Daily supplement of sesame oil prevents postmenopausal osteoporosis via maintaining serum estrogen and aromatase levels in rats.

Estrogen deficiency is one of the main causes of postmenopausal osteoporosis in elderly women. Hormone replacement therapy has been employed to manage postmenopausal osteoporosis; however, it has raised concerns related to heart attacks and breast cancer. Sesame oil has been reported to affect sex hormone status. The aim of the present study is to evaluate the effect of sesame oil supplement on postmenopausal osteoporosis in rats. We used female Sprague Dawley rats that underwent bilaterally ovariectomy (OVX) as an experimental postmenopausal osteoporosis animal model. These rats were orally administrated sesame oil (0.25 or 0.5 mL/kg/day) for four months as the therapeutic group. We assessed bone mineral density (BMD) and the levels of osteocalcin, procollagen-I C-terminal propeptide (PICP), collagen cross-linked N-telopeptide (NTx), estradiol, and aromatase in the sera. The daily supplementation of sesame oil significantly increased BMD, serum osteocalcin levels, and trabecular areas in the OVX-treated rats. Sesame oil also elevated serum PICP levels and decreased NTx levels in these rats. Furthermore, sesame oil effectively maintained serum estradiol and aromatase levels in the OVX-induced osteoporosis rats. In conclusion, daily supplementation of sesame oil prevents postmenopausal osteoporosis by maintaining serum estrogen and aromatase levels, while also modulating the imbalance between bone formation and resorption in osteoporosis rats.

A cost and efficacy analysis of performing arthroscopic excision of wrist ganglions under wide-awake anaesthesia versus general anaesthesia.

BACKGROUND: Arthroscopic excision has currently become popular for the treatment of wrist ganglions. The objective of this study was to evaluate the clinical outcomes and cost effectiveness of arthroscopic wrist ganglion excisions under Wide-Awake Local Anaesthesia No Tourniquet versus general anaesthesia. METHODS: We retrospectively reviewed patients who underwent arthroscopic ganglionectomy from April 2009 to October 2016 at our institute. They were separated into two groups according to anaesthesia techniques: general anaesthesia and Wide-Awake Local Anaesthesia No Tourniquet. We compared the clinical outcomes and cost-effectiveness of the two groups. RESULTS: Seventy-four patients were included. Both groups were matched with regard to the demographics and preoperative clinical assessments. We found no significant differences between groups in postoperative visual analog scale, modified Mayo wrist score, Disabilities of Arm, Shoulder and Hand score, recurrence, residual pain, or complications. Recurrence was found in five of 74 patients, one (4.3%) in the Wide-Awake Local Anaesthesia No Tourniquet group and four (7.8%) in the general anaesthesia group. One extensor tendon injury and four extensor tenosynovitis cases occurred in the general anaesthesia group. Regarding cost effectiveness, the mean operating time in the Wide-Awake Local Anaesthesia No Tourniquet and general anaesthesia groups were 88.7 ± 24.51 and 121.5 ± 25.75 min, respectively (p < 0.001). The average total costs of the Wide-Awake Local Anaesthesia No Tourniquet and general anaesthesia groups were €487.4 ± 89.15 and €878.7 ± 182.13, respectively (p < 0.001). CONCLUSIONS: For arthroscopic wrist ganglion resections, both anaesthesia techniques were effective and safe regarding recurrence rates, complications, and residual pain. The most important finding of this study was that arthroscopic ganglionectomy under Wide-Awake Local Anaesthesia No Tourniquet was superior to that under general anaesthesia for cost-effectiveness. LEVEL OF EVIDENCE: Level III, Retrospective comparative study.

Effects of a task-based biofeedback training program on improving sensorimotor function in neuropathic hands in diabetic patients: a randomized controlled trial.

