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PubMed1980

Comparison between the delayed outward current in slow and fast twitch skeletal muscle in the rat.

1. A comparison of the delayed outward current of isolated fibres from rat soleus and iliacus muscle has been made using a double sucrose-gap voltage-clamp method. 2. The fast and slow components of the outward current were separated using time constants of the tail currents. The results indicate that in both iliacus and soleus fibres there is a shift in reversal potential which depends on the quantity of current that flows during depolarization. 3. The shift is larger in iliacus than in soleus; it is absent in glycerol-treated muscles. 4. The results obtained in normal and in detubulated fibres show that the shift is due to an accumulation process of potassium ions in the lumen of the T-tubules. 5. In detubulated soleus fibres the outward current is composed of a fast and a slow component, each with the same reversal potential; in detubulated iliacus the slow component is absent. 6. In both types of muscles TEA produces a dose-dependent block of the total outward current. 4-aminopyridine has different effects; it inhibits the total outward current in iliacus fibres and only the fast component in soleus fibres. 7. These results show that in soleus fibres a fast and a slow component participate in the potassium outward current, while only a fast component is present in iliacus muscle.

Aminopyridines↗

PubMed2003

Retro-sartorius bypass in the treatment of graft infection after peripheral vascular surgery.

Extra-anatomic bypass is preferred for revascularization after removal of infected vascular grafts. The obturator canal technique has been used to bypass an infected field in the groin, although this method has not always been definitive because of several drawbacks. We present a unique method of extra-anatomic revascularization for use in such a situation. An autogenous graft is placed just below the sartorius muscle in the thigh and penetrates the iliacus muscle near the lateral end of the inguinal ligament. Limb loss and recurrent infection are prevented postoperatively. This retro-sartorius bypass technique may be a useful alternative to obturator bypass grafting in selected patients.

Aged↗

PubMed2001

Primary skeletal muscle lymphoma presenting as refractory cellulitis.

The right torso of a 55-year-old woman showed diffuse skin and soft-tissue changes suggestive of cellulitis. However, several clinical and radiologic features, including the subacute and non-toxic nature of the illness and the patient's lack of response to antibiotic therapy, indicated a noninfectious etiology. Malignancy was suggested by striking changes seen on computed tomographic scanning--including extensive infiltration and enlargement of the musculature of the right shoulder girdle, the intercostal musculature, the latissimus dorsi, and the rhomboids; focal enlargement of the right paraspinal muscles; and enlargement of the psoas and the iliacus muscles and of the musculature around the hip joint. The mediastinal, hilar, and paraaortic regions showed no adenopathy. A large hypodense lesion of approximately 4.5 cm, which was seen in the caudate lobe of the liver, raised the concern of a metastatic focus of malignancy. Because of these findings, an immediate muscle biopsy was performed. Results showed a non-Hodgkin's lymphoma with a B-cell phenotype. Although primary skeletal muscle lymphoma is very uncommon in patients without human immunodeficiency virus infection, clinical presentation of refractory cellulitis, as seen in the current case, is extremely rare.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1991

[Femoral nerve lesion in heparin therapy].

Two case reports on femoral nerve lesion due to hematoma in the iliopsoas muscle or as the case may be in the iliacus muscles on both sides are presented with review of the literature. Synopsis of the reported cases--certainly a minority of anticoagulant therapy complications nevertheless increasingly mentioned in the literature--suggests that there might be a higher risk of bleeding for women within the first week of so-called high-dose heparin therapy. Coagulation studies do not contribute essentially in preventing retroperitoneal haematoma since they are within therapeutic limits in many cases. So clinical observation is crucial in the diagnosis of this complication of heparin therapy, which might occur more frequently under concomitant administration of acetacylic acid. Early surgical decompression of the femoral nerve seems to provide better results seen on follow-up than conservative treatment, especially in patients with rapid onset of severe limb weakness.

Blood Coagulation Tests↗

PubMed1978

Ionic currents in mammalian fast skeletal muscle.

