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Sample records for amyloid shoulder nodulesin

  1. Shoulder Instability

    Science.gov (United States)

    ... Risk Factors Is shoulder instability the same as shoulder dislocation? No. The signs of dislocation and instability might ... the same to you--weakness and pain. However, dislocation occurs when your shoulder goes completely out of place. The shoulder ligaments ...

  2. Frozen shoulder

    Science.gov (United States)

    ... a frozen shoulder are: Decreased motion of the shoulder Pain Stiffness Frozen shoulder without any known cause starts ... If you have shoulder pain and stiffness and think you have a frozen shoulder, contact your health care provider for referral and treatment.

  3. Shoulder arthroscopy

    Science.gov (United States)

    SLAP repair; SLAP lesion; Acromioplasty; Bankart repair; Bankart lesion; Shoulder repair; Shoulder surgery; Rotator cuff repair ... the lower part of the shoulder joint. A SLAP lesion involves the labrum and the ligament on ...

  4. Shoulder pain

    Science.gov (United States)

    Pain - shoulder ... changes around the rotator cuff can cause shoulder pain. You may have pain when lifting the arm above your head or ... The most common cause of shoulder pain occurs when rotator cuff tendons ... The tendons become inflamed or damaged. This condition ...

  5. Shoulder Arthroscopy

    Science.gov (United States)

    ... inflamed tissue or loose cartilage • Repair for recurrent shoulder dislocation Less common procedures such as nerve release, fracture repair, and cyst excision can also be performed using an arthroscope. ... as shoulder replacement, still require open surgery with more extensive ...

  6. Shoulder reflexes

    DEFF Research Database (Denmark)

    Diederichsen, Louise; Krogsgaard, Michael; Voigt, Michael;

    2002-01-01

    Dynamic shoulder stability is dependent on muscular coordination and sensory inputs. In the shoulder, mechanoreceptors are found in the coracoacromial ligament, the rotator cuff tendons, the musculotendinous junctions of the rotator cuff and in the capsule. The number of receptors in the capsule...

  7. Shoulder instability

    International Nuclear Information System (INIS)

    In the shoulder, the advantages of range of motion are traded for the disadvantages of vulnerability to injury and the development of instability. Shoulder instability and the lesion it produces represent one of the main causes of shoulder discomfort and pain. Shoulder instability is defined as a symptomatic abnormal motion of the humeral head relative to the glenoid during active shoulder motion. Glenohumeral instabilities are classified according to their causative factors as the pathogenesis of instability plays an important role with respect to treatment options: instabilities are classified in traumatic and atraumatic instabilities as part of a multidirectional instability syndrome, and in microtraumatic instabilities. Plain radiographs ('trauma series') are performed to document shoulder dislocation and its successful reposition. Direct MR arthrography is the most important imaging modality for delineation the different injury patterns on the labral-ligamentous complex and bony structures. Monocontrast CT-arthrography with use of multidetector CT scanners may be an alternative imaging modality, however, regarding the younger patient age, MR imaging should be preferred in the diagnostic work-up of shoulder instabilities. (orig.)

  8. Shoulder replacement

    Science.gov (United States)

    ... are able to return to sports such as golf, swimming, gardening, bowling, and others. Your new shoulder ... important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy , ...

  9. Shoulder Problems

    Science.gov (United States)

    ... ibuprofen, for pain. No 11. Do you feel pain when you move your shoulder but there's no swelling or redness? Yes You may have BURSITIS or ROTATOR CUFF SYNDROME. Use an anti-inflammatory medicine, such as ibuprofen, ...

  10. Shoulder instability

    International Nuclear Information System (INIS)

    Shoulder instability is a common clinical feature leading to recurrent pain and limitated range of motion within the glenohumeral joint. Instability can be due a single traumatic event, general joint laxity or repeated episodes of microtrauma. Differentiation between traumatic and atraumatic forms of shoulder instability requires careful history and a systemic clinical examination. Shoulder laxity has to be differentiated from true instability followed by the clinical assessment of direction and degree of glenohumeral translation. Conventional radiography and CT are used for the diagnosis of bony lesions. MR imaging and MR arthrography help in the detection of soft tissue affection, especially of the glenoid labrum and the capsuloligamentous complex. The most common lesion involving the labrum is the anterior labral tear, associated with capsuloperiostal stripping (Bankart lesion). A number of variants of the Bankart lesion have been described, such as ALPSA, SLAP or HAGL lesions. The purpose of this review is to highlight different forms of shoulder instability and its associated radiological findings with a focus on MR imaging. (orig.)

  11. Transmissible amyloid.

    Science.gov (United States)

    Tjernberg, L O; Rising, A; Johansson, J; Jaudzems, K; Westermark, P

    2016-08-01

    There are around 30 human diseases associated with protein misfolding and amyloid formation, each one caused by a certain protein or peptide. Many of these diseases are lethal and together they pose an enormous burden to society. The prion protein has attracted particular interest as being shown to be the pathogenic agent in transmissible diseases such as kuru, Creutzfeldt-Jakob disease and bovine spongiform encephalopathy. Whether similar transmission could occur also in other amyloidoses such as Alzheimer's disease, Parkinson's disease and serum amyloid A amyloidosis is a matter of intense research and debate. Furthermore, it has been suggested that novel biomaterials such as artificial spider silk are potentially amyloidogenic. Here, we provide a brief introduction to amyloid, prions and other proteins involved in amyloid disease and review recent evidence for their potential transmission. We discuss the similarities and differences between amyloid and silk, as well as the potential hazards associated with protein-based biomaterials. PMID:27002185

  12. Dislocated shoulder - aftercare

    Science.gov (United States)

    Shoulder dislocation - aftercare; Shoulder subluxation - aftercare; Shoulder reduction - aftercare ... Horn AE, Ufberg JW. Management of common dislocations. In: ... Extremity 6th ed. Philadelphia, PA: ElsevierMosby; 2011:chap 92.

  13. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... by almost ten years, is shoulders. So by definition, the average shoulder-replacement patient is almost ten ... DOUGLAS BOARDMAN III, MD: Exactly. Choices -- selection of primary versus reverse shoulder arthroplasty. 00:51:24 GERALD ...

  14. Bilateral anterior shoulder dislocation

    OpenAIRE

    Meena, Sanjay; Saini, Pramod; Singh, Vivek; Kumar, Ramakant; Trikha, Vivek

    2013-01-01

    Shoulder dislocations are the most common major joint dislocations encountered in the emergency departments. Bilateral shoulder dislocations are rare and of these, bilateral posterior shoulder dislocations are more prevalent than bilateral anterior shoulder dislocations. Bilateral anterior shoulder dislocation is very rare. We present a case of 24-year-old male who sustained bilateral anterior shoulder dislocation following minor trauma, with associated greater tuberosity fracture on one side...

  15. Shoulder Injuries and Disorders

    Science.gov (United States)

    ... of many common problems. They include sprains, strains, dislocations, separations, tendinitis, bursitis, torn rotator cuffs, frozen shoulder, fractures and arthritis. Usually shoulder problems are treated ...

  16. Floating shoulder

    Directory of Open Access Journals (Sweden)

    B. de Pablo Márquez

    2014-09-01

    Full Text Available La fractura concomitante de clavícula y escápula es una entidad poco frecuente que puede ser una de las causas de afectación del complejo suspensorio del hombro también denominado hombro flotante (floating shoulder. Se relaciona frecuentemente con traumatismos de alta energía. Presentamos un caso de esta patología en un paciente varón de 28 años que consultó por caída en bicicleta con contusión sobre hombro izquierdo. Se describen las diferentes opciones terapéuticas planteadas, las imágenes radiológicas y una revisión de la literatura.

  17. Evaluating shoulder instability treatment

    OpenAIRE

    Linde, J. A.

    2016-01-01

    Shoulder instability common occurs. When treated nonoperatively, the resulting societal costs based on health care utilization and productivity losses are significant. Shoulder function can be evaluated using patient reported outcome measurements (PROMs). For shoulder instability, these include the Western Ontario Shoulder Instability index (WOSI) and the Oxford Shoulder Instability Score (OSIS). When translated and validated for the dutch population, both have good measurment properties. Sco...

  18. 9. Painful shoulder complaints.

    Science.gov (United States)

    Huygen, Frank; Patijn, Jacob; Rohof, Olav; Lataster, Arno; Mekhail, Nagy; van Kleef, Maarten; Van Zundert, Jan

    2010-01-01

    Painful shoulder complaints have a high incidence and prevalence. The etiology is not always clear. Clinical history and the active and passive motion examination of the shoulder are the cornerstones of the diagnostic process. Three shoulder tests are important for the examination of shoulder complaints: shoulder abduction, shoulder external rotation, and horizontal shoulder adduction. These tests can guide the examiner to the correct diagnosis. Based on this diagnosis, in most cases, primarily a conservative treatment with nonsteroidal anti-inflammatory drugs possibly in combination with manual and/or exercise therapy can be started. When conservative treatment fails, injection with local anesthetics and corticosteroids can be considered. In the case of frozen shoulder, a continuous cervical epidural infusion of local anesthetic and small doses of opioids or a pulsed radiofrequency treatment of the nervus suprascapularis can be considered.

  19. What Are Shoulder Problems?

    Science.gov (United States)

    ... tears are severe. Rotator Cuff Disease: Tendinitis and Bursitis In tendinitis of the shoulder, tendons become inflamed ( ... from being pinched by parts around the shoulder. Bursitis occurs when the bursa—a small fluid-filled ...

  20. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... 10 ANNOUNCER: DePuy Orthopedics is continually advancing the standard of orthopedic patient care. In a few moments, ... by almost ten years, is shoulders. So by definition, the average shoulder-replacement patient is almost ten ...

  1. Frozen shoulder - aftercare

    Science.gov (United States)

    ... shoulder level. Store food in cupboards, drawers, and refrigerator shelves that are between your waist and shoulder level. Get help with housecleaning, taking out the garbage, gardening, and other household tasks.

  2. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... case of reverse shoulder arthroplasty for cuff deficient arthritis. You should be aware that I helped design ... in the last decade for cuff deficient shoulder arthritis in the United States. The indications are a ...

  3. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available GLOBAL AP ANATOMIC TOTAL SHOULDER SYSTEM METHODIST HOSPITAL PHILADELPHIA, PA April 17, 2008 00:00:10 ANNOUNCER: ... you'll be able to watch a live global AP anatomic total shoulder surgery from Methodist Hospital ...

  4. Shoulder Problems in Athletes.

    Science.gov (United States)

    Clancy, William G., Jr.

    A description is given of typical sport-related injuries to the shoulder area. These include: (1) brachial plexus injuries; (2) peripheral nerve injuries about the shoulder; (3) acromioclavicular injuries; (4) sternoclavicular injuries; (5) shoulder dislocations; (6) recurrent traumatic subluxation/dislocations; and (7) overuse injuries.…

  5. Restoration of Shoulder Function.

    Science.gov (United States)

    Boe, Chelsea C; Elhassan, Bassem T

    2016-08-01

    Restoration of shoulder function in patients with brachial plexus injury can be challenging. Initial reported efforts were focused on stabilizing the shoulder, improving inferior subluxation and restoring abduction and flexion of the joint. Recent advancements and improved understanding of coordinated shoulder motion and the biomechanical properties of the muscles around the shoulder applicable to tendon transfer have expanded available surgical options to improve shoulder function, specifically external rotation. Despite the advances in reconstructive options, brachial plexus injury remains a serious problem that requires complex surgical solutions, prolonged recovery, and acceptance of functional loss. PMID:27387074

  6. The painful shoulder

    International Nuclear Information System (INIS)

    The painful shoulder syndrome is very common. Diagnosis and differential diagnosis may be difficult. Shoulder pain may be caused by local processes or systemic diseases or can be referred. Periarthritis humeroscapularis (frozen shoulder) is the most common cause of painful shoulder syndrome. Biomechanical factors concerning the rotator cuff are involved in the etiopathogenesis of these pain syndromes. The therapy of frozen shoulder includes physical treatment, antirheumatic drugs, or X-ray treatment. Surgical measures may become necessary. In the course of rheumatoid arthritis the shoulder may be involved. Milwaukee-shoulder-syndrome has been described recently in crystal deposit diseases. Shoulder pain may be referred by mechanical irritations of nerve roots in the course of degenerative lesions of the cervical spine and also in the course of internal diseases of the heart, the lungs, or the gastrointestinal tract. In cases of shoulder pain without pathological data from arthrological, radiological or laboratory studies, one should always consider localized fibromyalgia in the shoulder-neck-region. The precise diagnosis of shoulder pain is an important prerequisite for treatment, the success of which should not be judged as pessimistic as it has been commonly done in the past. (orig.)

  7. Shoulder pain in primary care: frozen shoulder.

    Science.gov (United States)

    Cadogan, Angela; Mohammed, Khalid D

    2016-03-01

    BACKGROUND AND CONTEXT Frozen shoulder is a painful condition that follows a protracted clinical course. We aim to review the management of patients with a diagnosis of frozen shoulder who are referred for specialist orthopaedic evaluation against existing guidelines in primary care. ASSESSMENT OF PROBLEM Referrals and clinical records were reviewed for all patients referred for orthopaedic specialist assessment who received a specialist diagnosis of frozen shoulder. Diagnostic, investigation and management practices from a regional primary health care setting in New Zealand were compared with guideline-recommended management. RESULTS Eighty patients with frozen shoulder were referred for orthopaedic evaluation in the 13 month study period, mostly from general practice. Fifteen patients (19%) were identified as having a frozen shoulder in their medical referral. Most (99%) had received previous imaging. Seven patients (12%) had received guideline recommended treatment. STRATEGIES FOR IMPROVEMENT Education of all clinicians involved in patient management is important to ensure an understanding of the long natural history of frozen shoulder and provide reassurance that outcomes are generally excellent. HealthPathways now include more information regarding diagnosis, imaging and evidence-based management for frozen shoulder. LESSONS Frozen shoulder may be under-diagnosed among patients referred for orthopaedic review. Ultrasound imaging is commonly used and may identify occult and unrelated pathology in this age-group. When managed according to clinical guidelines, patients report significant clinical and functional improvement with most reporting 80% function compared with normal after 1 year. KEYWORDS Adhesive capsulitis; bursitis; injections; practice guideline; primary health care; ultrasound. PMID:27477374

  8. US of the shoulder

    International Nuclear Information System (INIS)

    Twenty five healty people and 25 patients with shoulder pain underwent US control over a 12-month period: 24 patients with shoulder pain had rotator cuff and/or biceps tendon lesions. The US findings on rotator cuff and biceps tendon lesions are compared with those of arthrography and/or surgery (96% sensitivity). US is rapid, safe, non invasive, inexpensive and often more accurate, and its use is recommended for the routine examination of the shoulder joint insteat of arthrography

  9. Using your shoulder after surgery

    Science.gov (United States)

    ... Rotator cuff problems Rotator cuff repair Shoulder arthroscopy Shoulder pain Patient Instructions Rotator cuff exercises Rotator cuff - self-care Shoulder surgery - discharge Update Date 11/26/2014 Updated ...

  10. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... advancing the standard of orthopedic patient care. In a few moments, you'll be able to watch a live global AP anatomic total shoulder surgery from Methodist Hospital in Philadelphia. A revolution in shoulder orthopedics, the Global AP gives ...

  11. Work related shoulder disorders

    DEFF Research Database (Denmark)

    Svendsen, Susanne Wulff; Bonde, Jens Peter; Mathiassen, S.E.;

    2004-01-01

    Aims: To determine quantitative exposure-response relations between work with highly elevated arms and supraspinatus tendinitis, shoulder pain with disability, and shoulder pain without disability. Methods: A cross sectional study was conducted in a historical cohort of 1886 males from three.......39) for supraspinatus tendinitis, 1.16 (95% CI 1.08 to 1.24) for shoulder pain with disability, and 1.08 (95% CI 1.04 to 1.13) for shoulder pain without disability. The outcomes were not related to duration of employment in one of the three trades. Conclusions: Quantitative exposure-response relations were established...... between current work with highly elevated arms and clinically verified shoulder disorders. Substantial long term cumulative effects were not shown. A potential for primary prevention was revealed....

  12. MRI of the shoulder

    International Nuclear Information System (INIS)

    Magnetic resonance imaging has become available at a time in which shoulder pathology is more frequently seen. It is a noninvasive procedure that does not use ionizing radiation. It provides detailed visualization of soft-tissue structures that is not possible with other imaging modalities. Though not as widely available as conventional radiographs or computed tomography scanning, the number of MRI units worldwide is increasing steadily. The main features of the present book are as follows: The physical basis of Magnetic Resonance Imaging (MRI), normal shoulder anatomy and MRI, diagnosis of shoulder disorders, MRI of patients with shoulder pain or instability, case studies as well as treatment of shoulder disorders. (orig./MG) With 145 figs

  13. Shoulder instability; Schulterinstabilitaeten

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, Karl-Friedrich [Mainiz Univ. (Germany). Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie

    2014-06-15

    In the shoulder, the advantages of range of motion are traded for the disadvantages of vulnerability to injury and the development of instability. Shoulder instability and the lesion it produces represent one of the main causes of shoulder discomfort and pain. Shoulder instability is defined as a symptomatic abnormal motion of the humeral head relative to the glenoid during active shoulder motion. Glenohumeral instabilities are classified according to their causative factors as the pathogenesis of instability plays an important role with respect to treatment options: instabilities are classified in traumatic and atraumatic instabilities as part of a multidirectional instability syndrome, and in microtraumatic instabilities. Plain radiographs ('trauma series') are performed to document shoulder dislocation and its successful reposition. Direct MR arthrography is the most important imaging modality for delineation the different injury patterns on the labral-ligamentous complex and bony structures. Monocontrast CT-arthrography with use of multidetector CT scanners may be an alternative imaging modality, however, regarding the younger patient age, MR imaging should be preferred in the diagnostic work-up of shoulder instabilities. (orig.)

  14. Painful/unstable shoulder

    International Nuclear Information System (INIS)

    This paper reports on the diagnostic performance of CT-arthrography of the painful/unstable shoulder that was evaluated in more than 300 patients. We have encountered a great variety of painful shoulder pathology, including impingement syndrome, cuff tear arthropathy, lesions of the long head of the biceps tendon, calcifying tendinitis, adhesive capsulitis, dead arm syndrome, and degenerative joint disease. Lesions related to instability include cases of capsular avulsions, disruption of the glenohumeral ligaments, labral pathology, glenoid fractures, Hill-Sachs lesions, and changes in glenoid angulation. CT-arthrography is an accurate exploration for both unstable and painful shoulders

  15. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... N. DOUGLAS BOARDMAN III, MD: That's an occupational hazard of shoulder surgery. 00:50:53 GERALD WILLIAMS, MD: That's an occupational hazard. I'm going to become disabled at some ...

  16. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available GLOBAL AP ANATOMIC TOTAL SHOULDER SYSTEM METHODIST HOSPITAL PHILADELPHIA, PA April 17, 2008 00:00:10 ANNOUNCER: DePuy Orthopedics is continually advancing the standard of orthopedic patient care. In a few ...

  17. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... to longevity of total shoulders versus hips and knees. 00:46:20 GERALD WILLIAMS, MD: Well, obviously, ... ten years younger than the average hip or knee replacement patient. But if you look at the ...

  18. Shoulder Joint Replacement

    Science.gov (United States)

    ... en because of implant loosening, wear, infection, and dislocation. When this occurs, a second joint replacement surgery — called a revision surgery — may be necessary. Is Shoulder Joint Replacement for You? The decision to have ...

  19. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... you can use for reverse shoulder replacement. The standard delto-pectoral approach, or the superior approach, which ... that are different between a reverse and a standard total is, first of all, we don't ...

  20. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... is tight, in terms of tension? What's your thinking on that? Well, when we originally started doing ... learn about shoulder replacement. You can do a skills course at the learning center that the academy ...

  1. [The Throwing Shoulder].

    Science.gov (United States)

    Wieser, Karl; Gerber, Christian; Meyer, Dominik C

    2016-02-01

    Repetitive top-performance of overhead athletes induces a tremendous stress for the throwing shoulder. Throwers reach rotational speed of their arm of more than 7000°/s with joint compression and distraction forces of more than 1000 N. This performance is tributary to adaption of the shoulder muscles and the joint itself. These adaptions may, however lead to two specific problems of the throwing shoulder: 1. The posterosuperior internal impingement of the rotator cuff and labrum between glenoid and humeral head during late cooking phase; 2. A decreased internal rotation of the glenohumeral joint (GIRD) with compensatory problems of the scapula-stabilizing muscles. Precise analysis of kinematics and pathomechanics aims to improve understanding and treatment of those specific problems of the throwing shoulder. PMID:26837325

  2. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... We had a question with regard to physical therapy after total shoulder arthroplasty: expectations and limitations. 00: ... opposite. We don't -- we do hardly any therapy at all to reverse. With reverse patients, they ...

  3. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... here in New York to bring you a video of a recent case of reverse shoulder arthroplasty ... helped design the system that's shown in this video, so I receive royalties and therefore have a ...

  4. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... shoulder arthroplasty. Before we go to Dr. Williams, I'd like to encourage viewers to feel free ... utilizing the buttons on your screen. And now I'll turn it over to Dr. Williams. 00: ...

  5. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... with an intact cuff, we would consider a traditional shoulder replacement. There are two basic approaches you ... less limited with the superior reverse versus the traditional. And I assume the question means the approach: ...

  6. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... to a patient's unique anatomical makeup. Dr. Gerald R. Williams, Jr., a shoulder specialist from the Rothman ... That might help. Could you raise the O.R. table, please? 00:28:35 WOMAN: Can you ...

  7. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... MD: This is Doug Boardman from Richmond, Virginia. We're here at Methodist Hospital in Philadelphia, where ... will be performing a total shoulder arthroplasty. Before we go to Dr. Williams, I'd like to ...

  8. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... patient is a 78-year-old male who has osteoarthritis of his left shoulder. If you look ... does not have a really big inferior osteophyte. Has a little bit of proximal migration and even ...

  9. SHOULDER ARTHROPLASTY RECORDS

    Science.gov (United States)

    Filho, Geraldo Motta; Galvão, Marcus Vinicius; Monteiro, Martim; Cohen, Marcio; Brandão, Bruno

    2015-01-01

    The study's objective is to evaluate the characteristics and problems of patients who underwent shoulder arthroplasties between July 2004 and November 2006. Methodology: During the period of the study, 145 shoulder arthroplasties were performed. A prospective protocol was used for every patient; demographic, clinical and surgical procedure data were collected. All gathered data were included in the data base. The patients were divided in three major groups: fractures, degenerative diseases and trauma sequels. Information obtained from the data base was correlated in order to determine patients' epidemiologic, injuries, and surgical procedure profiles. Results: Of the 145 shoulder arthroplasties performed, 37% presented trauma sequels, 30% degenerative diseases, and 33% proximal humerus fracture. 12% of the cases required total arthroplasties and 88% partial arthroplasties. Five major complications were observed on early postoperative period. Conclusion: Shoulder arthroplasties have become a common procedure in orthopaedic practice. Surgical records are important in evidencing progressive evolution and in enabling future clinical outcomes evaluation. PMID:26998463

  10. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... be performing a total shoulder arthroplasty. Before we go to Dr. Williams, I'd like to encourage ... It's always a question about how deep we go with this osteotomy. I tend to go almost ...

  11. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available GLOBAL AP ANATOMIC TOTAL SHOULDER SYSTEM METHODIST HOSPITAL PHILADELPHIA, PA April 17, 2008 00:00:10 ANNOUNCER: DePuy Orthopedics is continually advancing the standard of orthopedic patient ...

  12. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... WILLIAMS, MD: The patients that have a total shoulder replacement will come in on their first postoperative visit and tell you their pain's gone. The hemi arthroplasty without interposition will come ...

  13. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... option in the last decade for cuff deficient shoulder arthritis in the United States. The indications are a patient with painful arthritis, absent rotator cuff, a less demanding occupation ...

  14. Normal shoulder: MR imaging

    International Nuclear Information System (INIS)

    Relatively poor spatial resolution has been obtained in magnetic resonance (MR) imaging of the shoulder because the shoulder can only be placed in the periphery of the magnetic field. The authors have devised an anatomically shaped surface coil that enables MR to demonstrate normal shoulder anatomy in different planes with high spatial resolution. In the axial plane anatomy analogous to that seen on computed tomographic (CT) scans can be demonstrated. Variations in scapular position (produced by patient positioning) may make reproducibility of sagittal and coronal plane images difficult by changing the relationship of the plane to the shoulder anatomy. Oblique planes, for which the angle is chosen from the axial image, have the advantage of easy reproducibility. Obliquely oriented structures and relationships are best seen in oblique plane images and can be evaluated in detail

  15. Radiotherapy for shoulder impingement

    International Nuclear Information System (INIS)

    Background and Purpose: Up to now, degenerative shoulder diseases were summarized by the term ''periarthritis humeroscapularis''. Actual shoulder diseases can be differentiated etiopathologically according to a primary and secondary impingement syndrome. Narrowing of the subacromial space, which is caused by an osseous shape variant, leads to primary impingement. Secondary impingement develops, when the subacromial space is reduced by swelling tissue below the osseous shoulder roof. This study aimed for the exact diagnosis to indicate therapy and to classify the results according to the Constant score. Patients and Methods: From August 1999 to September 2002, 102 patients with 115 shoulder joint conditions underwent radiation therapy (RT). All joints received two RT series (6 x 0.5 Gy/series) applied in two to three weekly fractions, totaling a dosage of 6.0 Gy (250 kV, 15 mAs, 1-mm Cu filter). The second RT course started 6 weeks after the end of the first. 115 shoulders were examined before RT, 6 weeks after the second RT course and, finally, during the follow-up from January to May 2003. Results: Pain relief was achieved in 94/115 shoulder joints (82%) after 18-month follow-up (median). A significant difference existed between secondary impingement and primary/non-impingement according to response. Tendinosis calcarea, bursitis subdeltoidea, tendovaginitis of the long biceps tendon, and capsulitis adhaesiva responded well to therapy. Conclusion: Shoulder diseases of secondary impingement demonstrate a good response to RT. Less or no benefit was found in primary impingement syndrome or complete rotator cuff disruption and acute shoulder injuries, respectively. (orig.)

  16. The Painful Shoulder: Shoulder Impingement Syndrome

    OpenAIRE

    Khan, Yousaf; Nagy, Mathias Thomas; Malal, Joby; Waseem, Mohammad

    2013-01-01

    Rotator cuff disorders are considered to be among the most common causes of shoulder pain and disability encountered in both primary and secondary care. The general pathology of subacromial impingment generally relates to a chronic repetitive process in which the conjoint tendon of the rotator cuff undergoes repetitive compression and micro trauma as it passes under the coracoacromial arch. However acute traumatic injuries may also lead to this condition. Diagnosis remains a clinical one, how...

  17. [Leading symptom shoulder pain].

    Science.gov (United States)

    Wittke, R

    2003-09-25

    Pain in the shoulder should prompt a systematic clinical examination that adheres closely to the functional anatomy. The basic examination of the shoulder joint comprises active and passive movements and isometric resistance tests with the aid of which external and internal rotation and abduction/adduction can be investigated. The results of these tests provide the physician with a "pattern of findings" which unequivocally identifies the pain-triggering structure. Accordingly, shoulder pain can be classified into four categories as proposed by Cyriax. As treatment, intra-articular injections of corticoids or local anesthetics as determined by findings, where necessary supported by physiotherapeutic measures. Rupture of a tendon, in particular in the case of an active patient, is an indication for surgery.

  18. Shoulder proprioception in baseball pitchers.

    Science.gov (United States)

    Safran, M R; Borsa, P A; Lephart, S M; Fu, F H; Warner, J J

    2001-01-01

    We examined proprioceptive differences between the dominant and nondominant shoulders of 21 collegiate baseball pitchers without a history of shoulder instability or surgery. A proprioceptive testing device was used to measure kinesthesia and joint position sense. Joint position sense was significantly (P =.05) more accurate in the nondominant shoulder than in the dominant shoulder when starting at 75% of maximal external rotation and moving into internal rotation. There were no significant differences for proprioception in the other measured positions or with kinesthesia testing. Six pitchers with recent shoulder pain had a significant (P =.04) kinesthetic deficit in the symptomatic dominant shoulder compared with the asymptomatic shoulder, as measured in neutral rotation moving into internal rotation. The net effect of training, exercise-induced laxity, and increased external rotation in baseball pitchers does not affect proprioception, although shoulder pain, possibly due to rotator cuff inflammation or tendinitis, is associated with reduced kinesthetic sensation. PMID:11641701

  19. Sleep position and shoulder pain.

    Science.gov (United States)

    Zenian, John

    2010-04-01

    The overuse theory for musculoskeletal joint pain cannot explain adequately the occurrence of shoulder pain in those who do not engage in activities that involve repeated and stressful use of the shoulder since the percentage of the painful right shoulders usually does not match the percentage of dominant right arms in such individuals. An alternative hypothesis is presented to propose that shoulder pain is caused by postural immobility in the decubitus or side position during sleep. Prolonged pressure on the shoulder caused by the weight of the thorax can produce enough damage to cause subsequent shoulder pain. In order to test this hypothesis, a preliminary study was carried out to compare the laterality of shoulder pain with the laterality of sleep position. The calculated laterality ratios for sleep position and shoulder pain were found to be strikingly similar, suggesting a causal relationship between the two phenomena. However, the prevalence of shoulder pain in the general population was found to be smaller than the percentage of the time people would spend sleeping in the decubitus position. This discrepancy could be explained by the idea that in order for shoulder pain to develop subjects may have to spend longer times in the same decubitus position before changing to another position than the average person would. Additional evidence from published clinical studies also supports the postural theory of shoulder pain. More studies can be done to test this hypothesis by focusing on the sleep habits of patients with shoulder pain. According to the present hypothesis shoulder pain should for the most part occur on the side that the patient preferred to sleep on before the onset of shoulder pain. The postural theory of shoulder pain provides the possibility for a new and noninvasive method to treat shoulder pain by the modification of posture during sleep.

  20. Arthroscopic findings after shoulder dislocation

    OpenAIRE

    Medenica Ivica; Radunović Aleksandar; Madžarac Dragan; Zorić Miodrag; Bokonjić Dubravko; Stojković Bratislav

    2009-01-01

    Background/Aim. Recurrent instability of the shoulder joint is frequently difficult to differentiate from diseased or injured rotator cuff or tendon of the forearm flexor (m. biceps brachii). Shoulder joint arthroscopy has been only recently introduced into instable shoulder joint lesion examination. The aim of this study was to present and analyze an arthroscopic finding on instable shoulder joint in order to determine causes and mechanisms of instability, as well as principles of surgical t...

  1. Exercise and Shoulder Pain

    Science.gov (United States)

    ... and disability • Fractures: A break in a bone • Dislocations/subluxations: Complete or partial separation of bones within the joint • Sprains: Stretch/damage to ligaments and connective tissue within the joint • Frozen Shoulder: Stiffness & loss of movement; a tight connective joint ...

  2. Adhesive Capsulitis (Frozen Shoulder)

    Science.gov (United States)

    ... Reaching: Put things you use every day (shoes, coffee cup, toothbrush) on a high shelf. This way you have to reach up for things more often. The reaching is a good stretch for your shoulder. Do the exercises once or twice a day even after your ...

  3. Mortality after shoulder arthroplasty

    DEFF Research Database (Denmark)

    Amundsen, Alexander; Rasmussen, Jeppe Vejlgaard; Olsen, Bo Sanderhoff;

    2016-01-01

    BACKGROUND: The primary aim was to quantify the 30-day, 90-day, and 1-year mortality rates after primary shoulder replacement. The secondary aims were to assess the association between mortality and diagnoses and to compare the mortality rate with that of the general population. METHODS: The stud...

  4. Anatomic Total Shoulder System

    Medline Plus

    Full Text Available ... Erika, she must've left. She got scared. Kevin from DePuy. And we have Dr. Song visiting us from South Korea. This patient is a 78-year-old male who has osteoarthritis of his left shoulder. If you look at his AP view here, what we can see is that he doesn't have quite the ...

  5. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available Reverse Shoulder Arthroplasty Zimmer, Inc. New York City, New York March 17, 2010 Welcome to this OR Live presentation, brought to you by Zimmer. Hi. I'm ... my partner, Brad Parsons. We're here in New York to bring you a video of a ...

  6. Swimmer's Shoulder: Painful Shoulder in the Competitive Swimmer.

    Science.gov (United States)

    Matzkin, Elizabeth; Suslavich, Kaytelin; Wes, David

    2016-08-01

    Swimmer's shoulder is a broad term often used to diagnose shoulder injury in swimmers. However, research has elucidated several specific shoulder injuries that often are incurred by the competitive swimmer. Hyperlaxity, scapular dyskinesis, subacromial impingement, labral damage, os acromiale, suprascapular nerve entrapment, and glenohumeral rotational imbalances all may be included within a differential diagnosis for shoulder pain in the competitive swimmer. An understanding of the mechanics of the swim stroke, in combination with the complex static and dynamic properties of the shoulder, is essential to the comprehension and identification of the painful swimmer's shoulder. It is important for the athlete, coach, and clinician to be aware of the discerning characteristics among these different injuries to ensure a proper diagnosis and treatment plan to aid the swimmer in his or her return to competition.

  7. Acupuncture Treatment of Shoulder Pain

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Case History Mr. Wen Senting, an Italian of 41 years old, paid his first visit on Mar. 17, 2004, with a chief complaint of the left shoulder pain for over a year. The patient stated that the pain resulted from an injury in his left shoulder one year before while playing the tennis. It was then diagnosed as soft tissue injury of the shoulder. The pain had been alleviated by massage treatment, but it would appear upon tiredness or exposure to cold, and had gradually impaired the shoulder movement. In recent half a year, the pain had gone worse, with obvious motor impairment.

  8. Cerebral amyloid angiopathy

    Science.gov (United States)

    ... Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice . 6th ed. Philadelphia, PA: Elsevier ... al. Course of cerebral amyloid angiopathy-related inflammation. Neurology. 2007;68:1411-1416. PMID: 17452586 www.ncbi. ...

  9. {beta} - amyloid imaging probes

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Jae Min [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2007-04-15

    Imaging distribution of {beta} - amyloid plaques in Alzheimer's disease is very important for early and accurate diagnosis. Early trial of the {beta} -amyloid plaques includes using radiolabeled peptides which can be only applied for peripheral {beta} - amyloid plaques due to limited penetration through the blood brain barrier (BBB). Congo red or Chrysamine G derivatives were labeled with Tc-99m for imaging {beta} - amyloid plaques of Alzheimer patient's brain without success due to problem with BBB penetration. Thioflavin T derivatives gave breakthrough for {beta} - amyloid imaging in vivo, and a benzothiazole derivative [C-11]6-OH-BTA-1 brought a great success. Many other benzothiazole, benzoxazole, benzofuran, imidazopyridine, and styrylbenzene derivatives have been labeled with F-18 and I-123 to improve the imaging quality. However, [C-11]6-OH-BTA-1 still remains as the best. However, short half-life of C-11 is a limitation of wide distribution of this agent. So, it is still required to develop an Tc-99m, F-18 or I-123 labeled agent for {beta} - amyloid imaging agent.

  10. Shoulder instability; Schultergelenkinstabilitaet

    Energy Technology Data Exchange (ETDEWEB)

    Sailer, J.; Imhof, H. [Abteilung Osteoradiologie, Univ.-Klinik fuer Radiodiagnostik Wien (Austria)

    2004-06-01

    Shoulder instability is a common clinical feature leading to recurrent pain and limitated range of motion within the glenohumeral joint. Instability can be due a single traumatic event, general joint laxity or repeated episodes of microtrauma. Differentiation between traumatic and atraumatic forms of shoulder instability requires careful history and a systemic clinical examination. Shoulder laxity has to be differentiated from true instability followed by the clinical assessment of direction and degree of glenohumeral translation. Conventional radiography and CT are used for the diagnosis of bony lesions. MR imaging and MR arthrography help in the detection of soft tissue affection, especially of the glenoid labrum and the capsuloligamentous complex. The most common lesion involving the labrum is the anterior labral tear, associated with capsuloperiostal stripping (Bankart lesion). A number of variants of the Bankart lesion have been described, such as ALPSA, SLAP or HAGL lesions. The purpose of this review is to highlight different forms of shoulder instability and its associated radiological findings with a focus on MR imaging. (orig.) [German] Die Schultergelenkinstabilitaet ist haeufig fuer wiederholt auftretende Schmerzen sowie eine eingeschraenkte Beweglichkeit im Glenohumeralgelenk verantwortlich. Sie kann als Folge eines vorangegangenen Traumas, einer generellen Hyperlaxitaet oder infolge wiederholter Mikrotraumen entstehen. Die Differenzierung zwischen traumatischer und atraumatischer Form der Gelenkinstabilitaet erfordert eine sorgfaeltige Anamnese und eine genaue klinische Untersuchung. Die Gelelenklaxitaet als Differenzialdiagnose muss von der echten Instabilitaet unterschieden werden, die Instabilitaet wird dann im Rahmen des klinischen Status nach Grad und Richtung der glenohumeralen Translation unterteilt. Zur Diagnose knoecherner Laesionen werden das konventionelle Roentgen sowie die CT herangezogen. MRT sowie MR-Arthrographie dienen zur Detektion

  11. Fluid collections and juxta-articular cystic lesions of the shoulder: spectrum of MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Mellado, J.M.; Salvado, E.; Camins, A.; Ramos, A.; Sauri, A. [Institut de Diagnostic per la Imatge, Hospital Joan XXIII, Tarragona (Spain); Merino, X. [Institut de Diagnostic per la Imatge, Hospital Vall' Ebron, Barcelona (Spain); Calmet, J. [Orthopaedic Surgery, Hospital Joan XXIII, Carrer Doctor Mallafre Guasch, Tarragona (Spain)

    2002-03-01

    The MR imaging features of fluid collections and juxta-articular cystic lesions of the shoulder are discussed, with special focus on those related to subacromial impingement and rotator cuff tears. Other more unusual fluid collections and cystic lesions are described, including rice-bodies bursitis, idiopathic synovial osteochondromatosis, dialysis-related amyloid arthropathy, hemophilic arthropathy, infectious conditions, non-infectious inflammatory arthritis, and paralabral cysts. (orig.)

