Glenohumeral joint motion after subscapularis tendon repair: an analysis of cadaver shoulder models

BACKGROUND: As for the surgical treatment of the rotator cuff tears, the subscapularis tendon tears have recently received much attention for the mini-open or arthroscopic repair. The results of surgical repair for the subscapularis tendon tear are satisfactory, but the range of external rotation is reported to be restricted after the repair. The purpose of this study was to evaluate the range of glenohumeral joint motion after repairs of various sizes of subscapularis tendon tears. METHODS: Using eight fresh frozen human cadaveric shoulders (mean age at death, 81.5 years), three sizes of subscapularis tendon tear (small, medium, and large) were made and then repaired. With the scapula fixed to the wooden jig, the end-range of glenohumeral motion was measured with passive movement applied through 1.0-Nm torque in the directions of scapular elevation, flexion, abduction, extension, horizontal abduction, and horizontal adduction. The passive end-ranges of external and internal rotation in various positions with rotational torque of 1.0 Nm were also measured. Differences in the ranges among the three type tears were analyzed. RESULTS: As tear size increased, range of glenohumeral motion in horizontal abduction after repair decreased gradually and was significantly decreased with the large size tear (P < 0.01). The end-range of external rotation decreased progressively with increasing tear size in every glenohumeral position. The prominent decrease in external rotation (around 40° reduction from intact shoulders) was observed in shoulders after repair of large size tear at 30° to 60° of scapular elevation and abduction. CONCLUSIONS: As the size of the subscapularis tendon tear increased, the passive ranges of horizontal abduction and external rotation of the glenohumeral joint after repair decreased significantly. In shoulders with a subscapularis tendon tear, it is necessary to consider the reduction of external rotation depending on tear size

Ghrelin, Des-Acyl Ghrelin, and Obestatin: Regulatory Roles on the Gastrointestinal Motility

Ghrelin, des-acyl ghrelin, and obestatin are derived from a common prohormone, preproghrelin by posttranslational processing, originating from endocrine cells in the stomach. To examine the regulatory roles of these peptides, we applied the manometric measurement of gastrointestinal motility in freely moving conscious rat or mouse model. Ghrelin exerts stimulatory effects on the motility of antrum and duodenum in both fed and fasted state of animals. Des-acyl ghrelin exerts inhibitory effects on the motility of antrum but not on the motility of duodenum in the fasted state of animals. Obestatin exerts inhibitory effects on the motility of antrum and duodenum in the fed state but not in the fasted state of animals. NPY Y2 and Y4 receptors in the brain may mediate the action of ghrelin, CRF type 2 receptor in the brain may mediate the action of des-acyl ghrelin, whereas CRF type 1 and type 2 receptors in the brain may mediate the action of obestatin. Vagal afferent pathways might be involved in the action of ghrelin, but not involved in the action of des-acyl ghrelin, whereas vagal afferent pathways might be partially involved in the action of obestatin

RELATIONSHIP BETWEEN THE SHEAR ELASTIC MODULUS AND PASSIVE FORCE IN POSTERIOR SHOULDER CAPSULES: A CADAVERIC STUDY

Although shear wave elastography (SWE) has been used to indirectly measure passive force in muscle tissues, it is unknown whether SWE can be utilized to evaluate passive force in capsule tissues. This study investigated the relationship between the shear elastic modulus and passive force in posterior shoulder capsules using SWE. Four middle and four inferior posterior shoulder capsules were dissected from four fresh-frozen cadavers. Passive force (0-400 g in 25-g increments) was applied to each capsule, and elasticity was measured simultaneously using SWE. The relationship between elasticity and passive capsule force was highly linear for all tested capsules (coefficients of determination range: 0.853-0.963). SWE is a valid and useful method of evaluating indirectly and noninvasively the passive force of the posterior shoulder capsules

p16INK4A-expressing mesenchymal stromal cells restore the senescence– clearance– regeneration sequence that is impaired in chronic muscle inflammation

