Osteosarcoma with delayed metastasis to the stomach

This case illustrates a primary osteosarcoma in a child that has metastasized to the stomach. Such a presentation has only been documented once before and raises the importance of vigilant and thorough follow-up. In addition, this case questions the relationship of prolonged treatment and subsequent sites of recurrence.     

Skeletal muscle metastasis from colorectal adenocarcinoma: A literature review

BACKGROUNDColorectal adenocarcinoma is the third most common cancer worldwide. It accounts for almost 10% of all cancer-related deaths. Skeletal muscle is a very unusual site for metastasis from colorectal cancers and is associated with a poor prognosis and high mortality.AIMTo review the literature for cases of skeletal muscle metastasis (SMM) from colorectal adenocarcinoma.METHODSA systematic literature search using a validated search strategy was carried out to identify the incidence of SMM associated with colorectal adenocarcinoma. The studies identified were tabulated in a PRISMA, and data was extracted in a tabulated form.RESULTSTwenty-nine studies were included in this literature review. SMM was most commonly detected in the thigh muscles. Most of the tumours had originated from the rectum or the right colon. The histopathology of the primary tumour was generally advanced. The mean time interval between the primary tumour and onset of SMM was 22 mo. In 3 cases, asymptomatic SMM had been picked up by advanced imaging systems, like fluorodeoxyglucose-positron emission tomography scan.CONCLUSIONSMM from colorectal adenocarcinomas is a rare complication. However, it is possible that the low incidence could be due to under-reporting. Early use of advanced imaging techniques and a high index of clinical suspicion might increase the reporting of SMM from colorectal adenocarcinoma.     

nm23基因蛋白在骨肉瘤的表达及与肺转移的关系

目的：了解ｎｍ２３蛋白在骨肉瘤的表达及与肺转移的关系，探讨其对骨肉瘤转移的抑制作用。材料与方法：３９例骨肉瘤石蜡切片，以抗ｎｍ２３多克隆抗体进行免疫组化染色，并对有关的临床病理指标进行分析。结果与结论：１９例显示ｎｍ２３阳性，占４８．７％。ｎｍ２３在骨肉瘤的表达与病理分级、分型，肿瘤大小，以及转移无关，但显示ｎｍ２３表达的骨肉瘤有发生转移的倾向。本研究并未显示ｎｍ２３在骨肉瘤具有肿瘤抑制的作用。     

Metastatic Osteosarcoma in the Jejunum with Intussusception: Report of a Case

We report a case of metastatic osteosarcoma in the jejunum causing intestinal intussusception. A 58-year-old woman underwent right femoral region amputation, lower lobectomy of the left lung and complete left pneumonectomy after four courses of chemotherapy for osteosarcoma of the right femur with left lung metastases. She was referred to our department 13 months later with progressive abdominal pain and vomiting. Abdominal radiography showed a small-bowel obstruction. She underwent emergency laparotomy, which revealed jejunal intussusception. The lead point was found to be an intraluminal tumor. We resected the jejunum containing the tumor and histological examination confirmed that the tumor was osteosarcoma metastasis.     

Post-injection fibrosis of skeletal muscle: A clinical problem

Summary A personal series of 169 cases of post-injection fibrosis of skeletal muscle consisting of 78 cases of deltoid fibrosis, 84 cases of quadriceps fibrosis, 6 cases of gluteal fibrosis and one case of triceps fibrosis are presented. Discussion includes an extensive review of literature. A plea is made for prevention of the condition.

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Résumé Présentation d'une série personnelle de 169 cas de fibrose musculaire consécutive à des injections: 78 cas de fibrose du deltoïde, 84 cas de fibrose du quadriceps, 6 cas de fibrose des fessiers et un cas de fibrose du triceps. La discussion comporte une revue de la littérature. L'auteur propose des mesures préventives pour éviter cette complication.

