Electrical stimulation attenuates morphological alterations and prevents atrophy of the denervated cranial tibial muscle / Eletroestimulação atenua alterações morfológicas e previne atrofia do músculo tibial cranial desnervado

ABSTRACT Objective To investigate if electrical stimulation through Russian current is able to maintain morphology of the cranial tibial muscle of experimentally denervated rats. Methods Thirty-six Wistar rats were divided into four groups: the Initial Control Group, Final Control Group, Experimental Denervated and Treated Group, Experimental Denervated Group. The electrostimulation was performed with a protocol of Russian current applied three times per week, for 45 days. At the end, the animals were euthanized and histological and morphometric analyses were performed. Data were submitted to statistical analysis with a significance level of p<0.05. Results The Experimental Denervated Group and the Experimental Denervated and Treated Group had cross-sectional area of smaller fiber compared to the Final Control Group. However, there was significant difference between the Experimental Denervated Group and Experimental Denervated and Treated Group, showing that electrical stimulation minimized muscle atrophy. The Experimental Denervated and Treated Group and Initial Control Group showed similar results. Conclusion Electrical stimulation through Russian current acted favorably in maintaining morphology of the cranial tibial muscle that was experimentally denervated, minimizing muscle atrophy.

RESUMO Objetivo Investigar se a estimulação elétrica pela corrente russa é capaz de manter a morfologia do músculo tibial cranial de ratos desnervados experimentalmente. Métodos Foram utilizados 36 ratos Wistar, distribuídos em quatro grupos: Grupo Controle Inicial, Grupo Controle Final, Grupo Experimental Desnervado Tratado, Grupo Experimental Desnervado. A eletroestimulação foi realizada com um protocolo de corrente russa aplicada três vezes por semanas, durante 45 dias. Ao final, os animais foram eutanasiados e, em seguida, foram realizadas as análises histológica e morfométrica. Os dados foram submetidos à análise estatística, com nível de significância de p<0,05. Resultados Os Grupos Experimental Desnervado e o Grupo Experimental Desnervado Tratado apresentaram área de secção transversal da fibra menor quando comparados ao Grupo Controle Final. Entretanto, constatou-se diferença significativa entre o Grupo Experimental Desnervado e o Grupo Experimental Desnervado Tratado, mostrando que a estimulação elétrica minimizou atrofia muscular. Ainda, observou-se que o Grupo Experimental Desnervado Tratado apresentou resultados semelhantes ao Grupo Controle Inicial. Conclusão A estimulação elétrica por meio da corrente russa foi favorável na manutenção da morfologia do músculo tibial cranial desnervado experimentalmente, minimizando a atrofia muscular.

Descompressão artroscópica indireta do cisto espinoglenoidal com neuropatia do supraescapular: relato de dois casos e revisão da literatura / Indirect arthroscopic decompression of spinoglenoid cyst with suprascapular neuropathy: report of two cases and literature review

A compressão do nervo supraescapular é entidade rara e deve ser considerada no diagnóstico diferencial de pacientes com dor no ombro e déficit de rotação externa. O cisto espinoglenoidal pode ser a causa da compressão e a lesão do lábio posterossuperior da glenoide a hipótese mais provável que explica o seu aparecimento. A ressonância magnética e a eletroneuromiografia definem o diagnóstico. A descompressão artroscópica indireta do cisto e o reparo do lábio glenoidal permitem completa recuperação neurológica. Os autores relatam dois casos de paralisia isolada do músculo infraespinal causados pela compressão de cistos espinoglenoidais tratados por artroscopia, bem como sua avaliação pré e pós-operatória.

Suprascapular nerve compression is rare and should be considered in the differential diagnosis of patients with shoulder pain and lateral rotation strength deficit. Spinoglenoidal cyst may be the reason for compression and a posterior superior glenoid lip rupture may be the most probable hypothesis for their appearance. Magnetic resonance imaging and electromyography define the diagnosis. Indirect arthroscopic decompression of the cyst and repair of glenoid lip allow for a neurologically complete recovery. The authors report two cases of isolated paralysis of the infraspinatus muscle caused by compression of spinoglenoids cysts treated by arthroscopy, as well as its pre- and post-operative assessment.

