Muscular Lesions Research Articles

Importance of Preexisting Physical Factors in the Development of Dermatological and Muscular Lesions During Hiking.

Hiking has become very popular due to the physical and mental health benefits it provides. Skin lesions may occur with hiking and various factors contribute to their development. Although some lesions may appear to have little importance, something as simple as chaffing can cause serious ulcers in people with at-risk feet. Few studies have analyzed preexisting physical characteristics in hiking and addressed the development of lesions in hikers. This observational and longitudinal study examines the development of foot lesions during hiking, taking into account the influence of existing skin disorders, nail disorders, and/or toe deformities and other intrinsic factors of participants. The feet of 109 hikers doing a 29.6-km hike were analyzed, considering the intrinsic factors of participants and the possible influence of these factors in the development of foot lesions during the walk. The results show that some preexisting physical factors of participants such as gender, existing systemic disease, preexisting keratosis, dermatosis, nontraumatic and traumatic onychopathies, and toe deformities significantly predispose to the development of skin lesions. These factors also predispose to muscle lesions except for nontraumatic and traumatic onychopathies and toe deformities. Due to the influence of preexisting physical factors, such as preexisting keratosis, dermatosis, and toe deformities, in the development of foot lesions in hikers, it is worthwhile and advisable to check these factors before a hike to reduce the incidence of foot disorders. Ensuring adequate podiatry treatment a few days before the walk and warmup of muscles properly before starting are recommended.

Radiologic Manifestations of Musculoskeletal Sarcoidosis.

The purpose of this review article is to present the spectrum of abnormalities and multi-modality imaging evaluations in patients with musculoskeletal sarcoidosis. The articular manifestations of sarcoidosis are difficult to distinguish from those of the other inflammatory and degenerative arthropathies, and the muscular lesions in sarcoidosis are generally clinically silent and therefore often missed. Magnetic resonance imaging has shown these manifestations to be very common in active sarcoidosis, and should thus be included in the screening if musculoskeletal sarcoidosis is suspected. The clinician should consider magnetic resonance imaging for the evaluation of patients with sarcoidosis who have unexplained osteoarticular complaints if standard radiographs are negative. Furthermore, radiologists should include sarcoidosis in the differential diagnosis of musculoskeletal disease detected at magnetic resonance imaging in the appropriate clinical setting.

Autoantibodies in idiopathic inflammatory myopathies: Clinical associations and laboratory evaluation by mono- and multispecific immunoassays.

Idiopathic inflammatory myopathies (IIM) are a group of diseases characterized by immune-mediated muscular lesions that may be associated with extra-muscular manifestations involving skin, lungs, heart or joints. Four main groups of IIM can be distinguished: dermatomyositis (DM), overlap myositis including mainly anti-synthetase syndrome (ASS), immune mediated necrotizing myopathy (IMNM), and inclusion body myositis (IBM). Myositis-specific autoantibodies (MSA) are increasingly recognized as valuable tools for diagnosis, classification and prognosis of IIM. For example, ASS is associated with anti-aminoacyl tRNA synthetase antibodies (anti-Jo-1, PL-7, PL-12, …), IMNM with anti-SRP and anti-HMGCR; IBM with anti-cytosolic 5'nucleotidase 1A (cN1A), and DM with anti-Mi-2, anti-MDA-5, anti-TIF-1γ, anti-NXP-2 and anti-SAE. Moreover, anti-MDA-5 is associated with amyopathic myositis and interstitial lung disease and anti-TIF-1γ and anti-NXP-2 with juvenile DM as well as malignancy in patients >40 years. Most MSA have initially been discovered by immunoprecipitation. In routine laboratories, however, MSA are screened for by indirect immunofluorescence and identified by (automated) monospecific immunoassays or by multispecific immunoassays (mainly line/dot immunoassays). Validation of these (multispecific) assays is a challenge as the antibodies are rare and the assays diverse. In this review, we give an overview of the (clinical) performance characteristics of monospecific assays as well as of multispecific assays for detection of MSA. Although most assays are clinically useful, there are differences between techniques and between manufacturers. We discuss that efforts are needed to harmonize and standardize detection of MSA.

