Overexpression of Hepatocyte growth factor and its soluble receptor (s-cMet) in the serum of patients with different grades of meningioma

ObjectivesMeningiomas are the most common primary intracranial tumor. Hepatocyte growth factor (HGF) and its receptor, cMet, were shown to be involved in meningioma. This study was aimed to determine the concentration of HGF and soluble cMet (s-cMet) in the serum of patients with different grades of meningioma.MethodsNinety serum samples from different grades of meningioma patients (42 cases of grade I, 28 grade II, 20 grade III) and 51 controls were included in this study. The serum total protein concentration (TPC) was measured by a Bio-Rad protein assay and serum concentration of HGF and s-cMet by enzyme linked immunosorbent assay (ELISA).ResultsNo significant change in the serum TPC of patients was seen as compared to controls. We also showed that serum HGF and s-cMet concentration in meningioma patients was higher than in controls. The results showed that starting from grades I to III meningioma, a significant increase in HGF and s-cMet serum concentration was observed (HGF; 380 ± 57.69, 430.27 ± 48.72, 596.36 ± 104.49 pg/ml, respectively, as compared to controls which was 327.72 ± 49.68 pg/ml and for s-cMet was 274.45 ± 45.05, 314.81 ± 38.71, 433.54 ± 51.81 ng/ml, respectively, as compared to controls which was 213.72 ± 29.13 ng/ml). The results showed that a high concentration of HGF and s-cMet is associated with advanced grades of meningioma.ConclusionIt is concluded that HGF and s-cMet serum levels increased in meningioma patients and their concentration was significantly higher in more advanced grades of the disease. It is also suggested that HGF/s-cMet might be involved in the progression of meningioma.     

Sympathetic nerve innervation in cervical posterior longitudinal ligament as a potential causative factor in cervical spondylosis with sympathetic symptoms and preliminary evidence

Sympathetic symptoms associated with cervical disorders, such as vertigo, headache, dizziness, etc., are common clinical disorders bewildering both clinicians and patients. In our clinical practice we observed that sympathetic symptoms associated with cervical disorders were apparently relieved in some patients after undergoing routine anterior cervical decompression and fusion plus posterior longitudinal ligament (PLL) resection. This study was designed to investigate the sympathetic nerve innervations in the cervical PLL and its potential correlation with cervical sympathetic symptoms such as vertigo.     

The biomechanical influence of the facet joint orientation and the facet tropism in the lumbar spine

Background contextFacet joint orientation and facet tropism (FT) are presented as the potential anatomical predisposing factors for lumbar degenerative changes that may lead in turn to early degeneration and herniation of the corresponding disc or degenerative spondylolisthesis. However, no biomechanical study of this concept has been reported.PurposeTo investigate the biomechanical influence of the facet orientation and FT on stress on the corresponding segment.Study designFinite element analysis.MethodsThree models, F50, F55, and F60 were simulated with different facet joint orientations (50°, 55°, and 60° relative to coronal plane) at both L2–L3 facet joints. A FT model was also simulated to represent a 50° facet joint angle at the right side and a 60° facet joint angle at the left side in the L2–L3 segment. In each model, the intradiscal pressures were investigated under four pure moments and anterior shear force. Facet contact forces at the L2–L3 segment were also analyzed under extension and torsion moments and anterior shear force. This study was supported by 5000 CHF grant of 2011 AO Spine Research Korea fund. The authors of this study have no topic-specific potential conflicts of interest related to this study.ResultsThe F50, F55, and F60 models did not differ in the intradiscal pressures generated under four pure moments: but under anterior shear force, the F60 and FT models showed increases of intradiscal pressure. The F50 model under extension and the F60 model under torsion each generated an increase in facet contact force. In all conditions tested, the FT model yielded the greatest increase of intradiscal pressure and facet contact force of all the models.ConclusionsThe facet orientation per se did not increase disc stress or facet joint stress prominently at the corresponding level under four pure moments, but FT could make the corresponding segment more vulnerable to external moments or anterior shear force.     

Fractures of the patella in children

Fractures of the patella are relatively rare injuries for children. Fourteen patients with patellar fractures were reviewed. There were 12 boys and two girls with the age ranging between 9 and 15 years and an average of 11.4 years. Sleeve fractures were the most common type of patellar fractures observed (eight cases), followed by transverse fractures (four cases) and comminuted fractures (two cases). All the fractures were treated with open reduction and followed up for 2 to 20 years. Overall results were good in 13 patients, and flexion limitation of the knee was seen in one. Fractures of the patella in children are characterised by sleeve fractures. The prognosis of the patients treated with open reduction is generally good.     

