiographical narratives as they remembered past events (recent and remote) and imagined future events (near and distant). All recent events occurred after the onset of memory impairment. The first experiment aimed to replicate the methods of Race et al. [Race E, Keane MM, Verfaellie M (2011) J Neurosci 31(28):10262-10269]. Transcripts from that study were kindly made available for independent analysis, which largely reproduced the findings from that study. Our patients produced marginally fewer episodic details than controls. Patients from the earlier study were more impaired than our patients. Patients in both groups had difficulty in returning to their narratives after going on tangents, suggesting that anterograde memory impairment may have interfered with narrative construction. In experiment 2, the experimenter used supportive questioning to help keep participants on task and reduce the burden on anterograde memory. This procedure increased the number of details produced by all participants and rescued the performance of our patients for the distant past. Neither of the two patient groups had any special difficulty in producing spatial details. The findings suggest that constructing narratives about the remote past and the future does not depend on MTL structures, except to the extent that anterograde amnesia affects performance. The results further suggest that different findings about the status of autobiographical memory likely depend on differences in the location and extent of brain damage in different patient groups.

  12. Map reading, navigating from maps, and the medial temporal lobe.

    Science.gov (United States)

    Urgolites, Zhisen J; Kim, Soyun; Hopkins, Ramona O; Squire, Larry R

    2016-12-13

    We administered map-reading tasks in which participants navigated an array of marks on the floor by following paths on hand-held maps that made up to nine turns. The burden on memory was minimal because the map was always available. Nevertheless, because the map was held in a fixed position in relation to the body, spatial computations were continually needed to transform map coordinates into geographical coordinates as participants followed the maps. Patients with lesions limited to the hippocampus (n = 5) performed similar to controls at all path lengths (experiment 1). They were also intact at executing single moves to an adjacent location, even when trials began by facing in a direction that put the map coordinates and geographical coordinates into conflict (experiment 2). By contrast, one patient with large medial temporal lobe (MTL) lesions performed poorly overall in experiment 1 and poorly in experiment 2 when trials began by facing in the direction that placed the map coordinates and geographical coordinates in maximal conflict. Directly after testing, all patients were impaired at remembering factual details about the task. The findings suggest that the hippocampus is not needed to carry out the spatial computations needed for map reading and navigating from maps. The impairment in map reading associated with large MTL lesions may depend on damage in or near the parahippocampal cortex.

  13. Medial temporal lobe roles in human path integration.

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    Naohide Yamamoto

    Full Text Available Path integration is a process in which observers derive their location by integrating self-motion signals along their locomotion trajectory. Although the medial temporal lobe (MTL is thought to take part in path integration, the scope of its role for path integration remains unclear. To address this issue, we administered a variety of tasks involving path integration and other related processes to a group of neurosurgical patients whose MTL was unilaterally resected as therapy for epilepsy. These patients were unimpaired relative to neurologically intact controls in many tasks that required integration of various kinds of sensory self-motion information. However, the same patients (especially those who had lesions in the right hemisphere walked farther than the controls when attempting to walk without vision to a previewed target. Importantly, this task was unique in our test battery in that it allowed participants to form a mental representation of the target location and anticipate their upcoming walking trajectory before they began moving. Thus, these results put forth a new idea that the role of MTL structures for human path integration may stem from their participation in predicting the consequences of one's locomotor actions. The strengths of this new theoretical viewpoint are discussed.

  14. Processing Chinese hand-radicals activates the medial frontal gyrus

    Institute of Scientific and Technical Information of China (English)

    Qing-Lin Wu; Yu-Chen Chan; Joseph P. Lavallee; Hsueh-Chin Chen; Kuo-En Chang; Yao-Ting Sung

    2013-01-01

    Embodied semantics theory asserts that the meaning of action-related words is neural y represented through networks that overlap with or are identical to networks involved in sory-motor processing. While some studies supporting this theory have focused on Chinese cha-racters, less attention has been paid to their semantic radicals. Indeed, there is stil disagreement about whether these radicals are processed independently. The present study investigated whether radicals are processed separately and, if so, whether this processing occurs in sensory-motor gions. Materials consisted of 72 high-frequency Chinese characters, with 18 in each of four ries:hand-action verbs with and without hand-radicals, and verbs not related to hand actions, with and without hand-radicals. Twenty-eight participants underwent functional MRI scans while reading the characters. Compared to characters without hand-radicals, reading characters with hand-radicals activated the right medial frontal gyrus. Verbs involving hand-action activated the left inferior parietal lobule, possibly reflecting integration of information in the radical with the semantic meaning of the verb. The findings may be consistent with embodied semantics theory and suggest that neural representation of radicals is indispensable in processing Chinese characters.

