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PubMed1997

The structure of superficial lymphatics in the human thigh: precollectors.

BACKGROUND: Little is known about the morphology of precollectors, the lymphatic vessels connecting the absorbing and the collecting vessels, which are regarded as the initial drainage routes of lymph. The aim of this study was to describe the structural features of human precollectors. METHODS: Samples of fat from around the saphenous veins were obtained from patients undergoing varicotomy, and serial sections were observed under light and transmission electron microscopy. Tridimensional reconstructions were also obtained by computer analysis. RESULTS: Precollectors were characterized by an irregular and discontinuous arrangement of smooth muscle cells in their wall. This arrangement was unrelated to the site of valves. When present, muscular elements were arranged helicoidally, as shown in tridimensional reconstructions. Under transmission electron microscopy, the endothelium of precollectors was similar to that of absorbing lymphatic vessels, irrespective of the presence of smooth muscle cells, and was thin, rich in pinocytotic vesicles, supported by a discontinous basal lamina, and connected by anchoring filaments to the surrounding connective tissue. Myoendothelial contacts were frequent. Valves were similar to those of collecting vessels, except for the presence of numerous zonulae adherentes connecting the characteristic "tip cells" of the free edge. CONCLUSIONS: Human thigh precollectors are characterized by the alternation of portions with a well-developed muscular coat and portions with an absorbing structure. These morphological features suggest that the precollectors contribute to fluid absorption and lymph propulsion. The frequent myoendothelial contacts suggest that smooth muscle contraction is regulated locally.

Aged↗
PubMed1981

The effect of the Anatomic setting on the results of surgical procedures for soft parts sarcoma of the thigh.

The results of surgical treatment in 40 patients with a soft tissue sarcoma of the thigh were analyzed to determine the influence of the anatomic setting on the effectiveness of the procedure. The anatomic setting, based on functional anatomic compartments, was defined as either intra- or extracompartmental. The lesions were graded for aggressiveness as either high or low. The lesions were staged by biologic aggressiveness, anatomic setting, and metastases. The procedures, whether amputations or local resections, were classified by the relationship of the surgical margin to the pseudocapsule and reactive zone about the lesion as marginal, wide, or radical. Marginal procedures were done four times with two recurrences. Wide margins were achieved 12 times. When done for low grade lesions, there were no recurrences (0/2), but when done for high grade lesions, the recurrence rate was 30% (3/10). Radical margins were obtained 24 times. There was one recurrence after a radical procedure. Recurrence rates did not depend upon whether the procedure was a resection or amputation but upon the margin achieved. The anatomic setting of the lesion was intracompartmental in 13 cases and extracompartmental in 27. Not only were surgically adequate margins achieved more often for intracompartmental lesions (10/13) than for extracompartmental lesions (17/27), but there was a significant difference in the manner required to achieve an adequate margin. Although 9 of the 13 intracompartmental lesions were amenable to nonablative resection, only 3 of 27 extracompartmental lesions were resectable. The margin required for local control (wide vs. radical) was dictated by the biologic aggressiveness (grade) of the lesion. How the necessary margin was most satisfactorily achieved (resection vs. amputation) was determined by the anatomic setting (intra- vs. extracompartmental).

Adolescent↗
PubMed1991

Ultrastructural and morphometric analysis of the separation of two thigh muscles in the chick.

