Left common carotid artery arising from the brachiocephalic trunk: a case report

An abnormal origin of the left common carotid artery from the initial portion of the brachiocephalic trunk was found in the superior mediastinum in a 81-year-old Caucasian male cadaver during dissection practice. We report on the exact morphology of that variant that is appeared in an incidence of 0,2% in the literature. We discuss the relative literature and pay attention on the significance of such a variation for clinicians in its recognition and protection

The role of proprioception in shoulder instability

The aim of this prospective study was the histologic and clinical evaluation of proprioception in patients with chronic shoulder instability and the comparison with healthy patients. The study group consists of 15 patients with shoulder instability who underwent arthroscopic repair. All patients were evaluated clinically pre- and post-operatively with a special device which was constructed for this particular study. The clinical tests were the TTDPM (threshold to detection of passive motion) and PRJP (passive reproduction of joint position). Both the unstable and the non-affected shoulders were examined. Intra-operatively, tissue sample was taken from joint capsule and quantification of proprioceptors was done. As control group fresh cadaveric shoulders were used, from which a tissue sample was taken for quantification of proprioceptors. Reduced proprioception was noticed in unstable shoulders in comparison to the contralateral healthy shoulder, but the proprioception was improved one year post-operatively. These results were applied for PRPJ test (p<0.001) as well as for TTDPM test (p<0,001). During the histological evaluation numerous proprioceptors were noticed in the form of Pacinian corpuscles, Ruffini corpuscles, Golgi tendons and free nerve endings. The vast majority however consists of Pacinian corpuscles. In total, 900 histological preparations were studied (450 from the study group and 450 from the control group). The number of Pacinian corpuscles in patients with unstable shoulder was found to be decreased comparing with the cadaveric preparations, and the difference was statistically significant (p<0,001). Shoulder proprioception is reduced in unstable shoulders and one reason could be the decrease in the number of proprioceptors. This decrease can be the result of lengthening of the shoulder capsule or the degeneration of the proprioceptors. In any case, the result is the reduced response of the proprioceptive signaling. A reparative operation is breaking the vicious cycle of instability – decreased proprioception.Σκοπός της προοπτικής αυτής μελέτης ήταν η ιστολογική και κλινική αξιολόγηση της ιδιοδεκτικότητας σε ασθενείς με χρόνια αστάθεια του ώμου και η σύγκριση με υγιείς, ως προς την αστάθεια, ώμους. Η μελέτη έγινε σε 15 ασθενείς με αστάθεια του ώμου οι οποίοι υποβλήθηκαν σε επανορθωτική αρθροσκοπική επέμβαση. Όλοι αξιολογήθηκαν προεγχειρητικά και ένα έτος μετεγχειρητικά για την ιδιοδεκτικότητα του ώμου με κλινικές δοκιμασίες με τη χρήση ειδικής συσκευής μέτρησης που κατασκευάστηκε για τη μελέτη αυτή. Οι δοκιμασίες που χρησιμοποιήθηκαν ήταν η ουδός αντίληψης της παθητικής κίνησης (TTDPM : threshold to detection of passive motion) και η παθητική αναπαραγωγή της θέσης της άρθρωσης (PRJP : passive reproduction of joint position). Επίσης, έγινε μέτρηση όχι μόνο του πάσχοντος, αλλά και του υγιούς ώμου σε κάθε ασθενή. Διεγχειρητικά σε όλους τους ασθενείς έγινε λήψη ιστοτεμαχίου από τον αρθρικό θύλακο και καταμέτρηση των ιδιοδεκτικών υποδοχέων ιστολογικά. Ως ομάδα σύγκρισης χρησιμοποιήθηκαν νωποί πτωματικοί ώμοι, από τους οποίους έγινε λήψη παρόμοιων ιστοτεμαχίων αρθρικού θυλάκου. Παρατηρήθηκε μειωμένη ιδιοδεκτικότητα των πασχόντων σε σχέση με τους υγιείς ώμους προεγχειρητικά, ενώ βελτίωση της ιδιοδεκτικότητας διαπιστώθηκε ένα χρόνο μετεγχειρητικά. Τα αποτελέσματα αυτά παρατηρήθηκαν τόσο για τη δοκιμασία PRPJ (p<0,001), όσο και για τη δοκιμασία TTDPM (p<0.001). Κατά την ιστολογική εξέταση παρατηρήθηκαν πολυάριθμοι ιδιοδεκτικοί υποδοχείς με τη μορφή των σωματίων Pacini, σωματίων Ruffini, οργανιδίων Golgi και ελεύθερων νευρικών απολήξεων. Τη συντριπτική πλειοψηφία αποτελούσαν τα σωμάτια Pacini. Συνολικά μελετήθηκαν 900 ιστολογικά παρασκευάσματα (450 από την ομάδα μελέτης και 450 από την ομάδα ελέγχου). Ο αριθμός των υποδοχέων Pacini στους ασθενείς με αστάθεια βρέθηκε μειωμένος σε σχέση με τα πτωματικά παρασκευάσματα και η διαφορά ήταν στατιστικά σημαντική (p<0.001). Η ιδιοδεκτικότητα του ώμου μειώνεται στην αστάθεια και ως αιτία μπορεί να θεωρηθεί η μείωση του απόλυτου αριθμού των υποδοχέων. Η ελάττωση του αριθμού των υποδοχέων ανά μονάδα επιφάνειας μπορεί να οφείλεται στη διάταση του θυλάκου ή στην αδρανοποίηση και εκφύλισή τους. Σε κάθε περίπτωση το αποτέλεσμα είναι η μειωμένη ανταπόκριση των ερεθισμάτων της ιδιοδεκτικότητας. Η επανορθωτική χειρουργική επέμβαση λύει τον φαύλο κύκλο της αστάθειας – μειωμένης ιδιοδεκτικότητας