  15. False positives to confusable objects predict medial temporal lobe atrophy.

    Science.gov (United States)

    Kivisaari, Sasa L; Monsch, Andreas U; Taylor, Kirsten I

    2013-09-01

    Animal models agree that the perirhinal cortex plays a critical role in object recognition memory, but qualitative aspects of this mnemonic function are still debated. A recent model claims that the perirhinal cortex is required to recognize the novelty of confusable distractor stimuli, and that damage here results in an increased propensity to judge confusable novel objects as familiar (i.e., false positives). We tested this model in healthy participants and patients with varying degrees of perirhinal cortex damage, i.e., amnestic mild cognitive impairment and very early Alzheimer's disease (AD), with a recognition memory task with confusable and less confusable realistic object pictures, and from whom we acquired high-resolution anatomic MRI scans. Logistic mixed-model behavioral analyses revealed that both patient groups committed more false positives with confusable than less confusable distractors, whereas healthy participants performed comparably in both conditions. A voxel-based morphometry analysis demonstrated that this effect was associated with atrophy of the anteromedial temporal lobe, including the perirhinal cortex. These findings suggest that also the human perirhinal cortex recognizes the novelty of confusable objects, consistent with its border position between the hierarchical visual object processing and medial temporal lobe memory systems, and explains why AD patients exhibit a heightened propensity to commit false positive responses with inherently confusable stimuli.

  16. The role of medial frontal gyrus in action anticipation in professional badminton players

    Directory of Open Access Journals (Sweden)

    Huan Xu

    2016-11-01

    Full Text Available Some studies show that the medial frontal cortex is associated with more skilled action anticipation, while similar findings are not observed in some other studies, possibly due to the stimuli employed and the participants used as the control group. In addition, no studies have investigated whether there is any functional connectivity between the medial frontal cortex and other brain regions in more skilled action anticipation. Therefore, the present study aimed to re-investigate how the medial frontal cortex is involved in more skilled action anticipation by circumventing the limitations of previous research and to investigate that the medial frontal cortex functionally connected with other brain regions involved in action processing in more skilled action anticipation. To this end, professional badminton players and novices were asked to anticipate the landing position of the shuttlecock while watching badminton match videos or to judge the gender of the players in the matches. The video clips ended right at the point that the shuttlecock and the racket came into contact to reduce the effect of information about the trajectory of the shuttlecock. Novices who lacked training and watching experience were recruited for the control group to reduce the effect of sport-related experience on the medial frontal cortex. Blood oxygenation level-dependent (BOLD activation was assessed by means of functional magnetic resonance imaging (fMRI. Compared to novices, badminton players exhibited stronger activation in the left medial frontal cortex during action anticipation and greater functional connectivity between left medial frontal cortex and some other brain regions (e.g., right posterior cingulate cortex. Therefore, the present study supports the position that the medial frontal cortex plays a role in more skilled action anticipation and that there is a specific brain network for more skilled action anticipation that involves right posterior cingulate

  17. Prevalence and cognitive impact of medial temporal atrophy in a hospital stroke service: retrospective cohort study.

    Science.gov (United States)

    Kebets, Valeria; Gregoire, Simone M; Charidimou, Andreas; Barnes, Josephine; Rantell, Khadija; Brown, Martin M; Jäger, Hans R; Cipolotti, Lisa; Werring, David J

    2015-08-01

    Cerebrovascular disease and neurodegeneration cause cognitive impairment and frequently coexist. Our objectives were to investigate the prevalence and cognitive impact of medial temporal lobe atrophy - a radiological marker often associated with Alzheimer's disease - in a hospital stroke service. Retrospective cohort study of patients from a hospital stroke service. Patients assessed for suspected ischemic stroke or transient ischemic attack, irrespective of final diagnosis, underwent neuropsychological testing and magnetic resonance imaging. medial temporal lobe atrophy, white matter hyperintensities, lacunes, and cerebral microbleeds were rated using established criteria and validated scales. The associations between medial temporal lobe atrophy and cognition were tested using multivariable logistic regression analyses, adjusted for age and imaging markers of cerebrovascular disease. Three hundred and ninety-three patients were included, of whom 169 (43%; 95% confidence interval: 38·1-48·1%) had medial temporal lobe atrophy; in 38 patients (9·7%), medial temporal lobe atrophy was severe (mean score ≥2). In unadjusted logistic regression analyses in the whole cohort, mean medial temporal lobe atrophy score was associated with verbal memory, nominal and perceptual skills, executive function, and speed and attention. After adjustment for age, white matter hyperintensities, number of lacunes, presence of cerebral microbleeds, previous ischemic stroke or transient ischemic attack, and premorbid intelligence quotient, mean medial temporal lobe atrophy score remained associated with impairment in verbal memory (odds ratio: 1·64; 95% confidence interval 1·04-2·58) and nominal skills (odds ratio: 1·61; 95% confidence interval 1·04-2·48). Medial temporal lobe atrophy is common and has an independent impact on cognitive function in a stroke service population, independent of confounding factors including age and magnetic resonance imaging markers of

