Device for lengthening of a musculotendinous unit by direct continuous traction in the sheep

Background Retraction, atrophy and fatty infiltration are signs subsequent to chronic rotator cuff tendon tears. They are associated with an increased pennation angle and a shortening of the muscle fibers in series. These deleterious changes of the muscular architecture are not reversible with current repair techniques and are the main factors for failed rotator cuff tendon repair. Whereas fast stretching of the retracted musculotendinous unit results in proliferation of non-contractile fibrous tissue, slow stretching may lead to muscle regeneration in terms of sarcomerogenesis. To slowly stretch the retracted musculotendinous unit in a sheep model, two here described tensioning devices have been developed and mounted on the scapular spine of the sheep using an expandable threaded rod, which has been interposed between the retracted tendon end and the original insertion site at the humeral head. Traction is transmitted in line with the musculotendinous unit by sutures knotted on the expandable threaded rod. The threaded rod of the tensioner is driven within the body through a rotating axis, which enters the body on the opposite side. The tendon end, which was previously released (16 weeks prior) from its insertion site with a bone chip, was elongated with a velocity of 1 mm/day. Results After several steps of technical improvements, the tensioner proved to be capable of actively stretching the retracted and degenerated muscle back to the original length and to withstand the external forces acting on it. Conclusion This technical report describes the experimental technique for continuous elongation of the musculotendinous unit and reversion of the length of chronically shortened muscle

Costamere protein expression and tissue composition of rotator cuff muscle after tendon release in sheep

Previous studies suggested that degradation of contractile tissue requires cleavage of the costamere, a structural protein complex that holds sarcomeres in place. This study examined if costamere turnover is affected by a rotator cuff tear in a previously established ovine model. We found the activity of focal adhesion kinase (FAK), a main regulator of costamere turnover, was unchanged at 2 weeks but decreased by 27% 16 weeks after surgical release of the infraspinatus tendon. This was accompanied by cleavage of the costamere protein talin into a 190 kDa fragment while full length talin remained unchanged. At 2 weeks after tendon release, muscle volume decreased by 17 cm from an initial 185 cm(3) , the fatty tissue volume was halved, and the contractile tissue volume remained unchanged. After 16 weeks, the muscle volume decreased by 36 cm(3) , contractile tissue was quantitatively lost, and the fat content increased by 184%. Nandrolone administration mitigated the loss of contractile tissue by 26% and prevented fat accumulation, alterations in FAK activity, and talin cleavage. Taken together, these findings imply that muscle remodeling after tendon release occurs in two stages. The early decrease of muscle volume is associated with reduction of fat; while, the second stage is characterized by substantial loss of contractile tissue accompanied by massive fat accumulation. Regulation of costamere turnover is associated with the loss of contractile tissue and seems to be impacted by nandrolone treatment. Clinically, the costamere may represent a potential intervention target to mitigate muscle loss after a rotator cuff tear. © 2017 The Authors. Journal of Orthopaedic Research published by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society. J Orthop Res

The Critical Shoulder Angle: Acromial Coverage is More Relevant than Glenoid Inclination

It is still unknown whether glenoid inclination or lateral acromial roof extension is a more important determinant for development of rotator cuff tears (RCT) or osteoarthritis (OA) of the shoulder. It was the purpose of this study, to evaluate whether there is a potential predominance of one of these factors in pathogenesis of RCT or concentric OA. We analyzed 70 shoulders with advanced degenerative RCT and 54 shoulders with concentric OA undergoing primary shoulder arthroplasty (anatomical or reverse) using antero-posterior radiography and multiplanar computed tomography. The two groups were compared in relation to glenoid inclination, lateral acromion roof extension, acromial height and critical shoulder angle (CSA). All measured parameters were highly significantly different between RCT and concentric OA (p < 0.001). Based on Cohen's d effect size, group differences were most distinct in lateral acromial roof extension (1.36 , 0.92 ) compared with acromial height (1.06 , 0.73 ) and glenoid inclination (0.60 , 0.61 ). However, no single factor showed an effect size which was as high as that of the CSA (1.63 ). Interestingly, a ratio of lateral acromion roof extension and acromial height could enhance the effect size (1.60 , 1.16 ) near to values of the CSA (1.63 ). In summary, lateral acromial roof extension has a greater influence in pathogenesis of degenerative RCT and concentric OA than acromial height or glenoid inclination. This article is protected by copyright. All rights reserved

