Avaliação volumétrica e funcional do músculo glúteo máximo submetido a gluteoplastia de aumento com implantes de silicone

A operação para aumento de glúteos com implantes teve início no fim da década de 1960, entretanto a técnica intramuscular, considerada padrão atualmente, foi descrita cerca de 30 anos depois. Cirurgiões e pacientes apresentam crescente interesse na realização do aumento de glúteos haja vista que sua frequência apresenta aumento nos últimos anos. A utilização de implantes intramusculares que superam o volume do músculo em mais de cinquenta por cento configura uma situação nova que deve ser estudada. O tecido muscular estriado esquelético apresenta grande suscetibilidade para atrofia secundariamente à compressão, e sendo o glúteo máximo um músculo importante na manutenção da postura ereta, deambulação, corrida e salto, é necessário pesquisar possíveis alterações musculares decorrentes da operação. O objetivo deste estudo é avaliar o volume e força do músculo glúteo máximo ao longo de 12 meses após a introdução de implantes intramusculares, o posicionamento destes implantes no interior da musculatura e mudanças antropométricas obtidas com a operação. Foram selecionadas 48 mulheres, 24 candidatas a gluteoplastia de aumento com implantes compuseram o grupo de estudo e 24 candidatas a mamoplastia de aumento compuseram o grupo controle de acordo com os critérios de inclusão e exclusão. As pacientes foram avaliadas em quatro momentos diferentes: pré-operatório e após três, seis e 12 meses da operação. Em todas as etapas foi realizada avaliação clínica nutricional, tomografia computadorizada com reconstrução 3D e teste isocinético. Todas as pacientes permaneceram afastadas de atividades físicas durante três meses após a operação. Foram utilizados implantes glúteos em gel coesivo de base oval e superfície lisa com volumes de 350 cm3 e 400 cm3. O nível de significância estatística foi mantido em 5%. As pacientes candidatas a gluteoplastia apresentaram valores da relação entre as medidas da cintura e do quadril maiores que aquelas do grupo controle. A operação de aumento glúteo com implantes demonstrou eficácia na melhora desta relação. Os implantes apresentaram posição obliqua com inclinação semelhante à das fibras musculares após três meses da operação, independente da posição em que foram inseridos. As pacientes do grupo de estudo apresentaram atrofia muscular após 12 meses em 6,14% à esquerda e 6,43% à direita, as pacientes do grupo controle não apresentaram atrofia. A força muscular apresentou redução do valor de torque máximo durante a flexão do quadril a 30 /s em ambos os grupos e aumento do torque máximo durante a adução a 60 /s apenas no grupo de estudo. Concluímos que a introdução de implante de silicone no interior do músculo glúteo máximo causa atrofia muscular após 12 meses. As variações na força deste músculo nesse período não podem ser atribuídas primariamente à operação ou à presença dos implantes em seu interior. Os implantes permaneceram em posição obliqua. O aumento de glúteos com implantes gera mudanças antropométricas nas mulheres submetidas a esta operação.

Avaliação dos efeitos do implante de silicone sobre o parênquima mamário e a musculatura peitoral maior

