ABSTRACT We present our expeilence of pedicled Anterolateral thigh flap for reconstruction of groin defects in cancer patients. Total of 17 flaps in 16 patients were performed between January 2001 to ...May 2003. 15 flaps were used for groin defects after node dissection for carcinoma of Penis (bilateral groin defects in one patient), 1 case of Squamous Cell Carcinoma of groin and 1 case of Soft Tissue Sarcoma of groin. All patients were male. 16 were myocutaneous variety and 1 was fasciocutaneous flap based on the septocutaneous perforator. Complications were few and all patients achieved durable long-term coverage. We found the flap to be technically easy and reliable.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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•Absolute and relative voltage criteria derived similar AMTs in a single testing session.•Relative criterion exhibited superior test–retest reliability compared to the absolute ...criterion.•TMS researchers aiming to track corticospinal characteristics in the quadriceps across visits should consider using relative voltage criteria to determine AMT.
The determination of active motor threshold (AMT) is a critical step in transcranial magnetic stimulation (TMS) research. As AMT is frequently determined using an absolute electromyographic (EMG) threshold (e.g., 200 µV peak-to-peak amplitude), wide variation in EMG recordings across participants has given reason to consider relative thresholds (e.g., = 2 × background sEMG) for AMT determination. However, these approaches have not been systemically compared. Our purpose was to compare AMT estimations derived from absolute and relative criteria commonly used in the quadriceps, and assess the test–retest reliability of each approach. We used a repeated measures design to assess AMT estimations in the vastus lateralis (VL) from eighteen young adults (9 males and 9 females; mean ± SD age = 23 ± 2 years) across two laboratory visits. AMT was determined for each criterion, at each lab visit. A paired samples t-test was used to compare mean differences in AMT estimations during the second laboratory visit. Paired samples t-tests and intraclass correlation coefficients (ICC2,1) were calculated to assess test–retest reliability of each criterion. Differences between the criteria were small and not statistically significant (p = 0.309). The absolute criterion demonstrated moderate to excellent reliability (ICC2,1 = 0.866 0.648–0.950), but higher AMTs were observed in the second visit (p = 0.043). The relative criteria demonstrated good-to-excellent test–retest reliability (ICC2,1 = 0.894 0.746–0.959) and AMTs were not different between visits (p = 0.420). TMS researchers aiming to track corticospinal characteristics across visits should consider implementing relative criterion approaches during their AMT determination protocol.
Motor unit firing and contractile properties during a submaximal contraction until failure were assessed with a new tracking technique. Two distinct phases in firing behavior were observed, which ...compensated for changes in twitch area and predicted time to failure. However, the late increase in firing rate was below the rates attained in the absence of fatigue, which points to an inability of the central nervous system to sufficiently increase the neural drive to muscle with fatigue.
We investigated changes in motor unit (MU) behavior and vasti-muscle contractile properties during sustained submaximal fatiguing contractions with a new time-domain tracking technique to understand the mechanisms responsible for task failure. Sixteen participants performed a nonfatiguing 15-s isometric knee extension at 50% of the maximum voluntary (MVC) torque, followed by a 30% MVC sustained contraction until exhaustion. Two grids of 64 surface electromyography electrodes were placed over vastus medialis and lateralis. Signals were decomposed into MU discharge times and the MUs from the 30% MVC sustained contraction were followed until task failure by overlapping decomposition intervals. These MUs were then tracked between 50% and 30% MVC. During the sustained fatiguing contraction, MUs of the two muscles decreased their discharge rate until ∼40% of the endurance time, referred to as the reversal time, and then increased their discharge rate until task failure. This reversal in firing behavior predicted total endurance time and was matched by opposite changes in twitch force (increase followed by a decrease). Despite the later increase in MU firing rates, peak discharge rates at task failure did not reach the frequency attained during a nonfatiguing 50% MVC contraction. These results show that changes in MU firing properties are influenced by adjustments in contractile properties during the course of the contraction, allowing the identification of two phases. Nevertheless, the contraction cannot be sustained, possibly because of progressive motoneuron inhibition/decreased excitability, as the later increase in firing rate saturates at a much lower frequency compared with a higher-force nonfatiguing contraction.
