Morphological Classification of the Sagittal Tendon Plate in the Soleus Muscle in Japanese Cadavers / Clasificación Morfológica de la Lámina Tendinosa Sagital del Músculo Sóleo en Cadáveres Japoneses

SUMMARY: The human soleus muscle has attracted attention in the fields of sport science, rehabilitation medicine, etc. for improving exercise performance in training, preventing injuries, and rehabilitation. The sagittal tendon plate of the soleus muscle is particularly important in rehabilitation. Few studies, however, have evaluated the shape of the sagittal tendon plate in the human soleus muscle in detail and attempted to classify its variations based on its morphology. In this study, we conducted a detailed analysis of the morphology of the sagittal tendon plates in soleus muscle specimens from Japanese cadavers and constructed a morphology-based classification system and evaluated their frequencies of occurrence. First, the specimens were divided into those with a sagittal tendon plate that was visible on the anterior surface (pennate muscle group) and those without (non-pennate muscle group). Next, based on the "number" and "breadth" of the sagittal tendon plates, the pennate muscle group specimens were further classified into four classes: Class I (one tendon, thin), Class II (one tendon, slightly broad), Class III (one tendon, very broad), and Class IV (two tendons, thin). Subsequently, the specimens were further divided into three types based on the position where the sagittal tendon plate joined the Achilles tendon: median tendon type, lateral tendon type, and medial tendon type (a total 13 divisions). When 458 Japanese soleus muscle specimens were classified into these divisions, the occurrence frequencies of Class I-IV were 80.57 %, 4.59 %, 5.46 %, and 1.09 %, respectively. In Class I, the median tendon type was more frequent than the lateral and medial tendon types, accounting for 48.47 % overall. The classification types of the sagittal tendon plate and their respective occurrence frequencies shown in this study are expected to serve as fundamental data in implementing rehabilitation of soleus muscle.

El músculo sóleo humano ha atraído la atención de la ciencia del deporte, la medicina de rehabilitación, etc. para mejorar el rendimiento del ejercicio en el entrenamiento, prevenir las lesiones y rehabilitación. La lámina tendinosa sagital del músculo sóleo es particularmente importante en la rehabilitación. Sin embargo, pocos estudios han evaluado en detalle la forma de la placa lámina sagital en el músculo sóleo humano y han intentado clasificar sus variaciones en función de su morfología. Realizamos un análisis detallado de la morfología de las láminas de los tendones sagitales en muestras de músculo sóleo de cadáveres japoneses y construimos un sistema de clasificación basado en la morfología y, además, evaluamos su frecuencia de aparición. Los especímenes se dividieron en aquellos con una lámina de tendón sagital que era visible en la superficie anterior (grupo muscular pennado) y aquellos sin (grupo muscular no pennado). A continuación, según el "número" y el "ancho" de las láminas de los tendones sagitales, las muestras del grupo de músculos pennados se clasificaron en cuatro clases: Clase I (un tendón, delgado), Clase II (un tendón, ligeramente ancho), Clase III (un tendón, muy ancho) y Clase IV (dos tendones delgados). Posteriormente, las muestras se dividieron en tres tipos, según la posición donde la lámina del tendón sagital se unía al tendón calcáneo: tipo de tendón mediano, tipo de tendón lateral y tipo de tendón medial (un total de 13 divisiones). En estas divisiones se clasificaron 458 especímenes de músculo sóleo de indiviuos japoneses, las frecuencias de ocurrencia de Clase I-IV fueron 80,57 %, 4,59 %, 5,46 % y 1,09 %, respectivamente. En la Clase I, el tipo de tendón mediano era más frecuente que los tipos de tendón lateral y medial, representando el 48,47 % del total. Se espera que los tipos de clasificación de la lámina del tendón sagital y sus respectivas frecuencias de aparición, que se reportan en este estudio, sirvan como datos fundamentales para implementar la rehabilitación del músculo sóleo.

Comparative study of soleus H-reflex in normal humans and in patients with neuropathies

Background: The H-reflex derived its name from Hoffman. Hoffmann reflex is an electrically induced reflex analogous to the mechanically induced spinal stretch reflex. This measurement can be used to assess the response of the nervous system to various neurological conditions, musculoskeletal injuries, and application of therapeutic modalities, pain, exercise training, and performance of motor tasks. This simple and reproducible physiological response was studied to evaluate conduction along the course of the whole “final common pathway” from the moto neuron to the terminal axon as well as to gain some information regarding the function of large diameter group la afferent fibers supplying the muscle spindle. Aims and Objectives: The aim of the study was to compare the H-reflex latency between the normal person and in neuropathic patients. The study aimed to see whether there is any difference in H-reflex latency in the right leg of normal person and in neuropathic patients. The study aimed to see whether there is any difference in H-reflex latency in the left leg of normal person and in neuropathic patients. Materials and Methods: The study was conducted among 25 normal subjects and 25 neuropathic patients between 20 and 70 years of age from Nootan Medical College and Research Centre, Visnagar. The normal subjects were evaluated clinically to find their normal condition. The neuropathic patients which are included in study are of diabetic neuropathy, plexopathy, radiculopathy, vitamin deficiency, and Guillain Barre Syndrome. The patients who had bilateral neuropathy were included in the study. The study was conducted using mainly stimulator circuit, stimulating and recording electrodes, preamplifier, and oscilloscope. The software used for this experiment was RMS EMG EPMK II, one of the latest software with facilities for nerve conduction velocity, electromyography, F-wave, and H-reflex recording. Results: Out of the 50 participants, 25 participants who were suffering with any kind of neuropathy evaluated for their H-reflex latency in both leg. Patients with neuropathy showed higher latency in the right leg compared to the 25 participants in the control group in the right leg demonstrated significantly higher latency in the group with neuropathy. The 25 participants who were suffering with any kind of neuropathy evaluated for their H-reflex latency left leg compared to the 25 participants in the control group left leg demonstrated significantly higher latency in the group with neuropathy. Conclusion: The results show that there is an increase in the H-reflex latency in neuropathy patients as compared to normal subjects but it can be not used as a specific test for diagnosis of neuropathies, because the H-reflex latency may also change in normal subjects as the age of the persons is increases or the height of the persons increases but H-reflex latency can be used for the diagnosis of the proximal nerve root injuries as it mainly investigates the proximal nerve reflex arc.

