Muscular Groups Research Articles

Muscle synergies during the walk-run and run-walk transitions.

Muscular synergies could represent the patterns of muscular activation used by the central nervous system (CNS) to simplify the production of movement. Studies in walking-running transitions described up to nine synergy modules, and an earlier activation of flexor and extension ankle muscular groups compared to running or walking. Our project aims to study the behaviour of muscle synergies in different stance and swing variations of walking-running (WRT) and running-walking (RWT) transitions. Twenty-four trained men participated in this study. A variable speed protocol on a treadmill was developed to record the activity of 14 muscle during walking, running and relative transitions. The protocol was based on five ramps of 50 seconds each around±10 and 20% of the WRT speed. WRT and RWT were identified according to an abrupt change of the duty factor. Analysing surface electromyography using non-negative matrix factorization (NMF) we obtained synergy modules and temporal activation profiles. Alpha threshold for statistical tests set at 0.05. We described four different transition strides, two for increasing speed transitions, and two for decreasing speed transitions. Four to six synergy modules were found in each condition. According to the maximum cosine similarity results, the two identified WRT conditions shared five modules, while the two RWT conditions shared four modules. WRT and RWT overall shared 4.33±0.58 modules. The activation profiles and centres of activation revealed differences among conditions. Transition occurred at step level, and transition strides were composed by walk-like and run-like steps. Compared with previous studies in running and walking, both transitions needed earlier activation of a comparable number of synergy modules. Synergies were affected by acceleration: during RWT the need to dissipate energy, to decrease the speed, was achieved by increasing the number of co-activating muscles. This was reflected in fewer synergy modules and different activation profiles compared to WRT. We believe that our results could be enforced in different applied fields, like clinical gait analysis, physiotherapy and rehabilitation, where plans including co-activation of specific muscular groups could be useful. Gait transitions are common in different sports, and therefore also application in training and sport science would be possible.

Relationship among muscle strength, muscle endurance, and skeletal muscle oxygenation dynamics during ramp incremental cycle exercise.

Peak oxygen uptake (VO2), evaluated as exercise tolerance, is a strong predictor of life prognosis regardless of health condition. Several previous studies have reported that peak VO2 is higher in those with a greater decrease in muscle oxygen saturation (SmO2) in the active muscles during incremental exercise. However, the skeletal muscle characteristics of individuals exhibiting a greater decrease in SmO2 during active muscle engagement in incremental exercise remain unclear. This study aimed to clarify the relationship among muscle strength, muscle endurance, and skeletal muscle oxygenation dynamics in active leg muscles during incremental exercise. Twenty-four healthy young men were included and categorized into the non-moderate-to-high muscular strength and endurance group (those with low leg muscle strength, endurance, or both; n = 11) and the moderate-to-high muscular strength and endurance group (those with both moderate-to-high leg muscle strength and endurance; n = 13). All participants underwent cardiopulmonary exercise testing combined with near-infrared spectroscopy to assess whole-body peak VO2 and the change in SmO2 at the lateral vastus lateralis from rest to each exercise stage as skeletal muscle oxygenation dynamics. A linear mixed-effects model, with the change in SmO2 from rest to each stage as the dependent variable, individual participants as random effects, and group and exercise load as fixed effects, revealed significant main effects for both group (P = 0.001) and exercise load (P < 0.001) as well as a significant interaction between the two factors (P < 0.001). Furthermore, multiple-comparison test results showed that the change in SmO2 from rest to 40%-100% peak VO2 was significantly higher in the moderate-to-high muscular strength and endurance group than in the non-moderate-to-high muscular strength and endurance group. Maintaining both muscle strength and endurance at moderate or higher levels contributes to high skeletal muscle oxygenation dynamics (i.e., greater decrease in SmO2) during moderate- or high-intensity exercise.

The Effect of C2 Muscular Exposure Technique on Radiographic and Clinical Outcomes After C2-T2 Posterior Cervical Fusion.

