ABSTRACT
The effect and safety of anterior debridement and fusion with a minimally invasive approach combined with posterior fixation via the Wiltse approach were assessed in the single-level lumbar pyogenic spondylodiscitis. Seventeen patients from 2007 to 2009 underwent anterior debridement and fusion with a minimally invasive approach combined with posterior fixation via the Wiltse approach. Postoperative follow-up time was 24-41 months. Data included the patients' general information, microbiology, operative time, intraoperative blood loss, postoperative complications, intervertebral fusion rate, and preoperative and final follow-up scores for American Spinal Injury Association (ASIA) impairment, visual analogue scale (VAS), and Oswestry Disability Index (ODI). Ten patients had undergone a prior spinal invasive procedure, and 7 had hematogenous infection. The infected segments included L1-2, L2-3, L3-4, and L4-5 in 1, 2, 5, and 9 cases, respectively. Thirteen bacterial cultures were positive for Staphylococcus aureus (5 cases), Staphylococcus epidermidis (4), Streptococcus (3), and Escherichia coli (1). The operative time was 213.8±45.6 min, and the intraoperative blood loss was 180.6±88.1 mL. Postoperative complications consisted of urinary retention (2 cases), constipation (3), and deep vein thrombosis (2). On the final follow-up, VAS scores and ODIs were significantly lower than those of preoperation, while the ASIA grades improved. All the cases achieved good intervertebral bony fusion. Anterior debridement and fusion with a minimally invasive approach combined with posterior fixation via the Wiltse approach can successfully treat single-level lumbar pyogenic spondylodiscitis, with less trauma and reliable immobilization. It is a viable option for clinical application.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Back Pain , Bacterial Infections , Microbiology , Constipation , Debridement , Methods , Disability Evaluation , Discitis , General Surgery , Escherichia coli , Follow-Up Studies , Lumbar Vertebrae , Microbiology , General Surgery , Minimally Invasive Surgical Procedures , Methods , Pain Measurement , Retrospective Studies , Spinal Fusion , Methods , Staphylococcus aureus , Staphylococcus epidermidis , Streptococcus , Treatment Outcome , Urinary Retention , Venous ThrombosisABSTRACT
Patients with type 2 diabetes mellitus (T2DM) exhibit hyperglycemia and hyperinsulinemia and increased risk of fracture at early stage, but they were found to have normal or even enhanced bone mineral density (BMD). This study was aimed to examine the molecular mechanisms governing changes in bone structure and integrity under both hyperglycemic and hyperinsulinemic conditions. Monocytes were isolated from the bone marrow of the C57BL/6 mice, induced to differentiate into osteoclasts by receptor activator of nuclear factor kappa-B ligand (RANKL) and macrophage colony-stimulating factor (M-CSF) and exposed to high glucose (33.6 mmol/L), high insulin (1 μmol/L), or a combination of high glucose/high insulin (33.6 mmol/L glucose and 1 μmol/L insulin). Cells cultured in α-MEM alone served as control. After four days of incubation, the cells were harvested and stained for tartrate resistant acid phosphatase (TRAP). Osteoclast-related genes including RANK, cathepsin K and TRAP were determined by using real-time PCR. The resorptive activity of osteoclasts was measured by using a pit formation assay. Osteoclasts that were derived from monocytes were of multinucleated nature and positive for TRAP, a characteristic marker of osteoclasts. Cell counting showed that the number of osteoclasts was much less in high glucose and high glucose/high insulin groups than in normal glucose and high insulin groups. The expression levels of RANK and cathepsin K were significantly decreased in high glucose, high insulin and high glucose/high insulin groups as compared with normal glucose group, and the TRAP activity was substantially inhibited in high glucose environment. The pit formation assay revealed that the resorptive activity of osteoclasts was obviously decreased in high glucose group and high glucose/high insulin group as compared with normal group. It was concluded that osteoclastogenesis is suppressed under hyperglycemic and hyperinsulinemic conditions, suggesting a disruption of the bone metabolism in diabetic patients.
