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1.
BMC Musculoskelet Disord ; 23(1): 256, 2022 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-35296296

RESUMO

BACKGROUND: Limited chondrocyte migration and impaired cartilage-to-cartilage healing is a barrier in cartilage regenerative therapy. Collagenase treatment and delivery of a chemotactic agent may play a positive role in chondrocyte repopulation at the site of cartilage damage. This study evaluated chondrocyte migratory activity after enzymatic treatment in cultured cartilage explant. Differential effects of platelet-derived growth factor (PDGF) dimeric isoforms on the migratory activity were investigated to define major chemotactic factors for cartilage. METHODS: Full-thickness cartilage (4-mm3 blocks) were harvested from porcine femoral condyles and subjected to explant culture. After 15 min or 60 min of actinase and collagenase treatments, chondrocyte migration and infiltration into a 0.5-mm cartilage gap was investigated. Cell morphology and lubricin, keratan sulfate, and chondroitin 4 sulfate expression in superficial- and deep-zone chondrocytes were assessed. The chemotactic activities of PDGF-AA, -AB, and -BB were measured in each zone of chondrocytes, using a modified Boyden chamber assay. The protein and mRNA expression and histological localization of PDGF-ß were analyzed by western blot analysis, real-time reverse transcription polymerase chain reaction (RT-PCR), and immunohistochemistry, and results in each cartilage zone were compared. RESULTS: Superficial-zone chondrocytes had higher migratory activity than deep-zone chondrocytes and actively bridged the cartilage gap, while metachromatic staining by toluidine blue and immunoreactivities of keratan sulfate and chondroitin 4 sulfate were detected around the cells migrating from the superficial zone. These superficial-zone cells with weak immunoreactivity for lubricin tended to enter the cartilage gap and possessed higher migratory activity, while the deep-zone chondrocytes remained in the lacuna and exhibited less migratory activity. Among PDGF isoforms, PDGF-AB maximized the degree of chemotactic activity of superficial zone chondrocytes. Increased expression of PDGF receptor-ß was associated with higher migratory activity of the superficial-zone chondrocytes. CONCLUSIONS: In enzymatically treated cartilage explant culture, chondrocyte migration and infiltration into the cartilage gap was higher in the superficial zone than in the deep zone. Preferential expression of PDGF receptor-ß combined with the PDGF-AB dimeric isoform may explain the increased migratory activity of the superficial-zone chondrocytes. Cells migrating from superficial zone may contribute to cartilage regeneration.


Assuntos
Cartilagem , Condrócitos , Regeneração , Animais , Movimento Celular , Condrócitos/metabolismo , Articulação do Joelho , Proteínas Proto-Oncogênicas c-sis , Suínos
2.
J Spinal Disord Tech ; 26(6): E248-53, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23429319

RESUMO

STUDY DESIGN: A morphometric measurement of cortical bone trajectory (CBT) for the lumbar pedicle screw insertion using computed tomography (CT). OBJECTIVE: The aim of this study was to conduct a detailed morphometric measurement of the CBT. SUMMARY OF BACKGROUND DATA: The CBT is a novel lumbar pedicle screw trajectory, which follows a caudocephalad path sagittally and a laterally directed path in the transverse plane. The advantage associated with this modified technique is increased cortical bone contact, providing an enhanced screw purchase. However, little is known about the possible screw size or detailed direction of the trajectory. METHODS: The CT scans of 100 adults who underwent examination for spinal problems were studied. A total of 470 lumbar vertebrae excluding spondylosis, malformation, and tumor were observed. In this trajectory, the starting point was supposed to be the junction of the center of the superior articular process and 1 mm inferior to the inferior border of the transverse process. The CT images were analyzed using 3-dimensional reconstruction software. The diameter, length, lateral angle to the vertebral sagittal plane, and cephalad angle to the vertebral horizontal plane of the trajectory were measured. RESULTS: The mean diameter gradually increased from L1 to L5 (from 6.2 mm at L1 to 8.4 mm at L5). The mean length from L1 to L5 were 36.8, 38.2, 39.3, 39.8, and 38.3 mm, respectively. The lateral angle from L1 to L5 were 8.6, 8.5, 9.1, 9.1, and 8.8 degrees, respectively. The cephalad angle from L1 to L5 were 26.2, 25.5, 26.2, 26.0, and 25.8 degrees, respectively. CONCLUSIONS: The morphology of the pedicle, such as shape and pedicle axis angle, differed over the lumbar levels, our measurements demonstrated similar data excluding the diameter of the trajectory. There were no significant differences between each level of the lateral and cephalad angles.