Limb muscles separate from one another in a complex but highly stereotyped sequence and spatial pattern. The process of separation is characterized by the progression of a region of increased extracellular space, the cleavage zone, along the proximodistal axis between the individual muscle anlagen. We analyzed ultrastructurally the muscles and cleavage zone during the separation of two representative muscles, the developing sartorius and iliotibialis in the chick thigh, to establish an accurate baseline for an analysis of the mechanisms of separation. Comparisons of the morphology and distribution of cells before and after separation show no evidence that muscles became separated by the massive influx of an exterior cell population; if populations invade the cleavage zone, they are small. We do find characteristic transitions within the cell population of the cleavage zone in situ that could accomplish cleavage without invoking massive cell movements. These progressive transitions within the cleavage zone include a loss of close cell-cell interactions, an increase in extracellular space, the assumption of a more stellate morphology by mesenchyme cells, and a gradual alteration in the composition of the extracellular matrix from one typical of early muscle to one typical of loose connective tissue. Myotubes do differentiate between the incipient muscles, ruling out the possibility that the location where muscles will separate is defined by sites where myotubes fail to differentiate. Instead, the myotubes in the cleavage zone gradually diminish in number and appear to be specifically recognized and removed from the cleavage zone by phagocytes. We suggest that the transitions within the cleavage zone, including the loss of muscle cells, are a result of the progressive differentiation of loose connective tissue. If so, then the spatial pattern and process of cleavage is a consequence of spatially programmed cell differentiation.

Animals↗
PubMedDate not supplied

Longitudinal studies of thigh circumference growth in normal fetuses.

To characterize the growth of the thigh circumference (ThC) in individual fetuses, longitudinal studies of ThC growth were carried out in 20 fetuses between 19 (+/- 1.8) and 38 (+/- 1.5) weeks, menstrual age. Because of measurement uncertainties, analysis of growth patterns was limited to the data collected after 22 weeks. The Rossavik growth model fit the data well [R2: 95.8(+/- 2.9 SD)%], but considerable coefficient variability was seen, particularly for the coefficient k. Use of the coefficient k-value (1.138) derived from a cross-sectional data set reduced the variability of the coefficient c by 95% and made the results of the longitudinal and cross-sectional studies consistent with each other. This k-value was taken as the appropriate one for ThC growth curves. Studies of ThC growth in individual fetuses revealed considerable variability in growth curve shape, although the majority of curves could be approximated by a straight line. No differences between growth curves for males and females could be detected. The average longitudinal ThC growth curve was found to be very similar to the growth curve obtained in a cross-sectional study of ThC growth. ThC growth after 26.1 weeks could be predicted with an accuracy of +/- 15% from growth models derived from the data obtained before 26.1 weeks. These results indicate that ThC growth after 22 weeks (as with other parameters) can be followed in individual fetuses. However, because of the greater inherent variability in growth patterns, using each fetus as its own control may be more important.

Embryonic and Fetal Development↗
PubMed2004

Primary hydatid cyst in the anterior thigh: Sonographic findings.

Hydatid cysts rarely involve the musculoskeletal system. We present the case of a 23-year-old man with a primary hydatid cyst between the femur and the quadriceps muscle in his left thigh. No cysts were located in the adjacent femur or quadriceps muscle. Cyst resection with sparing of the surrounding muscles, combined with anthelmintic therapy, was curative. In regions where hydatidosis is endemic, hydatid cysts should be included in the differential diagnosis of any unusual soft-tissue swelling.

Adult↗
PubMed1984

Malignant neoplasm of mixed mesenchymal and neuroepithelial origin (ectomesenchymoma) of thigh.

A 49-year-old man had a malignant soft tissue tumor of the right thigh with metastasis to the femoral region and lower quadrant of the anterior abdominal wall on the right side and the left supraclavicular lymph nodes. The neoplasm showed features of chondrosarcoma and primitive neuroectodermal tumor (combined neuroblastoma, ependymoma, astrocytoma, and oligodendroglioma). The gliomatous part of the mixed tumor was confirmed by identification of the glial fibrillary acidic protein (GFAP). The diverse cellular population suggests a tumor origin from the ectomesenchymal remnant of the neural crest. The mesenchymal component of the neural crest would differentiate into the chondrosarcoma and the neuroectodermal component into the primitive neuroectodermal neoplasm. These various neoplastic elements, then, would form a neoplasm of mixed mesenchymal and neuroepithelial origin or an ectomesenchymoma.

Astrocytoma↗
PubMed2006

Application of the pedicled anterolateral thigh flap to defects from the pelvis to the knee.