  12. Give Someone the Cold Shoulder

    Institute of Scientific and Technical Information of China (English)

    程炜

    2002-01-01

    The snowman in this illustration is happy to allow a bird to rest on its cold shoulder.., but that's not what this idiom means.To give someone the cold shoulder is to be un-friendly, usually by ignoring them.

  13. Biomechanics of the shoulder.

    Science.gov (United States)

    Bechtol, C O

    1980-01-01

    Man's shoulder girdle is of the general pattern of his tree-swinging ancestors. With assumption of the upright posture, man's thorax has flattened from anterior-posterior. This results in a rotation of the scapula to a position of 45 degrees with the sagittal plane. In addition to this, man's forearm is habitually used in a position of approximately 45 degrees of internal rotation. This places the biceps tendon "off its trolley" and leads to biceps tinosynovitis. Motions of the glenohumeral joints result from the force couple of the deltoid muscle plus the rotator cuff muscles. The rotator cuff alone can abduct the arm with 50% force throughout the full range of its motion. In the absence of the supraspinatus muscle, however, the force couple is disrupted. Although initiation of abduction is with full force, the force rapidly falls off to 90 degrees. Above 90 degrees the arm can barely support its own weight. Although the shoulder undergoes progressive degenerative changes with age, the necessity for a joint implant, either partial or total--although successful--is rare.

  14. Shoulder joint tuberculosis

    International Nuclear Information System (INIS)

    Despite the fact that joint tuberculosis is one of the most common forms of extrapulmonary tuberculosis, it is a disease entity that is very rare in Poland (less than 100 cases a year in the last 10 years). The symptoms are non-specific, and thus the disease is rarely taken into account in preliminary differential diagnosis. A 68-year-old female patient was admitted to the Internal Diseases Clinic due to oedema and pain of the right shoulder joint. The pain has been increasing for about 8 months. Physical examination revealed increased circumference and elevated temperature of the right shoulder joint. Limb function was retained. The full range of radiological and laboratory diagnostic examinations was performed, including the biopsy of the affected tissue which revealed the presence of Mycobacterium tuberculosis in the bacterial culture. Clinical improvement was obtained after introduction of TB drugs. Radiological diagnostic methods (X-ray, CT scans, MRI scans) provide high precision monitoring of articular lesions. However, the decisive diagnosis requires additional laboratory tests as well as histopathological and bacteriological assays

  15. Shoulder Pain After Thoracic Surgery

    DEFF Research Database (Denmark)

    Blichfeldt-Eckhardt, Morten R; Andersen, Claus; Ørding, Helle;

    2016-01-01

    OBJECTIVES: To study the time course of ipsilateral shoulder pain after thoracic surgery with respect to incidence, pain intensity, type of pain (referred versus musculoskeletal), and surgical approach. DESIGN: Prospective, observational cohort study. SETTING: Odense University Hospital, Denmark....... PARTICIPANTS: Sixty patients for major lung resection. INTERVENTIONS: Postoperative observation of ipsilateral shoulder pain. MEASUREMENTS AND MAIN RESULTS: Postoperative numeric rating scale score of shoulder pain and thoracic pain and postoperative examination of the sites of shoulder pain...... for musculoskeletal involvement (muscle tenderness on palpation and movement) with follow-up 12 months after surgery. Clinically relevant pain was defined as a numeric rating scale score>3. Of the 60 patients included, 47 (78%) experienced ipsilateral shoulder pain, but only 25 (42%) reported clinically relevant...

  16. Amyloid Fibril Solubility

    CERN Document Server

    Rizzi, L G

    2015-01-01

    It is well established that amyloid fibril solubility is protein specific, but how solubility depends on the interactions between the fibril building blocks is not clear. Here we use a simple protein model and perform Monte Carlo simulations to directly measure the solubility of amyloid fibrils as a function of the interaction between the fibril building blocks. Our simulations confirms that the fibril solubility depends on the fibril thickness and that the relationship between the interactions and the solubility can be described by a simple analytical formula. The results presented in this study reveal general rules how side-chain side-chain interactions, backbone hydrogen bonding and temperature affect amyloid fibril solubility, which might prove a powerful tool to design protein fibrils with desired solubility and aggregation properties in general.

  17. MRI of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Vahlensieck, M.

    2000-02-01

    Shoulder imaging is one of the major applications in musculoskeletal MRI. In order to analyze the images it is important to keep informed about anatomical and pathological findings and publications. In this article MRI technique, anatomy and pathology is reviewed. Technical considerations about MR sequences and examination strategy are only shortly discussed with emphasis on turbo spin echo and short T1 inversion recovery imaging. Basic anatomy as well as recent findings, including macroscopic aspects of the supraspinatus fat pad, composition of the supraspinatus muscle belly, and variability of the glenohumeral ligaments or coracoid ligament, are presented. Basic pathological conditions are described in detail, e. g. instability particularly problems in differentiating the various subtypes of labral pathology. Rotator cuff diseases are elucidated with emphasis on some rarer entities such as subscapularis calcifying tendinitis, coracoid impingement, chronic bursitis producing the double-line sign, prominent coraco-acromial ligament and the impingement due to an inflamed os acromiale. (orig.)

  18. Shoulder Stiffness : Current Concepts and Concerns

    NARCIS (Netherlands)

    Itoi, Eiji; Arce, Guillermo; Bain, Gregory I.; Diercks, Ronald L.; Guttmann, Dan; Imhoff, Andreas B.; Mazzocca, Augustus D.; Sugaya, Hiroyuki; Yoo, Yon-Sik

    2016-01-01

    Shoulder stiffness can be caused by various etiologies such as immobilization, trauma, or surgical interventions. The Upper Extremity Committee of ISAKOS defined the term "frozen shoulder" as idiopathic stiff shoulder, that is, without a known cause. Secondary stiff shoulder is a term that should be

  19. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... the shoulder comes in is a group of muscles behind the shoulder. That group of muscles is known as the scapular stabilizers, and we ... time working very hard to get those shoulder muscles strong so that when that shoulder is in ...

  20. Ultrasonography of the painful shoulder

    International Nuclear Information System (INIS)

    A thorough knowledge of the normal anatomy was applied in the study of 132 patients with painful shoulder to establish the ultrasonographic findings that indicate the diagnosis of lesions of the rotator cuff of the shoulder (tendentious, tendons degeneration and the different types of fracture) as well as bursitis, lesions of the tendon of the long head of the biceps, joint effusions, lesions of the humeral head, etc. As an initial method of studying painful shoulder using standard plain radiography, this techniques is considered a reliable diagnostic procedure. (Author)

  1. Shoulder disorders in the elderly (a hospital study).

    OpenAIRE

    Chard, M D; Hazleman, B L

    1987-01-01

    One hundred acute geriatric inpatients were assessed to investigate the prevalence of shoulder disorders; 21 had symptoms due to shoulder disease. Conditions included supraspinatus tendinitis (five), chronic rotator cuff rupture (seven), frozen shoulder (two), glenohumeral osteoarthritis (two), apatite related shoulder arthritis (one), stroke related shoulder disease (six). (Some patients had more than one shoulder condition.) The last group included painful stiff shoulders (three), glenohume...

  2. Shoulder injuries in overhead sports

    International Nuclear Information System (INIS)

    Overhead sport places great demands on the shoulder joint. Shoulder pain in overhead athletes and throwers can in the majority of cases be attributed to lesions resulting from chronic overuse of tendons and capsuloligamentous structures or to sequels of microinstability and secondary impingement. Due to its great impact on therapeutic decisions, imaging in athletes with unclear shoulder pain is a challenge. In this connection, magnetic resonance (MR) arthrography represents the cross-sectional imaging modality of first choice, as it allows depiction and exclusion of pathologic alterations of all relevant joint structures with sufficient confidence. This article reviews the biomechanical and clinical aspects and MR arthrographic features of the most common shoulder pathologies in overhead athletes, including biceps tendinopathy, superior labral anterior-posterior (SLAP) lesions, rotator cuff lesions, as well as extrinsic and intrinsic impingement syndromes. (orig.)

  3. Shoulder Joint For Protective Suit

    Science.gov (United States)

    Kosmo, Joseph J.; Smallcombe, Richard D.

    1994-01-01

    Shoulder joint allows full range of natural motion: wearer senses little or no resisting force or torque. Developed for space suit, joint offers advantages in protective garments for underwater work, firefighting, or cleanup of hazardous materials.

  4. Human Islet Amyloid Polypeptide

    DEFF Research Database (Denmark)

    Kosicka, Iga

    2014-01-01

    Diabetes mellitus type II is a metabolic disease affecting millions of people worldwide. The disease is associated with occurence of insoluble, fibrillar, protein aggregates in islets of Langerhans in the pancreas - islet amyloid. The main constituent of these protein fibers is the human islet...

  5. Arthroscopic findings after shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Medenica Ivica

    2009-01-01

    Full Text Available Background/Aim. Recurrent instability of the shoulder joint is frequently difficult to differentiate from diseased or injured rotator cuff or tendon of the forearm flexor (m. biceps brachii. Shoulder joint arthroscopy has been only recently introduced into instable shoulder joint lesion examination. The aim of this study was to present and analyze an arthroscopic finding on instable shoulder joint in order to determine causes and mechanisms of instability, as well as principles of surgical treatment. Methods. Arthroscopy of the shoulder joint was performed in 158 patients with at least one documented shoulder joint dislocation. These patients were divided into two groups. The group I included the patients with one to three dislocations, while the group II those with more than three dislocations. Preoperative diagnosis was based on anamnestic data and clinical examination using specific tests, and on the diagnosis of shoulder joint using radiography or computed tomography. Results. Out of the total number of the patients 138 (87.34% had injury of the anterior patellar brim, 119 (75.32% had failure of the anterior capsule, 126 (79.75% had compressive cartilage injury of the posterior part of the head of the upper arm bone (Hill-Sachs lesion, 102 (64.56% had insufficiency of glenohumeral tendon, 11 (6.96 had complete cut of the rotator cuff, 23 (14.56% had injury of the posterior patellar brim, 12 (7.59% had injury of the upper anterior-posterior patellar brim (SLAP. Conclusion. According to the obtained results it could be concluded that there is no a unique injury that leads to shoulder joint instability. It is necessary to point out to the significance of anamnesis and clinical examination in making diagnosis. Arthroscopic diagnostics is indicated in clinically unreliable findings as an additional method for determining operative treatment.

  6. Simultaneous shoulder and elbow dislocation

    OpenAIRE

    Çobanoğlu, Mutlu; Yumrukcal, Feridun; KARATAŞ, Cengiz; Duygun, Fatih

    2014-01-01

    Ipsilateral shoulder and elbow dislocation is very rare and only six articles are present in the literature mentioning this kind of a complex injury. With this presentation we aim to emphasise the importance of assessing the adjacent joints in patients with trauma in order not to miss any accompanying pathologies. We report a case of a 43-year-old female patient with ipsilateral right shoulder and elbow dislocation treated conservatively. The patient reported elbow pain when first admitted to...

  7. Management of the frozen shoulder

    OpenAIRE

    van de Laar SM; van der Zwaal P

    2014-01-01

    Suzanne Margaretha van de Laar, Peer van der Zwaal Department of Orthopaedic Surgery and Trauma, Medical Center Haaglanden, The Hague, the Netherlands Abstract: Frozen shoulder is a very common condition with a prevalence of 2%–5% in the general population. Decrease in joint volume as a result of fibrosis and hyperplasia of the joint capsule leads to painful and restricted glenohumeral motion. Frozen shoulder is a self-limiting disease with a chronic character, and is mostly treated in...

  8. Management of the frozen shoulder

    OpenAIRE

    van der Zwaal, Peer

    2014-01-01

    Suzanne Margaretha van de Laar, Peer van der Zwaal Department of Orthopaedic Surgery and Trauma, Medical Center Haaglanden, The Hague, the Netherlands Abstract: Frozen shoulder is a very common condition with a prevalence of 2%–5% in the general population. Decrease in joint volume as a result of fibrosis and hyperplasia of the joint capsule leads to painful and restricted glenohumeral motion. Frozen shoulder is a self-limiting disease with a chronic character, and is mostly treate...

  9. New concepts in restoring shoulder elevation in a stiff and painful shoulder patient.

    Science.gov (United States)

    Donatelli, Robert; Ruivo, R M; Thurner, Michael; Ibrahim, Mahmoud Ibrahim

    2014-02-01

    The treatment and evaluation of a stiff and painful shoulder, characteristic of adhesive capsulitis and "frozen" shoulders, is a dilemma for orthopedic rehabilitation specialists. A stiff and painful shoulder is all-inclusive of Adhesive capsulitis and Frozen Shoulder diagnoses. Adhesive capsulitis and frozen shoulder will be referred to as a stiff and painful shoulder, throughout this paper. Shoulder motion occurs in multiple planes of movement. Loss of shoulder mobility can result in significant functional impairment. The traditional treatment approach to restore shoulder mobility emphasizes mobilization of the shoulder overhead. Forced elevation in a stiff and painful shoulder can be painful and potentially destructive to the glenohumeral joint. This manuscript will introduce a new biomechanical approach to evaluate and treat patients with stiff and painful shoulders.

  10. Frozen shoulder: a sympathetic dystrophy?

    Science.gov (United States)

    Müller, L P; Müller, L A; Happ, J; Kerschbaumer, F

    2000-01-01

    Diagnostic and clinical features of the frozen shoulder syndrome and the Sudeck syndrome are similar in many aspects. Radioisotope bone scan shows an increased uptake in affected areas in both diseases, while native radiographs show a progressive demineralisation. Measurement of bone mineral density (BMD) by quantitative digital radiography objectified these local decalcification processes in an early stage of the frozen shoulder syndrome; 10 of 12 patients with primary frozen shoulder had BMD decreases greater 21% in the humeral head of the affected shoulder compared to the non-affected side. In the immobilised control group with degenerative changes of the rotator cuff, calcifying tendinitis and shoulder instability (n = 12) and in the group of healthy probands (n = 20), the difference between the affected and non-affected side (left and right humerus of the healthy probands) was only more than 21% in one case each. There are several references in the literature that assume frozen shoulder to be an algoneurodystrophic process; our observations support this hypothesis, possibly leading to earlier diagnoses and extended therapeutic management. PMID:10653111

  11. Amyloid Aggregation and Membrane Disruption by Amyloid Proteins

    Science.gov (United States)

    Ramamoorthy, Ayyalusamy

    2013-03-01

    Amyloidogenesis has been the focus of intense basic and clinical research, as an increasing number of amyloidogenic proteins have been linked to common and incurable degenerative diseases including Alzheimer's, type II diabetes, and Parkinson's. Recent studies suggest that the cell toxicity is mainly due to intermediates generated during the assembly process of amyloid fibers, which have been proposed to attack cells in a variety of ways. Disruption of cell membranes is believed to be one of the key components of amyloid toxicity. However, the mechanism by which this occurs is not fully understood. Our research in this area is focused on the investigation of the early events in the aggregation and membrane disruption of amyloid proteins, Islet amyloid polypeptide protein (IAPP, also known as amylin) and amyloid-beta peptide, on the molecular level. Structural insights into the mechanisms of membrane disruption by these amyloid proteins and the role of membrane components on the membrane disruption will be presented.

  12. Amyloids here, amyloids there…What’s wrong with them?

    OpenAIRE

    Gharibyan, Anna

    2012-01-01

    Amyloid formation is inherent property of proteins which under certain circumstances can become a pathologic feature of a group of diseases called amyloidosis. There are about 30 known human amyloidosis and more than 27 identified proteins involved in these pathologies.  Besides these proteins, there are a growing number of proteins non-related to diseases shown to form amyloid-like structures in vitro, which make them excellent tools for studying amyloid formation mechanisms, physicochemical...

  13. MR imaging of the shoulder

    International Nuclear Information System (INIS)

    Magnetic resonance (MR) imaging (1.5-T unit) was performed in over 600 shoulders to evaluate shoulder pain. Ultrasound (US) and arthrography were performed in over 100 patients. Surgery was performed in over 75 patients. MR imaging offers information not well evaluated with other modalities, including bony impingement, tendinitis, bursitis, and osseous abnormalities, such as primary arthritis, avascular necrosis, occult fractures, and tumors. US and MR findings correlate well with surgical findings for medium to large rotator cuff tears. MR imaging with T2 weighting is superior for differentiating small tears from associated tendinitis. An algorithm for cost-effective shoulder imaging integrating US, MR imaging, arthrography, and computed tomographic arthrography are presented

  14. Heterotopic bone formation following total shoulder arthroplasty

    DEFF Research Database (Denmark)

    Kjaersgaard-Andersen, P.; Frich, Lars Henrik; Sjøbjerg, J.O.;

    1989-01-01

    the glenohumeral and/or the glenoacromial space. There was no correlation between shoulder pain and the development of ossification. Shoulders with grade III heterotopic bone formation had a limited range of active elevation compared with shoulders without or with only a milder lesion. Men and patients......The incidence and location of heterotopic bone formation following total shoulder arthroplasty were evaluated in 58 Neer Mark-II total shoulder replacements. One year after surgery, 45% had developed some ectopic ossification. In six shoulders (10%) the ossifications roentgenographically bridged...... with osteoarthritis of the shoulder joint were significantly disposed to the development of heterotopic bone. Heterotopic bone formation following total shoulder arthroplasty is frequent, but disabling heterotopic ossifications seem to be rare....

  15. Painful Shoulder in Swimmers: A Diagnostic Challenge.

    Science.gov (United States)

    McMaster, William C.

    1986-01-01

    This article discusses the incidence, diagnosis, and treatment of painful shoulder in swimmers, including: regional problems that can cause shoulder pain; physical, clinical, and laboratory tests for diagnostic use; and approaches to management of the problem. (Author/CB)

  16. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... 13:23 Now we're moving into the space between that ball and cup that Joe so… ... glenoid socket for the shoulder. There's a wide space in this boy's shoulder, which is partially due ...

  17. An investigation of shoulder forces in active shoulder tackles in rugby union football.

    Science.gov (United States)

    Usman, Juliana; McIntosh, Andrew S; Fréchède, Bertrand

    2011-11-01

    In rugby union football the tackle is the most frequently executed skill and one most associated with injury, including shoulder injury to the tackler. Despite the importance of the tackle, little is known about the magnitude of shoulder forces in the tackle and influencing factors. The objectives of the study were to measure the shoulder force in the tackle, as well as the effects of shoulder padding, skill level, side of body, player size, and experimental setting on shoulder force. Experiments were conducted in laboratory and field settings using a repeated measures design. Thirty-five participants were recruited to the laboratory and 98 to the field setting. All were male aged over 18 years with rugby experience. The maximum force applied to the shoulder in an active shoulder tackle was measured with a custom built forceplate incorporated into a 45 kg tackle bag. The overall average maximum shoulder force was 1660 N in the laboratory and 1997 N in the field. This difference was significant. The shoulder force for tackling without shoulder pads was 1684 N compared to 1635 N with shoulder pads. There was no difference between the shoulder forces on the dominant and non-dominant sides. Shoulder force reduced with tackle repetition. No relationship was observed between player skill level and size. A substantial force can be applied to the shoulder and to an opponent in the tackle. This force is within the shoulder's injury tolerance range and is unaffected by shoulder pads.

  18. 21 CFR 888.3690 - Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... uncemented prosthesis. 888.3690 Section 888.3690 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis. (a) Identification. A shoulder joint humeral (hemi-shoulder) metallic uncemented prosthesis is a device made of alloys, such as...

  19. Shoulder Impingement/Rotator Cuff Tendinitis

    Science.gov (United States)

    .org Shoulder Impingement/Rotator Cuff Tendinitis Page ( 1 ) One of the most common physical complaints is shoulder pain. Your shoulder is made up of several ... is vulnerable to many different problems. The rotator cuff is a frequent source of pain in the ...

  20. 49 CFR 572.184 - Shoulder assembly.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Shoulder assembly. 572.184 Section 572.184... Dummy, 50th Percentile Adult Male § 572.184 Shoulder assembly. (a) The shoulder (175-3000) is part of the body assembly shown in drawing 175-0000. When subjected to impact tests specified in paragraph...

  1. Gimbaled-shoulder friction stir welding tool

    Science.gov (United States)

    Carter, Robert W. (Inventor); Lawless, Kirby G. (Inventor)

    2010-01-01

    A gimbaled-shoulder friction stir welding tool includes a pin and first and second annular shoulders coupled to the pin. At least one of the annular shoulders is coupled to the pin for gimbaled motion with respect thereto as the tool is rotated by a friction stir welding apparatus.

  2. Periarthritis of the shoulder-MRI findings

    International Nuclear Information System (INIS)

    We examined MRI findings in patients with periarthritis of the shoulder. We excluded cuff tears, calcified tendinitis, instability of the shoulder, fracture and impingement syndrome of young patients. Subjects comprised 36 cases, 38 shoulders (25 men and 11 women), with an average age of 59.1 years (42-75). Scanning was performed on a Gyroscan T5-II 0.5-T (Philips). T1-weighted and T2-weighted sequences in the coronal oblique plane, T2-weighted sequences in the coronal sagittal plane and horizontal plane were taken. Twelve shoulders showed some change in the humeral heads. Degeneration of the rotator cuff was observed in 15 shoulders. Joint fluid collection was observed in the gleno-humeral joints of 15 shoulders, in the subacromial bursa of 11 shoulders and in the acromio-clavicular joints of 7 shoulders. Twenty four shoulders had fluid collection in the sheath of the long head of the biceps long tendon. Localized high signal area was observed around the inferior pouch in 11 shoulders. We studied the relationship between MRI findings and clinical symptoms. There was no significant relationship but the shoulders with night pain and severe contractures had a higher positive rate of joint fluid collection on MRI than the shoulders without night pain and with less contractures. (author)

  3. Shoulder Osteoarthritis Treatment (Beyond the Basics)

    Science.gov (United States)

    ... shoulder to the point of tension but not pain. SHOULDER-STRENTGTHENING EXERCISES — Muscle-toning exercises should be performed ... diagnosis of rotator cuff tears Rotator cuff tendinopathy Shoulder impingement syndrome The following organizations also provide reliable health information. ● ...

  4. Correlation between shoulder muscle strength and shoulder impingement in baseball players

    OpenAIRE

    嘉手川, 啓; 上里, 智美; 高良,宏明; 金谷, 文則; Kadekawa, Kei; Uesato, Tomomi; TAKARA,HIROAKI; Kanaya, Fuminori; 琉球大学医学部整形外科学講座; 浦添総合病院整形外科; 琉球大学保健管理センター

    1998-01-01

    The shoulder impingement syndrome may occur through the imbalance of the muscle strength around the shoulder of baseball players. Our previous study suggested that latissimus dorsi (LD), the back muscle which is the adductor and internal rotator of the shoulder, would possibly prevent shoulder impingement. The purposes of this study were to clarify the correlation between the muscle strength around shoulder and impingement signs in baseball players and to identify the influence of LD on impin...

  5. Shoulder pain in general practice

    OpenAIRE

    Vassallo, Kenneth

    2008-01-01

    Case scenario A 65 year old gentleman presented with a 1 week history of pain in the left shoulder. Pain started after spending 2 days painting his house. He was taking paracetamol regularly yet it only gave him minor relief. On examination he had a painful arch and was tender under the acromium.

  6. Extraskeletal problems and amyloid.

    Science.gov (United States)

    Drüeke, T B

    1999-12-01

    The major clinical manifestations of dialysis-associated A beta 2M amyloidosis are chronic arthralgias, destructive arthropathy and the carpal tunnel syndrome. For dialysis patients who have been maintained on renal replacement therapy for more than 10-15 years, this complication may become a major physical handicap. It may even be life-threatening in some instances due to cervical cord compression. Amyloid deposits in joint areas precede clinical symptoms and signs by several years. Systemic deposits may also occur but their clinical manifestations are infrequent. The diagnosis of dialysis arthropathy associated with beta 2-microglobulin-associated (A beta 2M) amyloidosis mostly relies on indirect clinical and radiological evidence. Histologic proof is rarely obtained in vivo. The pathogenesis of the disease is complex. It includes reduced elimination of beta 2M and potentially also as impaired degradation of A beta 2M as well as enhanced production of A beta 2M amyloid fibrils. Non enzymatic modifications of beta 2M probably play a role, including beta 2M protein modification with advanced glycation end-products (AGE) and advanced oxidation protein products. Modified beta 2M, collagen and proteoglycans appear actively involved in the induction of a local inflammatory response and beta 2M amyloid formation. There is also evidence in favor of treatment-related factors such as the type of hemodialysis membrane and the purity of dialysis water. Hopefully, the translation of our improving knowledge of all the factors involved will lead to a better treatment and eventually to the prevention of this dramatic complication of dialysis.

  7. Management of the frozen shoulder

    Directory of Open Access Journals (Sweden)

    van de Laar SM

    2014-10-01

    Full Text Available Suzanne Margaretha van de Laar, Peer van der Zwaal Department of Orthopaedic Surgery and Trauma, Medical Center Haaglanden, The Hague, the Netherlands Abstract: Frozen shoulder is a very common condition with a prevalence of 2%–5% in the general population. Decrease in joint volume as a result of fibrosis and hyperplasia of the joint capsule leads to painful and restricted glenohumeral motion. Frozen shoulder is a self-limiting disease with a chronic character, and is mostly treated in a primary care setting. In this review, we set out to address the current evidence-based literature on management of this disabling disease using a PubMed search. Many non-surgical and surgical therapeutic options are described, including supervised neglect, intra-articular corticosteroid injections, physical therapy, manipulation under anesthesia, capsular distension, and arthroscopic capsular release. In the literature, the long-term outcome shows a significant decrease in pain and improvement of shoulder function for all treatment modalities without clear evidence of superiority of one over the other. This possibly indicates that a self-limiting character is the most important factor in the course of the disease. Management of frozen shoulder is primarily conservative. Supervised neglect is combined with analgesia and stretching exercises as the pain subsides. In the early painful phase, intra-articular corticosteroid injections are recommended for pain relief. When the patient has persistent pain and glenohumeral stiffness after adequate conservative treatment, invasive options can be considered, like arthroscopic capsular release, manipulation under anesthesia, or capsular distension. Keywords: frozen shoulder, adhesive capsulitis, treatment, pathophysiology

  8. [Classification of periprosthetic shoulder fractures].

    Science.gov (United States)

    Kirchhoff, C; Kirchhoff, S; Biberthaler, P

    2016-04-01

    The key targets in the treatment of periprosthetic humeral fractures (PHF) are the preservation of bone, successful bony consolidation and provision of a stable anchoring of the prosthesis with the major goal of restoring the shoulder-arm function. A substantial problem of periprosthetic shoulder fractures is the fact that treatment is determined not only by the fracture itself but also by the implanted prosthesis and its function. Consequently, the exact preoperative shoulder function and, in the case of an implanted anatomical prosthesis, the status and function of the rotator cuff need to be assessed in order to clarify the possibility of a secondarily occurring malfunction. Of equal importance in this context is the type of implanted prosthesis. The existing classification systems of Wright and Cofield, Campbell et al., Groh et al. and Worland et al. have several drawbacks from a shoulder surgeon's point of view, such as a missing reference to the great variability of the available prostheses and the lack of an evaluation of rotator cuff function. The presented 6‑stage classification for the evaluation of periprosthetic fractures of the shoulder can be considered just as simple or complex to understand as the classification of the working group for osteosynthesis problems (AO, Arbeitsgemeinschaft für Osteosynthesefragen), depending on the viewpoint. From our point of view the classification presented here encompasses the essential points of the existing classification systems and also covers the otherwise missing points, which should be considered in the assessment of such periprosthetic fractures. The classification presented here should provide helpful assistance in the daily routine to find the most convenient form of therapy. PMID:26992712

  9. Acute Shoulder Injuries in Adults.

    Science.gov (United States)

    Monica, James; Vredenburgh, Zachary; Korsh, Jeremy; Gatt, Charles

    2016-07-15

    Acute shoulder injuries in adults are often initially managed by family physicians. Common acute shoulder injuries include acromioclavicular joint injuries, clavicle fractures, glenohumeral dislocations, proximal humerus fractures, and rotator cuff tears. Acromioclavicular joint injuries and clavicle fractures mostly occur in young adults as the result of a sports injury or direct trauma. Most nondisplaced or minimally displaced injuries can be treated conservatively. Treatment includes pain management, short-term use of a sling for comfort, and physical therapy as needed. Glenohumeral dislocations can result from contact sports, falls, bicycle accidents, and similar high-impact trauma. Patients will usually hold the affected arm in their contralateral hand and have pain with motion and decreased motion at the shoulder. Physical findings may include a palpable humeral head in the axilla or a dimple inferior to the acromion laterally. Reduction maneuvers usually require intra-articular lidocaine or intravenous analgesia. Proximal humerus fractures often occur in older patients after a low-energy fall. Radiography of the shoulder should include a true anteroposterior view of the glenoid, scapular Y view, and axillary view. Most of these fractures can be managed nonoperatively, using a sling, early range-of-motion exercises, and strength training. Rotator cuff tears can cause difficulty with overhead activities or pain that awakens the patient from sleep. On physical examination, patients may be unable to hold the affected arm in an elevated position. It is important to recognize the sometimes subtle signs and symptoms of acute shoulder injuries to ensure proper management and timely referral if necessary. PMID:27419328

  10. Hacking the code of amyloid formation: the amyloid stretch hypothesis.

    Science.gov (United States)

    Pastor, M Teresa; Esteras-Chopo, Alexandra; Serrano, Luis

    2007-01-01

    Many research efforts in the last years have been directed towards understanding the factors determining protein misfolding and amyloid formation. Protein stability and amino acid composition have been identified as the two major factors in vitro. The research of our group has been focused on understanding the relationship between amino acid sequence and amyloid formation. Our approach has been the design of simple model systems that reproduce the biophysical properties of natural amyloids. An amyloid sequence pattern was extracted that can be used to detect amyloidogenic hexapeptide stretches in proteins. We have added evidence supporting that these amyloidogenic stretches can trigger amyloid formation by nonamyloidogenic proteins. Some experimental results in other amyloid proteins will be analyzed under the conclusions obtained in these studies. Our conclusions together with evidences from other groups suggest that amyloid formation is the result of the interplay between a decrease of protein stability, and the presence of highly amyloidogenic regions in proteins. As many of these results have been obtained in vitro, the challenge for the next years will be to demonstrate their validity in in vivo systems.

  11. Serum amyloid P component scintigraphy in familial amyloid polyneuropathy: regression of visceral amyloid following liver transplantation

    International Nuclear Information System (INIS)

    Familial amyloid polyneuropathy (FAP) associated with transthyretin (TTR) mutations is the commonest type of hereditary amyloidosis. Plasma TTR is produced almost exclusively in the liver and orthotopic liver transplantation is the only available treatment, although the clinical outcome varies. Serum amyloid P component (SAP) scintigraphy is a method for identifying and quantitatively monitoring amyloid deposits in vivo, but it has not previously been used to study the outcome of visceral amyloid deposits in FAP following liver transplantation. Whole body scintigraphy following injection of iodine-123 labelled SAP was performed in 17 patients with FAP associated with TTR Met30 and in five asymptomatic gene carriers. Follow-up studies were performed in ten patients, eight of whom had undergone orthotopic liver transplantation 1-5 years beforehand. There was abnormal uptake of 123I-SAP in all FAP patients, including the kidneys in each case, the spleen in five cases and the adrenal glands in three cases. Renal amyloid deposits were also present in three of the asymptomatic carriers. Follow-up studies 1-5 years after liver transplantation showed that there had been substantial regression of the visceral amyloid deposits in two patients and modest improvement in three cases. The amyloid deposits were unchanged in two patients. In conclusion, 123I-SAP scintigraphy identified unsuspected visceral amyloid in each patient with FAP due to TTR Met30. The universal presence of renal amyloid probably underlies the high frequency of renal failure that occurs in FAP following liver transplantation. The variable capacity of patients to mobilise amyloid deposits following liver transplantation may contribute to their long-term clinical outcome. (orig.)

  12. Serum amyloid P component scintigraphy in familial amyloid polyneuropathy: regression of visceral amyloid following liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Rydh, A.; Hietala, S.O.; Aahlstroem, K.R. [Department of Diagnostic Radiology, University Hospital of Northern Sweden, Umeaa (Sweden); Suhr, O. [Department of Internal Medicine, University Hospital of Northern Sweden, Umeaa (Sweden); Pepys, M.B.; Hawkins, P.N. [Immunological Medicine Unit, Department of Medicine, Imperial College School of Medicine, London (United Kingdom)

    1998-07-01

    Familial amyloid polyneuropathy (FAP) associated with transthyretin (TTR) mutations is the commonest type of hereditary amyloidosis. Plasma TTR is produced almost exclusively in the liver and orthotopic liver transplantation is the only available treatment, although the clinical outcome varies. Serum amyloid P component (SAP) scintigraphy is a method for identifying and quantitatively monitoring amyloid deposits in vivo, but it has not previously been used to study the outcome of visceral amyloid deposits in FAP following liver transplantation. Whole body scintigraphy following injection of iodine-123 labelled SAP was performed in 17 patients with FAP associated with TTR Met30 and in five asymptomatic gene carriers. Follow-up studies were performed in ten patients, eight of whom had undergone orthotopic liver transplantation 1-5 years beforehand. There was abnormal uptake of {sup 123}I-SAP in all FAP patients, including the kidneys in each case, the spleen in five cases and the adrenal glands in three cases. Renal amyloid deposits were also present in three of the asymptomatic carriers. Follow-up studies 1-5 years after liver transplantation showed that there had been substantial regression of the visceral amyloid deposits in two patients and modest improvement in three cases. The amyloid deposits were unchanged in two patients. In conclusion, {sup 123}I-SAP scintigraphy identified unsuspected visceral amyloid in each patient with FAP due to TTR Met30. The universal presence of renal amyloid probably underlies the high frequency of renal failure that occurs in FAP following liver transplantation. The variable capacity of patients to mobilise amyloid deposits following liver transplantation may contribute to their long-term clinical outcome. (orig.) With 2 figs., 2 tabs., 22 refs.

  13. Shoulder impingement syndrome: MR findings in 53 shoulders

    OpenAIRE

    Seeger, LL; Gold, RH; Bassett, LW; Ellman, H

    1988-01-01

    The shoulder impingement syndrome refers to a condition in which the supraspinatus tendon and subacromial bursa are chronically entrapped between the humeral head inferiorly and either the anterior acromion itself, spurs of the anterior acromion or acromioclavicular joint, or the coracoacromial ligament superiorly. As a result, the space for the bursa and tendon is reduced, and repeated trauma to these structures leads to burstitis and rotator cuff injury. Although pain and limitation of moti...

  14. The nerves around the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Blum, Alain, E-mail: alain.blum@gmail.com [Service d’Imagerie GUILLOZ, CHU Nancy, Nancy 54000 (France); Lecocq, Sophie; Louis, Matthias; Wassel, Johnny; Moisei, Andreea; Teixeira, Pedro [Service d’Imagerie GUILLOZ, CHU Nancy, Nancy 54000 (France)

    2013-01-15

    Neuropathies of the shoulder are considered to be entrapment syndromes. They are relatively common, accounting for about 2% of cases of sport-related shoulder pain. Many instances involve suprascapular neuropathy, but the clinical diagnosis is often delayed because of nonspecific symptoms. Classically, EMG is the gold standard investigation but MRI currently reveals muscular abnormality in 50% of cases. Muscle edema, the most characteristic symptom, is nonspecific. In general, the topography of edema, the presence of a lesion compressing the nerve and clinical history contribute to the diagnosis. Although atrophy and fatty degeneration may persist after the disappearance of edema, they are rarely symptomatic. The main differential diagnosis is Parsonage–Turner syndrome. Evidence of a cyst pressing on a nerve may prompt puncture-infiltration guided by ultrasonography or CT-scan.

  15. Impingement syndrome of the shoulder

    International Nuclear Information System (INIS)

    The impingement syndrome is a clinical entity characterized by shoulder pain due to primary or secondary mechanical irritation of the rotator cuff. The primary factors for the development of impingement are a curved or hook-shaped anterior acromion as well as subacromial osteophytes, which may lead to tearing of the supraspinatus tendon. Secondary impingement is mainly caused by calcific tendinopathy, glenohumeral instability, os acromiale and degenerative changes of the acromioclavicular joint. Conventional radiographs are initially obtained, mainly for evaluation of the bony structures of the shoulder. If available, sonography can be used for detection of lesions and tears of the rotator cuff. Finally, MR-imaging provides detailed information about the relationship of the acromion and the acromioclavicular joint to the rotator cuff itself. In many cases however, no morphologic cause for impingement syndrome can be found. While patients are initially treated conservatively, chronic disease usually requires surgical intervention. (orig.)