Biometría del nervio para el músculo sóleo y sus implicancias clínicas / Nerve biometry for the soleus muscle and its clinical implications

RESUMEN: Las lesiones del nervio fibular común y/o sus ramos derivados trae como consecuencia, pérdida total o parcial de la capacidad para realizar flexión dorsal del complejo tobillo-pie, una opción viable para tratar esta patología es la transferencia nerviosa, que consiste en utilizar un nervio donante para restaurar la función de un nervio dañado. Es frecuente la utilización del nervio para el músculo sóleo (NS) como donante para restaurar la función del nervio fibular común o profundo, por lo cual es indispensable conocer en detalle la anatomía de este nervio. Se utilizaron 22 miembros inferiores pertenecientes a las Unidades de Anatomía de las Universidades de Chile y de Santiago, Chile. Se realizó disección del nervio para el músculo sóleo, se observó número de ramos principales y secundarios, así como también se registró su origen y la longitud de ellos, además se dividió a la pierna en cuadrantes para determinar la localización de los puntos motores. El nervio para el músculo sóleo en la mayoría de los casos (95,4 %) es único y se origina desde el nervio tibial o en tronco común con otro ramo muscular. La distancia promedio entre el origen de NS y la línea biepicondilar fue de 28,77 mm; la longitud promedio de NS hasta su división en ramos secundarios o penetración directa fue de 52 mm. El NS se dividió en ramos secundarios (RS), observándose que en 12 casos fue en 2 RS, en 3 casos en 3 RS y en 7 casos no hubo RS. Los puntos motores se localizaron en el quinto proximal de la pierna, 23 casos en el primer cuadrante lateral y 4 casos en el primer cuadrante medial; en el cuarto proximal de la pierna, 7 casos en el segundo cuadrante lateral y 4 casos en el segundo cuadrante medial. Los datos obtenidos serán un aporte al conocimiento anatómico y a la cirugía reconstructiva de los nervios de la región.

SUMMARY: Injuries to the common fibular nerve and/or its derived branches result in total or partial loss of the ability to dorsiflex the ankle-foot complex. A viable option to treat this pathology is nerve transfer, which consists of using a donor nerve to restore function to a damaged nerve. The use of the nerve for the soleus muscle (SN) is frequent as a donor to restore the function of the common or deep fibular nerve, for which it is essential to know in detail the anatomy of this nerve. Twenty-two lower limbs belonging to the anatomy units of the Universities of Chile and Santiago were used. Dissection was performed until the SN was reached, the number of main and secondary branches (SB) was observed, as well as their origin and length, and the leg was divided into quadrants to determine the location of the motor points. The SN in most cases (95.4 %) is unique and originates from the tibial nerve or from the common trunk with another muscular branch. The average distance between the origin of the NS and the biepicondylar line was 28.77 mm; the average length of NS until its division into SB or direct penetration was 52 mm. The NS was divided into SB, observing that in 12 cases it was in 2 branches, in 3 cases in 3 branches and in 7 cases there were no SB. The motor points were located in the proximal fifth of the leg, 23 cases in the first lateral quadrant and 4 cases in the first medial quadrant; in the proximal quarter of the leg, 7 cases in the second lateral quadrant and 4 cases in the second medial quadrant. The data obtained will be a contribution to anatomical knowledge and reconstructive surgery of the nerves of the region.

Reliability of a simple novel field test for the measurement of plantar flexor muscle strength / Confiabilidade de um novo teste de campo simples para medir a força dos músculos flexores plantares / Confiabilidad de un nuevo test de campo simple para medir la fuerza de los músculos flexores plantares

ABSTRACT Introduction When a person is in a standing position, the plantar flexor muscles are involved in most static and dynamic body movements. Objectives The aim of this study was to investigate the trial to trial and factorial reliability of measuring the contractile characteristics of PF muscles using a simple novel field test. Methods The sample consisted of 452 healthy subjects, 120 male and 332 female. The research was conducted by means of the trial to trial testing method, using isometric dynamometry performed in field conditions. ANOVA was used to estimate the differences among the trials, Cronbach's alpha and interclass correlation to estimate the correlations among the trials, and principal component analysis to evaluate the contribution of each trial to overall variability. Results The main findings of this study are that trials differed significantly (p<0.000) for maximal force (Fmax) and maximal rate of force development (RFDmax), indicating that the three procedural trials were necessary. The trials were highly correlated (Fmax, RFDmax, r>0.9), proving that measuring was reliable, and the factorial analysis separated the second and third trials, the second trial accounting for most of the total variability. Conclusions The simple novel field test for the measurement of plantar flexor contractile characteristics recommended by this study proved to be as highly reliable as laboratory testing, but was easy to perform in conditions outside of scientific or diagnostic institutions, which greatly facilitates the work of scientists, coaches and professionals. Level of Evidence II; Diagnostic Studies - Investigating a diagnostics test.

