Indian Hedgehog Signaling Promotes Chondrocyte Differentiation in Enchondral Ossification in Human Cervical Ossification of the Posterior Longitudinal Ligament.
Indian hedgehog signaling promotes chondrocyte differentiation in enchondral ossification in human cervical ossification of the posterior longitudinal ligament.
Spine (Phila Pa 1976). 2013 Jul 23;
Sugita D, Yayama T, Uchida K, Kokubo Y, Nakajima H, Yamagishi A, Takeura N, Baba H
Study Design. Histological, immunohistochemical, and immunoblot analysis of the expression of Indian hedgehog (Ihh) signaling in human cervical ossification of the posterior longitudinal ligament (OPLL).Objective. To examine the hypothesis that Ihh signaling in correlation with Sox9 and parathyroid related peptide hormone (PTHrP) facilitates chondrocyte differentiation in enchondral ossification process in human cervical OPLL.Summary of Background Data. In enchondral ossification, certain transcriptional factors regulate cell differentiation. OPLL is characterized by overexpression of these factors and disturbance of the normal cell differentiation process. Ihh signaling is essential for enchondral ossification, especially in chondrocyte hypertrophy.Methods. Samples of ossified ligaments were harvested from 45 patients who underwent anterior cervical decompressive surgery for symptomatic OPLL, and 6 control samples from cervical spondylotic myelo/radiculopathy patients without OPLL. The harvested sections were stained with hematoxylin-eosin and toluidine blue, examined by transmission electron microscopy, and immunohistochemically stained for Ihh, PTHrP, Sox9, type X, XI collagen, and alkaline phosphatase. Immunoblot analysis was performed in cultured cells derived from the posterior longitudinal ligaments in the vicinity of the ossified plaque, and examined for the expression of the above factors.Results. The ossification front in OPLL contained chondrocytes at various differentiation stages, including proliferating chondrocytes in fibrocartilaginous area, hypertrophic chondrocytes around the calcification front, and apoptotic chondrocytes near the ossified area. Immunoreactivity for Ihh and Sox9 was evident in proliferating chondrocytes, and PTHrP was strongly positive in hypertrophic chondrocytes. Mesenchymal cells with blood vessel formation were positive for Ihh, PTHrP, and Sox9. Cultured cells from OPLL tissues expressed significantly higher levels of Ihh, PTHrP, and Sox9 compared with non-OPLL cells.Conclusion. Our results indicated that overexpression of Ihh signaling promotes abnormal chondrocyte differentiation in enchondral ossification, and enhances bone formation in OPLL. HubMed – rehab
Nutrition support team (NST) intervention for hip fracture in elderly patients over 90 years old -Validation effect using the Functional Independence Measure-.
Nihon Ronen Igakkai Zasshi. 2012; 49(6): 775-82
Hagiwara N, Ibayashi S
Aim: Malnutrition is common in the hospitalized elderly with hip fractures and has been linked to poorer recovery and increased complications. Hence, the aim of this study is to investigate whether nutrition support team (NST) intervention has a beneficial effect on rehabilitation outcome in the elderly, especially in the oldest-old patients with hip fracture using the Functional Independence Measure (FIM). Method: Patients were classified into two groups before and after NST intervention, and we evaluated FIM gain, FIM efficacy, and discharge outcomes. Every item was compared in low-ADL patients with an FIM of 54 or less on admission. Results: The numbers of patients were 18 in the non-NST and 22 in the NST group. Although nutritional indicators on admission showed no significant difference in the groups, FIM gain and FIM efficacy were significantly higher (p<0.01) and walking ability at discharge was better in the NST group (p<0.05). In low-ADL patients, the same results were confirmed. Conclusion: Although the malnourished patients often have a poor prognosis, there was a significant improvement in rehabilitation effect and discharge outcome in the NST group. Thus, these results suggest the effectiveness of multidisciplinary NST intervention. Moreover, even in elderly patients with low ADL on admission, significant effect of rehabilitation can be expected by appropriate nutritional management. HubMed – rehab
Performance-based tests to assess physical function in osteoarthritis of the hip or knee: Comment and proposal.
Osteoarthritis Cartilage. 2013 Jul 21;
Dekker J
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