A mamoplastia de aumento está associada a alto grau de satisfação e significativa melhora da qualidade de vida das pacientes. Apesar disso, uma das principais causas de reoperação após esse procedimento se refere a deformidades de contorno e questões volumétricas. Ainda existem poucos dados objetivos para análise volumétrica pós-operatória da mamoplastia de aumento. O parênquima mamário sofre alterações microvasculares quando sob compressão mecânica, porém o tecido muscular é mais suscetível à lesão quando submetido a pressão do que outros tecidos, tendo pouca tolerância à compressão mecânica. O objetivo deste estudo é avaliar e comparar as alterações no parênquima mamário na mamoplastia de aumento subglandular e submuscular, além de avaliar as alterações volumétricas e funcionais da musculatura peitoral após a inserção de implantes no plano submuscular. Cinquenta e oito pacientes do sexo feminino foram randomizadas em dois grupos de estudo, com 24 pacientes cada, e um grupo controle com dez pacientes, de acordo com critérios de inclusão e não inclusão. Das pacientes do grupo de estudo, 24 foram submetidas à mamoplastia de aumento com inserção de implantes no plano suglandular e 24 foram submetidas ao procedimento no plano submuscular. As pacientes do grupo subglandular realizaram análise volumétrica da glândula mamária e as pacientes dos grupos submuscular e controle, além da volumetria mamária, também realizaram volumetria do músculo peitoral maior. A avaliação volumétrica foi realizada no pré-operatório e no pós-operatório, aos seis e 12 meses, por meio de ressonância magnética. Apenas as pacientes do grupo submuscular foram submetidas à avaliação da força muscular, com a utilização de teste isocinético, no pré-operatório e no pós-operatório, aos três, seis e 12 meses. Todas as pacientes estavam sob uso de anticoncepcional oral de baixa dosagem e as pacientes do grupo submuscular permaneceram afastadas de atividades físicas por um período de dois meses no pós-operatório. O grupo subglandular apresentou 22,8% de atrofia da glândula mamária ao final dos 12 meses, enquanto que o grupo submuscular não apresentou atrofia glandular ao final de um ano. O grupo submuscular apresentou atrofia muscular de 49,80% e redução da força muscular em adução após um ano de estudo. Não se observou correlação da forca muscular com a perda volumétrica, assim como não se observou alteração de forca em abdução. Concluímos que a mamoplastia de aumento suglandular causa atrofia do parênquima mamário, enquanto que o procedimento submuscular não causa esta alteração no parênquima mamário após o período de 12 meses pós-operatórios. Em contrapartida, a mamoplastia de aumento submuscular causa atrofia do músculo peitoral maior com diminuição da força muscular em adução após 12 meses de pós-operatório, sem correlação com a alteração de volume muscular.