BACKGROUND: Symptoms of diabetic hands have been gradually elucidated, however the interventions for these hand problems are typically underemphasized. Few studies have discussed intervention effects on sensorimotor problems in hands, which prevent diabetic patients from executing their daily routines and lower their quality of life (QoL). AIM: This study has investigated the effects of task-based biofeedback training compared with home-based programs on sensorimotor function and QoL in diabetic patients with neuropathic hands. DESIGN: A single blind randomized controlled trial. SETTING: Outpatient clinic at a university hospital. POPULATION: Thirty-eight patients with diabetic hand neuropathy whose sensorimotor functions were impaired based on screening with a pinch-holding-up activity (PHUA) test. METHODS: Participants were randomly assigned to either a computerized evaluation and re-education biofeedback (CERB) (N.=20) or a home-based (tendon gliding exercise in conjunction with resistive exercise) (N.=18) group. The primary outcome was sensorimotor control of a hand using the PHUA test. Secondary outcomes included changes in Semmes-Weinstein monofilament, two-point discrimination, the Purdue Pegboard test and a self-reported QoL questionnaire. The measurements were conducted before and after a 6-week treatment program. RESULTS: The CERB group significantly improved efficiency in pinch force output during the PHUA test by reducing the percentage of maximum pinch strength (change from 34.5±11.66 to 30.7±10.16%, P=0.001), and there was a statistically significant between-group difference (P=0.00, 95% CI: -12.59 to -3.34, F=9.42). The CERB group showed superior treatment effects as compared to the control group on the two-point discrimination results (P=0.01) as well as the pin insertion subtests in the Purdue pegboard test (P=0.01). The QoL results also revealed significant between-group differences in several items of the Diabetes-39 (P<0.05). CONCLUSIONS: This study showed that a task-based biofeedback training program provides superior benefits for restoration of hand sensorimotor functioning in diabetic patients as compared to a home-based program combining tendon gliding exercise and resistive exercise. CLINICAL REHABILITATION IMPACT: Using task-based biofeedback training as one of the rehabilitation strategies may be an effective approach for restoration of sensory function, precision pinch performance, hand dexterity, and QoL for patients with diabetes-related neuropathy.

Sesame oil improves functional recovery by attenuating nerve oxidative stress in a mouse model of acute peripheral nerve injury: role of Nrf-2.

Peripheral nervous injury (PNI) is a common form of trauma in modern society, especially in sport players. Despite the advance of therapy for PNI, the recovery of function can never reach the preinjury level after treatments. Recently, inhibiting neural oxidative stress shows a beneficial effect in improving functional recovery after PNI. In addition, sesame oil has been reported to possess the excellent antioxidative properties. However, whether sesame oil can improve the functional recovery after PNI by its antioxidative effect has never been investigated. Thirty mice were randomly divided into five groups of six: group I mice received sham operation; group II mice received sciatic nerve crush; and groups III-V mice daily ingested 0.5, 1 and 2 ml/kg of sesame oil for 6 days, respectively, after sciatic nerve crush. Oxidative stress, GAP43 and nuclear Nrf2 levels as well as spinal somatosensory evoked potentials were assessed on day 6, while paw withdrawal latency and sciatic function index were assessed on days 0, 3, and 6. Sesame oil significantly decreased lipid peroxidation and increased nuclear factor erythroid 2-related factor 2 and GAP43 expression in sciatic nerve. Furthermore, sesame oil improved electrophysiological and functional assessments in mice with sciatic nerve crush. In conclusion, sesame oil may improve nerve functional recovery by attenuating nerve oxidative stress in mouse acute peripheral nerve injury. Further, application of natural product sesame oil may be an alternative approach for improving nerve functional recovery in the clinical setting.

Daily sesame oil supplement attenuates joint pain by inhibiting muscular oxidative stress in osteoarthritis rat model.

Osteoarthritis (OA) is the most common form of arthritis, affecting approximately 15% of the population. The aim of this study was to evaluate the efficacy of sesame oil in controlling OA pain in rats. Rat joint pain was induced by medial meniscal transection in Sprague-Dawley rats and assessed by using hindlimb weight distribution method. Muscular oxidative stress was assessed by determining lipid peroxidation, reactive oxygen species and circulating antioxidants. Sesame oil significantly decreased joint pain compared with positive control group in a dose-dependent manner. Sesame oil decreased lipid peroxidation in muscle but not in serum. Further, sesame oil significantly decreased muscular superoxide anion and peroxynitrite generations but increased muscular glutathione and glutathione peroxidase levels. Further, sesame oil significantly increased nuclear factor erythroid-2-related factor (Nrf2) expression compared with positive control group. We concluded that daily sesame oil supplement may attenuate early joint pain by inhibiting Nrf2-associated muscular oxidative stress in OA rat model.

