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- Agardh, Carl-David, et al.
(författare)
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Expression of antioxidant enzymes in rat retinal ischemia followed by reperfusion.
- 2006
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Ingår i: Metabolism, Clinical and Experimental. - : Elsevier BV. - 1532-8600. ; 55:7, s. 892-898
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the expression and protein levels of antioxidant enzymes in the rat retina exposed to oxidative stress induced by ischemia-reperfusion injury. Retinal ischemia was induced in female Wistar rats by ligation of the optic nerve and vessels behind the left eye bulb, and was followed by reperfusion for 0, 3, 6, or 24 hours. The right eye served as control. RNA and protein were extracted simultaneously from each retina. Expressions of the endogenous antioxidant enzymes glutathione peroxidase (GPx1), catalase (CAT), copper/zinc superoxide dismutase, manganese superoxide dismutase, and the catalytic subunit of glutamylcysteine ligase (GCLc) were analyzed with real-time reverse transcription polymerase chain reaction and related to the endogenous control cyclophilin B. Protein levels were measured with Western blot analysis. During the early phase (0 or 3 hours) of reperfusion, no changes were seen in enzyme expression. After 6 hours, GCLc expression increased by a factor of 1.14 (P =.034), followed by a decline of 0.80 after 24 hours (P =.00004), according to the comparative Ct method. After 24 hours of reperfusion, GPx1 expression increased by a factor of 1.14 (P =.028), and CAT had decreased by 0.82 (P =.022). Expressions of copper/zinc superoxide dismutase and manganese superoxide dismutase showed a tendency toward a decrease by factors of 0.86 (P =.055) and 0.88 (P =.053), respectively, after 24 hours. Protein levels did not differ for any of the antioxidants, regardless of reperfusion time. The slightly increased messenger RNA expression of GPx1 after 24 hours of reperfusion with a concomitant very modest decrease in CAT and GCLc expression and no change in protein levels indicate a very modest, if any, response to oxidative stress generated by ischemia followed by reperfusion in rat retina.
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- Andersson, Jonny K, 1972, et al.
(författare)
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Cartilage Injuries and Posttraumatic Osteoarthritis in the Wrist: A Review
- 2021
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Ingår i: Cartilage. - : SAGE Publications. - 1947-6035 .- 1947-6043. ; 13:1_suppl
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Focal cartilage injuries, and posttraumatic osteoarthritis (OA) in the wrist are likely common and a cause of wrist pain. To estimate the incidence of cartilage lesions and to understand the pathomechanisms leading to wrist cartilage injuries and OA, a literature review on the subject was performed combined with a presentation of one of the authors’ own experience. Design: This study includes a literature review of the topic. As a comparison to the review findings, the observations of one of the authors’ consecutive 48 wrist arthroscopies, were assessed. PubMed, Scholar, and Cochrane databases were searched using the keywords “cartilage injury AND wrist AND treatment” and “wrist AND cartilage AND chondral AND osteochondral AND degenerative OA.” :Result: A total of 11 articles, including 9 concerning chondral and osteochondral repair and treatment and 2 regarding posttraumatic OA, were retrieved. The cartilage repair treatments used in these articles were drilling, osteochondral autograft, juvenile articular cartilage allograft, and chondrocyte implantation. One article displayed concomitant cartilage injuries in displaced distal radius fractures in 32% of the patients. The review of our findings from a 1-year cohort of wrist arthroscopies showed 17% cartilage injuries. Conclusion: There is a lack of knowledge in current literature on cartilage injuries and treatment, as well as posttraumatic OA in the wrist. Cartilage injuries appear to be common, being found in 17% to 32% of all wrist arthroscopies after trauma, but no guidelines regarding conservative or surgical treatment can be recommended at the moment. Larger prospective comparative studies are needed. © The Author(s) 2021.
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- Bahm, J., et al.
