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PubMedDate not supplied

Blood and tissue concentrations of tricyclic antidepressant drugs in post mortem cases: literature survey and a study of forty deaths.

Blood, urine, heart, liver, and psoas muscle concentrations of tricyclic antidepressant (TCA) drugs and their N-desmethyl metabolites were determined in forty medical examiner cases. The cases were evaluated for the role played by the TCA drugs in the cause of death and compared to a literature survey of previously reported cases. The incidence of the various individual TCA drugs as a factor and the significance of the disposition of the drugs and their metabolites is included. Comparing TCA drug concentrations in the heart and skeletal muscle and considering the differences in perfusion to these organs, TCA drugs and metabolites showed an affinity for the cardiac over the skeletal muscle. The case results were correlated with experimental studies to suggest the relationships of blood concentrations with toxicity.

Adult↗
PubMed1975

Myosin aggregates as a requirement for contraction and a proposal to the mechanism of contraction of actomyosin systems.

Glycerinated fibers of rabbit psoas muscle showed no augmentation of tension development upon incubation with heavy meromyosin, irrespective of whether the fibers were of standard length, stretched, or extracted of their myosin content. The effect of heavy meromyosin was to suppress contraction. These observations are in disagreement with certain recent published reports (Oplatka et al., 1974) and do tend to support the current sliding filament theory of muscle contraction and the necessity of bipolar myosin filaments for contraction. A possible mechanism of contraction in protein systems, including tension generation in actomyosin fibers and superprecipitation, is described emphasizing the polarity of both myosin and actin filaments.

Actins↗
PubMed1979

Effect of a serine protease on isolated myofibrils.

Morphological changes occurred in myofibrils prepared from the glycerinated psoas muscle of rabbit during incubation with a serine protease crystallized from rat skeletal muscle. Two notable phenomena were observed: (1) loss of the Z band in the early stage of incubation and (2) complete disappearance of the A band after swelling of the myofibrils. The results indicate that the serine protease has an action on myofibrils different from that of Ca2+-dependent neutral protease.

Animals↗
PubMed1982

Interaction of myosin with thin filaments during contraction and relaxation: effect of ionic strength.

The influence of ionic strength on the isometric tension, stiffness, shortening velocity and ATPase activity of glycerol-treated rabbit psoas muscle fiber in the presence and the absence of Ca2+ has been studied. When the ionic strength of an activating solution (containing Mg2+-ATP and Ca2+) was decreased by varying the KCl concentration from 120 to 5 mM at 20 degrees C, the isometric tension and stiffness increased by 30% and 50%, respectively. The ATPase activity increased 3-fold, while the shortening velocity decreased to one-fourth. At 6 degrees C, similar results were obtained. These results suggest that at low ionic strengths ATP is hydrolyzed predominantly without dissociation of myosin cross-bridges from F-actin. In the absence of Ca2+, with decreasing KCl concentration the isometric tension and stiffness developed remarkably at 20 degrees C. However, the ATPase activity and shortening velocity were very low. At low ionic strength, even in the absence of Ca2+ myosin heads are bound to thin filaments. The development of the tension and stiffness were greatly reduced at 6 degrees C or at physiological ionic strength.

Adenosine Triphosphatases↗
PubMed1989

Back support mechanisms during manual lifting.

The ability of individuals to lift heavy loads without injury to the vertebral elements has led to the formulation of several explanations of this phenomenon. In this article, the existing literature on lifting is reviewed and mechanisms of back support during lifting are described. These mechanisms include the intra-abdominal pressure mechanism, the thoracolumbar fascia mechanism, and combinations of these mechanisms with the use of the erector spinae, multifidus, and psoas muscles. Physical therapists are often responsible for teaching patients and workers "proper" lifting techniques; however, controversy exists concerning the proper lift. Although lifting with the lower back in flexion and lifting in extension have been proposed, there are indications for each depending on individual circumstances. Lifting instructions for workers without low back injuries should be distinguished from instructions for patients with low back pain. General rules for lifting include: plan the lift, avoid twisting, keep the load close to the body, and bend at the knees.

Back↗
PubMed1995

Expression of SQ10 (a preprorelaxin-like gene) in the pregnant rabbit placenta and uterus.

