Increased interleukin-6 and TP53 levels in rotator cuff tendon repair patients with hypercholesterolemia

Background@#A previous study reported that hyperlipidemia increases the incidence of tears in the rotator cuff tendon and affects healing after repair. The aim of our study was to compare the gene and protein expression of torn rotator cuff tendons in patients both with and without hypercholesterolemia. @*Methods@#Thirty patients who provided rotator cuff tendon samples were classified into either a non-hypercholesterolemia group (n=19, serum total cholesterol [TC] <200 mg/dL) and hypercholesterolemia group (n=11, serum TC ≥240 mg/dL) based on their concentrations of serum TC. The expression of various genes of interest, including COL1A1, IGF1, IL-6, MMP2, MMP3, MMP9, MMP13, TNMD, and TP53, was analyzed by real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). In addition, Western blot analysis was performed on the proteins encoded by interleukin (IL)-6 and TP53 that showed significantly different expression levels in real-time qRT-PCR. @*Results@#Except for IGF1, the gene expression levels of IL-6, MMP2, MMP9, and TP53 were significantly higher in the hypercholesterolemic group than in the non-hypercholesterolemia group. Western blot analysis confirmed significantly higher protein levels of IL-6 and TP53 in the hypercholesterolemic group (p<0.05). @*Conclusions@#We observed an increase in inflammatory cytokine and matrix metalloproteinase (MMP) levels in hypercholesterolemic patients with rotator cuff tears. Increased levels of IL-6 and TP53 were observed at both the mRNA and protein levels. We suggest that the overexpression of IL-6 and TP53 may be a specific feature in rotator cuff disease patients with hypercholesterolemia.

Biological Enhancement of Healing with Kartogenin Injection at the Tendon-to-Bone Interface in a Rat Rotator Cuff Tear Model / 대한스포츠의학회지

Purpose@#The purpose of this study was to investigate the effects of kartogenin (KGN) on the tendon-bone interface in a rat rotator cuff tear model. @*Methods@#Twenty male rats were divided into two equal groups; group 1 (repair only) and group 2 (KGN single injection). A rat rotator cuff rupture model was prepared, and KGN (500 μM) was injected into the repair site. The specimens were collected after 8 weeks, and biomechanical and histological analyses were performed. We assessed the healing quality of the tendon-to-bone repair site using six aspects of tendon tissue. The histological findings were classified semiquantitatively into four grades (grade 0, the poorest appearance; grade 1, poorer; grade 2, better; and grade 3, marked regeneration). @*Results@#Group 2 showed a higher mean ultimate load to failure than the control group (group 1: 25.78±31.38 N, group 2: 55.64±36.02 N; p=0.011). On histological analysis, group 2 exhibited a significantly greater total score (group 1: 7.20±2.14, group 2: 9.50±1.84; p=0.019), collagen fiber continuity (group 1: 1.20±0.42, group 2: 1.70±0.48; p=0.024), and collagen fiber density (group 1: 1.50±0.52, group 2: 2.20±0.63; p=0.080). Metachromasia were more intense in group 2 than in the control group. @*Conclusion@#A single injection of KGN reinforces biomechanical strength and the formation of collagen and fibrocartilage at the tendon-to-bone interface in a rat rotator cuff tear model.

Osteogenic Differentiation of Bone Marrow Stem Cell using Bi-phase Alginate Scaffold Including BMP-2

PURPOSE: The object of this study is to develop a novel BMP-2 delivery system for continuous osteogenic differentiation and to induce osteogenesis of stem cells using a bi-phase alginate carrier in vitro. METHODS: Alginate nanoparticle loaded BMP-2 was prepared by the reverse emulsification-diffusion technique. Physical properties and release profiles of alginate carriers were measured by Instron and ELISA kit, respectively. Cell viability and alkaline phosphate activity of hBMSCs differentiation was also evaluated by MTS and Metra(R)BAP assays, respectively. RESULTS: Optimal concentration for bi-phase alginate carrier was determined as 2wt% by evaluating mechanical and biological properties, and differentiation of BMSCs for bone regeneration. The 2% bi-phase alginate carrier had the lowest initial and final release ratio. In addition, the 2% bi-phase alginate carrier had a little higher ALP activity than the homogeneous carrier. An improved controlled release profile was obtained by combining alginate hydrogel with lyophilized particles. CONCLUSION: Bi-phase alginate carrier has many advantages such as biocompatibility and controlled release capability. It is expected to be effective as a scaffold and carrier in bone tissue engineering.

Congenital central hypoventilation syndrome combined with Hirschsprung disease diagnosed in the neonatal period / 소아과

Congenital central hypoventilation syndrome (CCHS) or Ondine's curse is a very rare sleep disorder that is the result of a congenital failure of the autonomic control of ventilation caused by insensitivity of the chemoreceptor to hypercapnea during sleep. Gastrointestinal motility disorders, particularly a congenital megacolon (Hirschsprung disease) is often combined with CCHS. This combination can be explained by a defect in the migration of neuronal cells from the neural crest (neurocristopathy) during the intrauterine period. A diagnosis of CCHS is made by confirming the failure of adequate ventilation in response to hypercapnea and hypoxia during sleep and the exclusion of other diseases. Young infants frequently show atypical clinical courses, and their conditions are frequently complicated with the long-term sequela of hypoxemic episodes. Therefore, a high index of suspicion and active treatment with mechanical ventilation are important for reducing recurrent hypoxemic episodes in the neonatal period. This paper reports the follow up of a case of CCHS in a neonate who showed frequent intractable apnea and cyanosis and was given artificial mechanical ventilation during sleep.

The Clinical Characteristics and Coronary Complication of Infantile Kawasaki Disease

PURPOSE: We evaluated Kawasaki disease(KD) in children in order to evaluate the clinical characteristics and coronary complication of infantile Kawasaki disease. METHODS: A total of 226 medical records of children with KD admitted to The Catholic University of Korea, St. Mary's Hospital, from 1994 to 2003 were retrospectively analyzed. RESULTS: The incidence of lymphadenopathy was statistically lower in infantile Kawasaki disease than in Kawasaki disease of children older than one year. The incidence of atypical Kawasaki disease in infant(32%) was greater than that of total patients(24%), but there was no statistically significant difference in two groups. The incidence of coronary complication in atypical Kawasaki disease in children younger than one year was 50%(6/12), which was greater than that of coronary complication in typical KD of children older than one year. CONCLUSION: Diagnostic difficulties in infantile Kawasaki disease are due to high incidence of atypical characteristics of Kawasaki disease. Yet, early treatment with IVGV and aspirin is necessary because of its high incidence of coronary complication.