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At least 1,351 records · Page 75Linked to original sources
PubMed1992

Postburn breast reconstruction: tissue expansion prior to contracture release.

Tissue expansion of the scarred chest following burns results in a poor breast mound shape with little projection or inframammary fold, since the expander, like normal developing breast tissue, is kept flat by the scarred skin envelope. We present a case that demonstrates that adequate projection of the breast and formation of an inframammary fold can be achieved by expansion if extensive release and skin grafting of contractures over the breast mound are performed after expansion. Maintained expansion will act as a stent reducing secondary contracture of the grafted-areas.

Adult↗
PubMed1992

Evaluation of greyhound susceptibility to malignant hyperthermia using halothane-succinylcholine anesthesia and caffeine-halothane muscle contractures.

We investigated Greyhounds because of prior reports of malignant hyperthermia (MH) episodes and because Greyhounds may express high genetic relatedness due to inbreeding for generations. Seven Greyhound and six mongrel dogs were given halothane and succinylcholine anesthesia as a challenge to trigger MH. They also underwent semitendinosus muscle biopsy for contracture study with halothane and caffeine. Measurements in vivo of mixed venous and arterial blood gases, cardiac output by thermodilution, temperature, blood pressure, and pulse rate provided sequential data regarding whole body O2 consumption (product of cardiac output and arterial-mixed venous O2 content difference), acid-base status, and arterial CO2 tension. Greyhounds and mongrels had uniformly similar in vivo and in vitro responses, without evidence for MH. Contracture thresholds were higher than those reported for normal swine and humans (8 mM vs. 4 mM). Information on MH susceptibility in this breed is important for laboratory investigation in Greyhounds as well as to veterinary medicine in general. Neither mongrels nor this group of Greyhounds were obviously susceptible to MH. If all Greyhounds are genetically homologous, then Greyhounds may not be specifically MH susceptible. These findings overall may provide a protocol and baseline normal comparative data for determining MH susceptibility in dogs and other species.

Anesthesia, Inhalation↗
PubMed2005

Muscle contracture emulating system for studying artificially induced pathological gait in intact individuals.

When studying pathological gait it is important to correctly identify primary gait anomalies originating from damage to the central nervous and musculoskeletal system and separate them from compensatory changes of gait pattern, which is often challenging due to the lack of knowledge related to biomechanics of pathological gait. A mechanical system consisting of specially designed trousers, special shoe arrangement, and elastic ropes attached to selected locations on the trousers and shoes is proposed to allow emulation of muscle contractures of soleus (SOL) and gastrocnemius (GAS) muscles and both SOL-GAS. The main objective of this study was to evaluate and compare gait variability as recorded in normal gait and when being constrained with the proposed system. Six neurologically and orthopedically intact volunteers walked along a 7-m walkway while gait kinematics and kinetics were recorded using VICON motion analysis system and two AMTI forceplates. Statistical analysis of coefficient of variation of kinematics and kinetics as recorded in normal walking and during the most constrained SOL-GAS condition showed comparable gait variability. Inspection of resulting group averaged gait patterns revealed considerable resemblance to a selected clinical example of spastic diplegia, indicating that the proposed mechanical system potentially represents a novel method for studying emulated pathological gait arising from artificially induced muscle contractures in neurologically intact individuals.

Adaptation, Physiological↗
PubMed2006

Adolescent scar contracture scoliosis caused by back scalding during the infantile period.

To investigate the pathogenesis, clinical manifestation and treatment of the adolescent scar contracture scoliosis caused by back scalding during infancy. From August 1997 to May 2005, about 1300 patients with scoliosis received surgery in our department. Only four of them were diagnosed with adolescent scar contracture scoliosis. One patient was first treated with skin expansion, back scar excision, and skin flap transfer, followed with anterior correction with TSRH instrumentation. Two patients were first treated with back scar excision and anterior spinal release, then treated with posterior correction with TSRH instrumentation; thoracoplasty was performed after 50 days in halo-wheelchair traction. The other patient was treated with posterior correction with TSRH instrumentation. No management of scalding was performed on the fourth patient. Anterior release and posterior correction were performed at intervals of 3 weeks. The deformities of four patients were well corrected. The trunk balance was restored and the pelvis leveled. The skin incision wounds healed well. Minor loss of correction was recorded during the last follow-up.

Adolescent↗
PubMed1991

[Neurovascular transfer of the m. gracilis for the treatment of Volkmann's contracture following supracondylar fracture in childhood].

