The anatomical and functional relation between gluteus maximus and fascia lata.

There is not full agreement regarding the distal insertions of the gluteus maximus muscle (GM), particularly the insertions into the iliotibial band and lateral intermuscular septum. 6 cadavers, 4 males and 2 females, mean age 69 yr, were dissected to evaluate the insertions of the GM into the iliotibial band, fascia lata, lateral intermuscular septum and femur. The iliotibial band is a reinforcement of the fascia lata and cannot be separated from it. Its inner side is in continuity with the lateral intermuscular septum, which divides the quadriceps from the hamstring. In all subjects the gluteus maximus presented a major insertion into the fascia lata, so large that the iliotibial tract could be considered a tendon of insertion of the gluteus maximus. The fascial insertion of the gluteus maximus muscle could explain the transmission of the forces from the thoracolumbar fascia to the knee.

Liver function test abnormalities in anorexia nervosa--cause or effect.

OBJECTIVE: Two females with severe anorexia nervosa (BMI of 10) were seen with marked abnormalities in their liver function tests before the initiation of refeeding. These paradoxically resolved with progressive refeeding and weight restoration. METHOD: Clinical observation during regimented medical stabilization and refeeding of two patients with severe anorexia nervosa with frequent monitoring of liver function tests. RESULTS: Normalization of liver function tests ensued as caloric intake increased and weight gain progressed. DISCUSSION: Although classically liver function test elevations occur during refeeding, as a manifestation of excessive calories and fat deposition in the liver, they may also be elevated due to severe malnutrition before refeeding has commenced and improved as refeeding occurs.