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PubMed1983

A specific substance P antagonist attenuates non-cholinergic electrically induced contractures of the guinea pig isolated ileum.

The substance P (SP) analog, D-Pro2,D-Tryp7,9-SP attenuated in a dose-dependent fashion non-cholinergic excitatory responses of the guinea pig ileum to the exogenous administration of SP, but did not affect the atropine-resistant contractures produced by serotonin (1 microM), histamine (1 microM), bradykinin (0.01 microM) or prostaglandin F2 alpha (10 microM). Pretreatment with D-Pro2,D-Tryp7,9-SP also significantly reduced the magnitude of the non-cholinergic contracture evoked by field stimulation at 20 Hz. These results suggest that enteric SP-containing neurons can function in an efferent motor capacity to bring about non-cholinergic excitation of the longitudinal muscle layer of the guinea pig small bowel.

Animals↗
PubMed1985

The action of intravenous anaesthetic and central depressant drugs on the contractures elicited by tetraethylammonium in the chick biventer cervicis muscle.

A group of intravenous anaesthetic drugs was compared with methohexitone sodium for their ability to potentiate tetraethylammonium induced contractures of the chick biventer cervicis muscle (TEA test). The equipotent concentrations in the TEA test were: methohexitone 8.8 X 10(-5) M, propanidid 1.78 X 10(-4) M, althesin 3.58 X 10(-5) M (in terms of alphaxalone), etomidate 1.6 X 10(-4) M, thiopentone 2.13 X 10(-5) M and valium 4.95 X 10(-5) M. There was no relation between activity in the TEA test and excitatory muscular activity reported clinically. The central depressant drugs ethyl alcohol and urethane also potentiated TEA but they were only active in high concentrations (10(-1) - 10(-2) M). alpha-Chloralose was inactive but paraldehyde (3.8 X 10(-3) M) actually reduced TEA induced contractures. Lipophilicity is only one factor in determining activity in the TEA test, the ability to block Ca2+ reuptake may also be important.

Alfaxalone Alfadolone Mixture↗
PubMed1992

Adhesions between muscle and bone after forearm fracture mimicking mild Volkmann's ischemic contracture.

Five cases of digital flexion contractures after healed forearm fractures were incorrectly diagnosed as mild Volkmann ischemic contractures. All failed to respond to conservative therapy and were considered significant enough to require surgical correction. At surgery, the involved muscle-tendon units were densely adherent to the bone and callus of the fracture site with no evidence of ischemic involvement of the muscle. Lysis of adhesions and lengthening of the contracted muscle corrected the deformities.

Adolescent↗
PubMed1983

Twitch potentiation and caffeine contractures in isolated rat soleus muscle.

1. Electrically-evoked twitch and tetanic tension were measured in isolated rat soleus muscle after exposure to caffeine. 2. Between 0.01 and 2.5 mM caffeine twitch tension was potentiated, reaching a peak of 150% of Resting Tension at 0.5 mM. 3. Biphasic Tension development with relaxation was observed at 2.5 mM caffeine with maximal contractures (110% tetanic tension) occurring at 20 mM. 4. Creatine phosphate and ATP stores were maintained throughout the period of tension development and relaxation. 5. In contrast with amphibian muscle, the isolated soleus is very sensitive to low doses of caffeine and produces biphasic caffeine contractures which relax in the presence of caffeine.

Adenosine Triphosphate↗
PubMed2004

Classification of equinus in ambulatory children with cerebral palsy-discrimination between dynamic tightness and fixed contracture.

In this study a generalised dynamic neural network (GDNN) was designed to process gait analysis parameters to evaluate equinus deformity in ambulatory children with cerebral palsy. The aim was to differentiate dynamic calf muscle tightness from fixed muscle contracture. Patients underwent clinical examination and had instrumented gait analysis before evaluating their equinus under anaesthesia and muscle relaxation at the time of surgery to improve gait. The performance of the clinical examination, the subjective interpretation of gait analysis results, and the application of the neural network to assess ankle function were compared to the examination under anaesthesia. Evaluation of equinus by a Neural Network showed high sensitivity and specificity values with a likelihood ratio of +14.63. The results indicate that dynamic calf muscle tightness can be differentiated from fixed calf muscle contracture with considerable precision that might facilitate clinical decision-making.

Algorithms↗
PubMed2006

Management of established Volkmann's contracture of the forearm in children.

