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1.
Trends Plant Sci ; 2024 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-39395880

RESUMO

Volatile organic compounds (VOCs) are essential airborne mediators of interactions between plants. These plant-plant interactions require sophisticated VOC-sensing mechanisms that enable plants to regulate their defenses against pests. However, these interactions are not limited to specific plants or even conspecifics, and can function in very flexible interactions between plants. Sensing and responding to VOCs in plants is finely controlled by their uptake and transport systems as well as by cellular signaling via, for example, chromatin remodeling system-based transcriptional regulation for defense gene activation. Based on the accumulated knowledge about the interactions between plants and their major VOCs, companion plants and biostimulants are being developed for practical applications in agricultural and horticultural pest control, providing a sustainable alternative to harmful chemicals.

2.
J Plant Res ; 2024 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-39419929

RESUMO

Plants defend themselves against herbivores by recognizing herbivore-derived elicitors and activating intracellular signaling. In Arabidopsis, the receptor-like kinase HAK1 recognizes the poly-saccharide elicitor (FrA) from Spodoptera litura larvae, leading to the expression of defense-related genes such as PDF1.2. During this process, the cytoplasmic kinase CRK2 phosphorylates PBL27, triggers the ERF13 expression via ethylene signaling and subsequently leads to PDF1.2 expression. Herein, we investigated four cytoplasmic kinases from the same receptor-like cytoplasmic kinase (RLCK) VII family as PBL27 that interacts with CRK2. Among them, PBL11, like PBL27, is phosphorylated by CRK2 and induces PDF1.2 expression but does not affect ERF13 expression. The weight gain of S. litura larvae on PBL11-deficient mutant plants was only slightly higher than that of wild-type plants, suggesting that PBL11 may function as a minor RLCK that supports the defense response.

3.
Cureus ; 16(7): e65365, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39184636

RESUMO

Acute traumatic dislocation without fractures of the thumb carpometacarpal (CMC) joint is extremely rare in children. Treatment options, such as closed reduction with casting or pinning and open reduction with primary ligament repair, remain controversial. Here, we report the first case of an 11-year-old boy with recurrent left thumb CMC joint dislocation due to idiopathic generalized hyperjoint laxity, even after primary open reduction with capsular ligament repair of the thumb CMC joint, eventually treated with Eaton-Littler's ligament reconstruction. Intraoperatively, a drill hole was made in the base of the first metacarpal bone while carefully preventing growth plate injury. Primary ligament reconstruction of the thumb CMC joint may be considered in pediatric cases with systemic hyperjoint laxity or recurrent thumb CMC joint dislocation. In such cases, Eaton-Littler's ligament reconstruction is recommended for thumb CMC joint stability because two prime stabilizers of the dorsoradial ligament and the volar anterior oblique ligament (AOL) are appropriately reconstructed by a half-slip of the flexor carpi radialis tendon.

4.
Immunology ; 173(1): 76-92, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38720202

RESUMO

Our newly developed menthyl esters of valine and isoleucine exhibit anti-inflammatory properties beyond those of the well-known menthol in macrophages stimulated by lipopolysaccharide (LPS) and in a mouse model of colitis induced by sodium dextran sulfate. Unlike menthol, which acts primarily through the cold-sensitive TRPM8 channel, these menthyl esters displayed unique mechanisms that operate independently of this receptor. They readily penetrated target cells and efficiently suppressed LPS-stimulated tumour necrosis factor-alpha (Tnf) expression mediated by liver X receptor (LXR), a key nuclear receptor that regulates intracellular cholesterol and lipid balance. The menthyl esters showed affinity for LXR and enhanced the transcriptional activity through their non-competitive and potentially synergistic agonistic effect. This effect can be attributed to the crucial involvement of SCD1, an enzyme regulated by LXR, which is central to lipid metabolism and plays a key role in the anti-inflammatory response. In addition, we discovered that the menthyl esters showed remarkable efficacy in suppressing adipogenesis in 3T3-L1 adipocytes at the mitotic clonal expansion stage in an LXR-independent manner as well as in mice subjected to diet-induced obesity. These multiple capabilities of our compounds establish them as formidable allies in the fight against inflammation and obesity, paving the way for a range of potential therapeutic applications.