     

骨骼肌组织工程研究进展

骨骼肌组织工程是组织工程学研究较少的一个领域，以往有关骨骼肌组织工程的综述类文献。都局限于从种子细胞、生物材料及生长因子等方面论述。而近年来本领域研究成果不断涌现，本文结合最新国内外文献，从组织工程骨骼肌构建的基本问题到其血管化、神经化等方面，对骨骼肌组织工程研究现状进行回顾，并对其研究前景作一展望。     

术中预缺血对猪骨骼肌保护作用的实验研究

目的　研究术中预缺血对骨骼肌缺血坏死的保护作用及相关的肌肉代谢变化。方法　１０ 只猪背阔肌瓣在４ｈ 缺血前先进行３ 个循环１０ ｍｉｎ 的术中预缺血,４８ｈ 后用染色法记录肌肉成活率,于肌肉缺血前、缺血后２ ,４ｈ 和再灌流１５ｈ 分别作肌肉活检。结果　４ｈ 缺血后的肌瓣,术中预缺血组成活率高出对照组４４ ％ ,肌肉活检三磷酸腺苷（ Ａ Ｔ Ｐ） 增加和乳酸降低（ Ｐ＜ ００５） 。结论　术中预缺血可增加骨骼肌对缺血坏死的保护作用,这与肌肉中能量代谢的减低相关。     

The impact of severe burns on skeletal muscle mitochondrial function

Severe burns induce a pathophysiological response that affects almost every physiological system within the body. Inflammation, hypermetabolism, muscle wasting, and insulin resistance are all hallmarks of the pathophysiological response to severe burns, with perturbations in metabolism known to persist for several years post injury. Skeletal muscle is the principal depot of lean tissue within the body and as the primary site of peripheral glucose disposal, plays an important role in metabolic regulation. Following a large burn, skeletal muscle functions as and endogenous amino acid store, providing substrates for more pressing functions, such as the synthesis of acute phase proteins and the deposition of new skin. Subsequently, burn patients become cachectic, which is associated with poor outcomes in terms of metabolic health and functional capacity. While a loss of skeletal muscle contractile proteins per se will no doubt negatively impact functional capacity, detriments in skeletal muscle quality, i.e. a loss in mitochondrial number and/or function may be quantitatively just as important. The goal of this review article is to summarise the current understanding of the impact of thermal trauma on skeletal muscle mitochondrial content and function, to offer direction for future research concerning skeletal muscle mitochondrial function in patients with severe burns, and to renew interest in the role of these organelles in metabolic dysfunction following severe burns.     

术中预缺血对猪骨骼肌保护作用的实验研究

目的研究术中预缺血对骨骼肌缺血坏死的保护作用及相关的肌肉代谢变化。方法 10只猪背阔肌瓣在4h 缺血前先进行3个循环10min 的术中预缺血,48h 后用染色法记录肌肉成活率,于肌肉缺血前、缺血后2,4h 和再灌流1.5h 分别作肌肉活检。结果 4h 缺血后的肌瓣,术中预缺血组成活率高出对照组44％,肌肉活检三磷酸腺苷(ATP)增加和乳酸降低(P<0.05)。结论术中预缺血可增加骨骼肌对缺血坏死的保护作用,这与肌肉中能量代谢的减低相关。     

自噬在骨骼肌质量维持中的作用

作为人体重要的运动和能量代谢器官,骨骼肌质量的正常维持对于机体发挥正常的生理功能至关重要。自噬-溶酶体(autophagy-lysosome,AL)途径是一种在正常和病态细胞中普遍存在的生理或病理机制,对于维持细胞内蛋白质平衡,清除细胞内受损的细胞器,及维持内环境稳定起到关键作用。自噬过程的顺利进行需要经历多个步骤,在多重因子的协调作用下完成。自噬通过清除受损的肌原纤维和隔离的胞浆蛋白等细胞成分来维持健康机体的肌肉内稳态。自噬还可以提供细胞增殖所需的初始能量,促进损伤后肌肉的再生和重塑。同时,自噬失调也是导致年龄相关性骨骼肌萎缩的一个重要诱因。自噬可以影响骨骼肌对运动的反应,增加基础自噬水平有利于提高骨骼肌对运动的适应性。本文将自噬在骨骼肌质量维持中的作用与通路进行总结,以便为临床预防和治疗肌萎缩提供有效的康复策略。     