(författare)
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Ulnar Wrist Deviation in Children With Obstetric Brachial Plexus Palsy: A Descriptive Study of Clinical and Radiological Findings of Impaired Ulnar Growth and Associated Incongruence of the Distal Radioulnar Joint
- 2019
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Ingår i: Hand. - : SAGE Publications. - 1558-9447 .- 1558-9455. ; 15:5, s. 615-619
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Tidskriftsartikel (refereegranskat)abstract
- Backround: Some children with obstetric brachial plexus palsy (OBPP) present later on with an ulnarly deviated wrist. The aim of this study was to present a retrospective analysis of a subgroup of OBPP children with ulnarly deviated wrists and to describe their morphologic wrist deformity in terms of clinical and radiological appearance. Methods: We present a retrospective analysis of the records of 27 children with an ulnarly deviated wrist as a consequence of OBPP. Radiographs of the affected wrist were performed when the ulnar deformity became clinically manifest and merited investigation, at a mean age of 15 (range: 6.5-27) years. Available clinical and radiological data were analyzed and categorized. Results: The ulnar-deviated position was associated with impaired active and passive pronosupination in all patients. Fifteen fixed supination deformities and 3 anterior radial head dislocations were noted clinically. Plain radiographs were completed in 24 patients and could be analyzed in 18, showing variations in ulnar variance (7 neutral, 7 ulna minus, and 4 ulna plus) along with 6 subluxations of the distal radioulnar joint (DRUJ). Of the patients treated surgically (n = 7), only the 2 patients treated with wrist fusion had an actual improvement in ulnar wrist deformity. Conclusion: Radiologically visible ulnar head hypoplasia, overgrowth of the distal ulna, or a shortened ulnar diaphysis and an incongruent DRUJ were present in all examined OBPP patients with a clinically evident ulnarly deviated wrists. The radiological findings highlight the morphologic adaptation behind this clinical condition and could allow further investigation into suitable treatment strategies. © The Author(s) 2019.
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- Ge, C. R., et al.
(författare)
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Antibodies to Cartilage Oligomeric Matrix Protein Are Pathogenic in Mice and May Be Clinically Relevant in Rheumatoid Arthritis
- 2022
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Ingår i: Arthritis & Rheumatology. - : Wiley. - 2326-5191 .- 2326-5205.
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Tidskriftsartikel (refereegranskat)abstract
- Objective Cartilage oligomeric matrix protein (COMP) is an autoantigen in rheumatoid arthritis (RA) and experimental models of arthritis. This study was undertaken to investigate the structure, function, and relevance of anti-COMP antibodies. Methods We investigated the pathogenicity of monoclonal anti-COMP antibodies in mice using passive transfer experiments, and we explored the interaction of anti-COMP antibodies with cartilage using immunohistochemical staining. The interaction of the monoclonal antibody 15A11 in complex with its specific COMP epitope P6 was determined by x-ray crystallography. An enzyme-linked immunosorbent assay and a surface plasma resonance technique were used to study the modulation of calcium ion binding to 15A11. The clinical relevance and value of serum IgG specific to the COMP P6 epitope and its citrullinated variants were evaluated in a large Swedish cohort of RA patients. Results The murine monoclonal anti-COMP antibody 15A11 induced arthritis in naive mice. The crystal structure of the 15A11-P6 complex explained how the antibody could bind to COMP, which can be modulated by calcium ions. Moreover, serum IgG specific to the COMP P6 peptide and its citrullinated variants was detectable at significantly higher levels in RA patients compared to healthy controls and correlated with a higher disease activity score. Conclusion Our findings provide the structural basis for binding a pathogenic anti-COMP antibody to cartilage. The recognized epitope can be citrullinated, and levels of antibodies to this epitope are elevated in RA patients and correlate with higher disease activity, implicating a pathogenic role of anti-COMP antibodies in a subset of RA patients.