Assuntos
Anti-Inflamatórios , Fármacos Antiobesidade , Receptores X do Fígado , Obesidade , Animais , Camundongos , Obesidade/tratamento farmacológico , Obesidade/metabolismo , Receptores X do Fígado/metabolismo , Receptores X do Fígado/agonistas , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/uso terapêutico , Fármacos Antiobesidade/farmacologia , Fármacos Antiobesidade/uso terapêutico , Adipogenia/efeitos dos fármacos , Ésteres/química , Colite/tratamento farmacológico , Colite/induzido quimicamente , Colite/metabolismo , Humanos , Mentol/farmacologia , Camundongos Endogâmicos C57BL , Lipopolissacarídeos , Fator de Necrose Tumoral alfa/metabolismo , Células 3T3-L1 , Sulfato de Dextrana , Adipócitos/metabolismo , Adipócitos/efeitos dos fármacos , Macrófagos/imunologia , Macrófagos/metabolismo , Macrófagos/efeitos dos fármacos , Canais de Cátion TRPM/metabolismo
5.
Clin Neurol Neurosurg ; 236: 108051, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37995621

RESUMO

PURPOSE: To repair peripheral nerve defects and seek alternatives for autografts, nerve conduits with various growth factors and cells have been invented. Few pieces of literature report the effect of nerve conduits plus platelet-rich fibrin (PRF). This study aimed to investigate the effectiveness of nerve conduits filled with PRF. METHODS: The model of a 10 mm sciatic nerve gap in a rat was used to evaluate peripheral nerve regeneration. The thirty rats were randomly divided into one of the following three groups (n = 10 per group). Autogenous nerve grafts (autograft group), conduits filled with phosphate-buffered saline (PBS) (PBS group), or conduits filled with PRF group (PRF group). We assessed motor and sensory functions for the three groups at 4, 8, and 12 weeks postoperatively. In addition, axon numbers were measured 12 weeks after repair of the peripheral nerve gaps. RESULTS: Significant differences in motor function were observed between the autograft group and the other two groups at 12 weeks postoperatively. In the test to evaluate the recovery of sensory function, there were significant differences between the PBS group and the other two groups at all time points. The most axon number was found in the autograft group. The axon number of the PRF group was significantly more extensive than that of the PBS group. CONCLUSIONS: The nerve conduit filled with PRF promoted the axon regeneration of the sciatic nerve and improved sensory function.


Assuntos
Implantes Absorvíveis , Fibrina Rica em Plaquetas , Ratos , Humanos , Animais , Axônios , Regeneração Nervosa/fisiologia , Nervo Isquiático/cirurgia
6.
J Hand Microsurg ; 15(5): 395-398, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38152678

RESUMO

Isolated injury to the deep motor branch of the ulnar nerve caused by stabbing is sporadic, with only one reported case in the English-language literature. We report one such case treated successfully using nerve grafting. A 33-year-old patient had sustained a stab wound to the right hypothenar eminence and showed a claw hand deformity. Needle electromyography study revealed denervation potentials with no voluntary motor unit action potentials (MUAPs) in the first dorsal interosseous (FDI) muscles. Nerve exploration revealed a neuroma-in-continuity in the intrinsic motor branch of the ulnar nerve. Intraoperative nerve stimulation confirmed the absence of compound muscle action potentials in the FDI. The damaged scarred nerve was resected, and the 15-mm defects were reconstructed with cable autografting. Two years and 5 months after the surgery, voluntary MUAPs were observed in the FDI. The pinch strengths recovered. Laceration of the deep branch of the ulnar nerve caused by stabbing can sometimes remain hidden as the hand sensation remains intact. Pre- and intraoperative electrophysiological examination is essential to assess the severity of the injured nerve and determine an appropriate surgical option. Even nerve grafting can facilitate satisfactory results as target intrinsic muscles are quite close to the repair site.

