Role of biomechanical assessment in rotator cuff tear repair: Arthroscopic vs mini-open approach

BACKGROUND Rotator cuff (RC) tears are one of the most frequent pathologies within the shoulder girdle. Hand dominance and older age are associated with RC tears. Two different surgical procedures, the mini-open (MO) and all-arthroscopic (AA) approach, represented the standard of treatment. AIM To compare the clinical and biomechanical outcomes of two surgical techniques (AA vs MO procedure) performed to address the painful shoulder syndrome with partial or total supraspinatus tendon tear. METHODS Eighty-eight participants, 50 following RC repair with AA and 38 with MO approach, were recruited in the present cross-sectional case-control study (ORTHO-SHOULDER, Prot. 0054602). All patients underwent postoperative clinical evaluation for pain (Visual analogic scale), impairment, and disability (disability of the arm, shoulder, and hand) and limitation in daily activity (Constant-Murley score). Patients\u2019 shoulder mobility was also assessed in our Laboratory of Functional Movement through a wearable inertial sensor and surface electromyography to monitor kinematics and muscle activity during the movement on the frontal (abduction/adduction) and sagittal (flexion-extension) planes. RESULTS No statistically significant differences between the two procedures were observed in either main clinical score or range of motion. A significant increase in velocity during the movement execution and a higher contribution of upper trapezius muscles were found in the AA group compared with MO patients. CONCLUSION In terms of clinical scores, our findings were in line with previous results. However, the use of technology-based assessment of shoulder mobility has revealed significant differences between the two techniques in terms of mean velocity and pattern of muscle activation

Long-term storage does not impact the quality of cryopreserved human ovarian tissue

Background: Ovarian tissue cryopreservation is an emerging technique, also addressed to very young cancer patients, for whom it is not possible to perform an ovarian stimulation for oocytes freezing, before gonadotoxic treatment. In this cases, ovarian tissue must be cryopreserved for a long period of time and it is very important to know if it maintains fertility function after a long period of storage. Here we aimed to assess the effect of long-term storage on preservation and viability of cryopreserved human ovarian tissue. Methods: Descriptive study of three cases of cancer patients whose cryopreserved ovarian tissue remained stored for 18 years. Long-term stored tissue was examined by histological and immunohistochemical analysis, transmission electron microscopy, TUNEL assay and LIVE/DEAD viability/citotoxicity test. Results: Ovarian tissue stored for 18 years showed a good morphology. Follicles presented negative staining for estrogen and progesterone receptors, positive staining for ki67 in granulosa cells and/or oocytes and for bcl2 in granulosa cells. Regarding stroma, patch/focal positive expression was found for estrogen receptor and ki67, diffusely positive expression for progesterone receptor and bcl2. After long-term storage, ultrastructural examination showed sub-cellular integrity of follicles and interstitial oedema foci. No apoptosis was observable by TUNEL assay. Stromal cell viability remained >97 % during the culture period. Conclusion: The evaluation of different aspects o f the tissue provides evidence that the storage time does not impact on tissue quality and gives hope especially to cancer girls, whose tissues could remain cryopreserved for a very long time

A Giant Gastric Hyperplastic Polyp in Non-Familial Juvenile Polyposis of the Stomach: A Case Report

Juvenile Polyposis Syndrome (JPS) is a rare genetic disorder characterized by juvenile polyps of the gastrointestinal tract, which may also occur in people with no family history of the disorder. It usually involves the colorectum and more rarely the stomach. Juvenile polyps can vary in size from a few millimeters to over 5cm, and, although they have microscopically specific characteristics, the distinction between them and inflammatory polyps is often difficult. Here we present a case of 41 year old woman with no family history of polyposis who underwent esophagogastroduodenoscopy (EGDS) because of anemia that showed a huge and extensive gastric lesion (10 cm in diameter) and other small polyps scattered through the stomach lumen and duodenum. The histology report revealed the big lesion and the polyps were hyperplastic polyps with infiltration of inflammatory cells. Due to clinical history and EGDS findings, the patient underwent a pylorus-preserving gastrectomy, and to define a final diagnosis genetic test was performed and showed mutation in the SMAD4 gene. Thus non-familial juvenile polyposis of the stomach was diagnosed. An original feature of the current case was the rare finding of huge hyperplastic gastric polyp in a woman with rare non-familial JPS of the stomach. In fact, to our best knowledge this is the first report describing a so giant gastric polyp in JPS of the stomach in an adult woman. Furthermore, our report suggests that it is noteworthy to consider JP as differential diagnosis in patients with non-familial polyposis, anemia or hypoproteinemia and polyps histologically diagnosed as hyperplastic and performing genetic testing for confirming diagnosis and helping in the timely and appropriate management

Improved mental representation of space in beginner orienteers.

