Anatomical Review of Anterolateral Thigh Flap for the Oral and Maxillofacial Reconstruction

Histochemistry and morphometric analysis of muscle fibers from patients with duchenne muscular dystrophy (DMD) / Histoquímica y análisis morfométrico de las fibras musculares de p0acientes con distrofia muscular de duchenne (DMD)

The aim of the study was to analyze the muscle fibers by histochemistry and morphometric methods from patients with Duchenne muscular dystrophy (DMD). Muscle biopsies were taken from the vastus lateralis muscle of five boys between 13 and 15-years of age, with clinical diagnosis of DMD. The histochemistry was performed using myofibrillar ATPases (9.6, 4.6 and 4.3). To morphometrical analysis a computerized semiautomatic system and software Image-Lab was used. ATPase staining showed atrophy of muscle fibers. Fibrosis and adipose deposition occurred in variable degree depending of muscular involvement. The morphometrical analysis showed an increase of size (percentage) to type I fiber than other types in all patients. Furthermore, the type I fiber had a larger cross-sectional area and mean diameter than type IIa and IIb fibers. Both histochemistry and morphometric analysis could be important tools for qualitative and quantitative diagnostics of muscle fibers attacked in this type of disease.

El objetivo del estudio fue analizar las fibras musculares mediante histoquímica y métodos morfométricos en pacientes con distrofia muscular de Duchenne (DMD). Se tomaron biopsias musculares del músculo vasto lateral de cinco niños entre 13 y 15 años de edad, con diagnóstico clínico de DMD. La histoquímica se realizó mediante ATPasa miofibrilar (9.6, 4.6 y 4.3). Para el análisis morfométrico se utilizó un sistema semiautomático computarizado y software de imagen de laboratorio. La tinción de ATPasa mostró una atrofia de las fibras musculares. La fibrosis y depósito adiposo se observó en grado variable dependiendo del compromiso muscular. El análisis morfométrico mostró un aumento de tamaño (porcentaje) de fibras tipo I en todos los pacientes. Además, la fibra tipo I tuvo un área de sección transversal y diámetro medio mayor que las fibras tipos IIa y IIb. Tanto la histoquímica y el análisis morfométrico pueden ser herramientas importantes para el diagnóstico cualitativo y cuantitativo de las fibras musculares comprometidas en este tipo de enfermedad.

Efeito imediato da estimulação elétrica neuromuscular seletiva na atividade eletromiográfica do músculo vasto medial oblíquo / Immediate effect of selective neuromuscular electrical stimulation on the electromyographic activity of the vastus medialis oblique muscle

A Síndrome da dor patelofemoral (SDPF) é descrita como dor anterior ou retro-patelar do joelho na ausência de outras patologias associadas, sendo freqüentemente associada à disfunção do Vasto Medial Oblíquo (VMO). Entretanto, diversos estudos têm demonstrado a impossibilidade de ativar seletivamente este músculo através de exercícios. O objetivo do presente estudo foi analisar o efeito imediato da estimulação elétrica neuromuscular (EENM) seletiva no músculo VMO por meio do comportamento eletromiográfico dos músculos VMO e vasto lateral (VL). Foram avaliadas 18 mulheres saudáveis, com idade média de 23,2 anos e IMC médio de 20 Kg/m2. Os procedimentos do estudo incluíram uma análise eletromiográfica dos músculos VMO e VL, antes e imediatamente após a EENM do músculo VMO. Durante a análise eletromiográfica, as voluntárias realizaram uma contração isométrica voluntária máxima durante a extensão do joelho a 60° em um dinamômetro isocinético. A estimulação elétrica foi realizada através da corrente Russa. A análise dos dados mostrou um aumento significativo na intensidade de ativação do músculo VMO imediatamente após a estimulação do mesmo (p=0,0125), enquanto que a intensidade de ativação do músculo VL, não mostrou aumento significativo (p=0,924). Além disso, verificou-se também um aumento significativo na relação VMO/VL (p=0,048). No presente estudo, observou-se uma modificação na relação VMO/VL após a EENM, sugerindo que a mesma tem um efeito favorável no fortalecimento seletivo do VMO...

