Effect of Purified Paper Wasp Ropalidia marginata Venom Toxin Enzyme Activity in Blood Serum, Liver, and Gastrocnemius Muscle of Albino Mice

In the present, investigation effects of sub-lethal dose of purified paper wasp Ropalidia marginata venom toxins were evaluated on important metabolic enzymes i.e. ALP ACP, GPT, GOT, LDH, and AchE enzyme activity in serum, liver, and gastrocnemius muscles of albino mice. Alkaline phosphatase was found to be increased up to 119.9% at the 6th hr of the toxin injection in comparison to control. This elevation may be due to cytolysis. Maximum increase i.e., 153.33% level of glutamate pyruvate transaminase (GPT) was found at 6 hrs of 40% of 24-h LD50 treatment while it was found to be 151.1% at 6 hrs of 24 hr 80% of LD50, venom injection. A significant elevation was observed in LDH activity in serum, liver, and muscles, while the activity of AchE was decreased in serum, liver, and gastrocnemius muscles of albino mice after injecting the sub-lethal dose of Ropalidia marginata venom. This increase in the activity of LDH produces liver damage, massive disintegration and necrosis of hepatic cells. This elevation in LDH level led to a significant increase in the glucose catabolism and elevated oxidative stress in muscle and liver cells. It also displays insufficient oxygen supply and consequently leads to cell death. In experimental animals, venom toxin treatment decreased AchE level, and animals showed muscular paralysis. When mice were treated with 40% and 80% of 24-h LD50 of purified venom caused a significant (p < 0.05) elevation in the level of ACP, GOT, GPT, and LDH while the reduction in ALP and AChE level. Present study will be useful in the development of prototypes for study of pharmacological and therapeutic effects of various venom toxins. For this purpose structure activity relationship of enzyme and venom toxin, its due interaction to various metabolic enzymes and receptors must be explored.

Small Cell Lymphoma of the Gastrocnemius Muscle: A Case Report

Introduction: The primary localization of non-Hodgkin lymphoma of the muscle is rare. Only the biopsy allows the certainty diagnosis. The aim was to report a first case of small cell lymphoma of the gastrocnemius in Mali and to do a review of the literature. Clinical Observation: It was about a 34-year-old woman who consulted 3 months after the onset of symptoms for swelling and pain in the left calf. On clinical examination there was a hard, painful and warm mass in the left calf, with paresthesias in the tibial nerve territory associated with partial functional impotence of the leg. The ultrasound revealed a hyper echogenic and heterogeneous non-vascularized mass of the left gastrocnemius muscle measuring 65 × 45 × 40 mm non-vascularized on color Doppler and pulsed in favor of myositis. Magnetic resonance imaging (MRI) concluded in a well-limited heterogeneous cystic mass in the left gastrocnemius muscle respecting the bone of benign appearance: remodeled Baker’s cyst? Considering the radioclinical unconformity, thoraco-abdominal CT was performed and revealed pulmonary metastasis. The biopsy carried out concluded with a small cell lymphoma of the gastrocnemial muscle. Marginal resection was performed associated with adjuvant chemotherapy. The advancement at 9 months was satisfactory.

Histochemical pattern of gastrocnemius muscle in fluoride toxicity syndrome

Objective:To evaluate the effect of sodium fluoride(NaF) on cytochemical distribution of proteins,DNA,and RNA in the gastrocnemius muscle of rat in experimental fluorosis.Methods: Young Sprague Dawley albino rats were administered with NaF at 30,45,and 75 mg/kg bw/ day subcutaneously for 15 and 30 days,respectively.The control animals were given the vehicle(1cc deionized double distilled water/kg bw/day).Results:In the first phase of 15 days experimentation,the gastrocnemius muscle of rats intoxicated with NaF at 30,45,and 75 mg /kg bw/ day showed decline in proteins including a amino acids as compared to control. In the second phase of 30 days experimentation,the muscle fibers of rat showed elevation in sarcolemmal and sarcoplasmic proteins in 30 mg NaF dose group,and angulated fibers exhibited increase in sarcolemmal proteins in 45 mg NaF group.The marginal regions of angular and rim fibers showed deeply stained rings of sarcoplasmic proteins whereas the split fibers were faindy stained in rats treated with NaF at 75 mg/kg bw/day for 30 days.In rats treated with NaF at 30 mg/kg bw/day for 15 days,the hypertrophied peripheral muscle fibers contained more DNA,however the atrophied fibers had more RNA.In 45 mg NaF group,RNA was located in sarcolemmal regions,while DNA content decreased as compared to control.In 75 mg NaF group,the muscle fibers had dark and light staining regions of DNA and RNA.In the 30 days of experimentation,the DNA level decreased whereas RNA content increased in the gastrocnemius muscle fibers of the rat treated with NaF at 30 mg/kg bw/day.In treatment group with NaF at 45 mg/kg bw/day,the RNA content slighdy declined in comparison to control,in all treatments for 15 days as well as in treatment group with NaF at 30 mg/kg bw/day for 30 days whereas the amount of DNA slightly increased as compared to treatment group with NaF at 75 mg/kg bw/day for 15 days.The highest dose group revealed elevated amount of RNA whereas DNA content remained stable.Conclusions:The findings of present study demonstrate that certain concentrations of fluoride can induce muscle lesions and damage DNA,RNA,and protein in muscle cells and excessive intake and accumulation of fluoride is therefore a serious risk factor for muscular abnormalities in fluorosis.