刺参急性口围肿胀病和皱纹盘鲍肌肉萎缩症的病理学研究

本论文以大连沿海养殖刺参劾皱纹盘鲍为研究对象，利用组织学、超微病理学、病理生理学的方法，开展了患病病理学研究，并对可能诱发刺参和皱纹盘鲍病害的原因，以及病变过程进行了初步探讨。 中国北方养殖刺参[Apostichopus japonicus (Selenka)]幼参和成参的急性口围肿胀病。急性口围肿胀病是爆发于中国北方辽宁省和山东省沿岸养殖刺参群体中的一种新发现的疾病，并且从2004年开始已经引起刺参的大面积死亡现象，经济损失重大。 本文报道在养殖患病刺参的肠上皮细胞内发现大量的病毒样颗粒。这是首次报道病毒样粒子感染刺参。组织学检查表明该病毒具有包涵体结构，寄生于肠上皮细胞中。电镜检查的结果表明，该病毒粒子呈球形，直径80-100纳米，螺旋状核衣壳，具有囊膜结构且囊膜表面具有纤突结构。 进一步的形态学和病理学分析发现该病毒具有许多报道的关于冠状病毒的特征。细胞质内的 病毒颗粒大部分以团聚方式存在于一个完整的包膜内，形成典型的病毒包涵体结构。最明显的细胞病理学特征是细胞质内大面积的粒状物质的存在，该区域相对缺少相应的细胞器。在病毒包涵体内的管状结构，核衣壳包涵体以及双层膜囊泡也在病变细胞内发现。 在病参体内未发现立克次氏体，衣原体，细菌以及其他寄生生物。 中国北方养殖皱纹盘鲍(Haliotis discus hannai)的肌肉萎缩症病理研究 。 在2004年和2005年的中国北方海区，养殖皱纹盘鲍幼体和成体群体中爆发了严重的肌肉萎缩症。肌电图监测显示病鲍的肌肉萎缩是肌源性的而不是神经源性的。 与正常对照组对比结果显示，病鲍的肌纤维数量和肌纤维直径都显著降低。 肌酶谱测定结果显示，病鲍血清中的肌酸激酶水平，肌酸激酶—肌同工酶水平和乳酸脱氢酶水平，与正常血清对比，呈显著升高状态，说明病鲍体内发生了肌细胞损伤。超薄切片电镜检测结果显示在发生病变的肌细胞内存在双螺旋丝状结构的包涵体（Paired helical filaments, PHFs）, 该结构是人类患包涵体肌炎的主要的病理特征。 本文首次报道在无脊椎动物中发现双螺旋丝包涵体结构。 对损伤的肌纤维的进一步研究发现了异常增生的小圆柱体结构（Small Cylinder Structure, SCS）和致密小体(Dense colored particles, DCP),同时观察到这两种异常结构与肌纤维的损伤直接相关。本文还对该病的感染机制作了探讨。 中国北方皱纹盘鲍(Haliotis discus hannai)肌肉萎缩的病理生理研究。严重的足肌肉萎缩症是鲍的一种慢性致死性疾病。在中国北方的养殖皱纹盘鲍群体中第一次发现是在2000年，随后在各养殖海区，自然海区及实验室养殖过程中都发现了该病的暴发。 超微结构电镜检测显示肌肉纤维损伤严重，其内的大部分肌原纤维断裂或消失。 大量的花瓣状的糖原颗粒聚集在断裂的肌原纤维中，还有一些被包裹在包膜内。 这说明在病鲍体内的糖原代谢处于被抑制状态（或停止状态），随后的血清学检测表明病鲍血清中的葡萄糖含量与正常对照的含量显著降低，也证明了糖代谢途径的终止。病鲍血清中胆固醇和甘油三酯的量显著降低，伴随着高密度脂蛋白的水平显著升高，说明脂肪代谢途径的亢进状态。病鲍血清中的二氧化碳水平的显著降低说明出现了酸碱平衡紊乱，通过病因学分析可知该酸碱平衡紊乱应属于代谢性酸中毒。病鲍血清中的钠离子和钾离子浓度显著升高，无机磷和镁离子浓度显著降低说明出现了患病皱纹盘鲍体内出现了电解质紊乱。病鲍血清中蛋白质含量的检测表明患病皱纹盘鲍已出现低蛋白血症，说明病鲍出现了严重的营养不良。病鲍血清中的尿酸含量，胆碱酯酶水平和γ-转肽酶水平与正常对照组相比显著降低。各项指标检测的结果说明糖代谢途径的终止造成了病鲍一系列的调节体系的不平衡和各种生理功能的紊乱，甚至造成了鲍的最终死亡。

Fiber type-specific nitric oxide protects oxidative myofibers against cachectic stimuli.

Oxidative skeletal muscles are more resistant than glycolytic muscles to cachexia caused by chronic heart failure and other chronic diseases. The molecular mechanism for the protection associated with oxidative phenotype remains elusive. We hypothesized that differences in reactive oxygen species (ROS) and nitric oxide (NO) determine the fiber type susceptibility. Here, we show that intraperitoneal injection of endotoxin (lipopolysaccharide, LPS) in mice resulted in higher level of ROS and greater expression of muscle-specific E3 ubiqitin ligases, muscle atrophy F-box (MAFbx)/atrogin-1 and muscle RING finger-1 (MuRF1), in glycolytic white vastus lateralis muscle than in oxidative soleus muscle. By contrast, NO production, inducible NO synthase (iNos) and antioxidant gene expression were greatly enhanced in oxidative, but not in glycolytic muscles, suggesting that NO mediates protection against muscle wasting. NO donors enhanced iNos and antioxidant gene expression and blocked cytokine/endotoxin-induced MAFbx/atrogin-1 expression in cultured myoblasts and in skeletal muscle in vivo. Our studies reveal a novel protective mechanism in oxidative myofibers mediated by enhanced iNos and antioxidant gene expression and suggest a significant value of enhanced NO signaling as a new therapeutic strategy for cachexia.

Characterization of CD4 and CD8 T cell responses in MuSK myasthenia gravis.