  16. The nerves around the shoulder

    International Nuclear Information System (INIS)

    Neuropathies of the shoulder are considered to be entrapment syndromes. They are relatively common, accounting for about 2% of cases of sport-related shoulder pain. Many instances involve suprascapular neuropathy, but the clinical diagnosis is often delayed because of nonspecific symptoms. Classically, EMG is the gold standard investigation but MRI currently reveals muscular abnormality in 50% of cases. Muscle edema, the most characteristic symptom, is nonspecific. In general, the topography of edema, the presence of a lesion compressing the nerve and clinical history contribute to the diagnosis. Although atrophy and fatty degeneration may persist after the disappearance of edema, they are rarely symptomatic. The main differential diagnosis is Parsonage–Turner syndrome. Evidence of a cyst pressing on a nerve may prompt puncture-infiltration guided by ultrasonography or CT-scan

  17. Diagnosis of shoulder impingement syndrome

    International Nuclear Information System (INIS)

    This article reviews the pathogenesis and clinical and imaging findings in shoulder impingement syndrome. Different stages of impingement syndrome are described. Stage I relates to edema and hemorrhage of the supraspinatus tendon. Stage II is characterized by bursal inflammation and fibrosis, as well as tendinopathy. In stage III there is a tear of the rotator cuff. Clinical signs many overlap. Moreover, calcifying tendinitis, fractures and pain originating from the cervical spine may mimic shoulder impingement syndrome. Imaging is important for the exact diagnosis. Standard radiographs are the basis of imaging in shoulder impingement syndrome. They may demonstrate subchondral sclerosis of the major tuberosity, subacromial spurs, and form anomalies of the acromion. They are also important in the differential diagnosis of shoulder impingement syndrome and demonstrate calcifying tendinitis, fractures and neoplasm. Ultrasonography has found acceptance as a screening tool and even as a final diagnostic method by many authors. However, there is a high interobserver variability in the demonstration of rotator cuff tears. Its usefulness has therefore been questioned. MR imaging is probably the method of choice in the evaluation of the rotator cuff and surrounding structures. Several investigations have demonstrated that differentiation of early findings, such as tendinopathy versus partial tears, may be difficult with MR imaging. However, reproducibility for fullthickness tears appears to be higher than for sonography. Moreover, specificity appears to be superior to sonography. MR arthrography is not universally accepted. However, it allows for more exact differentiation of discrete findings and may be indicated in preoperative planning. Standard arthrography and CT have a limited role in the current assessment of the rotator cuff. (orig.)

  18. Shoulder injuries from attacking motion

    Science.gov (United States)

    Yanagi, Shigeru; Nishimura, Tetsu; Itoh, Masaru; Wada, Yuhei; Watanabe, Naoki

    1997-03-01

    Sports injuries have bothered professional players. Although many medical doctors try to treat injured players, to prevent sports injuries is more important. Hence, it is required to clear a kinematic mechanism of the sport injuries. A shoulder of volleyball attacker or baseball pitcher is often inured by playing motion. The injuries are mainly caused at the end of long head tendon, which is located in the upper side of scapula. Generally, a muscle and tendon have enough strength against tensile force, however, it seems that they are sometimes defeated by the lateral force. It is imagined that the effect of the lateral force has a possibility of injuring the tendon. If we find the influence of the lateral force on the injured portion, the mechanism of injuries must be cleared. In our research, volleyball attacking motion is taken by high speed video cameras. We analyze the motion as links system and obtain an acceleration of an arm and a shoulder from video image data. The generated force at a shoulder joint is calculated and resolved into the lateral and longitudinal forces. Our final goal is to discuss a possibility that the lateral force causes the injuries.

  19. Lessons learnt from the painful shoulder; a case series of malignant shoulder girdle tumours misdiagnosed as frozen shoulder

    OpenAIRE

    Quan, Gerald MY; Carr, Derek; Schlicht, Steven; Powell, Gerard; Choong, Peter FM

    2005-01-01

    Adhesive capsulitis or frozen shoulder is a common condition characterized by shoulder pain and stiffness. In patients in whom conservative measures have failed, more invasive interventions such as arthrographic or arthroscopic distension can be very effective in relieving symptoms and improving range of movement. However, absolute contraindications to these procedures include the presence of neoplasia around the shoulder girdle. We present five cases referred to our institution where the dia...

  20. Kinematics of chiropteran shoulder girdle in flight.

    Science.gov (United States)

    Panyutina, A A; Kuznetsov, A N; Korzun, L P

    2013-03-01

    New data on the mechanisms of movements of the shoulder girdle and humerus of bats are described; potential mobility is compared to the movements actually used in flight. The study was performed on the basis of morphological and functional analysis of anatomical specimens of 15 species, high speed and high definition filming of two species and X-ray survey of Rousettus aegyptiacus flight. Our observations indicate that any excursions of the shoulder girdle in bats have relatively small input in the wing amplitude. Shoulder girdle movements resemble kinematics of a crank mechanism: clavicle plays the role of crank, and scapula-the role of connecting rod. Previously described osseous "locking mechanisms" in shoulder joint of advanced bats do not affect the movements, actually used in flight. The wing beats in bats are performed predominantly by movements of humerus relative to shoulder girdle, although these movements occupy the caudal-most sector of available shoulder mobility. PMID:23381941

  1. Rare Inferior Shoulder Dislocation (Luxatio Erecta)

    OpenAIRE

    Hakan Cift; Salih Soylemez; Murat Demiroglu; Korhan Ozkan; Vahit Emre Ozden; Ozkut, Afsar T.

    2015-01-01

    Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients’ ages were 78, 62, 65, and 76. All patients’ reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitat...

  2. Gimballed Shoulders for Friction Stir Welding

    Science.gov (United States)

    Carter, Robert; Lawless, Kirby

    2008-01-01

    In a proposed improvement of tooling for friction stir welding, gimballed shoulders would supplant shoulders that, heretofore, have been fixedly aligned with pins. The proposal is especially relevant to self-reacting friction stir welding. Some definitions of terms, recapitulated from related prior NASA Tech Briefs articles, are prerequisite to a meaningful description of the proposed improvement. In friction stir welding, one uses a tool that includes (1) a rotating shoulder on top (or front) of the workpiece and (2) a pin that rotates with the shoulder and protrudes from the shoulder into the depth of the workpiece. In conventional friction stir welding, the main axial force exerted by the tool on the workpiece is reacted through a ridged backing anvil under (behind) the workpiece. When conventional friction stir welding is augmented with an auto-adjustable pin-tool (APT) capability, the depth of penetration of the pin into the workpiece is varied in real time by a position- or forcecontrol system that extends or retracts the pin as needed to obtain the desired effect. In self-reacting (also known as self-reacted) friction stir welding as practiced heretofore, there are two shoulders: one on top (or front) and one on the bottom (or back) of the workpiece. In this case, a threaded shaft protrudes from the tip of the pin to beyond the back surface of the workpiece. The back shoulder is held axially in place against tension by a nut on the threaded shaft. Both shoulders rotate with the pin and remain aligned coaxially with the pin. The main axial force exerted on the workpiece by the tool and front shoulder is reacted through the back shoulder and the threaded shaft into the friction-stir-welding machine head, so that a backing anvil is no longer needed. A key transmits torque between the bottom shoulder and the threaded shaft, so that the bottom shoulder rotates with the shaft. This concludes the prerequisite definitions of terms.

  3. FROZEN SHOULDER TREATMENT: TRIAMCENALONE OR METHYLPREDNISOLONE INJECTION

    OpenAIRE

    Sanjib; Prabin Ch

    2015-01-01

    OBJECTIVE: To compare the effectiveness of Triamcinolone acetonide [40mg] and Methylprednisolone acetate [40mg] in 210 patients attending the Outpatient Department of Orthopedics of FAAMCH Barpeta with primary and secondary frozen shoulder. METHODS: A total number o f 210 patients with frozen shoulder who attended the Outpatient clinic of Orthopedics at FAAMCH from Jan 2013 to Jan 2015 were enrolled in our study. The diagnosis of frozen shoulder was made using...

  4. Risk of shoulder tendinitis in relation to shoulder loads in monotonous repetitive work

    DEFF Research Database (Denmark)

    Frost, P.; Bonde, J. P.; Mikkelsen, S.;

    2002-01-01

    in repetitive work and 782 referents. Shoulder loads were quantified at task level and measures of exposures were assigned based on task distribution. Symptoms in combination with clinical criteria defined shoulder tendinitis. RESULTS: The prevalence of shoulder tendinitis was higher among exposed workers...... risk slightly (OR 1.6, 95% CI 1.0-2.6 per unit). CONCLUSIONS: The results indicate that workers with repetitive tasks have increased risk of shoulder tendinitis, which partially can be attributed to force requirements...

  5. Reducing Shoulder by Vertical Traction: A One-Man Method for Shoulder Reduction

    OpenAIRE

    Hayat Ahmad Khan; Younis Kamal; Mohammad Ashraf Khan; Munir Farooq; Naseemul Gani; Nazia Hassan; Adil Bashir Shah; Mohammad Shahid Bhat

    2016-01-01

    Fifty percent of joint dislocations reported to the emergency department are of shoulder joint. Various techniques are used to reduce the shoulder and Spaso technique is the least known to the orthopaedic residents which is a simple one-man vertical traction method of shoulder reduction. We evaluated the effectiveness of vertical traction method for anterior shoulder dislocation by orthopaedic residents. Sixty consecutive patients of anterior glenohumeral dislocation attending the emergency d...

  6. Posterior shoulder tightness and rotator cuff strength assessments in painful shoulders of amateur tennis players

    OpenAIRE

    Marcondes, Freddy B.; Julio F. Jesus; Flavio F. Bryk; Vasconcelos, Rodrigo A.; Thiago Y. Fukuda

    2013-01-01

    BACKGROUND: Previous studies have shown a relationship between shoulder posterior capsule tightness and shoulder pain in overhead athletes. However, this relationship has not been studied in tennis players. OBJECTIVES: Assessment of the shoulder range of motion (ROM), strength and posterior capsule tightness of skilled amateur tennis players who had complaints of dominant shoulder pain in comparison with tennis players without pain. METHOD: Forty-nine skilled amateur tennis players we...

  7. FROZEN SHOULDER TREATMENT: TRIAMCENALONE OR METHYLPREDNISOLONE INJECTION

    Directory of Open Access Journals (Sweden)

    Sanjib

    2015-10-01

    Full Text Available OBJECTIVE: To compare the effectiveness of Triamcinolone acetonide [40mg] and Methylprednisolone acetate [40mg] in 210 patients attending the Outpatient Department of Orthopedics of FAAMCH Barpeta with primary and secondary frozen shoulder. METHODS: A total number o f 210 patients with frozen shoulder who attended the Outpatient clinic of Orthopedics at FAAMCH from Jan 2013 to Jan 2015 were enrolled in our study. The diagnosis of frozen shoulder was made using the guidelines for shoulder complain issued by the Dutch C ollege of General Practitioners. Intra - articular injections of Triamcinolone acetonide [40mg] was used in 110 patients [ M ale - 50, female - 60] and 40mg Methylprednisolone was given to 100 patients [M ale - 35, female 65]. Injection was repeated every 3 weeks [ N o t more than 3 injections] by the posterior route. RESULTS: Triamcinolone acetonide was found to be more effective in diabetic patients with frozen shoulder in comparison to Methyprednisolone acetate. Triamcinolone acetonide was found to be more effective i n those patients presenting with severe grades of frozen shoulder and also these patients required lesser number of injections compared to Methylprednisolone acetate. However both Triamcinolone acatonide and Methyprednisolone were equally effective in prim ary frozen shoulder. CONCLUSION: We conclude that Triamcinolone acetonide and Methylprednisolone acetate are effective in the treatment of painful stiff shoulder; however injection Triamcinolone acetonide is a superior alternative in the treatment of diabe tics with frozen shoulder & resistant cases, with less number of injections.

  8. Shoulder distention arthrography as a treatment modality

    International Nuclear Information System (INIS)

    18 patients with painful stiff shoulder joint were underwent shoulder distension arthrography as a treatment modality, followed by physical therapy. Range of motion of shoulder joint was evaluated at 1 week and 4 weeks after arthrography. The results were as follows; 1. Arthrographic findings were decreased volume of joint cavity, obliteration of axillary recess, small subscapularis bursa, serrated capsular margin and non-filling of biceps tendon sheath. In 3 cases, rotator cuff tear was found. 2. Range of motion of shoulder joint was improved after distension arthrography. 3. In 3 patients have rotator cuff tear, range of motion was not improved

  9. Posttraumatic focal dystonia of the shoulder.

    Science.gov (United States)

    Vasileiadis, Georgios I; Sakellariou, Vasileios I; Papagelopoulos, Panayiotis J; Zoubos, Aristeides B

    2012-06-01

    Focal posttraumatic shoulder dystonia is a rare and not easily identifiable entity. Its true pathophysiologic nature, predisposing factors, and disease course remain debatable.This article describes a rare case of a 40-year-old man with late symptoms of focal shoulder dystonia after peripheral trauma of his left shoulder girdle. The shoulder was indirectly injured from the impact of a fall off his motorbike 3 years earlier. He was referred to the authors' institution because remarkable reduction of arm abduction, muscle spasms, and circumscribed hypertrophy of the trapezius muscle were noted while his head and neck were in neutral position and had a full range of motion. The left shoulder had a fixed elevated posture compared with the contralateral shoulder. A continuous burning pain was localized over the area of the hypertrophied trapezius muscle, radiating to the ipsilateral side of the head and neck. Dystonic movements of the trapezius, rhomboid, and supraspinatus muscles were observed. The abduction of the shoulder was significantly decreased, and any repetitive effort for arm abduction induced an exaggeration of his movement disorder, leading to a more pronounced shoulder elevation.Plain radiographs and magnetic resonance imaging of the left shoulder revealed a suprascapular tendinitis with no other abnormalities. Repeated needle electromyography of the left trapezius muscle and neurography of the accessory nerve on both sides were normal. Injections of botulinum toxin A were effective in the resolution of muscle hypertrophy and abnormal posture. PMID:22691679

  10. Towards a Pharmacophore for Amyloid

    Energy Technology Data Exchange (ETDEWEB)

    Landau, Meytal; Sawaya, Michael R.; Faull, Kym F.; Laganowsky, Arthur; Jiang, Lin; Sievers, Stuart A.; Liu, Jie; Barrio, Jorge R.; Eisenberg, David (UCLA)

    2011-09-16

    Diagnosing and treating Alzheimer's and other diseases associated with amyloid fibers remains a great challenge despite intensive research. To aid in this effort, we present atomic structures of fiber-forming segments of proteins involved in Alzheimer's disease in complex with small molecule binders, determined by X-ray microcrystallography. The fiber-like complexes consist of pairs of {beta}-sheets, with small molecules binding between the sheets, roughly parallel to the fiber axis. The structures suggest that apolar molecules drift along the fiber, consistent with the observation of nonspecific binding to a variety of amyloid proteins. In contrast, negatively charged orange-G binds specifically to lysine side chains of adjacent sheets. These structures provide molecular frameworks for the design of diagnostics and drugs for protein aggregation diseases. The devastating and incurable dementia known as Alzheimer's disease affects the thinking, memory, and behavior of dozens of millions of people worldwide. Although amyloid fibers and oligomers of two proteins, tau and amyloid-{beta}, have been identified in association with this disease, the development of diagnostics and therapeutics has proceeded to date in a near vacuum of information about their structures. Here we report the first atomic structures of small molecules bound to amyloid. These are of the dye orange-G, the natural compound curcumin, and the Alzheimer's diagnostic compound DDNP bound to amyloid-like segments of tau and amyloid-{beta}. The structures reveal the molecular framework of small-molecule binding, within cylindrical cavities running along the {beta}-spines of the fibers. Negatively charged orange-G wedges into a specific binding site between two sheets of the fiber, combining apolar binding with electrostatic interactions, whereas uncharged compounds slide along the cavity. We observed that different amyloid polymorphs bind different small molecules, revealing that a

  11. Porcine prion protein amyloid.

    Science.gov (United States)

    Hammarström, Per; Nyström, Sofie

    2015-01-01

    Mammalian prions are composed of misfolded aggregated prion protein (PrP) with amyloid-like features. Prions are zoonotic disease agents that infect a wide variety of mammalian species including humans. Mammals and by-products thereof which are frequently encountered in daily life are most important for human health. It is established that bovine prions (BSE) can infect humans while there is no such evidence for any other prion susceptible species in the human food chain (sheep, goat, elk, deer) and largely prion resistant species (pig) or susceptible and resistant pets (cat and dogs, respectively). PrPs from these species have been characterized using biochemistry, biophysics and neurobiology. Recently we studied PrPs from several mammals in vitro and found evidence for generic amyloidogenicity as well as cross-seeding fibril formation activity of all PrPs on the human PrP sequence regardless if the original species was resistant or susceptible to prion disease. Porcine PrP amyloidogenicity was among the studied. Experimentally inoculated pigs as well as transgenic mouse lines overexpressing porcine PrP have, in the past, been used to investigate the possibility of prion transmission in pigs. The pig is a species with extraordinarily wide use within human daily life with over a billion pigs harvested for human consumption each year. Here we discuss the possibility that the largely prion disease resistant pig can be a clinically silent carrier of replicating prions.

  12. Low-Cost Alternative External Rotation Shoulder Brace and Review of Treatment in Acute Shoulder Dislocations

    Directory of Open Access Journals (Sweden)

    Lacy, Kyle

    2015-01-01

    Full Text Available Traumatic dislocations of the shoulder commonly present to emergency departments (EDs. Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED. Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of immobilization with the shoulder in a position of external rotation, for both anterior and posterior shoulder dislocations.7-11,19 In this study, we present a technique for assembling a low-cost external rotation shoulder brace using materials found in most hospitals: cotton roll, stockinette, and shoulder immobilizers. This brace is particularly suited for the uninsured patient, who lacks the financial resources to pay for a pre-fabricated brace out of pocket. We also performed a cost analysis for our low-cost external rotation shoulder brace, and a cost comparison with pre-fabricated brand name braces. At our institution, the total materials cost for our brace was $19.15. The cost of a pre-fabricated shoulder brace at our institution is $150 with markup, which is reimbursed on average at $50.40 according to our hospital billing data. The low-cost external rotation shoulder brace is therefore a more affordable option for the uninsured patient presenting with acute shoulder dislocation. [West J Emerg Med. 2015;16(1:114–120.

  13. Concept of healing of recurrent shoulder dislocation☆

    Science.gov (United States)

    D’Angelo, Donato

    2014-01-01

    This paper presents the main surgical techniques applied in the treatment of anterior recurrent shoulder dislocation, aiming the achievement of the normality of articulate movements. This was obtained by combining distinct surgical procedures, which allowed the recovery of a complete functional capacity of the shoulder, without jeopardizing the normality of movement, something that has not been recorded in the case of the tense sutures of the surgical procedures of Putti-Platt, Bankart, Latarjet, Dickson-O’Dell and others. The careful review of the methods applied supports the conclusion that recurrent shoulder dislocation can be cured, since cure has been obtained in 97% of the treated cases. However, some degree of limitation in the shoulder movement has been observed in most of the treated cases. Our main goal was to achieve a complete shoulder functional recovery, by treating simultaneously all of the anatomical–pathological lesions, without considering the so-called essential lesions. The period of post-operatory immobilization only last for the healing of soft parts; this takes place in a position of neutral shoulder rotation, since the use of vascular bone graft eliminates the need for long time immobilization, due to the shoulder stabilization provided by rigid fixation of the coracoid at the glenoid edge, as in the Latarjet's technique. Our procedure, used since 1959, comprises the association of several techniques, which has permitted shoulder healing without movement limitation. That was because of the tension reduction in the sutures of the subescapularis, capsule, and coracobraquialis muscles. PMID:26229839

  14. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... taking down any muscles in front of the shoulder, and I think yielding less pain for the patient pos-top, potentially less scar ... that he had an open shift. Now the shoulder is maybe too tight and leading to pain, but if you could talk about that issue ...

  15. Concept of healing of recurrent shoulder dislocation.

    Science.gov (United States)

    D'Angelo, Donato

    2014-01-01

    This paper presents the main surgical techniques applied in the treatment of anterior recurrent shoulder dislocation, aiming the achievement of the normality of articulate movements. This was obtained by combining distinct surgical procedures, which allowed the recovery of a complete functional capacity of the shoulder, without jeopardizing the normality of movement, something that has not been recorded in the case of the tense sutures of the surgical procedures of Putti-Platt, Bankart, Latarjet, Dickson-O'Dell and others. The careful review of the methods applied supports the conclusion that recurrent shoulder dislocation can be cured, since cure has been obtained in 97% of the treated cases. However, some degree of limitation in the shoulder movement has been observed in most of the treated cases. Our main goal was to achieve a complete shoulder functional recovery, by treating simultaneously all of the anatomical-pathological lesions, without considering the so-called essential lesions. The period of post-operatory immobilization only last for the healing of soft parts; this takes place in a position of neutral shoulder rotation, since the use of vascular bone graft eliminates the need for long time immobilization, due to the shoulder stabilization provided by rigid fixation of the coracoid at the glenoid edge, as in the Latarjet's technique. Our procedure, used since 1959, comprises the association of several techniques, which has permitted shoulder healing without movement limitation. That was because of the tension reduction in the sutures of the subescapularis, capsule, and coracobraquialis muscles. PMID:26229839

  16. Arthrography of the dog's shoulder

    International Nuclear Information System (INIS)

    Different volumes with varying concentrations of meglumine-sodium diatrizoate were injected to study positive contrast shoulder arthrograms in six experimental dogs weighing 23-37 kg. The best delineation of the articular cartilage was obtained following injection of 1.5 ml of a 25% solution (185 mg iodine/joint). To visualize the bicipital tendon sheet and the different pouches of the shoulder joint, 6 ml of a 25% solution (750 mg iodine/joint) should be used. If no definite lesions are previewed, 6 ml of a 19% solution (550 mg iodine/joint) offers an acceptable compromise since with this volume and concentration no pooling of contrast medium overlapping the caudal area of the humeral head was seen. Radiographs should be obtained within 5 minutes after injection of the contrast medium. After that period the delineation of the joint structures is vaguening by absorption of the contrast medium. Repeated contrast examination with meglumine-sodium diatrizoate should be avoided. After four procedures at weekly intervals, the necropsy performed on two dogs showed inflammatory changes of the synovial membrane

  17. Frozen shoulder--an algoneurodystrophic process?

    Science.gov (United States)

    Müller, L P; Rittmeister, M; John, J; Happ, J; Kerschbaumer, F

    1998-12-01

    The frozen shoulder syndrome and the Sudeck syndrome are clinically in many aspects similar. Radioisotope bone scan shows an increased uptake in the affected areas in both diseases, while standard radiographs show a progressive demineralization. With measurement of bone-mineral density by quantitative digital radiography these local decalcification processes were diagnosed in an early stage of the frozen shoulder syndrome: of 12 patients with primary frozen shoulder 10 had a bone-mineral density decrease of more than 21% in the humeral head of the affected shoulder compared to the unaffected side. In the control groups (n = 32) the difference between affected and unaffected side (left and right humerus of the healthy probands) was in only one case each above 21%. There are several indications in the literature assuming the frozen shoulder to be an algoneurodystrophic process. Our observation supports this hypothesis, and may possibly lead to earlier diagnosis and improved therapeutic management. PMID:9922549

  18. Shoulder Ultrasonography: Performance and Common Findings

    Directory of Open Access Journals (Sweden)

    Diana Gaitini

    2012-01-01

    Full Text Available Ultrasound (US of the shoulder is the most commonly requested examination in musculoskeletal US diagnosis. Sports injuries and degenerative and inflammatory processes are the main sources of shoulder pain and functional limitations. Because of its availability, low cost, dynamic examination process, absence of radiation exposure, and ease of patient compliance, US is the preferred mode for shoulder imaging over other, more sophisticated, and expensive methods. Operator dependence is the main disadvantage of US examinations. Use of high range equipment with high resolution transducers, adhering to a strict examination protocol, good knowledge of normal anatomy and pathological processes and an awareness of common pitfalls are essential for the optimal performance and interpretation of shoulder US. This article addresses examination techniques, the normal sonographic appearance of tendons, bursae and joints, and the main pathological conditions found in shoulder ultrasonography.

  19. Postoperative pectoral swelling after shoulder arthroscopy

    Science.gov (United States)

    ERCIN, ERSIN; BILGILI, MUSTAFA GOKHAN; ONES, HALIL NADIR; KURAL, CEMAL

    2015-01-01

    Fluid extravasation is possibly the most common complication of shoulder arthroscopy. Shoulder arthroscopy can lead to major increases in the compartment pressure of adjacent muscles and this phenomenon is significant when an infusion pump is used. This article describes a case of pectoral swelling due to fluid extravasation after shoulder arthroscopy. A 24-year-old male underwent an arthroscopic Bankart repair for recurrent shoulder dislocation. The surgery was performed in the beach chair position and lasted two hours. At the end of the procedure, the patient was found to have left pectoral swelling. A chest radiography showed no abnormality. Pectoral swelling due to fluid extravasation after shoulder arthroscopy has not previously been documented. PMID:26889473

  20. MRI of the posttraumatic shoulder

    International Nuclear Information System (INIS)

    Full text: Abnormalities of the shoulder are common but still unclear for both GPs and the orthopedic surgeon in our community. Difficult and late these patients are directed to a specialist for diagnosis and treatment. Our goal is to address some of the key and most common problem conditions related to the complaints in this area. Incidence of symptomatic ruptures of the shoulder’s rotator cuff is difficult to be evaluated. But it is by no means rare, concerning the research in the world - historically and today. It is also known that ruptures can be asymptomatic. Despite the large percentage of them, many of them are at risk for progression of the symptoms. While, on the world, the authors explicitly state that dealing with a rotator cuff rupture is one of the top 10 issues that are most important for orthopedic surgeons, in our country the most common diagnosis for shoulder complaints is still periarthritis, without specifying of individual muscles pathology. Another major concern is shoulder instability associated with multiple incidents of luxation started either in adolescence with minor traumatic incident, such as recurrent dislocation, or started after severe trauma in older ages. It has to be specified diagnostic type of instability: front, rear or multidirection. Especially it is important to make the initial stabilization period of unavoidable long series of repeated dislocations in adolescents and young people, whether actively practicing sports or not. This point is often missed, and later for large lesions it leads to more invasive surgery. Not infrequently this condition is characterized by pain and limited movement without true dislocation. Then it is mandatory to assess the diagnostic changes in labrum, ligaments and muscles, not to leave the patient to reach first dislocation. Impingement syndrome (IC) is a common suffering, engaging soft tissues in the subacromial bursitis. IC characterizes by pain during the upper limb removal and the

  1. Posterior shoulder tightness and rotator cuff strength assessments in painful shoulders of amateur tennis players

    Directory of Open Access Journals (Sweden)

    Freddy B. Marcondes

    2013-04-01

    Full Text Available BACKGROUND: Previous studies have shown a relationship between shoulder posterior capsule tightness and shoulder pain in overhead athletes. However, this relationship has not been studied in tennis players. OBJECTIVES: Assessment of the shoulder range of motion (ROM, strength and posterior capsule tightness of skilled amateur tennis players who had complaints of dominant shoulder pain in comparison with tennis players without pain. METHOD: Forty-nine skilled amateur tennis players were distributed in 2 groups: Control Group (n=22 and Painful Group (n=27. The first group was composed of asymptomatic subjects, and the second was composed of subjects with shoulder pain on the dominant side. These groups were evaluated to determine the dominant and non-dominant shoulder ROM (internal and external rotation, isometric shoulder strength (internal and external rotation and posterior shoulder tightness by blind evaluators. RESULTS: The ANOVA results indicated significant differences between the groups in the dominant shoulder ROM, posterior capsule tightness, external rotation strength and strength ratio (p<0.05. The intragroup analysis (dominant versus non-dominant in the Painful Group displayed a significant difference for ROM, posterior capsule tightness and external rotation strength (p<0.05. CONCLUSIONS: The tennis players with pain in the dominant shoulder presented greater posterior capsule tightness, internal rotation deficit (ROM, external rotation gain (ROM and deficits in external rotation strength than the tennis players without pain.

  2. Nanomechanical properties of single amyloid fibrils

    Science.gov (United States)

    Sweers, K. K. M.; Bennink, M. L.; Subramaniam, V.

    2012-06-01

    Amyloid fibrils are traditionally associated with neurodegenerative diseases like Alzheimer’s disease, Parkinson’s disease or Creutzfeldt-Jakob disease. However, the ability to form amyloid fibrils appears to be a more generic property of proteins. While disease-related, or pathological, amyloid fibrils are relevant for understanding the pathology and course of the disease, functional amyloids are involved, for example, in the exceptionally strong adhesive properties of natural adhesives. Amyloid fibrils are thus becoming increasingly interesting as versatile nanobiomaterials for applications in biotechnology. In the last decade a number of studies have reported on the intriguing mechanical characteristics of amyloid fibrils. In most of these studies atomic force microscopy (AFM) and atomic force spectroscopy play a central role. AFM techniques make it possible to probe, at nanometer length scales, and with exquisite control over the applied forces, biological samples in different environmental conditions. In this review we describe the different AFM techniques used for probing mechanical properties of single amyloid fibrils on the nanoscale. An overview is given of the existing mechanical studies on amyloid. We discuss the difficulties encountered with respect to the small fibril sizes and polymorphic behavior of amyloid fibrils. In particular, the different conformational packing of monomers within the fibrils leads to a heterogeneity in mechanical properties. We conclude with a brief outlook on how our knowledge of these mechanical properties of the amyloid fibrils can be exploited in the construction of nanomaterials from amyloid fibrils.

  3. Functional Amyloid Formation within Mammalian Tissue.

    Directory of Open Access Journals (Sweden)

    2005-11-01

    Full Text Available Amyloid is a generally insoluble, fibrous cross-beta sheet protein aggregate. The process of amyloidogenesis is associated with a variety of neurodegenerative diseases including Alzheimer, Parkinson, and Huntington disease. We report the discovery of an unprecedented functional mammalian amyloid structure generated by the protein Pmel17. This discovery demonstrates that amyloid is a fundamental nonpathological protein fold utilized by organisms from bacteria to humans. We have found that Pmel17 amyloid templates and accelerates the covalent polymerization of reactive small molecules into melanin-a critically important biopolymer that protects against a broad range of cytotoxic insults including UV and oxidative damage. Pmel17 amyloid also appears to play a role in mitigating the toxicity associated with melanin formation by sequestering and minimizing diffusion of highly reactive, toxic melanin precursors out of the melanosome. Intracellular Pmel17 amyloidogenesis is carefully orchestrated by the secretory pathway, utilizing membrane sequestration and proteolytic steps to protect the cell from amyloid and amyloidogenic intermediates that can be toxic. While functional and pathological amyloid share similar structural features, critical differences in packaging and kinetics of assembly enable the usage of Pmel17 amyloid for normal function. The discovery of native Pmel17 amyloid in mammals provides key insight into the molecular basis of both melanin formation and amyloid pathology, and demonstrates that native amyloid (amyloidin may be an ancient, evolutionarily conserved protein quaternary structure underpinning diverse pathways contributing to normal cell and tissue physiology.

  4. UnconStrained ShoUlder arthroplasty

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To evaluate the results of 36unconstrained shoulder arthroplasties. Methods: In the series, 24 total and 12 hemiarthroplasties of the shoulders were performed with unconstrained shoulder prostheses in 29 patients who suffered from glenohumeral degenerative arthritis, rheumatoid arthritis, avascular necrosis and proximal fracture of humerus, respectively. Follow-up averaged 6.2years. All patients were evaluated pre- and post-operatively using the rating system of the Society of American Shoulder and Elbow Surgeons which assesses the severity of pain,strength of muscles around shoulder, stability, range of motion and functional activities of daily living. Radiolucent line and migration of prostheses were observed postoperatively on X-rays. Results: Postoperatively, the rate of pain relief was 91.3%, and active range of motion increased by 47° inforward flexion, 43° in abduction , 30° in external rotation,and 4 segments in internal rotation. Preoperatively the average points of 6 functional activities patients could perform was 0.8, and postoperatively 3.1. On postoperative X-ray, proximal migration of the humerus was seen in 8 shoulders, 6 of which had either a torn or absent rotator cuff. Radiolucent lines were seen around 1humeral component and 9 glenoid components. Onehumeral and 2 glenoid components loosened. Conclusions: These results suggest that unconstrained shoulder arthroplasty is a satisfactory and safe technique.

  5. Navigating the Alphabet Soup of Labroligamentous Pathology of the Shoulder.

    Science.gov (United States)

    Fitzpatrick, Darren; Grubin, Jeremy

    2016-02-01

    Because of the widespread use of eponyms and acronyms to describe labroligamentous findings in the shoulder, interpreting shoulder magnetic resonance imaging reports can be challenging. A summary of the appearance of these lesions on shoulder magnetic resonance images can help the orthopedic surgeon to understand these entities as imaging findings and to determine the appropriate treatment for patients with shoulder injuries. PMID:26866313

  6. Management of sequalae of neglected septic shoulder

    Directory of Open Access Journals (Sweden)

    Pawar Uday

    2009-01-01

    Full Text Available Complex deformities following septic arthritis of the shoulder in infancy are mild and therefore rarely reported. A 12 year old girl presented with shortening of upper extremity right side, with dislocation of shoulder and with entire extremity rotated to 180 degrees. The palm faced posteriorly and the olecranon anteriorly. Arthrodesis of shoulder and unifocal lengthening of humerus was achieved with three 4 mm cannulated cancellous screws and an ilizarov frame. A lengthening of 9 centimeters was achieved and regenerate healed at 12 months. At 10 years follow-up she is able to perfom her activities of daily living.

  7. Imaging of bursae around the shoulder joint

    Energy Technology Data Exchange (ETDEWEB)

    Bureau, N.J. [Department of Radiology, Hotel-Dieu de Montreal Hospital, Montreal, Quebec (Canada); Dussault, R.G. [Department of Radiology, Health Sciences Center, University of Virginia, Charlottesville, Virginia (United States); Keats, T.E. [Department of Radiology, Health Sciences Center, University of Virginia, Charlottesville, Virginia (United States)

    1996-08-01

    The authors present a review of the anatomy of the major bursae around the shoulder joint and discuss the use of the different imaging modalities which demonstrate their radiologic features. The calcified subacromial-subdeltoid bursa has a characteristic appearance on plain radiographs. When inflamed it can be visualized by ultrasound and magnetic resonance imaging. Calcific bursitis may involve the subcoracoid bursa. This bursa may mimic adhesive capsulitis of the shoulder or complete rotator cuff tear when injected inadvertently during shoulder arthrography. Less well known are three coracoclavicular ligament bursae. These are also subject to calcific bursitis and have a typical radiologic appearance. (orig.). With 6 figs.

  8. Soft Tissue Aspects of the Shoulder Joint

    OpenAIRE

    Khoschnau, Shwan

    2012-01-01

    The aim of this thesis was to study different aspects of the soft tissues of the shoulder joint. The variation in the quality of the tendons and ligaments can be explained by genetic factors. To test the hypothesis that collagen 1 α1 Sp1 polymorphism is related to the occurrence of cruciate ligament ruptures and shoulder dislocations, a total of 358 patients (233 patients with cruciate ligament ruptures and 126 with shoulder dislocations) were included in the study. We found a decreased risk ...

  9. Nerve Transfers to Restore Shoulder Function.

    Science.gov (United States)

    Leechavengvongs, Somsak; Malungpaishorpe, Kanchai; Uerpairojkit, Chairoj; Ng, Chye Yew; Witoonchart, Kiat

    2016-05-01

    The restoration of shoulder function after brachial plexus injury represents a significant challenge facing the peripheral nerve surgeons. This is owing to a combination of the complex biomechanics of the shoulder girdle, the multitude of muscles and nerves that could be potentially injured, and a limited number of donor options. In general, nerve transfer is favored over tendon transfer, because the biomechanics of the musculotendinous units are not altered. This article summarizes the surgical techniques and clinical results of nerve transfers for restoration of shoulder function. PMID:27094888

  10. MRI findings in little leaguer's shoulder

    International Nuclear Information System (INIS)

    Little leaguer's shoulder, a stress injury of the proximal humeral physis, should be considered in the differential diagnosis for an adolescent baseball player with shoulder pain, especially if the player is pitching regularly in a competitive environment. While roentgenographs may or may not be helpful, depending on the duration and severity of the injury, we report the MRI appearance of a case of little leaguer's shoulder. We found MRI helpful in diagnosing injury to the growth plate that was radiographically occult; furthermore, we were able to document the patient's progress with a follow-up MRI examination, which showed improvement with treatment. (orig.)

  11. Shoulder injuries in soccer goalkeepers: review and development of a FIFA 11+ shoulder injury prevention program.

    Science.gov (United States)

    Ejnisman, Benno; Barbosa, Gisele; Andreoli, Carlos V; de Castro Pochini, A; Lobo, Thiago; Zogaib, Rodrigo; Cohen, Moises; Bizzini, Mario; Dvorak, Jiri

    2016-01-01

    In the last years, shoulder injuries have represented an increasing health problem in soccer players. The goalkeepers are more exposed to shoulder disorders than other field players. Injury prevention exercises for upper limbs were cited in few studies involving throwing athletes, but we know that goalkeepers need a specific program. The purpose of this study is to describe the development of an adapted Fédération Internationale de Football Association (FIFA) 11+ program, namely the FIFA 11+ shoulder, which targets the prevention of shoulder injuries in soccer goalkeepers. The FIFA 11+ shoulder program is structured into three parts: general warming-up exercises, exercises to improve strength and balance of the shoulder, elbow, wrist, and finger muscles, and advanced exercises for core stability and muscle control. The exercises were selected based on recommendations from studies demonstrating high electromyographic activity. PMID:27563262

  12. State of the Art Priciples in Shoulder Rehabilitation

    Institute of Scientific and Technical Information of China (English)

    Edward R. Laskowski

    2003-01-01

    @@ The primary goal of shoulder rehabilitation is to restore optimal pain-free shoulder function. In general terms, shoulder rehabilitation involves control of pain and inflammation,early non-traumatic motion, muscle reactivation, strengthening of shoulder group muscles, and restoration of normal shoulder function within the kinetic-kinematic chain. Finally, sports and activity-specific rehabilitative exercise are essential to maximize function and return the patient to their prior sport or activity without deficit. This discussion will review recent research findings that have expanded our knowledge and understanding of shoulder function and which will serve as guidelines for a state-of-the-art shoulder rehabilitation program.

  13. Low-Cost Alternative External Rotation Shoulder Brace and Review of Treatment in Acute Shoulder Dislocations

    OpenAIRE

    Lacy, Kyle; Cooke, Chris; Cooke, Pat; Schupbach, Justin; Vaidya, Rahul

    2015-01-01

    Traumatic dislocations of the shoulder commonly present to emergency departments (EDs). Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED. Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions) are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of im...