Epidemiological profile of thoracic trauma in a reference hospital of Foz do Rio Itajai.

to describe the epidemiological profile of thoracic trauma in the region of Foz do Rio Itajai, in the state of Santa Catarina, Brazil. observational, descriptive and prospective study performed through the collection of data starting with a form elaborated by researchers and filled in by the team in charge of a reference hospital between June 2017 and May 2018. one hundred and nineteen forms from victims of thoracic trauma were analyzed, constituted of 70.5% male patients and 29.4% female patients, with an average of 39.8 years of age. Medical care happened mainly in daytime (67.9%), 30.2% of patients arriving by their own means, and 52.9% of patients one hour after suffering trauma. As to admission exams, most victims only went through chest X-ray (67.2%). There was a prevalence of closed thoracic trauma (89%), whose main cause was motorcycle accidents (35.2%) and the predominant lesion was rib fracture (42%). Most patients (53.8%) went through a conservative treatment. The average admission time was 2.6 days and the death rate was 5%. the profile of patients with thoracic trauma in Itajai comprises young men, admitted during the day, most of them presenting rib fracture, with closed thoracic trauma due to a road traffic accident involving a motorcycle. Chest X-ray were used to confirm most of the diagnoses, and there was a prevalence for conservative treatment. The admission time and the death rate were smaller than those cited in medical literature, which can be explained by the high index of exclusive muscular lesions.

Three Cases of Canine Dermatomyositis-Like Disease

Background: Dermatomyositis is an idiopathic, inflammatory/immunemediated disease of the skin, muscles and bloodvessels of hereditary nature and unclear pathogenesis. This familial disease has been described in certain breeds, especially collies and Shetland sheep dogs and is of rare occurrence in mongrel dogs. To describe and discuss three clinical cases of dermatomyositis-like disease and provide a brief review of the literature.Cases: Three young mongrel dogs are included in this report. Case 1: Mandarino, a 4-year-old mongrel dog, having a history of skin lesions for at least a year. Showed an underweight patient, skin ulcers, crusts, alopecia, peri-ocular scarring causing severe lagophthalmia and a corneal ulcer. Muscle atrophy was most notable in the head and legs; the dog haddifficulty and pain walking. Treatment was initialised with cephalexin 30 mg/kg BID, pentoxifylline 25 mg/kg BID, and prednisone 2.2 mg/kg SID. The patient was presented after two weeks for follow up; the anaemia and skin condition had improved, the weight had increased by 2 kg, dysphagia and locomotor abnormalities were not present. Case 2: Milagros,a mongrel female dog approximately two years of age, rescued from a shelter. Physical examination showed facial alopecia, erythema and scarring of the periocular skin, crusting and scaling in alopecic areas, pinnae tip necrosis and crusting, ear alopecia, tail tip necrosis and crusting. Also present were distal limb alopecia, crusting and ulcers in areas of trauma in the hock and carpal surfaces; some nails presented onychorhexis and onychoschizia. The patient has been treated for12 months with a good clinical outcome, with pentoxifylline, azathioprine 2.2 mg/kg EOD alternating with prednisone 1 mg/kg EOD. Case 3: Chuchito, an 11-month-old male mongrel rescued dog had been previously hospitalised due to his skin condition. Physical examination showed depigmented and alopecic areas in the nasal planum, perioral and periocular areas, and inflammation of the palpebral tissues. Necrosis of the distal pinnae, alopecia and scales were evident, along with sloughing of scales and ulcers. Skin lesions were also present in the distal limbs, and alopecia, erythema and some crusting and scales in the carpal, tarsal and digital areas. Onychodystrophy was present in several digits. This study describes the physical examination and the clinical pathological findings, including skin scrapings, fungal cultures, and skin biopsies, in three dogs with dermatomyositis-like disease, as well as the clinical outcomes after slightly different treatment protocols were used. The biopsy results of two dogs showed ischaemic dermatopathy.Discussion: The most common initial signs of the disease are erythema, desquamation and alopecia in the facial area, ears, distal limbs and pinnae in young puppies aged between two and six months of age, followed by pigmentary changes. Muscular lesions are uncommon; when present, they represent the most severe form of this disease. Dysphagia is a common sign and mega-oesophagus may be present. Patients with muscular disease can manifest difficulty walking, with a stiff high gait. The immune mediated pathogenesis of dermatomyositis can relate to triggering factors in some dogs, such as drugs, infections, paraneoplasms, or toxins. Other potential inducing stressors include oestrus, whelping and excessive solar exposure. Dermatomyositis-like or familiar dermatomyositis is diagnosed using clinical findings, histopathologyof skin and muscle, and muscle physiology studies. Electromyography, breed predisposition and genetic background can be helpful in some cases. The clinical findings and response to the treatment of all three cases were compatible with dermatomyositis-like disease in mongrel dogs.Keywords: dermatomyositis, dermatopathy, vascular disease, inflammatory myopathies, mongrel dog.