RESUMO Introdução Quando uma pessoa está em pé, os músculos flexores plantares são envolvidos na maioria dos movimentos corporais estáticos e dinâmicos. Objetivos O objetivo deste estudo foi investigar a confiabilidade teste-reteste e fatorial da mensuração das características contráteis dos músculos plantares, usando um novo teste de campo simples. Métodos A amostra consistiu em 452 indivíduos saudáveis, 120 homens e 332 mulheres. O estudo foi realizado pelo método de teste-reteste, com dinamometria isométrica conduzida em condições de campo. Empregou-se a ANOVA para estimar a diferença entre os testes o alfa de Cronbach e a correlação interclasse para estimar a correlação entre os testes e análise de componentes principais , para avaliar a contribuição de cada teste para a variabilidade global. Resultados Os principais achados deste estudo são que os testes diferiram significativamente (p < 0,000) para a força máxima (Fmáx) e a taxa máxima de desenvolvimento de força (TDFmáx), indicando que os três testes de procedimento foram necessários. Os testes foram altamente correlacionados (Fmáx, TDFmáx, r > 0,9), provando que a medição era confiável, e a análise fatorial separou o segundo e o terceiro testes, sendo que o segundo teste apresentou a maior parte da variabilidade total. Conclusões O novo teste de campo simples para medição das características contráteis dos flexores plantares recomendado por este estudo provou ser tão confiável quanto os testes de laboratório e, ao mesmo tempo, mais fácil de realizar fora das instituições científicas ou de diagnóstico, o que facilita muito o trabalho de cientistas, treinadores e profissionais. Nível de Evidência II; Estudos Diagnósticos - Investigação de um exame para diagnóstico.

RESUMEN Introducción Cuando una persona está de pie, los músculos flexores plantares son involucrados en la mayoría de los movimientos corporales estáticos y dinámicos. Objetivos El objetivo de este estudio fue investigar la confiabilidad test-retest y factorial de la medición de las características contráctiles de los músculos plantares, usando un nuevo test de campo simple. Métodos La muestra consistió en 452 individuos saludables, 120 hombres y 332 mujeres. El estudio fue realizado a través del método de test-retest, con dinamometría isométrica conducida en condiciones de campo. Se empleó ANOVA para estimar la diferencia entre los tests, alpha de Crombach y la correlación interclase para estimar la correlación entre los tests y el análisis de componentes principales, para evaluar la contribución de cada test para la variabilidad global. Resultados Los principales hallazgos de este estudio son que los tests difirieron significativamente (p<0,000) para la fuerza máxima (Fmáx) y la tasa máxima de desarrollo de fuerza (TDFmáx) indicando que los tres tests de procedimiento fueron necesarios. Los tests fueron altamente correlacionados (Fmáx, TDFmáx, r>0,9) probando que la medición era confiable, y el análisis factorial separó el segundo y tercer test, siendo que el segundo test presentó la mayor parte de variabilidad total. Conclusiones El nuevo test de campo simple para medición de las características contráctiles de los flexores plantares recomendado por este estudio probó ser tan confiable como los tests de laboratorio y, al mismo tiempo, más fácil de realizar fuera de las instituciones científicas o de diagnóstico, lo que facilita mucho el trabajo de científicos, entrenadores y profesionales. Nivel de evidencia II; Estudios diagnósticos - Investigación de un examen para diagnóstico.

Effects of electroacupuncture combined with passive stretch exercise on disused muscle atrophy and expression of skeletal troponin in mice / 针刺研究

OBJECTIVE: To observe the efficacy of electroacupuncture (EA) plus passive stretch exercise in the treatment of disused atrophy of gastrocnemius and soleus muscles in mice. METHODS: Fifty C57BL/6 mice were randomly and equally divided into 5 groups: blank control, model, passive stretch exercise (exercise), EA and EA+exercise groups. The muscular atrophy model was established by fixing the gastrocnemius and soleus muscles with plaster immobilization (by putting the right leg into a plastic vial and then twining the vial with medical plaster bandage from the ankle upwards to the thigh and groin to maintain the knee-joint flexion and ankle joint plantar flexion for 7 days). EA (2 Hz/100 Hz, 1 mA)was applied to bilateral "Zusanli"(ST36) for 10 min, once a day for 4 weeks. For mice with the passive exercise, the plastic vial was removed first, followed by pulling out the hindleg to seize the toes to stretch them until the right hindleg is fully extended, then, pushed the leg towards the body. The procedures were repeated once again and again for 10 min. The exercise was conducted once daily, for 4 weeks. The cross-sectional area of fast and slow muscle fibers of the soleus and gastrocnemius was measured under electronic microscope after ATPase histochemical stain and the expression of slow skeletal muscle troponin (TNNI1) and fast skeletal muscle troponin (TNNI2) in the soleus and gastrocnemius was detected by Western blot. RESULTS: Compared with the blank control group, the cross-sectional areas of the fast and slow muscle fibers of the soleus and gastrocnemius muscles were significantly decreased in the model group (P<0.05, P<0.01). Following the interventions, the cross-sectional areas of the fast and slow muscle fibers of soleus muscle in the EA+exercise group, and those of the fast and slow muscle fibers of the gastrocnemius muscle in the EA and EA+exercise groups, and the expression levels of TNNI1 and TNNI2 proteins in the gastrocnemius muscle of the EA+exercise group were significantly increased in comparison with the model group (P<0.05, P<0.01). CONCLUSION: EA combined with passive stretch exercise can promote the recovery of the soleus and gastrocnemius muscles in disused muscle atrophy mice, which may be related to its effect in up-regulating the expression of TNNI1 and TNNI2 proteins.

