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At least 667 records · Page 37Linked to original sources
PubMed1996

Poststorage diastolic abnormalities of heart transplants: is vascular dysfunction or myocardial contracture the culprit?

BACKGROUND: Vascular dysfunction and myocardial contracture can both contribute to posttransplantation diastolic abnormalities commonly exhibited by heart transplants, but their respective importance remains incompletely elucidated. To address this issue, we assessed the effects of supplementing a new heart preservation solution, Celsior, with a nitric oxide precursor (L-arginine) and a compound known to uncouple excitation from contraction (2, 3-butanedione monoxime). METHODS: Fifty isolated buffer-perfused rat hearts were divided into four groups. In group 1, hearts were arrested with St. Thomas' Hospital solution No. 2 (Plegisol) and stored in normal saline solution. In group 2, Celsior solution was used for cardiac arrest and storage. Group 3 hearts were arrested with and stored in Celsior solution supplemented with 2 mmol/L of L-arginine. In group 4, Celsior solution used for arrest and storage was supplemented with both 2 mmol/L of L-arginine and 30 mmol/L of 2, 3-butanedione monoxime. All hearts were stored for 10 hours, subsequently reperfused for 1 hour on a Langendorff column, and left ventricular pressure-volume curves were constructed. 5-Hydroxytryptamine (10(-7) mol/L) and papaverine (5 x 10(-6) mol/L) were used to test changes in endothelium-dependent and endothelium-independent coronary vascular responses, respectively, and compared with those obtained during the preischemic period. RESULTS: After 10 hours of cold storage, a major postischemic contracture was found in group 1. Left ventricular diastolic function was best preserved in group 4 at the end of storage and over the entire period of reperfusion. Coronary vasodilatory response to 5-hydroxytryptamine was completely lost in all groups after cold storage and reperfusion. Endothelium-independent vasodilatory response to papaverine was preserved in 2, 3-butanedione monoxime-treated hearts, whereas it was reduced in other groups. CONCLUSIONS: Our results suggest that myocardial contracture plays a major role in posttransplantation diastolic abnormalities shown by cardiac allografts. Alleviation of contracture significantly improves the responsiveness of coronary smooth muscles but does not affect that of the vascular endothelium which needs to be handled by separate interventions.

Animals↗
PubMed1997

[Effect of chlorocresol vs caffeine on muscle contracture in malignant hyperthermia susceptible patients].

The phenotype of susceptibility to malignant hyperthermia (MHS); can only be detected reliably by the in vitro caffeine-halothane contracture test (CHCT). Enhanced sensitivity of the calcium-induced calcium release mechanism is responsible for the exaggerated contracture response of skeletal muscle fibers from MHS patients to halothane and caffeine. Chlorocresol was demonstrated to be a potent activator of Ca++ release from skeletal muscle sarcoplasmic reticulum. This effect is probably mediated through action on a ryanodine sensitive Ca++ release channel known to be more sensitive in MH. We studied the effect of chlorocresol on the mechanical contracture response of skeletal muscle from patients presenting for the in vitro CHCT. Chlorocresol induces contracture response in a concentration 1/200 of that of caffeine in muscle strips from MH patients. By adding chlorocresol to the protocol of the CHCT, there is clearer discrimination between the responses of MH patients and normal subjects can be achieved.

Adolescent↗
PubMed1997

Changes in ryanodine-induced contractures by stimulus frequency in malignant hyperthermia susceptible and malignant hyperthermia nonsusceptible dog skeletal muscle.

Elective diagnosis of malignant hyperthermia depends on halothane and caffeine contracture testing of biopsied skeletal muscle. Ryanodine-induced contractures may provide greater sensitivity and specificity for malignant hyperthermia (MH) diagnosis. This study investigated the effects of ryanodine concentration and stimulus frequency to distinguish between MH susceptible (MHS) and MH non-susceptible (MHN) dogs. Increasing ryanodine concentrations (1, 2.5 and 5 microM) increased peak isometric contracture tension, but similar responses in MHS and MHN muscle precluded use for diagnosis. Time to tension onset and to peak tension decreased with increasing ryanodine concentration, and these times were shorter in MH skeletal muscle. Increasing stimulus frequency (0.1, 0.5 and 1 Hz) decreased the time to tension onset and to peak tension, but the effect was greater in MHN muscle which decreased the difference between MHN and MHS muscle responses. When ryanodine contracture tension onset time was selected to detect MHS muscle, combinations of either 0.1 Hz and 1 microM ryanodine or 0.5 Hz and 1 microM ryanodine reduced the probabilty of a false diagnosis to less than 1%. Similar studies performed on human muscle might identify optimal stimulus frequency and ryanodine concentration for detecting MH in patients.