A Northern blot containing poly(A)+ RNA isolated from pregnant rabbit placenta, uterus, ovary, mammary gland, psoas muscle, and intestine was hybridized with an oligonucleotide probe to porcine preprorelaxin. Only the placenta and uterus exhibited high levels of a 1-kb mRNA that hybridized to the probe. Porcine preprorelaxin primers were used to generate and amplify cDNAs from placental and uterine poly(A)+ RNA. Southern blot analysis of the placental and uterine cDNAs each revealed a single PCR product that hybridized with the porcine relaxin probe. The sequence of the cDNAs exhibited 100% identity with SQ10, a preprorelaxin-like gene identified in rabbit tracheobronchial epithelial cells. Identical results were obtained with primers specific for SQ10. SQ10 is expressed in tracheobronchial epithelial cells during abnormal conditions, such as mechanical or toxic injury. The protein is believed to have a role in tracheal epithelial cell differentiation and transformation that occurs under the above conditions. This work shows, for the first time, the presence of high levels of message for SQ10 in normal reproductive tissues. The expression of SQ10 in the uterus and placenta may suggest an important role in cell differentiation and transformation that occurs in these tissues during pregnancy.

Amino Acid Sequence↗
PubMed1996

Postmortem diffusion of drugs from gastric residue: an experimental study.

Postmortem drug diffusion from gastric residue was assessed in a human cadaver model. Fifty milligrams of amitriptyline (Ami) and 5 g of paracetamol (Par) suspended in 350 ml of 10% methanol, 0.1 N HCl, and 50 ml urograffin with 5 g lithium carbonate (alkaline model) or without lithium (acidic model) was instilled into the stomach through an esophageal tube via a neck dissection. Multiple samples were obtained after 48 h at room temperature (range in mean hourly room temperature: 15.6-20.7 degrees C, n = 9). The pH of the gastric contents (alkaline model range = 8.3-8.9, n = 5; acidic model range = 3.4-3.8, n = 5) had no significant effect. Drug diffusion was most marked in the left lung base, with drug concentrations (micrograms/g) of 0.1-13.9 for Ami, 65-524 for Par, and 13-161 for lithium. Similarly affected were the left lobe of the liver (Ami, 0.1-54.9; Par, 7-218; lithium, 7-39), the spleen (Ami, 0.6-24.3; Par, 104-663; lithium, 27-106), and pericardial fluid (Ami, 0-4.5; Par, 48-641; lithium, 12-56). Diffusion into gallbladder bile, cardiac blood, aortic blood, and blood of the inferior vena cava was less severe. The left kidney and left lung were more severely affected than the right kidney and lung, and similarly the left and right psoas muscles. Least affected was the right anterior lobe of the liver and the lung apexes. This phenomenon may significantly influence drug concentrations in liver and in blood samples obtained from the torso, and consequently liver/blood drug ratios. To circumvent the problem of postmortem drug diffusion from the stomach, it is recommended that blood be sampled from a peripheral vessel, skeletal muscle from a limb, liver from deep within the right lobe, and lung from the apex rather than the base.

Acetaminophen↗
PubMed1998

Comparison of the three-in-one and fascia iliaca compartment blocks in adults: clinical and radiographic analysis.

UNLABELLED: The 3-in-1 (Group 1) and fascia iliaca compartment (Group 2) blocks, two single-injection, anterior approach procedures used to simultaneously block the femoral, obturator, and lateral femoral cutaneous (LFC) nerves, were compared in 100 adults after lower limb surgery. Pain control, sensory and motor blockades, and radiographically visualized spread of local anesthetic solution were studied prospectively. Both approaches provided efficient pain control using 30 mL of 2% lidocaine with 1:200,000 epinephrine and 0.5% bupivacaine and 5 mL of contrast media (iopamidol). Complete lumbar plexus blockade was achieved in 18 (38%) Group 1 and 17 (34%) Group 2 patients (n = 50 patients per group). Sensory block of the femoral, obturator, genitofemoral, and LFC nerves was obtained in 90% and 88%, 52% and 38%, 38% and 34%, and 62% and 90% of the patients in Groups 1 and 2, respectively (P < 0.05). Sensory LFC blockade was obtained more rapidly for the patients in Group 2 (P < 0.05). Concurrent internal and external spread of the local anesthetic solution under the fascia iliaca and between the iliacus and psoas muscles was noted in 62 of the 92 block procedures analyzed radiographically. Isolated external spreads under the fascia iliaca and over the iliacus muscle were noted in 10% and 36% of the patients in Groups 1 and 2, respectively (P < 0.05). The local anesthetic solution reached the lumbar plexus in only five radiographs. We conclude that the fascia iliaca compartment block is more effective than the 3-in-1 block in producing simultaneous blockade of the LFC and femoral nerves in adults. After both procedures, blockade was obtained primarily by the spread of local anesthetic under the fascia iliaca and only rarely by contact with the lumbar plexus. IMPLICATIONS: In adults, the two anterior approaches, 3-in-1 and fascia iliaca compartment blocks, provide effective postoperative analgesia. The fascia iliaca compartment technique provides faster and more consistent simultaneous blockade of the lateral femoral cutaneous and femoral nerves. Sensory block is caused by the spread of local anesthetic solution under the fascia iliaca and only rarely to the lumbar plexus.

