Current rehabilitation applications for shoulder ultrasound imaging.

SYNOPSIS: The available body of knowledge on shoulder ultrasound imaging has grown considerably within the past decade, and physical therapists are among the many health care professions currently exploring the potential clinical integration of this imaging technology and the knowledge derived from it. Therefore, the primary purpose of this commentary was to review the recent evidence and emerging uses of ultrasound imaging for the clinical evaluation of shoulder disorders. This includes a detailed description of common measurement techniques along with their known clinimetric properties. Specifically provided are critical appraisals of the existing measures used to estimate soft tissue and bony morphometry, muscle contractile states, and lean muscle density. These appraisals are intended to help clinicians clarify the scope of physical therapy practice for which these measurement techniques are effectively utilized and to highlight areas in need of further development.

Assessment of muscle architecture of the biceps femoris and vastus lateralis by ultrasound after a chronic stretching program.

OBJECTIVE: To evaluate the chronic effects of a static stretching program on the muscle architecture of biceps femoris (BF) and vastus lateralis (VL) muscles in ultrasound (US) images. DESIGN: Randomized controlled longitudinal trial. SETTING: Biomechanics Laboratory of Physical Education School of the Army, Rio de Janeiro, Brazil. PARTICIPANTS: The study included 24 healthy and physically active male volunteers (19.05 ± 1.40 years, 1.73 ± 0.07 m, and 73.15 ± 8.33 kg), randomly allocated to 1 of 2 groups: stretching group (SG, n = 12) and control group (n = 12). INTERVENTIONS: The SG was submitted to 3 sets of 30 seconds of static stretching 3 times a week during 8 weeks. MAIN OUTCOME MEASURES: Ultrasound equipment (7.5 MHz) was used for the evaluation of BF and VL muscle architecture variables (pennation angle, fiber length, muscle thickness, and fascicle displacement) before and after training. Knee range of motion (ROM) and isometric flexion and extension torque (TQ) were also measured. RESULTS: There were no significant changes in muscle architecture, TQ, and maximum knee flexion angle (P > 0.05). However, maximum knee extension angle (MEA) increased significantly in the SG (pretraining: 159.37 ± 7.27 degrees and posttraining: 168.9 ± 3.7 degrees; P < 0.05). CONCLUSIONS: Volume or intensity (or both) of the stretching protocol was insufficient to cause structural changes in the VL and BF muscles. The increase in MEA could not be explained by muscle architecture changes. CLINICAL RELEVANCE: To describe changes in the VL and BF muscle tendon unit using US after a long-term stretching program to identify which structures are responsible for ROM increase.

Effects of changes in muscle activation level and spine and hip posture on erector spinae fiber orientation.

INTRODUCTION: During lumbar flexion, the fiber orientation of the lumbar erector spinae (LES) muscle becomes oriented more along the spine compressive axis. It is unknown how changes in LES activation effect fiber orientation. METHODS: Ultrasound images of LES were collected during 2 sets of experimental conditions: (1) varying levels of LES activation while lying prone; and (2) varying spine and hip angles while seated. Electromyographic activity and lumbar spine and hip angles were also recorded. RESULTS: As LES activation increased, increases in fiber orientation (signifying increased orientation along the posterior shear axis) were found (P<0.001). Compared with the relaxed sitting posture, decreases in fiber orientation were found with full spine flexion and combined spine and hip flexion (P<0.001), but there were no changes with full hip flexion alone. CONCLUSIONS: Activation magnitude and spine posture both affect LES fiber orientation, thus modifying its ability to protect the spine against anterior shear forces.

Heterogeneous fascicle behavior within the biceps femoris long head at different muscle activation levels.

