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Sample records for superior rectus extraocular

  1. Ultrastructural organization of muscle fiber types and their distribution in the rat superior rectus extraocular muscle.

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    Rashed, Rashed M; El-Alfy, Sherif H

    2012-05-01

    Extraocular muscles (EOMs) are unique as they show greater variation in anatomical and physiological properties than any other skeletal muscles. To investigate the muscle fiber types and to understand better the structure-function correlation of the extraocular muscles, the present study examined the ultrastructural characteristics of the superior rectus muscle of rat. The superior rectus muscle is organized into two layers: a central global layer of mainly large-diameter fibers and an outer C-shaped orbital layer of principally small-diameter fibers. Six morphologically distinct fiber types were identified within the superior rectus muscle. Four muscle fiber types, three single innervated fibers (SIFs) and one multiple innervated fiber (MIF), were recognized in the global layer. The single innervated fibers included red, white and intermediate fibers. They differed from one another with respect to diameter, mitochondrial size and distribution, sarcoplasmic reticulum and myofibrillar size. The orbital layer contained two distinct MIFs in addition to the red and intermediate SIFs. The orbital MIFs were categorized into low oxidative and high oxidative types according to their mitochondrial content and distribution. The highly specialized function of the superior rectus extraocular muscle is reflected in the multiplicity of its fiber types, which exhibit unique structural features. The unique ultrastructural features of the extraocular muscles and their possible relation to muscle function are discussed. Copyright © 2011 Elsevier GmbH. All rights reserved.

  2. The properties of the extraocular muscles of the frog. II. Pharmacological properties of the isolated superior oblique and superior rectus muscles.

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    Asmussen, G

    1978-01-01

    The pharmacological properties of the superior oblique and the superior rectus muscles of the frog's eye were investigated in comparison with those of a skeletal muscle (iliofibularis muscle) of the same animal. Acetylcholine causes sustained contractures of the extraocular muscles; this effect is increased by physostigmine and decreased or abolished by d-tubocurarine. Also the applications of succinylcholine, choline or caffeine are able to evoke contractures. There are no striking differences in pharmacological properties between extraocular and skeletal muscles of the frog. The time-course of the contractures and the sensitivity of the muscle preparations to the drugs which evoke contractures are identical in extraocular and iliofibularis muscles. In comparison with skeletal muscles there is no higher sensitivity of the extraocular muscles against curare-like drugs. The existence of adrenergic receptors could not be found neither in extraocular nor in skeletal muscles of the frog. It is concluded that in frogs no pharmacological differences exist between the muscle fibre types which compose the extraocular and the skeletal muscles.

  3. The properties of the extraocular muscles of the frog. I. Mechanical properties of the isolated superior oblique and superior rectus muscles.

    Science.gov (United States)

    Asmussen, G

    1978-01-01

    The mechanical properties of two extraocular muscles (superior oblique and superior rectus muscles) of the frog were studied and compared with those of a frog's skeletal muscle (iliofibularis muscle) which contains the same types of muscle fibres as the oculorotatory muscles. The extraocular muscles are very fast twitching muscles. They exhibit a smaller contraction time, a smaller half-relaxation time, a higher fusion frequency, and a lower twitch-tetanus ratio than the skeletal muscles. The maximum isometric tetanic tension produced per unit cross-sectional area is lower in the extraocular muscles than in skeletal muscles. However, the extraocular muscles show a higher fatigue resistance than the skeletal muscles. With respect to the dynamic properties there are some differences between the various oculorotatory muscles of the frog. The superior rectus muscle exhibits a faster time-course of the contraction, a higher fusion frequency, and a higher fatigability than the superior oblique muscle. An increase of the extracellular K+-concentration evokes sustained contractures not only in the extraocular muscles but also in the iliofibularis muscle; between these muscles there are no striking differences in the mechanical threshold of the whole muscle preparation. The mechanical threshold depends on the Ca++-concentration of the bathing solution and it is found in a range between 12.5 and 17.5 mM K+ in a normal Ringer solution containing 1.8 mM Ca++. The static-mechanical properties of the extraocular muscles of the frog and the dependence of the active developed tension on the muscle extension are very similar to those which are known to exist in the extraocular muscles of other vertebrates. In tetanic activated frog's oculorotatory muscles a linear relationship exists between length and tension. A variation of the stimulation frequency does not change the slope of this curve but causes parallel shifts of the curve. The peculiar properties of the extraocular muscles

  4. Isolated abscess in superior rectus muscle in a child

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    Sushank Ashok Bhalerao

    2015-01-01

    Full Text Available Pyomyositis is a primary bacterial infection of striated muscles nearly always caused by Staphylococcus aureus. Development of the intramuscular abscess involving the extra-ocular muscles (EOMs remains an extremely rare process. We herein present a case of isolated EOM pyomyositis involving superior rectus muscle in a 2-year male child who was referred with complaints of swelling in left eye (LE and inability to open LE since last 1-month. Orbital computed tomography (CT scan showed a well-defined, hypo-dense, peripheral rim-enhancing lesion in relation to left superior rectus muscle suggestive of left superior rectus abscess. The abscess was drained through skin approach. We concluded that pyomyositis of EOM should be considered in any patient presenting with acute onset of orbital inflammation and characteristic CT or magnetic resonance imaging features. Management consists of incision and drainage coupled with antibiotic therapy.

  5. Superior calcium homeostasis of extraocular muscles.

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    Zeiger, Ulrike; Mitchell, Claire H; Khurana, Tejvir S

    2010-11-01

    Extraocular muscles (EOMs) are a unique group of skeletal muscles with unusual physiological properties such as being able to undergo rapid twitch contractions over extended periods and escape damage in the presence of excess intracellular calcium (Ca(2+)) in Duchenne's muscular dystrophy (DMD). Enhanced Ca(2+) buffering has been proposed as a contributory mechanism to explain these properties; however, the mechanisms are not well understood. We investigated mechanisms modulating Ca(2+) levels in EOM and tibialis anterior (TA) limb muscles. Using Fura-2 based ratiometric Ca(2+) imaging of primary myotubes we found that EOM myotubes reduced elevated Ca(2+) ˜2-fold faster than TA myotubes, demonstrating more efficient Ca(2+) buffering. Quantitative PCR (qPCR) and western blotting revealed higher expression of key components of the Ca(2+) regulation system in EOM, such as the cardiac/slow isoforms sarcoplasmic Ca(2+)-ATPase 2 (Serca2) and calsequestrin 2 (Casq2). Interestingly EOM expressed monomeric rather than multimeric forms of phospholamban (Pln), which was phosphorylated at threonine 17 (Thr17) but not at the serine 16 (Ser16) residue. EOM Pln remained monomeric and unphosphorylated at Ser16 despite protein kinase A (PKA) treatment, suggesting differential signalling and modulation cascades involving Pln-mediated Ca(2+) regulation in EOM. Increased expression of Ca(2+)/SR mRNA, proteins, differential post-translational modification of Pln and superior Ca(2+) buffering is consistent with the improved ability of EOM to handle elevated intracellular Ca(2+) levels. These characteristics provide mechanistic insight for the potential role of superior Ca(2+) buffering in the unusual physiology of EOM and their sparing in DMD.

  6. Outcome of inferior and superior rectus recession in Graves' orbitopathy patients

    NARCIS (Netherlands)

    Jellema, Hinke Marijke; Saeed, Peerooz; Groenveld, Linda; Kloos, Roel; Mourits, Maarten P

    2015-01-01

    PURPOSE: To evaluate the surgical effect of unilateral inferior rectus recession (IR-group) with or without a recession of contralateral superior rectus (IR-SR-group) on squint angle and motility restrictions in Graves' Orbitopathy (GO) patients. DESIGN: Retrospective case series. MATERIALS AND METH

  7. Frequency of the superior rectus muscle overaction/contracture syndrome in unilateral fourth nerve palsy.

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    Molinari, Andrea; Ugrin, Maria Cristina

    2009-12-01

    Superior oblique palsy is accompanied in most cases by overaction of the muscle's ipsilateral antagonist, the inferior oblique muscle. Overaction and contracture of the ipsilateral superior rectus muscle in patients with unilateral fourth (trochlear) nerve palsy is seldom discussed in the literature. The purpose of this study is to evaluate the frequency of superior rectus muscle overaction/contracture syndrome in patients with unilateral trochlear nerve palsy. The records of 198 patients with unilateral trochlear nerve palsy examined by the authors between July 1987 and July 2008 were reviewed retrospectively. All patients underwent complete eye examination with measurement of the deviation in the 9 positions of gaze and with the head tilted to both sides in all cooperative patients. Selection criteria for superior rectus muscle overaction/contracture syndrome in these patients were as follows: vertical deviation of 15(Delta) or larger in primary position, equal or larger hypertropia with the ipsilateral forced tilt test than with the eyes looking straight ahead, more than 5(Delta) hypertropia of the affected eye in horizontal gaze to the same side, hypertropia in all upgazes, and overaction of the contralateral superior oblique muscle. Of 198 patients, 33 (16.6%) met the selection criteria for superior rectus muscle overaction/contracture syndrome. Superior rectus muscle overaction/contracture syndrome frequently occurs in unilateral superior oblique palsy.

  8. A new teaching model for demonstrating the movement of the extraocular muscles.

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    Iwanaga, Joe; Refsland, Jason; Iovino, Lee; Holley, Gary; Laws, Tyler; Oskouian, Rod J; Tubbs, R Shane

    2017-09-01

    The extraocular muscles consist of the superior, inferior, lateral, and medial rectus muscles and the superior and inferior oblique muscles. This study aimed to create a new teaching model for demonstrating the function of the extraocular muscles. A coronal section of the head was prepared and sutures attached to the levator palpebral superioris muscle and six extraocular muscles. Tension was placed on each muscle from a posterior approach and movement of the eye documented from an anterior view. All movements were clearly seen less than that of the inferior rectus muscle. To our knowledge, this is the first cadaveric teaching model for demonstrating the movements of the extraocular muscles. Clin. Anat. 30:733-735, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  9. Effects of the Rho-Kinase Inhibitor Y-27632 on Extraocular Muscle Surgery in Rabbits

    OpenAIRE

    Ji‐Sun Moon; Hyun Kyung Kim; Sun Young Shin

    2017-01-01

    Purpose. To evaluate the effect of the Rho-kinase inhibitor Y-27632 on postoperative inflammation and adhesion following extraocular muscle surgery in rabbits. Methods. The superior rectus muscle reinsertion was performed on both eyes of 8 New Zealand white rabbits. After reinsertion, the rabbits received subconjunctival injections of the Rho-kinase inhibitor and saline on each eye. To assess acute and late inflammatory changes, Ki-67, CD11β+, and F4/80 were evaluated and the sites of muscle ...

  10. Original hydroxyapatite orbital implant covered with small autoscleral flap with extraocular rectus muscles orbital implantation%直肌及其止端处小巩膜瓣下义眼台植入术研究

    Institute of Scientific and Technical Information of China (English)

    景明; 孙琰; 周哲; 高玉; 马戈; 葛茸茸; 王传星; 蔡金辉

    2015-01-01

    目的 观察自创的带直肌止点处小巩膜瓣下羟基磷灰石(HA)义眼台植入术的临床效果.方法 用自创方法行义眼台植入术296例(296只眼),随机对其中32例(32只眼)进行眼眶增强MRI检查以观察术后1周、1、2、3、4、5、6及18个月义眼台血管化进程.结果 所有病例随访1 ~18个月,义眼台活动良好,无义眼台外露发生.增强MRI检查显示义眼台于术后1个月即完全血管化,随着时间进展,血管化密度逐渐增大.结论 作者自创的带直肌止点区域小巩膜瓣下HA义眼台植入术,彻底解决了HA义眼台植入术外露的问题,促进义眼台血管化的优势明显,具有良好的使用前景.%Objective To observe the clinical efficacy of orbital implantation with original hydroxyapatite (HA) orbital implant covered with small autoscleral flap at extraocular rectus muscles insertions area which was designed by the author.Methods Thirty-two cases were randomly selected from a total of 296 patients who were treated with the original hydroxyapatite implantation method.Serial precontrast and postcontrast T1-weighted magnetic resonance imaging (MRI) were obtained at 1 week,1,2,3,4,5,6 and 18 months after implantation to assess the fibrovascularization of HA orbital implants.Results Patients were followed up for 1to18 months.In all cases HAs were fixed to orbit and moved well.There was no complication of prostheses exposure.Contrast-enhanced MRI showed the HA spheres had achieved complete vascularization 1 month after implantation.The vascularization density increased with time.Conclusion The author' s original hydroxyapatite orbital implantation covered with small autoscleral flap with extraocular rectus muscles method completely solves the problem of prostheses exposure complication and its advantage of promoting the fibrovascularization is obvious.The application prospect is good.

  11. Histotopographical study of human periocular elastic fibers using aldehyde-fuchsin staining with special reference to the sleeve and pulley system for extraocular rectus muscles.

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    Osanai, Hajime; Murakami, Gen; Ohtsuka, Aiji; Suzuki, Daisuke; Nakagawa, Takashi; Tatsumi, Haruyuki

    2009-09-01

    The aim of this study was to investigate the detailed configuration of periocular elastic fibers. Semiserial paraffin sections were made using 40 whole orbital contents from 27 elderly cadavers and stained by the aldehyde-fuchsin method. Periocular tissues were classified into three types according to directions of the elastic fibers, i.e., tissues containing anteroposteriorly running elastic fibers, those with mediolateral fibers, and those with meshwork of fibers. Anteroposterior elastic fiber-dominant tissue was seen in the upper eyelid and newly defined pulley plate for the medial and lateral recti (MR, LR). Mediolateral fibers were predominant in the central part of the inferior rectus pulley. In the pulley plates for the MR and LR, anteroposteriorly running fibers encased the striated muscle. Tenon's capsule and the epimysium of the recti were mediolateral fiber-dominant. However, at the entrance of the muscle terminal where Tenon's capsule reflects and continues to the epimysium, composite elastic fibers provided a meshwork-like skeleton. The elastic mesh was also seen around the lacrimal canaliculi. The pulley for the recti seemed to be composed of two parts--a connective tissue plate encasing the recti and specialized Tenon's capsule at an entrance or porta of the muscle. For both parts, elastic fibers were major functional components. The anteroposterior elastic fibers in the MR and LR pulley plates, especially, seemed to receive anteroposteriorly directed stress and tension from these striated muscles. The elastic interfaces seemed to prevent any concentration of stress that would interfere with periocular striated muscle functions, including hypothetical active pulleys.

  12. A Case of Extrusion of a Solid Silicone Tire Migrating through the Superior Rectus Muscle with Aeromonas hydrophila Infection following a Scleral Buckling Procedure

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    Shinji Makino

    2012-01-01

    Full Text Available To our knowledge, there are no reports of Aeromonas hydrophila infection after a scleral buckling procedure. Also, migration of a silicone explant element through the rectus muscles is extremely rare. Herein, we describe a case experiencing extrusion of a solid silicone tire migrating through the superior rectus muscle with Aeromonas hydrophila infection following a scleral buckling procedure. A 42-year-old man was referred to our hospital complaining of ocular pain and purulent discharge in his left eye which has persisted for several months. He had a history of bilateral rhegmatogenous retinal detachment which had been treated with scleral buckling. The left eye showed extrusion of the solid silicone buckle which had migrated through the superior rectus muscle and an infection in the upper quadrant of the sclera. The buckle was removed, and the patient was treated with antibiotics. After the removal of the buckle, the symptoms showed rapid amelioration and there was no recurrence of retinal detachment. Aeromonas hydrophila was isolated from the discharge and the removed explant. He used well water in daily life. In this case, the Aeromonas hydrophila infection of the extruded buckle might have originated from contaminated well water.

  13. Regenerating nerve fiber innervation of extraocular muscles and motor functional changes following oculomotor nerve injuries at different sites

    Institute of Scientific and Technical Information of China (English)

    Wenchuan Zhang; Massimiliano Visocchi; Eduardo Fernandez; Xuhui Wang; Xinyuan Li; Shiting Li

    2011-01-01

    In the present study, the oculomotor nerves were sectioned at the proximal (subtentorial) and distal (superior orbital fissure) ends and repaired. After 24 weeks, vestibulo-ocular reflex evaluation confirmed that the regenerating nerve fibers following oculomotor nerve injury in the superior orbital fissure had a high level of specificity for innervating extraocular muscles. The level of functional recovery of extraocular muscles in rats in the superior orbital fissure injury group was remarkably superior over that in rats undergoing oculomotor nerve injuries at the proximal end (subtentorium). Horseradish peroxidase retrograde tracing through the right superior rectus muscle showed that the distribution of neurons in the nucleus of the oculomotor nerve was directly associated with the injury site, and that crude fibers were badly damaged. The closer the site of injury of the oculomotor nerve was to the extraocular muscle, the better the recovery of neurological function was. The mechanism may be associated with the aberrant number of regenerated nerve fibers passing through the injury site.

  14. Unilateral blindness with third cranial nerve palsy and abnormal enhancement of extraocular muscles on magnetic resonance imaging of orbit after the ingestion of methanol.

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    Chung, Tae Nyoung; Kim, Sun Wook; Park, Yoo Seok; Park, Incheol

    2010-05-01

    Methanol is generally known to cause visual impairment and various systemic manifestations. There are a few reported specific findings for methanol intoxication on magnetic resonance imaging (MRI) of the brain. A case is reported of unilateral blindness with third cranial nerve palsy oculus sinister (OS) after the ingestion of methanol. Unilateral damage of the retina and optic nerve were confirmed by fundoscopy, flourescein angiography, visual evoked potential and electroretinogram. The optic nerve and extraocular muscles (superior rectus, medial rectus, inferior rectus and inferior oblique muscle) were enhanced by gadolinium-DTPA on MRI of the orbit. This is the first case report of permanent monocular blindness with confirmed unilateral damage of the retina and optic nerve, combined with third cranial nerve palsy after methanol ingestion.

  15. Successful repair of injury to the eyelid, lacrimal passage, and extraocular muscle

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    Shah, Shreya Mehul

    2016-03-01

    Full Text Available Introduction: Injury is a known cause of monocular blindness. Ocular trauma may affect lacrimal canaliculi and the extraocular muscle. We report this case as it includes injury to lid, lacrimal canaliculi and inferior rectus. Case description: A 25-year-old male presented with an injury caused by a sharp object that resulted in a conjunctival tear, lid tear involving the lacrimal canal, and rupture of the inferior rectus muscle. All of the structures were repaired successfully during a single procedure. Conclusion: An extraocular injury involving the conjunctiva, lid, lacrimal passages, and extraocular muscles can be repaired successfully during a single procedure.

  16. Extraocular muscle function testing

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    ... page: //medlineplus.gov/ency/article/003397.htm Extraocular muscle function testing To use the sharing features on this page, please enable JavaScript. Extraocular muscle function testing examines the function of the eye ...

  17. Atomic Force Microscopy Determination of Young’s Modulus of Bovine Extra-ocular Tendon Fiber Bundles

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

    2014-01-01

    Extra-ocular tendons (EOTs) transmit the oculorotary force of the muscles to the eyeball to generate dynamic eye movements and align the eyes, yet the mechanical properties of the EOTs remain undefined. The EOTs are known to be composed of parallel bundles of small fibers whose mechanical properties must be determined in order to characterize the overall behavior of EOTs. The current study aimed to investigate the transverse Young’s modulus of EOT fiber bundles using atomic force microscopy (AFM). Fresh bovine EOT fiber bundle specimens were maintained under temperature and humidity control, and indented 100 nm by the inverted pyramid tip of an AFM (Veeco Digital Instruments, NY). Ten indentations were conducted for each of 3 different locations of 10 different specimens from each of 6 EOTs, comprising a total of 1,800 indentations. Young’s modulus for each EOT was determined using a Hertzian contact model. Young’s moduli for fiber bundles from all six EOTs were determined. Mean Young’s moduli for fiber bundles were similar for the six anatomical EOTs: lateral rectus 60.12 ± 2.69 (±SD) MPa, inferior rectus 59.69 ± 5.34 MPa, medial rectus 56.92 ±1.91 MPa, superior rectus 59.66 ±2.64 MPa, inferior oblique 57.7± 1.36 MPa, and superior oblique 59.15± 2.03. Variation in Young’s moduli among the six EOTs was not significant (P > 0.25). The Young’s modulus of bovine EOT fibers is highly uniform among the six extraocular muscles, suggesting that each EOT is assembled from fiber bundles representing the same biomechanical elements. This uniformity will simplify overall modeling. PMID:24767704

  18. Effects of the Rho-Kinase Inhibitor Y-27632 on Extraocular Muscle Surgery in Rabbits

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    Ji‐Sun Moon

    2017-01-01

    Full Text Available Purpose. To evaluate the effect of the Rho-kinase inhibitor Y-27632 on postoperative inflammation and adhesion following extraocular muscle surgery in rabbits. Methods. The superior rectus muscle reinsertion was performed on both eyes of 8 New Zealand white rabbits. After reinsertion, the rabbits received subconjunctival injections of the Rho-kinase inhibitor and saline on each eye. To assess acute and late inflammatory changes, Ki-67, CD11β+, and F4/80 were evaluated and the sites of muscle reattachment were evaluated for a postoperative adhesion score and histopathologically for collagen formation. Results. F4/80 antibody expression was significantly different in the Rho-kinase inhibitor-injected group at both postoperative day 3 and week 4 (p=0.038, 0.031. However, Ki-67 and CD11β+ were not different the between two groups. The difference in the SRM/conjunctiva adhesion score between the two groups was also significant (p=0.034. Conclusion. Intraoperative subconjunctival injection of the Rho-kinase inhibitor may be effective for adjunctive management of inflammation and fibrosis in rabbit eyes following extraocular muscle surgery.

  19. Extraocular muscle dynamics in diplopia from enophthalmos.

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    Yoon, Michael K; Economides, John R; Horton, Jonathan C

    2011-12-01

    The mechanism of diplopia from enophthalmos is not well understood. We describe a 55-year-old man who underwent a left transorbital craniotomy for clipping of a basilar aneurysm. The lateral orbital wall was not reconstructed properly, resulting in 8 mm of left enophthalmos. Months after surgery the patient developed diplopia with ocular excursions, although he remained orthotropic in primary gaze. The left eye was limited in elevation, adduction, and abduction. These findings were confirmed by eye movement recordings, which showed ocular separation increasing with gaze eccentricity. A CT scan demonstrated a defect in the sphenoid and frontal bones, profound enophthalmos, and shortening of the rectus muscles. Slack in the extraocular muscles reduced the force generated by each muscle, causing diplopia with ocular rotation. This case underscores the value of careful orbital wall reconstruction after orbitotomy and suggests a mechanism for diplopia produced by postoperative enophthalmos.

  20. Referred pain elicited by manual exploration of the lateral rectus muscle in chronic tension-type headache.

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    Fernández-de-Las-Peñas, César; Cuadrado, Maria Luz; Gerwin, Robert D; Pareja, Juan A

    2009-01-01

    To analyze the presence of referred pain elicited by manual examination of the lateral rectus muscle in patients with chronic tension-type headache (CTTH). A case-control blinded study. It has been found previously that the manual examination of the superior oblique muscle can elicit referred pain to the head in some patients with migraine or tension-type headache. However, a referred pain from other extraocular muscles has not been investigated. Fifteen patients with CTTH and 15 healthy subjects without headache history were included. A blinded assessor performed a manual examination focused on the search for myofascial trigger points (TrPs) in the right and left lateral rectus muscles. TrP diagnosis was made when there was referred pain evoked by maintained pressure on the lateral corner of the orbit (anatomical projection of the lateral rectus muscle) for 20 seconds, and increased referred pain while the subject maintained a medial gaze on the corresponding side (active stretching of the muscle) for 15 seconds. On each side, a 10-point numerical pain rate scale was used to assess the intensity of referred pain at both stages of the examination. Ten patients with CTTH (66.6%) had referred pain that satisfied TrPs diagnostic criteria, while only one healthy control (0.07%) reported referred pain upon the examination of the lateral rectus muscles (P < 0.001). The elicited referred pain was perceived as a deep ache located at the supraorbital region or the homolateral forehead. Pain was evoked on both sides in all subjects with TrPs, with no difference in pain intensity between the right and the left. The average pain intensity was significantly greater in the patient group (P < 0.001). All CTTH patients with referred pain recognized it as the frontal pain that they usually experienced during their headache attacks, which was consistent with active TrPs. In some patients with CTTH, the manual examination of lateral rectus muscle TrPs elicits a referred pain that

  1. Study of crotoxin on the induction of paralysis in extraocular muscle in animal model

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    Geraldo de Barros Ribeiro

    2012-10-01

    Full Text Available PURPOSE: Crotoxin is the major toxin of the venom of the South American rattlesnake Crotalus durissus terrificus, capable of causing a blockade of the neurotransmitters at the neuromuscular junction. The objective of this study was to appraise the action and effectiveness of the crotoxin induced paralysis of the extraocular muscle and to compare its effects with the botulinum toxin type A (BT-A. METHODS: The crotoxin, with LD50 of 1.5 µg, was injected into the superior rectus muscle in ten New Zealand rabbits. The concentration variance was 0.015 up to 150 µg. Two rabbits received 2 units of botulinum toxin type A for comparative analysis. The evaluation of the paralysis was performed using serial electromyography. After the functional recovery of the muscles, which occurred after two months, six rabbits were sacrificed for anatomopathology study. RESULTS: The animals did not show any evidence of systemic toxicity. Transitory ptosis was observed in almost every animal and remained up to fourteen days. These toxins caused immediate blockade of the electrical potentials. The recovery was gradual in the average of one month with regeneration signs evident on the electromyography. The paralysis effect of the crotoxin on the muscle was proportional to its concentration. The changes with 1.5 µg crotoxin were similar to those produced by the botulinum toxin type A. The histopathology findings were localized to the site of the injection. No signs of muscle fiber's necrosis were seen in any sample. The alterations induced by crotoxin were also proportional to the concentration and similar to botulinum toxin type A in concentration of 1.5 µg. CONCLUSION: Crotoxin was able to induce transitory paralysis of the superior rectus muscle. This effect was characterized by reduction of action potentials and non-specific signs of fibrillation. Crotoxin, in concentration of 1.5 µg was able to induce similar effects as botulinum toxin type A.

  2. Structural Functional Associations of the Orbit in Thyroid Eye Disease: Kalman Filters to Track Extraocular Rectal Muscles.

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    Chaganti, Shikha; Nelson, Katrina; Mundy, Kevin; Luo, Yifu; Harrigan, Robert L; Damon, Steve; Fabbri, Daniel; Mawn, Louise; Landman, Bennett

    2016-02-27

    Pathologies of the optic nerve and orbit impact millions of Americans and quantitative assessment of the orbital structures on 3-D imaging would provide objective markers to enhance diagnostic accuracy, improve timely intervention and eventually preserve visual function. Recent studies have shown that the multi-atlas methodology is suitable for identifying orbital structures, but challenges arise in the identification of the individual extraocular rectus muscles that control eye movement. This is increasingly problematic in diseased eyes, where these muscles often appear to fuse at the back of the orbit (at the resolution of clinical computed tomography imaging) due to inflammation or crowding. We propose the use of Kalman filters to track the muscles in three-dimensions to refine multi-atlas segmentation and resolve ambiguity due to imaging resolution, noise, and artifacts. The purpose of our study is to investigate a method of automatically generating orbital metrics from CT imaging and demonstrate the utility of the approach by correlating structural metrics of the eye orbit with clinical data and visual function measures in subjects with thyroid eye disease. The pilot study demonstrates that automatically calculated orbital metrics are strongly correlated with several clinical characteristics. Moreover, the superior, inferior, medial and lateral rectus muscles obtained using Kalman filters are each correlated with different categories of functional deficit. These findings serve as foundation for further investigation in the use of CT imaging in the study, analysis and diagnosis of ocular diseases, specifically thyroid eye disease.

  3. Structural functional associations of the orbit in thyroid eye disease: Kalman filters to track extraocular rectal muscles

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    Chaganti, Shikha; Nelson, Katrina; Mundy, Kevin; Luo, Yifu; Harrigan, Robert L.; Damon, Steve; Fabbri, Daniel; Mawn, Louise; Landman, Bennett

    2016-03-01

    Pathologies of the optic nerve and orbit impact millions of Americans and quantitative assessment of the orbital structures on 3-D imaging would provide objective markers to enhance diagnostic accuracy, improve timely intervention, and eventually preserve visual function. Recent studies have shown that the multi-atlas methodology is suitable for identifying orbital structures, but challenges arise in the identification of the individual extraocular rectus muscles that control eye movement. This is increasingly problematic in diseased eyes, where these muscles often appear to fuse at the back of the orbit (at the resolution of clinical computed tomography imaging) due to inflammation or crowding. We propose the use of Kalman filters to track the muscles in three-dimensions to refine multi-atlas segmentation and resolve ambiguity due to imaging resolution, noise, and artifacts. The purpose of our study is to investigate a method of automatically generating orbital metrics from CT imaging and demonstrate the utility of the approach by correlating structural metrics of the eye orbit with clinical data and visual function measures in subjects with thyroid eye disease. The pilot study demonstrates that automatically calculated orbital metrics are strongly correlated with several clinical characteristics. Moreover, it is shown that the superior, inferior, medial and lateral rectus muscles obtained using Kalman filters are each correlated with different categories of functional deficit. These findings serve as foundation for further investigation in the use of CT imaging in the study, analysis and diagnosis of ocular diseases, specifically thyroid eye disease.

  4. Restrictive extraocular myopathy: A presenting feature of acromegaly

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    Steven Heireman

    2011-01-01

    Full Text Available A 45-year-old man presented with binocular diplopia in primary gaze for 1 year. Orthoptic evaluation showed 10-prism diopter right eye hypotropia and 6-prism diopter right eye esotropia. The elevation and abduction of the right eye were mechanically restricted. This was associated with systemic features suggestive of acromegaly. Magnetic resonance imaging (MRI of the brain demonstrated a pituitary macroadenoma. An elevated serum insulin-like growth factor I level and the failure of growth hormone suppression after an oral glucose load biochemically confirmed the diagnosis of acromegaly. Computed tomography (CT of the orbit demonstrated bilateral symmetrical enlargement of the medial rectus and inferior rectus muscle bellies. All tests regarding Graves-Basedow disease were negative. Although rare, diplopia due to a restrictive extraocular myopathy could be the presenting symptom of acromegaly.

  5. Microanatomy of adult zebrafish extraocular muscles.

    Directory of Open Access Journals (Sweden)

    Daniel S Kasprick

    Full Text Available Binocular vision requires intricate control of eye movement to align overlapping visual fields for fusion in the visual cortex, and each eye is controlled by 6 extraocular muscles (EOMs. Disorders of EOMs are an important cause of symptomatic vision loss. Importantly, EOMs represent specialized skeletal muscles with distinct gene expression profile and susceptibility to neuromuscular disorders. We aim to investigate and describe the anatomy of adult zebrafish extraocular muscles (EOMs to enable comparison with human EOM anatomy and facilitate the use of zebrafish as a model for EOM research. Using differential interference contrast (DIC, epifluorescence microscopy, and precise sectioning techniques, we evaluate the anatomy of zebrafish EOM origin, muscle course, and insertion on the eye. Immunofluorescence is used to identify components of tendons, basement membrane and neuromuscular junctions (NMJs, and to analyze myofiber characteristics. We find that adult zebrafish EOM insertions on the globe parallel the organization of human EOMs, including the close proximity of specific EOM insertions to one another. However, analysis of EOM origins reveals important differences between human and zebrafish, such as the common rostral origin of both oblique muscles and the caudal origin of the lateral rectus muscles. Thrombospondin 4 marks the EOM tendons in regions that are highly innervated, and laminin marks the basement membrane, enabling evaluation of myofiber size and distribution. The NMJs appear to include both en plaque and en grappe synapses, while NMJ density is much higher in EOMs than in somatic muscles. In conclusion, zebrafish and human EOM anatomy are generally homologous, supporting the use of zebrafish for studying EOM biology. However, anatomic differences exist, revealing divergent evolutionary pressures.

  6. Presurgical Botulinum Toxin A Treatment Increases Angiogenesis by Hypoxia-Inducible Factor-1α/Vascular Endothelial Growth Factor and Subsequent Superiorly Based Transverse Rectus Abdominis Myocutaneous Flap Survival in a Rat Model.

    Science.gov (United States)

    Park, Tae Hwan; Lee, Song Hyun; Park, Yun Joo; Lee, Young Seok; Rah, Dong Kyun; Kim, Sung Young

    2016-06-01

    To date, there have been several experimental studies to assess tissue viability of transverse rectus abdominis myocutaneous (TRAM) flaps. Botulinum toxin A (BoTA) has gained popularity in many clinical fields, for a variety of therapeutic and aesthetic purposes. In addition, there have been reports regarding the positive effect of BoTA on flap survival by various mechanisms. In this study, we hypothesized that pretreatment with BoTA could augment the survival of TRAM flaps via increased hypoxia-inducible factor (HIF)1α/vascular endothelial growth factor (VEGF)-dependent angiogenesis.Twenty-four Sprague-Dawley rats were randomly divided into 2 groups: a control group and a BoTA group. Five days before superiorly based TRAM flap elevation, the BoTA group was pretreated with BoTA, whereas the control group was pretreated with normal saline. Gross flap survival rates were assessed, and quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR) and Western blotting were performed for the evaluation of angiogenesis-related factors (CD34, HIF-1α, and VEGF).In the BoTA group, the gross flap survival rate was significantly higher than that in the control group on both ipsilateral (92.78.3 ± 5.05% vs 86.8 ± 3.88%, P = 0.009) and contralateral (91.57 ± 5.79% vs 74.28 ± 11.83%, P model.

  7. Lymphomas and metastases of the extra-ocular musculature

    Energy Technology Data Exchange (ETDEWEB)

    Surov, Alexey; Behrmann, Curd; Koesling, Sabrina [Martin Luther University of Halle-Wittenberg, Department of Radiology, Halle (Germany); Holzhausen, Hans-Juergen [Martin Luther University of Halle-Wittenberg, Department of Pathology, Halle (Germany)

    2011-11-15

    The involvement of extra-ocular muscles in malignant diseases has been described only sporadically. The purpose of this study was to estimate the prevalence of orbital muscle lymphoma and metastases and to analyse their radiological findings. In the time period from January 2000 to January 2010, 11 patients with extra-ocular muscle malignancies (EOMM) were retrospectively identified in the radiological database of our institution. There were four women and seven men with a median age of 58 years (range, 47 to 72 years). In three patients non-Hodgkin lymphoma (NHL), in seven cases intramuscular metastases of solid tumours and in one patient plasmacytoma of orbital muscles were diagnosed. In all, magnetic resonance imaging (MRI) was performed on 11 patients using a 1.5-T MRI scanner (Magnetom Vision Sonata Upgrade, Siemens, Germany). The diagnosis of EOMM was confirmed histopathologically by muscle biopsy in all cases. The prevalence of orbital muscle involvement in plasmacytoma was 0.3%, in NHL 0.4% and in carcinomas 0.1%. Clinically, EOMM presented as painless proptosis and motility disturbance. Medial and lateral rectus muscles were involved in most patients. On T2-weighted images, the lesions were isointense or mixed iso-to-hyperintense in comparison to the unaffected musculature. On T1-weighted images, all tumours were homogeneously isointense. After intravenous administration of contrast medium, most lesions showed moderate heterogeneous enhancement. Lymphomas and metastases are rare lesions of the extra-ocular musculature with a prevalence below 0.5%. Their radiological and clinical signs are non-specific and include painless muscle enlargement or masses. They should be considered in the differential diagnosis of diseases of extra-ocular muscles. (orig.)

  8. Human Brain Reacts to Transcranial Extraocular Light.

    Science.gov (United States)

    Sun, Lihua; Peräkylä, Jari; Kovalainen, Anselmi; Ogawa, Keith H; Karhunen, Pekka J; Hartikainen, Kaisa M

    2016-01-01

    Transcranial extraocular light affects the brains of birds and modulates their seasonal changes in physiology and behavior. However, whether the human brain is sensitive to extraocular light is unknown. To test whether extraocular light has any effect on human brain functioning, we measured brain electrophysiology of 18 young healthy subjects using event-related potentials while they performed a visual attention task embedded with emotional distractors. Extraocular light delivered via ear canals abolished normal emotional modulation of attention related brain responses. With no extraocular light delivered, emotional distractors reduced centro-parietal P300 amplitude compared to neutral distractors. This phenomenon disappeared with extraocular light delivery. Extraocular light delivered through the ear canals was shown to penetrate at the base of the scull of a cadaver. Thus, we have shown that extraocular light impacts human brain functioning calling for further research on the mechanisms of action of light on the human brain.

  9. An unusual extraocular muscle anomaly in a patient with Crouzon's disease.

    OpenAIRE

    SNIR, M.; Gilad, E.; Ben-Sira, I

    1982-01-01

    A 29-year-old female suffering from Crouzon's disease was admitted to hospital with retinal detachment in the right eye. At operation agenesis of 4 extraocular muscles (superior and inferior recti and obliquus) was found, together with abnormal insertion of the 2 horizontal muscles. The same extraocular muscular abnormalities were found in the left eye. We suggest here a new surgical treatment in such cases and discuss the reasons for the limitation of ocular motility in such cases.

  10. An unusual extraocular muscle anomaly in a patient with Crouzon's disease.

    Science.gov (United States)

    Snir, M.; Gilad, E.; Ben-Sira, I.

    1982-01-01

    A 29-year-old female suffering from Crouzon's disease was admitted to hospital with retinal detachment in the right eye. At operation agenesis of 4 extraocular muscles (superior and inferior recti and obliquus) was found, together with abnormal insertion of the 2 horizontal muscles. The same extraocular muscular abnormalities were found in the left eye. We suggest here a new surgical treatment in such cases and discuss the reasons for the limitation of ocular motility in such cases. Images PMID:7066280

  11. Localising rectus muscle insertions using high frequency wide-field ultrasound biomicroscopy.

    Science.gov (United States)

    Khan, Hayat Ahmad; Smith, David R; Kraft, Stephen P

    2012-05-01

    The ultrasound biomicroscope (UBM) can accurately locate an extraocular muscle (EOM) insertion. The authors compared the accuracy of the Sonomed UBM (SUBM), a new 'wide-field ultrasound biomicroscope', with the older model Humphrey UBM (HUBM) in localising EOM insertions and compared their ranges of detection of muscle insertions. Prospective, double-masked, observational study of 27 patients undergoing primary (n=40 muscles) or repeat (n=10 muscles) horizontal or vertical rectus muscle surgery. EOM insertional distances were measured with SUBM, and then intraoperatively with callipers. A Bland-Altman analysis and intraclass correlation coefficient were used to compare the SUBM and surgical data. For all muscles, the differences between SUBM and surgery measurements were less than 1.0 mm. The mean of the SUBM insertion distances was 6.67 mm (SD 1.65 mm) versus 6.7 mm (SD 1.6 mm) at surgery. The intraclass correlation coefficient showed 'excellent' correlation between the two sets of data and was higher than that reported with HUBM. The image quality with the SUBM was superior to the HUBM, and its range of field was much larger (14×18 mm vs 5×6 mm). The SUBM with its smaller, more manoeuvrable probe handpiece and a wider scanning field was more accurate in detecting muscle insertions compared with HUBM.

  12. 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.

  13. Autologous grafting of extraocular muscles: experimental study in rabbits Transplante autólogo de musculatura ocular extrínseca: estudo experimental em coelhos

    Directory of Open Access Journals (Sweden)

    Jorge Meireles-Teixeira

    2005-06-01

    Full Text Available PURPOSE: To evaluate the feasibility of autologous extraocular muscle grafting as a type of muscle expansion surgery. METHODS: The left superior rectus muscle of twenty-nine rabbits was resected and this fragment was attached to the endpoint of the respective right superior rectus (test group. Thereafter, the superior rectus of the left eye was reattached to the sclera (control group. Both groups were examined during different postoperative periods in order to assess their outcomes. RESULTS: The presence of hyperemia was slightly more frequent in the grafted group. Secretion and muscle atrophy were negligible in both groups. Fibrosis was greater in grafted animals. These muscles were weaker than the control muscles, although the force required to split muscular parts was always greater than the physiological one. CONCLUSIONS: This surgical technique was reliable and useful if one intends to achieve muscle expansion without the intrinsic risks of dealing with heterologous/artificial materials.OBJETIVO: Avaliar a viabilidade do uso de segmentos de músculos oculares extrínsecos como expansores de tendões musculares. MÉTODOS: Vinte e nove coelhos tiveram seu músculo reto superior esquerdo ressecado e o fragmento de cada um foi transplantado para o reto superior contralateral (grupo-teste. Então, o reto superior esquerdo foi reinserido na esclera (grupo-controle. Os animais foram então examinados em diversos períodos pós-operatórios, até os seus sacrifícios, para que se avaliasse o desenrolar dessa técnica cirúrgica. RESULTADOS: A hiperemia foi maior entre os testes. A secreção e a atrofia muscular foram mínimas nos dois grupos. Houve maior presença de fibrose no grupo-teste, mas não tão expressiva a ponto de inviabilizar os efeitos da cirurgia. Esses músculos também se romperam mais facilmente do que os do grupo-controle, porém, a força de rompimento foi sempre bem maior do que aquela presente numa contração muscular normal

  14. Spiral CT localization of the point where superior epigastric artery perforates rectus abdominis muscle%对腹壁上动脉穿腹直肌点的螺旋电子计算机断层扫描定位及其意义

    Institute of Scientific and Technical Information of China (English)

    张佳琦; 张金明; 陈宇宏; 冀晨阳

    2013-01-01

    目的 通过应用螺旋电子计算机断层扫描(CT)血管造影对腹壁上动脉进行定位,以评估乳房再造术后其预防供区并发症的意义.方法 对50例无上腹部手术史患者进行螺旋CT血管造影.建立坐标系,以脐为原点,平脐水平线为X轴,脐垂直线为Y轴.在上述坐标系中定位腹壁上动脉穿腹直肌点(下简称穿肌点)的位置.结果 50例患者在CT检测下共发现392个穿肌点,平均每例7.84个穿肌点.第1象限的穿肌点横轴主要分布在1.45~5.47 cm,纵轴主要分布在2.52~16.38 cm.第2象限的穿肌点横轴主要分布在2.02~6.80 cm,纵轴主要分布在2.30~14.46 cm.结论 螺旋CT血管造影具有高度的敏感性和特异性,进行腹壁上动脉穿肌点的定位可以避免术中切取多余的腹直肌,对减少腹壁供区的并发症有很大意义.%Objective To locate the points where the superior epigastric artery perforates the rectus abdominis muscle by using the spiral CT,in order to evaluate its control on abdominal complications after breast reconstruction.Methods Fifty cases had received abdominal spiral CT angiography,respectively.Then the coordinate system was established,with the umbilicus as the origin,the umbilicus horizontal line as X axis,vertical umbilical level line as Y axis.The point where superior epigastric artery perforates the rectus abdominis muscle in the coordinate system was located as described above.Results There were 392 perforating points in the rectus abdominis muscle in all 50 cases,with a mean of 7.84 perforators per patient.In the first quadrant,the points where superior epigastric artery perforate the rectus abdominis muscle were located in the range from 1.45 cm to 5.47 cm on the X axis,and in the range from 2.52 cm to 16.38 cm on the Y axis,respectively.In the second quadrant,the points where superior epigastric artery perforates the rectus abdominis muscle were located in the range from 2.02 cm to 6.80 cm on the X axis,and in

  15. Rectus Femoris Tendon Calcification

    Science.gov (United States)

    Zini, Raul; Panascì, Manlio; Papalia, Rocco; Franceschi, Francesco; Vasta, Sebastiano; Denaro, Vincenzo

    2014-01-01

    Background: Since it was developed, hip arthroscopy has become the favored treatment for femoroacetabular impingement. Due to recent considerable improvements, the indications for this technique have been widely extended. Injuries of the rectus femoris tendon origin, after an acute phase, could result in a chronic tendinopathy with calcium hydroxyapatite crystal deposition, leading to pain and loss of function. Traditionally, this condition is addressed by local injection of anesthetic and corticosteroids or, when conservative measures fail, by open excision of the calcific lesion by an anterior approach. Purpose: To assess whether arthroscopic excision of calcification of the proximal rectus is a safe and effective treatment. Study Design: Case series; Level of evidence, 4. Methods: Outcomes were studied from 6 top amateur athletes (age range, 30-43 years; mean, 32.6 years) affected by calcification of the proximal rectus who underwent arthroscopic excision of the calcification. Patients were preoperatively assessed radiographically, and diagnosis was confirmed by a 3-dimensional computed tomography scan. To evaluate the outcome, standardized hip rating scores were used pre- and postoperatively (at 6 and 12 months): the Hip disability and Osteoarthritis Outcome Score, Oxford Hip Score, and Modified Harris Hip Score. Moreover, visual analog scales (VAS) for pain, sport activity level (SAL), and activities of daily living (ADL) were also used. Results: One year after surgery, all patients reported satisfactory outcomes, with 3 of 6 rating their return-to-sport level as high as preinjury level, and the remaining 3 with a percentage higher than 80%. Five patients ranked their ability to carry on daily activities at 100%. Statistical analysis showed significant improvement of the Oxford Hip Score, the Modified Harris Hip Score, and all 3 VAS subscales (pain, SAL, and ADL) from pre- to latest postoperative assessment (P < .05). Conclusion: Arthroscopic excision of

  16. Surgically mismanaged ptosis in a patient with congenital fibrosis of the extraocular muscles type I

    Directory of Open Access Journals (Sweden)

    Hatem A Tawfik

    2012-01-01

    Full Text Available Fibrosis syndromes comprise a rare form of severe limitation of ocular motility. An 11-year-old girl was referred for the correction of eyelid retraction. The eyelid retraction occurred immediately following levator resection surgery performed by a plastic surgeon who missed the restrictive extraocular muscle abnormalities. On examination, both eyes were fixed in an infraducted position (20 prism diopters (Δ, with a chin-up position and significant lagophthalmos. Bilateral 12-mm inferior rectus recession with adjustable sutures was performed, which resulted in significant reduction of lagophthalmos and elimination of the head tilt.

  17. 放疗对上蒂横行腹直肌肌皮瓣乳房再造的影响%Impacts of radiation on reconstructed breasts by superior epigastric vessel pedicled transverse rectus abdominal myocutaneous in breast cancer patients

    Institute of Scientific and Technical Information of China (English)

    路忠志; 肖春花; 李东生; 祝清华; 孙思敬; 李敏; 曹旭晨

    2015-01-01

    目的 评估放疗对上蒂横行腹直肌肌皮瓣(TRAM)乳房再造的影响.方法 回顾性分析2009年6月-2012年6月于天津医科大学肿瘤医院行上蒂TRAM术式乳腺癌490例,去除双乳再造18例,分为4组,A组即刻乳房再造+术后放疗组(123例),B组即刻乳房再造无放疗组(262例),C组放疗后择期乳房再造组(34例),D组延期乳房再造无放疗组(53例).主要评估指标为:术后3个月及术后或放疗后1年术后并发症及腹部功能、外观及心理学(BREAST-Q量表)评分,放疗对上蒂TRAM乳房再造的影响.结果 1.1%患者术后发生皮瓣坏死,2.5%切口延期愈合,1.1%血管栓塞,6.1%脂肪液化;7.0%患者术后发生脂肪坏死,5.3%再造乳房缩小,3.6%皮瓣挛缩,0.8%腹壁膨出及疝.与无放疗组患者相比,放疗组患者在肿瘤临床分期方面差异有统计学意义(P<0.05).本组平均随访时间(24.98 ±6.99)个月.在术后早期并发症方面差异均无统计学意义(均P>0.05),术后或放疗后晚期并发症方面差异有统计学意义(均P<0.05).各组患者在同一随访点对乳房美学、腹部功能与外观及心理学评价差异均无统计学意义(均P>0.05). 结论 TRAM乳房重建患者中,术前明确无需术后放疗者,可行即刻乳房重建;术后需放疗者,应在完成放疗后再行乳房重建.%Objective To assess the impact of radiation on superior epigastric vessel pedicled transverse rectus abdominal myocutaneous (TRAM) for breast reconstruction.Methods Female breast cancer patients were divided into 4 groups:group A (immediate breast reconstruction + radiation therapy,123 cases),group B (immediate breast reconstruction,262 cases),group C (radiation therapy + delayed breast reconstruction,34 cases),group D (delayed breast reconstruction,53 cases) from June 2009 to June 2012 at Department of Breast Oncology,Tianjin Medical University.Patient demographics,operative details,radiation therapy details

  18. Altered Protein Composition and Gene Expression in Strabismic Human Extraocular Muscles and Tendons

    Science.gov (United States)

    Agarwal, Andrea B.; Feng, Cheng-Yuan; Altick, Amy L.; Quilici, David R.; Wen, Dan; Johnson, L. Alan; von Bartheld, Christopher S.

    2016-01-01

    Purpose To determine whether structural protein composition and expression of key regulatory genes are altered in strabismic human extraocular muscles. Methods Samples from strabismic horizontal extraocular muscles were obtained during strabismus surgery and compared with normal muscles from organ donors. We used proteomics, standard and customized PCR arrays, and microarrays to identify changes in major structural proteins and changes in gene expression. We focused on muscle and connective tissue and its control by enzymes, growth factors, and cytokines. Results Strabismic muscles showed downregulation of myosins, tropomyosins, troponins, and titin. Expression of collagens and regulators of collagen synthesis and degradation, the collagenase matrix metalloproteinase (MMP)2 and its inhibitors, tissue inhibitor of metalloproteinase (TIMP)1 and TIMP2, was upregulated, along with tumor necrosis factor (TNF), TNF receptors, and connective tissue growth factor (CTGF), as well as proteoglycans. Growth factors controlling extracellular matrix (ECM) were also upregulated. Among 410 signaling genes examined by PCR arrays, molecules with downregulation in the strabismic phenotype included GDNF, NRG1, and PAX7; CTGF, CXCR4, NPY1R, TNF, NTRK1, and NTRK2 were upregulated. Signaling molecules known to control extraocular muscle plasticity were predominantly expressed in the tendon rather than the muscle component. The two horizontal muscles, medial and lateral rectus, displayed similar changes in protein and gene expression, and no obvious effect of age. Conclusions Quantification of proteins and gene expression showed significant differences in the composition of extraocular muscles of strabismic patients with respect to important motor proteins, elements of the ECM, and connective tissue. Therefore, our study supports the emerging view that the molecular composition of strabismic muscles is substantially altered. PMID:27768799

  19. 21 CFR 886.3340 - Extraocular orbital implant.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Extraocular orbital implant. 886.3340 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Prosthetic Devices § 886.3340 Extraocular orbital implant. (a) Identification. An extraocular orbital implant is a nonabsorbable device intended to be implanted during...

  20. [Enthesopathy of the upper insertion of the musculus rectus femoris. A retrospective sign of tendon rupture in sports pathology].

    Science.gov (United States)

    Baudrillard, J C; Lerais, J M; Segal, P; Durot, J F; Gatfosse, M; Auquier, F; Toubas, O

    1986-03-01

    We report 4 cases of post-traumatic enthesopathy occurring later after rupture of rectus femoris tendon from the anterior superior iliac spine. Radiographic feature and clinical picture are typical of diagnosis.

  1. Rectus sheath abscess after laparoscopic appendicectomy

    Directory of Open Access Journals (Sweden)

    Golash Vishwanath

    2007-01-01

    Full Text Available Port site wound infection, abdominal wall hematoma and intraabdominal abscess formation has been reported after laparoscopic appendicectomy. We describe here a rectus sheath abscess which occurred three weeks after the laparoscopic appendicectomy. It was most likely the result of secondary infection of the rectus sheath hematoma due to bleeding into the rectus sheath from damage to the inferior epigastric arteries or a direct tear of the rectus muscle. As far as we are aware this complication has not been reported after laparoscopic appendicectomy.

  2. Congenital Fibrosis of the Extraocular Muscles

    Directory of Open Access Journals (Sweden)

    Leyla Niyaz

    2014-08-01

    Full Text Available Congenital fibrosis of the extraocular muscles (CFEOM is a rare disorder characterized by hereditary non-progressive restrictive strabismus and blepharoptosis. Although most of the cases are bilateral and isolated, some patients may have systemic findings. CFEOM is divided into three groups as CFEOM 1, 2, and 3 according to the phenotype. Primary responsible genes are KIF21A for CFEOM type 1 and 3 and PHOX2A/ARIX gene for CFEOM type 2. Studies suggest that abnormal innervation of the extraocular muscles is the cause of muscle fibrosis. Early treatment is important because of the risk of amblyopia. Surgery is the primary treatment option for strabismus and blepharoptosis. (Turk J Ophthalmol 2014; 44: 312-5

  3. Thoracic empyema caused by Campylobacter rectus.

    Science.gov (United States)

    Ogata, Tomoyuki; Urata, Teruo; Nemoto, Daisuke; Hitomi, Shigemi

    2017-03-01

    We report a case of thoracic empyema caused by Campylobacter rectus, an organism considered as a periodontal pathogen but rarely recovered from extraoral specimens. The patient fully recovered through drainage of purulent pleural fluid and administration of antibiotics. The present case illustrates that C. rectus can be a cause of not only periodontal disease but also pulmonary infection.

  4. Magnetic resonance imaging of the extraocular muscles and corresponding cranial nerves in patients with special forms of strabismus

    Institute of Scientific and Technical Information of China (English)

    JIAO Yong-hong; ZHAO Kan-xing; WANG Zhen-chang; QIAN Xue-han; WU Xiao; MAN Feng-yuan; LU Wei; SHE Hai-cheng

    2009-01-01

    Background With the technical advances, magnetic resonance imaging (MRI) is now sensitive enough to detect subtle structural abnormalities of ocular motor nerves arising from the brainstem and orbits of living subjects. This study was designed to delineate the MRI characteristics in patients with special forms of strabismus.Methods A total of 29 patients with special forms of strabismus underwent orbital and intracalvarium MRI. Imaging of the ocular motor nerves in the brainstem was performed in 0.8 mm thickness image planes using the three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA) sequence. Nerves to extraocular muscles (EOMs), EOMs and their associated connective tissues were imaged with T1 weighting in tri-planar scans by dual-phased coils within 2.0 mm thick planes.Results Patients with congenital fibrosis of the extraocular muscles exhibited hypoplasia of the oculomotor (CN3), abducens (CN6), trochlear (CN4) nerves, and the EOMs; hypoplasia of CN6 in the brainstem and an extra branch of the inferior division of CN3 to the lateral rectus were the most common but not the only presentation of Duane's retraction syndrome. Hypoplasia of CN6, facial (CN7) and hypoglossal (CN12) nerves were revealed in patients with M(o)bius syndrome. In a rare case of bilateral synergistic convergence and divergence, an enlarged branch of CN3 to the medial rectus and a questionable branch of CN3 to the inferior rectus bilaterally were found.Conclusion MRI can reveal subtle structures of the ocular motor nerves and their corresponding EOMs. This can provide valuable information regarding pathogenesis in some special forms of strabismus.

  5. Loss of MAFB Function in Humans and Mice Causes Duane Syndrome, Aberrant Extraocular Muscle Innervation, and Inner-Ear Defects.

    Science.gov (United States)

    Park, Jong G; Tischfield, Max A; Nugent, Alicia A; Cheng, Long; Di Gioia, Silvio Alessandro; Chan, Wai-Man; Maconachie, Gail; Bosley, Thomas M; Summers, C Gail; Hunter, David G; Robson, Caroline D; Gottlob, Irene; Engle, Elizabeth C

    2016-06-02

    Duane retraction syndrome (DRS) is a congenital eye-movement disorder defined by limited outward gaze and retraction of the eye on attempted inward gaze. Here, we report on three heterozygous loss-of-function MAFB mutations causing DRS and a dominant-negative MAFB mutation causing DRS and deafness. Using genotype-phenotype correlations in humans and Mafb-knockout mice, we propose a threshold model for variable loss of MAFB function. Postmortem studies of DRS have reported abducens nerve hypoplasia and aberrant innervation of the lateral rectus muscle by the oculomotor nerve. Our studies in mice now confirm this human DRS pathology. Moreover, we demonstrate that selectively disrupting abducens nerve development is sufficient to cause secondary innervation of the lateral rectus muscle by aberrant oculomotor nerve branches, which form at developmental decision regions close to target extraocular muscles. Thus, we present evidence that the primary cause of DRS is failure of the abducens nerve to fully innervate the lateral rectus muscle in early development.

  6. Creep Behavior of Passive Bovine Extraocular Muscle

    OpenAIRE

    Lawrence Yoo; Hansang Kim; Andrew Shin; Vijay Gupta; Demer, Joseph L.

    2011-01-01

    This paper characterized bovine extraocular muscles (EOMs) using creep, which represents long-term stretching induced by a constant force. After preliminary optimization of testing conditions, 20 fresh EOM samples were subjected to four different loading rates of 1.67, 3.33, 8.33, and 16.67%/s, after which creep was observed for 1,500 s. A published quasilinear viscoelastic (QLV) relaxation function was transformed to a creep function that was compared with data. Repeatable creep was observed...

  7. Rectus sheath hematoma: three case reports

    Directory of Open Access Journals (Sweden)

    Kapan Selin

    2008-01-01

    Full Text Available Abstract Introduction Rectus sheath hematoma is an uncommon cause of acute abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. It could occur spontaneously or after trauma. They are usually located infraumblically and often misdiagnosed as acute abdomen, inflammatory diseases or tumours of the abdomen. Case presentation We reported three cases of rectus sheath hematoma presenting with a mass in the abdomen and diagnosed by computerized tomography. The patients recovered uneventfully after bed rest, intravenous fluid replacement, blood transfusion and analgesic treatment. Conclusion Rectus sheath hematoma is a rarely seen pathology often misdiagnosed as acute abdomen that may lead to unnecessary laparotomies. Computerized tomography must be chosen for definitive diagnosis since ultrasonography is subject to error due to misinterpretation of the images. Main therapy is conservative management.

  8. Extraocular muscle afferent signals modulate visual attention.

    Science.gov (United States)

    Balslev, Daniela; Newman, William; Knox, Paul C

    2012-10-09

    Extraocular muscle afferent signals contribute to oculomotor control and visual localization. Prompted by the close links between the oculomotor and attention systems, it was investigated whether these proprioceptive signals also modulated the allocation of attention in space. A suction sclera contact lens was used to impose an eye rotation on the nonviewing, dominant eye. With their viewing, nondominant eye, participants (n = 4) fixated centrally and detected targets presented at 5° in the left or right visual hemifield. The position of the viewing eye was monitored throughout the experiment. As a control, visual localization was tested using finger pointing without visual feedback of the hand, whereas the nonviewing eye remained deviated. The sustained passive rotation of the occluded, dominant eye, while the other eye maintained central fixation, resulted in a lateralized change in the detectability of visual targets. In all participants, the advantage in speed and accuracy for detecting right versus left hemifield targets that occurred during a sustained rightward eye rotation of the dominant eye was reduced or reversed by a leftward eye rotation. The control experiment confirmed that the eye deviation procedure caused pointing errors consistent with an approximately 2° shift in perceived eye position, in the direction of rotation of the nonviewing eye. With the caveat of the small number of participants, these results suggest that extraocular muscle afferent signals modulate the deployment of attention in visual space.

  9. Full-tendon nasal transposition of the vertical rectus muscles: a retrospective review.

    Science.gov (United States)

    Dawson, Emma L M; Boyle, Natalie J; Lee, John P

    2007-01-01

    The authors report the results of a retrospective review of patients who underwent nasal transposition of the vertical rectus muscles between 1997 and 2004. Eight patients were identified, 4 males and 4 females. There was an average age at surgery of 37 years, with a range from 8 to 79 years. The aetiologies included 6 patients with trauma to their medial rectus (4 following endoscopic sinus surgery) and 2 patients with paralytic medial rectus muscles secondary to 3rd nerve palsy. All patients underwent whole tendon transposition of the superior and inferior rectus muscles, with resection of both muscles in 7 cases, before reattachment adjacent to the upper and lower borders of the medial rectus, respectively. One patient had a reduced amount of resection and this was combined with inferior oblique disinsertion and traction sutures. All patients had a reduction in deviation in the primary position and in 5 patients there was some improvement in adduction. A consequence of surgery was a degree of limitation of abduction, elevation and depression in some patients. Overall, patients were satisfied with the improvement in their appearance.

  10. Preservation and Observation of Amterior Ciliary Vessels in Rectus Muscles during Strabismus Surgery

    Institute of Scientific and Technical Information of China (English)

    GuanghuanMai; JianhuaYan

    1995-01-01

    Purpose:To observe the form and number of the anterior ciliary vessels(ACV)in rectus muscles.To train technician in preservation an d obsevation of ACV,so preservation can be done in caes with a rish of anterior segment ischemia(ASI).Methods:Curved foreign knife,iris hook,plastic rubber band and standard operat-ing loupes(3x)or microscope were used in the surgery on 34cases of comitant strabismus and 18cases of paralytic strabismus.Results:The ACVs per muscle in medial,lateral,superior,inferior rectus were3.08,3.26,3.50and3.50respectively in 89muscles of 52surgical strabismus cas-es.All ACVs in 16rectus muscles and 90out of 220ACVs in 73rectus muscles were too small ortoo short to be dissected.The sucess rate of ACV preservation was91.5%(119/130).105out of 130vessels were saved using loupe magnifica-tion and 14pit pf130vessels were saved under operating microscope.Conclusions:The number of ACVinrectus muscles are more than 2in our obser-vation cases.The ACVpreservation has the clinical value of allowing us toper-form muscle sugery on three or more rectus muscles simultaneously and get fonal surgical results more earlier after acv in each muscle are dissected and preserved otherwinse staged surgery are needed.The each strabismus surgeon must knov this technique.

  11. Flap tear of rectus muscles: an underlying cause of strabismus after orbital trauma.

    Science.gov (United States)

    Ludwig, Irene H; Brown, Mark S

    2002-11-01

    To present an avulsion injury of the rectus muscle after orbital trauma, usually the inferior rectus, and detail its diagnosis and operative repair. Forty-three patients underwent repair of flap tears of 62 rectus muscles. During surgery, we found the muscle abnormality was often subtle, with narrowing or thinning of the remaining attached global layer of muscle. The detached flap of external (orbital) muscle was found embedded in surrounding orbital fat and connective tissue. Retrieval and repair were performed in each case. The causes of orbital trauma were as follows: orbital fractures (15 patients), blunt trauma with no fracture (11 patients), suspected trauma but did not undergo computerized tomographic scan (12 patients), and status after retinal detachment repair (5 patients). Of note, 15 of the 43 patients (35%) underwent repair of the flap tear alone, without any additional orbital or strabismus surgery. Diagnostically, the predominant motility defect in 45 muscles was limitation toward the field of action of the muscle, presumably as a result of a tether created by the torn flap; these tethers simulated muscle palsy. Seventeen muscles were restricted away from their field of action, simulating entrapment. The direction taken by the flap during healing determined the resultant strabismus pattern. All patients with gaze limitation toward an orbital fracture had flap tears. The worst results after flap tear repair were seen in patients (1) who had undergone orbital fracture repair before presentation, (2) who had undergone previous attempts at strabismus repair, and (3) who had the longest intervals between the precipitating event and the repair. The best results were obtained in patients who underwent simultaneous fracture and strabismus repair or early strabismus repair alone. Avulsion-type flap tears of the extraocular muscles are a common cause of posttraumatic strabismus. Early repair produces the best results, but improvement is possible despite long

  12. Inferior Rectus Transposition: A Novel Procedure for Abducens Palsy.

    Science.gov (United States)

    Velez, Federico G; Chang, Melinda Y; Pineles, Stacy L

    2017-05-01

    Superior rectus transposition has been popularized for the treatment of abduction deficiencies. Potential complications include induced vertical deviation and torsion. A new procedure, the inferior rectus transposition (IRT), may be similarly beneficial for patients at risk for postoperative vertical deviation or incyclotropia. The purpose of this study is to describe the outcomes of patients undergoing IRT. Prospective, interventional case series. Five patients in an academic pediatric ophthalmology and strabismus practice with a complete lateral rectus palsy who underwent IRT were studied. Changes in anomalous head posture, ocular rotations, ocular alignment, and torsion preoperatively to postoperatively were compared. The patients ranged in age from 19-89 years. There was a significant correction in the angle of esotropia (ET) from 39±17Δ (14-55Δ) to 12 ± 9.8Δ (0-22Δ) postoperatively (P = .02). Two of 5 patients had preoperative hypertropia of the affected eye (1.4 ± 2.2Δ; range, 2-5Δ). One of those had no vertical deviation postoperatively and 1 patient resulted in 2Δ hypotropia. One patient without vertical misalignment preoperatively developed a small postoperative vertical deviation. Torticollis significantly improved from 31.4 ± 11.6° to 5 ± 5.8° (P = .004). All patients improved abduction, with a mean of -4.4 ± 0.5 preoperatively to -3.4 ± 0.9 postoperatively (P = .07). Initial postoperative follow-up in patients with abducens palsy undergoing IRT shows a significant improvement in ocular alignment and torticollis. In patients with preoperative hypertropia, IRT resulted in a downward shifting effect on the operated eye. IRT may be a beneficial procedure for patients with preoperative hypertropia or intorsion requiring transposition procedures. Future studies with larger populations and longer durations of follow-up will be required before this procedure can be recommended. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. The Effect of Acute Superior Oblique Palsy on Torsional Optokinetic Nystagmus in Monkeys

    Science.gov (United States)

    Shan, Xiaoyan; Tian, Jing; Ying, Howard S.; Walker, Mark F.; Guyton, David; Quaia, Christian; Optican, Lance M.; Tamargo, Rafael J.; Zee, David S.

    2008-01-01

    Purpose To investigate the effects of acquired superior oblique palsy (SOP) and corrective strabismus surgery on torsional optokinetic nystagmus (tOKN) in monkeys. Methods The trochlear nerve was severed intracranially in two rhesus monkeys (M1 and M2). For each monkey, more than 4 months after the SOP, the ipsilateral inferior oblique muscle was denervated and extirpated. For M2, 4 months later, the contralateral inferior rectus muscle was recessed by 2 mm. tOKN was elicited during monocular viewing of a rotating stimulus that was rear projected onto a screen 43.5 cm in front of the animal. Angular rotation of the stimulus about the center was 40 deg/s clockwise or counterclockwise. Results The main findings after trochlear nerve sectioning were (1) the amplitude and peak velocity of torsional quick and slow phases of the paretic eye was less than that in the normal eye for both intorsion and extorsion, and (2) the vertical motion of the paretic eye increased during both torsional slow and quick phases. After corrective inferior oblique surgery, both of these effects were even greater. Conclusions Acquired SOP and corrective inferior oblique–weakening surgery create characteristic patterns of change in tOKN that reflect alterations in the dynamic properties of the extraocular muscles involved in eye torsion. tOKN also provides information complementary to that provided by the traditional Bielschowsky head-tilt test and potentially can help distinguish among different causes of vertical ocular misalignment. PMID:18385059

  14. Presumed isotretinoin-induced extraocular myopathy

    Directory of Open Access Journals (Sweden)

    Md. Shahid Alam

    2016-01-01

    Full Text Available Isotretinoin a synthetic analogue of vitamin A is primarily used for cystic acne not responding to conventional treatment. Several ocular side effects including blurring of vision, decreased dark adaptation, corneal opacities and meibomian gland atrophy have been reported with prolonged use of isotretinoin. There have been reports of muscular damage caused by isotretinoin. Extra ocular myopathy as an adverse effect of long term used of isotretinoin has never been mentioned in literature. We report a case of a young male who presented to us with complaints of diplopia after using isotretinoin for a prolonged period. He was diagnosed as a case of presumed isotretinoin extraocular myopathy after imaging and other blood investigations.

  15. Using weights in abdominal exercises: electromyography response of the Rectus Abdominis and Rectus Femoris muscles.

    Science.gov (United States)

    Moraes, A C; Bankoff, A D; Almeida, T L; Simões, E C; Rodrigues, C E; Okano, A H

    2003-12-01

    Among persons who do regular exercises, many include abdominal exercises in their customary routine. For this, there are a growing variety of movements being created for strengthening the abdominal muscles. This work aims to know, through electromyography analysis, the action potencies of the supra and infra umbilical of the Rectus Abdominis and Rectus Femoris muscles during the execution of abdominal exercises with and without the addition of weights. Lying on the backside, seven flexing movements of the trunk--one without weight, three with 2 Kg on the neck, elbow and chest and three with 4 Kg on the same points--were executed. Nine female university students between 18 and 23 years old participated in the study. Surface electrodes were fixed to the supra and infra umbilical areas of the Rectus Abdominis and Rectus Femoris muscles. The results showed that the utilization of weights in the abdominal exercises did not appear to be effective for the Rectus Abdominis muscle since greater action potencies were only verified in the Rectus Femoris muscle. We concluded that the differences observed in the RMS were not relevant to the point of indicating the utilization of weights to improve abdominal exercises because greater action potencies were only observed in the Rectus Femoris muscle.

  16. Rectus Abdominis Endometrioma after Caesarean Section

    Directory of Open Access Journals (Sweden)

    Igor Mishin

    2016-01-01

    Full Text Available Isolated rectus abdominis muscle endometriosis is very uncommon with less than 20 case reports being published to date since its first description in 1984 by Amato and Levitt. We report another case of isolated rectus abdominis endometriosis in a 37-year-old patient with a previous caesarian section. We also discuss the diagnostic and treatment particularities in these patients. In our case, the treatment was only surgical and currently the patient is disease-free during the 24-month follow-up.

  17. CT in the diagnosis of isolated cysticercal infestation of extraocular muscle

    Energy Technology Data Exchange (ETDEWEB)

    Rauniyar, R.K.; Thakur, S.K.D.; Panda, A

    2003-02-01

    AIM: To evaluate the use of computed tomography (CT) and ultrasound (US) to diagnose orbital cysticercosis, and present the diagnostic features. METHOD: US and CT were used to evaluate patients with proptosis. Four patients were diagnosed as having orbital myocysticercosis and treated with oral albendazole and corticosteroid. Follow-up was undertaken with US and CT. RESULT: US features were confirmatory of myocysticercosis in two eyes where as CT was effective in diagnosing the condition in all four eyes. In two patients the medial rectus was involved, in one the superior rectus and, in the other, the inferior rectus muscles. Serial US and CT revealed complete resolution of the lesions in 3 months. CONCLUSION: CT is useful method in diagnosing isolated orbital myocysticercosis. Our report demonstrated that ophthalmic signs and symptoms in the presence of proptosis, especially in an endemic region, should alert the clinician to the possibility of myocysticercosis. Though CT is superior, US can be used as a economical follow-up investigation. Rauniyar, R. K. etal. (2003) Clinical Radiology58, 154--156.

  18. Single motor unit activity in human extraocular muscles during the vestibulo-ocular reflex.

    Science.gov (United States)

    Weber, Konrad P; Rosengren, Sally M; Michels, Rike; Sturm, Veit; Straumann, Dominik; Landau, Klara

    2012-07-01

    Motor unit activity in human eye muscles during the vestibulo-ocular reflex (VOR) is not well understood, since the associated head and eye movements normally preclude single unit recordings. Therefore we recorded single motor unit activity following bursts of skull vibration and sound, two vestibular otolith stimuli that elicit only small head and eye movements. Inferior oblique (IO) and inferior rectus (IR) muscle activity was measured in healthy humans with concentric needle electrodes. Vibration elicited highly synchronous, short-latency bursts of motor unit activity in the IO (latency: 10.5 ms) and IR (14.5 ms) muscles. The activation patterns of the two muscles were similar, but reciprocal, with delayed activation of the IR muscle. Sound produced short-latency excitation of the IO muscle (13.3 ms) in the eye contralateral to the stimulus. Simultaneous needle and surface recordings identified the IO as the muscle of origin of the vestibular evoked myogenic potential (oVEMP) thus validating the physiological basis of this recently developed clinical test of otolith function. Single extraocular motor unit recordings provide a window into neural activity in humans that can normally only be examined using animal models and help identify the pathways of the translational VOR from otoliths to individual eye muscles.

  19. Anterior transposition of the inferior oblique muscle as the initial treatment of a snapped inferior rectus muscle.

    Science.gov (United States)

    Aguirre-Aquino, B I; Riemann, C D; Lewis, H; Traboulsi, E I

    2001-02-01

    Snapping or tearing of an extraocular muscle refers to its rupture across its width, usually at the junction between muscle and tendon several millimeters behind the insertion. Tearing occurs during strabismus or retinal reattachment surgery, or after trauma. If the proximal end of the muscle cannot be located, transposition procedures are necessary to achieve ocular realignment. These surgical procedures carry the risk of anterior segment ischemia, especially in the elderly. Anterior transposition of the inferior oblique muscle has been used for the treatment of inferior oblique overaction, especially in the presence of a dissociated vertical deviation, and in patients with fourth nerve palsy. We transposed the inferior oblique muscle insertion in a 73-year-old woman with a snapped inferior rectus muscle.

  20. Origin of the direct and reflected head of the rectus femoris: an anatomic study.

    Science.gov (United States)

    Ryan, John M; Harris, Joshua D; Graham, William C; Virk, Sohrab S; Ellis, Thomas J

    2014-07-01

    This study aimed to define the footprint of the direct and reflected heads of the rectus femoris and the relation of the anterior inferior iliac spine (AIIS) to adjacent neurovascular (lateral circumflex femoral artery and femoral nerve), bony (anterior superior iliac spine [ASIS]), and tendinous structures (iliopsoas). Twelve fresh-frozen cadaveric hip joints from 6 cadavers, average age of 44.5 (±9.9) years, were carefully dissected of skin and fascia to expose the muscular, capsular, and bony structures of the anterior hip and pelvis. Using digital calipers, measurements were taken of the footprint of the rectus femoris on the AIIS, superior-lateral acetabulum and hip capsule, and adjacent anatomic structures. The average dimensions of the footprint of the direct head of the rectus femoris were 13.4 mm (±1.7) × 26.0 mm (±4.1), whereas the dimensions of the reflected head footprint were 47.7 mm (±4.4) × 16.8 mm (±2.2). Important anatomic structures, including the femoral nerve, psoas tendon, and lateral circumflex femoral artery, were noted in proximity to the AIIS. The neurovascular structure closest to the AIIS was the femoral nerve (20.8 ± 3.4 mm). The rectus femoris direct and reflected heads originate over a broad area of the anterolateral pelvis and are in close proximity to critical neurovascular structures, and care must be taken to avoid them during hip arthroscopy. A thorough knowledge of the anatomy of the proximal rectus femoris is valuable for any surgical exposure of the anterior hip joint, particularly arthroscopic subspine decompression and open femoroacetabular impingement (FAI) surgery. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  1. Metástase no músculo reto inferior como sinal de apresentação de adenocarcinoma renal: relato de caso Inferior rectus muscle metastasis as a presenting sign of renal cell carcinoma: case report

    Directory of Open Access Journals (Sweden)

    Allan Christian Pieroni Gonçalves

    2006-06-01

    Full Text Available Proptose e diplopia decorrentes de alargamento de músculo extra-ocular representam importante sinal de apresentação de várias afecções da órbita. Embora a causa mais comum de alargamento de músculo extra-ocular seja a orbitopatia distiroidiana, o diagnóstico diferencial destas doenças é extenso. Relatamos neste trabalho o caso de um paciente com história de diplopia e proptose unilateral de três meses que apresentava importante espessamento isolado do músculo reto inferior direito e após investigação clínica, radiológica e biopsia incisional teve o diagnóstico de tumor metastático de células renais para o músculo reto inferior. Há poucos casos relatados de metástases para a musculatura ocular extrínseca sendo assim nosso objetivo relatar um novo caso, revisar a literatura e reforçar a inclusão deste distúrbio no diagnóstico diferencial do espessamento da musculatura extra-ocular.Proptosis and diplopia due to enlargement of extraocular muscles represent important presenting signs of many orbital disorders. Although dysthyroid ophthalmopathy is the most common cause of enlargement of extraocular muscles, the differential diagnosis is extensive. We report a patient with a 3-month history of diplopia and unilateral proptosis and a markedly enlarged inferior rectus muscle on imaging studies. A biopsy of the lesion followed by systemic evaluation established the diagnosis of metastatic renal cell carcinoma. There are few cases of metastatic tumors to the extraocular muscles reported in the literature and thus our objective is to report a new case, review the literature and reiterate the inclusion of this disorder in the differential diagnosis of enlargement of the extraocular muscles.

