T1ρ/T2 mapping and histopathology of degenerative cartilage in advanced knee osteoarthritis

AIM To investigate whether normal thickness cartilage in osteoarthritic knees demonstrate depletion of proteoglycan or collagen content compared to healthy knees.METHODS Magnetic resonance(MR) images were acquired from5 subjects scheduled for total knee arthroplasty(TKA)(mean age 70 years) and 20 young healthy control subjects without knee pain(mean age 28.9 years). MR images of T1ρ mapping, T2 mapping, and fat suppressed proton-density weighted sequences were obtained.Following TKA each condyle was divided into 4 parts(distal medial, posterior medial, distal lateral, posterior lateral) for cartilage analysis. Twenty specimens(bone and cartilage blocks) were examined. For each joint,the degree and extent of cartilage destruction was determined using the Osteoarthritis Research Society International cartilage histopathology assessment system.In magnetic resonance imaging(MRI) analysis, 2 readers performed cartilage segmentation for T1ρ/T2 values and cartilage thickness measurement.RESULTS Eleven areas in MRI including normal or near normal cartilage thickness were selected. The corresponding histopathological sections demonstrated mild to moderate osteoarthritis(OA). There was no significant difference in cartilage thickness in MRI between control and advanced OA samples [medial distal condyle, P = 0.461;medial posterior condyle(MPC), P = 0.352; lateral distal condyle, P = 0.654; lateral posterior condyle, P = 0.550],suggesting arthritic specimens were morphologically similar to normal or early staged degenerative cartilage.Cartilage T2 and T1ρ values from the MPC were significantly higher among the patients with advanced OA(P= 0.043). For remaining condylar samples there was no statistical difference in T2 and T1ρ values between cases and controls but there was a trend towards higher values in advanced OA patients. CONCLUSION Though cartilage is morphologically normal or near normal, degenerative changes exist in advanced OA patients. These changes can be detected with T2 and T1ρ MRI techniques.     

Effects of articular cartilage and meniscus injuries at the time of surgery on osteoarthritic changes after anterior cruciate ligament reconstruction in patients under 40?years old

Introduction  The development of osteoarthritis (OA) after anterior cruciate ligament (ACL) reconstruction is an unsolved problem. Articular cartilage and meniscus injuries are particularly important factors that contribute to OA progression. Aim  The purpose of this study was to investigate how articular cartilage and meniscus injuries at the time of surgery affected the development of OA under limited conditions retrospectively. Exclusion criteria of this study were (1) age 40 years or over, (2) previous surgery, (3) another combined knee ligament injury, and (4) unstable reconstructed knees. Material  This study included 49 knees in 46 patients (average 26 years; range, 13–39 years) who had undergone isolated ACL reconstruction. Mean follow-up period was 3.9 years (range, 2–8 years). We classified patients into two groups, cartilage-damaged and non-damaged. Patients were also classified into two groups on the basis of treatment for meniscus: meniscectomy group and meniscus intact group. OA changes were investigated using weigh-bearing anteroposterior radiographs taken before surgery and at evaluation. OA changes were evaluated in terms of joint space narrowing, atrophy, sclerosis, cysts, spurs, flattening of the femoral condyle, concavity of the tibial condyle, and sharpening of the eminence. Each parameter was scored, and the total number of points was recorded as the OA score. Results  Differences between the preoperative OA score and that at evaluation were defined as the increase of the OA score. OA progressed in 28 knees (57%). OA score was higher at evaluation than before surgery (P < 0.001). In the cartilage-damaged group, the Lysholm score at evaluation was lower (P < 0.05) and the increase in the OA score was higher than in the non-damaged group (P < 0.05). The increase in the OA score was higher in the meniscectomy group (P < 0.05). Conclusion  We concluded that patients with cartilage damage and who had undergone meniscectomy show more progression of OA. These patients require long-term follow-up. Level of evidence  Level 4, case series, therapeutic studies, investigating the results of treatment. Presented at 6th Biennial Congress of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine.     