Return to physical activity after gastrocnemius recession

AIM To prospectively investigate the time taken and patients' ability to resume preoperative level of physical activity after gastrocnemius recession. METHODS Endoscopic gastrocnemius recession(EGR) was performed on 48 feet in 46 consecutive sportspersons, with a minimum follow-up of 24 mo. The Halasi Ankle Activity Score was used to quantify the level of physical activity. Time taken to return to work and physical activity was recorded. Functional outcomes were evaluated using the short form 36(SF-36), American Orthopedic Foot and Ankle Society(AOFAS) Hindfoot score and modified Olerud and Molander(O and M) scores respectively. Patient's satisfaction and pain experienced were assessed using a modified Likert scale and visual analogue scales. P-value < 0.05 was considered statistically significant.RESULTS Ninety-one percent(n = 42) of all patients returned to their preoperative level of physical activity after EGR. The mean time for return to physical activity was 7.5(2-24) mo. Ninety-eight percent(n = 45) of all patients were able to return to their preoperative employment status, with a mean time of 3.6(1-12) mo. Ninety-six percent(n = 23) of all patients with an activity score > 2 were able to resume their preoperative level of physical activity in mean time of 8.8 mo, as compared to 86%(n = 19) of patients whose activity score was ≤ 2, with mean time of 6.1 mo. Significant improvements were noted in SF-36, AOFAS hindfoot and modified O and M scores. Ninety percent of all patients rated good or very good outcomes on the Likert scale.CONCLUSION The majority of patients were able to return to their pre-operative level of sporting activity after EGR.

Crohn's disease-related'gastrocnemius myalgia syndrome'successfully treated with infliximab:A case report

BACKGROUND Extra-intestinal manifestations in inflammatory bowel diseases(IBD)are frequent and involve virtually all organs.Conversely,the clinical characteristics and course of inflammatory myopathies in IBD remain poorly described and mostly related to orbital myositis.Moreover,alternative therapeutic strategies in non-responder patients to corticosteroid therapy must still be clarified.CASE SUMMARY A 33-year-old woman with a history of unclassified colitis presented with acute bilateral calf pain.On admission,her clinical and biological examinations were non-specific.However,magnetic resonance imaging showed bilateral inflammatory changes in gastrocnemius muscles suggestive of myositis.Muscle biopsy confirmed the diagnosis of myositis and demonstrated an inflammatory infiltrate mainly located in the perimysial compartment including lympho-plasmocytic cells with the formation of several granulomatous structures while the endomysium was relatively spared.The combined clinical,biological and histomyopathological findings were concordant with the diagnosis of‘gastrocnemius myalgia syndrome’(GMS),a rare disorder associated with Crohn’s disease(CD).Ileocolonoscopy confirmed CD diagnosis and systemic corticosteroids(CS)therapy was started,resulting in a rapid clinical improvement.During CS tapering,however,she experienced a relapse of GMS together with a severe active ileocolitis.Infliximab was started and allowed a sustained remission of both conditions at the latest follow-up(20 mo).CONCLUSION The GMS represent a rare CD-associated inflammatory myopathy for which anti-tumour necrosis factor-αtherapy might be considered as an effective therapeutic option.

