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PubMed2000

Investigation of trunk and extremity movement associated with passive head turning in newborns.

BACKGROUND AND PURPOSE: Physical therapist examination of pediatric clients or clients with neurological conditions often includes the observation of stereotypical movement patterns such as the asymmetrical tonic neck reflex and righting reactions. The purpose of this study was to investigate whether extremity and trunk responses to passive head turning could be documented in newborn infants. SUBJECTS AND METHODS: Forty-two newborns with no known medical problems were videotaped within 5 days of birth while an investigator turned their heads left and right. Videotapes were stopped at 5-second intervals to record the direction of head turn with the rest of the body obscured. A second investigator recorded trunk and extremity position with the head obscured. RESULTS: The direction of head turning affected upper- and lower-extremity position, with extension stronger on the face side. The direction of trunk convexity was also affected by head position, with the trunk convex to the side to which the face was turned. CONCLUSION AND DISCUSSION: Extremity responses and trunk responses to passive head turning can be documented corresponding to patterns reported for the asymmetrical tonic neck reflex and righting reflexes in neonates with no known medical problems more frequently than would occur by chance.

Back↗

PubMed2001

[Anatomical study of reconstruction of vertebral artery with neighboring non-trunk arteries].

OBJECTIVE: To study the anatomical basis for reconstruction of vertebral artery with neighboring non-trunk arteries. METHODS: Twenty preserved adult cadavers were used in this study to observe the morphology of superior thyroid artery, inferior thyroid artery, transverse cervical artery, thyrocervical trunk and extracerebral portion of vertebral artery, and reconstruction of vertebral artery with these arteries was simulated in two preserved cadavers. RESULTS: The calibers of superior or inferior thyroid artery, or transverse cervical artery were more than 2 mm in diameter, and the arteries had suitable free length for end-to-side anastomosis with vertebral artery. Thyrocervical artery had similar caliber to vertebral artery so that end-to-end anastomosis could be carried out between them, but only 38.5% of this artery had adequate artery trunk (more than 10 mm). It was proved from the simulated procedures that the reconstruction of vertebral artery with these neighboring non-trunk arteries was possible. CONCLUSION: Reconstruction of vertebral artery with neighboring non-trunk arteries has anatomical basis and can be used clinically for treatment of the lesion affecting the first or second portion of vertebral artery.

Anastomosis, Surgical↗

PubMed1999

Surgical treatment of DeBakey type I aortic dissection using the "elephant trunk technique".

OBJECTIVES: To review the indications, operative methods and postoperative management of the "elephant trunk technique", and to report two cases of DeBakey type I aortic dissection treated with the "elephant trunk technique". METHODS: Two cases of DeBakey type I aortic dissection were operated with selective cerebral perfusion via the right subclavian artery. At the first stage, a tubular dangling aortic graft prosthesis ("elephant trunk") was inserted into the distal aorta while replacing the ascending aorta and aortic arch. The distal elephant trunk prosthesis was then used at the second stage involving the replacement of the sections of the distal aorta via a left-sided thoracotomy. RESULTS: The two operations were successful. Ultrafast computed tomograph (UFCT) showed that the two patients were cured after the first stage operation, and the second stage procedure could have been avoided. CONCLUSIONS: The "elephant trunk technique" is a multiple stage approach in the treatment of extensive aneurysmal diseases of the aorta. The procedure is indicated for patients who have combined diseases of both ascending aorta plus aortic arch segments and descending aortic aneurysm. It can also be used for patients with DeBakey type I aortic dissection. Some patients can be cured after the first stage operation.

Aortic Dissection↗

PubMed2002

Congenital megacolon: diagnosis using size of sub-mucosal nerve trunk as a criteria.

UNLABELLED: Cholinergic hyperinnervation in submucosa of aganglionic segment of Hirschsprung's disease has been described. However, objective measurement of the nerve fibers was insufficiently reported. OBJECTIVES: To study the amount and size of hypertrophic submucosal nerve trunks in the aganglionic segment of Hirschsprung's disease, semiquantitatively and evaluate the possibility of using the size as objective diagnostic criteria. MATERIAL AND METHOD: Thirteen specimens from aganglionic segments from Hirschsprung's disease and six specimens from the age-matched control subjected without colonic innervation disorders were studied with the S-100 immunohistochemical technic. The submucosal nerve trunks were counted per ten HPF and measured in width, semiquantitatively. Fiber sizes were stratified into small (<20 micrometers), medium (20-40 micrometers), and large (>40 micrometers). Maximum fiber size in each specimen was also recorded. RESULTS: Average density of submucosal nerve trunk in the aganglionic segment and the control were 12.5 and 3.4 fibers per ten HPF, respectively. The large nerve trunks were detected in 12 of 13 aganglionic specimens and none was detected in the controls. The maximum fiber size in aganglionic segments was 78.2 micrometers, compared to 24.1 micrometers in the control group. The sensitivity and specificity to set the presence of hypertrophic nerve trunk, larger than 40 micrometers as a diagnostic criteria for Hirschsprung's disease were 92.3 and 100 per cent, respectively. The data suggest the use of this size as an objective diagnostic criterion, which may be valuable in rectal suction biopsy specimens.