Stem cells for the treatment of early to moderate osteoarthritis of the knee: a systematic review

Abstract Purpose Mesenchymal stem cells (MSCs) present a valuable treatment option for knee osteoarthritis with promising results. The purpose of the present study was to systematically review the clinical and functional outcomes following mesenchymal stem cell application focusing on early to moderate knee osteoarthritis. Methods A systematic search was done using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines in Pubmed, Scopus, Web of Science, and Cochrane Library databases. All Studies published between 2017 and March 2023 on patients treated with single mesenchymal stem cell injection for Kellgren‐Lawrence grade I—III knee osteoarthritis reported on clinical and functional outcomes were included. Results Twelve articles comprising 539 patients and 576 knees treated with a single intraarticular injection of MSCs for knee osteoarthritis were included in the current systematic review. In eligible studies, the reported outcomes were improved concerning patient‐reported outcomes measures, knee function, pain relief, and quality of patient's life. Conclusion Based on high‐level evidence studies, single intraarticular injection of MSCs is a safe, reliable, and effective treatment option for Kellgren‐Lawrence grade I—III knee osteoarthritis. However, the lack of homogeneity in the included studies and the variance in MSCs sources and preparations should be noted. Level of evidence III

Stem cells for the treatment of early to moderate osteoarthritis of the knee: a systematic review

Purpose: Mesenchymal stem cells (MSCs) present a valuable treatment option for knee osteoarthritis with promising results. The purpose of the present study was to systematically review the clinical and functional outcomes following mesenchymal stem cell application focusing on early to moderate knee osteoarthritis. Methods: A systematic search was done using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in Pubmed, Scopus, Web of Science, and Cochrane Library databases. All Studies published between 2017 and March 2023 on patients treated with single mesenchymal stem cell injection for Kellgren-Lawrence grade I—III knee osteoarthritis reported on clinical and functional outcomes were included. Results: Twelve articles comprising 539 patients and 576 knees treated with a single intraarticular injection of MSCs for knee osteoarthritis were included in the current systematic review. In eligible studies, the reported outcomes were improved concerning patient-reported outcomes measures, knee function, pain relief, and quality of patient's life. Conclusion: Based on high-level evidence studies, single intraarticular injection of MSCs is a safe, reliable, and effective treatment option for Kellgren-Lawrence grade I—III knee osteoarthritis. However, the lack of homogeneity in the included studies and the variance in MSCs sources and preparations should be noted. Level of evidence: III.SCOPUS: re.jinfo:eu-repo/semantics/publishe