Animals↗
PubMed1998

Volkmann's ischemic contracture of the upper extremity.

Upper extremity deformity of ischemic contracture usually includes elbow flexion, forearm pronation, wrist flexion, thumb flexion and adduction, digital metacarpophalangeal joint extension, and interphalangeal joint flexion. Treatment of mild contractures consists of either nonoperative management with a comprehensive rehabilitation program (to increase range of motion and strenght) or operative management consisting of infarct excision or tendon lengthening. Treatment of moderate-to-severe contractures consists of release of secondary nerve compression, treatment of contractures (with tendon lengthening or recession), tendon or free-tissue transfers to restore lost function, and/or salvage procedures for the severely contracted or neglected extremity.

Arm↗
PubMed1989

[A study on the prevalence and risk factors of muscular fibrotic contracture in Jia-Dong Township, Pingtung County, Taiwan].

In order to examine the prevalence and risk factors of muscular fibrotic contracture (MFC) among school children in Jia-Dong Township, Pingtung County, a prevalence survey combined case-control study was carried out from January to April, 1988. All the school children aged from 6 to 19 years old were first screened at schools and then referred to the Provincial Pingtung Hospital for confirmatory diagnosis based on the non-invasion criteria. A total of 83 MFC cases were identified including 79 gluteal fibrotic contracture (GFC) patients, 3 deltoid fibrotic contracture (DFC) patients, and 1 affected both GFC and DFC. The prevalence was significantly higher in males (17.3 per 1,000) than in females (10.5 per 1,000). The prevalence was found to increase with age after 6 years of age, peaked at the age group of 13-15 years, and decline thereafter. Most MFC cases clustered in both Wen-Fon and Yuan-Wen villages locate in the southern coast of Taiwan Island. Among 83 MFC patients, 65 were further interviewed to obtain information on the risk factors of MFC. A total of 65 healthy classmates one-to-one matched with MFC cases on aged, sex, and living villages were selected as the control group which was also interviewed. The case-control study showed a positive association between the frequency of injection and the MFC in a dose-response relationship. The injection site also correlated with the development of the GFC and DFC. It was reasoned that the injection might be the most important risk factor of MFC. Follow-up study of 65 operated MFC cases indicated a high percentage (89.2%) of hyperscar formation in the incision region.

Adolescent↗
PubMed1998

Is there a relationship between hypertension and lower-extremity contracture release in cerebral palsy?

Recent reports have suggested a relationship between release of lower-extremity contractures and the development of hypertension in cerebral palsy and poliomyelitis patients. A retrospective study was performed on 119 cerebral palsy patients who had undergone lower-extremity contracture releases. Temporary elevation of systolic blood pressure in the perioperative and intraoperative periods occurred in 46 patients (39%), and temporary elevation of diastolic blood pressure occurred in 14 patients (12%). Type of cerebral palsy, patient age, patient sex, type of anesthesia, and type of procedure were not significantly correlated with the temporary blood pressure elevations. No patient developed sustained elevation of systolic and diastolic blood pressure. We conclude that lower-extremity contracture release in pediatric patients is not associated with an increased incidence of postoperative hypertension.

Adolescent↗
PubMed1998

Sodium withdrawal contractures in developing and regenerating rat extensor digitorum longus muscles.

During postnatal development of extensor digitorum longus (EDL) muscle, sodium withdrawal contractures were observed during the first 6 days after birth, and not after this time. In regenerating EDL muscles, zero-Na contractures were demonstrated: (1) 7 days after bupivacaine injection, but not 14 or 90 days after this injection; (2) 7, 14, and 90 days after autotransplantation; and (3) 7, 14, and 90 days after the intervention in sliced muscles. The present findings emphasize the role of the denervation in the development of zero-Na contractures in the regenerating muscles and suggest that a calcium-sodium exchange across the sarcolemma may appear in these muscles.

Anesthetics, Local↗
PubMed1983

Part I. Amyoplasia: a common, sporadic condition with congenital contractures.