Magnetic resonance and ultrasound imaging have shown hamstring strain injuries occur most often in the biceps femoris long head (BFLH), and particularly in the proximal vs. distal region of this muscle. Animal research and musculoskeletal modeling (MSK) have detected heterogeneous fascicle behavior within muscle regions, and within fascicles. Understanding architectural behavior differences during muscle contractions may help to discern possible mechanisms behind proximal BFLH injuries. The purpose of our study was to assess the magnitude of shortening of the proximal and distal fascicles of the BFLH under a range of muscle activation levels under isometric conditions using ultrasound imaging (US). Thirteen healthy adults performed targeted sustained isometric contractions while US were taken of the entire BFLH. Measurements of fascicle lengths in both muscle regions were compared at 20%, 30%, 50%, and 67% MVIC. The results showed that while both regions shortened significantly with activation, the proximal fascicles were significantly longer, regardless of activation level (~38%), and shortened significantly more than the distal fascicles overall (~40%), and cumulatively at higher activation levels (30% and above). No significant strain differences were found between the two regions. These data suggest heterogeneous fascicle behavior exists in an absolute sense; however, differences in behavior are eliminated when normalized (strain). Coupled with MSK literature, the absence of regional fascicle strain differences in this study may indicate strain heterogeneity is not detectable at the whole fascicle level. Further knowledge of this commonly strained muscle's regional behavior during dynamic movements could provide evidence of proximal hamstring strain predisposition.

Ultrasound investigation of vastus medialis oblique muscle architecture: an in vivo study.

There is thought to be a link between vastus medialis oblique (VMO) architecture and patellofemoral pain syndrome (PFPS). Historical data are largely derived from older populations, whereas PFPS commonly affects younger populations. The aim of this study was to gather data on VMO architecture in young asymptomatic adults, to provide baseline values for comparison with symptomatic sufferers. VMO maximum fiber angle and insertion ratio were measured with ultrasound. The insertion ratio represents the proportion (%) of the patella which has the muscle fibers attaching to its medial border. Eighty knees from 40 healthy young subjects (18 males, 22 females, and age 20-30) were assessed. Individual Tegner scores were recorded to assess participants' level of physical activity. Results were compared with data in the literature for PFPS sufferers and normal older individuals. Mean fiber angle and insertion ratio were 56.6° and 57.8%, respectively. There was no significant difference between age groups. The insertion ratio was higher among females (61.2% F:53.6% M). There was some evidence of increased fiber angle and decreased insertion ratio with increased Tegner score. There was some overlap in fiber angle between healthy knees in this study and values reported elsewhere for pathological knees. VMO fiber angle and insertion ratio are not age-related. The overlap in fiber angle values between healthy and pathological knees suggests that the cause of PFPS is multifactorial. An individual's VMO architecture may be affected by their physical activity level, which could have important implications for PFPS.

An efficient framework for estimation of muscle fiber orientation using ultrasonography.

BACKGROUND: Muscle fiber orientation (MFO) is an important parameter related to musculoskeletal functions. The traditional manual method for MFO estimation in sonograms was labor-intensive. The automatic methods proposed in recent years also involved voting procedures which were computationally expensive. METHODS: In this paper, we proposed a new framework to efficiently estimate MFO in sonograms. We firstly employed Multi-scale Vessel Enhancement Filtering (MVEF) to enhance fascicles in the sonograms and then the enhanced images were binarized. Finally, line-shaped patterns in the binary map were detected one by one, according to their shape properties. Specifically speaking, for the long-and-thinner regions, the orientation of the targeted muscle fibre was directly computed, without voting procedures, as the orientation of the ellipse that had the same normalized second central moments as the region. For other cases, the Hough voting procedure might be employed for orientation estimation. The performance of the algorithm was evaluated using four various group of sonograms, which are a dataset used in previous reports, 33 sonograms of gastrocnemius from 11 young healthy subjects, one sonogram sequence including 200 frames from a subject and 256 frames from an aged subject with cerebral infarction respectively. RESULTS: It was demonstrated in the experiments that measurements of the proposed method agreed well with those of the manual method and achieved much more efficiency than the previous Re-voting Hough Transform (RVHT) algorithm. CONCLUSIONS: Results of the experiments suggested that, without compromising the accuracy, in the proposed framework the previous orientation estimation algorithm was accelerated by reduction of its dependence on voting procedures.