  18. Diethyl hexyl phthalate-induced changes in insulin signaling molecules and the protective role of antioxidant vitamins in gastrocnemius muscle of adult male rat

    Energy Technology Data Exchange (ETDEWEB)

    Srinivasan, Chinnapaiyan; Khan, Adam Ismail; Balaji, Venkataraman; Selvaraj, Jayaraman; Balasubramanian, Karundevi, E-mail: kbala82@rediffmail.com

    2011-12-15

    Diethyl hexyl phthalate (DEHP) is an endocrine disruptor, it influences various organ systems in human beings and experimental animals. DEHP reduced the serum testosterone and increased the blood glucose, estradiol, T{sub 3} and T{sub 4} in rats. However, the effect of DEHP on insulin signaling and glucose oxidation in skeletal muscle is not known. Adult male albino rats were divided into four groups: Group I: Control; Groups II and III: DEHP treated (dissolved in olive oil at a dose of 10 and 100 mg/kg body weight, respectively, once daily through gastric intubation for 30 days); and Group IV: DEHP (100 mg/kg body weight) plus vitamins E (50 mg/kg body weight) and C (100 mg/kg body weight) dissolved in olive oil and distilled water, respectively, once daily through gastric intubation for 30 days. On completion of treatment, animals were euthanized and perfused (whole body); gastrocnemius muscle was dissected out and subjected to assessment of various parameters. DEHP treatment increased the H{sub 2}O{sub 2}, hydroxyl radical levels and lipid peroxidation which disrupt the membrane integrity and insulin receptor. DEHP impaired the insulin signal transduction, glucose uptake and oxidation through decreased expression of plasma membrane GLUT4, which may partly be responsible for the elevation of fasting blood glucose level. The present study suggests that DEHP exposure affects glucose oxidation in skeletal muscle and is mediated through enhanced lipid peroxidation, impaired insulin signaling and GLUT4 expression in plasma membrane. Antioxidant vitamins (C and E) have a protective role against the adverse effect of DEHP. -- Highlights: Black-Right-Pointing-Pointer DEHP treatment significantly decreased serum insulin and testosterone levels. Black-Right-Pointing-Pointer Increased ROS and decreased glucose uptake were observed in DEHP treated animals. Black-Right-Pointing-Pointer Impaired insulin signaling in gastrocnemius muscle was observed in DEHP treatment. Black

  19. Symptomatic Os Subtibiale Associated with Chronic Pain Around the Medial Malleolus in a Young Athlete

    Directory of Open Access Journals (Sweden)

    Iliev Alexandar A.

    2016-03-01

    Full Text Available An os subtibiale is a rare accessory bone located below or behind the medial malleolus. Herein we present a rare case of a painful os subtibiale in a young triathlete who presented with pain, redness and swelling below his left medial malleolus. Plain radiographs and three-dimensional computed tomography revealed a well-defined oval bone distal to the left medial malleolus. After conservative treatment failed, the ossicle was excised in an open surgery with complete resolution of symptoms. This case report emphasizes the need for clinical awareness of different anatomical variations of the bones of the foot.

  20. Anatomical study of the arrangement and attachments of the human medial pterygoid muscle.

    Science.gov (United States)

    El Haddioui, Aziz; Bravetti, P; Gaudy, J-F

    2007-03-01

    The authors have studied the medial pterygoid muscle on 179 fresh cadavers using anatomical dissection and magnetic resonance imaging (MRI). The aim of this study was to define the general morphology and architectural organisation of the human medial pterygoid. Plane by plane dissection, anatomical sections in different spatial planes on half heads and isolated blocks demonstrated that the medial pterygoid has different architectural disposition and insertional zones from those which are normally described. The study has shown that the muscle has a typical penniform structure made up of seven alternating muscular/aponeurotic layers and that the tendinous intramuscular sheets were particularly well developed. This allows supporting a future functional study.