Assuntos
Vértebras Lombares/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Parafusos Ósseos , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Vértebras Lombares/anatomia & histologia , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Radiografia
4.
Surg Case Rep ; 9(1): 116, 2023 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-37356034

RESUMO

BACKGROUND: Acute diaphragmatic hernia is a life-threatening condition caused by prolapse of an abdominal organ into the thoracic cavity through a defect in the diaphragm. We present herein a case of acquired diaphragmatic hernia following a peritoneal biopsy for gastric cancer dissemination in the diaphragm. CASE PRESENTATION: A 72-year-old, female patient presented with a complaint of acute abdomen 10 months after receiving a diagnosis of stage IV gastric cancer with peritoneal dissemination based on peritoneal biopsy findings during staging laparoscopy. Computed tomography demonstrated herniation of the small intestine into the thoracic cavity. Emergency surgery was performed, and a full-thickness diaphragmatic defect was found intraoperatively at the same location as the previous, peritoneal biopsy. The incarcerated small intestine was atraumatically repositioned into the abdominal cavity, and the defect was closed laparoscopically using an absorbable barbed suture. CONCLUSIONS: Although complications of staging laparoscopy are extremely rare, excising disseminated nodules from the diaphragm carries the risk of diaphragmatic hernia. For this reason, avoiding excision is desirable unless a diaphragmatic biopsy is needed.

5.
Lasers Surg Med ; 43(3): 221-9, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21412806

RESUMO

BACKGROUND AND OBJECTIVE: Bacterial arthritis does not respond well to antibiotics and moreover multidrug resistance is spreading. We previously tested photodynamic therapy (PDT) mediated by systemic Photofrin® in a mouse model of methicillin-resistant Staphylococcus aureus (MRSA) arthritis, but found that neutrophils were killed by PDT and therefore the infection was potentiated. STUDY DESIGN/MATERIALS AND METHODS: The present study used an intra-articular injection of Photofrin® and optimized the light dosimetry in order to maximize bacterial killing and minimize killing of host neutrophils. MRSA (5 × 10(7) CFU) was injected into the mouse knee followed 3 days later by 1 µg of Photofrin® and 635-nm diode laser illumination with a range of fluences within 5 minutes. Synovial fluid was sampled 6 hours or 1-3, 5, and 7 days after PDT to determine MRSA colony-forming units (CFU), neutrophil numbers, and levels of cytokines. RESULTS: A biphasic light dose response was observed with the greatest reduction of MRSA CFU seen with a fluence of 20 J cm(-2), whereas lower antibacterial efficacy was observed with fluences that were either lower or higher. Consistent with these results, a significantly higher concentration of macrophage inflammatory protein-2, a CXC chemokine, and greater accumulation of neutrophils were seen in the infected knee joint after PDT with a fluence of 20 J cm(-2) compared to fluences of 5 or 70 J cm(-2). CONCLUSION: PDT for murine MRSA arthritis requires appropriate light dosimetry to simultaneously maximize bacterial killing and neutrophil accumulation into the infected site, while too little light does not kill sufficient bacteria and too much light kills neutrophils and damages host tissue as well as bacteria and allows bacteria to grow unimpeded by host defense.


Assuntos
Artrite Experimental/tratamento farmacológico , Artrite Infecciosa/tratamento farmacológico , Éter de Diematoporfirina/uso terapêutico , Fotorradiação com Hematoporfirina , Articulação do Joelho/patologia , Staphylococcus aureus Resistente à Meticilina , Neutrófilos/metabolismo , Fármacos Fotossensibilizantes/uso terapêutico , Infecções Estafilocócicas/tratamento farmacológico , Animais , Artrite Experimental/imunologia , Artrite Experimental/radioterapia , Artrite Infecciosa/imunologia , Artrite Infecciosa/radioterapia , Éter de Diematoporfirina/administração & dosagem , Relação Dose-Resposta à Radiação , Esquema de Medicação , Injeções Intra-Articulares , Articulação do Joelho/imunologia , Lasers Semicondutores/uso terapêutico , Leucócitos/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Fármacos Fotossensibilizantes/administração & dosagem , Infecções Estafilocócicas/imunologia , Infecções Estafilocócicas/radioterapia , Líquido Sinovial/imunologia , Líquido Sinovial/microbiologia
6.
Mol Ther ; 17(1): 42-50, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18941443