As with many diagnoses in medicine, the best treatment for Volkmann's ischemic contracture is prevention. Early recognition and prompt treatment of impending Volkmann's ischemia should decrease the presentation and severity of late contracture and hand dysfunction. The authors have found the flexor muscle slide the best treatment option for mild and moderate deformity. This procedure can be combined with additional reconstructive procedures to maximize functional outcome. The authors believe this procedure results in the best preservation of the muscle resting length and limits the scarring around the adjacent muscles. For severe cases,early wide excision with functional free-muscle transfer may limit the injury to the nerves, decreasing the distal problems associated with mo-tor and sensory impairment in the hand.

Child↗
PubMed2004

Spastic paretic hemifacial contracture (SPHC) in a patient with multiple sclerosis. A clinical, EMG and neuroimaging study.

We present the case of a 42-year-old woman with a 4-year history of definite multiple sclerosis (MS) and sustained contracture of the left hemiface with marked left deviation of the nose, deepened left nasolabial groove, narrowed palpebral fissure and weakness of the contracting muscles. Needle electromyography showed continuous resting activity of irregularly firing motor unit potentials (MUP) in the left orbicularis oculi (OO) and orbicularis oris, but not in the left frontalis. Simultaneous recording of maximal voluntary contraction of the OO on both sides showed marked preponderance on the right. Blink reflex findings were consistent with an injury in the pons, mainly in the vicinity of the left facial nucleus. A magnetic resonance imaging study showed multiple supra- and infra-tentorial white matter lesions, as well as multiple lesions at the level of the pons. Complete recovery was observed after 3 months. This condition has been described in cases of brainstem tumor as spastic paretic hemifacial contracture (SPHC). Up to now SPHC has not been explicitly associated with MS and, in this case, it could be arguably attributed to hyperexcitability of the facial neurons due to demyelination of the corticofacial fibers.

Adult↗
PubMed1999

Alteration of fetal oxygenation and responses to acute hypoxemia by increased myometrial contracture frequency produced by pulse administration of oxytocin to the pregnant ewe from 96 to 131 days' gestation.

OBJECTIVES: This study examined the effects of increased myometrial contracture frequency from 96 to 131 days' gestation on ovine fetal oxygen transport and physiologic response to acute hypoxemia. STUDY DESIGN: Ten pregnant ewes received either saline solution (control, n = 5) or long-term administration of oxytocin (600 microU. kg-1. min-1) in 5-minute pulses every 20 minutes to the maternal jugular vein beginning at 96 days' gestation (n = 5). Maternal tracheal tubes, fetal carotid artery and jugular vein catheters, and electrocorticographic and electromyographic electrodes were placed with the animals under halothane general anesthesia at 122 days' gestation. At 131 days' gestation fetal hypoxemia was induced for 1 hour. Maternal and fetal arterial blood gas samples were obtained at 60, 15, and 5 minutes before the start of hypoxemia and at 5, 10, 20, 30, 40, 60, and 120 minutes after the start of hypoxemia. RESULTS: Baseline PO2 before hypoxemia was significantly lower and oxygen content was significantly higher in fetuses in the long-term oxytocin group than in control fetuses. At the end of hypoxemia the fetal pH, oxygen saturation, and oxygen content were significantly higher in the long-term oxytocin group than in the control group, although PO2 did not differ between groups. The fetal blood oxygen dissociation curve was shifted to the left in the long-term oxytocin group. During hypoxemia the absolute fetal blood pH was higher and the blood pH variation was lower in long-term oxytocin group than in the control group. Lower baseline and hypoxia-induced fetal plasma cortisol concentrations were observed in fetuses in the long-term oxytocin group than in fetuses of control ewes. CONCLUSION: Increased contracture frequency during a period of 35 days shifts the fetal oxygen dissociation curve toward the left and alters fetal response to acute hypoxemia.

Adrenocorticotropic Hormone↗
PubMed1997

Prevention of ischemic rigor contracture during coronary occlusion by inhibition of Na(+)-H+ exchange.

OBJECTIVE: To determine the effect of Na(+)-H+ exchange blockade on ischemic rigor contracture and reperfusion-induced hypercontracture. METHODS: Thirty-six pigs were submitted to 55 min of coronary occlusion and 5 h reperfusion. Myocardial segment length analysis with ultrasonic microcrystals was used to detect ischemic rigor (reduction in passive segment length change) and hypercontracture (reduction in end-diastolic length). RESULTS: Pretreatment with the new, highly selective Na(+)-H+ exchange inhibitor HOE642 before occlusion reduced ischemic rigor (P < 0.05), attenuated segment shrinkage (P < 0.05) during subsequent reperfusion, dramatically reduced infarct size (P < 0.0001) and attenuated arrhythmias (P < 0.01). Inhibition of Na(+)-H+ exchange only during reperfusion by means of direct intracoronary infusion of HOE642 into the area at risk prevented reperfusion arrhythmias but had no effect on final infarct size, while treatment with intravenous HOE642 immediately before reperfusion had no detectable effects. CONCLUSION: These results indicate that inhibition of Na(+)-H+ exchange during ischemia is necessary to limit myocardial necrosis secondary to transient coronary occlusion, and that this action could by mediated by a protective effect against ischemic contracture. Inhibition of Na(+)-H+ exchange only during reperfusion has a partial and transient beneficial effect, but only when the inhibitor reaches the area at risk before reflow.