  14. Stemless shoulder prosthesis versus conventional anatomic shoulder prosthesis in patients with osteoarthritis

    OpenAIRE

    Berth, Alexander; Pap, Géza

    2012-01-01

    Background The stemless shoulder prosthesis is a new concept in shoulder arthroplasty. To date, only a few studies have investigated the results of this prosthesis. The aim of this study was to investigate the clinical and radiological midterm results of this implant in comparison with a standard anatomic stemmed shoulder prosthesis. Materials and methods The Constant score, the DASH score, the active range of motion (abduction, anteversion, external rotation), and the radiological results we...

  15. Influence of shoulder pain on muscle function: implications for the assessment and therapy of shoulder disorders.

    Science.gov (United States)

    Struyf, Filip; Lluch, Enrique; Falla, Deborah; Meeus, Mira; Noten, Suzie; Nijs, Jo

    2015-02-01

    Shoulder pain is often a challenging clinical phenomenon because of the potential mismatch between pathology and the perception of pain. Current evidence clearly emphasizes an incomplete understanding of the nature of shoulder pain. Indeed, the effective diagnosis and treatment of shoulder pain should not only rely upon a detailed knowledge of the peripheral pathologies that may be present in the shoulder, but also on current knowledge of pain neurophysiology. To assess and treat shoulder pain, a comprehensive understanding of the way in which pain is processed is essential. This review reflects modern pain neurophysiology to the shoulder and aims to answer the following questions: why does my shoulder hurt? What is the impact of shoulder pain on muscle function? What are the implications for the clinical examination of the shoulder? And finally, what are the clinical implications for therapy? Despite the increasing amount of research in this area, an in-depth understanding of the bidirectional nociception-motor interaction is still far from being achieved. Many questions remain, especially related to the treatment of nociception-motor interactions.

  16. Arthroscopic Release of Adhesive Capsulitis of the Shoulder Complicated With Shoulder Dislocation and Brachial Plexus Injury.

    Science.gov (United States)

    Nunez, Fiesky A; Papadonikolakis, Anastasios; Li, Zhongyu

    2016-01-01

    The incidence of brachial plexus injury after shoulder dislocation or arthroscopic shoulder surgery is low. Complex regional pain syndrome (CRPS) is an uncommon but painful condition that can develop after nerve injury. Historically, CRPS has been difficult to treat and therapeutic efforts are sometimes limited to ameliorating symptoms. However, if a dystrophic focus can be identified, the condition can be addressed with surgical exploration for potential neurolysis or nerve repair. The present article reports on a case of type II CRPS that developed in the postoperative setting of arthroscopic shoulder surgery complicated with simple shoulder dislocation. PMID:27518297

  17. Amyloid formation: functional friend or fearful foe?

    Science.gov (United States)

    Bergman, P; Roan, N R; Römling, U; Bevins, C L; Münch, J

    2016-08-01

    Amyloid formation has been most studied in the context of neurodegenerative diseases, such as Alzheimer's disease and Parkinson's disease, as well as in amyloidosis. However, it is becoming increasingly clear that amyloid is also present in the healthy setting; for example nontoxic amyloid formation is important for melanin synthesis and in innate immunity. Furthermore, bacteria have mechanisms to produce functional amyloid structures with important roles in bacterial physiology and interaction with host cells. Here, we will discuss some novel aspects of fibril-forming proteins in humans and bacteria. First, the amyloid-forming properties of the antimicrobial peptide human defensin 6 (HD6) will be considered. Intriguingly, unlike other antimicrobial peptides, HD6 does not kill bacteria. However, recent data show that HD6 can form amyloid structures at the gut mucosa with strong affinity for bacterial surfaces. These so-called nanonets block bacterial invasion by entangling the bacteria in net-like structures. Next, the role of functional amyloid fibrils in human semen will be discussed. These fibrils were discovered through their property to enhance HIV infection but they may also have other yet unknown functions. Finally, the role of amyloid formation in bacteria will be reviewed. The recent finding that bacteria can make amyloid in a controlled fashion without toxic effects is of particular interest and may have implications for human disease. The role of amyloid in health and disease is beginning to be unravelled, and here, we will review some of the most recent findings in this exciting area. PMID:27151743

  18. MRI findings in the painful hemiplegic shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Tavora, D.G.F., E-mail: danielgurgel@sarah.b [Department of Radiology, Sarah Network of Hospitals for Rehabilitation, Fortaleza (Brazil); Gama, R.L.; Bomfim, R.C. [Department of Radiology, Sarah Network of Hospitals for Rehabilitation, Fortaleza (Brazil); Nakayama, M. [Department of Radiology, Federal University of Grande Dourados, Dourados (Brazil); Silva, C.E.P. [Department of Statistics, Sarah Network of Hospitals for Rehabilitation, Fortaleza (Brazil)

    2010-10-15

    Aim: To evaluate the magnetic resonance imaging (MRI) findings in painful hemiplegic shoulder (PHS) in hemiplegic post-stroke patients. Materials and methods: Patients with hemiplegia following their first cerebrovascular accident who were admitted to the Sarah Network of Hospitals for Rehabilitation were studied. Forty-five patients with pain in the hemiplegic shoulder and 23 post-stroke patients without shoulder pain were investigated. MRI and radiographic findings of the hemiplegic and contralateral asymptomatic shoulders were evaluated. Results: Some MRI findings were more frequent in PHS group, including synovial capsule thickening, synovial capsule enhancement, and enhancement in the rotator cuff interval. Conclusions: Adhesive capsulitis was found to be a possible cause of PHS.

  19. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... 34:32 MEAGAN: At first I started doing gravity assisted exercises like Codman's which are…I laid ... hang off and just did circles with the gravity taking my shoulder, just to gain some of ...

  20. Rare Inferior Shoulder Dislocation (Luxatio Erecta

    Directory of Open Access Journals (Sweden)

    Hakan Cift

    2015-01-01

    Full Text Available Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients’ ages were 78, 62, 65, and 76. All patients’ reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitation of range of motion of their shoulder at their last control. Luxatio erecta is seen rarely, and these patients may have neurovascular injury. These patients should be carefully examined and treated by the orthopaedic and traumatology surgeons.

  1. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... for perhaps some other things you do in life a stiff shoulder isn't so bad. But ... were interested in getting me back to normal life. I wouldn't go to anyplace different. I ...

  2. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... of get some of their competitiveness and their energy into the rehabilitation and then a lot of ... JOE CONGENI, MD: ---are more forceful. There's more energy placed, more stress placed across that shoulder joint. ...

  3. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... that comes under a lot of load and stress to it and is injured not infrequently. The ... are more forceful. There's more energy placed, more stress placed across that shoulder joint. And I know ...

  4. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... and the people who are sitting at home right now watching it's difficult for them to understand. ... an incision over the front of their shoulder, right there, that measures about five inches in length. ...

  5. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... that kid's going to have arthritis in the future. It's a surgery that's done to change a ... of my goals, in the not too distant future, is to work on a shoulder dislocation prevention ...

  6. Candida infection of a prosthetic shoulder joint

    International Nuclear Information System (INIS)

    A heroin addict developed a Candida parapsilosis infection in a prosthetic shoulder joint. Radiographs showed loose fragments of cement with prosthetic loosening. The patient was treated with removal of the prosthesis and intravenous amphotericin B followed by oral ketoconazole. (orig.)

  7. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available BANKART REPAIR TO CORRECT SHOULDER INSTABILITY AKRON CHILDREN'S HOSPITAL AKRON, OHIO February 21, 2008 00:00:11 NARRATOR: Welcome to Akron Children's Hospital. Over the next hour you'll see a ...

  8. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... instability, or the shoulder dislocating again with other activities. Nonetheless, we always approach these patients first with physical therapy and rehab. So, Joe, maybe if you ...

  9. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... through the shoulder joint in order to, one, clean it out, but also just to keep it ... you can see we're going to gently clean back some of the excess cartilage there. Try ...

  10. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... weeks of time trying to get that shoulder stronger; often four, six, eight weeks of a strengthening ... suture anchor? And which do you feel is stronger? I think this is a good time as ...

  11. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... Hospital. Over the next hour you'll see a Bankart repair to correct shoulder instability. Bankart lesions ... three small incisions. You'll also hear from a patient who has undergone the surgery, and meet ...

  12. MRI findings in the painful hemiplegic shoulder

    International Nuclear Information System (INIS)

    Aim: To evaluate the magnetic resonance imaging (MRI) findings in painful hemiplegic shoulder (PHS) in hemiplegic post-stroke patients. Materials and methods: Patients with hemiplegia following their first cerebrovascular accident who were admitted to the Sarah Network of Hospitals for Rehabilitation were studied. Forty-five patients with pain in the hemiplegic shoulder and 23 post-stroke patients without shoulder pain were investigated. MRI and radiographic findings of the hemiplegic and contralateral asymptomatic shoulders were evaluated. Results: Some MRI findings were more frequent in PHS group, including synovial capsule thickening, synovial capsule enhancement, and enhancement in the rotator cuff interval. Conclusions: Adhesive capsulitis was found to be a possible cause of PHS.

  13. Diagnosing patients with longstanding shoulder joint pain

    DEFF Research Database (Denmark)

    Nørregaard, J; Krogsgaard, M R; Lorenzen, T;

    2002-01-01

    OBJECTIVE: To examine the interobserver agreement of commonly used clinical tests and diagnoses in patients with shoulder pain, and the accuracy of these tests and ultrasonographic findings in comparison with arthroscopic findings. METHODS: Eighty six patients with longstanding shoulder joint pain...... lesion also showed poor agreement. Pain during muscle contraction showed moderate agreement. The agreement of clinical diagnoses was poor and the accuracy was low in comparison with arthroscopy. Ultrasonography was accurate in full thickness supraspinatus tendon tears, but inaccurate for partial tears...

  14. An atypical mycobacterial infection of the shoulder

    Directory of Open Access Journals (Sweden)

    Christopher L Talbot

    2012-01-01

    Full Text Available Mycobacterium malmoense is an acid-fast non-tuberculous organism that most commonly causes pulmonary infection. Extrapulmonary infection has also been reported. With an increased emphasis being placed on the clinical importance of this organism, especially within Europe, we report the first case of septic arthritis of the shoulder caused by this organism. We also highlight the importance of considering atypical mycobacterium infection in the differential diagnosis of shoulder infection and issues surrounding the management of this entity.

  15. The epidemiology of shoulder dislocations in Oslo

    OpenAIRE

    Liavaag, S; Svenningsen, S; Reikerås, O.; Enger, M; Fjalestad, T; Pripp, A H; Brox, J I

    2011-01-01

    There are few previous studies on the incidence of shoulder dislocation in the general population. The aim of the study was to report the incidence of acute shoulder dislocations in the capital of Norway (Oslo) in 2009. Patients of all ages living in Oslo, sustaining a dislocation of the glenohumeral joint, were identified using electronic diagnosis registers, patient protocols, radiological registers of the hospitals, and the Norwegian Patient Register (NPR). The overall incidence rate was 5...

  16. Concept of healing of recurrent shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Donato D'Angelo

    2014-08-01

    Full Text Available This paper presents the main surgical techniques applied in the treatment of anterior recurrent shoulder dislocation, aiming the achievement of the normality of articulate movements. This was obtained by combining distinct surgical procedures, which allowed the recovery of a complete functional capacity of the shoulder, without jeopardizing the normality of movement, something that has not been recorded in the case of the tense sutures of the surgical procedures of Putti-Platt, Bankart, Latarjet, Dickson-O'Dell and others.The careful review of the methods applied supports the conclusion that recurrent shoulder dislocation can be cured, since cure has been obtained in 97% of the treated cases. However, some degree of limitation in the shoulder movement has been observed in most of the treated cases.Our main goal was to achieve a complete shoulder functional recovery, by treating simultaneously all of the anatomical–pathological lesions, without considering the so-called essential lesions.The period of post-operatory immobilization only last for the healing of soft parts; this takes place in a position of neutral shoulder rotation, since the use of vascular bone graft eliminates the need for long time immobilization, due to the shoulder stabilization provided by rigid fixation of the coracoid at the glenoid edge, as in the Latarjet's technique.Our procedure, used since 1959, comprises the association of several techniques, which has permitted shoulder healing without movement limitation. That was because of the tension reduction in the sutures of the subescapularis, capsule, and coracobraquialis muscles.

  17. Management of complications after total shoulder arthroplasty

    OpenAIRE

    Josef K Eichinger; Galvin, Joseph W.

    2015-01-01

    The outcomes of total shoulder arthroplasty (TSA) for painful arthritis of the glenohumeral joint are excellent with significant improvement in pain and function. Increased use of total shoulder arthroplasty over the past decade has led to identification of common complications. Although the complication rate is low, accurate and timely diagnosis, appropriate management, and implementation of methods for prevention are critical to a successful long-term outcome. The most common complications ...

  18. Conservative treatment and rehabilitation of shoulder problems

    International Nuclear Information System (INIS)

    The shoulder joint has an important influence on arm- and handfunction. Therefore, activities of daily living, working and leisure time can be negatively influenced by diseases of the shoulder joint. Problems of the shoulder joint can be induced by muscular dysbalance and poor body posture. There is a strong relationship between shoulder function and body posture. Conservative treatment and rehabilitation of the shoulder joint aims at improving the local dysfunction of the shoulder joint as well as at improving function and social participation. Antiinflammatory and pain medication, exercise, occupational, electro-, ultrasound and shock wave therapy, massage, thermotherapy and pulsed electromagnetic fields are used as conservative treatments. Exercise therapy aims at improving muscular performance, joint mobility and body posture. Occupational therapy aims at improving functional movements for daily living and work. Electrotherapy is primarily used to relieve pain. Shock wave and ultrasound therapy proved to be an effective treatment for patients with calcific tendinitis. The subacromial impingement syndrome can be effectively treated by conservative therapy. (orig.)

  19. Amyloid Goiter Secondary to Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Bunyamin Aydin

    2016-01-01

    Full Text Available Diffuse amyloid goiter (AG is an entity characterized by the deposition of amyloid in the thyroid gland. AG may be associated with either primary or secondary amyloidosis. Secondary amyloidosis is rarely caused by inflammatory bowel diseases. Secondary amyloidosis is relatively more common in the patients with Crohn’s disease, whereas it is highly rare in patients with ulcerative colitis. Diffuse amyloid goiter caused by ulcerative colitis is also a rare condition. In the presence of amyloid in the thyroid gland, medullary thyroid cancer should be kept in mind in the differential diagnosis. Imaging techniques and biochemical tests are not very helpful in the diagnosis of secondary amyloid goiter and the definitive diagnosis is established based on the histopathologic analysis and histochemical staining techniques. In this report, we present a 35-year-old male patient with diffuse amyloid goiter caused by secondary amyloidosis associated with ulcerative colitis.

  20. Amyloid Goiter Secondary to Ulcerative Colitis.

    Science.gov (United States)

    Aydin, Bunyamin; Koca, Yavuz Savas; Koca, Tugba; Yildiz, Ihsan; Gerek Celikden, Sevda; Ciris, Metin

    2016-01-01

    Diffuse amyloid goiter (AG) is an entity characterized by the deposition of amyloid in the thyroid gland. AG may be associated with either primary or secondary amyloidosis. Secondary amyloidosis is rarely caused by inflammatory bowel diseases. Secondary amyloidosis is relatively more common in the patients with Crohn's disease, whereas it is highly rare in patients with ulcerative colitis. Diffuse amyloid goiter caused by ulcerative colitis is also a rare condition. In the presence of amyloid in the thyroid gland, medullary thyroid cancer should be kept in mind in the differential diagnosis. Imaging techniques and biochemical tests are not very helpful in the diagnosis of secondary amyloid goiter and the definitive diagnosis is established based on the histopathologic analysis and histochemical staining techniques. In this report, we present a 35-year-old male patient with diffuse amyloid goiter caused by secondary amyloidosis associated with ulcerative colitis. PMID:27051538

  1. DNA aptamers detecting generic amyloid epitopes

    OpenAIRE

    Mitkevich, Olga V.; Kochneva-Pervukhova, Natalia V; Surina, Elizaveta R.; Benevolensky, Sergei V.; Kushnirov, Vitaly V.; Ter-Avanesyan, Michael D.

    2012-01-01

    Amyloids are fibrillar protein aggregates resulting from non-covalent autocatalytic polymerization of various structurally and functionally unrelated proteins. Previously we have selected DNA aptamers, which bind specifically to the in vitro assembled amyloid fibrils of the yeast prionogenic protein Sup35. Here we show that such DNA aptamers can be used to detect SDS-insoluble amyloid aggregates of the Sup35 protein, and of some other amyloidogenic proteins, including mouse PrP, formed in yea...

  2. Amyloid myopathy: a diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Heli Tuomaala

    2009-08-01

    Full Text Available Amyloid myopathy (AM is a rare manifestation of primary systemic amyloidosis (AL. Like inflammatory myopathies, it presents with proximal muscle weakness and an increased creatine kinase level. We describe a case of AL with severe, rapidly progressive myopathy as the initial symptom. The clinical manifestation and muscle biopsy were suggestive of inclusion body myositis. AM was not suspected until amyloidosis was seen in the gastric mucosal biopsy. The muscle biopsy was then re-examined more specifically, and Congo red staining eventually showed vascular and interstitial amyloid accumulation, which led to a diagnosis of AM. The present case illustrates the fact that the clinical picture of AM can mimic that of inclusion body myositis.

  3. Towards a Pharmacophore for Amyloid

    Science.gov (United States)

    Landau, Meytal; Sawaya, Michael R.; Faull, Kym F.; Laganowsky, Arthur; Jiang, Lin; Sievers, Stuart A.; Liu, Jie; Barrio, Jorge R.; Eisenberg, David

    2011-01-01

    Diagnosing and treating Alzheimer's and other diseases associated with amyloid fibers remains a great challenge despite intensive research. To aid in this effort, we present atomic structures of fiber-forming segments of proteins involved in Alzheimer's disease in complex with small molecule binders, determined by X-ray microcrystallography. The fiber-like complexes consist of pairs of β-sheets, with small molecules binding between the sheets, roughly parallel to the fiber axis. The structures suggest that apolar molecules drift along the fiber, consistent with the observation of nonspecific binding to a variety of amyloid proteins. In contrast, negatively charged orange-G binds specifically to lysine side chains of adjacent sheets. These structures provide molecular frameworks for the design of diagnostics and drugs for protein aggregation diseases. PMID:21695112

  4. Reducing Shoulder by Vertical Traction: A One-Man Method for Shoulder Reduction

    Directory of Open Access Journals (Sweden)

    Hayat Ahmad Khan

    2016-01-01

    Full Text Available Fifty percent of joint dislocations reported to the emergency department are of shoulder joint. Various techniques are used to reduce the shoulder and Spaso technique is the least known to the orthopaedic residents which is a simple one-man vertical traction method of shoulder reduction. We evaluated the effectiveness of vertical traction method for anterior shoulder dislocation by orthopaedic residents. Sixty consecutive patients of anterior glenohumeral dislocation attending the emergency department of our hospital were taken up for the study. The reduction was done using Spaso technique. Right shoulder was dislocated in 40 patients and 31 patients had recurrent shoulder dislocation. In 55 patients, shoulder was reduced without the use of any anaesthesia. In patients where no anaesthesia was used, the time of traction ranged from 45 seconds to 5 minutes, while under anaesthesia the time of traction ranged from 1 to 4 minutes. Twenty-one patients had associated greater tuberosity fracture which did not affect the method of reduction and all of them were reducible. No complication was reported, and all the patients were satisfied with the method. In conclusion vertical traction method is a good technique for reducing anterior shoulder dislocation with an easy learning curve among the residents and no complication has been reported so far.

  5. Clinical Outcomes Following Revision Anterior Shoulder Stabilization

    Science.gov (United States)

    Frank, Rachel M.; Mellano, Chris; Shin, Jason J.; Feldheim, Terrence F.; Mascarenhas, Randhir; Yanke, Adam Blair; Cole, Brian J.; Nicholson, Gregory P.; Romeo, Anthony A.; Verma, Nikhil N.

    2015-01-01

    Objectives: The purpose of this study was to determine the clinical outcomes following revision anterior shoulder stabilization performed either via all-arthroscopic soft tissue repair or via Latarjet coracoid transfer. Methods: A retrospective review of prospectively collected data on 91 shoulders undergoing revision anterior shoulder stabilization was performed. All patients underwent prior soft tissue stabilization; those with prior open bone grafting procedures were excluded. For patients with 25% glenoid bone loss, Latarjet was performed (n=28). Patients were queried regarding recurrent instability (subluxation or dislocation). Clinical outcomes were evaluated using validated patient reported outcome questionnaires including the American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), visual analog scale (VAS) for pain, and Western Ontario Shoulder Instability Index (WOSI). Results: A total of 63 shoulders in 62 patients (46 males, 16 females) with an average age of 23.2 ± 6.9 years were included in the revision arthroscopy group. At an average follow-up of 46.9 ± 16.8 months (range, 15 to 78), the mean WOSI score was 80.1 (range, 15.0 to 100), and there were significant improvements (pLatarjet group. Thirteen (46%) had more than one previous stabilization attempt. ), the average WOSI score was 71.9, and there were significant improvements (pLatarjet. Conclusion: Both arthroscopic revision stabilization and Latarjet coracoid transfer result in satisfactory outcomes in patients who have failed previous arthroscopic capsulolabral repair. Recurrent instability rates were higher in the all-arthroscopic group (19% versus 7%). Longer-term studies are required to determine whether similar results are maintained over time, and to provide guidance on focused clinical indications for this challenging patient population.

  6. The primer for sports medicine professionals on imaging: the shoulder.

    Science.gov (United States)

    Farshad-Amacker, Nadja A; Jain Palrecha, Sapna; Farshad, Mazda

    2013-01-01

    Because of its inherent superior soft tissue contrast and lack of ionizing radiation, magnetic resonance imaging (MRI) is highly suited to study the complex anatomy of the shoulder joint, particularly when assessing the relatively high incidence of shoulder injuries in young, athletic patients. This review aims to serve as a primer for understanding shoulder MRI in an algorithmical approach, including MRI protocol and technique, normal anatomy and anatomical variations of the shoulder, pathologic conditions of the rotator cuff tendons and muscles, the long head of the biceps tendon, shoulder impingement, labral and glenohumeral ligament pathology, MR findings in shoulder instability, adhesive capsulitis, and osteoarthritis. PMID:24381700

  7. Primary Frozen Shoulder Syndrome: Arthroscopic Capsular Release.

    Science.gov (United States)

    Arce, Guillermo

    2015-12-01

    Idiopathic adhesive capsulitis, or primary frozen shoulder syndrome, is a fairly common orthopaedic problem characterized by shoulder pain and loss of motion. In most cases, conservative treatment (6-month physical therapy program and intra-articular steroid injections) improves symptoms and restores shoulder motion. In refractory cases, arthroscopic capsular release is indicated. This surgical procedure carries several advantages over other treatment modalities. First, it provides precise and controlled release of the capsule and ligaments, reducing the risk of traumatic complications observed after forceful shoulder manipulation. Second, release of the capsule and the involved structures with a radiofrequency device delays healing, which prevents adhesion formation. Third, the technique is straightforward, and an oral postoperative steroid program decreases pain and allows for a pleasant early rehabilitation program. Fourth, the procedure is performed with the patient fully awake under an interscalene block, which boosts the patient's confidence and adherence to the physical therapy protocol. In patients with refractory primary frozen shoulder syndrome, arthroscopic capsular release emerges as a suitable option that leads to a faster and long-lasting recovery. PMID:26870652

  8. Computational reverse shoulder prosthesis model: Experimental data and verification.

    Science.gov (United States)

    Martins, A; Quental, C; Folgado, J; Ambrósio, J; Monteiro, J; Sarmento, M

    2015-09-18

    The reverse shoulder prosthesis aims to restore the stability and function of pathological shoulders, but the biomechanical aspects of the geometrical changes induced by the implant are yet to be fully understood. Considering a large-scale musculoskeletal model of the upper limb, the aim of this study is to evaluate how the Delta reverse shoulder prosthesis influences the biomechanical behavior of the shoulder joint. In this study, the kinematic data of an unloaded abduction in the frontal plane and an unloaded forward flexion in the sagittal plane were experimentally acquired through video-imaging for a control group, composed of 10 healthy shoulders, and a reverse shoulder group, composed of 3 reverse shoulders. Synchronously, the EMG data of 7 superficial muscles were also collected. The muscle force sharing problem was solved through the minimization of the metabolic energy consumption. The evaluation of the shoulder kinematics shows an increase in the lateral rotation of the scapula in the reverse shoulder group, and an increase in the contribution of the scapulothoracic joint to the shoulder joint. Regarding the muscle force sharing problem, the musculoskeletal model estimates an increased activity of the deltoid, teres minor, clavicular fibers of the pectoralis major, and coracobrachialis muscles in the reverse shoulder group. The comparison between the muscle forces predicted and the EMG data acquired revealed a good correlation, which provides further confidence in the model. Overall, the shoulder joint reaction force was lower in the reverse shoulder group than in the control group. PMID:26206550

  9. The Effect of Fatigued External Rotator Muscles of the Shoulder on the Shoulder Position Sense

    Directory of Open Access Journals (Sweden)

    Naoya Iida

    2011-10-01

    Full Text Available This study aimed to investigate the effect of fatigue in shoulder external rotator muscles on position sense of shoulder abduction, internal rotation, and external rotation. The study included 10 healthy subjects. Shoulder position sense was measured before and after a fatigue task involving shoulder external rotator muscles. The fatigue task was performed using an isokinetic machine. To confirm the muscle fatigue, electromyography (EMG was recorded, and an integrated EMG and median power frequency (MDF during 3 sec performed target torque were calculated. After the fatigue task, the MDF of the infraspinatus muscle significantly decreased. This indicates that the infraspinatus muscle was involved in the fatigue task. In addition, the shoulder position sense of internal and external rotation significantly decreased after the fatigue task. These results suggest that the fatigue reduced the accuracy of sensory input from muscle spindles. However, no significant difference was observed in shoulder position sense of abduction before and after the fatigue task. This may be due to the fact that infraspinatus muscle did not act as prime movers in shoulder abduction. These results suggest that muscle fatigue decreased position sense during movements in which the affected muscles acted as prime movers.

  10. Shoulder injuries in soccer goalkeepers: review and development of a FIFA 11+ shoulder injury prevention program

    Directory of Open Access Journals (Sweden)

    Ejnisman B

    2016-08-01

    Full Text Available Benno Ejnisman,1 Gisele Barbosa,1 Carlos V Andreoli,1 A de Castro Pochini,1 Thiago Lobo,2 Rodrigo Zogaib,2 Moises Cohen,1 Mario Bizzini,3 Jiri Dvorak3 1Department of Orthopaedics, Federal University of São Paulo, 2Sports Medicine Department, Santos FC, São Paulo, Brazil; 3FIFA-Medical Assessment and Research Centre, Schulthess Clinic, Zurich, Switzerland Abstract: In the last years, shoulder injuries have represented an increasing health problem in soccer players. The goalkeepers are more exposed to shoulder disorders than other field players. Injury prevention exercises for upper limbs were cited in few studies involving throwing athletes, but we know that goalkeepers need a specific program. The purpose of this study is to describe the development of an adapted Fédération Internationale de Football Association (FIFA 11+ program, namely the FIFA 11+ shoulder, which targets the prevention of shoulder injuries in soccer goalkeepers. The FIFA 11+ shoulder program is structured into three parts: general warming-up exercises, exercises to improve strength and balance of the shoulder, elbow, wrist, and finger muscles, and advanced exercises for core stability and muscle control. The exercises were selected based on recommendations from studies demonstrating high electromyographic activity. Keywords: goalkeeper, shoulder, injury prevention, prevention program

  11. Evaluation and treatment of shoulder pain.

    Science.gov (United States)

    Greenberg, Deborah L

    2014-05-01

    Shoulder pain is a common symptom in the adult population. The most common cause of shoulder pain is SIS, reflecting a problem with the rotator cuff or subacromial bursa. Determining the cause of a patient’s pain is usually a clinical diagnosis based on careful history taking and physical examination. Limited use of imaging studies will be needed in the setting of trauma, possible glenohumeral arthritis, or when a complete tendon tear is suspected. Therapy is based on pain control and therapeutic exercises in almost all cases. Despite the prevalence of shoulder pain, there is no consensus on the best way to achieve pain control or on the type of exercise most likely to achieve speedy recovery.

  12. Cost Analysis in Shoulder Arthroplasty Surgery

    Directory of Open Access Journals (Sweden)

    Matthew J. Teusink

    2012-01-01

    Full Text Available Cost in shoulder surgery has taken on a new focus with passage of the Patient Protection and Affordable Care Act. As part of this law, there is a provision for Accountable Care Organizations (ACOs and the bundled payment initiative. In this model, one entity would receive a single payment for an episode of care and distribute funds to all other parties involved. Given its reproducible nature, shoulder arthroplasty is ideally situated to become a model for an episode of care. Currently, there is little research into cost in shoulder arthroplasty surgery. The current analyses do not provide surgeons with a method for determining the cost and outcomes of their interventions, which is necessary to the success of bundled payment. Surgeons are ideally positioned to become leaders in ACOs, but in order for them to do so a methodology must be developed where accurate costs and outcomes can be determined for the episode of care.

  13. Resuscitating the Baby after Shoulder Dystocia

    Directory of Open Access Journals (Sweden)

    Savas Menticoglou

    2016-01-01

    Full Text Available Background. To propose hypovolemic shock as a possible explanation for the failure to resuscitate some babies after shoulder dystocia and to suggest a change in clinical practice. Case Presentation. Two cases are presented in which severe shoulder dystocia was resolved within five minutes. Both babies were born without a heartbeat. Despite standard resuscitation by expert neonatologists, no heartbeat was obtained until volume resuscitation was started, at 25 minutes in the first case and 11 minutes in the second. After volume resuscitation circulation was restored, there was profound brain damage and the babies died. Conclusion. Unsuspected hypovolemic shock may explain some cases of failed resuscitation after shoulder dystocia. This may require a change in clinical practice. Rather than immediately clamping the cord after the baby is delivered, it is proposed that (1 the obstetrician delay cord clamping to allow autotransfusion of the baby from the placenta and (2 the neonatal resuscitators give volume much sooner.

  14. Characterization of Amyloid Cores in Prion Domains

    Science.gov (United States)

    Sant’Anna, Ricardo; Fernández, Maria Rosario; Batlle, Cristina; Navarro, Susanna; de Groot, Natalia S.; Serpell, Louise; Ventura, Salvador

    2016-01-01

    Amyloids consist of repetitions of a specific polypeptide chain in a regular cross-β-sheet conformation. Amyloid propensity is largely determined by the protein sequence, the aggregation process being nucleated by specific and short segments. Prions are special amyloids that become self-perpetuating after aggregation. Prions are responsible for neuropathology in mammals, but they can also be functional, as in yeast prions. The conversion of these last proteins to the prion state is driven by prion forming domains (PFDs), which are generally large, intrinsically disordered, enriched in glutamines/asparagines and depleted in hydrophobic residues. The self-assembly of PFDs has been thought to rely mostly on their particular amino acid composition, rather than on their sequence. Instead, we have recently proposed that specific amyloid-prone sequences within PFDs might be key to their prion behaviour. Here, we demonstrate experimentally the existence of these amyloid stretches inside the PFDs of the canonical Sup35, Swi1, Mot3 and Ure2 prions. These sequences self-assemble efficiently into highly ordered amyloid fibrils, that are functionally competent, being able to promote the PFD amyloid conversion in vitro and in vivo. Computational analyses indicate that these kind of amyloid stretches may act as typical nucleating signals in a number of different prion domains. PMID:27686217

  15. The influence of experimentally induced pain on shoulder muscle activity

    DEFF Research Database (Denmark)

    Diederichsen, Louise Pyndt; Winther, Annika; Dyhre-Poulsen, Poul;

    2009-01-01

    Muscle function is altered in painful shoulder conditions. However, the influence of shoulder pain on muscle coordination of the shoulder has not been fully clarified. The aim of the present study was to examine the effect of experimentally induced shoulder pain on shoulder muscle function. Eleven...... healthy men (range 22-27 years), with no history of shoulder or cervical problems, were included in the study. Pain was induced by 5% hypertonic saline injections into the supraspinatus muscle or subacromially. Seated in a shoulder machine, subjects performed standardized concentric abduction (0 degrees...... subacromially and in the supraspinatus muscle modulates coordination of the shoulder muscles during voluntary movements. During painful conditions, an increased activity was detected in the antagonist (latissimus), which support the idea that localized pain affects muscle activation in a way that protects...

  16. The influence of experimentally induced pain on shoulder muscle activity

    DEFF Research Database (Denmark)

    Diederichsen, L.P.; Winther, A.; Dyhre-Poulsen, P.;

    2009-01-01

    Muscle function is altered in painful shoulder conditions. However, the influence of shoulder pain on muscle coordination of the shoulder has not been fully clarified. The aim of the present study was to examine the effect of experimentally induced shoulder pain on shoulder muscle function. Eleven...... healthy men (range 22-27 years), with no history of shoulder or cervical problems, were included in the study. Pain was induced by 5% hypertonic saline injections into the supraspinatus muscle or subacromially. Seated in a shoulder machine, subjects performed standardized concentric abduction (0A degrees...... that acute pain both subacromially and in the supraspinatus muscle modulates coordination of the shoulder muscles during voluntary movements. During painful conditions, an increased activity was detected in the antagonist (latissimus), which support the idea that localized pain affects muscle activation...

  17. Amyloid fibrils compared to peptide nanotubes.

    Science.gov (United States)

    Zganec, Matjaž; Zerovnik, Eva

    2014-09-01

    Prefibrillar oligomeric states and amyloid fibrils of amyloid-forming proteins qualify as nanoparticles. We aim to predict what biophysical and biochemical properties they could share in common with better researched peptide nanotubes. We first describe what is known of amyloid fibrils and prefibrillar aggregates (oligomers and protofibrils): their structure, mechanisms of formation and putative mechanism of cytotoxicity. In distinction from other neuronal fibrillar constituents, amyloid fibrils are believed to cause pathology, however, some can also be functional. Second, we give a review of known biophysical properties of peptide nanotubes. Finally, we compare properties of these two macromolecular states side by side and discuss which measurements that have already been done with peptide nanotubes could be done with amyloid fibrils as well.

  18. Upper arm elevation and repetitive shoulder movements

    DEFF Research Database (Denmark)

    Dalbøge, Annett; Hansson, Gert-Åke; Frost, Poul;

    2016-01-01

    OBJECTIVES: We recently constructed a general population job exposure matrix (JEM), The Shoulder JEM, based on expert ratings. The overall aim of this study was to convert expert-rated job exposures for upper arm elevation and repetitive shoulder movements to measurement scales. METHODS: The...... Spearman rank correlations and the explained variance[Formula: see text] according to linear regression analyses (36 job groups). We used the linear regression equations to convert the expert-rated job exposures for all 172 job groups into predicted measured job exposures. Bland-Altman analyses were used...

  19. EVALUATION OF PAINFUL SHOULDER IN BASEBALL PLAYERS

    OpenAIRE

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; da Silva, Luciana Andrade; do Val Sella, Guilherme; Junior, Adriano Fernando Mendes; Soares, André Lopes; Aihara, Leandro Jun; Checchia, Sérgio Luiz

    2015-01-01

    Objective: To assess the relationship between shoulder mobility and strength and the presence of pain among baseball players. Methods: Between April and July 2009, 55 baseball players were assessed by the Shoulder and Elbow Group of the School of Medical Sciences, Santa Casa de Misericórdia, São Paulo. They were all males, aged between 15 and 33 years (mean of 21); they attended an average of three training sessions per week and had been doing this sport for a mean of 10 years. Results: 14 of...

  20. Functional MR imaging study of the shoulder

    International Nuclear Information System (INIS)

    This paper presents a functional MR study of the shoulder performed with the positioning in which patients were about to complain of shoulder pain. A 0.064-T permanent MR system was used. The effectiveness of this study was evaluated in the diagnosis of rotator cuff impingement syndrome. Thirteen patients (11 males and two female) were examined prospectively. Three-dimensional Fourier transformation coronal images were obtained with patients' arms at the maximal abduction. They were compared with images obtained while patients' arms were at their sides, chiefly from the viewpoint of severity of impingement and intensity change of the supraspinatus muscle

  1. Treatment of 47 Cases of Shoulder Periarthritis with Acupuncture and Tuina

    Institute of Scientific and Technical Information of China (English)

    王文礼; 张伟; 经蕾; 沈卫东; 肖元春

    2010-01-01

    @@ Shoulder periarthritis is often defined as shoulder pain and confined movement of the shoulder joint due to degeneration and strain of the shoulder joint and its surrounding soft tissues.Patients with shoulder pefiarthritis usually undergo great suffering.During the past two years,we treated 47 shoulder periarthritis cases using acupuncture and tuina.It is now reported as follows.

  2. Posterior Shoulder Dislocation Due to an Atypical Trauma Mechanism

    OpenAIRE

    Güzel, Şevket Ergun; Baysal, Özgür; Eceviz, Engin; Elmalı, Nurzat

    2014-01-01

    Objectives: A 32 year old man who was admitted to the emergency department with serious pain and absent movement of the right upper extremity due to passing the ball in a basketball game. He had no shoulder dislocation in his medical history. The right shoulder position was flexion and adduction. The shoulder range of motion was restricted and the neurovascular examination was intact. Posterior shoulder dislocation was diagnosed in radiographs.The aim of the study is pointed out an unusual me...

  3. Bilateral locked posterior shoulder dislocation in a footballer.

    OpenAIRE

    Ryan, J; Whitten, M

    1997-01-01

    Posterior dislocation of the shoulder is an uncommon injury, accounting for between 2% and 4% of all shoulder dislocations. It occurs most frequently in patients following convulsions or direct anterior force to the shoulder. It is a particularly uncommon injury in sport. This paper reports an unusual case of bilateal locked posteriorly dislocated shoulders in a previously healthy young man who fell while playing football.