RESUMO

Peripheral nerve injury occasionally causes chronic neuropathic pain with hyperalgesia and allodynia. However, its treatment is difficult. Here, we used a chronic constriction injury (CCI) model in rats to investigate the effects on experimental neuropathic pain of the human hepatocyte growth factor (HGF) gene delivered into the nervous system by retrograde axonal transport following its repeated intramuscular transfer, using liposomes containing the hemagglutinating virus of Japan (HVJ). CCI (control) rats exhibited marked mechanical allodynia and thermal hyperalgesia, and decreased blood flow in sciatic nerve and hind paw. All these changes were significantly reversed by HGF gene transfer. In the sciatic nerve in HGF-treated rats, the size-frequency distributions for myelinated and unmyelinated axons each showed a rightward shift, the number of myelinated axons >5 microm in diameter was significantly increased, and the mean diameter of unmyelinated axons was significantly increased (versus CCI rats). Levels of P2X3, P2X4, and P2Y1 receptor mRNAs, and of interleukin-6 (IL-6) and activating transcription factor 3 (ATF3) mRNAs, were elevated in the ipsilateral dorsal root ganglia and/or sciatic nerve by CCI, and these levels were decreased by HGF gene transfer. These results may point toward a potential new treatment strategy for chronic neuropathic pain in this model.


Assuntos
Hiperalgesia/terapia , Neuralgia/terapia , Fator 3 Ativador da Transcrição/genética , Animais , Vetores Genéticos , Fator de Crescimento de Hepatócito , Humanos , Hiperalgesia/metabolismo , Hiperalgesia/fisiopatologia , Interleucina-6/genética , Lipossomos , Masculino , Neuralgia/metabolismo , Neuralgia/fisiopatologia , Ratos , Ratos Wistar , Vírus Sendai/genética
7.
PLoS One ; 15(8): e0237156, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32780756

RESUMO

Ischemic neuropathy is common in subjects with critical limb ischemia, frequently causing chronic neuropathic pain. However, neuropathic pain caused by ischemia is hard to control despite the restoration of an adequate blood flow. Here, we used a rat model of ischemic-reperfusion nerve injury (IRI) to investigate possible effects of hepatocyte growth factor (HGF) against ischemic neuropathy. Hemagglutinating virus of Japan (HVJ) liposomes containing plasmids encoded with HGF was delivered into the peripheral nervous system by retrograde axonal transport following its repeated injections into the tibialis anterior muscle in the right hindlimb. First HGF gene transfer was done immediately after IRI, and repeated at 1, 2 and 3 weeks later. Rats with IRI exhibited pronounced mechanical allodynia and thermal hyperalgesia, decreased blood flow and skin temperature, and lowered thresholds of plantar stimuli in the hind paw. These were all significantly improved by HGF gene transfer, as also were sciatic nerve conduction velocity and muscle action potential amplitudes. Histologically, HGF gene transfer resulted in a significant increase of endoneurial microvessels in sciatic and tibial nerves and promoted nerve regeneration which were confirmed by morphometric analysis. Neovascularization was observed in the contralateral side of peripheral nerves as well. In addition, IRI elevated mRNA levels of P2X3 and P2Y1 receptors, and transient receptor potential vanilloid receptor subtype 1 (TRPV1) in sciatic nerves, dorsal root ganglia and spinal cord, and these elevated levels were inhibited by HGF gene transfer. In conclusion, HGF gene transfer is a potent candidate for treatment of acute ischemic neuropathy caused by reperfusion injury, because of robust angiogenesis and enhanced nerve regeneration.