Early changes of arginine vasopressin and angiotensin Ⅱ in patients with acute cerebral injury

OBJECTIVE: To study the changes and clinical significance of arginine vasopressin (AVP) and angiotensin II (AT-II) in patients with acute moderate and severe cerebral injury. METHODS: The early plasma concentration was checked by radioimmunoassay in 47 cases of acute moderate and severe cerebral injury, 30 cases of non-cerebral injury and 30 healthy volunteers. RESULTS: The early plasma concentrations of AVP (50.23 ng/L +/- 15.31 ng/L) and AT-II (248.18 ng/L +/- 82.47 ng/L) in cerebral injury group were higher than those in non-cerebral injury group (AVP for 30.91 ng/L +/- 11.48 ng/L and AT-II for 120.67 ng/L +/- 42.49 ng/L, P<0.01). The early plasma concentrations of AVP and AT-II in cerebral injury group were also obviously higher than those of the volunteers (AVP for 5.16 ng/L +/- 4.23 ng/L and AT-II for 43.11 ng/L +/- 16.39 ng /L, P<0.001). At the same time, the early plasma level of AVP (58.90 ng/L +/- 18.12 ng/L) and AT-II (292.13 ng/L +/- 101.17 ng/ L) was higher in severe cerebral injured patients than moderate cerebral injured ones (AVP for 36.68 ng/L +/- 12.16 ng/L and AT-II for 201.42 ng/L +/- 66.10 ng/L, P<0.01). The early level of AVP and AT-II was negatively related to the GCS scales in acute cerebral injury. The early plasma concentrations of AVP (45.98 ng/L +/- 13.48 ng/L) and AT-II (263. 28 ng/L +/- 80.23 ng/L) were lower in epidural hematoma group than those of subdural hematoma and cerebral injury group (AVP for 64.12 ng/L +/- 15.56 ng /L and AT-II for 319.82 ng/L +/- 108.11 ng/L, P<0. 01). CONCLUSIONS: AVP and AT-II may play an important role in pathophysiologic process in the secondary cerebral injury. The more severe the cerebral injury is, the higher the early level of AVP and AT-II will be. The early plasma level of AVP and AT-II may be one of the severity indexes of cerebral injury.     

Early changes of arginine vasopressin and angiotensin II in patients with acute cerebral injury

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Morphological changes of roof of subacromial bursa in patients with rotator cuff tear

Objective: To investigate the morphological changes of the roof of the subacromial bursa (SAB) and its involvement extent after rotator cuff tear. Methods: In the experimental group, the roof of SAB was obtained from 30 cases of rotator cuff tear both at the tear site and a site 2.5-3.0 cm distal to the tear site during rotator cuff repair. In the control group, the roof of SAB was obtained from the exposed site of recurrently dislocated shoulder or fractured humeral shaft of 8 cases. The specimens were stained with hematoxylin and eosin and observed under a transmission electron microscope. The cell number was quantitated through counting the bluestained nucleus in SAB with a computer image analysis system.Results:The mumber of calls increased significantly in the roof of SAB in the experimental group compared with that of the control group. However, no difference of the bursal reaction was found among the type of rotator cuff tear, the bursa thickness and the presence of fluid in the bursa. The great majority of cells were type B cells observed under the transmission electron microscope. Conclusions: The increase in cell number in the roof of SAB in the experimental group is a reactive increase rather than an inflammatory process and the involvement of SAB is not limited in extent. The change of the roof of SAB is a secondary reaction to the rotator cuff tear.     