1. The double sucrose-gap technique has been applied to rat skeletal muscle fibres to study the ionic currents under voltage-clamp conditions. 2. The iliacus muscle was found to be of 'fast' type according to the characteristics of the twitch generated by an action potential. 3. Micro-electrode measurements have shown that the intracellular potential is under good control even when an inward current develops. 4. The components of an equivalent circuit with two time constants have been estimated from the records of the capacitive current. 5. In rat muscle, between 15 and 21 degrees C, inward and outward currents are similar to sodium and potassium currents found in frog muscle at lower temperature (1--3 degrees C). 6. The inward current which depends on [Na]o and is abolished by tetrodotoxin is carried by sodium ions. Related to the mean value for the holding potential (-90.5 mV) this current reaches its maximum amplitude a +40 and +50 mV, reverses between +130 and +150 mV and its half inactivation occurs between +14 and +22 mV. The effect of low doses of tetrodotoxin suggests that two components participate in the sodium current. 7. The delayed outward current which shows inactivation is divided in two components: (i) the fast has a linear instantaneous current-voltage relation and differs from the fast component of frog muscle in that its equilibrium potential is more negative than the resting potential; (ii) the slow has a linear instantaneous current-voltage relation and the mean value for its equilibrium potential is 26 mV less negative than the resting potential. 8. Inward-going rectification is present in rat muscle.

Action Potentials↗

PubMed1996

Iliacus pyomyositis mimicking septic arthritis of the hip joint.

The iliacus muscle is closely associated with the psoas muscle, femoral nerve, hip joint, pelvic and intraabdominal structures; thus, its disorders may present as lower abdominal pain, hip pain, or femoral neuropathy. Iliacus pyomyositis, a primary bacterial infection of the skeletal muscle not secondary to a contiguous skin, bone, or soft-tissue infection, presenting as hip pain, femoral neuropathy, and sympathetic effusion of the hip joint in an 8-year-old boy mimicked septic arthritis of the hip joint. Computed tomography was helpful in delineating the accurate location of the lesion. Surgical drainage and appropriate antibiotic therapy led to complete resolution and full functional recovery.

Arthritis, Infectious↗

PubMed2002

Examination of the variations of lateral femoral cutaneous nerves: report of two cases.

The origins, courses and relations of lateral femoral cutaneous nerves (LFCNs) were examined bilaterally in 28 cadavers, and the variations were observed in two. On the right side of one cadaver, the ventral rami of the first and second lumbar spinal nerves were united and then this nerve was divided into four branches. From medial to lateral, these branches were the obturator nerve, the femoral nerve, the medially located LFCN and the laterally located LFCN. On the left side of another cadaver, there were three LFCNs. All of these nerves pierced the psoas major muscle anterolaterally. Two of these nerves, which pierced the psoas major muscle more proximally than the third, united with each other by a communicating branch anterior to the iliacus muscle. These types of variations are very important, especially in the presence of paresthesias or pain in the anterior thigh, lateral thigh and gluteal region. In these cases, surgeons must always remember the possible variations of the LFCN during surgical procedures in order to prevent injury and the occurrence of meralgia paresthetica.

Bone Transplantation↗

PubMed1989

[The "3-in-1" block: myth or reality?].

The technique described by Winnie in 1973 is supposed to provide a regional block of the femoral, femoral cutaneous, and obturator nerves by a single injection within the femoral nerve sheath. This study aimed to assess the diffusion spaces for the local anaesthetic solution used in this technique. The anatomical study included the dissection of 2 adult and 1 foetal cadavers. It was associated with a radiographic study in adult volunteers. About 20 to 60 ml of an isotonic radiographic contrast (iopamidol 150) were injected into the femoral nerve sheath located with the help of a nerve stimulator. Standard pelvic radiographs and computerised tomographic scans were carried out at the time of injection, and 30 min later. Two different unpredictable distributions were found; which were independent of the injected volume. One type consisted in an internal diffusion towards the psoas major muscle, the liquid thus reaching the three nerves. The other type was an external diffusion, in front of the iliacus muscle, the liquid never reaching the internal side of the psoas major muscle, and therefore the obturator nerve. The "3 in 1" block would therefore seem to be useful for those surgical acts requiring only a block of the femoral and femoral cutaneous nerves, i.e. those involving the anterior aspect of the thigh and knee, the femoral shaft, and the patella. On the other hand, its usefulness for surgery of the hip (dislocation, fractured neck of femur) is rather uncertain.