  1. Las encuadernaciones mudéjares de lacerías, tipo «toledano» y «salmantino», en la Catedral de Toledo

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    Carpallo-Bautista, Antonio

    2013-02-01

    Full Text Available In the history of Spanish bookbinding the Mudéjar style of the thirteenth to sixteenth centuries stands out, particularly in works produced in cities like Toledo. The Capitular Library of the Cathedral of Toledo contains one of the most important collections in Spain in both size and quality, although many volumes are not in the best state of preservation. The present work will study and analyze the different kinds of Mudéjar bookbindings with interlaces, a style of decoration typical of cities like Toledo, Salamanca and Barcelona. We have studied the decorative structures and their artistic elements, the techniques of decoration and construction, and the materials employed; through them we have established the origin or provenance of each bookbinding based on its decorative structure, its individual decorative motifs, the watermarks of its original flyleaves, and the style of its cabezada

    Dentro de la historia de la encuadernación española destaca el florecimiento del estilo mudéjar entre los siglos XIII y XVI, sobre todo en la península Ibérica, sobresaliendo los trabajos realizados en algunas ciudades como Toledo. La Biblioteca Capitular de la Catedral de Toledo dispone de uno de los grupos más importantes de España, cuantitativa y cualitativamente, aunque su estado de conservación no es el más adecuado en muchos de los ejemplares. El presente trabajo pretende estudiar y analizar los diferentes tipos de encuadernaciones mudéjares con lacerías, tipo de decoración muy propio de ciudades como Toledo, Salamanca y Barcelona. Se han estudiado las estructuras decorativas y los elementos artísticos empleados, las técnicas de decoración y de construcción, así como los materiales utilizados en la elaboración, con lo que hemos podido establecer el origen o procedencia de cada encuadernación en función de la estructura decorativa, de los motivos decorativos individuales, de las filigranas de las guardas originales y

  2. Colgajo sural medial: un nuevo colgajo de perforantes para la reconstrucción del territorio maxilofacial Medial sural flap: a new flap for maxillofacial reconstruction

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    Ignacio Arribas-García

    2012-12-01

    Full Text Available Introducción: La reconstrucción microquirúrgica de defectos mucocutáneos craneofaciales se realiza con técnicas descritas desde hace muchos años y se basan fundamentalmente en el colgajo radial, el anterolateral de muslo y el lateral de brazo, entre otros. Se presenta un nuevo colgajo microvascularizado fasciocutáneo para la reconstrucción de defectos en el territorio de cabeza y cuello, el colgajo de perforantes dependiente de la arteria sural medial. Material y métodos: Se presentan 4 pacientes con carcinoma epidermoide de cavidad oral, donde se realizaron 4 colgajos dependientes de la arteria sural medial para la reconstrucción de sus defectos tras la cirugía ablativa de la lesión tumoral. Resultados: El colgajo sural medial presentó una excelente adaptabilidad y una adecuada viabilidad en todos los casos, con unos buenos resultados funcionales, estéticos y con escasa morbilidad de la zona donante. Conclusión: Se presenta una nueva técnica reconstructiva en defectos de cabeza y cuello.Introduction: Microsurgical reconstruction of craniofacial mucocutaneous defects have been performed for many years using well-known techniques, that are mainly based on flaps from the radial forearm, the anterolateral thigh and lateral arm, among others. We present the medial sural artery perforator flap, a new vascularized fasciocutaneous flap for head and neck reconstruction. Material and methods: We present four patients with oral squamous cell carcinoma. A medial sural artery flap was performed for the oral reconstruction after tumour ablation surgery. Results: The medial sural flap showed excellent adaptability and adequate viability in all cases, with good functional and aesthetic results and low donor site morbidity. Conclusion: We present a new reconstructive technique in head and neck defects.

  3. Botulinum Neurotoxin A Injections Influence Stretching of the Gastrocnemius Muscle-Tendon Unit in an Animal Model

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    Christopher J. Tuohy

    2012-08-01

    Full Text Available Botulinum Neurotoxin A (BoNT-A injections have been used for the treatment of muscle contractures and spasticity. This study assessed the influence of (BoNT-A injections on passive biomechanical properties of the muscle-tendon unit. Mouse gastrocnemius muscle (GC was injected with BoNT-A (n = 18 or normal saline (n = 18 and passive, non-destructive, in vivo load relaxation experimentation was performed to examine how the muscle-tendon unit behaves after chemical denervation with BoNT-A. Injection of BoNT-A impaired passive muscle recovery (15% vs. 35% recovery to pre-stretching baseline, p < 0.05 and decreased GC stiffness (0.531 ± 0.061 N/mm vs. 0.780 ± 0.037 N/mm, p < 0.05 compared to saline controls. The successful use of BoNT-A injections as an adjunct to physical therapy may be in part attributed to the disruption of the stretch reflex; thereby modulating in vivo passive muscle properties. However, it is also possible that BoNT-A injection may alter the structure of skeletal muscle; thus modulating the in vivo passive biomechanical properties of the muscle-tendon unit.