Tests of linkage and/or association of TGF-β1 and COL1A1 genes with bone mass

Transforming growth factor beta 1 (TGF-1) is involved in bone metabolism and collagen type I alpha 1 (COL1A1) is the most abundant protein of bone matrix. Both have been considered as candidate genes for osteoporosis. In this study, we employed the transmission disequilibrium test (TDT) to examine the relationship between each of the two genes with bone mineral density (BMD) and bone mineral content (BMC) at the spine and hip in a sample of 1668 subjects from 387 Caucasian nuclear families. For the TGF-1 gene, three SNPs, SNP1, SNP2, and SNP4 (located in exon 1, intron 4 and intron 5, respectively) were tested and the minor allele frequencies were 30.9%, 2.1% and 27.0%, respectively. All eight possible haplotypes (TGF1–8) were observed. For the COL1A1 gene, the minor allele frequencies of SNP5, SNP6 and SNP8 (located in exon 1, intron 1, and exon 45, respectively) were 15.2%, 18.7%, 2.0%, respectively, and only six of eight potential haplotypes (COL1–6) were obtained. In the whole sample, total associations were observed between haplotype COL5 with spine BMD (P=0.027), haplotypes COL3 and TGF4 with hip BMC (P=0.002, 0.003, respectively). Within-family associations were found for spine BMD at haplotypes TGF4 (P=0.027) in female offspring families and TGF3 (P=0.021) in male offspring families. Further studies with denser markers and larger sample size are required to eventually define the relationship between these two genes with bone mass at the spine and hip.     

Does three-grade classification of T2-weighted increased signal intensity reflect the severity of myelopathy and surgical outcomes in patients with cervical compressive myelopathy? A systematic review and meta-analysis

Neurosurgical Review - The three-grade classification of increased signal intensity (ISI) on T2-weighted magnetic resonance imaging (MRI) is used extensively in patients with cervical compressive...     

T1ρ, T2 mapping,and EPIC-µCT Imaging in a Canine Model of Knee Osteochondral Injury

The dog is the most commonly used large animal model for the study of osteoarthritis. Optimizing methods for assessing cartilage health would prove useful in reducing the number of dogs needed for a valid study of osteoarthritis and cartilage repair. Twelve beagles had critical-sized osteochondral defects created in the medial femoral condyle of both knees. Eight dogs had T1ρ and T2 magnetic resonance imaging (MRI) performed approximately 6 months after defect creation. Following MRI evaluations, all 12 dogs were humanely euthanatized and cartilage samples were obtained from the medial and lateral femoral condyles, medial and lateral tibial plateaus, trochlear groove, and patella for proteoglycan and collagen quantification. Equilibrium partitioning of an ionic contrast (EPIC)-µCT was then performed followed by the histologic assessment of the knees. Correlations between T1ρ, T2, EPIC-µCT and proteoglycan, collagen, and histology scores were assessed using a multivariate analysis accounting for correlations from samples within the same knee and in the same dog. Pearson's correlation coefficients were calculated to assess the strength of significant relationships. Correlations between µCT values and biochemical or histologic assessment were weak to moderately strong (0.09–0.41; p < 0.0001–0.66). There was a weak correlation between the T2 values and cartilage proteoglycan (−0.32; p = 0.04). The correlation between T1ρ values and cartilage proteoglycan were moderately strong (−0.38; p < 0.05) while the strongest correlation was between the T1ρ values and histological assessment of cartilage with a correlation coefficient of 0.58 (p < 0.0001). These data suggest that T1ρ shows promise for possible utility in the translational study of cartilage health and warrants further development in this species. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:368-377, 2020     

The association of oxidant–antioxidant status in patients with chronic renal failure

Oxidative stress has been linked to disease progression, including chronic renal failure (CRF). The aim of the present study was to determine malondialdehyde (MDA) as a sign of lipid peroxidation, and to investigate the association between antioxidant activities and three trace elements, in 49 patients with CRF. The erythrocyte and plasma trace elements [selenium (Se), zinc (Zn), and copper (Cu)] and antioxidant defense levels were determined: glutathione peroxidase (GPx), superoxide dismutase (SOD), catalase (CAT), vitamins E and C. The obtained values were compared with 42 age- and sex-matched healthy controls. There were significantly lower mean values of plasma Se, GPx, vitamins E and C, erythrocyte Se, SOD and CAT levels in the patient group compared to the control group (p?相似文献