Case-Control Studies↗

PubMed1992

Measurement of torque of trunk flexors at different velocities.

The purpose of this study was to determine the test-retest reliability of recording isometric and isokinetic torque of the trunk flexors and to examine the effect of velocity on the torque curves. Thirty healthy subjects were tested on two occasions for isometric torque of trunk flexion at four angles and eccentric and concentric torque at three velocities. Two subjects repeated these tests in the passive mode to determine the torque produced by the trunk when there was no active flexion effort. Intraclass correlation coefficients were above 0.85 for all isometric and isokinetic measures. Standard errors of measurement ranged from 6.9 to 19.5 Nm. Student t-tests indicated no significant differences between occasions for all outcome measures. Examination of passive and active torque curves indicated that the torque produced by the mass of the trunk increased with increasing velocity. It is concluded that both isometric and isokinetic testing of the trunk flexors are reliable, but that testing at higher velocities may not provide a valid measure of muscle performance.

Abdominal Muscles↗

PubMed2004

Lumbar paraspinal electromyographic activity during trunk extension exercises on two types of exercise machines.

The objective of this study was to evaluate and compare lumbar paraspinal muscle activity during trunk extension exercises on two lumbar extension machines with different types of pelvic stabilization mechanisms. Thirteen healthy male (n = 9) and female (n = 4) volunteers aged 21-24 (22.6 +/- 1.4) were recruited in a university setting. Surface electromyographic activity was recorded bilaterally from the L3-4 paraspinal region during trunk extension exercises performed on two different exercise machines. One machine, the MedX, has a complex pelvic stabilization mechanism. The other machine, the Cybex, has a relatively simple pelvic stabilization mechanism. There was no significant difference between lumbar paraspinal electromyographic activity during trunk extension on the MedX compared to the Cybex dynamic variable resistance trunk extension machine. These results suggest that a complex pelvic stabilization mechanism does not significantly enhance the level of activation of the lumbar paraspinal muscles during lumbar extension exercises. Thus, a less expensive trunk extension machine with a less sophisticated pelvic stabilization mechanism, such as the Cybex, can be used to train the lumbar paraspinal muscles. This is important to rehabilitation clinicians because these machines are often more readily available and easier for patients to use. Further research is warranted to determine the applicability of these findings to a patient population.

Adult↗

PubMed2002

Spine deformity correlates better than trunk deformity with idiopathic scoliosis patients' quality of life questionnaire responses.

AIM: To determine whether either spine or trunk deformity measurements correlate with patients quality of life questionnaire responses. MATERIALS AND METHODS: Forty five pre operative patients (5M, 40F), average age 15 years, 9 months (range, 10-20) met the inclusion criteria of age (< or = 20 years), Posterior Trunk Symmetry Index (POTSI) and Suzuki Hump Sum (SHS) determination from surface topography, and Scoliosis Research Society-22 (SRS-22)patient questionnaire completion. Average measurement and measurement ranges were largest Cobb 62 degrees (range, 40-137 degrees), POTSI 49 (range, 17-149), SHS 16 (5-32), and SRS-22 subtotal score 3.86 (range, 4.7-2.35). The individual SRS-22 domain scores were function 4.13 (4.80-2.20), pain 4.01 (5-1.60), self image 3.34 (4.4-1.80) and mental health 4.01 (5-1.80). (Scale 5 Best-1 Worst). Correlations between deformity and questionnaire measurements were determined, p<0.01 considered significant. RESULTS: Spine deformity (Cobb) correlated with the SRS-22 subtotal scores (cc-04207, p<0.005) and with the function and self image SRS-22 domain scores: cc0.5182, p<0.001) and cc-0.3981, p<0.01 respectively. Neither trunk deformity score correlated with the SRS-22 Score: POTSI versus SRS-22 (cc 0.0449, ns) and SHS versus SRS-22 (cc-0.0311, ns) CONCLUSION: Spine deformity correlates well with quality of life questionnaire responses whereas trunk deformity magnitude does not. This is somewhat surprising as it is the trunk deformity that the patient can they themselves see. These findings illustrate the pitfalls of assuming what is important to the patient based on clinical measurements.