Application of soleus perforator flapfrom the lateral leg in repair of oral and maxil-lofacial defects / 医学研究生学报

ObjectiveReconstruction of oral and maxillofacial defects following resection of oral and maxillofacial malignant tumors is required to restore the patient's appearance and oral function. The aim of this study was to evaluate the application and value ofsoleus perforator flap from the lateral leg in repair of oral and maxillofacial defects.MethodsIn this retrospective study, ten patients with oral and maxil-lofacial malignancies who were admitted to the Department of Oral and Maxillofacial Surgery in Fuyang People's Hospital during the period from May 2015 to March 2019 were enrolled. The effect of soleus perforator flap from the lateral leg was ana-lyzed.At 1 month and 3 months after surgery, the recovery of oral function and donor sites, quality of life and surgical satisfaction were followed.ResultsAllpatients underwent operation successfully without skin flap necrosis or serious complications.At 3 months after surgery,voice function and swallowing func-tion were level 3. The scar hyperplasia was 1 case,donor itching1 case and paresthesia or dysfunction 0 case.Compared with those at 1 month after surgery, the scores at 3 months after surgery were increased using the University of Washington Quality of Life (UW-QOL) questionnaire(P<0.05). At 1 month and 3 months after sur-gery,patient satisfaction rateswere 80.00% and 90.00%, respectively.ConclusionThe soleus perforator flap from the lateral leg isideal for repairing oral and maxillofacial defects. The postoperative recovery of oral functio-nand donor sites is goodwith high quality of life and surgical satisfaction.

MRI presentation and pathogenesis of tennis legs / 中华放射学杂志

Objective To evaluate the imaging features of MRI of tennis legs and to explore the pathogenesis of tennis legs. Methods A retrospective analysis was made on the MRI images of 38 patients with tennis legs which met the criteria and were clinically diagnosed in our hospital from May 2014 to June 2018. All patients underwent non?enhanced MRI. Coronal T1WI、T2WI fast spin echo (TSE) and transverse proton density weighted imaging (PDWI) were performed. The signs of fluid collection between gastrocnemius muscle (GM) and soleus muscle (SM),muscle and tendon injuries, superficial vein dilatation of calf were observed and recorded. Results Coronal T1WI, T2WI TSE and transverse PDWI sequences showed 30 (75.0%) places fluid collection (hematoma or effusion) between medial head of the gastrocnemius muscle (MCM) and SM, 11 (27.5%) places fluid collection (hematoma or effusion) between lateral head of gastrocnemius muscle(LGM)and SM,7 (17.5%) places fluid collection (hematoma or effusion) in MGM and 2 (5.0%) placesin SM. There were 17 (42.5%) places that hematoma or effusion spread around the fascia of the lower leg. The diameter and thickness of hematoma or effusion are about 1.7-22.3 cm and 0.2-3.5 cm, respectively. Rupture of the GM was seen in 37 (92.5%) places,including 37 places rupture of the MGM at the myotendinous junction, 15 places rupture of the LGM at the myotendinous junction, 24 places tendonrupture of MGM,3 places tendon rupture of MGM and LGM,and 2 places tendon rupture of LGM. The maximum diameter of tendon rupture was 1.2-27.0 mm. The muscle rupture of MGM was seen in one place, and muscle rupture of MGM and LGM was seen in one place at the same time. Rupture of the SM was seen in 15 (37.5%) places, including 15 places rupture of the SM at the myotendinous junction, 2 places muscle rupture of SM, 6 places tendonrupture of SM. The maximum diameter of tendon rupture was 2.5-14.9 mm. Rupture of plantaris tendon (PT) was seen in 4 (10.0%) places. Superficial vein dilatation was seen in 3 (7.5%) places. Conclusion This study shows that the rupture of the MGM at the myotendinous junction and the tendon is the main responsibility of tennis leg.

A Case Report Of A Variant Head Of Gastrocnemius

The Gastrocnemius muscle is a fusiform, two-headed, two-joint muscle. The two heads of origin are lateral andmedial head taking origin from medial and lateral condyles of femur. In between the two heads tibial nervepasses. Its other end forms a common tendon with the soleus muscle; this tendon is known as the tendocalcaneusor Achilles tendon which get inserted to posterior surface of calcaneum. The case was reported during routinedissection for undergraduate M.B.B.S. students in Government Medical College and Hospital, Chandigarh. Thesubject was 70-year-old male cadaver of North Indian origin. The accessory head was observed during thedissection of popliteal fossa. The Gastrocnemius muscle was bulky. The inferolateral and inferomedial boundaryof the popliteal fossa were made by medial and lateral head of gastrocnemius. In addition to the normal medialand lateral head an accessory head of gastrocnemius was observed. The accessory head had bipennatearrangement of the muscle fibers. in the left lower limb were observed. All the heads were innervated by branchesfrom tibial nerve. It is possible that this variant muscle could have a compressive effect on the tibial nerve andpopliteal vessels, and the awareness of this may prevent its misinterpretation as a pathological structure byradiologists and surgeons

Cadaveric Study Of Aberrant Tendoachilles Tendon In South Gujarat Region And Its Clinical Significance