Ultrastructural and molecular characterization of Vairimorpha austropotamobii sp. nov. (Microsporidia: Burenellidae) and Thelohania contejeani (Microsporidia: Thelohaniidae), two parasites of the white-clawed crayfish, Austropotamobius pallipes complex (Decapoda: Astacidae).

The microsporidiosis of the endangered white-clawed crayfish Austropotamobius pallipes complex has generally been attributed to only one species, Thelohania contejeani, the agent of porcelain disease. Species identification was mostly assessed by macroscopic examination or microscopic evaluation of muscle samples rather than by molecular or ultrastructural analyses. A survey conducted on A. pallipes complex populations in Northern Italy highlighted the presence of two different microsporidia causing similar muscular lesions, T. contejeani and an undescribed octosporoblastic species Vairimorpha austropotamobii sp. nov. Mature spores and earlier developmental stages of V. austropotamobii sp. nov. were found within striated muscle cells of the thorax, abdomen, and appendages of the crayfish. Only octosporoblastic sporogony within sporophorous vesicles (SPVs) was observed. Diplokaryotic sporonts separated into two uninucleate daughter cells, which gave rise to a rosette-shaped plasmodium, and eight uninucleate spores were produced within the persistent SPV. Ultrastructural features of stages in the octosporoblastic sequence were similar to those described for Vairimorpha necatrix, the type species. Mature spores were pyriform in shape and an average of 3.9 × 2.2 µm in size. The polar filament was coiled 11-14 times, lateral to the posterior vacuole. The small subunit ribosomal RNA gene (SSU rRNA) and the large subunit RNA polymerase II gene (RPB1) of V. austropotamobii sp. nov. were sequenced and compared with other microsporidia. The highest sequence identity of SSU rRNA (99%) and RPB1 (74%) genes was with the amphipod parasite Nosema granulosis and subsequently with V. cheracis, which infects the Australian yabby Cherax destructor. In our work we discuss about the reasons for placing this new species in the genus Vairimorpha. In addition, we provide for T. contejeani a RPB1 gene sequence, supplemental sequences of SSU rRNA gene and ultrastructural details of its sporogony in the host A. pallipes complex.