ABSTRACT
The effect and safety of anterior debridement and fusion with a minimally invasive approach combined with posterior fixation via the Wiltse approach were assessed in the single-level lumbar pyogenic spondylodiscitis. Seventeen patients from 2007 to 2009 underwent anterior debridement and fusion with a minimally invasive approach combined with posterior fixation via the Wiltse approach. Postoperative follow-up time was 24-41 months. Data included the patients' general information, microbiology, operative time, intraoperative blood loss, postoperative complications, intervertebral fusion rate, and preoperative and final follow-up scores for American Spinal Injury Association (ASIA) impairment, visual analogue scale (VAS), and Oswestry Disability Index (ODI). Ten patients had undergone a prior spinal invasive procedure, and 7 had hematogenous infection. The infected segments included L1-2, L2-3, L3-4, and L4-5 in 1, 2, 5, and 9 cases, respectively. Thirteen bacterial cultures were positive for Staphylococcus aureus (5 cases), Staphylococcus epidermidis (4), Streptococcus (3), and Escherichia coli (1). The operative time was 213.8±45.6 min, and the intraoperative blood loss was 180.6±88.1 mL. Postoperative complications consisted of urinary retention (2 cases), constipation (3), and deep vein thrombosis (2). On the final follow-up, VAS scores and ODIs were significantly lower than those of preoperation, while the ASIA grades improved. All the cases achieved good intervertebral bony fusion. Anterior debridement and fusion with a minimally invasive approach combined with posterior fixation via the Wiltse approach can successfully treat single-level lumbar pyogenic spondylodiscitis, with less trauma and reliable immobilization. It is a viable option for clinical application.
ABSTRACT
As a result of the complex anatomy in upper cervical spine, the operative treatment of axis neoplasms is always complicated. Although the procedure for the second cervical vertebra (C2) surgery had been described previously in diverse approaches and reconstruction forms, each has its own limitations and restrictions that usually result in less satisfactory conclusions. The purpose of this study was to evaluate the operation efficacy for axis tumors by using a combined anterior (retropharyngeal) cervical and posterior approach in achieving total resection of C2 and circumferential reconstruction. Eight consecutive C2 tumor patients with mean age of 47.6 years in our institute sequentially underwent vertebra resection and fixation through aforementioned approach from Jan. 2006 to Dec. 2010. No surgical mortality or severe morbidity occurred in our group. In terms of complications, 2 cases developed transient difficulty in swallowing liquids (one of them experienced dysphonia) and 1 developed cerebrospinal fluid leakage (CSFL) that was resolved later. During a mean follow-up period of 31.9 months, the visual analogue scale (VAS) and Japanese orthopedic association (JOA) score revealed that the pain level and neurological function in all patients were improved postoperatively, and there was no evidence of fixation failure and local recurrence. It is concluded that the anterior cervical retropharyngeal approach permits a visible exposure to facilitate the C2 vertebra resection and perform an effective anterior reconstruction at the same time. The custom-made mesh cage applied in our cases can be acted as a firm and convenient implant in circumferential fixation.