7.
Nat Commun ; 14(1): 6236, 2023 10 17.
Artigo em Inglês | MEDLINE | ID: mdl-37848440

RESUMO

Plants perceive volatile organic compounds (VOCs) released by mechanically- or herbivore-damaged neighboring plants and induce various defense responses. Such interplant communication protects plants from environmental threats. However, the spatiotemporal dynamics of VOC sensory transduction in plants remain largely unknown. Using a wide-field real-time imaging method, we visualize an increase in cytosolic Ca2+ concentration ([Ca2+]cyt) in Arabidopsis leaves following exposure to VOCs emitted by injured plants. We identify two green leaf volatiles (GLVs), (Z)-3-hexenal (Z-3-HAL) and (E)-2-hexenal (E-2-HAL), which increase [Ca2+]cyt in Arabidopsis. These volatiles trigger the expression of biotic and abiotic stress-responsive genes in a Ca2+-dependent manner. Tissue-specific high-resolution Ca2+ imaging and stomatal mutant analysis reveal that [Ca2+]cyt increases instantly in guard cells and subsequently in mesophyll cells upon Z-3-HAL exposure. These results suggest that GLVs in the atmosphere are rapidly taken up by the inner tissues via stomata, leading to [Ca2+]cyt increases and subsequent defense responses in Arabidopsis leaves.


Assuntos
Arabidopsis , Compostos Orgânicos Voláteis , Arabidopsis/genética , Arabidopsis/metabolismo , Cálcio/metabolismo , Citosol/metabolismo , Folhas de Planta/metabolismo , Plantas/metabolismo , Compostos Orgânicos Voláteis/metabolismo
8.
J Plast Reconstr Aesthet Surg ; 84: 107-114, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37327733

RESUMO

BACKGROUND: Dexmedetomidine (DEX) provides a unique conscious sedation without respiratory depression. We examined the usefulness of intravenous (IV) DEX sedation combined with brachial plexus block for long-duration upper extremity surgery without an anesthesiologist. METHODS: We retrospectively reviewed 90 limbs of 86 patients and measured the actual operative time course in detail. The adverse events and the patient-reported outcomes regarding intraoperative pain and depth of sedation were evaluated. RESULTS: The mean total time of the operation, tourniquet use, and the IV DEX sedation were 150 min, 132 min, and 117 min, respectively. The mean time between discontinuation of IV DEX sedation and completion of the operation was 51 min. The intraoperative adverse events involved bradycardia (21%), hypotension (18%), and oxygen desaturation (3%). The mean visual analog scale scores of pain during brachial plexus block, surgical site pain, tourniquet pain, and depth of the sedation were 23.4 mm, 0.14 mm, 4.2 mm, and 6.6 mm, respectively. Furthermore, 96% patients expressed a preference for receiving anesthesia as brachial plexus block with IV DEX sedation. CONCLUSIONS: Long-duration upper extremity surgery, even longer than 2 h, was feasible under brachial plexus block combined with IV DEX sedation without an anesthesiologist. For patients with low blood pressure and/or low heart rate, it is recommended to adjust the continuous infusion of IV DEX to less than 0.4 µg/kg/h. To ensure that the patients are able to promptly leave the operating room fully awake, IV DEX infusion should be stopped at least 30 min before finishing the operation.


Assuntos
Anestesia , Bloqueio do Plexo Braquial , Dexmedetomidina , Humanos , Dexmedetomidina/efeitos adversos , Anestesiologistas , Estudos Retrospectivos , Dor , Extremidade Superior/cirurgia
9.
Plants (Basel) ; 12(9)2023 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-37176805

