Electrical stimulation as a countermeasure to muscle alteration in space.
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Journal Article↗
Biomedical subjects
G Freilinger
Publications and source records attributed to G Freilinger.
MYOSTIM-FES to prevent muscle atrophy in microgravity and bed rest: preliminary report.
Long-term flights in microgravity cause atrophy and morphological changes of skeletal muscles. Training with mechanical devices is insufficient regarding the required time to exercise and space for devices. The objective of this project is to develop a passive training method based on functional electrostimulation (FES) to preserve muscle mass and fiber composition with minimal impairment to the cosmonaut. For a pilot experiment on the MIR space station, a suitable 8 channel FES device was developed. It consists of electrode trousers that carry surface electrodes and cables, 2 interconnected 4 channel stimulators, and a laptop personal computer (PC) for stimulator programming and processing compliance data. An automatic extensive training of 4 muscle groups of the lower extremities is performed for 6 h/day, with 1 s on and 2 s off tetanic contractions at 20-30% of maximum tetanic muscle force. The synchronous activation of antagonists of the thigh and lower leg prevents uncoordinated movements.
Bed Rest↗
Human facial muscles: dimensions, motor endplate distribution, and presence of muscle fibers with multiple motor endplates.
BACKGROUND: Extrafusal muscle fibers of human striated skeletal muscles are known to have a uniform innervation pattern. Motor endplates (MEP) of the "en plaque" type are located near the center of muscle fibers and distributed within the muscles in a narrow band. The aim of this study was to evaluate the innervation pattern of human facial muscles and compare it with that of skeletal muscles. METHODS: Ten facial muscles from 11 human cadavers were dissected, the nerve entrance points located, and the dimensions measured. All muscles were stained in toto for MEPs using Acetylcholinesterase (AChE) and examined under the microscope to determine their location. Single muscle fibers were teased to evaluate the stained MEPs. RESULTS: The length of the different facial muscles varied from 29 to 65 mm, which correlated to the length of the corresponding muscle fibers. MEP zones were found on the muscles in the immediate vicinity of the nerves' entrance points and located eccentrically. Numbers and locations varied from muscle to muscle. Three MEP zone distribution patterns were differentiated: numerous small MEP zones were evenly spread over the muscle, a predominant MEP zone and two to three small zones were spread at random, and two to four MEP zones of equal size were randomly scattered. One MEP of the "en plaque" type was found in 73.8% of the muscle fibers and two to five MEPs were found in 26.2%. The distances between the multiple MEPs on one muscle fiber varied from 10 to 500 microm. CONCLUSIONS: This study suggests that facial muscles differ from skeletal muscles regarding distribution and number of MEPs. The eccentric location of MEP zones and multiple MEPs suggests there is an independent mechanism of neural regulation in the facial muscle system.
Acetylcholinesterase↗
[Utilization potential of the CO2-laser in dermal changes].
44 patients with various cutaneous lesions including 18 tattoos, 13 hypertrophic scars or keloids, 4 xanthelasmas, 4 capillary haemangiomas, and 5 other benign cutaneous lesions were treated by CO2-Laser. 28 of these patients were reexamined after a follow-up period of three to four years. Good results were achieved with the CO2-Laser in the treatment of tattoos, xanthelasmas, and haemangiomas. Satisfactory results were obtained in one patient with peri-ungual Koenen-tumors and in two patients with perianal condylomas. Keloids and plantar warts recurred after an initial improvement. The attempts to remove hypertrophic scars did not bring the desired results. In four cases a superficial local wound infection led to a delayed healing process together with an aesthetically unsatisfying final appearance. CO2-Laser treatment brings certain advantages in selected cases where traditional techniques of plastic surgery have a higher complication rate and are additionally a greater burden for the patient. Particularly larger tattoos, multiple xanthelasmas, and capillary haemangiomas are successfully removed with the CO2-Laser, despite the time consuming method for the attending physician.
Adolescent↗
[Results of various reconstructive methods after subcutaneous mastectomy and objective evaluation of tissue fibrosis with a new measurement procedure].
Of 35 patients undergoing subcutaneous mastectomy performed within the last 15 years, 25 were evaluated for follow-up studies. Reconstruction had been achieved either using silicone implants or autologous tissue formed from the resulting dermal-fat pedicles. The patients were interviewed for subjective results. In addition, firmness of the breast according to the classification of Baker was investigated. The compressibility of the breast was electronically measured, employing a new compression device. In 13 patients, the breast was distorted after reconstruction with implants. The deformity did not correlate with submuscular or subcutaneous placement of the implants. The aesthetic results after dermal-fat pedicle techniques were superior to reconstruction with silicone implants. Compressibility to 32% of breast diameter was defined to be a border value between a soft and firmer breast, correlating with clinical conditions between Baker 2 and Baker 3.