ABSTRACT
As a result of the complex anatomy in upper cervical spine, the operative treatment of axis neoplasms is always complicated. Although the procedure for the second cervical vertebra (C2) surgery had been described previously in diverse approaches and reconstruction forms, each has its own limitations and restrictions that usually result in less satisfactory conclusions. The purpose of this study was to evaluate the operation efficacy for axis tumors by using a combined anterior (retropharyngeal) cervical and posterior approach in achieving total resection of C2 and circumferential reconstruction. Eight consecutive C2 tumor patients with mean age of 47.6 years in our institute sequentially underwent vertebra resection and fixation through aforementioned approach from Jan. 2006 to Dec. 2010. No surgical mortality or severe morbidity occurred in our group. In terms of complications, 2 cases developed transient difficulty in swallowing liquids (one of them experienced dysphonia) and 1 developed cerebrospinal fluid leakage (CSFL) that was resolved later. During a mean follow-up period of 31.9 months, the visual analogue scale (VAS) and Japanese orthopedic association (JOA) score revealed that the pain level and neurological function in all patients were improved postoperatively, and there was no evidence of fixation failure and local recurrence. It is concluded that the anterior cervical retropharyngeal approach permits a visible exposure to facilitate the C2 vertebra resection and perform an effective anterior reconstruction at the same time. The custom-made mesh cage applied in our cases can be acted as a firm and convenient implant in circumferential fixation.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Axis, Cervical Vertebra , Diagnostic Imaging , General Surgery , Combined Modality Therapy , Laminectomy , Methods , Radiography , Plastic Surgery Procedures , Methods , Spinal Neoplasms , Diagnostic Imaging , General Surgery , Treatment OutcomeABSTRACT
Patients with type 2 diabetes mellitus (T2DM) exhibit hyperglycemia and hyperinsulinemia and increased risk of fracture at early stage, but they were found to have normal or even enhanced bone mineral density (BMD). This study was aimed to examine the molecular mechanisms governing changes in bone structure and integrity under both hyperglycemic and hyperinsulinemic conditions. Monocytes were isolated from the bone marrow of the C57BL/6 mice, induced to differentiate into osteoclasts by receptor activator of nuclear factor kappa-B ligand (RANKL) and macrophage colony-stimulating factor (M-CSF) and exposed to high glucose (33.6 mmol/L), high insulin (1 μmol/L), or a combination of high glucose/high insulin (33.6 mmol/L glucose and 1 μmol/L insulin). Cells cultured in α-MEM alone served as control. After four days of incubation, the cells were harvested and stained for tartrate resistant acid phosphatase (TRAP). Osteoclast-related genes including RANK, cathepsin K and TRAP were determined by using real-time PCR. The resorptive activity of osteoclasts was measured by using a pit formation assay. Osteoclasts that were derived from monocytes were of multinucleated nature and positive for TRAP, a characteristic marker of osteoclasts. Cell counting showed that the number of osteoclasts was much less in high glucose and high glucose/high insulin groups than in normal glucose and high insulin groups. The expression levels of RANK and cathepsin K were significantly decreased in high glucose, high insulin and high glucose/high insulin groups as compared with normal glucose group, and the TRAP activity was substantially inhibited in high glucose environment. The pit formation assay revealed that the resorptive activity of osteoclasts was obviously decreased in high glucose group and high glucose/high insulin group as compared with normal group. It was concluded that osteoclastogenesis is suppressed under hyperglycemic and hyperinsulinemic conditions, suggesting a disruption of the bone metabolism in diabetic patients.
Subject(s)