Assuntos
Terapia Genética/métodos , Fator de Crescimento de Hepatócito/genética , Neuralgia/terapia , Traumatismo por Reperfusão/terapia , Animais , Modelos Animais de Doenças , Gânglios Espinais/metabolismo , Técnicas de Transferência de Genes , Vetores Genéticos , Fator de Crescimento de Hepatócito/metabolismo , Humanos , Hiperalgesia/metabolismo , Lipossomos/metabolismo , Masculino , Ratos , Ratos Wistar , Nervo Isquiático/metabolismo , Vírus Sendai/genética , Resultado do Tratamento
8.
Artif Organs ; 33(1): 74-7, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19178444

RESUMO

UV light irradiation to a photocrosslinkable chitosan (Az-CH-LA) resulted in an insoluble and flexible hydrogel within 30 s. The purpose of this study was to evaluate the ability of the photocrosslinkable chitosan to inhibit bone formation in the bone defects. A 5-mm-diameter defect was made in the rat calvarium, and then photocrosslinkable chitosan was implanted and irradiated with UV for 30 s. Furthermore, a 2-mm defect was made in the fibula of a rat hind leg, and then photocrosslinkable chitosan was implanted and irradiated with UV. Bone formations in the rat skull and fibula defects with photocrosslinkable chitosan hydrogel were significantly prevented for 8 weeks. Thus, the chitosan hydrogel has an inhibitory effect on bone formation.


Assuntos
Quitosana/farmacologia , Fíbula/efeitos dos fármacos , Hidrogéis/farmacologia , Osteogênese/efeitos dos fármacos , Crânio/efeitos dos fármacos , Animais , Quitosana/efeitos da radiação , Hidrogéis/efeitos da radiação , Masculino , Ratos , Ratos Sprague-Dawley , Raios Ultravioleta
9.
J Orthop Sci ; 14(6): 693-8, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19997814

RESUMO

OBJECTIVE: Of necessity, naval crews live in confined spaces when on board warships, which may lead to decreased bone mass and to subsequent bone fractures. Therefore, we investigated the bone mass of crew members and the relationship between bone mass and lifestyle factors. METHODS: We selected 1510 crew members of the Japan Maritime Self-Defense Force. All were men between 18 and 58 years of age. We measured their bone mass by applying quantitative ultrasound (QUS) to the calcaneus. In addition, we reviewed daily milk consumption, levels of physical exercise, type of on-board job, fracture history, nutritional supplementation habits, and body mass index (BMI). RESULTS: Bone mass values were lower than the published mean values for Japanese men across the twenties to forties age groups. CONCLUSIONS: The factors found to be related to bone mass in this study were age, type of on-board job, exercise level, and milk consumption. Lifestyle factors are usually within our control. Our data suggest that moderate levels of regular exercise and milk consumption may maintain bone mass.


Assuntos
Densidade Óssea , Doenças Ósseas Metabólicas/etiologia , Calcâneo/diagnóstico por imagem , Comportamento Alimentar , Estilo de Vida , Militares , Adolescente , Adulto , Doenças Ósseas Metabólicas/diagnóstico , Laticínios , Inquéritos sobre Dietas , Exercício Físico , Humanos , Masculino , Pessoa de Meia-Idade , Navios , Ultrassonografia , Adulto Jovem
10.
J Pediatr Orthop B ; 17(3): 145-7, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18391814

RESUMO

Although the growth of the proximal epiphysis of the humerus is thought to contribute 80% of the total increase in humeral length, few articles have provided evidence for this. A 9-year-old boy with a pathological fracture at the humeral neck, owing to a solitary bone cyst, was treated by the decompression method using cannulated screws for 7.5 years. During this period, we measured the longitudinal humeral bone growth. The value obtained for the longitudinal growth contribution of the proximal humerus was 88% in this particular case.


Assuntos
Cistos Ósseos/complicações , Cistos Ósseos/cirurgia , Parafusos Ósseos , Fraturas Espontâneas/etiologia , Úmero/crescimento & desenvolvimento , Úmero/cirurgia , Fraturas do Ombro/etiologia , Cistos Ósseos/etiologia , Criança , Humanos , Masculino
11.
Inj Epidemiol ; 5(1): 19, 2018 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-29713920