Retrospective cohort analysis. To determine whether the C2 exposure technique was a predictor of change in cervical alignment and patient-reported outcomes measures (PROMs) after posterior cervical decompression and fusion (PCDF) for degenerative indications. In PCDF handling of the C2 posterior paraspinal musculature during the operative approach varies by surgeon technique. To date, no studies have investigated whether maintenance of the upper cervical semispinalis cervicis attachments as compared with complete reflection of upper cervical paraspinal musculature from the posterior bony elements is associated with superior radiographic and clinical outcomes after PCDF. All adult patients who underwent C2-T2 PCDF for myelopathy or myeloradiculopathy at multi-institutional academic centers between 2013 and 2020 were retrospectively identified. Patients were dichotomized by the C2 exposure technique into semispinalis preservation or midline muscular reflection groups. Preoperative and short and long-term postoperative radiographic outcomes (upper cervical alignment, global alignment, and fusion status) and PROMs (Visual Analog Scale-Neck, Neck Disability Index, and Short Form-12) were collected. Univariate analysis compared patient factors, radiographic measures, and PROMs across C2 exposure groups. A total of 129 patients met the inclusion/exclusion criteria (73 muscle preservation and 56 muscle reflection). Patients in the muscular preservation group were on average younger (P= 0.005) and more likely to have bone morphogenic protein (P< 0.001) and C2 pars screws (P= 0.006) used during surgery. Preoperative to postoperative changes in C2 slope, C2 tilt, C2-C3 segmental lordosis, C2-C3 listhesis, C0-C2 Cobb angle, proximal junctional kyphosis, ADI, C1 lamina-occiput distance, C2 sagittal vertical axis, C2-C7 lordosis, and PROMs at all follow-up intervals did not vary significantly by C2 exposure technique. Likewise, there were no significant differences in fusion status, C2-C3 pseudoarthrosis, C2 screw loosening, and complication and revision rates between C2 exposure groups. Preservation of C2 semispinalis attachments versus muscular reflection did not significantly impact cervical alignment, clinical outcomes, or proximal junction complications in long-segment PCDF. Level III.

Outcomes after elevation of serratus anterior fascia flap versus serratus muscle flap in direct-to-implant breast reconstruction following mastectomy: a prospective study.

The purpose of this study was to compare postoperative pain between SF flap and serratus anterior muscle (SM) in direct-to-implant breast reconstruction. This is a prospective cohort study that included 53 women diagnosed with breast cancer who underwent mastectomy and one-stage implant-based breast reconstruction from January 2020 to March 2021. Twenty-nine patients (54.7%) had SF elevation, and 24 patients (45.3%) underwent SM elevation. We evaluated patient-reported early postoperative pain on the first day after surgery. Also, it was reported that all surgical complications in the first month and patient reported outcomes (PROs) were measured with the BRECON 23 questionnaire. The serratus fascia group used implants with larger volumes, 407.6 ± 98.9 cc (p < 0.01). There was no significant difference between the fascial and muscular groups regarding the postoperative pain score reported by the patients (2 versus 3; p = 0.30). Also, there was no difference between the groups regarding early surgical complications and PROs after breast reconstruction. The use of SF seems to cause less morbidity, which makes the technique an alternative to be considered in breast reconstruction. Although there was no statistical difference in postoperative pain scores between the fascia and serratus muscle groups.

Age-Related Differences in Physical Fitness and Performance of an “Ability Test” among Firefighters

This study’s primary objective was to examine the differences in body composition, abdominal strength, absolute and relative power, handgrip strength, one repetition maximum for squat and bench press, and the maximum count of push-up and sit-up repetitions executed within a minute across different age cohorts of firefighters. Furthermore, this study aimed to evaluate the age-related differences in firefighters’ completion times of six firefighting tasks. Eighty-four male volunteer firefighters (age 33.79 ± 6.97 years) were grouped into three age categories, 20–30 years, 31–40 years, and 41–50 years, and underwent the aforementioned evaluations. One-way analysis of variance (MANOVA) revealed that age exerts a statistically significant influence (p &lt; 0.001) on body fat percentage, waist circumference, and waist-to-hip ratio. Furthermore, age significantly affected the overall time of the ability test (p &lt; 0.001) and the duration required to accomplish each individual task (p &lt; 0.001). Additionally, age significantly affected abdominal strength, relative power (as measured by the step test), and the maximum count of push-up and sit-up repetitions performed within a minute. These outcomes support earlier research indicating an age-associated decrement in physical fitness parameters among firefighters. It is recommended that firefighters prioritize maintaining strength and endurance of the abdominal muscles, upper body muscular endurance, and a healthy body weight. The emphasis on specific muscular groups is essential for improving task performance within this profession.