RESUMO

Plants defend against folivores by responding to folivore-derived elicitors following activation of signaling cascade networks. In Arabidopsis, HAK1, a receptor-like kinase, responds to polysaccharide elicitors (Frα) that are present in oral secretions of Spodoptera litura larvae to upregulate defense genes (e.g., PDF1.2) mediated through downstream cytoplasmic kinase PBL27. Here, we explored whether other protein kinases, including CPKs and CRKs, function with PBL27 in the intracellular signaling network for anti-herbivore responses. We showed that CRK2 and CRK3 were found to interact with PBL27, but CPKs did not. Although transcripts of PDF1.2 were upregulated in leaves of wild-type Arabidopsis plants in response to mechanical damage with Frα, this failed in CRK2- and PBL27-deficient mutant plants, indicating that the CRK2/PBL27 system is predominantly responsible for the Frα-responsive transcription of PDF1.2 in S. litura-damaged plants. In addition to CRK2-phosphorylated ERF13, as shown previously, ethylene signaling in connection to CRK2-phosphorylated PBL27 was predicted to be responsible for transcriptional regulation of a gene for ethylene response factor 13 (ERF13). Taken together, these findings show that CRK2 regulates not only ERF13 phosphorylation but also PBL27-dependent de novo synthesis of ERF13, thus determining active defense traits against S. litura larvae via transcriptional regulation of PDF1.2.

11.
Indian J Orthop ; 57(2): 253-261, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36777116

RESUMO

Background: We surgically treated comminuted radial head and neck fractures using headless compression screws, including multiple screws for the radial head and a single oblique screw for the radial neck. This study aimed to compare the clinical and radiological results for comminuted radial head and neck fractures between surgery using headless compression screws with a single oblique screw for the radial neck, our new procedure, and a plate system precontoured to the proximal radius. Methods: This retrospective study included 23 patients (11 and 12 in the screw and plate groups, respectively). The fractures were type 3 according to the Mason-Johnston classification modified by Broberg and Morrey. Clinical outcomes analyzed included the motion range of the elbow and forearm, Mayo Elbow Performance Score, and radiological assessments. In addition, postoperative complications were also investigated. The average follow-up was 18 months. Results: The bone union was achieved in all the patients, and there were no significant differences in clinical outcomes and radiological assessments except forearm supination (p = 0.02). Furthermore, additional surgical procedures were performed in one and five patients in the screw and plate groups, respectively (p = 0.16). Posterior nerve palsy was observed in two patients in the plate group. Complications were observed in one and six patients in the screw and plate groups, respectively (p = 0.07). Conclusion: Both surgical procedures achieved good clinical and radiological outcomes with bone and ligament injury repair. The screw group had a greater range of forearm supination than the plate group.

12.
Microsurgery ; 43(5): 507-511, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36756760

RESUMO

Postprocedural peroneal nerve palsy after endovenous laser ablation (EVLA) for varicose veins is rare and is associated with poor functional recovery. There have been no reports using tibial nerve transfer for iatrogenic peroneal nerve palsy after EVLA. Herein, we present a case with peroneal nerve injury after EVLA, which was successfully treated by partial tibial nerve transfer for the first time. A 75-year-old female presented with a right foot drop immediately after EVLA of the lesser saphenous vein. The ankle and toe dorsiflexion had a muscle grade of M0 on the British Medical Research Council muscle scale, without voluntary motor unit action potentials (MUAP) in the tibialis anterior (TA) muscle on the needle electromyography. Three months after the injury, surgical nerve exploration revealed a damaged common peroneal nerve with discoloration and scarring at the fibular head. Intraoperative deep peroneal nerve stimulation confirmed the absence of compound muscle action potentials in the TA. The best functioning motor fascicles of the tibial nerve were transferred to the deep peroneal main trunk involving motor branches of the TA, extensor digitorum longus, and extensor hallucis longus (EHL) through the interosseous membrane. The postoperative course was uneventful, with no complications. After 3 months of surgery, nascent MUAP appeared in the TA. After 24 months, the patient regained the TA and EHL muscle function and ambulation without an ankle-foot orthosis and tibial nerve deficits. Thus, our procedure may serve as an alternative to nerve grafting, tendon transfer, and orthoses for better management of the major neural complications associated with EVLA.