Animals , Humans , Mice , Bone Resorption , Metabolism , Pathology , Cells, Cultured , Cellular Microenvironment , Diabetes Mellitus, Type 2 , Metabolism , Pathology , Glucose , Metabolism , Insulin , Metabolism , Mice, Inbred C57BL , Osteoclasts , Metabolism , PathologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the surgical results of one stage total en bloc spondylectomy (TES) by anterior and posterior approaches for lumbar vertebral tumors and evaluate its benefit for these tumors.</p><p><b>METHODS</b>A total of 21 patients with the lumbar vertebral tumor treated with on stage TES by posterior and anterior approaches from April 2003 to August 2007 were reviewed, which included 14 males and 7 females with an average age of 47.6 years. Thirteen patients were suffered with the primary lumbar vertebral tumors and 8 patients were diagnosed for the lumbar vertebral metastasis tumors. There were 8 of S3, 3 of I A and 2 of II according to Ennekinng stage system. And there were 1 of Grade B, 4 of Grade C, 8 of Grade D, and 6 of Grade E according to Frankel grade system. The spinal reconstruction was obtained by titanium mesh filled with autograft for benign and low-grade malignant tumors and methylmethacrylate-filled titanium mesh for malignant tumors. The spinal stability was enhanced by posterior internal fixation with rod-screw system.</p><p><b>RESULTS</b>The operation time was 250 min and bleed loss was 2100 ml on average. The follow-up period lasted from 1.0 to 5.5 years. All cases had pain before operation, among which 14 cases obtained complete relief and 7 cases obtained partly relief after operation. In all cases with neurological deficit, they improved neurologically by more than one grade using the Frankel grading system. Up to now, 1 patient had be local recurrence after operation and 4 patients were dead on the following time. The others still are alive and no local recurrence.</p><p><b>CONCLUSION</b>One-stage TES by anterior and posterior approaches for lumbar vertebral tumor is feasible, safe and effective to lumbar vertebral tumor resection and stability reconstruction, which has many advantages such as controlling local recurrence, spinal cord decompression thoroughly, relieving the pain, improving the life quality and prolonging the lifetime.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Feasibility Studies , Follow-Up Studies , Lumbar Vertebrae , Spinal Neoplasms , General Surgery , Spine , General Surgery , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and clinical value of the strategy of posterior simultaneous correction by bilateral corrective rod on the convex and concave sides in the treatment of adolescent idiopathic scoliosis (AIS).</p><p><b>METHODS</b>From February 2006 to August 2008, posterior fusion was performed to 48 AIS patients. There were 16 males and 32 females, with an average age at the time of surgery of 17.1 years. Lenke Type I was found in 17 cases, Type II in 9, Type III in 14 and Type IV in 8. There were 27 patients used selective posterior fusion in thoracic, 21 cases without selective fusion. Observation index: the Cobb angle on coronal plane, translation and rotation of apical vertebrae, the coronal balance, the Cobb angle on sagittal plane, obliquity between lowest instrumented vertebrae (LIV) and the pelvis, intervertebral angle and rotation of the LIV. The patients were followed up at an average time of 15.1 months (12-27 months).</p><p><b>RESULTS</b>In the 27 cases with selective fusion, thoracic coronal Cobb angle was (17 + or - 8) degrees after the operation, with an average correction rate of (76 + or - 11)% at final follow up. The lumbar Cobb angle was (13 + or - 7) degrees after the operation, with an average correction rate of (72 + or - 9)% at final follow up. In the 21 cases without selective fusion, the thoracic Cobb angle was (20 + or - 7) degrees after the operation, with an average correction rate of (74 + or - 15)% at final follow up. The lumbar Cobb angle was (16 + or - 8) degrees after the operation, with an average correction rate of (69 + or - 9)% at final follow up. The average number of vertebrae retained below LIV was 4.4. There was 1 case developing thoracolumbar kyphosis. During the follow up, there were no major complication of neurological injury, no pseudarthrosis and no spine decompensation.</p><p><b>CONCLUSION</b>Posterior bilateral segmental pedicle screw simultaneous correction technique as a technique for correcting thoracic and lumbar curves scoliosis can improve the treatment of idiopathic scoliosis with fewer vertebral fusion and complications.</p>
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Young Adult , Follow-Up Studies , Scoliosis , General Surgery , Spinal Fusion , Methods , Treatment OutcomeABSTRACT