Muscle specific tyrosine kinase myasthenia gravis (MuSK MG) is a form of autoimmune MG that predominantly affects women and has unique clinical features, including prominent bulbar weakness, muscle atrophy, and excellent response to therapeutic plasma exchange. Patients with MuSK MG have predominantly IgG4 autoantibodies directed against MuSK on the postsynaptic muscle membrane. Lymphocyte functionality has not been reported in this condition. The goal of this study was to characterize T cell responses in patients with MuSK MG. Intracellular production of IFN-gamma, TNF-alpha, IL-2, IL-17, and IL-21 by CD4+ and CD8+ T cells was measured by polychromatic flow cytometry in peripheral blood samples from 11 Musk MG patients and 10 healthy controls. Only one MuSK MG patient was not receiving immunosuppressive therapy. Regulatory T cells (Treg) were also included in our analysis to determine if changes in T cell function were due to altered Treg frequencies. CD8+ T cells from MuSK MG patients had higher frequencies of polyfunctional responses than controls, and CD4+ T cells had higher IL-2, TNF-alpha, and IL-17. MuSK MG patients had a higher percentage of CD4+ T cells producing combinations of IFN-gamma/IL-2/TNF-gamma, TNF-alpha/IL-2, and IFN-gamma/TNF-alpha. Interestingly, Treg numbers and CD39 expression were not different from control values. MuSK MG patients had increased frequencies of Th1 and Th17 cytokines and were primed for polyfunctional proinflammatory responses that cannot be explained by a defect in CD39 expression or Treg number.

Characterization of the 5' upstream regulatory region of the human myostatin gene: regulation of myostatin gene transcription by dexamethasone in vitro

We cloned and characterized a 3.3-kb fragment containing the 5'-regulatory region of the human myostatin gene. The promoter sequence contains putative muscle growth response elements for glucocorticoid, androgen, thyroid hormone, myogenic differentiation factor 1, myocyte enhancer factor 2, peroxisome proliferator-activated receptor, and nuclear factor-kappaB. To identify sites important for myostatin's gene transcription and regulation, eight deletion constructs were placed in C(2)C(12) and L6 skeletal muscle cells. Transcriptional activity of the constructs was found to be significantly higher in myotubes compared with that of myoblasts. To investigate whether glucocorticoids regulate myostatin gene expression, we incubated both cell lines with dexamethasone. On both occasions, dexamethasone dose dependently increased both the promoter's transcriptional activity and the endogenous myostatin expression. The effects of dexamethasone were blocked when the cells were coincubated with the glucocorticoid receptor antagonist RU-486. These findings suggest that glucocorticoids upregulate myostatin expression by inducing gene transcription, possibly through a glucocorticoid receptor-mediated pathway. We speculate that glucocorticoid-associated muscle atrophy might be due in part to the upregulation of myostatin expression.

Periodontal Manifestations of Chronic Atypical Neutrophilic Dermatosis With Lipodystrophy and Elevated Temperature (CANDLE) Syndrome in an 11 Year Old Patient

Introduction: Chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE) is an auto inflammatory syndrome caused by an autosomal recessive gene mutation. This very rare syndrome has been reported in only 14 patients worldwide. A number of clinical signs have been reported including joint contractures, muscle atrophy, microcytic anaemia, and panniculitis-induced childhood lipodystrophy. Further symptoms include recurrent fevers, purpuric skin lesions, periorbital erythema and failure to thrive. This is the first reported case of periodontal manifestations associated with CANDLE syndrome. 
Case Presentation: An 11 year old boy was referred to Cork University Dental School and Hospital with evidence of severe periodontal destruction. The patient’s medical condition was managed in Great Ormond Street Children’s Hospital, London. The patient’s dental management included initial treatment to remove teeth of hopeless prognosis followed by prosthodontic rehabilitation using removable partial dentures. This was followed by further non-surgical periodontal treatment and maintenance. In the long term, the potential definitive restorative options, including dental implants, will be evaluated in discussion with the patient’s medical team.
Conclusion: Periodontitis as a manifestation of systemic disease is one of seven categories of periodontitis as defined by the American Academy of Periodontology 1999 classification system. A number of systemic diseases have been associated with advanced periodontal destruction including Diabetes Mellitus, Leukaemia and Papillon-Lefevre Syndrome. In the case described, treatment necessitated a multidisciplinary approach with input from medical and dental specialities for a young patient with severe periodontal destruction associated with CANDLE syndrome.