  2. Creep behavior of passive bovine extraocular muscle.

    Science.gov (United States)

    Yoo, Lawrence; Kim, Hansang; Shin, Andrew; Gupta, Vijay; Demer, Joseph L

    2011-01-01

    This paper characterized bovine extraocular muscles (EOMs) using creep, which represents long-term stretching induced by a constant force. After preliminary optimization of testing conditions, 20 fresh EOM samples were subjected to four different loading rates of 1.67, 3.33, 8.33, and 16.67%/s, after which creep was observed for 1,500 s. A published quasilinear viscoelastic (QLV) relaxation function was transformed to a creep function that was compared with data. Repeatable creep was observed for each loading rate and was similar among all six anatomical EOMs. The mean creep coefficient after 1,500 seconds for a wide range of initial loading rates was at 1.37 ± 0.03 (standard deviation, SD). The creep function derived from the relaxation-based QLV model agreed with observed creep to within 2.7% following 16.67%/s ramp loading. Measured creep agrees closely with a derived QLV model of EOM relaxation, validating a previous QLV model for characterization of EOM biomechanics.

  3. Creep Behavior of Passive Bovine Extraocular Muscle

    Directory of Open Access Journals (Sweden)

    Lawrence Yoo

    2011-01-01

    Full Text Available This paper characterized bovine extraocular muscles (EOMs using creep, which represents long-term stretching induced by a constant force. After preliminary optimization of testing conditions, 20 fresh EOM samples were subjected to four different loading rates of 1.67, 3.33, 8.33, and 16.67%/s, after which creep was observed for 1,500 s. A published quasilinear viscoelastic (QLV relaxation function was transformed to a creep function that was compared with data. Repeatable creep was observed for each loading rate and was similar among all six anatomical EOMs. The mean creep coefficient after 1,500 seconds for a wide range of initial loading rates was at 1.37±0.03 (standard deviation, SD. The creep function derived from the relaxation-based QLV model agreed with observed creep to within 2.7% following 16.67%/s ramp loading. Measured creep agrees closely with a derived QLV model of EOM relaxation, validating a previous QLV model for characterization of EOM biomechanics.

  4. Study of crotoxin on the induction of paralysis in extraocular muscle in animal model Estudo da crotoxina na indução de paralisia da musculatura extraocular em modelo animal

    Directory of Open Access Journals (Sweden)

    Geraldo de Barros Ribeiro

    2012-10-01

    Full Text Available PURPOSE: Crotoxin is the major toxin of the venom of the South American rattlesnake Crotalus durissus terrificus, capable of causing a blockade of the neurotransmitters at the neuromuscular junction. The objective of this study was to appraise the action and effectiveness of the crotoxin induced paralysis of the extraocular muscle and to compare its effects with the botulinum toxin type A (BT-A. METHODS: The crotoxin, with LD50 of 1.5 µg, was injected into the superior rectus muscle in ten New Zealand rabbits. The concentration variance was 0.015 up to 150 µg. Two rabbits received 2 units of botulinum toxin type A for comparative analysis. The evaluation of the paralysis was performed using serial electromyography. After the functional recovery of the muscles, which occurred after two months, six rabbits were sacrificed for anatomopathology study. RESULTS: The animals did not show any evidence of systemic toxicity. Transitory ptosis was observed in almost every animal and remained up to fourteen days. These toxins caused immediate blockade of the electrical potentials. The recovery was gradual in the average of one month with regeneration signs evident on the electromyography. The paralysis effect of the crotoxin on the muscle was proportional to its concentration. The changes with 1.5 µg crotoxin were similar to those produced by the botulinum toxin type A. The histopathology findings were localized to the site of the injection. No signs of muscle fiber's necrosis were seen in any sample. The alterations induced by crotoxin were also proportional to the concentration and similar to botulinum toxin type A in concentration of 1.5 µg. CONCLUSION: Crotoxin was able to induce transitory paralysis of the superior rectus muscle. This effect was characterized by reduction of action potentials and non-specific signs of fibrillation. Crotoxin, in concentration of 1.5 µg was able to induce similar effects as botulinum toxin type A.OBJETIVO: A

  5. Transabdominal sacrocolpopexy with autologous rectus fascia graft.

    Science.gov (United States)

    Abraham, Nitya; Quirouet, Adrienne; Goldman, Howard B

    2016-08-01

    Extrusion and infection are potential postoperative complications when using synthetic mesh for abdominal sacrocolpopexy. Long-term follow-up in the Colpopexy and Urinary Reduction Efforts (CARE) trial revealed an estimated 9.9 % risk of mesh extrusion. There are 26 reports of spondylodiscitis after sacrocolpopexy with synthetic mesh. These surgical risks may be decreased by using autologous fascia. To date, there have been no reports of extrusion or spondylodiscitis after using autologous fascia for sacrocolpopexy. This video demonstrates transabdominal sacrocolpopexy with an autologous rectus fascia graft. A 76-year-old woman with symptomatic stage 3 prolapse also had a history of diverticulitis and sigmoid abscess requiring sigmoid colectomy with end colostomy and incidental left ureteral transection with subsequent left nephrostomy tube placement. She presented for colostomy reversal, ureteral reimplantation, and prolapse repair. Given the need for concomitant colon and ureteral reconstruction, the risk of infection was potentially higher if synthetic mesh were used. The patient therefore underwent transabdominal sacrocolpopexy with autologous rectus fascia graft. At 4 months' follow-up the patient reported resolution of her symptoms and on examination she had no pelvic organ prolapse. Transabdominal sacrocolpopexy using autologous rectus fascia graft is a feasible option, especially in cases in which infection and synthetic mesh extrusion risks are potentially higher.

  6. Wnt and Extraocular Muscle Sparing in Amyotrophic Lateral Sclerosis

    OpenAIRE

    2014-01-01

    The potential role of Wnt signaling factors in extraocular muscle (EOM) sparing in amyotrophic lateral sclerosis (ALS) was examined. Three of the Wnts were preferentially upregulated in EOM, suggesting that they may be involved in maintenance of neuromuscular junctions in the EOM of ALS patients.

  7. The role of extraocular muscle pulleys in incomitant non-paralytic strabismus

    Directory of Open Access Journals (Sweden)

    Robert A Clark

    2015-01-01

    Full Text Available The rectus extraocular muscles (EOMs and inferior oblique muscle have paths through the orbit constrained by connective tissue pulleys. These pulleys shift position during contraction and relaxation of the EOMs, dynamically changing the biomechanics of force transfer from the tendon onto the globe. The paths of the EOMs are tightly conserved in normal patients and disorders in the location and/or stability of the pulleys can create patterns of incomitant strabismus that may mimic oblique muscle dysfunction and cranial nerve paresis. Developmental disorders of pulley location can occur in conjunction with large, obvious abnormalities of orbital anatomy (e.g., craniosynostosis syndromes or subtle, isolated abnormalities in the location of one or more pulleys. Acquired disorders of pulley location can be divided into four broad categories: Connective tissue disorders (e.g., Marfan syndrome, globe size disorders (e.g., high myopia, senile degeneration (e.g., sagging eye syndrome, and trauma (e.g., orbital fracture or postsurgical. Recognition of these disorders is important because abnormalities in pulley location and movement are often resistant to standard surgical approaches that involve strengthening or weakening the oblique muscles or changing the positions of the EOM insertions. Preoperative diagnosis is aided by: (1 Clinical history of predisposing risk factors, (2 observation of malpositioning of the medial canthus, lateral canthus, and globe, and (3 gaze-controlled orbital imaging using direct coronal slices. Finally, surgical correction frequently involves novel techniques that reposition and stabilize the pulley and posterior muscle belly within the orbit using permanent scleral sutures or silicone bands without changing the location of the muscle′s insertion.

  8. Impact of Amyotrophic Lateral Sclerosis on Slow Tonic Myofiber Composition in Human Extraocular Muscles.

    Science.gov (United States)

    Tjust, Anton E; Danielsson, Adam; Andersen, Peter M; Brännström, Thomas; Pedrosa Domellöf, Fatima

    2017-07-01

    To analyze the proportion and cross-sectional area of myofibers containing myosin heavy chain slow-twitch (MyHCI) and myosin heavy chain slow tonic (MyHCsto) in extraocular muscles of autopsied amyotrophic lateral sclerosis (ALS) patients with either spinal or bulbar site of disease onset. Whole-muscle cross sections from the middle portion of the medial rectus were labeled with antibodies against MyHCI or MyHCsto and laminin. Myofibers labeled with the MyHC antibodies (MyHCI+sto) and the total number of myofibers were quantified in the orbital and global layer of 6 control individuals and 18 ALS patients. The cross-sectional area of myofibers labeled for either MyHC was quantified in 130 to 472 fibers/individual in the orbital and in 180 to 573 fibers/individual in the global layer of each specimen. The proportion of MyHCI+sto myofibers was significantly smaller in the orbital and global layer of ALS compared to control individuals. MyHCI+sto myofibers were significantly smaller in the global layer than in the orbital layer of ALS, whereas they were of similar size in control subjects. The decreased proportion of MyHCI+sto fibers correlated significantly with the age of death, but not disease duration, in patients who had the bulbar-onset variant of ALS but not in patients with spinal variant. ALS, regardless of site of onset, involves a loss of myofibers containing MyHCI+sto. Only in bulbar-onset cases did aging seem to play a role in the pathophysiological processes underlying the loss of MyHCI+sto fibers.

  9. Imaging of rectus femoris proximal tendinopathies

    Energy Technology Data Exchange (ETDEWEB)

    Pesquer, Lionel; Poussange, Nicolas; Meyer, Philippe; Dallaudiere, Benjamin; Feldis, Matthieu [Clinique du Sport de Bordeaux, Centre d' Imagerie Osteo-articulaire, Merignac (France); Sonnery-Cottet, Bertrand [Groupe Ramsay Generale de Sante - Hopital Prive Jean Mermoz, Centre Orthopedique Santy, Lyon (France); Graveleau, Nicolas [Clinique du Sport de Bordeaux, Centre de Chirurgie Orthopedique et Sportive, Merignac (France)

    2016-07-15

    The rectus femoris is the most commonly injured muscle of the anterior thigh among athletes, especially soccer players. Although the injury pattern of the muscle belly is well documented, less is known about the anatomy and specific lesions of the proximal tendons. For each head, three distinctive patterns may be encountered according to the location of the injury, which can be at the enthesis, within the tendon, or at the musculotendinous junction. In children, injuries correspond most commonly to avulsion of the anteroinferior iliac spine from the direct head and can lead to subspine impingement. Calcific tendinitis and traumatic tears may be encountered in adults. Recent studies have shown that traumatic injuries of the indirect head may be underdiagnosed and that injuries of both heads may have a surgical issue. Finally, in the case of tears, functional outcome and treatment may vary if the rupture involves one or both tendons and if the tear is partial or complete. Thus, it is mandatory for the radiologist to know the different ultrasound and magnetic resonance imaging (MRI) patterns of these lesions in order to provide accurate diagnosis and treatment. The purpose of this article is to recall the anatomy of the two heads of rectus femoris, describe a reliable method of assessment with ultrasound and MRI and know the main injury patterns, through our own experience and literature review. (orig.)

  10. Agreement between intraoperative measurements and optical coherence tomography of the limbus-insertion distance of the extraocular muscles.

    Science.gov (United States)

    de-Pablo-Gómez-de-Liaño, L; Fernández-Vigo, J I; Ventura-Abreu, N; Morales-Fernández, L; García-Feijóo, J; Gómez-de-Liaño, R

    2016-12-01

    To assess the agreement between intraoperative measurements of the limbus-insertion distance of the extraocular muscles with those measured by spectral domain optical coherence tomography. An analysis was made of a total of 67 muscles of 21 patients with strabismus. The limbus-insertion distance of the horizontal rectus muscles were measured using pre-operative SD-OCT and intra-operatively in 2 ways: 1) direct, after a conjunctival dissection in patients who underwent surgery, or 2) transconjunctival in patients who were treated with botulinum toxin, or in those who were not going to be operated. The intraclass correlation coefficient and Bland-Altman plots were calculated to determine the concordance between the 2 methods. The mean age was 45.9 ±20.9 years (range 16 to 85), with 52% being women. The percentage of identification by direct intraoperative measurement was 95.6% (22/23), by transconjunctival intraoperative measurement 90.9% (40/44), and by OCT 85% (57/67), with 22 muscles finally being analysed for the agreement study between direct intraoperative measurement and OCT measurements, and 35 muscles for the agreement between transconjuctival intraoperative measurement and OCT. The intraclass correlation coefficient showed good agreement with OCT and direct intraoperative measurements (0.931; 95% confidence interval (95% CI): 0.839-0.972; P<.001), and with transconjunctival intraoperative measurements (0.889; 95% CI: 0.790-0.942; P<.001). The SD-OCT is an effective technique to measure the distance from the insertion of the horizontal rectus muscles to the limbus, with a high agreement with intraoperative measurements being demonstrated. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. A continuum of myofibers in adult rabbit extraocular muscle: force, shortening velocity, and patterns of myosin heavy chain colocalization.

    Science.gov (United States)

    McLoon, Linda K; Park, Han Na; Kim, Jong-Hee; Pedrosa-Domellöf, Fatima; Thompson, Ladora V

    2011-10-01

    Extraocular muscle (EOM) myofibers do not fit the traditional fiber typing classifications normally used in noncranial skeletal muscle, in part, due to the complexity of their individual myofibers. With single skinned myofibers isolated from rectus muscles of normal adult rabbits, force and shortening velocity were determined for 220 fibers. Each fiber was examined for myosin heavy chain (MyHC) isoform composition by densitometric analysis of electrophoresis gels. Rectus muscle serial sections were examined for coexpression of eight MyHC isoforms. A continuum was seen in single myofiber shortening velocities as well as force generation, both in absolute force (g) and specific tension (kN/m(2)). Shortening velocity correlated with MyHCIIB, IIA, and I content, the more abundant MyHC isoforms expressed within individual myofibers. Importantly, single fibers with similar or identical shortening velocities expressed significantly different ratios of MyHC isoforms. The vast majority of myofibers in both the orbital and global layers expressed more than one MyHC isoform, with up to six isoforms in single fiber segments. MyHC expression varied significantly and unpredictably along the length of single myofibers. Thus EOM myofibers represent a continuum in their histological and physiological characteristics. This continuum would facilitate fine motor control of eye position, speed, and direction of movement in all positions of gaze and with all types of eye movements-from slow vergence movements to fast saccades. To fully understand how the brain controls eye position and movements, it is critical that this significant EOM myofiber heterogeneity be integrated into hypotheses of oculomotor control.

  12. INNERVATED RECTUS-ABDOMINIS MYOFASCIAL FLAP FOR DYNAMIC CARDIOMYOPLASTY

    NARCIS (Netherlands)

    WIJNBERG, DS; EBELS, T; ROBINSON, PH

    1994-01-01

    This study examined the rectus abdominis myofascial flap as an innervated nap for dynamic cardiomyoplastic purposes. It is common to use the latissimus dorsi to wrap or patch around or in the heart, but there is a need for more innervated skeletal muscle for a variety of reasons. The rectus abdomini

  13. Avoiding Complications in Abdominal Wall Surgery: A Mathematical Model to Predict the Course of the Motor Innervation of the Rectus Abdominis.

    Science.gov (United States)

    Tessone, Ariel; Nava, Maurizio; Blondeel, Phillip; Spano, Andrea

    2016-02-01

    Ever since its introduction, the transverse rectus abdominis myocutaneous flap has become the mainstay of autologous breast reconstruction. However, concerns regarding donor site morbidity due to the breach of abdominal wall musculature integrity soon followed. Muscle-sparing techniques, eventually eliminating the muscle from the flap all-together with the deep inferior epigastric artery perforator flap, did not eliminate the problem of abdominal wall weakness. This led to the conclusion that motor innervation might be at fault. Studies have shown that even in the presence of an intact rectus abdominis muscle, and an intact anterior rectus sheath, denervation of the rectus abdominis muscle results in significant abdominal wall weakness leading to superior and inferior abdominal bulges, and abdominal herniation. Our aim was to establish a mathematical model to predict the location of the motor innervation to the rectus abdominis muscle, and thus provide surgeons with a tool that will allow them to reduce abdominal morbidity during deep inferior epigastric artery perforator and free muscle-sparing transverse rectus abdominis myocutaneous surgery. We dissected 42 cadaveric hemiabdomens and mapped the course of the thoracolumbar nerves. We then standardized and analyzed our findings and presented them as a relative map which can be adjusted to body type and dimensions. Our dissections show that the motor innervation is closely related to the lateral vascular supply. Thus, when possible, we support the preferred utilization of the medial vascular supply, and the preservation of the lateral supply and motor innervation.

  14. THE RECTUS ABDOMINIS MUSCLE IN MALES AND FEMALES OF KERALA- A CADAVERIC STUDY

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    Vijayamma Kunnath Narayanan

    2017-06-01

    Full Text Available BACKGROUND The rectus abdominis is a long, flat strap muscle which extends vertically upward along the linea alba from the pubic symphysis below to the costal margin above. It is a flexor of the vertebral column and thereby plays an important role in maintaining the normal body posture. As it is a part of the anterior abdominal wall, the strength of the muscle plays a very important role in maintaining the integrity of the anterior abdominal wall. Weakness of the rectus abdominis is seen mainly in multiparous women resulting in the divarication of the recti. The lateral border of the rectus abdominis forms the medial boundary of the Hesselbach’s triangle, which is the commonest site of direct inguinal hernia. It arises by two tendinous heads: Medial head arises from the anterior surface of the pubic symphysis and the lateral head arises from the lateral part of the pubic crest and the pubic tubercle. The muscle is inserted on the anterior thoracic wall by four fleshy slips along a horizontal line passing laterally from the xiphoid process and cutting in that order, the 7 th , 6 th and 5 th costal cartilages. The paired recti muscles are separated in the median plane by the linea alba. The muscle is three times as wide superiorly as inferiorly. It is broad and thin superiorly and narrow and thick inferiorly. It has a tendinous origin and a muscular insertion that is in the form of four fleshy slips that are attached in a horizontal manner to the lower part of the anterior thoracic wall. The rectus abdominis is enclosed in the rectus sheath, which is formed by the aponeuroses of the anterolateral muscles of the anterior abdominal wall. The muscle usually presents tendinous intersections along its length. MATERIALS AND METHODS The study was carried out in the Department of Anatomy, Government Medical College, Kottayam by the dissection of 20 adult cadavers and 5 foetal cadavers during the routine dissection time of the undergraduates and

  15. Bilateral multiple extraocular muscle metastasis from breast carcinoma

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    Ramesh Murthy

    2011-01-01

    Full Text Available We report a rare presentation of an initially misdiagnosed case of a pseudotumor, which on histopathology was diagnosed as bilateral breast metastases of lobular carcinoma involving multiple extraocular muscles. A 61-year-old lady presented with external ophthalmoplegia and diplopia. Incisional biopsy was performed using a lid crease approach and the patient received radiotherapy and hormonal therapy. Following prolonged hormonal therapy, complete remission was achieved, with improvement in ocular motility and resolution of diplopia, about 18 months after the initial presentation. Multiple extraocular muscle involvement by breast carcinoma metastasis is very rare and should be considered in the differential diagnosis, especially in patients with a prior history of breast carcinoma.

  16. [Treatment of primary retinal detachment. Minimal extraocular or intraocular?].

    Science.gov (United States)

    Kreissig, I

    2002-06-01

    The developments in treatment modalities for a primary retinal detachment over the last 70 years have been reviewed. There was a change from a surgery limited to the area of the break to a form of prophylactic surgery including the extent of the detachment. In between Rosengren had limited the treatment to the break with an intraocular gas bubble. A change was brought about by Custodis in 1953 who limited surgery to the break and omitted drainage. This procedure had serious postoperative complications which were eliminated by Lincoff by developing the cryosurgical detachment operation which was subsequently refined to extraocular minimal surgery. The ultimate realization of a minimal extraocular approach was the operation with a temporary balloon. Two additional intraocular procedures evolved, pneumatic retinopexy and primary vitrectomy, following one or the other pattern of treatment. With all four methods reattachment can result in 94-99% of the cases but differences can be seen in the morbidity and rate of reoperations.

  17. Fatigue resistance of rat extraocular muscles does not depend on creatine kinase activity.

    Science.gov (United States)

    McMullen, Colleen A; Hayess, Katrin; Andrade, Francisco H

    2005-08-17

    Creatine kinase (CK) links phosphocreatine, an energy storage system, to cellular ATPases. CK activity serves as a temporal and spatial buffer for ATP content, particularly in fast-twitch skeletal muscles. The extraocular muscles are notoriously fast and active, suggesting the need for efficient ATP buffering. This study tested the hypotheses that (1) CK isoform expression and activity in rat extraocular muscles would be higher, and (2) the resistance of these muscles to fatigue would depend on CK activity. We found that mRNA and protein levels for cytosolic and mitochondrial CK isoforms were lower in the extraocular muscles than in extensor digitorum longus (EDL). Total CK activity was correspondingly decreased in the extraocular muscles. Moreover, cytoskeletal components of the sarcomeric M line, where a fraction of CK activity is found, were downregulated in the extraocular muscles as was shown by immunocytochemistry and western blotting. CK inhibition significantly accelerated the development of fatigue in EDL muscle bundles, but had no major effect on the extraocular muscles. Searching for alternative ATP buffers that could compensate for the relative lack of CK in extraocular muscles, we determined that mRNAs for two adenylate kinase (AK) isoforms were expressed at higher levels in these muscles. Total AK activity was similar in EDL and extraocular muscles. These data indicate that the characteristic fatigue resistance of the extraocular muscles does not depend on CK activity.

  18. Fatigue resistance of rat extraocular muscles does not depend on creatine kinase activity

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    Hayeß Katrin

    2005-08-01

    Full Text Available Abstract Background Creatine kinase (CK links phosphocreatine, an energy storage system, to cellular ATPases. CK activity serves as a temporal and spatial buffer for ATP content, particularly in fast-twitch skeletal muscles. The extraocular muscles are notoriously fast and active, suggesting the need for efficient ATP buffering. This study tested the hypotheses that (1 CK isoform expression and activity in rat extraocular muscles would be higher, and (2 the resistance of these muscles to fatigue would depend on CK activity. Results We found that mRNA and protein levels for cytosolic and mitochondrial CK isoforms were lower in the extraocular muscles than in extensor digitorum longus (EDL. Total CK activity was correspondingly decreased in the extraocular muscles. Moreover, cytoskeletal components of the sarcomeric M line, where a fraction of CK activity is found, were downregulated in the extraocular muscles as was shown by immunocytochemistry and western blotting. CK inhibition significantly accelerated the development of fatigue in EDL muscle bundles, but had no major effect on the extraocular muscles. Searching for alternative ATP buffers that could compensate for the relative lack of CK in extraocular muscles, we determined that mRNAs for two adenylate kinase (AK isoforms were expressed at higher levels in these muscles. Total AK activity was similar in EDL and extraocular muscles. Conclusion These data indicate that the characteristic fatigue resistance of the extraocular muscles does not depend on CK activity.

  19. Sacroiliitis and Septicemia Caused by Campylobacter rectus and Actinomyces odontolyticus

    Directory of Open Access Journals (Sweden)

    Pierre Harvey

    1994-01-01

    Full Text Available Campylobacter rectus, formerly known as Wolinella recta, is an anaerobic Gram-negative bacillus, generally recognized as an agent responsible for severe periodontitis; only two cases of extra-oral infections have been reported. The first case of septicemia with C rectus and Actinomyces odontolyticus is described in a 37-year-old farmer who suffered from severe sacroiliitis. Also presented are a review of C rectus in human pathology, and a brief review of pyogenic sacroiliitis, a rather rare disease.

  20. Study of extraocular muscle with direct injection of insulin-like growth factorⅠ%胰岛素样生长因子局部注射对眼外肌作用的实验研究

    Institute of Scientific and Technical Information of China (English)

    余新平; 许金玲; 陈洁; 黄盈; 余焕云; 张芳; 高军

    2010-01-01

    Objective To evaluate the effects on muscle mass and force generation of IGF-I injection in adult rabbit superior rectus muscle. Methods One superior rectus muscle in normal adult rabbits received a single injection of 10ug (0.05ml) IGF-I, and the contralateral muscle received an injection of 0.05ml saline only. One week after injection, muscle force and muscle morphology were studied both in IGF treated and control muscles. Results In the treated muscles, the mean single-twitch force generation was 2.4515+1.1019mN compared with 1.1511+0.6755mN (t =2.58, P =0.049) in control muscles. Mean titanic force generation was increased significantly at all stimulation frequencies. The cross-sectional area of muscles was 10.04+2.52mm2 compared with 7.79+1.85 mm2 (t =2.84, P =0.047) in control. The frequency of activated satellite cells was 30.63+6.76% compared with 17.07+5.36% in control (t =8.73, P =0.000). Conclusions Direct injection of IGF-I effectively increase extraocular muscle force generation with increased number of activated satellite cells.%目的 探讨局部注射胰岛素样生长因子(insulin-like growth factor-Ⅰ,IGF-Ⅰ)对成年兔眼外肌的作用及机制.方法 7只成年新西兰大白兔,双眼上直肌随机注射0.05ml(10靏)IGF-Ⅰ或0.05ml生理盐水,1周后肌肉张力换能器检测上直肌肌肉力量,获取上直肌行组织学检查.结果 实验组上直肌单刺激收缩力为(2.4515±1.1019)mN,对照组上直肌为(1.1511±0.6755)mN,差异有统计学意义(t =2.58,P =0.049),实验组上直肌各刺激频率的强直收缩力比对照组明显更大,均有显著性差别.实验组单位重量肌肉的收缩力比对照组更大,各刺激频率均有显著性差异.实验组上直肌横截面面积为(10.04±2.52)mm2较对照组(7.79±1.85) mm2明显更大,差异有统计学意义(t =2.84,P =0.047);实验组上直肌中活化的卫星细胞为(30.63±6.76)%,比对照组(17.07±5.36)%显著更高(t =8.73,P =0.000).结论 成年动物

  1. Efficiency of Medial Rectus Advancement Surgery in Consecutive Exotropia

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    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

  2. Intraocular and extraocular hemorrhage associated with ligature release of non-valved glaucoma drainage implant

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    Michelle Go

    2017-04-01

    Conclusions: and importance: This is the first report of a rare occurrence of intraocular and extraocular hemorrhage associated following spontaneous release of ligature of a non-valved glaucoma drainage implant. The presumed mechanism was sudden shallowing of the anterior chamber resulting in the tube irritating uveal vasculature. We do not have an explanation for the extraocular blood.

  3. Stimulation of the retina with a multielectrode extraocular visual prosthesis.

    Science.gov (United States)

    Chowdhury, Vivek; Morley, John W; Coroneo, Minas T

    2005-08-01

    An extraocular approach to developing a retinal prosthesis for blind patients using electrodes placed on the outer surface of the eye is suggested. Experiments were carried out to determine the feasibility of this approach, and evaluate electrode configurations and parameters for stimulation. In anaesthetized cats, a 21-electrode extraocular retinal prosthesis (ERP) array was sutured to the sclera over the lateral surface of the eye. Electrically evoked potentials (EEP) were recorded at the visual cortex bilaterally in response to retinal stimulation with the electrode array. Bipolar stimulation of the ERP array electrodes in horizontal and vertical configurations and at different interelectrode separations was investigated with biphasic constant-current pulses. Electrical stimulation of the lateral retina with an ERP elicited EEP that were higher in the ipsilateral visual cortex. The threshold for bipolar retinal stimulation was 500 microA. EEP amplitude increased with increases in stimulus pulse duration and current intensity. Retinal stimulation was slightly more effective with electrodes in a vertical as opposed to horizontal orientation. A larger interelectrode separation resulted in a higher EEP amplitude. Retinal stimulation with a prototype ERP array is demonstrated. The thresholds for retinal excitation are below safe charge-density limits for chronic neural stimulation. Ipsilateral localization of the EEP suggests that localized retinal stimulation is occurring. An ERP is a new approach to retinal prosthesis research, and might lead to the development of a low-resolution visual prosthesis for blind patients.

  4. MRI of extraocular orbital diseases; Comparison with CT

    Energy Technology Data Exchange (ETDEWEB)

    Takeda, Hiroyuki (Nagasaki Univ. (Japan). School of Medicine)

    1990-12-01

    The author investigated the usefulness of MRI in the diagnosis of extraocular orbital diseases, and the diagnostic ability of MRI was compared with that of CT. The materials consisted of 38 cases of diseases in extraocular orbital region (all cases were examined with MRI and 34 of them were also examined with CT). MRI was performed with spin echo or STIR sequences using a 1.5 tesla superconductive unit (GE SIGNA). CT was performed using SOMATOM CR and DR-H. The study showed that MRI was equally or more useful than CT in detecting lesions as well as assessing the internal architecture and extension of the lesions. Differentiation between benign and malignant tumors by MRI is difficult from their signal intensity only and can be made from their extraorbital extension, just as by CT. In Graves' orbitopathy, T{sub 2}-weighted images were more sensitive in reflecting its new or old pathological changes than CT. T{sub 1}-weighted images enhanced with Gd-DTPA were useful in differentiating sphenoid wing meningiomas from other tumors, but not useful in assessing the degree of intraorbital extension. STIR sequences were particularly useful in the diagnosis of optic nerve atrophy and expectd to be applied to the lesions which were not detected or poorly demonstrated with CT and spin echo sequences. (author).

  5. Reconstruction of an emergency thoracotomy wound with free rectus abdominis flap: Anatomic and radiologic basis for the surgical technique.

    Science.gov (United States)

    Gilman, Kaitlyn; Ipaktchi, Kyros; Moore, Ernest E; Barnett, Carlton; Gurunluoglu, Raffi

    2010-05-07

    An alcoholic 50-year-old male patient with a history of schizophrenia sustained stab wounds into both ventricles and left lung, and survived following an emergency department thoracotomy. The EDT wound, however became infected requiring serial debridements of soft tissue, rib cartilage and sternum. Regional flap options such as pectoralis major and latissimus dorsi muscle flaps could not be employed due to inadequate reach of these flaps. Additionally, bilateral transection of the internal mammary arteries during emergency thoracotomy eliminated the use of rectus abdominis muscles as pedicled flaps based on the superior epigastric vasculature. Therefore, the EDT wound was reconstructed by using the right rectus abdominis muscle as a free flap. The deep inferior epigastric vessels of the flap were anastomosed to the right internal mammary vessels proximal to their transection level in the third-forth intercostal space. The flap healed with no further wound complications.

  6. Reconstruction of an emergency thoracotomy wound with free rectus abdominis flap: Anatomic and radiologic basis for the surgical technique

    Directory of Open Access Journals (Sweden)

    Barnett Carlton

    2010-05-01

    Full Text Available Abstract An alcoholic 50-year-old male patient with a history of schizophrenia sustained stab wounds into both ventricles and left lung, and survived following an emergency department thoracotomy. The EDT wound, however became infected requiring serial debridements of soft tissue, rib cartilage and sternum. Regional flap options such as pectoralis major and latissimus dorsi muscle flaps could not be employed due to inadequate reach of these flaps. Additionally, bilateral transection of the internal mammary arteries during emergency thoracotomy eliminated the use of rectus abdominis muscles as pedicled flaps based on the superior epigastric vasculature. Therefore, the EDT wound was reconstructed by using the right rectus abdominis muscle as a free flap. The deep inferior epigastric vessels of the flap were anastomosed to the right internal mammary vessels proximal to their transection level in the third-forth intercostal space. The flap healed with no further wound complications.

  7. Magnetic resonance imaging of congenital fibrosis of extraocular muscle associated with limb movement disorder in a family%伴有肢体运动障碍的先天性眼外肌纤维化综合征家系的影像学研究

    Institute of Scientific and Technical Information of China (English)

    周炼红; 李春义; 查云飞; 张俊涛; 刘甜

    2013-01-01

    Background Congenital fibrosis of extraocular muscles (CFEOM) affects patient' s appearance and quality of life,and no effective treatment for this disease is available.Imaging study is helpful for exploring the pathogenesis of CFEOM.Objective This study was to describe the characteristics of CFEOM associated with limb movement disorder using magnetic resonance imaging (MRI).Methods A family with CFEOM associated with limb movement disorder was investigated in Renmin Hospital of Wuhan University.Disease history was collected and the pedigree was investigated.Ophthalmologic examinations,including corrected visual acuity,refractive error,slitlamp examination,ophthalmoscopic examination,force of levator palpebrae superioris,ocular movement,eye position,forced duction test,and bell phenomenon examination,were performed.Ocular orbital and cranial MRI was performed in 4 CFEOM patients and 10 normal subjects to compare the structures of the extraocular muscles,motor nerve and cranium.Oral informed consent was obtained from each patient prior to any medical examination.Results A total of 1 1 members from 3 generations were investigated in this study,presenting with 4 cases of disease.The mode of inheritance of this family complied with the Mendelian autosomal dominant inheritance law.Clinical signs included disturbance of eye movement,deviation of eye position,ptosis,lack of Bell sign and positive reaction of passive pull test.In addition,unstable gait,improper body limb alignment,dysphasia and mental retardation were ohserved in 1 patient,which coincided with the diagnostic criteria of type 3 CFEOM.MRI results demonstrated that the levator palpebrae superioris,superior rectus and superior oblique muscle were clearly thinner,and the medial rectus,lateral rectus,inferior rectus muscle were thinning in the patients,showing significant differences in comparison with the normal controls(P<O.05).The oculomotor and abducens nerves became thinner and even absent in the patients

  8. Prevalence of Diplopia and Extraocular Movement Limitation according to the Location of Isolated Pure Blowout Fractures

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    Min Seok Park

    2012-05-01

    Full Text Available Background Isolated pure blowout fractures are clinically important because they are themain cause of serious complications such as diplopia and limitation of extraocular movement.Many reports have described the incidence of blowout fractures associated with diplopiaand limitation of extraocular movement; however, no studies have statistically analyzedthis relationship. The purpose of this study was to demonstrate the correlation betweenthe location of isolated pure blowout fractures and orbital symptoms such as diplopia andlimitation of extraocular movement.Methods We enrolled a total of 354 patients who had been diagnosed with isolated pureblowout fractures, based on computed tomography, from June 2008 to November 2011.Medical records were reviewed, and the prevalence of extraocular movement limitations anddiplopia were determined.Results There were 14 patients with extraocular movement limitation and 58 patientscomplained of diplopia. Extraocular movement limitation was associated with the followingfindings, in decreasing order of frequency: floor fracture (7.1%, extended fracture (3.6%,and medial wall (1.7%. However, there was no significant difference among the types offractures (P=0.60. Diplopia was more commonly associated with floor fractures (21.4%and extended type fractures (23.6% than medial wall fractures (10.4%. The difference wasstatistically significant (Bonferroni-corrected chi-squared test P<0.016.Conclusions Data indicate that extended type fractures and orbital floor fractures tend tocause diplopia more commonly than medial wall fractures. However, extraocular movementlimitation was not found to be dependent on the location of the orbital wall fracture.

  9. Myosin heavy chain isoform expression in human extraocular muscles: longitudinal variation and patterns of expression in global and orbital layers.

    Science.gov (United States)

    Park, Kyung-Ah; Lim, Jeonghee; Sohn, Seongsoo; Oh, Sei Yeul

    2012-05-01

    We investigated the distribution of myosin heavy chain (MyHC) isoforms along the length of the global and orbital layers of human extraocular muscles (EOMs). Whole muscle tissue extracts of human EOMs were cross-sectioned consecutively and separated into orbital and global layers. The extracts from these layers were subjected to electrophoretic analysis, followed by quantification with scanning densitometry. MyHC isoforms displayed different distributions along the lengths of EOMs. In the orbital and global layers of all EOMs except for the superior oblique muscle, MyHCeom was enriched in the central regions. MyHCIIa and MyHCI were most abundant in the proximal and distal ends. A variation in MyHC isoform expression was apparent along the lengths of human EOMs. These results provide a basis for understanding the molecular mechanisms underlying the functional diversity of EOMs. Copyright © 2012 Wiley Periodicals, Inc.

  10. Dengue Fever with rectus sheath hematoma: a case report.

    Science.gov (United States)

    Sharma, Anurag; Bhatia, Sonia; Singh, Rajendra Pratap; Malik, Gaurav

    2014-04-01

    Dengue fever, also known as breakbone fever, is an infectious tropical disease caused by the Dengue virus. It is associated with a number of complications, which are well documented. However, Dengue fever associated with rectus sheath hematoma (RSH) is a very rare complication. Only one case report has been published prior supporting the association of Dengue fever with RSH. We report a case of Dengue fever who presented with RSH and was successfully treated conservatively. RSH is also an uncommon cause of acute abdominal pain. It is accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear.

  11. Dengue fever with rectus sheath hematoma: A case report

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    Anurag Sharma

    2014-01-01

    Full Text Available Dengue fever, also known as breakbone fever, is an infectious tropical disease caused by the Dengue virus. It is associated with a number of complications, which are well documented. However, Dengue fever associated with rectus sheath hematoma (RSH is a very rare complication. Only one case report has been published prior supporting the association of Dengue fever with RSH. We report a case of Dengue fever who presented with RSH and was successfully treated conservatively. RSH is also an uncommon cause of acute abdominal pain. It is accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear.

  12. Graves' disease: measurement of the extraocular muscle thickness with the echobiometer.

    Science.gov (United States)

    Schenome, M; Polizzi, A; Buono, C; Ciurlo, C; Ciurlo, G

    1998-01-01

    The authors measured extraocular muscle thickness in normal subjects and in patients affected by Graves' disease, using a Sonomed A-2000 echobiometer (probe with 10-MHz frequency); Hertel's exophthalmometry was also performed. Statistically significant differences in muscle thickness between normals and patients were found. This technique seems to be sufficiently useful and reliable in extraocular thickness evaluation, showing data similar to those of the recent literature.

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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  19. File list: His.Neu.50.AllAg.Gyrus_rectus [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  20. Magnetic resonance imaging findings after rectus femoris transfer surgery

    Energy Technology Data Exchange (ETDEWEB)

    Gold, Garry E. [Department of Radiology, Stanford University, Stanford, CA (United States); Asakawa, Deanna S.; Blemker, Silvia S. [Department of Mechanical Engineering, Stanford University, Stanford, CA (United States); Delp, Scott L. [Department of Mechanical Engineering, Stanford University, Stanford, CA (United States); Department of Bioengineering, Stanford University, Stanford, CA (United States)

    2004-01-01

    We describe the magnetic resonance (MR) imaging appearance of the knee flexor and extensor tendons after bilateral rectus femoris transfer and hamstring lengthening surgery in five patients (10 limbs) with cerebral palsy. Three-dimensional models of the path of the transferred tendon were constructed in all cases. MR images of the transferred and lengthened tendons were examined and compared with images from ten non-surgical subjects. The models showed that the path of the transferred rectus femoris tendon had a marked angular deviation near the transfer site in all cases. MR imaging demonstrated irregular areas of low signal intensity near the transferred rectus femoris and around the hamstrings in all subjects. Eight of the ten post-surgical limbs showed evidence of fluid near or around the transferred or lengthened tendons. This was not observed in the non-surgical subjects. Thus, MR imaging of patients with cerebral palsy after rectus femoris transfer and hamstring-lengthening surgery shows evidence of signal intensity and contour changes, even several years after surgery. (orig.)

  1. THE RECTUS-ABDOMINIS CARDIOMYOPLASTIC PROCEDURE - PRELIMINARY-RESULTS

    NARCIS (Netherlands)

    WIJNBERG, DS; HENSEN, AG; GRANDJEAN, PA; SCHREUDER, JAH; ROBINSON, PH; EBELS, T

    1994-01-01

    The rectus abdominis myofascial flap (RAMF) was investigated as a viable alternative to the latissimus dorsi flap for dynamic cardiomyoplasty. In human and animal cadaver experiments and live sheep, it was possible to use the RAMF for innervated intrathoracic use. The RAMF was stimulated by a specia

  2. THE RECTUS-ABDOMINIS CARDIOMYOPLASTIC PROCEDURE - PRELIMINARY-RESULTS

    NARCIS (Netherlands)

    WIJNBERG, DS; HENSEN, AG; GRANDJEAN, PA; SCHREUDER, JAH; ROBINSON, PH; EBELS, T

    1994-01-01

    The rectus abdominis myofascial flap (RAMF) was investigated as a viable alternative to the latissimus dorsi flap for dynamic cardiomyoplasty. In human and animal cadaver experiments and live sheep, it was possible to use the RAMF for innervated intrathoracic use. The RAMF was stimulated by a specia

  3. Extensive chest wall tissue loss and its management by vertical rectus abdominis myocutaneous flap

    Directory of Open Access Journals (Sweden)

    Sandip Kanti Basu

    2017-01-01

    Full Text Available Extensive electric burn around the chest in children is rare and this type of injury always poses a great challenge for its management. A 12-year-old male child with extensive electric burn of the chest wall was admitted to hospital. It was a neglected case of 9 days old burn; the young boy was in critical condition having systemic features of toxemia with widespread necrosis of the skin, subcutaneous tissues, and muscles along with exposed bones (ribs and sternum with the risk of impending rupture of pleura through the exposed intercostal spaces. After initial resuscitation, a thorough debridement of all necrotic tissues was done. Thereafter, a superiorly based vertical rectus abdominis myocutaneous flap was harvested to cover the exposed bones and intercostal spaces. The remaining raw areas were skin grafted. The child made an excellent recovery with good outcome.

  4. Determinants of Extraocular Muscle Volume in Patients with Graves' Disease

    Directory of Open Access Journals (Sweden)

    Samer El-Kaissi

    2012-01-01

    Full Text Available Background. To examine factors contributing to extraocular muscle (EOM volume enlargement in patients with Graves’ hyperthyroidism. Methods. EOM volumes were measured with orbital magnetic resonance imaging (MRI in 39 patients with recently diagnosed Graves’ disease, and compared to EOM volumes of 13 normal volunteers. Thyroid function tests, uptake on thyroid scintigraphy, anti-TSH-receptor antibody positivity and other parameters were then evaluated in patients with EOM enlargement. Results. 31/39 patients had one or more enlarged EOM, of whom only 2 patients had clinical EOM dysfunction. Compared to Graves’ disease patients with normal EOM volumes, those with EOM enlargement had significantly higher mean serum TSH (0.020±0.005 versus 0.007±0.002 mIU/L; P value 0.012, free-T4 (52.9±3.3 versus 41.2±1.7 pmol/L; P value 0.003 and technetium uptake on thyroid scintigraphy (13.51±1.7% versus 8.55±1.6%; P value 0.045. There were no differences between the 2 groups in anti-TSH-receptor antibody positivity, the proportion of males, tobacco smokers, or those with active ophthalmopathy. Conclusions. Patients with recently diagnosed Graves’ disease and EOM volume enlargement have higher serum TSH and more severe hyperthyroidism than patients with normal EOM volumes, with no difference in anti-TSH-receptor antibody positivity between the two groups.

  5. Repair of rectus femoris rupture with LARS ligament.

    Science.gov (United States)

    Taylor, Clare; Yarlagadda, Rathan; Keenan, Jonathan

    2012-03-20

    The rectus femoris muscle is the most frequently involved quadriceps muscle in strain pathologies. The majority of quadriceps muscle belly injuries can be successfully treated conservatively and even significant tears in the less active and older population, non-operative management is a reasonable option. The authors report the delayed presentation of a 17-year-old male who sustained an injury to his rectus femoris muscle belly while playing football. This young patient did not recover the functional outcome required to get back to running and participating in sport despite 15 months of physiotherapy and non-operative management. Operative treatment using the ligament augmentation and reconstruction system ligament to augment Kessler repair allowed immediate full passive flexion of the knee and an early graduated physiotherapy programme. Our patient was able to return to running and his previous level of sport without any restrictions.

  6. Intraoperative topical administration of mitomycin C, in different concentrations, on the cicatrization of mioplasties of the dorsal rectus of rabbits Administração tópica per-operatória da mitomicina C, em diferentes concentrações, sobre a cicatrização de mioplastias do reto dorsal de coelhos

    Directory of Open Access Journals (Sweden)

    Fabrício Villela Mamede

    2008-02-01

    Full Text Available Myoplasties of the extraocular muscle may cause adhesions between the operated muscle and the adjacent tissues, commonly generating cicatricial strabismus. With the purpose of reducing to a minimum the occurrence of adhesion, the effects of mitomycin C, an antifibrotic agent, were studied in concentrations of 0.008%, 0.02%, and 0.04% applied during intraoperative of myoplasties of the superior rectus muscle of rabbits. Fifty six animals were divided in five groups. During the postoperative, the operated areas were washed with physiological solution. Eye drop instillation to prevent inflammation and bacterial infection were used. The method to analyze the results consisted of clinical and histological evaluation and statistical analyzes. We also evaluated at the same time the amount of basic fibroblast growth factor (FGF-2 by immunohistochemical study. Clinically, more adhesions were found in the eyes of the control group than in the groups of treated eyes. However there was no significant statistics difference between the two groups (P>0.05. Histologically, mitomycin C caused a delayed cicatrization in the mioplastic areas, specially in the group who received the 0.02% concentration. The immunohistochemical showed FGF-2 marking in fibroblasts and macrophages, but between the groups there wasn't no difference. Based on those results, mitomycin C in the utilized concentrations was capable of delaying the cicatrization and consequently avoid the secondary strabismus without undesirable side effects.Mioplastias da musculatura extra-ocular podem ensejar aderências entre o músculo operado e os tecidos adjacentes, produzindo, não raro, estrabismos cicatriciais. Com intuito de se minimizar a ocorrência de aderências, investigaram-se os efeitos da mitomicina C, como agente antifibrótico, em concentrações ascendentes de 0,008, 0,02 e 0,04%, aplicada no per-operatório de mioplastias do reto superior do bulbo do olho de coelhos. Operaram-se 56

  7. Surgical Management of Rectus Femoris Avulsion Among Professional Soccer Players

    Science.gov (United States)

    Sonnery-Cottet, Bertrand; Barbosa, Nuno Camelo; Tuteja, Sanesh; Gardon, Roland; Daggett, Matt; Monnot, Damien; Kajetanek, Charles; Thaunat, Mathieu

    2017-01-01

    Background: Rectus femoris injuries are common among athletes, especially in kicking sports such as soccer; however, proximal rectus femoris avulsions in athletes are a relatively rare entity. Purpose/Hypothesis: The purpose of this study was to describe and report the results of an original technique of surgical excision of the proximal tendon remnant followed by a muscular suture repair. Our hypothesis was that this technique limits the risk of recurrence in high-level athletes and allows for rapid recovery without loss of quadriceps strength. Study Design: Case series; Level of evidence, 4. Methods: Our retrospective series included 5 players aged 31.8 ± 3.9 years with acute proximal rectus femoris avulsion injuries who underwent a surgical resection of the proximal tendon between March 2012 and June 2014. Four of these players had recurrent rectus femoris injuries in the 9 months before surgery, while 1 player had surgery after a first injury. Mean follow-up was 18.2 ± 12.6 months, and minimum follow-up was 9 months. We analyzed the age, sex distribution, physical examination outcomes, type and mechanism of injury, diagnosis, treatment and complications during surgery, postoperative follow-up, and time to return to play. The Lower Extremity Functional Scale (LEFS) and Marx scores were obtained at 3-month follow-up, and isokinetic tests were performed before return to sports. A telephone interview was completed to determine the presence of recurrence at an average follow-up of 18.2 months. Results: At 3-month follow-up, all patients had Marx activity scores of 16 and LEFS scores of 80. Return to the previous level of play occurred at a mean of 15.8 ± 2.6 weeks after surgery, and none of the athletes suffered a recurrence. Isokinetic test results were comparable between both sides. Conclusion: The surgical treatment of proximal rectus femoris avulsions, consisting of resection of the tendinous part of the muscle, is a reliable and safe technique allowing a

  8. MAGNETIC RESONANCE IMAGING CONTRAST ENHANCEMENT OF EXTRA-OCULAR MUSCLES IN DOGS WITH NO CLINICAL EVIDENCE OF ORBITAL DISEASE

    NARCIS (Netherlands)

    JOSLYN, S.; Richards, S.; Boroffka, S.A.E.B.; Mitchell, M.; Hammond, G.; Sullivan, M.T.

    2013-01-01

    Enhancement of extra-ocular muscles has been reported in cases of orbital pathology in both veterinary and medical magnetic resonance imaging.We have also observed this finding in the absence of orbital disease. The purpose of this retrospective study was to describe extra-ocular muscle contrast enh

  9. Extraocular muscle is spared despite the absence of an intact sarcoglycan complex in gamma- or delta-sarcoglycan-deficient mice.

    Science.gov (United States)

    Porter, J D; Merriam, A P; Hack, A A; Andrade, F H; McNally, E M

    2001-03-01

    Models of the dystrophin-glycoprotein complex do not reconcile the novel sparing of extraocular muscle in muscular dystrophy. Extraocular muscle sparing in Duchenne muscular dystrophy implies the existence of adaptive properties in these muscles that may extend protection to other neuromuscular diseases. We studied the extraocular muscle morphology and dystrophin-glycoprotein complex organization in murine targeted deletion of the gamma-sarcoglycan (gsg(-/-)) and delta-sarcoglycan (dsg(-/-)) genes, two models of autosomal recessive limb girdle muscular dystrophy. In contrast to limb and diaphragm, the principal extraocular muscles were intact in gsg(-/-) and dsg(-/-) mice. However, central nucleated, presumptive regenerative, fibers were seen in the accessory extraocular muscles (retractor bulbi, levator palpebrae superioris) of both strains. Skeletal muscles of gsg(-/-) mice exhibited in vivo Evans Blue dye permeability, while the principal extraocular muscles did not. Disruption of gamma-sarcoglycan produced secondary displacement of alpha- and beta-sarcoglycans in the extraocular muscles. The intensity of immunofluorescence for dystrophin and alpha- and beta-dystroglycan also appeared to be slightly reduced. Utrophin localization was unchanged. The finding that sarcoglycan disruption was insufficient to elicit alterations in extraocular muscle suggests that loss of mechanical stability and increased sarcolemmal permeability are not inevitable consequences of mutations that disrupt the dystrophin-glycoprotein complex organization and must be accounted for in models of muscular dystrophy.

  10. MAGNETIC RESONANCE IMAGING CONTRAST ENHANCEMENT OF EXTRA-OCULAR MUSCLES IN DOGS WITH NO CLINICAL EVIDENCE OF ORBITAL DISEASE

    NARCIS (Netherlands)

    JOSLYN, S.; Richards, S.; Boroffka, S.A.E.B.; Mitchell, M.; Hammond, G.; Sullivan, M.T.

    2013-01-01

    Enhancement of extra-ocular muscles has been reported in cases of orbital pathology in both veterinary and medical magnetic resonance imaging.We have also observed this finding in the absence of orbital disease. The purpose of this retrospective study was to describe extra-ocular muscle contrast enh

  11. Rectus abdominis muscle free flap harvest by laparoscopic sheath-sparing technique.

    Science.gov (United States)

    Greensmith, A; Januszkiewicz, J; Poole, G

    2000-04-01

    Previous reports of endoscopic rectus abdominis muscle harvest have described techniques that are hampered by the need for anterior rectus sheath division or mechanical devices to maintain the optical cavity. The authors report the first successful clinical case of a laparoscopic sheath-sparing rectus abdominis muscle harvest for free tissue transfer. It offers considerable advantages over the traditional open method and, with the help of an experienced laparoscopic surgeon, it should add little to operative time.

  12. Architecture of the rectus abdominis, quadratus lumborum, and erector spinae.

    Science.gov (United States)

    Delp, S L; Suryanarayanan, S; Murray, W M; Uhlir, J; Triolo, R J

    2001-03-01

    Quantitative descriptions of muscle architecture are needed to characterize the force-generating capabilities of muscles. This study reports the architecture of three major trunk muscles: the rectus abdominis, quadratus lumborum, and three columns of the erector spinae (spinalis thoracis, longissimus thoracis and iliocostalis lumborum). Musculotendon lengths, muscle lengths, fascicle lengths, sarcomere lengths, pennation angles, and muscle masses were measured in five cadavers. Optimal fascicle lengths (the fascicle length at which the muscle generates maximum force) and physiologic cross-sectional areas (the ratio of muscle volume to optimal fascicle length) were computed from these measurements. The rectus abdominis had the longest fascicles of the muscles studied, with a mean (S.D.) optimal fascicle length of 28.3 (4.2)cm. The three columns of the erector spinae had mean optimal fascicle lengths that ranged from 6.4 (0.6)cm in the spinalis thoracis to 14.2 (2.1)cm in the iliocostalis lumborum. The proximal portion of the quadratus lumborum had a mean optimal fascicle length of 8.5 (1.5)cm and the distal segment of this muscle had a mean optimal fascicle length of 5.6 (0.9)cm. The physiologic cross-sectional area of the rectus abdominis was 2.6 (0.9)cm(2), the combined physiologic cross-sectional area of the erector spinae was 11.6 (1.8)cm(2), and the physiologic cross-sectional area of the quadratus lumborum was 2.8 (0.5)cm(2). These data provide the basis for estimation of the force-generating potential of these muscles.

  13. Retracted: Spontaneous rectus sheath haematoma associated with rivaroxaban treatment.

    Science.gov (United States)

    Tas Tuna, A; Palabiyik, O; Beyaz, S G

    2015-08-01

    http://onlinelibrary.wiley.com/doi/10.1111/jcpt.12228/pdf The above article, published online on 10 November 2014 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors, the journal Editor in Chief, A. Li Wan Po, and John Wiley & Sons Ltd. The retraction has been agreed because, unknown to the authors, another group published a similar study based on the same material in the Indian Journal of Pharmacology: Kocayigit I, Can Y, Sahinkus S, et al. Spontaneous rectus sheath haematoma during rivaroxaban therapy. Indian Journal of Pharmacology. 2014;46(3):339-340. doi:10.4103/0253-7613.132193.

  14. Extraocular Light Therapy in Winter Depression : A Double-blind Placebo-controlled Study

    NARCIS (Netherlands)

    Koorengevel, Kathelijne M.; Gordijn, Marijke C.M.; Beersma, Domien G.M.; Meesters, Ybe; den Boer, Johan; Hoofdakker, Rutger H. van den; Daan, Serge

    2001-01-01

    Background: It has been hypothesized that the circadian pacemaker is phase delayed in seasonal affective disorder, (SAD) winter type, and that the phase advance resulting from morning ocular light accounts for the efficacy of light therapy. Extraocular light has been reported to produce phase-shifts

  15. Transcriptional and functional differences in stem cell populations isolated from Extraocular and Limb muscles

    DEFF Research Database (Denmark)

    Pacheco-Pinedo, Eugenia Cristina; Budak, Murat T; Zeiger, Ulrike

    2008-01-01

    The extraocular muscles (EOMs) are a distinct muscle group that displays an array of unique contractile, structural and regenerative properties. They also have differential sensitivity to certain diseases and are enigmatically spared in Duchenne muscular dystrophy (DMD). The EOMs are so distinct ...

  16. MRI manifestations of enlarged superior ophthalmic vein

    Institute of Scientific and Technical Information of China (English)

    WEI Rui-li; MA Xiao-ye; CAI Ji-ping; ZHU Huang

    2002-01-01

    Objective:To assess MRI in the evaluation of enlarged superior ophthalmic vein (SOV). Methods: MRI manifestations and etiology of forty-six patients with enlarged SOV were analyzed. Results: SOV enlargement was noted to occur in carotid-cavernous fistula, ophthalmic Graves'disease, Tolosa-Hunt syndrome, inflammation at the apex of the orbit, orbital pseudotumor and thrombosis of cavernous sinus. The dilated vein appeared as signal void tubular shadows on both T1 and T2 weighted images. The diameter of the enlarged vein was 3.5-6.0 mm. Extraocular muscle enlargement, orbital pathologies, enlarged carotid cavernous sinus etc were also revealed by MRI. Conclusion: The dilated SOV may be well demonstrated by MRI. The etiological diagnosis of enlarged SOV can be made in combination with the associated findings.

  17. Forward Head Posture and Activation of Rectus Capitis Posterior Muscles.

    Science.gov (United States)

    Hallgren, Richard C; Pierce, Steven J; Sharma, Dhruv B; Rowan, Jacob J

    2017-01-01

    Rectus capitis posterior (RCP) muscles have physical attachments to the pain-sensitive spinal dura. Atrophy of these muscles is associated with chronic headache in some patients. The authors suspect that the significance of atrophy in the RCP muscles has been undervalued because the functional role of these muscles is not well defined. To determine whether a statistically significant change in normalized levels of electromyographic activity in RCP muscles occurs when the head is voluntarily moved from a self-selected neutral head position to a protruded head position. Fine wire, intramuscular electrodes were used to collect electromyographic data as asymptomatic participants moved their head from a neutral head position into a forward head position and back into the neutral head position. This sequence was repeated 4 times. Normalized levels of electromyographic activity were quantified using a 2-head position × 2 sides of the body repeated measures design that incorporated mixed-effects β regression models. Twenty participants were studied. Electromyographic activity collected from RCP muscles was found to increase as the head was voluntarily moved from a self-selected neutral head position (11% of maximum voluntary isometric contraction [MVIC] in RCP minor, 14% of MVIC in RCP major) into a protruded head position (35% of MVIC in RCP minor, 39% of MVIC in RCP major) (P<.001). Rectus capitis posterior muscles may contribute to segmental stabilization of the occipitoatlantal and atlantoaxial joints by helping to maintain joint congruency during movement of the head.

  18. Possible postsynaptic action of aminoglycosides in the frog rectus abdominis.

    Directory of Open Access Journals (Sweden)

    Karataş Y

    2000-04-01

    Full Text Available The present study was undertaken to investigate the postsynaptic effects of aminoglycosides on contractions evoked by acetylcholine (ACh, KCl, electrical field stimulation (EFS and Na(+- and Ca(2+-free Ringer solution with 0.2 mM Na2 EDTA (NaFCaFR in the isolated frog rectus abdominis. Neomycin inhibited contraction elicited by ACh, NaFCaFR, and EFS at the higher frequencies (8 and 10 Hz but not those elicited by KCl and EFS at the lower frequencies (2, 3 and 5 Hz. D-tubocurarine inhibited ACh-induced contractions in a concentration-dependent manner. In addition, drug reduced EFS-evoked contractions to a limited extent. Lower concentrations (10(-5, 5 x 10(-5, 10(-4, 2 x 10(-4 and 3 x 10(-4 M but not higher concentrations (4 x 10(-4 and 5 x 10(-4 M of methoxyverapamil exhibited a concentration-dependent inhibitory action on NaFCaFR-induced contractions. Similar inhibitions of the same type of contraction were displayed by aminoglycosides (neomycin, streptomycin, netilmycin, gentamycin and amikacin. These results suggest that in addition to their antagonistic action on nicotinic receptors in the frog rectus abdominis, aminoglycosides may exert stabilizing effects on some functional components contributing to contractions at the membrane.

  19. Lateral rectus muscle disinsertion and reattachment to the lateral orbital wall

    OpenAIRE

    Morad, Y.; KOWAL, L.; Scott, A B

    2005-01-01

    Background/aims: Surgical correction of ocular alignment in patients with third cranial nerve paralysis is challenging, as the unopposed lateral rectus muscle often pulls the eye back to exotropia following surgery. The authors present a simple surgical approach to overcome this difficulty. This approach is also applicable to removal of unwanted overactivity of the lateral rectus in Duane syndrome.

  20. 眼外肌矫正术治疗先天性下睑退缩%Repair of lower eyelid retraction via diorthosis of the extraocular muscle

    Institute of Scientific and Technical Information of China (English)

    张丽蓉; 胡兰; 何伟

    2013-01-01

    Objective To assess the effects of balanced adjustment of superior or inferior rectus insertion in both eye for the treatment of lower eyelid retraction.Methods The anatomical structure of eyelid and eyeball was analyzed,and the binocular vision function and fundus in 2 adult lower eyelid retractors were totally examined.Plication of both inferior rectus was performed in one case,and the other with recession of both superior rectus.Eye position and binocular vision were assessed intraoperatively and postoperative follow-up was carried out.Results Eye movement was normal in both cases,non accompanied with diplopia,decreased vision,headache and dizziness.The width of palpebral fissure is normal in all eye,and there were no scar and pathological changes.Patients looked naturelly and the satisfaction was obtained.Conclusion Surgery of superior or inferior rectus is effective with little damage and quick recovery.%目的 通过均衡调整双眼球上、下直肌的附着点,使眼球向下移位,矫正下睑退缩外观.方法 对2例成年先天性下睑退缩患者,进行眼睑及眼球解剖结构特点的分析,全面检查分析双眼视功能及眼底功能,选择局部麻醉下双眼下直肌折叠缩短术1例,双眼上直肌后徙术1例,并在术中调整眼球位置及观察双眼视觉效果,术后跟踪随访.结果 本组2例患者术后眼球各向运动无明显受限,双眼无复视,无视力下降及头痛头晕,双眼无不适感.双眼睑裂高度正常,眼睑皮肤无手术瘢痕及病理性改变,患者容貌自然美观,效果满意.结论 此术式损伤轻微,术后恢复快,效果理想.

  1. Sparing of extraocular muscle in aging and muscular dystrophies: A myogenic precursor cell hypothesis

    Energy Technology Data Exchange (ETDEWEB)

    Kallestad, Kristen M.; Hebert, Sadie L.; McDonald, Abby A.; Daniel, Mark L.; Cu, Sharon R.; McLoon, Linda K., E-mail: mcloo001@tc.umn.edu

    2011-04-01

    The extraocular muscles (EOM) are spared from pathology in aging and many forms of muscular dystrophy. Despite many studies, this sparing remains an enigma. The EOM have a distinct embryonic lineage compared to somite-derived muscles, and we have shown that they continuously remodel throughout life, maintaining a population of activated satellite cells even in aging. These data suggested the hypothesis that there is a population of myogenic precursor cells (mpcs) in EOM that is different from those in limb, with either elevated numbers of stem cells and/or mpcs with superior proliferative capacity compared to mpcs in limb. Using flow cytometry, EOM and limb muscle mononuclear cells were compared, and a number of differences were seen. Using two different cell isolation methods, EOM have significantly more mpcs per mg muscle than limb skeletal muscle. One specific subpopulation significantly increased in EOM compared to limb was positive for CD34 and negative for Sca-1, M-cadherin, CD31, and CD45. We named these the EOMCD34 cells. Similar percentages of EOMCD34 cells were present in both newborn EOM and limb muscle. They were retained in aged EOM, whereas the population decreased significantly in adult limb muscle and were extremely scarce in aged limb muscle. Most importantly, the percentage of EOMCD34 cells was elevated in the EOM from both the mdx and the mdx/utrophin{sup -/-} (DKO) mouse models of DMD and extremely scarce in the limb muscles of these mice. In vitro, the EOMCD34 cells had myogenic potential, forming myotubes in differentiation media. After determining a media better able to induce proliferation in these cells, a fusion index was calculated. The cells isolated from EOM had a 40% higher fusion index compared to the same cells isolated from limb muscle. The EOMCD34 cells were resistant to both oxidative stress and mechanical injury. These data support our hypothesis that the EOM may be spared in aging and in muscular dystrophies due to a

  2. Sparing of extraocular muscle in aging and muscular dystrophies: a myogenic precursor cell hypothesis.

    Science.gov (United States)

    Kallestad, Kristen M; Hebert, Sadie L; McDonald, Abby A; Daniel, Mark L; Cu, Sharon R; McLoon, Linda K

    2011-04-01

    The extraocular muscles (EOM) are spared from pathology in aging and many forms of muscular dystrophy. Despite many studies, this sparing remains an enigma. The EOM have a distinct embryonic lineage compared to somite-derived muscles, and we have shown that they continuously remodel throughout life, maintaining a population of activated satellite cells even in aging. These data suggested the hypothesis that there is a population of myogenic precursor cells (mpcs) in EOM that is different from those in limb, with either elevated numbers of stem cells and/or mpcs with superior proliferative capacity compared to mpcs in limb. Using flow cytometry, EOM and limb muscle mononuclear cells were compared, and a number of differences were seen. Using two different cell isolation methods, EOM have significantly more mpcs per mg muscle than limb skeletal muscle. One specific subpopulation significantly increased in EOM compared to limb was positive for CD34 and negative for Sca-1, M-cadherin, CD31, and CD45. We named these the EOMCD34 cells. Similar percentages of EOMCD34 cells were present in both newborn EOM and limb muscle. They were retained in aged EOM, whereas the population decreased significantly in adult limb muscle and were extremely scarce in aged limb muscle. Most importantly, the percentage of EOMCD34 cells was elevated in the EOM from both the mdx and the mdx/utrophin(-/-) (DKO) mouse models of DMD and extremely scarce in the limb muscles of these mice. In vitro, the EOMCD34 cells had myogenic potential, forming myotubes in differentiation media. After determining a media better able to induce proliferation in these cells, a fusion index was calculated. The cells isolated from EOM had a 40% higher fusion index compared to the same cells isolated from limb muscle. The EOMCD34 cells were resistant to both oxidative stress and mechanical injury. These data support our hypothesis that the EOM may be spared in aging and in muscular dystrophies due to a subpopulation

  3. Regional neuromuscular regulation within human rectus femoris muscle during gait.

    Science.gov (United States)

    Watanabe, Kohei; Kouzaki, Motoki; Moritani, Toshio

    2014-11-01

    The spatial distribution pattern of neuromuscular activation within the human rectus femoris (RF) muscle was investigated during gait by multi-channel surface electromyography (surface EMG). Eleven healthy men walked on a treadmill with three gait speeds (4, 5, and 6 km/h) and gradients (0°, 12.5°, and 25°). The spatial distribution of surface EMG was tested by central locus activation (CLA), which is calculated from 2-D multi-channel surface EMG with 46 surface electrodes. For all conditions, CLA was around the middle regions during the swing-to-stance transition and moved in a proximal direction during the stance phase and stance-to-swing transition (pphase significantly moved to proximal site with increasing gait speed (pphases, with increasing grade, CLA significantly moved distally (pgait cycle and is non-uniformly regulated longitudinally.

  4. Mechanisms of Vertical Fusional Vergence in Patients With "Congenital Superior Oblique Paresis" Investigated With an Eye-Tracking Haploscope.

    Science.gov (United States)

    Irsch, Kristina; Guyton, David L; Park, Hee-Jung S; Ying, Howard S

    2015-08-01

    To determine the mechanisms of vertical fusional vergence in patients with "congenital unilateral superior oblique paresis" (SOP) and to discuss the implications of these mechanisms. Eleven patients were examined with our eye-tracking haploscope. Three different fusion mechanisms were found, producing significantly different cyclovergence to vertical vergence ratios (P < 0.05): primary use of the vertical rectus muscles in seven patients (ratio: 0.36 ± 1.6), primary use of the oblique muscles in one patient (0.04), and use of the superior oblique muscle in the higher eye and the superior rectus muscle in the lower eye in three patients (1.15 ± 0.32). Lancaster red-green testing showed alignment differences among these groups, primarily differences in amount of subjective extorsion between the two eyes in straight-ahead gaze: The patient with oblique-muscle-mediated fusion showed essentially no subjective extorsion (0.5°), the patients with vertical-rectus-muscle-mediated vertical fusion showed a mean ± SD subjective extorsion of 3.6° ± 1.4°, and the patients with the mixed (oblique/rectus) fusion mechanism showed 7.0° ± 1.7° (P < 0.05). The choice of fusion mechanism may be a function of how much intorting effect is needed. Use of the oblique muscles bilaterally causes the least intorting effect, use of the vertical rectus muscles bilaterally adds more intorting effect, and activation of the "paretic" superior oblique muscle in the higher eye and the superior rectus muscle in the lower eye provides the greatest intorting effect. Subclassifying "congenital SOP" in this way (in which the "paretic" muscle may remain functional in many cases) may help guide its optimal surgical correction.

  5. The development of longitudinal variation of Myosin isoforms in the orbital fibers of extraocular muscles of rats.

    Science.gov (United States)

    Rubinstein, Neal A; Porter, John D; Hoh, Joseph F Y

    2004-09-01

    To examine the appearance of longitudinal variation of extraocular and embryonic myosin heavy chain (MyHC) isoforms during the development of orbital singly innervated fibers of rat extraocular muscles (EOMs). EOMs were dissected from rat pups of various ages and stained with isoform-specific monoclonal antibodies to the embryonic and extraocular MyHC isoforms and to neurofilaments, as well as with labeled alpha-bungarotoxin. The orbital layers of whole muscles were examined by confocal microscopy. RNase protection assays for the embryonic (Myh3) and extraocular (Myh13) MyHC isoform mRNAs were also performed. At 10 days postpartum, the EOM MyHC RNA was first detected by RNase protection assay. At 11 days postpartum, the extraocular isoform was detected in the orbital fibers as two thin stripes just proximal and distal to the neuromuscular junction (NMJ). Over the next few weeks, the area occupied by the extraocular isoform increased to include the entire central region of the orbital fibers at and surrounding the NMJ. At the same time, the embryonic isoform became excluded from the region of the NMJ. The orbital layer fibers of rat EOMs contain a longitudinal variation in MyHC isoforms not seen in other skeletal muscles. Development of this longitudinal variation begins as a late event postpartum; and the first appearance of it may be closely linked to neural contact. This targeting of MyHC isoforms to distinct domains is unique to EOMs. Copyright Association for Research in Vision and Ophthalmology

  6. Superior Oblique Anterior Transposition with Horizontal Recti Recession-Resection for Total Third-Nerve Palsy

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    Muhsin Eraslan

    2015-01-01

    Full Text Available Aims. To report the results of lateral rectus muscle recession, medial rectus muscle resection, and superior oblique muscle transposition in the restoration and maintenance of ocular alignment in primary position for patients with total third-nerve palsy. Methods. The medical records of patients who underwent surgery between March 2007 and September 2011 for total third-nerve palsy were reviewed. All patients underwent a preoperative assessment, including a detailed ophthalmologic examination. Results. A total of 6 patients (age range, 14–45 years were included. The median preoperative horizontal deviation was 67.5 Prism Diopter (PD (interquartile range [IQR] 57.5–70 and vertical deviation was 13.5 PD (IQR 10–20. The median postoperative horizontal residual exodeviation was 8.0 PD (IQR 1–16, and the vertical deviation was 0 PD (IQR 0–4. The median correction of hypotropia following superior oblique transposition was 13.5 ± 2.9 PD (range, 10–16. All cases were vertically aligned within 5 PD. Four of the six cases were aligned within 10 PD of the horizontal deviation. Adduction and head posture were improved in all patients. All patients gained new area of binocular single vision in the primary position after the operation. Conclusion. Lateral rectus recession, medial rectus resection, and superior oblique transposition may be used to achieve satisfactory cosmetic and functional results in total third-nerve palsy.

  7. Superior Oblique Anterior Transposition with Horizontal Recti Recession-Resection for Total Third-Nerve Palsy

    Science.gov (United States)

    Eraslan, Muhsin; Cerman, Eren; Onal, Sumru; Ogut, Mehdi Suha

    2015-01-01

    Aims. To report the results of lateral rectus muscle recession, medial rectus muscle resection, and superior oblique muscle transposition in the restoration and maintenance of ocular alignment in primary position for patients with total third-nerve palsy. Methods. The medical records of patients who underwent surgery between March 2007 and September 2011 for total third-nerve palsy were reviewed. All patients underwent a preoperative assessment, including a detailed ophthalmologic examination. Results. A total of 6 patients (age range, 14–45 years) were included. The median preoperative horizontal deviation was 67.5 Prism Diopter (PD) (interquartile range [IQR] 57.5–70) and vertical deviation was 13.5 PD (IQR 10–20). The median postoperative horizontal residual exodeviation was 8.0 PD (IQR 1–16), and the vertical deviation was 0 PD (IQR 0–4). The median correction of hypotropia following superior oblique transposition was 13.5 ± 2.9 PD (range, 10–16). All cases were vertically aligned within 5 PD. Four of the six cases were aligned within 10 PD of the horizontal deviation. Adduction and head posture were improved in all patients. All patients gained new area of binocular single vision in the primary position after the operation. Conclusion. Lateral rectus recession, medial rectus resection, and superior oblique transposition may be used to achieve satisfactory cosmetic and functional results in total third-nerve palsy. PMID:26640703

  8. Squamous cell carcinoma of the conjunctiva with extraocular involvement: case report and literature review

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    Ignacio Goñi Espildora

    2016-05-01

    Full Text Available Resumen El carcinoma escamoso de la conjuntiva es el tumor maligno más frecuente de la superficie ocular. Constituye una enfermedad rara con una incidencia de 0,13 a 1,9 por 100 000 habitantes que afecta principalmente a individuos entre los 50 y los 75 años. Suele tener un curso lento y poco agresivo. El tratamiento depende de la extensión tumoral. En presencia de compromiso intraocular la enucleación está indicada y en presencia de compromiso extraocular la exanteración orbitaria es el tratamiento estándar. Reportamos el caso de un paciente de 82 años con carcinoma escamoso conjuntival con compromiso intra y extraocular, se discute el caso y se revisa la literatura.