  4. The Acute Effects of Unilateral Ankle Plantar Flexors Static- Stretching on Postural Sway and Gastrocnemius Muscle Activity During Single-Leg Balance Tasks

    Directory of Open Access Journals (Sweden)

    Bráulio N. Lima, Paulo R.G. Lucareli, Willy A. Gomes, Josinaldo J. Silva, Andre S. Bley, Erin H. Hartigan, Paulo H. Marchetti

    2014-09-01

    Full Text Available The aim of this study was to investigate the acute effects of unilateral ankle plantar flexors static- stretching on surface electromyography (sEMG and the center of pressure (COP during a single-leg balance task in both lower limbs. Fourteen young healthy, non-athletic individuals performed unipodal quiet standing for 30s before and after (stretched limb: immediately post-stretch, 10 and 20 minutes and non-stretched limb: immediately post-stretch a unilateral ankle plantar flexor static- stretching protocol [6 sets of 45s/15s, 70-90% point of discomfort (POD]. Postural sway was described using the COP area, COP speed (antero-posterior and medio-lateral directions and COP frequency (antero-posterior and medio-lateral directions. Surface EMG (EMG integral [IEMG] and Median frequency[FM] was used to describe the muscular activity of gastrocnemius lateralis. Ankle dorsiflexion passive range of motion increased in the stretched limb before and after the static-stretching protocol (mean ± SD: 15.0° ± 6.0 and 21.5° ± 7.0 [p < 0.001]. COP area and IEMG increased in the stretch limb between pre-stretching and immediately post-stretching (p = 0.015 and p = 0.036, respectively. In conclusion, our static- stretching protocol effectively increased passive ankle ROM. The increased ROM appears to increase postural sway and muscle activity; however these finding were only a temporary or transient effect.

  5. Segregation of the human medial prefrontal cortex in social cognition

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    Danilo eBzdok

    2013-05-01

    Full Text Available While the human medial prefrontal cortex (mPFC is widely believed to be a key node of neural networks relevant for socio-emotional processing, its functional subspecialization is still poorly understood. We thus revisited the often assumed differentiation of the mPFC in social cognition along its ventral-dorsal axis. Our neuroinformatic analysis was based on a neuroimaging meta-analysis of perspective-taking that yielded two separate clusters in the ventral and dorsal mPFC, respectively. We determined each seed region’s brain-wide interaction pattern by two complementary measures of functional connectivity: co-activation across a wide range of neuroimaging studies archived in the BrainMap database and correlated signal fluctuations during unconstrained (resting cognition. Furthermore, we characterized the functions associated with these two regions using the BrainMap database. Across methods, the ventral mPFC was more strongly connected with the nucleus accumbens, hippocampus, posterior cingulate cortex, and retrosplenial cortex, while the dorsal mPFC was more strongly connected with the inferior frontal gyrus, temporo-parietal junction, and middle temporal gyrus. Further, the ventral mPFC was selectively associated with action execution, olfaction, and reward related tasks, while the dorsal mPFC was selectively associated with perspective-taking and episodic memory retrieval. The ventral mPFC is therefore predominantly involved in sensory-driven, approach/avoidance-modulating, and evaluation-related processing, whereas the dorsal mPFC is predominantly involved in internally driven, memory-informed, and metacognition-related processing in social cognition.

  6. Morphology of the medial collateral ligament of the knee

    Directory of Open Access Journals (Sweden)

    Gill Thomas J

    2010-09-01

    Full Text Available Abstract Background Quantitative knowledge on the anatomy of the medial collateral ligament (MCL is important for treatment of MCL injury and for MCL release during total knee arthroplasty (TKA. The objective of this study was to quantitatively determine the morphology of the MCL of human knees. Methods 10 cadaveric human knees were dissected to investigate the MCL anatomy. The specimens were fixed in full extension and this position was maintained during the dissection and morphometric measurements. The outlines of the insertion sites of the superficial MCL (sMCL and deep MCL (dMCL were digitized using a 3D digitizing system. Results The insertion areas of the superficial MCL (sMCL were 348.6 ± 42.8 mm2 and 79.7 ± 17.6 mm2 on the tibia and femur, respectively. The insertion areas of the deep MCL (dMCL were 63.6 ± 13.4 mm2 and 71.9 ± 14.8 mm2 on the tibia and femur, respectively. The distances from the centroids of the tibial and femoral insertions of the sMCL to the tibial and femoral joint line were 62.4 ± 5.5 mm and 31.1 ± 4.6 mm, respectively. The distances from the centroids of dMCL in the tibial insertion and the femoral insertion to the tibial and femoral joint line were 6.5 ± 1.3 mm and 20.5 ± 4.2 mm, respectively. The distal portion of the dMCL (meniscotibial ligament - MTL was approximately 1.7 times wider than the proximal portion of the dMCL (meniscofemoral ligament - MFL, whereas the MFL was approximately 3 times longer than the MTL. Conclusions The morphologic data on the MCL may provide useful information for improving treatments of MCL-related pathology and performing MCL release during TKA.