Effects of exercise training on atrophy gene expression in skeletal muscle of mice with chronic allergic lung inflammation

We evaluated the effects of chronic allergic airway inflammation and of treadmill training (12 weeks) of low and moderate intensity on muscle fiber cross-sectional area and mRNA levels of atrogin-1 and MuRF1 in the mouse tibialis anterior muscle. Six 4-month-old male BALB/c mice (28.5 ± 0.8 g) per group were examined: 1) control, non-sensitized and non-trained (C); 2) ovalbumin sensitized (OA, 20 µg per mouse); 3) non-sensitized and trained at 50 percent maximum speed _ low intensity (PT50 percent); 4) non-sensitized and trained at 75 percent maximum speed _ moderate intensity (PT75 percent); 5) OA-sensitized and trained at 50 percent (OA+PT50 percent), 6) OA-sensitized and trained at 75 percent (OA+PT75 percent). There was no difference in muscle fiber cross-sectional area among groups and no difference in atrogin-1 and MuRF1 expression between C and OA groups. All exercised groups showed significantly decreased expression of atrogin-1 compared to C (1.01 ± 0.2-fold): PT50 percent = 0.71 ± 0.12-fold; OA+PT50 percent = 0.74 ± 0.03-fold; PT75 percent = 0.71 ± 0.09-fold; OA+PT75 percent = 0.74 ± 0.09-fold. Similarly significant results were obtained regarding MuRF1 gene expression compared to C (1.01 ± 0.23-fold): PT50 percent = 0.53 ± 0.20-fold; OA+PT50 percent = 0.55 ± 0.11-fold; PT75 percent = 0.35 ± 0.15-fold; OA+PT75 percent = 0.37 ± 0.08-fold. A short period of OA did not induce skeletal muscle atrophy in the mouse tibialis anterior muscle and aerobic training at low and moderate intensity negatively regulates the atrophy pathway in skeletal muscle of healthy mice or mice with allergic lung inflammation.

Long term evaluation of functional and morphological bladder alterations on alloxan-induced diabetes and aging: experimental study in rats / Avaliação funcional e morfológica tardia de alterações na bexiga secundárias ao diabetes induzido por aloxano e no envelhecimento: estudo experimental em ratos

PURPOSE: to evaluate structural and functional effects of Alloxan- induced diabetes and aging on bladder of rats. METHODS: evaluations were performed in three groups: A - 8 weeks of age, B - 44 weeks of age, C - 44 weeks of age with alloxan-induced diabetes. Muscle layer thickness, extracellular matrix fibrosis and collagen were quantified on digital images of bladder samples. Cystometric evaluations before surgical vesical denervation (SVD), included maximum cystometric capacity (MCC), maximum bladder pressure (MBP), bladder contraction frequency (VCF), duration of bladder contraction (DC), threshold pressure (TP) and bladder compliance (BC). After SVD, maximum cystometric capacity (MCC), BC and maximum urethral closing pressure (MUCP) were also measured. RESULTS: Reduced extracellular matrix fibrosis concentration and contraction strength were found in the bladders of group C. Before SVD, bladder compliance was not different between groups. Alterations were observed in MCC after SVD. CONCLUSIONS: We did not notice smooth muscle hypertrophy in Alloxan-induced diabetic rats after 44 weeks. There was alteration in the total and relative amount of fibrosis and collagen. The cystometric studies support the idea that this morphological alterations are important to determine the different bladder functional patterns found in the aging and the Alloxan-induced diabetic animals.