  9. Convergence excess esotropia treated surgically with fadenoperation and medical rectus muscle recessions.

    Science.gov (United States)

    Leitch, R J; Burke, J P; Strachan, I M

    1990-05-01

    Convergence excess esotropia has been treated with bifocals, miotics, medial rectus recession(s), fadenoperation, or a combination of these. However, comparatively few studies on the sensory status of these patients exist. We present the sensory findings in 31 children treated surgically. Twenty-one had fadenoperations combined with bimedial rectus recessions, one had a fadenoperation alone, and nine had augmented bimedial rectus recessions. Five children (16%) achieved bifoveal fusion, 22 (71%) had varying degrees of peripheral fusion, and four (13%) had no detectable binocularity after a mean postoperative follow-up of 2.4 years.

  10. Use of extraocular muscle flaps in the correction of orbital implant exposure.

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    Hsueh-Yen Chu

    Full Text Available PURPOSES: The study is to describe a new surgical technique for correcting large orbital implant exposure with extraocular muscle flaps and to propose a treatment algorithm for orbital implant exposure. METHODS: In a retrospective study, seven patients with orbital implant exposure were treated with extraocular muscle flaps. All data were collected from patients in Chang Gung Memorial Hospital, Taiwan during 2007-2012. All surgeries were performed by one surgeon (Y.J.T. Patient demographics, the original etiology, details of surgical procedures, implant types, and follow-up interval were recorded. Small exposure, defined as exposure area smaller than 3 mm in diameter, was treated conservatively first with topical lubricant and prophylactic antibiotics. Larger defects were managed surgically. RESULTS: Seven patients consisting of two males and five females were successfully treated for orbital implant exposure with extraocular muscle flaps. The average age was 36.4 (range, 3-55 years old. Five patients were referred from other hospitals. One eye was enucleated for retinoblastoma. The other six eyes were eviscerated, including one for endophthalmitis and five for trauma. Mean follow-up time of all seven patients was 19.5 (range, 2-60 months. No patient developed recurrence of exposure during follow-up. All patients were fitted with an acceptable prosthesis and had satisfactory cosmetic and functional results. CONCLUSIONS: The most common complication of orbital implant is exposure, caused by breakdown of the covering layers, leading to extrusion. Several methods were reported to manage the exposed implants. We report our experience of treating implant exposure with extraocular muscle flaps to establish a well-vascularized environment that supplies both the wrapping material and the overlying ocular surface tissue. We believe it can work as a good strategy to manage or to prevent orbital implant exposure.

  11. Current concepts in MRI of rectus femoris musculotendinous (myotendinous) and myofascial injuries in elite athletes

    Energy Technology Data Exchange (ETDEWEB)

    Kassarjian, A., E-mail: Kassarjian@mac.com [Consultant Radiologist, Corades, S. L., Calle Galeon 2, 28220 Majadahonda, Madrid (Spain); Rodrigo, R.M., E-mail: rmrodrigo@resonanciamagneticabilbao.com [Resonancia Magnetica Bilbao, Hospital San Francisco Javier, Gordoniz 12, 40010 Bilbao, Vizcaya, Basque Country (Spain); Santisteban, J.M., E-mail: j.santisteban@athletic-club.net [Medical Services, Athletic Club Bilbao, Basurto Medical Institute, Faculty of Medicine and Odontology, University of the Basque Country, Barrio de Garaioltza 147, 48197 Lezama, Vizcaya, Basque Country (Spain)

    2012-12-15

    Rectus femoris injuries are extremely common in athletes, particularly in soccer players, rugby player, and sprinters. Magnetic resonance imaging (MRI) plays a key role in diagnosis, prognosis, and rehabilitation of these injuries. The current article discusses current concepts in the diagnosis and treatment of rectus femoris injuries in elite athletes, including a discussion of the less well known myofascial injuries and key prognostic factors as seen at MR imaging.

  12. Ultrasound-guided rectus sheath block in children with umbilical hernia: Case series

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    Abdul Hamid Alsaeed

    2013-01-01

    Full Text Available Background: Umbilical hernia repair, a common day-case surgery procedure in children, is associated with a significant postoperative pain. The most popular peripheral nerve blocks used in umbilical hernia repair are rectus sheath infiltration and caudal block. The rectus sheath block may offer improved pain relief following umbilical hernia repair with no undesired effects such as lower limb motor weakness or urinary retention seen with caudal block which might delay discharge from the hospital. Ultrasound guidance of peripheral nerve blocks has reduced the number of complications and improved the quality of blocks.The aim of this case series is to assess the post rectus sheath block pain relief in pediatric patients coming for umbilical surgery. Methods: Twenty two (22 children (age range: 1.5-8 years scheduled for umbilical hernia repair were included in the study. Following the induction of general anesthesia, the ultrasonographic anatomy of the umbilical region was studied with a 5-16 MHz 50 mm linear probe. An ultrasound-guided posterior rectus sheath block of both rectus abdominis muscles (RMs was performed (total of 44 punctures. An in-plain technique using Stimuplex A insulated facet tip needle 22G 50mm. Surgical conditions, intraoperative hemodynamic parameters, and postoperative analgesia by means of the modified CHEOPS scale were evaluated. Results: ultrasonograghic visualization of the posterior sheath was possible in all patients. The ultrasound guided rectus sheath blockade provided sufficient analgesia in all children with no need for additional analgesia except for one patient who postoperatively required morphine 0.1 mg/kg intravenously. There were no complications. Conclusions: Ultrasound guidance enables performances of an effective rectus sheath block for umbilical hernia. Use of the Stimuplex A insulated facet tip needle 22G 50mm provides easy, less traumatic skin and rectus muscle penetration and satisfactory needle

  13. THE RECTUS ABDOMINIS MUSCLE IN MALES AND FEMALES OF KERALA- A CADAVERIC STUDY

    OpenAIRE

    Vijayamma Kunnath Narayanan; Serin Peter; Anjana Jayakumaran Nair

    2017-01-01

    BACKGROUND The rectus abdominis is a long, flat strap muscle which extends vertically upward along the linea alba from the pubic symphysis below to the costal margin above. It is a flexor of the vertebral column and thereby plays an important role in maintaining the normal body posture. As it is a part of the anterior abdominal wall, the strength of the muscle plays a very important role in maintaining the integrity of the anterior abdominal wall. Weakness of the rectus abdomin...

  14. Ultrasound-guided rectus sheath block in children with umbilical hernia: Case series.

    Science.gov (United States)

    Alsaeed, Abdul Hamid; Thallaj, Ahmed; Khalil, Nancy; Almutaq, Nada; Aljazaeri, Ayman

    2013-10-01

    Umbilical hernia repair, a common day-case surgery procedure in children, is associated with a significant postoperative pain. The most popular peripheral nerve blocks used in umbilical hernia repair are rectus sheath infiltration and caudal block. The rectus sheath block may offer improved pain relief following umbilical hernia repair with no undesired effects such as lower limb motor weakness or urinary retention seen with caudal block which might delay discharge from the hospital. Ultrasound guidance of peripheral nerve blocks has reduced the number of complications and improved the quality of blocks. The aim of this case series is to assess the post rectus sheath block pain relief in pediatric patients coming for umbilical surgery. Twenty two (22) children (age range: 1.5-8 years) scheduled for umbilical hernia repair were included in the study. Following the induction of general anesthesia, the ultrasonographic anatomy of the umbilical region was studied with a 5-16 MHz 50 mm linear probe. An ultrasound-guided posterior rectus sheath block of both rectus abdominis muscles (RMs) was performed (total of 44 punctures). An in-plain technique using Stimuplex A insulated facet tip needle 22G 50mm. Surgical conditions, intraoperative hemodynamic parameters, and postoperative analgesia by means of the modified CHEOPS scale were evaluated. ultrasonograghic visualization of the posterior sheath was possible in all patients. The ultrasound guided rectus sheath blockade provided sufficient analgesia in all children with no need for additional analgesia except for one patient who postoperatively required morphine 0.1 mg/kg intravenously. There were no complications. Ultrasound guidance enables performances of an effective rectus sheath block for umbilical hernia. Use of the Stimuplex A insulated facet tip needle 22G 50mm provides easy, less traumatic skin and rectus muscle penetration and satisfactory needle visualiza.

  15. [Paragliding-associated bilateral partial rupture of the rectus femoris muscle].

    Science.gov (United States)

    Schulze Bertelsbeck, D; Veelken, D

    2004-12-01

    Pain in the thigh or groin due to a rupture of the rectus femoris muscle is rather uncommon. We report on a patient with a bilateral rupture of the rectus femoris muscle that occurred due to a landing maneuver while para-gliding. The diagnosis was confirmed by ultrasound and MRI. Additionally, an old unilateral anterior cruciate ligament rupture was present. As a functional deficit of the quadriceps muscle could not be observed, a primarily conservative treatment seems to be appropriate.

  16. Rectus sheath haematoma or leaking aortic aneurysm - a diagnostic challenge: a case report

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    Shaw Aidan G

    2009-11-01

    Full Text Available Abstract Introduction A rectus sheath haematoma is a rare condition that arises from the accumulation of blood within the rectus sheath from either muscular tear or rupture of the epigastric vessels. It is a known complication of either blunt abdominal trauma, anticoagulation therapy or the repetitive contraction of the rectus muscle such as paroxysms of coughing. It remains an uncommon and elusive entity and is often clinically misdiagnosed. Case presentation An 80-year-old British man with a known aortic aneurysm was admitted with sudden onset of right iliac fossa pain. The patient was hemodynamically stable and underwent a computed tomography scan which revealed an intact aorta and an acute rectus sheath hematoma. Conclusion To the best of our knowledge, no case has previously been reported involving the diagnostic challenge of a rectus sheath hematoma in a patient with a known aortic aneurysm. Here we discuss the symptoms and signs of a rectus sheath hematoma, as well as the radiological modalities that could be utilized to reach the diagnosis.

  17. Musculo-tendon length and lengthening velocity of rectus femoris in stiff knee gait.

    Science.gov (United States)

    Jonkers, Ilse; Stewart, Caroline; Desloovere, Kaat; Molenaers, Guy; Spaepen, Arthur

    2006-02-01

    Inappropriate activity of M. rectus femoris (RF) during swing is believed to contribute to stiff knee gait in cerebral palsy. This study used musculoskeletal modeling techniques to analyze rectus femoris musculo-tendon (MT) length and lengthening velocity during stiff knee gait in 35 children with diplegic cerebral palsy (CP). Duncan Ely test scores were used to categorize the patients into four groups with increasing levels of rectus femoris spasticity. Knee kinematics confirmed a significant reduction and delay of maximal peak knee flexion during swing in the patient groups compared to reference values. Maximal musculo-tendon length of M. rectus femoris was reduced and occurred prematurely in swing. Musculo-tendon lengthening velocity was significantly reduced and the timing of the maximal lengthening velocity was shifted into stance phase. The present study demonstrates altered dynamic behavior of the M. rectus femoris in stiff knee gait and the results indicate that maximal knee flexion in swing was not a valid reference for the MT length of the M. rectus femoris. Furthermore, in the patient group maximal musculo-tendon lengthening velocity of the muscle related to the stance phase rather than the stance-swing transition.

  18. Changes of orbital tissue volumes and proptosis in patients with thyroid extraocular muscle swelling after methylprednisolone pulse therapy.

    Science.gov (United States)

    Higashiyama, Tomoaki; Nishida, Yasuhiro; Ohji, Masahito

    2015-11-01

    To evaluate the changes of orbital tissue volumes and proptosis after methylprednisolone pulse therapy in thyroid-associated ophthalmopathy (TAO). The cross-sectional areas of orbital tissues and proptosis were measured with magnetic resonance imaging in 40 orbits of 20 patients with TAO before and after methylprednisolone pulse therapy. The volumes of the whole orbit, orbital fatty tissue, and extraocular muscles were calculated. The volumes and proptosis were compared before and after treatment using a paired t test. Before treatment, the mean volumes were 33.0 ± 4.8 cm(3) in the whole orbit, 19.9 ± 4.1 cm(3) in the orbital fatty tissue, and 4.6 ± 1.2 cm(3) in the total extraocular muscles. After treatment, the mean volumes were 32.5 ± 4.4 cm(3) in the whole orbit, 19.9 ± 3.7 cm(3) in the orbital fatty tissue, and 4.0 ± 1.0 cm(3) in the total extraocular muscles. The mean volumes of the whole orbit (P = 0.17) and orbital fatty tissue (P = 0.82) were not significantly decreased after treatment, while the mean volume of total extraocular muscles was significantly decreased (P tissue seemed to be unchanged after methylprednisolone pulse therapy while that of total extraocular muscles was decreased. The proptosis value seemed to be unchanged after treatment.

  19. [Transfer of the psoas tendon to the, at its origin detached, rectus femoris muscle in infantile cerebral palsy].

    Science.gov (United States)

    Heimkes, B; Engert, K; Stotz, S

    1999-09-01

    Correction of flexion contracture of hip allowing an erect position while standing and walking. The gain in function helps to prevent a neurogenic dislocation of the coxofemoral joint. In infants with cerebral palsy unable to straighten the body before they can stand or walk. In ambulatory spastic children and adolescents with bothersome hip flexion contracture. Severe retardation of motor development in patients with cerebral palsy in whom walking and standing cannot be anticipated. Marked spastic-dystonic muscle weakness. In general, soft tissue releases at hip and knee are performed at the same sitting. Anterior approach to the hip. Detachment of the sartorius from the anterior superior iliac spine and mobilization in a distal direction. Detachment of the rectus femoris from the anterior inferior iliac spine and retraction distally. Exposure of the femoral nerve in the lacuna musculorum. Exposure of the psoas and detachment from the lesser tuberosity. The tendon is mobilized in a proximal direction. Transfer of the rectus tendon on the divided psoas tendon. Reattachment of the sartorius or distal displacement into the fascia of the thigh. A clinical and radiological follow-up of 71 bilaterally operated patients. A pertinent complete radiographic documentation was possible in all but 1 patient. 49.3% (n=35) of patients were able to walk preoperatively compared to 80.3% (n=57) at the time of follow-up. The average migration percentage according to Reimers amounted to 28.4% preoperatively; it had regressed to 18.2% at the time of follow-up. In none of the patients did a subluxation or dislocation occur.

  20. The Bernese periacetabular osteotomy: is transection of the rectus femoris tendon essential?

    Science.gov (United States)

    Novais, Eduardo N; Kim, Young-Jo; Carry, Patrick M; Millis, Michael B

    2014-10-01

    The Bernese periacetabular osteotomy (PAO) traditionally is performed using the iliofemoral or the ilioinguinal approach with transection of the rectus femoris tendon attachments. Although a rectus-preserving approach has been developed, there is limited direct comparison data regarding the surgical safety, radiographic correction, and improvement in hip pain and function between the rectus-preserving and the classic approaches. The purposes of this study were to determine whether preserving the rectus femoris tendon attachment would (1) reduce intraoperative blood loss and length of surgery; (2) improve Harris hip scores (HHS); (3) decrease the rate of complications; and (4) affect the radiographic correction when compared with the classic approach. A retrospective matched cohort study was used to compare the endpoints listed above after PAO using a rectus-preserving approach versus the classic approach. Operative blood loss, preoperative and postoperative hematocrit, duration of surgery, HHS, and postoperative complications were recorded for the two groups. Pelvic radiographs were reviewed for measurement of the lateral center-edge angle, anterior center-edge angle, and Tönnis acetabular inclination angle. A total of 64 patients were included (32 in each group). Followup was at a minimum of 1 year (mean, 20 months; range, 13-44 months). Blood loss (p = 0.2405), hematocrit change (p = 0.3277), and operative time (p = 0.3960) were similar between groups. At latest followup, the HHS improved in the rectus-preserving (mean improvement, 25; 95% CI, 21-29; p < 0.0001) and control groups (mean improvement, 21; 95% CI, 17-25; p < 0.0001) with no difference in HHS improvement between the groups (mean difference, 4.3; 95% CI, -1.6 to 10.1; p = 0.1523). The complication rate was 12.5% (four of 32) in the rectus-preserving group and 25% (eight of 32) in the classic approach groups, respectively (p = 0.2002). The rectus-preserving approach allowed for similar lateral center

  1. Nonabsorbable versus absorbable sutures in large, hang-back medial rectus muscle recessions.

    Science.gov (United States)

    Awadein, Ahmed; Marsh, Justin D; Guyton, David L

    2016-06-01

    To investigate the value of nonabsorbable sutures in reducing the incidence of consecutive exotropia after large, "hang-back" medial rectus recessions. The medical records of patients who underwent medial rectus recession of ≥6.5 mm in individuals ≤2 years of age, or ≥7.0 mm in those >2 years were retrospectively reviewed. Patients were divided into two groups based on suture material used: absorbable, polyglactin 910 sutures (44 patients); nonabsorbable, polyester sutures (50 patients). Preoperative measurements, ductions, strabismus surgery, and postoperative results were analyzed. Inadequate anchoring of the medial rectus muscle was suspected when consecutive exotropia developed 4-7 weeks after surgery after initial satisfactory alignment and was confirmed if during reoperation the medial rectus muscle appeared recessed >2 mm beyond the originally intended recession. Consecutive exotropia due to inadequate anchoring of the medial rectus muscle occurred in 11 of 66 muscles (17%) in the absorbable suture group. The muscle was found 6-10 mm posterior to the intended recession. Limited duction in the field of action of the involved medial rectus muscle occurred in 9 of the 11 muscles (82%). None of the eyes with nonabsorbable sutures showed inadequate anchoring. The incidence of consecutive exotropia was higher in the absorbable suture group (30%) than in the nonabsorbable suture group (6%) (P < 0.005). Using nonabsorbable suture for large, hang-back medial rectus recessions greatly reduces the incidence of consecutive exotropia that can occur when absorbable suture dissolves. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  2. Distribution of the Toxin following Medial Rectus Muscular Injection of Botulinum Toxin Gel in Rabbits

    Institute of Scientific and Technical Information of China (English)

    Jingchang Chen; Guanghuan Mai; Xinping Yu; Huanyuan Yu; Heping Wu; Xiaoming Lin; Daming Deng; Ying Kang

    2005-01-01

    Purpose: To determine the distribution of the toxin among individual muscles after intramuscular injection of botulinum toxin gel.Methods: One eye of 7 New Zealand white rabbits was randomized into group A, and the contralateral eye was into group B. Eyes in group A received medial rectus intramuscular injection of 2.5 IU of 125I-BTX-A gel in 0.1 ml, and those in group B received equivalent amount of 125I-BTX-A solution by medial rectus intramuscular injection. Four rectus muscles and the levator palpebrae superioris were harvested and the radioactivity of muscles was measured 16 hours after the injection.Results: In group A, the radioactivity of per gram medial rectus was significantly higher than that of other muscles (P < 0.01), and there was no statistically significant difference in the radioactivity of per gram muscles among other muscles (P > 0.05). In group B, the radioactivity of per gram medial rectus and levator palpebrae superioris was significantly higher than that of other muscles respectively(P < 0.05), and the difference in the radioactivity of per gram muscles between medial rectus and levator palpebrae superioris was not statistically significant (P > 0.05). The radioactivity of per gram medial rectus in group A was higher than that in group B (t=3.731 ,P=0.01), and there was no significant difference in the radioactivity of per gram muscles among other homonymous muscles (P > 0.05).Conclusion: The toxin dispersed principally in the injected muscle and the local concentration of the toxin was much high following intramuscular injection of botulinum toxin gel.

  3. Crotoxin in humans: analysis of the effects on extraocular and facial muscles

    Directory of Open Access Journals (Sweden)

    Geraldo de Barros Ribeiro

    2012-12-01

    Full Text Available PURPOSE: Crotoxin is the main neurotoxin of South American rattlesnake Crotalus durissus terrificus. The neurotoxic action is characterized by a presynaptic blockade. The purpose of this research is to assess the ability of crotoxin to induce temporary paralysis of extraocular and facial muscles in humans. METHODS: Doses of crotoxin used ranged from 2 to 5 units (U, each unit corresponding to one LD50. We first applied 2U of crotoxin in one of the extraocular muscles of 3 amaurotic individuals to be submitted to ocular evisceration. In the second stage, we applied crotoxin in 12 extraocular muscles of 9 patients with strabismic amblyopia. In the last stage, crotoxin was used in the treatment of blepharospasm in another 3 patients. RESULTS: No patient showed any systemic side effect or change in vision or any eye structure problem after the procedure. The only local side effects observed were slight conjunctival hyperemia, which recovered spontaneously. In 2 patients there was no change in ocular deviation after 2U crotoxin application. Limitation of the muscle action was observed in 8 of the 12 applications. The change in ocular deviation after application of 2U of crotoxin (9 injections was in average 15.7 prism diopters (PD. When the dose was 4U (2 applications the change was in average 37.5 PD and a single application of 5U produced a change of 16 PD in ocular deviation. This effect lasted from 1 to 3 months. Two of the 3 patients with blepharospasm had the hemifacial spasm improved with crotoxin, which returned after 2 months. CONCLUSIONS: This study provides data suggesting that crotoxin may be a useful new therapeutic option for the treatment of strabismus and blepharospasm. We expect that with further studies crotoxin could be an option for many other medical areas.

  4. Dynamic Imaging of the Eye, Optic Nerve, and Extraocular Muscles With Golden Angle Radial MRI.

    Science.gov (United States)

    Sengupta, Saikat; Smith, David S; Smith, Alex K; Welch, E Brian; Smith, Seth A

    2017-08-01

    The eye and its accessory structures, the optic nerve and the extraocular muscles, form a complex dynamic system. In vivo magnetic resonance imaging (MRI) of this system in motion can have substantial benefits in understanding oculomotor functioning in health and disease, but has been restricted to date to imaging of static gazes only. The purpose of this work was to develop a technique to image the eye and its accessory visual structures in motion. Dynamic imaging of the eye was developed on a 3-Tesla MRI scanner, based on a golden angle radial sequence that allows freely selectable frame-rate and temporal-span image reconstructions from the same acquired data set. Retrospective image reconstructions at a chosen frame rate of 57 ms per image yielded high-quality in vivo movies of various eye motion tasks performed in the scanner. Motion analysis was performed for a left-right version task where motion paths, lengths, and strains/globe angle of the medial and lateral extraocular muscles and the optic nerves were estimated. Offline image reconstructions resulted in dynamic images of bilateral visual structures of healthy adults in only ∼15-s imaging time. Qualitative and quantitative analyses of the motion enabled estimation of trajectories, lengths, and strains on the optic nerves and extraocular muscles at very high frame rates of ∼18 frames/s. This work presents an MRI technique that enables high-frame-rate dynamic imaging of the eyes and orbital structures. The presented sequence has the potential to be used in furthering the understanding of oculomotor mechanics in vivo, both in health and disease.

  5. Multi-purpose extraocular forceps for small-gauge pars plana vitrectomy.

    Science.gov (United States)

    Reichel, Elias; Chun, Dal W; Gurley, Kiersten

    2012-01-01

    A multi-purpose titanium forceps has been developed for small-gauge pars plana vitrectomy surgery. These forceps were designed to provide the vitreoretinal surgeon with a single tool for the extraocular manipulations that are necessary for the placement and removal of 23- and 25-gauge trochars for small-incision, sutureless pars plana vitrectomy surgery. The forceps has been designed to allow for the atraumatic manipulation of the conjunctiva, measurement of distance from the limbus, and a strong purchase of the trochar for both its fixation and removal.

  6. Sushruta in 600 B.C. introduced extraocular expulsion of lens material.

    Science.gov (United States)

    Grzybowski, Andrzej; Ascaso, Francisco J

    2014-03-01

    It is generally accepted that Jacques Daviel introduced in the 18th century the extracapsular technique of extraction of the lens while the couching method of cataract operation had already been practiced since ancient times. Present study analyses the first known cataract surgery description in three translations into English from the original Sanskrit Sushruta textbook and all the available literature on the subject. We found evidences that some sort of extraocular expulsion of lens material through a limbal puncture (paracentesis) was described by the Indian surgeon. Nevertheless, this incision cannot be considered as a classic extracapsular procedure because it was not large enough to allow the extraction of the entire lens.

  7. Absence of all cyclovertical extraocular muscles in a child who has Apert syndrome.

    Science.gov (United States)

    Bustos, Daniel E; Donahue, Sean P

    2007-08-01

    A 6-month-old patient with Apert syndrome underwent strabismus surgery for a hypertropic eye. At surgery, the patient was found to have agenesis of all four cyclovertical muscles in one eye. Further investigation by computed tomography demonstrated absence of all four cyclovertical muscles in the fellow eye as well. A transposition procedure corrected the strabismus. While isolated aberrant or missing extraocular muscles are well documented in patients with craniofacial syndromes, bilateral absence of all four cyclovertical muscles, as demonstrated in this patient, poses unique treatment challenges.

  8. Evaluation of dysthyroid optic neuropathy using T2-relaxation time of extraocular muscle as parameter

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Fumihiko; Maeda, Toshine; Inoue, Toyoko; Inoue, Yoichi [Olympia Eye Hospital, Tokyo (Japan)

    2001-11-01

    The T2 value of magnetic resonance imaging (MRI) is useful in evaluating the activity of dysthyroid ophthlamopathy. We applied this method in evaluating dysthyroid optic neuropathy in 15 affected eyes of 15 patients. Another group of 40 eyes of 20 patients of dysthyroid opthalmopathy without hypertrophy of extraocular muscles served as control. The T2 value in dysthyroid optic neuropathy significantly decreased following treatment with corticosteroid but the value was still higher than that in control eyes. The findings show that the T2 value of MRI is useful in evaluating the therapeutic effect of dysthyroid optic neuropathy. (author)

  9. Rectus femoris transfer and musculo-skeletal modeling: effect of surgical treatment on gait and on rectus femoris kinematics.

    Science.gov (United States)

    Desailly, Eric; Khouri, Nejib; Sardain, Philippe; Yepremian, Daniel; Lacouture, Patrick

    2011-10-01

    Spasticity of the rectus femoris (RF) is one of the possible causes of stiff knee gait (SKG) in cerebral palsy. Musculoskeletal studies have shown that in SKG, length and speed of the RF are affected. No evaluation had been made to quantify the modifications of those parameters after surgery. The effect of this operation on gait quality and on RF kinematics was assessed in this study in order to identify kinematic patterns that may aid its diagnosis. For 26 transfers, clinical gait analysis pre- and post-surgery was used to compute the Gait Deviation Index (GDI) and Goldberg's index. The kinematics of the Original RF path (ORFp) was studied before and after surgery. The expression ORFp was chosen to avoid any confusion between this modeling parameter, whose computation was unchanged, and the actual anatomical path that was modified by surgery. The gait quality was improved (+18±12GDI) and there was an inverse relation between the pre-operative GDI and its improvement. The Golberg's index was improved (88% of the cases). The operation had a significant effect on the normalization of the timings of maximum length and speed of the ORFp. The improvement of SKG was correlated with the normalization of the timing of the ORFp's maximum length. The global improvement of the gait quality and of the SKG was demonstrated. Some parameters of muscular kinematics (RF length and velocity) have been standardized, showing an effect of the transfer not only during the swing, but also during stance. The premature timing of the ORFp peak length has been identified as a prognostic factor of a successful surgical outcome.

  10. Surgical management of hypotropia in congenital fibrosis of extraocular muscles (CFEOM presented by pseudoptosis

    Directory of Open Access Journals (Sweden)

    Tawfik HA

    2012-12-01

    Full Text Available Hatem A Tawfik,1 Mohammad A Rashad21Oculoplastic Service, 2Pediatric Ophthalmology Service, Ophthalmology Department, Ain Shams University, Cairo, EgyptPurpose: To describe the demographics, characteristics, management pitfalls, and outcomes of pseudoptosis associated with congenital fibrosis of the extraocular muscles (CFEOM.Methods: A retrospective review was performed of eight patients presenting with ptosis and hypotropia to oculoplastic service. All patients underwent full ocular evaluation and magnetic resonance imaging of brain and orbit. Five of these patients underwent stepwise correction of hypotropia by single-stage adjustable strabismus surgery (SSASS, followed by a frontalis sling if needed.Results: Eight patients had congenital strabismus with severe ptosis and a positive forced duction test. There was a highly significant improvement from preoperative mean hypotropia angle of 30 prism diopters (PD to 9 PD mean postoperative angle (P = 0.006. Surgery for ptosis was not needed in 80% of eyes.Conclusion: CFEOM involving both ptosis and hypotropia could be properly managed with the correct sequence of surgical steps. Proper vertical alignment by correction of hypotropia utilizing SSASS may alleviate the need for ptosis surgery.Keywords: congenital fibrosis of extraocular muscles, CFEOM, single-stage adjustable suture surgery, SSASS, pseudoptosis

  11. Simple Eyes, Extraocular Photoreceptors and Opsins in the American Horseshoe Crab.

    Science.gov (United States)

    Battelle, Barbara-Anne

    2016-11-01

    The eyes and photoreceptors of the American horseshoe crab Limulus polyphemus have been studied since the 1930s, and this work has been critical for understanding basic mechanisms of vision. One of the attractions of Limulus as a preparation for studies of vision is that it has three different types of eyes-a pair of later compound, image-forming eyes and two types of simple eyes, a pair of median ocelli, and three pair of larval eyes. Each eye type is tractable for experimentation. Limulus also has extraocular photoreceptors in its segmental ganglia and tail. The current contribution focuses on photoreceptors in Limulus larval eyes and ocelli and its extraocular photoreceptors with the goal of summarizing what is currently known and not known about their physiology and function and the opsins they express. The Limulus genome encodes a surprisingly large number of opsins (18), and studies of their expression pattern have raised new questions about the role of opsin co-expression, the functions of peropsins expressed outside of eyes, and the physiological relevance of opsins with apparently very low expression levels. Studies of opsin expression in Limulus lead one to wonder whether photoreceptors yet to be discovered might be present throughout its central nervous system. © The Author 2016. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

  12. Blunt transection of rectus abdominis following seatbelt related trauma with associated small and large bowel injury☆

    Science.gov (United States)

    Patel, K.; Doolin, R.; Suggett, N.

    2013-01-01

    INTRODUCTION Closed rupture of rectus abdominis following seatbelt related trauma is rare. PRESENTATION OF CASE We present the case of a 45 year old female who presented with closed rupture of the rectus abdominis in conjunction with damage to small bowel mesentery and infarction of small and large bowel following a high velocity road traffic accident. Multiple intestinal resections were required resulting in short bowel syndrome and abdominal wall reconstruction with a porcine collagen mesh. Post-operative complications included intra-abdominal sepsis and an enterocutaneous fistula. DISCUSSION The presence of rupture of rectus abdominis muscle secondary to seatbelt injury should raise the suspicion of intra-abdominal injury. CONCLUSION Our case highlights the need for suspicion, investigation and subsequent surgical management of intra-abdominal injury following identification of this rare consequence of seatbelt trauma. PMID:24055917

  13. Rectus muscle flap tear as an independent cause of restricted motility.

    Science.gov (United States)

    Raab, Edward L; Ackert, Jessica M; Ostrovsky, Ann

    2012-08-01

    Most published cases of rectus muscle flap tear have been associated with orbital trauma of various degrees of severity. When they accompany an orbital fracture, however, it is difficult to determine whether the flap tear is merely an incidental additional finding or a major contributing cause of the resulting restriction. How to treat the flap itself remains an open question. We report a 24-year-old man with an inferior rectus muscle flap tear caused by direct laceration of the muscle. The major finding was a "reverse leash" vertical restriction. Discarding the flap instead of reattaching it did not prevent a successful result. Our case supports the proposition that rectus muscle flap tear can be a restriction-producing entity. Copyright © 2012 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  14. Correlation between the Limbus-Insertion Distance of the Lateral Rectus Muscle and Lateral Rectus Recession Surgery in Intermittent Exotropia.

    Directory of Open Access Journals (Sweden)

    Ju-Yeun Lee

    Full Text Available The aim of this study was to investigate whether the limbus-insertion distance (LID of the lateral rectus (LR muscle can be a useful indicator for predicting the surgical effect of recession surgery in intermittent exotropia (IXT. Patients who underwent unilateral or bilateral LR recession for the basic type of IXT were included. The distance between the corneal limbus and the posterior edge of the insertion of LR muscle (limbus-insertion distance was measured intraoperatively using surgical calipers (graded with 0.25 mm precision. We calculated the actual dose-response effect as the difference between the angle of preoperative deviation and the angle of postoperative deviation, and then divided the figure by the total amount of recession at postoperative months 1, 3, and 6. The correlation between the limbus-insertion distance (LID of LR muscle and each dose-response effect was statistically analyzed. A total of 60 subjects were enrolled in this study. The mean LID of LR muscle was 5.8±0.7 mm. The dose-response effect was 3.2±1.0 prism diopters (PD/mm at postoperative month 1, 3.4±1.0 PD/mm at postoperative month 3, and 3.4±1.1 PD/mm at postoperative month 6. The LID of the LR muscle was significantly correlated with dose-response effects in cases of unilateral and bilateral LR recession at postoperative months 3 and 6 (P = 0.01, <0.01, 0.04 and <0.01 respectively. As the LID of the LR muscle increased by 1 mm, the dose-response effect increased by 0.2PD/mm in unilateral LR recession, and by 0.4 PD/mm in bilateral LR recession at postoperative month 6. In conclusion, the LID of the LR muscle can be used as one predictor of the recession effect to assist in surgical planning for IXT. Moreover, undercorrection at the time of LR recession might be considered in patients with long LID of the LR muscle.

  15. Ocular and extra-ocular features of patients with Leber congenital amaurosis and mutations in CEP290

    NARCIS (Netherlands)

    Yzer, Suzanne; den Hollander, Anneke I.; Lopez, Irma; Pott, Jan-Willem R.; de Faber, Jan Tjeerd H. N.; Cremers, Frans P. M.; Koenekoop, Robert K.; van den Born, L. Ingeborgh

    2012-01-01

    Purpose: This study investigated the centrosomal protein, 290-KD (CEP290) associated genotype and ocular and extra-ocular phenotype in 18 patients with Leber congenital amaurosis (LCA). Methods: Eighteen patients with LCA from 14 families with mutations in the CEP290 gene were identified with sequen

  16. Ocular and extra-ocular features of patients with Leber congenital amaurosis and mutations in CEP290

    NARCIS (Netherlands)

    Yzer, S.; Hollander, A.I. den; Lopez, I.; Pott, J.W.; Faber, J.T. de; Cremers, F.P.; Koenekoop, R.K.; Born, L.I. van den

    2012-01-01

    PURPOSE: This study investigated the centrosomal protein, 290-KD (CEP290) associated genotype and ocular and extra-ocular phenotype in 18 patients with Leber congenital amaurosis (LCA). METHODS: Eighteen patients with LCA from 14 families with mutations in the CEP290 gene were identified with sequen

  17. Sparing of the extraocular muscles in mdx mice with absent or reduced utrophin expression: A life span analysis.

    Science.gov (United States)

    McDonald, Abby A; Hebert, Sadie L; McLoon, Linda K

    2015-11-01

    Sparing of the extraocular muscles in muscular dystrophy is controversial. To address the potential role of utrophin in this sparing, mdx:utrophin(+/-) and mdx:utrophin(-/-) mice were examined for changes in myofiber size, central nucleation, and Pax7-positive and MyoD-positive cell density at intervals over their life span. Known to be spared in the mdx mouse, and contrary to previous reports, the extraocular muscles from both the mdx:utrophin(+/-) and mdx:utrophin(-/-) mice were also morphologically spared. In the mdx:utrophin(+/)(-) mice, which have a normal life span compared to the mdx:utrophin(-/-) mice, the myofibers were larger at 3 and 12 months than the wild type age-matched eye muscles. While there was a significant increase in central nucleation in the extraocular muscles from all mdx:utrophin(+/)(-) mice, the levels were still very low compared to age-matched limb skeletal muscles. Pax7- and MyoD-positive myogenic precursor cell populations were retained and were similar to age-matched wild type controls. These results support the hypothesis that utrophin is not involved in extraocular muscle sparing in these genotypes. In addition, it appears that these muscles retain the myogenic precursors that would allow them to maintain their regenerative capacity and normal morphology over a lifetime even in these more severe models of muscular dystrophy.

  18. Ocular and extra-ocular features of patients with Leber congenital amaurosis and mutations in CEP290

    NARCIS (Netherlands)

    Yzer, Suzanne; den Hollander, Anneke I.; Lopez, Irma; Pott, Jan-Willem R.; de Faber, Jan Tjeerd H. N.; Cremers, Frans P. M.; Koenekoop, Robert K.; van den Born, L. Ingeborgh

    2012-01-01

    Purpose: This study investigated the centrosomal protein, 290-KD (CEP290) associated genotype and ocular and extra-ocular phenotype in 18 patients with Leber congenital amaurosis (LCA). Methods: Eighteen patients with LCA from 14 families with mutations in the CEP290 gene were identified with sequen

  19. Application of the FlexiForce contact surface force sensor to continuous extraocular compression monitoring during craniotomy for cerebral aneurysms.

    Science.gov (United States)

    Mutoh, Tatsushi; Ishikawa, Tatsuya; Nishimura, Hiromi; Yasui, Nobuyuki

    2010-01-01

    The aims of this study were to introduce our newly developed device equipped with a contact surface force sensor (FlexiForce) for monitoring extraocular compression continuously, and to illustrate its potential clinical application using this device in patients undergoing uncomplicated frontotemporal or bifrontal craniotomy for surgical clipping of unruptured anterior circulation aneurysms. In a pilot study with volunteers, we determined the critical force of 100 gf to cause painful ocular sensation. Then we performed the bilateral extraocular force measurements in 15 patients undergoing uncomplicated frontotemporal or bifrontal craniotomy for surgical clipping of unruptured anterior circulation aneurysms. Extraocular force increased immediately after retraction of the flap, increased to 144+/-26 gf (mean+/-SD) during lower craniotomy close to the orbit, was maintained at 91+/-18 gf during microsurgery, and returned close to baseline at 24+/-14 gf after restoration of skin flap retraction. Such changes were observed only on the surgical side in frontotemporal craniotomy. Abnormal increase in extraocular force was effectively reduced by placing a real-time digital panel meter to warn surgeons to avoid excessive skin flap retraction during the surgical procedure. In conclusion, this new tool may allow us to monitor the external forces that can be applied intraoperatively to the ocular globe in the supine position.

  20. Heterozygous mutations of the kinesin KIF21A in congenital fibrosis of the extraocular muscles type 1 (CFEOM1)

    NARCIS (Netherlands)

    Yamada, K; Andrews, C; Chan, WM; McKeown, CA; Magli, A; de Berardinis, T; Loewenstein, A; Lazar, M; O'Keefe, M; Letson, R; London, A; Ruttum, M; Matsumoto, N; Saito, N; Morris, L; Del Monte, M; Johnson, RH; Uyama, E; Houtman, WA; de Vries, B; Carlow, TJ; Hart, BL; Krawiecki, N; Shoffner, J; Vogel, MC; Katowitz, J; Goldstein, SM; Levin, AV; Sener, EC; Ozturk, BT; Akarsu, AN; Brodsky, MC; Hanisch, F; Cruse, RP; Zubcov, AA; Robb, RM; Roggenkaemper, P; Gottlob, [No Value; Kowal, L; Battu, R; Traboulsi, EI; Franceschini, P; Newlin, A; Demer, JL; Engle, EC

    2003-01-01

    Congenital fibrosis of the extraocular muscles type 1 (CFEOM1; OMIM #135700) is an autosomal dominant strabismus disorder associated with defects of the oculomotor nerve. We show that individuals with CFEOM1 harbor heterozygous missense mutations in a kinesin motor protein encoded by KIF21A. We iden

  1. Want to operate an abdominal lump? Think twice; it might be spontaneous rectus sheath hematoma: a case report

    Directory of Open Access Journals (Sweden)

    Manisha Sarkar

    2016-09-01

    Full Text Available Rectus sheath hematoma is a rare, but potentially misdiagnosed clinical entity. It occurs when there is direct tear in the rectus abdominis muscle fibres or in the supplying blood vessels. It may be associated with trauma, raised intra-abdominal pressure, or muscle weakness. When non-traumatic, the condition is termed as spontaneous rectus sheath hematoma. Because of its rarity, spontaneous rectus hematoma can be easily missed, endangering patient management. With progressively increasing use of anticoagulant and antiplatelet agents, the incidence of this pathology is rising. We are reporting a case of spontaneous rectus sheath hematoma in a 56 year old female, known diabetic, hypertensive with dyslipidaemia on combination drug therapy but not on anticoagulant/antiplatelet medications, that was clinically misdiagnosed as omental hernia. The main presenting complaint was swelling in abdomen for 1 month. There was no history of trauma. Radiologic findings showed hypoechoic multiloculated complex cystic lesion. Cytological findings showed features of old hematoma. This case report intends to increase awareness in considering rectus sheath hematoma as an important differential diagnosis of lump abdomen. Rectus sheath hematoma, a rarely seen pathology, often confuses clinicians leading to unnecessary negative laparotomies. Definitive operative procedure should not be undertaken depending on sonographic findings alone, as the images are prone to subjective error. The main treatment modality of rectus sheath hematoma is conservative management. [Int J Res Med Sci 2016; 4(9.000: 4208-4211

  2. Observation of superior oblique musule at the scleral insertion%上斜肌止端前缘解剖部位的观察

    Institute of Scientific and Technical Information of China (English)

    朱德海; 甘晓玲

    2001-01-01

    目的 了解上斜肌止端前缘的解剖部位。方法 在19例DVD病人(24眼)上直肌后徙手术中对上斜肌的止端进行测量、记录。结果 上斜肌止端前缘距上直肌止端距离为4.0~10.00mm,水平方向从偏鼻侧4.0mm到偏颞侧2.0mm。结论 上斜肌止端解剖部位变异大,在行上直肌和上斜肌手术时应该注意。%Objective To observe superior oblique muscle at the scleral insertion. Methods The superior oblique muscle at the scleral insertion in 18 cases (22 eyes) was measured during the recession procedure of superior rectus. Results The front end of superior oblique musule at the scleral insertion is 4~9.5mm behind the temproal insertion of superior rectus, from 4mm nasal to 2mm temporal. Conclusions The superior oblique muscle at the scleral insertion varies greatly in anatomy, therefore attention should be paid during operation of superior obliqe and superior rectus.

  3. Anatomic and radiologic correlations in spontaneous hematomas of the rectus abdomninis muscles; Correlazioni anatomo-radiologiche negli ematomi spontanei dei muscoli retti dell'addome

    Energy Technology Data Exchange (ETDEWEB)

    Cavagna, E.; Carubia, G.; Schiavon, F. [Ospedale di S. Martino, Unita' Operativa Autonoma di Radiologia, Belluno (Italy)

    2000-06-01

    Rectus sheath hematomas are a frequent but sometimes misdiagnosed disease in patients under anticoagulative drugs, hemodialysis, or simply in the elderly. The most frequent localization is in the lower part of the abdomen: the explanation lies in the anatomy of the abdominal wall, especially in the arcuate line of the rectus sheath. Aim of this work is to explain the reason of the almost constant location correlating the anatomy with the CT features. The rectus abdominis muscle lies between the aponeuroses of the transverse and oblique muscles which form the so called rectus sheath. This arrangement is found from the costal arch to a level approximately between the umbilicus and the pubic symphisis, where the rear layer of the rectus sheath ends with a curved edge, called the arcuate or semicircular line of Douglas. Beneath this line the aponeuroses of the three muscles pass in front of the rectus which is separated from the peritoneum only by the fascia trasversalis, a thin connective layer between the rectus and the preperitoneal fat. In this lower aspect of the muscle the perforating branches of the inferior epigastric artery running in the preperitoneal fat may rupture causing a large hematoma widely spreading in this loose space. 11 cases of rectus sheath hematoma diagnosed over 5 years were reviewed. They were referred to US because of a rapidly growing palpable mass o painful swelling of the abdominal wall with acute anemia. Sonography was performed in 11 patients and CT in 7. 10 hematomas were located in the lower third of the rectus muscle below the arcuate line in the pelvis, 1 was in the upper third of the muscle: the vast majority of pelvic hematomas is easily accounted for by the peculiar anatomy of the region. The diagnosis of hematoma of the rectus abdominis, sometimes misleading, should be included as a differential in all the patients who present with acute abdominal pain and blood loss. The anatomy of abdominal wall correlates well with CT

  4. Acute calcific tendinitis of the rectus femoris associated with intraosseous involvement: a case report with serial CT and MRI findings.

    Science.gov (United States)

    Kim, Young Sung; Lee, Ho Min; Kim, Jong Pil

    2013-11-01

    Acute calcific tendinitis of the shoulder is a well-known condition, but it is rare in the rectus femoris origin. Mostly reported cases were occurred in the reflected head of the rectus femoris, and only few cases were in the direct head of the rectus femoris. Intraosseous marrow involvement of calcific tendinitis is a more rare condition; it often goes misdiagnosed as an infection or a neoplasm. We report a rare, unusual case of acute calcific tendinitis of the direct head of the rectus femoris associated with intraosseous marrow involvement of calcification in anterior inferior iliac spine with serial CT and MRI findings. Aggressive osseous change may occur in acute calcific tendinitis of the rectus femoris as in this case which should be made an appropriate diagnosis to avoid unnecessary investigation and overtreatment like a surgery.

  5. Capillary perfusion in the superior rectus muscle in rabbit with the use of radioactive /sup 133/Xe

    Energy Technology Data Exchange (ETDEWEB)

    Moszczy' nska-Kowalska, A.

    1975-05-01

    A method of tissues clearance was adapted for investigation of the blood flow in external eye muscles in rabbit. It was established that it amounts to 0.1315 ml/min/g and this is about six times the amount of blood flow in skeletal muscles during rest. It was shown that adrenalin, pridazol, and sadamin reduce the blood flow. (auth)

  6. Reply to: Can we avoid rectus abdominis muscle atrophy and midline shift after colostomy creation?

    NARCIS (Netherlands)

    L. Timmermans (Lucas); E.B. Deerenberg (Eva); S.M. van Dijk (Sven); B. Lamme (Bas); A.H.J. Koning (Anton); G.J. Kleinrensink (Gert Jan); J. Jeekel (Johannes); J.F. Lange (Johan)

    2015-01-01

    markdownabstractWe read with interest the letter to the editor by Stephenson et al regarding our article “Abdominal rectus muscle atrophy and midline shift after colostomy creation.” Any attempt to decrease the risk of parastomal herniation should be applauded, because its incidence of greater than

  7. A rare cause of acute abdomen-Spontaneous rectus sheath hematoma

    Institute of Scientific and Technical Information of China (English)

    Hock Chin Chong; Feng Yih Chai; Yew Eng Tan; Sophia Si Ling Heng; Siti Asilah Mohd Desa

    2016-01-01

    Spontaneous rectus sheath hematoma (SRSH) is a rare entity that mimics acute abdomen. Rectus sheath hematoma is the accumulation of blood in rectus sheath due to muscle or epigastric vessel injury. However, SRSH without a trauma or anticoagulation is rare. It frequently mimics acute abdomen and it may lead to misdiagnosis and unnecessary laparotomy. In this article, we described two cases of SRSH with their diagnostic and therapeutic strategy. Both of our patients in report were neither consumed antiplatelet nor coagulopathy. They both had abdominal muscle straining before their symptoms pre-sentation. We hypothesized that the SRSH may be induced by rectus muscle injury secondary to inappropriate straining or posture. To diagnose SRSH, clinical findings are important but radiologic imaging such as computed tomography, can be diagnostic. In expanding SRSH, percutaneous arterial embolization of epigastric artery is useful to secure the bleeding. If embolization is not feasible, surgical exploration hemostasis is curative. In non-expanding SRSH, it can be managed nonoperatively. SRSH is an important initial differential for acute abdomen. Radiologic imaging helps in diagnosis. Stable SRSH can be managed conservatively with good outcome.

  8. The long-term durability of plication of the anterior rectus sheath assessed by ultrasonography

    NARCIS (Netherlands)

    van Uchelen, J H; Kon, M; Werker, P M

    The purpose of this study was to assess the long-term durability of a standard vertical plication of the anterior rectus sheath. For this purpose, 70 women who had undergone this procedure as part of an abdominoplasty were sent a questionnaire, their records were studied, and they were invited back

  9. Transposition of the rectus abdominis muscle for complicated pouch and rectal fistulas

    NARCIS (Netherlands)

    Tran, KTC; Kuijpers, HC; van Nieuwenhoven, EJ; van Goor, Harry; Spauwen, PH

    1999-01-01

    PURPOSE: Operative repair for complicated pouch and rectal fistulas is often difficult. We present our experience with ten consecutive patients operated on for complicated pouch and rectal fistulas by transposition of the rectus abdominis muscle. METHODS: Ten patients with high and complex pouch and

  10. Surgical Responses of Medial Rectus Muscle Recession in Thyroid Eye Disease-Related Esotropia.

    Directory of Open Access Journals (Sweden)

    In Jeong Lyu

    Full Text Available We evaluate the surgical outcomes and surgical responses of medial rectus muscle (MR recession patients with thyroid eye disease (TED-related esotropia (ET. The surgical dose-response curves 1 week postoperatively and at the final visit were analyzed. Univariable and multivariable linear regression analyses were applied to investigate factors influencing surgical dose-response. A total of 43 patients with TED-related ET that underwent MR recession were included. The final success rate was 86.0% and the rate of undercorrection was 14.0%. The surgical dose-response curves of TED-related ET showed a gentle slope compared with those of standard surgical tables. In the univariable model, simultaneous vertical rectus muscle recession was the only significant factor influencing surgical dose-response of MR recession in TED-related ET (β = -0.397, P = 0.044. In a model adjusted for age, sex, type of surgery, and preoperative horizontal angle of deviation, simultaneous vertical rectus muscle recession showed marginal significance (β = -0.389, P = 0.064. The surgical dose-response curve of TED-related ET was unique. Simultaneous vertical rectus muscle recession was associated with increased surgical dose-response in TED-related ET.

  11. Lateral fixation of sclera to the periosteum with medial rectus disinsertion for severe myopic strabismus fixus

    Directory of Open Access Journals (Sweden)

    Murthy Ramesh

    2008-01-01

    Full Text Available Myopic strabismus fixus is characterized by severe ocular motility restriction with the development of progressive esotropia and hypotropia. Management of severe cases with strongly positive forced duction test can be challenging. We describe a longstanding case of myopic strabismus fixus, which was managed by bilateral medial rectus disinsertion and scleral fixation laterally to the periosteum.

  12. Transposition of the rectus abdominis muscle for complicated pouch and rectal fistulas

    NARCIS (Netherlands)

    Tran, KTC; Kuijpers, HC; van Nieuwenhoven, EJ; van Goor, Harry; Spauwen, PH

    1999-01-01

    PURPOSE: Operative repair for complicated pouch and rectal fistulas is often difficult. We present our experience with ten consecutive patients operated on for complicated pouch and rectal fistulas by transposition of the rectus abdominis muscle. METHODS: Ten patients with high and complex pouch and

  13. Diced Cartilage Grafts Wrapped in Rectus Abdominis Fascia for Nasal Dorsum Augmentation.

    Science.gov (United States)

    Cerkes, Nazim; Basaran, Karaca

    2016-01-01

    Dorsum augmentation is one of the most delicate components of rhinoplasty. Although various solid grafts have been used in the past for this purpose, diced cartilage grafts wrapped in fascia have become popular in recent decades. In this study, the authors analyze and discuss the results of using diced cartilage grafts wrapped in rectus abdominis muscle fascia for dorsal augmentation. Nasal dorsum augmentation using the diced cartilage wrapped in rectus abdominis fascia technique was performed on 109 patients between 2008 and 2014. Six patients were primary cases, 69 patients were secondary, and 18 were tertiary. Sixteen patients had previously undergone more than three operations. In all patients, the rectus abdominis fascia was harvested with the described technique and wrapped around the diced cartilages obtained from the costal cartilage. The average follow-up period was 19.6 months (range, 6 to 47 months). Satisfactory results were obtained with acceptable complications and revision rates. Three patients underwent reoperation because of overcorrection. Insufficient augmentation was seen in five patients. In four patients, infection developed after postoperative day 5. One patient complained of a hypertrophic scar on the donor site. None of the patients showed any symptoms indicating an abdominal hernia. Techniques using diced cartilage grafts wrapped in fascia have now become the gold standard for dorsal augmentations. When it is considered that secondary cases requiring dorsal augmentation are usually those also needing costal cartilage grafts, rectus abdominis fascia becomes a useful carrier for diced cartilages, which is in the same donor area. Therapeutic, IV.

  14. Improvements in Vertebral-Column Angles and Psychological Metrics After Abdominoplasty With Rectus Plication.

    Science.gov (United States)

    Temel, Metin; Türkmen, Arif; Berberoğlu, Ömer

    2016-05-01

    Substantial fluctuations in body weight can result in diastasis recti and weakening of the connections between the lateral abdominal muscles and the rectus sheath. The authors sought to determine the postural and psychological effects of abdominoplasty with vertical rectus plication. Forty women with substantial back and lumbar pain owing to abdominal lipodystrophy were evaluated in a prospective study. Preoperatively and 6 months postoperatively, patients underwent bidirectional radiography of the thoracic and lumbar regions. A visual analog scale (VAS), the Beck Depression Inventory (BDI), and the Nottingham Health Profile (NHP) were applied to assess physical, psychological, and quality-of-life changes following surgery. Significant improvements in posture, assessed in terms of lumbar lordosis, thoracic kyphosis, and the lumbosacral angle, were observed 6 months after abdominoplasty with rectus plication. Results of the VAS and BDI indicated significant improvements in pain and quality of life, respectively. Results of the NHP indicated significant postoperative improvements in fatigue, pain, and sleep. Abdominoplasty with rectus plication improves posture by tightening the thoracolumbar fascia. In selected patients, abdominoplasty can reduce back and lumbar pain, thereby improving quality of life. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  15. Followup of a Dog with an Intraocular Silicone Prosthesis Combined with an Extraocular Glass Prosthesis

    Directory of Open Access Journals (Sweden)

    Gwendolyna Romkes

    2012-01-01

    Full Text Available Because of unpredictable corneal changes, evisceration and implantation of a silicone prosthesis does not always lead to a satisfying cosmetic result. This paper describes the use of an intraocular silicone prosthesis in combination with an extraocular glass prosthesis and shows a followup of two and a half years in a nonexperimental study. An intraocular silicone prosthesis was implanted after evisceration of the left eye in a five-month-old Bernese mountain dog. A glass prosthesis was fitted four weeks after evisceration. Two and a half years after the operation, the dog is in good health and free of medication. No short-term or long-term complications were seen. The owners do not have trouble with handling the glass prosthesis. The combination of both prostheses shows a perfect solution to retrieve a normal looking and moving eye after evisceration.

  16. Reconstruction of maxillary defect with musculo-adipose rectus free flap.

    Science.gov (United States)

    Low, Tsu-Hui Hubert; Lindsay, Andrew; Clark, Jonathan; Chai, Francis; Lewis, Richard

    2017-02-01

    The rectus myocutaneous free flap (RMFF) is used for medium to large maxillectomy defects. However, in patients with central obesity the inset could be difficult due to the bulk from excessive layer of adipose tissue. We describe a modification of the RMFF for patients with excessive central obesity with a flap consisting of adipose tissue with minimal rectus muscle; the musculo-adipose rectus free flap (MARF). Five cases of MARF reconstruction were performed between 2003 and 2013, with patients' body mass indexes ranging from 29.0 to 41.2 kg/m(2) . All patients had sinonasal tumor, of which three were adenoid cystic carcinoma, one squamous cell carcinoma, and one melanoma. Four patients had Codeiro IIIb defects and one had Codeiro II defect. Using the MARF technique, the maxillectomy defect was obliterated with vascularized adipose tissue overlying the rectus muscle and was trimmed to fit the maxillectomy defect. The adipose tissue was allowed to granulate and mucosalize. The volume of adipose tissue harvested was between 120 and 160 mL. All flaps survived with no requirement for re-exploration. Complete oro-nasal separation was achieved in all patients. The time to commencement of oral intake ranges from 5 to 15 days. One patient developed seroma and one developed wound breakdown on the donor site. The length of stay at the hospital ranges from 9 to 22 days. On follow-up ranging 7.5-32.8 months, two patients died from their malignancies. The other three patients were able to tolerate oral soft diet. The MARF may be considered as an alternative to myocutaneous rectus free flap particularly for the reconstruction of maxillary defects in patients with central obesity. © 2015 Wiley Periodicals, Inc. Microsurgery 37:137-141, 2017. © 2015 Wiley Periodicals, Inc.

  17. SELECTIVE ACTIVATION OF THE RECTUS ABDOMINIS MUSCLE DURING LOW-INTENSITY AND FATIGUING TASKS

    Directory of Open Access Journals (Sweden)

    Paulo H. Marchetti

    2011-06-01

    Full Text Available In order to understand the potential selective activation of the rectus abdominis muscle, we conducted two experiments. In the first, subjects performed two controlled isometric exercises: the curl up (supine trunk raise and the leg raise (supine bent leg raise at low intensity (in which only a few motor units are recruited. In the second experiment, subjects performed the same exercises, but they were required to maintain a certain force level in order to induce fatigue. We recorded the electromyographic (EMG activities of the lower and upper portions of the rectus abdominis muscle during the exercises and used spatial-temporal and frequency analyses to describe muscle activation patterns. At low-intensity contractions, the ratio between the EMG intensities of the upper and lower portions during the curl up exercise was significantly larger than during the leg raise exercise (p = 0.02. A cross-correlation analysis indicated that the signals of the abdominal portions were related to each other and this relation did not differ between the tasks (p = 0.12. In the fatiguing condition, fatigue for the upper portion was higher than for the lower portion during the curl up exercise (p = 0.008. We conclude that different exercises evoked, to a certain degree, individualized activation of each part of the rectus abdominis muscle, but different portions of the rectus abdominis muscle contributed to the same task, acting like a functional unit. These results corroborate the relevance of varying exercise to modify activation patterns of the rectus abdominis muscle

  18. Breast reconstruction by pedicled transverse rectus abdominis myocutaneous flap

    Directory of Open Access Journals (Sweden)

    Kozarski Jefta

    2004-01-01

    Full Text Available Reconstruction of the amputated breast in female patients after surgical management of breast carcinoma is possible with the use of autologous tissue, synthetic implants, or by combining autologous tissue and synthetic materials. Autologous tissue provides soft and sufficiently elastic tissue which is usable for breast reconstruction and eventually obtains original characteristics of the surrounding tissue on the chest wall. The use of the TRAM flap for breast reconstruction was introduced in 1982 by Hartrampf Scheflan, and Black. The amount of the TRAM flap tissue allows breast reconstruction in the shape most adequate to the remaining breast. The possibilities of using the TRAM flap as pedicled myocutaneous flap or as free TRAM flap make this flap a superior choice for breast reconstruction in comparison with other flaps.

  19. Mechanisms of Vertical Fusional Vergence in Patients With “Congenital Superior Oblique Paresis” Investigated With an Eye-Tracking Haploscope

    Science.gov (United States)

    Irsch, Kristina; Guyton, David L.; Park, Hee-Jung S.; Ying, Howard S.

    2015-01-01

    Purpose To determine the mechanisms of vertical fusional vergence in patients with “congenital unilateral superior oblique paresis” (SOP) and to discuss the implications of these mechanisms. Methods Eleven patients were examined with our eye-tracking haploscope. Results Three different fusion mechanisms were found, producing significantly different cyclovergence to vertical vergence ratios (P eye and the superior rectus muscle in the lower eye in three patients (1.15 ± 0.32). Lancaster red-green testing showed alignment differences among these groups, primarily differences in amount of subjective extorsion between the two eyes in straight-ahead gaze: The patient with oblique-muscle–mediated fusion showed essentially no subjective extorsion (0.5°), the patients with vertical-rectus-muscle–mediated vertical fusion showed a mean ± SD subjective extorsion of 3.6° ± 1.4°, and the patients with the mixed (oblique/rectus) fusion mechanism showed 7.0° ± 1.7° (P eye and the superior rectus muscle in the lower eye provides the greatest intorting effect. Subclassifying “congenital SOP” in this way (in which the “paretic” muscle may remain functional in many cases) may help guide its optimal surgical correction. PMID:26275134

  20. Electromyographic activity of rectus abdominis muscles during dynamic Pilates abdominal exercises.

    Science.gov (United States)

    Silva, Gabriela Bueno; Morgan, Mirele Minussi; Gomes de Carvalho, Wellington Roberto; Silva, Elisangela; de Freitas, Wagner Zeferino; da Silva, Fabiano Fernandes; de Souza, Renato Aparecido

    2015-10-01

    To assess the electrical behaviour of the upper rectus abdominis (URA) and lower rectus abdominis (LRA) by electromyography (EMG) during the following dynamic Pilates abdominal exercises: roll up, double leg stretch, coordination, crisscross and foot work. The results were compared with EMG findings of traditional abdominal exercises (sit up and crunch). Seventeen female subjects (with no experience of the Pilates method) were recruited. The URA and LRA were evaluated while 12 isotonic contractions were performed using the Pilates principles or traditional abdominal exercises. The data were normalised by a maximal voluntary isometric contraction. Normality was accepted, and ANOVA followed by Tukey test was used to determine data differences (P Pilates exercises double leg stretch, coordination, crisscross and foot work promoted greater muscle activation than traditional exercises, mainly in URA. Thus, these exercises have the potential to be prescribed for muscle strengthening programmes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Activation of rectus capitis posterior major muscles during voluntary retraction of the head in asymptomatic subjects.

    Science.gov (United States)

    Hallgren, Richard C; Rowan, Jacob J; Bai, Peng; Pierce, Steven J; Shafer-Crane, Gail A; Prokop, Lawrence L

    2014-01-01

    The purpose of this study was to assess levels of electromyographic activity measured from rectus capitis posterior major (RCPM) muscles of asymptomatic subjects as their heads moved from a self-defined neutral position to a retracted position. A 2 × 2 within-subjects factorial research design was used. Disposable, intramuscular electrodes were used to collect electromyographic data from asymptomatic subjects between the ages of 20 and 40 years old. Data analysis was performed using mixed effects β regression models. Activation of RCPM muscles was found to significantly increase (P < .0001) as the head moved from a self-defined neutral position to a retracted position. Rectus capitis posterior major muscle activation levels, measured as a function of head position, have not been previously reported. The findings from this study showed that RCPM muscle activation significantly increases during voluntary retraction of the head. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  2. Arthroscopic treatment of chronically painful calcific tendinitis of the rectus femoris.

    Science.gov (United States)

    Peng, Xu; Feng, Yong; Chen, Guangxing; Yang, Liu

    2013-11-23

    Relatively large calcific tendinitis with persistent symptoms after extended periods of conservative treatment is an indication for operative therapy. Arthroscopy, as a treatment for calcific tendinitis of the hip abductors and calcinosis circumscripta, has been described previously; however, to our knowledge, the clinical and radiological response to arthroscopic removal of calcific tendinitis of the rectus femoris tendon has not. We present arthroscopic treatment of unusual calcific tendonitis of the origin of the rectus femoris and associated intra-articular lesions in 3 patients with chronic coxa pain. Our cases show that hip arthroscopy is an effective therapeutic modality for calcific tendinitis of the hip joint with satisfactory short-term outcomes. Calcific tendinitis, although an uncommon clinical entity, should be a part of the differential diagnosis of acute or chronic hip pain.

  3. Proximal rectus femoris avulsion in an elite, olympic-level sprinter.

    Science.gov (United States)

    Langer, Phillip R; Selesnick, Harlan

    2010-11-01

    Quadriceps injuries, ranging from simple strains to disabling muscle ruptures, are common athletic injuries. The rectus femoris is the most commonly injure portion of the quadriceps musculature. This article is, to our knowledge, the first report of a proximal rectus femoris avulsion in an elite, Olympic-level 100-meter sprinter, acutely managed with surgical repair. Several key factors must be considered and carefully assessed when determining the appropriate course of management (ie, deciding between operative and nonoperative treatment): amount of distal retraction of the tendon, severity of associated soft-tissue trauma, physical examination, and postoperative goals (eg, return to elite-level competitive sports involving running or kicking vs resuming basic activities of daily living). We believe that these factors in our elite, high-performance athlete dictated an operative course of management.

  4. Intrafascial hematoma of the musculus rectus abdominis as a complication after laparoscopic operations; Intrafasziale Haematome des Musculus rectus abdominis als Komplikation nach laparoskopischen Operationen

    Energy Technology Data Exchange (ETDEWEB)

    Pennekamp, W. [Radiologische Universitaetsklinik am St. Josef-Hospital, Bochum (Germany); Barbera, L. [Chirurgische Universitaetsklinik am St. Josef-Hospital, Bochum (Germany)

    1998-01-01

    We report on two patients with intrafascial hematoma of the musculus rectus abdominis following laparoscopic operations. One patient was operated on a stenosis of the common iliac artery for an aortofemoral bypass. The other patient was operated on an inguinal hernia. Only a CT scan of the abdomen led to the correct diagnosis, because the use of ultrasound was limited by pneumoperitoneum and bandages, and retroperitoneal bleeding could not be recognized. Computed tomography is a valid method for detecting this complication of laparoscopic surgery. (orig.) [Deutsch] Es wird ueber zwei Patienten berichtet, die nach einer laparoskopischen Operation ein intrafasziales Haematom des Musculus rectus abdominis entwickelten. Bei einem Patienten wurde laparoskopisch ein aortofemoraler Bypass bei hochgradiger A.-iliaca-communis-Stenose, bei dem anderen Patienten ein laparoskopischer Bruchlueckenverschluss bei einer Inguinalhernie durchgefuehrt. Erst die Computertomographie des Abdomens fuehrte in beiden Faellen zur richtigen Diagnose, da Ultraschall aufgrund des Pneumoperitoneous und der Verbandsmaterialien nur bedingt einsetzbar war und retroperitoneale Blutungsansteile nicht erkannt werden konnten. Der Stellenwert der Computertomographie zur Erkennung dieser Komplikation wird hervorgehoben. (orig.)

  5. Mechanical characterisation of porcine rectus sheath under uniaxial and biaxial tension.

    LENUS (Irish Health Repository)

    Lyons, Mathew

    2014-06-03

    Incisional hernia development is a significant complication after laparoscopic abdominal surgery. Intra-abdominal pressure (IAP) is known to initiate the extrusion of intestines through the abdominal wall, but there is limited data on the mechanics of IAP generation and the structural properties of rectus sheath. This paper presents an explanation of the mechanics of IAP development, a study of the uniaxial and biaxial tensile properties of porcine rectus sheath, and a simple computational investigation of the tissue. Analysis using Laplace׳s law showed a circumferential stress in the abdominal wall of approx. 1.1MPa due to an IAP of 11kPa, commonly seen during coughing. Uniaxial and biaxial tensile tests were conducted on samples of porcine rectus sheath to characterise the stress-stretch responses of the tissue. Under uniaxial tension, fibre direction samples failed on average at a stress of 4.5MPa at a stretch of 1.07 while cross-fibre samples failed at a stress of 1.6MPa under a stretch of 1.29. Under equi-biaxial tension, failure occurred at 1.6MPa with the fibre direction stretching to only 1.02 while the cross-fibre direction stretched to 1.13. Uniaxial and biaxial stress-stretch plots are presented allowing detailed modelling of the tissue either in silico or in a surrogate material. An FeBio computational model of the tissue is presented using a combination of an Ogden and an exponential power law model to represent the matrix and fibres respectively. The structural properties of porcine rectus sheath have been characterised and add to the small set of human data in the literature with which it may be possible to develop methods to reduce the incidence of incisional hernia development.

  6. Insertional tendinopathy of the adductors and rectus abdominis in athletes: a review

    OpenAIRE

    Valent, Alessandro; Frizziero, Antonio; Bressan, Stefano; Zanella, Elena; Giannotti, Erika; Masiero, Stefano

    2012-01-01

    Insertional tendinopathy of the adductors and rectus abdominis is common in male athletes, especially in soccer players. It may be worsened by physical activity and it usually limits sport performance. The management goal in the acute phase consists of analgesic and anti-inflammatory drugs and physical rehabilitation. In the early stages of rehabilitation, strengthening exercises of adductors and abdominal muscles, such as postural exercises, have been suggested. In the sub-acute phase, muscu...

  7. Lateral rectus myositis mimicking an abducens nerve palsy in a pregnant woman.

    Science.gov (United States)

    Haslinda, Abd-Rahim; Shatriah, Ismail; Azhany, Yaakub; Nik-Ahmad-Zuky, Nik-Lah; Yunus, Rohaizan

    2014-01-01

    Myositis is a rare unknown inflammatory disorder of the skeletal muscle tissue. Generalized inflammatory myopathies, polymyositis, and dermatomyositis have been reported during pregnancy. Isolated orbital myositis in pregnancy has not been previously described in the literature. The authors report a case of left isolated orbital myositis in a primigravida at 38 weeks gestation affecting the patient's left lateral rectus muscle. MRI of the orbit was consistent with the diagnosis. She showed remarkable clinical improvement with oral corticosteroids therapy.

  8. Normal composition and histo-ultrastructure of the rectus femoris muscle

    Directory of Open Access Journals (Sweden)

    T. N. Mosendz

    2012-02-01

    Full Text Available The information on histometric and electron microscopic study of the muscle fibers of the rats’ rectus femoris in the norm is presented. The basic types of muscle fibers and their composition are described. The composition reflects the close morphological interdependence of the structure of myoneural junctions and elements of muscular tissue. It may determine different patterns of both reactive and destructive processes in the skeletal muscles.

  9. Bilateral combined resection and recession of the medial rectus muscle for convergence excess esotropia.

    Science.gov (United States)

    Ramasamy, Balasubramanian; Rowe, Fiona; Whitfield, Kath; Nayak, Harish; Noonan, Carmel P

    2007-06-01

    Five patients with true convergence excess esotropia were surgically managed with combined resection and recession of the medial rectus muscles. This technique was chosen to address the near/distance angle disparity. The use of this surgical technique produced full asymptomatic binocular control at near and distance fixation in four patients. One patient developed a consecutive exotropia but regained full binocular control following a second surgical procedure.

  10. Arthroscopic treatment of chronically painful calcific tendinitis of the rectus femoris

    OpenAIRE

    Peng, Xu; Feng, Yong; Chen, Guangxing; Liu YANG

    2013-01-01

    Background Relatively large calcific tendinitis with persistent symptoms after extended periods of conservative treatment is an indication for operative therapy. Arthroscopy, as a treatment for calcific tendinitis of the hip abductors and calcinosis circumscripta, has been described previously; however, to our knowledge, the clinical and radiological response to arthroscopic removal of calcific tendinitis of the rectus femoris tendon has not. Methods We present arthroscopic treatment of unusu...

  11. Rectus abdominis muscle injuries in elite handball players: management and rehabilitation

    Directory of Open Access Journals (Sweden)

    Balius R

    2011-07-01

    Full Text Available Ramon Balius1, Carles Pedret2, Laura Pacheco1, Josep Antoni Gutierrez3, Joan Vives4, Jaume Escoda11Consell Català de l’Esport, Generalitat de Catalunya, Barcelona; 2Centro Mapfre de Medicina del Tenis, Barcelona; 3Spanish National Handball Team, Spain; 4Granollers Handball Club, Granollers, Barcelona, SpainAbstract: Muscle injuries generally occur in two-joint muscles with a high percentage of type II fibers during the performance of eccentric activity. Some muscle injuries, such as those located in the adductor longus, a monoarticular muscle, as well as rectus abdominis do not fully comply with these requirements. This study examines five cases of elite handball players with ruptured rectus abdominals. Sonographically, lesions in rectus abdominis are shown as a disruption of the fibrillar pattern with a hematic suffusion that invades the entire lesion. In some of the cases, the ultrasound study was complemented with a MRI. A unified rehabilitation protocol was applied and the return to play time of each handball player ranged between 16 and 22 days, with an average of 18.2 days. Follow-up at 15 months showed no evidence of re-injury or residual discomfort and all of them are playing at their highest level. The aim of this study was to illustrate a feature of handball injury that, as in tennis and volleyball, is uncommon and so far has not been specifically reported. The phenomenon of contralateral abdominal hypertrophy in handball appears in the dominant arm as in tennis and volleyball.Keywords: rectus abdominis, muscle injury, sonography, MRI, handball 

  12. Large asymmetric hypertrophy of rectus abdominis muscle in professional tennis players.

    Directory of Open Access Journals (Sweden)

    Joaquin Sanchis-Moysi

    Full Text Available PURPOSE: To determine the volume and degree of asymmetry of the musculus rectus abdominis (RA in professional tennis players. METHODS: The volume of the RA was determined using magnetic resonance imaging (MRI in 8 professional male tennis players and 6 non-active male control subjects. RESULTS: Tennis players had 58% greater RA volume than controls (P = 0.01, due to hypertrophy of both the dominant (34% greater volume, P = 0.02 and non-dominant (82% greater volume, P = 0.01 sides, after accounting for age, the length of the RA muscle and body mass index (BMI as covariates. In tennis players, there was a marked asymmetry in the development of the RA, which volume was 35% greater in the non-dominant compared to the dominant side (P<0.001. In contrast, no side-to-side difference in RA volume was observed in the controls (P = 0.75. The degree of side-to-side asymmetry increased linearly from the first lumbar disc to the pubic symphysis (r = 0.97, P<0.001. CONCLUSIONS: Professional tennis is associated with marked hypertrophy of the musculus rectus abdominis, which achieves a volume that is 58% greater than in non-active controls. Rectus abdominis hypertrophy is more marked in the non-dominant than in the dominant side, particularly in the more distal regions. Our study supports the concept that humans can differentially recruit both rectus abdominis but also the upper and lower regions of each muscle. It remains to be determined if this disequilibrium raises the risk of injury.

  13. Soccer attenuates the asymmetry of rectus abdominis muscle observed in non-athletes.

    Directory of Open Access Journals (Sweden)

    Fernando Idoate

    Full Text Available PURPOSE: To determine the volume and degree of asymmetry of the rectus abdominis muscle (RA in professional soccer players. METHODS: The volume of the RA was determined using magnetic resonance imaging (MRI in 15 professional male soccer players and 6 non-active male control subjects. RESULTS: Soccer players had 26% greater RA volume than controls (P<0.05, due to hypertrophy of both the dominant (28% greater volume, P<0.05 and non-dominant (25% greater volume, P<0.01 sides, after adjusting for age, length of the RA muscle and body mass index (BMI as covariates. Total volume of the dominant side was similar to the contralateral in soccer players (P = 0.42 and in controls (P = 0.75 (Dominant/non-dominant = 0.99, in both groups. Segmental analysis showed a progressive increase in the degree of side-to-side asymmetry from the first lumbar disc to the pubic symphysis in soccer players (r = 0.80, P<0.05 and in controls (r = 0.75, P<0.05. The slope of the relationship was lower in soccer players, although this trend was not statistically significant (P = 0.14. CONCLUSIONS: Professional soccer is associated with marked hypertrophy of the rectus abdominis muscle, which achieves a volume that is 26% greater than in non-active controls. Soccer induces the hypertrophy of the non-dominant side in proximal regions and the dominant side in regions closer to pubic symphysis, which attenuates the pattern of asymmetry of rectus abdominis observed in non-active population. It remains to be determined whether the hypertrophy of rectus abdominis in soccer players modifies the risk of injury.