細胞治療として用いられる間葉系幹/間質細胞は，細胞老化を起こすことで貪食細胞を損傷部分へ動員し，組織のリモデリングを促進する

Phosphorylated Platelet-Derived Growth Factor Receptor-Positive Cells With Anti-apoptotic Properties Accumulate in the Synovium of Patients With Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease caused by inflammation of the synovium and characterized by chronic polyarthritis that destroys bone and cartilage. Fibroblast-like synoviocytes (FLSs) in the synovium of patients with RA can promote cartilage and bone destruction by producing proteins such as matrix metalloproteinases and receptor activator of NF-κB ligand, thereby representing an important therapeutic target for RA. FLSs have several phenotypes depending on which cell surface proteins and adhesion factors are expressed. Identifying the cellular functions associated with different phenotypes and methods of controlling them are considered essential for developing therapeutic strategies for RA. In this study, synovial tissue was collected from patients with RA and control subjects who required surgery due to ligament injury or fracture. Immunohistological analysis was used to investigate the rates of positivity for phosphorylated platelet-derived growth factor receptor-αβ (pPDGFRαβ) and cadherin-11 (CDH11) expression, and apoptosis-related markers were assessed for each cell phenotype. Next, FLSs were isolated in vitro and stimulated with tumor necrosis factor-α (TNF-α) in addition to a combination of PDGF and transforming growth factor (2GF) to investigate pPDGFRαβ and CDH11 expression and the effects of the inhibition of TNF and cyclin-dependent kinase (CDK) 4/6 on FLSs. Immunohistological analysis showed a large percentage of pPDGFRαβ+CDH11– cells in the sub-lining layer (SL) of patients with RA. These cells exhibited increased B-cell lymphoma-2 expression, reduced TNF receptor-1 expression, resistance to cell death, and abnormal proliferation, suggesting a tendency to accumulate in the synovium. Further, in vitro 2GF stimulation of FLSs lowered, whereas 2GF + TNF stimulation increased the pPDGFRαβ/CDH11 ratio. Hypothesizing that FLSs stimulated with 2GF + TNF would accumulate in vivo in RA, we determined the therapeutic effects of TNF and CDK4/6 inhibitors. The TNF inhibitor lowered the pPDGFRαβ/CDH11 ratio, whereas the CDK4/6 inhibitor suppressed cell proliferation. However, a synergistic effect was not observed by combining both the drugs. We observed an increase in pPDGFRαβ+CDH11– cells in the SL of the RA synovium and accumulation of these cells in the synovium. We found that the TNF inhibitor suppressed FLS activity and the CDK4/6 inhibitor reduced cell proliferation

Identification of a novel therapeutic target that produces irreversible diabeticg lucotoxicky

科学研究費補助金研究成果報告書研究種目: 基盤研究(B)研究期間: 2006～2007課題番号: 18390100研究代表者: 小島 秀人（滋賀医科大学・医学部・准教授）研究分担者: 木村 博（滋賀医科大学・医学部・教授）研究分担者: 藤宮 峯子（滋賀医科大学・医学部・准教授

脊椎椎弓根スクリュー誤挿入後,再挿入を行った際の引き抜き強度についての研究

Screw malposition, such as lateral wall breach or end-plate breach, is one of the main pitfalls of inserting pedicle screws. Methods: From 17 fresh spines 54 vertebrae were harvested. In each vertebra on one pedicle the screw was inserted correctly down the axis of the pedicle, while on the other pedicle the screw was inserted to breach the lateral wall or the end-plate. The 18 pedicle screws that breached the lateral wall were then removed and re-directed along the correct axis of the pedicle. The 18 pedicle screws that breached the end-plate were removed and re-directed along the correct axis of the pedicle. The 18 other pedicle screws that had breached the end-plate were not removed. The pullout force of pedicle screws was measured. Results: 1) The mean pullout strength for the re-directed screws following lateral wall breach was 24.0% less as compared to the correctly aligned screws; 2) The mean pullout strength for the re-directed screws following end-plate breach was 23.3% less as compared to the correctly aligned screws; 3) The mean pullout strength for the pedicle screws end-plate breach was 7.6% less as compared to the correctly aligned screws. Conclusion: The pullout strength of re-directed pedicle screws after either a lateral pedicle breach or end-plate breach is significantly less than the pullout strength of correctly aligned screw. A pedicle screw that is not re-directed after end-plate breach is weaker than a pedicle screw correctly aligned, however the difference is not significant

Effects of Initial Graft Tension during Anterior Talofibular Ligament Reconstruction on Ankle Kinematics, Laxity, and In-situ Forces of the Reconstructed Graft

前距腓靭帯は，足関節の安定性に関わる重要な靱帯である．前距腓靱帯の損傷後に慢性的な足関節の不安定性が残存した場合，前距腓靱帯再建手術が必要となるが，その際に再建靭帯にかける適切な張力について研究した報告はなかった．本論文では，再建靭帯にかける張力の違いが，足関節のキネマティクス，制動性，術後の靱帯張力に及ぼす影響と適切な再建靭帯初期固定張力を明らかにした