Background: The tendoachilles tendon is the strongest and thickest tendon in the body begins near the middle ofthe back of leg which is made up of the tendons of the soleus and two heads of the gastrocnemius muscles andis attached to the midpoint of the posterior surface of the calcaneum. An aberrant (abnormal) tendoachilles isattached to just posterior to the tendo-achilles tendon, calcaneal tuberocity and on medial aspect of calcaneum.An aberrant tendoachilles tendon is responsible for resistant equines deformity of club foot. The existence ofaberrant tendoachilles tendon should be kept in mind by the orthopedic surgeons, podiatrist, sports physiciansand physiotherapists. A lack of awareness such variations might complicate surgical repair.Aim: The current study aimed at finding out the attachment of tendoachilles tendon, presence of any aberrant(abnormal) tendoachilles tendon insertion and related clinical significance i.e. resistant club foot.Materials and Methods: 108 lower limbs, 54 right and 54 left lower limbs of 54 donated embalmed cadavers (31males & 23 females) of age group ranging from 55 to 85 years were procured for dissection. The study wascarried out for a period of 7 years in the department of Anatomy SMIMER Surat.Results: The length of the tendoachilles tendon is 0-2cm in 3.70% of cases, 2-4 cm in 25.92% of cases, 4-6 cm in53.70% of cases, 6-8 cm in 9.25% of cases, 8-10 cm in 5.55% of cases, >10 cm only in 1.85% of cases. In all cases,attachment of tendoachilles tendon was found on posterior aspect of calcaneun that is normal. In addition tothat one of the case of left lower limb (0.92% of cases), tendoachilles tendon was found attached on medialaspect of calcaneun that is called as aberrant tendoachilles tendon.Conclusion: Aberrant tendoachilles tendon is responsible for resistant equines deformity of club foot. Most ofresistant club foot can be treated with use of an extensive posteromedial release of aberrant tendoachillestendon with satisfactory functional results. The presence of such aberrant tendoachilles tendon should be keptin mind by the orthopaedicians. A lack of awareness such variations might complicate surgical repair.

Effects of Treadmill Running on Intramyocellular Lipid Deposition and VEGFB Expression in Soleus Muscle of High-fat Diet Mice / 中国运动医学杂志

Objective To observe the effect of treadmill running on skeletal muscle lipid deposition,and the expression of vascular endothelial growth factor-B(VEGFB)and its receptor in soleus muscles of high-fat diet mice.Methods Thirty-two 5-week-old C57BL/6 male mice were randomly divided into a control group(n=8)and a high-fat diet group(n=24),and fed with normal and high-fat diet respectively.Eight weeks later,16 obesity mice were selected from the latter group and randomly divided into a sedentary group(n=8)and a treadmill running group(n=8).The running group underwent treadmill running at 25 m/min for an hour every day,five days a week for 8 weeks,while the other two groups did not do any exercises.The weight was measured before the mice were killed.The soleus lipid deposition level was determined using oil red O staining,The expression of VEGFR1 and Neuropilin-1(NRP1)was determined using the immunohistochemical staining,while the mRNA expression of VEGFB,VEG-FR1,NRP1 and peroxisome proliferator-activated receptor-γcoactivator-1α (PGC-1α) was detected using the real-time PCR.Results Compared with the control group,a significant increase was observed in the weight and the soleus lipid deposition of the high-fat diet group,while there were no significant differences in the expression of VEGFB,NRP1,VEGFR1 and PGC-1α.mRNA between the two groups.Compared with the sedentary obese mice,significant decrease in the body weight and soleus lipid deposition,significant increase in VEGFR1 mRNA expression,but no significant changes in the expression of VEGFB,NRP1 and PGC-1α mRNA were observed in the treadmill-running obese mice.Conclusion The treadmill running has no effect on the VEGFR1 expression in soleus of obese mice,but significantly up-regulates the expression of its receptors.It indicates that the treadmill running can lower the intramyocellular lipid deposition as it can strengthen the VEGFB/VEGFR1 in soleus muscles.

Effects of Treadmill Running on Capillary Density and Apelin Expression in Soleus Muscle of High-fat Diet Rats / 中国运动医学杂志

Objective To observe the alteration of capillary density and apelin/APJ expression in soleus muscles of high-fat diet rats.Methods Male 5-week-old Sprague-Dawley rats were randomly divided into a control group and a high-fat diet group.After 12 weeks of high-fat diet,16 rats were se lected and randomly divided into a sedentary group and a treadmill running group.The exercise rats underwent 60-minute treadmill running at 26 m/min 5 days a week for 10 weeks.The body weight,body fat and blood lipid level were measured for all rats.The protein expression of Soleus CD31 and apelin was determined using immunohistochemical staining,soleus apelin content was determined using the radioimmunoassay,and the mRNA expression of apelin/APJ was detected using real-time PCR.Results Compared with the control group,significant increase was observed in the body weight,body fat and the level of total triglyceride,total cholesterol and low density lipoprotein cholesterin,but significant decrease was found in the high density lipoprotein cholesterin in the high-fat diet group.There were no significant differences in the capillary density and mRNA levels of apelin/APJ between the two groups.Compared with the sedentary high-fat diet group,significant improvement was observed in the body weight and blood lipid level of the treadmill running group.Moreover,significant increase was also observed in the capillary density,the expression of apelin/APJ mRNA,as well as that of apelin protein in the treadmill running group (P＜0.05).Conclusion The treadmill running can significantly increase capillary density of obese rats,as it may activate the expression of Apelin/APJ.