The Effect of Stretching Hamstring, Gastrocnemius, Iliopsoas and Back Muscles on Pain and Functional Activities in Patients with Chronic Low Back Pain: A Randomized Clinical Trial

A back pain lasting more than 12 weeks has been defined as a chronic low back pain (LBP) [1]. More than half of people suffer from LBP [1]. The purpose of this study was to examine the effect of gastrocnemius muscle stretching in the treatment of chronic low back pain. Methods: Forty patients with chronic low back pain, ages ranging from 25 to 40 years, were recruited and divided randomly into two groups. The control group followed a physical therapy program that included stretching exercises for back, hamstring and iliopsoas muscles. Strengthening exercises for abdominal muscle and postural instructions for activities of daily living were also performed. The experimental group followed the same control-group exercises with the addition of stretching exercises for gastrocnemius muscles. The interventions for both groups consisted of three sessions per week for six weeks, each session lasting for an hour. The outcome measures were visual analog scale (VAS) for pain severity, modified fingertip to floor (FTF) for range of motion (ROM) of trunk flexion, Oswestry Disability Index (ODI), and loading X-ray to detect lumbosacral angle. Results: There was no significant difference between groups at baseline characteristics. At final follow up, the two groups were significantly different in all outcome measures in terms of pain (p p p p < 0.01). Conclusion: Gastrocnemius manual stretching exercise is more beneficial in reducing pain and improving functions for patients with chronic low back pain when adding to stretching exercises for hamstring, iliopsoas, and back muscles, and strengthening exercise for abdominal muscles.

The Effect of Internal Heat Acupuncture on the Tolerance Time of Plantar Hot Plate and Pain Threshold of Gastrocnemius Muscle in Rats with Chronic Myofascial Pain Syndrome

Objective:To investigate the effect of internal heat acupuncture on the tolerance time of plantar hot plate and the pain threshold of gastrocnemius in rats with chronic myofascial pain syndrome(MPS).Methods:A total of 80 adult Wistar rats were randomly selected to establish chronic MPS rat models,and randomly divided into four groups:control group,acupuncture group,internal heat acupuncture group A,and internal heat acupuncture group B,with 20 rats in each group.The rats in the control group were not given any treatment,and the rats in the acupuncture group were only given acupuncture treatment.The rats in group A were treated with internal heat acupuncture(needle heating up to 42℃),and the rats in group B were treated with internal heat acupuncture(needle heating up to 44℃).The tolerance time of plantar hot plate,the pain threshold of gastrocnemius muscle and the level of tumor necrosis factor-α(TNF-α)were observed and compared before modeling,1 d before treatment,and 1,7 and 14 d after treatment.Results:There were significant differences in hot plate tolerance time,time and interaction among the four groups(P<0.05),as well as in gastrocnemius tenderness threshold,time and interaction among the four groups(P<0.05),and there were also significant differences in TNF-αlevel among the three groups(P>0.05).There were significant differences in the number of electric shocks,time and interaction among the four groups(P<0.05).Conclusion:In contrast to conventional acupuncture treatment,internal heat acupuncture demonstrates greater efficacy in extending the tolerance duration of hot plate exposure and enhancing the pain threshold of the gastrocnemius muscle in rats afflicted with myofascial pain syndrome.Additionally,it accelerates the amelioration of inflammatory markers and motor function.However,it is important to note that the therapeutic impact of internal heat acupuncture may be influenced by its temperature,with 44℃being the most effective in this research.

Comparison of Electroacupuncture and Body Acupuncture on Gastrocnemius Muscle Tone in Children with Spastic Cerebral Palsy: A Single Blinded, Randomized Controlled Pilot Trial

Objective:To compare the immediate effects of electroacupuncture(EA)and body acupuncture(BA)on gastrocnemius muscle tone in children with spastic cerebral palsy(CP).Methods:Children with spastic CP,age from 24 to 60 months,who all received rehabilitation treatment in the Department of Developmental and Behavioral Pediatrics,the First Hospital of Jilin University from April 2016 to May 2017 were enrolled in this trial and assigned to EA group and BA group through a random number table.Both EA and BA therapies were performed on acupoints of Zusanli(ST 36),Shangjuxu(ST 37),Sanyinjiao(SP 6),and Xuanzhong(GB 39)for 30 min once.The root mean square(RMS),integrated electromyogram(iEMG)of the gastrocnemius of surface electromyography(sEMG),and Modified Tardieu Scale(MTS)of the two groups were evaluated before and after treatment.All adverse events were accurately recorded.Results:Thirty-six children with spastic CP completed the study(18 cases and 32 legs in the EA group;18 cases and 31 legs in the BA group).There was no significant difference in RMS,iEMG and MTS between the two groups before treatment(P>0.05).After treatment,compared with before treatment,RMS and iEMG significantly reduced and MTS(R2–R1)significantly increased in both EA and BA groups(P<0.05),and EA was more effective than BA in RMS and MTS(P<0.05).However,the iEMG between the two groups were not statistically significant after treatment(P>0.05).There was no serious adverse event during this clinical trial.Conclusion:Both EA and BA could significantly relieve the gastrocnemius muscle tone in spastic CP,and EA was more effective than BA.