Adult↗
PubMed1991

Heterotopic Tc-99m MDP uptake secondary to phlebitis.

A patient with blastomycosis complained of pain in his lower back after the administration of amphotericin B and parenteral alimentation via a femoral venous catheter. A bone scan that was performed to exclude bony involvement with blastomycosis showed abnormal tracer accumulation in the right paravertebral region. Computed tomography revealed the venous catheter to lie in the right ascending lumbar vein. There was calcification of a portion of the right psoas muscle. In addition, the epidural venous plexus was calcified from L2 to L4. It was this dystrophic calcification that caused the heterotopic accumulation of bone tracer.

Adolescent↗
PubMed1996

Overlooked spine injuries associated with lumbar transverse process fractures.

Transverse process fractures of the lumbar spine often are considered benign fractures related to direct trauma or psoas muscle avulsion. Treatment of these usually stable injuries is primarily administered when the patient becomes symptomatic. However, significant force often is required to cause these injuries, and other injuries may occur concomitantly. For this study, all patients who presented with identified lumbar transverse process fractures were further evaluated radiographically with computed tomography for the detection of other possible spine injuries. Medical and radiology records of 28 consecutive patients who had plain radiographs and computed tomography scans taken of their lumbar spine were reviewed retrospectively; these patients presented with lumbar spine transverse process fractures between January 1, 1989 and June 30, 1992. Three of the 28 patients (11%) had a lumbar spine fracture that was identified by computed tomography but overlooked on plain radiographs. Approximately 11% of patients with major injuries may be misdiagnosed if only plain radiographs are used in the evaluation of transverse process fractures. Computed tomography scanning of all lumbar spine transverse process fractures resulting from acute trauma should be considered because this diagnostic measure decreases the risk of overlooking potentially serious injuries.

Diagnostic Errors↗
PubMed1997

Fibromatosis of soft tissue type involving the female genital tract: a report of two cases.

Two cases of soft tissue-type fibromatosis of the female genital tract are described. One involved the vulva of a 19-year-old woman, and was approximately 6.0 cm in greatest dimension and had a rubbery consistency with a gray-white, whorled cut surface. Microscopically, it had infiltrating borders and extended to the ischio-rectal region. All gross tumor was resected. There was no evidence of recurrent disease 6 years later. The other tumor involved primarily the ovary of a 20-year-old woman. It was 24 cm in greatest dimension and infiltrated the mesentery, psoas muscle, and iliac vessels. The tumor was resected along with the sigmoid colon and the patient was free of disease 3 months later. Fibromatosis of the female genital tract, histologically identical to the soft tissue lesion and distinct from so-called "ovarian fibromatosis," should be included in the differential diagnosis of low-grade spindle cell lesions of this region.

Adult↗
PubMed1981

Case report. Aortic aneurysm presenting as psoas enlargement.

We present a case of abdominal aortic aneurysm in which erosion and bleeding into the psoas muscle caused enlargement of that structure but remained confined within it until needle biopsy produced communication with the extraperitoneal space. This confirms the observation that separate compartmentalization of retrofascial and extraperitoneal spaces normally maintains.

Aorta, Abdominal↗
PubMedDate not supplied

Percutaneous lumbar sympathetic plexus catheter placement for short- and long-term pain relief: CT technique and results.

PURPOSE: The purpose of this work was to evaluate the use of percutaneously placed lumbar sympathetic plexus catheter placement under CT guidance in patients with complex regional pain syndrome (CRPS) or nonspecified neuropathic pain (NP) of the lower extremity. METHOD: Sixteen lumbar sympathetic plexus catheter placements were performed in seven patients with CRPS and seven patients with NP. A 19 gauge epidural catheter was placed anterior to the psoas muscle at the L2-3 level. Twenty-five to 840 mg of bupivacaine hydrochloride per day was administered for a 1 to 8 day duration. RESULTS: In CRPS patients, there was complete short-term pain relief in one patient, considerable in four, mild in one, and none in one. There was total long-term pain relief in one patient and considerable long-term pain relief in three. In three patients, there was enduring pain relief at last follow-up. In NP patients, the procedure yielded considerable short-term pain relief in four, mild in two, and none in one. There was no enduring long-term in any of these patients. A retroperitoneal abscess developed in one patient and resolved on intravenous antibiotics without sequelae. CONCLUSION: Percutaneous lumbar sympathetic plexus catheter placement is easily performed, achieves short-term pain relief in the majority of patients, and may prove effective in long-term pain relief of CRPS patients.