  14. The extensile rectus snip exposure in revision of total knee arthroplasty.

    Science.gov (United States)

    Meek, R M D; Greidanus, N V; McGraw, R W; Masri, B A

    2003-11-01

    Revision of a total knee arthroplasty may require an extensile approach to permit a satisfactory exposure without compromising the attachment of the patellar tendon. It has been assumed that a rectus snip is a relatively benign form of release, but the effect of using this approach on function, pain and patient satisfaction is not known. From January 1997 to December 1999, 107 patients who underwent revision of total knee arthroplasty were followed up at a minimum of two years (mean 40.5 months) and assessed by the Oxford Hip Score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Short-Form (SF)-12 and patient satisfaction. Co-morbidity, surgical exposure, the Hospital for Special Surgery (HSS) knee scores and the range of movement were also used. A standard medial parapatellar approach was used in 57 patients and the rectus snip in 50. The two groups were equivalent for age, sex and co-morbidity scores. The WOMAC function, pain, stiffness and satisfaction scores demonstrated no statistical difference. The use of a rectus snip as an extensile procedure has no effect on outcome.

  15. Rectus abdominis muscle injuries in elite handball players: management and rehabilitation.

    Science.gov (United States)

    Balius, Ramon; Pedret, Carles; Pacheco, Laura; Gutierrez, Josep Antoni; Vives, Joan; Escoda, Jaume

    2011-01-01

    Muscle injuries generally occur in two-joint muscles with a high percentage of type II fibers during the performance of eccentric activity. Some muscle injuries, such as those located in the adductor longus, a monoarticular muscle, as well as rectus abdominis do not fully comply with these requirements. This study examines five cases of elite handball players with ruptured rectus abdominals. Sonographically, lesions in rectus abdominis are shown as a disruption of the fibrillar pattern with a hematic suffusion that invades the entire lesion. In some of the cases, the ultrasound study was complemented with a MRI. A unified rehabilitation protocol was applied and the return to play time of each handball player ranged between 16 and 22 days, with an average of 18.2 days. Follow-up at 15 months showed no evidence of re-injury or residual discomfort and all of them are playing at their highest level. The aim of this study was to illustrate a feature of handball injury that, as in tennis and volleyball, is uncommon and so far has not been specifically reported. The phenomenon of contralateral abdominal hypertrophy in handball appears in the dominant arm as in tennis and volleyball.

  16. Accommodation: The role of the external muscles of the eye: A consideration of refractive errors in relation to extraocular malfunction.

    Science.gov (United States)

    Hargrave, B K

    2014-11-01

    Speculation as to optical malfunction has led to dissatisfaction with the theory that the lens is the sole agent in accommodation and to the suggestion that other parts of the eye are also conjointly involved. Around half-a-century ago, Robert Brooks Simpkins suggested that the mechanical features of the human eye were precisely such as to allow for a lengthening of the globe when the eye accommodated. Simpkins was not an optical man but his theory is both imaginative and comprehensive and deserves consideration. It is submitted here that accommodation is in fact a twofold process, and that although involving the lens, is achieved primarily by means of a give - and - take interplay between adducting and abducting external muscles, whereby an elongation of the eyeball is brought about by a stretching of the delicate elastic fibres immediately behind the cornea. The three muscles responsible for convergence (superior, internal and inferior recti) all pull from in front backwards, while of the three abductors (external rectus and the two obliques) the obliques pull from behind forwards, allowing for an easy elongation as the eye turns inwards and a return to its original length as the abducting muscles regain their former tension, returning the eye to distance vision. In refractive errors, the altered length of the eyeball disturbs the harmonious give - and - take relationship between adductors and abductors. Such stresses are likely to be perpetuated and the error exacerbated. Speculation is not directed towards a search for a possible cause of the muscular imbalance, since none is suspected. Muscles not used rapidly lose tone, as evidenced after removal of a limb from plaster. Early attention to the need for restorative exercise is essential and results usually impressive. If flexibility of the external muscles of the eyes is essential for continuing good sight, presbyopia can be avoided and with it the supposed necessity of glasses in middle life. Early attention

  17. Extra-ocular muscle MRI in genetically-defined mitochondrial disease

    Energy Technology Data Exchange (ETDEWEB)

    Pitceathly, Robert D.S.; Morrow, Jasper M.; Hanna, Michael G. [UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, MRC Centre for Neuromuscular Diseases, London (United Kingdom); Sinclair, Christopher D.J.; Yousry, Tarek A.; Thornton, John S. [UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, MRC Centre for Neuromuscular Diseases, London (United Kingdom); UCL Institute of Neurology, Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, London (United Kingdom); Woodward, Cathy; Sweeney, Mary G. [National Hospital for Neurology and Neurosurgery, Neurogenetics Unit, London (United Kingdom); Rahman, Shamima [UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, MRC Centre for Neuromuscular Diseases, London (United Kingdom); UCL Institute of Child Health, Mitochondrial Research Group, Clinical and Molecular Genetics Unit, London (United Kingdom); Plant, Gordon T.; Ali, Nadeem [National Hospital for Neurology and Neurosurgery, Department of Neuro-ophthalmology, London (United Kingdom); Moorfields Eye Hospital, Department of Neuro-ophthalmology, London (United Kingdom); Bremner, Fion [National Hospital for Neurology and Neurosurgery, Department of Neuro-ophthalmology, London (United Kingdom); Davagnanam, Indran [National Hospital for Neurology and Neurosurgery, The Lysholm Department of Neuroradiology, London (United Kingdom)

    2016-01-15

    Conventional and quantitative MRI was performed in patients with chronic progressive external ophthalmoplegia (CPEO), a common manifestation of mitochondrial disease, to characterise MRI findings in the extra-ocular muscles (EOMs) and investigate whether quantitative MRI provides clinically relevant measures of disease. Patients with CPEO due to single mitochondrial DNA deletions were compared with controls. Range of eye movement (ROEM) measurements, peri-orbital 3 T MRI T1-weighted (T1w) and short-tau-inversion-recovery (STIR) images, and T2 relaxation time maps were obtained. Blinded observers graded muscle atrophy and T1w/STIR hyperintensity. Cross-sectional areas and EOM mean T2s were recorded and correlated with clinical parameters. Nine patients and nine healthy controls were examined. Patients had reduced ROEM (patients 13.3 , controls 49.3 , p < 0.001), greater mean atrophy score and increased T1w hyperintensities. EOM mean cross-sectional area was 43 % of controls and mean T2s were prolonged (patients 75.6 ± 7.0 ms, controls 55.2 ± 4.1 ms, p < 0.001). ROEM correlated negatively with EOM T2 (rho = -0.89, p < 0.01), whilst cross-sectional area failed to correlate with any clinical measures. MRI demonstrates EOM atrophy, characteristic signal changes and prolonged T2 in CPEO. Correlation between elevated EOM T2 and ROEM impairment represents a potential measure of disease severity that warrants further evaluation. (orig.)

  18. Constitutive properties, not molecular adaptations, mediate extraocular muscle sparing in dystrophic mdx mice.

    Science.gov (United States)

    Porter, John D; Merriam, Anita P; Khanna, Sangeeta; Andrade, Francisco H; Richmonds, Chelliah R; Leahy, Patrick; Cheng, Georgiana; Karathanasis, Paraskevi; Zhou, Xiaohua; Kusner, Linda L; Adams, Marvin E; Willem, Michael; Mayer, Ulrike; Kaminski, Henry J

    2003-05-01

    Extraocular muscle (EOM) is spared in Duchenne muscular dystrophy. Here, we tested putative EOM sparing mechanisms predicted from existing dystrophinopathy models. Data show that mdx mouse EOM contains dystrophin-glycoprotein complex (DGC)-competent and DGC-deficient myofibers distributed in a fiber type-specific pattern. Up-regulation of a dystrophin homologue, utrophin, mediates selective DGC retention. Counter to the DGC mechanical hypothesis, an intact DGC is not a precondition for EOM sarcolemmal integrity, and active adaptation at the level of calcium homeostasis is not mechanistic in protection. A partial, fiber type-specific retention of antiischemic nitric oxide to vascular smooth muscle signaling is not a factor in EOM sparing, because mice deficient in dystrophin and alpha-syntrophin, which localizes neuronal nitric oxide synthase to the sarcolemma, have normal EOMs. Moreover, an alternative transmembrane protein, alpha7beta1 integrin, does not appear to substitute for the DGC in EOM. Finally, genomewide expression profiling showed that EOM does not actively adapt to dystrophinopathy but identified candidate genes for the constitutive protection of mdx EOM. Taken together, data emphasize the conditional nature of dystrophinopathy and the potential importance of nonmechanical DGC roles and support the hypothesis that broad, constitutive structural cell signaling, and/or biochemical differences between EOM and other skeletal muscles are determinants of differential disease responsiveness.

  19. 甲状腺相关性眼病眼外肌病变的手术治疗%Operative effect about extraocular myopathy in patients with Thyroid-associated ophthalmopathy

    Institute of Scientific and Technical Information of China (English)

    黄勇志; 何剑峰

    2016-01-01

    Objective:To discuss surgery effect about extraocular myopathy in patients with Thyroid -associated ophthalmopathy . Methods:The surgical management of strabismus in 13 cases with Thyroid -associated ophthalmopathy who received extraocular muscle surgery in our hospital were retrospectively analyzed .Nine cases were males and 4 were females,ranging in age from 28 to 61 years(mean:46 years).All patients were Vertical strabismus.The preoperative deciation of all cases was 25°to 45°.The patients were followed up for 3 ~18 months.Postoperative results were divided into 2 categories:successful outcome :orthotropia, or deviation ≤5°,there was no di-plopia or residual little diplopia could being corrected by low degree prism in primary position or reading position ,compensatory head pos-ture disappeared;Failure:deviation >5°in primary position,There are persistent diplopia that it was not easy being corrected by prism in primary position or reading position ,Compensatory head posture could not being significantly improved .Results:All patients accepted sin-gle vertical rectus recession .Postoperatively,76.9% patients were orthotropic in primary position , rebuilded binocular field of single vi-sion.There was small residual deviation (≤5°) in primary position in 15.4%patients .All patients could significantly improve compensa-tory head posture. Surgical success rate was 92.8%.Diplopia could not being eliminated in secondary positions .Postoperative eyeball motility improved markedly .Serious complications were not found .Conclusion:The surgical management of extraocular myopathy in pa-tients with TAO was safe and effective after inflammation disappeared and stable eye position , single rectus recession could correct large deviation in patients with restrictive strabismus , It could significantly improve diplopia and compensatory head posture .%目的:观察甲状腺相关性眼病眼外肌病变手术治疗临床效果. 方法:回顾性分析我院13例14眼TAO

  20. Effect of Horizontal Rectus Surgery on Clinical and Paraclinical Indices in Congenital Nystagmus

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    Abbas Bagheri

    2008-11-01

    Full Text Available

    PURPOSE: To determine the effect of horizontal rectus muscle surgery on visual acuity, head posture and electronystagmographic indices in patients with congenital nystagmus. METHODS: This prospective comparative case series was conducted on 58 patients with congenital nystagmus over a period of three years. Patients were divided into three groups: the first group (29 cases had head posture less than 20D, binocular visual acuity (BOVA less than 20/30 and tropia less than 30D and underwent large recession of all four horizontal rectus muscles; the second group (23 cases had head posture less than 20D, BOVA < 20/30 and tropia more than 30D who underwent large recession of two horizontal rectus muscles; and the third group (6 cases had head posture more than 20D with any BOVA or tropia who underwent Kestenbaum-Anderson surgery. RESULTS: Mean age of the patients was 18.7±9.1 years and mean follow-up period was 17.5±7.4 months. Visual acuity improved in all three study groups and was statistically significant in the 2-rectus group (P < 0.001. The speed and amplitude of nystagmus waves decreased in all groups which was statistically significant in the 4-rectus group (P values, 0.02 and 0.04, respectively. A small myopic shift was seen in the 2-rectus and 4-rectus groups and a small hyperopic shift was found in the Kestenbaum

  1. Dystrophic changes in extraocular muscles after gamma irradiation in mdx:utrophin(+/-) mice.

    Science.gov (United States)

    McDonald, Abby A; Kunz, Matthew D; McLoon, Linda K

    2014-01-01

    Extraocular muscles (EOM) have a strikingly different disease profile than limb skeletal muscles. It has long been known that they are spared in Duchenne (DMD) and other forms of muscular dystrophy. Despite many studies, the cause for this sparing is not understood. We have proposed that differences in myogenic precursor cell properties in EOM maintain normal morphology over the lifetime of individuals with DMD due to either greater proliferative potential or greater resistance to injury. This hypothesis was tested by exposing wild type and mdx:utrophin(+/-) (het) mouse EOM and limb skeletal muscles to 18 Gy gamma irradiation, a dose known to inhibit satellite cell proliferation in limb muscles. As expected, over time het limb skeletal muscles displayed reduced central nucleation mirrored by a reduction in Pax7-positive cells, demonstrating a significant loss in regenerative potential. In contrast, in the first month post-irradiation in the het EOM, myofiber cross-sectional areas first decreased, then increased, but ultimately returned to normal compared to non-irradiated het EOM. Central nucleation significantly increased in the first post-irradiation month, resembling the dystrophic limb phenotype. This correlated with decreased EECD34 stem cells and a concomitant increase and subsequent return to normalcy of both Pax7 and Pitx2-positive cell density. By two months, normal het EOM morphology returned. It appears that irradiation disrupts the normal method of EOM remodeling, which react paradoxically to produce increased numbers of myogenic precursor cells. This suggests that the EOM contain myogenic precursor cell types resistant to 18 Gy gamma irradiation, allowing return to normal morphology 2 months post-irradiation. This supports our hypothesis that ongoing proliferation of specialized regenerative populations in the het EOM actively maintains normal EOM morphology in DMD. Ongoing studies are working to define the differences in the myogenic precursor cells

  2. Extraocular muscle atrophy and central nervous system involvement in chronic progressive external ophthalmoplegia.

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    Cynthia Yu-Wai-Man

    Full Text Available Chronic progressive external ophthalmoplegia (CPEO is a classical mitochondrial ocular disorder characterised by bilateral progressive ptosis and ophthalmoplegia. These ocular features can develop either in isolation or in association with other prominent neurological deficits (CPEO+. Molecularly, CPEO can be classified into two distinct genetic subgroups depending on whether patients harbour single, large-scale mitochondrial DNA (mtDNA deletions or multiple mtDNA deletions secondary to a nuclear mutation disrupting mtDNA replication or repair. The aim of this magnetic resonance imaging (MRI study was to investigate whether the ophthalmoplegia in CPEO is primarily myopathic in origin or whether there is evidence of contributory supranuclear pathway dysfunction.Ten age-matched normal controls and twenty patients with CPEO were recruited nine patients with single, large-scale mtDNA deletions and eleven patients with multiple mtDNA deletions secondary to mutations in POLG, PEO1, OPA1, and RRM2B. All subjects underwent a standardised brain and orbital MRI protocol, together with proton magnetic resonance spectroscopy in two voxels located within the parietal white matter and the brainstem.There was evidence of significant extraocular muscle atrophy in patients with single or multiple mtDNA deletions compared with controls. There was no significant difference in metabolite concentrations between the patient and control groups in both the parietal white matter and brainstem voxels. Volumetric brain measurements revealed marked cortical and cerebellar atrophy among patients with CPEO+ phenotypes.The results of this study support a primary myopathic aetiology for the progressive limitation of eye movements that develops in CPEO.

  3. Differential involvement of orbital fat and extraocular muscles in graves' ophthalmopathy.

    Science.gov (United States)

    Wiersinga, Wilmar M; Regensburg, Noortje I; Mourits, Maarten P

    2013-03-01

    Graves' ophthalmopathy (GO) is characterized by swelling of orbital fat and extraocular muscles, but little attention has been given to differential involvement of fat and muscles. Advancements in imaging allow rather accurate measurements of orbital bony cavity volume (OV), fat volume (FV) and muscle volume (MV), and are the topics of this review. Ratios of FV/OV and MV/OV neutralize gender differences. In adult Caucasian controls, mean values ± SD of FV/OV are 0.56 ± 0.11 and of MV/OV are 0.15 ± 0.02. FV increases substantially and MV decreases slightly with advancing age, requiring age-specific reference ranges. In 95 consecutive untreated Caucasian GO patients, both FV and MV were within normal limits in 25%, increased FV but normal MV was present in 5%, normal FV but increased MV was detected in 61%, and both increased FV and MV was evident in 9%. Increased FV was associated with more proptosis and longer GO duration. Increased MV was associated with older age, more severe GO (more proptosis and diplopia, worse eye muscle ductions), higher TBII and current smoking. At the cellular and molecular level differential involvement of fat and muscles might be related to differences between fibroblast phenotypes and cytokine profiles in each compartment, to different orbital T cell subsets during the course of the disease and to peroxisome proliferator activator receptor-γ polymorphisms and modulation of 11β-hydroxysteroid dehydrogenase-1. Enlarged muscles are apparently a rather early phenomenon in GO, whereas increases in fat mass occur relatively late. Why a minor subset of GO patients presents with an increase of only fat remains poorly understood.

  4. Analysis of neurotrophic factors in limb and extraocular muscles of mouse model of amyotrophic lateral sclerosis.

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    Vahid M Harandi

    Full Text Available Amyotrophic lateral sclerosis (ALS is currently an incurable fatal motor neuron syndrome characterized by progressive weakness, muscle wasting and death ensuing 3-5 years after diagnosis. Neurotrophic factors (NTFs are known to be important in both nervous system development and maintenance. However, the attempt to translate the potential of NTFs into the therapeutic options remains limited despite substantial number of approaches, which have been tested clinically. Using quantitative RT-PCR (qRT-PCR technique, the present study investigated mRNA expression of four different NTFs: brain-derived neurotrophic factor (BDNF, neurotrophin-3 (NT-3, neurotrophin-4/5 (NT-4 and glial cell line-derived neurotrophic factor (GDNF in limb muscles and extraocular muscles (EOMs from SOD1G93A transgenic mice at early and terminal stages of ALS. General morphological examination revealed that muscle fibres were well preserved in both limb muscles and EOMs in early stage ALS mice. However, in terminal ALS mice, most muscle fibres were either atrophied or hypertrophied in limb muscles but unaffected in EOMs. qRT-PCR analysis showed that in early stage ALS mice, NT-4 was significantly down-regulated in limb muscles whereas NT-3 and GDNF were markedly up-regulated in EOMs. In terminal ALS mice, only GDNF was significantly up-regulated in limb muscles. We concluded that the early down-regulation of NT-4 in limb muscles is closely associated with muscle dystrophy and dysfunction at late stage, whereas the early up-regulations of GDNF and NT-3 in EOMs are closely associated with the relatively well-preserved muscle morphology at late stage. Collectively, the data suggested that comparing NTFs expression between limb muscles and EOMs from different stages of ALS animal models is a useful method in revealing the patho-physiology and progression of ALS, and eventually rescuing motor neuron in ALS patients.

  5. What happens to the rectus abdominus fascia after laparoscopic ventral hernia repair?

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    Sickle, K R Van; Baghai, M; Mattar, S G; Bowers, S P; Ramaswamy, A; Swafford, V; Smith, C D; Ramshaw, B J

    2005-12-01

    One criticism of laparoscopic ventral hernia repair (LVH) is that the rectus muscles are not re-approximated to the midline, and the effect of LVH repair on the fascial edges is unclear. Progressive migration of the fascial edges toward the midline has been observed anecdotally, but objective evidence remains limited. The purpose of this study is to observe the effect of LVH repair on the rectus abdominus fascia. Patients undergoing LVH repair with defects > 10 cm in horizontal diameter were identified prospectively and enrolled. All were repaired laparoscopically with intraperitoneal placement of mesh (DualMesh, W.L. Gore and Associates) using a standard approach. Radio-opaque clips were placed at the fascial edges intraoperatively to mark the defect, and plain abdominal films were taken postoperatively (Time 1) to establish the initial distance between clips (measured in cm). A subsequent follow-up film was taken (Time 2), and the difference in clip distance per patient was recorded. Results were analyzed using a chi-squared test. Twelve patients qualified for analysis and their results were compared. Mean fascial defect size was 15.1 cm (range 8.3-22.0). With respect to change in clip distance from Times 1 to 2, three events were observed: (1) Diminished (i.e. medialized), (2) Enlarged, or (3) No Change. Ten patients (83%) medialized, one patient enlarged, and one patient showed no change (chi2 (d.f. = 2) 9.17, p < 0.0023). Medialization of the rectus abdominus fascia occurs in the majority of patients undergoing LVH repair. Causes for this phenomenon are unclear: however eliminating intrabdominal pressure with intraperitoneal mesh placement likely plays a role.

  6. Double Augmented Vertical Rectus Transposition for Large-Angle Esotropia Due to Sixth Nerve Palsy.

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    Singh, Priyanka; Vijayalakshmi, Perumalsamy; Shetty, Shashikant; Vora, Priyanka; Kalwaniya, Suresh

    2016-11-01

    To study the binocular alignment and ocular motility in patients with large-angle esotropia due to sixth nerve palsy treated with double augmented vertical recti transposition. This was a prospective interventional study. Fifteen patients with non-resolving sixth nerve palsy who underwent surgical correction were included in the study. Fourteen patients also underwent an additional medial rectus recession. Two patients with an associated small vertical deviation had a selective augmentation of one vertical rectus muscle. Binocular alignment, ocular motility, duction limitation, improvement in head posture, induced vertical deviations, and field of diplopia-free binocular single vision (when possible) were analyzed. Successful outcome was defined as a residual horizontal deviation of 10 prism diopters (PD) or less with no vertical deviation at final follow-up (6 months). The double augmented Hummelsheim procedure improved esotropia from 58.3 ± 10.8 PD preoperatively to 7.2 ± 5.1 PD postoperatively (P = .001). Three (20%) patients had residual deviation of greater than 10 PD, of which 1 patient had diplopia and was treated with prisms. Postoperative binocular field of vision was performed in 6 patients, the mean of which was 20° for abduction and 45° for adduction. Three of 6 patients had elimination of face turn and the rest had residual head posture of less than 5°. Two patients had an induced vertical deviation of less than 4 PD. In patients who had selective augmentation, the vertical deviation was completely corrected. The patients operated on with double augmentation of the Hummelsheim procedure combined with medial rectus recession had reduced mean primary esotropia and improved diplopia-free field of vision postoperatively. [J Pediatr Ophthalmol Strabismus. 2016;53(6):369-374.]. Copyright 2016, SLACK Incorporated.

  7. Effective rectus sheath canal: does it affect total extraperitoneal approach for inguinal mesh hernioplasty?

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    Maulana Mohammad Ansari

    2013-02-01

    Full Text Available Objectives: This study aimed to compare the effects of the 1st port placement at two different levels below umbilicus during the total extraperitoneal (TEP laparoscopic repair of inguinal hernia and to check the hypothesis that shorter effective rectus sheath canal would facilitate the TEP procedure. Methods: Eighteen adult males underwent TEP repair for uncomplicated primary inguinal hernia in one year. First (optical port was placed 1 cm and 2.5 cm below the umblicus in the two groups (I and II, respectively. Effective rectus sheath canal (ERSC was measured. Primary outcome measures (endoscopic vision, ease of the procedure and operating time were compared between the two groups. Results: ERSC (mean ± SD was found 3.24 ± 0.41 and 2.08 ± 0.27 cm in group I (n = 7 and group II (n = 11, respectively (P < 0.05. Endoscopic vision was found significantly better in group II compared to group I; visual analogue score (VAS 8.82 ± 0.41 vs 4.57 ± 0.45, respectively (P < 0.05. Procedure was found significantly easier in group II compared to group I (VAS 8.91 ± 0.44 vs 5.5 ± 0.65; P < 0.05. Operating time was found significantly lower in group II compared to group I (1.83 ± 0.3 vs 2.71 ± 0.42 h; P < 0.05. Conclusions: Shorter effective rectus sheath canal of ≤ 2 cm greatly facilitates the TEP hernioplasty in terms of endoscopic vision, ease of the procedure and operating time, and is highly recommended, especially for the beginners. [J Exp Integr Med 2013; 3(1: 73-76

  8. Bilateral rectus femoris intramuscular haematoma following simultaneous quadriceps strain in an athlete: a case report

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    Papathanasiou Efthymia

    2010-02-01

    Full Text Available Abstract Introduction Bilateral rectus femoris haematoma following a simultaneous strain of the quadriceps muscles is a very rare condition. Case presentation We report the case of a 21-year-old Greek Caucasian female rowing athlete who was injured on both thighs. She complained of pain and inability to walk. Physical examination revealed tenderness over the thighs and restriction of knee movement. The result of a roentgenogram was normal, and there was no evidence of fracture or patella displacement. Magnetic resonance imaging revealed haematoma formation in both the rectus femoris muscles. The diameters of the left and right haematomas within the muscles were 6 cm and 5 cm, respectively. Therapeutic approaches included compression bandages, ice application, rest, elevation, and administration of muscle relaxant drugs. Active stretching and isometric exercises were performed after three days. The patient was able to walk using crutches two days after the initiation of treatment. On the seventh day, she had regained her full ability to walk without crutches. Non-steroidal anti-inflammatory drugs were administered on the fifth day and continued for one week. Six weeks later, she had pain-free function and the result of magnetic resonance imaging was normal. She was able to resume her training programme and two weeks later, she returned to her previous sport activities and competitions. Conclusion There are references in the literature regarding the occurrence of unilateral quadriceps haematomas following strain and bilateral quadriceps tendon rupture in athletes. Simultaneous bilateral rectus femoris haematomas after a muscle strain is a rare condition. It must be diagnosed early. The three phases of treatment are rest, knee mobilization, and restoration of quadriceps function.

  9. Imaging-based assessment of rectus abdominis muscle thickness in an adult population: evaluating possible anthropometric relationships

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    Ogugua Augustine Egwu

    2014-09-01

    Full Text Available Introduction: Very little attention has been paid to muscle architecture in the Sub-Saharan African environment, and the rectus abdominis muscle, being a stabilising agent in the trunk, should not be left out. Considering the incidence of trunk musculoskeletal discomfort, it is necessary to assess the rectus abdominis muscle. Aim of the research: To assess the thickness of the rectus abdominis muscle in an apparently healthy adult population using ultrasound and to evaluate its possible relationship with important anthropometric variables. Material and methods : A total of 120 healthy subjects made up of 60 males and 60 females, who gave their written consent, were recruited for this study. B-mode ultrasound was used to assess the rectus abdominis muscle. Anthropometric variables were also assessed. Results: The results show that the rectus abdominis thickness (RAT was 14.68 ±2.92 mm and 14.37 ±2.74 mm for the right (RRAT and left (LRAT sides, respectively. The males had significantly thicker muscles than the females (p = 0.004 and the RAT correlated positively with age, weight, height, body mass index, body surface area, waist circumference, and conicity index. Conclusions: These results show robust myoanthropometric relationships that will assist surgeons in reconstructive procedures involving the muscle. They will also serve as a guidepost in the biomechanical assessment of the muscle in lifting sports for an African population, in the study of muscle flaps, and in the general evaluation of trunk mass.

  10. Reconstruction of Abdominal Wall of a Chronically Infected Postoperative Wound with a Rectus Abdominis Myofascial Splitting Flap

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    Sung Kyu Bae

    2013-01-01

    Full Text Available BackgroundIf a chronically infected abdominal wound develops, complications such as peritonitis and an abdominal wall defect could occur. This could prolong the patient's hospital stay and increase the possibility of re-operation or another infection as well. For this reason, a solution for infection control is necessary. In this study, surgery using a rectus abdominis muscle myofascial splitting flap was performed on an abdominal wall defect.MethodsFrom 2009 to 2012, 5 patients who underwent surgery due to ovarian rupture, cesarean section, or uterine myoma were chosen. In each case, during the first week after operation, the wound showed signs of infection. Surgery was chosen because the wounds did not resolve with dressing. Debridement was performed along the previous operation wound and dissection of the skin was performed to separate the skin and subcutaneous tissue from the attenuated rectus muscle and Scarpa's fascial layers. Once the anterior rectus sheath and muscle were adequately mobilized, the fascia and muscle flap were advanced medially so that the skin defect could be covered for reconstruction.ResultsUpon 3-week follow-up after a rectus abdominis myofascial splitting flap operation, no major complication occurred. In addition, all of the patients showed satisfaction in terms of function and esthetics at 3 to 6 months post-surgery.ConclusionsUsing a rectus abdominis myofascial splitting flap has many esthetic and functional benefits over previous methods of abdominal defect treatment, and notably, it enabled infection control by reconstruction using muscle.

  11. Reconstruction of Abdominal Wall of a Chronically Infected Postoperative Wound with a Rectus Abdominis Myofascial Splitting Flap

    Directory of Open Access Journals (Sweden)

    Sung Kyu Bae

    2013-01-01

    Full Text Available Background If a chronically infected abdominal wound develops, complications such asperitonitis and an abdominal wall defect could occur. This could prolong the patient’s hospitalstay and increase the possibility of re-operation or another infection as well. For this reason,a solution for infection control is necessary. In this study, surgery using a rectus abdominismuscle myofascial splitting flap was performed on an abdominal wall defect.Methods From 2009 to 2012, 5 patients who underwent surgery due to ovarian rupture,cesarean section, or uterine myoma were chosen. In each case, during the first week afteroperation, the wound showed signs of infection. Surgery was chosen because the wounds didnot resolve with dressing. Debridement was performed along the previous operation woundand dissection of the skin was performed to separate the skin and subcutaneous tissue fromthe attenuated rectus muscle and Scarpa’s fascial layers. Once the anterior rectus sheath andmuscle were adequately mobilized, the fascia and muscle flap were advanced medially sothat the skin defect could be covered for reconstruction.Results Upon 3-week follow-up after a rectus abdominis myofascial splitting flap operation,no major complication occurred. In addition, all of the patients showed satisfaction in termsof function and esthetics at 3 to 6 months post-surgery.Conclusions Using a rectus abdominis myofascial splitting flap has many esthetic andfunctional benefits over previous methods of abdominal defect treatment, and notably, itenabled infection control by reconstruction using muscle.

  12. Delayed Soft Tissue Reconstruction with a Horizontal Rectus Abdominis Musculocutaneous Flap following Hip Exarticulation

    Directory of Open Access Journals (Sweden)

    Jes Christian Rødgaard

    2013-01-01

    Full Text Available Coverage of large soft tissue defects at the hip region constitutes a challenge for plastic surgeons. We report the case of a 43-year-old female with necrotizing fasciitis of the right thigh, necessitating hip exarticulation and substantial debridement of necrotic tissue. An ipsilateral horizontal rectus abdominis myocutaneous (HRAM flap was used to cover the defect. The reconstruction was carried out after the attempt of local tissue rearrangement. In light of the successful outcome, we propose that this flap be considered in the future planning of soft tissue reconstruction at the hip region.

  13. [Recession of the inferior rectus muscle in superficial anesthesia in the treatment of thyroid orbitopathy].

    Science.gov (United States)

    Koniszewski, G; Zagórski, Z

    1989-06-01

    Recession of the inferior rectus in surface anaesthesia by 5% cocaine drops was performed in 8 patients with signs of hypotropia in the course of thyroid orbitopathia and with diplopia persisting after conservatory treatment and not corrected by prisms. This method enables us an accurate intraoperative settlement of the distance of recession and it may be recommended in cases metabolically normalized, with not too much advanced exophthalmos, with a stability of the motor disturbances for at least 6 months and without any signs of inflammation.

  14. Low-Grade Myxofibrosarcoma of the Rectus Abdominus Muscle Infiltrating into Abdominal Cavity: A Case Report.

    Science.gov (United States)

    Nomura, Tadashi; Sakakibara, Shunsuke; Moriwaki, Aya; Kawamoto, Teruya; Suzuki, Satoshi; Ishimura, Takeshi; Hashikawa, Kazunobu; Terashi, Hiroto

    2017-01-01

    Objective: Myxofibrosarcoma (MFS) is a relatively rare tumor that is histologically characterized by myxoid stroma and spindle cell proliferation. This tumor most commonly arises as a slow growing, enlarging painless mass in the extremities of elderly patients. Methods: We report a case of a primary, low-grade MFS in the rectus abdominis muscle infiltrating the abdominal cavity of a 75-year-old man. Results: The patient underwent a wide excision of the right abdominal wall mass with a 3-cm surgical margin from the scar due to a biopsy. The tumor infiltrated the urinary bladder, peritoneum, and external iliac vessels. Twenty-six months after the initial operation, he had recurrences in his abdominal wall, urinary bladder, and right iliac vessels. Conclusions: To our knowledge, primary MFS of the muscle in the abdomen has not been documented previously. Although this case was histopathologically classified as a low-grade tumor, it infiltrated the abdominal cavity. The tumor is suspected to have penetrated the abdominal cavity below the linea arcuata, which lacks the posterior sheath of the rectus abdominis muscle; from there, it could easily spread without being blocked by any biological barriers.

  15. A cadaver knee simulator to evaluate the biomechanics of rectus femoris transfer.

    Science.gov (United States)

    Anderson, Michael C; Brown, Nicholas A T; Bachus, Kent N; Macwilliams, Bruce A

    2009-07-01

    A cadaver knee simulator has been developed to model surgical transfer of the rectus femoris. The simulator allows knee specimens six degrees of freedom and is capable of modeling both the swing and stance phases of human gait. Experiments were conducted using a mechanical hinge analog of the knee to verify that time, flexion angle, and knee extension force measurements recorded when using the simulator were not influenced by its design or operation. A ballistic double pendulum model was used to model the swing phase of gait, and the contributions of hip and ankle torques and hamstrings cocontraction were included when modeling the stance phase of gait. When modeling swing, range of motion and time to peak knee flexion in swing for the hinge knee were similar to those of in vivo test subjects. Measurements of hinge knee extension force when modeling stance under various biomechanical conditions matched those predicted using an analytical model. Future studies using cadaver knee specimens will apply techniques described in this paper to further our understanding of changes in knee biomechanics caused by rectus femoris transfer surgery.

  16. Rectus Femoris Echo Intensity Correlates with Muscle Strength, but Not Endurance, in Younger and Older Men.

    Science.gov (United States)

    Mota, Jacob A; Stock, Matt S

    2017-08-01

    We examined correlations between echo intensity and muscle strength and endurance. Rectus femoris echo intensity, maximal voluntary contraction (MVC) force and time to task failure during a 50% MVC task were determined for 12 younger (mean age = 25 y) and 13 older (mean age = 74 y) men. Bivariate correlations between echo intensity and normalized MVC force were similar for younger and older men, but was only statistically significant for the latter (younger r = -0.559, p = 0.059; older r = -0.580, p = 0.038). When all patients were combined, the correlation was significant (r = -0.733, p correlations were not observed for time to task failure (younger r = -0.382, p = 0.221; older r = -0.347, p = 0.246; all patients r = -0.229, p = 0.270). Rectus femoris echo intensity is associated with muscle strength, but not endurance, in younger and older men. Copyright © 2017 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  17. Comparison of surgically induced astigmatism in patients with horizontal rectus muscle recession

    Institute of Scientific and Technical Information of China (English)

    Harun; akmak; Tolga; Kocatürk; Sema; Oru; Dündar

    2014-01-01

    ·AIM: To compare surgically induced astigmatism(SIA)following horizontal rectus muscle recession surgery between suspension recession with both the "hang-back" technique and conventional recession technique.·METHODS: Totally, 48 eyes of 24 patients who had undergone horizontal rectus muscle recession surgery were reviewed retrospectively. The patients were divided into two groups. Twelve patients were operated on by the hang-back technique(Group 1), and 12 by the conventional recession technique(Group 2). SIA was calculated on the 1stwk, 1stand in the 3rdmo after surgery using the SIA calculator.·RESULTS: SIA was statistically higher in the Group 1all postoperative follow-up. SIA was the highest in the 1st wk, and decreased gradually in both groups.·CONCLUSION: The suspension recession technique induced much more SIA than the conventional recession technique. This difference also continued in the following visits. Therefore, the refractive power should be checked postoperatively in order to avoid refractive amblyopia.Conventional recession surgery should be the preferred method so as to minimize the postoperative refractive changes in patients with amblyopia.

  18. Spontaneous Rectus Sheath Hematoma in the Elderly: An Unusual Case and Update on Proper Management

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    George Galyfos

    2014-01-01

    Full Text Available Spontaneous rectus sheath hematoma (SRSH is an uncommon medical emergency in the elderly. We present a case of SRSH with an atypical clinical presentation and discuss literature regarding diagnosis and proper management. A 75-year-old female patient was transferred to the emergency department due to acute dyspnoea and confusion. Her medical history revealed a viral infection of the upper respiratory tract, and no coughing or use of anticoagulants. The clinical examination showed tenderness of the left lower abdomen, although palpation was misleading due to patient’s obesity. Laboratory investigations showed light anaemia. Ultrasonography and computed tomography revealed a large rectus sheath hematoma of the left abdominal wall. Despite further deterioration of the patient, conservative management including bed rest, fluid replacement, blood products transfusion, and proper analgesia was successful. No surgical intervention was needed. Prompt diagnosis and management of SRSH plays significant role in the prognosis, especially in elder patients. Independently of size and severity, conservative management remains the first therapeutic choice. Only by failure of supportive management, progressive and large hematoma or uncontrollable hemodynamic patients, interventional management including surgery or less invasive newer techniques is indicated.

  19. Superior Hiking Trail

    Data.gov (United States)

    Minnesota Department of Natural Resources — Superior Hiking Trail main trail, spurs, and camp spurs for completed trail throughout Cook, Lake, St. Louis and Carlton counties. These data were collected with...

  20. Bathymetry of Lake Superior

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Bathymetry of Lake Superior has been compiled as a component of a NOAA project to rescue Great Lakes lake floor geological and geophysical data and make it more...

  1. Superior Hiking Trail Facilities

    Data.gov (United States)

    Minnesota Department of Natural Resources — Superior Hiking Trail main trail, spurs, and camp spurs for completed trail throughout Cook, Lake, St. Louis and Carlton counties. These data were collected with...

  2. Immediate reconstruction following resection of oral cancer with free rectus abdominis myocutaneous flap

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    目的:研究游离腹直肌肌皮瓣即刻修复口腔颌面部恶性肿瘤切除术后缺损的方法并评价其作用.方法:6例患者在进行广泛的口腔癌切除术后,应用游离腹直肌肌皮瓣进行缺损即刻修复,3例颊癌患者分别切除唇,颊,下颌骨及上颌骨后造成大面积洞穿性缺损,2例舌癌及1例下颌骨恶性肿瘤患者在进行舌切除及下颌骨切除后造成大面积及复杂的缺损,缺损修复的转移皮瓣最大面积达110mm×230mm.结果:游离腹直肌肌皮瓣及供区无严重的手术并发症,6例游离腹直肌肌皮瓣有5例愈合无并发症,1例皮瓣出现部分坏死,供皮区腹壁无组织感染及裂开.结论:游离腹直肌肌皮瓣使口腔颌面部缺损修复在功能和美观上达到满意的效果,提高了口腔颌面部恶性肿瘤患者广泛切除术后的生存质量.%Objective:To study the method of rectus abdominis myocutaneous free flap for immediate reconstruction of defects resulting from orofacial cancer resections and evaluate the effect of the flap. Methods:There were six patients with oral cancer following extensive surgery received the rectus abdominis myocutaneous free flaps for immediate reconstruction of defects.In three patients with buccle mucosa carcinoma,extensive perforating defects had resulted from resection of large areas of the lip,cheek,mandible,and maxilla.In two patients with tongue cancer and one patient with mandibular carcinoma,extensive and complex defects had resulted from glossectomy and mandibulectomy.The maximal size of the skin peddle of the transferred flap was 110mm×230mm. Results:There were no serious complications of the transferred rectus abdominis myocutaneous free flaps and donor sites.Five of six rectus abdominis myocutaneous free flaps healed without immediate complications and one flap had partial necrosis.There were no infections and dehiscences of the abdominal wall. Conclusions:The rectus abdominis myocutaneous free flap provide

  3. Intraocular and extraocular cameras for retinal prostheses: Effects of foveation by means of visual prosthesis simulation

    Science.gov (United States)

    McIntosh, Benjamin Patrick

    Blindness due to Age-Related Macular Degeneration and Retinitis Pigmentosa is unfortunately both widespread and largely incurable. Advances in visual prostheses that can restore functional vision in those afflicted by these diseases have evolved rapidly from new areas of research in ophthalmology and biomedical engineering. This thesis is focused on further advancing the state-of-the-art of both visual prostheses and implantable biomedical devices. A novel real-time system with a high performance head-mounted display is described that enables enhanced realistic simulation of intraocular retinal prostheses. A set of visual psychophysics experiments is presented using the visual prosthesis simulator that quantify, in several ways, the benefit of foveation afforded by an eye-pointed camera (such as an eye-tracked extraocular camera or an implantable intraocular camera) as compared with a head-pointed camera. A visual search experiment demonstrates a significant improvement in the time to locate a target on a screen when using an eye-pointed camera. A reach and grasp experiment demonstrates a 20% to 70% improvement in time to grasp an object when using an eye-pointed camera, with the improvement maximized when the percept is blurred. A navigation and mobility experiment shows a 10% faster walking speed and a 50% better ability to avoid obstacles when using an eye-pointed camera. Improvements to implantable biomedical devices are also described, including the design and testing of VLSI-integrable positive mobile ion contamination sensors and humidity sensors that can validate the hermeticity of biomedical device packages encapsulated by hermetic coatings, and can provide early warning of leaks or contamination that may jeopardize the implant. The positive mobile ion contamination sensors are shown to be sensitive to externally applied contamination. A model is proposed to describe sensitivity as a function of device geometry, and verified experimentally. Guidelines are

  4. Sporadic and familial blepharophimosis -ptosis-epicanthus inversus syndrome: FOXL2 mutation screen and MRI study of the superior levator eyelid muscle.

    Science.gov (United States)

    Dollfus, H; Stoetzel, C; Riehm, S; Lahlou Boukoffa, W; Bediard Boulaneb, F; Quillet, R; Abu-Eid, M; Speeg-Schatz, C; Francfort, J J; Flament, J; Veillon, F; Perrin-Schmitt, F

    2003-02-01

    The analysis of the FOXL2 gene (3q23) in a series of two families and two sporadic cases affected with Blepharophimosis-Ptosis-Epicanthus Inversus Syndrome (BPES) is presented. This study detected two novel FOXL2 mutations (missence and nonsens mutations) and confirmed the recurrence of a previously described duplication. Magnetic Resonance Imaging (MRI) of the orbit, in one family, showed absence or hypotrophy of the eyelid superior levator muscle suggesting a possible role of FOXL2 in the development of this extra-ocular muscle.

  5. Morphological and histomorphometric evaluation of the ventral rectus sheath of the rectus abdominis muscle, fascia lata and pectoral fascia. The beginning of a morphological information bank of human fascias.

    Science.gov (United States)

    Morales-Avalos, Rodolfo; Soto-Domínguez, Adolfo; García-Juárez, Jaime; Cardenas-Serna, Marcela; Esparza-Hernández, Claudia N; Carreño-Salcedo, Sofía Alejandra; Montes-de-Oca-Luna, Roberto; Loera-Arias, María de Jesús; Saucedo-Cárdenas, Odila; Elizondo-Omaña, Rodrigo E; Guzmán-López, Santos

    2017-03-01

    The aim of this study was to characterize and compare the morphological and histomorphometric characteristics of the pectoral fascia, fascia lata and ventral rectus sheath. Twenty cadaveric samples of these fascias were analyzed and stained with hematoxylin and eosin, orcein, Van Gieson, Masson's trichrome and Verhoeff¨s stain (1200 slides in total). Morphological evaluation, semiquantitative, morphometric and microdensitometric analysis of elastic fibers present in each of the tissues and a morphometrical analysis of tissue thickness were performed. The mean value of the pectoral fascia thickness was 612±68.13 μm; 84±246 μm for the fascia lata and 584±92 μm for the ventral rectus sheath. The area occupied by the elastic fibers in the pectoral fascia was 12.24±5.84%; 6,54±3.85% for the fascia lata and 11.11±5.26% for the ventral rectus sheath. There were no statistically significant differences when comparing the mean values between the pectoral fascia and the ventral rectus sheath (p=0.07). There were statistically significant differences when comparing the fascia lata to the pectoral fascia and the ventral rectus sheath (p≤0.001). This study reports other morphological characteristics not described in previous histological studies of the analyzed tissues. The results of the morphometric and densitometric analysis in this study reveal that the fascia lata has the fewest elastic fibers of all the tissues analyzed, and the pectoral fascia has the most. These results will be useful for the beginning of a morphological information bank of human fascias.

  6. Fibromatosis in vertical rectus abdominis myocutaneous flap imitating tumor recurrence after surgery for locally advanced rectal cancer: case report.

    Science.gov (United States)

    Goscinski, Mariusz Adam; Hole, Knut Håkon; Tønne, Elin; Ryder, Truls; Grøholt, Krystyna Kotanska; Flatmark, Kjersti

    2016-03-03

    Abdominoperineal excision is performed in patients with locally advanced, low rectal carcinoma. Reconstruction of the dorsal vagina and perineum using the vertical rectus abdominis myocutaneous flap following extensive surgery results in favorable surgical outcome and quality of life. However, the rectus abdominis muscle, as part of the anterior abdominal wall, may develop fibrous lesions also as a transplant. A 39-year-old female patient with low rectal cancer and extensive colorectal polyposis was treated with neoadjuvant chemoradiotherapy followed by colectomy and abdominoperineal excision with resection of the dorsal vaginal wall and subsequent reconstruction of the perineum using the vertical rectus abdominis myocutaneous flap. At the 6-month follow-up, a suspected 2 × 2 cm tumor recurrence was detected in the transposed tissue and was subsequently surgically removed. Histologic examination concluded with fibromatosis. Genetic testing revealed a known disease-causing mutation in the adenomatous polyposis coli gene, confirming the diagnosis of familial adenomatous polyposis. Fibromatosis may affect the anterior abdominal wall, that is the rectus abdominis muscle, at the primary site or may develop in the muscle after its transposition into the perineum at pelvic reconstruction. Fibromatosis in the muscle flap after pelvic reconstruction may present a difficult diagnostic challenge for the multidisciplinary team.

  7. PERSISTENT LEFT SUPERIOR VENACAVA

    Directory of Open Access Journals (Sweden)

    Devinder Singh

    2014-05-01

    Full Text Available A Persistent Left Superior Venacava (PLSVC is the most common variation of the thoracic venous system and rare congenital vascular anomaly and is prevalent in 0.3% of the population. It may be associated with other cardiovascular abnormalities including atrial septal defect, bicuspid aortic valve, coarctation of aorta, coronary sinus ostial atresia, and cor triatriatum. Incidental rotation of a dilated coronary sinus on echocardiography should raise the suspicion of PLSVC. The diagnosis should be confirmed by saline contrast echocardiography. Condition is usually asymptomatic. Here we present a rare case of persistent left superior vena cava presented in OPD with dyspnoea & palpitations.

  8. The rectus abdominis myocutaneous flap combined with vascularized costal cartilages in reconstructive craniofacial surgery.

    Science.gov (United States)

    Yamamoto, Y; Minakawa, H; Kokubu, I; Kawashima, K; Sugihara, T; Satoh, N; Fukuda, S

    1997-08-01

    The efficacy of osteocutaneous or vascularized bone flaps for reconstruction of massive skeletal and soft-tissue defects has been supported by recent descriptions in the literature. In this article we presented an alternative technique, which is the rectus abdominis myocutaneous flap combined with vascularized eighth and ninth costal cartilages, for reconstruction of midfacial composite defects. The vascular pedicle of the composite flap is the deep inferior epigastric artery and vein. The costal cartilages are supplied by the perichondrial vascular network through the anterior intercostal vessels connecting with the deep epigastric vascular system. Vascularized costal cartilages are considered to reduce the incidence of postoperative complications and resorption of this material. This technique is a useful tool for restoration of craniofacial contour in reconstructive head and neck surgery.

  9. RARE CASE OF CYSTICERCOSIS OF RECTUS ABDOMINIS MUSCLE PRESENTING AS PELVI ABDOMINAL LUMP DURING PUERPERIUM

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    Bangal V

    2010-06-01

    Full Text Available Cysticercosis is a parasitic disease caused by Taenia solium. It is a major public health problem indeveloping countries. Infection is acquired through ingestion of raw or undercooked meat containingthe cysticercus. Man is the intermediate host and pig is definitive host. Cases usually present withvague abdominal discomfort, indigestion and diarrhoea. Cysticerci can be found anywhere in the body, but are most commonly detected in brain, eye, skeletal muscle and subcutaneous tissue.Diagnosis is made by the demonstration of eggs or proglottids (Fig. 1 in faeces and definitive diagnosis is by biopsy of the lesion. We report an unusual case, who presented with a pelvi -abdominal lump during puerperium. Diagnosis of cysticercosis of rectus abdominis muscle was confirmed by histopathology. She was treated by surgery and pharmacotherapy.

  10. Successful pregnancy "during" pedicled transverse rectus abdominis musculocutaneous flap for breast reconstruction with normal vaginal delivery

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    Siew Cheng Chai

    2015-01-01

    Full Text Available A transverse rectus abdominis myocutaneous (TRAM flap is a popular choice for breast reconstruction. Pregnancies in women following a TRAM flap present concerns regarding both safety and the integrity of the abdominal wall. We report a case of a patient who was pregnant during immediate breast reconstruction with pedicled TRAM flap and had a successful spontaneous vaginal delivery. We also conducted a literature review using PubMed on pregnancy post TRAM flap, type of reconstruction, timing of pregnancy after TRAM flap, complication, and mode of delivery, which are summarised in this report. We concluded that patients may have safe pregnancies and normal deliveries following TRAM flap breast reconstruction regardless of the time frame of pregnancy after the procedure. Therefore, TRAM flaps can continue to be a reconstruction option, even in women of childbearing age.

  11. The use of rectus abdominis sheath for wrapping of the hydroxyapatite orbital implants.

    Science.gov (United States)

    Kao, S C; Chen, S

    1999-01-01

    Because of the decreasing availability of whole eye donation, the source of banked sclera is becoming less available. We used autogenous Rectus abdominis sheath (RAS) as an alternative to banked sclera in wrapping the hydroxyapatite (HA)orbital implant. Five anophthalmic patients were included in this study from July 1994 to December 1997. Identical surgical methods were used in every case. The average follow-up time was 18.4 months. The motility associated with sheath-wrapped HA implants was excellent and good vascular ingrowth was found in each patient during peg drilling. The complications are minimal in all the cases. Use of RAS as wrapping material for HA orbital implant has promising results. The RAS served as a practical substitute for banked donor sclera.

  12. A panel data set on harvest and perfusion decellularization of porcine rectus abdominis

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    Jian Zhang

    2016-06-01

    Full Text Available In this dataset, we particularly depicted the harvest and perfusion decellularization of porcine rectus abdominis (RA, accompanied with displaying of the retained vascular trees within the perfusion-decellularized skeletal muscle matrix (pM-ECM using vascular corrosion casting. In addition, several important tips for successful pM-ECM preparation were emphasized, which including using anatomically isolated skeletal muscle as tissue source with all main feeding and draining vessels perfused, preserving the internal microcirculation availability, aseptic technique and pyrogen free in all steps, sequential perfusion via artery or vein, and longtime washing after decellularization. The data are supplemental to our original research article describing detailed associations of pM-ECM as a clinically relevant scale, three-dimensional scaffold with a vascular network template for tissue-specific regeneration, “Perfusion-decellularized skeletal muscle as a three-dimensional scaffold with a vascular network template” Zhang et al. (2016 [1].

  13. Electromyographic activity of the rectus abdominis during a traditional crunch and the basic jackknife exercise with the Ab Lounge™.

    Science.gov (United States)

    Nelson, Gail A; Bent-Forsythe, Denise A; Roopchand-Martin, Sharmella C

    2012-06-01

    The use of nontraditional exercise devices such as the Ab Lounge™ has been promoted as being as effective as the traditional abdominal crunch in strengthening the abdominal musculature. Evidence for this is lacking, however. The purpose of this study was to compare the degree of activation of the upper and lower rectus abdominis using electromyography (EMG) during a traditional crunch with the basic jackknife using the Ab Lounge™. Twenty-two subjects (6 men and 16 women) were randomly selected from the student population at the University of the West Indies (Mona Campus). The mean age of the participants was 20.5 ± 1.5 years, height 166.4 ± 6.2 cm, weight 64 ± 10.3 kg, and waist-hip ratio 0.7 ± 0.1. Surface EMG was used to assess the muscle activity from the upper and lower rectus abdominis while each exercise was performed. The EMG data were full-wave rectified and normalized using a mathematical model that was set up in Microsoft Excel for Windows XP. Statistical analysis was performed on the data using a univariate analysis of variance with gender as a covariate. Significance was determined by p crunch when compared with the basic jackknife performed on the Ab Lounge™ (F = 4.39, p = 0.04). The traditional crunch produced a higher level of activity in the lower rectus abdominis when compared with the basic jackknife, but this was not statistically significant (F = 0.249, p = 0.62). There was no significant interaction between gender and the effect of the type of exercise on upper and lower rectus abdominis activation. These results suggest that the traditional abdominal crunch is more effective than the basic jackknife is in activating the rectus abdominis musculature.

  14. Validity and reliability of rectus femoris ultrasound measurements: Comparison of curved-array and linear-array transducers

    Directory of Open Access Journals (Sweden)

    Kendra Hammond, MD

    2014-11-01

    Full Text Available Muscle-mass loss augers increased morbidity and mortality in critically ill patients. Muscle-mass loss can be assessed by wide linear-array ultrasound transducers connected to cumbersome, expensive console units. Whether cheaper, hand-carried units equipped with curved-array transducers can be used as alternatives is unknown. Accordingly, our primary aim was to investigate in 15 nondisabled subjects the validity of measurements of rectus femoris cross-sectional area by using a curved-array transducer against a linear-array transducer—the reference-standard technique. In these subjects, we also determined the reliability of measurements obtained by a novice operator versus measurements obtained by an experienced operator. Lastly, the relationship between quadriceps strength and rectus area recorded by two experienced operators with a curved-array transducer was assessed in 17 patients with chronic obstructive pulmonary disease (COPD. In nondisabled subjects, the rectus cross-sectional area measured with the curved-array transducer by the novice and experienced operators was valid (intraclass correlation coefficient [ICC]: 0.98, typical percentage error [%TE]: 3.7% and reliable (ICC: 0.79, %TE: 9.7%. In the subjects with COPD, both reliability (ICC: 0.99 and repeatability (%TE: 7.6% and 9.8% were high. Rectus area was related to quadriceps strength in COPD for both experienced operators (coefficient of determination: 0.67 and 0.70. In conclusion, measurements of rectus femoris cross-sectional area recorded with a curved-array transducer connected to a hand-carried unit are valid, reliable, and reproducible, leading us to contend that this technique is suitable for cross-sectional and longitudinal studies.

  15. Crotoxin in humans: analysis of the effects on extraocular and facial muscles Crotoxina em humanos: estudo da ação em músculos extraoculares e faciais

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    Geraldo de Barros Ribeiro

    2012-12-01

    Full Text Available PURPOSE: Crotoxin is the main neurotoxin of South American rattlesnake Crotalus durissus terrificus. The neurotoxic action is characterized by a presynaptic blockade. The purpose of this research is to assess the ability of crotoxin to induce temporary paralysis of extraocular and facial muscles in humans. METHODS: Doses of crotoxin used ranged from 2 to 5 units (U, each unit corresponding to one LD50. We first applied 2U of crotoxin in one of the extraocular muscles of 3 amaurotic individuals to be submitted to ocular evisceration. In the second stage, we applied crotoxin in 12 extraocular muscles of 9 patients with strabismic amblyopia. In the last stage, crotoxin was used in the treatment of blepharospasm in another 3 patients. RESULTS: No patient showed any systemic side effect or change in vision or any eye structure problem after the procedure. The only local side effects observed were slight conjunctival hyperemia, which recovered spontaneously. In 2 patients there was no change in ocular deviation after 2U crotoxin application. Limitation of the muscle action was observed in 8 of the 12 applications. The change in ocular deviation after application of 2U of crotoxin (9 injections was in average 15.7 prism diopters (PD. When the dose was 4U (2 applications the change was in average 37.5 PD and a single application of 5U produced a change of 16 PD in ocular deviation. This effect lasted from 1 to 3 months. Two of the 3 patients with blepharospasm had the hemifacial spasm improved with crotoxin, which returned after 2 months. CONCLUSIONS: This study provides data suggesting that crotoxin may be a useful new therapeutic option for the treatment of strabismus and blepharospasm. We expect that with further studies crotoxin could be an option for many other medical areas.OBJETIVO: A crotoxina é a principal neurotoxina da cascavel sul-americana Crotalus durissus terrificus e sua ação neurotóxica caracteriza-se por um bloqueio pr

  16. Surgical Results in Unilateral Superior Oblique Muscle Palsy

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    Aylin Tenlik

    2014-08-01

    Full Text Available Objectives: To evaluate the surgical treatments and results of the patients with superior oblique muscle palsy (SOMP. Materials and Methods: Clinical charts of the patients with unilateral SOMP who were operated in our clinic between 1999 and 2009 were evaluated retrospectively. Patients’ demographics, preoperative signs, surgical procedure, complications, and final results were recorded. Results: Thirty-seven patients were included in the study, [21 (59% male, 15 (41% female]. The mean age was 20.6 years at the time of operation. The mean time interval between diagnosis and operation was 7.3 years. Postoperative follow-up period was 2.04 (ranging 1-10 years. Diplopia was determined in seven (18.9% patients, and abnormal head position in 36 (97.3% patients. Only inferior oblique tenotomy with distal muscle resection was performed in 25 patients. In addition, five patients had recession of the contralateral inferior rectus muscle and two patients had recession of the ipsilateral superior rectus muscle additional to inferior oblique tenotomy. Abnormal head position was completely improved in all of the patients postoperatively. The preoperative average score of the inferior oblique muscle (IOM overaction was +3.3±0.8, and postoperative overaction was found in only two patients (+1.5. There was statistically significant difference between the two periods (p<0.001. The average score of the superior oblique muscle hypofunction was -2.18 preoperatively, and in only three patients, the score was found -1.0 postoperatively. Difference between the two periods was statistically significant (p<0.001. While the preoperative average vertical deviation was 22 PD in primary position, none of the patients had hyperdeviation postoperatively. Diplopia was resolved in all seven affected patients postoperatively. Contralateral IOM hyperfunction was the most common complication (13.5%. Adherence syndrome was seen in none of the patients. Conclusion: It was found

  17. [The gene mutation screening of a family with congenital fibrosis of the extraocular muscles associated with corpus callosum agenesis].

    Science.gov (United States)

    Zhang, Jun-tao; Zhou, Lian-hong; Zha, Yun-fei; Liu, Tian; Tian, Ming-xing; Yuan, Jing; Xing, Yi-qiao

    2013-07-01

    To identify TUBB3 gene mutations in a Chinese family with congenital fibrosis of the extraocular muscle associated with corpus callosum agenesis. We have found a family with CFEOM associated with corpus callosum agenesis, including 4 affected individuals in three generations of 11 familial members. 4 affected individuals were sequenced by direct TUBB3 sequencing, 4 unaffected individuals in the family and 100 cases of unrelated normal person as a control. This family is in line with Mendelian autosomal dominant inheritance. Clinical manifestations belongs to CFEOM3. All affected individuals were detected with TUBB3 c.1249G > A mutation, the mutation is in exon 4, resulting in wild-type gene encoding the Aspartic acid ( Asp or D ) replaced .by Asparagine (Asn or N ). Our study supports that TUBB3 gene mutation c.1249G > A (p. Asp417Asn), is the underlying molecular pathogenesis of this family with CFEOM3.

  18. Phenothiourea sensitizes zebrafish cranial neural crest and extraocular muscle development to changes in retinoic acid and IGF signaling.

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    Brenda L Bohnsack

    Full Text Available 1-Phenyl 2-thiourea (PTU is a tyrosinase inhibitor commonly used to block pigmentation and aid visualization of zebrafish development. At the standard concentration of 0.003% (200 µM, PTU inhibits melanogenesis and reportedly has minimal other effects on zebrafish embryogenesis. We found that 0.003% PTU altered retinoic acid and insulin-like growth factor (IGF regulation of neural crest and mesodermal components of craniofacial development. Reduction of retinoic acid synthesis by the pan-aldehyde dehydrogenase inhibitor diethylbenzaldehyde, only when combined with 0.003% PTU, resulted in extraocular muscle disorganization. PTU also decreased retinoic acid-induced teratogenic effects on pharyngeal arch and jaw cartilage despite morphologically normal appearing PTU-treated controls. Furthermore, 0.003% PTU in combination with inhibition of IGF signaling through either morpholino knockdown or pharmacologic inhibition of tyrosine kinase receptor phosphorylation, disrupted jaw development and extraocular muscle organization. PTU in and of itself inhibited neural crest development at higher concentrations (0.03% and had the greatest inhibitory effect when added prior to 22 hours post fertilization (hpf. Addition of 0.003% PTU between 4 and 20 hpf decreased thyroxine (T4 in thyroid follicles in the nasopharynx of 96 hpf embryos. Treatment with exogenous triiodothyronine (T3 and T4 improved, but did not completely rescue, PTU-induced neural crest defects. Thus, PTU should be used with caution when studying zebrafish embryogenesis as it alters the threshold of different signaling pathways important during craniofacial development. The effects of PTU on neural crest development are partially caused by thyroid hormone signaling.

  19. Phenothiourea sensitizes zebrafish cranial neural crest and extraocular muscle development to changes in retinoic acid and IGF signaling.

    Science.gov (United States)

    Bohnsack, Brenda L; Gallina, Donika; Kahana, Alon

    2011-01-01

    1-Phenyl 2-thiourea (PTU) is a tyrosinase inhibitor commonly used to block pigmentation and aid visualization of zebrafish development. At the standard concentration of 0.003% (200 µM), PTU inhibits melanogenesis and reportedly has minimal other effects on zebrafish embryogenesis. We found that 0.003% PTU altered retinoic acid and insulin-like growth factor (IGF) regulation of neural crest and mesodermal components of craniofacial development. Reduction of retinoic acid synthesis by the pan-aldehyde dehydrogenase inhibitor diethylbenzaldehyde, only when combined with 0.003% PTU, resulted in extraocular muscle disorganization. PTU also decreased retinoic acid-induced teratogenic effects on pharyngeal arch and jaw cartilage despite morphologically normal appearing PTU-treated controls. Furthermore, 0.003% PTU in combination with inhibition of IGF signaling through either morpholino knockdown or pharmacologic inhibition of tyrosine kinase receptor phosphorylation, disrupted jaw development and extraocular muscle organization. PTU in and of itself inhibited neural crest development at higher concentrations (0.03%) and had the greatest inhibitory effect when added prior to 22 hours post fertilization (hpf). Addition of 0.003% PTU between 4 and 20 hpf decreased thyroxine (T4) in thyroid follicles in the nasopharynx of 96 hpf embryos. Treatment with exogenous triiodothyronine (T3) and T4 improved, but did not completely rescue, PTU-induced neural crest defects. Thus, PTU should be used with caution when studying zebrafish embryogenesis as it alters the threshold of different signaling pathways important during craniofacial development. The effects of PTU on neural crest development are partially caused by thyroid hormone signaling.

  20. A study of the pathological changes and expression of the hepatocyte growth factor in the extraocular muscle in concomitant strabismus%共同性斜视眼外肌的病理变化及肝细胞生长因子表达研究

    Institute of Scientific and Technical Information of China (English)

    罗琪; 周炼红; 易贝茜; 叶美红; 徐永红

    2015-01-01

    . Methods In a experimental study, 58 concomitant strabismus patients were recruited for the strabismus group and 10 normal subjects were recruited as the control group. Strabismus patients were divided into a concomitant exotropia group (32 cases) and a concomitant esotropia group (26 cases). All the resected tissues of the rectus muscles were obtained from patients with concomitant strabismus during resection surgery and corneal implants. The mean average optical density of HGF was measured by the SABC method for immunohistochemistry using an image analyzer. The amounts of HGF in the resected muscles of patients were compared with normal subjects , and correlated with factors such as age and degree of deviation in the clinical data of the patients. Results ①The thickness of the cross-sectional area of muscle fiber in the resected rectus muscles of patients with constant exotropia was 308.9 ±68.4 μm2 and for patients with constant esotropia was 217.9 ±34.7 μm2, which were significantly lower than those of normal subjects (t=16.74, 28.34, P<0.05). ②Masson staining showed that the weak side of the extraocular muscles of patients with concomitant strabismus had a decrease in the number of muscle fibers, an increase in collagen fiber content, and a disordered arrangement compared to the normal control group. ③The amount of HGF in the resected rectus muscles of patients with constant exotropia and constant esotropia were significantly lower than those of normal subjects (t=6.33, 4.75, P<0.05). ④The amount of HGF was negatively correlated with age and the degree of deviation (r=-0.856,-0.525, P<0.05). Conclusion A decreased level of HGF expression may contribute to the incidence of concomitant strabismus. The change in the expression of HGF in extraocular muscles may result in a deterioration of concomitant strabismus.

  1. Air Superiority Fighter Characteristics.

    Science.gov (United States)

    1998-06-05

    many a dispute could have been deflated into a single paragraph if the disputants had just dared to define their terms.7 Aristotle ...meaningful. This section will expand on some key ideology concepts. The phrase "air superiority fighter" may bring to mind visions of fighter... biographies are useful in garnering airpower advocate theories as well as identifying key characteristics. Air campaign results, starting with World

  2. Contabilidad Financiera Superior

    OpenAIRE

    Ipiñazar Petralanda, Izaskun

    2013-01-01

    Duración (en horas): De 31 a 40 horas. Destinatario: Estudiante y Docente A través de este material se presentan las pautas necesarias para implementar un aprendizaje basado en problemas en la asignatura de Contabilidad Financiera Superior dentro de los temas “Constitución de S.A. y S.R.L.” (Tema 2), “Ampliaciones de Capital” (Tema 3) y “Reducciones de Capital” (Tema 4). En primer lugar se presentan las guías generales de la asignatura, y a continuación, las diferentes activida...

  3. Contabilidad Financiera Superior

    OpenAIRE

    Ipiñazar Petralanda, Izaskun

    2013-01-01

    Duración (en horas): De 31 a 40 horas. Destinatario: Estudiante y Docente A través de este material se presentan las pautas necesarias para implementar un aprendizaje basado en problemas en la asignatura de Contabilidad Financiera Superior dentro de los temas “Constitución de S.A. y S.R.L.” (Tema 2), “Ampliaciones de Capital” (Tema 3) y “Reducciones de Capital” (Tema 4). En primer lugar se presentan las guías generales de la asignatura, y a continuación, las diferentes activida...

  4. An Uncommon Presentation of Spontaneous Rectus Sheath Hematoma with Acute Kidney Injury due to Obstructive Uropathy and Prerenal Azotemia

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    Eleni Paschou

    2014-01-01

    Full Text Available Rectus Sheath Hematoma (RSH represents an unusual entity which is characterized by acute abdominal pain and tender palpable abdominal mass usually, among elderly patients receiving anticoagulant therapy. We report the case of an 81-year-old woman admitted to our department due to acute abdominal pain and oligoanuria. The patient had recently been hospitalized due to acute myocardial infarction (AMI and atrial fibrillation (AF and received both anticoagulant and antiplatelet therapies. The radiological assessments revealed an extended Rectus Sheath Hematoma and bilateral hydronephrosis. Treatment of the hematoma required cessation of anticoagulants and antiplatelet agents, immobilization, blood and fresh frozen plasma transfusion, and administration of vasopressors. The patient recovered gradually and was discharged home fifteen (15 days later.

  5. EFFECTS OF 2-PAM AND EA 1814 ON NEUROMUSCULAR TRANSMISSION. I. EFFECTS OF 2-PAM AND EA 1814 ON THE FROG RECTUS ABDOMINIS MUSCLE PREPARATION

    Science.gov (United States)

    Contracture of the isolated frog Rectus abdominis muscle was used to study pharmacological properties of 2-PAM (2-pyridine aldoxime methiodide) and...example, concentrations of 2-PAM in excess of 4 x 10 to the -5th power M potentiate contractures of the frog rectus muscle elicited by acetylcholine...2-PAM inhibits the response to the depolarizing agents, decamethonium and carbamylcholine, which are not susceptible to hydrolysis by the ChE of frog

  6. Evaluation of periosteal fixation of lateral rectus and partial VRT for cases of exotropic Duane retraction syndrome

    Directory of Open Access Journals (Sweden)

    Pradeep Sharma

    2014-01-01

    Full Text Available Purpose: The purpose of this study is to evaluate the lateral rectus periosteal fixation and partial vertical rectus transpositioning (VRT as treatment modalities to correct exotropic Duane retraction syndrome (Exo-DRS. Materials and Methods: Prospective interventional case study of cases of Exo-DRS with limitation of adduction. A total of 13 patients were subdivided into two groups. Six patients underwent only lateral rectus periosteal fixation (group A and seven patients also underwent partial VRT (group B. Assessment involved prism bar cover test, abduction and adduction range, extent of binocular single visual field and exophthalmometry. These tests were repeated at 1 week, 1 month and 3 months post-operatively and data analyzed. Results: The pre-operative mean values and ranges were 26.2 Δ (22-35 exotropia for group A and −21.3 Δ (14-30 exotropia for group B. The post-operative mean and range was +0.6 Δ esotropia (+20 to −8 for group A and 8 Δ (−2 to −20 exotropia for group B. Mean grade of limitation of abduction changed from −3.8 to −3.6 versus −3.6 to −2.8 and mean grade of limitation of adduction changed from −1.9 to −0.7 versus −1.5 to −0.5 in the groups A and B respectively. Mean binocular single visual field changed from 14.7° to 23.3° in group A and 11.8° to 26.4° in the group B respectively. Conclusion: Lateral rectus periosteal fixation is an effective surgery to correct the exodeviation, anomalous head posture and improving adduction in Exo-DRS and partial VRT in addition is effective in improving abduction and binocular single visual fields.

  7. Single-stage maxillary and nasal floor reconstruction with the double-paddle rectus abdominis musculocutaneous free flap.

    Science.gov (United States)

    Herman, Charles K; Benacquista, Teresa; Brindzei, Nelya; Berdichevsky, Max; Baum, Thomas; Strauch, Berish

    2007-04-01

    Palatal integrity is essential for useful speech, deglutition, good oral hygiene, and prevention of nasal regurgitation. Maxillary defects after tumor extirpation, therefore, can have serious functional and cosmetic implications. Given the often disappointing results obtained with local and regional pedicled flaps for maxillary reconstruction, a variety of microvascular free flaps have been utilized in recent years, including the rectus abdominis, fibular, radial forearm, and latissimus dorsi flaps. Experience with these techniques has been documented in a limited number of case reports. We describe our single-stage approach to maxillary and nasal floor reconstruction with the double skin-paddle rectus abdominis musculocutaneous free flap. A series of five patients is presented; six of these immediate free flap reconstructions were performed for defects resulting from tumor resection. A vertical rectus abdominis musculocutaneous free flap was used in all cases, designing two separate skin paddles to accommodate the measured maxillary and nasal floor deficiencies. Anastomoses of the deep inferior epigastric artery and vena comitans were performed end-to-end to the facial artery and vein, respectively. In addition, orbital floor reconstruction with calvarial bone grafts or titanium mesh was performed in all five patients. Separation of the oral and nasal cavities was maintained postoperatively. No intraoperative complications, perioperative mortalities, flap losses, instances of skin paddle necrosis, hematomas, or oronasal fistulae were observed. One patient required bedside drainage of a surgical site abscess that resolved without adverse sequelae. Over the past 4 years, the double skin-paddle rectus abdominis musculocutaneous free flap has provided reliable results at our institution for single-stage reconstruction of maxillary and nasal floor defects. This reconstructive technique should be considered a viable method that can alleviate the functional and cosmetic

  8. A functional SNP in the regulatory region of the decay-accelerating factor gene associates with extraocular muscle pareses in myasthenia gravis

    OpenAIRE

    Heckmann, J M; Uwimpuhwe, H; Ballo, R; Kaur, M.; Bajic, V.B.; Prince, S.

    2009-01-01

    Complement activation in myasthenia gravis (MG) may damage muscle endplate and complement regulatory proteins such as decay-accelerating factor (DAF) or CD55 may be protective. We hypothesize that the increased prevalence of severe extraocular muscle (EOM) dysfunction among African MG subjects reported earlier may result from altered DAF expression. To test this hypothesis, we screened the DAF gene sequences relevant to the classical complement pathway and found an association between myasthe...

  9. Statistics of superior records

    Science.gov (United States)

    Ben-Naim, E.; Krapivsky, P. L.

    2013-08-01

    We study statistics of records in a sequence of random variables. These identical and independently distributed variables are drawn from the parent distribution ρ. The running record equals the maximum of all elements in the sequence up to a given point. We define a superior sequence as one where all running records are above the average record expected for the parent distribution ρ. We find that the fraction of superior sequences SN decays algebraically with sequence length N, SN˜N-β in the limit N→∞. Interestingly, the decay exponent β is nontrivial, being the root of an integral equation. For example, when ρ is a uniform distribution with compact support, we find β=0.450265. In general, the tail of the parent distribution governs the exponent β. We also consider the dual problem of inferior sequences, where all records are below average, and find that the fraction of inferior sequences IN decays algebraically, albeit with a different decay exponent, IN˜N-α. We use the above statistical measures to analyze earthquake data.

  10. Frenillo labial superior doble

    Directory of Open Access Journals (Sweden)

    Carlos Albornoz López del Castillo

    Full Text Available El frenillo labial superior doble no sindrómico es una anomalía del desarrollo que no hemos encontrado reportada en la revisión bibliográfica realizada. Se presenta una niña de 11 años de edad que fue remitida al servicio de Cirugía Maxilofacial del Hospital "Eduardo Agramonte Piña", de Camagüey, por presentar un frenillo labial superior doble de baja inserción. Se describen los síntomas clínicos asociados a esta anomalía y el tratamiento quirúrgico utilizado para su solución: una frenectomía y plastia sobre la banda muscular frénica anormal que provocaba exceso de tejido en la mucosa labial. Consideramos muy interesante la descripción de este caso, por no haber encontrado reporte similar en la literatura revisada.