Mechanical ventilation leads to remodeling of diaphragma and soleus in rats / 中华危重病急救医学

Objective To investigate the structural response of diaphragm and soleus of the rat after mechanical ventilation (MV), and to explore the specific mechanism of the dysfunction of both muscles.Methods Sixteen male Sprague-Dawley (SD) rats were randomly divided into control group and MV group, with 8 rats in each group. Rats in MV group were treated with controlled ventilation and maintained anesthesia, and those in control group were only anesthetized without MV and maintained anesthesia. The diaphragm and soleus were harvested after MV for 18 hours, and the morphology changes were observed with light microscope. The cross section of muscle fiber was observed by immunofluorescence technique analysis, and the cross-sectional area of muscle fiber was calculated. The ultra structural changes in muscle fibers were observed under transmission electron microscope.Results ① Observed under light microscope, the cross section of the diaphragm and soleus muscle in the control group was regular, the nucleus was normal and the cytoplasm was homogeneous. The fibers in the diaphragm-biopsy specimens from MV subjects were smaller than those from control subjects, whereas these signs were not found in soleus. But fiber atrophy in MV specimens was not accompanied by an inflammatory-cell infiltrate. ② Under the fluorescence microscope, the control group had a smaller cross-section of the slow-twitch muscle in diaphragm, while the fast-twitch muscle fibers werelarger. As compared with diaphragm-biopsy specimens from control, specimens from MV subjects showed decreased cross-sectional areas of slow-twitch and fast-twitch fibers, respectively (μm2: 1069.00±155.24 vs. 1297.12±331.15, 2279.66±442.31 vs. 3031.80±596.11, bothP 0.05). ③ In the control group, the muscle fibers of the diaphragm and soleus were arranged orderly, the boundary of the light and dark bands and the Z-line were clear, and there was no autophagy in the visual field. The outer membrane of the mitochondria was complete, and the cristae were in the shape of clapboard. The signs of misalignment of myofibrils, disruption of Z-line and vacuolar mitochondria were found in diaphragm from MV group, whereas these signs were not found in soleus. Diaphragm from MV group exhibited an increase in autophagic vesicles visualized by transmission electron microscopy as compared with control group.Conclusions Controlled MV for 18 hours resulted in diaphragmatic inactivity and promoted muscle injury and atrophy, while autophagy and mitochondrial dysfunction were enhanced. Soleus immobilization for 18 hours was not associated with muscle atrophy. These facts suggest that the signaling associated with diaphragm atrophy during MV may involve different mechanisms compared with other models of muscle atrophy. Diaphragm appeared to be more susceptible to MV.

The effect of ß-hydroxy-ß-methylbutyrate (HMB) on the morphology of skeletal muscle after concurrent training

The aim of the present study was to investigate the effects of β-hydroxy-β-methylbutyrate (HMB) supplementation in association with concurrent training on morphological soleus muscle of rats. Wistar male rats were divided randomly into four groups: Control (C), Supplemented (S), Training (T) and Training + Supplemented (TS). Groups S and TS received 76mg/kg/day of HMB and the training groups (T and TS) were inserted into concurrent training program 3 times/week for 8 weeks. HMB had positive effects either on body composition of the animals or in type II muscle fibers. The concurrent exercise training was able in reducing the total fat mass as well as in increasing the diameter of muscle fibers. Our findings shows that HMB had an anti-catabolic effect with reference to the parameters of volume, weight and morphology of the soleus muscle, and there was a positive interaction between HMB supplementation and concurrent exercise training

Effects and mechanisms of endurance exercise for 8 weeks on contractile function and mitochondrial biogenesis in rat skeletal muscles / 中国药理学通报

Aim This study was aimed to explore the influence and mechanism of the long-term exercise on skeletal muscle contraction and mitochondrial biosyn-thesis in different muscle fibers.Methods Soleus (SOL)and extensor digitorum longus (EDL)were i-solated from SD male rats with platform running train-ing for eight weeks.The changes of contractility under different electrical stimulation were observed, mito-chondrial biosynthesis,including ATP content,mito-chondrial DNA,the gene expression of PGC-1αand NRF were also detected.Results Long-term endur-ance exercise can improve twitch tension and titanic tension of SOL and EDL ,but only enhanced the fa-tigue resistance in SOL.ATP contents were significant-ly increased in the two types of muscles,but mtDNA content,PGC-1αexpression and NRF translation were only obviously enhanced in SOL,in accompanied with an increase in p-AMPK/AMPK protein ratio.Conclu-sion Long-term endurance exercise increased skeletal muscle contractility and improved the anti-fatigue abili-ty in SOL,which may be associated with increase in mitochondrial biosynthesis via activated AMPK-PGC-1αaxis.

Tratamento das áreas cruentas de perna com retalhos locais / Treatment of open wounds of the leg by using local flaps

INTRODUÇÃO: Até os anos 70, a reparação de perdas de substância na perna representava, quase sempre, um problema de solução muito difícil ou, até, insolúvel. Atualmente, embora ainda constitua um campo para os mais experientes, as áreas cruentas na perna já contam com várias técnicas confiáveis e algumas relativamente simples para sua reparação. Este trabalho visa equacionar condutas reparadoras de feridas de perna, utilizando tecidos locais. MÉTODO: Estudo retrospectivo pela análise de casos de reconstrução de perna com retalhos locais realizados pelos autores. Foram incluídos os retalhos dermoadiposos, fasciocutâneos, fasciossubcutâneos e musculares. RESULTADOS: Foram operados 70 pacientes que possuíam áreas cruentas na perna, em consequência de fratura de tíbia, osteomielite, perda tecidual isquêmica, úlcera crônica e tumoração de pele. Os resultados foram avaliados segundo etiologia, tipo de procedimento cirúrgico e complicações. CONCLUSÕES: A opção do tratamento de áreas cruentas de membros inferiores com retalhos locais é bastante válida. A escolha do retalho vai depender de condições locais da perna e da região anatômica afetada. No terço superior da perna, utilizamos retalhos fasciocutâneos baseados na rede vascular do joelho ou retalho de gastrocnêmio. Já no médio, os principais retalhos foram o solear e o fasciossubcutâneo de panturrilha. E, por fim, no inferior, o principal retalho usado foi o fasciossubcutâneo de panturrilha.