Assuntos
Terapia a Laser , Transferência de Nervo , Neuropatias Fibulares , Varizes , Feminino , Humanos , Idoso , Transferência de Nervo/métodos , Neuropatias Fibulares/etiologia , Neuropatias Fibulares/cirurgia , Nervo Fibular/cirurgia , Extremidade Inferior , Nervo Tibial/cirurgia , Terapia a Laser/efeitos adversos , Paralisia/cirurgia , Varizes/cirurgia , Doença Iatrogênica
14.
J Reconstr Microsurg ; 38(9): 711-720, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36122572

RESUMO

BACKGROUND: The treatment of painful neuroma remains challenging. Recently, a nerve-end capping technique using a bioabsorbable nerve conduit was newly introduced to treat amputation neuroma. A collagen-coated polyglycolic acid (PGA) conduit has been commercially available for the reconstruction of peripheral nerve defects, yielding successful clinical outcomes. However, no experimental research has been conducted using this PGA nerve conduit as capping device for treating amputation neuroma. The purpose of this study was to investigate nerve-end capping treatment with the PGA conduit in the rat sciatic nerve amputation model, focusing on histological scar formation and neuroinflammation. METHODS: Forty-seven rats were divided into two groups: no capping (transected nerve stump without capping; n = 25) and capping (nerve-end capping with collagen-coated PGA nerve conduit; n = 22). Twelve weeks after sciatic neurectomy, neuropathic pain was evaluated using the autotomy score. Stump neuromas were histologically evaluated or perineural scar and neuroinflammation. RESULTS: While autotomy scores gradually exacerbated in both groups, they were consistently lower in the capping group at 4, 8, and 12 weeks postprocedure. Twelve weeks after surgery, the transected nerve stumps in the no-capping group had formed macroscopic bulbous neuromas strongly adhering to surrounding tissues, whereas they remained wrapped with the PGA nerve conduits loosely adhering to surrounding tissues in the capping group. Histologically, distal axonal fibers were expanded radially and formed neuromas in the no-capping group, while they were terminated within the PGA conduit in the capping group. Perineural scars and neuroinflammation were widely found surrounding the randomly sprouting nerve end in the no-capping group. In capped counterparts, scars and inflammation were limited to closely around the terminated nerve end. CONCLUSION: Nerve-end capping with a collagen-coated PGA conduit after rat sciatic neurectomy might prevent neuroma formation by suppressing perineural scar formation and neuroinflammation around the nerve stump, potentially relieving neuropathic pain.


Assuntos
Neuralgia , Neuroma , Animais , Ratos , Cicatriz/patologia , Colágeno , Regeneração Nervosa/fisiologia , Neuroma/cirurgia , Ácido Poliglicólico , Nervo Isquiático/cirurgia , Nervo Isquiático/patologia
15.
Neurol Res ; 44(10): 937-945, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35574983

RESUMO

BACKGROUND AND AIMS: Intraoperative fluorescence angiography with indocyanine green or fluorescein is used in ophthalmology and neurosurgery. However, there are few reports on the use of fluorescence angiography for peripheral neuropathy. This study aimed to assess the validity of fluorescein angiography (FAG) for peripheral nerve entrapment neuropathy. METHODS: We used an established model of chronic nerve compression (CNC) neuropathy in C57BL/6 mice by entrapping their left sciatic nerve with a silastic tube. Mice were assigned to the uninjured group (control), two-week CNC neuropathy group, four-week CNC neuropathy group, or six-week CNC neuropathy group. We then performed FAG to assess neural blood flow and quantified the peak of the luminance at the compression site with luminance analysis software. Following FAG, histological examinations using an anti-fluorescein antibody and Masson's trichrome staining were performed to evaluate the area of fluorescein distribution and epineural fibrosis. RESULTS: The luminance in the CNC neuropathy groups was significantly lower than that in the control group. Histological analysis revealed the fluorescein positive areas in the CNC neuropathy groups were significantly smaller than that in the control group, and the epineural fibrosis areas in the CNC neuropathy groups were significantly larger than that in the control group. CONCLUSION: We observed a significant decline of luminance in the CNC neuropathy groups, and the histological assessment was consistent with this result. FAG was found to be a valid method for assessing CNC neuropathy in mice.


