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PubMed1998

Image-analysis-based assessment of the effects of the "Ca2+-jump" technique on sarcomere uniformity.

A new image analysis-based technique was used to quantitatively examine the effects of the "Ca2+-jump" activation protocol on the maintenance of fiber quality in skinned rabbit psoas muscle fiber segments. Specifically, contractions in pCa 4.6 were preceded by short-duration "preactivation" soaks in a solution in which EGTA was replaced with the low-Ca2+ buffering capacity analog hexamethylenediamine-N, N, N', N'-tetraacetate, which facilitated rapid Ca2+ equilibration within the fiber segments. Fiber quality was assessed by examining the Fourier spectra of the muscle fiber images before, during, and after activation. Segment lengths were typically below 500 micrometer, thus allowing the majority of the sarcomeres to be visualized in the field of view (x200 and x400 magnification). The preactivation protocol resulted in less deterioration of fiber quality with repetitive activation. In addition, there was also a significant reduction in the time required to reach the 50% level of maximum tension, with no significant change in the maximum tension level.

Animals↗
PubMed2002

The use of the tissue adhesive enbucrilate (histoacryl) in the treatment of symptomatic nephroptosis.

PURPOSE: To evaluate the use of the tissue adhesive enbucrilate in the treatment of symptomatic nephroptosis. MATERIALS AND METHODS: We performed adhesive nephropexy in 9 patients who presented with well-documented symptomatic nephroptosis that was demonstrated with intravenous pyelography and/or radionuclide renogram studies. The ptotic kidney was fixed on the psoas muscle using 0.5 ml of enbucrilate (Histoacryl). RESULTS: Adhesive nephropexy was successful in all 9 patients. Average operative time was 37 min. Postoperative opioid analgesia duration and hospital stay were limited (mean 2 and 4.4 days, respectively). Most patients returned to normal activity within 2 weeks (mean 14.2 days). Mean follow-up was 25 months and showed postoperatively a good anatomical result in radiographic studies as well as significant pain alleviation (mean 1 vs. 7 preoperatively, on a 10-point scale, p < 0.005 Wilcoxon rank test). CONCLUSIONS: The tissue adhesive enbucrilate seems to be a safe, efficient agent to obtain good results in a simple, quick approach in the surgical treatment of symptomatic nephroptosis.

Adult↗
PubMed2006

Increased TGF-alpha and EGF Receptor mRNA expression in response to neonatal unilateral partial ureter obstruction in rats.

AIM: To evaluate the potential role of members of the epidermal growth factor (EGF) family in altered renal growth caused by partial ureteral obstruction in the developing obstructed and non-obstructed kidneys. METHODS: During anesthesia either the upper fourth (n = 6-7) or the upper two-thirds of the left ureter (n = 6-7) were embedded into the psoas muscle in newborn rats resulting in mild or severe partial unilateral obstruction, respectively, which was maintained during the following 24 weeks. Sham-operated control rats were prepared in parallel (n = 6-7). Real time PCR assays were used to quantify mRNA encoding EGF, TGF-alpha, HB-EGF and EGF receptor. The expression of ribosomal RNA was determined to relate the specific mRNA expression of members of the EGF system. RESULTS: Relative expression of TGF-alpha and EGF receptor mRNA levels were elevated significantly both in the severe and mild obstructed kidney compared with the contralateral or sham-operated kidneys after 24 weeks of obstruction. However, the expression of neither EGF nor HB-EGF was changed after obstruction. CONCLUSION: The increased expression of TGF-alpha and its receptor in the obstructed kidney might be related to a cell-survival function in the affected cells possibly by protecting them from entering apoptosis.

Animals↗
PubMed2007

Spontaneous reduction of a traumatic L2-L3 subluxation without fracture in a 14-year-old boy.

OBJECTIVE: To report a rare case of lumbar vertebral subluxation associated with spontaneous reduction in an adolescent treated conservatively. CLINICAL PRESENTATION AND INTERVENTION: A 14-year-old male victim of a snowboard accident, which caused a lumbar spinal injury, was referred to the emergency room with significant lumbar pain. Neurologic examination was normal. Radiographic assessment at admission showed a unilateral left lateral subluxation of the L2-L3 vertebrae without associated fractures. These findings were confirmed by CT scan and a surgical management was decided. The preoperative MRI performed 24 h after the accident, however, revealed the spontaneous reduction of the subluxation, and an associated tear of the quadratus lumborum and the psoas muscles on the right side at the level of L2, L3 and L4. Following these findings conservative treatment with a plaster brace for 2 months was carried out. The brace was removed after 2 months. The patient had no pain and the range of motion of his lumbar spine was normal. Three months after injury, sports activities were resumed. At follow-up of 24 months, the patient was free of pain and radiographs showed a right positional bending without rotational or translation anomaly. CONCLUSION: To date, this is the first case of subluxation without fracture in a child, presenting without neurological deficit and where spontaneous reduction occurred. In this case, conservative treatment was effective and the outcome at 2-year follow-up was excellent.

