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, Koshy J, Morey J, Lin C, DiPoce J. The bone scan. Semin Nucl Med 2012; 42(1): 11-26. 9. Ghosh P. The role of SPECT/CT in skeletal malignances. Semin Musculoskelet Radiol 2014; 18(2): 175-93. 10. Krzhivitskii PI, Kanaev SV, Novikov SN, Zhukova LA, Ponomarëva OI, Negustorov IuF. SPECT-CT in the diagnosis of metastatic skeletal lesion. Vopr Onkol 2014; 60(1): 56-63. 11. Kuwert T. Bone Imaging with SPECT-CT. In: Fanti S, Farsad M, Mansi L et al. Atlas of SPECT/CT. Springer - Verlag Berlin Heidelberg 2011: 105-19. 12. Tan JC, Chatterton BE. Is there an added clinical

-8 Long J, Wang X, Gao H, Liu Z, Liu C, Miao M, Liu J. Malonaldehyde acts as a mitochondrial toxin: Inhibitory effects on respiratory function and enzyme activities in isolated rat liver mitochondria. Life Sci. 2006; 79(15): 1466-7 Kumaran S, Subathra M, Balu M, Panneerselvam C. Age-associated decreased activities of mitochondrial electron transport chain complexes in heart and skeletal muscle: role of L-carnitine. Chem Biol Interact. 2004; 148(1-2): 11-8 Tatarková Z, Kuka S, Račay P, Lehotský J, Dobrota D, Mištuna D, Kaplán P. Effects of aging on activities of

, Hudečková H. The public health importance of physical load assessment. In: Proceedings of the International Scientific Conference Ergonomy 2017; 2017 Nov 29-30; Ostrava, Czech Republic. Žilina: Slovak ergonomic society; 2017. p. 81-89. (in Slovak) 17. Magee DJ, Zachazewski JE, Quillen WS, Manske RC. Pathology and Intervention in Mus cu lo - skeletal Rehabilitation. Missouri: Saunders; 2016. 18. US Bureau of Labor statistics: Occupational Injuries and Illnesses Requiring Days Away From Work [Internet]. Washington D.C.: United States department of labor; c2018 [cited 2018

. 2017;81:1736-1738. doi: 10.1253/circj.CJ-17-055. 19. Nakano Y, Mizuno T, Niwa T, et al. Impact of continuous administration of tolvaptan on preventing medium-term worsening renal function and long-term adverse events in heart failure patients with chronic kidney disease. Int Heart J. 2018;59:105-111. doi: 10.1536/ihj.16-625. 20. Kortebein P, Ferrando A, Lombeida J, Wolfe R, Evans WJ. Effect of 10 days of bed rest on skeletal muscle in healthy older adults. JAMA. 2007;297:1772-1774. doi: 10.1001/jama.297.16.1772-b. 21. Uemura Y, Shibata R, Takemoto K, et al

arterial stiffness in clinical research: focus on new methodologies and diabetes mellitus. Med Sci Monit. 2003;9(5):RA101-109. 23. Vervoort G, Wetzels JF, Lutterman JA, van Doorn LG, Berden JH, Smits P. Elevated skeletal muscle blood flow in noncomplicated type 1 diabetes mellitus. Hypertension. 1999; 34:1080-1085. 24. Wilkinson IB, MacCallum H, Rooijmans DF, et al. Increased augmentation index and systolic stress in type 1 diabetes mellitus. Q J Med. 2000;93:441-448. 25. Westerbacka J, Wilkinson I, Cockcroft J, Utriainen T, Vehkavaara S, Yki-Jarvinen H. Diminished Wave

REFERENCES 1. Gosselink R, Troosters T, Decramer M. Peripheral muscle weakness contributes to exercise limitation in COPD. Am J Respir Crit Care Med 1996;153:976-80. 2. Clark CJ, Cochrane LM, Mackay E, Paton B. Skeletal muscle strength and endurance in patients with mild COPD and the effects of weight training. Eur Respir J 2000;15:92-7. 3. Debigaré R, Maltais F. The major limitation to exercise performance in COPD is lower limb muscle dysfunction. J Appl Physiol 2008; 105: 751-3. 4. Donaldson AV, Maddocks M, Martolini D, Polkey MI, Man WD-C. Muscle function in

, it has been demonstrated that FGF-21 mRNA expression is increased in skeletal muscle in patients with HIV-related lipodystrophy and that FGF-21 mRNA expression in muscle is associated with decreased limb fat mass, increased waist-to-hip ratio, and increased triglycerides [ 28 ] . Another well-conducted study found highly significant correlation between FGF21 levels and indicators of altered fat distribution in lipodystrophy and a positive relationship between FGF21 levels and the extent of lipodystrophy [ 29 ] . On the contrary, there is no strict correlation

Abstract

Hypokalemic periodic paralysis (HOKPP) is a rare neuromuscular disorder caused by altered transport of cellular potassium that leads to significant muscle weakness of the extremities. Paralytic attacks are induced by a drop in the serum potassium level and they have been associated with specific triggers. This case describes a 21-year-old male who has had recurrent presentations of acute paralytic attacks following vigorous physical activity. At presentation, this patient exhibited flaccid paralysis of all skeletal muscles below the neck, but was alert and oriented with stable vital signs. The patient was found to have a potassium level of 2.1 mmol/L and an EKG demonstrating U waves (characteristic of hypokalemia). The patient was treated with potassium supplementation with resolution of symptoms. The mainstay of prevention of long term permanent muscle weakness is avoidance of triggers that can lead to hypokalemia. Through education on disease process and lifestyle modifications, we were able to end the cycle of recurrent hospital readmissions and the subsequent financial burden this generated for the patient and his family.

, Hollak CE et al. 2000. Novel oral treatment of Gaucher's disease with N-butyldeoxynojirimycin (OGT918) to decrease substrate biosynthesis. Lancet. 355; 1481-1485; 5. Zimran A, Altarescu G, Rudensky B, Abrahamov A. 2005. Survey of haematological aspects of Gaucher disease. Haematology, 10, 151-156; 6. Deegan P, Pavlova E, Tindall J et al. 2011. Osseous Manifestations of Adult Gaucher Disease in the Era of Enzyme Replacement Therapy.Medicine, 90, 52-60; 7. Wenstrup RJ, Roca-Espiau M, Weinreb N et al. 2002. Skeletal aspects of Gaucher disease: A review. Br J Radiol. 75

proliferative myositis: original MR description with pathologic correlation: case report. Skeletal Radiol. 2014; 43(8):1155-9. 9. ENZINGER FM, DULCEY F. Proliferative myositis. Report of thirty-three cases. Cancer. 1967; 20(12):2213-23. 10. JAYAWICKRAMA MM, JAYASEKARA HR, DE SILVA MV. Proliferating myositis and proliferating fasciitis: benign lesions often misdiagnosed as sarcomas. Ceylon Med J. 2005; 50(4):169-70. 11. WLACHOVSKA B, ABRAHAM B, DEUX JF, SIBONY M, MARSAULT C, LE BRETON C. Proliferative myositis in a patient with AIDS, Skeletal Radiol. 2004 Apr; 33