RESUMO

BACKGROUND: The epidemiological patterns of musculoskeletal injuries or disorders in military personnel have not been well documented and a better understanding is required for proper preventative measures and treatment. Here, we investigated musculoskeletal injuries or disorders among members of the Japan Self-Defense Forces. METHODS: All orthopedic patients (n = 22,340) who consulted to Japan Self-Defense Forces Hospitals were investigated for their type of injury or disorder, the injured body part, the mechanism, and the cause of injuries. RESULTS: Thirty-nine percent of the cases were classified as traumatic injuries, and 61% were classified as non-traumatic disorders. Of the traumatic injury patients, the injured body part was the upper extremity in 32%, the trunk in 23%, and the lower extremities in 45% of the cases. The most common injured body location was the knee followed by the hand/finger and ankle. Exercise was the most common cause of injury, followed by traffic accident and military training. Contusions were the most common traumatic injuries, followed by sprains and fractures. Of non-traumatic disorders, the lower extremities were reported as the injured part in 43% of the disorders. Lumbar spine disorders were the most common non-traumatic disorders, followed by tendon and joint disorders. CONCLUSIONS: Over one-third of orthopedic cases among members of the Japan Self-Defense Forces are traumatic injuries, with the knee being the body part most commonly injured and exercise being the leading cause of injury.

12.
Eur Spine J ; 16(12): 2072-7, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17726618

RESUMO

A total of 64 patients with cervical spondylotic myelopathy (CSM) were assessed in this study. Forty-two patients underwent selective expansive open-door laminoplasty (ELAP). Twenty-two patients who underwent conventional C3-7 ELAP served as controls. There were no significant differences in recovery rate of JOA scores, C2-C7 angle or cervical range of motion between two groups. Incidence of axial symptoms and segmental motor paralysis in selective ELAP was significantly lower than those in the C3-7 ELAP. Size of anterior compression mass, postoperative spinal cord positions and decompression conditions were evaluated using preoperative or postoperative MRI in 50 of 64 patients. There was a positive correlation between number of expanded laminae and maximum anterior spaces of spinal cord. Incomplete decompression was developed in three of 37 patients in selective ELAP and in two of 13 patients in C3-7ELAP. Mean size of anterior compression mass at incomplete decompression levels was significantly greater than that at complete decompression levels. Since, there was less posterior movement of the spinal cord in selective ELAP than that in C3-7ELAP, minute concerns about size of anterior compression mass is necessary to decide the number of expanded laminae. Overall, selective ELAP was less invasive and useful in reducing axial symptoms and segmental motor paralysis. This new surgical strategy was effective in improving the surgical outcomes of CSM, and short-term results were satisfactory.


Assuntos
Vértebras Cervicais/cirurgia , Descompressão Cirúrgica/métodos , Laminectomia/métodos , Compressão da Medula Espinal/cirurgia , Fusão Vertebral/métodos , Osteofitose Vertebral/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/patologia , Estudos de Coortes , Descompressão Cirúrgica/instrumentação , Descompressão Cirúrgica/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Laminectomia/instrumentação , Laminectomia/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Paralisia/etiologia , Paralisia/prevenção & controle , Paralisia/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/prevenção & controle , Radiografia , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , Medula Espinal/patologia , Medula Espinal/cirurgia , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/fisiopatologia , Fusão Vertebral/instrumentação , Fusão Vertebral/estatística & dados numéricos , Osteofitose Vertebral/diagnóstico por imagem , Osteofitose Vertebral/patologia , Resultado do Tratamento
13.
J Neurosurg Spine ; 6(6): 574-8, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17561749

RESUMO

The authors report a case of spontaneous resorption of intradural disc material in a patient with recurrent intradural lumbar disc herniation and review magnetic resonance (MR) imaging and histopathological findings. Intradural lumbar disc herniation is rare, and most patients with this condition require surgical intervention due to severe leg pain and vesicorectal disturbance. In the present case, however, the recurrent intradural herniated mass had completely disappeared by 9 months after onset. Histological examination of intradural herniated disc tissue demonstrated infiltrated macrophages and angiogenesis within the herniated tissue, and Gd-enhanced MR images showed rim enhancement not only at the initial presentation, but also at recurrence. The authors conclude that when rim enhancement is present on Gd-enhanced MR images, there is a possibility of spontaneous resorption even though the herniated mass may be located within the intradural space. Moreover, when radiculopathy is controllable and cauda equina syndrome is absent, conservative therapy can be selected.