Adolescent↗
PubMed1994

Tuberculosis of the spine (Pott's disease) in patients with end-stage renal disease.

Extrapulmonary tuberculosis is more common in end-stage renal disease than in normal subjects, and it frequently poses both diagnostic and therapeutic challenges. We describe 2 dialysis patients with tuberculosis of the spine (Pott's disease). The 1st patient presented with back and left hip pain, low-grade fever, left-quadriceps weakness, hypoesthesia of the left thigh, and hypoactive left-knee jerk. X-rays of the spine showed only osteophytes. Magnetic resonance imaging showed increased signal intensity of L3 with focal expansion into the spinal canal. A computerized tomography guided biopsy revealed granulomas, and Ziehl-Neelsen stain was positive. Therapy with rifampin, isoniazid, ethambutol, and pyrazinamide caused peripheral neuropathy and optic neuritis. The 2nd patient developed bilateral proximal thigh pain and weakness that progressed to paraplegia. Magnetic resonance imaging showed destructive lesion of L3-5, involving both psoas muscles, prevertebral space, and neural foramina. Ziehl-Neelsen stain of the biopsy specimen was negative, but culture was positive for Mycobacterium tuberculosis. Paraplegia improved only partially after 1 year of therapy. Pott's disease should be suspected in end-stage renal disease patients with back pain and/or neuromuscular complaints, particularly in those who immigrated from Asian and Latin-American countries. Treatment of tuberculosis in dialysis patients may cause significant morbidity.

Adult↗
PubMed1984

Pressure-flow relationship in partial obstruction of ureter in pigs.

In 10 female pigs, the proximal part of the left ureter was obstructed for 10 weeks by implantation of the ureter into the psoas muscle. After 9 weeks of obstruction, 6 systems showed delayed or impaired drainage at renographic examination. Renal function was slightly impaired in 1 case. At operation, 4 systems were macroscopically normal while the rest showed slight to moderate dilatation. The intrapelvic resting pressure was normal in 8 of 9 cases. At perfusion, all systems responded within the normal limits at 8 cm3/min while high-pressure responses were found in 4 units above 8 cm3/min. No correlation was found between the resting pressure and the pressure response and the degree of dilatation or impairment of renal function.

Animals↗
PubMedDate not supplied

Cytodiagnosis of a herniated disk presenting as a soft tissue mass. A case report.

BACKGROUND: Extraforaminal disk herniation has been recognized with increasing frequency. When the herniated disk (HD) fragment detaches and migrates away from the spinal column, it can be confused with other space-occupying paraspinal lesions. CASE: A 63-year-old female presented with right leg pain and weakness. A magnetic resonance image showed a right psoas muscle mass. Fine needle aspiration biopsy (FNAB) established a diagnosis of HD. CONCLUSION: The cytologic appearance of HD is characteristic. When correlated with clinical findings, the diagnosis of HD can be established by FNAB.

Biopsy, Needle↗
PubMed1978

A technical aid to performance of neurolytic lumbar sympathectomy.

The injection of ten ml of air into the retroperitoneal space outlines the anterior margin of the psoas muscle. This been found to be useful, using an Image Intensifier, for the accurate location of needle tips in the performance of neurolytic lumbar sympathectomy.

Autonomic Nerve Block↗
PubMed2005

Intestinal microdialysis--applicability, reproducibility and local tissue response in a pig model.