利用腹壁反射重建人工膀胱反射弧的实验研究

目的 研究利用腹壁反射建立“腹壁反射-脊髓中枢-膀胱”神经传导通路，探讨躯体运动神经纤维长入副交感神经纤维后支配膀胱平滑肌产生控制性排尿的作用机制。方法 建立SD大鼠右侧“腹壁反射-脊髓中枢-膀胱”人工膀胱反射弧以左侧为对照侧，通过刺激右侧下腹壁反射激发截瘫动物排尿。神经缝合术后8个月；（1）在破坏L5-S4脊髓节段前后，观察神经电生理，进行膀胱测压；（2）采用辣根过氧化物酶（HRP）逆行追踪标记技术，观察大鼠T11-L1及L4-S4节段脊髓冰冻切片内HRP标记细胞的形态及分布情况。结果 （1）在破坏L5-S4脊髓节段造成截瘫前后，单相方波（3mA,0.3ms)刺激实验侧T13后根可记录到实验侧动作电位，膀胱平滑肌复合股肉动作电位及膀胱平均内压，其形态及波幅与对照侧相似。（2）实验侧T13脊髓前角及双侧L6-S4节段脊髓中间带外侧核区有HRP标记阳性细胞，而对照侧T13脊髓前角未发现HRP标记细胞。结论 体神经的运动传出支经自体神经移植，其轴突能再生长入膀胱平滑肌内副交感神经节细胞，并具有良好的传导运动兴奋的功能；利用截瘫平面以上的体反射，通过硬膜囊内神经根自体神经移植缝合的方法，可建立新的人工膀胱反射弧，使截瘫患者可控制性排尿。     

Kartogenin with PRP promotes the formation of fibrocartilage zone in the tendon–bone interface

Treatment of tendon–bone junction injuries is a challenge because tendon–bone interface often heals poorly and the fibrocartilage zone, which reduces stress concentration, at the interface is not formed. In this study, we used a compound called kartogenin (KGN) with platelet‐rich plasma (PRP) to induce the formation of fibrocartilage zone in a rat tendon graft–bone tunnel model. The experimental rats received KGN‐PRP or PRP injections in the tendon graft–bone tunnel interface. The control group received saline. After 4, 8 and 12 weeks, Safranin O staining of the tendon graft–bone tunnels revealed abundant proteoglycans in the KGN‐PRP group indicating the formation of cartilage‐like transition zone. Immunohistochemical and immuno‐fluorescence staining revealed collagen types I (Col‐I) and II (Col‐II) in the newly formed fibrocartilage zone. Both fibrocartilage zone formation and maturation were healing time dependent. In contrast, the PRP and saline control groups had no cartilage‐like tissues and minimal Col‐I and Col‐II staining. Some gaps were also present in the saline control group. Finally, pull‐out strength in the KGN‐PRP‐treated group at 8 weeks was 1.4‐fold higher than the PRP‐treated group and 1.6‐fold higher than the saline control group. These findings indicate that KGN, with PRP as a carrier, promotes the formation of fibrocartilage zone between the tendon graft and bone interface. Thus, KGN‐PRP may be used as a convenient cell‐free therapy in clinics to promote fibrocartilage zone formation in rotator calf repair and anterior cruciate ligament reconstruction, thereby enhancing the mechanical strength of the tendon–bone interface and hence the clinical outcome of these procedures. Copyright © 2017 John Wiley & Sons, Ltd.     

Evaluation of coracoclavicular stabilization of acute acromioclavicular joint dislocation with multistrand titanium cables

Purpose

The aim of this study was to evaluate the outcome of surgical treatment of acute acromioclavicular (AC) joint dislocation with multistrand titanium cables for coracoclavicular (CC) stabilization.

Methods

Forty-two patients with acute AC joint dislocation, including Rockwood type III 14 cases, type IV 2 cases and type V 26 cases, were operated with CC stabilization using multistrand titanium cables. The cables were removed 3–12 months after surgery. The function outcome was evaluated by Constant scores and visual analog scale (VAS) scores. Radiological examination included bilateral antero-posterior and axillary radiography.

Results

Three patients were lost to follow-up. Thirty-nine patients had an average follow-up time of 42 months (range 34–60). The Constant scores were 95.3 ± 9.3 at final evaluation. Preoperative and final follow-up VAS scores were 5.6 ± 1.5 and 0.4 ± 1.2, respectively (P < 0.05). Radiographs showed anatomical reduction in 32 patients. Cables breakage occurred in two patients.

Conclusions

CC stabilization with multistrand titanium cables was an effective and safe alternative to other procedures for the treatment of acute high-grade AC joint dislocations. It can provide immediate joint stabilization and allow early mobilization of limb with satisfied functional recovery.     

Reliability and validity of Simplified Chinese version of Quick Disabilities of the Arm,Shoulder, and Hand (QuickDASH) questionnaire: cross-cultural adaptation and validation

Clinical Rheumatology - To translate and cross-culturally adapt Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) Questionnaire into a Simplified Chinese version (QuickDASH-C), and...