  7. Medial olivocochlear efferent reflex inhibition of human cochlear nerve responses.

    Science.gov (United States)

    Lichtenhan, J T; Wilson, U S; Hancock, K E; Guinan, J J

    2016-03-01

    Inhibition of cochlear amplifier gain by the medial olivocochlear (MOC) efferent system has several putative roles: aiding listening in noise, protection against damage from acoustic overexposure, and slowing age-induced hearing loss. The human MOC reflex has been studied almost exclusively by measuring changes in otoacoustic emissions. However, to help understand how the MOC system influences what we hear, it is important to have measurements of the MOC effect on the total output of the organ of Corti, i.e., on cochlear nerve responses that couple sounds to the brain. In this work we measured the inhibition produced by the MOC reflex on the amplitude of cochlear nerve compound action potentials (CAPs) in response to moderate level (52-60 dB peSPL) clicks from five, young, normal hearing, awake, alert, human adults. MOC activity was elicited by 65 dB SPL, contralateral broadband noise (CAS). Using tympanic membrane electrodes, approximately 10 h of data collection were needed from each subject to yield reliable measurements of the MOC reflex inhibition on CAP amplitudes from one click level. The CAS produced a 16% reduction of CAP amplitude, equivalent to a 1.98 dB effective attenuation (averaged over five subjects). Based on previous reports of efferent effects as functions of level and frequency, it is possible that much larger effective attenuations would be observed at lower sound levels or with clicks of higher frequency content. For a preliminary comparison, we also measured MOC reflex inhibition of DPOAEs evoked from the same ears with f2's near 4 kHz. The resulting effective attenuations on DPOAEs were, on average, less than half the effective attenuations on CAPs.

  8. Medial Temporal Lobe Activity Predicts Successful Relational Memory Binding

    Science.gov (United States)

    Hannula, Deborah E.; Ranganath, Charan

    2009-01-01

    Previous neuropsychological findings have implicated medial temporal lobe (MTL) structures in retaining object-location relations over the course of short delays, but MTL effects have not always been reported in neuroimaging investigations with similar short-term memory requirements. Here, we used event-related functional magnetic resonance imaging to test the hypothesis that the hippocampus and related MTL structures support accurate retention of relational memory representations, even across short delays. On every trial, four objects were presented, each in one of nine possible locations of a three-dimensional grid. Participants were to mentally rotate the grid and then maintain the rotated representation in anticipation of a test stimulus: a rendering of the grid, rotated 90° from the original viewpoint. The test stimulus was either a “match” display, in which object-location relations were intact, or a “mismatch” display, in which one object occupied a new, previously unfilled location (mismatch position), or two objects had swapped locations (mismatch swap). Encoding phase activation in anterior and posterior regions of the left hippocampus, and in bilateral perirhinal cortex, predicted subsequent accuracy on the short-term memory decision, as did bilateral posterior hippocampal activity after the test stimulus. Notably, activation in these posterior hippocampal regions was also sensitive to the degree to which object-location bindings were preserved in the test stimulus; activation was greatest for match displays, followed by mismatch-position displays, and finally mismatch-swap displays. These results indicate that the hippocampus and related MTL structures contribute to successful encoding and retrieval of relational information in visual short-term memory. PMID:18171929

  9. Lateralizing value of semiology in medial temporal lobe epilepsy.

    Science.gov (United States)

    Dupont, S; Samson, Y; Nguyen-Michel, V-H; Zavanone, C; Navarro, V; Baulac, M; Adam, C