BACKGROUND AND AIMS: Microdialysis has been applied to the intestinal wall for the purpose of monitoring local ischemia. The aim of this study was to investigate the applicability, reproducibility and local response to microdialysis in the intestinal wall. MATERIALS AND METHODS: In 12 pigs two microdialysis probes were inserted into the ileal wall, one in the peritoneal cavity and one in the psoas muscle. Relative recovery was measured for all probes by the no net flux method. Metabolic measurements of glucose, lactate and glycerol were performed over six hours. The ileal wall segments containing the probes were processed for histological examination. RESULTS: Large intra- and inter-group differences in the relative recovery were found between all locations. Absolute values of metabolites showed no significant changes during the study period. The lactate in blood was 25-30% of the intra-tissue values. A severe inflammatory reaction was seen in the ileal wall around all probes. CONCLUSION: Measurement of the relative recovery is essential for valid measurements of metabolites when using microdialysis. The inflammatory reaction around the probe in the intestinal wall is likely to affect metabolism and measurements hereof. Therefore intestinal wall microdialysis seems confined to experimental research, and future studies should consider the intra-peritoneal approach.

Animals↗
PubMed2005

Perforated appendicitis causing thigh emphysema: a case report.

We report a case of thigh emphysema resulting from perforated appendicitis. The patient was an 83-year-old man who had no apparent abdominal signs and was initially misdiagnosed as having psoas abscess. Magnetic resonance imaging of the pelvis revealed appendicitis, and a barium enema showed a leakage of enhanced contrast material from the appendix region down into the thigh. A retroperitoneal perforation of the retrocaecal appendix without peritonitis was diagnosed. The patient underwent an appendectomy and curettage of the retroperitoneal and psoas muscle spaces, as well as the thigh. He recovered gradually, though the abscess had extended into the hip joint and resulted in osteomyelitis, requiring an additional procedure of resection arthroplasty. The patient fully recovered with no signs of infection one year postoperatively.

Abscess↗
PubMed2006

Adult clear cell sarcoma of the kidney: a case report.

BACKGROUND: Clear cell sarcoma of the kidney (CCSK) in adults is extremely rare. Optimal treatment of adult patients with CCSK remains unclear. CASE PRESENTATION: A 22-year-old man presented with a 2-month history of left flank pain. A color duplex sonography revealed a hypervascular, heterogeneous renal mass. Abdominal and pelvic computerized tomography showed a heterogeneous mass originating from the lower pole of the left kidney and infiltrating to the psoas muscle. Further evaluation including bone scan did not demonstrate any evidence of metastases. A left radical nephrectomy with hilar lymphadenectomy through an intraperitoneal approach with an anterior subcostal incision was performed. The histopathological diagnosis of the mass was a clear cell sarcoma of the kidney. No lymph node metastases were found. Concomitant chemo-radiotherapy was performed. Therapy-related serious side effects were not observed. There was no evidence of local recurrence or metastases during the following twenty-four months after therapy. CONCLUSION: We believe that the combination therapy is efficacious for preventing the local recurrence and distant metastases. Accurate diagnosis is very important and therapy must also include doxorubicin regardless of the disease stage in adult patients with CCSK.

Adult↗
PubMed2004

Extraabdominal fibromatosis in retroperitoneal space.

BACKGROUND: Fibromatosis or desmoid tumor covers a broad spectrum of benign fibrous tissue proliferations. It is characterized by infiltrative growth and a tendency towards recurrence; however, unlike sarcoma, it never metastasizes. CASE PRESENTATION: We report on a case of extraabdominal fibromatosis originating from the retroperitoneal space in a 43-year-old woman. Seven years earlier she had undergone ureterolysis and ureteroureterostomy for ureteral obstruction. Computed tomography revealed a tumor between the iliocostalis and the psoas muscle. Histopathological evaluation revealed uniform proliferation of spindle cells, with a moderate amount of collagen fibers, suggesting extraabdominal fibromatosis (desmoid tumor). The tumor was surgically resected, and since then, the patient has remained asymptomatic without any restrictions of daily living activities and without any signs of tumor recurrence during the two-year follow-up. CONCLUSIONS: Complete resection is the treatment of choice. Adjuvant therapy using non steroidal anti-inflammatory agents, tamoxifen, interferon, anti-neoplastic agents, and radiotherapy, either alone or in combination finds application for unresectable or recurrent cases.

Journal Article↗
PubMed2006

Cholestanol metabolism in patients with cerebrotendinous xanthomatosis: absorption, turnover, and tissue deposition.