OBJETIVOS: avaliar alterações estruturais e funcionais da bexiga de ratos machos, associadas ao diabetes induzido por aloxano e ao envelhecimento. MÉTODOS: três grupos de animais: A - 8 semanas de idade; B- 44 semanas de idade; C - 44 semanas de idade com diabetes induzido por aloxano, foram avaliados. Realizadas medidas de espessura da camada muscular, fibrose de matriz extracelular e quantidade de colágeno, através de análise de imagem digital dos tecidos. Realizados também testes cistométricos, antes da desnervação vesical cirúrgica (DVC), para avaliar capacidade vesical (CV), intensidade máxima de contração vesical (IMCV) e complacência vesical. Após a DVC, foram avaliadas capacidade vesical após a desnervação (CVAD), complacência vesical (CV) e pressão de perda uretral (PPU). RESULTADOS: não foi observada hipertrofia da camada muscular nas bexigas; houve diminuição da concentração de fibrose da matriz extracelular e diminuição da força contrátil, e aumento da capacidade vesical no grupo C. CONCLUSÕES: a atrofia da camadas muscular da bexiga esta relacionada ao diabetes induzido por aloxano. O envelhecimento, como fenômeno isolado, provoca alterações nos parâmetros funcionais, porém associado ao diabetes, gera alterações na IMCV, CV e CVAD. Existe correlação entre alterações estruturais e funcionais nos animais diabéticos após a desnervação.

Distal hereditary motor neuropathy in Korean patients with a small heat shock protein 27 mutation

Distal hereditary motor neuropathy (dHMN) is a heterogeneous disorder characterized by degeneration of motor nerves in the absence of sensory abnormalities. Recently, mutations in the small heat shock protein 27 (HSP27) gene were found to cause dHMN type II or Charcot-Marie-Tooth disease type 2F (CMT2F). The authors studied 151 Korean axonal CMT or dHMN families, and found a large Korean dHMN type II family with the Ser135Phe mutation in HSP27. This mutation was inherited in an autosomal dominant manner, and was well associated with familial members with the dHMN phenotype. This mutation site is located in the ?-crystallin domain and is highly conserved between different species. The frequency of this HSP27 mutation in Koreans was 0.6%. Magnetic resonance imaging analysis revealed that fatty infiltrations tended to progressively extend distal to proximal muscles in lower extremities. In addition, fatty infiltrations in thigh muscles progressed to affect posterior and anterior compartments but to lesser extents in medial compartment, which differs from CMT1A patients presenting with severe involvements of posterior and medial compartments but less involvement of anterior compartment. The authors describe the clinical and neuroimaging findings of the first Korean dHMN patients with the HSP27 Ser135Phe mutation. To our knowledge, this is the first report of the neuroimaging findings of dHMN type II.

Indicadores antropométricos, composición corporal y limitaciones funcionales en ancianos / Anthropometry, body composition and functional limitations in the elderly

Background: Functional limitations limit the independence and jeopardize the quality of life of elderly subjects. Aim: To assess the association between anthropometric measures and body composition with functional íimitations in community-living older people. Material and Methods: Cross-sectional survey of 377 people >6 5 years old (238 women), randomly selected from the SABE/Chile project. Complete anthropometric measurements were done. Handgrip muscle strength was measured using dynamometers. Body composition was determined using Dual-Energy X-Ray Absorptiometry. Functional limitations were assessed using self reported and observed activities. Results: Body mass index was strongly associated with fat mass (men r =0.87; women r =0.91) and with lean mass (men r =0.55; women r =0.62). Males had significantly greater lean mass (48.9 kg vs 34.9 kg), and bone mass than females (2.6 kg vs 1.8 kg) and women had higher fat mass than men (26.3 kg vs 22.9 kg). The prevalence of functional íimitations was high, affecting more women than men (63.7 percent vs 37.5 percent, p <0.01). Functional íimitations were associated with lower handgrip strength in both sexes. In the multiple regression models, with functional íimitations as dependent variable and anthropometric measures as contributing variables, only hand grip strength had a significant association (negative) with functional íimitation in both genders. Age was also a significant risk factor for functional íimitations among women. Conclusions: Hand grip strength was strongly and inversely associated with functional íimitations. Handgrip dynamometry is an easy, cheap and low time-consuming indicator for the assessment of functional íimitations and the evaluation of geriatric interventions aimed to improve functional ability.