Estimating skeletal muscle fascicle curvature from B-mode ultrasound image sequences.

We address the problem of tracking in vivo muscle fascicle shape and length changes using ultrasound video sequences. Quantifying fascicle behavior is required to improve understanding of the functional significance of a muscle's geometric properties. Ultrasound imaging provides a noninvasive means of capturing information on fascicle behavior during dynamic movements; to date however, computational approaches to assess such images are limited. Our approach to the problem is novel because we permit fascicles to take up nonlinear shape configurations. We achieve this using a Bayesian tracking framework that is: 1) robust, conditioning shape estimates on the entire history of image observations; and 2) flexible, enforcing only a very weak Gaussian Process shape prior that requires fascicles to be locally smooth. The method allows us to track and quantify fascicle behavior in vivo during a range of movements, providing insight into dynamic changes in muscle geometric properties which may be linked to patterns of activation and intramuscular forces and pressures.

Dynamic measurement of pennation angle of gastrocnemius muscles during contractions based on ultrasound imaging.

BACKGROUND: Muscle fascicle pennation angle (PA) is an important parameter related to musculoskeletal functions, and ultrasound imaging has been widely used for measuring PA, but manually and frame by frame in most cases. We have earlier reported an automatic method to estimate aponeurosis orientation based on Gabor transform and Revoting Hough Transform (RVHT). METHODS: In this paper, we proposed a method to estimate the overall orientation of muscle fascicles in a region of interest, in order to complete computing the orientation of the other side of the pennation angle, but the side found by RVHT. The measurements for orientations of both fascicles and aponeurosis were conducted in each frame of ultrasound images, and then the dynamic change of pennation angle during muscle contraction was obtained automatically. The method for fascicle orientation estimation was evaluated using synthetic images with different noise levels and later on 500 ultrasound images of human gastrocnemius muscles during isometric plantarflexion. RESULTS: The muscle fascicle orientations were also estimated manually by two operators. From the results it's found that the proposed automatic method demonstrated a comparable performance to the manual method. CONCLUSIONS: With the proposed methods, ultrasound measurement for muscle pennation angles can be more widely used for functional assessment of muscles.

Subject-specific tendon-aponeurosis definition in Hill-type model predicts higher muscle forces in dynamic tasks.

Neuromusculoskeletal models are a common method to estimate muscle forces. Developing accurate neuromusculoskeletal models is a challenging task due to the complexity of the system and large inter-subject variability. The estimation of muscles force is based on the mechanical properties of tendon-aponeurosis complex. Most neuromusculoskeletal models use a generic definition of the tendon-aponeurosis complex based on in vitro test, perhaps limiting their validity. Ultrasonography allows subject-specific estimates of the tendon-aponeurosis complex's mechanical properties. The aim of this study was to investigate the influence of subject-specific mechanical properties of the tendon-aponeurosis complex on a neuromusculoskeletal model of the ankle joint. Seven subjects performed isometric contractions from which the tendon-aponeurosis force-strain relationship was estimated. Hopping and running tasks were performed and muscle forces were estimated using subject-specific tendon-aponeurosis and generic tendon properties. Two ultrasound probes positioned over the muscle-tendon junction and the mid-belly were combined with motion capture to estimate the in vivo tendon and aponeurosis strain of the medial head of gastrocnemius muscle. The tendon-aponeurosis force-strain relationship was scaled for the other ankle muscles based on tendon and aponeurosis length of each muscle measured by ultrasonography. The EMG-driven model was calibrated twice - using the generic tendon definition and a subject-specific tendon-aponeurosis force-strain definition. The use of subject-specific tendon-aponeurosis definition leads to a higher muscle force estimate for the soleus muscle and the plantar-flexor group, and to a better model prediction of the ankle joint moment compared to the model estimate which used a generic definition. Furthermore, the subject-specific tendon-aponeurosis definition leads to a decoupling behaviour between the muscle fibre and muscle-tendon unit in agreement with previous experiments using ultrasonography. These results indicate the use of subject-specific tendon-aponeurosis definitions in a neuromusculoskeletal model produce better agreement with measured external loads and more physiological model behaviour.

