Uncovering the effect of low-frequency static magnetic field on tendon-derived cells: from mechanosensing to tenogenesis

Magnetotherapy has been receiving increased attention as an attractive strategy for modulating cell physiology directly at the site of injury, thereby providing the medical community with a safe and non- invasive therapy. Yet, how magnetic eld in uences tendon cells both at the cellular and molecular levels remains unclear. Thus, the in uence of a low-frequency static magnetic eld (2 Hz, 350 mT) on human tendon-derived cells was studied using di erent exposure times (4 and 8 h; short-term studies) and di erent regimens of exposure to an 8h-period of magnetic stimulation (continuous, every 24 h or every 48 h; long-term studies). Herein, 8 h stimulation in short-term studies signi cantly upregulated the expression of tendon-associated genes SCX, COL1A1, TNC and DCN (p < 0.05) and altered intracellular Ca2+ levels (p < 0.05). Additionally, every 24 h regimen of stimulation signi cantly upregulated COL1A1, COL3A1 and TNC at day 14 in comparison to control (p < 0.05), whereas continuous exposure di erentially regulated the release of the immunomodulatory cytokines IL-1β and IL-10 (p < 0.001) but only at day 7 in comparison to controls. Altogether, these results provide new insights on how low-frequency static magnetic eld ne-tune the behaviour of tendon cells according to the magnetic settings used, which we foresee to represent an interesting candidate to guide tendon regeneration.info:eu-repo/semantics/publishedVersio

Shoulder hemiarthroplasty for fractures of the proximal humerus

Proximal humeral fractures were managed with primary hemiarthroplasty in 57 patients, 53 women (93%) and 4 men (7%) aged 51–87 years (mean 72.2). The mean follow-up period was 52 months (range 12–98), and the mean Constant score was 59.2 (range 38–76). Patients were very satisfied (n = 19); satisfied (n = 32) or dissatisfied with the outcome (n = 5). One patient required early revision surgery. Surgical treatment of three- and four-part fractures of the proximal humerus with hemiarthroplasty is a safe and effective approach, the outcome of which appears to be related to the quality of the anatomical reconstruction of the tuberosities

Repair-Mediated Duplication by Capture of Proximal Chromosomal DNA Has Shaped Vertebrate Genome Evolution

DNA double-strand breaks (DSBs) are a common form of cellular damage that can lead to cell death if not repaired promptly. Experimental systems have shown that DSB repair in eukaryotic cells is often imperfect and may result in the insertion of extra chromosomal DNA or the duplication of existing DNA at the breakpoint. These events are thought to be a source of genomic instability and human diseases, but it is unclear whether they have contributed significantly to genome evolution. Here we developed an innovative computational pipeline that takes advantage of the repetitive structure of genomes to detect repair-mediated duplication events (RDs) that occurred in the germline and created insertions of at least 50 bp of genomic DNA. Using this pipeline we identified over 1,000 probable RDs in the human genome. Of these, 824 were intra-chromosomal, closely linked duplications of up to 619 bp bearing the hallmarks of the synthesis-dependent strand-annealing repair pathway. This mechanism has duplicated hundreds of sequences predicted to be functional in the human genome, including exons, UTRs, intron splice sites and transcription factor binding sites. Dating of the duplication events using comparative genomics and experimental validation revealed that the mechanism has operated continuously but with decreasing intensity throughout primate evolution. The mechanism has produced species-specific duplications in all primate species surveyed and is contributing to genomic variation among humans. Finally, we show that RDs have also occurred, albeit at a lower frequency, in non-primate mammals and other vertebrates, indicating that this mechanism has been an important force shaping vertebrate genome evolution

Less exposure surgery for multilevel anterior cervical fusion using 2 transverse incisions

Multilevel anterior cervical fusion often necessitates a large extensile incision for exposure and substantial retraction of the esophagus for placing long plates, potentially predisposing patients to complications such as dysphagia, dysphonia, and neurovascular injury. To the authors' knowledge, the use of 2 incisions as an option has not been published, and so it is not intuitive to young surgeons or widely practiced. In this report, the authors discuss the advantages and raise awareness of using 2 incisions for multilevel anterior cervical fusion, and they document a safe skin bridge length. They also describe the advantages of using 2 incisions for performing multilevel anterior cervical fusion either at contiguous or noncontiguous levels as in adjacent-segment disease. By using the 2-incision technique, the authors made the surgery technically easier and diminished the amount of esophageal retraction otherwise needed through 1 long transverse or longitudinal incision. A skin bridge of 3 cm was safe.</jats:p

Rotator cuff repair: challenges and solutions

Michael H Amini,1 Eric T Ricchetti,1 Joseph P Iannotti,1 Kathleen A Derwin2 1Orthopaedic and Rheumatologic Institute, Cleveland Clinic, Cleveland, OH, USA; 2Department of Biomedical Engineering and Orthopaedic Surgery, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA Abstract: Each year, 250,000 rotator cuff repairs are performed in the United States at a cost of $3 billion. Despite advancements in repair techniques and rehabilitation, 20%&ndash;70% of repairs continue to undergo structural failure; however, there is a poor correlation between clinical and structural outcomes, both before and after surgery. &quot;Failure in continuity&quot;, or retraction of the repair site without a structural defect, is likely a common phenomenon after rotator cuff repair, and this retraction of the myotendinous unit and interposing scar tissue may be one explanation for the discordance between clinical and structural outcomes. Scaffolds, both synthetic and biologic, have shown promise in both augmentation of repairs and interposition of irreparable tears, but most studies are small retrospective case series without control groups. Future efforts will need to determine the ideal indications for use, methods of application, and comparative effectiveness between the devices. Platelet-rich plasma also has potential to improve rotator cuff healing, but current limitations include the significant variation in preparation methods, biologic makeup, and application methods. Future work may help us understand whether application of platelet-rich plasma and its growth factors should be done at the time of surgery or later during a more advanced stage of healing. Regardless of the device or technique, mechanical and/or biologic augmentation of rotator cuff repairs requires the surgeon to be technically proficient in its use and aware of its associated increased operative time and cost. In order to justify the use of these technologies and their associated incremental cost, we must demonstrate efficacy in improving both clinical and structural outcomes. Keywords: rotator cuff, repair, tear, augmentation, scaffold, biologic, PR