Study on Mechanism of Dendrobium officinale Kimura et Migo in Preventing and Treating Exercise-induced Muscle Damage(EIMD)in Rats

[Objectives]This study was conducted to observe the mechanism of Dendrobium officinale Kimura et Migo on gastrocnemius muscle in rats with exercise-induced muscle damage(EIMD).[Methods]The micro-injury model of skeletal muscle was established by treadmill training.Forty two SD rats were randomly divided into a control group,1,12 and 24 h exercise groups,D.officinale 2 ml+1 h exercise group,D.officinale 2 ml+12 h exercise group,and D.officinale 2 ml+24 h exercise group,with 6 rats in each group.Various D.officinale groups were given the drug once in the morning and once in the evening at a dose of 2 ml/time,a week in advance.Except for the quiet group,the samples were collected from the 1,12 and 24 h exercise groups after anesthesia following 1,12 and 24 h of exercise for the last time,respectively,and the D.officinale 2 ml+1 h exercise group,D.officinale 2 ml+12 h exercise group and D.officinale 2 ml+24 h exercise group were also sampled after anesthesia following 1,12 and 24 h of exercise for the last time,respectively.The contents of ATP,CK-MM and CK in rat serum were determined by enzyme-linked immunosorbent assay(ELISA).The histopathological changes of gastrocnemius muscle were observed by HE staining.PCR and Western-blot detection were carried out to analyze the effects of D.officinale on IGF-1 mRNA and protein expression in gastrocnemius muscle.[Results]Compared with the quiet group,the ATP contents in the serum of rats in the 1,12 and 24 h exercise groups significantly decreased(P<0.01),while the CK and CK-MM contents significantly increased(P<0.01).The expression of IGF-1 mRNA and protein in the gastrocnemius muscle tissue significantly increased(P<0.01).Compared with the 1 h exercise group,the ATP content and IGF-1 protein expression in the gastrocnemius muscle tissue of the D.officinale liquid+1 h exercise group significantly increased(P<0.05),while the CK and CK-MM contents significantly decreased(P<0.01).Compared with the 12 h exercise group,the D.officinale liquid+12 h exercise group showed a significant increase in ATP content(P<0.01),significant increases in IGF-1 mRNA and protein expression in the gastrocnemius muscle tissue(P<0.01),and significant decreases in CK and CK-MM contents(P<0.01).Compared with the 24 h exercise group,the ATP content and IGF-1 mRNA and protein expression in the gastrocnemius muscle tissue of the D.officinale liquid+24 h exercise group significantly increased(P<0.01),while the CK and CK-MM contents significantly decreased(P<0.01).From the pathological tissue morphology of the gastrocnemius muscle in rats with EIMD treated with D.officinale,it could be concluded that the gastrocnemius muscle of each exercise group was significantly damaged,and the damage was significantly alleviated after administration of D.officinale liquid.[Conclusions]The effects and mechanism of D.officinale on prevention and treatment of EIMD in rats might be related to the promotion of IGF-1 mRNA and protein expression in injured tissues by reducing ATP energy consumption,CK-MM and CK activity.

