The Effects of Continuous and Withdrawal Voluntary Wheel Running Exercise on the Expression of Senescence-Related Genes in the Visceral Adipose Tissue of Young Mice.

Obesity has become a global medical problem. The upregulation of senescence-related markers in adipose tissue may cause impairment of adipose tissue and disorders of systemic metabolism. Weight control through diet has been found to ameliorate senescence in the adipose tissue. Exercise is also important in maintaining a healthy lifestyle, however, very few researchers have examined the relationship between senescence-related markers in adipose tissue. Dietary restriction is also reported to have a legacy effect, wherein the effects are maintained for some periods after the termination of the intervention. However, very few researchers have examined the relationship between exercise and senescence-related markers in adipose tissue. Besides, there is no study on the long-term effects of exercise. Hence, we investigated whether the exercise could change the expression of senescence-related genes in the visceral adipose tissue of young mice and whether there was a legacy effect of exercise for 10 weeks after the termination of exercise. Four-week-old male ICR mice were assigned to one of the three groups: 20 weeks of sedentary condition, 20 weeks of voluntary wheel running exercise, or 10 weeks of exercise followed by 10 weeks of sedentary condition. The mice showed decreased expression in genes related to senescence and senescence-associated secretory phenotype, such as p53, p16, and IL-6, in the visceral adipose tissue in response to exercise. These effects were maintained for 10 weeks after the mice stopped exercising. Our study is the first report that exercise reduces the expression of senescence-related genes in the visceral adipose tissue of young mice, and that exercise causes the legacy effect.

Dorsal Tear of Triangular Fibrocartilage Complex: Clinical Features and Treatment.

Background Several different triangular fibrocartilage complex (TFCC) tear patterns have been classified through the use of wrist arthroscopy. A tear of the dorsal aspect of the TFCC has been previously reported, but it is not included in Palmer original classification. Our purpose was to describe this type of tear pattern along with the clinical presentation. Methods An isolated dorsal TFCC tear was encountered in seven wrists of six patients (three men and three women; average age was 31 years). All patients were evaluated by physical exam, X-ray, plain axial computed tomography with pronation, neutral and supination position, magnetic resonance imaging (MRI) with coronal, sagittal, and axial section and arthroscopy. Results The clinical findings varied and included the following: tenderness at the dorsoulnar aspect of the wrist was positive in all wrists, fovea sign was positive in five wrists, and tenderness at the dorsal aspect of the distal radioulnar joint was present in one wrist. Pain with forearm rotation was positive in all wrists. The ulnar head ballottement test induced pain in all wrists, whereas dorsal instability of the ulnar head was present in one wrist with this test. The ulnocarpal stress test was positive in five wrists. Axial and sagittal images on MRI revealed the dorsal tear in five wrists. All wrists were treated with an arthroscopic capsular repair. The final functional outcome at an average follow-up of 16.1 months was four excellent and one good wrist according to the modified Mayo wrist score. Conclusions The aim of this article is to describe our experiences with tears involving the dorsal aspect of the TFCC, which may be misdiagnosed if the surgeon is not cognizant of this injury. Type of study/level of evidence Diagnostic/level IV.

The efficacy of neuromuscular electrical stimulation with alternating currents in the kilohertz frequency to stimulate gait rhythm in rats following spinal cord injury.

BACKGROUND: Rehabilitation facilitates the reorganization of residual/regenerated neural pathways and is key in improving motor function following spinal cord injury. Neuromuscular electrical stimulation (NMES) has been reported as being clinically effective. Although it can be used after the acute phase post-injury, the optimal stimulation conditions to improve motor function remain unclear. In this paper, we examined the effectiveness of NMES with alternating currents in the kilohertz (kHz) frequency in gait rhythm stimulation therapy. METHODS: Tests were performed using 20 mature female Fischer rats. Incomplete spinal cord injuries (T9 level) were made with an IH impactor using a force of 150 kdyn, and NMES was administered for 3 days from the 7th day post-injury. The needle electrodes were inserted percutaneously near the motor point of each muscle in conscious rats, and each muscle on the left and right leg was stimulated for 15 min at two frequencies, 75 Hz and 8 kHz, to induce a gait rhythm. Motor function was evaluated using Basso, Beattie, Bresnahan (BBB) scores and three-dimensional (3D) gait analysis. Rats were divided into four groups (5 rats/group), including the NMES treatment 75-Hz group (iSCI-NMES 75 Hz), 8-kHz group (iSCI-NMES 8 kHz), injury control group (iSCI-NT), and normal group (Normal-CT), and were compared. RESULTS: There was no significant difference in BBB scores among the three groups. In 3D gait analysis, compared with the injury control group, the 8-kHz group showed a significant improvement in synergistic movement of both hindlimbs. CONCLUSION: We suggest that kHz stimulation is effective in gait rhythm stimulation using NMES.

