No Relationship Between Preoperative and Early Postoperative Strength After ACL Reconstruction

Context: All rehabilitative programs before ACL reconstructive surgery, which are focused on recovery of proprioception and muscular strength, are defined as prehabilitation. While it has shown that prehabilitation positively affects the overall outcome after ACL reconstruction, it is still controversial whether enhancing preoperatively quadriceps strength has some beneficial effect on postoperative strength, mainly during the first period. Objective: To determine whether there is any relationship between pre- and early postoperative quadriceps strength. Design: Case control. Setting: University research laboratory. Participants: Fifty-nine males (18-33 y; age: 23.69 (0.71) y) who underwent ACL reconstruction with patellar-tendon autograft were examined the day before surgery, at 60 and at 90 days after surgery. Main Outcome Measures: The limb-symmetry-index (LSI) was quantified for maximal voluntary isometric contraction (MVIC) of the knee extensor muscles and of the knee flexor muscles at 90° joint angle. K-means analysis was performed on either quadriceps or hamstrings LSI before surgery to classify the patients in high and low preoperative LSI clusters. Differences in postoperative LSI were then evaluated between the high and low preoperative LSI clusters. Results: Following surgery, there were no differences in the quadriceps LSI between patients with high and low preoperative quadriceps LSI. Sixty days after surgery, the hamstrings LSI was higher in patients with high than low preoperative hamstrings LSI (84.0±13.0% vs 75.4±15.9%; P<0.05). Conclusions: Findings suggest that quadriceps strength deficit is related to the ACL injury and increases further after the reconstruction without any correlation between the pre-operative and postoperative values. Therefore, it appears that there is no need to delay surgery in order to increase the preoperative quadriceps strength before surgery

Quadriceps muscle compensatory activations are delayed following anterior cruciate ligament reconstruction using hamstring tendon graft

Objective: To investigate compensatory and anticipatory quadriceps muscle activations before and after anterior cruciate ligament reconstruction (ACLR) using hamstrings tendon graft. Design:Twelve participants who underwent ACLR and 12 healthy controls were exposed to 10 either unpredictable or predictable perturbations of the knee joint before ACLR (T1), 2 months (T2) and 6 months (T3) after surgery. Latencies of compensatory and anticipatory postural activations in the vastus lateralis (VL), rectus femoris (RF) and vastus medialis (VM) muscles were recorded by surface electromyography with respect to the arrival of the perturbations. Results:Latency of compensatory activations was significantly delayed in ACLR compared to that in healthy participants at T1 for VL (105 ± 25 vs. 57 ± 9 ms; P<0.001), RF (102 ± 23 vs. 56 ± 9 ms; P<0.001) and VM (107 ± 24 vs. 66 ± 16 ms;P<0.001), at T2 for VL (68 ± 14 vs. 55 ± 10 ms;29 P<0.01) and at T3 for VL (105 ± 22 vs. 58 ± 7 ms;P<0.001), RF (102 ± 22 vs. 58 ± 12 ms; P<0.001) and VM (106 ± 20 vs. 63 ± 8 ms;P<0.001). Anticipatory activations occurred earlier in ACLR than in healthy participants at T1 for VL (-82 ± 64 vs. -14 ± 11 ms; P<0.05) and VM (-105 ± 32 68 vs. -9 ± 12 ms;P<0.05). Conclusion:While anticipatory quadriceps activations show no alterations, compensatory muscle activations are delayed following ACLR with hamstring graft. Post-surgical rehabilitation should address alterations in compensatory lower limb postural control

Celecoxib inhibits proliferation and survival of chronic myelogeous leukemia (CML) cells via AMPK-dependent regulation of β-catenin and mTORC1/2.