Effects of Purified Indian Cattle Tick Rhipicephalus microplus Saliva Toxins on Various Enzymes in Blood Serum, Liver and Muscles of Albino Mice

In the present investigation, in vivo effects of purified ticks’ saliva toxin were evaluated on the level of certain important cellular metabolic enzymes i.e. acid phosphatase (ACP), alkaline phosphatase (ALP), glutamate pyruvate transaminase, glutamate oxaloacetate transaminase and lactic dehydrogenase. For this purpose, sub-lethal doses, 40% and 80% of 24 h LD50 purified saliva toxins of Rhipicephalus microplus (Canestrini, 1888) were injected subcutaneously in the albino mice. In treated mice saliva toxins targeted membrane-bound enzymes i.e. serum acid phosphatase and alkaline phosphatase, its level was increased from 118.30% to 163.63% at the 6th hr in comparison to the control. Besides this, the levels of serum glutamate pyruvate transaminase (GPT) and glutamate oxaloacetate transaminase (GOT) and lactic dehydrogenase (LDH) also increased up to 161.11% (at 6th hr), 148.27 (at 8th hr) and 125.45% (at 6th hr) respectively in comparison to control. An increase in the level of LDH showed insufficient oxygen supply, massive disintegration of cells and leakage of the enzyme into the circulation. It clearly indicated the toxic effects of saliva toxins on the membrane of blood cells, hepatocytes and myocardial muscle cell functions in albino mice. On the other hand activity of acetyl cholinesterase was reduced by 65.51% at the 6th hr of the saliva toxin injection in comparison to the control. This inhibition of acetyl cholinesterase activity caused the accumulation of acetylcholine molecules at the synaptic junctions and led to prolonged activation of acetylcholine receptors. It caused permanent stimulation of nerves and muscle cells that may result in muscular paralysis and finally death of the animal.

Analyzing the Use of Ultrasound: Achilles Tendon Rupture

Growing evidence has made it obvious that early intervention in patients with Achilles tendon rupture extensively affects the prognosis. This requires the use of easily accessible imaging modalities such as ultrasound in establishing accurate diagnosis of tendinopathies so that early therapeutic decisions can be made. Ultrasound allows for assessment of tendons in a dynamic real time setting. Physicians can interact with patients and receive feedback regarding the symptomatic area, and assessing the tendon from different angles while under stress. It also offers a faster method to diagnose Achilles tendon rupture and therefore provide early intervention. Furthermore, ultrasound is a safe, non-invasive, and a patient friendly method that has become less expensive, portable, and a faster imaging modality to diagnose tendinopathies. In this paper, we review the application of ultrasound in diagnosing Achilles tendon rupture and comparing it with other imaging modalities, after thoroughly studying the current literature.

The anatomical,electrophysiological and histological observations of muscle contraction units in rabbits:a new perspective on nerve injury and regeneration

In the conventional view a muscle is composed of intermediate structures before its further division into microscopic muscle fibers.Our experiments in mice have confirmed this intermediate structure is composed of the lamella cluster formed by motor endplates,the innervating nerve branches and the corresponding muscle fibers,which can be viewed as an independent structural and functional unit.In this study,we verified the presence of these muscle construction units in rabbits.The results showed that the muscular branch of the femoral nerve sent out 4–6 nerve branches into the quadriceps and the tibial nerve sent out 4–7 nerve branches into the gastrocnemius.When each nerve branch of the femoral nerve was stimulated from the most lateral to the medial,the contraction of the lateral muscle,intermediate muscle and medial muscle of the quadriceps could be induced by electrically stimulating at least one nerve branch.When stimulating each nerve branch of the tibial nerve from the lateral to the medial,the muscle contraction of the lateral muscle 1,lateral muscle 2,lateral muscle 3 and medial muscle of the gastrocnemius could be induced by electrically stimulating at least one nerve branch.Electrical stimulation of each nerve branch resulted in different electromyographical waves recorded in different muscle subgroups.Hematoxylin-eosin staining showed most of the nerve branches around the neuromuscular junctions consisted of one individual neural tract,a few consisted of two or more neural tracts.The muscles of the lower limb in the rabbit can be subdivided into different muscle subgroups,each innervated by different nerve branches,thereby allowing much more complex muscle activities than traditionally stated.Together,the nerve branches and the innervated muscle subgroups can be viewed as an independent structural and functional unit.This study was approved by the Animal Ethics Committee of Peking University People’s Hospital(approval No.2019 PHE027)on October 20,2019.

Heat shock protein 90 is a potential therapeutic target for ameliorating skeletal muscle abnormalities in Parkinson's disease

Previous studies have confirmed that heat shock protein 90 overexpression can lead to dopami- nergic neuronal death. This study was designed to further investigate what effects are produced by heat shock protein 90 after endurance exercise training. Immunohistochemistry results showed that exercise training significantly inhibited heat shock protein 90 overexpression in the soleus and gastrocnemius in Parkinson＇s disease rats, which is a potential therapeutic target for ameliorating skeletal muscle abnormalities in Parkinso^s disease.