Animals↗
PubMed1976

Joint contracture--common manifestation of childhood diabetes mellitus.

Sixty-five of 229 seven to eighteen-year-old campers with diabetes were found to have contractures of finger joints; in two thirds of affected children only the fifth finger was involved. Stiff resistance to passive finger manipulation and thickened adherent skin over the dorsa of the hands were additional features. Short stature was associated with involvement of more than one finger; the shortest youngsters also had contractures of large joints. Joint changes were independent of age, sex, age of onset of diabetes, and control of diabetes, but correlated with duration of the diabetes.

Adolescent↗
PubMed1997

Scar contracture: cellular and connective tissue aspects in Peyronie's disease.

PURPOSE: The understanding of the mechanism of how the plaque in Peyronie's disease causes functional distortions is presented in terms of scar formation and maturation. The repair process is important for survival. The expected biological response to tissue loss and disruption is scarring but in some situations, such as Peyronie's disease, the resultant scar creates major problems. MATERIALS AND METHODS: The development of scar involves the deposition of connective tissue which histologically can be studied in patients and in animal models as well as with in vitro models. Abnormal scarring can involve excessive connective tissue deposition. Clinically examples of excess scarring are hypertrophic scars common in healed burn patients and keloid scars seen in patients with this inherited defect in healing. In addition to excessive connective tissue deposition, another aspect of abnormal scarring is scar contracture, when the compaction of the scar tissue distorts the anatomical appearance and functional capacity of adjacent tissues and organs. The fibroblast populated collagen lattice model demonstrates the organization of connective tissue in a controlled environment and the information gained can be related to scarring. RESULTS: The compaction of scar tissue involves the reorganization of collagen fibers by resident fibroblasts using cell tractional forces rather than cell contraction forces. These findings were documented with the fibroblast populated collagen lattice model. In Peyronie's disease the distortion caused by the scar or plaque is neither related to scar contracture nor active compaction of scar tissue but, rather, the expansion of the surrounding unscarred tissue and the inflexibility of the scar tissue composing the plaque. CONCLUSIONS: Peyronie's disease plaques are rigid structures due to the organization of the deposited collagen fibers. Those fibers are independent in their connective tissue organization, which makes the plaque incompatable with adjacent structures.

Cicatrix↗
PubMed1976

A second look at injection of vesical neck contractures with triamcinolone.

Adjuvant therapy for vesical neck contractures with triamcinolone injection has given good results with long-term followup but similar results have been obtained with transurethral resection alone in our current re-evaluation. Herein we review 220 consecutive vesical neck contractures treated by the aforementioned modalities.

Aged↗
PubMed1975

Bladder neck contracture and urethral stricture as complications of renal transplantation.

From 1963 to July 26, 1974, 211 men underwent renal transplantation at our clinic. Urethral strictures were present prior to the initial transplant in 4 patients (1.8 per cent) and developed in the post-transplant period in 13 patients (6.1 per cent). Postoperative bladder neck contractures occurred in 2 patients (0.9 per cent). Repeated urethral dilations and surgical procedures on the lower urinary tract were generally well tolerated. Infectious problems were the most common secondary complications. No patient or allograft was lost as a direct result of the lower tract obstruction or its treatment. The greatest morbidity occurred in those patients who had a combination of urethral stricture and/or bladder neck contracture, uremia, previous or current immunosuppression and the absence of urine flowing through the urinary tract. This combination occurred most often in the patient who experienced failure of the first allograft and was being prepared for a second or third transplant. To avoid potentially serious urologic complications, male patients should have a repeat lower urinary tract evaluation and definitive correction of existing obstruction before re-transplantation is considered.

Humans↗
PubMed1976

Volkmann's ischemic contracture due to soft tissue injury alone.

Fifteen upper extremities, in 14 patients in whom incipient or actual Volkmann's ischemic contracture was present, were seen in a 5 year period. Nine patients were stuporous due to drug overdose and had laid on the extremity; two had received a recent injury of main arterial trunks; two had sudden severe compression; one with chronic myelogenous leukemia had each arm involved at different times in a bizarre autoimmune response causing massive swelling. No patient had a fracture or dislocation. Pain and tenderness, loss of sensibility, resistant muscle contracture, and rock-hard muscle compartments were warning signs. Immediate fasciotomy was done. Useful function was restored when treatment was carried out in the early stages of the ischemia.