Assuntos
Reabsorção Óssea , Dura-Máter/fisiopatologia , Deslocamento do Disco Intervertebral/fisiopatologia , Deslocamento do Disco Intervertebral/cirurgia , Disco Intervertebral/fisiopatologia , Vértebras Lombares , Idoso , Feminino , Humanos , Deslocamento do Disco Intervertebral/diagnóstico , Deslocamento do Disco Intervertebral/patologia , Imageamento por Ressonância Magnética , Recidiva , Remissão Espontânea
14.
Knee ; 14(1): 59-62, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17169564

RESUMO

Periprosthetic supracondylar femoral fractures after total knee arthroplasty (TKA) are difficult surgical problems. We report a case of an 84-year-old female, in which an original method was applied to treat a periprosthetic supracondylar femoral nonunion just proximal a femoral component. The new method features extending the stem of the femoral component with a Küntcher nail. Eventually bony union was obtained and the patient is now able to walk without any support.


Assuntos
Artroplastia do Joelho , Pinos Ortopédicos , Fraturas do Fêmur/cirurgia , Fixação Interna de Fraturas/métodos , Acidentes por Quedas , Idoso de 80 Anos ou mais , Feminino , Humanos , Reoperação
15.
Orthop J Sports Med ; 5(9): 2325967117728684, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28989939

RESUMO

BACKGROUND: Shoulder rotational muscles act as dynamic stabilizers of the glenohumeral joint, and the recovery of muscle strength plays an important role in stabilizing the joint during postoperative rehabilitation. However, temporal changes in muscle strength after arthroscopic Bankart repair have not been clarified. PURPOSE: To better understand the temporal recovery of shoulder rotational muscle strength after arthroscopic Bankart repair. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Isokinetic concentric shoulder rotational muscle strength was evaluated in 50 patients who were diagnosed with recurrent dislocations of the glenohumeral joint and treated with arthroscopic Bankart repair. RESULTS: The mean peak torque/weight and total work were reduced significantly at 1.5 months after surgery (P < .0001) and returned to preoperative levels by 6 months for external rotation and 4.5 months for internal rotation. The contralateral peak torque ratios reached preoperative levels by 6 months after surgery. The ipsilateral peak torque ratios were reduced between 1.5 and 3 months after surgery and returned to preoperative levels at 6 months for external rotation and 4.5 months for internal rotation. CONCLUSION: Isokinetic shoulder rotational muscle strength after arthroscopic Bankart repair recovered to preoperative levels by 6 months for external rotation and 4.5 months for internal rotation.

16.
Clin Spine Surg ; 30(7): 301-307, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28746125

RESUMO

STUDY DESIGN: Comparative biomechanical study by finite element (FE) method. OBJECTIVE: To investigate the pullout strength of pedicle screws using different insertional trajectories. SUMMARY OF BACKGROUND DATA: Pedicle screw fixation has become the gold standard for spinal fusion, however, not much has been done to clarify how the fixation strength of pedicle screws are affected by insertional trajectories and bone properties. MATERIALS AND METHODS: Three-dimensional FE models of 20 L4 vertebrae were constructed from the computed tomographic data. Five different transpedicular trajectories were compared: the traditional trajectory, the vertical trajectory, and the 3 lateral trajectories with different sagittal directions (caudal, parallel, cranial). For a valid comparison, screws of the same shape and size were inserted into the same pedicle in each subject, and the pullout strength were compared with nonlinear FE analyses. In addition, the pullout strength was correlated with bone mineral density (BMD). RESULTS: The mean pullout strength showed a 3.9% increase for the vertical trajectory relative to the traditional trajectory, 6.1% for the lateral-caudal trajectory, 21.1% for the lateral-parallel trajectory, and 34.7% for the lateral-cranial trajectory. The lateral-cranial trajectory demonstrated the highest value among all trajectories (P<0.001). In each trajectory, the correlation coefficient between the pullout strength and BMD of the femoral neck (r=0.74-0.83, P<0.01) was higher than the mean BMD of all the lumbar vertebrae (r=0.49-0.75, P<0.01), BMD of the L4 vertebra (r=0.39-0.64, P<0.01), and regional BMD of the L4 pedicle (r=0.53-0.76, P<0.01). CONCLUSIONS: Regional variation in the vertebral bone density and the amount of denser bone-screw interface contribute to the differences of stiffness among different screw trajectories. BMD of the femoral neck is considered to be a better objective predictor of pedicle screw stability than that of the lumbar vertebra.