Vascularized sural nerve graft and extracorporeally irradiated osteochondral autograft for oncological reconstruction of wrist sarcoma: case report and review of literature.

For tumors that are located beside the main peripheral nerve, combined wide resection of both the tumor and peripheral nerve is mandatory. We here present an interesting case with synovial sarcoma of the wrist. An 8 cm of ulnar nerve defect was reconstructed by vascularized, folded sural nerve graft with the peroneal flap, whereas an 8 cm of distal ulna was reconstructed using extracorporeally irradiated osteochondral autograft. Our case showed excellent nerve regeneration. Extracorporeal irradiated osteochondral graft was a good option for reconstruction of the distal ulna. This procedure should be indicated for the reconstruction of non-weight-bearing joints. These kinds of reconstruction have been addressed in only a few cases of oncological reconstruction.

Development of less invasive neuromuscular electrical stimulation model for motor therapy in rodents.

BACKGROUND: Combination therapy is essential for functional repairs of the spinal cord. Rehabilitative therapy can be considered as the key for reorganizing the nervous system after spinal cord regeneration therapy. Functional electrical stimulation has been used as a neuroprosthesis in quadriplegia and can be used for providing rehabilitative therapy to tap the capability for central nervous system reorganization after spinal cord regeneration therapy. OBJECTIVE: To develop a less invasive muscular electrical stimulation model capable of being combined with spinal cord regeneration therapy especially for motor therapy in the acute stage after spinal cord injury. METHODS: The tibialis anterior and gastrocnemius motor points were identified in intact anesthetized adult female Fischer rats, and stimulation needle electrodes were percutaneously inserted into these points. Threshold currents for visual twitches were obtained upon stimulation using pulses of 75 or 8 kHz for 200 ms. Biphasic pulse widths of 20, 40, 80, 100, 300, and 500 µs per phase were used to determine strength-duration curves. Using these parameters and previously obtained locomotor electromyogram data, stimulations were performed on bilateral joint muscle pairs to produce reciprocal flexion/extension movements of the ankle for 15 minutes while three-dimensional joint kinematics were assessed. RESULTS: Rhythmic muscular electrical stimulation with needle electrodes was successfully done, but decreased range of motion (ROM) over time. High-frequency and high-amplitude stimulation was also shown to be effective in alleviating decreases in ROM due to muscle fatigue. CONCLUSIONS: This model will be useful for investigating the ability of rhythmic muscular electrical stimulation therapy to promote motor recovery, in addition to the efficacy of combining treatments with spinal cord regeneration therapy after spinal cord injuries.

Transplantation of neurospheres derived from bone marrow stromal cells promotes neurological recovery in rats with spinal cord injury.

Previous studies have revealed that cell therapy using bone marrow stromal cells (BMSCs) could promote motor functional recovery in animals with spinal cord injury (SCI). We describe here the development of cell biology technique and the experimental study of regeneration in SCI. The aim of this study was to investigate the potential for neurological recovery by transplantation neurospheres (NS) derived from BMSCs into thoracic SCI. Adult Fisher rats were used: 45 were subjected to complete thoracic SCI performed by the balloon compression method. BMSCs were cultured in vitro to obtain NS. Seven days after thoracic SCI, groups of 15 rats each received transplants of BMSCs-NS (group A), BMSCs (group B), or injection of medium only (group C) into the SCI lesion. Rats from each group were evaluated and compared longitudinally for motor function recovery. The spinal cords (SC) of injured rats were harvested at day 21 or day 42 and prepared for histological analysis. Five weeks after transplantation, many neuronal or axonal sproutings were observed and replaced by host cells in the SCI lesion of group A. Also, transplanted BMSCs-NS expressed neuronal lineage markers. Transplanted rats could walk with weight bearing and showed recovered motor evoked potentials (MEPs).

Myeloablative irradiation, granulocyte-colony stimulating factor, and FK506 can induce macrochimerism and prolong the survival of experimental extremity allografts.