CML is effectively treated with tyrosine kinase inhibitors (TKIs). However, the efficacy of these drugs is confined to the chronic phase of the disease and development of resistance to TKIs remains a pressing issue. The anti-inflammatory COX2 inhibitor celecoxib has been utilized as anti-tumour drug due to its anti-proliferative activity. However, its effects in hematological malignancies, in particular CML, have not been investigated yet. Thus, we tested biological effects and mechanisms of action of celecoxib in Philadelphia-positive (Ph+) CML and ALL cells.We show here that celecoxib suppresses the growth of Ph+ cell lines by increasing G1-phase and apoptotic cells and reducing S- and G2-phase cells. These effects were independent of COX2 inhibition but required the rapid activation of AMP-activated protein kinase (AMPK) and the consequent inhibition mTORC1 and 2. Treatment with celecoxib also restored GSK3β function and led to down-regulation of β-catenin activity through transcriptional and post-translational mechanisms, two effects likely to contribute to Ph+ cell growth suppression by celecoxib.Celecoxib inhibited colony formation of TKI-resistant Ph+ cell lines including those with the T315I BCR-ABL mutation and acted synergistically with imatinib in suppressing colony formation of TKI-sensitive Ph+ cell lines. Finally, it suppressed colony formation of CD34+ cells from CML patients, while sparing most CD34+ progenitors from healthy donors, and induced apoptosis of primary Ph+ ALL cells.Together, these findings indicate that celecoxib may serve as a COX2-independent lead compound to simultaneously target the mTOR and β-catenin pathways, key players in the resistance of CML stem cells to TKIs

Asymmetrical lower extremity loading early after ACL reconstruction is a significant predictor of asymmetrical loading at the time of return to sport

OBJECTIVES: The aim of this study was to examine whether asymmetrical lower limb loading early after anterior cruciate ligament reconstruction (1 mo) can predict asymmetrical lower limb loading at the time of return to sport (6 mos) and whether other early predictors as knee joint range of motion or maximal isometric strength affect this relationship. DESIGN: Ground reaction forces were measured during a sit-to-stand task 1 mo after anterior cruciate ligament reconstruction and a vertical countermovement jump 6 mos after anterior cruciate ligament reconstruction in 58 athletes. Other early postoperative measurements were knee joint range of motion (2 wks, 1 mo, and 2 mos after surgery) and maximal isometric strength of the knee extensor and flexor muscles (2 mos after surgery). Linear regression models were developed using side-to-side limb symmetry index (LSI) of countermovement jump as the dependent variable. RESULTS: LSI of sit-to-stand task 1 mo after surgery was a significant independent predictor of LSI of countermovement jump 6 mos after surgery. After accounting for deficits in knee joint range of motion and LSI of maximal isometric strength (ΔR² = 0.35, P < 0.01), LSI of sit-to-stand task predicted LSI of countermovement jump (ΔR² = 0.14 P < 0.01). CONCLUSIONS: Asymmetrical lower extremity loading 1 mo after anterior cruciate ligament reconstruction is an early predictor of asymmetrical lower extremity loading 6 mos after surgery

Micro-Raman mapping of the polymorphs of serpentine

Serpentinites are rocks, often used in buildings, formed in large extent by minerals of the serpentine group: chrysotile, antigorite, lizardite, and polygonal serpentine. The fibrous type (e.g. chrysotile) of serpentine group minerals, along with several amphibole varieties (e.g. actinolite and tremolite), are the major components of asbestos family. The exposure to fine fibrous asbestos powder is linked to diseases such as pleural mesothelioma and asbestosis. The identification of the main varieties of the serpentine group, laminated or fibrous, becomes an issue of great interest for public health. This work introduces an analytical strategy able to distinguish the different serpentine polymorphs directly on the sample, allowing the analysiswithin their textural environment, evidencing at themicrometer scale the mineral reactions of the phases. Samples coming from the Koniambo massif (Grande Terre Island, New Caledonia) were studied by means of optical microscopy, scanning electron microscopy–energy dispersive X-ray spectroscopy, and Raman spectroscopy. Raman peaks observed in the high wavenumber spectral range of 3550–3850 cm-1, associated with OH stretching vibrations, allow the iscrimination of the all four serpentine varieties. The relationship between the different varieties of serpentine, at a micrometric scale, in complex samples, has been investigated by two-dimensional Raman mapping

The Proto-Oncogene LRF Is under Post-Transcriptional Control of MiR-20a: Implications for Senescence