神经提取液对周围神经及骨骼肌的作用

目的研究周围神经提取液对失神经骨骼肌、损伤恢复期周围神经和骨骼肌的作用。方法将Wistar大鼠48只随机分为对照组和实验组,将羊周围神经提取液注射于大鼠离断神经和修复神经损伤后的趾长伸肌中,检测其周围神经和骨骼肌的组织学指标。结果失神经实验中,实验组中肌纤维平均面积、肌纤维平均直径、肌肉内肌纤维平均面积百分比、趾长伸肌指数均优于对照组。损伤恢复期实验中,实验组各指标均优于对照组。其中坐骨神经提取液组和粗提周围神经提取液组趾长伸肌指数为(68.24±9.54)％、(66.15±4.46)％,较生理盐水组(61.31±4.52)％差异有显著性(P＜0.05);腓总神经传导速度(3.39±0.91)m/s、(5.31±2 72)m/s[生理盐水组为(0.86±0.77)m/s];有髓神经面积恢复率为(16.49±3.49)μm2、(16.02±4.15)μm2[生理盐水组为(6.40±3.49)μm2];骨骼肌纤维平均面积为(1 311±429)μm2、(1 256±363)μm2[生理盐水组为(598±195)μm2]。结论周围神经中含有缓解失神经肌肉萎缩的骨骼肌营养物质,周围神经提取液缓解了失神经骨骼肌的萎缩,促进了修复后神经和骨骼肌的恢复。     

缺血后处理对减轻骨骼肌缺血再灌注损伤作用的实验研究

目的：研究缺血后处理对鼠骨骼肌缺血再灌注损伤的保护影响,组织中凋亡和胀亡的存在情况。方法将54只SD大鼠随机分为空白对照组、缺血再灌注组、缺血后处理组,持续缺血4 h,再灌注6 h,24 h,48 h。检测血浆乳酸脱氢酶（LDH）、肌酸磷酸激酶（CPK）活性、肌肉内丙二醛（MDA）含量及总超氧化物歧化酶（SOD）活性,进行组织学、免疫组化、超微结构分析。结果相比缺血再灌注组,后处理组在再灌注6 h时,只SOD活性明显升高,而再灌注24 h,48 h时,在MDA含量下降、SOD活性升高、W/D值下降、组织学改变范围及免疫组化阳性范围方面,均较缺血再灌注组有明显差异。结论再灌注开始时应用后处理对于缺血再灌注损伤有明显的保护作用,主要体现在再灌注的稍后期阶段（再灌注24 h,48 h）。缺血再灌注过程中,凋亡和胀亡是并存的。     

Effects of hyperbaric oxygen therapy on rabbit skeletal muscle during extremity lengthening

Introduction  Extremity lengthening through distraction osteogenesis is limited by the surrounding skeletal muscle and neurovascular structures rather than the bone itself. The purpose of this study is to evaluate the effects of hyperbaric oxygen therapy on skeletal muscle during distraction osteogenesis. Materials and methods  Twenty New Zealand white rabbits were randomly divided into two groups. Right tibia of all rabbits was distracted at a rate of 0.125 mm per 6 h (0.5 mm/day) for 10 days with circular external fixator. Experimental group rabbits (N = 10) underwent 2.5 ATA hyperbaric oxygen therapy for 2 h everyday for 20 days, control group rabbits (N = 10) did not receive any corresponding treatment. Skeletal muscle perfusion was evaluated with scintigraphy before and after the distraction period. Serum CPK, LDH and AST levels were measured before and after the distraction period. All animals were killed on the 27th day. The right tibias of all animals were removed and tibialis posterior muscle was harvested for histopathologic and histomorphometric assessment with light and electron microscopy. Results  Skeletal muscle perfusion was decreased in the control group in comparison with pre-distraction level (P = 0.008). However, no significant decrease was observed in the experimental group (P = 0.678). There were no statistical differences in serum CPK, LDH and AST levels between groups (P = 0.340, P = 0.077, P = 0.796). The mean area of the muscle fibers was measured as 398.66 ± 9.16 μ² in the experimental group and 349.44 ±5.76 μ² in the control group (P = 0.000) with light microscopy. Mild fibrosis was observed in connective tissue component of muscle tissue in control group. An average of 26 myofibrils (20–32) was counted in a 16-cm² unit area in experimental group and 50 myofibrils (35–65) in the control group with electron microscopy. Enlargement in the sarcoplasmic reticulum, degenerative changes in nuclear cytoplasm and increase in myofibril diameter were observed in the control group, which was not observed in the experimental group Conclusion  Results of this study suggest that HBO treatment alleviates the detrimental effects of distraction on skeletal muscles and preserves its ultrastructure.     