Passive mechanical properties of gastrocnemius muscles of people with ankle contracture after stroke.

OBJECTIVE: To investigate the mechanisms of contracture after stroke by comparing passive mechanical properties of gastrocnemius muscle-tendon units, muscle fascicles, and tendons in people with ankle contracture after stroke with control participants. DESIGN: Cross-sectional study. SETTING: Laboratory in a research institution. PARTICIPANTS: A convenience sample of people with ankle contracture after stroke (n=20) and able-bodied control subjects (n=30). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Stiffness and lengths of gastrocnemius muscle-tendon units, lengths of muscle fascicles, and tendons at specific tensions. RESULTS: At a tension of 100N, the gastrocnemius muscle-tendon unit was significantly shorter in participants with stroke (mean, 436mm) than in able-bodied control participants (mean, 444mm; difference, 8mm; 95% confidence interval [CI], 0.2-15mm; P=.04). Muscle fascicles were also shorter in the stroke group (mean, 44mm) than in the control group (mean, 50mm; difference, 6mm; 95% CI, 1-12mm; P=.03). There were no significant differences between groups in the mean stiffness or length of the muscle-tendon units and fascicles at low tension, or in the mean length of the tendons at any tension. CONCLUSIONS: People with ankle contracture after stroke have shorter gastrocnemius muscle-tendon units and muscle fascicles than control participants at high tension. This difference is not apparent at low tension.

Modulation of the soleus H-reflex during knee rotations is not consistent with muscle fascicle length changes.

The purpose of this study was to examine whether passively rotating the knee would result in parallel or differential changes to the medial gastrocnemius (MG) and soleus (SOL) H-reflex amplitudes. Since passive knee rotation alters the muscle length of the MG, but not the SOL, it was hypothesized that the MG H-reflex would reflect the lengthening or shortening actions that occur during knee rotation, whereas the SOL H-reflex would remain unaltered. MG and SOL Hoffman reflexes (H-reflexes) were evoked with the knee joint held static at 10° or as the joint was passively flexed or extended past 10°. Ultrasound recordings were used to confirm whether the knee rotations altered MG but not SOL muscle fascicle lengths. In contrast to our hypothesis, results indicated that the MG and SOL H-reflexes were similarly affected during knee rotations, with both MG and SOL H(max):M(max) smaller during the knee extension than the knee flexion (33-43% reduction) and static (22-28% reduction) conditions. Parallel changes to the MG and SOL H-reflexes occurred despite a differential effect of knee rotation on muscle fascicle lengths. Whereas, MG muscle fascicles lengthened and shortened during knee extension and flexion, respectively, SOL fascicles length remained unchanged. Given the strong neural coupling between the MG and SOL motoneuron pools, the results highlight the difficulty in isolating specific variables (e.g., muscle length) when determining the modulatory influences on the triceps surae H-reflex amplitude.

[Sonographic evaluation of the levator ani muscle in women with stress urinary incontinence]. / Ultrasonograficzna ocena miesnia dzwigacza odbytu u kobiet z wysilkowym nietrzymaniem moczu.

