Muscle Gain after Transjugular Intrahepatic Portosystemic Shunt Creation: Time Course and Prognostic Implications for Survival in Cirrhosis.

PURPOSE: To examine the association of transjugular intrahepatic portosystemic shunt (TIPS) creation with muscle gains and patient mortality, and to identify the timeframe of these changes. MATERIALS AND METHODS: Patients with cirrhosis undergoing TIPS creation with available abdominal computed tomography before and after TIPS from 2004-2015 were included (n = 76). The primary indications for TIPS included refractory ascites (52.6%) or variceal bleeding (47.4%). Axial truncal muscle area and attenuation were measured at the L4 level using free-hand region of interest technique, and pre- and post-TIPS values were compared. The association of TIPS-related muscle changes with mortality was evaluated using Cox multiple regression. Logistic regression analysis was performed to evaluate associations of baseline muscle area and clinical variables with post-TIPS changes. RESULTS: TIPS creation was associated with significant increases in psoas, paraspinal, and total muscle areas (P < .001, 0.004, and 0.002), and psoas muscle attenuation (P = .022) at a median of 13.5 months after TIPS. Maximal muscle gains occurred within 6 months after TIPS creation (P < .001). Muscle gain at 1-year after TIPS was independently associated with lower mortality (psoas hazard ratio [HR] 0.14, P = .016; paraspinal HR 0.15, P = .016; abdominal HR 0.05, P = .005; core HR 0.06, P = .001; and total HR 0.05, P = .003). Baseline demographic or clinical variables were not associated with muscle gain after TIPS. CONCLUSIONS: TIPS creation was strongly associated with truncal muscle gains and attenuation in patients with cirrhosis. Maximal muscle gain occurred within 6 months after TIPS creation. TIPS-related increased muscle mass was independently associated with lower patient mortality.

Morphometric analysis of somatotropic cells of the adenohypophysis and muscle fibers of the psoas muscle in the process of aging in humans.

The aim of this research was to quantify changes of the adenohypophyseal somatotropes and types 1 and 2 muscle fibers with aging, as well as to establish mutual interactions and correlations with age. Material was samples of hypophysis and psoas major muscle of 27 cadavers of both genders, aged from 30 to 90 years. Adenohypophyseal and psoas major tissue sections were immunohistochemically processed and stained by anti-human growth hormone and anti-fast myosin antibodies, respectively. Morphometric analysis was performed by ImageJ. Results of morphometric analysis showed a significant increase in the somatotrope area, and significant decrease in somatotrope volume density and nucleocytoplasmic ratio with age. Cross-sectional areas of types 1 and 2, and volume density of type 2 muscle fibers decreased significantly with age. One Way ANOVA showed that the latter cited changes in the somatotropes and types 1 and 2 muscle fibers mostly become significant after the age of 70. Significant positive correlation was observed between the area of the somatotropes and volume density of type 2 muscle fibers. A significant negative correlation was detected between the nucleocytoplasmic ratio of the somatotropes and cross-sectional areas of types 1 and 2 muscle fibers. So, it can be concluded that after the age of 70, there is significant loss of the anterior pituitary's somatotropes associated with hypertrophy and possible functional decline of the remained cells. Age-related changes in the somatotropes are correlated with the simultaneous atrophy of type 1, as well as with the atrophy and loss of type 2 muscle fibers.

Nutritional evaluation of the lipid fraction of Iberian red deer (Cervus elaphus hispanicus) tenderloin.

The meat lipid fraction of psoas major muscle from 20 adult (10 males and 10 females) feral Iberian red deer (Cervus elaphus hispanicus) was characterized by quantification of total fat, total cholesterol, vitamin E and fatty acid (FA) composition, including detailed trans octadecenoate isomers and conjugated linoleic acid (CLA) isomeric profile. The total lipid content revealed a very lean meat (0.99 g/100g of meat), with total cholesterol content averaging 55.6 mg/100g of muscle. The FA profile displayed a very high PUFA level for ruminant meat (30.2g/100g FA). The 18:2 cis-9,trans-11 content was fairly low (0.26% of total FA) compared with other ruminant meats. The comparison of stags and hinds showed more similarities than differences. Nevertheless, hinds displayed superior contents of α-tocopherol and trans MUFA and a better n-6/n-3 ratio than stags.

Anatomical study on the psoas minor muscle in human fetuses / Estudio anatómico del músculo psoas menor en fetos humanos

The anatomy of the psoas minor muscle in human beings has frequently been correlated with ethnic and racial characteristics. The present study had the aim of investigating the anatomy of the psoas minor, by observing its occurrence, distal insertion points, relationship with the psoas major muscle and the relationship between its tendon and muscle portions. Twenty-two human fetuses were used (eleven of each gender), fixed in 10 percent formol solution that had been perfused through the umbilical artery. The psoas minor muscle was found in eight male fetuses: seven bilaterally and one unilaterally, in the right hemicorpus. Five female fetuses presented the psoas minor muscle: three bilaterally and two unilaterally, one in the right and one in the left hemicorpus. The muscle was independent, inconstant, with unilateral or bilateral presence, with distal insertions at different anatomical points, and its tendon portion was always longer than the belly of the muscle.

