Muscular Rupture Research Articles

CT venography and pathological characterization of crus haemorrhage in Pekin ducks

ABSTRACTThe crus haemorrhage is one of the main causes of carcass defects in Pekin duck processing houses. However, its pathologic features are currently unclear. In order to examine the injury to the hind limb veins and illustrate the pathologic characteristics of crus haemorrhage in Pekin ducks, a total of 68 Pekin ducks with crus haemorrhage (test group) and 10 unaffected ducks (control group) were collected in this study. Five ducks randomly selected from each group were examined by computed tomographic venography with 2.0 mm thickness, 120 kVp, and 90 mA. Pathological changes were observed macroscopically, and under a microscope and electron microscope. The computed tomographic venography results showed no differences in the main hind limb veins between Pekin ducks with crus haemorrhage and the control. Macroscopic results demonstrated that the haemorrhage only occurred in crural muscles, most frequently in musculus gastrocnemius and musculus tibialis cranialis. In severe cases, muscular rupture and multiple intermuscular blood clots could be observed. Histological analysis showed rupture of myofibers and massive red blood cells between muscle bundles. Besides, infiltration of connective tissues and inflammatory lesions could be seen. However, no differences were observed in other organs between these two groups. The main ultrastructural characteristics were myofibrillar rupture and split, accompanied by mitochondrial membrane disintegration and vacuolization. All these results indicate that the haemorrhage in crus is a focal myopathy with the characteristics of bleeding, rupture, and inflammatory lesions.Research highlightsCTV was a feasible method to evaluate the hind limb veins in Pekin ducks.The focal myopathy presented here only affected crural muscles.The focal myopathy was characterized by bleeding, rupture and inflammatory lesions.

Effect of chromium supplementation with rehabilitation exercises on the restoration of functional efficiency of the posterior femoral muscles with partial muscular rupture

Effect of chromium supplementation with rehabilitation exercises on the restoration of functional efficiency of the posterior femoral muscles with partial muscular rupture

Effect of chromium supplementation with rehabilitation exercises on the restoration of functional efficiency of the posterior femoral muscles with partial muscular rupture

Effect of chromium supplementation with rehabilitation exercises on the restoration of functional efficiency of the posterior femoral muscles with partial muscular rupture

Delivery modes and their influencing factors of pregnant women with previous cesarean section: a retrospective study of 474 gravidas

Objective To investigate the safety of vaginal delivery in gravidas with previous cesarean section and its influencing factors. Methods Four hundred and seventy-four full-term gravidas who received cesarean section at the Department of Obstetrics and Gynecology of Peking University First Hospital from January 1, 2012 to August 31, 2014 were enrolled in this study. Among those subjects, 38 who underwent successful vaginal delivery were grouped into vaginal birth after cesarean (VBAC) group, and the other 436 accepting repeated cesarean section were grouped into cesarean group. Delivery outcomes and maternal/neonatal complications of the two groups were retrospectively analyzed with two-sample t-test and Chi-square test. Results Among the 45 patients (9.5%) who attempted VBAC, seven underwent cesarean section for suspected fetal distress and the other 38 (84.4%) succeeded in vaginal birth without uterine rupture. The amount of postpartum hemorrhage in patients of cesarean group was more than that of VBAC group [(330.8±94.8) vs (257.7±199.7) ml, t=2.021, P<0.01] after exclusion of three patients with dangerous placenta previa, and the postpartum hospital stay was shorter than that of cesarean group [(2.5±1.4) vs (4.5±1.3) d, t=7.952, P<0.01]. There were three newborns with neonatal asphyxia, twelve with neonatal infections and forty transferred to the Pediatrics Department following cesarean section. Besides, complications of headache and urinary retention occurred in 20 and 32 mothers after cesarean section, respectively. However, no complication occurred in VBAC group. Sixty-three cesarean sections were indicated as thin lower uterine segment and among them, fourteen (22.2%) had muscular rupture. Among the six patients who complained of tenderness in lower uterine segment, three were found having muscular rupture during cesarean section. Conclusion VBAC is an option for gravidas with history of cesarean section only if they meet the criteria for VBAC attempt. VBAC could lower the cesarean section rate without increase the incidence of complications. The rate of trial of labor after cesarean was low, patients education should be strengthened to increase it. Key words: Vaginal birth after cesarean; Trial of labor; Premature rupture of fetal membranes; Natural childbirth

Electrophysiology Updates in Adult Congenital Heart Disease.