Efficacy of topical cross-linked hyaluronic acid hydrogel in preventing post laminectomy/laminotomy fibrosis in a rat model.

Post-laminectomy/laminotomy epidural fibrosis (EF) has been implicated as an important cause of failed back syndrome (FBS). The various clinical approaches used to control EF yield mixed outcomes. Cross-linked hyaluronic acid hydrogel (cHA) was synthesized to increase mechanical stability and residence time. We evaluated the therapeutic attenuation of proliferative EF in laminectomy/laminotomy groups treated and not treated with cHA. A bilateral T11-L1 total laminectomy or unilateral T12 laminotomy was done on four groups (n = 10 each) of Sprague-Dawley rats and then histologically examined 2 months post-surgery: (I) laminectomy group treated with and (II) not treated with cHA, (III) laminotomy group treated with and (IV) not treated with cHA. The grade of EF, the diameters within the spinal canal, dura mater thickness, and the area of the epidural space, subarachnoid space, and conus medullaris space were assessed. The cHA-treated subgroups (I, III) had a significantly lower grade of EF, thinner dura mater, and larger epidural and subarachnoid spaces than did the control subgroups (II, IV) (p < 0.05). The cHA formed a solid interpositional membrane barrier that prevented invasive fibrosis, and also helped reduce pathological changes to the adjacent structures. In conclusion, topically applied cHA is effective for reducing EF.

Sonographically assisted percutaneous removal of screws in dynamization of the interlocking intramedullary nail.

OBJECTIVES: Dynamization is a method of removing the interlocking screw(s) farthest from the fracture site for improving healing in femoral and tibial fractures that show delayed healing after static interlocking nailing. We describe a simple sonographically assisted technique for percutaneous dynamization of deep-seated impalpable screws. METHODS: Between March 2001 and March 2005, 20 dynamization procedures were completed using the developed technique under the diagnosis of delayed healing or a nonunion at a mean of 4.8 months after index surgery. After adequately positioning the involved leg, the transducer was placed on the area of the inlet of the screw. Longitudinal and transverse sonographically scanned sections, used to show the head of the screw, were then marked on the skin where the two sections intersected. After this precise marking, a small incision on the mark allowed insertion of the screwdriver and easy percutaneous removal of the screw using only local anesthesia for pain control. RESULTS: We removed 31 screws: 9 proximal femoral screws, 20 distal femoral screws, and 2 proximal tibial screws. The mean depth of the screws was 3.4 cm. The mean operation times were 1.6 minutes for the sonographic examination and 3.5 minutes for removal of one screw. No infections or morbidities were caused by the procedure. CONCLUSIONS: Sonography is an effective tool for localizing a locked screw and facilitates percutaneous removal of screws under only local anesthesia for dynamization. This method needs no special instruments and reduces the time needed for dissecting the tissue and locating the screw.

Setup of a novel biofeedback prototype for sensorimotor control of the hand and preliminary application in patients with peripheral nerve injuries.

BACKGROUND: Biofeedback training is widely used for rehabilitative intervention in patients with central or peripheral nervous impairment to train correct movement patterns; however, no biofeedback apparatus is currently available to correct pinch force ratios for patients with sensory deficiencies. DESIGN: A cross-sectional and longitudinal design was used in an observational measurement study for establishing a prototype and to determine the effects of biofeedback intervention, respectively. OBJECTIVE: This study aimed to develop a computerized evaluation and re-education biofeedback (CERB) prototype for application in clinical settings. METHODS: A CERB prototype was developed integrating pinch apparatus hardware, a biofeedback user-controlled interface, and a data processing/analysis interface to detect momentary pinch performances in 79 people with normal hand sensation. Nine patients with hand sensory impairments were recruited to investigate the effects of training hand function with the CERB prototype. RESULTS: Hand dominance, pinch pattern, and age significantly affected the peak pinch force and force ratio for lifting a 480-g object with a steel surface. In the case of the 79 volunteers with normal hand sensation, hand dominance affected the time lag between peak pinch force and maximum load; however, it was unaffected by pinch pattern or age. Training with the CERB prototype produced significant improvements in force ratio and better performance in the pin insertion subtests, although the results for both 2-point discriminative and Semmes-Weinstein monofilament tests did not change significantly. LIMITATIONS: The intervention findings are preliminary. CONCLUSIONS: This study developed a conjunct system suited for evaluating and restoring sensorimotor function for patients with impaired hand sensibility. The results from the participants with normal hand sensation could serve as a reference database for comparison with patients with nerve injuries.