Lower-Limb Motion-Based Ankle-Foot Movement Classification Using 2D-CNN

Recently,the Muscle-Computer Interface(MCI)has been extensively popular for employing Electromyography(EMG)signals to help the development of various assistive devices.However,few studies have focused on ankle foot movement classification considering EMG signals at limb position.This work proposes a new framework considering two EMG signals at a lower-limb position to classify the ankle movement characteristics based on normal walking cycles.For this purpose,we introduce a human anklefoot movement classification method using a two-dimensional-convolutional neural network(2D-CNN)with low-cost EMG sensors based on lowerlimb motion.The time-domain signals of EMG obtained from two sensors belonging to Dorsiflexion,Neutral-position,and Plantarflexion are firstly converted into time-frequency spectrograms by short-time Fourier transform.Afterward,the spectrograms of the three ankle-foot movement types are used as input to the 2D-CNN such that the EMG foot movement types are finally classified.For the evaluation phase,the proposed method is investigated using the healthy volunteer for 5-fold cross-validation,and the accuracy is used as a standard evaluation.The results demonstrate that our approach provides an average accuracy of 99.34%.This exhibits the usefulness of 2D-CNN with low-cost EMG sensors in terms of ankle-foot movement classification at limb position,which offers feasibility for walking.However,the obtained EMG signal is not directly considered at the ankle position.

Expression of Genes Related to Glycolysis in the Liver and Skeletal Muscle of Rats after Citric Acid Administration

Citric acid is known to alleviate physical fatigue and improve athletic performance;however, the underlying mechanism is unknown. Therefore, we aimed to investigate the effect of citric acid administration on the expression of key glycolysis-related genes in the liver and skeletal muscle of rats. Eight-week-old male Sprague-Dawley rats were divided into two groups—control and citric acid groups. The rats were fasted overnight, after which distilled water or citric acid solution was administered intragastrically;after 150 min, the rats were sacrificed, and the liver and skeletal muscle were collected. In the skeletal muscle, namely soleus and gastrocnemius muscles, the phosphofructokinase and pyruvate kinase gene expression were significantly decreased by citric acid administration. In contrast, the glucokinase and pyruvate kinase gene expression in the liver was significantly increased. These results suggest that exogenous dietary citric acid suppresses glycolysis in the skeletal muscle at the transcription level.

Critical Limb Ischaemia in Adult Human Skeletal Muscle Increases Satellite Cell Proliferation but Not Differentiation

Critical Limb Ischaemia (CLI) is defined as the presence of rest pain, ulcers and/or gangrene in a limb for over 2 weeks. Associated exercise intolerance is caused by muscle fibre atrophy, fibro- fatty infiltration, nerve dysfunction, mitochondrial damage and myofibril disorder. We aimed to determine the behaviour of satellite cells, responsible for the repair and regeneration of damaged muscle, in repairing the damage caused to critically ischaemic adult human skeletal muscle. CD34, pax7 and MyoD are all markers of satellite cells at different stages of the cell cycle and allow for an assessment of their number and activity in ischaemia. Local ethical committee approval and informed consent was obtained. Samples of harvested gastrocnemius muscle of patients undergoing major perigenicular amputation for CLI (n = 10) were analysed and compared to a control group undergoing coronary artery bypass grafting (n = 10). Using immunohistochemistry, the expression of pax7, CD34 and MyoD was assessed in five sequential blinded randomly generated fields. Statistical testing of the data collected was made via the Mann Whitney U test. Protein electrophoresis was used to confirm overall protein expression of the satellite cell markers. There was a significant increase in the number of satellite cells observed in CLI muscle sections as demonstrated by the expression of pax7 (2.4×?fold p ?Haematopoietic Stem Cells?(HSCs) and satellite cells were also more abundant, with a 2×?fold increase observed (p < 0.0001) whilst those cells expressing both CD34 and pax7 and identified as quiescent satellite cells, were significantly greater in number in the CLI samples (2.9×?fold p < 0.0001), confirmed via immunohistochemistry and protein electrophoresis. There was a significant decrease in the expression of MyoD positive or activated satellite cells (p < 0.0001). This indicates an increase in the proliferation of the satellite cell population as a response to CLI but less active cells are observed.