  4. Midterm results after operatively stabilised shoulder dislocations in elderly patients

    OpenAIRE

    Maier, Marcus; Geiger, Emanuel V.; Ilius, Christine; FRANK, JOHANNES; Marzi, Ingo

    2008-01-01

    Anterior shoulder dislocation is frequently seen in young patients. The therapeutic regime in elderly patients after shoulder dislocation is less clearly defined. The aim of this study was to compare the clinical benefit of operative stabilisation following anterior shoulder dislocation in young versus elderly patients. Seventy-two patients with anterior shoulder dislocations were allocated into two groups. Group 1 (> 40 years of age) consisted of 23 patients, and group 2 (

  5. Bilateral posterior shoulder dislocation after electrical shock: A case report

    OpenAIRE

    Ismail Emre Ketenci; Tahir Mutlu Duymus; Ayhan Ulusoy; Hakan Serhat Yanik; Serhat Mutlu; Mehmet Oguz Durakbasa

    2015-01-01

    Introduction: Posterior dislocation of the shoulder is a rare and commonly missed injury. Unilateral dislocations occur mostly due to trauma. Bilateral posterior shoulder dislocations are even more rare and result mainly from epileptic seizures. Electrical injury is a rare cause of posterior shoulder dislocation. Injury mechanism in electrical injury is similar to epileptic seizures, where the shoulder is forced to internal rotation, flexion and adduction. Presentation of case: This report...

  6. Outcome evaluation in shoulder surgery using 3D kinematics sensors

    OpenAIRE

    Coley, B.; Jolles, B.; Farron, A.; Bourgeois, A; Nussbaumer, F.; Pichonnaz, C.; Aminian, K.

    2007-01-01

    A new method of scoring systems for the functional assessment of the shoulder is presented. 3D accelerometers and gyroscopes attached on the humerus were used to differentiate a healthy from a painful shoulder. The method was first tested on 10 healthy volunteer subjects without any shoulder pathologies. Then, the system was tested on 10 patients with unilateral shoulder pathology (rotator cuff disease, osteoarthritis) before and after surgery (3, 6 months). To evalua...

  7. Shoulder Impingement Syndromes: Implications on Physical Therapy Examination and Intervention

    OpenAIRE

    Lazaro, Rolando

    2005-01-01

    A painful shoulder presents challenges in examination, diagnosis and intervention for the physical therapist because of the complexity of the structures involved. A common cause of shoulder pain is shoulder impingement syndrome. This was first described as a condition in which the soft tissues of the subacromial space were chronically entrapped and compressed between the humeral head and the subacromial arch. This definition does not account for the myriad potential causes of shoulder impinge...

  8. Interobserver reliability of physical examination of shoulder girdle

    NARCIS (Netherlands)

    Nomden, Jettie G.; Slagers, Anton J.; Bergman, Geert; Winters, Jan C.; Kropmans, Thomas J. B.; Dijkstra, Pieter U.

    2009-01-01

    The object of this study was to assess interobserver reliability in 23 tests concerning physical examination of the shoulder girdle. A physical therapist and a physical therapist/manual therapist independently performed a physical examination of the shoulder girdle in 91 patients with shoulder compl

  9. Essentials for Acupuncture Treatment of Periarthritis of Shoulder

    Institute of Scientific and Technical Information of China (English)

    Zhang Ping

    2006-01-01

    @@ Periarthritis of shoulder, also called "congealed shoulder" in TCM, is a disease characterized by progressive pain and movement restriction in the peripheral tissues of the unilateral shoulder joint.Acupuncture can give very good therapeutic effects for this disease. If attention is paid to the following aspects, the therapeutic effect of acupuncture treatment will be much better.

  10. Shoulder instability : A clinical and MRI-based analysis

    OpenAIRE

    Salomonsson, Björn

    2009-01-01

    Shoulder instability is a common but complex and challenging area of shoulder pathology, and new diagnostic methods and treatments are continuously developed. We conducted this study to evaluate the clinical outcome of shoulder instability with respect to different diagnostic possibilities and surgical treatments. We have studied the patient material from our department, consisting of atraumatic instability, posttraumatic recurrent anterior instability, and primary shoul...

  11. Nocturnal seizure and simultaneous bilateral shoulder fracture-dislocation.

    Science.gov (United States)

    Sahbudin, Ilfita; Filer, Andrew

    2016-01-01

    An otherwise fit and well 27-year-old man presented with acute onset unexplained bilateral shoulder pain, and was found to have bilateral shoulder fractures and dislocations on imaging. Although features were atypical, a nocturnal seizure causing the bilateral shoulder fractures was suspected and EEG showed features compatible with epilepsy. PMID:26838296

  12. General amyloid inhibitors? A critical examination of the inhibition of IAPP amyloid formation by inositol stereoisomers.

    Directory of Open Access Journals (Sweden)

    Hui Wang

    Full Text Available Islet amyloid polypeptide (IAPP or amylin forms amyloid deposits in the islets of Langerhans; a process that is believed to contribute to the progression of type 2 diabetes and to the failure of islet transplants. An emerging theme in amyloid research is the hypothesis that the toxic species produced during amyloid formation by different polypeptides share common features and exert their effects by common mechanisms. If correct, this suggests that inhibitors of amyloid formation by one polypeptide might be effective against other amyloidogenic sequences. IAPP and Aβ, the peptide responsible for amyloid formation in Alzheimer's disease, are particularly interesting in this regard as they are both natively unfolded in their monomeric states and share some common characteristics. Comparatively little effort has been expended on the design of IAPP amyloid inhibitors, thus it is natural to inquire if Aβ inhibitors are effective against IAPP, especially since no IAPP inhibitors have been clinically approved. A range of compounds inhibit Aβ amyloid formation, including various stereoisomers of inositol. Myo-, scyllo-, and epi-inositol have been shown to induce conformational changes in Aβ and prevent Aβ amyloid fibril formation by stabilizing non-fibrillar β-sheet structures. We investigate the ability of inositol stereoisomers to inhibit amyloid formation by IAPP. The compounds do not induce a conformational change in IAPP and are ineffective inhibitors of IAPP amyloid formation, although some do lead to modest apparent changes in IAPP amyloid fibril morphology. Thus not all classes of Aβ inhibitors are effective against IAPP. This work provides a basis of comparison to work on polyphenol based inhibitors of IAPP amyloid formation and helps provide clues as to the features which render them effective. The study also helps provide information for further efforts in rational inhibitor design.

  13. Effect of the Push-up Plus (PUP) Exercise at Different Shoulder Rotation Angles on Shoulder Muscle Activities

    OpenAIRE

    Cho, Sung-Hak; Baek, Il-hun; Cheon, Ju Young; Cho, Min Jung; Choi, Mi Young; JUNG, DA HYE

    2014-01-01

    [Purpose] Although the Push-Up Plus is a useful exercise method for shoulder stabilization, few studies have examined its effects at different angles of shoulder rotation. Therefore, the present study investigated the most effective exercise method for shoulder stabilization by analyzing muscle activities of the rotator cuff muscles at different angles of shoulder rotation. [Subjects] Fifteen healthy university students in their 20s were the subjects of this study. [Methods] Changes in muscle...

  14. The Effect of the Modified Lateral Suprascapular Block on Shoulder Function in Patients With Chronic Shoulder Pain

    OpenAIRE

    Dorn, Christian; Rumpold-Seitlinger, Gudrun; Farzi, Sylvia; Auer, Johann; Bornemann-Cimenti, Helmar

    2015-01-01

    Background: Suprascapular nerve block (SSNB) is commonly used in pain therapy for patients with chronic shoulder pain. The effect of SSNB on shoulder function has, however, not been investigated so far. If in shoulder function, i.e. the range of motion is increased after application of the nerve block, it can be expected that subsequent physiotherapy, besides being less painful, is also more effective in terms of restoring shoulder mobility. Objectives: Our aim was to evaluate the effect of S...

  15. Protocol for Shoulder function training reducing musculoskeletal pain in shoulder and neck: a randomized controlled trial

    DEFF Research Database (Denmark)

    Andersen, Christoffer H; Andersen, Lars L; Mortensen, Ole S;

    2011-01-01

    ABSTRACT: BACKGROUND: Neck and shoulder complaints are common among employees in sedentary occupations characterized by intensive computer use. Such musculoskeletal pain - which is often associated with restricted range of motion and loss of muscle strength - is one of the most common conditions...... training of the painful area. Our study investigates the effect of the latter approach. METHODS/DESIGN: A randomized controlled trial of 10 weeks duration is currently being conducted. Employed office workers with severe neck-shoulder pain are randomized to 3 × 20 min shoulder function training...... including jobs characterized by intensive computer work. The first 100 positive replies entered the study. Among these inclusion criteria were pain intensity in the neck/shoulder of at least 3 on a 0-9 scale. Exclusion criteria were cardiovascular disease, trauma, hypertension, or serious chronic disease...

  16. 21 CFR 888.3680 - Shoulder joint glenoid (hemi-shoulder) metallic cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3680... glenoid (hemi-shoulder) metallic cemented prosthesis is a device that has a glenoid (socket)...

  17. Reading on the Shoulders of Giants

    Science.gov (United States)

    Ben-Chaim, Michael; Riendeau, Michael

    2012-01-01

    Reflecting on his successful scientific career, Isaac Newton highlighted his intellectual debt to his predecessors. "If I have seen further," he wrote, "it was "only" by standing on the shoulders of giants." The authors have chosen the title of their article as a token of recognition of their debt to the teachings of Newton and other intellectuals…

  18. Bankart Repair to Correct Shoulder Instability

    Science.gov (United States)

    ... very excellent conservative care, non-operative care for sports injuries, shoulder injuries. If necessary, we can communicate with ... to get you through from the day of injury to that six or nine month point post-op where you're ready to get back to your sport. 00:50:07 This webcast will be archived ...

  19. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... very excellent conservative care, non-operative care for sports injuries, shoulder injuries. If necessary, we can communicate with ... to get you through from the day of injury to that six or nine month point post-op where you're ready to get back to your sport. 00:50:07 This webcast will be archived ...

  20. Shoulder Impingement Syndrome (Beyond the Basics)

    Science.gov (United States)

    ... activities: ● Swim ● Throw ● Play tennis ● Lift weights ● Play golf ● Play volleyball ● Do gymnastics ● Paint ● Stock shelves SHOULDER ... impingement, your healthcare provider will examine you to learn what movements elicit symptoms. As part of the ...

  1. Shoulder complaints : the occurence, course and diagnosis

    NARCIS (Netherlands)

    J.J. Luime (Jolanda)

    2004-01-01

    textabstractShoulder complaints are expressed in a variety of symptoms. In many cases, the prominent symptom is pain. In some cases, pain is present most of the day and frequently also at night. In other cases, it is provoked primarily by physical activities. Often it is accompanied by restricted ra

  2. Bankart Repair to Correct Shoulder Instability

    Medline Plus

    Full Text Available ... the shoulder pops out of place from an injury. Oftentimes those kids may fail physical therapy and end up requiring surgery. 00:06:19 ... we know that the patient with the traumatic injury, that had a dislocation that ... first with physical therapy and rehab. So, Joe, maybe if you could ...

  3. Radiographic analysis of shoulder anatomical arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Merolla, Giovanni [Unit of Shoulder and Elbow Surgery, ' D. Cervesi' Hospital, L. Van Beethoven 46 Street, 47841 Cattolica (Italy)], E-mail: gmerolla@shouldertech.it; Di Pietto, Francesco; Romano, Stefania [Department of Diagnostic Imaging, ' A. Cardarelli' Hospital, Naples (Italy); Paladini, Paolo; Campi, Fabrizio; Porcellini, Giuseppe [Unit of Shoulder and Elbow Surgery, ' D. Cervesi' Hospital, L. Van Beethoven 46 Street, 47841 Cattolica (Italy)

    2008-10-15

    Arthroplasty is the standard treatment for advanced shoulder osteoarthritis. Modern prostheses designs have modular features whose size, shaft/head and body morphology can be adjusted. Total Shoulder Arthroplasty (TSA) provides better results. A complete X-ray follow-up is essential to assess the results and evaluate the survival rates of a shoulder prosthesis. Antero-posterior at 40 deg. in both internal and external rotation (true AP view) and axillary view are recommended to assess the following parameters: orientation and translation of the humeral component, offset, size and height of the humeral head, acromio-humeral distance, distribution and fixation of the cement, stress shielding and cortical resorption, radiolucent lines, subsidence and tilt, glenoid wear and 'bone stock', prostheses instability, glenoid component shift. Shoulder hemiarthroplasty can lead to glenoid wear; the true AP film at 40 deg. of internal rotation provides the best profile of gleno-humeral joint to depict glenoid erosion. Shift of the glenoid component in TSA is identified as tilting or medial migration on true AP and axillary views in the early postoperative period (1-2 months) and at minimum of 2 years. An exhaustive radiographic analysis remains essential to monitor the prosthetic implant and detect early and late complications or risk factors of prosthetic loosening.

  4. [A strong man with a weak shoulder].

    Science.gov (United States)

    Henket, Marjolijn; Lycklama á Nijeholt, Geert J; van der Zwaal, Peer

    2013-01-01

    A 47-year-old former olympic athlete had pain and weakness of his left shoulder. There was no prior trauma. He had full range-of-motion and a scapular dyskinesia. There was atrophy of the trapezius and sternocleidomastoideus muscles. He was diagnosed with 'idiopathic neuritis of the accessorius nerve'. PMID:24326139

  5. A Simple Technique for Shoulder Arthrography

    International Nuclear Information System (INIS)

    Purpose: To present a systematic approach to teaching a technique for arthrography of the shoulder. Using an adhesive marker-plate with radiopaque coordinates, precise sites for puncture can be identified and the need for fluoroscopic guidance obviated. Material and Methods: Forty-six glenohumeral arthrograms were performed in 45 patients; in 1 case involving examination of both shoulders. The stages of the technique are described in detail, as are the fundamental aspects of achieving an effective glenohumeral injection. Pain intensity was measured in all patients using a verbal description scale. Results: Shoulder arthrography was successful in all cases. Average time taken for the procedure was 7 min, with no difference in the respective times required by an experienced radiologist and a resident. The procedure was well tolerated by most patients, with slight discomfort being observed in a very few cases. Conclusion: The arthrographic technique used in this study is simple, safe, rapid, and reproducible, and has the advantage of precise localization of the site for puncture without need for fluoroscopic guidance. The procedure described in this study can be of help in teaching residents and can reduce the learning curve for radiologists with no experience in arthrographic methods. It also reduces the time of exposure to fluoroscopy Keywords: Arthrography, joint, shoulder

  6. Protocol for Shoulder function training reducing musculoskeletal pain in shoulder and neck: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Mortensen Ole S

    2011-01-01

    Full Text Available Abstract Background Neck and shoulder complaints are common among employees in sedentary occupations characterized by intensive computer use. Such musculoskeletal pain - which is often associated with restricted range of motion and loss of muscle strength - is one of the most common conditions treated by physical therapists. The exact mechanism of neck pain is rarely revealed by clinical examination and the treatment has varied from passive rest to active treatments. Active treatments have often been divided into either training of the painful area or the surrounding musculature avoiding direct training of the painful area. Our study investigates the effect of the latter approach. Methods/Design A randomized controlled trial of 10 weeks duration is currently being conducted. Employed office workers with severe neck-shoulder pain are randomized to 3 × 20 min shoulder function training with training supervision or to a reference group receiving advice to stay physically active. Shoulder function training primarily focuses on the serratus anterior and lower trapezius muscle with only minimal activation the upper trapezius. An announcement was sent to the administrative section of the university including jobs characterized by intensive computer work. The first 100 positive replies entered the study. Among these inclusion criteria were pain intensity in the neck/shoulder of at least 3 on a 0-9 scale. Exclusion criteria were cardiovascular disease, trauma, hypertension, or serious chronic disease. Before and after the intervention period the participants replied to a questionnaire about musculoskeletal disorders and work disability, and underwent a standardized clinical examination of the neck and shoulder girdle. Further, on a weekly basis the participants log pain intensity of the neck and shoulder during the previous week. The primary outcome measure is pain in the neck and shoulders at week 10 based on the weekly pain registration and results

  7. Amyloid-associated nucleic acid hybridisation.

    Directory of Open Access Journals (Sweden)

    Sebastian Braun

    Full Text Available Nucleic acids promote amyloid formation in diseases including Alzheimer's and Creutzfeldt-Jakob disease. However, it remains unclear whether the close interactions between amyloid and nucleic acid allow nucleic acid secondary structure to play a role in modulating amyloid structure and function. Here we have used a simplified system of short basic peptides with alternating hydrophobic and hydrophilic amino acid residues to study nucleic acid - amyloid interactions. Employing biophysical techniques including X-ray fibre diffraction, circular dichroism spectroscopy and electron microscopy we show that the polymerized charges of nucleic acids concentrate and enhance the formation of amyloid from short basic peptides, many of which would not otherwise form fibres. In turn, the amyloid component binds nucleic acids and promotes their hybridisation at concentrations below their solution K(d, as shown by time-resolved FRET studies. The self-reinforcing interactions between peptides and nucleic acids lead to the formation of amyloid nucleic acid (ANA fibres whose properties are distinct from their component polymers. In addition to their importance in disease and potential in engineering, ANA fibres formed from prebiotically-produced peptides and nucleic acids may have played a role in early evolution, constituting the first entities subject to Darwinian evolution.

  8. Hacking the Code of Amyloid Formation

    Science.gov (United States)

    Pastor, M Teresa; Esteras-Chopo, Alexandra

    2007-01-01

    Many research efforts in the last years have been directed towards understanding the factors determining protein misfolding and amyloid formation. Protein stability and amino acid composition have been identified as the two major factors in vitro. The research of our group has been focused on understanding the relationship between amino acid sequence and amyloid formation. Our approach has been the design of simple model systems that reproduce the biophysical properties of natural amyloids. An amyloid sequence pattern was extracted that can be used to detect amyloidogenic hexapeptide stretches in proteins. We have added evidence supporting that these amyloidogenic stretches can trigger amyloid formation by nonamyloidogenic proteins. Some experimental results in other amyloid proteins will be analyzed under the conclusions obtained in these studies. Our conclusions together with evidences from other groups suggest that amyloid formation is the result of the interplay between a decrease of protein stability, and the presence of highly amyloidogenic regions in proteins. As many of these results have been obtained in vitro, the challenge for the next years will be to demonstrate their validity in in vivo systems. PMID:19164912

  9. Neuroinflammation in Lyme neuroborreliosis affects amyloid metabolism

    Directory of Open Access Journals (Sweden)

    Anckarsäter Henrik

    2010-06-01

    Full Text Available Abstract Background The metabolism of amyloid precursor protein (APP and β-amyloid (Aβ is widely studied in Alzheimer's disease, where Aβ deposition and plaque development are essential components of the pathogenesis. However, the physiological role of amyloid in the adult nervous system remains largely unknown. We have previously found altered cerebral amyloid metabolism in other neuroinflammatory conditions. To further elucidate this, we investigated amyloid metabolism in patients with Lyme neuroborreliosis (LNB. Methods The first part of the study was a cross-sectional cohort study in 61 patients with acute facial palsy (19 with LNB and 42 with idiopathic facial paresis, Bell's palsy and 22 healthy controls. CSF was analysed for the β-amyloid peptides Aβ38, Aβ40 and Aβ42, and the amyloid precursor protein (APP isoforms α-sAPP and β-sAPP. CSF total-tau (T-tau, phosphorylated tau (P-tau and neurofilament protein (NFL were measured to monitor neural cell damage. The second part of the study was a prospective cohort-study in 26 LNB patients undergoing consecutive lumbar punctures before and after antibiotic treatment to study time-dependent dynamics of the biomarkers. Results In the cross-sectional study, LNB patients had lower levels of CSF α-sAPP, β-sAPP and P-tau, and higher levels of CSF NFL than healthy controls and patients with Bell's palsy. In the prospective study, LNB patients had low levels of CSF α-sAPP, β-sAPP and P-tau at baseline, which all increased towards normal at follow-up. Conclusions Amyloid metabolism is altered in LNB. CSF levels of α-sAPP, β-sAPP and P-tau are decreased in acute infection and increase after treatment. In combination with earlier findings in multiple sclerosis, cerebral SLE and HIV with cerebral engagement, this points to an influence of neuroinflammation on amyloid metabolism.

  10. Painful shoulder. Introduction into fundamental facts and problems

    Energy Technology Data Exchange (ETDEWEB)

    Hartl, P.W.

    1987-10-19

    The painful shoulder syndrome is very common. Diagnosis and differential diagnosis may be difficult. Shoulder pain may be caused by local processes or systemic diseases or can be referred. Periarthritis humeroscapularis (frozen shoulder) is the most common cause of painful shoulder syndrome. Biomechanical factors concerning the rotator cuff are involved in the etiopathogenesis of these pain syndromes. The therapy of frozen shoulder includes physical treatment, antirheumatic drugs, or X-ray treatment. Surgical measures may become necessary. In the course of rheumatoid arthritis the shoulder may be involved. Milwaukee-shoulder-syndrome has been described recently in crystal deposit diseases. Shoulder pain may be referred by mechanical irritations of nerve roots in the course of degenerative lesions of the cervical spine and also in the course of internal diseases of the heart, the lungs, or the gastrointestinal tract. In cases of shoulder pain without pathological data from arthrological, radiological or laboratory studies, one should always consider localized fibromyalgia in the shoulder-neck-region. The precise diagnosis of shoulder pain is an important prerequisite for treatment, the success of which should not be judged as pessimistic as it has been commonly done in the past.

  11. Optimal Design of a Bio-Inspired Anthropocentric Shoulder Rehabilitator

    Directory of Open Access Journals (Sweden)

    S. K. Mustafa

    2006-01-01

    Full Text Available This paper presents the design of a bio-inspired anthropocentric 7-DOF wearable robotic arm for the purpose of stroke rehabilitation. The proposed arm rehabilitator synergistically utilizes the human arm structure with non-invasive kinematically under-deterministic cable-driven mechanisms to form a completely deterministic structure. It offers the advantages of being lightweight and having high dexterity. Adopting an anthropocentric design concept also allows it to conform to the human anatomical structure. The focus of this paper is on the analysis and design of the 3-DOF-shoulder module, called the shoulder rehabilitator. The design methodology is divided into three main steps: (1 performance evaluation of the cable-driven shoulder rehabilitator, (2 performance requirements of the shoulder joint based on its physiological characteristics and (3 design optimization of the shoulder rehabilitator based on shoulder joint physiological limitations. The aim is to determine a suitable configuration for the development of a shoulder rehabilitator prototype.

  12. Synovial cutaneous fistula complicating a reverse total shoulder arthroplasty.

    Science.gov (United States)

    Letter, Haley P; Limback, Joseph; Wasyliw, Christopher; Bancroft, Laura; Scherer, Kurt

    2016-06-01

    Reverse total shoulder arthroplasty is becoming a common form of shoulder arthroplasty that is often performed in the setting of rotator cuff pathology. Infection is a rare complication but is more common in reverse total shoulder arthroplasty than in hemiarthroplasty or anatomic total shoulder arthroplasty. We present the case of a 69-year-old patient with a reverse total shoulder arthroplasty who presented with purulent drainage from the skin of his anterior shoulder. Computed tomography arthrogram confirmed the presence of a synovial cutaneous fistula. Synovial cutaneous fistula is a rare variant of periprosthetic infection that, to our knowledge, has not been described previously in the setting of a reverse total shoulder arthroplasty. Computed tomography arthrogram proved to be a reliable method for confirming the diagnosis and was used for operative planning to remove the hardware. PMID:27257460

  13. Amyloid Imaging in Aging and Dementia: Testing the Amyloid Hypothesis In Vivo

    Directory of Open Access Journals (Sweden)

    G. D. Rabinovici

    2009-01-01

    Full Text Available Amyloid imaging represents a major advance in neuroscience, enabling the detection and quantification of pathologic protein aggregations in the brain. In this review we survey current amyloid imaging techniques, focusing on positron emission tomography (PET with ^{11}carbon-labelled Pittsburgh Compound-B (11C-PIB, the most extensively studied and best validated tracer. PIB binds specifically to fibrillar beta-amyloid (Aβ deposits, and is a sensitive marker for Aβ pathology in cognitively normal older individuals and patients with mild cognitive impairment (MCI and Alzheimer’s disease (AD. PIB-PET provides us with a powerful tool to examine in vivo the relationship between amyloid deposition, clinical symptoms, and structural and functional brain changes in the continuum between normal aging and AD. Amyloid imaging studies support a model in which amyloid deposition is an early event on the path to dementia, beginning insidiously in cognitively normal individuals, and accompanied by subtle cognitive decline and functional and structural brain changes suggestive of incipient AD. As patients progress to dementia, clinical decline and neurodegeneration accelerate and proceed independently of amyloid accumulation. In the future, amyloid imaging is likely to supplement clinical evaluation in selecting patients for anti-amyloid therapies, while MRI and FDG-PET may be more appropriate markers of clinical progression.

  14. Bilateral Traumatic Anterior Dislocation of Shoulder – a rare entity

    Directory of Open Access Journals (Sweden)

    Yashavantha Kumar C

    2013-01-01

    Full Text Available Introduction: Bilateral shoulder dislocation are most commonly posterior type. These are most commonly due to seizure disorder and electrocution. Anterior shoulder dislocations occurring bilaterally without any predisposing factors are very rare. These types of injuries are due to trauma with a unique mechanism of injury. To best of our knowledge there are only few cases of similar kind are reported in literature. We hereby report a interesting case of posttraumatic, bilateral anterior dislocation of shoulder without associated fracture in a 45 old women without any predisposing pathoanatomy.Case Report: A 45-year-old women presented to casualty with sudden onset of pain and restriction of movement in both shoulders fallowing trauma. Immediately post trauma she had severe pain and restriction of both shoulders. On examination arms were abducted and externally rotated. Bilateral shoulder movements were painful and restricted . There was loss of round contour of shoulder with increased vertical diameter of axilla anteriorly. Radiological examination revealed bilateral anterior dislocation of the shoulders without any associated fractures. Closed reduction done by Milch technique after intraraticular lignocaine injection. MRI of bilateral shoulder showed no pathological lesion. Both shoulders were immobilized with a shoulder immobilizer for three weeks.Conclusion: Most of the bilateral shoulder dislocations are posterior type seen in seizure disorders. Bilateral traumatic anterior shoulder dislocations are rare and are seen as a result of unique mechanism of injury. In our case patient had a fall on her elbows causing forced extension. If diagnosed and treated promptly completely normal function of the shoulders can be restored.

  15. Double contrast CT arthrographic findings of shoulder instability

    International Nuclear Information System (INIS)

    Glenno-humeral joint is a ball and socket joint. It has the greatest range of movement among all the joints of the body. The greatest range of movement is inevitably accompanied by a considerable loss in stability. Thirty three persons underwent Double Contrast CT arthrography of the shoulder for the evaluation of suspected shoulder derangement. We performed 62 shoulder arthrography(33 abnormal shoulders and 29 normal shoulders) and reviewed their findings retrospectively. They had recurrent shoulder dislocation(30 shoulders) or nonspecific shoulder pain(3 shoulders). Injury of the glenoid labrum was seen in 28 shoulders at double contrast CT arthrography. Among 28 cases of the labral injury, labral detachment was seen in 15 cases, labral tear in 5 cases, and labral erosion in 8 cases. Double contrast CT arthrography also showed Hill-Sachs defection in 20 shoulders. The numbers of type 1, type 2, and type 3 capsulolabral attachment in 33 shoulder instability cases were 10, 16,and 7, respectivity, while, 16, 12, and , 1 in 29 normal controls. Type 2 and 3 are more common in shoulder instability group than normal control group. Operation was done in 18 shoulders. Comparing with operation findings, the sensitivity of double contrast CT arthrography in the detection of Hill-Sachs defect was 100% with the specificity of 71% and the accuracy of 89%. The sensitivity, specificity, and accuracy of double contrast CT arthrography in the detection of labral injury were 94%, 100%, and 95%, respectively. Double contrast CT arthrography is a minimally invasive and highly accurate technique for in the evaluation of glenohumeral instability

  16. Genetics Home Reference: hereditary cerebral amyloid angiopathy

    Science.gov (United States)

    ... prognosis of a genetic condition? Genetic and Rare Diseases Information Center Frequency The prevalence of hereditary cerebral amyloid angiopathy is unknown. The Dutch type is the most common, with over 200 ...

  17. Amyloid myopathy presenting with respiratory failure.

    OpenAIRE

    Ashe, J.; Borel, C O; Hart, G.; Humphrey, R L; Derrick, D A; Kuncl, R W

    1992-01-01

    Amyloidosis is a rare cause of myopathy. Its prominent or presenting feature may be respiratory failure. Physiological measurement of transdiaphragmatic pressure and biopsy specimens of muscle show the pathological mechanism to be diaphragm weakness due to amyloid infiltration of the diaphragm rather than parenchymal lung involvement. Thus amyloid myopathy even without the typical macroglossia and muscle pseudohypertrophy should be considered as one of the neurological causes of respiratory f...

  18. Molecular mechanisms of amyloid self-regulation

    OpenAIRE

    Landreh, Michael

    2012-01-01

    Amyloid is associated with both pathological protein deposits and the formation of functional protein structures. Therefore, several strategies have evolved to control the formation or inhibition of amyloid in vivo. In this thesis, three separate systems were investigated in which amyloidogenic protein segments are coupled to regulatory elements that prevent or promote fibrillation. We describe the molecular mechanism for how (a) a propeptide segment prevents the uncontrolled a...

  19. Islet Amyloid Polypeptide: Structure, Function, and Pathophysiology

    Directory of Open Access Journals (Sweden)

    Rehana Akter

    2016-01-01

    Full Text Available The hormone islet amyloid polypeptide (IAPP, or amylin plays a role in glucose homeostasis but aggregates to form islet amyloid in type-2 diabetes. Islet amyloid formation contributes to β-cell dysfunction and death in the disease and to the failure of islet transplants. Recent work suggests a role for IAPP aggregation in cardiovascular complications of type-2 diabetes and hints at a possible role in type-1 diabetes. The mechanisms of IAPP amyloid formation in vivo or in vitro are not understood and the mechanisms of IAPP induced β-cell death are not fully defined. Activation of the inflammasome, defects in autophagy, ER stress, generation of reactive oxygen species, membrane disruption, and receptor mediated mechanisms have all been proposed to play a role. Open questions in the field include the relative importance of the various mechanisms of β-cell death, the relevance of reductionist biophysical studies to the situation in vivo, the molecular mechanism of amyloid formation in vitro and in vivo, the factors which trigger amyloid formation in type-2 diabetes, the potential role of IAPP in type-1 diabetes, the development of clinically relevant inhibitors of islet amyloidosis toxicity, and the design of soluble, bioactive variants of IAPP for use as adjuncts to insulin therapy.

  20. Hybrid Amyloid Membranes for Continuous Flow Catalysis.

    Science.gov (United States)

    Bolisetty, Sreenath; Arcari, Mario; Adamcik, Jozef; Mezzenga, Raffaele

    2015-12-29

    Amyloid fibrils are promising nanomaterials for technological applications such as biosensors, tissue engineering, drug delivery, and optoelectronics. Here we show that amyloid-metal nanoparticle hybrids can be used both as efficient active materials for wet catalysis and as membranes for continuous flow catalysis applications. Initially, amyloid fibrils generated in vitro from the nontoxic β-lactoglobulin protein act as templates for the synthesis of gold and palladium metal nanoparticles from salt precursors. The resulting hybrids possess catalytic features as demonstrated by evaluating their activity in a model catalytic reaction in water, e.g., the reduction of 4-nitrophenol into 4-aminophenol, with the rate constant of the reduction increasing with the concentration of amyloid-nanoparticle hybrids. Importantly, the same nanoparticles adsorbed onto fibrils surface show improved catalytic efficiency compared to the same unattached particles, pointing at the important role played by the amyloid fibril templates. Then, filter membranes are prepared from the metal nanoparticle-decorated amyloid fibrils by vacuum filtration. The resulting membranes serve as efficient flow catalysis active materials, with a complete catalytic conversion achieved within a single flow passage of a feeding solution through the membrane.

  1. High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

    Directory of Open Access Journals (Sweden)

    Wensing Michel

    2011-06-01

    Full Text Available Abstract Background Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment. The pathophysiological mechanisms of shoulder pain are poorly understood. Furthermore, there is little evidence supporting the effectiveness of current treatment protocols. Although myofascial trigger points (MTrPs are rarely mentioned in relation to shoulder pain, they may present an alternative underlying mechanism, which would provide new treatment targets through MTrP inactivation. While previous research has demonstrated that trained physiotherapists can reliably identify MTrPs in patients with shoulder pain, the percentage of patients who actually have MTrPs remains unclear. The aim of this observational study was to assess the prevalence of muscles with MTrPs and the association between MTrPs and the severity of pain and functioning in patients with chronic non-traumatic unilateral shoulder pain. Methods An observational study was conducted. Subjects were recruited from patients participating in a controlled trial studying the effectiveness of physical therapy on patients with unilateral non-traumatic shoulder pain. Sociodemographic and patient-reported symptom scores, including the Disabilities of the Arm, Shoulder, and Hand (DASH Questionnaire, and Visual Analogue Scales for Pain were compared with other studies. To test for differences in age, gender distribution, and education level between the current study population and the populations from Dutch shoulder studies, the one sample T-test was used. One observer examined all subjects (n = 72 for the presence of MTrPs. Frequency distributions, means, medians, standard deviations, and 95% confidence intervals were calculated for descriptive purposes. The Spearman's rank-order correlation (ρ was used to test for association between variables. Results MTrPs were identified in all subjects. The median number of muscles with MTrPs per subject was 6 (active

  2. Multidetector spiral CT arthrography of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Lecouvet, Frederic E. [Departments of Radiology and Orthopaedic Surgery, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Hippocrate Avenue 10/2942, 1200 Brussels (Belgium)], E-mail: frederic.lecouvet@uclouvain.be; Simoni, Paolo; Koutaissoff, Sophie; Vande Berg, Bruno C.; Malghem, Jacques; Dubuc, Jean-Emile [Departments of Radiology and Orthopaedic Surgery, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Hippocrate Avenue 10/2942, 1200 Brussels (Belgium)

    2008-10-15

    Although MR imaging and MR arthrography are the first choice modalities for shoulder imaging, CT arthrography (CTA) may be used successfully to address many clinical questions. The advent of submillimeter multiple detector CT technology and subsequent excellent three-plane resolution has considerably increased the quality of CTA examinations and has propelled this technique to the forefront in a growing number of indications. The combined use of iodinated contrast material for fluoroscopic confirmation of the articular position of the needle before injection of gadolinium chelates for MR arthrography offers the unique opportunity to compare CTA and MRA findings in carefully selected cases. This paper illustrates capabilities and limits of CTA for the study of rotator cuff tears, shoulder instability, cartilage lesions, anatomical variants and abnormalities of the glenoid labrum, with correlations to MR arthrography and surgical findings.

  3. Common Shoulder Injuries in American Football Athletes.

    Science.gov (United States)

    Gibbs, Daniel B; Lynch, T Sean; Nuber, Erika D; Nuber, Gordon W

    2015-01-01

    American football is a collision sport played by athletes at high speeds. Despite the padding and conditioning in these athletes, the shoulder is a vulnerable joint, and injuries to the shoulder girdle are common at all levels of competitive football. Some of the most common injuries in these athletes include anterior and posterior glenohumeral instability, acromioclavicular pathology (including separation, osteolysis, and osteoarthritis), rotator cuff pathology (including contusions, partial thickness, and full thickness tears), and pectoralis major and minor tears. In this article, we will review the epidemiology and clinical and radiographic workup of these injuries. We also will evaluate the effectiveness of surgical and nonsurgical management specifically related to high school, collegiate, and professional football athletes. PMID:26359844

  4. Common Shoulder Injuries in American Football Athletes.

    Science.gov (United States)

    Gibbs, Daniel B; Lynch, T Sean; Nuber, Erika D; Nuber, Gordon W

    2015-01-01

    American football is a collision sport played by athletes at high speeds. Despite the padding and conditioning in these athletes, the shoulder is a vulnerable joint, and injuries to the shoulder girdle are common at all levels of competitive football. Some of the most common injuries in these athletes include anterior and posterior glenohumeral instability, acromioclavicular pathology (including separation, osteolysis, and osteoarthritis), rotator cuff pathology (including contusions, partial thickness, and full thickness tears), and pectoralis major and minor tears. In this article, we will review the epidemiology and clinical and radiographic workup of these injuries. We also will evaluate the effectiveness of surgical and nonsurgical management specifically related to high school, collegiate, and professional football athletes.

  5. Multidetector spiral CT arthrography of the shoulder

    International Nuclear Information System (INIS)

    Although MR imaging and MR arthrography are the first choice modalities for shoulder imaging, CT arthrography (CTA) may be used successfully to address many clinical questions. The advent of submillimeter multiple detector CT technology and subsequent excellent three-plane resolution has considerably increased the quality of CTA examinations and has propelled this technique to the forefront in a growing number of indications. The combined use of iodinated contrast material for fluoroscopic confirmation of the articular position of the needle before injection of gadolinium chelates for MR arthrography offers the unique opportunity to compare CTA and MRA findings in carefully selected cases. This paper illustrates capabilities and limits of CTA for the study of rotator cuff tears, shoulder instability, cartilage lesions, anatomical variants and abnormalities of the glenoid labrum, with correlations to MR arthrography and surgical findings

  6. Detailed Shoulder MRI Findings in Manual Wheelchair Users with Shoulder Pain

    Directory of Open Access Journals (Sweden)

    Melissa M. B. Morrow

    2014-01-01

    Full Text Available Shoulder pain and pathology are common in manual wheelchair (MWC users with paraplegia, and the biomechanical mechanism of injury is largely unknown. Establishing patterns of MRI characteristics in MWC users would help advance understanding of the mechanical etiology of rotator cuff disease, thus improving the logic for prescribed interventions. The purpose of this study was to report detailed shoulder MRI findings in a sample of 10 MWC users with anterolateral shoulder pain. The imaging assessments were performed using our standardized MRI Assessment of the Shoulder (MAS guide. The tendon most commonly torn was the supraspinatus at the insertion site in the anterior portion in either the intrasubstance or articular region. Additionally, widespread tendinopathy, CA ligament thickening, subacromial bursitis, labral tears, and AC joint degenerative arthrosis and edema were common. Further reporting of detailed shoulder imaging findings is needed to confirm patterns of tears in MWC users regarding probable tendon tear zone, region, and portion. This investigation was a small sample observational study and did not yield data that can define patterns of pathology. However, synthesis of detailed findings from multiple studies could define patterns of pathological MRI findings allowing for associations of imaging findings to risk factors including specific activities.