Acute hypoxia reduces plasma myostatin independent of hypoxic dose

Background: Muscle atrophy is seen ~ 25 % of patients with cardiopulmonary disorders, such as chronic obstructive pulmonary disorder and chronic heart failure. Multiple hypotheses exist for this loss, including inactivity, inflammation, malnutrition and hypoxia. Healthy individuals exposed to chronic hypobaric hypoxia also show wasting, suggesting hypoxia alone is sufficient to induce atrophy. Myostatin regulates muscle mass and may underlie hypoxic-induced atrophy. Our previous work suggests a decrease in plasma myostatin and increase in muscle myostatin following 10 hours of exposure to 12 % O2. Aims: To establish the effect of hypoxic dose on plasma myostatin concentration. Concentration of plasma myostatin following two doses of normobaric hypoxia (10.7 % and 12.3 % O2) in a randomised, single-blinded crossover design (n = 8 lowlanders, n = 1 Sherpa), with plasma collected pre (0 hours), post (2 hours) and 2 hours following (4 hours) exposure. Results: An effect of time was noted, plasma myostatin decreased at 4 hours but not 2 hours relative to 0 hours (p = 0.01; 0 hours = 3.26 [0.408] ng.mL-1, 2 hours = 3.33, [0.426] ng.mL-1, 4 hours = 2.92, [0.342] ng.mL-1). No difference in plasma myostatin response was seen between hypoxic conditions (10.7 % vs. 12.3 % O2). Myostatin reduction in the Sherpa case study was similar to the lowlander cohort. Conclusions: Decreased myostatin peptide expression suggests hypoxia in isolation is sufficient to challenge muscle homeostasis, independent of confounding factors seen in chronic cardiopulmonary disorders, in a manner consistent with our previous work. Decreased myostatin peptide may represent flux towards peripheral muscle, or a reduction to protect muscle mass. Chronic adaption to hypoxia does not appear to protect against this response, however larger cohorts are needed to confirm this. Future work will examine tissue changes in parallel with systemic effects.

Caracterización de las variables nutricionales en pacientes incidentes de diálisis peritoneal rts 2011-2012

Los pacientes con enfermedad renal crónica (ERC) terminal se caracterizan por presentar alteraciones nutricionales que se perpetúan independiente de la modalidad de la Terapia de Reemplazo Renal (TRR). En la diálisis peritoneal, tanto APD (automated peritoneal dialysis) como la CAPD (continuous ambulatory peritoneal dialysis) existe un alto riesgo de pérdida de albúmina por el filtrado peritoneal, sin diferencias claras en el estatus nutricional. El presente estudio caracteriza el estado nutricional de los pacientes incidentes en diálisis peritoneal de RTS Bogotá Regional 1, con un seguimiento de un año, para conocer los cambios en las variables nutricionales. Se realizó un estudio de cohortes retrospectivo, analizando 2 grupos según el tipo de diálisis peritoneal escogida (APD o CAPD), con un análisis análisis descriptivo trimestral de las características nutricionales y posteriormente una comparación entre las 2 modalidades de TRR. Encontrando un promedio de edad de 60,8 años, la mayoría hombres y etiología principal nefropatía diabética. La mayoría de las variables nutricionales permanecieron sin cambios durante seguimiento. El Test de equilibrio peritoneal para glucosa y creatinina mostró valores promedio bajo y promedio alto y la mayoría de pacientes un rango nutricional normal. Al comparar APD y CAPD, solo se encontraron de forma aislada, diferencias significativas en algunas variables aisladas. Este es el primer estudio en Colombia que evalúa diferentes aspectos nutricionales en diálisis peritoneal. Aunque con limitaciones metodológicas, es un punto de partida para la realización de estudios más robustos que del estado nutricional de los pacientes en diálisis peritoneal