Adolescent↗

PubMed2005

Comparison of multifidus muscle atrophy and trunk extension muscle strength: percutaneous versus open pedicle screw fixation.

STUDY DESIGN: This study was conducted by retrospective case selection and prospective observation of longitudinal changes of the multifidus muscle cross-sectional area and of trunk extension muscle strength in percutaneous and open pedicle screw fixations. OBJECTIVES: To compare postoperative multifidus muscle atrophy and trunk muscle performance of percutaneous pedicle screw fixation against those of open pedicle screw fixation. SUMMARY OF BACKGROUND DATA: Recent attempts to combine percutaneous pedicle screw fixation with minimally invasive fusion techniques are based on an anecdotal presupposition that percutaneous pedicle screw fixation is superior to its open counterpart. However, the benefits of percutaneous pedicle screw fixation are currently poorly defined. METHODS: Nineteen enrolled patients were divided as follows: 11 in the open pedicle screw fixation group (OPF group) and eight in the percutaneous pedicle screw fixation group (PPF group). The preoperative and postoperative cross-sectional area and T2-weighted signal intensity of multifidus muscle were measured by MRI, and trunk extension muscle strength was measured. In addition, various clinical variables were compared between two groups. RESULTS: There was significant decrease in the cross-sectional area of multifidus muscle in the OPF group. In contrast, the results in the PPF group showed no statistical difference between preoperative results and that of the follow-up MRI. Although percutaneous pedicle screw fixation had positive effects on postoperative trunk muscle performance, clinical outcomes were not significantly different in areas of pain score, JOA score, and patient's opinion regarding the outcome of the surgery. However, percutaneous pedicle screw fixation caused less blood loss, and the proportion of patients who did not need postoperative oral analgesics was greater in the PPF group. CONCLUSIONS: Percutaneous pedicle screw fixation caused less paraspinal muscle damage than open pediclescrew fixation and had positive effects on postoperative trunk muscle performance.

Aged↗

PubMed2005

[Aneurysms of the pancreaticoduodenal artery in association with stenosis or occlusion of the celiac trunk].

On the basis of an analysis of 69 patients including 2 personal observations the authors discuss the questions of pathogenesis, clinical picture, diagnosis and treatment of aneurysms of the pancreaticoduodenal artery in association with stenosis or occlusion of the celiac trunk (CT). A description of 2 cases with a true not broken aneurysms of the inferior pancreaticoduodenal artery and subocclusion of the celiac trunk is given which was caused by compression of the latter by the median arcuate ligament of the diaphragm and neurofibrous tissue of the celiac plexus. These patients were detected as a result of examinations and operative treatment of 556 patients with compressive stenosis of the celiac trunk for the period from 1982 through 2002. In one case a transcatheter embolization of the aneurysm was fulfilled followed in 3 months by a compression of the celiac trunk, in the other case a compression of the celiac trunk was made first and then in 5 months it was followed by resection of the aneurysm with a favorable outcome.

Adult↗

PubMed2003

Paresthesiae during radiofrequency neurolysis of lumbar sympathetic trunk in CRPS: human evidence of a sympatho-sensory connection?

Radiofrequency heat lesioning has been advocated to prolong the duration of therapeutic effect of lumbar sympathetic block in Complex Region Pain Syndrome (CRPS) of the lower extremity. Prior to radiofrequency lesioning of the lumbar sympathetic trunk, sensory and motor stimulation may be used to verify that the active needle tip is not adjacent to a spinal nerve to avoid unwanted neural injury. However, the value of sensory stimulation to aid in precise needle positioning at the desired target remains controversial. In this report we describe our observations using sensory stimulation to aid in needle placement for radiofrequency lesioning. We confirm a novel observation that paresthesiae to the lumbar sympathetic trunk is possible and hypothesize on pathophysiologic meaning. Two representative patients are presented who underwent sensory stimulation of the lumbar sympathetic trunk during needle placement for lumbar sympathetic radiofrequency neurolysis. Sensory stimulation was elicited at the L3 or L4 vertebral level using a 15 cm insulated radiofrequency needle with a 5-mm active tip. During sensory stimulation, patients described paresthesiae to the ipsilateral buttock and lower extremity. Stimulation intensity was less than 0.8 V at 50 Hz at impedance of 300 Ohms or less. Motor stimulation did not occur up to the maximum voltage tested (2.0 V at 2 Hz) Sensory stimulation of the lumbar sympathetic trunk may be used to aid in localization of the active tip of the radiofrequency needle, in preparation for lesioning. A dermatomal sensory pattern was observed, suggesting that afferent sensory fibers travel in the lumbar sympathetic trunk. The implications of this observation for understanding the mechanism of CRPS-related pain are discussed.