  7. Adaptation of the AnyBody™ Musculoskeletal Shoulder Model to the Nonconforming Total Shoulder Arthroplasty Context.

    Science.gov (United States)

    Sins, Lauranne; Tétreault, Patrice; Hagemeister, Nicola; Nuño, Natalia

    2015-10-01

    Current musculoskeletal inverse dynamics shoulder models have two limitations to use in the context of nonconforming total shoulder arthroplasty (NC-TSA). First, the ball and socket glenohumeral (GH) joint simplification avoids any humeral head translations. Second, there is no contact at the GH joint to compute the contact area and the center of pressure (COP) between the two components of NC-TSA. In this paper, we adapted the AnyBody™ shoulder model by introducing humeral head translations and contact between the two components of an NC-TSA. Abduction in the scapular plane was considered. The main objective of this study was to adapt the AnyBody™ shoulder model to a NC-TSA context and to compare the results of our model (translations, COP, contact area, GH joint reaction forces (GH-JRFs), and muscular forces) with previous numerical, experimental, and clinical studies. Humeral head translations and contact were successfully introduced in our adapted shoulder model with strong support for our findings by previous studies. PMID:26287772

  8. Revision reverse shoulder arthroplasty in failed shoulder arthroplasties for rotator cuff deficiency

    Science.gov (United States)

    RANDELLI, PIETRO; RANDELLI, FILIPPO; COMPAGNONI, RICCARDO; CABITZA, PAOLO; RAGONE, VINCENZA; PULICI, LUCA; BANFI, GIUSEPPE

    2015-01-01

    Purpose the aim of this systematic literature review is to report clinical outcomes of reverse shoulder arthroplasty (RSA) used as a revision surgery following failure of the primary implant due to rotator cuff insufficiency. Methods a systematic review was performed using the following key words: revision, shoulder, rotator cuff deficiency, outcome assessment, treatment outcome, complications. Studies eligible for inclusion in the review were clinical trials investigating patients in whom a primary shoulder arthroplasty implant with an incompetent rotator cuff was replaced with a reverse shoulder prosthesis. Results nine articles were identified and further reviewed. The results refer to a total of 226 shoulders that were treated with RSA as revision surgery. The patients in the studies had a mean age ranging from 64 to 72 years and the longest follow-up was 3.8 years. Improvements in function and reduction of pain were shown by many studies, but the mean Constant score ranged from 44.2 to 56. High complication rates (of up to 62%) were recorded, and a mean reoperation rate of 27.5%. Conclusions RSA as revision surgery for patients with rotator cuff deficiency is a valid option, and often the only solution available, but it should be limited to elderly patients with poor function and severe pain. Level of evidence level IV, systematic review of level I–IV studies. PMID:26151037

  9. Severe shoulder tendinopathy associated with levofloxacin

    Directory of Open Access Journals (Sweden)

    Walter de Araujo Eyer-Silva

    2012-08-01

    Full Text Available Fluoroquinolone (FQ-associated tendinopathy and myopathy are uncommon but well recognized complications of the use of this class of antibacterial agents. The case of a 63-year-old previously asymptomatic female patient who developed severe left shoulder tendinopathy after surreptitiously doubling the prescribed dose of levofloxacin for the treatment of community-acquired pneumonia is reported here. Surgical stabilization with suture anchors and subacromial decompression were needed.

  10. Treating Postlaparoscopic Surgery Shoulder Pain with Acupuncture

    OpenAIRE

    Gur Kreindler; Samuel Attias; Anna Kreindler; Haim Hen; Bassel Haj; Ibrahim Matter; Eran Ben-Arye; Elad Schiff

    2014-01-01

    Objective. The purpose of this study was to examine the effect of acupuncture on postlaparoscopic shoulder pain (PLSP) which is a common side effect in patients undergoing abdominal laparoscopic surgery. Methods. Patients with moderate to severe PLSP in spite of analgesic treatment, which were referred by the medical staff to the Complementary-Integrative Surgery Service (CISS) at our institution, were provided with acupuncture treatment. The severity of PLSP and of general pain was assessed ...

  11. Humeral shaft fracture with ipsilateral shoulder dislocation

    OpenAIRE

    Behera Prateek; Kumar Vishal; Aggarwal Sameer

    2014-01-01

    【Abstract】Although fracture of the humeral shaft or dislocation of the shoulder joint is a common injury, a simutaneous injury is rare. We present such a case combined with head injury which took precedence over the skeletal injuries. The postoperative rehabilitation was slowed down by the head injury. This case report makes us aware of some problems when managing the patient with this rare injury and helps us understand the management options better. Also the need for proper follow-up ...

  12. Standing on the shoulders of giants

    Institute of Scientific and Technical Information of China (English)

    Peter McDonald

    2007-01-01

    @@ The cover of this well-illustrated, monochrome book has mini-portraits of eight surgical pioneers that suggest the scope of this coffee table sized hardback. Andreas Vesalius rubs shoulders with Lister, Wangensteen, Pasteur and Ambroise Paré. Indeed this multi-author publication is the most comprehensive tome of the history of what is the core of general surgery (i.e. surgery of the gastrointestinal tract) published to date and browsing through it was an utter delight.

  13. Systematics of shoulder instability; Systematik der Schulterinstabilitaet

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, K.F.; Maehringer-Kunz, A. [Johannes-Gutenberg-Universitaet Mainz, Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Mainz (Germany)

    2015-03-01

    Shoulder instability is defined as a symptomatic abnormal motion of the humeral head relative to the glenoid during active shoulder motion. Glenohumeral instabilities are classified according to the causative factors as the pathogenesis of instability plays an important role with respect to treatment options. Instabilities are classified into traumatic and atraumatic instabilities as part of a multidirectional instability syndrome and into microtraumatic instabilities. For diagnostics plain radiographs (''trauma series'') are performed to document shoulder dislocation and its successful repositioning. Direct magnetic resonance (MR) arthrography is the most important imaging modality for delineation of the different injury patterns of the labral-ligamentous complex and bony structures. Monocontrast computed tomography (CT) arthrography with the use of multidetector CT scanners represents an alternative imaging modality; however, MR imaging should be preferred in the work-up of shoulder instabilities due to the mostly younger age of patients. (orig.) [German] Unter einer Schulterinstabilitaet versteht man jede zu Beschwerden fuehrende Translation des Humeruskopfs in Relation zur Gelenkpfanne waehrend einer aktiven Bewegung der Schulter. Glenohumerale Instabilitaeten werden heute nach ihrer Aetiologie eingeteilt, da bei der Wahl der Therapie der Entstehungsmechanismus der Instabilitaet eine wichtige Rolle spielt. Danach unterscheidet man primaer traumatisch von atraumatisch entstandenen Instabilitaeten sowie Mikroinstabilitaeten. Bei der Diagnostik dienen konventionelle Roentgenuebersichtsaufnahmen nur noch zur Dokumentation einer Luxation und zur Beurteilung der Reposition. Die durch eine Instabilitaet hervorgerufenen Verletzungsfolgen am labroligamentaeren Komplex und den knoechernen Strukturen werden heute bevorzugt mit der direkten MR-Arthrographie dargestellt. Hierbei koennen unterschiedliche Verletzungsmuster dargestellt werden. Nach

  14. On the pathogenesis of shoulder impingement syndrome

    OpenAIRE

    Hyvönen, P. (Pirkko)

    2003-01-01

    Abstract The pathomechanism of the shoulder impingement syndrome has been under debat. Two main theories of the pathogenesis of the disease exists; mechanical (extrinsic) and degenerative (intrinsic) theory. The purpose of this work was to evaluate the pathogenesis of impingement syndrome with five studies that consentrate to aspects related to ethiopathology as outcome and recovery after surgery, radiological diagnosis, immunohisto- and histopathology of subacromial bursa, and subacr...

  15. Posterior dislocation of the shoulder joint

    Directory of Open Access Journals (Sweden)

    Thakker Tejas

    2006-01-01

    Full Text Available Background: Posterior dislocation of shoulder is a rather uncommon injury that is often not diagnosed at the initial examination. However certain constant clinical signs may lead the examiner to suspect the presence of this condition. Even the routine antero-posterior roentgenogram may provide a few clues to diagnosis but the axillary view is mandatory to verify diagnosis. Material and methods : We report a series of 15 shoulders (14 patients with a locked posterior dislocation. Electric shock (7 patients, vehicular accident (4 patients and epileptic seizure (3 patients was causes of dislocation in these patients. The diagnosis was missed initially in 10 cases. An axillary radiograph confirmed the diagnosis in all. Treatment consisted of closed reduction, which was successful in 5, Neer′s modification of McLaughlin procedure (transfer of subscapularis in 6, hemireplacement arthroplasty in one shoulder and tuberosity fixation in one patient. Results : Follow-up ranged from 1 year to 4 years. Five patients had excellent, five good, two poor and one had fair result. Conclusion : Key to diagnosis is a high index of suspicion. The prognosis became less favorable and the therapeutic difficulties were found to be increased in direct proportion to the length of time, these lesions remain undiagnosed. With early recognisition of dislocation, prompt reduction is relatively easy. Surgical intervention is necessary for old unreduced posterior dislocations.

  16. Ironman triathletes: MRI assessment of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Hiller, W.D.; Dierenfield, Laura [North Hawaii Community Hospital, Kamuela, HI (United States); Ainge, George R.; Brown, David W. [North Hawaii Community Hospital, Department of Radiology, Kamuela, HI (United States); Shellock, Frank G. [University of Southern California, Education and Research, Keck School of Medicine, Los Angeles, CA (United States); Crues, John V. [Radnet Inc., Los Angeles, CA (United States); Reuter, Robert M.

    2008-08-15

    The objective of this paper was to demonstrate the prevalence of shoulder magnetic resonance imaging (MRI) abnormalities, including abnormal bone marrow signal at the acromioclavicular (AC) joint in symptomatic and asymptomatic Ironman Triathletes. The shoulders of 23 Ironman Triathletes, seven asymptomatic (group I) and 16 symptomatic (group II), were studied by MRI. A separate, non-triathlete group was evaluated specifically for AC joint marrow signal abnormalities to compare with the Ironman Triathletes. Partial thickness tears of the rotator cuff, rotator cuff tendinopathy, and AC joint arthrosis were common findings in both groups of triathletes. Tendinopathy was the only finding that was more prevalent in the symptomatic group, but this was not a statistically significant difference (p=0.35). There were no tears of the glenoid labrum seen in group I or II subjects. Of note is that 71% (5/7) of group I subjects and 62% (10/16) of group II subjects had increased signal changes in the marrow of the AC joint (p=0.68). The comparison group showed a lower prevalence (35%, p=0.06) of this finding. No statistically significant difference was found among the findings for group 1, group 2, or the comparison group, although the difference between the comparison group and Ironman Triathletes approached statistical significance when evaluating for AC joint abnormal signal. Shoulder MRI of Ironman Triathletes should be interpreted with an appreciation of the commonly seen findings in asymptomatic subjects. (orig.)

  17. Shoulder MRI after surgical treatment of instability

    Energy Technology Data Exchange (ETDEWEB)

    Vahlensieck, Martin [University of Bonn, Department of Radiology, Sigmund-Freud-Strasse 25, 53105 Bonn (Germany); Lang, Philipp [University of California San Francisco, Department of Radiology, 505 Pamassus Avenue, San Francisco, CA 94143 (United States); Wagner, Ulli [University of Bonn, Department of Orthopedic Surgery, Sigmund-Freud-Strasse 25, 53105 Bonn (Germany); Moeller, Frank [University of Bonn, Department of Orthopedic Surgery, Sigmund-Freud-Strasse 25, 53105 Bonn (Germany); Deimling, Urs van [University of Bonn, Department of Orthopedic Surgery, Sigmund-Freud-Strasse 25, 53105 Bonn (Germany); Genant, H.K. [University of California San Francisco, Department of Radiology, 505 Pamassus Avenue, San Francisco, CA 94143 (United States); Schild, Hans H. [University of Bonn, Department of Radiology, Sigmund-Freud-Strasse 25, 53105 Bonn (Germany)

    1999-04-01

    Objective: To analyze magnetic resonance imaging (MRI) findings of the shoulder after an instability operation. Materials and methods: Physical examinations, radiographs and MRI of 10 patients after anterior glenoid bone block insertion for ventral instability were compared. MRI included T{sub 1}-weighted spin-echo (TR=600, TE=20 ms) and T{sub 2}*-weighted gradient-echo sequences (TE=600, TE=18, Flip=30 deg.) in the axial, oblique-coronal and oblique-sagittal planes. Results: No patient suffered from recurrent subluxation. We found fusion of the bone block with the anterior glenoid in seven cases, dislocation of the bone block without contact to the glenoid in one case, and no visible bone block in two cases. On MRI, the bone block showed either signal intensity equivalent to fatty bone marrow (n=4) or was devoid of signal consistent with cortical bone or bone sclerosis (n=4). In all patients, a low signal intensity mass, 2-4 cm in diameter, was visible next to the glenoid insertion site. Conclusion: Insertion of a bone block onto the anterior glenoid induces formation of scar tissue, increasing the stability of the shoulder joint. This scar is well visible on MRI and forms independently of the behavior of the bone block itself. MRI is ideally suited for evaluating postoperative shoulder joints after bone-grafting procedures.

  18. Conventional X-ray after shoulder prosthesis

    International Nuclear Information System (INIS)

    Three types of shoulder prostheses are commonly used to cover the different indications of shoulder joint replacements: classical modular, inverse and cup. The modular prosthesis can replace the glenoid as well as the humeral head components. Exact visualization of the interface between the glenoid component and bone (or cement-bone interface) is necessary to detect osteolysis, which is relatively common. Therefore, it is mandatory to make true AP and axial projections. When describing the humeral component, the interface between bone and implant must again be considered. Additionally, the position of the humeral head in relation to the glenoid has to be noted. The glenoid component is usually fixed by screws to the bone and an osteolysis is often present at the inferior pole of the glenoid component due to prosthesis bone notching. If the implants are modular devices (classic modular prosthesis, inverse shoulder prosthesis) there is the possibility of dissociation of components and any suspicion of this should be reported. In case of reporting the conventional x-ray of cup prosthesis, the bone implant interface should be mentioned. Again the position of the humeral head to the glenoid requires attention. In all types of prostheses, dislocation of the glenohumeral joint is obvious and has to be addressed in the medical report. (orig.)

  19. Cine-MR imaging of the shoulder

    International Nuclear Information System (INIS)

    Purpose: Shoulder lesions are usually examined with the joint in only one or two positions. We examined the shoulder with the joint in a variety of positions. We also assessed the application of cine-MR to the detection of instability and impingement. Material and Methods: The cine-MR examinations were performed in 30 patients and 15 healthy volunteers. We used an open 0.2 T system and a closed 1.0 T system. Spoiled gradient echo 2D T1-weighted images and turbo spin-echo T1- and T2-weighted images were obtained with a field of view of 180 mm. The examinations were videotaped and evaluated later. Results: Normal variations of the glenohumeral joint were easy to recognize. Subluxations and luxations of the humeral head as well as rupture of the labrum were identified. It was also possible to identify the labrum with a signal change after arthroscopic refixation. And we were able to objectively assess distances between the osseous structures during dynamic movement. Conclusion: Unlike static MR, cine-MR would appear to be useful in visualizing the capsular ligament complex of the gleno-humeral joint in impingement and instability. It also provides information on dynamic changes and may thus prove to be an important tool for shoulder diagnostics. The method may provide an early diagnosis in the subacromial impingement syndrome. (orig.)

  20. Arthrography of the equine shoulder joint

    International Nuclear Information System (INIS)

    Techniques and normal radiographic anatomy for positive and double contrast shoulder arthrography in horses were evaluated. General anaesthesia was used for most radiographic projections of the shoulder. The mediolateral projection provided the most information during arthrography, although the supinated mediolateral view occasionally allowed better definition of the cartilage surfaces on the medial aspects of the humeral head. The craniocaudal mediolateral oblique and caudocranial projections provided limited additional information. Water soluble non-ionic contrast agents, such as metrizamide and iohexol, were suitable for shoulder arthrography; iohexol resulted in less synovitis and lameness. Arthrography in cases of osteochondrosis and osteochondritis dissecans allowed better evaluation of cartilage attachment to subchondral bone, better evaluation of the length and depth of cartilage lesions and more accurately defined the site and shape of osteocartilaginous free bodies. Cartilage thickening without detachment from the subchondral bone could only be determined by arthrography. Although these thick cartilage regions may later dissect from the subchondral bone, most cases where the cartilage was firmly adherent were not candidates for surgical debridement and carried a favourable prognosis. The determination of a free flap by arthrography indicated the need for surgery. Extensive humeral and glenoid cavity lesions were better defined by arthrography, allowing a rational decision between surgical debridement or euthanasia. Using arthrography, evaluation of the size and patency of the communicating canal to a subchondral cystic defect better separated cases with long, narrow and poorly patent canals for conservative rather than surgical therapy

  1. Cine-MR imaging of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Allmann, K.H.; Uhl, M.; Gufler, H.; Kotter, E.; Langer, M. [Univ. Hospital, Freiburg (Germany). Dept. of Diagnostic Radiology; Biebow, N.; Hauer, M.P.; Reichelt, A. [Univ. Hospital, Freiburg (Germany). Dept. of Orthopedic Surgery

    1997-11-01

    Purpose: Shoulder lesions are usually examined with the joint in only one or two positions. We examined the shoulder with the joint in a variety of positions. We also assessed the application of cine-MR to the detection of instability and impingement. Material and Methods: The cine-MR examinations were performed in 30 patients and 15 healthy volunteers. We used an open 0.2 T system and a closed 1.0 T system. Spoiled gradient echo 2D T1-weighted images and turbo spin-echo T1- and T2-weighted images were obtained with a field of view of 180 mm. The examinations were videotaped and evaluated later. Results: Normal variations of the glenohumeral joint were easy to recognize. Subluxations and luxations of the humeral head as well as rupture of the labrum were identified. It was also possible to identify the labrum with a signal change after arthroscopic refixation. And we were able to objectively assess distances between the osseous structures during dynamic movement. Conclusion: Unlike static MR, cine-MR would appear to be useful in visualizing the capsular ligament complex of the gleno-humeral joint in impingement and instability. It also provides information on dynamic changes and may thus prove to be an important tool for shoulder diagnostics. The method may provide an early diagnosis in the subacromial impingement syndrome. (orig.).

  2. Amyloid β-sheet mimics that antagonize protein aggregation and reduce amyloid toxicity

    Science.gov (United States)

    Cheng, Pin-Nan; Liu, Cong; Zhao, Minglei; Eisenberg, David; Nowick, James S.

    2012-11-01

    The amyloid protein aggregation associated with diseases such as Alzheimer's, Parkinson's and type II diabetes (among many others) features a bewildering variety of β-sheet-rich structures in transition from native proteins to ordered oligomers and fibres. The variation in the amino-acid sequences of the β-structures presents a challenge to developing a model system of β-sheets for the study of various amyloid aggregates. Here, we introduce a family of robust β-sheet macrocycles that can serve as a platform to display a variety of heptapeptide sequences from different amyloid proteins. We have tailored these amyloid β-sheet mimics (ABSMs) to antagonize the aggregation of various amyloid proteins, thereby reducing the toxicity of amyloid aggregates. We describe the structures and inhibitory properties of ABSMs containing amyloidogenic peptides from the amyloid-β peptide associated with Alzheimer's disease, β2-microglobulin associated with dialysis-related amyloidosis, α-synuclein associated with Parkinson's disease, islet amyloid polypeptide associated with type II diabetes, human and yeast prion proteins, and Tau, which forms neurofibrillary tangles.

  3. The Role of the 14–20 Domain of the Islet Amyloid Polypeptide in Amyloid Formation

    Directory of Open Access Journals (Sweden)

    Sharon Gilead

    2008-01-01

    Full Text Available The molecular mechanism of amyloid formation by the islet amyloid polypeptide (IAPP has been intensively studied since its identification in the late 1980s. The IAPP(20–29 region is considered to be the central amyloidogenic module of the polypeptide. This assumption is mainly based on the amyloidogenic properties of the region and on the large sequence diversity within this region between the human and mouse IAPP, as the mouse IAPP does not form amyloids. A few years ago, another region within IAPP was identified that seems to be at least as important as IAPP(20–29 in facilitation of molecular recognition that leads to amyloid formation. Here, we reinforce our and others' previous findings by analyzing supporting evidence from the recent literature. Moreover, we provide new proofs to our hypothesis by comparing between the amyloidogenic properties of the two regions derived from the IAPP of cats, which is also known to form amyloid fibrils.

  4. Islet amyloid polypeptide-induced membrane leakage involves uptake of lipids by forming amyloid fibers.

    Science.gov (United States)

    Sparr, Emma; Engel, Maarten F M; Sakharov, Dmitri V; Sprong, Mariette; Jacobs, Jet; de Kruijff, Ben; Höppener, Jo W M; Killian, J Antoinette

    2004-11-01

    Fibril formation of islet amyloid polypeptide (IAPP) is associated with cell death of the insulin-producing pancreatic beta-cells in patients with Type 2 Diabetes Mellitus. A likely cause for the cytotoxicity of human IAPP is that it destroys the barrier properties of the cell membrane. Here, we show by fluorescence confocal microscopy on lipid vesicles that the process of hIAPP amyloid formation is accompanied by a loss of barrier function, whereby lipids are extracted from the membrane and taken up in the forming amyloid deposits. No membrane interaction was observed when preformed fibrils were used. It is proposed that lipid uptake from the cell membrane is responsible for amyloid-induced membrane damage and that this represents a general mechanism underlying the cytotoxicity of amyloid forming proteins. PMID:15527771

  5. Engineering of a multi-station shoulder simulator.

    Science.gov (United States)

    Smith, Simon L; Li, Lisa; Joyce, Thomas J

    2016-05-01

    This work aimed to engineer a multi-station shoulder simulator in order to wear test shoulder prostheses using recognized shoulder activities of daily living. A bespoke simulator was designed, built and subject to commissioning trials before a first wear test was conducted. Five JRI Orthopaedics Reverse Shoulder VAIOS 42 mm prostheses were tested for 2.0 million cycles and a mean wear rate and standard deviation of 14.2 ± 2.1 mm(3)/10(6) cycles measured for the polymeric glenoid components. This result when adjusted for prostheses diameters and test conditions showed excellent agreement with results from hip simulator studies of similar materials in a lubricant of bovine serum. The Newcastle Shoulder Simulator is the first multi-station shoulder simulator capable of applying physiological motion and loading for typical activities of daily living. PMID:27160564

  6. Reverse Shoulder Arthroplasty for Trauma: When, Where, and How.

    Science.gov (United States)

    Szerlip, Benjamin W; Morris, Brent J; Edwards, T Bradley

    2016-01-01

    Reverse shoulder arthroplasty has become increasingly popular for the treatment of complex shoulder injuries, including proximal humerus fractures and fixed glenohumeral dislocation, in the elderly population. The early to midterm results of reverse shoulder arthroplasty for the treatment of proximal humerus fractures are promising compared with the results of unconstrained humeral head replacement, and patients may have more predictable improvement with less dependence on bone healing and rehabilitation. However, long-term follow-up is needed, and surgeons must be familiar with various complications that are specific to reverse shoulder arthroplasty. To achieve optimal patient outcomes for the management of traumatic shoulder injuries, surgeons must have a comprehensive understanding of the current implant options, indications, and surgical techniques for reverse shoulder arthroplasty. PMID:27049189

  7. Effects and predictors of shoulder muscle massage for patients with posterior shoulder tightness

    Directory of Open Access Journals (Sweden)

    Yang Jing-lan

    2012-03-01

    Full Text Available Abstract Background Clinical approaches like mobilization, stretching, and/or massage may decrease shoulder tightness and improve symptoms in subjects with stiff shoulders. We investigated the effect and predictors of effectiveness of massage in the treatment of patients with posterior shoulder tightness. Methods A randomized controlled trial was conducted in a hospital-based outpatient practice (orthopedic and rehabilitation. Forty-three women and 17 men (mean age = 54 years, range 43-73 years with posterior shoulder tightness participated and were randomized into massage and control groups (n = 30 per group. A physical therapist provided the massage on the posterior deltoid, infraspinatus, and teres minor of the involved shoulder for 18 minutes [about 6 minutes for each muscle] two times a week for 4 weeks. For the control group, one therapist applied light hand touch on the muscles 10 minutes two times a week for 4 weeks. Glenohumeral internal rotation ROM, functional status, and muscle tightness were the main outcomes. Additionally, the potential factors on the effectiveness of massage were analyzed by multivariate logistic regression. For this analysis, patients with functional score improvement at least 20% after massage were considered responsive, and the others were considered nonresponsive. Results Fifty-two patients completed the study (29 for the massage and 23 for the control. The overall mean internal rotation ROM increased significantly in the massage group compared to the control (54.9° v.s. 34.9°; P ≤ 0.001. There were 21 patients in the responsive group and 8 in the nonresponsive group. Among the factors, duration of symptoms, functional score, and posterior deltoid tightness were significant predictors of effectiveness of massage. Conclusions Massage was an effective treatment for patients with posterior shoulder tightness, but was less effective in patients with longer duration of symptoms, higher functional limitation

  8. Contemporary treatment of amyloid heart disease.

    Science.gov (United States)

    Palecek, Tomas; Fikrle, Michal; Nemecek, Eduard; Bauerova, Lenka; Kuchynka, Petr; Louch, William E; Spicka, Ivan; Rysava, Romana

    2015-01-01

    The amyloidoses represent a group of diseases characterized by extracellular deposition of abnormal protein, amyloid, which is formed by insoluble extracellular fibrils in β-pleated sheets. Although cardiac involvement may occur in all types of amyloidoses, clinically relevant amyloid cardiomyopathy is a typical feature of AL amyloidosis and transthyretin-related amyloidoses. Congestive heart failure represents the commonest manifestation of amyloid heart disease. Noninvasive imaging techniques, especially echocardiography and cardiac magnetic resonance, play a major role in the diagnosis of amyloid cardiomyopathy; however, histological confirmation and exact typing of amyloid deposits is necessary whether in extracardiac location or directly in the myocardium. Early diagnosis of amyloid heart disease is of utmost importance as the presence and especially the severity of cardiac involvement generally drives the prognosis of affected subjects and plays a major role in determining the intensity of specific treatment, namely in AL amyloidosis. The management of patients with amyloid heart disease is complex. Loop diuretics together with aldosterone antagonists represent the basis for influencing signs of congestion. In AL amyloidosis, high-dose chemotherapy followed by autologous stem cell transplantation is generally considered to be a front-line treatment option, if the disease is diagnosed at its early stage. The combination of mephalan with dexamethasone has been the standard therapy for severely affected individuals; however, the combinations with several novel agents including immunomodulatory drugs and bortezomibe have been tested in clinical trials with promising results. New therapeutic substances with the potential to slow or even stop the progression of transthyretin-related amyloidosis are also extensively studied. PMID:25483951

  9. Has the management of shoulder dislocation changed over time?

    OpenAIRE

    Chalidis, Byron; Sachinis, Nick; Dimitriou, Christos; Papadopoulos, Pericles; Samoladas, Efthimios; Pournaras, John

    2006-01-01

    Anterior shoulder dislocation is a disabling injury affecting all ages, young and old alike. Recently, the treatment of traumatic shoulder dislocation has included immobilisation for varying periods of time followed by physiotherapy. This study is the first in this country to address the demographic data and recurrence rates of shoulder dislocation. Three hundred and eight patients (170 men and 138 women) were followed up for an average of 5.9 years. The most frequent mechanism of injury was ...

  10. Intra-articular Lidocaine Injection for Shoulder Reductions

    OpenAIRE

    Waterbrook, Anna L; Paul, Stephen

    2011-01-01

    Context: The shoulder is the most commonly dislocated joint, and shoulder dislocations are very common in sports. Many of these dislocations present to the office or training room for evaluation. Usual practice is an attempt at manual reduction without analgesia and then transfer to the emergency department if unsuccessful. The clinical efficacy of intra-articular lidocaine for reduction of anterior shoulder dislocations in the outpatient setting was examined. Evidence Acquisition: An OVID ME...

  11. Neglected Traumatic Locked Anterior Shoulder Fracture-Dislocation

    OpenAIRE

    Er, Mehmet Serhan; Eroglu, Mehmet; Erten, Recep Abdullah; Metineren, Hasan; Altinel, Levent

    2015-01-01

    Anterior shoulder dislocations are the most common major joint dislocations encountered in the emergency departments and fractures of proximal humerus can accompany with dislocations. Although the treatment of acute isolated traumatic anterior shoulder dislocation is generally simple, the treatment of neglected fracture-dislocations becomes more complicated. In this report, a 22-year-old male patient who had posttraumatic locked, shoulder fracture-dislocation is presented. Open reduction and ...

  12. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

    OpenAIRE

    Patil, Mallanagouda N

    2013-01-01

    Introduction: Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence. Case Report: 35 year old male presented to emergency department with history fall by tripping on a stone (fall on outstretched hand). He complained of...

  13. Bilateral fracture dislocation of the shoulder (Presentation of a Case)

    OpenAIRE

    Kuzgun, Unal; Baskir, Orhan; Temelli, Yener; Yazicioglu, Onder; Temocin, Bahattin O.; Kokino, Misel

    2004-01-01

    The largest portion of the dislocations encountered in the adults comprises shoulder dislocations and 2.16% of these dislocations constitute posterior dislocations. It is possible to detect that a dislocation develops secondary to convulsions due to immediate loss of consciousness in the history of most of the posterior dislocations of the shoulder. Approximately 20 cases have been so far reported in literature regurding bilateral dislocations of the shoulder. Bilateral dislocation associated...

  14. Shoulder injuries in professional rugby: a retrospective analysis

    OpenAIRE

    Horsley, Ian G; Fowler, Elizabeth M; Rolf, Christer G

    2013-01-01

    Background In the literature, little is known about the level and pattern of rugby injuries. Of the shoulder injuries reported, 51% of these are caused during a tackle, and 65% of all match injuries affected the shoulder. Objective The study aims to describe a sport-specific unique intra-articular shoulder pathology of professional rugby players, who presented with persistent pain and dysfunction despite physiotherapeutic treatment and rest. Method This study is a retrospective analysis set a...

  15. A little-known cause of painful shoulder: os acromiale

    International Nuclear Information System (INIS)

    The incidental discovery of an 'os acromiale' might explain some cases of 'painful shoulder': this is what we have observed in three patients. The purpose of our article is to underline the relevance of the axillary roentgenogram of the shoulder for the correct diagnosis of this anomaly. In all patients the radiographic examination was performed using a computed radiography system; moreover we performed a computed tomographic examination of the acromioclavicular portion of the shoulders with three-dimensional reconstructions. (orig.)

  16. Frozen shoulder: an arthrographic and radionuclear scan assessment.

    OpenAIRE

    Binder, A I; Bulgen, D Y; Hazleman, B L; Tudor, J.; Wraight, P.

    1984-01-01

    The diagnostic criteria and nomenclature used to describe the painful stiff shoulder remain confused. Arthrographic features of capsulitis have come to be accepted as characteristic of the frozen shoulder. Increased technetium uptake has also been noted. Both features have been considered to have possible prognostic and therapeutic importance. During a therapeutic study of strictly defined clinical frozen shoulder 35 of 38 patients showed increased technetium diphosphonate uptake in the affec...

  17. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

    Directory of Open Access Journals (Sweden)

    Mallanagouda N Patil

    2013-04-01

    Full Text Available Introduction: Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence. Case Report: 35 year old male presented to emergency department with history fall by tripping on a stone (fall on outstretched hand. He complained of pain and difficulty in moving both the shoulders. On clinical examination, patient’s both upper limbs were abducted and externally rotated. Bilaterally shoulder contour was lost with flattening. Other classical signs of shoulder dislocation viz, Bryants test, Callway sign, Hamilton’s ruler test were positive. Diagnosis was confirmed on X rays. Both shoulders were reduced in emergency operation theater under general anaesthesia by Kocher’s method and were immobilised in sling. Conclusion: Though bilateral shoulder dislocations are commonly posterior, usually either secondary to convulsions or electric shock, anterior dislocation has to be kept in mind , especially in post traumatic injuries. This bilateral dislocation also presents with practical problems immobilization and day to day care of patients. Keywords: Simultaneous, bilateral, shoulder dislocation, traumatic.

  18. Bone mineral density measurement over the shoulder region

    DEFF Research Database (Denmark)

    Doetsch, A M; Faber, J; Lynnerup, N;

    2002-01-01

    The purpose of this study was to (1). establish a method for measuring bone mineral density (BMD) over the shoulder region; (2). compare the relationship between shoulder BMD levels with hip BMD and body mass index (BMI); and (3). discuss the relevance of the shoulder scan as an early indicator...... to the least relative influence of weight and stress loading because of migration of calcium to weight and stress-bearing areas. Since the effect of this migration could mask local osteoporotic bone loss, shoulder BMD measurement is likely to minimize false indicators of healthy bone in women with high BMI...

  19. Extrahepatic production of acute phase serum amyloid A

    OpenAIRE

    Upragarin, N.; Landman, W.J.M.; Gaastra, W; Gruys, E.

    2005-01-01

    Amyloidosis is a group of diseases characterized by the extracellular deposition of protein that contains non-branching, straight fibrils on electron microscopy (amyloid fibrils) that have a high content of ß-pleated sheet conformation. Various biochemically distinct proteins can undergo transformation into amyloid fibrils. The precursor protein of amyloid protein A (AA) is the acute phase protein serum amyloid A (SAA). The concentration of SAA in plasma increa...

  20. STIMULATED PLATELETS RELEASE AMYLOID β–PROTEIN PRECURSOR

    OpenAIRE

    Cole, Gregory M.; Galasko, Douglas; Shapiro, I. Paul; Saitoh, Tsunao

    1990-01-01

    Human platelets can be stimulated by thrombin or ionomycin to secrete soluble truncated amyloid β–protein precursor and particulate membrane fragments which contain C-terminal and N-terminal immunoreactive amyloid β–protein precursor. This suggests a possible circulating source of β–protein in serum which may play a role in the formation of amyloid deposits. The release of soluble amyloid β-protein precursor could be involved in normal platelet physiology.

  1. Appropriate Use Criteria for Amyloid PET

    Science.gov (United States)

    Johnson, Keith A.; Minoshima, Satoshi; Bohnen, Nicolaas I.; Donohoe, Kevin J.; Foster, Norman L.; Herscovitch, Peter; Karlawish, Jason H.; Rowe, Christopher C.; Carrillo, Maria C.; Hartley, Dean M.; Hedrick, Saima; Mitchell, Kristi; Pappas, Virginia; Thies, William H.

    2013-01-01

    Positron Emission Tomography (PET) of brain amyloid-beta is a technology that is becoming more available, but its clinical utility in medical practice requires careful definition. In order to provide guidance to dementia care practitioners, patients and caregivers, the Alzheimer Association and the Society of Nuclear Medicine and Molecular Imaging convened the Amyloid Imaging Taskforce (AIT). The AIT considered a broad range of specific clinical scenarios in which amyloid PET could potentially be appropriately used. Peer-reviewed, published literature was searched to ascertain available evidence relevant to these scenarios, and the AIT developed a consensus of expert opinion. While empirical evidence of impact on clinical outcomes is not yet available, a set of specific Appropriate Use Criteria (AUC) were agreed upon that define the types of patients and clinical circumstances in which amyloid PET could be used. Both appropriate and inappropriate uses were considered and formulated, and are reported and discussed here. Because both dementia care and amyloid PET technology are in active development, these AUC will require periodic reassessment. Future research directions are also outlined, including diagnostic utility and patient-centered outcomes. PMID:23360977

  2. The novel amyloid-beta peptide aptamer inhibits intracellular amyloid-beta peptide toxicity

    Institute of Scientific and Technical Information of China (English)

    Xu Wang; Yi Yang; Mingyue Jia; Chi Ma; Mingyu Wang; Lihe Che; Yu Yang; Jiang Wu

    2013-01-01

    Amyloid β peptide binding alcohol dehydrogenase (ABAD) decoy peptide (DP) can competitively antagonize binding of amyloid β peptide to ABAD and inhibit the cytotoxic effects of amyloid β peptide. Based on peptide aptamers, the present study inserted ABAD-DP into the disulfide bond of human thioredoxin (TRX) using molecular cloning technique to construct a fusion gene that can express the TRX1-ABAD-DP-TRX2 aptamer. Moreover, adeno-associated virus was used to allow its stable expression. Immunofluorescent staining revealed the co-expression of the transduced fusion gene TRX1-ABAD-DP-TRX2 and amyloid β peptide in NIH-3T3 cells, indicating that the TRX1-ABAD-DP-TRX2 aptamer can bind amyloid β peptide within cells. In addition, cell morphology and MTT results suggested that TRX1-ABAD-DP-TRX2 attenuated amyloid β peptide-induced SH-SY5Y cell injury and improved cell viability. These findings confirmed the possibility of constructing TRX-based peptide aptamer using ABAD-DP. Moreover, TRX1-ABAD-DP-TRX2 inhibited the cytotoxic effect of amyloid β peptide.