  11. DOES RECTUS FEMORIS TRANSFER INCREASE KNEE FLEXION DURING STANCE PHASE IN CEREBRAL PALSY?

    Science.gov (United States)

    de Morais, Mauro César; Blumetti, Francesco Camara; Kawamura, Cátia Miyuki; Lopes, José Augusto Fernandes; Neves, Daniella Lins; Cardoso, Michelle de Oliveira

    2016-01-01

    ABSTRACT Objective: To evaluate whether distal rectus femoris transfer (DRFT) is related to postoperative increase of knee flexion during the stance phase in cerebral palsy (CP). Methods: The inclusion criteria were Gross Motor Function Classification System (GMFCS) levels I-III, kinematic criteria for stiff-knee gait at baseline, and individuals who underwent orthopaedic surgery and had gait analyses performed before and after intervention. The patients included were divided into the following two groups: NO-DRFT (133 patients), which included patients who underwent orthopaedic surgery without DRFT, and DRFT (83 patients), which included patients who underwent orthopaedic surgery that included DRFT. The primary outcome was to evaluate in each group if minimum knee flexion in stance phase (FMJFA) changed after treatment. Results: The mean FMJFA increased from 13.19° to 16.74° (p=0.003) and from 10.60° to 14.80° (p=0.001) in Groups NO-DRFT and DRFT, respectively. The post-operative FMJFA was similar between groups NO-DRFT and DRFT (p=0.534). The increase of FMJFA during the second exam (from 13.01° to 22.51°) was higher among the GMFCS III patients in the DRFT group (p<0.001). Conclusion: In this study, DRFT did not generate additional increase of knee flexion during stance phase when compared to the control group. Level of Evidence III, Retrospective Comparative Study. PMID:26997910

  12. Task-dependent spatial distribution of neural activation pattern in human rectus femoris muscle.

    Science.gov (United States)

    Watanabe, Kohei; Kouzaki, Motoki; Moritani, Toshio

    2012-04-01

    Compartmentalization of skeletal muscle by multiple motor nerve branches, named as neuromuscular compartment (NMC), has been demonstrated in animals as well as humans. While different functional roles among individual NMCs were reported in the animal studies, no studies have clarified the region-specific functional role within a muscle related with NMCs arrangement in human skeletal muscle. It was reported that the rectus femoris (RF) muscle is innervated by two nerve branches attached at proximal and distal parts of the muscle. The purpose of the present study is to clarify the possible region-specific functional role in the human RF muscle. Multi-channel surface electromyography (SEMG) were recorded from the RF muscle by using 128 electrodes during two different submaximal isometric contractions that the muscle contributes, i.e. isometric knee extension and hip flexion, at 20%, 40%, 60% and 80% of maximal voluntary contraction (MVC). Results indicated that the central locus activation for the amplitude map of SEMG during hip flexion located at more proximal region compared with that during knee extension. Significant higher normalized root mean square (RMS) values were observed at the proximal region during the hip flexion in comparison to those at middle and distal regions at 60% and 80% of MVC (pMVC (p<0.05). The results of the present study suggest possible region-specific functional role in the human RF muscle.

  13. Ultrasound Assessment of the Rectus Femoris Cross-Sectional Area: Subject Position Implications.

    Science.gov (United States)

    Hacker, Eileen Danaher; Peters, Tara; Garkova, Miglena

    2016-09-01

    Ultrasonic measurement of the rectus femoris (RF) is a novel, proxy measure for muscle strength. The impact of hip flexion/head of bed positioning on RF cross-sectional area (CSA) has not been fully explored. This study describes and compares differences in RF CSA across four degrees of hip flexion. This repeated-measures, comparative study enrolled healthy, pre-menopausal women (n = 20). RF CSA of the dominant leg was measured using the SonoSite M-Turbo ultrasound system with the head of bed at 0°, 20°, 30°, and 60°. One-way repeated measures indicated significant differences in RF CSA, F(3, 17) = 14.18, p < .001, with variation in hip flexion/head of bed elevation and significant RF CSA differences between: (a) 0° and 20°, (b) 0° and 30°, (c) 0° and 60°, and (d) 20° and 60°. Standardizing patient positioning when conducting ultrasonic measurement of RF CSA is vital for researchers who assess muscle mass.

  14. Closure and augmentation of bladder exstrophy using rectus abdominis musculo-peritoneal flap.

    Science.gov (United States)

    Agarwal, P

    2011-09-01

    The aim of this study was to investigate the efficacy of the rectus abdominis myo-peritoneal flap (RAMP) technique for the closure and augmentation of small, non-elastic, non-compliant bladder exstrophies. The RAMP technique was used in three boys with bladder exstrophy who presented late with small, non-elastic, non-compliant bladder. The clinical outcome, imaging, cystoscopy, biochemical and microbiological studies were assessed during a follow-up of 36 months. Bladder closure and augmentation was achieved in all patients without any complications. There were no urinary tract infections, metabolic problems or electrolyte disturbances and the kidney function remained normal in all patients. Radiography confirmed intact function and anatomy of the urinary tract and cystoscopy showed complete coverage of the inner peritoneal layer of RAMP with uroepithelium. No stone formation or mucous production was detected. The RAMP technique is a good alternative for closing bladder exstrophies and achieves an increase in bladder capacity and compliance. The technique is indicated in the closure of large bladder defects, bladder exstrophies with small, inelastic, non-compliant bladder remnants and failed primary closures.

  15. Closure and augmentation of bladder exstrophy using rectus abdominis musculo-peritoneal flap

    Directory of Open Access Journals (Sweden)

    P Agarwal

    2011-01-01

    Full Text Available Background: The aim of this study was to investigate the efficacy of the rectus abdominis myo-peritoneal flap (RAMP technique for the closure and augmentation of small, non-elastic, non-compliant bladder exstrophies. Materials and Methods: The RAMP technique was used in three boys with bladder exstrophy who presented late with small, non-elastic, non-compliant bladder. The clinical outcome, imaging, cystoscopy, biochemical and microbiological studies were assessed during a follow-up of 36 months. Results: Bladder closure and augmentation was achieved in all patients without any complications. There were no urinary tract infections, metabolic problems or electrolyte disturbances and the kidney function remained normal in all patients. Radiography confirmed intact function and anatomy of the urinary tract and cystoscopy showed complete coverage of the inner peritoneal layer of RAMP with uroepithelium. No stone formation or mucous production was detected. Conclusions: The RAMP technique is a good alternative for closing bladder exstrophies and achieves an increase in bladder capacity and compliance. The technique is indicated in the closure of large bladder defects, bladder exstrophies with small, inelastic, non-compliant bladder remnants and failed primary closures.

  16. In vivo measurement of dynamic rectus femoris function at postures representative of early swing phase.

    Science.gov (United States)

    Hernández, Antonio; Dhaher, Yasin; Thelen, Darryl G

    2008-01-01

    Forward dynamic models suggest that muscle-induced joint motions depend on dynamic coupling between body segments. As a result, biarticular muscles may exhibit non-intuitive behavior in which the induced joint motion is opposite to that assumed based on anatomy. Empirical validation of such predictions is important for models to be relied upon to characterize muscle function. In this study, we measured, in vivo, the hip and knee accelerations induced by electrical stimulation of the rectus femoris (RF) and the vastus medialis (VM) at postures representatives of the toe-off and early swing phases of the gait cycle. Seven healthy young subjects were positioned side-lying with their lower limb supported on air bearings while a 90 ms pulse train stimulated each muscle separately or simultaneously. Lower limb kinematics were measured and compared to predictions from a similarly configured dynamic model of the lower limb. We found that both RF and VM, when stimulated independently, accelerated the hip and knee into extension at these postures, consistent with model predictions. Predicted ratios of hip acceleration to knee acceleration were generally within 1 s.d. of average values. In addition, measured responses to simultaneous RF and VM stimulation were within 13% of predictions based on the assumption that joint accelerations induced by activating two muscles simultaneously can be found by adding the joint accelerations induced by activating the same muscles independently. These results provide empirical evidence of the importance of considering dynamic effects when interpreting the role of muscles in generating movement.

  17. Modified Vertical Rectus Abdominis Musculocutaneous Flap for Limb Salvage Procedures in Proximal Lower Limb Musculoskeletal Sarcomas

    Directory of Open Access Journals (Sweden)

    Haitham H. Khalil

    2008-01-01

    Full Text Available Introduction and aim. Management of complicated wounds after tumor extipiration of pelvic and proximal lower limb musculoskeletal sarcoma represents an essential component in the outcome of these patients. The authors present modified vertical rectus abdominis musculocutaneous (VRAM flap techniques to reconstruct extensive defects after debridment of these complicated wounds. Material and Methods. Over a period of 4 years (2002–2005, 5 men and 2 women were managed. Median age was 21 years (range 15–49. The patients were managed for complicated lower trunk, groin, and upper thigh wounds after resection of three pelvic chondrosarcomas as well as two pelvic and two proximal femur osteosarcomas. The modifications included a VRAM flap with lateral and tongue-like extension design of the skin paddle (5 cases or a delayed extended VRAM flap (2 cases. Results. All flaps showed complete survival and healing with no ischemic events providing stable coverage. All patients were ambulant with good limb functions in terms of walking and gait after adequate rehabilitation, 2 needed support with crutches. Conclusion. The modified VRAM flaps offer reliable reconstructive tools for coverage of complex groin and thigh defects by providing larger well-vascularized soft tissue with acceptable donor site.

  18. Value of Free-Run Electromyographic Monitoring of Extraocular Cranial Nerves during Expanded Endonasal Surgery (EES) of the Skull Base.

    Science.gov (United States)

    Thirumala, Parthasarathy D; Mohanraj, Santhosh Kumar; Habeych, Miguel; Wichman, Kelley; Chang, Yue-Fang; Gardner, Paul; Snyderman, Carl; Crammond, Donald J; Balzer, Jeffrey

    2013-06-01

    Objective To evaluate the value of free-run electromyography (f-EMG) monitoring of extraocular cranial nerves (EOCN) III, IV, and VI during expanded endonasal surgery (EES) of the skull base in reducing iatrogenic cranial nerve (CN) deficits. Design We retrospectively identified 200 patients out of 990 who had at least one EOCN monitored during EES. We further separated patients into groups according to the specific CN monitored. In each CN group, we classified patients who had significant (SG) f-EMG activity as Group I and those who did not as Group II. Results A total of 696 EOCNs were monitored. The number of muscles supplied by EOCNs that had SG f-EMG activity was 88, including CN III = 46, CN IV = 21, and CN VI = 21. There were two deficits involving CN VI in patients who had SG f-EMG activity during surgery. There were 14 deficits observed, including CN III = 3, CN IV = 2, and CN VI = 9 in patients who did not have SG f-EMG activity during surgery. Conclusions f-EMG monitoring of EOCN during EES can be useful in identifying the location of the nerve. It seems to have limited value in predicting postoperative neurological deficits. Future studies to evaluate the EMG of EOCN during EES need to be done with both f-EMG and triggered EMG.

  19. Association Between Rectus Abdominis Denervation and Ventilation Dysfunction in Patients with Amyotrophic Lateral Sclerosis

    Institute of Scientific and Technical Information of China (English)

    Hua-Gang Zhang; Shuo Zhang; Ying-Sheng Xu; Nan Zhang; Dong-Sheng Fan

    2016-01-01

    Background:Spontaneous potentials in electromyography (EMG) ofparaspinal muscles are associated with diaphragm denervation and,therefore,poor respiratory function in amyotrophic lateral sclerosis (ALS) is understandable.EMG changes in the rectus abdominis (RA)display an effect similar to those in paraspinal muscles with respect to the function of lower motor neurons in the thoracic spinal cord.The RA denervation was examined to determine its association with ventilation dysfunction in ALS.Methods:We collected the clinical data of 128 patients with sporadic ALS in Department of Neurology of Peking University Third Hospital from 2009 to 2013.EMG,Revised ALS Functional Rating Scale (ALSFRS-R) and forced vital capacity (FVC) were performed in all patients and the differences in the EMG changes in RA between those with and without FVC ≥ 80% were analysed.Results:The mean FVC value was 83.4% ± 17.1% (range:45%-131%) of the predicted value.A total of 79 patients displayed FVC ≥80%,and 49 patients displayed FVC <80%.Compared with the patients displaying a normal FVC (60/79,75.9%),spontaneous activity in RA was significantly different among those patients displaying an FVC <80% (47/49,95.9%).In addition,spontaneous potentials in RA were more frequently detected in patients exhibiting dyspnea (32/33,97.0%) than in patients without dyspnea (75/95,78.9%).Conclusion:Spontaneous potentials in RA are associated with ventilation dysfunction and dyspnea in ALS patients.

  20. Pelvic floor reconstruction by modified rectus abdominis myoperitoneal (MRAM) flap after pelvic exenterations.

    Science.gov (United States)

    Cibula, D; Zikan, M; Fischerova, D; Kocian, R; Germanova, A; Burgetova, A; Dusek, L; Fartáková, Z; Schneiderová, M; Nemejcová, K; Slama, J

    2017-03-01

    To describe the technique and report experiences with pelvic floor reconstruction by modified rectus abdominis myoperitoneal (MRAM) flap after extensive pelvic procedures. Surgical technique of MRAM harvest and transposition is carefully described. The patients in whom pelvic floor reconstruction with MRAM after either infralevator pelvic exenteration and/or extended lateral pelvic sidewall excision was carried out were enrolled into the study (MRAM group, n=16). Surgical data, post-operative morbidity, and disease status were retrospectively assessed. The results were compared with a historical cohort of patients, in whom an exenterative procedure without pelvic floor reconstruction was performed at the same institution (control group, n=24). Both groups were balanced in age, BMI, tumor types, and previous treatment. Substantially less patients from the MRAM group required reoperation within 60days of the surgery (25% vs. 50%) which was due to much lower rate of complications potentially related to empty pelvis syndrome (1 vs. 7 reoperations) (p=0.114). Late post-operative complication rate was substantially lower in the MRAM group (any grade: 79% vs. 44%; grade≥3: 37% vs. 6%) (p=0.041). The performance status 6months after the surgery was ≤1 in the majority of patients in MRAM (81%) while in only 38% of patients from the control group (p=0.027). There was one incisional hernia in MRAM group while three cases were reported in the controls. Pelvic floor reconstruction by MRAM in patients after pelvic exenterative procedures is associated with a substantial decrease in postoperative complications that are potentially related to empty pelvis syndrome. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Tensiomyographic Characteristics of Rectus Femoris after a Single Bout of Intense Exercise

    Directory of Open Access Journals (Sweden)

    Luis C Paez

    2011-01-01

    Full Text Available Problem statement: It is not well known how local fatigue can impair the contractile properties of skeletal muscle, so the aim of this study was to determine the Tensiomyographic (TMG characteristics of Rectus Femoris (RF after a single bout of intense exercise. Approach: Twelve healthy male volunteers (mean±SEM; age, 24.16±0.62 years, height 172.02±1.21 cm, body mass 71.84±2.19 kg, BMI 24.42±0.70 kg m- were recruited. Results: In session 1, a graded exercise test on cycle ergometer was performed in order to determine subject’s maximal oxygen uptake (VO2max and power at this key point (pVO2max. In a second testing session, TMG rest values were assessed and then all subjects carried out 2 min of cycling at pVO2max after which TMG analysis was applied again. The results showed subject’s VO2max values of 53.44±2.67 ml kg-1 min-1 reaching a mean pVO2max of 270.83±8.61 W. Maximal radial displacement (Dm and time from the onset of electrical stimulus to 10% of Dm (Td were significantly lower at post-test (from 7.577.57±0.92-4.37±0.67 mm; p = 0.01, for Dm and from 25.25±0.57-22.44±0.89 ms; p≤0.05, for Td. Conclusion/Recommendations: It can be concluded that a brief and intense exercise consisting in 2 min of cycling at PVO2max provokes a reduction in contractile properties of RF considering TMG parameters such as Dm and Td. More studies are needed to clarify the role of muscle fatigue on temporal TMG parameters.

  2. Sobredentadura total superior implantosoportada

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.

  3. The Role of Thyroid Eye Disease and Other Factors in the Overcorrection of Hypotropia Following Unilateral Adjustable Suture Recession of the Inferior Rectus (An American Ophthalmological Society Thesis)

    Science.gov (United States)

    Kerr, Natalie C.

    2011-01-01

    Purpose Overcorrection of hypotropia subsequent to adjustable suture surgery following inferior rectus recession is undesirable, often resulting in persistent diplopia and reoperation. I hypothesized that overcorrection shift after suture adjustment may be unique to thyroid eye disease, and the use of a nonabsorbable suture may reduce the occurrence of overcorrection. Methods A retrospective chart review of adult patients who had undergone eye muscle surgery with an adjustable suture technique was performed. Overcorrection shifts that occurred between the time of suture adjustment and 2 months postoperatively were examined. Descriptive statistics, linear regression, Anderson-Darling tests, generalized Pareto distributions, odds ratios, and Fisher tests were performed for two overcorrection shift thresholds (>2 and >5 prism diopters [PD]). Results Seventy-seven patients were found: 34 had thyroid eye disease and inferior rectus recession, 30 had no thyroid eye disease and inferior rectus recession, and 13 patients had thyroid eye disease and medial rectus recession. Eighteen cases exceeded the 2 PD threshold, and 12 exceeded the 5 PD threshold. Statistical analyses indicated that overcorrection was associated with thyroid eye disease (P=6.7E-06), inferior rectus surgery (P=6.7E-06), and absorbable sutures (>2 PD: OR=3.7, 95% CI=0.4–35.0, P=0.19; and >5 PD: OR=6.0, 95% CI=1.1–33.5, P=0.041). Conclusions After unilateral muscle recession for hypotropia, overcorrection shifts are associated with thyroid eye disease, surgery of the inferior rectus, and use of absorbable sutures. Surgeons performing unilateral inferior rectus recession on adjustable suture in the setting of thyroid eye disease should consider using a nonabsorbable suture to reduce the incidence of postoperative overcorrection. PMID:22253487

  4. Are knee kinematic anomalies in swing due to rectus femoris spasticity different from those due to femoral anteversion in children with cerebral palsy? A quantitative evaluation using 3D gait analysis.

    Science.gov (United States)

    Cimolin, Veronica; Piccinini, Luigi; Turconi, Anna Carla; Crivellini, Marcello; Galli, Manuela

    2010-05-01

    Quantitative comparison of gait strategy between stiff knee gait caused by rectus femoris spasticity versus that caused by femoral anteversion was the objective of this study. Twenty-three diplegic were divided into group 1 (excessive femoral anteversion without rectus femoris spasticity) and group 2 (normal femoral anteversion and rectus femoris spasticity). Both groups showed low knee flexion during swing (KMSw), but although group 1 exhibited normal KMSw timing and high hip intrarotation, group 2 presented delayed KMSw timing, with normal hip rotation. Reduced KMSw may be because of two different conditions: excessive femoral anteversion, leading only to KMSw reduction, and rectus femoris spasticity, inducing coexistence of reduced KMSw and its delayed timing.

  5. Rectus muscle excyclorotation and V-pattern strabismus: a quantitative appraisal of clinical relevance in syndromic craniosynostosis.

    Science.gov (United States)

    Dagi, Linda R; MacKinnon, Sarah; Zurakowski, David; Prabhu, Sanjay P

    2017-03-20

    V-pattern strabismus observed with syndromic craniosynostosis has been attributed to disparate causes. We compared severity of V pattern with degree of excyclorotation of rectus muscles to appraise significance of this proposed aetiology. 43 patients with Apert, Crouzon or Pfeiffer syndrome referred to Boston Children's Hospital Department of Ophthalmology were identified. 28 met inclusion criteria for retrospective cohort study, specifically: (1) sensorimotor measurements in minimum of seven cardinal gazes, (2) quantified fundus torsion and (3) orbital CT imaging sufficient to measure rectus muscle cyclorotation in coronal and quasicoronal planes, posteriorly (near orbital apex) and anteriorly (near pulleys). Patients were placed in one of four V-pattern severity groups. The most severe group demonstrated inability to elevate abducted eye above midline with characteristic 'seesaw' misalignment during horizontal saccades. Rectus muscle cyclorotation was measured by paediatric neuroradiologist blinded to group placement. Primary outcome was correlation of severity of V pattern with degree of excyclorotation. Secondary outcome was correlation of severity with craniosynostosis syndrome. Increasing severity of V pattern correlated with greater excyclorotation in anterior coronal (p=0.009), anterior quasicoronal (p=0.021), posterior coronal (p=0.014) and posterior quasicoronal (p=0.040) planes for moderate-to-severe V pattern. Even greater excyclorotation was associated with seesaw V pattern in anterior quasicoronal (p=0.004) and posterior quasicoronal (p=0.001) views. Highly significant association was found between Apert syndrome and severity of V pattern (p=0.004). Severity of V pattern is associated with magnitude of excyclorotation. More severe V pattern and seesaw strabismus noted with Apert syndrome may relate to distinctive orbital morphology. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please

  6. Near-real time oculodynamic MRI: a feasibility study for evaluation of diplopia in comparison with clinical testing

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Isabelle; Schwenzer-Zimmerer, Katja; Zeilhofer, Hans-Florian; Kunz, Christoph [University Hospital Basel, Hightech Research Center of Cranio-Maxillofacial Surgery and Dept. of Cranio-Maxillofacial Surgery, Basel (Switzerland); Palmowski-Wolfe, Anja [University of Basel, Department of Ophthalmology, Basel (Switzerland); Kober, Cornelia [HAW Hamburg, Faculty of Life Sciences, Hamburg (Germany); Radue, Ernst-Wilhelm [University Hospital Basel, Department of Neuroradiology, Basel (Switzerland); Scheffler, Klaus [University Hospital Basel, Division of Radiological Physics, Basel (Switzerland); Buitrago-Tellez, Carlos [Hightech Research Center of Cranio-Maxillofacial Surgery, Spital Zofingen AG, Institute of Radiology, Zofingen (Switzerland); University Hospital Basel, Zofingen (Switzerland)

    2012-02-15

    To demonstrate feasibility of near-real-time oculodynamic magnetic resonance imaging (od-MRI) in depicting extraocular muscles and correlate quantitatively the motion degree in comparison with clinical testing in patients with diplopia. In 30 od-MRIs eye movements were tracked in the horizontal and sagittal plane using a a TrueFISP sequence with high temporal resolution. Three physicians graded the visibility of extraocular muscles by a qualitative scale. In 12 cases, the maximal monocular excursions in the horizontal and vertical direction of both eyes were measured in od-MRIs and a clinical test and correlated by the Pearson test. The medial and lateral rectus muscles were visible in the axial plane in 93% of the cases. The oblique, superior and inferior rectus muscles were overall only in 14% visible. Horizontal (p = 0,015) and vertical (p = 0,029) movements of the right eye and vertical movement of the left eye (p = 0,026) measured by od-MRI correlated positively to the clinical measurements. Od-MRI is a feasible technique. Visualization of the horizontal/vertical rectus muscles is better than for the superior/inferior oblique muscle. Od-MRI correlates well with clinical testing and may reproduce the extent of eye bulb motility and extraocular muscle structural or functional deteriorations. (orig.)

  7. Myostatin shows a specific expression pattern in pig skeletal and extraocular muscles during pre- and post-natal growth.

    Science.gov (United States)

    Patruno, Marco; Caliaro, Francesca; Maccatrozzo, Lisa; Sacchetto, Roberta; Martinello, Tiziana; Toniolo, Luana; Reggiani, Carlo; Mascarello, Francesco

    2008-02-01

    Myogenesis is driven by an extraordinary array of cellular signals that follow a common expression pattern among different animal phyla. Myostatin (mstn) is a secreted growth factor that plays a pivotal role in skeletal muscle mass regulation. The aim of the present study was to investigate mstn expression in a large mammal (the pig) in order to ascertain whether distinct expression changes of this factor might be linked to the fiber-type composition of the muscle examined and/or to specific developmental stages. To assess the expression pattern of mstn in relation to myogenic proliferative (Pax7 and MyoD) and differentiative (myogenin) markers, we evaluated muscles with different myosin heavy-chain compositions sampled during pre- and post-natal development and on myogenic cells isolated from the same muscles. Skeletal muscles showed higher levels of mRNA for mstn and all other genes examined during fetal development than after birth. The wide distribution of mstn was also confirmed by immunohistochemistry experiments supporting evidence for cytoplasmic staining in early fetal periods as well as the localization in type 1 fibers at the end of the gestation period. Extraocular muscles, in contrast, did not exhibit decreasing mRNA levels for mstn or other genes even in adult samples and expressed higher levels of both mstn mRNA and protein compared with skeletal muscles. Experiments carried out on myogenic cells showed that mstn mRNA levels decreased when myoblasts entered the differentiation program and that cells isolated at early post-natal stages maintained a high level of Pax7 expression. Our results showed that mstn had a specific expression pattern whose variations depended on the muscle type examined, thus supporting the hypothesis that at birth, porcine myogenic cells continue to be influenced by hyperplastic/proliferative mechanisms.

  8. Conserved and muscle-group-specific gene expression patterns shape postnatal development of the novel extraocular muscle phenotype.

    Science.gov (United States)

    Cheng, Georgiana; Merriam, Anita P; Gong, Bendi; Leahy, Patrick; Khanna, Sangeeta; Porter, John D

    2004-07-08

    Current models in skeletal muscle biology do not fully account for the breadth, causes, and consequences of phenotypic variation among skeletal muscle groups. The muscle allotype concept arose to explain frank differences between limb, masticatory, and extraocular (EOM) muscles, but there is little understanding of the developmental regulation of the skeletal muscle phenotypic range. Here, we used morphological and DNA microarray analyses to generate a comprehensive temporal profile for rat EOM development. Based upon coordinate regulation of morphologic/gene expression traits with key events in visual, vestibular, and oculomotor system development, we propose a model that the EOM phenotype is a consequence of extrinsic factors that are unique to its local environment and sensory-motor control system, acting upon a novel myoblast lineage. We identified a broad spectrum of differences between the postnatal transcriptional patterns of EOM and limb muscle allotypes, including numerous transcripts not traditionally associated with muscle fiber/group differences. Several transcription factors were differentially regulated and may be responsible for signaling muscle allotype specificity. Significant differences in cellular energetic mechanisms defined the EOM and limb allotypes. The allotypes were divergent in many other functional transcript classes that remain to be further explored. Taken together, we suggest that the EOM allotype is the consequence of tissue-specific mechanisms that direct expression of a limited number of EOM-specific transcripts and broader, incremental differences in transcripts that are conserved by the two allotypes. This represents an important first step in dissecting allotype-specific regulatory mechanisms that may, in turn, explain differential muscle group sensitivity to a variety of metabolic and neuromuscular diseases.

  9. Functional Reconstruction of a Combined Tendocutaneous Defect of the Achilles Using a Segmental Rectus Femoris Myofascial Construct: A Viable Alternative

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    Michael Vincent DeFazio

    2014-05-01

    Full Text Available The composite anterolateral thigh flap with vascularized fascia lata has emerged as a workhorse at our institution for complex Achilles defects requiring both tendon and soft tissue reconstruction. Safe elevation of this flap, however, is occasionally challenged by absent or inadequate perforators supplying the anterolateral thigh. When discovered intraoperatively, alternative options derived from the same vascular network can be pursued. We present the case of a 74-year-old male who underwent composite Achilles defect reconstruction using a segmental rectus femoris myofascial free flap. Following graduated rehabilitation, postoperatively, the patient resumed full activity and was able to ambulate on his tip-toes. At 1-year follow-up, active total range of motion of the reconstructed ankle exceeded 85% of the unaffected side, and donor site morbidity was negligible. American Orthopaedic Foot and Ankle Society and Short Form-36 scores improved by 78.8% and 28.8%, respectively, compared to preoperative baseline assessments. Based on our findings, we advocate for use of the combined rectus femoris myofascial free flap as a rescue option for reconstructing composite Achilles tendon/posterior leg defects in the setting of inadequate anterolateral thigh perforators. To our knowledge, this is the first report to describe use of this flap for such an indication.

  10. Inferior oblique muscle paresis as a sign of myasthenia gravis.

    Science.gov (United States)

    Almog, Yehoshua; Ben-David, Merav; Nemet, Arie Y

    2016-03-01

    Myasthenia gravis may affect any of the six extra-ocular muscles, masquerading as any type of ocular motor pathology. The frequency of involvement of each muscle is not well established in the medical literature. This study was designed to determine whether a specific muscle or combination of muscles tends to be predominantly affected. This retrospective review included 30 patients with a clinical diagnosis of myasthenia gravis who had extra-ocular muscle involvement with diplopia at presentation. The diagnosis was confirmed by at least one of the following tests: Tensilon test, acetylcholine receptor antibodies, thymoma on chest CT scan, or suggestive electromyography. Frequency of involvement of each muscle in this cohort was inferior oblique 19 (63.3%), lateral rectus nine (30%), superior rectus four (13.3%), inferior rectus six (20%), medial rectus four (13.3%), and superior oblique three (10%). The inferior oblique was involved more often than any other muscle (pmyasthenia gravis can be difficult, because the disease may mimic every pupil-sparing pattern of ocular misalignment. In addition diplopia caused by paresis of the inferior oblique muscle is rarely encountered (other than as a part of oculomotor nerve palsy). Hence, when a patient presents with vertical diplopia resulting from an isolated inferior oblique palsy, myasthenic etiology should be highly suspected.

  11. Preservation of venous outflow improves transverse rectus abdominis musculocutaneous flap survival following vascular delay.

    Science.gov (United States)

    Tsoutsos, D; Gravvanis, A; Kakagia, D; Ghali, S; Papalois, A

    2009-01-01

    The rat abdominal island model has proved to be a reliable and reproducible model for the study of surgical delay procedures. It has been customary to simultaneously divide both the artery and the accompanying vein to obtain maximum survival of the rat TRAM flap undergoing delay procedure. This study evaluates the effect of selective arterial interruption compared to standard vascular delay on flap survival in the rat TRAM flap model. Thirty-six Wistar rats were randomly assigned to three groups (n=12), depending on the vascular ligation selected for the initial experimental delay stage. In group A (control group) no vessels were ligated. In group B the right deep inferior epigastric vessels were preserved and the right superior and left inferior and superior deep vessels were ligated. In group C the right inferior epigastric vessels and the left inferior epigastric vein were preserved while superior epigastric vessels and the left inferior epigastric artery were ligated. For the second stage one week later, TRAM flaps were elevated based on the right deep inferior epigastric vessels, re-inset in their original position and digitally photographed. Skin island viability was determined 96 hours later using digital photography and image-analysis software SigmaScan (SPSS, Inc., Chicago, IL). The percentage of flap survival in control group A was 50+/-6%, in group B 60+/-4% and in group C 85+/-4%. The occlusion of the three vascular pairs in group B improved the survival percentage in comparison to the control group A, but this did not achieve statistical significance. In contrast, the percentage of flap survival in control group C was statistically significant compared to groups A and B (p<0.05, ANOVA). Zone IV exhibited no necrosis in any group C animals. This indicates that delay with preservation of the venous outflow of zone IV results in increased blood supply.

  12. Immediate electromyographic changes of the biceps brachii and upper rectus abdominis muscles due to the Pilates centring technique.

    Science.gov (United States)

    Barbosa, Alexandre Wesley Carvalho; Martins, Fábio Luiz Mendonça; Vitorino, Débora Fernandes de Melo; Barbosa, Michelle Cristina Sales Almeida

    2013-07-01

    To evaluate the electrical behaviour of the biceps brachii (BB) and upper rectus abdominis (URA) by surface electromyography (sEMG) during a forearm flexion with and without the Pilates centring technique. Ten female subjects (with a minimum of one week of experience with the Pilates method) were recruited. The long head of the BB and URA were evaluated while an isotonic contraction of the BB was performed using the Pilates breathing technique and powerhouse contraction, followed by another contraction without these techniques. The data were normalised by a maximal voluntary isometric contraction. Normality was accepted, and the paired t-test was used to determine data differences (p concentric compared to the eccentric phase. In addition, this last phase, the centring activation was greater than without the Pilates technique. The Pilates method seems to influence the increase in BB activity during dynamic contraction, especially during the eccentric phase. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Medial rectus muscle myositis as an atypical presentation of mucosa-associated lymphatic tissue lymphoma: a case report

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    Juliana Sá Freire Medrado Dias

    2014-04-01

    Full Text Available Here we describe the rare case of a 55-year-old man with medial rectus muscle myositis as an atypical presentation of non-Hodgkin B-cell mucosa-associated lymphoma (MALT. Pathology and immunohistochemistry of the affected muscle confirmed the diagnosis of a neoplasm. The primary etiology of orbital myositis is Graves' ophthalmopathy, but several other diseases may cause this clinical presentation. Therefore, the neoplastic causes must be eliminated from the differential diagnoses. non-Hodgkin B-cell mucosa-associated lymphoma is the most common histological type of lymphoma in the orbit, with the conjunctiva and lacrimal glands being the most commonly affected sites. However, it may also present in atypical forms involving others sites and tissues.

  14. Does the GMFCS level influence the improvement in knee range of motion after rectus femoris transfer in cerebral palsy?

    Science.gov (United States)

    Blumetti, Francesco C; Morais Filho, Mauro C; Kawamura, Cátia M; Cardoso, Michelle O; Neves, Daniella L; Fujino, Marcelo H; Lopes, José Augusto F

    2015-09-01

    The aim of this study was to evaluate the influence of the Gross Motor Function Classification System (GMFCS) on the outcomes of rectus femoris transfer (RFT) for patients with cerebral palsy and stiff knee gait. We performed a retrospective review of patients seen at our gait laboratory from 1996 to 2013. Inclusion criteria were (i) spastic diplegic cerebral palsy, (ii) GMFCS levels I-III, (iii) reduced peak knee flexion in swing (PKFSwGMFCS levels I and II. In the non-RFT group, no improvement in KROM was observed in any GMFCS level. In this study, patients at GMFCS levels I and II were more likely to benefit from the RFT procedure.

  15. Lengthening the pedicle of the rectus abdominis myocutaneous flap for repair of upper chest and neck defects.

    Science.gov (United States)

    Zhang, J Q; Zhang, J M; Liang, W Q; Ji, C Y; Chen, Y H

    2017-07-01

    INTRODUCTION The aim of this study was to investigate whether the pedicle of the rectus abdominis flap can be lengthened by resecting the inferior costal cartilage segments or associated muscle when repairing upper body defects. A formula was generated that calculates the expected increase in pedicle length. METHODS Thirty patients underwent computed tomography. The width and thickness of the third to seventh inferior costal cartilage segments as well as the width of the respective intercostal spaces were recorded. Four patients underwent reconstruction of an upper body defect with the relevant flap. RESULTS The expected mean increases in pedicle length were 4.07cm (standard deviation [SD]: 0.31cm) and 4.63cm (SD: 0.54cm) following resection of the left and right sides respectively of the seventh inferior costal cartilage segment, 7.99cm (SD: 0.49cm) and 10.82cm (SD: 0.23cm) following resection of the left and right sides respectively of the sixth and seventh inferior costal cartilage segments while resection of the fourth to seventh inferior costal cartilage segments would equate to increases of 17.48cm (SD: 0.62cm) and 22.05cm (SD: 0.21cm) for the left and right sides respectively. In four patients who required reconstruction, three flaps survived without problems but one flap developed partial necrosis. CONCLUSIONS Resecting inferior costal cartilage segments or associated muscle can lengthen the pedicle of the rectus abdominis flap for reconstruction of defects on the upper chest and neck.

  16. Oncological safety of immediate rectus abdominis myocutaneous breast reconstruction in patients with locally advanced disease (stage IIb and III

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    Mushtaq Mir

    2013-01-01

    Full Text Available Background: The management of locally advanced (Stage IIb and III breast cancer is challenging. It often includes multimodal treatment with systemic therapy and/or radiation therapy and surgery. Immediate breast reconstruction has not traditionally been performed in these patients. We review the results of immediate rectus abdominis musculo-cutaneous (TRAM/VRAM flap in 60 patients treated for Stage IIb and III breast cancer. Materials and Methods: Data were collected prospectively on 60 patients diagnosed with Stage IIb (32 patients and Stage III (28 patients breast cancer between May 2008 and May 2012. All patients had mastectomy and immediate rectus abdominis myocutaneous reconstruction (TRAM in 40 patients and VRAM in 20 patients. All patients received primary systemic therapy, and all patients received postoperative radiotherapy to the operative site. Results: Mean age was 40.13 (range 28-53 years, mean hospital stay was 8.86 days and mean follow-up for the group was 28 months. Neither of them developed local disease recurrence in the operative site till the last follow-up. Eight (13.3% patients had some delay in chemo-radiation therapy due to flap-related complications. Flap-related complications were present in eight patients (partial flap failure in four and superficial skin necrosis in four. There was no adverse effect of chemo-radiation therapy on reconstructed breast. Conclusion: Immediate TRAM/VRAM breast reconstruction for locally advanced breast cancer is not associated with a significant delay in adjuvant therapy or an increased risk of local relapse. Radiation therapy can be delivered to the reconstructed breast when indicated without difficulty. Breast reconstruction facilitates surgical resection of locally advanced breast cancer with primary closure and should be considered if the patient desires immediate breast reconstruction.

  17. Effects of barbell deadlift training on submaximal motor unit firing rates for the vastus lateralis and rectus femoris.

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    Matt S Stock

    Full Text Available Previous investigations that have studied motor unit firing rates following strength training have been limited to small muscles, isometric training, or interventions involving exercise machines. We examined the effects of ten weeks of supervised barbell deadlift training on motor unit firing rates for the vastus lateralis and rectus femoris during a 50% maximum voluntary contraction (MVC assessment. Twenty-four previously untrained men (mean age  = 24 years were randomly assigned to training (n = 15 or control (n = 9 groups. Before and following the intervention, the subjects performed isometric testing of the right knee extensors while bipolar surface electromyographic signals were detected from the two muscles. The signals were decomposed into their constituent motor unit action potential trains, and motor units that demonstrated accuracy levels less than 92.0% were not considered for analysis. One thousand eight hundred ninety-two and 2,013 motor units were examined for the vastus lateralis and rectus femoris, respectively. Regression analyses were used to determine the linear slope coefficients (pulses per second [pps]/% MVC and y-intercepts (pps of the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. Deadlift training significantly improved knee extensor MVC force (Cohen's d = .70, but did not influence force steadiness. Training had no influence on the slopes and y-intercepts for the mean firing rate and firing rate at recruitment versus recruitment threshold relationships. In agreement with previous cross-sectional comparisons and randomized control trials, our findings do not support the notion that strength training affects the submaximal control of motor units.

  18. 75 FR 28542 - Superior Resource Advisory Committee

    Science.gov (United States)

    2010-05-21

    ... orient the new Superior Resource Advisory Committee members on their roles and responsibilities. DATES... of the roles and responsibilities of the Superior Resource Advisory Committee members; Election of... Forest Service Superior Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice...

  19. [The superior laryngeal nerve and the superior laryngeal artery].

    Science.gov (United States)

    Lang, J; Nachbaur, S; Fischer, K; Vogel, E

    1987-01-01

    Length, diameter and anastomoses of the nervus vagus and its ganglion inferius were measured 44 halved heads. On the average, 8.65 fiber bundles of the vagus nerve leave the retro-olivary area. In the area of the jugular foramen is the near superior ganglion of the 10th cranial nerve. In this area were found 1.48 (mean value) anastomoses with the 9th cranial nerve. 11.34 mm below the margo terminalis sigmoidea branches off the ramus internus of the accessory nerve which has a length of 9.75 mm. Further anastomoses with the 10th cranial nerve were found. The inferior ganglion of the 10th nerve had a length of 25.47 mm and a diameter of 3.46 mm. Five mm below the ganglion the 10th nerve had a width of 2.9 and a thickness of 1.5 mm. The mean length of the superior sympathetic ganglion was 26.6 mm, its width 7.2 and its thickness 3.4 mm. In nearly all specimens anastomoses of the superior sympathetic ganglion with the ansa cervicalis profunda and the inferior ganglion of the 10th cranial nerve were found. The superior laryngeal nerve branches off about 36 mm below the margo terminalis sigmoidea. The width of this nerve was 1.9 mm, its thickness 0.8 mm on the right and 1.0 mm on the left side. The division in the internal and external rami was found about 21 mm below its origin. Between the n. vagus and thyreohyoid membrane the ramus internus had a length of 64 mm, the length of external ramus between the vagal nerve and the inferior pharyngeal constrictor muscle was 89 mm. Its mean length below the thyreopharyngeal part was 10.7 mm, 8.6 branchlets to the cricothyroid muscle were counted. The superior laryngeal artery had its origin in 80% of cases in the superior thyroideal artery, in 6.8% this vessel was a branch of the external carotid artery. Its average outer diameter was 1.23 mm on the right side and 1.39 mm on the left. The length of this vessel between its origin and the thyreohyoid membrane was 34 mm. In 7% on the right side and in 13% on the left, the superior

  20. Inferior oblique weakening surgery on ocular torsion in congenital superior oblique palsy

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    Jinho Lee

    2015-06-01

    Full Text Available AIM:To investigate changes in fundus excyclotorsion after inferior oblique myectomy or myotomy.METHODS:The records of 21 patients undergoing strabismus surgery by a single surgeon between 2009 and 2012 were examined. Only patients who had undergone an inferior oblique myectomy or myotomy, with or without horizontal rectus muscle surgery, were evaluated. Digital fundus photographs were obtained, and the angle formed by a horizontal line passing through the optic disc center and a reference line connecting the foveola and optic disc center was measured. Associated clinical factors examined include age at the time of surgery, presence or absence of a head tilt, degree of preoperative vertical deviation, torsional angle, inferior oblique muscle overaction/superior oblique muscle underaction, and surgery laterality. Whether the procedure was performed alone or in combination with a horizontal rectus muscle surgery was also examined.RESULTS:Mean preoperative torsional angle was 12.0±6.4°, which decreased to 6.9±5.7° after surgery (P<0.001, paired t-test. Torsional angle also decreased from 15.1±7.0° to 6.2±4.3° in the myectomy group (P<0.001, paired t-test but there were no significant changes in the myotomy group (P=0.093, Wilcoxon signed rank test. Multivariable linear regression analysis showed that preoperative torsional angle, degree of inferior oblique overaction, and age at surgery independently and significantly affected postoperative torsional angle.CONCLUSION:Mean torsional angle decreased after inferior oblique myectomy. Degree of preoperative torsional angle, inferior oblique overaction, and age at surgery influence postoperative torsional angle.

  1. What are Millian Qualitative Superiorities?

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    Jonathan Riley

    2008-04-01

    Full Text Available In an article published in Prolegomena 2006, Christoph Schmidt-Petri has defended his interpretation and attacked mine of Mill’s idea that higher kinds of pleasure are superior in quality to lower kinds, regardless of quantity. Millian qualitative superiorities as I understand them are infinite superiorities. In this paper, I clarify my interpretation and show how Schmidt-Petri has misrepresented it and ignored the obvious textual support for it. As a result, he fails to understand how genuine Millian qualitative superiorities determine the novel structure of Mill’s pluralistic utilitarianism, in which a social code of justice that distributes equal rights and duties takes absolute priority over competing considerations. Schmidt-Petri’s own interpretation is a non-starter, because it does noteven recognize that Mill is talking about different kinds of pleasant feelings, such that the higher kinds are intrinsically more valuable than the lower. I conclude by outlining why my interpretation is free of any metaphysical commitment to the “essence” of pleasure.

  2. Isolated superior mesenteric artery dissection

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    Lalitha Palle

    2010-01-01

    Full Text Available Isolated superior mesenteric artery (SMA dissection without involvement of the aorta and the SMA origin is unusual. We present a case of an elderly gentleman who had chronic abdominal pain, worse after meals. CT angiography, performed on a 64-slice CT scanner, revealed SMA dissection with a thrombus. A large artery of Drummond was also seen. The patient was managed conservatively.

  3. A escrita no Ensino Superior

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    Maria Conceição Pillon Christofoli

    2013-01-01

    Full Text Available http://dx.doi.org/10.5902/198464445865 O presente artigo trata de apresentar resultados oriundos de pesquisa realizada no Ensino Superior, enfocando a escrita em contextos universitários. Depoimentos por parte dos acadêmicos evidenciam certa resistência ao ato de escrever, o que acaba muitas vezes distanciando o sujeito da produção de um texto. Assim sendo, mesmo que parciais, os resultados até então analisados dão conta de que: pressuposto 1 – há ruptura da ideia de coerência entre o que pensamos, o que conseguimos escrever, o que entende nosso interlocutor; pressuposto 2 – a autocorreção de textos como exercício de pesquisa é imprescindível para a qualificação da escrita; pressuposto 3 – os diários de aula representam rico instrumento para a qualificação da escrita no Ensino Superior; pressuposto 4 – há necessidade de que o aluno do Ensino Superior escreva variados tipos de escrita, ainda que a universidade cumpra com seu papel, enfatizando a escrita acadêmica; pressuposto 5 – o trabalho com a escrita no Ensino Superior deve enfatizar os componentes básicos da expressão escrita: o código escrito e a composição da escrita. Palavras-chave: Escrita; Ensino Superior; formação de professores.

  4. The comparision study on bilateral medial rectus recession versus bilateral medial rectus recession combined with Faden procedure for treatment of convergence excess esotropia%单纯与双内直肌后徙联合Faden术矫正集合过强型内斜视的比较分析

    Institute of Scientific and Technical Information of China (English)

    张伟; 赵堪兴

    2011-01-01

    目的 比较单纯双内直肌后徙与双内直肌后徙联合Faden术在矫正集合过强型内斜视中的作用。方法 28例集合过强型内斜视,远近斜视角相差在15△以上,AC/A值〈6,看近斜视角为45~80△,看远25~45△,一组12例行单纯双内直肌后徙,另一组16例行双内直肌后徙联合Faden术。结果 12例行单纯双内直肌后徙组中9例视近仍残余>10△内斜视。16例行双内直肌后徙联合Faden术组14例视近时基本正位,2例视近仍残余>10△内斜视,2例视远过矫。结论 双内直肌后徙联合Faden术较单纯双内直肌后徙可有效矫正集合过强型内斜视,但需要注意防止过矫。%Objective To evaluate the effectiveness of bilateral medial rectus recession versus bilateral medial rectus recession combined with Faden procedure for treatment of convergence excess esotropia. Methods Twenty-eight cases of convergence excess esotropia with normal AC/A ratio (<6)were investigated. The esodeviation difference between near and distance was more than 15 prism diopters. Twelve cases were treated with bilateral medial rectus recession whereas 16 cases were treated with bilateral medial rectus recesi0n combined with Faden procedure. Results Nine of 12 patients who were treated with bilateral medial rectus recession alone were still residual more than 10 prism diopters, esodeviation at near. Fourteen of 16 patients who were treated with bilateral medial rectus recesion combined with Faden procedure were alignment at near whereas only 2 patients were still residual more than 10 prism diopters esodeviation at near, however, 2 patients were a little overaction in the distance. Conclusions The bilateral medial rectus recession combined with Faden procedure is better effective method for convergence esotropia than bilateral medial rectus recession.

  5. [Significance of the "V" syndrome with double "up shoot". Insufficiency of the two superior oblique muscles in craniofacial malformations].

    Science.gov (United States)

    Morax, S; Pascal, D; Barraco, P

    1983-01-01

    Craniofacial malformations (telorbitism, craniofaciostenosis, plagiocephalia, Franceschetti's syndrome) are frequently associated with oculomotor anomalies. The most common vertical anomaly is the existence of a "V" syndrome with double "up shoot", with deficiencies in the two superior oblique muscles. Several mechanisms may be involved in the origin of this anomaly, related to the anatomical orbital malformation: orbital torsion with antimongoloid clefts responsible for a syndrome of macular pseudo-ectopia with extorsion of the 4 rectus muscles; plagiocephalia responsible for sagitallization of the inferior obliques; retromaxillia with exorbitism responsible for modification of muscle contact arches. Muscle agenesis is very rarely observed. The pathogenesis of these different mechanisms is discussed based on a study of 64 cases.

  6. Behavior of the Linea Alba During a Curl-up Task in Diastasis Rectus Abdominis: An Observational Study.

    Science.gov (United States)

    Lee, Diane; Hodges, Paul W

    2016-07-01

    Study Design Cross-sectional repeated measures. Background Rehabilitation of diastasis rectus abdominis (DRA) generally aims to reduce the inter-rectus distance (IRD). We tested the hypothesis that activation of the transversus abdominis (TrA) before a curl-up would reduce IRD narrowing, with less linea alba (LA) distortion/deformation, which may allow better force transfer between sides of the abdominal wall. Objectives This study investigated behavior of the LA and IRD during curl-ups performed naturally and with preactivation of the TrA. Methods Curl-ups were performed by 26 women with DRA and 17 healthy control participants using a natural strategy (automatic curl-up) and with TrA preactivation (TrA curl-up). Ultrasound images were recorded at 2 points above the umbilicus (U point and UX point). Ultrasound measures of IRD and a novel measure of LA distortion (distortion index: average deviation of the LA from the shortest path between the recti) were compared between 3 tasks (rest, automatic curl-up, TrA curl-up), between groups, and between measurement points (analysis of variance). Results Automatic curl-up by women with DRA narrowed the IRD from resting values (mean U-point between-task difference, -1.19 cm; 95% confidence interval [CI]: -1.45, -0.93; PUX-point between-task difference, -0.51 cm; 95% CI: -0.69, -0.34; PUX-point between-task difference, 0.025; 95% CI: 0.004, 0.045; P = .02). Although TrA curl-up induced no narrowing or less IRD narrowing than automatic curl-up (mean U-point difference between TrA curl-up versus rest, -0.56 cm; 95% CI: -0.82, -0.31; PUX-point between-task difference, 0.02 cm; 95% CI: -0.22, 0.19; P = .86), LA distortion was less (mean U-point between-task difference, -0.025; 95% CI: -0.037, -0.012; PUX-point between-task difference, -0.021; 95% CI: -0.038, -0.005; P = .01). Inter-rectus distance and the distortion index did not change from rest or differ between tasks for controls (P≥.55). Conclusion Narrowing of the IRD

  7. Pensamiento Superior y Desarrollo Territorial

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    Víctor Manuel Racancoj Alonzo

    2015-04-01

    Full Text Available Esta reflexión pretende explicar el papel, fundamental, que juega el pensamiento superior, en la formulación y la práctica de modelos de desarrollo territorial local; para que contribuyan de forma sustantiva, en la transformación de las condiciones socioeconómicas adversas que hoy viven comunidades indígenas y rurales de muchos países, como Guatemala, situación que puede resumirse en altos índices de pobreza y desnutrición. Pero, el pensamiento superior, debe ser competencia de la población con pertenencia a lo local, pues si y solo si esta condición existe, se dará validez y viabilidad al desarrollo territorial. Para alcanzar competencias de pensamiento superior, en los espacios locales, se tiene que superar obstáculos en el modelo de universidad, que hoy estamos familiarizados a ver y pensar; modelos que tienen las características de: herencia colonial, disfunción con la problemática económica, cultural, social y política de la sociedad y la negación de los saberes ancestrales.

  8. Superior sulcus tumors (Pancoast tumors).

    Science.gov (United States)

    Marulli, Giuseppe; Battistella, Lucia; Mammana, Marco; Calabrese, Francesca; Rea, Federico

    2016-06-01

    Superior Sulcus Tumors, frequently termed as Pancoast tumors, are a wide range of tumors invading the apical chest wall. Due to its localization in the apex of the lung, with the potential invasion of the lower part of the brachial plexus, first ribs, vertebrae, subclavian vessels or stellate ganglion, the superior sulcus tumors cause characteristic symptoms, like arm or shoulder pain or Horner's syndrome. The management of superior sulcus tumors has dramatically evolved over the past 50 years. Originally deemed universally fatal, in 1956, Shaw and Paulson introduced a new treatment paradigm with combined radiotherapy and surgery ensuring 5-year survival of approximately 30%. During the 1990s, following the need to improve systemic as well as local control, a trimodality approach including induction concurrent chemoradiotherapy followed by surgical resection was introduced, reaching 5-year survival rates up to 44% and becoming the standard of care. Many efforts have been persecuted, also, to obtain higher complete resection rates using appropriate surgical approaches and involving multidisciplinary team including spine surgeon or vascular surgeon. Other potential treatment options are under consideration like prophylactic cranial irradiation or the addition of other chemotherapy agents or biologic agents to the trimodality approach.

  9. Free transverse rectus abdominis myocutaneous and deep inferior epigastric perforator flaps for breast reconstruction: a systematic review of flap complication rates and donor-site morbidity.

    Science.gov (United States)

    Sailon, Alexander M; Schachar, Jeffrey S; Levine, Jamie P

    2009-05-01

    Free transverse rectus abdominis myocutaneous and deep inferior epigastric perforator flaps represent increasingly popular options for breast reconstruction. Although several retrospective, small-scale studies comparing these flaps have been published, most have failed to find a significant difference in flap complication rates or donor-site morbidity. We systematically reviewed the current literature, and subsequently pooled and analyzed data from included studies. Included studies reported flap complications and/or donor site morbidities for both flap types. Eight studies met the inclusionary criteria. For flap complications, there was a statistically significant difference between deep inferior epigastric perforator and free transverse rectus abdominis myocutaneous flaps in fat necrosis rates (25.5 +/- 0.49 vs. 11.3% +/- 0.41%, P flap options.

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

    OpenAIRE

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

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three h...

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

    OpenAIRE

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

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test.Methods. Twenty-three he...

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

    Science.gov (United States)

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

    2015-01-01

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

  13. Selective lengthening of the psoas and rectus femoris and preservation of the iliacus for flexion deformity of the hip in cerebral palsy patients.

    Science.gov (United States)

    Matsuo, T; Hara, H; Tada, S

    1987-01-01

    Between 1978 and 1983, 52 Japanese patients with cerebral palsy underwent operative correction of flexion deformity of the hip. The results of lengthening of the psoas, rectus femoris, and proximal hamstrings were satisfactory. The iliacus was left intact. Improvement in gait and activities of daily living was attained. Concentric reduction was obtained in 27 of 33 dislocated or subluxated hips. Sitting and perineal care were facilitated, and pain was alleviated. We conclude that preservation of the iliacus is important.

  14. Spread patterns and effectiveness for surgery after ultrasound-guided rectus sheath block in adult day-case patients scheduled for umbilical hernia repair

    Directory of Open Access Journals (Sweden)

    Alberto Manassero

    2015-01-01

    Full Text Available Background and Aims: We conducted a prospective study to examine the local anesthetic (LA spread and the effectiveness for surgical anesthesia of ultrasound (US-guided rectus sheath block (RSB in adult patients undergoing umbilical hernia repair. Material and Methods: Thirty patients received at T-10 level a bilateral US-guided injection of 20 mL levobupivacaine 0.375% + epinephrine 5 μg/mL behind the rectus muscle to detach it from its sheath. Anesthetic spread into the rectus sheath was evaluated ultrasonographically at T-9 and T-11 levels and scored from 0 to 4. The RSB was defined effective for surgical anesthesia if it was able to guarantee an anesthetic level sufficient for surgery without any mepivacaine supplementation. Results: Overall, the block was effective for surgical anesthesia in 53.3% of patients (95% confidence interval, ±17.8. In the remaining patients, anesthesia supplementation was needed at cutaneous incision, whereas manipulation of the muscle and fascial planes was painless. No patients required general anesthesia. LA spreads as advocated (to T-9 and to T-11 bilaterally = spread score 4 in 8/30 patients (26.6%; in these cases, the block was 75% effective for surgery. The anesthetic spread was most negatively influenced by increased body mass index. Postoperative analgesia was excellent in 97% of patients. Conclusion: Use of RSB as an anesthetic management of umbilical herniorrhaphy is recommended only with anesthetic supplementation at the incision site.

  15. Predictors of the Dose-Effect Relationship regarding Unilateral Inferior Rectus Muscle Recession in Patients with Thyroid Eye Disease

    Directory of Open Access Journals (Sweden)

    Yasuhiro Takahashi

    2015-01-01

    Full Text Available Purpose. To evaluate whether inferior rectus muscle (IRM thickness, the degree of adipose change in the IRM, smoking status, and the previous history of orbital radiotherapy can predict the dose-effect relationship regarding unilateral IRM recession in thyroid eye disease (TED. Methods. Twenty-five patients were retrospectively reviewed. We calculated the largest IRM cross-sectional area and evaluated the degree of adipose change in the IRM using magnetic resonance imaging. The degree of adipose change and smoking status were classified using grading scales (0–3; previous orbital radiotherapy was graded as 0 when a history was not available and 1 when it was available. The correlation between the dose-effect relationship and the hypothesized predictive factors was evaluated using stepwise multiple regression analysis. Results. The multiple regression model, with the exception of the history of the previous orbital radiotherapy, estimated a significant dose-effect relationship for the parameters evaluated (YDOSE-EFFECT = 0.013XIRM AREA  − 0.222XADIPOSE  − 0.102XSMOKING + 1.694; r = 0.668; adjusted r2 = 0.367; P = 0.005. Conclusions. The dose-effect relationship regarding unilateral IRM recession in TED could be predicted using IRM thickness, degree of intramuscular adipose change, and smoking status but could not be predicted using the previous orbital radiotherapy history.

  16. Development of estimation system of knee extension strength using image features in ultrasound images of rectus femoris

    Science.gov (United States)

    Murakami, Hiroki; Watanabe, Tsuneo; Fukuoka, Daisuke; Terabayashi, Nobuo; Hara, Takeshi; Muramatsu, Chisako; Fujita, Hiroshi

    2016-04-01

    The word "Locomotive syndrome" has been proposed to describe the state of requiring care by musculoskeletal disorders and its high-risk condition. Reduction of the knee extension strength is cited as one of the risk factors, and the accurate measurement of the strength is needed for the evaluation. The measurement of knee extension strength using a dynamometer is one of the most direct and quantitative methods. This study aims to develop a system for measuring the knee extension strength using the ultrasound images of the rectus femoris muscles obtained with non-invasive ultrasonic diagnostic equipment. First, we extract the muscle area from the ultrasound images and determine the image features, such as the thickness of the muscle. We combine these features and physical features, such as the patient's height, and build a regression model of the knee extension strength from training data. We have developed a system for estimating the knee extension strength by applying the regression model to the features obtained from test data. Using the test data of 168 cases, correlation coefficient value between the measured values and estimated values was 0.82. This result suggests that this system can estimate knee extension strength with high accuracy.

  17. Entidades fiscalizadoras superiores y accountability

    OpenAIRE

    Estela Moreno, María

    2016-01-01

    OBJETIVOS DE LA TESIS: El objetivo general del trabajo es establecer el nivel de eficacia de las Entidades Fiscalizadoras Superiores (EFS) como agencia asignada y herramienta de accountability horizontal, a través de la valoración de su diseño institucional y de la calidad de sus productos finales, los informes de auditoría, estableciéndose los siguientes objetivos específicos: 1. Relevar las nociones de accountability, actualizando el Estado del Arte de la cuestión. 2. Analizar la ...

  18. Immunohistochemical analysis of collagen content and types in the rectus abdominis muscle of cadavers of different ages Imunohistoquímica do colágeno no músculo reto do abdome de cadáveres de diferentes grupos etários

    Directory of Open Access Journals (Sweden)

    Eliziane Nitz de Carvalho Calvi

    2011-01-01

    Full Text Available PURPOSE: To assess the collagen content and types in the rectus abdominis muscle of cadavers of different ages. METHODS: Forty fresh adult male cadavers, at room temperature, were obtained from the Institute of Legal Medicine of Franca and dissected within 24 hours of death. The cadavers were divided into two groups: Group A (n=20, 18 to 30 years of age, and Group B (n=20, 31 to 60 years of age. Bilateral incisions were made in the middle portion of anterior rectus sheath 3 cm superiorly and 2 cm inferiorly to the umbilicus and four fragments of the rectus abdominis muscle were dissected. The samples were fixed in 10% buffered formalin and sent for immunohistochemical analysis to determine collagen content and types. RESULTS: Immunohistochemical results revealed higher amounts of type I and type III collagen in Group A. However, no difference in the amount of type IV collagen was found between the groups. CONCLUSION: The amount of type I and type III collagen was higher in group A.OBJETIVO: Avaliar o colágeno no músculo reto do abdome em cadáveres de diferentes faixas etárias. MÉTODOS: Foram dissecados 40 cadáveres adultos masculinos, não fixados, com tempo de óbito de até 24 horas, em temperatura ambiente, provenientes do Instituto Médico-Legal de Franca (SP - Brasil. Os cadáveres foram distribuídos em dois grupos: GRUPO A (n=20 - 18 a 30 anos e GRUPO B (n=20 -31 a 60 anos. Realizou-se incisão na porção mediana da lâmina anterior da bainha do músculo reto a 3 cm superiormente e 2 cm inferiormente ao umbigo em ambos os lados, sendo retirados quatro fragmentos de músculo reto do abdome. Esse material foi conservado em formalina tamponado a 10% e enviado para imuno-histoquímica para determinação do tipo de colágeno. RESULTADOS: Na Imunihistoquímica os colágenos I e III foram estatisticamente maiores no grupo A, porém não houve diferença entre os grupos em relação ao colágeno IV. CONCLUSÃO: A quantidade de col

  19. The sentence superiority effect revisited.

    Science.gov (United States)

    Snell, Joshua; Grainger, Jonathan

    2017-11-01

    A sentence superiority effect was investigated using post-cued word-in-sequence identification with the rapid parallel visual presentation (RPVP) of four horizontally aligned words. The four words were presented for 200ms followed by a post-mask and cue for partial report. They could form a grammatically correct sentence or were formed of the same words in a scrambled agrammatical sequence. Word identification was higher in the syntactically correct sequences, and crucially, this sentence superiority effect did not vary as a function of the target's position in the sequence. Cloze probability measures for words at the final, arguably most predictable position, revealed overall low values that did not interact with the effects of sentence context, suggesting that these effects were not driven by word predictability. The results point to a level of parallel processing across multiple words that enables rapid extraction of their syntactic categories. These generate a sentence-level representation that constrains the recognition process for individual words, thus facilitating parallel word processing when the sequence is grammatically sound. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. 78 FR 21116 - Superior Supplier Incentive Program

    Science.gov (United States)

    2013-04-09

    ... Department of the Navy Superior Supplier Incentive Program AGENCY: Department of the Navy, DoD. ACTION... policy that will establish a Superior Supplier Incentive Program (SSIP). Under the SSIP, contractors that..., performance, quality, and business relations would be granted Superior Supplier Status (SSS). Contractors...

  1. superior en México

    Directory of Open Access Journals (Sweden)

    César Mureddu Torres

    2008-01-01

    Full Text Available El presente artículo desarrolla algunos de los retos que ha traído consigo el acceso a la información existente en la red de Internet y lo que ello supone. Se abordan principalmente las consecuencias de la presencia actual de una sociedad llamada del conocimiento, si se mantiene la confusión entre conocimiento e información. Por ello, la sola gestión de la información no puede ser tomada como definitoria respecto a la función de educación superior confiada a las universidades. Hacerlo sería cometer un error aún más grave que la confusión teórica entre los términos mencionados.

  2. Reinforcing the continent mechanism of continent cutaneous diversions by wrapped rectus abdominis muscle flap: a preliminary experimental study

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xin-ru; XU Yue-min; FENG Chao; YU Jian-jun; SONG Lu-jie; FEI Xiao-fang

    2009-01-01

    Background Continent cutaneous diversion (CCD) has been widely used in almost any lower urinary reconstruction. We have been continually trying to modify this procedure because of the high complications rate, especially as they relate to the efferent tube. In this study, we reported a modified procedure with a tapered ileum wrapped by the rectus abdominalis flap (RAMF) and assessed the feasibility of this new technique to achieve urinary continence. Methods A procedure in which two ileal segments were tapered and connected to a U-shaped reservoir was performed in ten dogs. A RAMF with its blood supply was wrapped around one of the tapered ileum, in control groups, the tapered ileum was brought to the abdominal skin. Urodynamic studies were conducted In the 1st, 3rd and 6th months post-operatively. The data of maximum inner pressure (MIP) and functional pressure length (FPL) in every group at each phase were recorded. Retrograde radiograms of the efferent limbs were performed before sacrifice.Results MIP in the study group was significantly higher than that in the control group at each phase (P<0.05). However, no significant differences in MIP or FPL were found in the study group between an empty and full reservoir. In the control group, MIP increased (P<0.05) and FPL decreased significantly (P<0.05) compared with an empty and full reservoir. Retrograde radiograms confirmed that efferent limbs were positioned straigh beneath the abdominal wall. Histological examination of the study group demonstrated a layer of striated muscle around the outside surface of the ileum.Conclusion The continent mechanism of tapered ileum can be enhanced by extra support from wrapped RAMF.

  3. Surface Electromyography Assessments of the Vastus medialis and Rectus femoris Muscles and Creatine Kinase after Eccentric Contraction Following Glutamine Supplementation.

    Science.gov (United States)

    Rahmani-Nia, Farhad; Farzaneh, Esmail; Damirchi, Arsalan; Majlan, Ali Shamsi; Tadibi, Vahid

    2014-03-01

    L-glutamine is the most abundant amino acid found in human muscle and plays an important role in protein synthesis and can reduce the levels of inflammation biomarkers and creatine kinase (CK) after training sessions. Delayed onset muscle soreness (DOMS) develops after intense exercise and is associated with an inflammatory response. The purpose of this study was to investigate the effect of glutamine supplementation on surface electromyography activity of the vastus medialis muscle (VMM) and rectus femoris muscle (RFM) and levels of creatine kinase after an eccentric contraction. SEVENTEEN HEALTHY MEN (AGE: 22.35±2.27yr; body mass: 69.91± 9.78kg; height: 177.08±4.32cm) were randomly assigned to experimental (n=9) and control groups (n=8) in a double-blind manner. In both groups, subjects were given L-glutamine supplementation (0.1g.kg(-1)) or placebo three times a week for 4 weeks. Median frequency (MDF) and mean power frequency (MPF) for VMM and RFM muscles and also CK measurements were performed before, 24h and 48 h after a resistance training session. The resistance training included 6 sets of eccentric leg extensions to exhaustion with 75% of 1RM. There was no significant difference between groups for MDF or MPF in VMM and RFM. The difference of CK level between the groups was also not significant. The results of this study indicate that glutamine supplementation has no positive effect on muscle injury markers after a resistance training session.

  4. A functional SNP in the regulatory region of the decay-accelerating factor gene associates with extraocular muscle pareses in myasthenia gravis

    KAUST Repository

    Heckmann, J M

    2009-08-13

    Complement activation in myasthenia gravis (MG) may damage muscle endplate and complement regulatory proteins such as decay-accelerating factor (DAF) or CD55 may be protective. We hypothesize that the increased prevalence of severe extraocular muscle (EOM) dysfunction among African MG subjects reported earlier may result from altered DAF expression. To test this hypothesis, we screened the DAF gene sequences relevant to the classical complement pathway and found an association between myasthenics with EOM paresis and the DAF regulatory region c.-198CG SNP (odds ratio8.6; P0.0003). This single nucleotide polymorphism (SNP) results in a twofold activation of a DAF 5?-flanking region luciferase reporter transfected into three different cell lines. Direct matching of the surrounding SNP sequence within the DAF regulatory region with the known transcription factor-binding sites suggests a loss of an Sp1-binding site. This was supported by the observation that the c.-198CG SNP did not show the normal lipopolysaccharide-induced DAF transcriptional upregulation in lymphoblasts from four patients. Our findings suggest that at critical periods during autoimmune MG, this SNP may result in inadequate DAF upregulation with consequent complement-mediated EOM damage. Susceptible individuals may benefit from anti-complement therapy in addition to immunosuppression. © 2010 Macmillan Publishers Limited. All rights reserved.

  5. Extraocular Muscles Tension, Tonus, and Proprioception in Infantile Strabismus: Role of the Oculomotor System in the Pathogenesis of Infantile Strabismus—Review of the Literature

    Directory of Open Access Journals (Sweden)

    Costantino Schiavi

    2016-01-01

    Full Text Available The role played by the extraocular muscles (EOMs in the etiology of concomitant infantile strabismus is still debated and it has not yet definitively established if the sensory anomalies in concomitant strabismus are a consequence or a primary cause of the deviation. The commonest theory supposes that most strabismus results from abnormal innervation of the EOMs, but the cause of this dysfunction and its origin, whether central or peripheral, are still unknown. The interaction between sensory factors and innervational factors, that is, esotonus, accommodation, convergence, divergence, and vestibular reflexes in visually immature infants with family predisposition, is suspected to create conditions that prevent binocular alignment from stabilizing and strengthening. Some role in the onset of fixation instability and infantile strabismus could be played by the feedback control of eye movements and by dysfunction of eye muscle proprioception during the critical period of development of the visual sensory system. A possible role in the onset, maintenance, or worsening of the deviation of abnormalities of muscle force which have their clinical equivalent in eye muscle overaction and underaction has been investigated under either isometric or isotonic conditions, and in essence no significant anomalies of muscle force have been found in concomitant strabismus.

  6. A functional SNP in the regulatory region of the decay-accelerating factor gene associates with extraocular muscle pareses in myasthenia gravis.

    Science.gov (United States)

    Heckmann, J M; Uwimpuhwe, H; Ballo, R; Kaur, M; Bajic, V B; Prince, S

    2010-01-01

    Complement activation in myasthenia gravis (MG) may damage muscle endplate and complement regulatory proteins such as decay-accelerating factor (DAF) or CD55 may be protective. We hypothesize that the increased prevalence of severe extraocular muscle (EOM) dysfunction among African MG subjects reported earlier may result from altered DAF expression. To test this hypothesis, we screened the DAF gene sequences relevant to the classical complement pathway and found an association between myasthenics with EOM paresis and the DAF regulatory region c.-198C>G SNP (odds ratio=8.6; P=0.0003). This single nucleotide polymorphism (SNP) results in a twofold activation of a DAF 5'-flanking region luciferase reporter transfected into three different cell lines. Direct matching of the surrounding SNP sequence within the DAF regulatory region with the known transcription factor-binding sites suggests a loss of an Sp1-binding site. This was supported by the observation that the c.-198C>G SNP did not show the normal lipopolysaccharide-induced DAF transcriptional upregulation in lymphoblasts from four patients. Our findings suggest that at critical periods during autoimmune MG, this SNP may result in inadequate DAF upregulation with consequent complement-mediated EOM damage. Susceptible individuals may benefit from anti-complement therapy in addition to immunosuppression.

  7. Escuela Superior de Palos Verdes

    Directory of Open Access Journals (Sweden)

    Neutra, Richard J.

    1965-02-01

    Full Text Available Before initiating the building operations for the «Palos Verdes» School, the site was divided into two large horizontal surfaces, at different levels. The lower one served to accommodate the playing fields, a car park, the physical training building, and shop and ancillary buildings. On the higher of these two surfaces, and to the West of the access road, there is a car park and also the building and plot of ground devoted to agricultural technology, as well as the literary studies and general purpose buildings. As a complement to these, there is a series of blocks, arranged in parallel rows, which house the administrative offices, the art school, the craft's school, the general classrooms, and those devoted to higher education. The fascinating aspect of this school is the outstanding penetration of the architect's mind into the essential function of the project. Its most evident merit is the sense of comradeship and harmony that permeates the whole architectural manifold.Antes de construir el complejo escolar «Palos Verdes» se comenzó por crear, en el terreno, dos grandes mesetas a niveles diferentes. Sobre el inferior se organizaron: los campos de juegos, de deportes, un aparcamiento, el edificio para educación física y los destinados a tiendas y servicios. Sobre la meseta superior, al oeste de la vía de acceso, se dispuso un aparcamiento y el edificio y campo para adiestramiento agrícola; al este, otro aparcamiento, el edificio dedicado a materias literarias, y el destinado a usos múltiples. Completan las instalaciones de la escuela una serie de bloques paralelos: la administración, la escuela de arte, las clases de trabajos manuales, las aulas de enseñanzas generales, y las de los cursos superiores. Lo fascinante de este complejo escolar es la perfecta y magistral compenetración del arquitecto con el tema proyectado, y su mayor mérito, la sensación de cordialidad y armonía con el ambiente.

  8. Ultrasonography for measuring rectus abdominis muscles diastasis Ultra-sonografia para medir a diástase dos músculos retos do abdome

    Directory of Open Access Journals (Sweden)

    Denise de Almeida Mendes

    2007-06-01

    Full Text Available PURPOSE: Preoperative imaging evaluation may be useful for determining the position of recti abdominis muscles before their correction. The purpose of this study is to evaluate the accuracy of ultrasonography to measure the width of rectus abdominis muscle diastasis. METHODS: Rectus diastasis was measured by ultrasonography preoperatively in 20 females. Rectus diastasis was measured in seven levels along the anterior rectus sheath by ultrasound after sustained deep inspiration and after expiration. Rectus diastasis, at the same levels, was also measured after its exposition during abdominoplasty by two independent observers, using a surgical compass. These values were compared using Wilcoxon's statistical text, for non independent values. RESULTS: There was no significant difference between the values obtained by ultrasound and those measured during surgery in the supra-umbilical levels and at the level of the umbilicus. However, below the umbilicus these values differed significantly, showing smaller values in the imaging evaluation. CONCLUSION: Ultrasonography is an accurate method to measure rectus diastasis above the umbilicus and at the umbilical level.OBJETIVO: Estudos radiológicos pré-operatórios podem ser úteis para determinar a posição dos músculos retos do abdome antes de sua correção. O objetivo deste estudo é avaliar a acurácia da ultra-sonografia para medir a largura da diástase dos músculos retos do abdome. MÉTODOS: A diástase dos músculos retos foi medida pela ultra-sonografia, no pré-operatório em 20 mulheres. A diástase dos retos foi medida em sete níveis da bainha anterior dos retos foram examinados com ultra-som após inspiração profunda sustentada e após expiração. A diástase dos retos, nos mesmos níveis, foi também medida após sua exposição durante a abdominoplastia, por dois observadores independentes, usando compasso cirúrgico. As medidas foram comparadas usando o teste estatístico de

  9. 不同术式治疗先天性上斜肌麻痹的疗效观察%Analysis the efficiency of different surgerys for the congenital superior oblique muscle paralysis

    Institute of Scientific and Technical Information of China (English)

    王淑娜; 林小铭; 马伟; 邓大明; 康瑛; 汪自文

    2011-01-01

    目的 探讨不同术式治疗先天性上斜肌麻痹的疗效及适应症.方法 本研究回顾分析30例先天性上斜肌麻痹患者手术方式和术后效果.根据下斜肌亢进程度和垂直斜视度数及患眼外旋程度选择不同的手术方式:下斜肌部分切除术、下斜肌前转位术,或联合上直肌或下直肌手术.结果 治愈25例,治愈率83.3%;好转5例,好转率16.7%.结论 根据下斜肌亢进程度、垂直斜视度及患眼外旋程度选择不同手术方式,可有效地获得较高治愈率,同时减少再次手术的风险.%Objective To evaluate the efficiency of different surgerys for the congenital superior oblique muscle paralysis. Methods We collected 30 patients of the congenital superior oblique muscle paralysis in Zhongshan ophthalmic center. According to the degrees of the overaction of superior oblique muscle, the extension of vertical deviation and the trouble eye outward turning degree, we performed three different surgery: inferior oblique muscle myotomy, inferior oblique muscle anterior transposition and inferior oblique muscle anterior transposition pluse superior rectus muscle shortening or inferior rectus muscle recession. Results 25 cases were cured (83.3%), 5 cases were improved (16.7%).Conclusions Choosing suitable operation procedures based on the degree of hyper deviation can get a good clinical effect to treat the congenital superior oblique paralysis.