Human sarcopenia reveals an increase in SOCS-3 and myostatin and a reduced efficiency of Akt phosphorylation

Age-related skeletal muscle sarcopenia is linked with increases in falls, fractures, and death and therefore has important socioeconomic consequences. The molecular mechanisms controlling age-related muscle loss in humans are not well understood, but are likely to involve multiple signaling pathways. This study investigated the regulation of several genes and proteins involved in the activation of key signaling pathways promoting muscle hypertrophy, including GH/STAT5, IGF-1/Akt/GSK-3β/4E-BP1, and muscle atrophy, including TNFα/SOCS-3 and Akt/FKHR/atrogene, in muscle biopsies from 13 young (20 ± 0.2 years) and 16 older (70 ± 0.3 years) males. In the older males compared to the young subjects, muscle fiber cross-sectional area was reduced by 40–45% in the type II muscle fibers. TNFα and SOCS-3 were increased by 2.8 and 1.5 fold, respectively. Growth hormone receptor protein (GHR) and IGF-1 mRNA were decreased by 45%. Total Akt, but not phosphorylated Akt, was increased by 2.5 fold, which corresponded to a 30% reduction in the efficiency of Akt phosphorylation in the older subjects. Phosphorylated and total GSK-3β were increased by 1.5 and 1.8 fold, respectively, while 4E-BP1 levels were not changed. Nuclear FKHR and FKHRL1 were decreased by 73 and 50%, respectively, with no changes in their atrophy target genes, atrogin-1 and MuRF1. Myostatin mRNA and protein levels were significantly elevated by 2 and 1.4 fold. Human sarcopenia may be linked to a reduction in the activity or sensitivity of anabolic signaling proteins such as GHR, IGF-1, and Akt. TNFα, SOCS-3, and myostatin are potential candidates influencing this anabolic perturbation.

NDRG2, a novel regulator of myoblast proliferation, is regulated by anabolic and catabolic factors

Skeletal muscle tissue undergoes adaptive changes in response to stress and the genes that control these processes are incompletely characterised. NDRG2 (N-myc downstream-regulated gene 2), a stress- and growth-related gene, was investigated in skeletal muscle growth and adaption. While NDRG2 expression levels were found to be up-regulated in both differentiated human and mouse myotubes compared with undifferentiated myoblasts, the suppression of NDRG2 in C2C12 myoblasts resulted in slowed myoblast proliferation. The increased expression levels of the cell cycle inhibitors, p21 Waf1/Cip1 and p27 Kip1, and of various muscle differentiation markers in NDRG2-deficient myoblasts indicate that a lack of NDRG2 promoted cell cycle exiting and the onset of myogenesis. Furthermore, the analysis of NDRG2 regulation in C2C12 myotubes treated with catabolic and anabolic agents and in skeletal muscle from human subjects following resistance exercise training revealed NDRG2 gene expression to be down-regulated during hypertrophic conditions, and conversely, up-regulated during muscle atrophy. Together, these data demonstrate that NDRG2 expression is highly responsive to different stress conditions in skeletal muscle and suggest that the level of NDRG2 expression may be critical to myoblast growth and differentiation.

The effect of estrogen on Akt signalling and protein synthesis in C2C12 mouse skeletal myotubes

The maintenance of skeletal muscle mass is a critical component of health in both chronic wasting diseases and aging. A considerable amount of progress has been made in the understanding of the signalling pathways that mediate skeletal muscle hypertrophy and atrophy. Akt is seen as a key molecular protein involved in the maintenance of skeletal muscle mass as it has the dual ability to positively influence protein syntheses and negatively regulate protein degradation in its active state (Glass, 2003). Potential mechanisms which may assist with maintaining skeletal muscle mass are the estrogen hormones. Estrogens increase the proliferation of mouse and rat myoblasts and can also attenuate immobilization-induced skeletal muscle atrophy in rats in vivo (Kahlert et al., 1997). No studies have investigated the effect of estrogens on the activation of skeletal muscle hypertrophy and atrophy signalling pathways. Estrogens may contribute to maintaining skeletal muscle mass via their activation of the Akt signalling pathways. Therefore, the aims of the present study were to determine if treatment of C2C12 myotubes with either 17β-estrodiol or estrone increases the activity of Akt and its downstream anabolic signalling proteins, GSK, p70s6k and 4E-BP1 and decreases its catabolic stimulating targets, FOXO, atrogin-1 and MuRF-1. A secondary aim was to determine if this was associated with an increased rate of protein synthesis.