  3. Sorting swimmers shoulders: An observational study on swimmers that presented to a shoulder surgeon

    Directory of Open Access Journals (Sweden)

    Daniel Butler

    2015-01-01

    Full Text Available Context: It is common for swimmers to suffer shoulder injuries resulting in a wealth of research focusing on the causes and types of injury. However, there is a lack of evidence regarding current management for shoulder injuries in swimmers. Aims: To investigate the diagnosis, subsequent management, and the return to swimming outcomes for swimmers presenting to an orthopedic practice. Settings and Design: Retrospective cohort study of competitive swimmers presenting to an orthopedic practice. Materials and Methods: The diagnosis, subsequent management, and the return to swimming outcomes were analyzed for 14 swimmers whose injuries were managed by a shoulder surgeon. Statistical Analysis Used: Descriptive analysis. Results: No significant association was identified between swimming stroke and type of injury. The majority of swimmers had good scapula rhythm, with no visible dyskinesis, including those with impingement. Swimmers with impingement did not require arthroscopy, and with nonoperative management had a mean time to return to swimming of 1.6 months. All labral tears required arthroscopic labral repair, with these swimmers having a mean time of 2.9 months postsurgery to return to swimming. Conclusion: The study demonstrated that an accurate diagnosis, and appropriate choice of nonoperative and surgical treatments lead to reassuring outcomes for swimmers suffering from shoulder injuries.

  4. Shoulder Injuries in US Astronauts Related to EVA Suit Design

    Science.gov (United States)

    Scheuring, R. A.; McCulloch, P.; Van Baalen, Mary; Minard, Charles; Watson, Richard; Blatt, T.

    2011-01-01

    Introduction: For every one hour spent performing extravehicular activity (EVA) in space, astronauts in the US space program spend approximately six to ten hours training in the EVA spacesuit at NASA-Johnson Space Center's Neutral Buoyancy Lab (NBL). In 1997, NASA introduced the planar hard upper torso (HUT) EVA spacesuit which subsequently replaced the existing pivoted HUT. An extra joint in the pivoted shoulder allows increased mobility but also increased complexity. Over the next decade a number of astronauts developed shoulder problems requiring surgical intervention, many of whom performed EVA training in the NBL. This study investigated whether changing HUT designs led to shoulder injuries requiring surgical repair. Methods: US astronaut EVA training data and spacesuit design employed were analyzed from the NBL data. Shoulder surgery data was acquired from the medical record database, and causal mechanisms were obtained from personal interviews Analysis of the individual HUT designs was performed as it related to normal shoulder biomechanics. Results: To date, 23 US astronauts have required 25 shoulder surgeries. Approximately 48% (11/23) directly attributed their injury to training in the planar HUT, whereas none attributed their injury to training in the pivoted HUT. The planar HUT design limits shoulder abduction to 90 degrees compared to approximately 120 degrees in the pivoted HUT. The planar HUT also forces the shoulder into a forward flexed position requiring active retraction and extension to increase abduction beyond 90 degrees. Discussion: Multiple factors are associated with mechanisms leading to shoulder injury requiring surgical repair. Limitations to normal shoulder mechanics, suit fit, donning/doffing, body position, pre-existing injury, tool weight and configuration, age, in-suit activity, and HUT design have all been identified as potential sources of injury. Conclusion: Crewmembers with pre-existing or current shoulder injuries or certain

  5. Humeral shaft fracture with ipsilateral shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    Prateek Behera; Vishal Kumar; Sameer Aggarwal

    2014-01-01

    Although fracture of the humeral shaft or dislocation of the shoulder joint is a common injury,a simutaneous injury is rare.We present such a case combined with head injury which took precedence over the skeletal injuries.The postoperative rehabilitation was slowed down by the head injury.This case report makes us aware of some problems when managing the patient with this rare injury and helps us understand the management options better.Also the need for proper follow-up and rehabilitation is emphasized.

  6. Shoulder-elbow exoskeleton as rehabilitation exerciser

    Science.gov (United States)

    Ianoşi, A.; Dimitrova, A.; Noveanu, S.; Tătar, O. M.; Mândru, D. S.

    2016-08-01

    This paper presents a 2 degree of freedom exoskeleton designed for the rehabilitation of the shoulder and elbow movement in the sagittal plane; a semi-portable design strategy was chosen, which enables an easy attachment to a standard medical chair as well as the patient upper limb. A dedicated driver enables the control from a graphical user interface, which also provides the option of customized rehabilitation exercises. The potential of future improvements is assessed, and recommendations of research direction are made in order to broaden the usability of the proposed device.

  7. Humeral shaft fracture with ipsilateral shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Behera Prateek

    2014-02-01

    Full Text Available 【Abstract】Although fracture of the humeral shaft or dislocation of the shoulder joint is a common injury, a simutaneous injury is rare. We present such a case combined with head injury which took precedence over the skeletal injuries. The postoperative rehabilitation was slowed down by the head injury. This case report makes us aware of some problems when managing the patient with this rare injury and helps us understand the management options better. Also the need for proper follow-up and rehabilitation is emphasized.

  8. The Square-Shoulder-Asakura-Oosawa model

    Science.gov (United States)

    Fantoni, Riccardo

    2016-09-01

    A new model for a colloidal size-asymmetric binary mixture is proposed: The Square-Shoulder-Asakura-Oosawa. This belongs to the larger class of non-additive hard-spheres models and has the property that its effective pair formulation is exact whenever the solvent particle fits inside the interstitial region of three touching solute particles. Therefore one can study its properties from the equivalent one-component effective problem. Some remarks on the phase diagram of this new model are also addressed.

  9. Neuropsychological Effects of Cerebral Amyloid Angiopathy.

    Science.gov (United States)

    Schrag, Matthew; Kirshner, Howard

    2016-08-01

    Cerebral amyloid angiopathy is a condition of the cerebral arterioles and to a lesser extent capillaries and veins, wherein beta-amyloid is deposited. In arterioles, this preferentially targets vascular smooth muscle cells and in the later stages undermines the stability of the vessel. This condition is frequently comorbid with Alzheimer's disease and its role in cognitive impairment and dementia is a topic of considerable recent research. This article reviews recent literature which confirms that CAA independently contributes to cognitive impairment by potentiating the neurodegeneration of Alzheimer's disease, by predisposing to microhemorrhagic and microischemic injury to the brain parenchyma, and by interfering with the autoregulation of CNS blood flow. In this review, we discuss the clinical presentation of cerebral amyloid angiopathy, with a focus on the neuropsychological manifestations of this vasculopathy. PMID:27357378

  10. Fibrillar dimer formation of islet amyloid polypeptides

    Energy Technology Data Exchange (ETDEWEB)

    Chiu, Chi-cheng [Univ. of Chicago, IL (United States); Argonne National Lab. (ANL), Argonne, IL (United States); de Pablo, Juan J. [Univ. of Chicago, IL (United States); Argonne National Lab. (ANL), Argonne, IL (United States)

    2015-05-08

    Amyloid deposits of human islet amyloid polypeptide (hIAPP), a 37-residue hormone co-produced with insulin, have been implicated in the development of type 2 diabetes. Residues 20 – 29 of hIAPP have been proposed to constitute the amyloidogenic core for the aggregation process, yet the segment is mostly unstructured in the mature fibril, according to solid-state NMR data. Here we use molecular simulations combined with bias-exchange metadynamics to characterize the conformational free energies of hIAPP fibrillar dimer and its derivative, pramlintide. We show that residues 20 – 29 are involved in an intermediate that exhibits transient β-sheets, consistent with recent experimental and simulation results. By comparing the aggregation of hIAPP and pramlintide, we illustrate the effects of proline residues on inhibition of the dimerization of IAPP. The mechanistic insights presented here could be useful for development of therapeutic inhibitors of hIAPP amyloid formation.

  11. Fibrillar dimer formation of islet amyloid polypeptides

    Science.gov (United States)

    Chiu, Chi-cheng; de Pablo, Juan J.

    2015-09-01

    Amyloid deposits of human islet amyloid polypeptide (hIAPP), a 37-residue hormone co-produced with insulin, have been implicated in the development of type 2 diabetes. Residues 20 - 29 of hIAPP have been proposed to constitute the amyloidogenic core for the aggregation process, yet the segment is mostly unstructured in the mature fibril, according to solid-state NMR data. Here we use molecular simulations combined with bias-exchange metadynamics to characterize the conformational free energies of hIAPP fibrillar dimer and its derivative, pramlintide. We show that residues 20 - 29 are involved in an intermediate that exhibits transient β-sheets, consistent with recent experimental and simulation results. By comparing the aggregation of hIAPP and pramlintide, we illustrate the effects of proline residues on inhibition of the dimerization of IAPP. The mechanistic insights presented here could be useful for development of therapeutic inhibitors of hIAPP amyloid formation.

  12. Compressive deformation of ultralong amyloid fibrils

    Science.gov (United States)

    Paparcone, Raffaella; Cranford, Steven; Buehler, Markus J.

    2010-12-01

    Involved in various neurodegenerative diseases, amyloid fibrils and plaques feature a hierarchical structure, ranging from the atomistic to the micrometer scale. At the atomistic level, a dense and organized hydrogen bond network is resembled in a beta-sheet rich secondary structure, which drives a remarkable stiffness in the range of 10-20GPa, larger than many other biological nanofibrils, a result confirmed by both experiment and theory. However, the understanding of how these exceptional mechanical properties transfer from the atomistic to the nanoscale remains unknown. Here we report a multiscale analysis that, from the atomistic-level structure of a single fibril, extends to the mesoscale level, reaching size scales of hundreds of nanometers. We use parameters directly derived from full atomistic simulations of A β (1-40) amyloid fibrils to parameterize a mesoscopic coarse-grained model, which is used to reproduce the elastic properties of amyloid fibrils. We then apply our mesoscopic model in an analysis of the buckling behavior of amyloid fibrils with different lengths and report a comparison with predictions from continuum beam theory. An important implication of our results is a severe reduction of the effective modulus due to buckling, an effect that could be important to interpret experimental results of ultra-long amyloid fibrils. Our model represents a powerful tool to mechanically characterize molecular structures on the order of hundreds of nanometers to micrometers on the basis of the underlying atomistic behavior. The work provides insight into structural and mechanical properties of amyloid fibrils and may enable further analysis of larger-scale assemblies such as amyloidogenic bundles or plaques as found in disease states.

  13. Amyloids or prions? That is the question.

    Science.gov (United States)

    Sabate, Raimon; Rousseau, Frederic; Schymkowitz, Joost; Batlle, Cristina; Ventura, Salvador

    2015-01-01

    Despite major efforts devoted to understanding the phenomenon of prion transmissibility, it is still poorly understood how this property is encoded in the amino acid sequence. In recent years, experimental data on yeast prion domains allow to start at least partially decrypting the sequence requirements of prion formation. These experiments illustrate the need for intrinsically disordered sequence regions enriched with a particularly high proportion of glutamine and asparagine. Bioinformatic analysis suggests that these regions strike a balance between sufficient amyloid nucleation propensity on the one hand and disorder on the other, which ensures availability of the amyloid prone regions but entropically prevents unwanted nucleation and facilitates brittleness required for propagation.

  14. Quenched Hydrogen Exchange NMR of Amyloid Fibrils.

    Science.gov (United States)

    Alexandrescu, Andrei T

    2016-01-01

    Amyloid fibrils are associated with a number of human diseases. These aggregatively misfolded intermolecular β-sheet assemblies constitute some of the most challenging targets in structural biology because to their complexity, size, and insolubility. Here, protocols and controls are described for experiments designed to study hydrogen-bonding in amyloid fibrils indirectly, by transferring information about amide proton occupancy in the fibrils to the dimethyl sulfoxide-denatured state. Since the denatured state is amenable to solution NMR spectroscopy, the method can provide residue-level-resolution data on hydrogen exchange for the monomers that make up the fibrils.

  15. Grading of shoulder ulcerations in sows by biopsies

    DEFF Research Database (Denmark)

    Jensen, Henrik Elvang; Dahl-Pedersen, Kirstin; Barington, Kristiane;

    2014-01-01

    , a punch biopsy was sampled from the center of the ulceration or from the tissue overlaying the tuber spina scapula. Afterward, the shoulders were cross-sectioned and evaluated grossly and histologically (“gold standard”). In total, 121 shoulders were included in the study, and the diagnostic value...

  16. Does scapular positioning predict shoulder pain in recreational overhead athletes?

    Science.gov (United States)

    Struyf, F; Nijs, J; Meeus, M; Roussel, N A; Mottram, S; Truijen, S; Meeusen, R

    2014-01-01

    The objective of this prospective study is to investigate possible scapular related risk factors for developing shoulder pain. Therefore, a 2-year follow-up study in a general community sports centre setting was conducted. A sample of convenience of 113 recreational overhead athletes (59 women and 54 men) with a mean age of 34 (17-64; SD 12) years were recruited. At baseline, visual observation for scapular dyskinesis, measured scapular protraction, upward scapular rotation and dynamic scapular control were evaluated. 22% (n=25) of all athletes developed shoulder pain during the 24 months following baseline assessment. The Mean Shoulder Disability Questionnaire (SDQ) score for the painful shoulders was 34.8 (6.3-62.5; SD 17.4). None of the scapular characteristics predicted the development of shoulder pain. However, the athletes that developed shoulder pain demonstrated significantly less upward scapular rotation at 45° (p=0.010) and 90° (p=0.016) of shoulder abduction in the frontal plane at baseline in comparison to the athletes that remained pain-free. In conclusion, although these scapular characteristics are not of predictive value for the development of shoulder pain, this study increases our understanding of the importance of a scapular upward rotation assessment among recreational overhead athletes.

  17. Association of fetal cranial shape with shoulder dystocia

    NARCIS (Netherlands)

    Belfort, M. A.; White, G. L.; Vermeulen, F. M.

    2012-01-01

    Objective To evaluate whether fetal cranial shape is related to shoulder dystocia. Methods We compared shoulder dystocia cases (n = 18) with controls (normal vaginal deliveries, n = 18) in a retrospective matched- pairs observational study. Subjects were matched for known maternal and fetal risk fac

  18. Subacronial shoulder complaints in physiotherapy an general practice.

    NARCIS (Netherlands)

    Kooijman, M.; Swinkels, I.; Veenhof, C.

    2011-01-01

    Purpose: The aim of this study is to describe the patient population and the process of care in patients with subacromial shoulder complaints both in physiotherapy and in general practice. Relevance: Shoulder complaints are common in the daily practice of a general practitioner (GP) and physiotherap

  19. Proprioception and Throwing Accuracy in the Dominant Shoulder After Cryotherapy

    OpenAIRE

    Wassinger, Craig A; Myers, Joseph B; Gatti, Joseph M; Conley, Kevin M; Lephart, Scott M.

    2007-01-01

    Context: Application of cryotherapy modalities is common after acute shoulder injury and as part of rehabilitation. During athletic events, athletes may return to play after this treatment. The effects of cryotherapy on dominant shoulder proprioception have been assessed, yet the effects on throwing performance are unknown.

  20. Miniopen coracohumeral ligament release and manipulation for idiopathic frozen shoulder

    Directory of Open Access Journals (Sweden)

    Abdelsalam Eid

    2012-01-01

    Full Text Available In the management of idiopathic frozen shoulder, manipulation under anaesthesia is known to have serious potential complications including fractures and intra-articular injuries. Arthroscopy is a safer treatment modality but requires special instruments, experience, and involves added cost. The aim of this work was to study the use of miniopen Coracohumeral ligament release and manipulation of the shoulder as a safe and simple method of treating idiopathic frozen shoulder that could be performed as a quick procedure under short duration anaesthesia obtaining a significant improvement of shoulder function while avoiding complications that are feared to occur with the use of manipulation under anaesthesia. Miniopen Coracohumeral ligament release is performed through a 3-cm incision. The Coracohumeral ligament is divided, and then the shoulder is manipulated without undue force. A case series including fifteen patients (19 shoulders with idiopathic frozen shoulder operated by this technique is described. Miniopen Coracohumeral ligament release and manipulation is a quick procedure that may be performed under short duration anaesthesia obtaining a significant improvement of shoulder function meanwhile avoiding complications that are feared to occur with the use of manipulation under anaesthesia.

  1. The role of sensitization in musculoskeletal shoulder pain

    OpenAIRE

    John Borstad; Christopher Woeste

    2015-01-01

    Introduction: Peripheral and central sensitization are neurophysiological processes that can prolong painful conditions. Painful shoulder conditions are often persistent, perhaps due to the presence of sensitization. Method: This manuscript summarizes six studies that have evaluated those with musculoskeletal shoulder pain for the presence of sensitization. Results: All six manuscripts report evidence of peripheral sensitization, while central sensitization was described in five of the studie...

  2. Ultrasound diagnosis of impingement syndrome of the shoulder joint

    International Nuclear Information System (INIS)

    The finding of ultrasound investigation of shoulder joints of 62 patients with complains of a prolonged (over 1 year) pain in the shoulder area, limited movement in the joint without obvious trauma in the history were analyzed. The ultrasound finding were compared with those of MRI and radiography.

  3. Designed amyloid fibers as materials for selective carbon dioxide capture.

    Science.gov (United States)

    Li, Dan; Furukawa, Hiroyasu; Deng, Hexiang; Liu, Cong; Yaghi, Omar M; Eisenberg, David S

    2014-01-01

    New materials capable of binding carbon dioxide are essential for addressing climate change. Here, we demonstrate that amyloids, self-assembling protein fibers, are effective for selective carbon dioxide capture. Solid-state NMR proves that amyloid fibers containing alkylamine groups reversibly bind carbon dioxide via carbamate formation. Thermodynamic and kinetic capture-and-release tests show the carbamate formation rate is fast enough to capture carbon dioxide by dynamic separation, undiminished by the presence of water, in both a natural amyloid and designed amyloids having increased carbon dioxide capacity. Heating to 100 °C regenerates the material. These results demonstrate the potential of amyloid fibers for environmental carbon dioxide capture.

  4. Isolated Pulmonary Embolism following Shoulder Arthroscopy

    Directory of Open Access Journals (Sweden)

    Nicole H. Goldhaber

    2014-01-01

    Full Text Available Pulmonary embolism (PE following shoulder arthroscopy is a rare complication. We present a unique case report of a 43-year-old right-hand dominant female who developed a PE 41 days postoperatively with no associated upper or lower extremity DVT. The patient had minimal preoperative and intraoperative risk factors. Additionally, she had no thromboembolic symptoms postoperatively until 41 days following surgery when she developed sudden right-hand swelling, labored breathing, and abdominal pain. A stat pulmonary computed tomography (CT angiogram of the chest revealed an acute PE in the right lower lobe, and subsequent extremity ultrasounds showed no upper or lower extremity deep vein thrombosis. After a thorough review of the literature, we present the first documented isolated PE following shoulder arthroscopy. Although rare, sudden development of an isolated PE is possible, and symptoms such as sudden hand swelling, trouble breathing, and systemic symptoms should be evaluated aggressively with a pulmonary CT angiogram given the fact that an extremity ultrasound may be negative for deep vein thrombosis.

  5. Optimal management of shoulder impingement syndrome

    Directory of Open Access Journals (Sweden)

    Escamilla RF

    2014-02-01

    Full Text Available Rafael F Escamilla,1,2 Todd R Hooks,3 Kevin E Wilk4 1Department of Physical Therapy, California State University, Sacramento, CA, USA; 2Andrews Research and Education Institute, Gulf Breeze, FL, USA; 3Drayer Physical Therapy Institute, Columbus, MS, USA; 4Champion Sports Medicine, Birmingham, AL, USA Abstract: Shoulder impingement is a progressive orthopedic condition that occurs as a result of altered biomechanics and/or structural abnormalities. An effective nonoperative treatment for impingement syndrome is aimed at addressing the underlying causative factor or factors that are identified after a complete and thorough evaluation. The clinician devises an effective rehabilitation program to regain full glenohumeral range of motion, reestablish dynamic rotator cuff stability, and implement a progression of resistive exercises to fully restore strength and local muscular endurance in the rotator cuff and scapular stabilizers. The clinician can introduce stresses and forces via sport-specific drills and functional activities to allow a return to activity. Keywords: rotator cuff impingement, internal impingement, overhead athlete, shoulder, rehabilitation

  6. Treating Postlaparoscopic Surgery Shoulder Pain with Acupuncture

    Directory of Open Access Journals (Sweden)

    Gur Kreindler

    2014-01-01

    Full Text Available Objective. The purpose of this study was to examine the effect of acupuncture on postlaparoscopic shoulder pain (PLSP which is a common side effect in patients undergoing abdominal laparoscopic surgery. Methods. Patients with moderate to severe PLSP in spite of analgesic treatment, which were referred by the medical staff to the Complementary-Integrative Surgery Service (CISS at our institution, were provided with acupuncture treatment. The severity of PLSP and of general pain was assessed using a Visual Analogue Scale (VAS from 0 to 10. Pain assessment was conducted prior to and two hours following acupuncture treatment. Acupuncture treatment was individualized based on traditional Chinese medicine diagnosis. Results. A total of 25 patients were evaluated during a 14-month period, from March 2011 to May 2012. A significant reduction in PLSP (mean reduction of 6.4±2.3  P<0.0001 and general pain (mean reduction 6.4±2.1  P<0.0001 were observed, and no significant side effects were reported. Conclusion. Individualized acupuncture treatments according to traditional Chinese medicine principles may improve postlaparoscopic shoulder pain and general pain when used in conjunction with conventional therapy. The primary findings of this study warrant verification in controlled studies.

  7. Clinical Measures of Shoulder Mobility in the Professional Baseball Player.

    Science.gov (United States)

    Downar, Jacquelyn M; Sauers, Eric L

    2005-03-01

    Context: Professional baseball players must achieve a delicate balance between shoulder mobility and stability to attain optimal sports performance. The sport-specific demands of repetitive overhead throwing may result in an altered mobility-stability relationship.Objective: To evaluate clinical measures of shoulder mobility in professional baseball players in order to examine differences between the throwing and the nonthrowing shoulders and to describe chronic adaptations to throwing.Design: Descriptive.Setting: The athletic training room at Maryvale Baseball Park, Phoenix, AZ.Patients or Other Participants: Twenty-seven professional baseball players (20 pitchers, 7 position players; age = 20 +/- 1.6 years, height = 190.5 +/- 4.8 cm, mass = 91.6 +/- 9.6 kg) with no previous history of shoulder or elbow injury.Main Outcome Measure(s): We recorded scapular upward rotation at 4 levels of humeral elevation in the scapular plane (rest, 60 degrees , 90 degrees , 120 degrees ); posterior shoulder tightness; and passive, isolated glenohumeral joint internal and external range of motion.Results: Scapular upward rotation was significantly greater in the throwing shoulder (14.2 +/- 6.5 degrees ) than in the nonthrowing shoulder (10.6 +/- 6.1 degrees ) at 90 degrees of humeral elevation (P = .04). We observed no statistically significant difference in posterior shoulder tightness between the throwing (30.2 +/- 4.6 cm) and the nonthrowing (28.0 +/- 4.8 cm) shoulder (P = .09). In addition, the throwing shoulder exhibited a statistically significant decrease in isolated glenohumeral internal rotation (56.6 +/- 12.5 degrees ) compared with the nonthrowing shoulder (68.6 +/- 12.6 degrees ) (P = .001), with a concomitant increase in isolated glenohumeral external rotation (throwing = 108.9 +/- 9.0 degrees , nonthrowing = 101.9 +/- 5.9 degrees , P = .0014). An analysis of the total arc of motion (internal rotation + external rotation) revealed no statistically significant

  8. Resurfacing shoulder arthroplasty for the treatment of severe rheumatoid arthritis

    DEFF Research Database (Denmark)

    Voorde, Pia C Ten; Rasmussen, Jeppe V; Olsen, Bo S;

    2015-01-01

    . INTERPRETATION: This study shows that shoulder arthroplasty, regardless of design, is a good option in terms of reducing pain and improving function in RA patients. The high revision rate in the RHA group suggests that other designs may offer better implant survival. However, this should be confirmed in larger......BACKGROUND AND PURPOSE: There is no consensus on which type of shoulder prosthesis should be used in patients with rheumatoid arthritis (RA). We describe patients with RA who were treated with shoulder replacement, regarding patient-reported outcome, prosthesis survival, and causes of revision......, and we compare outcome after resurfacing hemi-arthroplasty (RHA) and stemmed hemi-arthroplasty (SHA). PATIENTS AND METHODS: We used data from the national Danish Shoulder Arthroplasty Registry and included patients with RA who underwent shoulder arthroplasty in Denmark between 2006 and 2010. Patient...

  9. Epinephrine-enhanced computed tomographic arthrography of the canine shoulder.

    Science.gov (United States)

    De Rycke, Lieve; van Bree, Henri; Van Caelenberg, Annemie; Polis, Ingeborgh; Duchateau, Luc; Gielen, Ingrid

    2015-10-01

    The aim of this study was to investigate the effect of epinephrine-enhanced computed tomographic arthrography (CTA) on the image sharpness of the lateral and medial glenohumeral ligaments (LGHL and MGHL, respectively), biceps tendon (BT) and joint cartilage (JC) in the canine shoulder. The shoulders of eight normal dogs were examined using a 4-slice helical CT scanner. The right shoulders were injected with Iohexol and the left shoulders with a mixture of Iohexol and epinephrine. CTA images were obtained after 1, 3, 5, 9, 13, 20 and 30 min and the image sharpness of the intra-articular structures in both shoulders was graded for visibility. The attenuation values were measured to examine the persistence of contrast appearance. Admixture of epinephrine and Iohexol significantly improved the image sharpness of the LGHL and the BT, especially on delayed CTA images. The use of epinephrine did not negatively affect post-CTA recovery.

  10. Glenoid Dysplasia in the Recurrent Shoulder Dislocation: A Case Report

    Directory of Open Access Journals (Sweden)

    Hamza Sucuoglu

    2016-02-01

    Full Text Available Glenoid dysplasia, which is often ignored, is a rare developmental anomaly. In most cases the patients remain asymptomatic. Although glenoid dysplasia has been diagnosed by incidentally on chest radiograph, also it has been described because of the developing instability of shoulder joint. Our young male patient who has recurrent dislocation of the shoulder-joint 4-5 times a year for last 5 years, dislocation has been reduced in the emergency department and he has been discharged from hospital with shoulder strap and rest. Finally when he admitted to our outpatient clinic with recurrent shoulder dislocation, the diagnosis of glenoid dysplasia is revealed by X-ray examination. We present the diagnose of glenoid dysplasia with clinical and radiological findings which should be kept in mind in patients with recurrent dislocations of shoulder as in our case.

  11. Magnetic resonance imaging of the shoulder: Rationale and current applications

    International Nuclear Information System (INIS)

    Because it can demonstrate a wide range of tissue contrast with excellent resolution, magnetic resonance (MR) imaging has revolutionized imaging in many areas of the musculoskeletal system and has generated excitement among those interested in the painful shoulder. Shoulder impingement syndrome and glenohumeral instability constitute the two major categories of shoulder derangements. Correct diagnosis requires the use of appropriate pulse sequences and imaging planes, proper patient positioning, and a satisfactory surface coil. In addition the imager must have a thorough understanding of shoulder anatomy and pathology. We present a summary of the current status of MR imaging of the shoulder including technical, anatomic, and pathologic considerations and a review of the pertinent literature. (orig.)

  12. The influence of experimentally induced pain on shoulder muscle activity.

    Science.gov (United States)

    Diederichsen, Louise Pyndt; Winther, Annika; Dyhre-Poulsen, Poul; Krogsgaard, Michael R; Nørregaard, Jesper

    2009-04-01

    Muscle function is altered in painful shoulder conditions. However, the influence of shoulder pain on muscle coordination of the shoulder has not been fully clarified. The aim of the present study was to examine the effect of experimentally induced shoulder pain on shoulder muscle function. Eleven healthy men (range 22-27 years), with no history of shoulder or cervical problems, were included in the study. Pain was induced by 5% hypertonic saline injections into the supraspinatus muscle or subacromially. Seated in a shoulder machine, subjects performed standardized concentric abduction (0 degrees -105 degrees) at a speed of approximately 120 degrees/s, controlled by a metronome. During abduction, electromyographic (EMG) activity was recorded by intramuscular wire electrodes inserted in two deeply located shoulder muscles and by surface-electrodes over six superficially located shoulder muscles. EMG was recorded before pain, during pain and after pain had subsided and pain intensity was continuously scored on a visual analog scale (VAS). During abduction, experimentally induced pain in the supraspinatus muscle caused a significant decrease in activity of the anterior deltoid, upper trapezius and the infraspinatus and an increase in activity of lower trapezius and latissimus dorsi muscles. Following subacromial injection a significantly increased muscle activity was seen in the lower trapezius, the serratus anterior and the latissimus dorsi muscles. In conclusion, this study shows that acute pain both subacromially and in the supraspinatus muscle modulates coordination of the shoulder muscles during voluntary movements. During painful conditions, an increased activity was detected in the antagonist (latissimus), which support the idea that localized pain affects muscle activation in a way that protects the painful structure. Further, the changes in muscle activity following subacromial pain induction tend to expand the subacromial space and thereby decrease the load

  13. Difference in clinical outcome between total shoulder arthroplasty and reverse shoulder arthroplasty used in hemiarthroplasty revision surgery

    NARCIS (Netherlands)

    Hartel, B.P.; Alta, T.D.; Sewnath, M.E.; Willems, W.J.H.

    2015-01-01

    INTRODUCTION: The increase of shoulder replacements will lead to a higher revision rate of shoulder arthroplasties. The aim of this study is to evaluate the clinical results of revision surgery performed in our hospital, distinguish the differences in clinical outcome according to revision indicatio

  14. Bap: A New Type of Functional Amyloid.

    Science.gov (United States)

    Di Martino, Patrick

    2016-09-01

    Bacteria can build a biofilm matrix scaffold from exopolysaccharides or proteins, and DNA. In a recent report, Taglialegna and colleagues show that pathogenic Staphylococcus aureus produces a protein scaffold based on amyloid assembly of fragments from the biofilm-associated protein. Amyloidogenesis occurs in response to environmental signals.

  15. Calumenin interacts with serum amyloid P component

    DEFF Research Database (Denmark)

    Vorum, H; Jacobsen, Christian; Honoré, Bent

    2000-01-01

    with calumenin in the presence of Ca(2+). Amino acid sequencing identified this protein as serum amyloid P component (SAP). Furthermore, we verified and characterized the calumenin-SAP interaction by the surface plasmon resonance technique. The findings indicate that calumenin may participate...

  16. Bap: A New Type of Functional Amyloid.

    Science.gov (United States)

    Di Martino, Patrick

    2016-09-01

    Bacteria can build a biofilm matrix scaffold from exopolysaccharides or proteins, and DNA. In a recent report, Taglialegna and colleagues show that pathogenic Staphylococcus aureus produces a protein scaffold based on amyloid assembly of fragments from the biofilm-associated protein. Amyloidogenesis occurs in response to environmental signals. PMID:27451288

  17. Is amyloid A (AA) amyloidosis always secondary?

    OpenAIRE

    Maury, C P; Törnroth, T; Wegelius, O

    1985-01-01

    The case is reported of a patient with systemic AA amyloidosis associated with non-specific mesenteric lymphadenitis and chronic sideropenia. Renal, small bowel, and rectal biopsies showed amyloid deposits containing AA protein, as defined by potassium permanganate sensitivity and by reactivity with AA antiserum. Reversal of the nephrotic syndrome occurred during steroid-azathioprine therapy.

  18. Posterior shoulder pain and anterior instability: a preliminary clinical study.

    Science.gov (United States)

    Castagna, Alessandro; Conti, Marco; Borroni, Mario; Massazza, Giuseppe; Vinci, Enzo; Franceschi, Giorgio; Garofalo, Raffaele

    2008-02-01

    Different clinical tests have been suggested in the literature as significant indicators of anterior shoulder instability. Sometimes patients with recurrent anterior shoulder instability may show some muscular guarding thus making the evaluation of specific clinical tests very difficult. These patients may also report a medical history with posterior shoulder pain that can be also elicited during some clinical manoeuvres. From September 2005 to September 2006 we prospectively studied patients who underwent an arthroscopic anterior capsuloplasty. Shoulder clinical examination was performed including anterior shoulder instability tests (drawer, apprehension and relocation tests). Furthermore the exam was focused on the presence of scapular dyskinesia and posterior shoulder pain. The patients were also evaluated with ASES, Rowe, SST (Simple Shoulder Test), Constant and UCLA (University of California at Los Angeles) scoring system preoperatively and at the latest follow-up time. In the period of this study we observed 16 patients treated for anterior gleno-humeral arthroscopic stabilisation, who preoperatively complained also of a posterior scapular pain. The pain was referred at the level of lower trapezium and upper rhomboids tendon insertion on the medial border of the scapula. It was also reproducible upon local palpation by the examiner. Four of these patients also referred pain in the region of the insertion of the infraspinatus and teres minor. After arthroscopic stabilisation the shoulder was immobilised in a sling with the arm in the neutral rotation for a period of 4 weeks. A single physician supervised shoulder rehabilitation. After a mean time of 6.8 months of follow-up, all the shoulder scores were significantly improved and, moreover, at the same time the patients referred the disappearance of the posterior pain. Posterior scapular shoulder pain seems to be another complaint and sign that can be found in patients affected by anterior shoulder instability

  19. Constrained fixed-fulcrum reverse shoulder arthroplasty improves functional outcome in epileptic patients with recurrent shoulder instability

    Science.gov (United States)

    Thangarajah, Tanujan; Higgs, Deborah; Bayley, J I L; Lambert, Simon M

    2016-01-01

    AIM: To report the results of fixed-fulcrum fully constrained reverse shoulder arthroplasty for the treatment of recurrent shoulder instability in patients with epilepsy. METHODS: A retrospective review was conducted at a single facility. Cases were identified using a computerized database and all clinic notes and operative reports were reviewed. All patients with epilepsy and recurrent shoulder instability were included for study. Between July 2003 and August 2011 five shoulders in five consecutive patients with epilepsy underwent fixed-fulcrum fully constrained reverse shoulder arthroplasty for recurrent anterior shoulder instability. The mean duration of epilepsy in the cohort was 21 years (range, 5-51) and all patients suffered from grand mal seizures. RESULTS: Mean age at the time of surgery was 47 years (range, 32-64). The cohort consisted of four males and one female. Mean follow-up was 4.7 years (range, 4.3-5 years). There were no further episodes of instability, and no further stabilisation or revision procedures were performed. The mean Oxford shoulder instability score improved from 8 preoperatively (range, 5-15) to 30 postoperatively (range, 16-37) (P = 0.015) and the mean subjective shoulder value improved from 20 (range, 0-50) preoperatively to 60 (range, 50-70) postoperatively (P = 0.016). Mean active forward elevation improved from 71° preoperatively (range, 45°-130°) to 100° postoperatively (range, 80°-90°) and mean active external rotation improved from 15° preoperatively (range, 0°-30°) to 40° (20°-70°) postoperatively. No cases of scapular notching or loosening were noted. CONCLUSION: Fixed-fulcrum fully constrained reverse shoulder arthroplasty should be considered for the treatment of recurrent shoulder instability in patients with epilepsy. PMID:27458554

  20. Posterior shoulder instability following anatomic total shoulder arthroplasty: A case report and review of management

    Directory of Open Access Journals (Sweden)

    Joseph W Galvin

    2015-01-01

    Full Text Available We report a case of posterior shoulder instability following anatomic total shoulder arthroplasty (TSA. In addition, we present guidelines to aid in the management of posterior instability after TSA. A 50-year-old male underwent anatomic TSA for glenohumeral osteoarthritis. Postoperatively, the patient developed posterior instability secondary to glenoid retroversion. He did not improve despite conservative treatment. He underwent an arthroscopic posterior bone block procedure, 4-month after his index arthroplasty. At 14-month follow-up, the patient had regained near full motion and strength, and radiographs demonstrated osseous integration with no evidence of component loosening. Posterior instability following TSA is a relatively rare complication and challenging to manage. The posterior, arthroscopic iliac crest bone block grafting procedure represents a treatment option for posterior instability in the setting of a stable glenoid prosthesis following TSA.

  1. Current and future treatment of amyloid diseases.

    Science.gov (United States)

    Ankarcrona, M; Winblad, B; Monteiro, C; Fearns, C; Powers, E T; Johansson, J; Westermark, G T; Presto, J; Ericzon, B-G; Kelly, J W

    2016-08-01

    There are more than 30 human proteins whose aggregation appears to cause degenerative maladies referred to as amyloid diseases or amyloidoses. These disorders are named after the characteristic cross-β-sheet amyloid fibrils that accumulate systemically or are localized to specific organs. In most cases, current treatment is limited to symptomatic approaches and thus disease-modifying therapies are needed. Alzheimer's disease is a neurodegenerative disorder with extracellular amyloid β-peptide (Aβ) fibrils and intracellular tau neurofibrillary tangles as pathological hallmarks. Numerous clinical trials have been conducted with passive and active immunotherapy, and small molecules to inhibit Aβ formation and aggregation or to enhance Aβ clearance; so far such clinical trials have been unsuccessful. Novel strategies are therefore required and here we will discuss the possibility of utilizing the chaperone BRICHOS to prevent Aβ aggregation and toxicity. Type 2 diabetes mellitus is symptomatically treated with insulin. However, the underlying pathology is linked to the aggregation and progressive accumulation of islet amyloid polypeptide as fibrils and oligomers, which are cytotoxic. Several compounds have been shown to inhibit islet amyloid aggregation and cytotoxicity in vitro. Future animal studies and clinical trials have to be conducted to determine their efficacy in vivo. The transthyretin (TTR) amyloidoses are a group of systemic degenerative diseases compromising multiple organ systems, caused by TTR aggregation. Liver transplantation decreases the generation of misfolded TTR and improves the quality of life for a subgroup of this patient population. Compounds that stabilize the natively folded, nonamyloidogenic, tetrameric conformation of TTR have been developed and the drug tafamidis is available as a promising treatment. PMID:27165517

  2. Protocol for Shoulder function training reducing musculoskeletal pain in shoulder and neck: a randomized controlled trial

    OpenAIRE

    Mortensen Ole S; Andersen Lars L; Andersen Christoffer H; Zebis Mette K; Sjøgaard Gisela

    2011-01-01

    Abstract Background Neck and shoulder complaints are common among employees in sedentary occupations characterized by intensive computer use. Such musculoskeletal pain - which is often associated with restricted range of motion and loss of muscle strength - is one of the most common conditions treated by physical therapists. The exact mechanism of neck pain is rarely revealed by clinical examination and the treatment has varied from passive rest to active treatments. Active treatments have of...