    2015-12-01

    Analysing the clinical characteristics of seizures constitutes a fundamental aspect of the presurgical evaluation of patients with medial temporal lobe epilepsy and unilateral hippocampal sclerosis (MTLE-HS), the most frequent form of focal epilepsy accessible to surgery. We sought to retrospectively determine whether objective manifestations could have a reliable lateralizing value in a large population of MTLE-HS patients and if their presence could help to identify those patients who would be seizure free after surgery. We analysed the frequency and predictive lateralizing value of objective ictal and postictal signs in 391 patients with MTLE-HS (183 left/208 right). Data were derived from chart review and not from blinded videoEEG analysis. Correlation between the presence of reliable lateralizing signs and postoperative outcome was performed in a subgroup of 302 patients who underwent surgery. Contralateral dystonic posturing was the most frequent and reliable lateralizing sign that correctly lateralized the focus in 96% of patients. Unilateral head/eye deviation was noted in 42% of the patients and predicted unilateral focus in 67%. Ipsilateral postictal nose wiping, contralateral clonus and hypokinesia correctly lateralized the focus in 75%, 81%, respectively, and 100 of patients but were less frequently depicted. Postictal aphasia was a strong lateralizing sign for left MLE-HS. The presence of reliable lateralizing signs was not a predictor of seizure freedom. Seizure semiology is a simple tool that may permit reliable lateralization of the seizure focus in MTLE-HS. The presence of reliable lateralizing signs is not associated with a better postoperative outcome. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. 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.

  11. Imaging demonstration of fistulous gas communication between joint and ganglion of medial malleolus

    Energy Technology Data Exchange (ETDEWEB)

    Coulier, B. [Department of Diagnostic Imaging, Namur (Belgium); Devyver, B. [Orthopedic Surgery, Namur (Belgium); Hamels, J. [Institute of Pathology and Genetics, Gerpinnes (Belgium)

    2002-01-01

    We report an unusual demonstration of a fistulous gas communication between the ankle joint and ganglion of the medial malleolus. The imaging findings support the mechanical hypothesis for the genesis of intraosseous ganglion cysts. (orig.)

  12. Impact of Partial and complete rupture of anterior cruciate ligament on medial meniscus: A cadavaric study

    Directory of Open Access Journals (Sweden)

    Wei Jiang

    2012-01-01

    Conclusions: Similar to complete rupture, partial rupture of ACL can also trigger strain concentration on medial meniscus, especially posterior horn, which may be a more critical reason for meniscus injury associated with chronic ACL deficiency.

  13. Biomechanical validation of medial pie-crusting for soft-tissue balancing in knee arthroplasty.

    Science.gov (United States)

    Mihalko, William M; Woodard, Erik L; Hebert, Casey T; Crockarell, John R; Williams, John L

    2015-02-01

    Balancing a varus knee is traditionally accomplished by releasing the medial soft-tissue sleeve off the tibia. Recently, "pie-crusting" (PC) medial structures has been described. In a biomechanical cadaver study we compared PC to traditional release (TR) to determine their effects on flexion and extension gaps. PC was done in five specimens along the anterior half of the medial soft-tissue sleeve and five along the posterior half, followed by a traditional release. In 90° flexion, valgus laxity after TR was significantly greater than after PC alone. PC of the anterior or posterior aspect of the medial soft-tissue sleeve can effect changes more in flexion than in extension, respectively. Complete TR did not provide more gap opening than PC in extension, but produced more effect in flexion.

  14. Distal arterial occlusive disease in diabetes is related to medial arterial calcification.

    Science.gov (United States)

    Chantelau, E; Lee, K M; Jungblut, R

    1997-01-01

    In diabetes mellitus, peripheral arterial occlusive disease predominantly affects the lower leg (tibial and peroneal vessel disease). Our study suggests that this feature is related to the presence of forefoot medial arterial calcification.

  15. MR imaging of edematous anconeus epitrochlearis: another cause of medial elbow pain?

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, In-Ho; Neumann, Lars; Wallace, W. Angus [Nottingham City Hospital, Nottingham Shoulder and Elbow Unit, Nottingham (United Kingdom); Fairbairn, K. Julia [Nottingham City Hospital NHS Trust, Department of Radiology, Nottingham (United Kingdom)

    2005-02-01

    Two patients with unusual medial elbow pain had MRI scans performed that revealed edema of the aberrant muscle of the anconeus epitrochlearis. MRI of this anconeus epitrochlearis muscle are presented. (orig.)

  16. Post traumatic osteoma of tibial insertion of medial collateral ligament of knee joint.

    Science.gov (United States)

    Shanker, V S; Gadikoppula, S; Loeffler, M D

    1998-03-01

    Two cases are presented of post traumatic para-articular osteoma developing at the site of tibial attachment of the medial collateral ligament of knee joint. These occurred after injuries sustained while playing football and in one case the ossified mass was treated with surgical excision for unresolved symptoms after conservative measures. A comparison is made with Pellegrini Stieda disease, which is a similar affection of the femoral insertion of the medial ligament of the knee joint.

  17. Post traumatic osteoma of tibial insertion of medial collateral ligament of knee joint

    OpenAIRE

    Shanker, V. S.; Gadikoppula, S.; Loeffler, M. D.