Adolescent↗
PubMed1997

Femoral nerve palsy associated with an associated posterior wall transverse acetabular fracture.

A case is presented of a patient who sustained bilateral acetabular fractures in a motor vehicle crash. On the right, he sustained a variant associated posterior wall transverse fracture, with a femoral nerve lesion noted preoperatively. Open reduction and internal fixation of both fractures was performed in a staged fashion with an ilio-inguinal approach on the right. At surgery, the femoral nerve was 90% divided and damaged over approximately 5 cm of length, with marked damage also of the ilio-psoas muscle and tendon and the inguinal canal. No attempt was made to repair the nerve, and at 11-month follow-up he has had no recovery and electrodiagnostic tests indicate no femoral nerve function.

Accidents, Traffic↗
PubMed1986

Retroperitoneal actinomycosis.

A 44-year-old man had an abscess involving the left psoas muscle and inferior pole of the left kidney associated with characteristic sulfur granules of actinomycosis. The patient was treated with surgical drainage and debridement and with intensive and prolonged penicillin therapy, resulting in a clinical cure and resolution of both the hydronephrosis and the retroperitoneal mass.

Actinomycosis↗
PubMed1989

Pneumococcal meningitis due to psoas abscess.

We have described a patient who had meningitis from local extension of a primary pneumococcal abscess of the psoas muscle. With open surgical drainage and high-dose penicillin therapy, the patient did well and was discharged without neurologic sequelae.

Abscess↗
PubMed1978

Exposure of the vertebral bodies of the proximal lumbar segments. Some anatomic points.

The fascial structure of the left retroperitoneal region of the abdomen and its surgical anatomy are reviewed. The findings correlate with those of Tobin and Baumann. The muscular interval between the quadratus lumborum and the psoas muscle is elaborated upon as a useful route for entrance into the retroperitoneum. The occasional but significant occurrence of the artery of Haller is mentioned. The author's recommendation for exposure of the upper segments of the lumbar spin L1 through L3 is through a posterolateral abdominal incision with resection of the medial half of the twelfth rib (depending on the configuration of the twelfth rib) and oteotomy of the tip of the L1 transverse process as the routes of exposure of the proximal segments of the lumbar spine.

Fascia↗
PubMed2001

Biomechanical and morphologic evaluation of a three-dimensional fabric sheep artificial intervertebral disc: in vitro and in vivo analysis.

STUDY DESIGN: We have developed a new artificial intervertebral disc consisting of triaxial three-dimensional fabric for the sheep lumbar spine. To clarify the characteristics of the new implant, a series of biomechanical tests and morphologic evaluations were conducted. OBJECTIVES: To investigate the static, viscoelastic, and fatigue properties of the three-dimensional fabric disc in comparison with natural sheep disc and to evaluate their biomechanical and morphologic alteration in vivo. SUMMARY OF BACKGROUND DATA: In its human dimensions the three-dimensional fabric disc revealed mechanical properties similar to a natural human disc. METHODS: The disc-body units from sheep spine and the sheep three-dimensional fabric discs underwent tensile-compressive (200 N), torsional (5 Nm), and creep-recovery tests (30 minutes-30 minutes, 200 N). After fatigue loading (2 million, compressive 200 N) the biomechanical changes and the debris were investigated. For in vivo evaluation after placing in the sheep psoas muscles for 6 months, the surface of the three-dimensional fabric disc was evaluated using macroscopy and scanning electron microscopy, followed by previous biomechanical tests. RESULTS: The behavior of the sheep three-dimensional fabric disc was similar to that of natural sheep disc in tensile-compressive and creep-recovery tests. In torsional testing the behavior of natural sheep disc was more rigid than that of the sheep three-dimensional fabric disc. After fatigue loading there was no biomechanical change and no debris detected. Six months after surgery no morphologic deterioration was observed nor were there changes in biomechanical parameters. CONCLUSIONS: The sheep three-dimensional fabric disc exhibited biomechanical and morphologic biostability, appropriate viscoelasticity, and excellent fatigue properties. The three-dimensional fabric disc has a potential for clinical application of human intervertebral disc replacement.

Animals↗