Single indium atoms and few-atom indium clusters anchored onto graphene via silicon heteroatoms

Single atoms and few-atom nanoclusters are of high interest in catalysis and plasmonics, but pathways for their fabrication and stable placement remain scarce. We report here the self-assembly of room-temperature-stable single indium (In) atoms and few-atom In clusters (2-6 atoms) that are anchored to substitutional silicon (Si) impurity atoms in suspended monolayer graphene membranes. Using atomically resolved scanning transmission electron microscopy (STEM), we find that the exact atomic arrangements of the In atoms depend strongly on the original coordination of the Si anchors in the graphene lattice: Single In atoms and In clusters with 3-fold symmetry readily form on 3-fold coordinated Si atoms, whereas 4-fold symmetric clusters are found attached to 4-fold coordinated Si atoms. All structures are produced by our fabrication route without the requirement for electron-beam induced materials modification. In turn, when activated by electron beam irradiation in the STEM, we observe in situ the formation, restructuring and translation dynamics of the Si-anchored In structures: Hexagon-centered 4-fold symmetric In clusters can (reversibly) transform into In chains or In dimers, whereas C-centered 3-fold symmetric In clusters can move along the zig-zag direction of the graphene lattice due to the migration of Si atoms during electron-beam irradiation, or transform to Si-anchored single In atoms. Our results provide a novel framework for the controlled self-assembly and heteroatomic anchoring of single atoms and few-atom clusters on graphene

Combinatorial Strategy for Studying Biochemical Pathways in Double Emulsion Templated Cell-Sized Compartments

Abstract Cells rely upon producing enzymes at precise rates and stoichiometry for maximizing functionalities. The reasons for this optimal control are unknown, primarily because of the interconnectivity of the enzymatic cascade effects within multi-step pathways. Here, an elegant strategy for studying such behavior, by controlling segregation/combination of enzymes/metabolites in synthetic cell-sized compartments, while preserving vital cellular elements is presented. Therefore, compartments shaped into polymer GUVs are developed, producing via high-precision double-emulsion microfluidics that enable: i) tight control over the absolute and relative enzymatic contents inside the GUVs, reaching nearly 100% encapsulation and co-encapsulation efficiencies, and ii) functional reconstitution of biopores and membrane proteins in the GUVs polymeric membrane, thus supporting in situ reactions. GUVs equipped with biopores/membrane proteins and loaded with one or more enzymes are arranged in a variety of combinations that allow the study of a three-step cascade in multiple topologies. Due to the spatiotemporal control provided, optimum conditions for decreasing the accumulation of inhibitors are unveiled, and benefited from reactive intermediates to maximize the overall cascade efficiency in compartments. The non-system-specific feature of the novel strategy makes this system an ideal candidate for the development of new synthetic routes as well as for screening natural and more complex pathways

Surgical knot tightening: how much pull is necessary?