Assuntos
Verde de Indocianina , Síndromes de Compressão Nervosa , Animais , Artrogripose , Modelos Animais de Doenças , Fibrose , Fluoresceína , Angiofluoresceinografia/métodos , Neuropatia Hereditária Motora e Sensorial , Camundongos , Camundongos Endogâmicos C57BL , Síndromes de Compressão Nervosa/patologia
16.
Plant J ; 110(2): 470-481, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35061931

RESUMO

The nonexpressor of pathogenesis-related (NPR) gene family is well known to play a crucial role in transactivation of TGA transcription factors for salicylic acid (SA)-responsive genes, including pathogenesis-related protein 1 (PR1), during plants' immune response after pathogen attack in the model dicot Arabidopsis thaliana. However, little is known about NPR gene functions in monocots. We therefore explored the functions of NPRs in SA signaling in the model monocot Brachypodium distachyon. BdNPR1 and BdNPR2/3 share structural similarities with A. thaliana AtNPR1/2 and AtNPR3/4 subfamilies, respectively. The transcript level of BdNPR2 but not BdNPR1/3 appeared to be positively regulated in leaves in response to methyl salicylate. Reporter assays in protoplasts showed that BdNPR2 positively regulated BdTGA1-mediated activation of PR1. This transactivation occurred in an SA-dependent manner through SA binding at Arg468 of BdNPR2. In contrast, BdNPR1 functioned as a suppressor of BdNPR2/BdTGA1-mediated transcription of PR1. Collectively, our findings reveal that the TGA-promoted transcription of SA-inducible PR1 is orchestrated by the activator BdNPR2 and the repressor BdNPR1, which function competitively in B. distachyon.


Assuntos
Arabidopsis , Brachypodium , Arabidopsis/genética , Arabidopsis/metabolismo , Brachypodium/genética , Brachypodium/metabolismo , Regulação da Expressão Gênica de Plantas/genética , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Ácido Salicílico/metabolismo , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Ativação Transcricional/genética
18.
J Plast Surg Hand Surg ; 56(3): 167-171, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34324405

RESUMO

A number of outcome predictors for carpal tunnel release (CTR) for carpal tunnel syndrome (CTS) have been reported. However, some predictors are controversial, and few studies have referred to the early postoperative outcome prognostic factors after CTR. The aim of this study was to investigate whether pain and numbness at 1 month post-CTR were early postoperative predictors of clinical outcomes 6 months after surgery. Pain and numbness were evaluated using the visual analog scale (VAS) preoperatively and at 1 month post-surgery. Patient-reported outcome measures (PROMs), including the Quick Disabilities of the Arm, Shoulder and Hand (QDASH) measure, the Hand20 questionnaire and the Boston Carpal Tunnel Questionnaire (BCTQ), were recorded for each patient 6 months after surgery. The BCTQ consisted of the Symptom Severity Scale (SSS) and Functional Status Scale (FSS). Multivariable linear regression analysis was performed to investigate the association between the VAS scores and PROMs. We retrospectively identified 93 patients who underwent open carpal tunnel release (OCTR) or endoscopic carpal tunnel release. The mean age of the patients was 67.5 years, and 67 patients (72.0%) were female. Sixty patients were treated by OCTR (65.0%). With multivariable linear regression analysis, we found that pain and numbness, evaluated with VAS 1 month post-surgery had significant correlations with QDASH, Hand20, SSS and FSS 6 months after surgery. In conclusion, pain and numbness 1 month after CTR predict PROMs at 6 months.


