Selective Neurocoagulation of Gastrocnemius and Lateral Soleus Muscles for Calf Reduction.

BACKGROUND: Various methods have been attempted to improve the size and shape of calves, and selective neurocoagulation of the calf muscle using radio frequency (RF) is one of them. The objective of this study was to provide information about the efficacy and safety of selective neurocoagulation of the gastrocnemius (GCM) and lateral soleus muscles using RF for cosmetic purposes. METHODS: A retrospective analysis of 345 patients (686 legs), who underwent selective neurocoagulation using RF at our clinic for calf hypertrophy between January 2018 and March 2020, was performed. We measured the circumference of the calf and thickness of the medial GCM using ultrasonography before and after the procedure. Patient satisfaction and side effects were investigated through interviews. RESULTS: The average calf circumference had decreased by 2.9 ± 1.1 cm (GCM-only group) and 3.0 ± 1.4 cm (GCM + lateral soleus group), at 6 months after the procedure, and there was a statistically significant decrease in both groups. At 12 months after the procedure, the calf circumference slightly increased compared to that at 6 months, but the circumference was still smaller than that before the procedure. Most patients were satisfied with the size and contour of their calves and there were no severe adverse effects. CONCLUSIONS: Motor nerve coagulation using RF was effective in reducing the volume of the GCM and lateral soleus muscles and softening the contours of the calf. It was safe and without side effects in most patients. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Architectural Changes in the Medial Gastrocnemius on Sonography after Nerve Ablation in Healthy Adults.

Architectural changes in healthy muscle after denervation have not yet been reported. This study aimed to investigate architectural changes in the medial head of the gastrocnemius muscle (GCM) after aesthetic tibial nerve ablation in healthy adults using ultrasonography (US). The effects of tibial nerve ablation were verified by visual observation and surface electromyography analysis. US images of medial GCMs were taken by one trained physician using B-mode and real-time US with a linear-array probe before nerve ablation, at 1 week after nerve ablation and at 3 months after nerve ablation in an anatomic standing position with the feet about shoulder-width apart in 19 healthy adults (17 females and 2 males). Muscle thickness was significantly reduced on the left side at 1 week and 3 months after the procedure and on the right side at 3 months after the procedure (p<0.050). Although fascicle length was not significantly changed, pennation angle was significantly reduced on both sides at 3 months after the procedure (p<0.050). Muscle thickness and pennation angle of the muscle fascicle were significantly reduced, although fascicle length was not significantly changed, after tibial nerve ablation in the medial GCM of healthy adults.

Paralysis of the gastrocnemius medial head differentially affects gait patterns and muscle activity during level and stair ascent locomotion.

BACKGROUND: Prior studies have analyzed the activity of the gastrocnemius (GCM) medial and lateral heads as a single unit because it is technically challenging to separately analyze the function of each component in vivo. However, functional variation between the medial and lateral heads is expected due to their anatomical differences. RESEARCH QUESTION: What is the independent function of the medial GCM? How does paralysis of the GCM medial head affect gait kinematics?. METHODS: Twelve healthy adults (two males and ten females; age: 28.2 [±7.72] years) that were scheduled to undergo neurolysis of the tibial nerve branch supplying the medial head of the GCM for aesthetic calf reduction participated in the study. Gait analysis was performed using a computerized opto-electric gait analysis system to measure kinematic data. Surface electromyography (EMG) was recorded simultaneously during the gait analysis. Surface electrodes were placed on seven muscles. Pre-procedure and 1-week and 3-month post-procedure data were compared using a linear mixed model. RESULTS: During level walking, decreased activity of the GCM medial head did not significantly change gait kinematics. However, a significant increase in GCM lateral head and hamstring activities occurred after a branch nerve block to the GCM medial head. During stair ascent, in contrast to level walking, changes in EMG activity only occurred in the GCM medial head, and post-procedure ankle dorsiflexion angles at the end of the terminal-stance phase significantly increased. Ankle plantarflexion angles during the push-off phase were also decreased when compared with pre-procedure values. SIGNIFICANCE: The human body response to dysfunction of the GCM medial head depended on the type of locomotion.

Arterial Stiffness Is Associated With Cytomegalovirus-Specific Senescent CD8+ T Cells.

BACKGROUND: Arterial stiffness is a well-known predictor of future cardiovascular events. Search for the underlying mechanism of arterial stiffening is still under way. We investigated the relationship between arterial stiffness and cytomegalovirus infection in terms of T-cell senescence. METHODS AND RESULTS: Arterial stiffness was evaluated using pulse wave velocity measurements in 415 Koreans (age 59±12 years). We also investigated the frequency of CD57+ or CD28null senescent T cells in peripheral blood lymphocytes and analyzed which immune parameters were correlated with pulse wave velocity. Furthermore, cytomegalovirus-specific T cells were stimulated with overlapping peptides covering pp65 protein, and T-cell function was evaluated by intracellular cytokine staining of interferon-γ, tumor necrosis factor-α, and CD107a. In a multivariate analysis, it was found that the frequency of CD57+ cells in the CD8+ T-cell subset was independently correlated with pulse wave velocity after adjusting for traditional cardiovascular risk factors such as age, sex, diabetes mellitus history, smoking history, body mass index, blood pressure, serum creatinine, high-density lipoprotein cholesterol, and high-sensitivity C-reactive protein. Cytomegalovirus pp65-specific T cells were more frequently observed in the CD8+CD57+ population than in the CD8+CD57- population, and multivariate analysis revealed that the frequency of cytomegalovirus pp65-specific interferon-γ+, tumor necrosis factor-α+, or CD107a+ cells in the CD8+ T-cell subset was independently correlated with pulse wave velocity as well. CONCLUSIONS: We demonstrate that arterial stiffness is associated with senescent CD57+ T cells and CMV pp65-specific T cells in the CD8+ T-cell subset. The precise role of cytomegalovirus-specific, senescent T cells in vascular aging needs to be further investigated.

Activation of human natural killer cells by the soluble form of cellular prion protein.

Cellular prion protein (PrP(C)) is widely expressed in various cell types, including cells of the immune system. However, the specific roles of PrP(C) in the immune system have not been clearly elucidated. In the present study, we investigated the effects of a soluble form of recombinant PrP(C) protein on human natural killer (NK) cells. Recombinant soluble PrP(C) protein was generated by fusion of human PrP(C) with the Fc portion of human IgG1 (PrP(C)-Fc). PrP(C)-Fc binds to the surface of human NK cells, particularly to CD56(dim) NK cells. PrP(C)-Fc induced the production of cytokines and chemokines and the degranulation of granzyme B from NK cells. In addition, PrP(C)-Fc facilitated the IL-15-induced proliferation of NK cells. PrP(C)-Fc induced phosphorylation of ERK-1/2 and JNK in NK cells, and inhibitors of the ERK or the JNK pathways abrogated PrP(C)-Fc-induced cytokine production in NK cells. In conclusion, the soluble form of recombinant PrP(C)-Fc protein activates human NK cells via the ERK and JNK signaling pathways.