The use of platelet-rich plasma (PRP) in the treatment of gastrocnemius strains: a retrospective observational study

The aim of the present retrospective observational study was to evaluate the time of functional recovery following a specific combined therapeutic approach characterized by an active exercise therapy carried out immediately after Platelet-rich plasma (PRP) injections for the treatment of the muscular lesion of the distal musculotendinous junction of the gastrocnemius medial head.Medical records of 31 subjects treated with three PRP intra-lesional ultrasound guided injections and 30 patients treated with the standard therapeutic approach (control group) were analyzed. Both groups followed the same rehabilitation therapy. Patients in the control group were able to start active exercise with a significant delay when compared to the PRP treated subjects: 17 ± 7.2 days and 9 ± 3.8 days (p = 0.0001), respectively. This delay was mainly due to the persistence of pain in the subjects in the control group. The time necessary to return to walk without pain was significantly shorter in the PRP treated group: 24.27 ± 12.36 days versus 52.4 ± 20.03 days in the control group (p < 0.001) as well as the time needed to fully return to practice the previous sport activity: 53.33 ± 27.74 days versus 119.3 ± 43.87 days in the control group (p < 0.001).The present study showed that ultrasound guided delivery of PRP into the site of muscle injury has to be considered a valid therapeutic approach with the potentiality of significantly reduce time and costs for reaching a complete functional recovery.

Assessment of work-related accidents associated with waste handling in Belo Horizonte (Brazil).

As more urban solid waste is generated, managing it becomes ever more challenging and the potential impacts on the environment and human health also become greater. Handling waste - including collection, treatment and final disposal - entails risks of work accidents. This article assesses the perception of waste management workers regarding work-related accidents in domestic and health service contexts in Belo Horizonte, Brazil. These perceptions are compared with national data from the Ministry of Social Security on accidents involving workers in solid waste management. A high proportion of accidents involves cuts and puncture injuries; 53.9% among workers exposed to domestic waste and 75% among those exposed to health service waste. Muscular lesions and fractures accounted for 25.7% and 12.5% of accidents, respectively. Data from the Ministry of Social Security diverge from the local survey results, presumably owing to under-reporting, which is frequent in this sector. Greater commitment is needed from managers and supervisory entities to ensure that effective measures are taken to protect workers' health and quality of life. Moreover, workers should defend their right to demand an accurate registry of accidents to complement monitoring performed by health professionals trained in risk identification. This would contribute to the improved recovery of injured workers and would require managers in waste management to prepare effective preventive action.

An efficacy analysis of whole-body magnetic resonance imaging in the diagnosis and follow-up of polymyositis and dermatomyositis.

ObjectivesTo evaluate the value of whole-body magnetic resonance imaging (WBMRI) in diagnosing muscular and extra muscular lesions in patients with polymyositis (PM) and dermatomyositis (DM).MethodsA retrospective analysis of WBMRI data from PM/DM patients who met the Bohan and Peter diagnostic criteria was performed. X2 test was used to compare the rate of positive diagnosis of newly diagnosed patients using WBMRI, serum creatine kinase test, and EMG. McNemar test was used to compare the performance of WBMRI and chest CT in detecting interstitial lung disease (ILD).ResultsThe study included 129 patients (30 PM cases and 99 DM cases). Of them, 81.4% (105/129) showed a visible inflammatory muscular edema on their WBMRI; 29.5% (38/129) had varying degrees of fatty infiltration (9 cases with clear muscular atrophy). Of the 66 newly diagnosed patients, the positive rates of WBMRI, muscle biopsy, serum creatine kinase test and EMG were 86.4% (57/66), 92.4% (61/66), 71.2% (47/66) and 71.1% (32/45), respectively. There was no significant difference in the positive rates between WBMRI and muscle biopsy (X2 = 1.28, P = 0.258). The WBMRI had a higher positive rate than both serum creatine kinase test (X2 = 4.53, P = 0.033) and EMG (X2 = 3.92, P = 0.047). In addition to muscular changes, WBMRI also detected interstitial lung disease (ILD) in 38 cases (29.5%), osteonecrosis in 15 cases (11.6%), and neoplastic lesions (5 malignant; 7 benign) in 12 cases (9.3%). Of the 61 patients who underwent routine chest CT examinations, the WBMRI and CT revealed ILD in 29 cases and 35 cases respectively. There was no significant difference in the sensitivity between WBMRI and CT (p = 0.146).ConclusionsWBMRI is a sensitive, non-invasive and efficient imaging method. It comprehensively displays the extent of muscular involvement in PM/DM patients, and it has the ability to diagnose other associated extra muscular diseases, such as ILD and systemic malignancy. WBMRI can also help screen steroid-induced osteonecrosis.