<p><b>BACKGROUND AND OBJECTIVE</b>Studies showed that osteopontin (OPN) regulates cell migration and invasion in a variety of cancers, which associates with the activities of matrix metalloproteinase (MMP)-2 and MMP-9. This study was to investigate the role of OPN in the proliferation and invasion of human prostate cancer PC-3 cells and the possible functions of IgammaB kinase (IKK) in nuclear factor kappa B (NF-kappaB)-mediated signaling pathways.</p><p><b>METHODS</b>OPN short-hairpin RNA (shRNA) recombinant plasmids were transfected into PC-3 cells and different concentrations of IKK inhibitors were used to inhibit the activities of IKKalpha and IKKbeta. The mRNA and protein expression levers of OPN, MMP-2, and MMP-9 were detected by real-time polymerase chain reaction (PCR) and Western blot. Cell cycle was detected by flow cytometry, cell proliferation by MTT assay, and cell invasion by Transwell chamber assay.</p><p><b>RESULTS</b>Compared with untreated cells, the protein levers of OPN, MMP-2, and MMP-9 in OPN shRNA-transfected PC-3 cells were reduced by 55.22%, 51.71%, and 28.35%, respectively, and the ability of cell migration and invasion were decreased by 45.48% and 51.96%, respectively (P<0.05). Moreover, the inhibition of IKKbeta inhibited the expressions of MMP-2 and MMP-9.</p><p><b>CONCLUSION</b>A shRNA expression vector-mediated OPN gene silencing can inhibit the malignant biological behaviors of PC-3 cells. IKKbeta may play a crucial role in the OPN-induced activation of MMP-2 and MMP-9 via NF-kappaB-mediated IkappaB/IKKbeta pathways.</p>
Subject(s)
Humans , Male , Cell Cycle , Cell Line, Tumor , Cell Movement , Cell Proliferation , Genetic Vectors , I-kappa B Kinase , Metabolism , Matrix Metalloproteinase 2 , Genetics , Metabolism , Matrix Metalloproteinase 9 , Genetics , Metabolism , NF-kappa B , Metabolism , Neoplasm Invasiveness , Osteopontin , Genetics , Metabolism , Prostatic Neoplasms , Genetics , Metabolism , Pathology , RNA Interference , RNA, Messenger , Metabolism , RNA, Small Interfering , Signal Transduction , TransfectionABSTRACT
<p><b>OBJECTIVE</b>To differentiate rat adipose tissue-derived mesenchymal stem cells (ADSCs) into cells with a nucleus pulposus-like phenotype in vitro, so as to lay a foundation for the cell-based transplantation therapy of degenerated intervertebral discs.</p><p><b>METHODS</b>Rat ADSCs were isolated only from the subcutaneous inguinal region and purified by limited dilution. ADSCs of the third passages were analyzed by fluorescence activated cell sorter (FACS) to detect the cell surface markers (Sca-1, CD44, CD45, CD11b). To induce ADSCs towards a nucleus pulposus-like phenotype, ADSCs were immobilized in 3-dimensional alginate hydrogels and cultured in an inducing medium containing transforming growth factor-beta1 (TGF-beta1) under hypoxia (2% O(2)), while control groups under normoxia (21% O(2)) in alginate beads in medium with or without the presence of TGF-beta1. Semiquantitative reverse transcription polymerase chain reaction (RT-PCR) was carried out to evaluate phenotypic and biosynthetic activities in the process of differentiation. Meanwhile, Alcian blue staining were used to detect the formation of sulfated glycosaminoglycans (GAGs) in the differentiated cells.</p><p><b>RESULTS</b>The purified ADSCs were fibroblast-like and proliferated rapidly in vitro. The flow cytometry showed that ADSCs were positive for Sca-1 and CD44, negative for CD45 and CD11b. The results of RT-PCR manifested that the gene expressions of Sox-9, aggrecan and collagen II, which were chondrocyte specific, were upregulated in medium containing TGF-beta1 under hypoxia (2% O(2)). Likewise, gene expression of HIF-1a, which was characteristics of intervertebral discs, was also upregulated. Simultaneously, Alcian blue staining exhibited the formation of many GAGs.</p><p><b>CONCLUSIONS</b>The approach in our experiment is a simple and effective way to acquire a large quantity of homogenous ADSCs. Rat ADSCs can be differentiated into nucleus pulposus-like cells. ADSCs may replace bone marrow mesenchymal stem cells as a new kind of seed cells in regeneration of degenerated intervertebral discs using cell transplantation therapy.</p>
Subject(s)
Animals , Male , Rats , Alcian Blue , Alginates , Cell Differentiation , Physiology , Cells, Cultured , Coloring Agents , Flow Cytometry , Glucuronic Acid , Hexuronic Acids , Mesenchymal Stem Cells , Cell Biology , Metabolism , Rats, Sprague-Dawley , Reverse Transcriptase Polymerase Chain Reaction , Transforming Growth Factor beta , PharmacologyABSTRACT
With the increasing progress to know spinal cord injury (SCI) in experimental and clinical study and the confirming clinical effect to treat SCI with early methylprednisolone in ninety decade of 20th century, the mechanism of methylprednisolone therapy is understood continuously. Based on them above, a lot of new drugs are found effective for SCI. We want to give a review about it.