Electrophysiology Updates in Adult Congenital Heart Disease.

Isolated Total Rupture of Extraocular Muscles.

Total rupture of extraocular muscles is an infrequent clinical finding. Here we conducted this retrospective study to evaluate their causes of injury, clinical features, imaging, surgical management, and final outcomes in cases of isolated extraocular muscle rupture at a tertiary center in China.Thirty-six patients were identified (24 men and 12 women). Mean age was 34 years (range 2–60). The right eye was involved in 21 patients and the left 1 in 15. A sharp object or metal hook was the cause of this lesion in 16 patients, sinus surgery in 14 patients, traffic accident in 3 patients, orbital surgery in 2 patients, and conjunctive tumor surgery in 1 patient. The most commonly involved muscles were medial (18 patients) and inferior rectus muscles (13 patients). The function of the ruptured muscles revealed a scale of −3 to −4 defect of ocular motility and the amount of deviation in primary position varied from 10 to 140 PD (prism diopter). Computerized tomography (CT) confirmed the presence of ruptured muscles.An end-to-end muscle anastomosis was performed and 3 to 5 mm of muscle was resected in 23 patients. When the posterior border of the injured muscle could not be identified (13 patients), a partial tendon transposition was performed, together with recession of the antagonist in most patients, whereas a recession of the antagonist muscle plus a resection of the involved muscle with or without nasal periosteal fixation was performed in the remaining patients. After an average of 16.42 months of follow-up an excellent result was achieved in 23 patients and results of 13 patients were considered as a failure.In most patients, the posterior border of the ruptured muscle can be identified and an early surgery can be performed to restore function. Alternatively, a partial tendon transposition should be performed. When muscular rupture is suspected, an early orbital CT is required to confirm this possibility, which can then verify the necessity for an early surgical intervention.

Iliopsoas hematoma due to muscular rupture following defibrillation.

We describe a 62 year old patient who presented with acute anterior ischemia and subsequently developed an iliopsoas hematoma. The patient was treated surgically due to rapid progression and femoral neuropathy, and the iliopsoas muscle rupture was diagnosed intraoperatively. The rupture was related to the external electrical defibrillation the patient had on admission. This was a rare case, and we hope the report would help to raise physicians' awareness regarding this complication and treatment.

Oesophagogastric muscular rupture after resuscitation

Oesophagogastric muscular rupture after resuscitation

US evaluation and diagnosis of rupture of the medial head of the gastrocnemius (tennis leg)

Purpose The aim of this study is to demonstrate the diagnostic accuracy of ultrasonography (US) in the diagnosis of rupture of the medial head of the gastrocnemius muscle, also called “tennis leg” (TL). Materials and methods Thirty-five consecutive patients with acute traumatic injury of the calf underwent US examination. There were 25 men and 10 women; mean age 47.5 years (range 35–60 years). All examinations were performed using a 5–12 MHz broadband electronic linear array probe. Results Thirty-three out of 35 patients had TL; 24 cases of partial rupture and nine cases of complete rupture were diagnosed. In the remaining two cases, both with symptoms suggesting TL, one patient had a tear of the proximal musculotendinous junction and one had a ruptured Baker's cyst. Fluid collections caused by the muscular rupture were visible as hypoechoic areas; in 80% of cases associated by a hyperechoic oval area due to hematoma and local inflammation. The degree of fluid collection in the patients with complete rupture (6–16 mm; mean: 9.7 mm) was significantly greater than the one seen in patients with partial rupture (4–8 mm; mean: 6.8 mm). Conclusions US is the imaging modality of choice in clinical suspicion of TL, both in the initial workup of the patient and in the follow-up. US is easy to perform and is particularly useful to distinguish TL from other pathologies, especially ruptured Baker's cyst and deep vein thrombosis, which require a different therapeutic management.