Ultrasound visualization of an underestimated structure: the bicipital aponeurosis

PurposeWe established a detailed sonographic approach to the bicipital aponeurosis (BA), because different pathologies of this, sometimes underestimated, structure are associated with vascular, neural and muscular lesions; emphasizing its further implementation in routine clinical examinations.MethodsThe BA of 100 volunteers, in sitting position with the elbow lying on a suitable table, was investigated. Patients were aged between 18 and 28 with no history of distal biceps injury. Examination was performed using an 18–6 MHz linear transducer (LA435; system MyLab25 by Esaote, Genoa, Italy) utilizing the highest frequency, scanned in two planes (longitudinal and transverse view). In each proband, scanning was done with and without isometric contraction of the biceps brachii muscle.ResultsThe BA was characterized by two clearly distinguishable white lines enveloping a hypoechoic band. In all longitudinal images (plane 1), the lacertus fibrosus was clearly seen arising from the biceps muscle belly, the biceps tendon or the myotendinous junction, respectively. In transverse images (plane 2) the BA spanned the brachial artery and the median nerve in all subjects. In almost all probands (97/100), the BA was best distinguishable during isometric contraction of the biceps muscle.ConclusionWith the described sonographic approach, it should be feasible to detect alterations and unusual ruptures of the BA. Therefore, we suggest additional BA scanning during clinical examinations of several pathologies, not only for BA augmentation procedures in distal biceps tendon tears.

Dermite livédoïde de Nicolau avec atteinte neurologique sévère chez un enfant

Nicolau syndrome is a rare condition consisting in tissue ischemia and necrosis following intramuscular, intra-articular or subcutaneous injection. Immediately after gluteal intramuscular injection of benzathine-penicillin, a 10-year-old male child presented an extensive painful violaceous lesion on the left buttock associated with urinary incontinence and left lower-limb paresis. Additional underlying muscular damage was supported by high serum levels of creatine kinase and lactate dehydrogenase. Treatment was based on fluid expansion, intravenous steroids and anticoagulants, resulting in improvement of cutaneous and muscular lesions. Improvement in terms of neurological dysfunction was obtained after regular neuromuscular rehabilitation. This case underlines the need to prevent Nicolau syndrome by means of compliance with the technical recommendations for intramuscular injections.

Isolated muscular tuberculosis: unusual location of the Koch bacillus.

A 23-year-old female patient with a family history of pulmonary tuberculosis and tuberculous spondylodiscitis was hospitalized for swelling of the left anterior-external surface of the left thigh, (A) with altered general status. Biology has shown a biological inflammatory syndrome. The ultrasound showed a collection opposite the great trochanter fusing towards the lodge of the gluteus muscle and forward towards the terminal part of the common chief ischio-psoas. MRI of the hips revealed an intra-muscular collection of the antero-lateral side of the thigh root, taking contrast in the periphery, involving the quadriceps muscle and tensor of facia lata, (B and C). The biopsy of the collection under ultrasound guidance brought back 30 cc of casein. The diagnosis of tuberculosis of the quadriceps muscle and tensor of the facia lata was based on the positivity of the tuberculin skin test, (D), the positivity of the PCR for Mycobacterium tuberculosis in the puncture fluid and histology showing multiple epithelioid granulomas centered by caseous necrosis. There were no other tuberculous sites. The patient was treated with antituberculosis drugs for 12 months with good progress. Muscular tuberculosis (MT) is a rare localization of the disease (0.01 to 2%). Its occurrence without associated bone involvement is exceptional. MT often simulates a muscular tumor. MRI contributes to the improvement of the sensitivity of the diagnosis of MT because it allows to specify the extent of the muscular lesions and to orient the site of the muscular biopsy. The diagnosis is essentially based on histology.