Children are particularly prone to developing moderate to severe Volkmann's ischemic contracture following a supracondylar fracture of the humerus or its treatment. In order to treat such contractures, intensive hand therapy and a gracilis free muscle transfer to the digital flexors were used in 8 patients at an average age of 6 years 2 months. All transfers were successful. At follow-up (1 to 8 years, average 3 years), despite limited wrist extension in 5/8 patients and mean grip and pinch strengths between 22 and 43% of normal for age and dominance, all patients regained considerable finger flexor excursion (tip to crease distances of 0 to 5.0 cms, average 1.68 cms). Although fine motor assessment using the M.A.N.D. battery of tests placed the patients in the moderate disability range, 7/8 patients became independent in the tested activities of daily living with the exception of buttoning a cuff with the involved hand, which was difficult for 5/8 subjects. Quantifiable measurements underestimated the renewed importance of the operated hand. Compensatory motion at the shoulder allowed positioning the hand which changed from being nearly useless to becoming a functionally non-dominant hand well integrated into daily life.

Child↗
PubMed1991

Effect of rapid cooling contracture on ischemic tolerance in immature myocardium.

Hypothermic perfusion before cardioplegic ischemic arrest is commonly used in neonatal cardiac surgery. However, perfusion cooling of the heart in the nonarrested state results in an inotropic response and may induce myocardial contracture secondary to a sustained elevation of intracellular calcium levels. The effect of prearrest cardiac cooling was examined in two groups of isolated parabiotic, blood-perfused neonatal rabbit hearts. Group C (cooling group, n = 12) was exposed to 15 minutes of cold perfusion to 12 degrees C before 1 hour of cardioplegic arrest. Group N (normothermia group, n = 11) underwent identical arrest conditions but without prearrest cold perfusion. Developed pressure at constant volume in group C fell from 109 +/- 8.7 mm Hg at baseline to 55.2 +/- 5.5 mm Hg after 30 minutes of reperfusion versus no significant change in group N. Diastolic compliance showed significant deterioration in group C, with marked elevation of diastolic pressure from 9.8 +/- 0.4 mm Hg at baseline to 22.0 +/- 4.4 mm Hg after ischemia and reperfusion. This experimental data demonstrates that profound hypothermic perfusion of the myocardium in the nonarrested state may induce a rise in resting myocardial tension and that cardioplegic ischemic arrest in the presence of cooling contracture may result in important myocardial injury.

Animals↗
PubMed1991

Upper extremity contractures in a patient with eosinophilia-myalgia syndrome.

L-tryptophan is an essential amino acid taken as an over-the-counter nutritional supplement for a variety of conditions including chronic pain, insomnia, and depression. In October 1989 several patients were reported having eosinophilia-myalgia syndrome (EMS) who had taken L-tryptophan in large doses. Little is known about the long-term outcomes of EMS. A patient with EMS who developed contractures of the upper extremities because of severe myalgias is discussed. Early aggressive rehabilitative intervention may prevent contractures in patients with EMS.

Arm↗
PubMed1990

Pressure therapy in treatment of hypertrophic scar, burn contracture and keloid: the Kenyan experience.

A preliminary report of the results of pressure therapy for hypertrophic scar, burn contracture and keloid is presented. Thirty four patients over a four year period were treated with four types of pressure therapy. Results showed over 50% improvement in 21 (61.8%) cases. This method obviated the need for repetitive surgery and no recurrence was noted. Pressure therapy is advocated as an adjunct measure for all cases of hypertrophic scarring, burn contracture and keloid.

Adolescent↗
PubMed1990

Warm induction blood cardioplegia in the infant. A technique to avoid rapid cooling myocardial contracture.

The use of profound hypothermia and total circulatory arrest for repair of heart defects in neonates usually involves a period of systemic and myocardial bypass cooling. Rapid cooling of muscle (skeletal, smooth, and myocardial) can result in contracture through elevation of cytosolic calcium levels. The increased myocardial tone caused by cooling might render the heart more vulnerable to a subsequent period of cardioplegic ischemic arrest. Infants may be more susceptible to contracture because their small body mass allows more rapid myocardial temperature change when prearrest bypass cooling is used. The influence of avoiding rapid myocardial cooling before induced cardioplegic arrest was analyzed in a group of infants weighing less than 6 kg at the time of open cardiac operation. Myocardial ischemic arrest by warm (37 degrees C) induction blood cardioplegia was used in 57 infants and compared with results in 440 infants treated with standard blood cardioplegia. Multivariate logistic regression analysis revealed that patient diagnosis, weight, and age at operation were significant risk factors for operative mortality. The use of warm induction blood cardioplegia had a strongly positive independent effect on survival (p = 0.0003) for any patient weight, age, or diagnostic group. We recommend the avoidance of rapid myocardial cooling on bypass in all patients before induction of cardioplegic ischemic arrest.

