Calfplasty

The author describes a method of calf augmentation by a silicone prosthesis implant for correction of asymmetrical legs or aesthetic problems. Preference is given to the placement of soft silicone implants (Glitzentein implants); they are more natural looking than hard implants. The implants are placed over both heads of the gastrocnemius muscle or beneath the fascia cruris superficialis. Operations were performed from November 1985 to August 1999. One hundred patients were studied: 95 female and 5 male. Two hundred calf implants were performed: 188 soft implants (Glitzenstein), 6 hard implants (Aiache), and 6 together on the same leg (Glitzenstein and Aiache implants). No infection problems, prosthesis rupture, or hematomas occurred. There were four seromas, but they disappeared in 15 days. Four prostheses were removed in two patients who did not like the final result. One prosthesis changed place, to the upper part of the calf. The operation is performed under sedative and local anesthesia, with an incision of approximately 4 to 5 cm in the popliteal pleat, at the same height as the fascia cruris. To date, no functional problem or muscular dysfunction has been provoked by silicone prosthesis implants. The patient walks 8 h after the surgery. We selected 500 patients who received implants in the legs with calf prostheses, fat implants, and prosthesis and fat implant together, during 14 years of follow-up, but the focus of this paper is a calf implant with prosthesis in 100 patients with 200 calf prosthesis implants.     

糖尿病周围神经病变患者小腿运动神经及其支配肌肉病变的超声测值变化及相关性研究

目的:通过分析2型糖尿病患者小腿运动神经及其支配肌肉剪切波硬度测值变化及相关性,探讨高频灰阶超声与剪切波弹性成像联合评估糖尿病周围神经病变（DPN）患者小腿运动神经及肌肉病变的临床价值。方法:选取2020年8月至2021年11月南京医科大学康达学院附属连云港中医院糖尿病科住院病例80例对照研究。DPN患者40例中男18...     

小腿静脉血栓的影像学诊断

目的探讨彩色多普勒超声及静脉造影对小腿静脉血栓的诊断价值.方法采用彩色多普勒超声检出219例小腿静脉血栓,其中18例行下肢静脉造影.结果彩色多普勒超声检查出小腿陈旧性或附壁血栓152例,新鲜血栓67例.与静脉造影对照,彩色多普勒超声检测小腿胫后静脉、腓静脉的敏感性分别为87.5%、90.9%,特异性分别为100%、100%,而对于小腿腓肠肌和比目鱼肌间静脉血栓,彩色多普勒超声的诊断显示率明显高于静脉造影.小腿静脉血栓发生于单侧肢体者明显多于同时发生于双侧肢体者.两侧小腿血栓分布部位的次序都是腓静脉(28%)>胫后静脉(23.0%)>肌间静脉(15.1%)>肌间静脉 腓静脉(14.6%).结论彩色多普勒超声对小腿胫后、腓、胫前静脉、腓肠肌和比目鱼肌间血栓有较高的敏感性和特异性,可以了解小腿静脉血栓的发生部位、分布、延伸和大小的变化.静脉造影可以确诊胫后、腓、胫前静脉的血栓,但对小腿肌间静脉血栓的诊断有限.     

白牦牛繁育基地牧草病原性微生物污染状况调查研究

目的:对甘肃省天祝藏族自治县白牦牛繁育基地牧草致病菌的污染状况调查分析。方法:采用GB/T4789-2003。结果:冬春季牧草39份,检出志贺菌、金黄色葡萄球菌,致病菌检出率为17.9%,夏秋季牧草41份,检出志贺菌、沙门菌、致病大肠埃希菌、金黄色葡萄球菌,致病菌检出率为48.8%。结论:白牦牛繁育基地夏秋季牧草中致病菌的污染较为严重,对白牦牛繁育构成一定危害。     

腓肠神经营养血管筋膜皮瓣的临床应用

目的 探讨应用腓肠神经营养血管筋膜皮瓣修复小腿下段、踝、足跟、足底、足背的安全性及有效性.方法 2005年6月～2006年12月应用腓肠神经营养血管筋膜皮瓣修复小腿下段、踝、足跟、足底、足背的创面26例,所有患者术后3～6个月随访,对所有患者的临床疗效进行评价分析.结果 24例皮瓣完全成活,供区伤口愈合良好.仅有2例皮瓣远端部分坏死,但是其下的深筋膜层成活良好,肉芽生长快速,二期植皮均完全成活.术后3～6个月随访,25例皮瓣色泽正常,血供良好,外形、功能满意,皮瓣感觉逐渐恢复,仅有1例皮瓣稍显臃肿.结论 应用腓肠神经营养血管筋膜皮瓣修复足部创面操作简单方便,术后无特殊护理及用药,成活率极高.此方法较安全、有效,临床应用前景良好.     

