Metabolic profiling of serum and tissue from the rotator interval and anterior capsule in shoulder stiffness: a preliminary study.

BACKGROUND: Using mass spectrometry, we evaluated the metabolic profiles of patients who had rotator cuff tears with shoulder stiffness, or shoulder stiffness only, and compared these with samples from a control group. METHODS: This study enrolled 28 patients, including 10 patients with shoulder stiffness only (group I), nine patients with rotator cuff tear and stiffness (group II), and nine controls selected from patients diagnosed with impingement syndrome or long head of the biceps lesions without evident limitation of joint motion or rotator cuff tears. Serum and tissue from the rotator interval and anterior capsule were collected. In all, 82 samples were analyzed for metabolite profiling using the AbsoluteIDQ™p180 Kit. RESULTS: Comparison of 186 metabolites revealed that groups I and II had significantly higher concentrations of sphingolipids in serum (SM C24:1; group I = 65.16 µm, group II = 68.07 µm) than controls (55.37 µm, p = 0.005 & 0.015, respectively). Higher concentrations of sphingolipids were also present in the rotator interval tissue (SM C22:3) of groups 1 (0.0197 µm) and 2 (0.0144 µm) than controls (0.0081 µm, p = 0.012 & 0.014, respectively). The concentration of glycerophospholipid (PC aa C30:0) was higher in the anterior capsule tissue of groups I (0.850 µm) and II (1.164 µm) than controls (0.572 µm; p = 0.007) Total cholesterol was positively correlated with sphingolipid concentration in serum (SM C24:1, rho = 0.782, p = 0.008) and rotator interval tissue (SM C22:3, rho = 0.750, p = 0.017). There was no significant difference in the metabolites evaluated in groups I and II. CONCLUSION: Metabolic profiling showed that levels of lipid-related metabolites were increased in the anterior capsule tissue and rotator interval tissue of patients with shoulder stiffness. Sphingomyelin (SM C22:3) in the tissue of the rotator interval was positively correlated with the serum level of total cholesterol in patients with shoulder stiffness only. The level of glycerophospholipid (PC30:0) in the anterior capsule was positively correlated with the serum level of total cholesterol in patients who had rotator cuff tear with shoulder stiffness. The results indicate that serum total cholesterol may be related to shoulder stiffness. Future studies are needed to evaluate the role of serum cholesterol in the pathogenesis of shoulder stiffness. TRIAL REGISTRATION: KC12OISI0532. Registered Nov 15, 2012. approval by the Institutional Review Board of Seoul St. Mary's Hospital, the Catholic University of Korea.

Long-term Follow-up of Extensive Peri-anchor (Poly-L/D-lactic Acid) Cyst Formation after Arthroscopic Rotator Cuff Repair: A Case Report.

Suture anchors are commonly used in shoulder surgeries, especially for rotator cuff tears. Peri-anchor cyst formation, however, is sometimes detected on follow-up radiologic image after surgery. The purpose of this report is to discuss the case of a patient who presented with regression of extensive peri-anchor cyst on postoperative 4-year follow-up magnetic resonance imaging and had good clinical outcome despite peri-anchor cyst formation after arthroscopic rotator cuff repair.

Applying proprioceptive neuromuscular facilitation stretching: optimal contraction intensity to attain the maximum increase in range of motion in young males.

[Purpose] Proprioceptive neuromuscular facilitation (PNF) stretching is known to be effective in increasing joint ROM. The PNF stretching technique first induces an isometric contraction in the muscles to be stretched, but no agreement concerning the optimal contraction intensity has yet been reached. The purpose of the present study was to examine the effect of contraction intensity on ROM while applying PNF stretching. [Subjects and Methods] Sixty male subjects were randomly assigned to one of four groups (three experimental groups and one control group). Each experimental group applied one of three contraction intensities (100%, 60%, and 20%) defined by the MVIC ratio, and the control group did not receive any intervention during the experiment. PNF stretching was applied to left knee extensors to compare changes in the knee joint flexion angle. [Results] The results showed that the changes in ROM were larger for the 60% and 100% groups compared with the 20% group. The changes in ROM were lowest in the control group. [Conclusion] The present results indicate that while applying the PNF stretching, it is not necessary to apply the maximum intensity of muscle contraction. Moderate isometric contraction intensities may be optimal for healthy young males, while a sufficient effect can be obtained even with a low contraction intensity.

Bone regeneration in the maxillary sinus using an autologous fibrin-rich block with concentrated growth factors alone.

PURPOSE: The purpose of this study was to evaluate the predictability of new bone formation in the maxillary sinus using an autologous fibrin-rich blocks with concentrated growth factors (CGFs) alone as an alternative to graft material. MATERIALS AND METHODS: A total of sixty-one sinus grafts were consecutively performed using the lateral window approach. After making replaceable bony window, the sinus membrane was elevated to make a new compartment. After 113 implants (average 13 mm high) with 11 different systems were placed simultaneously, the collected fibrin-rich blocks with CGFs alone were inserted in the sinus. To seal the lateral window, the bony window was repositioned. Radiographic, clinical, and histologic evaluation was performed to verify sinus augmentation. RESULTS: No significant postoperative complications developed. New bone consolidation in all augmented maxillary sinus was observed along the implants on plain radiographs and on cone-beam computed tomograms. The success rate of implant was 98.2% after an average of 10 months loading. CONCLUSION: Fibrin-rich blocks with CGFs act as an alternative to bone grafting and can be a predictable procedure for sinus augmentation.