The purpose of the present study was to monitor any improvement in orienteering skills attributable to acquiring a better mental representation of space. Two groups were examined: the experimental group, who attended 6 mo. of orienteering lessons, versus the control group, who did jogging training instead. Each group, consisting of 20 children, was tested on the Corsi Block-tapping Test, run Forward and Backward, and the Star-Butterfly Test. Pre- and post-tests were administered. In the experimental group, scores increased in mean complexity from pre- to post-test on the Forward and the Backward Corsi tests, while on the Star-Butterfly Test both time and mistakes had decreased after the training. In the control group, mean complexity and Star-Butterfly Test scores were unchanged from pre- to post-test. These results showed that after continual training in orienteering techniques, the orienteering group was able to remember and repeat sequences of events with greater precision than before the training, while these skills were unchanged in the control group after training in jogging

Cryopreservation of Ovarian Tissue in Pediatric Patients

Cancer treatments improve the survival rate of children and adolescents; however chemo- and radiotherapy result in gonadal damage leading to acute ovarian failure and sterility. Ovarian tissue cryopreservation allows long-term storage of primordial follicles and represents the only possibility of preserving the potential fertility in prepubertal girls. The aim of the present study is to describe our experience in ovarian tissue cryopreservation in 45 pediatric patients. The number of follicles per square millimeter of the overall section area and follicle quality were evaluated histologically. A strong negative correlation was found between age and follicular density in patients both prior to and after chemotherapy (P < 0.0001). Damage in follicular quality, that is, increased oocyte vacuolization and detachment of the oocyte from granulosa cells, was found after chemotherapy. Ovarian tissue cryopreservation, preferably performed before initiation of chemotherapy, should be offered to pediatric patients, including prepubertal girls, at risk of sterility

Epigallocatechin-3-gallate inhibits doxorubicin-induced inflammation on human ovarian tissue

Chemotherapy protocol can destroy the reproductive potential of young cancer patients. Doxorubicin (DOX) is a potent anthracycline commonly used in the treatment of numerous malignancies. The purpose of the study was to evaluate the ovarian toxicity of DOX via inflammation and the possible protective effect of the green tea polyphenol epigallocatechin-3-gallate (EGCG). Ovarian tissue of three patients was cultured with 1 \ub5g/ml DOX and/or 10 \ub5g/ml EGCG for 24 and 48 h. Levels of inflammatory factors were determined by quantitative Real-Time PCR, western blot, zimography, and multiplex bead-based immunoassay. Morphological evaluation, damaged follicle count and TUNEL assay were also performed. DOX influenced inflammatory responses by inducing a significant increase in the expression of pro-inflammatory cytokines, such as tumor necrosis factor-\u3b1 (TNF-\u3b1) and cyclooxigenase-2 (COX-2), of inflammatory interleukins (IL), such as interleukin-6 (IL-6) and interleukin-8 (IL-8), and the inflammatory proteins mediators metalloproteinase-2 and metalloproteinase-9 (MMP2 and MMP9). IL-8 secretion in the culture supernatants and MMP9 activity also significantly raised after DOX treatment. Moreover, a histological evaluation of the ovarian tissue showed morphological damage to follicles and stroma after DOX exposure. EGCG significantly reduced DOX-induced inflammatory responses and improved the preservation of follicles. DOX-induced inflammation could be responsible for the ovarian function impairment of chemotherapy. EGCG could have a protective role in reducing DOX-mediated inflammatory responses in human ovarian tissue

Changing patterns in HIV-1 non-B clade prevalence and diversity in Italy over three decades

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