Blood↗
PubMed1986

Effects of Na-octanoate on potassium contractures in normal and denervated frog tonic fibres.

In frog twitch muscle fibres, Na-octanoate (NaC8) shifted the relation between potassium induced tension and membrane potential to the right. The present study has been carried out to investigate the effect of this fatty acid on frog tonic fibres. Potassium contractures measured on bundles of 30-40 fibres of ileofibularis muscles were less decreased by NaC8 (2.5-10 mmol/l) than those of twitch fibre bundles. In denervated muscles the sensitivity to NaC8 was increased, probably due to the development of sodium channels in the membranes. Experiments with mixed fibre bundles also showed a lower influence of NaC8 on potassium contracture of tonic fibres. On the other hand, tonic fibres showed a lower threshold of the potassium induced tension as well as a lower K+ concentration for maximal activation. This lower threshold was further lowered by NaC8, corresponding to a shift of the relation between potassium concentration and tension to the left. The membrane resting potentials were -58 +/- 9 mV in tonic fibres and -83 +/- 5 mV in twitch fibres. Five mmol/l NaC8 only induced depolarization of the membrane of tonic fibres. This depolarization (by about 20 mV) may be responsible for the threshold shift to lower K+ concentration in NaC8-exposed tonic fibres. In addition to the effects of NaC8 on sodium channels, interactions with Ca2+ binding sites are discussed.

Animals↗
PubMed1989

[Malignant hyperthermia; two cases of MH in the presence of general anesthesia and performing caffeine contracture test].

In the present report we described two cases of malignant hyperthermia under halothane anesthesia. Case 1; A 54-year-old, 58 kg-male was scheduled for the operation of giant arterio-venous malformation. Anesthesia was induced with thiamylal, fentanyl and pancuronium, and maintained with oxygen, nitrous oxide and halothane. The patient was subjected to halothane inhalation for 26 hours prior to the development of the malignant hyperthermia. Although body temperature rose to 41 degrees C, it returned to normal with the administration of 280 mg of dantrolene and systemic cooling. Case 2; A 31-year-old, 68 kg-female was scheduled for tonsillectomy. Anesthesia was induced with thiamylal, oxygen, nitrous oxide and halothane. After the administration of 70 mg of SCC, marked muscular rigidity occurred and endotracheal intubation was impossible. The operation was postponed. Two months after the first anesthesia, operation was successfully performed under NLA with droperidol and fentanyl. Caffeine contracture test was performed in each case by skinned fiber method and the result showed that the sensitivity to caffeine increased in the isolated skeletal muscle fiber bundles from these patients. Thresholds of caffeine contracture of these skinned fiber bundles were all lower than 5mM caffeine.

Adult↗
PubMed1989

[Effects of ketamine on K+-contracture in isolated vascular smooth muscle from rabbit].

The effects of ketamine on contraction induced by depolarization of cell membrane (high K+-induced contracture) were studied in isolated vascular smooth muscle from rabbit portal vein. Ketamine in concentrations above 5 x 10(-4) M caused relaxation in phasic contraction, and above 10(-4) M caused relaxation in tonic contraction. These effects of ketamine at concentrations of between 10(-5) to 10(-3) M were dose dependent and reversible. In concentration above 10(-5) M, ketamine decreased the contractile response (tonic contraction) induced by 2.5 mM Ca2+ after the temporary contracture in Ca2+-free, high K+ solution. The contractile responses to norepinephrine (10(-6) M) or serotonin (10(-6) M) were also inhibited by ketamine. From these findings, it is concluded that ketamine decreases contractile responses due to transmembrane Ca2+ influx after depolarization of cell membrane and may decrease the contractile responses in concentration above 5 x 10(-4) due to Ca2+ release inhibition from sarcoplasmic reticulum.

Animals↗
PubMed1988

Effects of sodium nitroprusside on potassium induced contracture in isolated vascular smooth muscle.