La anatomía del músculo psoas menor, en los seres humanos ha sido a menudo vinculada con cuestiones de orden étnico-raciales. Este estudio tuvo como objetivo evaluar la anatomía del músculo psoas menor en relación a su presencia, puntos de origen e inserción, relación con el músculo psoas mayor y sus porciones tendinosa y muscular. Se utilizaron 22 fetos humanos (11 de cada sexo) que fueron fijados en solución de formalina al 10 por ciento por perfusión a través de la arteria umbilical. El músculo psoas menor se encontró en 8 fetos de sexo masculino, siete bilateralmente y apenas uno unilateralmente en el hemicuerpo derecho. En los fetos de sexo femenino, cinco tenían el músculo psoas menor, tres bilateralmente y dos unilateralmente, siendo uno encontrado en el hemicuerpo derecho y otro en el izquierdo. El músculo es independiente, inconstante, de presencia unilateral o bilateral, con la inserción en diferentes sitios anatómicos y su porción tendinosa siempre mayor que el vientre muscular.

Polyneural innervation in the psoas muscle of the developing rat.

Polyneural innervation was studied in the psoas muscle in developing rats from P4 till P25 and at adult age, with the combined silver-acetylcholinesterase technique. Nerve endings were counted, and end-plates were measured. These data were compared with such data in the human. The end of polyneural innervation in the rat (around P20) and in the human (around 12 weeks postterm age) in both cases coincides with a transformation in motor behavior and postural control. The rat's psoas muscle at early stages is less heavily innervated than this muscle in the human. Up to three axons per motor end-plate were counted at P4, but in the human up to five axons at 25 weeks of post menstrual age. This difference might be related to the lower percentage of type I muscle fibers in the rat.

Age-related changes and location of type I, III and IV collagens during skeletal muscle development of double-muscled and normal bovine foetuses.

The aim of this study was to investigate age-related changes in collagen content in muscles of normal and double-muscled (DM) bovine foetuses. Psoas major (PM) and triceps brachii (TB) muscles were collected from foetuses at 110 to 260 days post-conception (p.c.), frozen and powdered. Cyanogen bromide (CNBr) digestion and hydroxyproline measurements were carried out on the powder. CNBr peptides underwent SDS-polyacrylamide gel electrophoresis, and type I and III collagen relative variations were measured by densitometric analysis. Type I and III procollagen mRNA were located by in situ hybridization and types I, III and IV collagen located by indirect immunofluorescence. Although there was no significant difference between normal and DM animals in the amounts of collagen (except in PM muscle at 180 and 230 days p.c.), there was nevertheless a tendency to lower collagen content in muscles of DM animals. Amounts of hydroxyproline in PM and TB muscles from 110 to 230 days p.c. increased two- and threefold to 8.5 micrograms per mg of dry matter (d.m.) and 12 micrograms per mg d.m., respectively, and then decreased up to 260 days p.c., when they were twice as high in TB muscle (9.1 micrograms per mg d.m.) as in PM (4.5 micrograms per mg d.m.). The same difference in hydroxyproline levels was observed between normal adult PM and TB muscles. These variations were explained, mainly, by those of type I. In foetal muscle, in both genotypes and as in adult muscle, perimysium was types I and III, and endomysium type I, III and IV. Procollagen type I and III mRNA were located in perimysium. In conclusion, this study emphasizes that at the end of foetal life, collagen content is representative of what it will be in adult in muscle of both normal and DM animals.

Regression of polyneural innervation in the human psoas muscle.

During the early stages of mammalian ontogeny muscle fibres are innervated by more than one axon. This polyneural innervation is replaced by mononeural innervation in the course of development. The regression of polyneural innervation in the psoas muscle in the human is the topic of the present study. Innervation patterns were studied in fetuses from 15 1/2 weeks of post menstrual age (PMA) and in babies until 80 weeks PMA (40 weeks after term age) and compared to data from two adults. Motor endplates were stained by a combined acetylcholinesterase stain. Innervation patterns and motor endplate morphology were studied and the sizes of endplates were measured. As a main result of our study polyneural innervation of the psoas muscle remains at a level of about 2 endings per endplate (range 1-5 terminals) until 18-25 weeks PMA and decreases thereafter. From 52 weeks PMA (12 weeks post term) onwards, muscle fibres are predominantly mononeurally innervated. During development the morphology of the terminal patterns of the nerve endings becomes more complex and the size of endplates increases, implying that the adult pattern of muscle innervation is reached at the age at which a major functional transformation in the neurobehavioural repertoire occurs (i.e. the end of the second and the beginning of the third month.

Metric features of the iliopsoas muscle in late fetuses and adults.

Differences in structure of iliopsoas muscle were documented in studies performed on 12 human fetuses, aging 37 to 40 weeks of gestational life and on 20 adult individuals. Results of measurements performed on the muscle were compared between fetuses of the perinatal age and adult individuals. Indirectly, the comparison allowed to draw conclusions as to changes in the muscle structure which take place in between the two developmental stages. The process was monitoring applying the metric techniques of studies and statistical interpretation of the results.