Subject(s)
Animals , Humans , Drug Discovery , Medicine, Chinese Traditional , Spinal Cord Injuries , Drug TherapyABSTRACT
<p><b>OBJECTIVE</b>To explore the relationship between multidrug resistance (Mdr) and malignancy. To observe whether P-glycoprotein (P-gp) overexpression had the same bioactivity as osteogenic stem cell turning into more mature cell or more complex phenotype when parent cell line turned to Mdr phenotype.</p><p><b>METHODS</b>Six cell sublines of Mdr phenotype with different expression degree were analyzed. Stathmin generally identified in malignancy cell and stem cell, was a microtubule associated protein and the signal of differentiation in osteogenic stem cell. RT-PCR and hybridization in situ were used to analyze the relationship between Mdr1 mRNA and expression of Stathmin mRNA and VEGF mRNA.</p><p><b>RESULTS</b>Morphological and functional analysis of Mdr phenotype showed the P-gp-positive cell lines were more differentiated than the parent cells in terms of enhanced activity of cellular alkaline phosphatase. These subclones all displayed a decrease in potential malignancy such as tumor growth rate and metastatic ability. A significant negative correlation could be identified between Mdr1 mRNA and expression of VEGF and Stathmin mRNA.</p><p><b>CONCLUSION</b>Expression of Mdr1/P170 indicated osteosarcoma cells differentiated towards more mature state, which will develop the new research field of Mdr and supply the new research method of the function of P- gp.</p>
Subject(s)
Humans , ATP Binding Cassette Transporter, Subfamily B, Member 1 , Genetics , Metabolism , Cell Differentiation , Cell Line, Tumor , Drug Resistance, Multiple , Drug Resistance, Neoplasm , Gene Expression , Multidrug Resistance-Associated Proteins , Genetics , Metabolism , Osteosarcoma , Genetics , Metabolism , Vascular Endothelial Growth Factor A , Genetics , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To analyze the failure factors treating femoral shaft fracture with interlocking intramedullary nailing, and to offer the measures for prevention.</p><p><b>METHODS</b>From April 1999 to September 2002, among the 213 cases of femoral shaft fracture treated by interlocking intramedullary nailing, 18 were failure. The data of these cases were analyzed.</p><p><b>RESULTS</b>The failure cases were divided into 6 types: 3 cases with nail break-down, 7 with distal screw backing out, 3 with proximal screw backing out, 3 with fibrous ankylosis of knee, 2 with late infection. Failure relative factors were regarded to operation technique, incorrect rehabilitation choice of operative indication, quality of interlocking intramedullary nailing.</p><p><b>CONCLUSIONS</b>An appropriate indication should be chosen as using interlocking intramedullary nailing for femoral shaft fracture. The skills should be mastered well. The suitable materials should be chosen carefully. And the rehabilitation exercises should be directed properly. All these are important measures for prevention.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Bone Nails , Femoral Fractures , General Surgery , Fracture Fixation, Intramedullary , Methods , Retrospective Studies , Treatment FailureABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of tacrolimus on expression of heat shock protein 70 (HSP 70) after spinal cord injuries (SCI) in rats and the relationship between expression of HSP 70 and apoptosis of neural cells.</p><p><b>METHODS</b>Seventy-two male rats were divided randomly into three groups: the sham-operation group, the injury group and the group treated with tacrolimus, and the latter two groups were SCI with a weight-drop impactor at the T(10) vertebrae level (10 g weight was dropped from a 4.0 cm height). The tacrolimus group was injected with tacrolimus 5 minutes after SCI, while the other groups received 0.9% saline likewise. The inclined plate and BBB (Basso, Beattie and Bresnahan) scales were used to evaluate hindlimb neurological function. The expression of HSP 70 mRNA after SCI was detected by using reverse transcription polymerase chain reactions (RT-PCR) and immunohistochemistry staining was performed to determine the protein expression of HSP 70 and Caspase-3. The apoptosis of neural cells was assessed with the terminal deoxynucleotidyl transferase-mediated deoxyuredine triphosphate-digoxin nick end labeling (TUNEL) method.