A specific congenital contracture (arthrogryposis) syndrome has been recognized in 135 out of 350 patients with various kinds of congenital contractures. This sporadic syndrome, designated amyoplasia is characterized by absence of limb muscles that are replaced by fibrous and fatty tissue. At birth there is characteristic positioning of the limbs with internal rotation at shoulders, extension at elbows, and flexion of the hands at the wrists. Severe equinovarus deformities of the feet are usually present. Contractures at knees and hips occur in a variety of positions. Typically, the face is round with a frontal midline capillary hemangioma and slightly small jaw. Intelligence is normal. Approximately 63% of our patients had involvement of four limbs (almost always symmetrically), 24% mainly of lower limbs, and 13% mainly upper limbs. Typically, no other malformations are present. However, minor anomalies are seen often, and include hypoplastic digits and hypoplasia of scrotum or labia, the umbilical cord may be wrapped about a limb at birth. In utero fetal activity is decreased and breech delivery is increased in amyoplasia. All cases were sporadic; identical twins are discordantly affected.

Adolescent↗
PubMed2003

A new autosomal recessive congenital contractural syndrome in an Israeli Bedouin kindred.

We describe 23 cases with a syndrome of congenital contractures belonging to a large, inbred Israeli-Bedouin kindred. The phenotype described is similar to the Finnish type lethal congenital contracture syndrome yet differs in the following ways: by some additional craniofacial/ocular findings, by the lack of hydrops, multiple pterygia, and fractures, and by the normal duration of pregnancy. The major unique and previously undescribed clinical feature in our patients is a markedly distended urinary bladder as well as other urinary abnormalities. The vast majority of the cases died shortly after birth. Sonographic prenatal diagnosis was possible as early as 15 weeks gestation by demonstrating fetal akinesia, limb contractures, hydramnios, and distended urinary bladder. Linkage to 5q and 9q34 loci has been excluded.

Arabs↗
PubMed2006

A new distal arthrogryposis syndrome characterized by plantar flexion contractures.

The distal arthrogryposis (DA) syndromes are a distinct group of disorders characterized by contractures of two or more different body areas. More than a decade ago, we revised the classification of DAs and distinguished several new syndromes. This revision has facilitated the identification of five genes (i.e., TNNI2, TNNT3, MYH3, MYH8, and TPM2) that encode components of the contractile apparatus of fast-twitch myofibers and cause DA syndromes. We now report on the phenotypic features of a novel DA disorder characterized primarily by plantar flexion contractures in a large five-generation Utah family. Contractures of hips, elbows, wrists, and fingers were much milder though they varied in severity among affected individuals. All affected individuals had normal neurological examinations; electromyography and creatinine kinase levels were normal on selected individuals. We have tentatively labeled this condition distal arthrogryposis type 10 (DA10).

Adolescent↗
PubMed1989

Sciatic nerve regeneration in the rat. Validity of walking track assessment in the presence of chronic contractures.

The ability of the walking track assessment of sciatic nerve function to correlate with results of a nerve repair has been well documented following acute nerve injury and after recovery of the nerve following nerve repair. The long-term effects of partial denervation upon the lower extremity of the rat include the development of chronic contractures due to residual partial muscle paralysis and imbalance. The present study evaluated the ability of the walking track technique to portray accurately the walking pattern in animals following chronic contracture as a result of sciatic nerve repair. Animals 18 months and 24 months after sciatic nerve repair were found to have morphometric analysis distal to the repair that was not statistically significantly different from normal. However, the walking track assessment was inadequate at twenty-four months due to the development of clawing, interphalangeal joint contractures, and ankle inversion or eversion with or without dorsiflexion. The presence of these chronic deformities invalidated the walking track as an appropriate assessment technique for long-term assessment of nerve function following nerve repair.

Animals↗
PubMed1989

Hereditary increased muscle mechanical irritability and progressive contracture with stretch-induced electromyographic activity.

A son and mother are reported with autosomal dominantly transmitted painless, increased mechanical irritability in the limb and trunk muscles and progressive finger contracture. Immediately after a tap, muscle swelling appeared. With light tapping, wavelike muscle surface movements appeared. Progressive contractures developed first in the proximal interphalangeal finger joints and subsequently involving the lower arm muscles. The contractures disappeared in the local curare test. No spontaneous activity was recorded on concentric needle recording. Serial repetitive activity was recorded with fine wire electrode recording, induced by muscle stretch, performed by percussion hammer blows or by prolonged finger grasp. A slight, irritative peripheral nervous lesion could be the cause. The chronic sensorimotor polyneuropathy may be also a part of the syndrome.

Adult↗
PubMed1997

Congenital extension contracture of metacarpophalangeal joints.

We report a case of congenital extension contracture of the fifth metacarpophalangeal joints in a 15-year-old boy who had no associated anomalies and was successfully treated by surgery. Congenital extension contracture of bilateral metacarpophalangeal joints has not been reported previously, and the entity can be considered to be a new subgroup of distal arthrogryposis with congenital distal limb contracture.

Adolescent↗
PubMed1993

Effect of cortisone on capsular contracture in double-lumen breast implants: ten years' experience.