Adult↗

PubMed2006

Femoral nerve palsy after mandibular reconstruction with microvascular iliac flap: a complication under anticoagulation therapy.

Pharmacological prophylaxis and intervention are used extensively in head and neck reconstructions with microvascular flaps. There is no universally accepted protocol, but the microvascular surgery literature recommends intraoperative anticoagulation with heparin. Here is reported a case of iliacus haematoma with subsequent femoral nerve palsy after the harvest of a microvascular iliac flap for mandibular reconstruction in a patient who had been treated with heparin. The association between femoral nerve palsy and anticoagulant therapy has been well described. It remains unclear as to why the iliacus muscle is particularly vulnerable to intramuscular haemorrhage. Femoral nerve neuropathy is also an uncommon but recognized complication after abdominopelvic surgery. Iliacus haematoma secondary to microvascular surgery has not been previously reported. This case illustrates the need to be aware of this type of complication and its clinical manifestations for patients under anticoagulant therapy in the perioperative period during microvascular reconstructions.

Adult↗

PubMedDate not supplied

Muscular amyloidoma presenting as inguinal masses in multiple myeloma.

We report a case with protruding inguinal masses for 6 months, in whom muscular amyloidoma was not suspected before muscle biopsy. On pelvic magnetic resonance imaging (MRI), round masses showing peripheral rim enhancement with gadolinium were observed in iliopsoas and iliacus muscles of both inguinal areas. The same lesions were also observed in gluteus muscles. The biopsy showed Congo red positive materials in a dense fibrous background. Serum and urine electrophoresis showed Bence Jones protein, lambda type. In bone marrow section, myeloma cells were found. Peripheral blood stem cell transplantation (PBSCT) following four cycles of VAD (vincristine, adriamycin, dexamethasone) chemotherapy was performed and the result was satisfactory. Amyloidoma lesions decreased in size and number on the following MRI.

Abdominal Wall↗

PubMedDate not supplied

Fate of the psoas muscle after open reduction for developmental dislocation of the hip (DDH).

We evaluated the anatomic and functional consequences of psoas lengthening during operative intervention for developmental dislocation of the hip (DDH). Possible anatomic changes were assessed by magnetic resonance imaging (MRI), and functional assessment included strength determination by an isokinetic dynamometer and gait analysis. Six girls and one boy, ranging in age from 15 to 20 months, had operative reduction of a unilateral DDH. One closed and six open reductions (three anteromedial and three anterolateral approaches) were performed. Follow-up ranged from 4 years 0 months to 9 years 2 months. The cross-sectional area determined by MRI of the lengthened psoas muscles was markedly reduced for all of the six open-reduction patients (three moderate and three severe). Atrophy of the iliacus muscle also was apparent by MRI in five of the six open-reduction patients. Maximum flexion torque, as determined by the isokinetic dynamometer, was diminished on the DDH side for the three patients whose hips were reduced open through the anteromedial approach. Average hip-flexion torque over the entire range of motion was decreased for both anteromedial and anterolateral groups on the operated-on side. Lengthening of the psoas tendon during open reduction of a DDH is associated with considerable atrophy of the psoas muscle.

Atrophy↗

PubMed2005

Femoral nerve palsy secondary to traumatic pseudoaneurysm and iliacus hematoma.