UNLABELLED: Three-dimensional sonography has been used for about 15 years, not only to examine the female genital organs, but also the lower urinary tract and pelvic floor. Three-dimensional sonography offers more information than traditional two-dimensional sonography allowing for a dynamic representation of the examined structures and observation at any angle necessary. Translabial sonography is the best way of a sonographic examination of the lower urinary tract, because it does not affect the mutual relationship of any parts in the lower pelvic area, contrary to the transrectal or transvaginal probes. In order to establish proper treatment of the urinary incontinence symptoms, not only a functional examination of the lower urinary tract, but also a very accurate assessment of the statics of the female genital organs and pelvic floor need to be performed. BACKGROUND: The aim of the study was to rate the area and diameters of the limbs of the levator ani muscle using a three-dimensional (3D) translabial sonography in women with stress urinary incontinence without the female genital tract prolapse. MATERIAL AND METHODS: The study group included 100 patients who were examined with the GE Kretz Voluson 730 (GE, Austria), equipped with 6-9 MHz translabial probe. The first group with stress urinary incontinence consisted of 50 women (mean age 56.22 (+/- 10.43) years) and the second group included 50 women without symptoms (mean age 49.40 (+/- 13.22) years). All cases of urinary stress incontinence in the first group were confirm by means of a urodynamic examination. Women in both groups had similar body weight (kilograms), mean (+/- SD): 26.88 (+/- 2.02) and 26.20 (+/- 4,14), respectively. Menopausal status in both groups was not statistically significant and amounted to 7.21 (+/- 8.71) in the group of women with stress urinary incontinence and 4.70 (+/- 6.32) in the group without symptoms. Mean (+/- SD) number of deliveries was significantly higher in the group of women with stress urinary incontinence than in the control group (2.40 (+/- 1.03) and 1.56 (+/- 1.34), respectively). In all cases 3D coronal view of the pelvic diaphragm was obtained and the area and thickness of limbs of the levator ani muscle were measured. All women had about 200 ml urine in the bladder. RESULTS: The results are presented as means +/- SD. Mean measurements of this area in both groups were 8.54 +/- 1.62 cm2 and 10.57 +/- 1.29 cm2, respectively. Mean thickness of the limbs in the groups were: 8.72 +/- 0.64mm and 10.85 +/- 0.89mm on the left side and 8.85 +/- 0.67mm and 10.89 +/- 0.87mm on right side, respectively. The differences between both groups in all measurements were statistically significant (p < 0.001). CONCLUSIONS: There are some differences involving measurements of the thickness and the area of the limbs of the levator ani muscle in women with and without stress urinary incontinence and without the genital tract prolapse in both groups. The observed differences could have implications in physiotherapy of the pelvic floor muscles in women without statics abnormalities.

Alterations in intramuscular water movement associated with mechanical changes in human skeletal muscle fibers: an evaluation using magnetic resonance diffusion-weighted imaging and B-mode ultrasonography.

BACKGROUND: Intramuscular water movement is expected to be affected by the mechanical changes of the muscle fibers. However, the effect of changes in fiber length (FL) and pennation angle (PA) on the water movement has not been sufficiently investigated in human skeletal muscles. PURPOSE: To determine the relationship between intramuscular water movement and the mechanical changes in human muscle fibers. MATERIAL AND METHODS: Axial magnetic resonance diffusion-weighted images of the right leg (eight men) were taken using a 1.5-Tesla device with the ankle joint maximally dorsiflexed and maximally plantar flexed. The apparent diffusion coefficient (ADC) values of both the dorsiflexors (the superficial and deep parts of the tibialis anterior) and the plantar flexors (medial gastrocnemius and soleus) were calculated along three orthogonal axes (S-I: superior-to-inferior, A-P: anterior-to-posterior, and R-L: right-to-left). FL and PA of both muscle groups were also calculated from longitudinal B-mode ultrasound images with the ankle joint maximally dorsiflexed and plantar flexed. RESULTS: There was a significant increase in the ADC in superficial (P < 0.05) and deep (P < 0.05) parts of the dorsiflexors in the S-I direction when the ankle was plantar flexed and in the A-P and R-L directions when the ankle was dorsiflexed (P < 0.05). The plantar flexors showed significantly elevated ADC in the S-I direction when the ankle was dorsiflexed (P < 0.05), and in the A-P and R-L directions when the ankle was plantar flexed (P < 0.05). The dorsiflexors also showed significantly increased PA and decreased FL values when the ankle was dorsiflexed (P < 0.05). The plantar flexors displayed similar morphological changes when the ankle was plantar flexed (P < 0.05). CONCLUSION: Water diffusion is affected by structural changes in the long axis of the muscle fibers, namely the changes in PA and FL.