  10. [Application of three-dimensional printing personalized acetabular wing-plate in treatment of complex acetabular fractures via lateral-rectus approach].

    Science.gov (United States)

    Mai, J G; Gu, C; Lin, X Z; Li, T; Huang, W Q; Wang, H; Tan, X Y; Lin, H; Wang, Y M; Yang, Y Q; Jin, D D; Fan, S C

    2017-03-01

    Objective: To investigate reduction and fixation of complex acetabular fractures using three-dimensional (3D) printing technique and personalized acetabular wing-plate via lateral-rectus approach. Methods: From March to July 2016, 8 patients with complex acetabular fractures were surgically managed through 3D printing personalized acetabular wing-plate via lateral-rectus approach at Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University. There were 4 male patients and 4 female patients, with an average age of 57 years (ranging from 31 to 76 years). According to Letournel-Judet classification, there were 2 anterior+ posterior hemitransverse fractures and 6 both-column fractures, without posterior wall fracture or contralateral pelvic fracture. The CT data files of acetabular fracture were imported into the computer and 3D printing technique was used to print the fractures models after reduction by digital orthopedic technique. The acetabular wing-plate was designed and printed with titanium. All fractures were treated via the lateral-rectus approach in a horizontal position after general anesthesia. The anterior column and the quadrilateral surface fractures were fixed by 3D printing personalized acetabular wing-plate, and the posterior column fractures were reduction and fixed by antegrade lag screws under direct vision. Results: All the 8 cases underwent the operation successfully. Postoperative X-ray and CT examination showed excellent or good reduction of anterior and posterior column, without any operation complications. Only 1 case with 75 years old was found screw loosening in the pubic bone with osteoporosis after 1 month's follow-up, who didn't accept any treatment because the patient didn't feel discomfort. According to the Matta radiological evaluation, the reduction of the acetabular fracture was rated as excellent in 3 cases, good in 4 cases and fair in 1 case. All patients were followed up for 3 to 6 months and all

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

    Directory of Open Access Journals (Sweden)

    Andrew D. Vigotsky

    2015-09-01

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

  12. PPARβ expression in rectus abdominis and abdominal subcutaneous fat of patients with gestational diabetes mellitus and its relationship with glucolipid metabolism

    Institute of Scientific and Technical Information of China (English)

    Xiao-Yan Zhang; Jing Tan; Yi-Peng Zhang

    2017-01-01

    Objective:To study the relationship between peroxisome proliferator-activated receptorβ(PPARβ) expression in rectus abdominis as well as abdominal subcutaneous fat of patients with gestational diabetes mellitus (GDM) and glucolipid metabolism.Methods:The pregnant women who received routine antenatal care and planned to receive selective caesarean section in Obstetrics Department of our hospital between May 2012 and March 2016 were retrospectively analyzed, and 74 healthy pregnant women and 58 pregnant women with GDM were screened and included in the control group and gestational diabetes mellitus group (GDM group) respectively. Rectus abdominis and abdominal subcutaneous fat were collected during Cesarean section to determine the expression of PPARβ was measured; peripheral blood was collected at middle-late pregnancy to determine the content of blood glucose metabolism and lipid metabolism indexes as well as adipocytokines.Results:PARβ mRNA expression and protein expression in rectus abdominis and abdominal subcutaneous fat of GDM group were significantly lower than those of control group (P<0.05); homeostasis model assessment insulin secretion index (HOMA-β), homeostasis model assessment insulin resistance (HOMA-IR) and OGTT glucose curve (AUCG) levels as well as serum low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), cholesterol (TC), Leptin, Resistin and Chemerin content of GDM group were significantly higher than those of control group (P<0.05) while early insulin secretion index (ΔI30/ΔG30) and insulin sensitive index composite (ISIcomp) levels as well as serum high-density lipoprotein cholesterol (HDL-C), Omentin-1 and Omentin-1 and adiponectin (ADPN) content were significantly lower than those of control group (P<0.05); PARβ mRNA expression and protein expression were negatively correlated with HOMA-β, HOMA IR, area under the AUCG, LDL-C, TG, TC, Leptin, Resistin and Chemerin, and positively correlated withΔI30/ΔG30, ISIcomp, HDL

  13. Palisade endings of extraocular muscles in eyes with congenital nystagmus%先天性眼球震颤眼外肌栅栏状终末结构的研究

    Institute of Scientific and Technical Information of China (English)

    尚艳峰; 张静; 宫华青; 陈霞

    2012-01-01

    Objective To evaluate the morphology,distribution and function of palisade endings (PE) in human extraocular muscles (EOM),and observe the alterations in eyes with congenital nystagmus (CN).The etiology and pathogenesis of CN were also investigated.Methods It was a experimental study.The distal myotendinous junctions of the EOM were obtained during operation for CN ( CN group) and concomitant strabismus ( control group). The samples from patients with similar age and same extraction sites in the two groups were compared.The muscles cut during operation were immediately put into 4% glutaraldehyde fixative solution.And 1 - 2 transverse bands of tissue were cut every 1 mm from tendon insertion for specimens processing.The ultrastructure of EOM and PE in the two groups was observed by transmission electron microscopy. The distal parts of EOM cut during operation were put into 4% paraformaldehyde promptly.Myotendinous junction region whole mounts were labeled with antibodies against choline acetyltransferase (ChAT).Muscle fibers were counterstained with phalloidin.And longitudinal and transverse cryostat serial sections were cut at 25 μm and analyzed by confocal laser scanning microscopy.The ChAT expression,morphology and distribution of PE were observed.The same fragment of myotendinous junction in the two groups was selected.After the total protein was extracted,ChAT was detected by western blot.The expression level of ChAT was analyzed.Results Compared with the controls,the ultrastructure in the CN group had considerable variations.The axon of PE was swelled and deformed partly.The electron density was increased and presented as addicted to osmic acid. In the muscle cells,mitochondria was swelled,and sarcoplasmic reticulum was dilated.All PE exhibited ChAT immunoreactivity in human EOM.In the longitudinal section,nerve fibers extended from the muscle into the tendon,looped back and divided into several terminal arborizations (palisade endings) around the muscle

  14. Sobredentadura total superior implantosoportada Superior total overdenture on implants

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.This is the case of a total maxilla edentulous patient seen in consultation of the "Pedro Ortíz" Clinic Implant of Habana del Este municipality in 2009 and con rehabilitation by prosthesis over osteointegration implants added to stomatology practice in Cuba as an alternative to conventional treatment in patients totally edentulous. We follow a protocol including a surgery or surgical phase, technique without or with flap creation and early or immediate load. This is a male patient aged 56 came to our multidisciplinary consultation worried because he had three prostheses in last two years and any fulfilled the requirements of retention to feel safe and comfortable with prostheses. The final result was the total satisfaction of rehabilitated patient improving its aesthetic and functional quality.

  15. Long-term outcome of medial rectus recession and pulley posterior fixation in esotropia with high AC/A ratio.

    Science.gov (United States)

    Wabulembo, Geoffrey; Demer, Joseph L

    2012-09-01

    Medial rectus (MR) recession with pulley posterior fixation (PF) can be used to treatesotropia (ET) with a high accommodative convergence to accommodation (AC/A) ratio as effectively in the short term as MR recession with scleral PF. This study provides a novel examination of the long-term results of MR recession with pulley PF (PPF). In 21 children we performed bilateral MR recession and pulley PF for ET greater at near than distance (high AC/A). Mean follow-up was 3.5 ± 2.5 (standard deviation [SD]) years. Mean age at presentation was 2.7 ± 1.8 and at surgery 4.3 ± 1.6 years. Fourteen (67%) children had amblyopia. Distance and near pre-operative ET averaged 19.6Δ ± 10.5Δ and 36.9Δ ±18.9Δ, respectively. Mean near-distance (N-D) disparity was 16.4Δ ± 12.3Δ. The MR recession averaged 4.4 ± 0.9 mm. Early mean postoperative ET was 1.3 ± 3.3Δ at distance and 2.8Δ ± 5.2Δ at near. Mean late postoperative ET was 0.1Δ ± 5.8Δ and 1.0Δ ± 6.2Δ at distance and near, respectively. At the final postoperative examination, mean N-D disparity was reduced to 0.9Δ ± 3.6Δ. MR recession with PPF has a high long-term effectiveness, even in patients with amblyopia and autism. Since no posterior scleral suturing is required, it minimizes the perforation risk associated with scleral PF. MR recession with PPF is a safe and highly effective long-term treatment for ET with high AC/A ratio. Long-term results may surpass those of alternate procedures.

  16. Coordination of two-joint rectus femoris and hamstrings during the swing phase of human walking and running.

    Science.gov (United States)

    Prilutsky, B I; Gregor, R J; Ryan, M M

    1998-06-01

    It has been hypothesized previously that because a strong correlation was found between the difference in electromyographic activity (EMG) of rectus femoris (RF) and hamstrings (HA; EMG(RF)-EMG(HA)) and the difference in the resultant moments at the knee and hip (Mk-Mh) during exertion of external forces on the ground by the leg, input from skin receptors of the foot may play an important role in the control of the distribution of the resultant moments between the knee and hip by modulating activation of the two-joint RF and HA. In the present study, we examined the coordination of RF and HA during the swing phase of walking and running at different speeds, where activity of foot mechanoreceptors is not modulated by an external force. Four subjects walked at speeds of 1.8 m/s and 2.7 m/s and ran at speeds of 2.7 m/s and 3.6 m/s on a motor-driven treadmill. Surface EMG of RF, semimembranosus (SM), and long head of biceps femoris (BF) and coordinates of the four leg joints were recorded. An inverse dynamics analysis was used to calculate the resultant moments at the ankle, knee, and hip during the swing phase. EMG signals were rectified and low-pass filtered to obtain linear envelopes and then shifted in time to account for electromechanical delay between EMG and joint moments. During walking and running at all studied speeds, mean EMG envelope values of RF were statistically (Pwalking at 2.7 m/s than during the swing phase of running at the same speed. Correlation coefficients calculated between the differences (EMG(RF)-EMG(HA)) and (Mk-Mh), taken every 1% of the swing phase, were higher than 0.90 for all speeds of walking and running. Since the close relationship between EMG and joint moments was obtained in the absence of an external force applied to the foot, it was suggested that the observed coordination of RF and HA can be regulated without a stance-specific modulation of cutaneous afferent input from the foot. The functional role of the observed coordination

  17. Rectus abdominis diastasis

    DEFF Research Database (Denmark)

    Akram, Javed; Matzen, Steen Henrik

    2014-01-01

    -term recurrence was reported by one study, while five reported no recurrence. Overall major complications were few, while minor complications were primarily seroma and wound complications. RD is by itself not a true hernia and, therefore, not associated with the risk of strangulation. Repair is mostly done due...

  18. Efectos de la vibración sobre la actividad del rectus abdominis y sobre la transmisión de aceleraciones durante la realización de un puente frontal. (Effects of whole body vibration on rectus abdominis activity and transmission of accelerations during a front bridge exercise.

    Directory of Open Access Journals (Sweden)

    Francisco José Vera-García

    2012-04-01

    Full Text Available Resumen Durante las dos últimas décadas se ha incrementado notablemente la utilización de la vibración como medio complementario de ejercicio físico. La literatura científica muestra distintos efectos positivos, aunque la mayor parte de ensayos se han centrado en el análisis del ejercicio de squat. El objetivo del presente estudio fue analizar la actividad muscular del rectus abdominis y la transmisión de la vibración en el cuerpo humano durante la realización de un puente frontal sobre una plataforma vibratoria oscilante vibrando a diferentes frecuencias (5, 16, 20 Hz y a una amplitud constante (3 mm. Las aceleraciones máximas en la cabeza (ejes X, Y, Z y la actividad electromiográfica media del rectus abdominis fueron determinadas en 31 sujetos sanos por medio de un acelerómetro triaxial y electromiografía de superficie. Para cada eje se calculó un coeficiente de amortiguación restando la aceleración máxima registrada en la cabeza a la aceleración máxima registrada sobre la plataforma. La actividad electromiográfica del rectus abdominis y los coeficientes de amortiguación en los ejes X y Z aumentaron significativamente con cada incremento en la frecuencia de vibración de la plataforma (p AbstractWhole-body vibration exercise have been widely used during the last two decades, with most scientific publications reporting various positive effects. Most commonly, squat exercises have been studied. Instead, this study explored the rectus abdominis activity and the transmission of sinusoidal vibration to the human body during the performance of front bridges on a oscillating vibration platform at different frequencies (5, 16, 20 Hz with constant amplitude (3 mm. Maximal vibration-induced accelerations at the head (axis X, Y, Z and mean electromyographic activity were assessed in thirty-one healthy subjects using a skin-mounted triaxial accelerometer and surface electromyography. A damping coefficient was calculated for each

  19. Experimental model to study correction of rectus diastasis by laparoscopy, in pigs Modelo experimental na correção de diástase de retos por laparoscopia

    Directory of Open Access Journals (Sweden)

    Fábio Xerfan Nahas

    2003-01-01

    Full Text Available The use of swines as an experimental model to correct rectus diastasis by laparoscopy is described on this article. The correction of this deformity was achieved by the plication of the posterior rectus sheath with the insertion of two trocars on the inferior abdominal fold. One trocar was placed in the midline whereas the other was inserted laterally to the right rectus muscle. A continuous suture was made on the posterior rectus sheath with 0-Polipropilene. This suture was anchored at the anterior rectus sheath under direct vision. An incision of all layers was performed on the flank and the abdominal wall was turned inside out so that the area of plication could be assessed and evaluated. The experimental model described showed to be feasible to demonstrate the correction of rectus diastasis by laparoscopy.O uso de suínos como modelo experimental para a correção de diástase de retos por laparoscopia é descrito no presente artigo. A correção desta deformidade foi obtida pela plicatura da aponeurose posterior dos retos pela inserção de dois trocares na prega abdominal inferior. Um trocar foi introduzido na linha média enquanto o outro foi inserido lateralmente ao músculo reto abdominal direito. Uma sutura contínua de polipropileno-0 foi realizada na aponeurose posterior. Esta sutura foi ancorada na aponeurose anterior do músculo reto sob visão direta. Uma incisão foi realizada em todos os planos na região do flanco e a parede abdominal foi evertida para visualização e avaliação da área onde fora realizada a plicatura na aponeurose anterior. O modelo experimental descrito mostrou-se factível em demonstrar a correção da diástase de retos por laparoscopia.

  20. Rehabilitation and Return to Sport Following Surgical Repair of the Rectus Abdominis and Adductor Longus in a Professional Basketball Player: A Case Report.

    Science.gov (United States)

    Short, Steven M; Anloague, Philip A; Strack, Donald S

    2016-08-01

    Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352.

  1. Oxidative Stress and Upregulation of Antioxidant Proteins, Including Adiponectin, in Extraocular Muscular Cells, Orbital Adipocytes, and Thyrocytes in Graves' Disease Associated with Orbitopathy.

    Science.gov (United States)

    Marique, Lancelot; Senou, Maximin; Craps, Julie; Delaigle, Aurélie; Van Regemorter, Elliott; Wérion, Alexis; Van Regemorter, Victoria; Mourad, Michel; Nyssen-Behets, Catherine; Lengelé, Benoit; Baldeschi, Lelio; Boschi, Antonella; Brichard, Sonia; Daumerie, Chantal; Many, Marie-Christine

    2015-09-01

    Graves' orbitopathy (GO) is the main extrathyroidal manifestation associated with Graves' disease (GD). It is characterized by reduced eye motility due to an increased volume of orbital fat and/or of extraocular muscles (EOMs) infiltrated by fibrosis and adipose tissue. The pathogenetic mechanisms leading to fibrosis and adipogenesis are mainly based on the interaction between orbital fibroblasts and immune cells (lymphocytes and mast cells) infiltrating the GO EOMs. Analysis of the morphological status, oxidative stress (OS), and antioxidant defenses in the orbital muscular cells and adipocytes in GO patients compared with controls was conducted. Both cell types are affected by OS, as shown by the increased expression of 4-hydroxynonenal, which leads to apoptosis in muscular cells. However, the EOMs and the adipocytes possess antioxidant defenses (peroxiredoxin 5 and catalase) against the OS, which are also upregulated in thyrocytes in GD. The expression of adiponectin (ApN) and proliferator-activated receptor gamma (PPARγ) is also increased in GO muscular cells and adipocytes. OS and antioxidant proteins expression are correlated to the level of blood antithyrotropin receptor antibodies (TSHR-Ab). Even when TSHR-Ab level is normalized, OS and antioxidant protein expression is high in EOM muscular cells and adipocytes in GO compared with controls. This justifies a supplementation with antioxidants in active as well as chronic GO patients. Orbital muscular cells are also the sources of PPARγ and ApN, which have direct or indirect local protective effects against OS. Modulation of these proteins could be considered as a future therapeutic approach for GO.

  2. Paso superior en una ladera

    Directory of Open Access Journals (Sweden)

    Bender, O.

    1965-07-01

    Full Text Available The Redwood highway, through the Californian forest, runs on a viaduct, as it crosses a mountain slope of about 45° inclination. The firm ground is fairly deep, and as an additional constructional difficulty, it was necessary to respect the natural beauty of the countryside. A structure of portal frames were built, forming a number of short spans. These spans were bridged with metal girders, on which a 19 m wide deck was placed. The columns are hollow and have a transversal cross beam, to join each pair. There was difficulty in excavating the foundations for the columns, as it was necessary to dig through the soft top soil, and also prevent this soil from hurting the trunks of the forest trees. Another significant difficulty in the construction of this viaduct was the access to the working site, since there were no suitable platforms from which to operate the appropriate machinery. This made it necessary to do a lot of the work by manual operation. As one of the edges of the deck is very close to the mountain side, a supporting beam was erected on this side. It was made of concrete, on metal piles. The formwork for the deck structure was placed on the concrete stems of the supporting piles.La autopista denominada Redwood (California salva, con un paso superior, la ladera de un bosque cuya pendiente es del 1/1. El terreno firme se halla a bastante profundidad, añadiéndose, a los naturales problemas de la construcción, el imperativo de respetar la belleza agreste del paraje. La solución adoptada consiste en una estructura porticada, con varios tramos de pequeñas luces, salvados con vigas metálicas, sobre los que se coloca la losa del tablero, de 19 m de anchura total. Los soportes están constituidos por pórticos de dos montantes huecos (con bases de hormigón en masa por debajo del suelo, hasta el firme coronados por un cabezal. La perforación de pozos para el hormigonado de los montantes presentaba la dificultad de atravesar el terreno

  3. Prolonged vestibular stimulation induces homeostatic plasticity of the vestibulo-ocular reflex in larval Xenopus laevis.

    Science.gov (United States)

    Dietrich, Haike; Straka, Hans

    2016-07-01

    Vestibulo-ocular reflexes (VOR) stabilise retinal images during head/body motion in vertebrates by generating spatio-temporally precise extraocular motor commands for corrective eye movements. While VOR performance is generally robust with a relatively stable gain, cerebellar circuits are capable of adapting the underlying sensory-motor transformation. Here, we studied cerebellum-dependent VOR plasticity by recording head motion-induced lateral rectus and superior oblique extraocular motor discharge in semi-intact preparations of Xenopus laevis tadpoles. In the absence of visual feedback, prolonged sinusoidal rotation caused either an increase or decrease of the VOR gain depending on the motion stimulus amplitude. The observed changes in extraocular motor discharge gradually saturated after 20 min of constant rotation and returned to baseline in the absence of motion stimulation. Furthermore, plastic changes in lateral rectus and superior oblique motor commands were plane-specific for horizontal and vertical rotations, respectively, suggesting that alterations are restricted to principal VOR connections. Comparison of multi- and single-unit activity indicated that plasticity occurs in all recorded units of a given extraocular motor nucleus. Ablation of the cerebellum abolished motoneuronal gain changes and prevented the induction of plasticity, thus demonstrating that both acquisition and retention of this type of plasticity require an intact cerebellar circuitry. In conclusion, the plane-specific and stimulus intensity-dependent modification of the VOR gain through the feed-forward cerebellar circuitry represents a homeostatic plasticity that likely maintains an optimal working range for the underlying sensory-motor transformation.

  4. Pseudodisplacements of superior vena cava catheter in the persistent left superior vena cava

    Energy Technology Data Exchange (ETDEWEB)

    Jantsch, H.; Draxler, V.; Muhar, U.; Schlemmer, M.; Waneck, R.

    1983-01-01

    Pseudodisplacement of a left sided superior vena cava catheter in a persistent superior vena cava may be expected in adults in 0,37% and in a group of children with congenital heart disease in 2,5%. Embryology, anatomy and clinical implications is discussed on the basis of our own cases. The vena cava superior sinistra persitents is depending on a sufficient calibre a suitable vessel for a superior cava catheter.

  5. Superiority in value and the repugnant conclusion

    DEFF Research Database (Denmark)

    Jensen, Karsten Klint

    2007-01-01

    James Griffin has considered a weak form of superiority in value a possible remedy to the Repugnant Conclusion. In this paper, I demonstrate that, in a context where value is additive, this weaker form collapses into a stronger form of superiority. And in a context where value is non-additive, weak...... superiority does not amount to a radical value difference at all. I then spell out the consequences of these results for different interpretations of Griffin's suggestion regarding population ethics. None of them comes out very successful, but perhaps they nevertheless retain some interest....

  6. Millian superiorities and the repugnant conclusion

    DEFF Research Database (Denmark)

    Jensen, Karsten Klint

    2008-01-01

    James Griffin has considered a form of superiority in value that is weaker than lexical priority as a possible remedy to the Repugnant Conclusion. In this article, I demonstrate that, in a context where value is additive, this weaker form collapses into the stronger form of superiority. And in a ......James Griffin has considered a form of superiority in value that is weaker than lexical priority as a possible remedy to the Repugnant Conclusion. In this article, I demonstrate that, in a context where value is additive, this weaker form collapses into the stronger form of superiority...... of these results for different interpretations of Griffin's suggestion regarding population ethics. None of them comes out very successful, but perhaps they nevertheless retain some interest....

  7. Measuring Financial Gains from Genetically Superior Trees

    Science.gov (United States)

    George Dutrow; Clark Row

    1976-01-01

    Planting genetically superior loblolly pines will probably yield high profits.Forest economists have made computer simulations that predict financial gains expected from a tree improvement program under actual field conditions.

  8. Superior mesenteric artery syndrome causing growth retardation

    Directory of Open Access Journals (Sweden)

    Halil İbrahim Taşcı

    2013-03-01

    Full Text Available Superior mesenteric artery syndrome is a rare and lifethreateningclinical condition caused by the compressionof the third portion of the duodenum between the aortaand the superior mesenteric artery’s proximal part. Thiscompression may lead to chronic intermittent, acute totalor partial obstruction. Sudden weight-loss and the relateddecrease in the fat tissue are considered to be the etiologicalreason of acute stenosis. Weight-loss accompaniedby nausea, vomiting, anorexia, epigastric pain, andbloating are the leading complaints. Barium radiographs,computerized tomography, conventional angiography,tomographic and magnetic resonance angiography areused in the diagnosis. There are medical and surgical approachesto treatment. We hereby present the case ofa patient with superior mesenteric artery syndrome withdelayed diagnosis.Key words: superior mesenteric artery syndrome, nausea-vomiting, anorexia

  9. Susceptible mechanisms of extraocular muscles in the passive transferred experimental myasthenia gravis rats%重症肌无力被动转移大鼠模型眼外肌的易感机制研究

    Institute of Scientific and Technical Information of China (English)

    刘睿; 王桂平; 杜婴; 周琼; 苗建亭; 李柱一

    2012-01-01

    目的 探讨眼外肌在重症肌无力发病过程中的易感机制.方法 给予SD大鼠腹腔注射mAb35建立重症肌无力被动转移(PTMG)大鼠模型,对照组大鼠注射等量生理盐水.选取PTMG组和对照组大鼠眼外肌、膈肌、胫前肌3种骨骼肌组织.采用乙酰胆碱酯酶(AChE)染色法观察神经肌肉接头(NMJ)并检测NMJ面积和灰度;采用银环蛇毒免疫组化法检测乙酰胆碱受体( AChR)数量;采用电镜观察NMJ超微结构和其AChR情况,并分析比较神经末端面积和突触后膜面积的比值以及突触前后膜长度的比值.结果 AChE染色结果显示,对照组眼外肌NMJ面积相对其他两种骨骼肌更小(P<0.01),PTMG组眼外肌与其他两种骨骼肌NMJ面积比较无统计学差异(P>0.05).银环蛇毒免疫组化结果显示,PTMG组和对照组眼外肌与其它两种骨骼肌间AChR灰度值比较均有统计学差异(P<0.01).电镜观察结果显示,PTMG组3种骨骼肌突触前后膜长度比值均较对照组下降(P<0.01),神经末端面积与突触后膜面积比值较对照组增加(P<0.01),其中眼外肌的变化较其他骨骼肌更为显著.结论 PTMG大鼠模型眼外肌易感机制可能与眼外肌和其他骨骼肌间NMJ面积、AChR数量差异造成眼外肌NMJ安全系数较低有关.%Objective To investigate the susceptible mechanisms of extraocular muscles in passive transferred experimental myasthenia gravis ( PTMG) rats. Methods PTMG model was induced by intraperitoneally injection of purified monoclonal antibody 35. The control group were intraperitoneally injected with normal saline. The extraocular muscles, diaphragms and tibial front muscles in the PTMG group and control group were dissected. Acetylcholinesterase staining, which showed neuromuscular junctions, and alpha bungarotoxin immunohistochemical reaction, which showed acetylcholine receptors (AChR) were used. Neuromuscular junction (NMJ) ultrastructure was observed by transmission

  10. Leiomyosarcoma of the superior vena cava.

    Science.gov (United States)

    de Chaumont, Arthus; Pierret, Charles; de Kerangal, Xavier; Le Moulec, Sylvestre; Laborde, François

    2014-08-01

    Leiomyosarcoma of the superior vena cava is a very rare tumor and only a few cases have been reported, with various techniques of vascular reconstruction. We describe a new case of leiomyosarcoma of the superior vena cava in a 61-year-old woman with extension to the brachiocephalic arterial trunk. Resection and vascular reconstruction were performed using, respectively, polytetrafluoroethylene and polyethylene terephtalate vascular grafts.

  11. Superior mesenteric artery compression syndrome - case report

    OpenAIRE

    Paulo Rocha França Neto; Rodrigo de Almeida Paiva; Antônio Lacerda Filho; Fábio Lopes de Queiroz; Teon Noronha

    2011-01-01

    Superior mesenteric artery syndrome is an entity generally caused by the loss of the intervening mesenteric fat pad, resulting in compression of the third portion of the duodenum by the superior mesenteric artery. This article reports the case of a patient with irremovable metastatic adenocarcinoma in the sigmoid colon, that evolved with intense vomiting. Intestinal transit was carried out, which showed important gastric dilation extended until the third portion of the duodenum, compatible wi...

  12. In children undergoing umbilical hernia repair is rectus sheath block effective at reducing post-operative pain? Best evidence topic (bet).

    Science.gov (United States)

    Rajwani, Kapil M; Butler, Sarah; Mahomed, Anies

    2014-12-01

    A best evidence topic was constructed according to a structured protocol. The question addressed was: In children undergoing umbilical hernia repair is a rectus sheath block (RSB) better than local anaesthetic infiltration of the surgical site, at reducing post-operative pain? From a total of 34 papers, three studies provided the best available evidence on this topic. One randomised clinical trial showed RSB had a better analgesic effect in the immediate post-operative period. In another randomised trial opioid consumption in the peri-operative period was found to be significantly lower in patients administered RSB. These improvements in pain and analgesia consumption need to be balanced against the expertise, training, equipment required, time implications and complications of performing a RSB.

  13. Transverse rectus abdominis musculocutaneous flap (TRAM flap - experimental model in rats Modelo experimental do retalho musculocutâneo abdominal transverso de músculo reto do abdome

    Directory of Open Access Journals (Sweden)

    Pedro Bins Ely

    2003-01-01

    Full Text Available The objective of this paper was to report the use of an experimental model of the Transverse Rectus Abdominis Musculocutaneous flap (TRAM flap, in rats. Thirty male Wistar rats weighing 180 to 220 g were submitted to the TRAM flap procedure. This article reports on the use of the caudally based, right unipedicled TRAM flap.Este artigo relata e divulga um modelo experimental do retalho musculocutâneo abdominal transverso de músculo reto do abdome (TRAM flap, em ratos. Foram utilizados 30 ratos Wistar (Rattus norvegicus albinus, Rodentia, Mammalia machos, adultos, com peso individual variando entre 180 e 220 gramas. Os animais foram submetidos ao procedimento operatório do retalho musculocutâneo abdominal transverso de músculo reto do abdome (TRAM flap, de base caudal com pedículo do músculo reto do abdome unilateral à direita.

  14. Immunohistochemical evaluation of fibrillar components of the extracellular matrix of transversalis fascia and anterior abdominal rectus sheath in men with inguinal hernia

    Directory of Open Access Journals (Sweden)

    Rogério De Oliveira Gonçalves

    Full Text Available OBJECTIVE: to evaluate the role of fibrillar extracellular matrix components in the pathogenesis of inguinal hernias. METHODS: samples of the transverse fascia and of the anterior sheath of the rectus abdominis muscle were collected from 40 men aged between 20 and 60 years with type II and IIIA Nyhus inguinal hernia and from 10 fresh male cadavers (controls without hernia in the same age range. The staining technique was immunohistochemistry for collagen I, collagen III and elastic fibers; quantification of fibrillar components was performed with an image analysis processing software. RESULTS: no statistically significant differences were found in the amount of elastic fibers, collagen I and collagen III, and the ratio of collagen I / III among patients with inguinal hernia when compared with subjects without hernia. CONCLUSION: the amount of fibrillar extracellular matrix components did not change in patients with and without inguinal hernia.

  15. Association of cross-sectional area of the rectus capitis posterior minor muscle with active trigger points in chronic tension-type headache: a pilot study.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Cuadrado, María Luz; Arendt-Nielsen, Lars; Ge, Hong-You; Pareja, Juan A

    2008-03-01

    To investigate whether cross-sectional area (CSA) of the suboccipital muscles was associated with active trigger points (TrPs) in chronic tension-type headache (CTTH). Magnetic resonance imaging (MRI) of the cervical spine was performed in 11 females with CTTH aged from 26 to 50 yrs old. CSA for both rectus capitis posterior minor (RCPmin) and rectus capitis posterior major (RCPmaj) muscles were measured from axial T1-weighted images, using axial MRI slices aligned parallel to the C2/3 intervertebral disc. A headache diary was kept for 4 wks to record the pain history. TrPs in the suboccipital muscle were identified by eliciting referred pain to palpation, and increased referred pain with muscle contraction. TrPs were considered active if the elicited referred pain reproduced the head pain pattern and features of the pattern seen during spontaneous headache attacks. Active TrPs were found in six patients (55%), whereas the remaining five patients showed latent TrPs. CSA of the RCPmin was significantly smaller (F = 13.843; P = 0.002) in the patients with active TrPs (right side: 55.9 +/- 4.4 mm; left side: 61.1 +/-: 3.8 mm) than in patients with latent TrPs (right side: 96.9 +/- 14.4 mm; left side: 88.7 +/- 9.7 mm). No significant differences were found for CSA of the RCPmaj between the patients with either active or latent TrP (P > 0.5). It seems that muscle atrophy in the RCPmin, but not in the RCPmaj, was associated with suboccipital active TrPs in CTTH, although studies with larger sample sizes are now required. It may be that nociceptive inputs in active TrPs could lead to muscle atrophy of the involved muscles. Muscle disuse or avoidance behavior can also be involved in atrophy.

  16. OUTCOMES OF BREAST RECONSTRUCTION WITH PEDICLED TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS (TRAM FLAP AT CANCER INSTITUTE, A RETROSPECTIVE STUDY OF 10 YEARS OF EXPERIENCE

    Directory of Open Access Journals (Sweden)

    R. Omranipour

    2008-06-01

    Full Text Available Reconstruction of breast with transverse rectus abdominis myocutaneous (TRAM flap is the standard for reconstruction of breast following mastectomy. In this article, authors report their experience with pedicled TRAM flap reconstruction of the breast. Records for the patients who had undergone breast reconstruction with pedicled TRAM flap were retrieved. Records of outpatient follow-ups were also obtained. Patient satisfaction with the outcome of surgery was assessed using a detailed questionnaire including a linear visual analogue scale ranging from zero (not satisfied to ten (most satisfied. There were 61 reconstructions in 59 patients. In 42 (71.2% cases a synthetic mesh and in 14 (23.7% cases dermal graft was used for closure of the abdominal fascial defect. The mean hospital stay was 10.67 (1 - 72 days. Patients were followed up for a mean period of 621 days. The overall rates of complications were as follows: partial flap necrosis: 11 (18.6%, flap hematoma: 2 (3.4%, flap seroma: 7 (11.9%, flap wound infection: 7 (11.9%, abdominal wound hematoma: 9 (15.3%, abdominal wound seroma: 5 (8.5%, abdominal wound ischemia: 1 (1.7%, abdominal wound incisional hernia: 6 (10.2%, deep vein thrombosis: 1 (1.7%, complication requiring rehospitalization: 9 (15.3%, complication requiring reoperation: 8 (13.6%. There were no abdominal wound infection, no umbilical necrosis, and no pulmonary embolism. Aesthetic results were classified as excellent (62%, good (28%, fair (10%. The mean satisfaction score was 9.5 (range 6-10. Breast reconstruction with pedicled transverse rectus abdominis myocutaneous flap was associated with a low complication rate and a high level of patient satisfaction in our center.

  17. Superior oblique surgery: when and how?

    Directory of Open Access Journals (Sweden)

    Taylan Şekeroğlu H

    2013-08-01

    Full Text Available Hande Taylan Şekeroğlu,1 Ali Sefik Sanac,1 Umut Arslan,2 Emin Cumhur Sener11Department of Ophthalmology, 2Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, TurkeyBackground: The purpose of this paper is to review different types of superior oblique muscle surgeries, to describe the main areas in clinical practice where superior oblique surgery is required or preferred, and to discuss the preferred types of superior oblique surgery with respect to their clinical outcomes.Methods: A consecutive nonrandomized retrospective series of patients who had undergone superior oblique muscle surgery as a single procedure were enrolled in the study. The diagnosis, clinical features, preoperative and postoperative vertical deviations in primary position, type of surgery, complications, and clinical outcomes were reviewed. The primary outcome measures were the type of strabismus and the type of superior oblique muscle surgery. The secondary outcome measure was the results of the surgeries.Results: The review identified 40 (20 male, 20 female patients with a median age of 6 (2–45 years. Nineteen patients (47.5% had Brown syndrome, eleven (27.5% had fourth nerve palsy, and ten (25.0% had horizontal deviations with A pattern. The most commonly performed surgery was superior oblique tenotomy in 29 (72.5% patients followed by superior oblique tuck in eleven (27.5% patients. The amount of vertical deviation in the fourth nerve palsy and Brown syndrome groups (P = 0.01 for both and the amount of A pattern in the A pattern group were significantly reduced postoperatively (P = 0.02.Conclusion: Surgery for the superior oblique muscle requires experience and appropriate preoperative evaluation in view of its challenging nature. The main indications are Brown syndrome, fourth nerve palsy, and A pattern deviations. Superior oblique surgery may be effective in terms of pattern collapse and correction of vertical deviations in primary

  18. Surgical treatment of congenital superior oblique muscle paralysis%先天性单侧上斜肌麻痹的手术方式分析

    Institute of Scientific and Technical Information of China (English)

    胡卫群; 蔡佳玉; 刘钊臣; 张丹娜

    2014-01-01

    目的:探讨先天性单侧上斜肌麻痹的手术治疗方法。  方法:本研究回顾分析对68例先天性单侧上斜肌麻痹患者,根据患眼的下斜肌功能亢进程度和原在位垂直斜度大小选择下斜肌切断并部分切除、下斜肌切断并前转位、下斜肌部分切除联合对侧眼下直肌或同侧眼直肌手术。伴有水平斜视者按水平斜视矫正原则一期或分期手术矫正。结果:治愈58例,治愈率85.3%,好转7例,好转率10.3%,无效3例,无效率4.4%。  结论:根据下斜肌亢进程度、垂直斜视度及水平斜度选择不同手术方式,通过一期或分期手术,可有效获得较高治愈率。%AIM: To investigate the surgical treatment of thecongenital superior oblique muscle paralysis. METHODS:The 68 cases of congenital superior oblique muscle paralysis were reviewed and analyzed.According to the degrees of the overaction of inferior oblique muscle and the extension of vertical deviation, we performed three different surgeries: inferior oblique muscle myotomy, inferior oblique muscle anterior transposition and inferior oblique muscle anterior transposition plus superior rectus muscle shortening or inferior rectus muscle recession. Based on the correct principles of horizontal strabismus, the patients were successfully treated if they also have horizontal strabismus problems.RESULTS:Totally 58 cases were cured (85.3%), 7 cases were improved ( 10.3%) and 3 cases had no effective improvement (4.4%). CONCLUSION:According to degree of the overaction of inferior oblique muscle, the extension of vertical and horizontal deviation, reasonable choice of surgical manners might increase cure rate of the congenital superior oblique muscle paralysis. The most patients obtained satisfactory results after one stage or multiple surgeries.

  19. Whisker-related afferents in superior colliculus.

    Science.gov (United States)

    Castro-Alamancos, Manuel A; Favero, Morgana

    2016-05-01

    Rodents use their whiskers to explore the environment, and the superior colliculus is part of the neural circuits that process this sensorimotor information. Cells in the intermediate layers of the superior colliculus integrate trigeminotectal afferents from trigeminal complex and corticotectal afferents from barrel cortex. Using histological methods in mice, we found that trigeminotectal and corticotectal synapses overlap somewhat as they innervate the lower and upper portions of the intermediate granular layer, respectively. Using electrophysiological recordings and optogenetics in anesthetized mice in vivo, we showed that, similar to rats, whisker deflections produce two successive responses that are driven by trigeminotectal and corticotectal afferents. We then employed in vivo and slice experiments to characterize the response properties of these afferents. In vivo, corticotectal responses triggered by electrical stimulation of the barrel cortex evoke activity in the superior colliculus that increases with stimulus intensity and depresses with increasing frequency. In slices from adult mice, optogenetic activation of channelrhodopsin-expressing trigeminotectal and corticotectal fibers revealed that cells in the intermediate layers receive more efficacious trigeminotectal, than corticotectal, synaptic inputs. Moreover, the efficacy of trigeminotectal inputs depresses more strongly with increasing frequency than that of corticotectal inputs. The intermediate layers of superior colliculus appear to be tuned to process strong but infrequent trigeminal inputs and weak but more persistent cortical inputs, which explains features of sensory responsiveness, such as the robust rapid sensory adaptation of whisker responses in the superior colliculus. Copyright © 2016 the American Physiological Society.

  20. Superior-subordinate relations as organizational processes

    DEFF Research Database (Denmark)

    Asmuss, Birte; Aggerholm, Helle Kryger; Oshima, Sae

    Since the emergence of the practice turn in social sciences (Golsorkhi et al. 2010), studies have shown a number of institutionally relevant aspects as achievements across time and by means of various resources (human and non-human) (Taylor & van Every 2000, Cooren et al. 2006). Such a process view...... on organizational practices relates closely to an increased focus on communication as being constitutive of the organization in general and the superior-subordinate relationship in specific. The current study aims to contribute to this line of research by investigating micro-practices involved in establishing...... superior-subordinate relations in a specific institutionalized setting: performance appraisal interviews (PAIs). While one main task of PAIs is to manage and integrate organizational and employee performance (Fletcher, 2001:473), PAIs are also organizational practices where superior-subordinate relations...

  1. Lake Superior Aquatic Invasive Species Complete Prevention Plan

    Science.gov (United States)

    The Lake Superior Aquatic Invasive Species Complete Prevention Plan is an expression of the best professional judgment of the members of the Lake Superior Task Force as to what is necessary to protect Lake Superior from new aquatic invasive species.

  2. The relation of the medial rectus muscle supernormal recession and consecutive exotropia%内直肌超常量后徙和继发性外斜视的关系

    Institute of Scientific and Technical Information of China (English)

    孙卫锋

    2010-01-01

    Objective To review the relation of the medial rectus muscle supernormal recession and consecutive exotropia. Methods The chart review of 43 patients who underwent surgery for consecutive extropia in a pediatric ophthalmology practice between 2003 and 2009 was performed retrospectively. To study the relation of the medial rectus muscle normal recession (medial rectus muscle placement from the limbus was ≤ 11.5mm) and supernormal recession (medial rectus muscle placement from the limbus was > 11.5mm) with consecutive exotropia and limitation of adduction. Results Thirteen patients had limitation of adduction, among them, 3/33 patients had a medial rectus muscle normal recession, and 10 patients had supernormal recession. The difference was significant according to the x2 test P <0.05. For 10 patients who had supernormal recession with limitation of adduction, among them, 6 patients readvancement of the medial rectus muscle obtained a suitable ocular alignment and with normal of adduction after operation, 4 patients who were resection of the medial rectus muscle, 1 patient had mild limitations of adduction, but had a suitable ocular alignment, the other 3 patients who persisted in limitation of adduction and consecutive exotropia. Of 39 patients who were medial rectus muscle placement from the limbus was ≤ 11.5mm, 35 patients (89.7%) had a suitable ocular alignment after operation; 4 patients who were medial rectus muscle placement from the limbus was >11.5 mm, only 1 patient (25%) had a suitable ocular alignment after operation. Conclusions The medial rectus muscle supemormal recession in patients with a residual limitation of adduction and the major reason of consecutive exotropia is a residual limitation of adduction. Only resection of the medial rectus muscle postoperative ocular alignment would drift, we recommend lateral rectus recession with medial rectus muscle advancement of the previously recessed medial rectus as a suitable procedure.%目的 研

  3. Endovascular treatment of superior vena cava syndrome

    DEFF Research Database (Denmark)

    Duvnjak, Stevo; Andersen, Poul Erik

    2011-01-01

    Abstract AIM: The aim of this study was to report our experience with palliative stent treatment of superior vena cava syndrome. METHODS: Between January 2008 and December 2009, 30 patients (mean age 60.7 years) were treated with stents because of stenosed superior vena cava. All patients presented...... there was an immediate clinical improvement with considerable reduction in the edema of upper extremities and head. There was, however, continous dyspnea in five patients (17%) and two patients (7%) had persistent visible collateral venous circulations on the upper chest. There were no stent associated complications...

  4. 先天性眼外肌纤维化一家系临床分析及手术治疗%Clinical features and surgical treatment on a family with congenital fibrosis of the extraocular muscles

    Institute of Scientific and Technical Information of China (English)

    张剑飞; 王亚丽; 陈静; 乔珊丽

    2014-01-01

    AIM: To investigate the clinical characteristics, surgical outcome and curative effect of congenital fibrosis of the extraocular muscles ( CFEOM) . METHODS: The eye exam of members in a Chinese family with CFEOM includes visual acuity, intraocular pressure, dilated fundus exam, extraocular muscle function test, orbital CT scan, and ultrasound. We did extraocular muscle surgery or frontalis suspension procedure for affected subjects in the family. RESULTS: The incidence of CFEOM in this family was 31%. All patients were affected bilateraly with symptom of congenital eye movement disorder, ptosis, hypotropia, perverted convergence on upgaze and chin up head position. As the age grows, the diseases worsen unobviously. No other systemic disorder was found. Surgical treatment improved the anomalous head position although the ocular movement disorder preserved. CONCLUSION: The pattern of inheritance in our serial patients are autosomal dominant. Surgery can improve chin up head position and cosmetic appearance. However, the eye movement deficiency cannot be improved.%目的:探讨家族性先天性眼外肌纤维化的临床特点、手术治疗方法及疗效。  方法:对先天性眼外肌纤维化家系成员进行眼部的各项检查,包括:视力、眼压、眼底、眼外肌功能、眼眶CT、双眼B超等检查,并对部分患者行斜视矫正术及额肌悬吊术。  结果:该家系眼外肌纤维化发病率为31%。该家系各患者均双眼受累,自幼表现为眼球运动障碍、上睑下垂,眼球位于下转位,向正前方注视时伴有异常辐辏,向前注视抬下颌。随年龄增长病情加重不明显。其他全身系统器官未见异常。经手术治疗,下颌上抬及外观可获得明显改善,眼球运动改善不明显。  结论:该家系具有常染色体显性遗传特征。通过手术治疗可改善头位及外观。眼球运动无明显改善。

  5. Magnetic resonance imaging evaluation of meniscoid superior labrum: normal variant or superior labral tear*

    Science.gov (United States)

    Simão, Marcelo Novelino; Vinson, Emily N.; Spritzer, Charles E.

    2016-01-01

    Objective The objective of this study was to determine the incidence of a "meniscoid" superior labrum. Materials and Methods This was a retrospective analysis of 582 magnetic resonance imaging examinations of shoulders. Of those 582 examinations, 110 were excluded, for a variety of reasons, and the final analysis therefore included 472 cases. Consensus readings were performed by three musculoskeletal radiologists using specific criteria to diagnose meniscoid labra. Results A meniscoid superior labrum was identified in 48 (10.2%) of the 472 cases evaluated. Arthroscopic proof was available in 21 cases (43.8%). In 10 (47.6%) of those 21 cases, the operative report did not include the mention a superior labral tear, thus suggesting the presence of a meniscoid labrum. In only one of those cases were there specific comments about a mobile superior labrum (i.e., meniscoid labrum). In the remaining 11 (52.4%), surgical correlation demonstrated superior labral tears. Conclusion A meniscoid superior labrum is not an infrequent finding. Depending upon assumptions and the requirement of surgical proof, the prevalence of a meniscoid superior labrum in this study was between 2.1% (surgically proven) and 4.8% (projected). However, superior labral tears are just as common and are often confused with meniscoid labra. PMID:27777474

  6. 80例以复视为首发症状的眼外肌麻痹病因分析%Analysis of 80 cases of extraocular muscles paralysis with diplopia

    Institute of Scientific and Technical Information of China (English)

    李彬

    2014-01-01

    目的:探讨以复视为首发症状的眼肌麻痹患者的临床特征、鉴别诊断,探讨其病因及发病机制。方法回顾分析2008至2013年我院神经内科收治以复视症状为主症的眼肌麻痹患者80例,根据病史、详细的查体和眼部检查,分析其发病原因。结果80例病例中,糖尿病性眼肌麻痹24例(动眼神经麻痹16例,外展神经麻痹6例,合并动眼神经、外展神经麻痹2例),脑血管病20例,动脉粥样硬化性动眼神经、外展神经麻痹18例,颅内动脉瘤者10例,重症肌无力眼肌型2例,躯体形式障碍1例,颅内肿瘤2例,多发性硬化1例,神经梅毒1例,脑干脑炎1例。结论很多神经系统疾病可引起复视的神经眼科体征,其中糖尿病性眼肌麻痹为最主要病因,脑血管病、动脉瘤眼肌麻痹、动脉粥样硬化也是重要原因,其他还有重症肌无力(眼肌型)、躯体形式障碍、颅内占位等。以复视为首发症状的急性眼外肌麻痹病因复杂,容易误诊,临床医生应高度重视,明确诊断,以达到正确治疗。%Objective To evaluate clinical features of extraocular muscles paralysis that initially presented with di -plopia.Methods Eighty cases with extraocular muscles paralysis were analyzed for causes of disease by reviewing medical history, a thorough physical examination and a complete eye examination .The clinical features were studied .Results Twenty-four patients with extraocular muscles paralysis were caused by diabetes , including oculomotor nerve paralysis ( 16 cases), abducent nerve paralysis (6 cases), and combination of oculomotor nerve and abducent nerve paralysis (2 cases). Twenty cases were caused by cerebrovascular diseases , and 18 cases were caused by arteriosclerosis resulted oculomotor and abducent nerve paralysis .Ten cases were caused by intracranial aneurysms ,two cases by myasthenia gravis ,one case by so-matization disorder ,two by

  7. 带状疱疹并发眼外肌麻痹11例临床分析%Analysis of 11 cases of herpes zoster complicated by extraocular muscles paralysis

    Institute of Scientific and Technical Information of China (English)

    杨晓鸥

    2012-01-01

    11例带状疱疹并发眼外肌麻痹患者均表现为眼睑及周围皮肤带状疱疹,疹后14天~2个月出现复视、斜视,持续4周~2个月.早期眼部外用、严重者系统应用糖皮质激素治疗可防止眼部后遗症的发生.%Eleven cases of herpes zoster complicated by extraocular muscles paralysis were reported. All cases presented herpes zoster of eyelids and nearby skin. Ten days to two months after the onset of herpes zoster, diplopia and esotropia occurred and lasted for 4 weeks to 2 months. Early application of glucocorticoids can prevent the occurrence of ocular sequelae.

  8. Reconstrucción mamaria con el colgajo musculocutáneo recto abdominal transverso (TRAM Breast reconstruction with the transverse rectus abdominis musculocutaneous (TRAM flap

    Directory of Open Access Journals (Sweden)

    J. A. Lozano

    2005-01-01

    Full Text Available El colgajo musculocutáneo de recto abdominal transverso ha sido la técnica quirúrgica más utilizada en reconstrucción mamaria autógena. Proporciona una nueva mama con volumen adecuado, ptosis, aspecto natural y no requiere la implantación de prótesis, obteniéndose una buena simetría con la mama contralateral, que perdura en el tiempo. El inconveniente de esta técnica es la morbilidad de la pared abdominal. Este colgajo sacrifica el músculo y la vaina anterior del recto que puede tener consecuencias como hernias y eventraciones. Para minimizar este problema se desarrolló el colgajo de recto abdominal microquirúrgico, que sólo sacrifica una porción muscular, disminuyendo significativamente el número de secuelas. Como inconveniente presenta la dificultad de la técnica quirúrgica, requiriendo dominio de la microcirugía vasculonerviosa. En conclusión, se puede devolver a la mujer mastectomizada una nueva mama de forma completamente autógena, con volumen, forma y textura similares al lado sano que ayude, en definitiva, a recuperar la autoestima perdida.The transverse rectus abdominis musculocutaneous (TRAM flap has been the most employed technique in autogenous breast reconstruction. It provides a new breast of adequate volume, ptosis and natural appearance, and does not require the implantation of prosthesis; a good symmetry with the contralateral breast is obtained, which lasts over time. The drawback of this technique is the morbidity of the abdominal wall. This flap sacrifices the muscle and the anterior rectus sheath which can result in consequences such as hernias and eventrations. To minimise this problem the microsurgical TRAM flap was developed, which only sacrifices a portion of muscle, significantly reducing the number of sequels. A drawback is the difficulty of the surgical technique, which requires mastery of vascular-nervous microsurgery. In conclusion, a new breast can be returned to the mastectomised woman in a

  9. Superior-subordinate relations as organizational processes

    DEFF Research Database (Denmark)

    Asmuss, Birte; Aggerholm, Helle Kryger; Oshima, Sae

    Since the emergence of the practice turn in social sciences (Golsorkhi et al. 2010), studies have shown a number of institutionally relevant aspects as achievements across time and by means of various resources (human and non-human) (Taylor & van Every 2000, Cooren et al. 2006). Such a process view...... superior-subordinate relations in a specific institutionalized setting: performance appraisal interviews (PAIs). While one main task of PAIs is to manage and integrate organizational and employee performance (Fletcher, 2001:473), PAIs are also organizational practices where superior-subordinate relations...... are shaped, (re)confirmed and re-evaluated. This paper pursues the better understanding of the latter aspect by looking at one substantial and recurrent activity in PAIs: the evaluation of employee performance. One resource for doing the evaluation work is making assessments (e.g. Goodwin & Goodwin, 1987...

  10. Exploring the word superiority effect using TVA

    DEFF Research Database (Denmark)

    Starrfelt, Randi

    Words are made of letters, and yet sometimes it is easier to identify a word than a single letter. This word superiority effect (WSE) has been observed when written stimuli are presented very briefly or degraded by visual noise. It is unclear, however, if this is due to a lower threshold...... for perception of words, or a higher speed of processing for words than letters. We have investigated the WSE using methods based on a Theory of Visual Attention. In an experiment using single stimuli (words or letters) presented centrally, we show that the classical WSE is specifically reflected in perceptual...... processing speed: words are simply processed faster than single letters. It is also clear from this experiment, that the word superiority effect can be observed at a large range of exposure durations, from the perceptual threshold to ceiling performance. Intriguingly, when multiple stimuli are presented...

  11. Resolution of superior oblique myokymia with memantine.

    Science.gov (United States)

    Jain, Saurabh; Farooq, Shegufta J; Gottlob, Irene

    2008-02-01

    We describe a novel treatment of superior oblique myokymia. A 40-year-old woman was treated with gabapentin for this disorder with partial success and reported significant side effects including loss of libido and weight gain. After a drug holiday, memantine therapy was initiated resulting in a substantial improvement in her symptoms with far fewer side effects and stability on long-term maintenance therapy.

  12. Locked Superior Dislocation of the Acromioclavicular Joint

    Directory of Open Access Journals (Sweden)

    Salma Eltoum Elamin

    2013-01-01

    Full Text Available Acromioclavicular (AC joint injuries account for approximately 3–5% of shoulder girdle injuries (Rockwood et al., 1998. Depending on severity of injury and direction of displacement these are classified using Rockwood classification system for AC joint dislocation. We present an unusual case presenting with locked superior dislocation of the AC joint highlighting the presentation and subsequent successful surgical management of such case. To our knowledge this has not been reported previously in literature.

  13. Reperfusion hemorrhage following superior mesenteric artery stenting.

    LENUS (Irish Health Repository)

    Moore, Michael

    2012-02-03

    Percutaneous transluminal angioplasty and stent placement is now an established treatment option for chronic mesenteric ischemia and is associated with low mortality and morbidity rates. We present a case of reperfusion hemorrhage complicating endovascular repair of superior mesenteric artery stenosis. Although a recognized complication following repair of carotid stenosis, hemorrhage has not previously been reported following mesenteric endovascular reperfusion. We describe both spontaneous cessation of bleeding and treatment with coil embolization.

  14. [Mitral surgery by superior biatrial septotomy].

    Science.gov (United States)

    Saade, A; Delepine, G; Lemaitre, C; Baehrel, B

    1995-01-01

    The superior biatrial septotomy approach consists of two semicircular right atrial and septal incisions joined at the superior end of the interatrial septum and extended across the dome of the left atrium, allowing exposure of the mitral valve by reflecting the ventricular side using stay sutures. From 1991 to 1993, 81 patients underwent mitral valve surgery by this technic. Mitral valve operation was combined with other cardiac procedures in 30 patients (37%) and was performed as a second operation in 21 patients (25.9%). Duration of cardiopulmonary bypass and aortic occlusion was not significantly different from that of patients operated via a conventional left atrial approach. The five hospital deaths (6.2%) were not related to this operative approach. Only 2 patients (3.3%) with preoperative in sinus rythm were discharged in atrial fibrillation after operation. In one patient (1.6%), atrioventricular block appeared at late follow-up. There were no cases of bleeding, atrioventricular nodal dysfunction or intra-atrial shunting related to the approach. This approach provides excellent exposure of the mitral valve even in unfavorable situations such as a small left atrium, dense adhesions from previous procedures or a previously implanted aortic prosthesis, without damage to various cardiac structures due to excessive traction. No retractor or vena cava repair are required. These data support a wide application of the superior biatrial septotomy approach in mitral valve surgery.

  15. Stretchability of the rectus femoris muscle: investigation of validity and intratester reliability of two methods including X-ray analysis of pelvic tilt.

    Science.gov (United States)

    Hamberg, J; Björklund, M; Nordgren, B; Sahlstedt, B

    1993-03-01

    Validity and intratester reliability of two test methods designed to identify stretchability of the rectus femoris muscle (RFM) was investigated, combined with x-ray analysis of pelvic tilt in the sagittal plane. The first method is commonly used in clinical practice. The second is a new technique supposed to tilt the pelvis posteriorly and thus further separate the origin and insertion of the muscle. Investigation of validity and intratester reliability of the two methods was made by testing and retesting a random sample of 71 persons. The tests were performed with an equipment that automatically recorded the angle of knee flexion from a previously determined applied torque, indicating the end point of motion for that particular subject. Angle of knee flexion and subjective estimation of pain sensation due to stretch were recorded at each measurement. The pelvic tilt-analysis consisted of test-retest reliability of x-ray measurements, comparison between the methods in both starting and final position, and x-ray and electronic goniometer measurements. All applied torques were measured with a strain gauge. Two out of three criteria of validity favored the new method and the third pointed out the two methods as equal. The two methods as well as the x-ray measurements showed high reliability, and the hypothesis of a more posterior tilted pelvis in the new method was confirmed. The electronic goniometer was less sensitive than x-ray, but proposed to analyse pelvic tilt clinically. Methodology procedures for joint angle measurements are discussed.

  16. Bilateral rectus sheath haematoma complicating dengue virus infection in a patient on warfarin for mechanical aortic valve replacement: a case report.

    Science.gov (United States)

    Rosa, Chamith Thushanga; Navinan, Mitrakrishnan Rayno; Samarawickrama, Sincy; Hamza, Himam; Gunarathne, Maheshika; Arulanantham, Arulprashanth; Subba, Neeha; Samarasiri, Udari; Mathias, Thushara; Kulatunga, Aruna

    2017-01-07

    The management of Dengue virus infection can be challenging. Varied presentations and numerous complications intrinsic to dengue by itself increase the complexity of treatment and potential mortality. When burdened with the presence of additional comorbidities and the need to continue compulsory medications, clear stepwise definitive guidance is lacking and patients tend to have more complex complications and outcomes calling to question the clinical decisions that may have been taken. The use and continuation of warfarin in dengue virus infection is one such example. We report a 65 year old South Asian female who presented with dengue fever. She had a history bronchial asthma, a prior abdominal surgery, and was on warfarin and maintained a therapeutically appropriate internationalized normalized ratio for a mechanical aortic valve replacement. Though preemptive decision to stop warfarin was taken with decreasing platelet counts, her clinical course was complicated with the development of bilateral rectus sheath haematoma's requiring resuscitation with blood transfusions. Though management of dengue viral fever has seen drastic evolution with recent updated guidance, clinical scenarios seen in the course of the illness still pose challenges to the managing physician. The need to continue obligatory anticoagulation which may seem counterintuitive during a complex disease such as dengue virus infection must be considered after understanding the potential risks versus that of its benefits. Though case by case decisions maybe warranted, a clear protocol would be very helpful in making clinical decisions, as the correct preemptive decision may potentially avert catastrophic and unpredictable bleeding events.

  17. Analysis of the abdominal musculo-aponeurotic anatomy in rectus diastasis: comparison of CT scanning and preoperative clinical assessment with direct measurement intraoperatively.

    Science.gov (United States)

    Emanuelsson, P; Dahlstrand, U; Strömsten, U; Gunnarsson, U; Strigård, K; Stark, B

    2014-08-01

    To evaluate and compare the consistency of agreement of two methods for measuring abdominal rectus diastasis (ARD), preoperative computed tomography (CT) scanning and preoperative clinical assessment were compared with direct measurement intraoperatively. Fifty-five consecutive patients were retrieved from an ongoing prospective randomised trial comparing two operative techniques for the repair of ARD. All patients underwent a preoperative clinical assessment and CT scan, and the results were compared with intraoperative measurement of the ARD width. Agreement between methods was described with Bland-Altman plots (BA plots) and calculated using Lin's Concordance Correlation Coefficient (CCC). The median width of the diastasis was 4.0 cm in the upper midline and 3.0 cm in the lower midline for the intraoperative measurement. BA plots showed that measurements on CT and intraoperatively are not in agreement in the lower midline, whereas the agreement was stronger between the clinical and the intraoperative method. The CCC was higher for clinical vs. intraoperative measurement (0.479) than for CT vs. intraoperative measurement (-0.002) in the lower midline, although the agreement was over all low. CT scanning underestimated the width of the ARD when compared to 87 % of preoperative clinical assessments, and 83 % of intraoperative measurements. Preoperative clinical assessment overestimated ARD in 35 % when compared with intraoperative measurements. Clinical assessment prior to surgery provides more accurate information than CT scanning in the assessment of ARD width. CT scanning underestimates ARD width when compared with intraoperative measurement.

  18. Soft tissue release of the spastic hip by psoas-rectus transfer and adductor tenotomy for long-term functional improvement and prevention of hip dislocation.

    Science.gov (United States)

    Heimkes, Bernhard; Martignoni, Kathrin; Utzschneider, Sandra; Stotz, Siegfried

    2011-07-01

    The purpose of this study was to assess the long-term development of children with cerebral palsy treated with soft tissue releases of the hip and, if necessary, also of the hamstrings and the Achilles tendon. The follow-up had to consider the functional status and the hip centration. Seventy-one patients (46 with tetrapareses, 24 with dipareses, and one with triparesis) who underwent soft tissue releases of the hip by the so-called psoas-rectus transfer at an average age of 7 years were assessed preoperatively, after 1 year and at an average age of 19 years. Functional status and the radiological lapse were assigned. The functional status of the patients significantly improved (P<0.001) after surgery. The number of patients who were able to walk increased from 49.3 to 80.3%. The migration percentage decreased from 26.6 to 17.3%. For medium-to-severe functional deficits, a clear gain of function and a safe prevention of spastic hip luxation were achieved.

  19. Effect of Ultrasound Guided Rectus Sheath Block on Postoperative Analgesia after Laparotomy with Transverse Incision in Children

    Directory of Open Access Journals (Sweden)

    Aydin Halefoglu

    2015-09-01

    Material and Methods: Forty patients with ASA I-II physical status, aged 3-7 years and undergoing laparotomy with transverse incision were randomly allocated into two groups. Patients were administered general anesthesia and before the beginning of surgery ultrasound guided RSB with 0.2 mL/kg, 0.25% of levobupivacaine and thirty minutes before the surgery the loading dose of morphine of 0.1 mg/kg intravenously were received in group RSB and group M, respectively. Analgesic drug pump with 0.01 mg/kg bolus doses of morphine and 30 minutes lockout interval was set up postoperatively in both groups. Concentrations (% and consumed amounts (mL/h of sevoflurane during the surgery and systolic and diastolic blood pressure, heart rate, and peripheral oxygen saturation values were recorded both intraoperative and postoperative period in each groups. Analgesic consumption with postoperative analgesic drug pump, FLACC pain scores, sedation level, nausea, vomiting, supplemental analgesic requirement and side effects were also recorded. Results: Demographic data and hemodynamic parameters were similar in both groups excepting that systolic arterial pressure values were reduced in group RSB than in group M. Inhaled concentration and consumed amounts of sevoflurane were decreased in group RSB compared with group M. Averages of consumptions of sevoflurane were 18.7+/-2.1 mL/h and 21.5 +/-2.9 mL/h in group RSB and group M, respectively (p<0.001. Postoperative FLACC scores, sedation scores, and morphine consumption for 24 hours were lower in group RSB than in group M (p<0.001. Three patients had nausea in group M, however no nausea and vomiting was observed in group RSB and any patients did not need supplemental analgesia postoperatively. Conclusions: Ultrasound guided RSB is superior to intravenous morphine according to intraoperative anesthetic gas consumption and postoperative pain control in children undergoing abdominal surgery using transverse incision. [Cukurova Med J 2015; 40

  20. Superior mesenteric artery compression syndrome - case report

    Directory of Open Access Journals (Sweden)

    Paulo Rocha França Neto

    2011-12-01

    Full Text Available Superior mesenteric artery syndrome is an entity generally caused by the loss of the intervening mesenteric fat pad, resulting in compression of the third portion of the duodenum by the superior mesenteric artery. This article reports the case of a patient with irremovable metastatic adenocarcinoma in the sigmoid colon, that evolved with intense vomiting. Intestinal transit was carried out, which showed important gastric dilation extended until the third portion of the duodenum, compatible with superior mesenteric artery syndrome. Considering the patient's nutritional condition, the medical team opted for the conservative treatment. Four months after the surgery and conservative measures, the patient did not present vomiting after eating, maintaining previous weight. Superior mesenteric artery syndrome is uncommon and can have unspecific symptoms. Thus, high suspicion is required for the appropriate clinical adjustment. A barium examination is required to make the diagnosis. The treatment can initially require gastric decompression and hydration, besides reversal of weight loss through adequate nutrition. Surgery should be adopted only in case of clinical treatment failure.A síndrome da artéria mesentérica superior é uma entidade clínica causada geralmente pela perda do tecido adiposo mesentérico, resultando na compressão da terceira porção do duodeno pela artéria mesentérica superior. Esse artigo relata o caso clínico de uma paciente portadora de adenocarcinoma de cólon sigmoide metastático irressecável, que evoluiu com vômitos incoercíveis. Realizou-se, então, trânsito intestinal que evidenciou dilatação gástrica importante, que se prolongava até a terceira porção duodenal, quadro radiológico compatível com pinçamento da artéria mesentérica superior. Diante da condição nutricional da paciente, foi optado por iniciar medidas conservadoras (porções alimentares pequenas e mais frequentes, além de dec

  1. 外直肌超常量后徙固定在知觉性外斜视手术中的应用%Clinical observation of improved supernormal lateral rectus muscle recession for treatment of sensory exotropia

    Institute of Scientific and Technical Information of China (English)

    陈彦茹; 张俊华; 翁景宁; 方丽君; 王丽

    2015-01-01

    目的 观察外直肌超常量后徙固定在知觉性外斜视手术中的远期疗效,分析其应用价值.方法 回顾性分析我科2012年5月至2013年9月行外直肌超常量后徙固定的知觉性外斜视病例12例.外斜视度数均>50△,患眼固视功能差.在斜视眼行外直肌超常量后徙固定(缝合于原肌止点后12.0 mm)联合内直肌缩短术(4.0~7.0 mm),观察术后眼位、眼球运动、眼面外观及视功能远期疗效.结果 随访13 ~ 27个月后,12例患者术后眼位正位,眼球外转稍有受限;眼面外观良好;均获得较稳定的患眼固视能力,但未建立明确的双眼视功能.结论 外直肌超常量后徙固定稳定了后徙外直肌的位置,减少了手术肌肉条数,具有安全可行、远期疗效稳定等优点.%Objective To determine the prospective efficacy of improved supernormal lateral rectus muscle recession in the surgery of sensory exotropia and analyze the value.Methods Twelve cases of sensory exotropia treated by improved supernormal lateral rectus muscle recession in our department from May 2012 to September 2013 were retrospectively analyzed.The angles of exotropia were higher than 50△ and the squint eyes had poor fixation.Supernormal lateral rectus muscle recession (the lateral rectus muscle was sutured at 12.0 mm behind the original insertion) and medial rectus muscle resection (4.0-7.0 mm) were performed on the squint eyes.The eye position,eye movement,appearance and vision function were observed after surgery.Resuits The follow-up lasted for 13-27 months.All the cases acquired alignment of the eyes and satisfactory appearance,but the abduction function was slightly limited.All the squint eyes showed stable fixation vision,but significant binocular vision was not established.Conclusion Supernormal lateral rectus muscle recession can stabilize the position of lateral rectus muscle,and reduce the muscles needing to surgery.The surgery is safe and feasible,and has stable

  2. Exploring the word superiority effect using TVA

    DEFF Research Database (Denmark)

    Starrfelt, Randi

    Words are made of letters, and yet sometimes it is easier to identify a word than a single letter. This word superiority effect (WSE) has been observed when written stimuli are presented very briefly or degraded by visual noise. It is unclear, however, if this is due to a lower threshold for perc...... simultaneously we find a different pattern: In a whole report experiment with six stimuli (letters or words), letters are perceived more easily than words, and this is reflected both in perceptual processing speed and short term memory capacity....

  3. de educación media superior

    Directory of Open Access Journals (Sweden)

    Enrique Cerón Ferrer

    2007-01-01

    Full Text Available El trabajo presenta los resultados obtenidos en relación al conocimiento y manejo que sobre matemáticas tienen los estudiantes de educación media superior, de los Centros de Estudios Tecnológicos y de Servicios del Distrito Federal, de diferentes carreras que se imparten en estos centros escolares, durante el año 2005. El instrumento de análisis es un cuestionario que contestaron los alumnos, la metodología utilizada es de tipo longitudinal y comparativa.

  4. Pancreaticoduodenectomy with early superior mesenteric artery dissection

    Institute of Scientific and Technical Information of China (English)

    Yu-Fei Xu; Zuo-Jin Liu; Jian-Ping Gong

    2010-01-01

    BACKGROUND: Pancreatic adenocarcinoma remains the fourth leading cause of cancer-related death and is one of the most aggressive human tumors. At present, surgical resection is the only potentially curative treatment. Early neck division is inadequate when invasion of the superior mesenteric artery (SMA) is suspected or in cases of replaced or accessory right hepatic artery. Malignant periampullary tumors often invade retroperitoneal peripancreatic tissues and a positive resection margin is associated with a poor long-term survival. DATA SOURCES: English-language medical databases, PubMed, ELSEVIER and SPRINGERLINK, were searched for articles on"posterior approach pancreaticoduodenectomy","superior mesenteric artery ifrst approach", "retroperitoneal tissue","hanging maneuver", and related topics. RESULTS:The modiifcation allowed the surgeon to early identify the nonresectability of a replaced right hepatic artery if present, enabling complete dissection of the right side of the SMA and portal vein as well as complete excision of the retroportal pancreatic lamina. CONCLUSION: Pancreaticoduodenectomy with early retro-pancreatic dissection is a useful and safe technical variant, which is indicated for the improvement of the safety and curative effect of the procedure.

  5. Radiation treatment of superior sulcus lung carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Millar, J.; Ball, D.; Worotniuk, V.; Smith, J.; Crennan, E.; Bishop, M. [Peter MacCallum Cancer Inst., East Melbourne, VIC (Australia)

    1996-02-01

    The survival of patients with superior sulcus lung carcinoma and the effects of treatment were reviewed. From a prospective database of 4123 consecutive new patients with lung carcinoma, 131 (3.2%) cases of superior sulcus lung carcinoma were identified. Seventy-four patients were planned to receive radiation with palliative intent, 53 radical radiotherapy and one was observed only. The remaining three patients, with small-cell carcinoma, were treated with chemotherapy with or without radiotherapy. Of the 53 radically treated patients, nine were treated with pre-operative radiation prior to intended radical resection. Analysis was carried out on the effect on survival of performance status, nodal involvement, weight loss, vertebral body or rib involvement, treatment intent and radical combined modality treatment compared with radical radiation alone. The estimated median survival for the whole group was 7.6 months; for those treated radically it was 18.3 months, while for the palliatively treated patients it was 3.7 months. Radically treated patients with no initial nodal involvement had an estimated median survival of 22 months, while radically treated patients with nodal involvement had an estimated median survival of 8.4 months (P = 0.003). There were no statistically significant differences in survival between radically treated patients grouped according to initial weight loss, performance status, or vertebral body and rib involvement. Patients treated with pre-operative radiation did not survive significantly longer than patients treated with radiation alone, although the numbers are small. 33 refs., 2 tabs., 4 figs.

  6. Studies on zooplankton of Lago Paione Superiore

    Directory of Open Access Journals (Sweden)

    Patrizia COMOLI

    1999-08-01

    Full Text Available We report here the results of a three year study on the zooplankton of Lago Paione Superiore, an acid sensitive lake above the tree line in the Italian Alps. The research was carried out within MOLAR, an EC-founded Project on “Measuring and Modeling the dynamic response of remote mountain lakes ecosystems to environmental change”. This study comes after a series of investigations on the effects of acidification, in which we documented the changes occurred with decreasing water pHs, by comparing the recent situation with that in the literature of the 40s, and reconstructed the beginning of anthropogenic disturbance through an analysis of the past cladocera assemblages archived in the lake sediments. A characteristic pattern in seasonal periodicity is a transition from a community dominated by small zooplankton (August to a community where the large particle-feeder Daphnia longispina dominates. This is a typical pattern observed in fishless, copepod-cladocera lakes. Regardless from which food is able to exploit, Daphnia population of Lago Paione Superiore is composed by well-fed organisms, visually rich in lipids, able to produce more than one generation/ year of parthenogenetic females at density levels which are rather high in an oligotrophic high mountain lake.

  7. SOD mRNA and MDA expression in rectus femoris muscle of rats with different eccentric exercise programs and time points.

    Science.gov (United States)

    Zhao, Heng; Liu, Jiani; Pan, Shinong; Sun, Yingwei; Li, Qi; Li, Fei; Ma, Li; Guo, Qiyong

    2013-01-01

    Although superoxide dismutase (SOD) and malondialdehyde (MDA) affect Delayed Onset Muscle Soreness (DOMS), their effects are unclear in rectus femoris muscles (RFM) of rats with different eccentric exercise programs and time points. The purpose of this study is to investigate the effects of the various eccentric exercise programs at different time points on the SOD mRNA expression and MDA using rat as the animal model. 248 male rats were randomly divided into 4 groups: control group (CTL, n = 8), once-only exercise group (OEG, n = 80), continuous exercise group (CEG, n = 80), and intermittent exercise group (IEG, n = 80). Each exercise group was divided into 10 subgroups that exercised 0.5 h, 6 h, 12 h, 24 h, 48 h, 72 h, 96 h, 120 h, 144 h, or 168 h. Rats were sacrificed and their SOD mRNA expression, and MDA concentrations of skeletal muscle tissue were measured. The specimen in all eccentric exercise programs showed increased RFM SOD1 mRNA expression levels at 0.5 h (Peccentric exercise (CE) significantly enhanced muscle SOD2 mRNA level at 0.5 h (Peccentric exercise (OE), SOD1, SOD2, and SOD3 mRNA expression significantly increased at 96 h, whereas MDA concentrations decreased at 96 h. After CE, the correlation coefficients of SOD1, SOD2, SOD3 mRNA expression levels and MDA concentrations were -0.814, -0.763, -0.845 (all Peccentric exercise, especially CE could enhance SOD1 and SOD2 mRNA expression in acute stage and the SOD2 mRNA expression correlates to MDA concentration in vivo, which may improve the oxidative adaption ability of skeletal muscles.