Physical and Rehabilitation Medicine: say relational or functional, not holistic.

Modern medicine tends to privilege disciplines promising "objective" laws governing body parts (from molecules to organs). Studies on a person's illness and disability are (apparently) confined to "subjectivity." The Specialty of Physical and Rehabilitation Medicine is often regarded as a humanitarian approach, belonging at best to the family of "soft," "qualitative," or "quasi-experimental" sciences. This specialty often claims specificity by labelling itself as "functional" and "holistic." However, it is shown here that the former term is acceptable, yet redundant, and the second misleading. When human behaviors and perceptions are at stake, "function" indicates a person's relationship with the outer world (already tackled by the definitional term "physical" from the Greek "physis"). The word "holistic" emphasizes mind-body unity and person-environment interdependence but, in current usage, overshadows the complementary need for an analytic, experimental approach to any function. Medicine aims at fighting disease and disability in single persons. This endeavor requires knowing body parts and mechanisms and understanding how interventions on "parts" affect the "whole." This understanding rests on the experimental method. For instance, returning to a given societal role (participation) may require restoration of walking (activity), which may require reinforcement of weakened muscular groups (impairment). Working only on holistic bio-psycho-social "wholes" may miss the therapeutic mission of medicine.

The effect of 6-week different resistance training on shooting performance among elite archers

Archery is a sport that needs archers to shoot the arrows to the target by using a bow that requires muscular strength and endurance to form a proper technique to hit the target precisely. Therefore, the purpose of this study is to investigate the effects of 6-week different resistance training on shooting accuracy among archers. This study was carried out using an experimental research design. 12 men were recruited in this study and were divided into two groups; muscular strength training group (n = 6) and muscular endurance training group (n = 6). Both groups had undergone 6-week training program differently and had to perform pre- and post-shooting tests. The result showed that there was a significant increment in the shooting accuracy in muscular strength group (p = .000) and muscular endurance group (p = .001). This increment was reflected in the nature of the archers when they had to pull the string strongly and repeatedly during a game. In conclusion, the 6-week resistance training has had a positive influence towards archers’ shooting accuracy. Future studies are recommended to compare between elite and non-elite archers for new finding on accuracy.

Comparison of clinical outcomes among patients with isolated axial vs muscular calf vein thrombosis: A systematic review and meta-analysis

ObjectiveThrombi in the axial calf veins have quite different anatomical and physiological characteristics from that in the muscular calf veins, but their treatment was usually addressed in the same manner. We performed a meta-analysis of randomized and cohort studies to compare clinical outcomes among patients with isolated axial vs muscular calf deep vein thrombosis (DVT). MethodsRecurrent venous thromboembolism (VTE) was selected as the primary outcome. Resolution, proximal propagation of calf DVT, pulmonary embolism (PE), major bleeds, and clinically relevant non-major bleeds were separately analyzed as secondary outcomes. Data were pooled and compared with risk ratio (RR) and 95% confidence interval (CI). ResultsThirteen studies, consisting of 4889 patients, met the inclusion criteria and were included for analysis. A greater rate of recurrent VTE (FE model: RR, 1.23; 95% CI, 1.00-1.53; I2 = 29%), resolution (FE model: RR, 1.32; 95% CI, 1.01-1.72; I2 = 31%), proximal propagation (FE model: RR, 1.63; 95% CI, 1.10-2.41; I2 = 40%), and PE (FE model: RR, 2.79; 95% CI, 1.31-5.95; I2 = 0%) in the axial group compared with the muscular group. There was no difference in the pooled estimates for major bleeds (FE model: RR, 1.09; 95% CI, 0.61-1.95; I2 = 0%), and clinically relevant non-major bleeds (FE model: RR, 1.80; 95% CI, 0.93-3.48) in the axial and muscular arms. ConclusionsPatients with calf DVT limited to muscular veins might have a lower rate of recurrent VTE, resolution, proximal propagation, and PE vs those with axial calf vein involvement and exhibited similar safety outcomes.

Prognostic Utility of Cardiovascular Magnetic Resonance-Based Phenotyping in Patients With Muscular Dystrophy.