PURPOSE: High-strength sutures allow tightening of a suture knot beyond the strength of the surgeon, possibly inflicting skin damage through the gloves. This study was undertaken to evaluate whether such effort is useful and how much tensioning on a surgical knot is necessary. METHODS: Three different suture materials were tested: No. 2 Vicryl™, FibreWire™, and PDS™. First, the force spontaneously applied on sutures during experimental knot tightening ("tying load") was measured in fifteen experienced surgeons. Second, with each suture material, surgical square knots were tied with increasing, standardized loads (range 0.5-50 N) using a custom-made apparatus. Thereby, knot seating after tying was evaluated, and by loading the knots to failure, evaluation for failure mode and failure load was performed. RESULTS: FibreWire™ 5-throw square knots always failed by complete slipping of all knots (resolving), independent on the tying load. A nonlinear decrease of knot slippage and increased failure load were seen with increasing tying loads for all sutures. Major differences were seen between 0.5 and 10 N for FibreWire™ (slippage: 25 mm) and PDS™ (99.6 mm), whereas Vicryl™ showed major differences (22.7 mm) between 0.5 and 2 N. Increasing the tying load from 10 to 50 N decreased the mean knot slippage from 12 (FibreWire™, ±2.6 SD), 9 (PDS™, ±1.8 SD) and 8 (Vicryl™, ±1.3 SD) mm to 6 (±2.9 SD), 3 (±1.5 SD) and 4 mm (±0.9 SD), respectively. CONCLUSION: Slippage and self-seating of the knots under load is unavoidable even with highest tying loads. Relatively minor but possibly important differences can be seen for tying loads exceeding 2 N (Vicryl™) and 10 N (PDS™ and FibreWire™) for failure load and knot slippage. But also with a tying load of 50 N, a minimal slippage of approximately 3 mm seems unavoidable for all suture types. However, it is important to state that intense tightening does not prevent knot resolution and is only necessary in clinical situations that demand very tight sutures. Numbers and proper appliance of throws are more relevant than tying strength to reach the maximum failure load

Shadows cast on the transition disk of HD 135344B. Multiwavelength VLT/SPHERE polarimetric differential imaging

The protoplanetary disk around the F-type star HD 135344B (SAO 206462) is in a transition stage and shows many intriguing structures both in scattered light and thermal (sub-)millimeter emission which are possibly related to planet formation processes. We study the morphology and surface brightness of the disk in scattered light to gain insight into the innermost disk regions, the formation of protoplanets, planet-disk interactions traced in the surface and midplane layers, and the dust grain properties of the disk surface. We have carried out high-contrast polarimetric differential imaging (PDI) observations with VLT/SPHERE and obtained polarized scattered light images with ZIMPOL in R- and I-band and with IRDIS in Y- and J-band. The scattered light images reveal with unprecedented angular resolution and sensitivity the spiral arms as well as the 25 au cavity of the disk. Multiple shadow features are discovered on the outer disk with one shadow only being present during the second observation epoch. A positive surface brightness gradient is observed in the stellar irradiation corrected images in southwest direction possibly due to an azimuthally asymmetric perturbation of the temperature and/or surface density by the passing spiral arms. The disk integrated polarized flux, normalized to the stellar flux, shows a positive trend towards longer wavelengths which we attribute to large aggregate dust grains in the disk surface. Part of the the non-azimuthal polarization signal in the Uphi image of the J-band observation could be the result of multiple scattering in the disk. The detected shadow features and their possible variability have the potential to provide insight into the structure of and processes occurring in the innermost disk regions.Comment: Accepted for publication in A&A, 20 pages, 15 figure

Exploring dust around HD142527 down to 0.025" / 4au using SPHERE/ZIMPOL

We have observed the protoplanetary disk of the well-known young Herbig star HD 142527 using ZIMPOL Polarimetric Differential Imaging with the VBB (Very Broad Band, ~600-900nm) filter. We obtained two datasets in May 2015 and March 2016. Our data allow us to explore dust scattering around the star down to a radius of ~0.025" (~4au). The well-known outer disk is clearly detected, at higher resolution than before, and shows previously unknown sub-structures, including spirals going inwards into the cavity. Close to the star, dust scattering is detected at high signal-to-noise ratio, but it is unclear whether the signal represents the inner disk, which has been linked to the two prominent local minima in the scattering of the outer disk, interpreted as shadows. An interpretation of an inclined inner disk combined with a dust halo is compatible with both our and previous observations, but other arrangements of the dust cannot be ruled out. Dust scattering is also present within the large gap between ~30 and ~140au. The comparison of the two datasets suggests rapid evolution of the inner regions of the disk, potentially driven by the interaction with the close-in M-dwarf companion, around which no polarimetric signal is detected.Comment: 11 pages, 7 figures, accepted for publication in A