  8. Can Sarcopenia Quantified by Ultrasound of the Rectus Femoris Muscle Predict Adverse Outcome of Surgical Intensive Care Unit Patients as well as Frailty? A Prospective, Observational Cohort Study.

    Science.gov (United States)

    Mueller, Noomi; Murthy, Sushila; Tainter, Christopher R; Lee, Jarone; Riddell, Kathleen; Fintelmann, Florian J; Grabitz, Stephanie D; Timm, Fanny P; Levi, Benjamin; Kurth, Tobias; Eikermann, Matthias

    2016-12-01

    To compare sarcopenia and frailty for outcome prediction in surgical intensive care unit (SICU) patients. Frailty has been associated with adverse outcomes and describes a status of muscle weakness and decreased physiological reserve leading to increased vulnerability to stressors. However, frailty assessment depends on patient cooperation. Sarcopenia can be quantified by ultrasound and the predictive value of sarcopenia at SICU admission for adverse outcome has not been defined. We conducted a prospective, observational study of SICU patients. Sarcopenia was diagnosed by ultrasound measurement of rectus femoris cross-sectional area. Frailty was diagnosed by the Frailty Index Questionnaire based on 50 variables. Relationship between variables and outcomes was assessed by multivariable regression analysis NCT02270502. Sarcopenia and frailty were quantified in 102 patients and observed in 43.1% and 38.2%, respectively. Sarcopenia predicted adverse discharge disposition (discharge to nursing facility or in-hospital mortality, odds ratio 7.49; 95% confidence interval 1.47-38.24; P = 0.015) independent of important clinical covariates, as did frailty (odds ratio 8.01; 95% confidence interval 1.82-35.27; P = 0.006); predictive ability did not differ between sarcopenia and frailty prediction model, reflected by χ values of 21.74 versus 23.44, respectively, and a net reclassification improvement (NRI) of -0.02 (P = 0.87). Sarcopenia and frailty predicted hospital length of stay and the frailty model had a moderately better predictive accuracy for this outcome. Bedside diagnosis of sarcopenia by ultrasound predicts adverse discharge disposition in SICU patients equally well as frailty. Sarcopenia assessed by ultrasound may be utilized as rapid beside modality for risk stratification of critically ill patients.

  9. Endoscopic-assisted linea alba reconstruction plus mesh augmentation (ELAR plus for treatment of umbilical and/or epigastric hernias and rectus abdominis diastasis – Early results

    Directory of Open Access Journals (Sweden)

    Ferdinand eKöckerling

    2016-05-01

    Full Text Available IntroductionSymptomatic umbilical and/or epigastric hernias are often seen concomitantly with rectus abdominis diastasis (RAD, and suture repair of such defects has a high recurrence rate. In the literature there are reports of both endoscopic and open techniques for repair of symptomatic umbilical and/or epigastric hernias in association with RAD. This paper now reports on the early results of a hybrid technique used for reconstruction of the linea alba and mesh augmentation (ELAR plus.Material and methodsBetween 15 June 2015 and 31 January 2016, 40 patients with symptomatic umbilical and /or epigastric hernia and concomitant RAD underwent reconstruction of the linea alba using a hybrid technique involving a small umbilical incision and the use of video endoscopic equipment. The patients comprised 29 men and 11 women with a mean age of 53.6 years and mean BMI of 32.6. The mean operating time was 120 minutes. The mesh had a mean longitudinal extension of 18.6 cm and transverse extension of 9.1 cm. ResultsThirty-day follow-up results are available for all patients. Thirty-seven out of 40 patients (92.5 % experienced no postoperative complication. Two cases of discrete impaired umbilical wound healing and one seroma were successfully managed with conservative treatment. On 30-day follow-up, three out of 40 patients (7.5 % complained of intermittent pain on exertion, and two out of 40 patients (5 % still took painkillers when required.ConclusionEndoscopic-assisted linea alba reconstruction plus mesh augmentation (ELAR plus is a novel minimally invasive procedure for repair of symptomatic umbilical and/or epigastric hernias with concomitant RAD. Reconstruction of the linea alba via a minimally invasive access route is able to restore the normal anatomy of the abdominal wall.

  10. Ultrasonography-guided bilateral rectus sheath block vs local anesthetic infiltration after pediatric umbilical hernia repair: a prospective randomized clinical trial.

    Science.gov (United States)

    Dingeman, R Scott; Barus, Lindsay M; Chung, Hyun Kee; Clendenin, David J; Lee, Christopher S; Tracy, Sarah; Johnson, Victor M; Dennett, Kate V; Zurakowski, David; Chen, Catherine

    2013-08-01

    Regional anesthetic techniques can be used to alleviate postoperative pain in children undergoing pediatric surgical procedures. Use of ultrasonographic guidance for bilateral rectus sheath block (BRSB) has been shown to improve immediate pain scores and reduce use of postoperative analgesia in the postanesthesia care unit (PACU). To compare efficacy of ultrasonography-guided BRSB and local anesthetic infiltration (LAI) in providing postoperative analgesia after pediatric umbilical hernia repair. Prospective, observer-blinded, randomized clinical trial. Tertiary-referral urban children's hospital. Eligible children 3 to 12 years of age undergoing elective umbilical hernia repair from November 16, 2009, through May 31, 2011. Ropivacaine hydrochloride administered at the conclusion of surgery as LAI by the surgeon (n = 25) or as ultrasonography-guided BRSB by the anesthesiologist (n = 27). Scores on the FACES Pain Rating Scale measured at 10-minute intervals and all use of analgesic medications in the PACU. Median FACES scores in the PACU were lower in the BRSB group compared with the LAI group at 10 minutes (0 vs 1; P = .04), 30 minutes (0 vs 1; P = .01), and 40 minutes or later (0 vs 1; P = .03). Fewer doses of opioid and nonopioid medications were given to the BRSB group compared with the LAI group (5 vs 11 doses for opioids; 5 vs 10 for nonopioids). In the PACU, ultrasonography-guided BRSB after umbilical hernia repair in children is associated with lower median FACES scores and decreased use of opioid and nonopioid medications compared with LAI. Future studies could examine the use of longer-acting anesthetic agents with ultrasonography-guided BRSB. clinicaltrials.gov Identifier: NCT01015053.

  11. Therapeutic results after ultrasound-guided intratissue percutaneous electrolysis (EPI®) in the treatment of rectus abdominis-related groin pain in professional footballers: a pilot study.

    Science.gov (United States)

    Moreno, Carlos; Mattiussi, Gabriele; Núñez, Francisco J

    2016-10-01

    Rectus abdominis-related groin pain (RAGP) is one of the possible clinical patterns that determine pubalgia. RAGP is one of the typical patterns in footballers and is due to the degeneration and tendinopathy of the distal tendon, at the level of the two pubic tubercles. Intratissue percutaneous electrolysis (EPI) is a novel technique used in the treatment of tendinopathies. The aim of this study was to examine the therapeutic benefits of EPI by contrasting the two basic components that characterize RAGP: painful symptoms and resultant functional deficits. Eight professional footballers at Udinese Calcio Spa Football Club underwent ultrasound-guided EPI intervention. No other type of treatment was combined with EPI. Pain was monitored with the Verbal Rating Scale, while functional deficit was monitored using the Patient Specific Functional Scale. The scales implementation took place before treatment, then 24 hours, 1 week, 1 month and 6 months after the end of treatment. Treatment with EPI produced a complete reduction of pain symptoms in one month and enabled excellent functional recovery for walking and jogging in one week; for getting out of bed, running, jumping and kicking within one month from the end of the treatment. Treatment with ultrasound-guided EPI has shown encouraging clinical results for RAGP. Data are preliminary: considering the limitations of this study more complex design studies are necessary to test the efficacy of the technique. This study introduces the EPI technique for the first time in the treatment of professional footballers suffering from RAGP. Its future use is proposed as a treatment solution, including complementary to conservative treatment.

  12. Cochlear implant outcomes in patients with superior canal dehiscence

    NARCIS (Netherlands)

    Puram, Sidharth V.; Roberts, Daniel S.; Niesten, Marlien E F; Dilger, Amanda E.; Lee, Daniel J.

    2015-01-01

    Objective: To determine whether adult cochlear implant (CI) users with superior canal dehiscence syndrome (SCDS) or asymptomatic superior semicircular canal dehiscence (SCD) have different surgical, vestibular, and audiologic outcomes when compared to CI users with normal temporal bone anatomy. Meth

  13. The Superior Transvelar Approach to the Fourth Ventricle and Brainstem

    OpenAIRE

    Ezer, Haim; Banerjee, Anirban Deep; Bollam, Papireddy; Guthikonda, Bharat; Nanda, Anil

    2012-01-01

    Objective The superior transvelar approach is used to access pathologies located in the fourth ventricle and brainstem. The surgical path is below the venous structures, through the superior medullary velum. Following splitting the tentorial edge, near the tentorial apex, the superior medullary velum is split in the cerebello-mesencephalic fissure. Using the supracerebellar infratentorial, transtentorial or parietal interhemispheric routes, the superior medullary velum is approached. Splittin...

  14. 14 CFR 385.7 - Exercise of authority by superiors.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Exercise of authority by superiors. 385.7... Exercise of authority by superiors. Any assignment of authority to a staff member other than the Chief... Department's principle of management responsibility, the superior may choose to exercise the assigned power...

  15. Superiority: China Mobile in the competition

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The market share between China Mobile and China Unicom has stabilized since 2002.It is found that China Mobile has the superiority in the competition, for example, the scissors movement between its revenue and cost indicates that it has a strong profit generating ability and there is enough room for it to reduce the price.The ratio between its price (marginal income) and marginal cost indicates that there is a very distant limit for it to reduce the price.Its demand is obviously flexible with the price, but it does not use the price weapon abundantly.The reason for the stabilization of the market is that China Mobile withdrew from the competition.

  16. Lightning activity during the 1999 Superior derecho

    Science.gov (United States)

    Price, Colin G.; Murphy, Brian P.

    2002-12-01

    On 4 July 1999, a severe convective windstorm, known as a derecho, caused extensive damage to forested regions along the United States/Canada border, west of Lake Superior. There were 665,000 acres of forest destroyed in the Boundary Waters Canoe Area Wilderness (BWCAW) in Minnesota and Quetico Provincial Park in Canada, with approximately 12.5 million trees blown down. This storm resulted in additional severe weather before and after the occurrence of the derecho, with continuous cloud-to-ground (CG) lightning occurring for more than 34 hours during its path across North America. At the time of the derecho the percentage of positive cloud-to-ground (+CG) lightning measured by the Canadian Lightning Detection Network (CLDN) was greater than 70% for more than three hours, with peak values reaching 97% positive CG lightning. Such high ratios of +CG are rare, and may be useful indicators of severe weather.

  17. Analgesia em modelo animal superior para ortopedia

    OpenAIRE

    Oliveira MT, Maria Teresa; Potes, José Alberto; Queiroga, Cristina; Castro, José António; Pereira, Alfredo; Reis, Joana

    2015-01-01

    O teste de novos biomateriais para aplicações clínicas em ortopedia, ou noutras áreas da medicina, em modelos animais vivos e sencientes, em prol do benefício humano, deve ser objecto de planeamento cuidado e ponderado, dado o conflito ético que se coloca. Compete-nos a nós, enquanto investigadores, garantir que as condições de vida, saúde e bem-estar são asseguradas. O uso de ovinos como modelo superior pré-clínico, para investigação em Ortopedia, tem-se evidenciado devido às suas caracterís...

  18. Superior vena cava syndrome in hemodialysis patient

    Directory of Open Access Journals (Sweden)

    Azeb Molhem

    2011-01-01

    Full Text Available Obstruction of blood flow in the superior vena cava (SVC results in symptoms and signs of SVC syndrome. SVC obstruction can be caused either by invasion or external compression of the SVC by contagious pathologic processes involving the right lung, lymph nodes, and other mediastinal structures, or by thrombosis of blood within the SVC. Occasionally, both mechanisms co-exist. We hereby report a case of a 28-year-old male, Saudi patient who was diagnosed with end-stage renal disease and was maintained on regular hemodiaysis via right jugular vein dual lumen catheter for ten months. Three years later, the patient presented with signs and symptoms suggestive of SVC obstruction that was successfully managed with SVC stenting.

  19. [Surgical treatment of superior thoracic outlet syndrome].

    Science.gov (United States)

    Gaibov, A D; Kakhorov, A Z; Sadriev, O N; Yunusov, Kh A

    2015-01-01

    The authors present immediate and long-term results of treatment of 117 patients with superior thoracic outlet syndrome (STOS). There were different reasons for compression of neu- rovascular fascicle in outlet of the thorax. The costaclavicular syndrome was a reason in 48 patients, additional cervical ribs had 36 patients. Skalenus syndrome was noted in 26 cases, rudimentary cervical ribs or hypertrophy of cervical vertebrae C7 had 7 patients. Raynaud's syndrome took place in 19 cases. The required volume of diagnostic procedures and surgical treatment of STOS were determined according to the cause of the syndrome. Differentiated approach to the different forms of STOS was used in relation to dominant symptoms of the disease and reasons for compression of neurovascular fascicle. This allowed getting positive results in majority of patients (90,4%) in long- term period.

  20. ANATOMIC RESEARCH OF SUPERIOR CLUNIAL NERVE TRAUMA

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    In order to find the mechanism of superior clunial nerve (SCN) trauma, we dissected and revealed SCN from 12 corpses (24 sides). Combining 100 sides of SCN trauma, we inspected the course of SCN, the relation between SCN and it's neighbour tissues with the situation of SCN when being subjected to force. We found that the following special anatomic characteristics and mechanical elements such as the course of SCN, it's turning angles, the bony fibrous tube at the iliac crest, the posterior layer of the lumbodorsal fascia and SCN neighbour adipose tissue, are the causes of external force inducing SCN trauma. The anatomic revealment is the guidance of SCN trauma treatment with edged needle.

  1. Superiorization: An optimization heuristic for medical physics

    CERN Document Server

    Herman, G T; Davidi, R; Censor, Y

    2012-01-01

    Purpose: To describe and mathematically validate the superiorization methodology, which is a recently-developed heuristic approach to optimization, and to discuss its applicability to medical physics problem formulations that specify the desired solution (of physically given or otherwise obtained constraints) by an optimization criterion. Methods: The underlying idea is that many iterative algorithms for finding such a solution are perturbation resilient in the sense that, even if certain kinds of changes are made at the end of each iterative step, the algorithm still produces a constraints-compatible solution. This property is exploited by using permitted changes to steer the algorithm to a solution that is not only constraints-compatible, but is also desirable according to a specified optimization criterion. The approach is very general, it is applicable to many iterative procedures and optimization criteria used in medical physics. Results: The main practical contribution is a procedure for automatically p...

  2. The management of superior sulcus tumors

    Energy Technology Data Exchange (ETDEWEB)

    Komaki, Ritsuko; Cox, J.D.; Putnam, J.B. Jr [Texas Univ., Houston, TX (United States). Anderson Cancer Center] (and others)

    2001-09-01

    Superior sulcus tumors are a rare type of lung cancer arising in the apex of the lung above the sulcus and cause specific symptoms and signs depending on the location and whether the tumor extends into the surrounding structures. Because of the closeness of critical structures to the tumor (e.g., the subclavian artery for anterior lesions, the brachial plexus for lesions in the middle location, and the sympathetic stellate ganglion causing Horner's syndrome [Pancoast's tumor], the vertebral bodies, nerve foramen, and spinal cord for posterior lesions), superior sulcus tumors were often considered marginally respectable or unresectable. Therefore, for many years, preoperative radiation therapy was considered routine treatment for those tumors. However, with the evolution in our understanding of these tumors and modern imaging techniques such as computerized tomography (CT) and magnetic resonant imaging (MRI) and surgical techniques, there is now considerable debate about the roles and timing of surgical resection, radiation therapy, and chemotherapy in the treatment of patients with these tumors. If mediastinoscopy reveals microscopic mediastinal lymph node involvement, the patient can be treated with preoperative concurrent chemoradiotherapy followed by surgery. If there was a gross mediastinal lymph node involvement (N2) on CT, N3 or T4 lesions, the patient can be treated with concurrent chemoradiotherapy with a curative intent; the outcome of such treatment appears to be better than that of sequential chemotherapy followed by radiation therapy. Whenever possible, without compromising the patient's quality of life, surgery should be considered to improve outcome. (author)

  3. STEREO Superior Solar Conjunction Mission Phase

    Science.gov (United States)

    Ossing, Daniel A.; Wilson, Daniel; Balon, Kevin; Hunt, Jack; Dudley, Owen; Chiu, George; Coulter, Timothy; Reese, Angel; Cox, Matthew; Srinivasan, Dipak; hide

    2017-01-01

    With its long duration and high gain antenna (HGA) feed thermal constraint; the NASA Solar-TErestrial RElations Observatory (STEREO) solar conjunction mission phase is quite unique to deep space operations. Originally designed for a two year heliocentric orbit mission to primarily study coronal mass ejection propagation, after 8 years of continuous science data collection, the twin STEREO observatories entered the solar conjunction mission phase, for which they were not designed. Nine months before entering conjunction, an unforeseen thermal constraint threatened to stop daily communications and science data collection for 15months. With a 3.5 month long communication blackout from the superior solar conjunction, without ground commands, each observatory will reset every 3 days, resulting in 35 system resets at an Earth range of 2 AU. As the observatories will be conjoined for the first time in 8 years, a unique opportunity for calibrating the same instruments on identical spacecraft will occur. As each observatory has lost redundancy, and with only a limited fidelity hardware simulator, how can the new observatory configuration be adequately and safely tested on each spacecraft? Without ground commands, how would a 3-axis stabilized spacecraft safely manage the ever accumulating system momentum without using propellant for thrusters? Could science data still be collected for the duration of the solar conjunction mission phase? Would the observatories survive? In its second extended mission, operational resources were limited at best. This paper discusses the solutions to the STEREO superior solar conjunction operational challenges, science data impact, testing, mission operations, results, and lessons learned while implementing.

  4. Clinical Analysis of 133 Cases of Extraocular Stage and Metastasis Stage Metastatic Retinoblastoma%眼外期及远处播散期视网膜母细胞瘤133例

    Institute of Scientific and Technical Information of China (English)

    张谊; 黄东生; 张伟令; 王一卓; 周燕; 韩涛; 洪亮; 杨怡平

    2011-01-01

    Objective To analyze the clinical characteristics and curative effect of terminal retinoblastoma(Rb). Methods The clinical document of 133 cases (162 eyes,78 male,55 female) with extraocular and metastasis stage of Rb confirmed in Department of Pediatrics of Tongren Hospital from Sep. 2005 to May 2010 were retrospectively analyzed. The average age of 133 cases was 2.04 years old( range 0. 33 -12.66 years old); primary eye types:the right eyes diagnosed primarily were 48 cases (extraocular 36 cases,metastasis stage 12 cases) ,left eyes diagnosed primarily were 56 cases (extraocular 46 cases, metastasis stage 10 cases), and double eyes diagnosed primarily were 29 cases.Results Leucocoria was the most common manifestation of terminal Rb with the primary diagnosis rate was 69.92% (93/133 cases) based on this symptom; secondly,lacrimation, flare, photophobia, exophthalmos ( 10.52% ) and side - glance ( 9.77% ), weak - eyed, blindness,cataract ( 6.77 % ), misdiagnose ( 1.51% ), recur after operation ( 1.51% ). The hospitalized rate of male [ 58 % (78/133 cases) ] was more than that of female. Seven cases (5.26%) showed the positive family history in all of cases. In all the 133 cases,131 cases (98.49%) had an increase in neurone specific enolase(NSE) ,the max was 370.00 μ.g · L-1. The total survival rate was 82.35% (98/119 cases), 14 cases ( in the metastasis stage 9 cases ,extraocular 5 cases) given up treatment and lost followed - up. One hundred and nineteen cases were followed up: the median follow - up visit was 27 months,the survival rate was 82.35% (98/119 cases). Moreover,the survival rate of Rb in the metastasis stage was 26.08% (6/23 cases); the survival rate of Rb in the extraocluar stage was 95.83% (92/96 cases). Conclusions The mortality of terminal Rb is very high, especially in metastasis stage. Therefore, it is very important to diagnose early and give an overall treatment.%目的 总结晚期视网膜母细胞瘤(Rb)患儿的

  5. Treatment of thyroid associated ophthalmopathy with periocular injections of triamcinolone

    Science.gov (United States)

    Ebner, R; Devoto, M H; Weil, D; Bordaberry, M; Mir, C; Martinez, H; Bonelli, L; Niepomniszcze, H

    2004-01-01

    Aim: To evaluate the efficacy of periocular triamcinolone acetonide for the treatment of thyroid associated ophthalmopathy (TAO), and the presence of ocular or systemic adverse effects. Methods: A multicentre prospective pilot study was performed on patients diagnosed with Graves’ ophthalmopathy less than 6 months before entry to the study. Patients were admitted to the study and were randomised into two groups: treatment and control. The treatment group received four doses of 20 mg of triamcinolone acetate 40 mg/ml in a peribulbar injection to the inferolateral orbital quadrant. Both groups were evaluated by measuring the area of binocular vision without diplopia on a Goldmann perimeter and the size of the extraocular muscles on computed tomography (CT) scans. Ophthalmological and systemic examinations were done to rule out ocular and systemic adverse effects. Follow up was 6 months for both groups. Results: 50 patients were eligible for the study. 41 patients completed the study. There was an increase in the area of binocular vision without diplopia in the treatment group (Σ initial: mean 231.1 (SD 99.9) and final absolute change, mean 107.1 (SD 129.0)) compared to the control group (Σ initial: mean 350.7 (SD 86.5) and final absolute change, mean −4.5 (SD 67.6)). The sizes of the extraocular muscles were reduced in the treatment group (mean (inferior rectus initial values): 1.3 (0.7), final percentage change: −13.2 (25.7), medial rectus initial values: 1.2 (0.6), final percentage change: −8.2 (20.7), superior rectus-levator palpebrae initial values: 1.2 (0.6), final percentage change: −9.5 (29.1), lateral rectus initial values: 1.0 (0.4), final percentage change: −11.5 (20.6)) compared to the control group (inferior rectus initial values: 0.9 (0.3), final percentage change: −4.0 (21.5), medial rectus initial values: 0.9 (0.3), final percentage change: 0.6 (22.4), superior rectus-levator palpebrae initial values: 0.9 (0.3), final percentage change

  6. Lake Superior Coastal Wetland Fish Assemblages and ...

    Science.gov (United States)

    The role of the coastal margin and the watershed context in defining the ecology of even very large lakes is increasingly being recognized and examined. Coastal wetlands are both important contributors to the biodiversity and productivity of large lakes and important mediators of the lake-basin connection. We explored wetland-watershed connections and their relationship to wetland function and condition using data collected from 37 Lake Superior wetlands spanning a substantial geographic and geomorphic gradient. While none of these wetlands are particularly disturbed, there were nevertheless clear relationships between watershed landuse and wetland habitat and biota, and these varied consistently across wetland type categories that reflected the strength of connection to the watershed. For example, water clarity and vegetation structure complexity declined with decreasing percent natural land cover, and these effects were strongest in riverine wetlands (having generally large watersheds and tributary-dominated hydrology) and weakest in lagoon wetlands (having generally small watersheds and lake-dominate hydrology). Fish abundance and species richness both increased with decreasing percent natural land cover while species diversity decreased, and again the effect was strongest in riverine wetlands. Lagoonal wetlands, which lack any substantial tributary, consistently harbored the fewest species of fish and a composition different from the more watershed-lin

  7. Carbon phosphide monolayers with superior carrier mobility

    Science.gov (United States)

    Wang, Gaoxue; Pandey, Ravindra; Karna, Shashi P.

    2016-04-01

    Two dimensional (2D) materials with a finite band gap and high carrier mobility are sought after materials from both fundamental and technological perspectives. In this paper, we present the results based on the particle swarm optimization method and density functional theory which predict three geometrically different phases of the carbon phosphide (CP) monolayer consisting of sp2 hybridized C atoms and sp3 hybridized P atoms in hexagonal networks. Two of the phases, referred to as α-CP and β-CP with puckered or buckled surfaces are semiconducting with highly anisotropic electronic and mechanical properties. More remarkably, they have the lightest electrons and holes among the known 2D semiconductors, yielding superior carrier mobility. The γ-CP has a distorted hexagonal network and exhibits a semi-metallic behavior with Dirac cones. These theoretical findings suggest that the binary CP monolayer is a yet unexplored 2D material holding great promise for applications in high-performance electronics and optoelectronics.Two dimensional (2D) materials with a finite band gap and high carrier mobility are sought after materials from both fundamental and technological perspectives. In this paper, we present the results based on the particle swarm optimization method and density functional theory which predict three geometrically different phases of the carbon phosphide (CP) monolayer consisting of sp2 hybridized C atoms and sp3 hybridized P atoms in hexagonal networks. Two of the phases, referred to as α-CP and β-CP with puckered or buckled surfaces are semiconducting with highly anisotropic electronic and mechanical properties. More remarkably, they have the lightest electrons and holes among the known 2D semiconductors, yielding superior carrier mobility. The γ-CP has a distorted hexagonal network and exhibits a semi-metallic behavior with Dirac cones. These theoretical findings suggest that the binary CP monolayer is a yet unexplored 2D material holding great

  8. Absent right superior caval vein in situs solitus

    DEFF Research Database (Denmark)

    Lytzen, Rebekka; Sundberg, Karin; Vejlstrup, Niels

    2015-01-01

    no postnatal complications. All children were found to have healthy hearts at follow-up. CONCLUSIONS: In all cases, the findings proved to be a benign condition with no clinical manifestations or complications. Although isolated absent right superior caval vein does not seem to affect the outcome, associated......Introduction In up to 0.07% of the general population, the right anterior cardinal vein obliterates and the left remains open, creating an absent right superior caval vein and a persistent left superior caval vein. Absent right superior caval vein is associated with additional congenital heart...... disease in about half the patients. We wished to study the consequences of absent right superior caval vein as an incidental finding on prenatal ultrasonic malformation screening. Material and methods This is a retrospective case series study of all foetuses diagnosed with absent right superior caval vein...

  9. The Business Value of Superior Energy Performance

    Energy Technology Data Exchange (ETDEWEB)

    McKane, Aimee; Scheihing, Paul; Evans, Tracy; Glatt, Sandy; Meffert, William

    2015-08-04

    Industrial facilities participating in the U.S. Department of Energy’s (US DOE) Superior Energy Performance (SEP) program are finding that it provides them with significant business value. This value starts with the implementation of ISO 50001-Energy management system standard, which provides an internationally-relevant framework for integration of energy management into an organization’s business processes. The resulting structure emphasizes effective use of available data and supports continual improvement of energy performance. International relevance is particularly important for companies with a global presence or trading interests, providing them with access to supporting ISO standards and a growing body of certified companies representing the collective knowledge of communities of practice. This paper examines the business value of SEP, a voluntary program that builds on ISO 50001, inviting industry to demonstrate an even greater commitment through third-party verification of energy performance improvement to a specified level of achievement. Information from 28 facilities that have already achieved SEP certification will illustrate key findings concerning both the value and the challenges from SEP/ISO 50001 implementation. These include the facilities’ experience with implementation, internal and external value of third-party verification of energy performance improvement; attractive payback periods and the importance of SEP tools and guidance. US DOE is working to bring the program to scale, including the Enterprise-Wide Accelerator (SEP for multiple facilities in a company), the Ratepayer-Funded Program Accelerator (supporting tools for utilities and program administrators to include SEP in their program offerings), and expansion of the program to other sectors and industry supply chains.

  10. Astigmatic changes after horizontal rectus muscle surgery in intermittent exotropia%间歇性外斜视患者水平直肌术后的散光改变

    Institute of Scientific and Technical Information of China (English)

    王子衿; 龚琦; 刘虎

    2015-01-01

    Objective To evaluate astigmatic changes after horizontal rectus muscle surgery in intermittent exotropic patitents.Methods Seventy-one exotropic patients with intermittent exotropia were enrolled in this case-series study.The subjects were divided into two groups: group 1 with lateral rectus recession (26 patients) and group 2 with unilateral lateral rectus recession and medial rectus resection (45 patients).Non-cycloplegic refractions were measured within 1 week before surgery, at 1 week, 1 month, and 3 months after surgery.CYL0 (horizontal or vertical vector of the cylinder) and CYL45 (oblique vector of the cylinder) using Fourier power vectors were calculated to determine and compare the changes of refractive astigmatism and axis in both groups.Results In group 1, CYL0 showed significant changes at 1 week, 1 month and 3 months after surgery.In group 2, CYL0 also changed significantly between 1 week and 3 months postoperatively.CYL45 did not change significantly as time passed in both groups.There was no statistically significant difference in the mean change of CYL0 and CYL45 after the 3-month follow-up.There was no significant correlation between the amount of lateral rectus recession and the amount of CYL0 in group 1 at 1 week, 1 month and 3 months after surgery.Conclusions Intermittent exotropic patients after horizontal rectus muscle surgery tend to develop statistically significant changes in astigmatism in the with-the-rule direction.At 3 months after surgery, the astigmatic changes seem to be still remarkable.Comparison between the two groups imply that the astigmatic effect caused by medial rectus resection is likely smaller compared to that caused by lateral rectus recession and study on large sample is necessary to prove it.%目的 了解间歇性外斜视患者行水平直肌手术后的散光改变.方法 临床病例对照研究.选取2013年7~9月在江苏省人民医院眼科就诊的71例间歇性外斜视患者进行病例系列研究.按照

  11. Coronary artery bypass and superior vena cava syndrome.

    OpenAIRE

    Thomas, T V; Masrani, K; Thomas, J.L.

    1999-01-01

    Superior vena cava syndrome is the obstruction of the superior vena cava or its main tributaries by benign or malignant lesions. The syndrome causes edema and engorgement of the vessels on the face, neck, and arms, nonproductive cough, and dyspnea. We discuss the case of a 48-year-old obese diabetic woman who was admitted with unstable angina. She had previously been diagnosed with superior vena cava syndrome. Urgent coronary artery bypass grafting was necessary Although thousands of coronary...

  12. Superiorization of incremental optimization algorithms for statistical tomographic image reconstruction

    Science.gov (United States)

    Helou, E. S.; Zibetti, M. V. W.; Miqueles, E. X.

    2017-04-01

    We propose the superiorization of incremental algorithms for tomographic image reconstruction. The resulting methods follow a better path in its way to finding the optimal solution for the maximum likelihood problem in the sense that they are closer to the Pareto optimal curve than the non-superiorized techniques. A new scaled gradient iteration is proposed and three superiorization schemes are evaluated. Theoretical analysis of the methods as well as computational experiments with both synthetic and real data are provided.

  13. 77 FR 48856 - Safety Zone; Superior Bay, Duluth, MN

    Science.gov (United States)

    2012-08-15

    ... spectators during the Superior Man Triathlon. DATES: This rule is effective from 6 a.m. to 8:30 a.m. on... Triathlon, which are discussed further below. Under 5 U.S.C. 553(d)(3), the Coast Guard finds that good... inaugural Superior Man Triathlon will occur along the Bay of Lake Superior. The 1.2 mile swim leg of...

  14. Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery

    Directory of Open Access Journals (Sweden)

    Metin Keskin

    2014-01-01

    Full Text Available Superior mesenteric artery syndrome is a rare condition that causes a proximal small intestinal obstruction due to contraction of the angle between the superior mesenteric artery and the aorta. Scoliosis surgery is one of the 15 reasons for superior mesenteric artery syndrome, which can present with acute or chronic manifestations. Although conservative treatment is usually possible, surgical treatment is required in certain cases that cannot be treated using conservative methods. In this paper, we describe a patient who developed superior mesenteric artery syndrome after scoliosis surgery and was treated with duodenojejunostomy due to failure and complications of conservative treatment.

  15. Superior Vena Cava Thrombosis in a Case of Lung Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Santanu Ghosh

    2013-01-01

    Full Text Available Superior vena cava syndrome is a common presentation of bronchogenic carcinoma. The mechanism of obstruction is by compression of superior vena cava by the bronchogenic tumor itself or enlarged mediastinal lymph nodes. However obstruction due to intravascular thrombosis is extremely uncommon. Here, we report a rare case of a 65-year-old male smoker who presented with superior vena cava syndrome and bilateral pleural and pericardial effusion with thrombotic occlusion of the superior vena cava in adenocarcinoma of the lung. He was given chemotherapy with carboplatin and gemcitabine with anticoagulant therapy.

  16. [Catheter in the superior vena cava for hemodialysis as a last resort in superior hemithorax].

    Science.gov (United States)

    Restrepo Valencia, C A; Buritica Barragán, C M; Arango, A

    2010-01-01

    We report four patients with chronic kidney disease undergoing haemodialysis therapy, which had exhausted conventional venous access (internal jugular, subclavian) and non-conventional access (axillary, innominate) in the upper hemithorax for haemodialysis. This was primarily due to thrombosis of these veins caused by previous catheterisation. These patients did not qualify for peritoneal dialysis. Using the technique recommended by Archundia et al., 4 indwelling catheters were implanted directly in the superior vena cava in each of the patients with subsequent subcutaneous tunneling. The catheters operated correctly and are currently permeable after being used for an average of 19 months.

  17. 缝匠肌和股直肌肌内神经分布研究及其临床意义%The research of distribution of intramuscular nerves in sartorius and rectus femoris and their clinical significance

    Institute of Scientific and Technical Information of China (English)

    张洪武; 薛黔; 杨宇平

    2011-01-01

    Objective: To study the distribution of intramuscular nerve branches, muscle spindles and nerve entering points in human sartorius and rectus femoris (RF) and to provide morphological data for clinical surgery. Methods: The morphological characteristics of sartorius and RF were studied by using the gross-anatomy. The locations of the nerve entering points to muscles were ascertained by measuring. HE staining technique and stereology method were used to study the two muscles' spindle distribution. Modified Sihler's neural staining technique was used to observe the two muscles' intramuscular nerve branch pattern. Results: Sartorius was a kind of ribbon muscle which was composed of long fascicle arranged parallel. RF was a kind of penniform muscle which was composed of short fascicle. The muscle spindle average densities of sartorius and RF were 38.04 number/g and 19.38 number/g, respectively. Sartorius had 2 primary branches entering the muscle and distributed to upper part and middle-lower part, respectively. RF had 2 primary branches and distributed to lateral-upper part and medial-lower part, respectively. The nerve entering points in sartorius laid (9.75 + 1.30) cm, and in RF laid ( 10.23 ± 0.97) cm and ( 14.48 ± 1.12) cm below anterior superior iliac spine, respectively. Conclusion: Sartorius is a ribbon muscle, but RF is a penniform muscle. Sartorius and RF both have two primary branches, respectively. There are less intramuscular nerve branches and less anastomoses and more obvious regional distribution in sartorius. The nerve entering points in sartorius and RF centralize mainly in the No.2 region of the front upper part of thigh.%目的:研究入缝匠肌和股直肌的肌内神经分支分布、肌梭密度和测定神经入肌点,为临床外科提供肌形态学资料.方法:大体解剖法观察20具尸体缝匠肌和股直肌的形态学特点,并以髂前上棘为标志定位缝匠肌和股直肌神经入肌点;H·E染色法研究5具尸体缝匠肌

  18. Study on etiologic causes of binocular diplopia in patients with extraocular related diseases in department of ophthalmology%眼科首诊双眼复视患者的眼外相关病因分析

    Institute of Scientific and Technical Information of China (English)

    王珣竹

    2012-01-01

    Objective To explore the etiologic causes of binocular diplopia as the first onset symptom in patients with extraocular related ophthalmic diseases. Methods On the basis of medical history, routine ophthalmologic examination and ocular muscle examination, general check - up and blood biochemical examinations were applied to explore the pathogenic causes. Results The main aetiological cause was vascular disease, then traumatic injury of cranial nerves and abducent nerve palsy were its secondary causes. Conclusion The pathogenic factors of binocular diplopia were complicated, therefore detail clinical data should be correctly collected and necessary diagnostic examinations should be performed for proper diagnosis and treatment.%目的 探讨眼科以双眼复视为首发症状的眼外相关病因的分布情况.方法 根据病史、眼科专科检查、全身相关检查及相关科室检查会诊意见分析病因.结果 68例双眼复视患者中,发病原因中以血管性疾病居多(占32.3%);外伤次之,占16.2%.眼外肌及颅神经受累情况,外展神经麻痹居多24例,占35.3%.结论 双眼复视病因复杂,详细正确的临床资料和必要的辅助检查有助于明确病因.

  19. Fatal pericardial tamponade after superior vena cava stenting.

    NARCIS (Netherlands)

    Ploegmakers, M.J.M.; Rutten, M.J.C.M.

    2009-01-01

    We discuss a fatal complication of percutaneous superior vena cava (SVC) self-expandable stent placement in a patient with superior vena cava syndrome (SVCS). The SVCS was caused by a malignant mediastinal mass with total occlusion of the SVC. Twenty-four hours after the procedure, the patient died

  20. 33 CFR 117.495 - Superior Oil Canal.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Superior Oil Canal. 117.495 Section 117.495 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Louisiana § 117.495 Superior Oil Canal. The draw of the S82 bridge, mile 6.3, in Cameron...

  1. [Superior vena cava syndrome--surgical solution--case report].

    Science.gov (United States)

    Galie, N; Vasile, R; Savu, C; Petreanu, C; Grigorie, V; Tabacu, E

    2010-01-01

    The patient of 52-year-old smoker was admitted in emergency with headaches, dyspnea, oedema and cyanosis of the cephalic extremity and of the superior members. This signs and symptoms suggest a superior vena cava sindrom. Thoracic CT scan shows the thrombosis of the superior vena cava and a tumor localized in the Bariety's Lodge of about 30/40 mm witch is around the right lateral wall of the traheea.This tumor is also tangent to the superior the superior vena cava. The patient was operated by total median sternotomy. By this approach we performed a complete excision of the mediastinal tumor mass. After that we effected a longitudinal cavotomy, we took out the endoluminal clot and we sutured the superior vena cava. The histological diagnosis of the mediastinal tumor was adenocarcinoma tubular-papillary moderately differentiated. The evolution post operative period was favorable the superior vena cava sindrom was a complet remission. The thoracic CT scan control after 9 months later didn't show a local relapse and blood flow was normally throw the superior vena cava.

  2. Fatal pericardial tamponade after superior vena cava stenting.

    NARCIS (Netherlands)

    Ploegmakers, M.J.M.; Rutten, M.J.C.M.

    2009-01-01

    We discuss a fatal complication of percutaneous superior vena cava (SVC) self-expandable stent placement in a patient with superior vena cava syndrome (SVCS). The SVCS was caused by a malignant mediastinal mass with total occlusion of the SVC. Twenty-four hours after the procedure, the patient died

  3. The superior transvelar approach to the fourth ventricle and brainstem.

    Science.gov (United States)

    Ezer, Haim; Banerjee, Anirban Deep; Bollam, Papireddy; Guthikonda, Bharat; Nanda, Anil

    2012-06-01

    Objective The superior transvelar approach is used to access pathologies located in the fourth ventricle and brainstem. The surgical path is below the venous structures, through the superior medullary velum. Following splitting the tentorial edge, near the tentorial apex, the superior medullary velum is split in the cerebello-mesencephalic fissure. Using the supracerebellar infratentorial, transtentorial or parietal interhemispheric routes, the superior medullary velum is approached. Splitting this velum provides a detailed view of the fourth ventricle and its floor. Materials and Methods A total of 10 formalin-fixed specimens were dissected in a stepwise manner to simulate the superior transvelar approach to the fourth ventricle. The exposure gained the distance from the craniotomy site and the ease of access was assessed for each of the routes. We also present an illustrative case, operated by the senior author (AN). Results The superior transvelar approach provides access to the entire length of the fourth ventricle floor, from the aqueduct to the obex, when using the parietal interhemispheric route. In addition, this approach provides access to the entire width of the floor of the fourth ventricle; however, this requires retracting the superior cerebellar peduncle. Using the supracerebellar infratentorial route gives a limited exposure of the superior part of the fourth ventricle. The occipital interhemispheric route is a compromise between these two. Conclusion The superior transvelar approach to the fourth ventricle provides a route for approaching the fourth ventricle from above. This approach does not require opening the posterior fossa in the traditional way, and provides a reasonable alternative for accessing the superior fourth ventricle.

  4. Síndrome de Deiscência de Canal Semicircular Superior Superior Canal Dehiscence Syndrome

    Directory of Open Access Journals (Sweden)

    Suzane da Cunha Ferreira

    2006-06-01

    Full Text Available A Síndrome de Deiscência de Canal Semicircular Superior (SDCSS, primeiramente descrita em 1998 por Minor et al., caracteriza-se por vertigem associada à presença de nistagmo, relacionados à exposição a estímulos sonoros intensos ou a modificações de pressão dentro da orelha média ou intracraniana. Disacusia, em sua maioria de padrão condutivo à audiometria tonal, também pode estar presente. Nesta revisão da literatura objetivou-se abordar a SDCSS, com seus principais sinais e sintomas, achados diagnósticos e tratamento, assim como enfatizar a importância de sua inclusão dentre as causas de vertigem, visto tratar-se de acometimento ainda pouco conhecido até mesmo entre especialistas. O diagnóstico correto, além de possibilitar seu tratamento, impede que abordagens diagnósticas e terapêuticas inapropriadas sejam realizadas.The Superior Canal Dehiscence Syndrome (SCDS was first reported by Minor at. Al. (1998, and has been characterized by vertigo and vertical-torsional eye movements related to loud sounds or stimuli that change middle ear or intracranial pressure. Hearing loss, for the most part with conductive patterns on audiometry, may be present in this syndrome. We performed a literature survey in order to to present symptoms, signs, diagnostic and therapeutic approaches to the SCDS, also aiming at stressing the great importance of including this syndrome among the tractable cause of vertigo. We should emphasize that this is a recent issue, still unknown by some specialists. The Correct SCDS diagnosis, besides enabling patient treatment, precludes misdiagnosis and inadequate therapeutic approaches.

  5. Acquired Brown Syndrome Treated With Traction of Superior Oblique Tendon.

    Science.gov (United States)

    Shin, Kwang Hoon; Paik, Hae Jung; Chi, Mijung

    2016-03-01

    Brown syndrome is a rare strabismic disease characterized by a limited elevation in adduction of the eye. The lengthening/weakening of superior oblique muscle is the main way of surgical intervention for this disease. A 7-year-old boy was diagnosed as having acquired Brown syndrome in his right eye after injury in his face. We experienced successful release of this Brown syndrome through mere pulling outward of superior oblique tendon during surgical exploration. We briefly discuss why this manipulation of superior oblique tendon that we performed was successful.

  6. Right superior vena cava draining into the left atrium

    Energy Technology Data Exchange (ETDEWEB)

    Calcagni, Giulio; Sidi, Daniel; Bonnet, Damien [University Rene Descartes-Paris 5, Department of Paediatric Cardiology, Hopital Necker-Enfants Malades, Paris (France); Batisse, Alain [Institut de Puericulture et de Perinatalogie, Paris (France); Vouhe, Pascal [University Rene Descartes-Paris 5, Department of Paediatric Cardiac Surgery, Hopital Necker-Enfants Malades, Paris (France); Ou, Phalla [University Rene Descartes-Paris 5, Department of Paediatric Cardiology, Hopital Necker-Enfants Malades, Paris (France); University Rene Descartes-Paris 5, Department of Pediatric Radiology, Hopital Necker-Enfants Malades, Paris (France)

    2008-08-15

    The right superior vena cava draining into the left atrium is a rare malformation causing cyanosis and clubbing in patients in whom no other signs of congenital heart defect are present. Diagnosis may be difficult as cyanosis may be mild and the anomaly is not always easily detectable by echocardiography. For this reason we report a 13-month-old male in whom we confirmed the clinical and echocardiographic suspicion of anomalous drainage of the right superior vena cava using multidetector CT. This allowed successful surgical reconnection of the right superior vena cava to the right atrium. (orig.)

  7. Noise management to achieve superiority in quantum information systems

    Science.gov (United States)

    Nemoto, Kae; Devitt, Simon; Munro, William J.

    2017-06-01

    Quantum information systems are expected to exhibit superiority compared with their classical counterparts. This superiority arises from the quantum coherences present in these quantum systems, which are obviously absent in classical ones. To exploit such quantum coherences, it is essential to control the phase information in the quantum state. The phase is analogue in nature, rather than binary. This makes quantum information technology fundamentally different from our classical digital information technology. In this paper, we analyse error sources and illustrate how these errors must be managed for the system to achieve the required fidelity and a quantum superiority. This article is part of the themed issue 'Quantum technology for the 21st century'.

  8. Transposição monocular vertical dos músculos retos horizontais em pacientes esotrópicos portadores de anisotropia em A Monocular vertical displacement of the horizontal rectus muscles in esotropic patients with "A" pattern

    Directory of Open Access Journals (Sweden)

    Ana Carolina Toledo Dias

    2004-10-01

    Full Text Available OBJETIVO: Estudar a eficácia da transposição vertical monocular dos mús-culos retos horizontais, proposta por Goldstein, em pacientes esotrópicos portadores de anisotropia em A, sem hiperfunção de músculos oblíquos. MÉTODOS: Foram analisados, retrospectivamente, 23 prontuários de pacientes esotrópicos portadores de anisotropia em A > 10delta, submetidos a transposição vertical monocular dos músculos retos horizontais. Os pacientes foram divididos em 2 grupos, de acordo com a magnitude da incomitância pré-operatória; grupo 1 era composto de pacientes com desvio entre 11delta e 20delta e grupo 2 entre 21delta e 30delta. Foram considerados co-mo resultados satisfatórios as correções com A PURPOSE: To report the effectiveness of the vertical monocular displacement of the horizontal rectus muscles, proposed by Goldstein, in esotropic patients with A pattern, without oblique muscle overaction. METHODS: A retrospective study was performed using the charts of 23 esotropic patients with A pattern > 10delta, submitted to vertical monocular displacement of the horizontal rectus muscles. The patients were divided into 2 groups in agreement with the magnitude of the preoperative deviation, group 1 (11delta to 20delta and group 2 (21delta to 30delta. Satisfactory results were considered when corrections A < 10delta or V < 15delta were obtained. RESULTS: The average of absolute correction was, in group 1, 16.5delta and, in group 2, 16.6delta. In group 1, 91.6% of the patients presented satisfactory surgical results and in group 2, 81.8% (p = 0.468. CONCLUSION: The surgical procedure, proposed by Goldstein, is effective and there was no statistical difference between the magnitude of the preoperative anisotropia and the obtained correction.

  9. 2010 Great Lakes Restoration Initiative Bathymetric Lidar: Lake Superior

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The data contained in this file contain hydrographic and topographic data collected by the Fugro LADS Mk II system along the Lake Superior coast of Minnessota,...

  10. 28 CFR 2.60 - Superior program achievement.

    Science.gov (United States)

    2010-07-01

    ... OF PRISONERS, YOUTH OFFENDERS, AND JUVENILE DELINQUENTS United States Code Prisoners and Parolees § 2... or a case with both superior program achievement and minor disciplinary infraction(s)). Advancements...

  11. Coronary artery bypass and superior vena cava syndrome.

    Science.gov (United States)

    Thomas, T V; Masrani, K; Thomas, J L

    1999-01-01

    Superior vena cava syndrome is the obstruction of the superior vena cava or its main tributaries by benign or malignant lesions. The syndrome causes edema and engorgement of the vessels on the face, neck, and arms, nonproductive cough, and dyspnea. We discuss the case of a 48-year-old obese diabetic woman who was admitted with unstable angina. She had previously been diagnosed with superior vena cava syndrome. Urgent coronary artery bypass grafting was necessary Although thousands of coronary artery bypasses are performed every year, there are not many reports on patients with superior vena cava syndrome who successfully undergo cardiopulmonary bypass and coronary artery grafting with an internal mammary artery as the conduit. The results of the case and alternative recommended methods are discussed.

  12. Superior memorizers employ different neural networks for encoding and recall.

    Science.gov (United States)

    Mallow, Johannes; Bernarding, Johannes; Luchtmann, Michael; Bethmann, Anja; Brechmann, André

    2015-01-01

    Superior memorizers often employ the method of loci (MoL) to memorize large amounts of information. The MoL, known since ancient times, relies on a complex process where information to be memorized is bound to landmarks along mental routes in a previously memorized environment. However, functional magnetic resonance imaging data on groups of trained superior memorizer are rare. Based on the memorizing strategy reported by superior memorizers, we developed a scheme of the processes successively employed during memorizing and recalling digits and relate these to brain activation that is specific for the encoding and recall period. In the examined superior memorizers several regions, suggested to be involved in mental navigation and digit-to-word processing, were specifically activated during encoding: bilateral early visual cortex, retrosplenial cortex, left parahippocampus, left visual cortex, and left superior parietal cortex. Although the scheme suggests that some steps during encoding and recall seem to be analog, none of the encoding areas were specifically activated during the recall. Instead, we found strong activation in left anterior superior temporal gyrus, which we relate to recalling the sequential order of the digits, and right motor cortex that may be related to reciting the digits.

  13. Superior Memorizers Employ Different Neural Networks for Encoding and Recall

    Directory of Open Access Journals (Sweden)

    Johannes eMallow

    2015-09-01

    Full Text Available Superior memorizers often employ the method of loci (MoL to memorize large amounts of information. The method of loci, known since ancient times, relies on a complex process where information to be memorized is bound to landmarks along mental routes in a previously memorized environment. However, fMRI data on groups of trained superior memorizer are rare. Based on the memorizing strategy reported by superior memorizers we developed a scheme of the processes successively employed during memorizing and recalling digits and relate these to brain activation that is specific for the encoding and recall period. In the examined superior memorizers several regions, suggested to be involved in mental navigation and digit-to-word processing, were specifically activated during encoding: bilateral early visual cortex, retrosplenial cortex, left parahippocampus, left visual cortex, and left superior parietal cortex. Although the scheme suggests that some steps during encoding and recall seem to be analog, none of the encoding areas were specifically activated during the recall. Instead, we found strong activation in left anterior superior temporal gyrus, which we relate to recalling the sequential order of the digits, and right motor cortex that may be related to reciting the digits.

  14. Differential diagnosis of cervical radiculopathy and superior pulmonary sulcus tumor

    Institute of Scientific and Technical Information of China (English)

    GU Rui; KANG Ming-yang; GAO Zhong-li; ZHAO Jian-wu; WANG Jin-cheng

    2012-01-01

    Background The result would be disastrous if the superior pulmonary sulcus tumor (Pancoast tumor) was misdiagnosed as degenerative cervical spine diseases.The aim of this study was to investigate the differential diagnosis methods of cervical radiculopathy and superior pulmonary sulcus tumor.Methods Clinical manifestations,physical,and radiological findings of 10 patients,whose main complaints were radiating shoulder and arm pain and later were diagnosed with superior pulmonary sulcus tumor,were reviewed and compared with those of cervical radiculopathy.Results Superior pulmonary sulcus tumor patients have shorter mean history and fewer complaints of neck pain or limitation of neck movement.Physical examination showed almost normal cervical spine range of motion.Spurling's neck compression test was negative in all patients.Anteroposterior cervical radiographs showed the lack of pulmonary air at the top of the affected lung in all cases and first rib encroachment in one case.The diagnosis of superior pulmonary sulcus tumor can be further confirmed by CT and MRI.Conclusions By the method of combination of history,physical examination,and radiological findings,superior pulmonary sulcus tumor can be efficiently differentiated from cervical radiculopathy.Normal motion range of the cervical spine,negative Spurling's neck compression test,and the lack of pulmonary air at the top of the affected lung in anteroposterior cervical radiographs should be considerad as indications for further chest radiograph examinations.

  15. Veia cava superior esquerda anômala com ausência de veia cava superior direita: achados de imagem Persistent left superior vena cava with absent right superior vena cava: image findings

    Directory of Open Access Journals (Sweden)

    Cyrillo Rodrigues de Araújo Júnior

    2003-10-01

    Full Text Available A persistência da veia cava superior esquerda com ausência da veia cava superior direita é uma anomalia rara, com menos de 150 casos descritos na literatura. A não-obliteração e regressão da veia cardinal anterior esquerda durante o desenvolvimento embriológico promove uma variação sistêmica de retorno venoso ao coração, com persistência da veia cava superior esquerda. Sua incidência varia de 0,3% em pacientes sem alterações cardíacas congênitas concomitantes a 4,3% naqueles com cardiopatias. Na maioria das vezes coexiste a veia cava superior direita, porém se houver regressão e degeneração da veia cardinal anterior direita, implicará a sua ausência e a drenagem venosa para o coração será feita pela veia cava superior esquerda ao átrio direito, através do seio coronariano. Mostramos um caso de um paciente submetido a radiografia de tórax e tomografia computadorizada para avaliação de doença pulmonar obstrutiva crônica, tendo como achado a persistência da veia cava superior esquerda com ausência da direita, sem qualquer cardiopatia associada e com a drenagem cardíaca sendo feita, através do seio coronariano, para o átrio direito.Persistent left superior vena cava with absent right superior vena cava is a rare anomaly, with less than 150 cases reported in the literature. Congenitally persistent left superior vena cava is the most common variant of systemic venous return to the heart, resulting embryologically from failure of the left anterior cardinal vein to become obliterated. Its incidence varies from 0.3% in patients with otherwise normal heart to 4.3% in patients with congenital heart disease. In the majority of the patients, a right superior vena cava is present as well, but rarely the right anterior cardinal vein degenerates resulting in the absence of the normal right superior vena cava. The blood from the right side is carried by the persistent left superior vena cava to the right atrium through the

  16. Superior Canal Dehiscence Syndrome: Lessons from the First 20 Years

    Directory of Open Access Journals (Sweden)

    Bryan K. Ward

    2017-04-01

    Full Text Available Superior semicircular canal dehiscence syndrome was first reported by Lloyd Minor and colleagues in 1998. Patients with a dehiscence in the bone overlying the superior semicircular canal experience symptoms of pressure or sound-induced vertigo, bone conduction hyperacusis, and pulsatile tinnitus. The initial series of patients were diagnosed based on common symptoms, a physical examination finding of eye movements in the plane of the superior semicircular canal when ear canal pressure or loud tones were applied to the ear, and high-resolution computed tomography imaging demonstrating a dehiscence in the bone over the superior semicircular canal. Research productivity directed at understanding better methods for diagnosing and treating this condition has substantially increased over the last two decades. We now have a sound understanding of the pathophysiology of third mobile window syndromes, higher resolution imaging protocols, and several sensitive and specific diagnostic tests. Furthermore, we have a treatment (surgical occlusion of the superior semicircular canal that has demonstrated efficacy. This review will highlight some of the fundamental insights gained in SCDS, propose diagnostic criteria, and discuss future research directions.

  17. La educación superior como eje del desarrollo

    Directory of Open Access Journals (Sweden)

    Benjamín Afanador Vargas

    2003-11-01

    Full Text Available Este documento analiza cómo ha sido la interacción entre la política educativa y las estrategiasde desarrollo en Colombia, a lo largo del siglo XX. Se presenta una revisión del estadoactual de la educación en Colombia, tanto a nivel de educación básica y media, como de laeducación superior. Para ello se toman tres criterios básicos que son la cobertura, la calidady la equidad en el acceso a la educación. Para el caso de la educación superior, se comparala oferta de cupos con la demanda existente, se clasifican los distintos segmentos en que sedivide la educación superior y se hace una breve reseña sobre el recurso humano con que secuenta en la educación superior colombiana. Así mismo, se expone una conceptualización delos retos que enfrenta la educación superior, sobretodo para lograr una cohesión de la sociedad,evitando que algunos de sus integrantes sean excluidos y permitiendo que todos losestamentos de la sociedad puedan compartir los mismos ideales y los consideren asequibles.Finalmente, se presentan unas conclusiones que se derivan del estudio y se proponen algunasrecomendaciones de política .

  18. Dose-effect relationship for lateral rectus muscle advancement in consecutive esotropia in children%儿童连续性内斜视外直肌加强手术量效关系的研究

    Institute of Scientific and Technical Information of China (English)

    刘丽丽; 于刚; 吴倩; 赵军阳; 崔燕辉; 梁天蔚; 李莉

    2016-01-01

    Objective To evaluate the dose-effect relationship for lateral rectus muscle advancement in consecutive esotropia in children.Methods Eleven cases (7 boys and 4 girls) with consecutive esotropia were retrospectively reviewed.All patients had undergone lateral rectus surgery.The alterations in muscle position and prism diopers (PD)and deviational change were determined by subtracting the angle of deviation l week after the operation.To quantify the clinical effect of muscle advancement,the ratio of the change in muscle position and reduction to the change in visual angle deviation was calculated (the surgical dose-effect relationship).Results The mean age of 11 cases was (8.91-± 3.01) years.Eight of 11 cases accepted lateral rectns muscle advancement in one eye and 3 of 11 cases accepted lateral rectus muscle advancement in two eyes.All patients were accompanied by the lateral limits.Strabismus degree was (31.00 ± 10.53) PD preoperatively and 1 week after the surgery the average strabismus degree was (3.00 ± 7.97) PD.The average correct rate was (3.97 ± 1.33) PD/mm.Rectus simply reset was in 6 cases and shorten reset was in 5 cases after the concentration-response.The difference in dose-effect relationship between the two groups had no statistical significance (P =0.410).The correlation coefficient was 5.74 (P =0.655).Conclusion The dose-effect relationship for lateral rectus muscle advancement in consecutive esotropia in children is (3.97 ± 1.33) PD/mm,and the dose-effect relationship has nothing to do with the degree of preoperative esotropia.The dose-effect relationship has no statistically significant difference between simply reset and shorten reset groups.%目的 评价儿童连续性内斜视(consective esotropia)外直肌加强手术效果与手术量之间的量效关系.方法 儿童连续性内斜视进行外直肌加强手术11例14只眼,均为外直肌复位或缩短后复位手术.男7例,女4例,年龄4 ~14岁.应用三棱镜遮盖试验分

  19. Design of a fifth generation air superiority fighter

    Science.gov (United States)

    Atique, Md. Saifuddin Ahmed; Barman, Shuvrodeb; Nafi, Asif Shahriar; Bellah, Masum; Salam, Md. Abdus

    2016-07-01

    Air Superiority Fighter is considered to be an effective dogfighter which is stealthy & highly maneuverable to surprise enemy along with improve survivability against the missile fire. This new generation fighter aircraft requires fantastic aerodynamics design, low wing loading (W/S), high thrust to weight ratio (T/W) with super cruise ability. Conceptual design is the first step to design an aircraft. In this paper conceptual design of an Air Superiority Fighter Aircraft is proposed to carry 1 crew member (pilot) that can fly at maximum Mach No of 2.3 covering a range of 1500 km with maximum ceiling of 61,000 ft. Payload capacity of this proposed aircraft is 6000 lb that covers two advanced missiles & one advanced gun. The Air Superiority Fighter Aircraft was designed to undertake all the following missions like: combat air petrol, air to air combat, maritime attack, close air support, suppression, destruction of enemy air defense and reconnaissance.

  20. Temporal Bone Fracture Causing Superior Semicircular Canal Dehiscence

    Directory of Open Access Journals (Sweden)

    Kevin A. Peng

    2014-01-01

    Full Text Available Importance. Superior semicircular canal dehiscence (SCD is a third window lesion of the inner ear causing symptoms of vertigo, autophony, tinnitus, and hearing loss. A “two-hit” hypothesis has traditionally been proposed, whereby thinly developed bone overlying the superior canal is disrupted by a sudden change in intracranial pressure. Although the symptoms of SCD may be precipitated by head injury, no previous reports have described a temporal bone fracture directly causing SCD. Observations. Two patients sustained temporal bone fractures after closed head trauma, and developed unilateral otologic symptoms consistent with SCD. In each instance, computed tomography imaging revealed fractures extending through the bony roof of the superior semicircular canal. Conclusions and Relevance. Temporal bone fractures, which are largely treated nonoperatively, have not previously been reported to cause SCD. As it is a potentially treatable entity, SCD resulting from temporal bone fracture must be recognized as a possibility and diagnosed promptly if present.

  1. Partial anomalous pulmonary venous connection to the superior vena cava.

    Science.gov (United States)

    Aramendi, José I; Rey, Estibaliz; Hamzeh, Gadah; Crespo, Alejandro; Luis, Maite; Voces, Roberto

    2011-04-01

    We describe the surgical technique of reimplantation of the right superior pulmonary vein into the left atrium in 2 patients with partial anomalous pulmonary venous connection to the superior vena cava without atrial septal defect. A right axillary minithoracotomy is done through the fourth intercostal space. The pulmonary vein is detached from its origin in the superior vena cava. This is sutured with 6-0 reabsorbable polydioxanone suture (Ethicon, Somerville, NJ). A lateral clamp is applied to the left atrium, and the pulmonary vein is reimplanted. The patient is extubated in the operating room. Neither cardiopulmonary bypass nor blood transfusion was required. It is simple, safe, and reproducible. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Anthropogenic climate change has altered primary productivity in Lake Superior

    Science.gov (United States)

    O'Beirne, M. D.; Werne, J. P.; Hecky, R. E.; Johnson, T. C.; Katsev, S.; Reavie, E. D.

    2017-06-01

    Anthropogenic climate change has the potential to alter many facets of Earth's freshwater resources, especially lacustrine ecosystems. The effects of anthropogenic changes in Lake Superior, which is Earth's largest freshwater lake by area, are not well documented (spatially or temporally) and predicted future states in response to climate change vary. Here we show that Lake Superior experienced a slow, steady increase in production throughout the Holocene using (paleo)productivity proxies in lacustrine sediments to reconstruct past changes in primary production. Furthermore, data from the last century indicate a rapid increase in primary production, which we attribute to increasing surface water temperatures and longer seasonal stratification related to longer ice-free periods in Lake Superior due to anthropogenic climate warming. These observations demonstrate that anthropogenic effects have become a prominent influence on one of Earth's largest, most pristine lacustrine ecosystems.

  3. Noise management to achieve superiority in quantum information systems.

    Science.gov (United States)

    Nemoto, Kae; Devitt, Simon; Munro, William J

    2017-08-06

    Quantum information systems are expected to exhibit superiority compared with their classical counterparts. This superiority arises from the quantum coherences present in these quantum systems, which are obviously absent in classical ones. To exploit such quantum coherences, it is essential to control the phase information in the quantum state. The phase is analogue in nature, rather than binary. This makes quantum information technology fundamentally different from our classical digital information technology. In this paper, we analyse error sources and illustrate how these errors must be managed for the system to achieve the required fidelity and a quantum superiority.This article is part of the themed issue 'Quantum technology for the 21st century'. © 2017 The Author(s).

  4. INFORMATION ASSURANCE - INTELLIGENCE - INFORMATION SUPERIORITY RELATIONSHIP WITHIN NATO OPERATIONS

    Directory of Open Access Journals (Sweden)

    Gheorghe BOARU, Ioan-Mihai ILIEŞ

    2011-01-01

    Full Text Available There is a tight relationship between information assurance, the intelligence cycle and information superiority within NATO operations. The intelligence cycle has a discrete architecture and provides on-time and relevant intelligence products to the joint force commanders and to other authorized users in a specifi c joint area of operations. The intelligence cycle must follow the evolution of the operation. A permanent intelligence estimate will be performed during the military decision making process and operations execution. Information superiority is one of the most powerful intelligence cycle achievements. and decisively infuences the success of NATO joint operations. Information superiority must be preserved and enhanced through information assurance. Information assurance is an information operation that must be planned by the military in charge of operation security or by non-military experts, executed by all personnel during the entire intelligence cycle life time and employed during the planning and execution of NATO joint operations.

  5. Status of the shortjaw cisco (Coregonus zenithicus) in Lake Superior

    Science.gov (United States)

    Hoff, Michael H.; Todd, Thomas N.

    2004-01-01

    The shortjaw cisco (Coregonus zenithicus) was historically found in Lakes Huron, Michigan, and Superior, but has been extirpated in Lakes Huron and Michigan apparently as the result of commercial overharvest. During 1999-2001, we conducted an assessment of shortjaw cisco abundance in five areas, spanning the U.S. waters of Lake Superior, and compared our results with the abundance measured at those areas in 1921-1922. The shortjaw cisco was found at four of the five areas sampled, but abundances were so low that they were not significantly different from zero. In the four areas where shortjaw ciscoes were found, abundance declined significantly by 99% from the 1920s to the present. To increase populations of this once economically and ecologically important species in Lake Superior, an interagency rehabilitation effort is needed. Population monitoring is recommended to assess population trends and to evaluate success of rehabilitation efforts.

  6. 直肌肌束部分转位移植矫正麻痹性斜视的临床观察%Clinical effect of partial rectus muscle transplantation surgery in the treatment of paralytic strabismus

    Institute of Scientific and Technical Information of China (English)

    陈建华; 邓大明; 麦光焕; 林小铭

    2008-01-01

    目的 探讨直肌肌束部分转位移植矫正麻痹性斜视手术方法和治疗效果.方法 总结27例麻痹性斜视行直肌肌束部分转位移植,并观察在术前、术后麻痹肌的运动情况、双眼视功能、眼球运动情况、眼位及复视消失情况等结果.结果 27例患者术后眼球运动功能有不同程度好转,除2例外全部过中线,转动1~2mm者12例、3mm者10例、4~5mm者2例、7mm者1例.术后被转位的肌肉运动正常.术后21例患者不同程度恢复了双眼视功能,其中具备Ⅰ度双眼单视功能13例,具备Ⅱ度双眼单视功能6例,2例有Ⅲ度双眼单视功能.6例同视机检测仍是单眼抑制.术后眼位正位22例,欠矫5~10度5例,23例复视消除,3例轻度改变注视方向也可消除复视.1例仍有复视不能耐受行二次手术.结论 直肌肌束部分转位移植可矫正麻痹性斜视眼位,消除复视,改善眼球运动,恢复部分双眼视功能,而且睫状肌血管分离保留可减少眼前段供血不足的危险,是目前安全、可行、有效地手术方法.%Purpose To describe and evaluate the clinical effect of partical rectus muscle transplantation surgery in the treatment of paralytic strabismus.Methods the following parameters were analyzed before and after the operation for the 27 patients who underwent partial rectus muscle transplantation surgery:(1) paralytic muscle movement;(2)binocular function;(3)eye movement;(4)primary eye position;(5)the existence of diplopia.Results All the patients (27 cases) to some degree retrieved muscle functions.The ocular movement was postoperatively 1-2mm in '12 patients,3mm in 10 patients,4-5mm in 2 patients and 7mm in 1 patient.Although 6 patients remained monocular suppression,21 patients regained single binocular vision to some extent(13 for simultaneous perception,6 for fusion and 2 for stereopsis).22 patients restored straight-ahead position post operation while 5 patients were lack of correction(5-10

  7. 内直肌后固定术治疗集合过强型内斜视的临床观察%Medial Rectus Posterior Fixation Sture for Convergence Excess Esotropia

    Institute of Scientific and Technical Information of China (English)

    殷小龙; 彭小维; 邓燕; 杨洋; 于春红; 廖瑜俊; 鄢涛

    2009-01-01

    目的 观察内直肌后固定术治疗集合过强型内斜视的临床效果.方法 回顾性分析2006年2月到2007年5月行内直肌后固定术治疗的17例集合过强型内斜视的临床资料.结果 17例患者中,术前平均看远内斜度为8.8△、平均看近内斜度为24.2△、平均AC/A比率为10.7.术前有12例无舣眼单视功能,仅5例具有远立体视.术后平均随访12.6月(9~15月),平均看远内斜度为2.8△、平均看近内斜度为3.9△、平均AC/A比率为5.9,其中看近内斜度较术前平均下降20.2△,AC/A比率均达到正常.术后有13例具有双眼单视功能.结论 内直肌后固定术可以减少看近的内斜视度数,降低AC/A比率,是一种治疗集合过强型内斜视的安全有效的方法.%Objective To observe the surgical effectiveness of convergence excess esotropia performed with medial rectus posterior fixation suture.Methods Retrospectively analyzed the clinical data of 17 cases convergence excess esotropia performed with medial rectus posterior fixation suture from 2003 to 2007.Results In 17 patients,the preoperative mean distance deviation was 8.8 prism diopter(PD)of esotropia and the mean near deviation was 24.2PD.The mean accommodative convergence/accommodation(AC/A)ratio preoperatively was 10.7.Except 5 eases,others without distance stereopsis in preoperation.Average follow-up was 12.6 months(ranged 9 to 15 months).Postoperatively the mean distance deviation was 2.SPD and the mean near deviation was 3.9PD.The mean decrease in the near deviation was 20.2PD.The mean postoperative AC/A ratio was 5.9 and all of the patients normalized.The 13 cases attained binocular single vision postoperation.Conclusions The medial rectus posterior fixation suture appears to be useful in convergence excess esotropia by reducing the near deviation and the AC/A ratio,so it is a safe and effective method.

  8. 股直肌岛状肌皮瓣修复瘫痪患者股骨大转子压疮效果%Repair of bedsore over greater trochanter in paraplegic patients with rectus femoris island myocutaneous flap

    Institute of Scientific and Technical Information of China (English)

    赵遵江; 张保德; 刘勇; 章荣涛; 梁其国; 胡育栋; 徐良媛; 王修坤

    2014-01-01

    Objective To observe the effect of rectus femoris island myocutaneous flap for repairing bedsores in Ⅲ and Ⅳphases at the femoral greater trochanter area as a result of paraplegia.Methods Thirteen paraplegic patients who suffered bedsores in Ⅲ and Ⅳ phases at the greater trochanter of femur area were hospitalized from July 2009 to June 2013.The bedsores ranged from 4.5 cm ×4.0 cm to 10.0 cm × 9.0 cm in area.After debridement,the size of soft tissue defect ranged from 5.0 cm ×4.5 cm to 10.5 cm × 10.0 cm.Rectus femoris island myocutaneous flaps were used to repair these defects,with flap area ranging from 5.0 cm×5.0 cm to 11.0 cm ×10.0 cm and muscular pedicle length ranging from8 to 12 cm.The donor sites of muscular pedicle were closed by direct suture,while those resulted from forming myocutaneous flap were closed by the transplantation of autologous skin obtained from thigh.Results Necrosis appeared at the edge of myocutaneous flap in one patient,and it was healed after dressing change.The other 12 myocutaneous flaps survived well.Patients were followed up for 2 to 30 months,and bedsore did not recur.Conclusions Rectus femoris island myocutaneous flap,with characteristics of reasonable design,large donor area,big rotation angle,and with wear-,tear-,and pressure-resistance,is suitable for repairing bedsores at Ⅲ and Ⅳ phases at the greater trochanter of femur area in paraplegic patients.%目的 观察用股直肌岛状肌皮瓣修复瘫痪患者股骨大转子Ⅲ~Ⅳ期压疮的效果.方法 2009年7月-2013年6月,笔者单位收治13例股骨大转子Ⅲ~Ⅳ期压疮瘫痪患者,压疮面积为4.5 cm ×4.0 cm~10.0 cm ×9.0 cm,扩创后缺损面积为5.0 cm ×4.5 cm~10.5 cm ×10.0 cm.采用股直肌岛状肌皮瓣修复创面,肌皮瓣面积为5.0 cm ×5.0 cm~11.0 cm×10.0 cm,肌蒂长8~12 cm.肌蒂切取区直接拉拢缝合固定,肌皮瓣切取区行自体大腿皮移植封闭. 结果 12例肌皮瓣全部成活;1例肌皮瓣的边

  9. The postdiction superiority effect in metacomprehension of text.

    Science.gov (United States)

    Pierce, B H; Smith, S M

    2001-01-01

    Metacomprehension accuracy for texts was greater after, rather than before, answering test questions about the texts-a postdiction superiority effect. Although postdiction superiority was found across successive sets of test questions and across successive texts, there was no improvement in metacomprehension accuracy after participants had taken more tests. Neither prediction nor postdiction gamma correlations with test performance improved with successive tests. Although the results are consistent with retrieval hypotheses, they contradict predictions made by test knowledge hypotheses, which state that increasing knowledge of the nature of the tests should increase metacomprehension accuracy.

  10. Imaging Evaluation of Superior Labral Anteroposterior (SLAP) Tears.

    Science.gov (United States)

    Grubin, Jeremy; Maderazo, Alex; Fitzpatrick, Darren

    2015-10-01

    Superior labral anteroposterior (SLAP) tears are common injuries that are best evaluated with magnetic resonance arthrography (MRA), as it provides the most detailed evaluation of the bicipital labral complex. Given the variety and complexity of SLAP tears, distention of the joint with intra-articular dilute gadolinium contrast properly separates the intra-articular biceps tendon, superior labrum, glenoid cartilage and glenohumeral ligaments to optimize assessment of these structures. This allows for increased diagnostic confidence of the interpreting radiologist and provides a better road map for the surgeon prior to arthroscopy. Indirect MRA and high-field magnetic resonance imaging are sensitive and specific alternative modalities if MRA cannot be performed.

  11. SUPERIOR MESENTERIC ARTERY SYNDROME - AN UNUSUAL CAUSE OF DUODENAL OBSTRUCTION

    OpenAIRE

    Sahu SK, , , , , , ,; Singh PK; Ray J; Uniyal M; Sharma C; Sekhar C; Kapruwan H; Sachan PK

    2012-01-01

    Superior mesenteric artery (SMA) arising from aorta at the level of first lumbar vertebra usually takes an angular downward course from ventral surface of aorta. It is through this vascular angle that the 3rd part of duodenum passes at the level of 4th lumbar vertebra. Fat and lymphatics around SMA maintains the angle at 25° to 60° with a mean of 450 and provide protection against duodenal compression. In Superior Mesenteric Artery Syndrome, the SMA-aorta angle in narrowed down to 7° to 22° w...