Benign monomelic amyotrophy with proximal upper limb involvement: case report

Monomelic amyotrophy (MA) is a rare condition in which neurogenic amyotrophy is restricted to an upper or lower limb. Usually sporadic, it usually has an insidious onset with a mean evolution of 2 to 4 years following first clinical manifestations, which is, in turned, followed by stabilization. We report a case of 20-years-old man who presented slowly progressive amyotrophy associated with proximal paresis of the right upper limb, which was followed by clinical stabilization 4 years later. Eletroneuromyography revealed denervation along with myofasciculations in various muscle groups of the right upper limb. We call atention to this rare location of MA, as well as describe some theories concerning its pathophysiology .

A amiotrofia monomélica é condição rara em que a amiotrofia neurogênica é restrita somente a um membro superior ou inferior. Usualmente esporádica, possui um início insidioso e evolução lenta de 2-4 anos após as primeiras manifestações, seguida por estabilização. Relatamos o caso de um homem que aos 20 anos apresentou lentamente amiotrofia e paresia proximal no membro superior direito, estabilizando-se em quatro anos. A eletroneuromiografia identificou a presença de desnervação e fasciculações em diversos músculos proximais do membro superior direito. Chamamos a atenção para esta rara localização desta entidade, assim como descrevemos algumas das hipóteses da fisiopatologia.

Estudio clínico de la hipertrofia maseterina / Clinical study of masseter hypertrophy

La hipertrofia maseterina es una condición que presentan algunos pacientes que acuden a la consulta odontológica. En muchas ocasiones son referidos por ser confundidos con una tumoración de glándulas salivales o de los maxilares, sobre todo las unilaterales. El odontólogo muchas veces se sorprende frente a esta condición que, en la mayoría de los casos, está acompañada de hábitos indeseables como masticar exagerado, el bruxismo y trastornos sicológicos asociados al estrés. Se hace una revisión de la literatura y se presenta un estudio clínico de los pacientes que asisten al servicio de postgrado de Cirugía Bucal de la Facultad, donde se encontró gran relación entre la hipertrofia maseterina clínica y el hábito del bruxismo; igualmente llama la atención el grupo etario de estos pacientes en la 2da y 3ra década de la vida. Se ofrece un aporte al conocimiento de los músculos masticatorios, en este caso del músculo masetero con una condición que prsenta relativa frecuencia de hipertrofia maseterina

Enfermedad de Charcot Marie Tooth (Neuropatía hereditaria sensitivo motora, NHSM). Manifestaciones clínicas y su tratamiento ortopédico en 21 pacientes / Charcot-Marie-Tooth disease (hereditary senso-motor neupathy). Clinical manifestations and their orthopaedic treatment in 21 patients

Se revisaron 21 pacientes con diagnóstico de enfermedad de Charcot-Marie-Tooth o Neuropatía Hereditarias Sensitivo Motora (CMT o NHSM) con edad promedio de 13.4 años (rango de 6 a 23), fueron 11 pacientes femeninos y 10 masculinos. El inicio de la sintomatología ocurrió a la edad promedio de 4.5 años (rango de 1 a 10.1). El diagnóstico se realizó en forma clínica, por velocidad de conducción nerviosa y biopsia en todos los pacientes. Del total de pacientes, 18 se diagnosticaron como CMT clásico o NHSM tipo I; 2 pacientes con variante Roussy-levy (NHSM tipo II), y un sólo pacientes con la variante Dejerine-Sottas (NHSM tipo III). El seguimiento mínimo fue de 1 año y máximo de 10 años (promedio de 6.8 años). Dentro de las manifestaciones clínicas encontramos deformidad cavo-varo de ambos pies en todos los pacientes y asociado a esta deformidad 4 pacientes presentaron ortejos en garra bilateral, uno tuvo segundo ortejo en garra bilateral, y en un paciente ambos pies se observaron péndulos. En 4 pacientes se presentó afección motora de extremidades superiores y en uno de estos también fue sensitiva en forma leve. Escoliosis de la columna se diagnósticó en el paciente con la variante (NHSM tipo III) y subluxación de la cadera en un paciente con CMT clásico. Los pacientes fueron clasificados de acuerdo a las características de la deformidad en tres estadios y en base a estos se estableció el tipo de tratamiento, siendo este de tipo conservador (estadio I) fisioterapia y ortesis; y Quirúrgico (estadio II y III) transferencias tendinosas, fasciotomías, tenotomías, osteotomías, falangectomías, artrodesis, cotiloplastía, e instrumentación segmentaria de columna. Conocemos que estos pacientes tarde o temprano llegaran al tratamiento quirúrgico pero el manejo conservador les permite una mejor marcha o función y disminución de la sintomatología