Two groups of patients are compared with respect to capsular contracture after insertion of silicone breast prostheses. Six hundred seventy four women received single-lumen gel prostheses and 700 received double-lumen prostheses with cortisone. The addition of 12.5 mg of prednisolone to double-lumen prostheses diminished capsular contracture (Baker II to IV) dramatically; in patients with simple augmentation from 19% to 4.9%, in patients with subcutaneous mastectomy from 54% to 14.9%, and in patients with breast reconstruction from 64% to 24.4%. The use of double-lumen implants has three distinct advantages: (1) There is no bleeding and therefore no contact of the body with the silicone gel. (2) There is no danger of ruptured implants, even if the outer shell shows leakage. (3) If prednisolone is administered, capsular contracture is prevented to a significant degree.

Contracture↗
PubMed1992

Subclinical infection of the silicone breast implant surface as a possible cause of capsular contracture.

In order to reexamine the possible association between bacterial presence and capsular contracture, 55 silicone devices (mammary implants or tissue expanders) were cultured at the time of their removal from 40 patients. Special culture techniques were used in an attempt to recover bacteria adhering to the smooth-surfaced implant and encased in glycocalyx biofilm. Bacteria were detected on 56% (15 of 27) of implants surrounded by contracted capsules and on 18% (5 of 28) of those without capsular contracture (p less than 0.05). Only three implants tested positive using routine plating techniques. The predominant isolate was Staphylococcus epidermidis. The concept that capsular contracture is associated with subclinical infection of silicone implants is supported by this study. With changes in the microbiological technique, bacterial recovery and growth occurs at a frequency greater than previously thought.

Adult↗
PubMed1987

Potassium contractures and asymmetric charge movement in extensor digitorum longus and soleus muscles from thyrotoxic rats.

Potassium contractures and asymmetric charge movement were recorded from extensor digitorum longus (EDL) and soleus muscle from normal rats and rats that had been made thyrotoxic by daily intraperitoneal injections of triiodothyronine (150 micrograms kg-1) for two to three weeks. Potassium contracture tension (relative to tetanic tension) in thyrotoxic rats was greater in EDL muscles and smaller in soleus muscles than in normal rats. As the relationship between membrane potential and potassium concentration was unaltered by thyroid treatment, it was concluded that the changes in potassium contracture tension were due to changes in excitation-contraction coupling. In thyrotoxic rats there was an average negative shift of -5 mV in the voltage sensitivity of tension in EDL fibres and a positive shift of 5 mV in soleus. As a result, the tension-membrane potential curves for EDL and soleus fibres essentially coincided. There was a corresponding average negative shift of -4 mV in the voltage sensitivity of asymmetric charge in EDL fibres, and a positive shift of 4 mV in soleus fibres from thyrotoxic rats. The dependence of asymmetric charge movement on membrane potential became essentially the same in EDL and soleus fibres from thyrotoxic rats. The maximum asymmetric charge in soleus fibres increased from an average value of 6.5 nC microF-1 in normal rats (n = 33) to 8.9 nC microF-1 in thyrotoxic rats (n = 32; p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2000

A retrospective analysis of the gluteal muscles contracture and discussion of the relative problems.

The operation methods, clinical classification, postoperative function exercise of gluteal muscles contracture were investigated. Clinically and retrospectively, treatment of 1280 patients with gluteal muscles contracture, being subjected to a "Z-shaped" release lengthening operation and efficiency exercise, was clearly standardized. All the cases were followed up from 3 months to 2 years with the effective rate being 100%, the cure rate being 98.5%, the recent complications being 5%, and the far complications being 0.2%. It was concluded that the clear diagnosis combined with standarized operation and efficiency functional exercise could greatly improve the therapeutic effects of gluteal muscles contracture.

Adolescent↗
PubMed1996

[Treatment of mentosternal contractures by flap-plasty].

Mentosternal contractures still represent a surgical challenge due to their exposed location. They require early operative treatment for both functional as well as aesthetic reasons. Careful clinical examination of scar location and traction forces both in the resting and functional, moving state including proper evaluation of the surrounding soft tissue is mandatory for exact preoperative planning of the reconstructive surgical procedure required. In general, the technically most feasible operation is favoured, if functional and aesthetic results are good and the postoperative risk of recurrent mentosternal contractures is low. Between 1987 and 1994, 21 patients with cervical, mentosternal and mentothoracic contractures underwent operative procedures at our clinic. Eight patients underwent a surgical reconstruction with local flaps and 13 patients received a free microvascularized flap.

Adolescent↗