Assuntos
Síndrome do Túnel Carpal , Idoso , Síndrome do Túnel Carpal/diagnóstico , Feminino , Humanos , Hipestesia/etiologia , Masculino , Dor , Medidas de Resultados Relatados pelo Paciente , Estudos Retrospectivos
19.
Orthopedics ; 45(1): e53-e56, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34734772

RESUMO

Arthrodesis and prosthetic arthroplasty have been used to treat severe proximal interphalangeal (PIP) joint arthritis. Silicone implant arthroplasty is an established treatment for rheumatoid arthritis (RA) of the fingers. However, few studies have reported the application of silicone implant arthroplasty for the treatment of severe ankylosis of the PIP joint in RA patients. The authors report, for the first time, the case of a 46-year-old woman who presented with severe bony ankylosis of the right fourth and fifth PIP joints at greater than 90° of flexion. Proximal interphalangeal silicone arthroplasty in combination with reconstruction of the extensor mechanism was successfully performed in the affected joints. Four years after surgery, active flexion of the fourth and fifth PIP joints was 55° and 75°, respectively, with an extensor lag of only 5° without pain and joint instability. Proper repair of the extensor mechanism with shortening of the central slips and mobilization of the lateral bands dorsally was most important in maintaining the extended position of the PIP joints. Proximal interphalangeal silicone arthroplasty with intensive reconstruction of the extensor mechanism could become a potential treatment option to maintain joint mobility even in severe ankylosis of the PIP joints in RA patients. [Orthopedics. 2022;45(1):e53-e56.].


Assuntos
Anquilose , Artrite Reumatoide , Artroplastia de Substituição de Dedo , Prótese Articular , Anquilose/diagnóstico por imagem , Anquilose/cirurgia , Artrite Reumatoide/complicações , Artrite Reumatoide/cirurgia , Artrodese , Artroplastia , Feminino , Articulações dos Dedos/diagnóstico por imagem , Articulações dos Dedos/cirurgia , Humanos , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Silicones , Resultado do Tratamento
20.
Clin Neurol Neurosurg ; 209: 106920, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34500341

RESUMO

BACKGROUND AND AIMS: Nerve capping treatment using bioabsorbable nerve conduits has recently been introduced for painful amputation neuroma. However, no clinical or experimental data are available for comparing nerve conduits with open distal ends and closed distal ends. Here, we investigated the nerve conduit with open or closed distal ends as the superior capping device, using a commercially available polyglycolic acid (PGA) nerve conduit in a rat sciatic nerve amputation model. METHODS: Ninety-one rats were assigned to three groups: no-capping (n = 30), capping the resected nerve stump with open ends (n = 31), and closed-end nerve conduits (n = 30). Twelve weeks after sciatic neurectomy, with or without capping, the evaluation of neuropathic pain using the autotomy score was performed. Stump neuromas with perineural scars and neuroinflammation were evaluated histologically. RESULTS: The mean autotomy scores in the closed-end nerve conduit group were significantly lower than those in the no-capping group. However, the difference between the open-end nerve conduit and the closed-end nerve conduit groups was insignificant. Histologically, distal axonal fibers expanded radially and formed neuromas in the no-capping group while they were terminated within the PGA conduit in both capping groups. In particular, the closed-end version of the PGA nerve conduit blocked scarring from intruding through the open end and protected the nerve stump with less neuroinflammation. Nerve capping with the closed-end version of the PGA nerve conduit most effectively suppressed perineural neuroinflammation and scar formation around the resected nerve stump. INTERPRETATION: Nerve capping with the PGA nerve conduit, particularly those with closed ends, after rat sciatic neurectomy prevented amputation neuroma and relieved neuropathic pain.


Assuntos
Implantes Absorvíveis , Amputação Cirúrgica/efeitos adversos , Neuralgia/cirurgia , Neuroma/cirurgia , Neoplasias do Sistema Nervoso Periférico/cirurgia , Nervo Isquiático/cirurgia , Animais , Masculino , Neuralgia/etiologia , Neuralgia/patologia , Neuroma/etiologia , Neuroma/patologia , Neoplasias do Sistema Nervoso Periférico/etiologia , Neoplasias do Sistema Nervoso Periférico/patologia , Ratos , Ratos Sprague-Dawley , Nervo Isquiático/patologia
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