Background The prognostic utility of cardiovascular magnetic resonance imaging, including strain analysis and tissue characterization, has not been comprehensively investigated in adult patients with muscular dystrophy. Methods and Results We prospectively enrolled 148 patients with dystrophinopathies (including heterozygotes), limb-girdle muscular dystrophy, and type 1 myotonic dystrophy (median age, 36.0 [interquartile range, 23.0-50.0] years; 51 [34.5%] women) over 7.7 years in addition to an age- and sex-matched healthy control cohort (n=50). Cardiovascular magnetic resonance markers, including 3-dimensional strain and fibrosis, were assessed for their respective association with major adverse cardiac events. Our results showed that markers of contractile performance were reduced across all muscular dystrophy groups. In particular, the dystrophinopathies cohort experienced reduced left ventricular (LV) ejection fraction and high burden of replacement fibrosis. Patients with type 1 myotonic dystrophy showed a 26.8% relative reduction in LV mass with corresponding reduction in chamber volumes. Eighty-two major adverse cardiac events occurred over a median follow-up of 5.2 years. Although LV ejection fraction was significantly associated with major adverse cardiac events (adjusted hazard ratio [aHR], 3.0 [95% CI, 1.4-6.4]) after adjusting for covariates, peak 3-dimensional strain amplitude demonstrated greater predictive value (minimum principal amplitude: aHR, 5.5 [95% CI, 2.5-11.9]; maximum principal amplitude: aHR, 3.3 [95% CI, 1.6-6.8]; circumferential amplitude: aHR, 3.4 [95% CI, 1.6-7.2]; longitudinal amplitude: aHR, 3.4 [95% CI, 1.7-6.9]; and radial strain amplitude: aHR, 3.0 [95% CI, 1.4-6.1]). Minimum principal strain yielded incremental prognostic value beyond LV ejection fraction for association with major adverse cardiac events (change in χ2=13.8; P<0.001). Conclusions Cardiac dysfunction is observed across all muscular dystrophy subtypes; however, the subtypes demonstrate distinct phenotypic profiles. Myocardial deformation analysis highlights unique markers of principal strain that improve risk assessment over other strain markers, LV ejection fraction, and late gadolinium enhancement in this vulnerable patient population.

Evolutionary study of the extrinsic thoracic limb muscles of the domestic cat (Felis catus, Feliformia, Carnivora) based on their topology and innervation

AbstractExtrinsic thoracic limb muscles are a muscular group that supports the thoracic limb in mammals without the clavicle and serve to move the scapula and shoulder joint. However, there are few evolutionary studies of these muscles in Felis catus, which should take into account the topology and innervation of the muscles to hypothesize the muscle derivation from a common ancestor. The main objective of this study was to check the extrinsic thoracic limb muscles in ten cadavers. Intra‐ and interspecific anatomical variants were found with that formerly described and other felids. Based on the topology and innervation found in this study, the evolutionary derivation was hypothesized. Therefore, the omotransversarius and rhomboideus muscles are derived from the serratus ventralis cervicis muscle. The cleidobrachialis muscle is derived mainly from the m. deltoideus and accessorily from the supracoracoid muscular group. The pectoantebrachialis and pectoralis abdominalis muscles are derived from the pectoralis descendens and cutaneus trunci muscles, respectively. In conclusion, most extrinsic thoracic limb muscles of F. catus may have evolutionary derivations from the last common ancestor of mammals, while some of them are from the last common ancestor of carnivorans or within the family Felidae.

Effects of Muscular Strength Training on Oral Health and Quality of Life: Using Korean Panel Survey Data, a Cross-Sectional Study.

The purpose of this study is to confirm the importance of muscular strength exercise by confirming the relationship between strength exercise, oral health, and quality of life. Using the 2019 and 2021 of the Korean National Health and Nutrition Examination Survey (KNHANES), 6535 people were selected as subjects. Complex sampling analysis was applied to all analyses; 2267 people were in the muscular strength training group (MSG), and 5841 people were in the non-muscular strength training group (NMSG). A multi-sample linear regression analysis was conducted to confirm the effect of muscular strength training on oral health and quality of life. As a result of confirming the effect of muscular strength training on oral health status, problems with chewing decreased by 0.105, and problems with speaking decreased by 0.028 with MSG compared to NMSG. In addition, compared to NMSG, it was confirmed that MSG reduced chewing discomfort by 0.047, while self-perceived oral health improved by 0.0123. Finally, as a result of confirming the effect of muscular strength training on oral health and quality of life in Korean adults, there was a significant effect on quality of life despite adjusting for sociodemographic characteristics and oral-health-related factors (p < 0.05). In this study, the relationship between muscular strength training and quality of life was confirmed. Therefore, efforts should be made to make oral health management and muscular strength training a part of life in relation to quality of life.