The authors report a case of traumatic femoral nerve palsy caused by a pseudoaneurysm of the iliolumbar artery and a iliacus muscle hematoma. This case report details not only the classic history and physical findings seen in patients such as this one, but also illustrates an unusual source of the hematoma and a discussion of its treatment. A 20-year-old man was assaulted and presented to the authors's institution with a 1-week history of severe pain in the left anterior thigh and groin, weakness in the left quadriceps muscle, and numbness in the anterior thigh and medial distal leg. Imaging studies demonstrated a large, 9.4 x 6.4 x 5.2-cm iliacus hematoma as well as a pseudoaneurysm originating from the left iliolumbar artery. The patient underwent angiographic embolization of the pseudoaneurysm followed by surgical evacuation of the hematoma. The embolization was performed before surgery to prevent any possible rebleeding from the pseudoaneurysm during evacuation of the hematoma. Femoral nerve palsy caused by traumatic iliacus hematoma is an infrequent diagnosis often missed because of its insidious presentation. In this case, embolization of the iliolumbar artery pseudoaneurysm followed by surgical evacuation of the hematoma resulted in a nearly full recovery of the femoral nerve as of the last follow-up examination.

Adult↗

PubMed2005

Spontaneous rupture of the distal iliopsoas tendon: clinical and imaging findings, with anatomic correlations.

We report the clinical and imaging findings in two elderly female patients with spontaneous rupture of the distal iliopsoas tendon from the lesser trochanter of the femur. We emphasize the key contribution of magnetic resonance (MR) imaging to this diagnosis and provide an anatomic correlation. Spontaneous rupture of the distal iliopsoas tendon should be kept in mind in the differential diagnosis of acute groin pain in the elderly. MR imaging enables positive diagnosis, by showing mass effect on the anterior aspect of the hip joint, proximal muscle thickening, and abnormal signal intensity, and by demonstrating interruption of the psoas tendon, whereas the distal insertion of the lateral portion of the iliacus muscle remains muscular and is preserved.

Aged↗

PubMed1980

Ionic currents in slow twitch skeletal muscle in the rat.

1. The ionic currents in slow fibres isolated from rat soleus muscle have been studied under voltage-clamp conditions with a double sucrose-gap method and the results are compared to those obtained from fast fibres isolated from the iliacus muscle. 2. The mean value of the resting potential in slow fibres is -70 mV. a value 8 mV more positive that the mean resting potential of fast fibres (-78 mV). 3. In slow muscle, a fast inward current which is blocked by tetrodotoxin and which depends on external sodium concentration is presumed to be carried by sodium ions. The characteristics of this current, which are time- and voltage-dependent, are similar to those of the iliacus fibres. From a holding potential at -86 mV, this inward current is maximal (2.6 mA/cm2 +/- 0.3) at +49.1 mV +/- 1.5 (mean +/- S.E. of mean), reverses at +127.3 mV +/- 2.2 (mean +/- S.E. of mean), and its half inactivation occurs at +23.2 mV +/- 0.8 (mean +/- S.E. of mean). 4. The delayed outward current in slow fibres is unchanged by exposure to chloride free solution and has a time course very different from that found in fast fibres. This current reaches an initial peak in 5-10 msec and a second peak or steady level after 40-150 msec. The decay of the outward current is also very different, being ten times slower than that in fast fibres (1500-3000 msec). 5. Analysis of the tail currents reveals the existence of two components of delayed current in slow fibres. The faster component reverses at a potential of 11.3 mV +/- 0.9 (mean +/- S.E. of mean) positive to the holding potential (equivalent to a membrane potential of about -75 mV), in contrast to a reversal potential of 35.4 mV +/- 2.5 (mean +/- S.E. of mean) positive to the holding potential for the slower component (equivalent to a membrane potential of about -51 mV. 6. In L-glutamate solution the characteristics of the inward-going rectification are the same in the two types of muscle.

Animals↗

PubMed2001

Subacute femoral compressive neuropathy from iliacus compartment hematoma.

BACKGROUND: Traumatic retroperitoneal hematoma in the iliacus muscle is an unusual but potentially serious cause of femoral compression neuropathy. CASE REPORT: We describe the clinical, imaging, and management features of a case of traumatic iliacus retroperitoneal hematoma with delayed manifestation of femoral neuropathy. DISCUSSION: The anatomical substrate for hematoma formation with subacute compression of the femoral nerve is emphasized. A subacute compartment syndrome with progressive edema, swelling and ischemia of iliacus compartment is suggested as the underlying cause. Early fasciotomy with or without hematoma evacuation should be considered in order to provide rapid decompression and to minimize the chance of permanent nerve injury.