BACKGROUND: A key component of composite tissue allografts is the vascularized limb/bone marrow because of its capacity to reconstitute the marrow cavity of the recipient. The efficacy of a new protocol that uses total body irradiation (TBI), granulocyte colony-stimulation factor (G-CSF), and FK506 to induce high level bone marrow chimerism was evaluated with particular reference to the dose requirement and toxicity of TBI. MATERIALS AND METHODS: In total, 82 whole-limb allotransplants from LacZ transgenic rats to LEW rats were performed. TBI was administered just prior to transplantation with various doses ranging from 100 to 1500 R (almost equal to 1-15 Gy). G-CSF was given for 4 d, while FK506 was used for 28 d. The level of chimerism was evaluated by semiquantitative polymerase chain reaction (PCR). RESULTS: The survival of limb allografts in recipients that were pretreated with a myeloablative TBI dose of >1000 R was prolonged to more than 1 y. Recipients pretreated with <500 R showed no prolongation of limb graft survival. A majority of long-term survivors showed chronic, nonlethal graft-versus-host disease (GVHD). PCR analysis revealed a high level of intra-bone marrow chimerism in the recipient, thus demonstrating successful induction of macrochimerism. CONCLUSION: Vascularized limb/bone marrow graft is a proven method for supplying donor cells to the bone marrow of irradiated recipients. A new protocol involving pretransplant myeloablative TBI with >1000 R followed by treatment with G-CSF and FK506 was found to induce a high level of chimerism and significantly prolong the survival of limb allografts without causing lethal GVHD.

Anatomical reconstruction of the knee extensor apparatus for prepatellar myxofibrosarcoma.

A novel reconstruction of the knee extensor apparatus was attempted in a 69-year-old patient with prepatellar myxoid fibrosarcoma. The skin (35×25 cm), subcutaneous tumor, quadriceps tendon, patella, anterior capsule, and patella tendon were widely resected en-bloc. Following wide resection, the excised quadriceps tendon, patella, and patella tendon were anatomically reimplanted into the original site after being devitalized in liquid nitrogen. These complexes were covered by a free vascularized latissimus dorsi myocutaneous flap. At 18-month follow-up, the strength of active knee extension was 4+ of 5 in the muscle manual test. The active range of motion was 110° in flexion and -10° in extension. The tumor showed no evidence of disease. The patella and femur joint showed no osteoarthritis on plain radiographs. This procedure is the only way to achieve anatomical reconstruction. Reattachment of patella tendon to the tibial tuberosity was possible. The use of liquid nitrogen to devitalize is straightforward and the operation time can be shortened. To our knowledge, this type of reconstructive procedure has never been reported in the English literature.

Myeloablative irradiation and granulocyte colony-stimulating factor prolong the survival of chimeric limb allografts in a rodent model.

BACKGROUND: Limb allografts consist of different types of tissues with varying antigenicities. One of the key components is the bone marrow. Removal and reconstitution of this tissue may allow better control of limb allograft rejection. The authors evaluated the efficacy of a new protocol for bone marrow removal that uses pretransplant graft irradiation, granulocyte colony-stimulating factor, and temporal FK506, with particular reference to the dose requirement and toxicity of irradiation. METHODS: In total, 57 whole-limb allotransplants from LacZ transgenic rats to Lewis rats were performed. Graft irradiation with various doses ranging from 250 to 1500 R was administered just before transplantation. Granulocyte colony-stimulating factor was given for 4 days, whereas FK506 was used for 28 days. The level of intra-bone marrow chimerism of the graft was evaluated by semiquantitative polymerase chain reaction. RESULTS: Rejection-free survival of grafts was increased significantly in groups that received more than 1000 R of pretransplant irradiation and granulocyte colony-stimulating factor, whereas grafts that received less than 500 R of irradiation showed no prolongation in survival. Bone marrow in the myeloablative irradiation groups was quickly reconstituted by recipient-derived cells. In the group treated with 1500 R of irradiation, the graft tissue was damaged and this led to infection of the recipient. In the 1000-R group, two of eight recipients showed rejection-free graft survival of more than 1 year without any immunosuppression. CONCLUSIONS: The authors study found that removal of allogeneic bone marrow in the limb graft and rapid reconstitution with recipient marrow cells reduced the recipient's immune response. Graft rejection was delayed significantly but not completely prevented.

Evaluation of C5 nerve root repairability in traumatic brachial plexus injuries: proposal of an evaluation scoring system.

We reviewed 36 traumatic brachial plexus injury patients with C5 nerve root injury. We used the choline acetyltransferase (CAT) activity measurement as a gold standard indicator of repairability to assess the reliability of the conventional techniques (preoperative clinical, electrophysiologic, and radiologic examination and intraoperative clinical and electrophysiologic examinations). We proposed a repairability scoring system composed of the correlated conventional techniques and tested the validity of this scoring system using the same reference technique (CAT activity measurement). We found no significant correlation between sensation at C5 dermatome and electromyography study with C5 repairability. On the other hand, we found a significant correlation of Tinel sign, myelography, macroscopic and microscopic examination, and electrical stimulation with C5 repairability. Based on these results, we propose a simple 21-point scoring system to evaluate the repairability of C5 nerve root that is composed of Tinel sign, myelography, macroscopic and microscopic appearance, and electrical stimulation. The scoring system was found to be highly significantly correlated with C5 repairability. We concluded that our proposed evaluation scoring system is a reliable method for C5 repairability evaluation, and it can replace sophisticated techniques.