</p><p><b>RESULTS</b>Compared with the injury group, the expression of HSP 70 was significantly higher in the tacrolimus group, and the peak expression of HSP 70 mRNA and protein was respectively observed at 6, 24 h after SCI. Caspase-3-positive or TUNEL-positive cells were significantly less in the tacrolimus group than in the injury group. Neurological function score of the tacrolimus group was significantly better than that of the injury group.</p><p><b>CONCLUSIONS</b>Tacrolimus may inhibit activity of Caspase-3, attenuate apoptosis of neural cells and ameliorate neurological function recovery after SCI by inducing high expression of HSP 70.</p>
Subject(s)
Animals , Male , Rats , Acute Disease , Apoptosis , Caspase 3 , Genetics , Metabolism , Disease Models, Animal , Gene Expression , HSP70 Heat-Shock Proteins , Genetics , Metabolism , Immunohistochemistry , Immunosuppressive Agents , Pharmacology , In Situ Nick-End Labeling , Neurons , Metabolism , Pathology , RNA, Messenger , Genetics , Metabolism , Random Allocation , Rats, Wistar , Reverse Transcriptase Polymerase Chain Reaction , Spinal Cord Injuries , Tacrolimus , PharmacologyABSTRACT
<p><b>OBJECTIVE</b>To explore the patterns of innervation of cervical facet joints and determine the pathways from facet joints to dorsal root ganglions (DRGs) in order to clarify the causes of diffuse neck pain, headache, and shoulder pain.</p><p><b>METHODS</b>Forty-two male-Sprague-Dawley rats, weighing 250-300 g, were randomly divided into three groups: Group A (n=18), Group B (n=18), and Group C (n=6). Under anesthesia with intraperitoneal pentobarbital sodium (45 mg/kg body weight), a midline dorsal longitudinal incision was made over the cervical spine to expose the left cervical facet joint capsule of all the rats under a microscope. The rats in Group A underwent sympathectomy, but the rats in Group B and Group C did not undergo sympathectomy. Then 0.6 microlitre 5% bisbenzimide (Bb) were injected into the C1-2, C3-4 and C5-6 facet joints of 6 rats respectively in Group A and Group B. The holes were immediately sealed with mineral wax to prevent leakage of Bb and the fascia and skin were closed. But in Group C, 0.9% normal saline was injected into the corresponding joint capsules. Then under deep re-anesthesia with intraperitoneal pentobarbital sodium (45 mg/kg body weight), C1-C8 left DRGs in all rats and the sympathetic ganglions in Group B were obtained and the number of the labeled neurons was determined.</p><p><b>RESULTS</b>Neurons labeled with Bb were present in C1-C8 DRGs in both Group A and Group B, and sympathetic ganglions in Group B. In the C1-2 and C3-4 subgroups, labeled neurons were present from C1 to C8 DRGs, while in C5-6 subgroups they were from C3 to C8. The number of Bb(+) neurons after sympathectomy was not significantly different in the injected level from that without sympathectomy. But in the other levels, the number of Bb(+) neurons after sympathectomy was significantly less than that without sympathectomy.</p><p><b>CONCLUSIONS</b>The innervation of the cervical facet joints is derived from both sensory and sympathetic nervous system, and DRGs are associated with sympathetic ganglions through nerve fibers outside the central nerve system.</p>
Subject(s)
Animals , Male , Rats , Cervical Vertebrae , Ganglia, Spinal , Cell Biology , Ganglia, Sympathetic , Cell Biology , Neurons, Afferent , Cell Biology , Rats, Sprague-DawleyABSTRACT