The blood flow and the blood perfusion of pedicled anterolateral thigh (ALT) flap was evaluated in 11 patients with skin and soft tissue defects by means of color Doppler ultrasonography and of near-infrared spectroscopy, respectively. Also, the authors assessed the ability of the pedicled perforator flap to cover the above defects. A proximally based flap was used to cover defects at the lower abdominal wall (two patients), the suprapubic area, the penis (two patients), the greater trochanter (two patients), the lateral gluteal area, and the ischial tuberosity. A distally based flap was used to cover the exposed knee joint (two patients). Near-infrared spectroscopy revealed excellent oxygen saturation and Doppler ultrasonography documented increased blood flow and decreased vascular resistance in the pedicled ALT flap, postoperatively. All flaps survived completely and the wounds healed uneventfully, resulting in excellent esthetic and functional results. The vascular anatomy of ALT flap facilitates the design of versatile pedicled flaps with tremendous vascularity, two pivot points and large arc of rotation, able to cover defects from the lower abdominal wall to the knee joint.

Abdominal Injuries↗
PubMed2002

Microsurgical anterolateral thigh fasciocutaneous flap for facial contour correction in patients with hemifacial microsomia.

The correction of facial asymmetry in complex hemifacial microsomia presents a challenging problem for reconstructive surgeons. Numerous microsurgical flaps have been introduced for reconstruction of facial asymmetry. This article reports our experience in facial soft tissue reconstruction with microsurgical anterolateral thigh fasciocutaneous flap transfer in six patients with hemifacial microsomia. This flap, which has a reliable vascular pedicle and relatively thin pliable soft tissue, can provide an ideal treatment for facial asymmetry in hemifacial microsomia.

Adult↗
PubMed2001

Inhibition of dynamic thigh muscle contraction by electrical stimulation of the posterior cruciate ligament in humans.

We investigated the influence of electrical stimulation of the posterior cruciate ligament (PCL) on the motoneuron pool of the thigh muscle during voluntary static and dynamic muscle contraction. The study group comprised nine young men with no history of injury to the knee joints. Multistranded Teflon-insulated stainless-steel wires were inserted into the PCL guided by ultrasound. In three subjects wires were also inserted into the fat pad of the knee. The PCL was electrically stimulated during static, concentric, or eccentric muscle contraction with a constant load of 20% of the maximal voluntary contraction of either the quadriceps or the hamstrings. Electromyographic signals were recorded with bipolar surface electrodes placed over the vastus medialis, rectus femoris, vastus lateralis, biceps femoris caput longum, and semitendinosus muscles. The stimuli consisted of four pulses delivered at 200 HZ; the stimulus amplitude was two to three times the sensory threshold. The electrical stimulation of the PCL inhibited the ongoing muscle activity in both the quadriceps and hamstrings with latencies of 114-150 ms and 99-130 ms, respectively. Stimulation of the fat pad of the knee did not influence the muscle activity. The study suggests that the mechanoreceptors in the PCL are involved in controlling muscle activity during both static and active muscle contractions. The relative long latency of the reflex makes it unlikely that it can serve as a directly protective reflex for the cruciate ligaments.

Adult↗
PubMed1988

Patterns of selective involvement of thigh muscles in neuromuscular disease.

In 14 patients with limb girdle muscular dystrophy, polymyositis, and type 3 spinal muscular atrophy, CT scans of the thigh muscles were correlated with single fiber EMG studies in vastus lateralis, semimembranosus and biceps femoris muscles. There was a relation between the extent of CT scan abnormality and increased fiber density in the three muscles studied, except in the most severely affected muscles in which in some muscles the fiber density values were lower than expected. These results were independent of the underlying pathology. Correlative CT/SFEMG studies provide insights into the pattern of selective involvement of certain muscles in neuromuscular disorders.

Adult↗
PubMed1989

Projections of group Ia afferents to motoneurons of thigh muscles in man.

