scholarly journals (in vivo Gastrocnemius Muscle) Tendon Ratio in Patients with Cerebral Palsy

2017 ◽  
Vol 11 (1) ◽  
pp. 577-582
Author(s):  
Muhammad Naghman Choudhry ◽  
Haris Naseem ◽  
Ihsan Mahmood ◽  
Adeel Aqil ◽  
Tahir Khan
Keyword(s):  
Cerebral Palsy ◽  
Gastrocnemius Muscle ◽  
Muscle Length ◽  
Leg Length ◽  
Normal Children ◽  
Surgical Incision ◽  
Average Percentage ◽  
Surgical Access ◽  
Iatrogenic Damage

Background: The position of the gastrocnemius tendon in relation to the leg length may be different in children with cerebral palsy as compared to normal children. The palpation of muscle bellies or previous experience of the operating surgeon is employed to place the surgical incision for lengthening of the gastrocnemius aponeurosis. Inaccurate localisation may cause incorrect incisions and a risk of iatrogenic damage to the vital structures (i.e. sural nerve). Objectives: The aim of our study is to compare gastrocnemius length in-vivo between paretic and unaffected children and create a formula to localise the muscle–tendon junction accurately. Methods: 10 children with di/hemiplegia (range 2-14y) were recruited. None of them had received any conventional medical treatment. An equal number of age/sex matched, typically developing children (range 4-14y) were recruited. Ultrasound scanning of the gastrocnemius muscle at rest was performed to measure the length of gastrocnemius bellies. We also measured the heights and leg lengths in all the children. Results: The gastrocnemius medial muscles were shorter in Cerebral Palsy children when compared to similar aged normal children. In cerebral palsy children, the gastrocnemius muscle and leg ratio ranged between 35 to 50% (average ratio of 45%). Conclusion: Using these figures, we created an average percentage for gastrocnemius muscle length that may be used clinically to identify the tendon for open/endoscopic lengthening and also to make simple and accurate localisation of gastrocnemius muscle-tendon junction for surgical access. This decreases the length of the surgical incision and may reduce the risk of iatrogenic injuries.

scholarly journals Concurrent YAP/TAZ and SMAD signaling mediate vocal fold fibrosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ryosuke Nakamura ◽  
Nao Hiwatashi ◽  
Renjie Bing ◽  
Carina P. Doyle ◽  
Ryan C. Branski
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Nuclear Accumulation ◽  
Smad Pathway ◽  
Surgical Interventions ◽  
Smad Signaling ◽  
Iatrogenic Damage ◽  
Tgf Β1

AbstractVocal fold (VF) fibrosis is a major cause of intractable voice-related disability and reduced quality of life. Excision of fibrotic regions is suboptimal and associated with scar recurrence and/or further iatrogenic damage. Non-surgical interventions are limited, putatively related to limited insight regarding biochemical events underlying fibrosis, and downstream, the lack of therapeutic targets. YAP/TAZ integrates diverse cell signaling events and interacts with signaling pathways related to fibrosis, including the TGF-β/SMAD pathway. We investigated the expression of YAP/TAZ following vocal fold injury in vivo as well as the effects of TGF-β1 on YAP/TAZ activity in human vocal fold fibroblasts, fibroblast-myofibroblast transition, and TGF-β/SMAD signaling. Iatrogenic injury increased nuclear localization of YAP and TAZ in fibrotic rat vocal folds. In vitro, TGF-β1 activated YAP and TAZ in human VF fibroblasts, and inhibition of YAP/TAZ reversed TGF-β1-stimulated fibroplastic gene upregulation. Additionally, TGF-β1 induced localization of YAP and TAZ in close proximity to SMAD2/3, and nuclear accumulation of SMAD2/3 was inhibited by a YAP/TAZ inhibitor. Collectively, YAP and TAZ were synergistically activated with the TGF-β/SMAD pathway, and likely essential for the fibroplastic phenotypic shift in VF fibroblasts. Based on these data, YAP/TAZ may evolve as an attractive therapeutic target for VF fibrosis.

Cerebral Palsy and Toe-Walking

1985 ◽  
Vol 6 (10) ◽  
pp. 304-304
Author(s):  
LAWRENCE T. TAFT
Keyword(s):  
Cerebral Palsy ◽  
General Population ◽  
Preschool Age ◽  
Learning Problems ◽  
Normal Children ◽  
Final Maturation ◽  
Walking Balance ◽  
Balance Problems ◽  
Toe Walking

A few readers of the article on cerebral palsy (PIR 1984;6:35-42) have indicated that persistent toe-walking may be a "normal" phenomenon. I know of no reported series of normal children who toe-walked at preschool age and older. In my own experience, walking intermittently on the toes without an obvious organic cause does occur. It probably reflects a mannerism whose dynamics remain unexplained. The concern is that persistent toe-walking without an evident organic cause may lead to heel cord contractures. Also, I have noted that toe-walking is seen in children who have personality, behavior, and/or learning problems. Admittedly, this association may simply reflect the type of children referred to me and cannot be applicable to the general population. I have speculated that if toe-walking in beginning walkers reflects the infant's compensatory attempt to throw his or her center of balance behind the hips so as not to fall forward when trying to establish walking balance, then, in those infants with subtle neuromotor balance problems, toe-walking may persist longer than usual. One might further speculate that, in spite of final maturation leading to better balance, toe-walking, which becomes unnecessary for balance, is continued as a "habit."

