Acromegaly: histochemical and electron microscopic changes in deltoid and intercostal muscle.
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The susceptibility and distribution of Trichinella spiralis infection in goats were examined in ten autochthonous kids, 2 months old and about 10 kg body weight. The animals were divided into two groups: one experimental group with eight animals, infected with 10,000 T. spiralis 'T1' encysted larvae and a control group with two non-infected animals. All the animals of the experimental group infected by the parasite showed that Trichinella larvae have a special affinity for the tongue, masseters, diaphragm, flexor-extensor muscles, intercostal muscles and myocardium in decreasing order. The ELISA test carried out showed the first increments of optical density (OD) on Day 16 postinfection (p.i), peaking on Days 37-44 p.i. and remaining elevated from this day on, with a slight fall at the end of the experiment (Day 90 p.i.). No alterations were observed in the OD obtained in control animals throughout the experiment. The great muscular establishment of T. spiralis larvae and the sigmoidal evolution of antibody levels confirm the host character of the goat to the parasite.
A spark sound was generated in the canine bronchus and sound waves were observed on the surface (skin) and on each layer (pectoralis major muscle, intercostal muscle and parietal pleura) of the chest wall. The sound wave observed on the surface of the chest wall was 5-10 ms in duration, 400-500 Hz in dominant frequency and 0.6-1.2 ms in the duration of the initial deflection. Reverse dispersion of the waves, i.e., the later components of the wave having longer periods, was also recognized. These characteristics of the wave were similar to those of time-expanded wave-form of crackle, i.e., discontinuous adventitious lung sounds, in clinical cases. Both the spark sound and the sound wave observed on the visceral pleura were of short duration, being 0.7 ms and 1 ms, respectively. therefore, the main component of the sound wave observed on the chest surface was considered to reflect the physical properties of the chest wall itself. The analysis of place relationship within the chest wall suggested that transmission of the sound across the chest occurred not as a surface wave but as a longitudinal wave, therewith traversing the chest wall directly from the sound source. The arrival time of the sound was well correlated with the distance between the sound source and the positions of the pick-ups on the surface of the chest wall. Assuming that the medium between the source and the lung and in the chest wall were 71.5 and 29.6 m/sec, respectively. Further studies will be necessary to clarify the theory of the sound transmission through the living tissue as a viscoelastic body.
Several three-dimensional (3D) finite element (FE) models of the human body have been developed to elucidate injury mechanisms due to automotive crashes. However, these models are mainly focused on 50(th) percentile male. As a first step towards a better understanding of injury biomechanics in the small female, a 3D FE model of a 5(th) percentile female human chest (FEM-5F) has been developed and validated against experimental data obtained from two sets of frontal impact, one set of lateral impact, two sets of oblique impact and a series of ballistic impacts. Two previous FE models, a small female Total HUman Model for Safety (THUMS-AF05) occupant version 1.0Beta (Kimpara et al. 2002) and the Wayne State University Human Thoracic Model (WSUHTM, Wang 1995 and Shah et al. 2001) were integrated and modified for this model development. The model incorporated not only geometrical gender differences, such as location of the internal organs and structure of the bony skeleton, but also the biomechanical differences of the ribs due to gender. It includes a detailed description of the sternum, ribs, costal cartilage, thoracic spine, skin, superficial muscles, intercostal muscles, heart, lung, diaphragm, major blood vessels and simplified abdominal internal organs and has been validated against a series of six cadaveric experiments on the small female reported by Nahum et al. (1970), Kroell et al. (1974), Viano (1989), Talantikite et al. (1998) and Wilhelm (2003). Results predicted by the model were well-matched to these experimental data for a range of impact speeds and impactor masses. More research is needed in order to increase the accuracy of predicting rib fractures so that the mechanisms responsible for small female injury can be more clearly defined.
Electrophysiologic examination of dorsal spinal cord injury (DSCI) is focused on transcranial magnetic stimulation induced motor evoked potentials. It were recorded at thenar muscles, exector spinae muscle, intercostals muscle, and internal oblique muscles. In complete spinal cord injury, the exector musle motor evoked potentials may occur although clinically that muscle shows no recovery. The ipsilateral exector and internal oblique muscles may be distributed by non-cross fibers in cerebrospinal tract. The progress in clinical sensory examination includes cutaneous electrical perceptional sensory threshold and quantitative sensory test. The former is more sensitive than two-points discrepentive test. Quantitative sensory test includes light touch threshold, vibration perceptual threshold, thermal threshold, pain, and cutaneous axon flare respone. It has been used in DSCI patients above and below the injury level. The thermal threshold elevates above the injury level in complete and incomplete DSCI patients.