INTRODUCTION: Until the 70s, repairing loss of tissue in the leg was almost always difficult, or even impossible. Currently, only the most experienced surgeons are able to repair open wounds of the leg. Nevertheless, several reliable and simple techniques are currently available. This work aimed to evaluate repair techniques for leg wounds by using local tissues. METHOD: The authors performed a retrospective study of cases of leg reconstruction using local flaps. Dermoadipose, fasciocutaneous, fasciosubcutaneous, and muscle flaps were used. RESULTS: Seventy patients who had open areas in the leg due to tibial fractures, osteomyelitis, ischemic tissue loss, chronic ulcer, or skin tumor underwent surgery. Results were evaluated according to etiology, type of surgical procedure, and complications. CONCLUSIONS: The option of treating open wounds of the lower limbs by using local flaps is very valid. Selection of the flap type depended on local conditions in the leg, and the anatomical region affected. In the upper third of the leg, we used fasciocutaneous flaps, based on the vascular network of the knee, or gastrocnemius flaps. In the middle third of the leg, we used the soleus muscle as the primary flap, and fasciosubcutaneous flaps in the calf region. In the lower third of the leg, a fasciosubcutaneous flap of the calf was primarily used.

Effects of calorie restriction for 8 weeks on contractile function and mito-chondrial biosynthesis in different types of rat skeletal muscles / 中国病理生理杂志

AIM:To investigate the influence of calorie restriction ( CR) on contractility and mitochondrial bi-osynthesis in different types of rat skeletal muscles .METHODS:CR rat model was set up by feeding 60%normal food in-take of control rat every day for 8 weeks.Soleus (SOL) and extensor digitorum longus (EDL) were isolated under anesthe-sia.The twitch tension, titanic tension and fatigue resistance of SOL and EDL in response to electrical stimulation were measured to reflect the contractile function of the muscles .The copy number ratio of mitochondrial gene cytochrome C oxi-dase subunit I ( COX I) to nuclear gene β-actin was determined to evaluate the mitochondrial biosynthesis .ATP content was measured to mirror mitochondrial function .RESULTS:Compared with control group , CR for 8 weeks significantly in-creased twitch tension and titanic tension of both SOL and EDL , but only improved fatigue resistance in SOL .Markedly in-crease in ATP content in both skeletal muscles by CR intervention was observed , especially in SOL .Although CR activated AMP-activated protein kinase (AMPK) in both 2 muscles, up-regulation of mitochondrial biosynthesis and transcription of mitochondrial regulatory genes peroxisome proliferator-activated receptor γcoactivator 1α( PGC-1α) and nuclear respirato-ry factor ( NRF) was only observed in SOL .CONCLUSION:CR for 8 weeks enhanced the contractility of both rat SOL and EDL in response to electrical stimulation , especially in SOL composed of slow-twitch fibers.The mechanisms may be related to the activation of AMPK and the promotion of mitochondrial biosynthesis in SOL .

Anatomical study of the nerve regeneration after selective neurectomy in the rabbit: clinical application for esthetic calf reduction / 대한해부학회지

The purposes of this study were therefore to characterize the degeneration and regeneration of nerves to the calf muscles after selective neurectomy, both macroscopically and microscopically, and to determine the incidence of such regeneration in a rabbit model. Seventy four New Zealand white rabbits were used. Selective neurectomy to the triceps surae muscles was performed, and the muscles were subsequently harvested and weighed 1-4 months postneurectomy. The gastrocnemius muscles were stained with Sihler's solution to enable the macroscopic observation of any nerve regeneration that may have occurred subsequent to neurectomy. The change in triceps surae muscle weight was measured along the time course of the experiment. After neurectomy, nerve degeneration was followed by regeneration in all cases. The weight of the triceps surae muscle decreased dramatically between completion of the neurectomy and 1 month postneurectomy, but increased thereafter. The nerve branches were weakly stained with Sihler's solution until 2 months postneurectomy, and then strongly stained after 3 months. The number of myelinated axons was decreased at 2 month after neurectomy compared to nonneurectomized controls, but then gradually increased thereafter. Although there are currently no reports on the incidence of recovery after calf reduction, it may be a very common occurrence in the clinical field based on our findings. The findings of this study provide fundamental anatomical and surgical information to aid planning and practice in calf-reduction surgery.