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- Hagert, E
(författare)
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Clinical diagnosis and wide-awake surgical treatment of proximal median nerve entrapment at the elbow: a prospective study
- 2013
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Ingår i: Hand (New York, N.Y.). - : SAGE Publications. - 1558-9447 .- 1558-9455. ; 8:1, s. 41-6
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Tidskriftsartikel (refereegranskat)abstract
- Proximal median nerve entrapment (PMNE, or pronator syndrome) at the elbow has traditionally been considered an elusive and rare diagnosis, as it is seldom detectable using electrophysiological techniques. In this paper, the clinical manifestations, physical diagnosis, surgical technique, and results of surgical treatment of PMNE are presented, with accompanying instructional video. Patients/Methods During 2011, 44 patients with PMNE were surgically released and followed prospectively, 22 women/22 men, mean age 48.8 (range 25-66). The patients were equally distributed between right/left hands (23/21) and the dominant hand was treated in 56 % of cases. The diagnosis was based on: (1) weakness in median innervated muscles distal to the lacertus fibrosus; (2) pain upon pressure over the median nerve at the level of the lacertus fibrosus; and (3) positive scratch collapse test. A minimally invasive surgical treatment using only local anesthesia with lidocaine–epinephrine and no tourniquet was used, and direct perioperative return of strength in median innervated muscles was seen in all subjects. Results The average preoperative quick DASH was 35.4 (range 6.8–77.2); work DASH, 44.3 (6.25–100); and activity DASH, 61.6 (12.5–100). There were 71.1 % patients who completed the 6-month follow-up, and the average postoperative quick DASH was 12.7 (range 0–43.1), which is a statistically significant reduction ( p<0.0001; Student's paired t test). Similarly, the work and activity DASH was significantly reduced ( p<0.001) to 12.5 (0-75) and 6.25 (0-50), respectively. Conclusions PMNE at the level of the lacertus fibrosus should be called lacertus tunnel syndrome to distinguish it from other levels of median nerve entrapment. It is a clinical diagnosis based on three distinct clinical findings: weakness, pain over point of compression, and positive scratch collapse test. Surgical release in local anesthesia allows for a safe, ambulatory, and cost-efficient procedure with low morbidity.
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- Hagert, E, et al.
(författare)
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The role of proprioception and neuromuscular stability in carpal instabilities
- 2016
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Ingår i: The Journal of hand surgery, European volume. - : SAGE Publications. - 2043-6289. ; 41:1, s. 94-101
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Tidskriftsartikel (refereegranskat)abstract
- Carpal stability has traditionally been defined as dependent on the articular congruity of joint surfaces, the static stability maintained by intact ligaments, and the dynamic stability caused by muscle contractions resulting in a compression of joint surfaces. In the past decade, a fourth factor in carpal stability has been proposed, involving the neuromuscular and proprioceptive control of joints. The proprioception of the wrist originates from afferent signals elicited by sensory end organs (mechanoreceptors) in ligaments and joint capsules that elicit spinal reflexes for immediate joint stability, as well as higher order neuromuscular influx to the cerebellum and sensorimotor cortices for planning and executing joint control. The aim of this review is to provide an understanding of the role of proprioception and neuromuscular control in carpal instabilities by delineating the sensory innervation and the neuromuscular control of the carpus, as well as descriptions of clinical applications of proprioception in carpal instabilities.
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- Lee, J, et al.