    1998-01-01

    Two cases are presented of post traumatic para-articular osteoma developing at the site of tibial attachment of the medial collateral ligament of knee joint. These occurred after injuries sustained while playing football and in one case the ossified mass was treated with surgical excision for unresolved symptoms after conservative measures. A comparison is made with Pellegrini Stieda disease, which is a similar affection of the femoral insertion of the medial ligament of the knee joint....

  18. Sagittal osteotomy inclination in medial open-wedge high tibial osteotomy.

    Science.gov (United States)

    Lee, Seung-Yup; Lim, Hong-Chul; Bae, Ji Hoon; Kim, Jae Gyoon; Yun, Se-Hyeok; Yang, Jae-Hyuk; Yoon, Jung-Ro

    2017-03-01

    Unlike postoperative changes in posterior tibial slope after medial open-wedge high tibial osteotomy, sagittal osteotomy inclination has not been examined. It has been recommended that the osteotomy line in the sagittal plane be parallel to the medial posterior tibial slope. The purpose of this study was to determine the frequency of parallel osteotomy in medial open-wedge high tibial osteotomy. To determine the sagittal osteotomy inclination, the angle between the medial joint line and the osteotomy line was measured in the lateral radiograph. A positive angle value indicates that the osteotomy is anteriorly inclined relative to the medial posterior tibial slope. Correlation between the sagittal osteotomy inclination and posterior tibial slope was also evaluated. The mean sagittal osteotomy inclination was 15.1 ± 7.5°. The majority 87.1 % of knees showed an anterior-inclined osteotomy. There was a significantly positive correlation between the postoperative posterior tibial slope and the sagittal osteotomy inclination (r, 0.33; 95 % confidence interval (CI) 0.19-0.46; P osteotomy inclination (r, 0.35; 95 % CI 0.21-0.47; P osteotomy in the sagittal plane relative to the medial joint line was planned, only 12.9 % of cases achieved osteotomy parallel to the medial posterior tibial slope in the sagittal plane. Because of high rate of the anterior-inclined osteotomy and their correlations with posterior tibial slope, surgeons should make all efforts to perform parallel osteotomy relative to medial posterior tibial slope. IV.

  19. On the isomorphism between the medial axis and a dual of the Delaunay graph

    DEFF Research Database (Denmark)

    Sharma, Ojaswa; Anton, François; Mioc, Darka

    2009-01-01

    In this paper, we show a graph isomorphism between a dual graph of the Delaunay graph of the sampled points and the medial axis of the sampled features. This dual graph captures the fact that two Delaunay triangles share two vertices or an edge. Then, we apply it to the computation of the medial ...... of (satellite) imagery and scanned maps. Applications include coastline extraction, extraction of fields, clear cuts, clouds, as well as heating or pollution monitoring and dense forest mapping among others....

  20. Sexual experience enhances cognitive flexibility and dendritic spine density in the medial prefrontal cortex.

    Science.gov (United States)

    Glasper, Erica R; LaMarca, Elizabeth A; Bocarsly, Miriam E; Fasolino, Maria; Opendak, Maya; Gould, Elizabeth

    2015-11-01

    The medial prefrontal cortex is important for cognitive flexibility, a capability that is affected by environmental conditions and specific experiences. Aversive experience, such as chronic restraint stress, is known to impair performance on a task of cognitive flexibility, specifically attentional set-shifting, in rats. Concomitant with this performance decrement, chronic stress reduces the number of dendritic spines on pyramidal neurons in the medial prefrontal cortex. No previous studies have examined whether a rewarding experience, namely mating, affects cognitive flexibility and dendritic spines in the medial prefrontal cortex of male rats. To test this possibility, we exposed adult male rats to sexual receptive females once daily for one week, assessed attentional set-shifting performance, and then analyzed their brains for changes in dendritic spines. We found that sexual experience improved performance on extradimensional set-shifting, which is known to require the medial prefrontal cortex. Additionally, we observed increased dendritic spine density on apical and basal dendrites of pyramidal neurons in the medial prefrontal cortex, but not the orbitofrontal cortex, after sexual experience. We also found that sexual experience enhanced dendritic spine density on granule neurons of the dentate gyrus. The ventral hippocampus sends a direct projection to the medial prefrontal cortex, raising the possibility that experience-dependent changes in the hippocampus are necessary for alterations in medial prefrontal cortex structure and function. As a first attempt at investigating this, we inactivated the ventral hippocampus with the GABA agonist muscimol, after each daily bout of sexual experience to observe whether the beneficial effects on cognitive flexibility were abolished. Contrary to our hypothesis, blocking hippocampal activity after sexual experience had no impact on enhanced cognitive flexibility. Taken together, these findings indicate that sexual