Adolescent↗

PubMed1988

A quantitative assessment of microvessel ultrastructure in C6 astrocytoma spheroids transplanted to brain and to muscle.

Normal blood vessels invading a growing neoplasm undergo dramatic changes in morphology. Whether vessel characteristics are dictated entirely by the tumor, or from developmental restrictions in normal vessels from which tumor vessels originate is not known. To address this question we challenged two morphologically different types of capillaries (brain and muscle) with the same tumor environment (C6 astrocytoma), and quantified the invading vessel morphology. A vascular spheroids of C6 astrocytoma cells were implanted singly into rat cerebral cortex or iliacus muscle. Microvessels from the tumor, peritumoral tissue and control tissue were examined ultrastructurally and quantified. Tumor vessels differed significantly from host vessels but not from each other, regardless of implantation site. Neoplastic vessels were thick-walled relative to normal host vessels, had low densities of mitochondria and vesicular structures, and had both fenestrations and enlarged junctional clefts characteristic of highly permeable vessels. Control brain vessels were typically thin-walled, had a high density of mitochondria, a low density of endothelial vesicles and continuous tight junctions. Control muscle vessels were thin-walled with a low density of mitochondria, high density of vesicles and junctional zones with occasional enlarged clefts. Peritumoral vessel morphology was intermediate between that of tumor and the corresponding control tissue. We propose that C6 astrocytoma cells influence invading endothelial cells to develop a permeable phenotype radically different from host tissue endothelium, and host vessel phenotype does not influence tumor vessel morphology.

Animals↗

PubMed1996

EMG activities of the quadratus lumborum and erector spinae muscles during flexion-relaxation and other motor tasks.

OBJECTIVE: The aim of this study was to provide new information on the myoelectrical activation of the quadratus lumborum, the deep lateral and the superficial medial lumbar erector spinae, the psoas, and the iliacus muscles in various motor tasks. DESIGN: An intramuscular electromyographic study was performed. BACKGROUND: The contribution of individual deep trunk muscles to the stability of the lumbar spine is relatively unknown in different tasks, including the flexion-relaxation phenomenon. METHODS: Seven healthy subjects participated. Fine-wire electrodes were inserted with a needle guided by ultrasound. RESULTS: The highest activity observed for quadratus lumborum and deep lateral erector spinae occurred in ipsilateral trunk flexion in a side-lying position and for superficial medial erector spinae during bilateral leg lift in a prone position. Quadratus lumborum and deep lateral erector spinae were activated when the flexion-relaxation phenomenon was present for superficial medial erector spinae, i.e. when its activity ceased in the latter part of full forward flexion of the trunk, held relaxed and kyphotic. CONCLUSIONS: In general, the activation of the investigated muscles showed a high degree of task specificity, where activation of a certain muscle was not always predictable from its anatomical arrangement and mechanical advantage.

Journal Article↗

PubMed1997

Architectural and histochemical properties of cat hip 'cuff' muscles.

The architectural properties and fiber-type composition of the cat hip 'cuff' muscles, i.e. the deep layer of muscles encircling the hip joint, were determined. The muscles studied included the gluteus minimus, obturator internus and externus, gemellus superior and inferior, pyriformis, quadratus femoris and capsularis. In addition, the fiber-type composition was determined for the iliacus muscle. Compared to other lower limb muscles, the cuff muscles were small (approximately 0.2 to 2.7 g) and short (approximately 15 to 40 mm long) and had short mean fiber lengths (approximately 7 to 12 mm long), small angles of fiber pinnation (< or = 12 degrees), and small physiological cross-sectional areas (approximately 0.2 to 2.8 cm2). The percentage of the cross-sectional area comprised of slow fibers ranged from 24 to 95% with this value being over 50% in 5/9 muscles studied. The small angle of pinnation and short fiber lengths optimize force production and the relatively high percentage of slow fibers suggest a high level of activation. Both of these properties are consistent with a hip stabilization role for these muscles. In addition, the high percentage of slow fibers suggests a high spindle density and a possible role of these muscles in providing proprioceptive feedback to the central nervous system for the control of posture and locomotion.

Animals↗