Pathology of muscular steatosis in the bovine species: report of two spontaneously arising cases and comparative overview of the condition

Muscular steatosis, a condition characterized by prominent fatty replacement of skeletal muscles, has been known from a long time ago to mainly involve meat animals, such as pig, sheep, and cattle. Although a variety of hypotheses are proposed for explaining the condition, its etiology and pathogenesis are still poorly understood. Spontaneously occurring lesions of muscular steatosis were recognized in two 2-year-old steers that were slaughtered for food. Significant clinical abnormalities indicative of motor dysfunction were not observed in these animals. Postmortem examination revealed a remarkable and bilaterally symmetrical deposition of adipose tissue in the semitendinosus muscle of one steer and the gluteus muscle of the other steer. Affected muscles were of normal volume but exhibited an irregularly streaked appearance due to ill-proportioned fat infiltration. On histopathology, the lesioned muscles were extensively replaced by much adipose tissue, showing complete loss of muscle fibers in some fascicles. Structure of the perimysial connective tissue network was well preserved. All fat cells did not exhibit immature morphology but were of a well-differentiated mature appearance. Although a small number of muscle fibers represented atrophic or degenerative changes, regenerative muscle fibers and proliferation of the perimysial connective tissue were not demonstrated elsewhere in the lesions. Intramuscular blood vessels and nerves showed no significant changes. Precise pathogenesis of muscular steatosis, such as that found in these steers, remained uncertain. These fatty muscular lesions were distinguished from those of advanced or end stages in previously described muscle disorders in cattle, including neurogenic muscular atrophy, nutritional myopathy, or muscular dystrophy. The present article makes a comment on the pathology of muscular steatosis involving the bovine species from the comparative viewpoint.

Isokinetic rehabilitation in the chronic former instability of the shoulder: For individualized rehabilitative care

The isokinetic exploration of the shoulder seems little standardized, particularly at the time of the choice of the studied muscular groups, of the installation of the subject as well as positioning of the articulation itself. Rehabilitation treatment of a 17 year old patient, hyperlaxe, swimmer, in the context of a painful chronic former instability of the shoulder without osseous, muscular lesion or labrale. An isokinetic work of reinforcement of the internal rotators is carried out, into concentric of 60°/s to 240°/s, position known as of Davies modified then in decubitus dorsal of 45° to 90° of abduction. At the end of the rehabilitation a work of reinforcement of the external rotators out of eccentric is associated with 60°/s in decubitus dorsal with 90° of abduction. The parameters of follow-up were the maximum moment of force, its bilateral comparison between homologous muscles, the quality of relative force and the shape of the curves of contraction. At 6 months, the evolution is favorable, with a complete disappearance of the painful phenomena and of instability, allowing even a resumption of swimming in competition. The isokinetic rehabilitation of the shoulder offers a rehabilitation treatment personalized interesting as regards chronic former instability of the shoulder, which corresponds to a muscular weakness of the RI and RE without imbalance determining of ratio RE/RI.

Degenerative and regenerative features of myofibers differ among skeletal muscles in a murine model of muscular dystrophy.