小牛类表皮生长因子活性肽对肝细胞增殖的影响

目的 :研究小牛类表皮生长因子活性肽 (C epidermalgrowthfactor likeactivepeptide,C EGF)在体内外对肝细胞再生的影响。方法 :从小牛颌下腺提取C EGF ,利用细胞培养及CCl4 诱导的大鼠肝坏死模型 ,检测了C EGF对肝细胞再生的刺激作用。结果 :C EGF可促进人肝癌细胞系SMMC 772 1细胞及小鼠胎肝细胞的增殖 ;在肝坏死动物模型中 ,C EGF可显著地启动并促进肝细胞的再生 ,C EGF对细胞增殖的刺激作用在体内外均可被胰岛素增强。结论 :C EGF在体内外对肝细胞的增殖均有促进作用 ,此结果为C EGF在肝病治疗中的应用提供了实验依据。     

Action Potential Control of Cardiac Contractility

The transient and/or sustained trans-sarcolemmal voltage induced zero to peak tension changes in cardiac contractility at any given level of diastolic dimensions and associated physical-chemical conditions establish the action potential as the predominant controller of cardiac contractility. Demonstration that the inotropic increases in peak tension effects of extra cellular [Ca++] occur and are determined by the duration and degree of positivity of the plateau phase of the action potential document the predominant role of this phase of the action potential relative to control of cardiac contractility. The large increases in peak tension induced by prolongation of the plateau phase of the action potential by interpolated stimuli (i.e., extrasystolic potentiation) and the immediate maximal peak tension following sustained contracture induced by sarcolemmal depolarization highlight this fact. The demonstration that this prolonged action potential induced maximal tension capability (peak inotropic state) of ventricular fibers can be achieved within a single cycle suggests an analogous technic would provide objective noninvasive measurements of the cardiac reserve of humans in health and disease. A potentially valuable measurement, the temporal resolution requirements of which, although beyond the scope of current three-dimensional imaging systems, is achievable with current state of the art technology. The unique experimental and clinical diagnostic value of such a system for noninvasive analogous measurements in humans with congenital and acquired cardiac abnormalities is as yet, however, not widely recognized. Hence, objective confirmation of the unique potential value of such a system awaits development of the required high fidelity [X,Y,Z 1 mm³ voxel) spatial and (10 ms)] temporal resolution capability system. © 2000 Biomedical Engineering Society. PAC00: 8719Hh, 8719Nn, 8716Uv     

Compensatory Hypertrophy of Calf Muscles After Selective Neurectomy

Background Unexpected contour changes frequently occurred after surgical contouring of the calves by selective neurectomy of the nerve to the medial gastrocnemius muscle. We recently experienced a rather unusual case, in which the nerve to the medial gastrocnemius muscle was selectively transected on one side, whereas on the other side, the nerve to the soleus was transected by mistake. Methods To investigate the reason for the contour change, the authors compared the muscle volume ratio of the posterior compartment of eight normal calves of eight normal volunteers with two calves in the reported case by using MRIs. Results The volume ration of normal control calves was 0.22:0.12:0.66, respectively, for the medial and lateral gastrocnemius muscles and the soleus muscle. In the case of the calf with atrophy of the medial gastrocnemius muscle, the volume ratio was 0.13:0.20:0.67, respectively. In the case of the calf with atrophy of the soleus muscle, the volume ratio was 0.27:0.14:0.59, respectively. Conclusions Physician and the patient should keep in mind before the operation that even though one muscle in the calf is selectively atrophied after the selective neurectomy, the other muscles can hypertrophy for compensation, thus causing possible distortion of aesthetic result.     

Calf circumference value for sarcopenia screening among older adults with stroke

PurposeThe Asia Working Group for Sarcopenia 2019 (AWGS) recommended using the calf circumference (CC) cut-off values to facilitate the case-finding of sarcopenia. However, the validity of the proposed cut-offs has not been examined in older patients with stroke. This study investigated the validity of the AWGS-recommended CC cut-off values for identifying sarcopenia among older patients with stroke.Materials and methodsThis cross-sectional study enrolled consecutive patients with stroke, aged 65 years and older, admitted to a convalescent rehabilitation ward. Sarcopenia was diagnosed based on the AWGS 2019 criteria. We drew a receiving operating characteristic curve to assess the ability of CC to predict sarcopenia diagnosis. Subsequently, we estimated the sensitivity, specificity, accuracy, F-value, and Matthews correlation coefficient (MCC) of the considered cut-off values.ResultsWe enrolled 256 patients (43 % women) (mean age, 76.6 ± 7.5 years). The prevalence of sarcopenia was 63.7 %. Among men who presented with CC < 34 cm (the AWGS-recommended cut-off value), sensitivity and specificity were 85 % and 66 %, respectively. Concurrently, estimates of accuracy, F-value, and MCC were the highest at cut-off value <34 cm. Among women, at <33 cm of the AWGS-recommended cut-off value, the sensitivity and specificity were 91 % and 28 %, respectively. At cut-off value <32 cm, sensitivity was maintained at 80 %, while specificity increased to 56 %; suggesting that this cut-off value might be a useful indicator for the case-finding of sarcopenia.ConclusionsThe AWGS-recommended CC cut-off values are valid. The predictive characteristics of sarcopenia differed among men and women with stroke.