Síndrome compressiva do nervo supraescapular: resumo de casos e revisäo da literatura / Compression syndrome of Suprascapular nerve: a summary of cases and review of the literature

A síndrome de compressao do nervo supra escapular é uma entidade ainda pouco diagnosticada na clínica médica. Geralmente o diagnóstico é tardio e somente lembrado após surgimento de atrofia importante de musculatura supra e ou infra espinhosa. O diagnóstico é fácil, fundamentalmente baseado na história clínica e nos achados eletromiográficos que sao característicos de neuropatia. O diagnóstico preciso do nível de lesao do nervo supra escapular deve ser corretamente pesquisado através de estudo eletroneuromiográfico. Descrevemos aqui 2 grupos de pacientes com diagnóstico de compressao do nervo supra escapular. A maioria destes eram jovens, homens, com lesao no dimidio direito, relato de dor em ombro, apresentando fraqueza e ou atrofia dos músculos infra e supra espinhosos. História de elevaçao de pesos ou de exercícios repetidos em ombro foi observada em 92,8 por cento destes pacientes, demonstrando assim a etiologia principalmente traumática desta doença.

Enfermedad de Landry-Guillain-Barre-Strohl: estudio clínicopatológico de 35 casos de autopsia / Landry-Guillain-Barre-Strohl disease: a clinical and pathological study of 35 autopsy cases

Se informa una serie de 35 casos autopsiados de polineuropatía inflamatoria idiopática aguda (Enfermedad de Guillain-Barré). La enfermedad fué más frecuente en hombres, principalmente en los decenios tercero y quinto de la vida. En lamayoría de los enfermos no xistió una infección viral previa y la elevación de proteínas en el líquido cerebro espinal fué sólo un hallazgo ocasional. El tiempo de evolución fué muy variable y el síntoma predominante fué déficit motor. Los hallazgos neuropatológicos fueron microscópicos, desde muy sutiles como edema, desmielinización de raíces motoras y activación de células de Schwann, hasta cromatólisis central en las neuronas de las astas anteriores de la médula espinal, indicaativa de daño axonal en casos de evolución de más de 10 días. Se comparan los datos obtenidos en nuestro estudio con los de otras series y se discute la probable patogenia de la entidad

Síndrome de Charcot-Marie-Tooth / Charcot-Marie-Tooth syndrome

El síndrome de Charcot-Marie-Tooth (sCMT) comprende un grupo de neuropatías periféricas hereditarias cuya ubicación nosográfica no es precisa. En nuesta serie de 25 pacientes la distribución de los casos fue claramente bimodal en relación con la velocidad de conducción nerviosa motora: un grupo a) presentó conducciones severamente reducidas y un grupo b) presentó conducciones normales o ligeramente reducidas (exceptuando un paciente con valores intermedios). El grupo b) pudo subdividirse en 1) pacientes con alteraciones sensitivas (clínicas o neurofisiológicas) y 2) pacientes sin alteraciones de la sensibilidad. Los tres grupos a, b1 y b2 corresponden a las formas hipertrófica, neuronal (y neuronal "plus" cuando se agregan alteraciones del SNC) y espinal. Las neuropatías hereditarias sensitivomotoras o motoras tipo sCMT deben tenerse en cuenta cuando no hay causas evidentes de polineuropatía en el primer caso y cuando la presentación es atípica en el segundo