Automatic tracking of muscle fascicles in ultrasound images using localized Radon transform.

Ultrasound images of muscle fascicles have been widely used to investigate muscle properties under static/dynamic and pathologic conditions. Fascicle images are usually detected and measured manually, which is subjective and time consuming, especially when dealing with large number of images. In this study, an automatic linear extraction method based on localized Radon transform and revoting strategy is proposed to detect and track muscle fascicles in ultrasound images. The performance of the proposed method is compared to another automatic linear feature extraction method of revoting Hough transform using both simulated images generated by Field II and clinical images from two human subjects. The proposed tracking method is further validated using experimental data. Both the simulation and experimental results show that the proposed method is robust in the presence of speckle noise, accurate in terms of orientation and position measurement, and feasible for analyzing clinical data.

Longitudinal enhancement of the hyperechoic regions in ultrasonography of muscles using a Gabor filter bank approach: a preparation for semi-automatic muscle fiber orientation estimation.

In this study, to complement our previously proposed method for estimating muscle fiber orientation, the Gabor filter bank (GF) technique was applied to sonograms of the biceps and forearm muscles to longitudinally enhance the coherently oriented and hyperechoic perimysiums regions. The method involved three steps: orientation field estimation, frequency map computation and Gabor filtering. The method was evaluated using a simulated image distorted with multiplicative speckle noises where the "muscles" were arranged in a bipennate fashion with an "aponeurosis" located in the middle. After enhancement using the GF approach, most of the original hyperechoic bands in the simulated image could be recovered. The proposed method was also tested using a group of biceps and forearm muscle sonograms collected from healthy adult subjects. Compared with the sonograms without enhancement, the enhanced images led to the detection of more linear patterns including muscle fascicles and smaller angle differences compared with the mean of manual results from two operators, therefore, were better prepared for the automatic estimation of muscle fiber orientation. The proposed method has the potential of assisting in the visualization of strongly oriented patterns in skeletal muscle sonograms as well as in the semi-automatic estimation of muscle fiber orientations.

Denervation dynamically regulates integrin alpha7 signaling pathways and microscopic structures in rats.

BACKGROUND: Peripheral nerve injury causes serious problems in orthopedic and plastic surgeries. Cell adhesion molecules such as integrin alpha7 provoke cell binding and signaling pathways within myofibers. Expression profiles of integrin alpha7 signaling pathways and the molecule's microscopic structure were assessed to investigate the long-term dynamic changes in denervated rat skeletal muscle. METHODS: A denervated rat skeletal muscle model was established by severing the sciatic nerve for 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks, 20 weeks, and 26 weeks. Molecular expressions were investigated by mRNA and Western blot. The structural alterations were detected by immunohistochemistry, scanning electron microscopy, and transmission electron microscopy. RESULTS: The denervated muscle atrophy presented the following dynamic molecular alterations: an initial increase around postdenervation in week (PIW) 8 and then a subsequent decay of integrin alpha7, integrin downstream signaling pathway (Ras or Raf or, ERK1/2), Akt, cleaved caspase-3, fast myosin heavy chain (MHC), beta actin, and RhoA. We demonstrated that the expressions of multiple signaling molecules were highly upregulated at PIW 8 (p<0.01). Scanning electron microscopy findings of the surface textures of myofibers showed more severe damage at PIW 8 and subsequently became smoother. Inner structures of myofibers separated with discontinuity on transmission electron microscopy examinations. CONCLUSION: Our novel finding showed that time-series alterations of integrin alpha7 signaling molecules and surface microstructures in the long-term denervated rat skeletal muscle are biphasic and coherently dynamic. Persisted p-Akt elevation suggested that denervated muscle may regenerate if reinnervation or other treatment was performed.