Adult↗
[Which changes occur in nerve grafts harvested with a nerve stripper? Morphological studies].
A histological and morphometric study was undertaken in order to evaluate the alterations in sural nerves harvested for nerve grafting using a nerve stripper. In 19 nerves biopsies were taken from the proximal and/or the distal end of the stripped nerve graft. Cross sections were examined for alterations of the perineurium and the myelin sheaths. In four nerves alterations within the perineurium were found, which affected 37% of the endoneural cross-sectional area on the average. In all specimens, the perineurial sheath was seen to be intact. The results of the present study suggest that harvesting of a nerve graft using a stripper does not cause major injuries to the graft and therefore successful neurotization of the graft should not be impaired.
Humans↗
Anatomy and histology of the mimic muscles and the supplying facial nerve.
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Facial Muscles↗
Temporalis transfer for correction of lagophthalmos.
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Adolescent↗
[The long-term changes after the implantation of silicone breast prostheses].
In a prospective study 60 patients with unilateral or bilateral mammary implants underwent mammography and sonography. Location, form and structure of the implants were evaluated. Additionally capsular fibrosis and its influence on the imaging quality of parenchyma was scored. We found increasing implant deformities and increasing density of the implants with increasing postoperative interval. There was poor statistically significant correlation between the thickness of the periprosthetic capsular and the postoperative interval in prepectoral implants (r = 0.555, p < 0.01); in case of subpectoral implants there was no such correlation. In 88% of the cases imaging quality was scored as adequate by two independent observers, with additional views in all cases. We conclude that sufficient imaging quality for the assessment of parenchyma and of potential implants complications may be obtained by the combination of mammography and sonography.
Adult↗
Clinical application of motorsensory differentiated nerve repair.
Since 1979 acetylcholinesterase has been used in clinical practice for motor sensory differentiation. It was first used for median and ulnar nerve injuries at the wrist. Recently the application was extended to secondary nerve repair, including plexus reconstruction. The aim of this study was to present, for the first time, clinical results of motor sensory differentiated median and ulnar nerve repair and to show the advantage of this method in secondary repair. We compared a group of nine patients with motor sensory differentiated median and ulnar nerve repair with a group of 13 patients without motor sensory differentiation. Sensibility testing, strength measurements, and anatomical examinations were performed. The hand function was expressed in percentage values. Compound muscle action potentials and sensory antidromic conduction velocities were measured electroneurographically. Sensibility recovery was significantly better after motor sensory differentiated median nerve repair (P < 0.05). In secondary nerve repair acetylcholinesterase was used additionally for evaluating the level of resection of the proximal stump. The time required for perioperative histochemical differentiation has now been reduced to 2 hr.
Acetylcholinesterase↗
Peripheral nerve repair in the hand with and without motor sensory differentiation.
To investigate the value of motor sensory differentiated nerve repair, we examined a group of 9 patients with motor sensory differentiated nerve repair and a group of 13 patients without motor sensory differentiated nerve repair. The clinical and electroneurographic findings were compared. For the clinical examination, Millesi's scoring system was used. The hand function after motor sensory differentiated median nerve repair was 72% +/- 16% compared with 57% +/- 14% without motor sensory differentiation. The hand function after motor sensory differentiated median and ulnar nerve repair was 53% +/- 12% compared with 43% +/- 24% without motor sensory differentiation. After ulnar nerve repair the achieved values for hand function were high even without motor sensory differentiation. Our results indicate that intraoperative motor sensory differentiation of injured nerves is helpful to reestablish particularly the sensory function in median nerve injuries.
Action Potentials↗
[Minimizing scar expansion using the B technique in form correction of the breast].
For the last two years, the B-technique has been used in mammaplasty to minimise the extent of scars, if the expected resection weight is 700 g or less. 33 patients were operated by means of this technique. Scar formation and areola sensation were examined and compared with 188 patients operated by the techniques of McKissock, Strömbeck or Pitanguy. 19 of those patients and 3 patients, who had been operated on by the B-technique, developed hypertrophic scars. The widths of the scars was significantly smaller after operation by the B-technique, than by other techniques. After operation by the B-technique, the areola sensation was unchanged in 67% compared to 46% after operation by above mentioned and other techniques. In cases, where the expected resection weight does not exceed 700 g, the B-technique is superior to other techniques, because the medial scars can be avoided.