Effect of Balloon Dilation of Ureter on Upper Tract Dynamics and Ureteral Wall Morphology

Sixteen male Yucatan minipigs underwent balloon dilation of the right ureterovesical junction (UVJ) and lower ureter to twice its normal caliber. With the bladder open, bilateral upper tract dynamics measurements under different perfusion rates (0.5, 2, and 4 ml/min) were recorded predilation, immediately after dilation, and 1, 2, 3, 4, and 6 weeks after dilation. Immediate and late antegrade nephrostograms, suprapubic cystograms, and right antegrade nephrostograms (oblique view) were taken. In the chronic experiment, no difference in renal pelvic pressure (Ppvs) was detectable between the control and dilated sides immediately after dilation. Only at 4 ml/min was there a statistically significant increase in the Ppvs of the dilated ureter 1 week after dilation when compared with the controls. At 2 weeks, this obstructive change had disappeared. At 3, 4, and 6 weeks, Ppvs of the dilated ureter declined progressively in comparison with the control side, but the difference was not statistically significant. At 6 weeks, Ppvs of the dilated ureter decreased significantly compared with predilation readings only at 4 ml/min. Immediate antegrade radiologic evaluation revealed that 69% of the experimental animals had no extravasation, while 31% showed variable degrees of extravasation, which disappeared completely on late antegrade nephrostograms (6 weeks). Grade 2 reflux occurred in 33% of the experimental animals at 1 week and had disappeared at 6 weeks. Histologic examinations at 1, 2, and 3 weeks revealed a nonhomogeneous pattern of ureteral damage, ranging from total rupture to much less dramatic injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Duplex ultrasound diagnosis of symptomatic proximal deep vein thrombosis of lower limbs

Real time ultrasound (US) was used to examine 165 consecutive inpatients with clinically suspected deep vein thrombosis of lower limbs. In order to evaluate accuracy, the results of non-invasive techniques were compared with ascending venography, performed in all patients. Assessment included only femoro-popliteal veins, because of difficulty in visualizing calf vein with US. Diagnosis of thrombosis was based on noncompressibility of the examined veins; pulsed Doppler provided further information by evaluating blood flow. In our series Duplex ultrasound was very accurate in detecting acute thrombosis of the proximal veins, sensitivity being 97% and specificity 98%. With US it is also possible to detect conditions that mimic deep vein thrombosis, such as muscular rupture, hematoma, popliteal cyst or compressive tumors. In conclusion US is considered a valid alternative to contrast venography in the diagnosis of proximal vein thrombosis of lower limbs.

High resolution real time sonography in sports specific muscle injuries. Sonomorphologic-anatomic correlation and diagnostic criteria

In 250 examinations of 86 patients, high resolution real time sonography with a 7.5 MHz linear transducer proved to be a readily available, low-cost and significantly relevant imaging method in diagnosis and follow-up of muscular lesions in sportsmen. The method offers a high measure of safety in excluding rupture or in enabling differential diagnosis between partial muscular rupture and muscular spasm, so that the choice of treatment can be decisively influenced by sonography. Hence, rapid rehabilitation, which is so essential in competitive sport, is speeded up even further. In extensive ruptures or rupture haematoma, therapeutic ultrasound-guided puncture can be performed or indication for surgery can be facilitated in subtotal or complete tears of a muscle that is important for high-level performance.

Zur Kenntnis der Ätiologie und Pathogenese der Lumbago und änlicher Rückenschmerzen.

Zur Kenntnis der Ätiologie und Pathogenese der Lumbago und änlicher Rückenschmerzen.