NEW & NOTEWORTHY Motor unit firing and contractile properties during a submaximal contraction until failure were assessed with a new tracking technique. Two distinct phases in firing behavior were observed, which compensated for changes in twitch area and predicted time to failure. However, the late increase in firing rate was below the rates attained in absence of fatigue, which points to an inability of the central nervous system to sufficiently increase the neural drive to muscle with fatigue.
This study aimed to compare the vastus medialis and vastus lateralis muscle activations during squat exercises performed on different surfaces. Recreationally active 14 males (age: 20.43±1.28 years; ...height: 176.94±6.58 cm; body weight: 72.78±10.72 kg) participated in this study. A ground surface is used as a stable surface, a gymnastics mat and a Bosu ball are used as an unstable surface. Participants performed two sets of squats on three surfaces and ten repetitions of each set. Participants performed squat exercises with their body weight. Muscle activation measurements were made from the vastus medialis and vastus lateralis muscles during the squat movement on each surface. A one-way repeated-measures analysis of variances was used to statistically compare muscle activations between surfaces. As a result of statistical analysis, no significant differences were found in the vastus medialis and vastus lateralis muscle activations between surfaces (p>0.05). In conclusion, it was determined that the vastus medialis and vastus lateralis muscle activation in the squat movement was not affected by the stability of the surfaces. Therefore, it can be suggested that the surfaces used in this study can be used interchangeably for vastus medialis (VM) and vastus lateralis (VL) muscle activation in the squat exercise.
At a constant power output, cyclists prefer to use a higher cadence than those that minimize metabolic cost. The neuromuscular mechanism underpinning the preferred higher cadence remains unclear.
...PURPOSEThe aim of this study was to investigate the effect of cadence on joint level work and vastus lateralis (VL) fascicle mechanics while cycling at a constant, submaximal, power output. We hypothesized that preferred cycling cadence would enhance the power capacity of the VL muscle when compared with a more economical cadence. Furthermore, we predicted that the most economical cadence would coincide with minimal total electromyographic activity from the leg muscles.
METHODSMetabolic cost, lower-limb kinematics, joint level work, VL fascicle mechanics, and muscle activation of the VL, rectus femoris, biceps femoris, gastrocnemius medialis, and soleus muscles were measured during cycling at a constant power output of 2.5 W·kg and cadences of 40, 60, 80, and 100 rpm. A preferred condition was also performed where cadence feedback was hidden from the participant.
RESULTSMetabolic cost was lowest at 60 rpm, but the mean preferred cadence was 81 rpm. The distribution of joint work remained constant across cadences, with the majority of positive work being performed at the knee. The preferred cadence coincided with the highest VL power capacity, without a significant penalty to efficiency, based on fascicle shortening velocity.
CONCLUSIONSCycling at a higher cadence is preferred to ensure that the muscle’s ability to produce positive power remains high. Further investigations are required to examine what feedback mechanism could be responsible for the optimization of this motor pattern.
Protocols for high-resolution respirometry (HRR) of intact cells, permeabilized cells, and permeabilized muscle fibers offer sensitive diagnostic tests of integrated mitochondrial function using ...standard cell culture techniques and small needle biopsies of muscle. Multiple substrate–uncoupler–inhibitor titration (SUIT) protocols for analysis of oxidative phosphorylation improve our understanding of mitochondrial respiratory control and the pathophysiology of mitochondrial diseases. Respiratory states are defined in functional terms to account for the network of metabolic interactions in complex SUIT protocols with stepwise modulation of coupling and substrate control. A regulated degree of intrinsic uncoupling is a hallmark of oxidative phosphorylation, whereas pathological and toxicological dyscoupling is evaluated as a mitochondrial defect. The noncoupled state of maximum respiration is experimentally induced by titration of established uncouplers (FCCP, DNP) to collapse the proton gradient across the mitochondrial inner membrane and measure the capacity of the electron transfer system (ETS, open-circuit operation of respiration). Intrinsic uncoupling and dyscoupling are evaluated as the flux control ratio between nonphosphorylating LEAK respiration (electron flow coupled to proton pumping to compensate for proton leaks) and ETS capacity. If OXPHOS capacity (maximally ADP-stimulated oxygen flux) is less than ETS capacity, the phosphorylation system contributes to flux control. Physiological Complex I + II substrate combinations are required to reconstitute TCA cycle function. This supports maximum ETS and OXPHOS capacities, due to the additive effect of multiple electron supply pathways converging at the Q-junction. Substrate control with electron entry separately through Complex I (pyruvate + malate or glutamate + malate) or Complex II (succinate + rotenone) restricts ETS capacity and artificially enhances flux control upstream of the Q-cycle, providing diagnostic information on specific branches of the ETS. Oxygen levels are maintained above air saturation in protocols with permeabilized muscle fibers to avoid experimental oxygen limitation of respiration. Standardized two-point calibration of the polarographic oxygen sensor (static sensor calibration), calibration of the sensor response time (dynamic sensor calibration), and evaluation of instrumental background oxygen flux (systemic flux compensation) provide the unique experimental basis for high accuracy of quantitative results and quality control in HRR.