Effects of voluntary running on the skeletal muscle of rats with pulmonary artery hypertension.

The effects of voluntary running on the skeletal muscle of rats with pulmonary arterial hypertension (PAH) were tested in the present study. PAH was induced in rats by a single injection of monocrotaline (MCT, 60mg/kg). Rats in the sedentary hypertension (HS) group had their tolerance to physical exertion reduced throughout the experiment, while those in the sedentary control (SC), exercise control (EC), exercise hypertension (EH) and median exercise (EM) groups maintained or increased. Despite that, the muscular citrate synthase activity was not different between groups. The survival time was higher in the EH (32days) than in the SH (28days) (p = 0.0032). SH and EH groups showed a lower percentage of muscle fiber and a higher percentage of extracellular matrix compared to control groups (p < 0.0001). However, the EM and EH groups presented higher percentage of muscle fiber and lower percentage of extracellular matrix than SH group (p < 0.0001). Regarding muscular gene expression, the SH and EM groups showed a lower expression of PGC1-α (p = 0.0024) and a higher expression of VEGF (p = 0.0033) compared to SC, while PGC1-α was elevated in the EH. No difference between groups was found for the carbonylated protein levels (p > 0.05), while the TNF-α/IL-10 ratio was augmented in the EH (p = 0.0277). In conclusion, voluntary running augments the proportion of fiber and affects the gene expression of inflammatory and mitochondrial biogenesis' markers in the skeletal muscle of rats with MCT-induced PAH, which benefits their survival and tolerance to physical effort.

Strategies for calculating contrast media dose for chest CT

BackgroundTotal body weight (TBW) is a frequently used contrast media (CM) strategy for dose calculation in enhanced CT, yet it is suboptimal as it lacks consideration of patient characteristics, such as body fat percentage (BFP) and muscle mass. Alternative CM dosage strategies are suggested by the literature. Our objectives were to analyze the CM dose impact when adjusting to body composition using methods of obtaining lean body mass (LBM) and body surface area (BSA) along with its correlation with demographic factors in contrast enhanced chest CT examinations.MethodsEighty-nine adult patients referred for CM thoracic CT were retrospectively included, categorized as either normal, muscular, or overweight. Patient body composition data was used to calculate the CM dose according to LBM or BSA. LBM was calculated with the James method, Boer method, and bioelectric impedance (BIA). BSA was calculated using the Mostellar formula. We then correlated the corresponding CM doses with demographic factors.ResultsBIA demonstrated the highest and lowest calculated CM dose in muscular and overweight groups respectively, compared to other strategies. For the normal group, the lowest calculated CM dose was achieved using TBW. The calculated CM dose was more closely correlated with BFP using the BIA method.ConclusionsThe BIA method is more adaptive to variations in patient body habitus especially in muscular and overweight patients and is most closely correlated to patient demographics. This study could support utilizing the BIA method for calculating LBM for a body-tailored CM dose protocol for enhanced chest CT examinations.Relevance statementThe BIA-based method is adaptive to variations in body habitus especially in muscular and overweight patients and is closely correlated to patient demographics for contrast-enhanced chest CT.Key points• Calculations based on BIA showed the largest variation in CM dose.• Lean body weight using BIA demonstrated the strongest correlation to patient demographics.• Lean body weight BIA protocol may be considered for CM dosing in chest CT.Graphical

Functional and phylogenetic interpretation of the forelimb myology of two South American carnivorans, the ring-tailed coati (Nasua nasua) and crab-eating raccoon (Procyon cancrivorus).