Solitary metastasis to the intercostal muscle from hepatocellular carcinoma: A case report

INTRODUCTIONSkeletal muscle metastases from carcinomas, especially to intercostal muscles, are rare. Most metastatic chest wall tumors from hepatocellular carcinoma (HCC) result from disseminations through needle tracts of intrahepatic HCC treatments.PRESENTATION OF CASEWe report the case of a 65-year-old man with chronic viral hepatitis B whose intrahepatic lesions were stabilized by repeated radiofrequency ablations and transcatheter arterial chemoembolization. Follow-up computed tomography demonstrated a well-enhanced mass in the right chest wall. Because α-fetoprotein and des-γ-carboxy prothrombin levels were elevated and no other tumors were detected, we diagnosed the mass as an extrahepatic metastasis from the HCC and resected it along with the surrounding ribs. There was no involvement of the bone, pleura, and lung.DISCUSSIONThe tumor was microscopically diagnosed as an intercostal muscle tumor metastasized from HCC, which has not been documented previously. The resection rate of extrahepatic tumors of HCC is low in literature. No other apparent extrahepatic recurrence has been observed for more than 20 months after the surgery.CONCLUSIONWe report the case of HCC patient who underwent surgical resection of an intercostal muscle tumor that had metastasized from HCC. Pathological examination of the tumor revealed the tumor cells in the blood vessels, and we speculate it hematogeneous metastasis.     

利多卡因对骨骼肌缺血-再灌注损伤作用的实验研究

目的 阐明利多卡因对骨骼肌缺血-再关注损伤的作用.方法 采用MTT法测定骨骼肌组织活力,分别对缺血后、再灌注后加入利多卡因与对照组进行比较,并结合透射电镜,观察利多卡因对缺血再灌注损伤后的作用.结果 缺血后、再灌注后加入利多卡因与对照组进行比较,P＜0.01,差异有统计学意义;缺血后与再灌注后2组比较,P＞0.05,差...     

The production of calcification in connective tissue and skeletal muscle using various chemical compounds

The subcutaneous injection into mice of small quantities of lead salts resulted in calcification of the dorsal fascia. Other reputed calcergens failed to produce a similar reaction. However, the injection of Zn Cl₂ and KMn O₄ in high doses caused damage to, and subsequent calcification of the panniculus carnosus muscle.     

Malignant lymphoma in skeletal muscle with rhabdomyolysis: a report of two cases

 Malignant lymphoma is rarely found in skeletal muscle. In this article, we present two cases of malignant lymphomas that were located in skeletal muscle and caused rhabdomyolysis. One case was a primary skeletal muscle lymphoma (which is quite rare), and the other was a skeletal muscle metastasis of lymphoma. The patient with primary skeletal muscle lymphoma was diagnosed with a diffuse type of non-Hodgkin's lymphoma of T-cell origin, which may be linked to a history of injury. Both patients exhibited diffuse, homogeneous lesions of the affected muscles on computed tomography (CT) and magnetic resonance imaging (MRI). The blood levels of some enzymes and potassium, indicative of rhabdomyolysis, were elevated. Bone scintigraphy depicted widespread, diffuse accumulation of the radioisotope in the affected muscles of both patients, typical of rhabdomyolysis. Rhabdomyolysis may be a sequela of lymphoma, as a result of the tendency of malignant lymphoma to infiltrate diffusely into muscles, to affect multiple neighboring muscle compartments, and to metastasize into other soft tissues, as well as being a sequela of possible cytotoxic or humoral actions, all of which may increase the amount of muscle damage. When a patient presents with diffuse muscle swelling, one should consider a diagnosis of a hematogenous disease, which may cause rhabdomyolysis complicated by renal dysfunction. Received: November 26, 2001 / Accepted: June 17, 2002 Offprint requests to: S. Masaoka     

The effect of acute denervation on the microcirculation of skeletal muscle: rat cremaster model

Although tissue is denervated during replantation of a severed part, tissue transfer, or muscle transplantation, there are few studies concerning the effects of acute denervation on muscle microcirculation. We have described a surgical procedure that totally denervates the rat cremaster muscle. Histological examination of the denervated tissue has given convincing evidence of nerve degeneration and skeletal muscle atrophy, accompanied by electrophysiological evidence of total denervation. The diameters of each component of the microcirculation were measured before and after denervation. Arterioles and arteries ranging in size from 10 to 70 microns in diameter were found to increase significantly in size immediately after acute denervation. Larger arteries and veins did not undergo significant diametrical increases. These findings suggest that total acute denervation significantly increases the diameter of small arteries and arterioles, thereby decreasing the resistance in the arterial bed and increasing blood flow. Since this phenomenon is of limited duration (20 min), it would appear to be ineffective in enhancing reperfusion and oxygenation at the time of reattachment of amputated parts or during vascularized tissue transfers, until methods of prolonging it for several hours or more are found.     