C2C12 myotubes were incubated at 37°C in serum free DMEM without phenol red containing 10 000 units/ml penicillin, 10 000 μg/ml streptomycin, and 250μg/ml amphotericin B for 24h. Myotubes were then stimulated with 17-β estradiol (10nM) for 24h. Phosphorylated and total proteins for Akt, p70S6k, GSK3β, 4E-BP1, FOXO and atrogin-1 were measured using western blotting techniques. Atrogin-1 and MuRF1 mRNA levels were measured using real time-PCR. Protein synthesis rates were measured by incorporation of [3H]-tyrosine into the myotubes during the last hour of treatment.

Compared to control myotubes, treatment with 17β-estradiol increased the ratio of phosphorylated to total protein contents for Akt, GSK-3β and P70s6k by, 1.62, 1.53 and 2.2 fold, respectively (n=6 per group; p < 0.05). There was, however, no difference in the ratios of phosphorylated to total 4E-BP1 or Foxo3a or Atrogin-1 and MuRF1 mRNA. Protein synthesis rates remained unchanged.

This study demonstrates that in C2C12 mouse myotubes, 17β-estradiol treatment increases the phosphorylation of the hypertrophy signalling protein, Akt, and its downstream hypertrophy signalling targets, GSK-3β and P70s6k; no associated changes in protein synthesis were observed. Future studies should investigate the ability of 17β-estradiol to activate these proteins in a model of myotube catabolism and to determine if protein degradation is attenuated.

Older adults' neuromuscular adaptations to resistence training and effects on challenging gait tasks

Community locomotion is threatened when older individuals are required to negotiate obstacles, which place considerable stress on the musculoskeletal system. The vulnerability of older adults during challenging locomotor tasks is further compromised by age-related strength decline and muscle atrophy. The first study in this investigation determined the relationship between the major muscle groups of the lower body and challenging locomotor tasks commonly found in the community environment of older adults. Twenty-nine females and sixteen males aged between 62 and 88 years old (68.2 ±6.5) were tested for the maximal voluntary contraction (MVC) strength of the knee extensors and 1-RM for the hip extensors, flexors, adductors, abductors, knee extensors and flexors and ankle plantar flexors. Temporal measurements of an obstacle course comprising four gait tasks set at three challenging levels were taken. The relationship between strength and the obstacle course dependent measures was explored using linear regression models. Significant associations (p≤0.05) between all the strength measures and the gait performances were found. The correlation values between strength and obstructed gait (r = 0.356-0.554) and the percentage of the variance explained by strength (R2 = 13%-31%), increased as a function of the challenging levels, especially for the stepping over and on and off conditions. While the difficulty of community older adults to negotiate obstacles cannot be attributed to a single causal pathway, the findings of the first study showed that strength is a critical requirement. That the magnitude of the association increased as a function of the challenging levels, suggests that interventions aimed at improving strength would potentially be effective in helping community older adults to negotiate environmental gait challenges. In view of the findings of the first study, a second investigation determined the effectiveness of a progressive resistance-training program on obstructed gait tasks measured under specific laboratory conditions and on an obstacle course mimicking a number of environmental challenges. The time courses of strength gains and neuromuscular mechanisms underpinning the exercise-induced strength improvements in community-dwelling older adults were also investigated. The obstructed gait conditions included stepping over an obstacle, on and off a raised surface, across an obstacle and foot targeting. Forty-three community-living adults with a mean age of 68 years (control =14 and experimental=29) completed a 24-week progressive resistance training program designed to improve strength and induce hypertrophy in the major muscles of the lower body. Specific laboratory gait kinetics and kinematics and temporal measures taken on the obstacle course were measured. Lean tissue mass and muscle activation of the lower body muscle groups were assessed. The MVC strength of the knee extensors and 1-RM of the hip extension, hip flexion, knee extension, knee flexion and ankle plantar flexion were measured. A 25% increase on the MVC of the knee extensors (p≤0.05) was reported in the training group. Gains ranging between 197% and 285% were recorded for the 1-RM exercises in the trained subjects with significant improvements found throughout the study (p≤0.05). The exercise-induced strength gains were mediated by hypertrophic and neural factors as shown by 8.7% and 27.7% increases (p≤0.05) in lean tissue mass and integrated electromyographic activity, respectively. Strength gains were accompanied by increases in crossing velocity, stride length and reductions in stride duration, stance and swing time for all gait tasks except for the foot targeting condition. Specific kinematic variables associated with safe obstacle traverse such as vertical obstacle heel clearance, limb flexion, horizontal foot placements prior to and at post obstacle crossing and landing velocities resulted in an improved crossing strategy in the experimental subjects. Significant increases in the vertical and anterior-posterior ground reaction forces accompanied the changes in the gait variables. While further long-term prospective studies of falls rates would be needed to confirm the benefits of lower limb enhanced strength, the findings of the present study provide conclusive evidence of significant improvements to gait efficiency associated with a systematic resistance-training program. It appears, however, that enhanced lower body strength has limited effects on gait tasks involving a dynamic balance component. In addition, due to the larger strength-induced increases in voluntary activation of the leg muscle compared to relatively smaller gains in lean tissue mass, neural adaptations appear to play a greater contributing role in explaining strength gains during the current resistance training protocol.