A comparative analysis of the forelimb myology of two neotropical procyonids (Nasua nasua and Procyon cancrivorus) was performed to assess how observed differences in their myological configuration would be related to their diverse ecological behaviors and phylogeny. Although both species are associated with the arboreal substrate, N. nasua is a more agile climber that usually digs; whereas P. cancrivorus spends most of its time on the ground foraging, climbing on the trees as shelter and is a good swimmer. Here, myological descriptions, muscle maps, phylogenetic optimizations, and muscle mass data of the forelimb of these two procyonids are presented. The main functional muscular groups are discussed in a comparative framework with other carnivorans that present a wide ecological diversity. Also, muscular characters were mapped onto a phylogeny to explore their evolution and to obtain ancestral state reconstructions. Results indicate clear myological differences among the two neotropical procyonids associated with their ecological preferences. One of the most remarkable anatomical differences is the arrangement and relative mass of the extrinsic musculature, mainly the musculus rhomboideus and the delto-pectoral complexes. In Nasua nasua, these suggested a greater stability in their shoulder girdle for climbing and digging and probably would provide stronger neck and head movements when they use them for foraging on the ground. Conversely, P. cancrivorus has a different extrinsic muscular configuration, which would allow an increment on the stride length and faster movements of the forelimb associated with more frequent terrestrial gaits. Also, significant differences are observed in the distal musculature, associated with strong movements of forepaws when climbing and digging in N. nasua; whereas, P. cancrivorus configuration suggested precise forearm and digits movements, related to manipulation of food items when they are catching prey or feeding. Most of the codified features of P. cancrivorus would reflect retention of plesiomorphies acquired in the common ancestor of caniforms or arctoids, whereas N. nasua shows derived traits, particularly in the proximal forelimb region. The present work increases the information available on the myology of these particular taxa and extant generalized arctoid models in general. The analyses presented here will be useful both for other comparative myological studies (morpho-functional and phylogenetic) and for muscular reconstruction in extinct procyonids, as well as other carnivorans.

Anti-helminthic effect of Punica granatum peel extract on Trichinella spiralis worms and muscle larvae: in vitro and in vivo studies.

Trichinella spiralis (T. spiralis) is a prevalent foodborne intestinal parasite in many developing countries. Albendazole (ABZ) is the drug of choice for treating trichinosis despite its several drawbacks as its week effect against encapsulated larvae, low bioavailability, and emerging drug resistance. As a result, new anthelmintic agents are required. This study aims to investigate the in vivo and in vitro effects of Punica granatum peels extract (PGPE) on intestinal and muscle phases of T. spiralis. The adult worms and larvae were isolated and cultured with different concentrations of PGPE ranging from 6.75 to 100µg/ml and measuring the survival rate was done after 1, 3, 18, 24 and 48h of incubation, followed by scanning electron microscopic (SEM) examination of isolated parasites. For the in vivo experiment, the infected animals were divided into two main groups: intestinal phase group and muscular phase group, each group was subdivided into; infected not treated, infected treated with PGPE, ABZ and combined PGPE and ABZ (6 mice in each). The drug effect was assessed by adults and larvae load. A significant increase in the percentage of dead adult parasite and muscle larvae cultured with PGPE with severe destruction and deformity of the tegument were observed with SEM. Also, a significant reduction of adult parasite number in the intestine and muscle larva number in the diaphragm of infected treated mice in comparison to the control group. This study proved that PGPE has a potential activity against trichinosis, particularly when combined with ABZ, and this could serve as a new agent in trichinosis therapy.

Application value of Ki67 and serum CA125 in the deep myometrial invasion of endometrial adenocarcinoma

ObjectiveTo investigate the application value of Ki67 and serum CA125 in diagnosing the deep myometrial invasion of endometrial adenocarcinoma.MethodsThis study retrospectively analyzed 80 patients with endometrial adenocarcinoma, who underwent procedure from January 2018 to June 2021 at Senior Department of Obstetrics & Gynecology, the Seventh Medical Center of PLA General Hospital assigned to the Fourth Medical Center. The general clinical data, serum CA125 and Ki67 levels were compared between the superficial muscular infiltration group and the deep myometrial invasion group. We investigated the application value of Ki67 and serum CA125 in diagnosing the deep myometrial invasion of endometrial adenocarcinoma by the ROC curve.Results80 patients were retrospectively analyzed, and 53 cases were superficial muscular infiltration, 27 cases were deep myometrial invasion. There was significant difference in age, tumor diameter, lymph node metastasis, Ki67, serum CA125, p53 status, serum CA125 and Ki67 levels between the two groups (p < 0.05). As high as 35% of Ki67 was the optimal cutoff value for predicting DMI in endometrial adenocarcinoma, and the area under ROC curve was 0.691, the sensitivity and specificity of diagnosis were 88.9% and 56.6%. As high as 43.645 U/ml of serum CA125 was the optimal cutoff value for predicting DMI in endometrial adenocarcinoma, and the area under ROC curve was 0.668, the sensitivity and specificity of diagnosis were 40.7% and 92.5%. After combined detection of both, the area under ROC curve was 0.719, and its sensitivity and specificity of diagnosis were 96.3% and 43.4%.ConclusionSerum CA125 and Ki67 may be used to evaluate DMI in patients with endometrial adenocarcinoma, and the diagnostic value of combination is higher, which provide reference for clinical treatment.