Assuntos
Análise de Elementos Finitos , Parafusos Pediculares , Adulto , Idoso , Idoso de 80 Anos ou mais , Fenômenos Biomecânicos , Densidade Óssea , Osso Cortical/diagnóstico por imagem , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Adulto Jovem
17.
Clin Spine Surg ; 30(5): E497-E504, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28525468

RESUMO

STUDY DESIGN: A morphometric measurement of new thoracic pedicle screw trajectory using computed tomography and a biomechanical study on cadaveric thoracic vertebrae using insertional torque. OBJECTIVE: To introduce a new thoracic pedicle screw trajectory which maximizes engagement with denser bone. SUMMARY OF BACKGROUND DATA: Cortical bone trajectory (CBT) which maximizes the thread contact with cortical bone provides enhanced screw purchase. Despite the increased use of CBT screws in the lumbar spine, no study has yet reported the insertional technique for thoracic CBT. METHODS: First, the computed tomography scans of 50 adults were studied for morphometric measurement of lower thoracic CBT. The starting point was determined to be the intersection of the lateral two thirds of the superior articular process and the inferior border of the transverse process. The trajectory was straight forward in the axial plane angulated cranially targeting the posterior third of the superior endplate. The maximum diameter, length, and the cephalad angle were investigated. Next, the insertional torque of pedicle screws using this new technique was measured and compared with that of the traditional technique on 24 cadaveric thoracic vertebrae. RESULTS: All morphometric parameters of thoracic CBT increased from T9 to T12 (the mean diameter: from 5.8 mm at T9 to 8.5 mm at T12; the length: from 29.7 mm at T9 to 32.0 mm at T12; and the cephalad angle: from 21.4 degrees at T9 to 27.6 degrees at T12). The mean maximum insertional torque of CBT screws and traditional screws were 1.02±0.25 and 0.66±0.15 Nm, respectively. The new technique demonstrated average 53.8% higher torque than the traditional technique (P<0.01). CONCLUSIONS: The detailed morphometric measurement and favorable screw fixation stability of thoracic CBT are reported. The insertional torque using thoracic CBT technique was 53.8% higher than that of the traditional technique.


Assuntos
Osso Cortical/cirurgia , Parafusos Pediculares , Vértebras Torácicas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Osso Cortical/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vértebras Torácicas/diagnóstico por imagem , Torque
18.
Diabetes ; 54(3): 846-54, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15734864

RESUMO

Peripheral neuropathy is common and ultimately accounts for significant morbidity in diabetes. Recently, several neurotrophic factors have been used to prevent progression of diabetic neuropathy. In this study, we gave repeated intramuscular injections of the human hepatocyte growth factor (HGF) gene percutaneously, using liposomes containing the hemagglutinating virus of Japan (HVJ), to examine therapeutic efficacy of nonviral gene transfer of HGF for experimental diabetic sensorimotor neuropathy in rats. Experimental diabetes induced by intraperitoneal injection of streptozotocin resulted in a marked tactile allodynia (but not in a thermal hyperalgesia), in a reduction of both the conduction velocity and the amplitude, and in a decreased laser Doppler flux of the nerve and the muscle at 6 weeks after the induction. All these changes were significantly reversed by repeated gene transfer of HGF. Furthermore, we analyzed the density of endoneurial capillaries and morphometrical changes of the nerve. The density of endoneurial capillaries, disclosing marked reduction in diabetic rats, was also reversed significantly by repeated gene transfer of HGF; however, no considerable differences were observed morphometrically in either myelinated or unmyelinated axons. These results suggest that nonviral HVJ liposome-mediated gene transfer of human HGF has potential for the safe effective treatment of diabetic sensorimotor neuropathy.