Skeletal muscle myofibers constantly undergo degeneration and regeneration. Histopathological features of 6 skeletal muscles (cranial tibial [CT], gastrocnemius, quadriceps femoris, triceps brachii [TB], lumbar longissimus muscles, and costal part of the diaphragm [CPD]) were compared using C57BL/10ScSn-Dmd mdx (mdx) mice, a model for muscular dystrophy versus control, C57BL/10 mice. Body weight and skeletal muscle mass were lower in mdx mice than the control at 4weeks of age; these results were similar at 6-30weeks. Additionally, muscular lesions were observed in all examined skeletal muscles in mdx mice after 4weeks, but none were noted in the controls. Immunohistochemical staining revealed numerous paired box 7-positive satellite cells surrounding the embryonic myosin heavy chain-positive regenerating myofibers, while the number of the former and staining intensity of the latter decreased as myofiber regeneration progressed. Persistent muscular lesions were observed in skeletal muscles of mdx mice between 4 and 14weeks of age, and normal myofibers decreased with age. Number of muscular lesions was lowest in CPD at all ages examined, while the ratio of normal myofibers was lowest in TB at 6weeks. In CT, TB, and CPD, Iba1-positive macrophages, the main inflammatory cells in skeletal muscle lesions, showed a significant positive correlation with the appearance of regenerating myofibers. Additionally, B220-positive B-cells showed positive and negative correlation with regenerating and regenerated myofibers, respectively. Our data suggest that degenerative and regenerative features of myofibers differ among skeletal muscles and that inflammatory cells are strongly associated with regenerative features of myofibers in mdx mice.

Review of Stieda's article (1908) on the Pellegrini-Stieda lesion

This classic discusses the original publication of Dr Stieda: Über eine typische Verletzung am unteren Femurende, published in 1908, on the ossified post-traumatic lesion at or near the medial collateral ligament (MCL), adjacent to the margin of the medial femoral condyle which is nowadays known as the Pellegrini-Stieda lesion. One of the presumed mechanisms of injury is an avulsion fracture at the MCL origin. Most patients are asymptomatic, in case of pain, however it is called a Pellegrini-Stieda syndrome. Recently, there are signs directing towards a muscular lesion, in particular the insertion of the adductor magnus muscle. In 1908, Alfred Stieda described a case series of an ossification on the medial side of the knee, which was treated operatively. During this operation, the origin to his belief was an avulsion from the medial epicondyle by the medial head of the gastrocnemius muscle. Although the theory that it concerned an avulsion fracture of the epicondyle is no longer accepted, the part of his findings that it concerned a muscle/tendon ossification at the insertion of the medial head of the gastrocnemius is interesting. Treatment is only indicated in symptomatic cases. When confronted with an ossification on the medial side of the knee, one should be aware that the MCL, the insertion of the adductor magnus or the gastrocnemius muscle might be involved. The first known publication was by Köhler in 1903. Historically, this entity should therefore be named the Köhler-Pellegrini-Stieda lesion.

Myogenic Differentiation Potential of Human Newborn Foreskin Stem Cells Combined with Polycaprolactone-Based Nanofiber

: A previous study performed by the authors of the current study revealed the characterization and differentiation of newly defined stem cells known as human newborn foreskin stem cells (hnFSSCs). According to their stem cell properties, this study aimed at investigating myogenic differentiation and related tissue engineering. Human newborn foreskin stem cells were characterized by flow cytometry. The results showed that hnFSSCs carries a noble prospective for myogenic differentiation and can be used as a beneficial method for muscle related diseases, including muscular dystrophy, neuromuscular disorders, muscle damages, muscle weakness, lesion formations, and other problems associated with tissue obtainability and multi-potency; these cells may be accepted as effortlessly accessible and functional, and even superior to other stem cell origins. Furthermore, hnFFSCs were also seeded onto 3D micro-wells and Polycaprolactone (PCL) scaffolds in order to examine tissue development. Human newborn foreskin stem cells on PCL scaffolds showed good cell-cell integration, so that they may be thought as a stem cell basis for tissue engineering.

Surgical Management of Recurrent Musculotendinous Hamstring Injury in Professional Athletes.