<p><b>OBJECTIVE</b>To investigate a new method to construct tissue-engineering bone that will be applicable clinically.</p><p><b>METHODS</b>The cultured 5th generation rabbit bone marrow stroma osteoblasts (MSO) was dissolved in 3% sodium alginate solution (the final concentration of sodium alginate in the solution being 1%, and MSO, 5x10(6)/L), and then inoculated into prepared true bone ceramic (TBC) and gelatinized the bone by dribbling with calcium gluconate. The standard bone defect models were made in 48 adult New Zealand rabbit's both radius. Among the 48 rabbits, 24 were in Groups A and B, in which the left radius was implanted with gelatinized MSO-TBC (Group A) and right radius implanted with autograft-bone (Group B); and the other 24 were in control group whose left radius was implanted with non-gelatinized MSO-TBC (Group C) and right radius implanted with gelatinized TBC (Group D). Outcomes of the implanted bones were assessed by radiology, pathological histology, osteogenetic quantitative analysis, and biomechanics at 2, 4, 8, 12 weeks postoperatively.</p><p><b>RESULTS</b>In Groups A and B, a satisfactory bone reparation and bony union was noted within 12 weeks. In Groups C and D, bone reparation was not satisfied compared with Group A in terms of ostogenetic quantity and biomechanics.</p><p><b>CONCLUSIONS</b>Gelatinized MSO-TBC is an ideal artificial active bone that overcomes TBC shortcomings of fragileness and smooth surface that is not eligible for seed cell's adhesion. It is promising to put into clinical use extensively.</p>
Subject(s)
Animals , Female , Male , Rabbits , Biomass , Bone Diseases , Diagnostic Imaging , Pathology , Therapeutics , Bone Marrow Cells , Cell Biology , Bone Substitutes , Ceramics , Disease Models, Animal , Gelatin , Osteoblasts , Cell Biology , Transplantation , Osteogenesis , Radiography , Radius , Diagnostic Imaging , Wounds and Injuries , Pathology , General Surgery , Stromal Cells , Cell Biology , Transplantation , Tissue Engineering , Methods , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical outcome of the repairing of soft tissue defects of foot with reverse island skin flap nourished by vasa vasorum of the sural nerve.</p><p><b>METHODS</b>The skin flap was designed with sural nerve and its vasa vasorum as the pedicle, and was harvested from the posterior crural region based on the size of the wounds. The defects of the foot in eighteen patients were repaired by reverse transplantation of the skin flap. The state of the skin flaps was observed post-operatively.</p><p><b>RESULTS</b>All the skin flaps survived. The biggest skin flap was 10.5 cm x 16.5 cm in size. The donor sites healed well with negligible change in appearance and function.</p><p><b>CONCLUSION</b>Reverse gastrocnemius musculocutaneous flap nourished by sural nerve vasa vasorum was easily procured with high survival rate, and it could be an ideal flap for the repair of soft tissue defect of the foot.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Foot Injuries , General Surgery , Plastic Surgery Procedures , Methods , Skin Transplantation , Methods , Soft Tissue Injuries , General Surgery , Sural Nerve , Surgical Flaps , Treatment Outcome , Wound HealingABSTRACT
<p><b>OBJECTIVE</b>To explore the possibility of repairing long segmental bone defects and preventing infection with cefazolin loaded bone matrix gelatin (C-BMG).</p><p><b>METHODS</b>C-BMG was made from putting cefazolin into BMG by vacuum absorption and lyophilization techniques. The sustaining period of effective drug concentration in vitro and in vivo was detected. The time of inhibiting bacteria, and the drug concentration in local tissues (bone and muscle) and plasma after implantation of C-BMG were examined by high performance liquid chromatography.</p><p><b>RESULTS</b>The effective inhibition time to staphylococcus aureus of C-BMG was 22 days in vitro; while 14 days in vivo. The cefazolin concentration in local tissues was higher in early stage, and later it kept a stable and low drug release. C-BMG showed an excellent ability to repair segmental long bone defects.</p><p><b>CONCLUSIONS</b>C-BMG can gradually release cefazolin with effective drug concentration and has excellent ability to repair segmental bone defects. It can be used to repair segmental long bone defects and prevent infection after operation.</p>