Brief report: amelioration of collagen-induced arthritis in mice by lentivirus-mediated silencing of microRNA-223.

OBJECTIVE: MicroRNA (miRNA) plays a role in autoimmune diseases. MiRNA-223 (miR-223) is up-regulated in patients with rheumatoid arthritis (RA) and is involved in osteoclastogenesis, which contributes to erosive disease. The aim of this study was to test the feasibility of using lentiviral vectors expressing the miR-223 target sequence (miR-223T) to suppress miR-223 activity as a therapeutic strategy in a mouse model of collagen-induced arthritis (CIA). METHODS: Levels of miR-223 in the synovial tissue of patients with RA or osteoarthritis (OA), as well as in the ankle joints of mice with CIA, were determined by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR). Lentiviral vectors expressing miR-223T (LVmiR-223T) or luciferase short hairpin RNA (LVshLuc) as a control vector were injected intraperitoneally into mice with CIA. Treatment responses and disease-related bone mineral density were monitored. Levels of nuclear factor 1A (NF-1A), a direct target of miR-223, and macrophage colony-stimulating factor receptor (M-CSFR), which is critical for osteoclastogenesis, were measured by immunohistochemistry and quantitative RT-PCR. Osteoclasts were assessed by tartrate-resistant acid phosphatase staining. RESULTS: MiR-223 expression was significantly higher in the synovium of RA patients and in the ankle joints of mice with CIA as compared to OA patients and normal mice. LVmiR-223T treatment reduced the arthritis score, histologic score, miR-223 expression, osteoclastogenesis, and bone erosion in mice with CIA. Down-regulation of miR-223 with concomitant increases in NF-1A levels and decreases in M-CSFR levels was detected in the synovium of LVmiR-223T-treated mice. CONCLUSION: This study is the first to demonstrate that lentivirus-mediated silencing of miR-223 can reduce disease severity of experimental arthritis. Furthermore, our results indicate that inhibition of miR-223 activity should be further explored as a therapeutic strategy in RA.

Amelioration of rat collagen-induced arthritis through CD4+ T cells apoptosis and synovial interleukin-17 reduction by indoleamine 2,3-dioxygenase gene therapy.

Indoleamine 2,3-dioxygenase (IDO) has been known as an emerging therapeutic target in autoimmunity-related arthritis. The treatment responses of adenoviral vectors encoding IDO (AdIDO) gene therapy in rat collagen-induced arthritis (CIA) were examined in this study. The therapeutic effects on ankle circumference, articular index, and radiographic and histological scores were evaluated in AdIDO-injected ankle joints. We further determined CD4+ T-cell numbers and their apoptotic status, CD68(+) macrophage numbers, kynurenine (a downstream tryptophan metabolite) concentrations, interleukin-17 (IL-17) levels, and retinoic acid-related orphan receptor γt (RORγt) expression in synovial tissues of CIA rats receiving AdIDO treatment. Reduction of ankle circumference, articular index, and radiographic and histological scores were noted in AdIDO-treated ankles, as compared with those receiving injection of control vectors. Furthermore, IDO gene transfer led to decreased infiltrating CD4+ T cells with enhanced apoptosis, reduced CD68+ macrophage numbers, increased kynurenine levels, lower IL-17 concentrations, and decreased RORγt expression within the ankle joints. In addition, such a therapy diminished type II collagen-specific IL-17 production and RORγt expression in CD4+ T cells from draining lymph nodes of CIA rats. Our results demonstrate for the first time that intra-articular delivery of IDO gene ameliorated ankle arthritis of CIA rats by induction of CD4+ T-cell apoptosis and reduction of synovial IL-17 production through the supplement of kynurenine. Taken together, these findings implicate the novel strategy of using IDO gene as a therapeutic approach in treating patients with rheumatoid arthritis.