The present study investigates the effects of Sodium Nitroprusside (SNP) on isometric developed tension (IDT) and tonic component of K+ induced contracture of rat portal vein. The availability of activator calcium for the contraction was modified by changing the ionic composition of the Krebs Ringer bicarbonate medium (KRB) or by using pharmacological agents such as nifedipine or KCl. In control conditions (KRB media) magnitude of IDT was 10.61 +/- 0.56 mN (n = 13). Addition of increasing concentrations of SNP (non cumulative) diminished IDT in a dose related manner. Tonic component of 60 mM KCl evoked contracture decayed 27.04 +/- 10.9% (n = 6) after 10(-4)M SNP incubation. Relaxant effect of SNP was more pronounced in the presence of nifedipine 10(-10)M (72.35 +/- 7.5% of inhibition, n = 6). The sensitivity of the preparation to SNP was strongly reduced in conditions of diminished Ca+2 efflux (slow sodium media = KRB sucrose). Experiments here presented support the hypothesis that the vasodilator effect of SNP could be attributed to an enhanced Ca+2 efflux from the vessel.

Animals↗
PubMed1988

A 5-year experience with polyurethane-covered mammary prostheses for treatment of capsular contracture, primary augmentation mammoplasty, and breast reconstruction.

This paper reviews a 5-year experience using polyurethane-covered mammary prostheses in the treatment of capsular contracture following placement of smooth-walled devices, primary augmentation mammoplasty, and breast reconstruction after mastectomy. The rate of occurrence of clinically significant capsular contracture has been reduced in all patient groups. Results in terms of aesthetic and functional improvement have been excellent. Major complications have been rare.

Breast↗
PubMed1987

[The study of structural proteins in the ischemic contracture muscle].

The purpose of this study was to make clear the changes of structural proteins in the ischemic contracture muscle. Ischemia experiments were conducted on the forelimb of canines. Contracture proteins (myosin, actin, alpha-actinin) were isolated and analysed by using SDS-polyacrylamide gel electrophoresis. In the muscle group after 7-hour-ischemia, the muscle structural proteins were changed remarkably, along the time course after the release of tourniquet. After 7 days, myosin heavy chain decreased to 1/2 to 1/3 the original value. It was especially myosin heavy chain that changed remarkably among muscle structural proteins. Actin showed changes after 10-hour-ischemia.

Actins↗
PubMed1987

Volkmann's ischemic contractures and blowout fractures.

Volkmann's ischemic contractures have long been recognized by orthopedic surgeons as a sequela of increased pressure within osseofascial muscle compartments. We present evidence that the same mechanism is a cause of fibrosis and contracture of extraocular muscles following orbital blowout fractures. Surgical treatment of a specific, recognizable type of blowout fracture is proposed.

Adolescent↗
PubMed1986

Capsular contracture: a prospective study of the effect of local antibacterial agents.

In a prospective, random, double-blind, and concurrently controlled clinical study of 124 patients having augmentation mammaplasty, using multiple independent subjective judges as well as objective compressibility measurements, the use of a variety of local antibacterials in or around inflatable retromammary prosthetic implants reduced the early postoperative onset of class III to IV capsular contracture by sevenfold (85 percent) and the final incidence by more than half (50 percent) (p less than 0.01). We believe this study provides the most unequivocal evidence to date that the cause of capsular contracture in retromammary augmentation is periprosthetic bacterial contamination. Irrigation with a 5 percent povidone-iodine (50 percent Betadine) solution was as effective as other techniques and is currently our procedure of choice.

Administration, Topical↗
PubMed1977

[Studies on the mechanism of action of vascular spasmolytics. 3. Effect of nitroprusside sodium, nitroglycerin, prenylamine and verapamil on the fluoride-induced contracture of the isolated coronary artery].

On isolated coronary arteries of cattle, nitroprusside-sodium, nitroglycerol, prenylamine, and verapamil were studied for their spasmolytic effects on a contracture induced by fluoride ions. With this contracture model, which is independent of extracellular calcium, nitroprosside-sodium and nitroglycerol showed strong spasmolytic action. Verapamil proved ineffective, and the effectiveness of prenylamine was strongly reduced. The results lend support to earlier findings suggesting that nitroglycerol and nitroprusside-sodium are endowed with a relaxation mechanism different from that of verapamil and analogously acting compounds.

Animals↗