Background:Hamstring injury is the most common muscular lesion in athletes. The conservative treatment is well described, and surgical management is often indicated for proximal tendinous avulsions. To our knowledge, no surgical treatment has been proposed for failure of conservative treatment in musculotendinous hamstring lesions.Purpose:To describe the surgical management of proximal and distal hamstring musculotendinous junction lesions in professional athletes after failure of conservative treatment.Study Design:Case series; Level of evidence, 4.Methods:A consecutive series of 10 professional athletes, including 4 soccer players, 4 rugby players, and 2 handball players, underwent surgical intervention between October 2010 and June 2014 for the treatment of recurrent musculotendinous hamstring injuries. All athletes had failed at least 3 months of conservative treatment for a recurrent musculotendinous hamstring injury. Surgical resection of the musculotendinous scar tissue was performed using a longitudinal muscular suture. Lower Extremity Functional Scale (LEFS) and Marx scores were obtained at the 3-month follow-up, and a final phone interview was completed to determine recurrence of hamstring injury and return to previous level of play.Results:The mean age at surgery was 25.2 years (range, 19-35 years). The musculotendinous hamstring lesions involved 8 semitendinosus and 2 biceps femoris, with 6 injuries located proximally and 4 distally. Conservative treatment lasted a mean 5.1 months (range, 3-9 months) after last recurrence, and the patients had an average of 2.7 (range, 2-5) separate incidents of injury recurrence before surgical intervention was decided upon. At the 3-month follow-up, all patients had Marx activity scores of 16 and LEFS scores of 80. All 10 patients returned to the same level of play at a mean 3.4 months (range, 2-5 months). At a mean follow-up of 28.7 months, none of the athletes had suffered a recurrence. No surgical complication was encountered.Conclusion:In cases of failed conservative treatment of musculotendinous hamstring lesions, surgical intervention may be a viable treatment option in professional athletes and allows the patient to return to the same level of play.

Multimodality evaluation of musculoskeletal sarcoidosis: Imaging findings and literature review.

Whilst the detailed X-ray features of thoracic manifestations of sarcoidosis are now clearly defined and known by most radiologists, the same does not apply to osteoarticular and muscular features of the disease, which may however raise major diagnostic problems, either because they are the presenting features of the disease (7% of cases) or because they develop during its course. The bony lesions of sarcoid dactylitis (classical Perthes-Jüngling disease) are very characteristic and well known. Many other presentations of bone and bone marrow sarcoidosis may however raise major diagnostic difficulties, particularly uni- or multifocal osteolytic and sclerotic forms of the disease. The articular manifestations of sarcoidosis are difficult to distinguish from those of the other inflammatory and degenerative arthropathies. The muscular lesions in sarcoidosis are generally clinically silent and therefore often missed. MRI has shown them to be very common in active sarcoidosis. Acute forms carry a good prognosis whereas chronic lesions are a presenting feature of multi-organ sarcoidosis. Finally, clinicians should always think about the possibility of an iatrogenic origin for musculoskeletal abnormalities seen in sarcoidosis, particularly those related to corticosteroid therapy.

&amp;#147;EFFECT OF CERVICAL TRACTION IN THE NECK NEUTRAL, FLEXION AND EXTENSION ON AUTONOMIC FUNCTION: AN OBSERVATIONAL STUDY&amp;#148;

Cervical traction is a physical therapy procedure which is most frequently used for cervical spasm, neck pain, radiating pain to upper limb which are caused due to cervical disk lesions, cervical spondylosis, hypomobile facet joints, cervical muscular dysfunction and cervical facet joint lesions. This study aims to investigate the effect of cervical traction in the various neck positions i.e. neutral, flexion and extension position on autonomic function. 100 healthy young individual were randomly divided into three groups. Group A (n = 34) were applied cervical traction in neutral position, group B (n = 33) in flexion and group C (n=33) in extension. The mechanical continuous cervical traction applied with 10% body weights6. Assessments of pulse rate, respiratory rate, systolic blood pressure and diastolic blood pressure were performed before, during, and after 20 minutes of traction. Systolic blood pressure in intra group comparison was found significant for groups A and B, in Pre vs during, and Increase in respiratory rate was noted in pre vs during cervical traction for group A cervical traction evaluation. The study concludes that the systolic blood pressure and respiratory rate, increased during traction in individuals with neck flexion or neutral. The cervical traction given in flexion or extension can be applied for the cardiac patients although caution is necessary in such an intervention so as to not aggravate the symptoms.