To study the metabolism of cholestanol in patients with cerebrotendinous xanthomatosis (CTX), we measured the cholestanol absorption, the cholesterol and cholestanol turnover, and the tissue content of sterols in two patients. Cholestanol absorption was approximately 5.0%. The rapid exchangeable pool of cholestanol was 233 mg, and the total exchangeable pool was 752 mg. The production rate of cholestanol in pool A was 39 mg/day. [4-14C]cholestanol was detected in the xanthomas, but neither [4-14C]cholestanol nor [4-14C]cholesterol was detected in peripheral nerves biopsied at 49 and 97 days after [4-14C]cholesterol given intravenously. Of the 18 tissues analyzed at biopsy and autopsy, the cholestanol content varied from 0.09 mg/g in psoas muscle to 76 mg/g in a cerebellar xanthoma. With the assumption that the cholestanol-to-cholesterol ratio is 1.0, the relative cholestanol-to-cholesterol ratio varied from 1.0 in plasma and liver to 30.0 in the cerebellar xanthoma; cholestanol was especially high in nerve tissue. Our data indicate that CTX patients absorb cholestanol from the diet. They have a higher than normal cholestanol production rate. Cholestanol was derived from cholesterol. In CTX patients, the blood-brain barrier was intact to the passage of [4-14C]cholesterol and [4-14C]cholestanol. The deposition of large amounts of cholestanol (up to 30% of total sterols in cerebellum) in nerve tissues must have an important role in the neurological symptoms in CTX patients. In view of the intact blood-brain barrier, several other explanations for the large amounts of cholestanol in the brain were postulated.

Carbon Radioisotopes↗
PubMed1981

Plasma clearance and organ distribution of native and desialylated rat and human transcortin: species specificity.

Plasma clearance of intact and desialylated rat and human transcortin after iv injection into rats and hamsters has been investigated. Intact rat transcortin was shown to have an approximately 5-fold longer half-life in the rat circulation than human transcortin. Removal of sialic acid residues resulted in a reduction of the half-life of rat transcortin from 4 h to 90 sec. This rapid clearance could be blocked by simultaneous injection of asialofetuin, but the clearance of intact rat transcortin was unaffected by asialofetuin. Five rat organs (pancreas, uterus, kidney, liver, and psoas muscle) were sampled at 30 and 60 min after injection of iodinated rat or human transcortin and examined for their intact transcortin levels relative to those of plasma and [14C]sucrose distribution volumes. With the exception of the liver, the organs had lower tissue:plasma ratios of [125I]iodo-transcortin than did [14C]sucrose. Liver was found to accumulate 3--8 times more human [125I]iodo-transcortin than rat [125I]iodo-transcortin, suggesting that this organ plays a greater role in the degradation and plasma clearance of human transcortin. When injected into hamsters, rat and human transcortin both had relatively long half-lives (5.8 and 6.8 h, respectively), which were dramatically shortened when sialic acid was removed. Our results suggest that the differences observed in the half-lives of these two species of transcortin in the rat are most likely due to differences in the metabolism of these two transcortins by the endogenous neuraminidase(s).

Animals↗
PubMed1983

Femoral neuropathy and retroperitoneal hemorrhage.

A case of femoral neuropathy secondary to psoas muscle hematoma in a patient on warfarin sodium anticoagulation therapy is presented. Computed tomography was used to establish the diagnosis. The literature is reviewed with regard to the pathophysiology, clinical presentation, and therapy of this case. Surgical decompression is suggested to shorten the recovery period and minimize residual neurological deficit.

Femoral Nerve↗
PubMed1998

Lumbar spine magnetic resonance imaging: comparison between fast spin echo proton density and spin echo T1 axial scans.

Spin echo (SE) T1 axial scans are routinely obtained in magnetic resonance imaging of the lumbar spine in many centres. This study directly compared matched SE T1 and fast SE (FSE) proton density (PD) axial scans. Both SE T1 and FSE PD axial scans of the lumbar spine were obtained in 116 consecutive patients. The imaging parameters (field-of-view, slice thickness, interslice gap, number of excitations and matrix size) and scan levels were identical for each pair of sequences. At two selected levels, L4/5 and L5/S1, various structures were independently graded by two observers. In 232 lumbar levels analysed, the bone marrow, epidural fat, disc, extradural nerve root and facet joint were equally well seen on both sequences by both observers (combined mean grades of 2.93-2.99). The thecal sac was marginally better depicted on FSE PD than on SE T1 images, with mean grades of 2.96 and 2.88, respectively. The psoas muscle was adequately visualized for diagnostic purposes on both sequences (mean grades of 2.30-2.32). The cauda equina were better seen on FSE PD (mean grade 1.92) than on SE T1 (mean grade 1.00) images. In conclusion, FSE PD scans are comparable to and may potentially replace SE T1 axial MR scans of the lumbar spine.

Humans↗