In 22 patients (19 men, 3 women; mean [+/- SD] age, 63 +/- 6 years) with chronic obstructive pulmonary disease (COPD), phosphorus content was measured by spectrophotometric methods on muscle fragments of both peripheral (quadriceps femoris needle biopsy in 22 patients) and respiratory muscles (external intercostal muscle surgical biopsy in 14 patients). Thirty age- and sex-matched subjects were used as controls (19 for quadriceps femoris muscle biopsy and 11 for intercostal muscle biopsy). Serum phosphorus levels, as well as the main determinants of overall phosphorus metabolism (dietary intake of phosphorus and renal phosphate handling), were also obtained in all patients and control subjects. Muscle phosphorus content of both respiratory and peripheral muscles was significantly reduced in the COPD patient group, no matter what reference index was used (fat-free dry muscle weight or muscle fragment DNA content); muscle phosphorus depletion was present in about 50 percent of patients with COPD. In the same patient group, a significant relationship between muscle and serum phosphorus levels was demonstrable in the case of peripheral muscles only. No relationship was found between phosphorus content of both types of skeletal muscles and dietary phosphorus intake levels or with nutritional status, even though patients with COPD had significantly reduced anthropometric, biochemical, and immunologic indices as compared with controls. Renal phosphorus handling indices of the COPD patient group were compatible with a condition of inadequacy of the renal compensatory mechanism to hypophosphatemia and phosphorus depletion (low percent tubular reabsorption of phosphorus, low renal threshold concentration values). Our study suggests that phosphorus depletion occurs frequently in COPD, but in this clinical condition serum phosphorus levels are not representative of cellular phosphorus levels. Phosphorus depletion, which is equally severe in respiratory and peripheral muscles, could depend, at least in part, on malnutrition and a condition of renal phosphorus wasting possibly linked to some drugs commonly used in patients with COPD (xanthine derivatives, diuretics, etc).
Malignant hyperthemia, which can be initiated in susceptible humans and swine by the volatile anesthetic halothane, appears to result from abnormal responses in skeletal muscle. We have inferred the primary defect in susceptible muscles by observing their responses to certain drugs. Furthermore, we compared the responses of cut muscle cell preparations, such as those used in the diagnostic caffeine test, with those of intact muscle cells. Specifically, we investigated the effects of halothane, caffeine, succinylcholine and catecholamines on the mechanical properties of intact muscle cells from normal pigs, mice and frogs and susceptible pigs. The results from intact and paired cut cell preparations were qualitatively similar. Halothane (2%) caused a 30% decrease in peak tetanic tension in susceptible porcine muscle but less than a 10% change in other muscles. Halothane potentiated twitch tension in frog and susceptible pig muscle. The latter was 4 times more sensitive to caffeine twitch potentiation than normal muscle. Porcine intercostal muscles were more sensitive to caffeine than limb extensor muscles and the difference between normal and susceptible muscle was less with intercostal muscles. Succinylcholine and catecholamines had small and opposite effects on porcine muscles; when used together in combination with halothane there was little effect on normal muscle but a dramatic decrease in tetanic tension and rapid onset of contracture in susceptible muscle.
In biopsied intercostal muscle from six patients with Eaton-Lambert syndrome, we measured acetylcholine content and release and choline acetyltransferase. Both the spontaneous and the KCl-evoked release of acetylcholine were abnormally low. On the other hand, the acetylcholine content and the level of choline acetyltransferase activity were within the range of values earlier found in healthy human intercostal muscle. These results are consistent with the view that the defect in this syndrome lies not in the synthesis or storage of the transmitter but in the mechanism of release itself.
The configuration and motion of the bony rib cage were studied from lateral chest roentgenograms in 10 young normal subjects (YN), 12 elderly normal subjects, and 12 hyperinflated emphysematous patients [chronic obstructive pulmonary disease subjects (COPD), mean total lung capacity (TLC) 133% of predicted]. The acute angles formed by the fourth through seventh ribs with an axial reference plane were measured at residual volume, functional residual capacity, and TLC in both supine and standing positions and correlated with corresponding lung volumes. both rib angles (RA) and changes in RA with lung volume were greatest with the fourth rib and decreased progressively going down (caudad) the chest. At TLC the RA of upper ribs was significantly less in EN and significantly greater in COPD than in YN. RA's were greater supine than standing. When RA information was used together with autopsy data on the angles formed by intercostal muscles with adjacent ribs, intercostal muscle lengths in hyperinflation could be calculated. Computed intercostal muscle length data suggested that hyperinflation should not be associated with degrees of intercostal muscle shortening or overstretching, that would interfere seriously with tension generation.
A 61-year-old man with pulmonary emphysema was admitted due to acute exacerbation of chronic respiratory failure and a complaint of chest pain. A chest CT scan on admission showed aneurysmal dissection from the ascending aorta to the descending aorta. Analgesia was noted below the fourth thoracic vertebra, which supplies the accessory respiratory muscles including the intercostal muscles. Even after recovery from circulatory failure, his chest muscles were weak and he could not be removed from mechanical ventilation. An autopsy revealed ischemia of the spinal cord at the T4 level. In contrast, The C3 level of the spinal cord, which supplies the diaphragm, was intact. Paralysis of accessory respiratory muscles including intercostal muscles may have caused the continuation of the respiratory failure. This case shows the importance of accessory respiratory muscles in maintaining chest wall movement in patients with chronic pulmonary emphysema.
It was shown that during muscular exertion the diaphragm muscle and the intercostal muscles utilize endogenous glycogen whereas only the diaphragm muscle utilizes endogenous triglycerides. The post-excercise glycogen repletion in the diaphragm muscle was much faster than in the intercostal muscles. In the diaphragm muscle, marked overshoot of the glycogen level occurred early after the exercise.
At the rostral level of the thorax, the intercostal muscles participate both in postural and respiratory functions to a variable degree depending upon the considered muscle: external intercostal, intercartilaginous, internal intercostal, and triangularis sterni. In order to determine if these physiological properties are related to a special organization at the spinal cord level, we have used the retrograde transport of horseradish peroxidase as a tool for studying the spinal distribution of intercostal motor cells in the adult cat. Results suggest that the intercostal motoneurones could be distributed, in the ventral grey horn, among two areas according to the respiratory or postural muscle specialization.