Arthroscopic Superior Capsular Reconstruction for Dislocation of the Shoulder with an Irreparable Rotator Cuff Tear: A Case Report.

CASE: A 49-year-old man presented with apprehension of a repeat dislocation after a left shoulder dislocation, which was accompanied by pain and restricted active range of motion of the shoulder. We performed an arthroscopic Bankart repair as well as an arthroscopic superior capsular reconstruction (ASCR) with fascia lata for the irreparable massive rotator cuff tear. Two years postoperatively, there was no shoulder pain or repeat dislocation; the range of motion had improved. CONCLUSION: We regard ASCR in combination with a Bankart repair as a useful treatment for recurrent shoulder dislocation that is accompanied by an irreparable massive rotator cuff tear.

Influence of Periostin on Synoviocytes in Knee Osteoarthritis.

BACKGROUND: Periostin (POSTN) is a protein that binds to integrins to support adhesion and migration of epithelial cells. Mice lacking this gene exhibit cardiac valve disease as well as skeletal and dental defects. Recent studies indicated that periostin is involved in the pathogenesis and progression of knee osteoarthritis (OA). We investigated the influence of periostin and matrix metalloproteinases (MMPs) on OA synoviocytes. MATERIALS AND METHODS: OA patients were classified according to the Kellgren-Lawrence system and the levels of periostin, interleukin (IL)-4, IL-13 and transforming growth factor-ß (TGFß) in the synovial fluid were measured. MMPs or tissue inhibitor of MMPs (TIMPs) with periostin in cultured cells were measured when periostin was added to OA-associated synovial cells. Dexamethasone, a steroid medication which shows immunosuppressive effects, was used to investigate the influence of the downstream cascade. RESULTS: Periostin and IL-13 levels were up-regulated during the progression of OA. MMP-2 and MMP-3 levels increased in a periostin concentration-dependent manner. Increase in MMP-2 and MMP-3 levels was inhibited by dexamethasone treatment. CONCLUSION: In vivo results herein indicate that IL-13 may induce periostin production in OA. Furthermore, periostin may facilitate MMP production in OA-associated synovial cells.

Influence of IL13 on Periostin Secretion by Synoviocytes in Osteoarthritis.

BACKGROUND: Our previous research provided evidence of periostin increase in parallel with interleukin-13 (IL13) increase in the synovial fluid of patients with osteoarthritis (OA). The reaction cascade from IL13 to periostin, however, remains unidentified. We, therefore, tested the hypothesis that periostin secretion is affected downstream of IL13. MATERIALS AND METHODS: OA synoviocytes were cultured under different concentrations of IL13. Periostin content in culture supernatants and the level of signal transducer and activator of transcription 6 (STAT6) in the cultured cells were measured using enzyme-linked immunosorbent assay (ELISA). Moreover, the influence of dexamethasone and leflunomide on periostin production in relation to the effect of IL13 on the cells was also examined. RESULTS: Periostin content in culture supernatants and the level of STAT6 in cultured cells were significantly increased by IL13. The increase of periostin was significantly inhibited by dexamethasone and leflunomide. CONCLUSION: Periostin may be up-regulated in OA synoviocytes via STAT6 downstream of IL13.

Influence of Palmatine on Bone Metabolism in Ovariectomized Mice and Cytokine Secretion of Osteoblasts.

BACKGROUND/AIM: Receptor activator of nuclear factor-κB ligand (RANKL) and osteoprotegerin (OPG), regulate the cognate receptor RANK on osteoclast precursor cells. Herein we examined the inhibitory effects of palmatine on bone metabolism using ovariectomized (OVX) mice. MATERIALS AND METHODS: The first experimentaI set was designed to histologically and biochemically examine mice randomly divided into four groups: sham-operated, OVX, and OVX-palmatine intake groups (1 mg/kg and 10 mg/kg). The second experimental set examined the influence of palmatine on osteoblast-like cells in vitro. RESULTS: Palmatine caused significant suppression of osteoclast numbers in tissues. In palmatine-treated mice, RANKL and OPG expression decreased. In the culture supernatant of MC3T3-E1 cells, RANKL and OPG levels were significantly reduced by palmatine addition. CONCLUSION: Palmatine may attenuate osteoclast differentiation through inhibition of RANKL and OPG expression by osteoblasts. Therefore, palmatine might be a candidate anti-resorptive agent for osteoporosis therapy.

Influence of Electroacupuncture Stimulation on Nitric Monoxide Production in Vascular Endothelial Cells in Rats.

BACKGROUND/AIM: In Chinese medicine, blood stasis termed as 'Oketsu' means 'preceding state' or 'symptomatic of sickness'. Traditional Chinese medicine may improve blood flow by vasodilation or blood clotting inhibition. Although acupuncture influences the blood circulatory system, its underlying mechanisms remain unclear. Herein we evaluated changes in NO, as reflected by changes in NO2 (-), platelet aggregation, oxidative stress and endocrine responses after acupuncture stimulation in rats. MATERIALS AND METHODS: Acupuncture stimulation was administered to rats randomly divided into five groups: control, N(G)-nitro-L-arginine methyl ester hydrochloride (L-NAME) injection, restraint stress (RS), restraint plus acupuncture stimulation (RA), and restraint plus acupuncture with L-NAME (RLA). RESULTS: Compared to those in the RS group, levels of NO2 (-), endothelial nitric oxide synthase (NOS) protein and its mRNA significantly increased and those of hydroperoxide and soluble P-selectin significantly decreased in the RA group. CONCLUSION: Acupuncture stimulation regulates vascular endothelium NOS function and affects vascular resistance and blood characteristics through NO. Additionally, NO produced may modulate excessive reactive oxygen development and blood platelet activation.