  12. 带蒂横行腹直肌皮瓣转移即刻乳房重建术10例报告%Immediate breast reconstruction with the pedicle transverse rectus abdominus myocutaneous flap

    Institute of Scientific and Technical Information of China (English)

    刘坚; 林乃弓; 封光华

    2009-01-01

    Objective To evaluate the clinical application of immediate breast reconstruction with the pedicle transverse rectus abdominus myocutaneons(TRAM)flap.Methods Ten breast cancer patients underwent immediate breast reconstruction with the pedicle TRAM flap after mastectomy,among which 4 cases used single pediele TRAM and 6 cases used bipedical TRAM.Polypropypene mesh were applied on all cases of patients to repair the abdominal defect. Results All the breast reconstructions were successful.Complications included grafting flap infection in one case and skin necrosis on partial abdominal skin flap in one case.The reconstructed breasts had a very good shape in 8 cases,and good in 2 cases.No local recurrence and distant metastasis occurred in the patients during the follow-up time ranging from 3 to 15 months. Conclutions Immediate breast reconstruction with the pedicle TRAM flap is an ideal breast reconstruction method for those patients undergoing mastectomy not only because it reconstructs the defective breast but for its cosmetic effect on the abdominal wall.%目的 探讨乳腺癌乳房切除后,带蒂横行腹直肌肌皮瓣(transverse rectus abdominis musculo cutaneous flap,TRAM)即刻乳房重建的方法及临床效果.方法 对2007年3月至2008年6月间10例乳房切除的乳腺癌患者行即刻带蒂TRAM乳房重建术,其中采用双蒂TRAM 6例,单蒂TRAM 4例.术中均用聚丙烯补片修补腹壁缺损.结果 10例患者重建乳房完全成活.1例发生乳房转移皮瓣感染,1例发生腹壁切口缘皮肤坏死.重建乳房形态:优8例,良2例.随访3~15月,所有病例无局部复发和远处转移.结论 带蒂TRAM乳房重建术在重建缺损乳房的同时达到了腹壁整形的效果,是一种较好的乳房重建方法.

  13. Experimental observation on the analgesic effect of NT on frog rectus abdominis N2 -receptor%中华眼镜蛇神经毒素的活性研究

    Institute of Scientific and Technical Information of China (English)

    高红瑾; 许云禄; 王少明; 陈燕

    2014-01-01

    Objective To study the analgesic effect and the drug-receptor interactions with frog rectus abdominis N2-receptor of the neurotoxin from Naja atra venom( NT). Methods Three model of pain( tail electric stimulation-vocali-zation test ,the hot-plate test ,and writhing responses in mice)were used. The effects of NT on acetylcholine-induced i-solated frog rectus abdoninis were observed. Results NT could dose-dependently raise the pain threshold in hot-plate test in mice and inhibit the writhing reaction induce by acetic acid in mice . The analgesic effect of NT effect at 2 h and peaked at 5 h. NT produced a concentration-dependent parallel shift to the right of dose-response curve of acetylcholine applied exogenously with no change in the maximal asymptotic response. Conclusion NT had a better analgesic effect on the pain due to hot- plate ,acetic acid and electric stimulation. NT was determined as the competitive antagonists of N2 -AChR.%目的:研究中华眼镜蛇神经毒素( NT)的镇痛活性和对离体蛙腹直肌N2-AChR的拮抗作用。方法采用三种模型(电刺激-嘶叫法,热板法,醋酸扭体法)观察NT的镇痛活性,并观察NT对ACh所致蛙离体腹直肌收缩的影响。结果 NT能提高电刺激-嘶叫法,热板法的痛阈,抑制醋酸引起的扭体次数。NT镇痛具有剂量-效应关系,给药后2 h起效,5 h达峰。NT能使ACh引起的蛙腹直肌收缩的量效曲线平行右移。结论 NT对三种致痛模型均有确切的镇痛活性,NT对N2-AChR的拮抗作用为竞争性拮抗。

  14. Traumatic avulsion of extraocular muscles: case reports

    Directory of Open Access Journals (Sweden)

    Nilza Minguini

    2013-04-01

    Full Text Available We described the clinical, surgical details and results (motor and sensory of the retrieving procedure of traumatically avulsed muscles in three patients with no previous history of strabismus or diplopia seen in the Department of Ophthalmology, State University of Campinas, Brazil. The slipped muscle portion was reinserted at the original insertion and under the remaining stump, which was sutured over the reinserted muscle. For all three cases there was recovery of single binocular vision and stereopsis.

  15. Síndrome de veia cava superior Superior vena cava syndrome

    Directory of Open Access Journals (Sweden)

    SAMUEL ZUÍNGLIO DE BIASI CORDEIRO

    2002-09-01

    Full Text Available A obstrução ao fluxo sanguíneo na VCS e suas manifestações clínicas têm hoje como causa principal o câncer de pulmão. A história relata que no século XVIII a sífilis e a tuberculose eram responsáveis por 40% dos casos conhecidos. O conhecimento das alterações hemodinâmicas compreendidas nesta síndrome assim como a apuração das técnicas de diagnóstico de imagem e de citopatologia permitem hoje que o médico possa tratar de seu paciente com mais segurança e conforto do que há 10 anos. A TC contrastada e a RM auxiliam no diagnóstico de localização da obstrução e técnicas mais antigas como a cavografia puderam ser abandonadas. O diagnóstico de obstrução da VCS e o estudo por Doppler realizado à beira do leito em muito contribuem para a realização de procedimentos de desobstrução como a angioplastia transluminal percutânea nos casos de trombose ou estenose do vaso. Também a utilização de próteses como PTFE é de importância fundamental na condução de casos de lesão traumática da VCS durante cirurgias para câncer pulmonar ou mediastinal. No campo da radioterapia, a técnica de fracionamento permite que altas doses de irradiação sejam administradas aos pacientes portadores de neoplasias malignas, com benefícios em 70% dos casos.Lung cancer is now the main cause of blood flow obstruction in the superior vena cava and of its clinical manifestations. History tells that in the 18th Century, syphilis and tuberculosis were responsible for 40% of the known cases. The knowledge of hemodynamic changes seen in this syndrome and the improvement of diagnostic and cytopathologic techniques allow for a safer and more comfortable treatment of the patient than 10 years ago. Contrast CT and MR added to the identification and location of the obstruction, and older techniques such as cavography could be abandoned. SVC obstruction diagnosis and Doppler studies carried out at the bed of the patient contribute to

  16. Biological Motion Task Performance Predicts Superior Temporal Sulcus Activity

    Science.gov (United States)

    Herrington, John D.; Nymberg, Charlotte; Schultz, Robert T.

    2011-01-01

    Numerous studies implicate superior temporal sulcus (STS) in the perception of human movement. More recent theories hold that STS is also involved in the "understanding" of human movement. However, almost no studies to date have associated STS function with observable variability in action understanding. The present study directly associated STS…

  17. O MARKETING NO ENSINO SUPERIOR: COMPARATIVO BRASIL-PORTUGAL

    Directory of Open Access Journals (Sweden)

    Helena Alves

    2010-12-01

    Full Text Available Ao abordar o marketing aplicado ao ensino superior, este estudo tem como objetivos discutir os conceitos teóricos do marketing educacional e aplicálos aos contextos brasileiro e português. Tendo em consideração que o marketing educacional tem a sua maior expressão nos E.U.A., a sua aplicação a diferentes realidades e culturas requer adaptações. Inicialmente, fez-se uma revisão dos conceitos tradicionais de marketing educacional, com ênfase nas vantagens, desvantagens e no marketing-mix aplicado à educação. Posteriormente realizou-se uma caraterização dos contextos atuais do ensino superior no Brasil e em Portugal, e fez-se uma comparação da aplicação do marketing educacional nas realidades brasileira e portuguesa, focando as análises no marketing-mix educacional. Percebeu-se que o ensino superior no Brasil tem caraterísticas muito diversas do ensino superior em Portugal e ambos divergem na aplicação dos conceitos mais tradicionais do marketing à educação. Desta forma, faz-se necessária a construção de abordagens teóricas específicas para a aplicação do marketing educacional a diferentes nações.

  18. Organizational Self-Awareness in the Key to Knowledge Superiority

    Science.gov (United States)

    2015-12-01

    a divisionalized bureaucracy (Mintzberg 1981). Designed as an innovation center, it is responsible for, among other things, forecasting and...the system, which prioritizes the needs and selection criteria for that system. 14. SUBJECT TERMS knowledge superiority, innovation , organizational...competitive advantage, knowledge is the critical element needed for any organization to innovate and succeed (Porter and Millar 1985). Its timely and

  19. Radiologic classification of superior canal dehiscence : Implications for surgical repair

    NARCIS (Netherlands)

    Lookabaugh, Sarah; Kelly, Hillary R.; Carter, Margaret S.; Niesten, Marlien E F; McKenna, Michael J.; Curtin, Hugh; Lee, Daniel J.

    2015-01-01

    Objective: Surgical access to repair a superior canal dehiscence (SCD) is influenced by the location of the bony defect and its relationship to surrounding tegmen topography as seen on computed tomography. There are currently no agreed-upon methods of characterizing these radiologic findings. We

  20. Mnemonic Training Reshapes Brain Networks to Support Superior Memory

    NARCIS (Netherlands)

    Dresler, M.; Shirer, W.R.; Konrad, B.N.; Muller, N.C.J.; Wagner, I.; Fernandez, G.S.E.; Czisch, M.; Greicius, M.D.

    2017-01-01

    Memory skills strongly differ across the general population; however, little is known about the brain characteristics supporting superior memory performance. Here we assess functional brain network organization of 23 of the world's most successful memory athletes and matched controls with fMRI

  1. Perturbation resilience and superiorization methodology of averaged mappings

    Science.gov (United States)

    He, Hongjin; Xu, Hong-Kun

    2017-04-01

    We first prove the bounded perturbation resilience for the successive fixed point algorithm of averaged mappings, which extends the string-averaging projection and block-iterative projection methods. We then apply the superiorization methodology to a constrained convex minimization problem where the constraint set is the intersection of fixed point sets of a finite family of averaged mappings.

  2. Measurement of ocular torsion variation following superior oblique tenectomy

    Directory of Open Access Journals (Sweden)

    Bruna Lana Ducca

    2014-12-01

    Full Text Available Purposes: To objectively evaluate the torsional effect of the superior oblique muscle-weakening surgery using the tenectomy technique proposed by Souza-Dias. Methods: The present prospective study included 10 patients (20 eyes with horizontal strabismus, bilateral superior oblique overaction and A-pattern of 15 to 30 prism diopters who underwent superior oblique tenectomy. Objective assessment of ocular torsion was performed by retinography immediately before and one month after surgery. The amount of ocular torsion was determined by measuring the angle formed by a horizontal line drawn across the geometric center of the optic disc and a second line connecting this point to the fovea. Results: The median preoperative angle was 5.56° in the right eyes and -3.43° in the left eyes. The median postoperative angle was 1.84° in the right eyes and -3.12° in the left eyes. The angle variation was statistically significant in both eyes (p=0.012 and p=0.01, respectively. Conclusion: The present study suggests that superior oblique tenectomy has an extorter effect, decreasing the intorsion detected on overaction of this muscle.

  3. Superior Mesenteric Artery Syndrome in a Young Military Basic Trainee

    Science.gov (United States)

    2013-03-01

    patients with severe anorexia nervosa .10 Severe cases may require surgery or parenteral feeding because of food avoidance leading to further loss of...2012. 10. Gwee K, Teh A, Huang C: Acute superior mesenteric artery syndrome and pancreatitis in anorexia nervosa . Australas Psychiatry 2010; 18(6): 523

  4. Morphological variation of siscowet lake trout in Lake Superior

    Science.gov (United States)

    Bronte, C.R.; Moore, S.A.

    2007-01-01

    Historically, Lake Superior has contained many morphologically distinct forms of the lake trout Salvelinus namaycush that have occupied specific depths and locations and spawned at specific times of the year. Today, as was probably the case historically, the siscowet morphotype is the most abundant. Recent interest in harvesting siscowets to extract oil containing omega-3 fatty acids will require additional knowledge of the biology and stock structure of these lightly exploited populations. The objective of this study was to determine whether shape differences exist among siscowet populations across Lake Superior and whether these shape differences can be used to infer stock structure. Morphometric analysis (truss protocol) was used to differentiate among siscowets sampled from 23 locations in Lake Superior. We analyzed 31 distance measurements among 14 anatomical landmarks taken from digital images of fish recorded in the field. Cluster analysis of size-corrected data separated fish into three geographic groups: The Isle Royale, eastern (Michigan), and western regions (Michigan). Finer scales of stock structure were also suggested. Discriminant function analysis demonstrated that head measurements contributed to most of the observed variation. Cross-validation classification rates indicated that 67–71% of individual fish were correctly classified to their region of capture. This is the first study to present shape differences associated with location within a lake trout morphotype in Lake Superior.

  5. El contexto virtual en la educación superior

    National Research Council Canada - National Science Library

    Vera Quintana, Mercedes

    2015-01-01

    ... técnicos, organizativos y metodológicos, por tanto, la virtualización de la educación superior durante su relativa corta vida, ha sido ese nuevo paradigma educativo resultante del uso de las tecnologías...

  6. Evaluation of the Superior Gluteal Nerve During Proximal Femoral Nailing

    Directory of Open Access Journals (Sweden)

    Mehmet Sonmez

    2017-05-01

    Full Text Available Aim: The superior gluteal nerve may be compromised during hip surgery. We retrospectively evaluated the patients who underwent proximal femoral nailing for unstable trochanteric fractures in order to investigate the presence of superior gluteal nerve injury and its clinical findings. Material and Method: Twenty five patients (14 women, 11 men were included in the study who had femoral nailing between January 2004 and March 2010 at Hamidiye Sisli Etfal Training and Research Hospital Department of Orthopaedics. Two different types of nails which have similar designs and surgical techniques were used for fracture fixation. Patients who had a history of cerebrovascular disease, electromyography findings of polyneuropathy, or degenerative vertebral disease were excluded from the study. Patients were evaluated clinically and radiologically. Findings related to acute denervation in the gluteus medius muscle and motor unit action potential changes were accepted as signs of superior gluteal nerve injury. Results: Eight patients were using support during walking and three of these patients had positive Trendelenburg sign, but only one patient had acute denervation signs of the superior gluteal nerve. Discussion: Based on the present study the incidence of iatrogenic nerve injury is a rare complication of proximal femoral nailing. Elderly patients, regardless of whether they have nerve injury, may limp and need to use a walking support.

  7. The effect of superior auditory skills on vocal accuracy

    Science.gov (United States)

    Amir, Ofer; Amir, Noam; Kishon-Rabin, Liat

    2003-02-01

    The relationship between auditory perception and vocal production has been typically investigated by evaluating the effect of either altered or degraded auditory feedback on speech production in either normal hearing or hearing-impaired individuals. Our goal in the present study was to examine this relationship in individuals with superior auditory abilities. Thirteen professional musicians and thirteen nonmusicians, with no vocal or singing training, participated in this study. For vocal production accuracy, subjects were presented with three tones. They were asked to reproduce the pitch using the vowel /a/. This procedure was repeated three times. The fundamental frequency of each production was measured using an autocorrelation pitch detection algorithm designed for this study. The musicians' superior auditory abilities (compared to the nonmusicians) were established in a frequency discrimination task reported elsewhere. Results indicate that (a) musicians had better vocal production accuracy than nonmusicians (production errors of 1/2 a semitone compared to 1.3 semitones, respectively); (b) frequency discrimination thresholds explain 43% of the variance of the production data, and (c) all subjects with superior frequency discrimination thresholds showed accurate vocal production; the reverse relationship, however, does not hold true. In this study we provide empirical evidence to the importance of auditory feedback on vocal production in listeners with superior auditory skills.

  8. Visuospatial Superiority in Developmental Dyslexia: Myth or Reality?

    Science.gov (United States)

    Brunswick, Nicola; Martin, G. Neil; Marzano, Lisa

    2010-01-01

    Anecdotal evidence indicates that dyslexia is positively associated with superior visuospatial ability but empirical evidence is inconsistent. We explicitly tested the hypothesis that dyslexia is associated with visuospatial advantage in 20 dyslexic and 21 unimpaired adult readers using paper-and-pencil measures and tests of "everyday"…

  9. Early detection of non-indigenous fishes in Lake Superior

    Science.gov (United States)

    Invasive species pose a serious threat to the ecological stability of the Great Lakes warranting continual monitoring for the arrival of new species. Three locations in Lake Superior were identified as “high risk” for new introductions: St. Louis River near Duluth, M...

  10. Preference for concentric orientations in the mouse superior colliculus

    NARCIS (Netherlands)

    Ahmadlou, Mehran; Heimel, J Alexander

    2015-01-01

    The superior colliculus is a layered structure important for body- and gaze-orienting responses. Its superficial layer is, next to the lateral geniculate nucleus, the second major target of retinal ganglion axons and is retinotopically organized. Here we show that in the mouse there is also a

  11. Funciones superiores en pacientes con accidente cerebro vascular

    National Research Council Canada - National Science Library

    Felipe Rodríguez; Alfonso Urzúa

    2009-01-01

    .... Con base a esto el objetivo de esta investigación fue elaborar un perfil de deterioro neuropsicológico de las diversas funciones cerebrales superiores causado por un ACV, en un grupo de 50 pacientes de la Unidad de Medicina...

  12. Absence of the superior petrosal veins and sinus: Surgical considerations

    Directory of Open Access Journals (Sweden)

    Ken Matsushima

    2015-01-01

    Conclusions: In cases in which the superior petrosal sinus and veins are absent, care should be directed to preserving the collateral drainage through the galenic and tentorial tributaries. Although surgical strategies for intraoperative management and preservation of venous structures are still controversial, knowledge of the possible anatomical variations is considered to be essential to improve surgical outcomes.

  13. Lake Superior supports novel clusters of cyanobacterial picoplankton.

    Science.gov (United States)

    Ivanikova, Natalia V; Popels, Linda C; McKay, R Michael L; Bullerjahn, George S

    2007-06-01

    Very little is known about the biodiversity of freshwater autotrophic picoplankton (APP) in the Laurentian Great Lakes, a system comprising 20% of the world's lacustrine freshwater. In this study, the genetic diversity of Lake Superior APP was examined by analyzing 16S rRNA gene and cpcBA PCR amplicons from water samples. By neighbor joining, the majority of 16S rRNA gene sequences clustered within the "picocyanobacterial clade" consisting of freshwater and marine Synechococcus and Prochlorococcus. Two new groups of Synechococcus spp., the pelagic Lake Superior clusters I and II, do not group with any of the known freshwater picocyanobacterial clusters and were the most abundant species (50 to 90% of the sequences) in samples collected from offshore Lake Superior stations. Conversely, at station Portage Deep (PD), located in a nearshore urbanized area, only 4% of the sequences belonged to these clusters and the remaining clones reflected the freshwater Synechococcus diversity described previously at sites throughout the world. Supporting the 16S rRNA gene data, the cpcBA library from nearshore station PD revealed a cosmopolitan diversity, whereas the majority of the cpcBA sequences (97.6%) from pelagic station CD1 fell within a unique Lake Superior cluster. Thus far, these picocyanobacteria have not been cultured, although their phylogenetic assignment suggests that they are phycoerythrin (PE) rich, consistent with the observation that PE-rich APP dominate Lake Superior picoplankton. Lastly, flow cytometry revealed that the summertime APP can exceed 10(5) cells ml-1 and suggests that the APP shifts from a community of PE and phycocyanin-rich picocyanobacteria and picoeukaryotes in winter to a PE-rich community in summer.

  14. [Examination of the hypothesis 'the factors and mechanisms of superiority'].

    Science.gov (United States)

    Sierra-Fitzgerald, O; Quevedo-Caicedo, J; López-Calderón, M G

    INTRODUCTION. The hypothesis of Geschwind and Galaburda suggests that specific cognitive superiority arises as a result of an alteration in development of the nervous system. In this article we review the co existence of superiority and inferiority . PATIENTS AND METHODS. A study was made of six children aged between 6 and 8 years old at the Instituto de Belles Artes Antonio Maria Valencia in Cali,Columbia with an educational level between second and third grade at a primary school and of medium low socio economic status. The children were considered to have superior musical ability by music experts, which is the way in which the concept of superiority was to be tested. The concept of inferiority was tested by neuropsychological tests = 1.5 DE below normal for the same age. We estimated the perinatal neurological risk in each case. Subsequently the children s general intelligence and specific cognitive abilities were evaluated. In the first case the WISC R and MSCA were used. The neuropsychological profiles were obtained by broad evaluation using a verbal fluency test, a test using counters, Boston vocabulary test, the Wechster memory scale, sequential verbal memory test, super imposed figures test, Piaget Head battery, Rey Osterrieth complex figure and the Wisconsin card classification test. The RESULTS showed slight/moderate deficits in practical construction ability and mild defects of memory and concept abilities. In general the results supported the hypothesis tested. The mechanisms of superiority proposed in the classical hypothesis mainly involve the contralateral hemisphere: in this study the ipsilateral mechanism was more important.

  15. Surgical management of third nerve palsy

    Directory of Open Access Journals (Sweden)

    Anupam Singh

    2016-01-01

    Full Text Available Third nerve paralysis has been known to be associated with a wide spectrum of presentation and other associated factors such as the presence of ptosis, pupillary involvement, amblyopia, aberrant regeneration, poor bell′s phenomenon, superior oblique (SO overaction, and lateral rectus (LR contracture. Correction of strabismus due to third nerve palsy can be complex as four out of the six extraocular muscles are involved and therefore should be approached differently. Third nerve palsy can be congenital or acquired. The common causes of isolated third nerve palsy in children are congenital (43%, trauma (20%, inflammation (13%, aneurysm (7%, and ophthalmoplegic migraine. Whereas, in adult population, common etiologies are vasculopathic disorders (diabetes mellitus, hypertension, aneurysm, and trauma. Treatment can be both nonsurgical and surgical. As nonsurgical modalities are not of much help, surgery remains the main-stay of treatment. Surgical strategies are different for complete and partial third nerve palsy. Surgery for complete third nerve palsy may involve supra-maximal recession - resection of the recti. This may be combined with SO transposition and augmented by surgery on the other eye. For partial third nerve, palsy surgery is determined according to nature and extent of involvement of extraocular muscles.

  16. 延伸蒂部的腹直肌肌皮瓣修复颈胸部创面的研究%LENGTHENED PEDICLE OF RECTUS ABDOMINIS FLAP TO REPAIR DEFECT ON NECK AND CHEST

    Institute of Scientific and Technical Information of China (English)

    张佳琦; 张金明; 梁伟强; 冀晨阳; 潘淑娟; 陈宇宏; 高守铨; 姚媛媛

    2014-01-01

    目的 通过CT血管造影(CT angiography,CTA)三维重建测量肋软骨宽度、厚度以及肋间隙距离,探讨采用截断下位肋软骨延伸蒂部的腹直肌肌皮瓣修复颈胸部创面的可行性.方法 以2013年7月-12月行胸部CTA的30例患者作为研究对象,其中男17例,女13例;年龄44~70岁,平均56岁.于CTA三维重建图像上测量第3~7肋软骨宽度、厚度以及第3~6肋肋间隙距离,计算顺序截断第7、6、5、4肋软骨后蒂部延伸长度.2012年7月-2013年11月,采用该方法延长带蒂腹直肌肌皮瓣的蒂部后修复4例颈胸部创面.结果 常规方法切取腹直肌肌皮瓣蒂部长度约为6 cm;按顺序截断左侧第7、6、5、4肋软骨后,皮瓣蒂部可平均延长4.07、7.99、12.50、17.48 cm;按顺序截断右侧第7、6、5、4肋软骨后,皮瓣蒂部平均延长4.63、10.82、16.64、22.05 cm.临床应用4例中,术后3例皮瓣顺利成活,1例皮瓣远端发生部分坏死,经对症处理后成活.除1例失访外,其余3例均获随访6个月,皮瓣外观、质地均较满意.结论 截断下位肋软骨可以延伸带蒂腹直肌肌皮瓣的蒂部,能满足修复颈胸部创面的要求.%Objective To explore the feasibility to repair defect on the neck and chest with the rectus abdominis flap which pedicle is lengthened by measuring the width,thickness,and the intercostal space of the inferior costicartilage using CT angiography (CTA).Methods Thirty cases receiving CTA and three-dimensional reconstruction between July and December 2013 were included in the study.Of 30 cases,17 were male and 13 were female,aged 44-70 years (mean,56 years).The width and thickness of the 3rd to 7th costicarfilages and the distance of the 3rd to 6th intercostal spaces were measured,and the lengthened pedicle was calculated after the 4th to 7th costicartilage was cut off.Between July 2012 and November 2013,the lengthened pedicle of the rectus abdominis flap was clinically used to repair the defect on

  17. Breast reconstruction with the bipedical transverse rectus abdominis%双蒂横行腹直肌肌皮瓣乳房再造术的临床应用

    Institute of Scientific and Technical Information of China (English)

    肖春花; 张学慧; 尹健; 宁连胜

    2006-01-01

    目的探讨乳腺癌根治术后双蒂横行腹直肌肌皮瓣(transverse rectus abdominis musculo-cutaneous flap,TRAM)乳房再造的手术方法及临床应用.方法对5例伴有剖腹产史的乳腺癌患者行双蒂TRAM瓣乳房再造术,术中切取双侧腹直肌作为转移皮瓣的蒂,转移至根治术后胸壁缺损处,塑造乳房外形,采用局部皮瓣再造乳头,游离皮瓣再造乳晕.结果4例患者再造乳房完全成活,形态自然,外形逼真,手感好;1例部分皮瓣坏死,面积3 cm×2 cm.结论双蒂TRAM瓣乳房再造术对有剖宫产史的乳腺癌患者是值得推荐的好方法,并非禁忌证.

  18. Fibrose congênita de reto inferior atípica com hipotonia muscular generalizada: relato de um caso Atipical inferior rectus congenital fibrosis with generalizated muscular hypotonia: case report

    Directory of Open Access Journals (Sweden)

    Ezon Vinicius Alves Pinto Ferraz

    1999-10-01

    Full Text Available O caso descrito apresentava uma hipotropia pouco severa com acuidade visual normal e binocularidade em infra-versão; além de uma hipotonia muscular generalizada, ao contrário da severa hipotropia e ambliopia encontrada nessa afecção. O procedimento cirúrgico levou estes fatos em consideração, tendo-se optado por um retrocesso pequeno do reto inferior para que se corrigisse o torcicolo sem interferir na posição de leitura. Os resultados pós-operatórios foram satisfatórios.A case report of an atipical inferior rectus congenital fibrosis associated with a generalized muscular hypotonia is presented. It shows mild hipotropia with a normal visual acuity and binocularity in infraversion position contrasting with the severe hipotropia and ambliopy found. The surgical procedure took these facts into consideration, so we performed a small retrocess of the muscle with the objective to correct the head position without changes in the reading position. The postoperative results were satisfactory.

  19. Bioaccumulation of toxaphene congeners in the lake superior food web

    Science.gov (United States)

    Muir, D.C.G.; Whittle, D.M.; De Vault, D. S.; Bronte, C.R.; Karlsson, H.; Backus, S.; Teixeira, C.

    2004-01-01

    The bioaccumulation and biotransformation of toxaphene was examined in the food webs of Lake Superior and Siskiwit Lake (Isle Royale) using congener specific analysis as well as stable isotope ratios of carbon and nitrogen to characterize food webs. Toxaphene concentrations (calculated using technical toxaphene) in lake trout (Salvelinus namaycush) from the western basin of Lake Superior (N = 95) averaged (±SD) 889 ± 896 ng/g wet wt and 60 ± 34 ng/g wet wt in Siskiwit Lake. Major congeners in lake trout were B8-789 (P38), B8-2226 (P44), B9-1679 (P50), and B9-1025 (P62). Toxaphene concentrations were found to vary seasonally, especially in lower food web organisms in Lake Superior and to a lesser extent in Siskiwit Lake. Toxaphene concentrations declined significantly in lake herring (Coregonus artedii), rainbow smelt (Omerus mordax), and slimy sculpin (Cottus cognatus) as well as in zooplankton (> 102 &mn;m) and Mysis (Mysis relicta) between May and October. The seasonal variation may reflect seasonal shifts in the species abundance within the zooplankton community. Trophic magnification factors (TMF) derived from regressions of toxaphene congener concentrations versus δ15N were > 1 for most octa- and nonachlorobornanes in Lake Superior except B8-1413 (P26) and B9-715. Log bioaccumulation factors (BAFs) for toxaphene congeners in lake trout (ng/g lipid/ng/L dissolved) ranged from 4.54 to 9.7 and were significantly correlated with log octanol-water partition coefficients. TMFs observed for total toxaphene and congener B9-1679 in Lake Superior were similar to those in Arctic lakes, as well as to previous studies in the Great Lakes, which suggests that the bioaccumulation behavior of toxaphene is similar in pelagic food webs of large, cold water systems. However, toxaphene concentrations were lower in lake trout from Siskiwit Lake and lakes in northwestern Ontario than in Lake Superior possibly because of shorter food chains and greater reliance on zooplankton or

  20. Can linear superiorization be useful for linear optimization problems?

    Science.gov (United States)

    Censor, Yair

    2017-04-01

    Linear superiorization (LinSup) considers linear programming problems but instead of attempting to solve them with linear optimization methods it employs perturbation resilient feasibility-seeking algorithms and steers them toward reduced (not necessarily minimal) target function values. The two questions that we set out to explore experimentally are: (i) does LinSup provide a feasible point whose linear target function value is lower than that obtained by running the same feasibility-seeking algorithm without superiorization under identical conditions? (ii) How does LinSup fare in comparison with the Simplex method for solving linear programming problems? Based on our computational experiments presented here, the answers to these two questions are: ‘yes’ and ‘very well’, respectively.

  1. Anterior superior instability with rotator cuff tearing: SLAC lesion.

    Science.gov (United States)

    Savoie, F H; Field, L D; Atchinson, S

    2001-07-01

    Anterosuperior instability of the shoulder may occur from a variety of pathologic lesions. We describe a specific entity, the SLAC (superior labrum, anterior cuff) lesion that involves an association of anterior-superior labral tear with a partial supraspinatus tear. We retrospectively isolated a group of 40 patients with this lesion. The presenting complaints, physical examination findings, surgical findings, and results were isolated. Overhead activities were the most common etiology; load and shift instability testing and whipple rotator cuff testing were the most common physical examination findings. Surgical repair was successful in 37 of the 40 patients. The SLAC lesion is a definable clinical entity with predictable history, examination, surgical pathology, and satisfactory results from surgery.

  2. Superior gluteal nerve entrapment between two bellies of piriformis muscle

    Directory of Open Access Journals (Sweden)

    Yadav Y

    2010-12-01

    Full Text Available A double belly composition of piriformis muscle with superior gluteal nerve entrapment between the two muscle masses was detected. Piriformis muscle and its relation to sciatic nerve has been suggested as a cause of piriformis syndrome. Patients suffering from buttock pain are most often diagnosed as having piriformis syndrome, where anatomical variation of the piriformis is an important contributor. The present variation showed two distinct bellies of piriformis muscle. Interestingly the superior gluteal nerve was interposed between the two bellies. Such incidental findings on cadavers may help the clinicians to establish a rare yet important cause of piriformis syndrome. Furthermore, such observations are also relevant to the radiologists while interpreting MRI scans in cases of undiagnosed chronic gluteal pain.

  3. Laparoscopic Pancreaticoduodenectomy: Right Posterior Superior Mesenteric Artery "First" Approach.

    Science.gov (United States)

    Pittau, Gabriella; Sànchez-Cabùs, Santiago; Laurenzi, Andrea; Gelli, Maximiliano; Cunha, Antonio Sa

    2015-12-01

    Pancreaticoduodenectomy (PD) is considered one of the most challenging abdominal operations for several reasons, including the anatomy, which is surrounded by vital vascular structures and also because of the serious complications that are possible in the postoperative period. Nowadays, thanks to the development of minimally invasive surgery and improvement of patients' selection, laparoscopic pancreatic resections have been proven to be technically feasible and safe especially in the case of left pancreatectomies. More recently, many series of laparoscopic PD for adenocarcinoma have been published demonstrating the feasibility of this technique. In pancreatic cancer, the advantage of superior mesenteric artery "first approach" is already known to achieve an oncological resection. The purpose of this video is to describe the different technical aspects of the laparoscopic superior mesenteric artery first approach in the right posterior fashion.

  4. Surgical approach to the superior mid-orbit.

    Science.gov (United States)

    Krohn-Hansen, Dag; Nicolaissen, Bjørn; Meling, Torstein R; Haaskjold, Erling

    2013-09-01

    Access to the superior mid-orbit is required for procedures on the levator muscle in the correction of upper eyelid ptosis and in surgery aimed at local lesions in this region. The purpose with this human cadaver study was to clarify the anatomical substrate for a surgical approach to the levator muscle and the upper mid-orbit structures, in which the orbital septum and the retroseptal fat pad is not harmed during surgery. Macro-anatomical dissections and histological examinations were performed on five human orbits from three formalin embalmed cadaver heads. It was found that the orbital septum extends posteriorly from its junction with the levator aponeurosis. This posterior continuation of the orbital septum encloses the superior orbital fat pad and separates this from the anterior surface of the levator muscle. In between the orbital septum and the levator, there is a dissection space that provides a minimal invasive access corridor to the structures in the upper mid-orbit.

  5. False memories in highly superior autobiographical memory individuals.

    Science.gov (United States)

    Patihis, Lawrence; Frenda, Steven J; LePort, Aurora K R; Petersen, Nicole; Nichols, Rebecca M; Stark, Craig E L; McGaugh, James L; Loftus, Elizabeth F

    2013-12-24

    The recent identification of highly superior autobiographical memory (HSAM) raised the possibility that there may be individuals who are immune to memory distortions. We measured HSAM participants' and age- and sex-matched controls' susceptibility to false memories using several research paradigms. HSAM participants and controls were both susceptible to false recognition of nonpresented critical lure words in an associative word-list task. In a misinformation task, HSAM participants showed higher overall false memory compared with that of controls for details in a photographic slideshow. HSAM participants were equally as likely as controls to mistakenly report they had seen nonexistent footage of a plane crash. Finding false memories in a superior-memory group suggests that malleable reconstructive mechanisms may be fundamental to episodic remembering. Paradoxically, HSAM individuals may retrieve abundant and accurate autobiographical memories using fallible reconstructive processes.

  6. Genomes for jeans: cotton genomics for engineering superior fiber.

    Science.gov (United States)

    Mansoor, Shahid; Paterson, Andrew H

    2012-10-01

    Twenty years ago, scientists predicted that better understanding of fiber development would lead to novel ways to engineer superior cotton fiber. Advances in genetic resources, DNA markers, DNA sequence information, and gene expression data have indeed provided new insights into fiber initiation, elongation and maturation. Many exciting applications of this knowledge offer the potential to select better cotton genotypes more effectively in mainstream breeding programs or engineer genotypes with improved agronomic and/or quality traits. Here, we discuss recent progress in understanding genes involved in fiber development, and their regulation and manipulation to engineer improved fibers. Better understanding of quantitative trait loci/gene interactions that influence fiber quality and yield may help to tailor superior cotton genotypes to diverse environments.

  7. Tullio phenomenon in superior semicircular canal dehiscence syndrome.

    Science.gov (United States)

    Basura, Gregory J; Cronin, Scott J; Heidenreich, Katherine D

    2014-03-18

    Tullio phenomenon refers to eye movements induced by sound.(1) This unusual examination finding may be seen in superior semicircular canal dehiscence (SSCD) syndrome.(2) This disorder is due to absent bone over the superior semicircular canal (figure). Patients complain of dizziness triggered by loud sound, aural fullness, autophony, and pulsatile tinnitus. When Tullio phenomenon exists in SSCD syndrome, the patient develops a mixed vertical-torsional nystagmus in which the slow phase rotates up and away from the affected ear (video on the Neurology® Web site at Neurology.org). This pattern of nystagmus aligns in the plane of the dehiscent semicircular canal and is due to excitation of its afferent nerves.

  8. CURRENT COLLOIDAL DISPERSION GELS ARE NOT SUPERIOR TO POLYMER FLOODING

    Institute of Scientific and Technical Information of China (English)

    Seright Randy; Han Peihui; Wang Dongmei

    2006-01-01

    The suggestion that the colloidal-dispersion-gel (CDG) process is superior to normal polymer flooding is misleading and generally incorrect. Colloidal dispersion gels, in their present state of technological development, should not be advocated as an improvement to, or substitute for, polymer flooding. Gels made from aluminum-citrate crosslinked polyacrylamides can act as conventional gels and provide effective conformance improvement in treating some types of excess water production problems if sound scientific and engineering principles are respected.

  9. Pseudoaneurysm of the superior gluteal artery following polytrauma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dennis [Vancouver General Hospital, University of British Columbia and Department of Radiology, Vancouver, BC (Canada); Legiehn, Gerald M. [Vancouver General Hospital, Interventional Radiology, University of British Columbia and Department of Radiology, Vancouver, BC (Canada); Munk, Peter L. [Vancouver General Hospital, MSK Section, University of British Columbia and Department of Radiology, Vancouver, BC (Canada)

    2007-09-15

    Gluteal artery aneurysms are rare and often secondary to pelvic fractures, blunt or penetrating trauma. We describe a case of a superior gluteal artery pseudoaneurysm that presented as back pain with numbness and weakness of the lower extremities. Diagnosis was confirmed by color Doppler sonography and angiography. A proximal and distal control was obtained over the aneurysm neck via coil embolization with excellent hemostasis within the pseudoaneurysm and maintenance of perfusion to the left pelvis. (orig.)

  10. [Superior gluteal nerve: a new block on the block?

    Science.gov (United States)

    Sá, Miguel; Graça, Rita; Reis, Hugo; Cardoso, José Miguel; Sampaio, José; Pinheiro, Célia; Machado, Duarte

    2017-05-24

    The superior gluteal nerve is responsible for innervating the gluteus medius, gluteus minimus and tensor fascia latae muscles, all of which can be injured during surgical procedures. We describe an ultrasound-guided approach to block the superior gluteal nerve which allowed us to provide efficient analgesia and anesthesia for two orthopedic procedures, in a patient who had significant risk factors for neuraxial techniques and deep peripheral nerve blocks. An 84-year-old female whose regular use of clopidogrel contraindicated neuraxial techniques or deep peripheral nerve blocks presented for urgent bipolar hemiarthroplasty in our hospital. Taking into consideration the surgical approach chosen by the orthopedic team, we set to use a combination of general anesthesia and superficial peripheral nerve blocks (femoral, lateral cutaneous of thigh and superior gluteal nerve) for the procedure. A month and a half post-discharge the patient was re-admitted for debriding and correction of suture dehiscence; we performed the same blocks and light sedation. She remained comfortable in both cases, and reported no pain in the post-operative period. Deep understanding of anatomy and innervation empowers anesthesiologists to solve potentially complex cases with safer, albeit creative, approaches. The relevance of this block in this case arises from its innervation of the gluteus medius muscle and posterolateral portion of the hip joint. To the best of our knowledge, this is the first report of an ultrasound-guided superior gluteal nerve block with an analgesic and anesthetic goal, which was successfully achieved. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  11. Superior gluteal nerve entrapment between two bellies of piriformis muscle

    OpenAIRE

    Yadav Y; Mehta V; Roy S; Suri R; Rath G

    2010-01-01

    A double belly composition of piriformis muscle with superior gluteal nerve entrapment between the two muscle masses was detected. Piriformis muscle and its relation to sciatic nerve has been suggested as a cause of piriformis syndrome. Patients suffering from buttock pain are most often diagnosed as having piriformis syndrome, where anatomical variation of the piriformis is an important contributor. The present variation showed two distinct bellies of piriformis muscle. Interestingly the sup...

  12. Pseudoaneurysm of the superior gluteal artery following polytrauma.

    Science.gov (United States)

    Lee, Dennis; Legiehn, Gerald M; Munk, Peter L

    2007-09-01

    Gluteal artery aneurysms are rare and often secondary to pelvic fractures, blunt or penetrating trauma. We describe a case of a superior gluteal artery pseudoaneurysm that presented as back pain with numbness and weakness of the lower extremities. Diagnosis was confirmed by color Doppler sonography and angiography. A proximal and distal control was obtained over the aneurysm neck via coil embolization with excellent hemostasis within the pseudoaneurysm and maintenance of perfusion to the left pelvis.

  13. Superior vesical fissure concealed by giant omphalocele: A case report

    Directory of Open Access Journals (Sweden)

    Danial Hayek

    2016-11-01

    Full Text Available Omphalocele is an abdominal wall defect characterized by exteriorization of abdominal viscera that is covered by a membrane. Omphalocele has a well-known association with chromosome abnormalities. Here we present a case of a superior vesical fissure (SVF initially disguised as a giant omphalocele in a newborn with trisomy 18. We also show unique prenatal imaging and discuss the importance and limitations of prenatal genetic testing.

  14. Information Superiority generated through proper application of Geoinformatics

    Science.gov (United States)

    Teichmann, F.

    2012-04-01

    Information Superiority generated through proper application of Geoinformatics Information management and especially geoscience information delivery is a very delicate task. If it is carried out successfully, geoscientific data will provide the main foundation of Information Superiority. However, improper implementation of geodata generation, assimilation, distribution or storage will not only waste valuable resources like manpower or money, but could also give rise to crucial deficiency in knowledge and might lead to potentially extremely harmful disasters or wrong decisions. Comprehensive Approach, Effect Based Operations and Network Enabled Capabilities are the current buzz terms in the security regime. However, they also apply to various interdisciplinary tasks like catastrophe relief missions, civil task operations or even in day to day business operations where geo-science data is used. Based on experience in the application of geoscience data for defence applications the following procedure or tool box for generating geodata should lead to the desired information superiority: 1. Understand and analyse the mission, the task and the environment for which the geodata is needed 2. Carry out a Information Exchange Requirement between the user or customer and the geodata provider 3. Implementation of current interoperability standards and a coherent metadata structure 4. Execute innovative data generation, data provision, data assimilation and data storage 5. Apply a cost-effective and reasonable data life cycle 6. Implement IT security by focusing of the three pillar concepts Integrity, Availability and Confidentiality of the critical data 7. Draft and execute a service level agreement or a memorandum of understanding between the involved parties 8. Execute a Continuous Improvement Cycle These ideas from the IT world should be transferred into the geoscience community and applied in a wide set of scenarios. A standardized approach of how to generate, provide

  15. Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery

    OpenAIRE

    Metin Keskin; Turgut Akgül; Adem Bayraktar; Fatih Dikici; Emre Balık

    2014-01-01

    Case Report Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery Metin Keskin,1 Turgut Akgül,2 Adem Bayraktar,1 Fatih Dikici,2 and Emre BalJk3 1 General Surgery Department, Istanbul Faculty of Medicine, Istanbul University, Capa, Millet Caddesi, 34093 Istanbul, Turkey 2Orthopedic Department, Istanbul Faculty of Medicine, Istanbul University, Capa, Millet Caddesi, 34093 Istanbul, Turkey 3 General Surgery Department, School of Medicine, Koc¸ Uni...

  16. São os membros superiores na Paralisia Cerebral negligenciados?

    Directory of Open Access Journals (Sweden)

    Ubiratan Brum Castro

    2014-06-01

    Full Text Available Objetivo: Avaliar se num serviço de atendimento especializado, o membro superior é preterido ou negligenciado no tratamento das alterações motoras da Paralisia Cerebral. Casuística e métodos: Foram analisados 80 pacientes portadores de Paralisia Cerebral menores de dezessete anos tratados institucionalmente. Foram avaliados pelo mesmo examinador quanto à classificação e tratamentos (cirúrgico ou não do aparelho locomotor. Resultados: O membro superior teve a seguinte abordagem terapêutica considerando o grupo de mão comprometida, 1 (2% foi submetido a transferência tendinosa no punho e 53 (98% não foram operados. Quanto a órteses, 9 (17% usavam estabilizadores de punho e 45 (83% não usavam. Quanto à toxina botulínica não houve aplicação nos membros superiores. Nos membros inferiores, considerando o total de pacientes, 16 (20% foram submetidos à cirurgia e 64(80% não foram operados. As cirurgias foram um tratamento cirúrgico de luxação do quadril, 7 a alongamentos múltiplos em membros inferiores, 5 alongamento de tendão calcâneo, 3 tenotomia de adutores. Quanto ao uso de órteses, 49 (61% faziam uso e 31(39% não utilizavam. Dos pacientes que faziam uso de órteses, 48 usavam tala estabilizadora de tornozelo, um usava estabilizador de joelho. Quanto à  o uso de toxina botulínica: 32 tiveram aplicação (40% e 48 não receberam aplicação (60%. Conclusão: No presente estudo, o tratamento do membro superior foi negligenciado.

  17. Effect of bilateral superior oblique split lengthening on torsion

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    Jitendra Jethani

    2015-01-01

    Full Text Available Introduction: Superior oblique split lengthening (SOSL is done for weakening of superior oblique. It corrects the superior oblique overaction (SOOA and A pattern. Its effect on the torsion of the eye is not known. We present our data on the effect of this particular procedure on torsion. Materials and Methods: We did a study of 16 patients (32 eyes who underwent bilateral SOSL and compared the disc foveal angle (DFA preoperatively and postoperatively. The split lengthening was done from 4 mm to 7 mm depending upon the overaction of superior oblique. Results: The mean age was 15.3 ± 8.4 years. Mean preoperative DFA in the right eye (RE was −3.9° and in the left eye (LE was −2.9°. Mean postoperative DFA in RE was 0.2° and in LE was 0.9°. The mean change in the DFA for RE was 4.1° ± 1.3° and for LE was 3.8° ± 1.2°. All the patients were aligned horizontally within 6 prism diopter and no pattern and no diplopia postoperatively. The A pattern was corrected in all the patient postsurgery. For each mm of surgery, an improvement of 0.8° was seen in the DFA. Conclusion: We report the effect of SOSL on torsion. The SOSL reduces intorsion postsurgery and is, therefore, a valuable procedure in SOOA where both pattern and in torsion needs to be corrected.

  18. A Rare Complication of Acute Appendicitis: Superior Mesenteric Vein Thrombosis

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    Hendra Koncoro

    2016-12-01

    Full Text Available Superior mesenteric vein (SMV thrombosis caused by acute appendicitis is quite rare nowadays. These conditions occurs secondary to infection in the region drained by the portal venous system. In this case, we report a successfully treated case of SMV thrombosis and liver abscess associated with appendicitis with antibiotics and anticoagulant.Early diagnosis and prompt treatment are basic to a favorable clinical course.

  19. Superior Gas Sensing Properties of Monolayer PtSe2

    KAUST Repository

    Sajjad, Muhammad

    2016-12-15

    First-principles calculations of the structural and electronic properties of monolayer 1T-PtSe2 with adsorbed (a) NO2, (b) NO, (c) NH3, (d) H2O, (e) CO2, and (f) CO molecules are discussed. The results point to great potential of the material in gas sensor applications. Superior sensitivity is demonstrated by transport calculations using the nonequilibrium Green\\'s function method.

  20. Superior parathyroid gland approach to the recurrent laryngeal nerve.

    Science.gov (United States)

    Elsheikh, Ezzeddin

    2017-07-01

    The superior parathyroid gland is known to be almost constant in its location under the false thyroid capsule. Could it be a landmark to point to the site of incision of the false thyroid capsule and find the plane of the recurrent laryngeal nerve (RLN) during thyroidectomy? The study included 48 patients with benign goiter scheduled for hemithyroidectomy or total thyroidectomy; there were 16 cases of solitary thyroid nodules, 27 cases of multinodular goiter, and 5 cases of toxic goiter. This study included 80 lobectomies. All patients showed no evidence of postoperative RLN palsy, bleeding, or hypoparathyroidism. The superior parathyroid gland was consistently found within the false capsule in all cases, whereas the inferior parathyroid was found within the same layer in 64 sides (80%). The described approach can accurately guide dissection between true and false capsules of the thyroid to reach and preserve both the RLN and the superior parathyroid gland. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1287-1290, 2017. © 2017 Wiley Periodicals, Inc.

  1. Hacia una educación superior inclusiva en Colombia

    Directory of Open Access Journals (Sweden)

    Sandra Lucia Arizabaleta Dominguez

    2016-12-01

    Full Text Available En este artículo se analizan concepciones teórico-conceptuales básicas que subyacen a la educación superior inclusiva, en el marco de los Lineamientos de la Política de Educación Superior Inclusiva del Ministerio de Educación Nacional de Colombia (men. Además, se plantean los desafíos que deben asumir las instituciones de educación superior (ies en la identificación de barreras de aprendizaje de su población estudiantil y la promoción de estrategias que garanticen la accesibilidad, permanencia, pertinencia académica y la graduación. Esta situación lleva a las ies a reflexionar y repensarse a partir de los procesos de autoevaluación institucional para crear estrategias participativas que promuevan la gestión inclusiva en un sistema educativo equitativo, pertinente y de calidad

  2. Anatomo-radiological study of the Superior Semicircular Canal Dehiscence

    Energy Technology Data Exchange (ETDEWEB)

    Crovetto, M., E-mail: macdlt@telefonica.net [Otolaryngology Department, Hospital de Basurto, University of the Basque Country, Avenida de Montevideo 18, Bilbao 48013, Vizcaya (Spain); Whyte, J., E-mail: jwhite@unizar.es [Faculty of Medicine, Department of Human Anatomy and Histology, University of Zaragoza, C/Domingo Mirall s/n, Zaragoza (Spain); Rodriguez, O.M., E-mail: OLIVIAMARIA.RODRIGUEZSANVICENT@osakidetza.net [Hospital de Cruces, Baracaldo, Vizcaya (Spain); Lecumberri, I., E-mail: INIGO.LECUMBERRICORTES@osakidetza.net [Hospital de Basurto, Avenida Montevideo 18, Bilbao 498013 (Spain); Martinez, C., E-mail: claudiorayosx@yahoo.es [Hospital General de la Defensa, Via Iberica s/n Zaragoza (Spain); Elexpuru, J., E-mail: jelexpuru@mac.com [Hospital de Basurto, Avenida de Montevideo 18, Bilbao 48013, Vizcaya (Spain)

    2010-11-15

    Introduction: The main purpose of this study is to determine the radiological incidence of Superior (SSCD) and Posterior Semicircular Canal Dehiscence (PSCD) and to compare radiologic SSCD to the incidence of this condition on cadaver specimen. We have also analysed the relation between the ossification state of the semicircular canals and the degree of mastoid pneumatization and integrity of Tegmen Tympani. Material and methods: Temporal bones have been investigated by means of CT scan on patients and direct observation on cadaver specimen, respectively. Results: 604 ears and 160 cadaver temporal bones have been investigated by means of CT scan and direct observation, respectively. 3.6% and 0.3% of the studied ears had SSCD and PSCD, respectively, on CT scan. Only 0.6% of the cadaver specimen ears did have anatomical SSCD. Degree of pneumatization of the mastoid bone is related to the mean thickness of bone overlying the Superior and Posterior Semicircular Canal. Radiological absence of Tegmen Tympani is more frequent in ears that also have radiologic SSCD. Conclusion: CT scanning gives higher incidence figures of SSCD than anatomical studies, 3.6% vs. 0.6%. We also found a 0.6% incidence of radiological PSCD in the studied ears. There is a direct relation between the degree of ossification of Superior and Posterior Semicircular Canal and certain temporal bone anatomic features: temporal bone pneumatization and absence/presence of Tegmen Tympani or Antri.

  3. Relative superiority analysis of Garut lamb and its crossbred

    Directory of Open Access Journals (Sweden)

    Ismeth Inounu

    2003-10-01

    Full Text Available The objective of the research was to evaluate the relative superiority of Garut lamb and its crosses with St. Croix and Moulton Charollais. The research was conducted at Animal Research Station, Indonesian Research Institute for Animal Production, Bogor, Indonesia. The data used for this paper was collected from 1995 to 2002. The results revealed that individual lamb weight at birth, at weaning, preweaning daily gain, at 6, 9 and 12 months of age of the composite sheep (HG = 50% St. Croix : 50% Garut, MG = 50% M. Charollais : 50% Garut, MHG (MG X HG dan HMG (HG X MG = 25% St. Croix : 25% M. Charollais : 50% Garut were higher than Garut sheep. The relative superiority were 6.7-13.1% for lamb weight at birth, 6.6- 15.6% for lamb weight at weaning, 3.2-20.8% for preweaning daily gain dan 6.2-17.9% for lamb weight at 9 month of age, respectively. The superiority of composite sheep were obtained in good and limited feed condition. Lamb growth parameters were also affected by feed condition, parity, sex, and rearing type.

  4. Superior metallic alloys through rapid solidification processing (RSP) by design

    Energy Technology Data Exchange (ETDEWEB)

    Flinn, J.E. [Idaho National Engineering Laboratory, Idaho Falls, ID (United States)

    1995-05-01

    Rapid solidification processing using powder atomization methods and the control of minor elements such as oxygen, nitrogen, and carbon can provide metallic alloys with superior properties and performance compared to conventionally processing alloys. Previous studies on nickel- and iron-base superalloys have provided the baseline information to properly couple RSP with alloy composition, and, therefore, enable alloys to be designed for performance improvements. The RSP approach produces powders, which need to be consolidated into suitable monolithic forms. This normally involves canning, consolidation, and decanning of the powders. Canning/decanning is expensive and raises the fabrication cost significantly above that of conventional, ingot metallurgy production methods. The cost differential can be offset by the superior performance of the RSP metallic alloys. However, without the performance database, it is difficult to convince potential users to adopt the RSP approach. Spray casting of the atomized molten droplets into suitable preforms for subsequent fabrication can be cost competitive with conventional processing. If the fine and stable microstructural features observed for the RSP approach are preserved during spray casing, a cost competitive product can be obtained that has superior properties and performance that cannot be obtained by conventional methods.

  5. Stomatitis sub-prosthesis in patients with superior dental prosthesis

    Directory of Open Access Journals (Sweden)

    Antonia Martina Francisco Local

    2009-04-01

    Full Text Available Background: The stomatitis sub-prosthesis is one of the most frequent changes in hard palate mucous membrane in patients with mucous-supported dental prosthesis. It can be caused by multiple factors, which makes its study and prognosis more difficult. Objective: To describe the occurrence of stomatitis sub-prosthesis and its causes in patients with superior dental prosthesis. Method: Descriptive study including all the patients with superior dental prosthesis examined in the odontology consultation “Barrio Adentro” in the state of Miranda, Venezuela, from November, 2005 to March, 2006. The analysed variables were: age, sex, stomatitis level, teeth brushing frequency, prosthesis condition and use, palate mucous condition and frequency of odontology consultations. Results: 89 patients were attended, more 50% of them had superior dental prosthesis and presented stomatitis sub-prosthesis; the group between 35 and 59 years was the most affected, mainly females. Sub-prosthesis stomatitis type II was the most common and the main causes included constant use of the prosthesis and loose prosthesis. Buccal hygiene was not adequate in these patients. Most of them declared never attending to the dentist, or just when presenting some particular problem. Conclusion: Stomatitis prevalence was related with incorrect hygiene habits and lack of knowledge; it shows the importance of performing educative tasks to reduce this disease incidence.  

  6. Water quality of streams tributary to Lakes Superior and Michigan

    Science.gov (United States)

    Zimmerman, Jerome W.

    1968-01-01

    Water quality of streams tributary to Lakes Superior and Michigan was analyzed for 142 stations on 99 streams tributary to Lake Superior and 83 stations on 56 streams tributary to Lake Michigan during 1962-65. Concentrations of aluminum, copper, and iron were not affected greatly by flow or season. Magnesium, calcium, chlorides, total alkalinity, total hardness, and conductivity varied with the flow, temperature, and season; the lowest values were during the spring runoff and heavy rains, and the highest were during low water in late summer and the colder periods of winter. Concentrations of nitrate, silica, and sulfates were lowest in the spring and summer. Concentrations of tanninlike and ligninlike compounds were highest during the spring runoff and other high-water periods, and were lowest during freezeup when surface runoff was minimal. The pH values were highest from June to September and lowest during the spring runoff. Phenolphthalein alkalinity was detected primarily in the summer and coincided occasionally with low flows just before the spring thaw. Total hardness usually was lower in streams tributary to Lake Superior than in streams tributary to Lake Michigan. The total hardness was higher in the streams in Wisconsin than in the streams in Michigan along the west shore of Lake Michigan. It was lowest in the northernmost streams. The water quality of the streams in an area was related to the geological characteristics of the land.

  7. Cooperation between ligninolytic enzymes produced by superior mixed flora

    Institute of Scientific and Technical Information of China (English)

    WANG Hai-lei; LI Zong-yi; GUO Wei-yun; WANG Zhen-yu; PAN Feng

    2005-01-01

    Since the ability to degrade lignin with one kind of white-rot fungi or bacteria was very limited, superior mixed flora's ability to degrade lignin was investigated by an orthogonal experiment in this paper. The results showed that superior mixed flora reinforced the ability to degrade lignin, the degradation rates of both sample 9 and 10 were beyond 80% on the day 9. The cooperation between lignin peroxidase(LiP), Mn-dependent peroxidase(MnP) and laccase (Lac) for lignin degradation was also studied. By examining the activities of three enzymes produced by superior mixed flora, it was found that Lac was a key enzyme in the process of biological degradation of lignin but Lip was not; the enzyme activity ratios of Lac/MnP and Lac/LiP were significantly correlative with the degradation rate of lignin at the 0.01 level; and the ratio of MnP/LiP was an important factor affecting the degradation rate of lignin.

  8. Preference for Audiovisual Speech Congruency in Superior Temporal Cortex.

    Science.gov (United States)

    Lüttke, Claudia S; Ekman, Matthias; van Gerven, Marcel A J; de Lange, Floris P

    2016-01-01

    Auditory speech perception can be altered by concurrent visual information. The superior temporal cortex is an important combining site for this integration process. This area was previously found to be sensitive to audiovisual congruency. However, the direction of this congruency effect (i.e., stronger or weaker activity for congruent compared to incongruent stimulation) has been more equivocal. Here, we used fMRI to look at the neural responses of human participants during the McGurk illusion--in which auditory /aba/ and visual /aga/ inputs are fused to perceived /ada/--in a large homogenous sample of participants who consistently experienced this illusion. This enabled us to compare the neuronal responses during congruent audiovisual stimulation with incongruent audiovisual stimulation leading to the McGurk illusion while avoiding the possible confounding factor of sensory surprise that can occur when McGurk stimuli are only occasionally perceived. We found larger activity for congruent audiovisual stimuli than for incongruent (McGurk) stimuli in bilateral superior temporal cortex, extending into the primary auditory cortex. This finding suggests that superior temporal cortex prefers when auditory and visual input support the same representation.

  9. Síndrome da artéria mesentérica superior Superior mesenteric artery syndrome

    OpenAIRE

    Haberlandh Sodré Lima; Accyoli Moreira Maia; Antonio Kneipp Pitta de Castro Neto

    2000-01-01

    The Superior Mesenteric Syndrome is a rare and controversial disease. The compression of the duodenum by the mesenteric artery and aorta causes an intermitent obstruction. Preoperative diagnosis is very difficult.We present one case of this syndrome in a pacient with severe weight loss and signs of high intestinal obstruction. The diagnosis was based on clinical and radiologic findings. A duodenojejunostomy was performed after medical treatment failure.This patient died on the 20th posoperati...

  10. Decoding the superior parietal lobule connections of the superior longitudinal fasciculus/arcuate fasciculus in the human brain.

    Science.gov (United States)

    Kamali, A; Sair, H I; Radmanesh, A; Hasan, K M

    2014-09-26

    The temporo-parietal (TP) white matter connections between the inferior parietal lobule and superior temporal gyrus as part of the superior longitudinal fasciculus/arcuate fasciculus (SLF/AF) or middle longitudinal fasciculus (MdLF) have been studied in prior diffusion tensor tractography (DTT) studies. However, few studies have been focusing on the higher TP connections of the superior parietal lobule with the temporal lobe. These higher TP connections have been shown to have a role in core processes such as attention, memory, emotions, and language. Our most recent study, for the first time, hinted to the possibility of a long white matter connection interconnecting the superior parietal lobule (SPL) with the posterior temporal lobe in human brain which we call the SLF/AF TP-SPL and for a shorter abbreviation, the TP-SPL. We decided to further investigate this white matter connection using fiber assignment by continuous tracking deterministic tractography and high spatial resolution diffusion tensor imaging on 3T. Five healthy right-handed men (age range 24-37 years) were studied. We delineated the SPL connections of the SLF/AF TP bilaterally in five normal adult human brains. Using a high resolution DTT technique, we demonstrate for the first time, the trajectory of a long fiber bundle connectivity between the SPL and posterior temporal lobe, called the SLF/AF TP-SPL (or the TP-SPL), bilaterally in five healthy adult human brains. We also demonstrate the trajectory of the vertically oriented posterior TP connections, interconnecting the inferior parietal lobule (IPL) with the posterior temporal lobe (TP-IPL) in relation to the TP-SPL, arcuate fasciculus and other major language pathways. In the current study, for the first time, we categorized the TP connections into the anterior and posterior connectivity groups and subcategorized each one into the SPL or IPL connections. Published by Elsevier Ltd.

  11. Análise do duplo retrocesso de retos mediais em pacientes esotrópicos portadores de incomitância longe/perto Analysis of double medium rectus recession in esotropic patients with near/distance incomitance

    Directory of Open Access Journals (Sweden)

    Ronaldo Boaventura Barcellos

    2001-06-01

    Full Text Available Introdução: Convergência acomodativa (CA é a convergência induzida por determinado grau de acomodação (A. Apesar de haver inúmeras técnicas cirúrgicas descritas para correção de esotropias, a presença de grandes incomitâncias longe/perto associadas acrescenta o desafio de se evitar o surgimento de exodesvio para longe, ou esodesvio residual para perto. Objetivo: Comparar as correções cirúrgicas obtidas com o duplo retrocesso dos retos mediais em pacientes esotrópicos quanto aos desvios de longe e de perto, comparando-se baixas e altas hipermetropias. Material: Foram analisados retrospectivamente os prontuários de 33 pacientes esotrópicos com incomitância longe/perto, operados com duplo retrocesso dos retos mediais na Santa Casa de São Paulo entre 1980 e 1990. Os pacientes foram divididos em 2 grupos: com mais de 3,50 dioptrias esféricas (DE de hipermetropia e com menos de 3,50 DE. Resultados: A magnitude da correção obtida no grupo I foi de 18,18 dioptrias prismáticas (DP (72,72% de correção para longe e 27,64 DP (62,36% para perto. A correção no grupo II foi de 20,20 DP para longe (87,83% e 34,60 DP (82,78% para perto. Conclusão: Não há diferença (estatisticamente significante na redução da incomitância longe/perto entre os pacientes com hipermetropia até 3,50 DE e pacientes com hipermetropia maior que 3,50 DE. O valor absoluto da redução em dioptrias do desvio para perto foi maior do que o encontrado para longe, no entanto, em porcentagem, a correção do desvio foi semelhante entre as medidas para perto e para longe.Introduction: Accommodative convergence (AC is the convergence induced by a determined amount of accommodation (A. Besides the many techniques described to correct esotropias, great distance/near incomitance is still a challenge in avoiding secondary exotropias and esotropias. Objective: To compare the surgical results obtained with double medial rectus recession and its relationship to

  12. THE HUMAN SUBJECTIVITY BETWEEN THE SUPERIOR AND INFERIOR TYPES A SUBJETIVIDADE HUMANA ENTRE OS TIPOS SUPERIORES E INFERIORES

    Directory of Open Access Journals (Sweden)

    Vagner Silva

    2011-12-01

    Full Text Available This article attempts to solve the following contradiction of Nietzsche's thought: man has a subjective drive constitution, these drives, however, are individuals, and its being (the being of the drives, is constituted for more power fight (the will to power. Nietzsche's superior man (educated and cultivated man is that one, in which there is harmony in the drives, who can give greater freedom to its most terrible drives, without, however, loses the control over them. That is the contradiction: if man has to control the drives, they are not harmonics. There is incompatibility between harmony and control. In other words, the superior man is indeed the man of culture and cultivated man of Nietzsche? If the answer to this question is yes, then, in this man, reigns the drives harmony. If, on the other hand, the answer is no, then, for this man does not become a barbarian destroyer, dangerous to himself and to others it is necessary that a drive dominates the others. However it is not possible to escape the contradiction: either there is harmony in human drive or control.Este artigo busca resolver a seguinte contradição do pensamento de Nietzsche: o homem possui uma constituição subjetiva pulsional, estas pulsões, porém, são individuais, e o seu ser, o das pulsões, constitui-se da luta por mais poder (vontade de poder. O homem superior de Nietzsche (homem culto e cultivado é aquele no qual há harmonia nas pulsões, aquele que pode dar mais liberdade às suas mais terríveis pulsões, sem, no entanto, perder o controle sobre elas. Eis a contradição: se o homem superior exerce controle sobre as pulsões então elas não são harmônicas. Há, aqui, a incompatibilidade entre harmonia e controle. Em outros termos: o homem superior é de fato o homem culto e cultivado de Nietzsche? Se a resposta para esta pergunta for sim, então neste homem reina a harmonia pulsional. Se, por outro lado, a resposta for não, então, para que este homem n

  13. Modified sliding myofascial flap of the rectus abdominus muscles for the closure of huge planned abdominal hernia%改良双侧腹直肌推徙术治疗巨大计划性腹疝

    Institute of Scientific and Technical Information of China (English)

    孙士锦; 张连阳

    2013-01-01

    Abdominal increment is applied to patients with abdominal compartment syndrome (ACS) after severe trauma,while for some patients,intra-abdominal volume increment could not close the fascia within the primary stage.For theses patients,abdominal wound skin grafting was conducted,and the planned hernia was formed.Planned abdominal hernia developed over time,and finally huge incisional hernia was formed.This article described a modified sliding myofascial flap of the rectus abdominus muscles for definitive abdominal wall reconstruction for a patient with huge planned abdominal hernia,and a good curative effect was obtained.%严重创伤后腹腔间隙综合征患者,需行腹腔扩容术.腹腔扩容术后部分患者不能行一期确定性关闭腹壁筋膜层,只能施行腹壁创面植皮术,从而形成计划性腹疝.随着时问延长,计划性腹疝的疝环进行性扩大,成为巨大腹壁切口疝.第三军医大学大坪医院野战外科研究所对1例巨大计划性腹疝患者施行改良双侧腹直肌推徙术,成功进行了确定性腹壁重建.实践证明该术式是一种安全、可靠的方法.

  14. Hematoma of the rectus abdominis caused by the application of warfarin sodium and other medicine%华法林钠与多药联用致腹直肌内血肿

    Institute of Scientific and Technical Information of China (English)

    冉明月; 毛敏; 李春岩; 黄力

    2015-01-01

    was a cystic structure in the left abdominal rectus muscle with the size of 4.5 cm × 2.7 cm × 1.5 cm, and the internal circular high density shadow in the left rectus muscle was found on abdominal ultrasonography.Left abdominal rectus muscle hematoma was considered.Intramuscular injection of vitamin K1 10 mg once daily was given immediately, and ceftazidime was used instead of piperacillin sodium and tazobactam sodium.Two days later, the patient's symptoms of abdominal pain disappeared, PT fell to 16 s, INR fell to 1.11.One week later, oral warfarin sodium (initial dose 2.25 mg once daily)was given, and adjusted the dose according to INR.One month later, the abdominal ultrasound examination showed that the size of hematoma significantly decreased (3.5 cm × 0.8 cm).

  15. Superior facet syndrome. Findings on metrizamide CT myelography

    Energy Technology Data Exchange (ETDEWEB)

    Kubo, Yoshichika; Igarashi, Seishi; Koyama, Tsunemaro

    1985-02-01

    Sciatica caused by root entrapment in the lateral recess was named superior facet syndrome by Epstein in 1972. Few reports on this subject based on large numbers of cases have been documented to date. Of the patients with sciatica, 32 patients were diagnosed to have root entrapment at the lateral recess L5 or/and S1 lumbar spine. Out of 32 patients, 20 patients were operated on and the lateral entrapment was recognized in all of surgical cases. Neuroradiological findings, especially of metrizamide CT (met. CT), were documented in detail. Thirty two patients were classified in three types according to radiological findings. They were congenital or developmental, degenerative, and combined type, respectively. Fourteen cases belonged to the congenital type, 13 to the degenerative and 5 to the combined type. Each group had the mean ages of 23.4, 53.8, and 36.8 years old, respectively. Of 32 cases the entrapment occured in 47 L5 roots and 11 S1 roots. There was no remarkable laterality. In operation the unroofing of the lateral recess were done and the sciatica subsided postoperatively in all of surgical cases. Met. CT revealed extreme medial protrusion of the superior articular joint in 18 of 24 cases(75%) and none filling of the root in the lateral recess in 21 of 24 cases (87.5%). In the degenerative type, met. CT showed some degenerative changes that were hypertrophy or deformity of the articular joints and spur formation of the vertebral body. In contrast to met. CT, metrizamide myelography revealed only slight changes, which were poor filling of the root before it turned out the pedicle of lateral compression of the root. In plain films or lumbar spine articular joints at Lsub(4/5) were formed in coronal plane in 69% of cases of the L5 root entrapment. Met. CT using ReView technique was of great diagnostic value in superior facet syndrome.

  16. QUAL DEMOCRATIZAÇÃO DO ENSINO SUPERIOR?

    Directory of Open Access Journals (Sweden)

    François Dubet

    Full Text Available Esse artigo, resultante de uma conferência, discute traços do processo de democratização do ensino superior. Procura distinguir analiticamente várias dimensões da democratização, baseadas, por sua vez, em concepções diferentes da justiça: igualdade de oportunidades, meritocracia, utilidades e equidade dos procedimentos. Cada sociedade constrói modelos de democratização desse ensino. A massificação do ensino superior desempenhou papel democrático objetivo, favorável aos grupos sociais antes excluídos. Mas massificação não equivale à democratização. Todas as categorias sociais não se beneficiam da mesma forma da massificação. A democratização do acesso ao ensino superior não depende apenas das famílias. Depende também da estrutura geral do sistema educativo. A meritocracia acadêmica constrói uma hierarquia de competências que é também social, com forte impacto reprodutivo. As desigualdades de utilidade das diferentes formações têm impacto sobre o conjunto das desigualdades sociais. Os sistemas educativos implementam distintos procedimentos de seleção, de concessão de gratuidades, bolsas e auxílios, que podem ser considerados como mais ou menos equitativos segundo as normas de justiça que mobilizam.

  17. Lipid peroxidation following superior mesenteric artery occlusion in rat intestine

    Directory of Open Access Journals (Sweden)

    P. Pasbakhsh

    2006-07-01

    Full Text Available Background: The aim of this study was to determine the level of lipid peroxidation and tissue protein after superior mesenteric artery occlusion tissue damage. The effect of melatonin as anti oxidant and free radical scavenger in prevention of tissue damage, were also evaluated. Methods: Thity six young male Wisatr-Albino rats (weight: 80-120 gr, were divided equally in 6 group with different concentrations of melatonin (10,20,30 mg/kg treatment. Group 1was control, group 2 the sham that surgical process was applied until superior mesenteric artery dissection and received vehicle solution only in equally volume by intra muscular route. Group 3 was ischemia- reperfusion (I/R, group 4 was I/R plus melatonin 10 mg/kg, group 5 I/R plus melatonin 20 mg/kg and finally group 6 I/R plus melatonin 30 mg/kg. After laparatomy, a microvascular atraumatic clip was placed across the superior mesenteric artery under general anaesthesia and itbremoved after ischemia for 30 minutes. The first dose of melatonin was applied just beforereperfusion, second dose, after reperfusion and third dose on the second day .On third day rats were killed and their bowels were removed. The level of tissue melandialdehyde (MDA as index of lipid peroxidation and tissue protein was determined. Results: The level of tissue MDA were significantly lower in group 4, 5, 6 than group 3 (p0, 05. Conclusion: These results suggest that melatonin 10 mg/kg has antioxidant effect in prevention of inducing tissue damage during SMA occlusion in rat intestine.

  18. LA EDUCACIÓN SUPERIOR CUBANA: LOGROS Y PERSPECTIVAS

    Directory of Open Access Journals (Sweden)

    Acela Cantero Zayas

    Full Text Available Resumen: El impetuoso desarrollo de la ciencia y la técnica contemporâneo en general y muy específicamente en la realidad cubana, estâ dirigido a satisfacer las necesidades creciente de nuestra sociedad, lo que conlleva a un continuo perfeccionamiento de todo el sistema educativo en correspondencia con las exigencias, demandas y necesidades de nuestro pueblo. En tal sentido, para comprender los resultados que exhibe la Educación cubana y dentro de ella la Educación Superior, se precisa de toda una reflexión histórica, como soporte lógico y metodológico del hecho educativo cubano. En la actualidad, el mayor impacto de nuestra Educación Superior, desde los puntos de vista social, político, económico y en especial formativo, lo constituye, el diseno e implementación del modelo de Universalización, el cual tiene como objetivo supremo la extensión de la Universidad a los distintos municipios del país, con la finalidad de irradiar cultura y saber, que son las únicas modalidades de garantizar un hombre libre y de hecho una sociedad independiente. En el presente trabajo se muestra una panorâmica de la Educación Superior en Cuba, partiendo del elemento histórico hasta la contemporaneidad y en ésta, los nuevos retos impuestos por el contexto socio-político a escala mundial.

  19. LA EDUCACIÓN SUPERIOR CUBANA: LOGROS Y PERSPECTIVAS

    Directory of Open Access Journals (Sweden)

    Acela Cantero Zayas

    2004-01-01

    Full Text Available El impetuoso desarrollo de la ciencia y la técnica contemporáneo en general y muy específicamente en la realidad cubana, está dirigido a satisfacer las necesidades creciente de nuestra sociedad, lo que conlleva a un continuo perfeccionamiento de todo el sistema educativo en correspondencia con las exigencias, demandas y necesidades de nuestro pueblo. En tal sentido, para comprender los resultados que exhibe la Educación cubana y dentro de ella la Educación Superior, se precisa de toda una reflexión histórica, como soporte lógico y metodológico del hecho educativo cubano. En la actualidad, el mayor impacto de nuestra Educación Superior, desde los puntos de vista social, político, económico y en especial formativo, lo constituye, el diseño e implementación del modelo de Universalización, el cual tiene como objetivo supremo la extensión de la Universidad a los distintos municipios del país, con la finalidad de irradiar cultura y saber, que son las únicas modalidades de garantizar un hombre libre y de hecho una sociedad independiente. En el presente trabajo se muestra una panorámica de la Educación Superior en Cuba, partiendo del elemento histórico hasta la contemporaneidad y en ésta, los nuevos retos impuestos por el contexto socio-político a escala mundial.

  20. Infantile intracranial aneurysm of the superior cerebellar artery.

    Science.gov (United States)

    Del Santo, Molly Ann; Cordina, Steve Mario

    2016-02-29

    Intracranial aneurysms in the pediatric population are rare. We report a case of a 3-month-old infant who presented with inconsolable crying, vomiting, and sunset eye sign. CT revealed a subarachnoid hemorrhage, with CT angiogram revealing a superior cerebellar artery aneurysm. An external ventricular drain was placed for acute management of hydrocephalus, with definitive treatment by endovascular technique with a total of six microcoils to embolize the aneurysm. Serial transcranial Dopplers revealed no subsequent vasospasm. Although aneurysms in the pediatric population are rare, once the diagnosis is established, early treatment results in better outcomes. 2016 BMJ Publishing Group Ltd.