Adolescent↗
Surgical treatment of developmental asymmetry of the breast. Long term results.
To evaluate our operative techniques for the treatment of breast asymmetry, 30 patients were interviewed and examined three to 16 years after correction of developmental asymmetry. Breast symmetry was assessed by linear measurements and by subjective evaluation. The most satisfactory long term results were found in the patients who had undergone bilateral reduction mammaplasty or unilateral reduction mammaplasty combined with a contralateral mastopexy. In some cases longer lasting symmetry could be achieved by operating on both breasts using similar techniques. Long term results were not significantly better in those patients who had been operated after reaching the age of 18 years, compared with those of patients operated on at the age of 17 years or younger. To avoid psychological consequences therefore it is not always justifiable to delay operation until the breasts have matured.
Adolescent↗
Clinical and electroneurographic evaluation of sensory/motor-differentiated nerve repair in the hand.
In 17 patients acetylcholinesterase activity was used to differentiate between sensory and motor fascicles in median and ulnar nerve repair of the hand. Eleven patients received follow-up evaluation 1 to 11 years after surgery, and at that time clinical and electroneurographic examinations were performed to evaluate the techniques. Clinical examination showed that four patients had regained on average 71.9% of hand function after median nerve repair, one patient had regained 83.6% of hand function after ulnar nerve repair, four patients had regained on average 53.3% of hand function after median and ulnar nerve repair, and two patients had regained on average 43.5% of hand function after median and partial ulnar nerve repair. The contribution of the ulnar nerve to reinnervation of the thenar muscles was 68.5%, whereas the median nerve did not contribute to reinnervation of the hypothenar muscles. Distal latencies for the median nerve showed a delay of 36% of the upper limit of normal value, and those for the ulnar nerve revealed a delay of 21.5%. This study demonstrated that sensory/motor-differentiated nerve repair of the median and ulnar nerves is possible and can be proven electroneurographically.
Adult↗
[Long-term results of the Wilhelm denervation operation in epicondylitis humeri radialis (tennis elbow)].
Fourteen patients with epicondylitis humeri radialis, resistant to conservative therapy were surgically treated according to Wilhelm's procedure at the II. Department of Plastic Surgery, University of Vienna. The mean follow-up period was 7.6 years (1 to 14 years). This study demonstrates a marked improvement of the symptoms after operative treatment, hence it follows that Wilhelm's procedure can be recommended in patients resistant to conservative therapy.
Adult↗
[Blepharoplasty with special reference to correction of xanthelasma].
Tissues in the periorbital region commonly change due to aging. We examined 31 patients for scar formation and symmetry after blepharoplasty and looked for symptoms of keratoconjunctivitis sicca by means of the Schirmer's I test. In eight patients the operation was done because of xanthelasma formation. Visible scars remained in the upper eyelid if the incision was placed too far medially or too far laterally beyond the lateral orbital rim or too close to the lid margin. In the lower eyelid, the scar is unsightly when near the lid margin. Since in all patients visible scars were left after correction of xanthelasma, the CO2 laser was used in four patients in addition to the surgical procedure in order to avoid extension of scars.
Adolescent↗
Transfer of the temporal muscle for lagophthalmos according to Gillies.
For correction of lagophthalmos different methods have been described such as gold weights, palpebral spring and magnets. Using the transposed temporal muscle is superior to implantation of foreign material. We present a method for correction of lagophthalmos that combines static support with dynamic function. During the last eight years we performed transposition of the temporal muscle in 17 patients. The anterior part of the temporal muscle has been transposed. Corneal irritation and epiphora disappeared in all patients, although a complete correction of lagophthalmos could not be achieved in each case. Chewing was not impaired and closure of the eye could be performed independently from chewing. Because of its low morbidity the transfer of the temporal muscle is the procedure of choice for repair of lagophthalmos.
Eyelid Diseases↗
Transfer of the temporal muscle for lagophthalmos according to Gillies.
For correction of lagophthalmos different methods have been described such as gold weights, palpebral spring and magnets. Using the transposed temporal muscle is superior to implantation of foreign material. We present a method for correction of lagophthalmos that combines static support with dynamic function. During the last eight years we performed transposition of the temporal muscle in 17 patients. The anterior part of the temporal muscle has been transposed. Corneal irritation and epiphora disappeared in all patients, although a complete correction of lagophthalmos could not be achieved in each case. Chewing was not impaired and closure of the eye could be performed independently from chewing. Because of its low morbidity the transfer of the temporal muscle is the procedure of choice for repair of lagophthalmos.
Aged↗