MicroRNAs (miRNAs) are short 20–22 nucleotide RNA molecules that act as negative regulators of gene expression via translational repression: they have been shown to play a role in development, proliferation, stress response, and apoptosis. The transcriptional regulator LRF (Leukemia/lymphoma Related Factor) has been shown to prevent p19ARF transcription and consequently to inhibit senescence in mouse embryonic fibroblasts (MEF). Here we report, for the first time, that LRF is post-transcriptionally regulated by miR-20a. Using a gene reporter assay, direct interaction of miR-20a with the LRF 3′UTR is demonstrated. To validate the interaction miR-20a/3′UTR LRF miR-20a was over-expressed, either by transient transfection or retroviral infection, in wild type mouse embryo fibroblasts and in LRF-null MEF derived from LRF knock-out mice. We observed LRF decrease, p19ARF increase, inhibition of cell proliferation and induction of senescence. The comparison of miR-20a activity in wt and LRF-null MEF indicates that LRF is the main mediator of the miR-20a-induced senescence and that other targets are cooperating. As LRF down-regulation/p19ARF induction is always accompanied by E2F1 down-regulation and increase of p16, we propose that all these events act in synergy to accomplish miR-20a-induced senescence in MEF. Senescence has been recently revaluated as a tumor suppressor mechanism, alternative to apoptosis; from this point of view the discovery of new physiological “senescence inducer” appears to be promising as this molecule could be used as anticancer drug

Recombinant Anti-Human Melanoma Antibodies Are Versatile Molecules

The low cost, high versatility, and reliable production of bacterially produced recombinant antibody fragments speeds up the development of tumor-targeting agents. High-quality recombinant anti-melanoma antibodies are much sought after in the scientific community. We cloned the murine antibody 225.28S, currently used in radioimmunoimaging of human melanoma lesions, in single-chain Fv configuration (scFv) for soluble expression in bacteria. The recombinant antibody fragment conserved the binding specificity of the parental antibody. In order to arm the scFv(225.28S) with biologically useful effector functions, we developed vectors for soluble expression of scFv(225.28S) in bacteria that allow both covalent and noncovalent chemical antibody modification at positions that do not interfere with antigen binding. An expression vector was developed that appends a cysteine residue at the C-terminal extremity of the recombinant antibody, thus allowing reaction with thiol-specific reagents, including 99mTc labeling, at a position that does not interfere with antigen binding. The scFv(225.28S) was also successfully expressed with a casein kinase II substrate tag that enables efficient and stable 32P labeling. For noncovalent antibody modification, we developed an expression vector that appends the human calmodulin gene at the C-terminal extremity of scFv(225.28S). The calmodulin domain is poorly immunogenic and can be targeted with chemically modified high-affinity calmodulin ligands. The recombinant anti-human melanoma antibodies described in this article should prove useful “building blocks” for the development of anti-melanoma diagnostic and therapeutic strategies

Fibroma of tendon sheath located within the ankle joint capsule

We report a very rare case of fibroma of the tendon sheath arising from the anteromedial ankle joint capsule, with no apparent connection to any tendon in the area, found in a 58-year-old patient complaining of progressive local swelling. This uncommon tumor has its usual localization in tendon sheaths, is extremely rare in joint capsules, and has never been described in this location previously. MRI showed nonuniform low signal intensity in T1- and T2-weighted images and high intensity in STIR images. The mass was completely excised by open surgery. Histopathological analysis later confirmed the diagnosis of a fibroma of the tendon sheath

the 45 degrees arthroscope a forgotten scope in knee surgery

Abstract The majority of knee arthroscopic procedures are performed with 30° scope while the 70° arthroscope is mainly used for surgery of posterior compartments. In the arthroscopic armamentarium, another scope, unknown to many surgeons, is also available: the 45° arthroscope. His field of view provides a wider intraoperative view than that of a 30° scope without the characteristic blind spot of a 70° scope. Therefore, the surgeon's orientation is not compromised. because the optic has always an element of forward vision. With these advantages, the 45° scope can be used in all knee surgical procedures without the need for having two scopes sterilized on the surgical table with less risk of contamination and less surgical time. The 45° scope may also be valuable for the arthroscopic surgery of other joints with the same advantages