Myasthenia gravis in current status: epidemiology, types, etiology, pathophysiology, symptoms, diagnostic tests, prevention, treatment, and complications - correspondence.

Myasthenia gravis in current status: epidemiology, types, etiology, pathophysiology, symptoms, diagnostic tests, prevention, treatment, and complications - correspondence.

Novel innervation of accessory slip of lateral head of gastrocnemius muscle

The two heads of the gastrocnemius muscle, as well as the plantaris and soleus muscles, forms the superficial muscular group in the posterior compartment of the leg. The incidental occurrence of accessory slip of the lateral head of the gastrocnemius muscle in the right lower limb, innervated by a twig from the common peroneal nerve, is described in this report. We identified an anomalous 8 cm long muscle in the right popliteal fossa during standard academic dissection of a male corpse at the Department of Anatomy. It was attached to the lateral side of the femur's popliteal surface proximally and joined the lateral head of the gastrocnemius distally. In the left lower limb, no similar variation was observed.

Muscle dystrophies in children

Muscular dystrophies are a heterogeneous inherited group of disorders characterized by a variable distribution of weakness, various ages of onset, the pattern of inheritance, rate of progression, and clinical severity. Muscle degeneration and regeneration characterize muscle biopsy and these disorders are typically associated with elevated serum creatine kinase. Objective: We wanted to study the clinical characteristics of patients with muscle dystrophies and study clinical and genetic correlation in patients with Duchenne muscular dystrophy. Methods: This cross-sectional descriptive study included a cohort of 60 patients diagnosed with muscular dystrophy and fulfilling the inclusion criteria. All patients were subjected to full history taking and full neurological examination. Results: Patients are divided into five groups to study clinical characteristics in each group. 1. Duchenne muscular dystrophy group: included 30 patients who have genetically confirmed DMD cases (50 %), 2. Limb-girdle muscular dystrophy group: included 23 patients (38.3 %), 3. Myotonic dystrophy group: included 3 patients (5 %), 4. Congenital muscular dystrophy group: included 3 patients who were diagnosed clinically as merosin deficient congenital muscle dystrophy (5 %), 5. Distal dystrophy group: included 1 patient with distal muscle dystrophy (1.7 %). Mean age, gender, age of symptoms onset, main motor symptoms, CPK level, echocardiography.

Muscle dystrophies in children

Muscular dystrophies are a heterogeneous inherited group of disorders characterized by a variable distribution of weakness, various ages of onset, the pattern of inheritance, rate of progression, and clinical severity. Muscle degeneration and regeneration characterize muscle biopsy and these disorders are typically associated with elevated serum creatine kinase. Objective: We wanted to study the clinical characteristics of patients with muscle dystrophies and study clinical and genetic correlation in patients with Duchenne muscular dystrophy. Methods: This cross-sectional descriptive study included a cohort of 60 patients diagnosed with muscular dystrophy and fulfilling the inclusion criteria. All patients were subjected to full history taking and full neurological examination. Results: Patients are divided into five groups to study clinical characteristics in each group. 1. Duchenne muscular dystrophy group: included 30 patients who have genetically confirmed DMD cases (50 %), 2. Limb-girdle muscular dystrophy group: included 23 patients (38.3 %), 3. Myotonic dystrophy group: included 3 patients (5 %), 4. Congenital muscular dystrophy group: included 3 patients who were diagnosed clinically as merosin deficient congenital muscle dystrophy (5 %), 5. Distal dystrophy group: included 1 patient with distal muscle dystrophy (1.7 %). Mean age, gender, age of symptoms onset, main motor symptoms, CPK level, echocardiography.