Aims
Motor unit recruitment and firing rate patterns of the vastus lateralis (VL) have not been compared between sexes during moderate‐ and high‐intensity contraction intensities. Additionally, the ...influence of fiber composition on potential sex‐related differences remains unquantified.
Methods
Eleven males and 11 females performed 40% and 70% maximal voluntary contractions (MVCs). Surface electromyographic (EMG) signals recorded from the VL were decomposed. Recruitment thresholds (RTs), MU action potential amplitudes (MUAPAMP), initial firing rates (IFRs), mean firing rates (MFRs), and normalized EMG amplitude (N‐EMGRMS) at steady torque were analyzed. Y‐intercepts and slopes were calculated for MUAPAMP, IFR, and MFR versus RT relationships. Type I myosin heavy chain isoform (MHC) was determined with muscle biopsies.
Results
There were no sex‐related differences in MU characteristics at 40% MVC. At 70% MVC, males exhibited greater slopes (p = 0.002) for the MUAPAMP, whereas females displayed greater slopes (p = 0.001–0.007) for the IFR and MFR versus RT relationships. N‐EMGRMS at 70% MVC was greater for females (p < 0.001). Type I %MHC was greater for females (p = 0.006), and was correlated (p = 0.018–0.031) with the slopes for the MUAPAMP, IFR, and MFR versus RT relationships at 70% MVC (r = −0.599–0.585).
Conclusion
Both sexes exhibited an inverse relationship between MU firing rates and recruitment thresholds. However, the sex‐related differences in MU recruitment and firing rate patterns and N‐EMGRMS at 70% MVC were likely due to greater type I% MHC and smaller twitch forces of the higher threshold MUs for the females. Evidence is provided that muscle fiber composition may explain divergent MU behavior between sexes.
Ultrasound-derived echo intensity (EI) has been used as a physiological marker for changes in skeletal muscle "quality" with physical training, disuse, aging, and neuromuscular disorders. However, ...the methodological and physiological factors influencing EI and its longitudinal change are still unclear. Here, we performed two separate experiments to investigate the effects of muscle temperature and fascicle angle, which are known to influence muscle tissue and sound wave properties and therefore affect EI.
In experiment 1 ( n = 16, 28.0 ± 6.6 yr), vastus lateralis (VL) ultrasonographic images were acquired and intramuscular temperature continuously recorded for 15 min after 20 min of heating to 40.4°C ± 0.7°C using a microwave device. In experiment 2 ( n = 17, 30.2 ± 9.8 yr), VL sonographic images were obtained with the knee both fully extended (0°) and flexed to 90° and EI and fascicle angle measured post hoc . Fascicle movement was tracked during the passive knee flexion to ensure that sonographic images were obtained at the same muscle region. Knee flexion reduced muscle thickness, and we therefore reran analyses calculating EI using identical dimensions to minimize this effect.
EI decreased only immediately after the passive heating, and although a moderate, negative correlation was observed between EI and temperature ( rrm = -0.36), the effect of muscle temperature was small ( β = 0.97 (-1.89 to -0.06) per degree Celsius, P = 0.051). Nonetheless, EI increased as fascicle angle decreased, and a large, negative correlation ( rrm = -0.85) was observed; the effect of fascicle angle on EI was large ( β = 3.0 (-3.8 to -2.2) per degree, P < 0.01), and this was maintained when analyses were performed at a constant depth of the region of interest ( β = 3.5 (-4.4 to -2.7) per degree, P < 0.01).
These findings support the hypothesis that fascicle angle meaningfully affects VL EI but provides weak evidence of a temperature effect in vivo . Thus, acute fascicle angle alterations should be accounted for in studies using EI measurements, and longer-term studies should consider whether changes in EI might be partly explained by a change in fascicle angle.
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