(författare)
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Immunofluorescent triple-staining technique to identify sensory nerve endings in human thumb ligaments
- 2012
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Ingår i: Cells, tissues, organs. - : S. Karger AG. - 1422-6421 .- 1422-6405. ; 195:5, s. 456-464
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Tidskriftsartikel (refereegranskat)abstract
- Ligament innervation purportedly plays a critical role in stability, proprioception and pathology of joints with minimal bony constraints. The human thumb carpometacarpal (CMC) joint is such a joint: with a complex saddle configuration and wide circumduction, its constraint is primarily ligamentous and it is prone to osteoarthritis. CMC reconstruction is the most commonly performed arthritis surgery in the upper extremity. Little, however, is known about CMC ligament innervation. We describe a novel triple-staining immunofluorescence technique using the markers for low-affinity neurotrophin receptor p75, the pan-neuronal marker protein gene product (PGP) 9.5 and 4′,6′-diamidino-2-phenylindole (DAPI) to simultaneously detect and differentiate between specific sensory nerve endings: the Pacini corpuscles, the Ruffini endings and nerve fascicles. Five primary CMC ligaments (dorsal radial, dorsal central, posterior oblique, anterior oblique and ulnar collateral ligaments) were harvested from 10 fresh-frozen human cadaver hands. Following paraffin sectioning, each ligament was stained using a triple-stain technique and imaged with fluorescence microscopy. Multidimensional acquisition permitted simultaneous capture of images at different wavelengths. Pacini corpuscles were distinguished by their distinct p75 immunoreactive capsules, and Ruffini endings by their overlapping p75 and PGP9.5 immunoreactive dendritic nerve endings. Simultaneous use of PGP9.5, p75 and DAPI immunofluorescence to analyze innervation patterns in human ligaments provides descriptive analysis of staining patterns and receptor structure as well as clues as to the proprioceptive function of CMC ligaments and the joint as a whole. Our novel findings of CMC ligament innervation augment the study of normal and pathological joint mechanics in this joint so prone to osteoarthritis.
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- Mobargha, N, et al.
(författare)
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The effect of individual isometric muscle loading on the alignment of the base of the thumb metacarpal: a cadaveric study
- 2016
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Ingår i: The Journal of hand surgery, European volume. - : SAGE Publications. - 2043-6289. ; 41:4, s. 374-379
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Tidskriftsartikel (refereegranskat)abstract
- Stability of the thumb carpometacarpal joint relies upon equilibrium between its ligaments, muscular support and joint congruity. We wanted to identify the muscles important in preventing or increasing dorsoradial subluxation of this joint. In ten cadaveric hands, a Fastrak® motion tracking device was used to assess the effects of individual isometric muscle loading on the base of the thumb metacarpal relative to the radius and to the base of the middle finger metacarpal. We found that the first dorsal interosseous muscle caused the least dorsoradial translation and highest distal migration of the base of the first metacarpal, whereas abductor pollicis longus was the primary destabilizer, increasing dorsoradial misalignment. The findings show different impacts of these muscles on joint alignment and stability, which suggests that treatment should be targeted to enhance the action of the primary stabilizing muscle, the first dorsal interosseous muscle.
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| 48. |
- Rein, S, et al.
(författare)
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Comparative analysis of inter- and intraligamentous distribution of sensory nerve endings in ankle ligaments: a cadaver study
- 2013
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Ingår i: Foot & ankle international. - : SAGE Publications. - 1071-1007 .- 1944-7876. ; 34:7, s. 1017-1024
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to analyze the inter-, intraligamentous, and side-related patterns of sensory nerve endings in ankle ligaments. Methods: A total of 140 ligaments from 10 cadaver feet were harvested. Lateral: calcaneofibular, anterior-, posterior talofibular; sinus tarsi: lateral- (IERL), intermediate-, medial-roots inferior extensor retinaculum, talocalcaneal oblique and canalis tarsi (CTL); medial: tibionavicular (TNL), tibiocalcaneal (TCL), superficial tibiotalar, anterior/posterior tibiotalar portions; syndesmosis: anterior tibiofibular. Following immunohistochemical staining, the innervation and vascularity was analyzed between ligaments of each anatomical complex, left/right feet, and within the 5 levels of each ligament. Results: Significantly more free nerve endings were seen in all ligaments as compared to Ruffini, Pacini, Golgi-like, and unclassifiable corpuscles ( P ≤ .005). The IERL had significantly more free nerve endings and blood vessels than the CTL ( P ≤ .001). No significant differences were seen in the side-related distribution, except for Ruffini endings in right TCL ( P = .016) and unclassifiable corpuscles in left TNL ( P = .008). The intraligamentous analysis in general revealed no significant differences in mechanoreceptor distribution. Conclusions: The IERL at the entrance of the sinus tarsi contained more free nerve endings and blood vessels, as compared to the deeper situated CTL. Despite different biomechanical functions in the medial and lateral ligaments, the interligamentous distribution of sensory nerve endings was equal. Clinical Relevance: The intrinsic innervation patterns of the ankle ligaments provides an understanding of their innate healing capacities following injury as well as the proprioception properties in postoperative rehabilitation.