Assuntos
Neuropatias Diabéticas/terapia , Técnicas de Transferência de Genes , Terapia Genética/métodos , Fator de Crescimento de Hepatócito/genética , Animais , Neuropatias Diabéticas/patologia , Neuropatias Diabéticas/fisiopatologia , Expressão Gênica/fisiologia , Vetores Genéticos , Fator de Crescimento de Hepatócito/biossíntese , Humanos , Lipossomos , Masculino , Condução Nervosa , Ratos , Ratos Wistar , Nervo Isquiático/patologia , Vírus Sendai
19.
J Orthop Res ; 24(7): 1521-34, 2006 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16705720

RESUMO

The reason that the anterior cruciate ligament (ACL) has a very poor healing potential after injury is not well understood. In this study, we investigated the role of nitric oxide (NO) in the apoptotic cell death of ACL cells using a rabbit model and in vitro cell culture. The apoptosis of ACL cells in vivo was analyzed by TUNEL assay and electron microscopy. NO synthase (NOS) expression was observed by immunohistochemical analysis. ACL cells were cultured and the susceptibility to NO-induced apoptosis was tested. Inducible NOS (iNOS) expression after treatment with cytokines was examined by immunohistochemical and RT-PCR analyses. Mitogen-activated protein kinase (MAPK) inhibitors were used for the analysis of downstream signals. A significant number of apoptotic cells were observed on days 1 to 3 after injury; the apoptotic rate returned to the control level by day 7. Upregulation of iNOS in the ACL remnant was observed at day 1. Intraarticular injection of NOS inhibitor suppressed the apoptotic rate. Isolated ACL cells showed much higher susceptibility to NO-induced apoptosis than did medial collateral ligament cells. IL-1beta stimulated ACL cells to upregulate iNOS mRNA and increase NO production. p38 MAPK inhibitor decreased NO-induced apoptosis. Rapid iNOS induction after injury contributes to the high apoptotic rate of ACL cells, and this may partly account for the poor healing capacity of this ligament. iNOS and NO production is suggested to be stimulated by IL-1beta, and NO activates the p38 MAPK pathway and triggers an apoptotic signal in ACL cells.


Assuntos
Ligamento Cruzado Anterior/fisiopatologia , Apoptose/fisiologia , Traumatismos do Joelho/fisiopatologia , Óxido Nítrico Sintase Tipo II/metabolismo , Animais , Ligamento Cruzado Anterior/citologia , Ligamento Cruzado Anterior/metabolismo , Lesões do Ligamento Cruzado Anterior , Modelos Animais de Doenças , Fibroblastos/fisiologia , Humanos , Interleucina-1/fisiologia , Traumatismos do Joelho/metabolismo , Ligamento Colateral Médio do Joelho/citologia , Ligamento Colateral Médio do Joelho/fisiologia , Óxido Nítrico/fisiologia , Coelhos , Regulação para Cima , Proteínas Quinases p38 Ativadas por Mitógeno/fisiologia
20.
J Biomed Mater Res B Appl Biomater ; 79(1): 25-34, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16506181

RESUMO

Adipose tissue derived stromal cells (ATSCs), which were isolated from adipose tissue of rabbit, have shown to possess multipotential, that is, they differentiate into osteoblasts and adipocytes in plate-culturing and into chondrocytes in an established aggregate culture using defined differentiation-inductive medium. The aim of this study was to evaluate the utility of ATSCs in tissue engineering procedures for repair of articular cartilage-defects using the atelocollagen honeycomb-shaped scaffold with a membrane sealing (ACHMS-scaffold). We intended to repair full-thickness articular cartilage defects in rabbit knees using autologously cultured ATSCs embedded in the ACHMS-scaffold. ATSCs were incubated within the ACHMS-scaffold to allow a high density and three-dimensional culture with control medium. An articular cartilage defect was created on the patellar groove of the femur, and the defect was filled with the ATSCs-containing ACHMS-scaffold, ACHMS-scaffold alone, or empty (control). Twelve weeks after the operation, the histological analyses showed that only the defects treated with the ATSCs-containing ACHMS-scaffold were filled with reparative hyaline cartilage, highly expressed Type II collagen. These results indicate that transplantation of autologous ATSCs-containing ACHMS-scaffold is effective in repairing articular cartilage defects.


Assuntos
Tecido Adiposo/citologia , Cartilagem Articular , Colágeno , Engenharia Tecidual , Animais , Técnicas de Cultura de Células , Células Cultivadas , Masculino , Coelhos , Regeneração/fisiologia , Células Estromais
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