Relationship between the Axillary Nerve and Accompanying Vessels and Proximal Humeral Locking Plates in Japanese: An MRI Study

We investigated the anatomical features of the axillary nerve and its accompanying vessels with respect to the lateral wall of the greater tuberosity, focusing on the relationship between the neurovascular bundle and the proximal humeral locking plates. Magnetic resonance images of 30 Japanese patients’ shoulders were examined. Oblique sagittal images across the greater tuberosity and the neurovascular bundle, which contain the axillary nerve and posterior circumflex humeral artery and vein, were obtained. The distance between the superior aspect of the greater tuberosity and the superior and inferior borders of the neurovascular bundles was measured at the anterior, middle, and posterior edges of the greater tuberosity. The neurovascular bundle was 28.5-36.7 mm, 32.6-41.3 mm, and 38.1-47.5 mm distal to the superior aspect of the greater tuberosity at the anterior, middle, and posterior edges, respectively. We evaluated the relationship between the neurovascular bundle and 3 different locking plates, which were placed at the lateral aspect of the greater tuberosity. Only 3 or four locking screws at the most proximal part could be safely inserted without axillary nerve interference

Differences in Risk Factors for Rotator Cuff Tears between Elderly Patients and Young Patients

It has been unclear whether the risk factors for rotator cuff tears are the same at all ages or differ between young and older populations. In this study, we examined the risk factors for rotator cuff tears using classification and regression tree analysis as methods of nonlinear regression analysis. There were 65 patients in the rotator cuff tears group and 45 patients in the intact rotator cuff group. Classification and regression tree analysis was performed to predict rotator cuff tears. The target factor was rotator cuff tears; explanatory variables were age, sex, trauma, and critical shoulder angle≥35°. In the results of classification and regression tree analysis, the tree was divided at age 64. For patients aged≥64, the tree was divided at trauma. For patients aged<64, the tree was divided at critical shoulder angle≥35°. The odds ratio for critical shoulder angle≥35° was significant for all ages (5.89), and for patients aged<64 (10.3) while trauma was only a significant factor for patients aged≥64 (5.13). Age, trauma, and critical shoulder angle≥35° were related to rotator cuff tears in this study. However, these risk factors showed different trends according to age group, not a linear relationship

Association between the Critical Shoulder Angle and Rotator Cuff Tears in Japan

Distinct anatomic variants of the scapula such as the critical shoulder angle (CSA) were found to be associated with rotator cuff tears (RCTs), but it is unclear whether the CSA is a risk factor in Japanese. Here we sought to determine whether the CSA is associated with RCTs in a Japanese population, and whether the CSA is a more useful parameter than the conventionally used parameters. Our RCT group and non-RCT group each consisted of 54 consecutive cases. We compared the groups’ values of CSA, the acromion index (AI), and the lateral acromion angle (LAA) obtained by X-ray imaging. Receiver operating characteristic (ROC) analyses were performed to determine cutoff values and the area under the curve (AUC), and to assess the odds ratio. The means of the CSA and the AI in the RCT group were significantly larger (36.3° vs. 33.7°, 0.74 vs 0.68), but the LAA did not show a significant between-group difference. The AUCs for the CSA and AI were 0.678 and 0.658, the cutoff values were 35.0° and 0.72, and the odds ratios were 3.1 and 2.5, respectively. In conclusion, the CSA was a strong risk factor compared to the AI and LAA for rotator cuff tears

Blood flow velocity in the anterior humeral circumflex artery and tear size can predict synovitis severity in patients with rotator cuff tears

Background Rotator cuff tears are often associated with synovitis, but the ability of noninvasive ultrasonography to predict the severity of synovitis remains unclear. We investigated whether ultrasound parameters, namely peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, reflect synovitis severity. Methods A total of 54 patients undergoing arthroscopic rotator cuff repair were selected. Doppler ultrasound was used to measure peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, and these values were compared with the intraoperative synovitis score in univariate and multivariate analyses. Results Univariate analyses revealed that tear size, peak systolic velocity in the anterior humeral circumflex artery, and Doppler activity in the glenohumeral joint were associated with synovitis in the glenohumeral joint (P=0.02, P<0.001, P=0.02, respectively). In the subacromial space, tear size, peak systolic velocity in the anterior humeral circumflex artery, and Doppler activity in the subacromial space were associated with synovitis severity (P=0.02, P<0.001, P=0.02, respectively). Multivariate analyses indicated that tear size and peak systolic velocity in the anterior humeral circumflex artery were independently associated with synovitis scores in both the glenohumeral joint and the subacromial space (all P<0.05). Conclusions These findings demonstrate that tear size and peak systolic velocity in the anterior humeral circumflex artery, which can both be measured noninvasively, are useful indicators of synovitis severity. Level of evidenceIV

Endoscopic carpal tunnel pressure measurement: a reliable technique for complete release

Carpal tunnel syndrome is diagnosed by clinical symptoms, Tinel's sign, Phalen's test and electromyography. Carpal tunnel pressure measurement can also aid in the precise identification of excessive pressure sites that indicate locations for release. In this study, pressure measurements made during endoscopic carpal tunnel release at 5 points were significantly higher anywhere in the carpal tunnel than outside the tunnel and decreased markedly after release. We concluded that our measurement technique can improve the reliability of endoscopic carpal tunnel release by decreasing the likelihood of missing any nerve entrapment sites.</p

Involvement of Girdin in the Determination of Cell Polarity during Cell Migration

Cell migration is a critical cellular process that determines embryonic development and the progression of human diseases. Therefore, cell- or context-specific mechanisms by which multiple promigratory proteins differentially regulate cell migration must be analyzed in detail. Girdin (girders of actin filaments) (also termed GIV, Gα-interacting vesicle associated protein) is an actin-binding protein that regulates migration of various cells such as endothelial cells, smooth muscle cells, neuroblasts, and cancer cells. Here we show that Girdin regulates the establishment of cell polarity, the deregulation of which may result in the disruption of directional cell migration. We found that Girdin interacts with Par-3, a scaffolding protein that is a component of the Par protein complex that has an established role in determining cell polarity. RNA interference-mediated depletion of Girdin leads to impaired polarization of fibroblasts and mammary epithelial cells in a way similar to that observed in Par-3-depleted cells. Accordingly, the expression of Par-3 mutants unable to interact with Girdin abrogates cell polarization in fibroblasts. Further biochemical analysis suggests that Girdin is present in the Par protein complex that includes Par-3, Par-6, and atypical protein kinase C. Considering previous reports showing the role of Girdin in the directional migration of neuroblasts, network formation of endothelial cells, and cancer invasion, these data may provide a specific mechanism by which Girdin regulates cell movement in biological contexts that require directional cell movement

産後うつとボンディングの関連の経産による変化: 子どもの健康と環境に関する全国調査からの経時的な結果より

富山大学・富医薬博乙77号・土田 暁子・2020/11/25関連論文Tsuchida A, Hamazaki K, Matsumura K, Miura K, Kasamatsu H, Inadera H; Japan Environment and Children\u27s Study (JECS) Group. Changes in the association between postpartum depression and mother-infant bonding by parity: Longitudinal results from the Japan Environment and Children\u27s Study. J Psychiatr Res. 2019 Mar;110:110-116. doi: 10.1016/j.jpsychires.2018.11.022. Epub 2018 Nov 28. PMID: 30616158.富山大