Journal Article↗

PubMed2006

Numerical variation of the celiac trunk and anatomical variation in origin and course of the dorsal pancreatic artery.

A numerical anomaly of the celiac trunk and anatomical variation in origin, and course of the dorsal pancreatic artery were encountered during a routine upper abdomen dissection of a 62-year-old male cadaver. The aim of this study was to describe a rare celiac trunk and dorsal pancreatic artery variation in detail, which can be a guide and precaution during operative procedures in this region. The abdominal aorta, its branches and the pancreas were cut and removed just above the celiac trunk and below the superior mesenteric artery to investigate the vascular distribution of the pancreas in detail. The celiac trunk divided into the left gastric, hepatic, splenic, and dorsal pancreatic arteries. The anatomical variation of the celiac trunk and splenic artery makes it vulnerable to iatrogenic surgery. Knowledge of the existing aberrations is important in planning and conducting surgical procedures.

Cadaver↗

PubMed2006

Trunk rotational strength training for the management of adolescent idiopathic scoliosis (AIS).

Quantified trunk rotational strength training has shown promise as a non-operative management option for individuals with AIS. The purposes of our study are to test whether a quantified trunk rotational strength training protocol can increase trunk strength and stabilize or decrease curve size. Seven adolescents with AIS (5 female 2 male; mean 14 yrs +/- 2.6 yrs; mean Cobb 28 degrees +/- 6 degrees range 20 degrees -37 degrees) underwent four months of supervised trunk rotational strength training, and repeat strength test. Trunk strength in both directions increased significantly after training (p<0.05). Average Cobb angle decreased to 23 degrees +/- 11 degrees (range 6 degrees -35 degrees). Four individuals showed reduction (>5 degrees) in their original curve, and 3 remained the same (+/-5 degrees). The strength training protocol significantly increased isometric rotational strength and scoliosis was stabilized short term.

Adolescent↗

PubMed1988

Avoidable complications of resection of major nerve trunk neurofibromas and schwannomas.

Neurofibromas and schwannomas of major nerve trunks may present with a variety of symptoms and other clinical concerns. These include: (1) the question of malignancy, (2) pain and paresthesias, (3) cosmesis, and (4) symptoms and impending problems related to compression of adjacent structures. For these reasons, patients with neurofibromas and schwannomas may have valid reasons for surgery. Precise delineation of the anatomical relationships of the lesions and their location within peripheral nerve trunks is essential for decision making regarding when and how they should be excised; judgement regarding risks vs. benefits must be made carefully. Microsurgical dissection can be utilized to remove some nerve trunk lesions with preservation of most or all motor and sensory functions. An important goal in resecting benign lesions is to avoid sacrificing major motor and sensory functions. Three cases are presented to illustrate these concepts: 2 cases with significant motor loss following partial resection of large neurofibromas involving peripheral nerve trunks and 1 case with a large femoral nerve neurofibroma excised from the nerve trunk with microsurgical dissection, leading to relief of symptoms and complete preservation of motor function.

Adult↗

PubMed1986

The distribution and significance of aberrant ganglion cells in the facial nerve trunk of the cat.

The distribution and peripheral connections of aberrant ganglion cells in the facial nerve trunk of the cat were studied by means of Klüver-Barrera staining and retrograde transport of horseradish peroxidase (HRP). By the Klüver-Barrera staining, aberrant ganglion cells were observed in the facial nerve trunk between the geniculate ganglion and the junction of the auricular branch of the vagus with the facial nerve trunk, although the number varied considerably with each animal. These cells were generally medium-sized and of round or oval shape, with densely stained Nissl substance, the features of which were essentially similar to those of the geniculate ganglion. In cases where HRP injections were made into the anterior wall of the auricle, several HRP-labeled cells were found ipsilaterally in the facial nerve trunk in addition to cell labeling of the geniculate ganglion. The present study in the cat demonstrated that at least some of the aberrant ganglion cells scattered in the facial nerve trunk are parental to the axons to the auricle, subserving the cutaneous sensory function.