Biomaterial and stem cell‐based strategies for skeletal muscle regeneration

Adult skeletal muscle can regenerate effectively after mild physical or chemical insult. Muscle trauma or disease can overwhelm this innate capacity for regeneration and result in heightened inflammation and fibrotic tissue deposition resulting in loss of structure and function. Recent studies have focused on biomaterial and stem cell‐based therapies to promote skeletal muscle regeneration following injury and disease. Many stem cell populations besides satellite cells are implicated in muscle regeneration. These stem cells include but are not limited to mesenchymal stem cells, adipose‐derived stem cells, hematopoietic stem cells, pericytes, fibroadipogenic progenitors, side population cells, and CD133⁺ stem cells. However, several challenges associated with their isolation, availability, delivery, survival, engraftment, and differentiation have been reported in recent studies. While acellular scaffolds offer a relatively safe and potentially off‐the‐shelf solution to cell‐based therapies, they are often unable to stimulate host cell migration and activity to a level that would result in clinically meaningful regeneration of traumatized muscle. Combining stem cells and biomaterials may offer a viable therapeutic strategy that may overcome the limitations associated with these therapies when they are used in isolation. In this article, we review the stem cell populations that can stimulate muscle regeneration in vitro and in vivo. We also discuss the regenerative potential of combination therapies that utilize both stem cell and biomaterials for the treatment of skeletal muscle injury and disease. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1246–1262, 2019.     

骨骼肌线粒体通透转换孔在骨质疏松症中的变化

目的 观察骨骼肌线粒体通透转换孔(MPTP)的变化,探讨骨骼肌与骨质疏松症的关系.方法 选择因腰椎间盘突出或者腰椎管狭窄症行手术治疗的女性骨质疏松患者13例,另选同时期需上述手术治疗的女性非骨质疏松患者13例.于术中收集肌肉组织,提取骨骼肌线粒体,进行细胞色素C氧化酶(COX)和MPTP的活性检测,并进行相关分析.结果 在MPTP活性变化的比较方面,两组差异有统计学意义(P<0.05).在线粒体COX的活性比较方面,两组差异有统计学意义(P<0.05).在MPTP与COX的相关分析中,MPTP的A比值与COX的活性呈正相关 (r=0.405,P<0.05).结论 骨质疏松骨骼肌的MPTP的通透性高于非骨质疏松,而COX的活性对MPTP的通透性有重要影响,揭示只要维持COX的活性,就能有效控制MPTP的变化,从而有效防治细胞的过早衰老.

Abstract：

Objective To investigate the relationship between osteoporosis and skeletal muscle by studying the change mechanism of the mitochondrial permeability transition pore (MPTP) of skeletal muscle. Methods Twenty-six female patients were selected between May 2008 and December 2008, who were diagnosed as having lumbar intervertebral disc herniation or lumbar spinal stenosis receiving surgical operation. They were divided into osteoporosis group (n=13) and non-osteoporosis group (n=13). Mitochondrions were extracted from the muscle tissue that were collected during the operation.Cytochrome Coxidase (COX) and MPTP were detected. Results The absorbance (A) ratio of MPTP in non-osteoporosis and osteoporosis groups was 0.994±0.007 and 0.985±0.006 respectively (P<0.05). The COX activity in non-osteoporosis and osteoporosis groups was 0.338±0.142 and 0.124±0.093 respectively (P<0.05). The correlation analysis revealed that there was a positive correlation between the A ratio of MPTP and COX activity (r=0.405,P<0.05). Conclusion The permeability of MMPT in osteoporotic muscle is greater than non-osteoporosis group, and COX is important for the permeability of MPTP, indicating that as long as maintaining the activity of COX, the change of MPTP could be effectively controlled, and cell aging would be prevented.