Adult↗
PubMed1994

Free muscle transfer in Volkmann's ischaemic contracture.

The results of treatment of 28 cases of Volkmann's ischaemic contracture by free muscle transfer are presented. Attention is drawn to the existence of an infarct in the median nerve in addition to the infarct in the muscle and that loss of nerve function is as important as the motor loss in determining functional outcome. Comparison of those cases treated early (within 6 months of injury) by free vascularised muscle transfer with those operated late showed better sensory recovery in the early treated group while the amount of motion obtained was not significantly different. Our present indications, timing, and technique of free muscle transfer in Volkmann's ischaemic contracture are discussed.

Adolescent↗
PubMed2003

Unicompartmental knee arthroplasty for osteoarthritis of the knee: remaining postoperative flexion contracture affecting overall results.

The success rate of unicompartmental knee arthroplasty has been variable, and controversy still surrounds its use. Achieving good functional results from this surgery may require understanding surgical principles, precise operative techniques, and careful patient selection. This paper evaluates clinical results and factors influencing postoperative knee function after unicompartmental knee arthroplasty. The follow-up assessment of 109 knees that underwent unicompartmental knee arthroplasty showed that 90 of 109 knees were classified as excellent or good (82.6%) using the Hospital for Special Surgery knee scoring system. In the excellent group (54 knees), 52% of the postoperative, standing femorotibial angles converged on a range of 170 degrees to 175 degrees with a mean of 174 degrees +/- 4 degrees. The knees with residual flexion contracture after surgery showed poorer clinical results. Therefore, complete elimination of the flexion contracture during surgery is considered mandatory.

Arthroplasty, Replacement, Knee↗
PubMed2002

Angiotensin II subtype 1 (AT1) receptors contribute to ischemic contracture and regulate chemomechanical energy transduction in isolated transgenic rat (alphaMHC-hAT1)594-17 hearts.

BACKGROUND: The role of AT1 receptors in myocardial ischemia/reperfusion injury is unclear. We, therefore, investigated the effects of the AT1 receptor antagonist irbesartan (Irb) in isolated hearts of selective myocardial AT1 overexpressing transgenic [transgenic(alphaMHC-hAT1)594-17] and Sprague-Dawley rats (SD) subjected to ischemia/reperfusion injury. METHODS AND RESULTS: Hearts of 4-week-old male SD or transgenic rats were isolated and perfused with Krebs-Henseleit buffer with or without 10 microM Irb in Langendorff mode. After 15 min of stabilization, pressure-volume curves were obtained and the hearts subjected to 20 min ischemia followed by 30 min reperfusion. A second set of pressure-volume curves was obtained thereafter. Left ventricular developed pressure (LVDP), end-diastolic pressure (LVEDP), total coronary flow (CF) and oxygen consumption (MVO2) were recorded continuously. Myocardial efficiency was derived from the slope of relations of MVO2 to pressure/volume area. After 20 min ischemia, LVEDP was significantly higher in transgenic than in SD (35.7+/-1.8 vs. 29.2+/-1.0 mmHg, P<0.05) or Irb treated transgenic hearts (24.3+/-1.6 mmHg, P<0.05). Myocardial efficiency was increased by Irb before ischemia. Ischemia increased efficiency in SD but not in transgenic rats, Irb increased efficiency in transgenic hearts post-ischemia. CONCLUSION: Transgenic hearts developed ischemic contracture more rapidly than SD hearts as indicated by higher LVEDP during ischemia. This response was antagonized by Irb, indicating a role of AT1 receptors in ischemic contracture, AT1-receptors also appear to be involved in the control of myocardial efficiency.

Animals↗
PubMed2001

Prenecrotic contracture damage in cardiomyocytes: photochemical fluorochrome staining and fluorescent microscopy of the myocardium.

Prenecrotic contracture changes in cardiomyocytes during ischemic and metabolic alteration of the myocardium are detected at the photooptic level by photochemical fluorochrome staining and examination in fluorescent light. Comparison of the fluorescent and polarization microscopic pictures of damaged cardiomyocytes showed relationships between optically active and isotropic constituents of the cell myofibrillar system. Contracture changes are determined by local mass redistribution in contractile compartments and transformations of the myofibril components, caused by protein structure coagulation in cardiomyocyte sarcomers.

Acute Disease↗