Animals↗

PubMedDate not supplied

Optical measurement of the change in trunk volume with breathing.

Optical mapping provides three-dimensional information about the size and shape of the trunk. We have used the technique to measure and partition the volume change of the trunk with breathing in upright subjects. In 13 subjects, 12 of whom were normal and one scoliotic, respired volume could be measured with an average error (+/- SEM) of 170 +/- 20 ml. In one of the normal subjects, 24 measurements of respired volume were in error by, on average, 120 +/- 20 ml. In a further eight normal subjects, partitioning of ventilation showed that the anterior trunk contributed 91 +/- 12%, the back 9 +/- 12%, the upper trunk 43 +/- 4%, the lower trunk 57 +/- 4% and the right and left sides 50 +/- 2% each, to a vital capacity expiration. The measurements of respired volume suggest that the technique is sufficiently accurate for clinical purposes, but it offers the added advantage that the information generated can be used to determine the spatial distribution of each breath.

Adult↗

PubMed1978

[Hemodynamic disorders resulting from angiography (selective arteriography of the celiac trunk and splenoportography) (author's transl)].

The hemodynamic disorders resulting from the selective arteriography of celiac trunk and splenoportography were studied in 30 dogs. The systemic blood pressure and peripheral pulse rate were considered in these instants: before, during, immediately after and 10 minutes after the angiographic procedures. The analysis of the results obtained permit to conclude that: a) catheterism of the celiac trunk only, increase the systolic systemic blood pressure but does not change the dyastolic; b) during the injection of the contrast medium in the celiac trunk there is an increase of the systemic blood pressure (systolic and dyastolic); c) the selective arteriography of the celiac trunk as well as the splenoportography cause decrease of the systemic blood pressure (systolic and dyastolic) immediately after (1 to 70 seconds) the procedure; d) the decrease of the systemic blood pressure (systolic and dyastolic) is greater after the arteriography than after the splenoportography; e) the decrease of the systemic blood pressure (systolic and dyastolic) is transitory; 10 minutes after the realization of angiographies the systemic blood pressure return to the values observed before the examination; f) selective arteriography of the celiac trunk as well as splenoportography cause decrease of the peripheral pulse rate 10 minutes after the realization of the angiographic procedures.

Angiography↗

PubMed1984

Physical properties of the human trunk as determined by computed tomography.

The purpose of this study was to determine the center of mass of the trunk in living subjects by using computed tomography (CT), thus providing more accurate data to aid scientists in their effort to describe human motion quantitatively. This advanced x-ray was used to analyze the trunk segment of four subjects, two men and two women, ranging in age from 46 to 68 years. Scans were taken at 1 cm intervals, from the level of the superior surface of the pubic symphysis to the suprasternal notch. Data were processed by an on-line computer, with the object represented on photographic film as a gradient image of gray levels. The intensity of the gray scale in each cross-sectional scan corresponded to a particular density of human body tissue. The computer program was capable of interpreting this information, thereby providing values for the center of mass, tissue density, segmental mass, and volume. The study's conclusions are based on data obtained from living subjects which may be representative of the general adult population. We found that the mean center of mass of the trunk segment was 49.35% of the total length as measured from the line joining the greater trochanters across the superior surface of the pubic symphysis to the suprasternal notch. Furthermore, the segmental mass of the trunk segment was found to be 52.58% of total body weight. These data differ from trunk cadaveric studies already published.

Aged↗

PubMed1980

Caliber and elastin content of the pulmonary trunk.

Internal diameter, thickness of media, and surface density of elastin in media of both pulmonary trunk and aorta were determined in a random group of 100 adults. Because of contrasting results of histologic vs chemical studies of the amount of elastin in the pulmonary trunk, we have used a television image analyzer for objective determination of surface density of elastin in histologic slides, applying the same method to the aorta for comparison. Both caliber and medial thickness of the pulmonary trunk increase somewhat with age. The surface density of elastin in the pulmonary trunk is not influenced by age and averages approximately 26%, with considerable individual variation. In patients with pulmonary hypertension, this percentage is consistently higher. We conclude that the decrease in extensibility of the aging pulmonary trunk is caused by changes in physical properties of the constituents of its wall, rather than by a decreasing elastin content.

Adolescent↗