The Patellofemoral pain syndrome (PFPS) is described as an anterior or retropatellar knee pain in the absence of other associated diseases, and has often been associated with dysfunction of the vastus medialis oblique muscle (VMO). However, several studies have demonstrated the impossibility of selectively activating this muscle with exercises. The aim of the present study was to analyze the immediate effect of neuromuscular electrical stimulation of VMO muscle by means of monitoring the electromyographic activity of the vastus medialis oblique (VMO) and vastus lateralis (VL) muscles. Eighteen healthy women with a mean age of 23.2 years and mean BMI of 20 Kg/m2 were evaluated. The study protocol included electromyographic analysis of VMO and VL muscles, before and immediately after neuromuscular electrical stimulation of the VMO muscle. During the electromyographic analysis, the volunteers performed maximal voluntary isometric contraction in a 60° knee extension on an isokinetic dynamometer. ôRussian currentõ apparatus was used for electrical stimulation. Results: The data analysis demonstrated a signifi cant increase in VMO activation intensity immediately after it had been electrically stimulated (p=0.0125), whereas VL activation intensity exhibited no signifi cant increase (p=0.924). Moreover, a signifi cant increase in the VMO/VL ratio was also detected (p=0.048). In this study it was observed that electrical stimulation modifi ed the VMO/VL ratio, which suggests electrical stimulation has a benefi cial effect on VMO muscle strength...

Pedicle and Skin Territory of the Vastus Lateralis Muscle for the Anterolateral Thigh Free Flap / 체질인류학회지

The pattern of location, perforator artery and skin territory of the descending branch of the lateral circumflex femoral artery are very important to the anterolateral thigh free flap surgery. The author studied the pattern of vascularization of the anterolateral thigh in 110 Korean cadavers using macroscopic dissection and radiographic methods. The location of the points in this study were expressed as XY coordination in reference to the line between ASIS and center of the lateral margin of the patella. The location of pedicle of the vastus lateralis muscle at XY coordination valued X: 20.8+/-6.0 cm, Y: -1.2+/-1.0 cm. The length and external diameter of the pedicle were 91.7+/-54.9 mm, and 2.7+/-0.8 mm respectively. The average number of perforator artery to the vastus lateralis muscle were 3.2+/-1.5. The skin territory of the perforator of the vastus lateralis muscle was 6 x 18 cm2, its location was 20.8 cm on the line AB. The pattern of distribution and territories of the anterolateral thigh obtained in this study will provide useful anatomical backgrounds for the flap surgery of anterior and anterolateral thigh.

Difference in oxygen supply-consumption balance in thigh muscles working together during knee-extension exercise / 体力科学

The purpose of this study was to clarify the changes in oxygen kinetics in two different thigh muscles recruited for dynamic knee-extension exercise at varying intensities in seven female subjects. Pulmonary oxygen uptake (Vo<SUB>2</SUB>) was measured by the 10-s mixing chamber method. Changes in oxygenated hemoglobin (HbO<SUB>2</SUB>), deoxygenated hemoglobin (Hb), and total hemoglobin (HbT) contents were measured in the vastus lateralis (VL) and rectus lemons (RF) muscles using near-infrared spectroscopy, and the oxygen saturation (SO<SUB>2</SUB>) was calculated as the HbO<SUB>2</SUB> divided by HbT in percent. The surface electromyograms (EMG) of both muscles were also recorded. The integrated EMGs (iEMG) of the VL and RF increased linearly with increasing exercise intensity up to 100%VO<SUB>2peak</SUB>. However, the HbO<SUB>2</SUB> and Hb remained unchanged when exercise intensity was below 50%Vo<SUB>2peak</SUB>, above which the increase in Hb and decrease in HbO<SUB>2</SUB> were observed. Thus the decline in SO<SUB>2</SUB> occurred at 60%Vo<SUB>2peak</SUB> in the RF, and 70%Vo<SUB>2peak</SUB> in the VL. These results suggest that muscle deoxygenation is accelerated during exercise above a certain intensity, which is lower in the RF than in the VL, during dynamic knee-extension exercise.