Changes in the firing probability of single motor units in response to electrical stimulation of muscle nerves and to tendon taps were used to derive the projections of large muscle afferents to the motoneurons of various thigh muscles in man. Homonymous facilitation was demonstrated to virtually all of the sampled motor units of biceps (BI), semitendinosus (ST), vastus lateralis (VL) and vastus medialis (VM). Heteronymous facilitation was readily demonstrated between VM and VL but was never obtained from ST to BI and never unequivocally obtained from BI to ST. Reciprocal inhibition was demonstrated from femoral nerve afferents to all of the sampled units of BI, and ST but reciprocal inhibition of VM or VL was never obtained from BI afferents and infrequently from ST afferents. These projections of group I afferents in man show certain specific differences from those of the cat and baboon that may reflect the normal function of the limb.

Action Potentials↗
PubMed1982

Insulin absorption from the abdomen and the thigh in healthy subjects during rest and exercise: blood glucose, plasma insulin, growth hormone, adrenaline and noradrenaline levels.

Insulin was absorbed faster from the abdomen than from the thigh under resting conditions and during exercise. Exercise enhanced the rate of insulin absorption marginally. The fall of blood glucose during rest and exercise was not significantly different after insulin injection into either site. The faster absorption of insulin from the abdomen during rest and exercise was reflected in a sharper rise of serum growth hormone levels and urinary adrenaline excretion. Therefore exercise should not be taken immediately after injection of a large dose of soluble insulin, particularly into the abdomen.

Abdomen↗
PubMed1988

EMG activities in mono- and bi-articular thigh muscles in combined hip and knee extension.

8 male subjects were tested to elucidate the organization of EMG activities in mono- and bi-articular thigh muscles when hip and knee extension are combined. 2 types of isometric movement, single and dual joint movements, were studied: 1) 20% of maximal voluntary contraction (MVC) in separate hip extension (HE20) and knee extension (KE20), 2) simultaneous HE20 and KE20, combined voluntarily (HE20.KE20). In HE20.KE20, the value of the integrated EMG (IEMG) from the muscles tested was normalized as a percentage (%IEMG) of the IEMG of each muscle in HE20 for gluteus maximus (GM) and semimembranosus (SM), and KE20 for vastus medialis (VM) and rectus femoris (RF). The average %IEMG was 50.5 +/- 16.9% for GM, 42.1 +/- 6.1% for SM, 153.4 +/- 22.8% for VM and 66.6 +/- 18.7% for RF. These data suggest that the EMG activities of GM, SM and RF are inhibited and the EMG activity of VM is facilitated by combining hip extension with knee extension.

Adolescent↗
PubMed1991

Leg skin temperature and thigh sweat output: possible central influence of local thermal inputs.

To demonstrate whether or not the skin temperature of one lower limb can have an influence on the sweat rate of the contralateral leg, the two legs of five subjects were exposed inside leg-chambers to specific local thermal conditions while sweat rates were measured on both limbs. Three experiments (C I, II, III) of 3 h were carried out: each included two phases A and B. During A, the right leg was not ventilated, while the left leg was (C I) or was not (C II-III) ventilated. During B, the legs were either removed from the leg-chambers (C I) or ventilated inside the chambers at differently controlled levels of leg skin temperature (C II-III). At all times, sweat capsules on both legs measured the sweat rates of local areas of the thigh which were also temperature-controlled. Results showed that, at constant or slightly increased mean skin and core temperatures, the sweat output of one leg could be decreased at constant (C II) or higher local skin temperature (C III) probably due to a decrease in the temperature of the opposite leg. This finding is interpreted as a consequence of a central negative effect, originating from contralateral thermal inputs.

Adult↗
PubMed1981

Unilateral absence of thigh muscles confirmed by CT scan.

A 5-month-old infant is presented with congenital absence of a group of muscles of the right thigh including the three adductors, gracilis, semimembranosus and semitendinosus. The diagnosis was suspected from the conventional radiographs and was confirmed by computerized tomography.

Female↗