Control of glycolysis in vertebrate skeletal muscle during exercise

1996 ◽  
Vol 270 (4) ◽  
pp. R821-R829 ◽  
Author(s):  
U. Krause ◽  
G. Wegener
Keyword(s):  
Gastrocnemius Muscle ◽  
Rana Temporaria ◽  
High Capacity ◽  
Repeated Exercise ◽  
Frog Rana Temporaria ◽  
Time Courses ◽  
Fructose 1,6 Bisphosphate ◽  
Assay Conditions

The gastrocnemius muscle of the frog (Rana temporaria) has a high capacity for anaerobic glycolysis from glycogen. Glycolytic metabolites and effectors of phosphofructokinase, particularly the hexose bisphosphates, were followed in muscle during exercise (swimming between 5 s and 5 min), recovery (rest for up to 2 h after 5 min of swimming), and repeated exercise (swimming for up to 60 s after 2 h of recovery). Glycogen phosphorylase and phosphofructokinase were swiftly activated with exercise. The hexose bisphosphates followed markedly different time courses. Fructose 1,6-bisphosphate was transiently increased in both exercise and repeated exercise. This appears to be an effect rather than a cause of phosphofructokinase activation. Glucose 1,6-biphosphate was accumulated only while phosphofructokinase was active and was unchanged at other times. Fructose 2,6-biphosphate showed a 10-fold transient increase on exercise in rested frogs, almost disappeared from the muscle during recovery, and did not change during repeated exercise. Fructose 2,6-biphosphate is a potent activator of phosphofructokinase in vitro under near physiological assay conditions, and it may serve this function also in vivo during exercise. Glucose 1,6-biphosphate could be an activator of phosphofructokinase in repeated exercise when fructose 2,6-biphosphate is not available.

Effect of inactivity and passive stretch on protein turnover in phasic and postural rat muscles

1986 ◽  
Vol 61 (1) ◽  
pp. 173-179 ◽  
Author(s):  
P. Loughna ◽  
G. Goldspink ◽  
D. F. Goldspink
Keyword(s):  
Soleus Muscle ◽  
Muscle Length ◽  
Protein Breakdown ◽  
Fractional Rate ◽  
Hindlimb Muscles ◽  
Synthetic Rate ◽  
Suspension Model ◽  
Fast Twitch ◽  
Passive Stretch

A state of hypokinesia and hypodynamia has been induced in the hindlimb muscles of the rat (100 g) using a suspension model. The ensuing muscle atrophy was assessed by reference to muscles in fully mobile control animals, which were either fed ad libitum or fed the same lower food intake of the suspended animals. Over a total of 7 days of suspension the slow-twitch postural soleus muscle underwent a much greater atrophy than the fast-twitch phasic extensor digitorum longus. Changes with respect to the position of the suspended foot, and hence muscle length, necessitate caution in comparing the extent of the atrophy between different muscle types. After 3 days of inactivity the atrophy of the soleus muscle was explained by a 21% decrease in the fractional rate of synthesis (measured in vivo) and a 100% increase in the rate of protein breakdown. The reduction in the synthetic rate was associated with a net loss (23%) of RNA and hence muscle ribosomes. In contrast when this inactive soleus muscle was permanently stretched the RNA content (44%) and protein synthetic rate increased (59%) markedly above control values. Although protein breakdown remained elevated in this stretched muscle, the extent of the atrophy in response to hypokinesia and hypodynamia was greatly reduced.

scholarly journals Technique description: Incisionless ultrasound-assisted biceps tenotomy in dogs

2021 ◽  
Vol 10 (4) ◽  
pp. 457-464
Author(s):  
David Lane ◽  
Teresa Schiller
Keyword(s):  
Ultrasound Imaging ◽  
Invasive Technique ◽  
Hypodermic Needle ◽  
Surgical Incision ◽  
Percutaneous Approach ◽  
Complete Transection ◽  
Biceps Tenotomy ◽  
Iatrogenic Damage ◽  
Scalpel Blade ◽  
Open Arthrotomy

Background: Bicipital tendinitis and/or tendinopathy is a common cause of forelimb lameness in dogs, particularly in larger and more active patients. Although conservative treatment aimed at resolving discomfort and preserving the tendon remains the primary therapeutic goal, in certain cases it is necessary to surgically transect the tendon to eliminate pain and lameness. Transection of the tendon can be performed by open arthrotomy, arthroscopically, or percutaneously using a scalpel blade. This paper examines the utility of a modified percutaneous approach using ahypodermic needle in place of a scalpel blade, under ultrasound-guided assistance.Aim: To develop and describe a surgical technique for performing a percutaneous biceps tenotomy using a hypodermic needle under ultrasound guidance Method: The technique was piloted using the shoulders of 12 cadaver dogs initially and once developed, then applied to another 12 cadavers. The final procedure was performed on a total of 22 shoulders. Assessments were recorded on time to complete the procedure, completeness of bicipital tendon transection, and presence of any iatrogenic damage to associated joint structures. Results: Procedure time averaged fewer than 2 minutes. Complete transection was achieved in 20 out of 22 of the shoulders, with evidence of incomplete transection discernable by ultrasound imaging in the remaining two shoulders. One cadaver shoulder experienced iatrogenic damage secondary to incorrect hypodermic needle angulation. Conclusion: Percutaneous biceps tenotomy using a hypodermic needle is an efficient and straightforward procedure. The lack of a surgical incision makes it the least invasive technique devised so far. Ultrasound imaging allows thepractitioner to assess the completeness of the transection increasing precision.

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