Micro-computed tomography with iodine staining resolves the arrangement of muscle fibres.

We illustrate here microCT images in which contrast between muscle and connective tissue has been achieved by means of staining with iodine. Enhancement is shown to be dependent on the concentration of iodine solution (I(2)KI), time in solution and specimen size. Histological examination confirms that the arrangement of individual muscle fibres can be visualised on the enhanced microCT images, and that the iodine accumulates in the muscle fibres in preference to the surrounding connective tissues. We explore the application of this technique to describe the fibrous structure of skeletal muscle, and conclude that it has the potential to become a non-destructive and cost-effective method for investigating muscle fascicle architecture, particularly in comparative morphological studies.

Relationship of intramyocellular lipid to insulin sensitivity may differ with ethnicity in healthy girls and women.

The prevalence of type 2 diabetes is greater among African Americans (AA) vs. European Americans (EA), independent of obesity and lifestyle. We tested the hypothesis that intramyocellular lipid (IMCL) or extramycellular lipid (EMCL) would be associated with insulin sensitivity among healthy young women, and that the associations would differ with ethnic background. We also explored the hypothesis that adipokines and estradiol would be associated with muscle lipid content. Participants were 57 healthy, normoglycemic, women and girls mean age 26 (±10) years; mean BMI 27.3 (±4.8) kg/m²; 32 AA, 25 EA. Soleus IMCL and EMCL were assessed with ¹H magnetic resonance spectroscopy (MRS); insulin sensitivity with an insulin-modified frequently sampled intravenous glucose tolerance test and minimal modeling; body composition with dual-energy X-ray absorptiometry; and intra-abdominal adipose tissue (IAAT) with computed tomography. Adiponectin, leptin, and estradiol were assessed in fasting sera. Analyses indicated that EMCL, but not IMCL, was greater in AA vs. EA (2.55 ± 0.16 vs. 1.98 ± 0.18 arbitrary units, respectively, P < 0.05; adjusted for total body fat). IMCL was associated with insulin sensitivity in EA (r = -0.54, P < 0.05, adjusted for total fat, IAAT, and age), but not AA (r = 0.16, P = 0.424). IMCL was inversely associated with adiponectin (r = -0.31, P < 0.05, adjusted for ethnicity, age, total fat, and IAAT). In conclusion, IMCL was a significant determinant of insulin sensitivity among healthy, young, EA but not AA women. Further research is needed to determine whether the component lipids of IMCL (e.g., diacylglycerol (DAG) or ceramide) are associated with insulin sensitivity in an ethnicity specific manner.

Post-transcriptional silencing of the Drosophila homolog of human ZASP: a molecular and functional analysis.

In humans, mutations in ZASP (the gene for Z-band alternatively spliced PDZ-motif protein) are associated with dilated cardiomyopathy and left ventricular non-compaction. In particular, mutations in or around the Zasp motif seem to be related to myofibrillar myopathy. Thus, "zaspopathies" include symptoms such as Z-line disgregation, proximal and distal muscle weakness, cardiomyopathies, and peripheral neuropathies. In order to understand the role of ZASP in muscle structure and function, we have performed a molecular characterization of the Drosophila ortholog of human ZASP and a functional analysis following the post-transcriptional silencing of the Drosophila gene. Transcriptional analysis of dzasp has revealed six additional exons, with respect to the known 16, and multiple splice variants. We have produced transgenic lines harboring constructs that, through the use of the UAS/Gal4 binary system, have enabled us to drive dsRNA interference of dzasp in a tissue-specific manner. Knockdown individuals show locomotor defects associated with alterations of muscle structure and ultrastructure, consistent with a role of dzasp specifically in the maintenance of muscular integrity.