Immobilization and therapeutic passive stretching generate thickening and increase the expression of laminin and dystrophin in skeletal muscle

Extracellular matrix and costamere proteins transmit the concentric, isometric, and eccentric forces produced by active muscle contraction. The expression of these proteins after application of passive tension stimuli to muscle remains unknown. This study investigated the expression of laminin and dystrophin in the soleus muscle of rats immobilized with the right ankle in plantar flexion for 10 days and subsequent remobilization, either by isolated free movement in a cage or associated with passive stretching for up to 10 days. The intensity of the macrophage response was also evaluated. One hundred and twenty-eight female Wistar rats were divided into 8 groups: free for 10 days; immobilized for 10 days; immobilized/free for 1, 3, or 10 days; or immobilized/stretched/free for 1, 3, or 10 days. After the experimental procedures, muscle tissue was processed for immunofluorescence (dystrophin/laminin/CD68) and Western blot analysis (dystrophin/laminin). Immobilization increased the expression of dystrophin and laminin but did not alter the number of macrophages in the muscle. In the stretched muscle groups, there was an increase in dystrophin and the number of macrophages after 3 days compared with the other groups; dystrophin showed a discontinuous labeling pattern, and laminin was found in the intracellular space. The amount of laminin was increased in the muscles treated by immobilization followed by free movement for 10 days. In the initial stages of postimmobilization (1 and 3 days), an exacerbated macrophage response and an increase of dystrophin suggested that the therapeutic stretching technique induced additional stress in the muscle fibers and costameres.

Influência de posições do joelho no torque e atividade mioelétrica do tríceps sural na flexão plantar isométrica máxima / Influence of knee positions on torque and myoelectric activity of triceps surae at maximum isometric plantar flexion

Os objetivos do estudo foram comparar o torque isométrico máximo de flexão plantar, em duas posições de joelho e analisar a variação da atividade miolétrica dos músculos do tríceps sural nas duas condições. A amostra composta de 14 homens saudáveis. O pé direito dos participantes foi fixado ao adaptador do aparelho isocinético com o tornozelo em 90 graus. Duas contrações isométricas voluntárias máximas de cinco segundos foram obtidas para cada posição do joelho: estendido e com 90 graus de flexão. Foram analisados o pico de torque flexor plantar médio e o valor RMS do sinal eletromiográfico (EMG) dos três segundos intermediários do gastrocnêmio lateral (GNL), gastrocnêmio medial (GNM) e sóleo para cada posição. Os torques médios nas posições de joelho em extensão e flexão foram 100,4 ± 17,4 Nm e 72,6 ± 18,4 Nm, respectivamente. Os gastrocnêmios apresentaram uma redução do valor RMS relativo com o joelho em flexão (40,5 ± 10,5 e 31,7 ± 25,6% para o GL e GM, respectivamente) enquanto o sóleo aumentou nessa condição (35,6 ± 28,9%). A redução do torque de flexão plantar parece estar associada ao resultado de um compromisso entre a inibição da atividade mioelétrica dos GNM e GNL, e otimização da ativação do sóleo. Os resultados podem contribuir no auxílio da prescrição de exercícios direcionados para o tríceps sural, enfatizando a ativação de diferentes músculos com variações no ângulo articular do joelho.

The aim of this study was to compare the maximum torque of plantar flexors using two knee positions and analyze the mioelectric activity variation of the muscles in both conditions. The sample was composed of 14 healthy men. The participants were positioned on the dynamometer with the right foot attached to the adapter in neutral position (ankle at 90º). Two five seconds of two consecutives maximum isometric voluntary contractions were obtained for each knee position: full extended and 90o. The gastrocnemius lateralis (GNL), medialis (GNM) and soleus RMS value of eletomyography signal and the plantar flexor peak torque average were acquired during three intermediate seconds. The average torques in the knee positions of extension and flexion were 100.4 ± 17.4 Nm and 72.6 ± 18.4 Nm respectively. With the knee flexed, the gastrocnemius presented a decreased activation (40.5 ± 10.5 e 31.7 ± 25.6% for lateral and medial, respectively) while the soleus showed an increased (35.6 ± 28.9%). The reduction of torque appears to result from a compromise between the inhibition of myoelectric activity of the gastrocnemius medialis and lateralis, while the soleus activation is optimized. The results may contribute to exercise prescription plantar flexors muscles emphasizing the different muscles activation varying the knee position.

Streptozotocin Diabetes Attenuates the Effects of Nondepolarizing Neuromuscular Relaxants on Rat Muscles

The hypothesis of this study was that diabetes-induced desensitization of rat soleus (SOL) and extensor digitorum longus (EDL) to non-depolarizing muscle relaxants (NDMRs) depends on the stage of diabetes and on the kind of NDMRs. We tested the different magnitude of resistance to vecuronium, cisatracurium, and rocuronium at different stages of streptozotocin (STZ)-induced diabetes by the EDL sciatic nerve-muscle preparations, and the SOL sciatic nerve-muscle preparations from rats after 4 and 16 weeks of STZ treatment. The concentration-twitch tension curves were significantly shifted from those of the control group to the right in the diabetic groups. Concentration giving 50% of maximal inhibition (IC50) was larger in the diabetic groups for all the NDMRs. For rocuronium and cisatracurium in both SOL and EDL, IC50 was significantly larger in diabetic 16 weeks group than those in the diabetic 4 weeks group. For SOL/EDL, the IC50 ratios were significantly largest in the diabetic 16 weeks group, second largest in the diabetic 4 weeks group, and smallest for the control group. Diabetes-induced desensitization to NDMRs depended on the stage of diabetes and on the different kind of muscles observed while was independent on different kind of NDMRs. The resistance to NDMRs was stronger in the later stage of diabetes (16 versus 4 weeks after STZ treatment). Additionally, when monitoring in SOL, diabetes attenuated the actions of neuromuscular blockade more intensely than that in EDL. Nonetheless, the hyposensitivity to NDMRs in diabetes was not relevant for the kind of NDMRs.