The role of PGC-1α and PGC-1β in myotube protein synthesis

Skeletal muscle mass is regulated by a balance between protein synthesis and protein degradation. Using molecular techniques, this PhD thesis identified that two proteins, PGC-1α and PGC-1β, can increase protein synthesis in myotubes in vitro. This has implications for the treatment of diseases associated with skeletal muscle atrophy.

Resistive simulated weightbearing exercise with whole body vibration reduces lumbar spine deconditioning in bed-rest

STUDY DESIGN: Randomized controlled trial. OBJECTIVE: Determine the effectiveness a resistive exercise countermeasure with whole-body vibration in relation to lumbo-pelvic muscle and spinal morphology changes during simulated spaceflight (bed-rest). SUMMARY OF BACKGROUND DATA: Spinal lengthening, flattening of the spinal curves, increases in disc size, and muscle atrophy are commonly seen in spaceflight simulation. This may represent a risk for low back injury. Consideration of exercise countermeasures against these changes is critical for success of long-term spaceflight missions. METHODS: Twenty healthy male subjects underwent 8-weeks of bed-rest with 6-months follow-up and were randomly allocated to an inactive control or countermeasure exercise group. Magnetic resonance imaging of the lumbo-pelvic region was conducted at regular time-points during and after bed-rest. Using uniplanar images at L4, cross-sectional areas of the multifidus, lumbar erector spinae, quadratus lumborum, psoas, anterolateral abdominal, and rectus abdominis muscles were measured. Sagittal scans were used to assess lumbar spine morphology (length, sagittal disc area and height, and intervertebral angles). RESULTS: The countermeasure group exhibited less multifidus muscle atrophy (P = 0.024) and its atrophy did not persist long-term as in the control group (up to 3-months; P < 0.006). Spinal lengthening (P = 0.03) and increases in disc area (P = 0.041) were also reduced. Significant partial correlations (P < 0.001) existed between spinal morphology and muscle cross-sectional area changes. CONCLUSION: The resistive vibration exercise countermeasure reduced, but did not entirely prevent, multifidus muscle atrophy and passive spinal tissue deconditioning during bed-rest. Atrophy of the multifidus muscles was persistent long-term in the inactive subjects. Future work could consider closer attention to spinal posture during exercise and optimizing exercise dose.