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| 49. |
- Rein, S, et al.
(författare)
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Histological analysis of the structural composition of ankle ligaments
- 2015
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Ingår i: Foot & ankle international. - : SAGE Publications. - 1944-7876 .- 1071-1007. ; 36:2, s. 211-224
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Tidskriftsartikel (refereegranskat)abstract
- Various ankle ligaments have different structural composition. The aim of this study was to analyze the morphological structure of ankle ligaments to further understand their function in ankle stability. Methods: One hundred forty ligaments from 10 fresh-frozen cadaver ankle joints were dissected: the calcaneofibular, anterior, and posterior talofibular ligaments; the inferior extensor retinaculum, the talocalcaneal oblique ligament, the canalis tarsi ligament; the deltoid ligament; and the anterior tibiofibular ligament. Hematoxylin-eosin and Elastica van Gieson stains were used for determination of tissue morphology. Results: Three different morphological compositions were identified: dense, mixed, and interlaced compositions. Densely packed ligaments, characterized by parallel bundles of collagen, were primarily seen in the lateral region, the canalis tarsi, and the anterior tibiofibular ligaments. Ligaments with mixed tight and loose parallel bundles of collagenous connective tissue were mainly found in the inferior extensor retinaculum and talocalcaneal oblique ligament. Densely packed and fiber-rich interlacing collagen was primarily seen in the areas of ligament insertion into bone of the deltoid ligament. Conclusions: Ligaments of the lateral region, the canalis tarsi, and the anterior tibiofibular ligaments have tightly packed, parallel collagen bundles and thus can resist high tensile forces. The mixed tight and loose, parallel oriented collagenous connective tissue of the inferior extensor retinaculum and the talocalcaneal oblique ligament support the dynamic positioning of the foot on the ground. The interlacing collagen bundles seen at the insertion of the deltoid ligament suggest that these insertion areas are susceptible to tension in a multitude of directions. Clinical Relevance: The morphology and mechanical properties of ankle ligaments may provide an understanding of their response to the loads to which they are subjected.
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| 50. |
- Rein, S, et al.
(författare)
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Histopathological analysis of the synovium in trapeziometacarpal osteoarthritis
- 2019
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Ingår i: The Journal of hand surgery, European volume. - : SAGE Publications. - 2043-6289. ; 44:10, s. 1079-1088
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Tidskriftsartikel (refereegranskat)abstract
- Dorsoradial and anterior oblique ligaments were harvested during surgery in 13 patients with symptomatic trapeziometacarpal osteoarthritis, which had been graded preoperatively by a modified Eaton-Littler radiographic grading. Ligaments, including the periligamentous synovium, were stained with S100 protein, neurotrophic receptor p75, protein gene product 9.5, calcitonin gene related peptide, acetylcholine, substance P, neuropeptide Y, noradrenaline, N-methyl-D-aspartate-receptor and Met/Leu-enkephalin. The synovium was classified as showing no, low-grade or high-grade synovitis. Free nerve endings had higher immunoreactivity for substance P than for N-methyl-D-aspartate-receptor, enkephalin and noradrenaline. The synovial stroma had less immunoreactivity for N-methyl-D-aspartate-receptor than for noradrenaline, substance P and calcitonin gene related peptide. There was no relation between the grade of osteoarthritis and the visual pain analogue scale, synovitis score, immunoreactivity of all antibodies and quantity of free nerve endings or blood vessels. Synovium in trapeziometacarpal joint osteoarthritis produces several neuromediators causing a polymodal neurogenic inflammation and which may serve as biomarkers for osteoarthritis or therapeutic targets.
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