  3. Platelet-Rich Plasma for Frozen Shoulder: A Case Report

    Directory of Open Access Journals (Sweden)

    Hamidreza Aslani

    2016-01-01

    Full Text Available Frozen shoulder is a glenohumeral joint disorder that perturbs movement because of adhesion and the existence of fibrosis in the shoulder capsule. Platelet-rich plasma can produce collagen and growth factors, which increases stem cells and consequently enhances the healing. To date, there is no evidence regarding the effectiveness of platelet-rich plasma in frozen shoulder. A 45-year-old man with shoulder adhesive capsulitis volunteered for this treatment. He underwent two consecutive platelet-rich plasma injections at the seventh and eighth month after initiation of symptoms. We measured pain, function, and ROM by the visual analogue scale (VAS, and scores from the Disabilities of the Arm, Shoulder and Hand (DASH questionnaire and goniometer; respectively. After the first injection, the patient reported 60% improvement regarding diurnal shoulder pain, and no night pains. Also, two-fold improvement for ROM and more than 70% improvement for function were reported. This study suggests the use of platelet-rich plasma in frozen shoulder to be tested in randomized trials.

  4. Lipidic characterization of Santa Inês lamb shoulder

    Directory of Open Access Journals (Sweden)

    Christian Albert Carvalho da Cruz

    2011-06-01

    Full Text Available The edible portion of the shoulder of 12 castrated and 12 non-castrated Santa Inês lambs slaughtered at different ages (84, 168, 210, 252 days were used. The shoulders were chemically analyzed to determine the quantity of total lipids, cholesterol, and fatty acids composition. Castrated and non-castrated lambs gained body weight (p = 0.0393, p = 0.0017 and half carcass weight (p = 0.0240, p = 0.0017, respectively. The shoulder weight was increased in the carcasses of non-castrated lambs (p = 0.0110. The edible portion of the shoulder of castrated lambs presented higher total lipids (16.09 g.100 g-1. The cholesterol content was influenced by castration (p = 0.0001 reducing with age. Castrated animals presented higher content of C18:1 T11, CLA, and C18:0. The shoulder weight is only increased with increasing age in the carcasses of non-castrated lambs. Castration influences the cholesterol content of the shoulder; however, both castrated and non-castrated lambs had their cholesterol contents reduced with increasing age. Castration and age interfered in the estearic acid concentration of the edible portion of lamb shoulder.

  5. [Recurrent instability and luxation of the shoulder].

    Science.gov (United States)

    Sedel, L

    1990-04-11

    Instability and recurrent dislocation of the shoulder result from injuries affecting the capsule, ligaments or bones. The positive diagnosis rests on careful clinical investigation where a well-oriented questioning plays an essential role. Paraclinical examinations, such as radiography, ultrasonography, CT and MRI, provide a very accurate assessment of the state of relevant structures. Surgical treatment consists of a stabilizing operation which may be Bankart operation (i.e. suture of the detached capsule onto the anterior part of the glenoid labrum), or a Latarget operation (i.e. screwing of a bony buttress) when the anterior part of the glenoid labrum is deformed by a fracture or worn out by frequent passages of the humeral head. When thoughtfully decided and well executed, these operations regularly give excellent results with resumption of previous activities at the same performance level.

  6. Septic Arthritis of the Shoulder Complicating Pregnancy

    Directory of Open Access Journals (Sweden)

    Sara Raiser

    2014-01-01

    Full Text Available Septic arthropathy leads to rapid joint destruction, impairment, and disability. Staphylococcus can be particularly virulent to bone and joints leading to adverse obstetric events. At 28 of weeks gestation, a patient presented with pyelonephritis and progressive left shoulder pain. Magnetic resonance imaging indicated early clavicular destruction and acromial involvement. Glenohumeral joint aspiration produced Staphylococcus aureus. The patient then had premature rupture of membranes and progressed rapidly to preterm delivery. Placental pathology revealed chorioamnionitis and microabscesses. Treatment of the infected joint required further surgical drainage and bone resection as well as extended antibiotics. It is important to remember that joint pain in pregnancy may indicate infective arthritis, and pyelonephritis can be a source of such an infection. Evaluation includes magnetic resonance imaging and consultation for joint aspiration. Prompt recognition and treatment are necessary to prevent joint destruction.

  7. Histological development of human foetal shoulder joint

    Directory of Open Access Journals (Sweden)

    Sabia Nazir

    2014-02-01

    Results: The bony structures - head of humerus and glenoid fossa and joint cavity appear by 10 weeks which prolongs into bicipital sulcus by 12-1/2 weeks. Synovial tissue appears by 10 weeks and synovial villi appear by 14 weeks. Glenoid labrum, capsular ligament, coracohumeral ligament and superior glenohumeral ligament are seen by 10 weeks. Middle glenohumeral ligament is seen at 12-1/2 weeks while inferior glenohumeral ligament is seen at 14 weeks. Tendon of biceps is seen at 10 weeks. Conclusions: By 10 weeks of gestational age various structures of shoulder joint develop in situ, resembling in form and arrangement as those of adults. From these early stages, development proceeds rapidly to achieve adult characteristics. There are no intermediate stages in between where structures similar to those of lower forms i.e. syn/amphi artroses appear temporarily. [Int J Res Med Sci 2014; 2(1.000: 293-299

  8. Impingement syndrome of the shoulder; Schulterimpingement

    Energy Technology Data Exchange (ETDEWEB)

    Mayerhoefer, M.E. [Klinische Abteilung fuer Osteologie, Klinik fuer Radiodiagnostik der Universitaet Wien (Austria); Klinische Abteilung Radiodiagnostik fuer chirurgische Faecher, Klinik fuer Radiodiagnostik der Universitaet Wien (Austria); Klinische Abteilung fuer Osteologie, Klinik fuer Radiodiagnostik der Universitaet, Waehringer Guertel 18-20, 1090, Wien (Austria); Breitenseher, M.J. [Klinische Abteilung fuer Osteologie, Klinik fuer Radiodiagnostik der Universitaet Wien (Austria); Waldviertelklinikum Horn (Austria)

    2004-06-01

    The impingement syndrome is a clinical entity characterized by shoulder pain due to primary or secondary mechanical irritation of the rotator cuff. The primary factors for the development of impingement are a curved or hook-shaped anterior acromion as well as subacromial osteophytes, which may lead to tearing of the supraspinatus tendon. Secondary impingement is mainly caused by calcific tendinopathy, glenohumeral instability, os acromiale and degenerative changes of the acromioclavicular joint. Conventional radiographs are initially obtained, mainly for evaluation of the bony structures of the shoulder. If available, sonography can be used for detection of lesions and tears of the rotator cuff. Finally, MR-imaging provides detailed information about the relationship of the acromion and the acromioclavicular joint to the rotator cuff itself. In many cases however, no morphologic cause for impingement syndrome can be found. While patients are initially treated conservatively, chronic disease usually requires surgical intervention. (orig.) [German] Das Impingementsyndrom ist ein klinisches Krankheitsbild multifaktorieller Genese, bei dem es primaer oder sekundaer zu einer schmerzhaften mechanischen Beeintraechtigung der Rotatorenmanschette kommt. Als primaere Faktoren gelten ein gebogener oder hakenfoermiger Vorderrand des Akromions oder von diesem entspringende Osteophyten, was zu Laesionen der Supraspinatussehne fuehren kann. Zu den sekundaeren Faktoren zaehlt man v. a. eine Tendinitis calcarea, eine glenohumerale Instabilitaet, ein Os acromiale sowie degenerative Veraenderungen im Bereich des Akromioklavikulargelenks. Bildgebend steht an erster Stelle ein Nativroentgen, mit dem sich die knoechernen Strukturen gut darstellen lassen. Falls vorhanden, kann in weiterer Folge die Sonographie Auskunft ueber den Zustand der Rotatorenmanschette geben. Mit der MRT schliesslich laesst sich die Beziehung von Akromion und gelenkassoziierten Strukturen zur Rotatorenmanschette

  9. POINT CLOUD ORIENTED SHOULDER LINE EXTRACTION IN LOESS HILLY AREA

    Directory of Open Access Journals (Sweden)

    L. Min

    2016-06-01

    Full Text Available Shoulder line is the significant line in hilly area of Loess Plateau in China, dividing the surface into positive and negative terrain (P-N terrains. Due to the point cloud vegetation removal methods of P-N terrains are different, there is an imperative need for shoulder line extraction. In this paper, we proposed an automatic shoulder line extraction method based on point cloud. The workflow is as below: (i ground points were selected by using a grid filter in order to remove most of noisy points. (ii Based on DEM interpolated by those ground points, slope was mapped and classified into two classes (P-N terrains, using Natural Break Classified method. (iii The common boundary between two slopes is extracted as shoulder line candidate. (iv Adjust the filter gird size and repeat step i-iii until the shoulder line candidate matches its real location. (v Generate shoulder line of the whole area. Test area locates in Madigou, Jingbian County of Shaanxi Province, China. A total of 600 million points are acquired in the test area of 0.23km2, using Riegl VZ400 3D Laser Scanner in August 2014. Due to the limit Granted computing performance, the test area is divided into 60 blocks and 13 of them around the shoulder line were selected for filter grid size optimizing. The experiment result shows that the optimal filter grid size varies in diverse sample area, and a power function relation exists between filter grid size and point density. The optimal grid size was determined by above relation and shoulder lines of 60 blocks were then extracted. Comparing with the manual interpretation results, the accuracy of the whole result reaches 85%. This method can be applied to shoulder line extraction in hilly area, which is crucial for point cloud denoising and high accuracy DEM generation.

  10. Point Cloud Oriented Shoulder Line Extraction in Loess Hilly Area

    Science.gov (United States)

    Min, Li; Xin, Yang; Liyang, Xiong

    2016-06-01

    Shoulder line is the significant line in hilly area of Loess Plateau in China, dividing the surface into positive and negative terrain (P-N terrains). Due to the point cloud vegetation removal methods of P-N terrains are different, there is an imperative need for shoulder line extraction. In this paper, we proposed an automatic shoulder line extraction method based on point cloud. The workflow is as below: (i) ground points were selected by using a grid filter in order to remove most of noisy points. (ii) Based on DEM interpolated by those ground points, slope was mapped and classified into two classes (P-N terrains), using Natural Break Classified method. (iii) The common boundary between two slopes is extracted as shoulder line candidate. (iv) Adjust the filter gird size and repeat step i-iii until the shoulder line candidate matches its real location. (v) Generate shoulder line of the whole area. Test area locates in Madigou, Jingbian County of Shaanxi Province, China. A total of 600 million points are acquired in the test area of 0.23km2, using Riegl VZ400 3D Laser Scanner in August 2014. Due to the limit Granted computing performance, the test area is divided into 60 blocks and 13 of them around the shoulder line were selected for filter grid size optimizing. The experiment result shows that the optimal filter grid size varies in diverse sample area, and a power function relation exists between filter grid size and point density. The optimal grid size was determined by above relation and shoulder lines of 60 blocks were then extracted. Comparing with the manual interpretation results, the accuracy of the whole result reaches 85%. This method can be applied to shoulder line extraction in hilly area, which is crucial for point cloud denoising and high accuracy DEM generation.

  11. Serum amyloid A inhibits osteoclast differentiation to maintain macrophage function.

    Science.gov (United States)

    Kim, Jiseon; Yang, Jihyun; Park, Ok-Jin; Kang, Seok-Seong; Yun, Cheol-Heui; Han, Seung Hyun

    2016-04-01

    Serum amyloid A is an acute phase protein that is elevated under inflammatory conditions. Additionally, the serum levels of serum amyloid A are associated with the progression of inflammatory arthritis; thus, serum amyloid A might be involved in the regulation of osteoclast differentiation. In the present study, we examined the effects of serum amyloid A on osteoclast differentiation and function. When bone marrow-derived macrophages, as osteoclast precursors, were stimulated with serum amyloid A in the presence of M-CSF and receptor activator of nuclear factor-κB ligand, osteoclast differentiation and its bone-resorption activity were substantially inhibited. TLR2 was important in the inhibitory effect of serum amyloid A on osteoclast differentiation, because serum amyloid A stimulated TLR2. The inhibitory effect was absent in bone marrow-derived macrophages obtained from TLR2-deficient mice. Furthermore, serum amyloid A inhibited the expression of c-Fos and nuclear factor of activated T cells c1, which are crucial transcription factors for osteoclast differentiation, but prevented downregulation of IFN regulatory factor-8, a negative regulator of osteoclast differentiation. In contrast, serum amyloid A sustained the endocytic capacity of bone marrow-derived macrophages and their ability to induce the proinflammatory cytokines, IL-6, IL-1β, and TNF-α. Taken together, these results suggest that serum amyloid A, when increased by inflammatory conditions, inhibits differentiation of macrophages to osteoclasts, likely to maintain macrophage function for host defense.

  12. A role for amyloid in cell aggregation and biofilm formation.

    Directory of Open Access Journals (Sweden)

    Melissa C Garcia

    Full Text Available Cell adhesion molecules in Saccharomyces cerevisiae and Candida albicans contain amyloid-forming sequences that are highly conserved. We have now used site-specific mutagenesis and specific peptide perturbants to explore amyloid-dependent activity in the Candida albicans adhesin Als5p. A V326N substitution in the amyloid-forming region conserved secondary structure and ligand binding, but abrogated formation of amyloid fibrils in soluble Als5p and reduced cell surface thioflavin T fluorescence. When displayed on the cell surface, Als5p with this substitution prevented formation of adhesion nanodomains and formation of large cellular aggregates and model biofilms. In addition, amyloid nanodomains were regulated by exogenous peptides. An amyloid-forming homologous peptide rescued aggregation and biofilm activity of Als5p(V326N cells, and V326N substitution peptide inhibited aggregation and biofilm activity in Als5p(WT cells. Therefore, specific site mutation, inhibition by anti-amyloid peturbants, and sequence-specificity of pro-amyloid and anti-amyloid peptides showed that amyloid formation is essential for nanodomain formation and activation.

  13. A little-known cause of painful shoulder: os acromiale

    Energy Technology Data Exchange (ETDEWEB)

    Granieri, G.F.; Bacarini, L. [Dipartimento di Radiologia Clinica, Ospedale Regionale, Treviso (Italy)

    1998-02-01

    The incidental discovery of an `os acromiale` might explain some cases of `painful shoulder`: this is what we have observed in three patients. The purpose of our article is to underline the relevance of the axillary roentgenogram of the shoulder for the correct diagnosis of this anomaly. In all patients the radiographic examination was performed using a computed radiography system; moreover we performed a computed tomographic examination of the acromioclavicular portion of the shoulders with three-dimensional reconstructions. (orig.) With 3 figs., 6 refs.

  14. Missed posterior shoulder dislocation with malunited proximal humerus fracture

    Institute of Scientific and Technical Information of China (English)

    Sunil Kumar; Rajesh Kumar Chopra; Abhishek Kashyap; Sumit Arora

    2013-01-01

    Posterior dislocation of the shoulder may be missed or neglected at initial presentation especially in developing countries.We present a case of 40-year-old Indian man who had 3-month missed posterior dislocation of the right shoulder along with malunited fracture of the anatomical neck of the humerus.Open reduction and stabilization with modified McLaughlin procedure was performed.Rotational osteotomy of proximal humerus had to be performed as supplementary procedure to keep the humeral head stable in glenoid cavity during functional range of movements.The patient had excellent result of the shoulder at 3 years follow-up.

  15. Prevalence of shoulder pain after stroke and associated factors

    Directory of Open Access Journals (Sweden)

    M.J. Hadianfar

    2008-01-01

    Full Text Available AbstractBackground and Purpose: Shoulder pain is a common complication from stroke that may cause some rehabilitation limits to achieve functional goals. The information regarding its prevalence and associated factors is limited. This study was conducted to investigate further details pertaining to its associated factors.Materials and Methods: This study was performed on 191 stroke patients at the Physical Medicine and Rehabilitation Ward at Shiraz-Medical School from 2001 to 2004. Each patient was followed up for one year. A questionnaire was prepared containing information about shoulder pain compliant, thorough history and physical examination, previous history of open heart surgery, scoliosis, limited neck range of motion, type of stroke (based on MRI and brain CT, osteoporosis (based on bone mineral density and X ray, shoulder adductor muscles and biceps spasticity (based on ashworth scale. In follow-up visits bi-monthly for one year, the questionnaire was filled out again and if present, shoulder pain was recorded.Results: Most patients developed shoulder pain between 2 and 6 months following their stroke. Forty-nine patients (32.2% developed shoulder pain, 39(79.6% of whom had spastic tone and 8 (16.3% had flaccid tone. In both groups, with shoulder pain and without shoulder pain respectively, 6.7% and 1.9% had a history of open heart surgery, 6.1% and 1% had scoliosis, 67.3% and 35.1% had Intracranial hemorrhage, 73.5% and 23.3% had limited neck range of motion, and 24.5% and 35% had osteopenia.Conclusion: Spasticity was significantly more common in the shoulder pain group, which can be due to capsulitis, soft tissue inflammation (especially ligament and rotator cuff muscle and anteroinferior subluxation of the shoulder. There was a significant statistical correlation between intracranial hemorrhage, reduced neck range of motion, and hemiplegic shoulder pain. It appears that treatment and rehabilitation of spasticity and underlying

  16. Spectrum of shoulder injuries in the baseball pitcher

    International Nuclear Information System (INIS)

    This review describes a range of shoulder injuries experienced by baseball pitchers. It is estimated that more than 57% of pitchers suffer some form of shoulder injury during a playing season. Knowledge of the overhead throwing cycle is crucial for our understanding of these shoulder injuries. Baseball pitchers are prone to rotator cuff tears from tensile overload and impingement. Glenoid labrum degeneration or tears are also common, due to overuse syndrome (micro-instability), internal impingement and microtrauma. An understanding of the lesions involved in overhead throwing is crucial in baseball pitchers, as long-term disability can result from these injuries, sometimes with severe financial consequences to the player. (orig.)

  17. Lipidic characterization of Santa Inês lamb shoulder

    OpenAIRE

    Christian Albert Carvalho da Cruz; Cristiane Leal dos Santos-Cruz; Carmen Josefina Contreras Castillo; Alexilda Oliveira de Souza; Lílian Borges da Silva; Priscila Nunes Brito

    2011-01-01

    The edible portion of the shoulder of 12 castrated and 12 non-castrated Santa Inês lambs slaughtered at different ages (84, 168, 210, 252 days) were used. The shoulders were chemically analyzed to determine the quantity of total lipids, cholesterol, and fatty acids composition. Castrated and non-castrated lambs gained body weight (p = 0.0393, p = 0.0017) and half carcass weight (p = 0.0240, p = 0.0017), respectively. The shoulder weight was increased in the carcasses of non-castrated lambs (p...

  18. POSTTRAUMATIC SHOULDER INSTABILITY IN CHILDREN: CLINICAL PRESENTATION, DIAGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Ярослав Николаевич Прощенко

    2014-09-01

    Full Text Available The article presents an analysis of the treatment of 15 patients with posttraumatic shoulder instability aged 11-17 years, as a result of primary traumatic dislocation and chronic instability. We identified the following causes of chronic shoulder instability: Bankart injury, SLAP-injury; Hill-Sachs defect; fracture of the glenoid, type 3 humeral head-glenoid relation, and retroversion of the humeral head, as well as defects in the treatment of primary shoulder dislocation. Surgical treatment is performed in 7 patients with chronic instability (7 joints. Unsatisfactory result was detected in 1 patient (1 joints, which is caused by a type 3 humeral head-glenoid relation.

  19. Fold modulating function: Bacterial toxins to functional amyloids

    Directory of Open Access Journals (Sweden)

    Adnan Khawaja Syed

    2014-08-01

    Full Text Available Many bacteria produce cytolytic toxins that target host cells or other competing microbes. It is well known that environmental factors control toxin expression, however recent work suggests that some bacteria manipulate the fold of these protein toxins to control their function. The β-sheet rich amyloid fold is a highly stable ordered aggregate that many toxins form in response to specific environmental conditions. When in the amyloid state, toxins become inert, losing the cytolytic activity they display in the soluble form. Emerging evidence suggest that some amyloids function as toxin storage systems until they are again needed, while other bacteria utilize amyloids as a structural matrix component of biofilms. This amyloid matrix component facilitates resistance to biofilm disruptive challenges. The bacterial amyloids discussed in this review reveal an elegant system where changes in protein fold and solubility dictate the function of proteins in response to the environment.

  20. Inhibition of insulin amyloid fibril formation by cyclodextrins.

    Science.gov (United States)

    Kitagawa, Keisuke; Misumi, Yohei; Ueda, Mitsuharu; Hayashi, Yuya; Tasaki, Masayoshi; Obayashi, Konen; Yamashita, Taro; Jono, Hirofumi; Arima, Hidetoshi; Ando, Yukio

    2015-01-01

    Localized insulin-derived amyloid masses occasionally form at the site of repeated insulin injections in patients with insulin-dependent diabetes and cause subcutaneous insulin resistance. Various kinds of insulin including porcine insulin, human insulin, and insulin analogues reportedly formed amyloid fibrils in vitro and in vivo, but the impact of the amino acid replacement in insulin molecules on amyloidogenicity is largely unknown. In the present study, we demonstrated the difference in amyloid fibril formation kinetics of human insulin and insulin analogues, which suggests an important role of the C-terminal domain of the insulin B chain in nuclear formation of amyloid fibrils. Furthermore, we determined that cyclodextrins, which are widely used as drug carriers in the pharmaceutical field, had an inhibitory effect on the nuclear formation of insulin amyloid fibrils. These findings have significant implications for the mechanism underlying insulin amyloid fibril formation and for developing optimal additives to prevent this subcutaneous adverse effect.

  1. Atomic View of a Toxic Amyloid Small Oligomer

    Energy Technology Data Exchange (ETDEWEB)

    Laganowsky, Arthur; Liu, Cong; Sawaya, Michael R.; Whitelegge, Julian P.; Park, Jiyong; Zhao, Minglei; Pensalfini, Anna; Soriaga, Angela B.; Landau, Meytal; Teng, Poh K.; Cascio, Duilio; Glabe, Charles; Eisenberg, David (UCI); (UCLA)

    2012-04-30

    Amyloid diseases, including Alzheimer's, Parkinson's, and the prion conditions, are each associated with a particular protein in fibrillar form. These amyloid fibrils were long suspected to be the disease agents, but evidence suggests that smaller, often transient and polymorphic oligomers are the toxic entities. Here, we identify a segment of the amyloid-forming protein {alpha}{beta} crystallin, which forms an oligomeric complex exhibiting properties of other amyloid oligomers: {beta}-sheet-rich structure, cytotoxicity, and recognition by an oligomer-specific antibody. The x-ray-derived atomic structure of the oligomer reveals a cylindrical barrel, formed from six antiparallel protein strands, that we term a cylindrin. The cylindrin structure is compatible with a sequence segment from the {beta}-amyloid protein of Alzheimer's disease. Cylindrins offer models for the hitherto elusive structures of amyloid oligomers.

  2. Shoulder arthroplasty with the Neer Mark-II prosthesis

    DEFF Research Database (Denmark)

    Frich, Lars Henrik; Møller, B.N.; Sneppen, O.

    1988-01-01

    Total shoulder joint replacement was used as primary intervention in 50 shoulders--35 with rheumatoid arthritis, eight with osteoarthritis, and seven with traumatic arthritis. Follow-up time was 27 (12-42) months. The primary indication for the operation was chronic severe pain; improvements...... in motion and function were secondary objectives. Relief of pain was obtained in 46 of 50 shoulders. The best results regarding pain, motion, and function were obtained in the osteoarthritic group. The majority of patients with rheumatoid arthritis obtained pain relief and the largest increase in range...... of motion occurred in this group, although full range of motion was never regained. The results in patients with traumatic arthritis seemed unpredictable. Two shoulders were complicated by glenoid loosening, one by humeral subluxation, and one by musculocutaneous nerve palsy....

  3. Missed posterior shoulder dislocation with malunited proximal humerus fracture

    Directory of Open Access Journals (Sweden)

    Kumar Sunil

    2013-12-01

    Full Text Available 【Abstract】Posterior dislocation of the shoulder may be missed or neglected at initial presentation especially in developing countries. We present a case of 40-year-old In- dian man who had 3-month missed posterior dislocation of the right shoulder along with malunited fracture of the ana- tomical neck of the humerus. Open reduction and stabiliza- tion with modified McLaughlin procedure was performed. Rotational osteotomy of proximal humerus had to be per- formed as supplementary procedure to keep the humeral head stable in glenoid cavity during functional range of movements. The patient had excellent result of the shoulder at 3 years follow-up. Key words: Shoulder dislocation; Humerus; Osteotomy

  4. Clinical Measures of Shoulder Mobility in the Professional Baseball Player

    OpenAIRE

    Downar, Jacquelyn M; Sauers, Eric L.

    2005-01-01

    Context: Professional baseball players must achieve a delicate balance between shoulder mobility and stability to attain optimal sports performance. The sport-specific demands of repetitive overhead throwing may result in an altered mobility-stability relationship.

  5. Measurement and Quantification of Gross Human Shoulder Motion

    Directory of Open Access Journals (Sweden)

    Jeremy T. Newkirk

    2013-01-01

    Full Text Available The shoulder girdle plays an important role in the large pointing workspace that humans enjoy. The goal of this work was to characterize the human shoulder girdle motion in relation to the arm. The overall motion of the human shoulder girdle was characterized based on motion studies completed on test subjects during voluntary (natural/unforced motion. The collected data from the experiments were used to develop surface fit equations that represent the position and orientation of the glenohumeral joint for a given humeral pointing direction. These equations completely quantify gross human shoulder girdle motion relative to the humerus. The equations are presented along with goodness-of-fit results that indicate the equations well approximate the motion of the human glenohumeral joint. This is the first time the motion has been quantified for the entire workspace, and the equations provide a reference against which to compare future work.

  6. Simple self-reduction method for anterior shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Reiner Wirbel

    2014-01-01

    Conclusion: The presented Boss-Holzach-Matter method for reduction of anterior shoulder dislocation is a simple method without the need of anaesthesia, but cooperation from patients is crucial. The successful rate is comparable with other established methods.

  7. Shoulder arthroplasty. Part 1: Prosthesis terminology and classification

    Energy Technology Data Exchange (ETDEWEB)

    Sheridan, B.D., E-mail: bdsheridan@hotmail.com [Department of Orthopaedic Surgery, Bristol Royal Infirmary, Bristol (United Kingdom); Ahearn, N.; Tasker, A.; Wakeley, C.; Sarangi, P. [Department of Orthopaedic Surgery, Bristol Royal Infirmary, Bristol (United Kingdom)

    2012-07-15

    Shoulder arthroplasty is the third most common joint replacement procedure in the UK, and there are a number of different implant options available to surgeons to treat a variety of shoulder disorders. With an increasing burden placed on clinical follow-up, more patients are remaining under the care of their general practitioners and musculoskeletal triage assessment services and are not necessarily being seen by specialists. Referrals to orthopaedic specialists are therefore often prompted by radiological reports describing evidence of implant failure. This article is the first of two reviews on shoulder arthroplasty, concentrating on implant features and the indications for their use. The second article will address the modes of failure of shoulder arthroplasty and describe the relevant associated radiological features.

  8. Sports-related shoulder dislocations: a state-hospital experience.

    Science.gov (United States)

    Hazmy, C H Wan; Parwathi, A

    2005-07-01

    This retrospective study was conducted in a state hospital set-up and aimed at identifying the incidence of sports-related shoulder dislocations and their characteristics and the sports events involved. All patients with shoulder dislocation related to sporting activities admitted to the hospital from January 1999 to December 2002 were included in the study. There were 18 sports-related shoulder dislocations out of 106 all shoulder dislocations admitted during this 4-year period. The average age of the patients was 25.4 years. All but two were male. All were anterior dislocations. Recurrent dislocation constitutes 78% of the cases with an average of 3 times re-dislocation. Rugby and badminton were the major contributors to the injuries followed by volleyball, soccer and swimming. Conservative treatment was successfully instituted for 88% of the patients and 12% opted for surgical intervention.

  9. Simulations of nucleation and elongation of amyloid fibrils

    OpenAIRE

    Zhang, Jianing; Muthukumar, M.

    2009-01-01

    We present a coarse-grained model for the growth kinetics of amyloid fibrils from solutions of peptides and address the fundamental mechanism of nucleation and elongation by using a lattice Monte Carlo procedure. We reproduce the three main characteristics of nucleation of amyloid fibrils: (1) existence of lag time, (2) occurrence of a critical concentration, and (3) seeding. We find the nucleation of amyloid fibrils to require a quasi-two-dimensional configuration, where a second layer of β ...

  10. Physical and structural basis for polymorphism in amyloid fibrils

    OpenAIRE

    Tycko, Robert

    2014-01-01

    As our understanding of the molecular structures of amyloid fibrils has matured over the past 15 years, it has become clear that, while amyloid fibrils do have well-defined molecular structures, their molecular structures are not uniquely determined by the amino acid sequences of their constituent peptides and proteins. Self-propagating molecular-level polymorphism is a common phenomenon. This article reviews current information about amyloid fibril structures, variations in molecular structu...

  11. New Insights in the Amyloid-Beta Interaction with Mitochondria

    OpenAIRE

    Carlos Spuch; Saida Ortolano; Carmen Navarro

    2012-01-01

    Biochemical and morphological alterations of mitochondria may play an important role in the pathogenesis of Alzheimer’s disease (AD). Particularly, mitochondrial dysfunction is a hallmark of amyloid-beta-induced neuronal toxicity in Alzheimer’s disease. The recent emphasis on the intracellular biology of amyloid-beta and its precursor protein (APP) has led researchers to consider the possibility that mitochondria-associated and mitochondrial amyloid-beta may directly cause neurotoxicity. Both...

  12. Generation of amyloid-β is reduced by the interaction of calreticulin with amyloid precursor protein, presenilin and nicastrin.

    Directory of Open Access Journals (Sweden)

    Nina Stemmer

    Full Text Available Dysregulation of the proteolytic processing of amyloid precursor protein by γ-secretase and the ensuing generation of amyloid-β is associated with the pathogenesis of Alzheimer's disease. Thus, the identification of amyloid precursor protein binding proteins involved in regulating processing of amyloid precursor protein by the γ-secretase complex is essential for understanding the mechanisms underlying the molecular pathology of the disease. We identified calreticulin as novel amyloid precursor protein interaction partner that binds to the γ-secretase cleavage site within amyloid precursor protein and showed that this Ca(2+- and N-glycan-independent interaction is mediated by amino acids 330-344 in the C-terminal C-domain of calreticulin. Co-immunoprecipitation confirmed that calreticulin is not only associated with amyloid precursor protein but also with the γ-secretase complex members presenilin and nicastrin. Calreticulin was detected at the cell surface by surface biotinylation of cells overexpressing amyloid precursor protein and was co-localized by immunostaining with amyloid precursor protein and presenilin at the cell surface of hippocampal neurons. The P-domain of calreticulin located between the N-terminal N-domain and the C-domain interacts with presenilin, the catalytic subunit of the γ-secretase complex. The P- and C-domains also interact with nicastrin, another functionally important subunit of this complex. Transfection of amyloid precursor protein overexpressing cells with full-length calreticulin leads to a decrease in amyloid-β42 levels in culture supernatants, while transfection with the P-domain increases amyloid-β40 levels. Similarly, application of the recombinant P- or C-domains and of a synthetic calreticulin peptide comprising amino acid 330-344 to amyloid precursor protein overexpressing cells result in elevated amyloid-β40 and amyloid-β42 levels, respectively. These findings indicate that the interaction of

  13. Surgical techniques to minimize shoulder pain after laparoscopic cholecystectomy

    DEFF Research Database (Denmark)

    Donatsky, Anders Meller; Bjerrum, Flemming; Gögenür, Ismayil

    2013-01-01

    BACKGROUND: Laparoscopic cholecystectomy (LC) is the treatment of choice for symptomatic cholecystolithiasis. Despite the many advantages over open surgery, many patients complain about referred pain to the shoulder during the postoperative course. The purpose of this review was to evaluate...... different intraoperative surgical methods to minimize shoulder pain (SP). METHODS: A search of the literature was conducted using PubMed, Excerpta Medica Database (EMBASE), and Cochrane database of systematic reviews. Eligibility criteria were: randomized clinical trials or meta-analysis evaluating...

  14. Radiotherapy for shoulder impingement; Bestrahlung beim Impingementsyndrom des Schultergelenks

    Energy Technology Data Exchange (ETDEWEB)

    Adamietz, B. [Universitaetsklinikum Erlangen (Germany). Inst. fuer Radiologie; Sauer, R.; Keilholz, L. [Universitaetsklinikum Erlangen (Germany). Strahlentherapeutische Klinik

    2008-05-15

    Background and Purpose: Up to now, degenerative shoulder diseases were summarized by the term 'periarthritis humeroscapularis'. Actual shoulder diseases can be differentiated etiopathologically according to a primary and secondary impingement syndrome. Narrowing of the subacromial space, which is caused by an osseous shape variant, leads to primary impingement. Secondary impingement develops, when the subacromial space is reduced by swelling tissue below the osseous shoulder roof. This study aimed for the exact diagnosis to indicate therapy and to classify the results according to the Constant score. Patients and Methods: From August 1999 to September 2002, 102 patients with 115 shoulder joint conditions underwent radiation therapy (RT). All joints received two RT series (6 x 0.5 Gy/series) applied in two to three weekly fractions, totaling a dosage of 6.0 Gy (250 kV, 15 mAs, 1-mm Cu filter). The second RT course started 6 weeks after the end of the first. 115 shoulders were examined before RT, 6 weeks after the second RT course and, finally, during the follow-up from January to May 2003. Results: Pain relief was achieved in 94/115 shoulder joints (82%) after 18-month follow-up (median). A significant difference existed between secondary impingement and primary/non-impingement according to response. Tendinosis calcarea, bursitis subdeltoidea, tendovaginitis of the long biceps tendon, and capsulitis adhaesiva responded well to therapy. Conclusion: Shoulder diseases of secondary impingement demonstrate a good response to RT. Less or no benefit was found in primary impingement syndrome or complete rotator cuff disruption and acute shoulder injuries, respectively. (orig.)

  15. Aquaflo pump vs FMS 4 pump for shoulder arthroscopic surgery.

    OpenAIRE

    Ampat, G.; Bruguera, J.; Copeland, S A

    1997-01-01

    A prospective controlled trial was carried out to compare two different fluid delivery systems used for shoulder arthroscopy. One an advanced pump system that controls both pressure and flow of fluid delivered, the other an air-driven diaphragm pump that only controls fluid pressure. Blood loss, presence of bleeding vessels and visual clarity were parameters used to assess the pump systems. There was no difference between the pumps in straightforward shoulder procedures. However, complicated ...

  16. Bilateral Traumatic Anterior Dislocation of Shoulder – a rare entity

    OpenAIRE

    Yashavantha Kumar C; Nalini K B; Lalit Maini; Prashanth Nagaraj

    2013-01-01

    Introduction: Bilateral shoulder dislocation are most commonly posterior type. These are most commonly due to seizure disorder and electrocution. Anterior shoulder dislocations occurring bilaterally without any predisposing factors are very rare. These types of injuries are due to trauma with a unique mechanism of injury. To best of our knowledge there are only few cases of similar kind are reported in literature. We hereby report a interesting case of posttraumatic, bilateral anterior dislo...

  17. Interscalene brachial plexus blocks in the management of shoulder dislocations.

    OpenAIRE

    Underhill, T J; Wan, A; Morrice, M

    1989-01-01

    Interscalene brachial plexus block is a simple and effective alternative to intravenous benzodiazepines or general anaesthesia for manipulation of the dislocated shoulder. Thirty interscalene brachial plexus blocks were performed on 29 patients with dislocations of the shoulder to provide regional anaesthesia for reduction. Pain was abolished by 14 out of the 30 blocks performed, improved by 13 and unchanged by three. Muscle relaxation (MRC grade 3 or less) occurred in 21 patients. In 26 case...

  18. New aspects in pathogenesis and therapy of shoulder instability

    OpenAIRE

    Krüger, David Richard

    2015-01-01

    Introduction: Instability of the glenohumeral joint is accompanied by macroscopic changes of the static stabilizers. Not much evidence is available whether these changes can be found on microscopic level and if they are influenced by demographic variables. Conservative and operative therapy options are available for the treatment of shoulder instability. Patients with failed operative shoulder stabilization resemble a special collective in which the value of arthroscopy for revision stabi...

  19. Subacronial shoulder complaints in physiotherapy an general practice.

    OpenAIRE

    Kooijman, M.; Swinkels, I.; Veenhof, C.

    2011-01-01

    Purpose: The aim of this study is to describe the patient population and the process of care in patients with subacromial shoulder complaints both in physiotherapy and in general practice. Relevance: Shoulder complaints are common in the daily practice of a general practitioner (GP) and physiotherapist. They often have a recurrent and lengthy clinical course and substantial disability in daily livingmayresult from it, leading to consumption of medical health care and sick leave from work. Abo...

  20. The Classic: Shoulder and Elbow Lesions Distinctive of Baseball Players

    OpenAIRE

    Bennett, George E.

    2012-01-01

    This Classic Article is a reprint of the original work by G. Bennett, Shoulder and Elbow Lesions Distinctive of Baseball Players. An accompanying biographical sketch of G. Bennett is available at DOI 10.1007/s11999-012-2334-3. The Classic Article is ©1947 and is reprinted with permission from Wolters Kluwer Health from Bennett G. Shoulder and elbow lesions distinctive of baseball players. Ann Surg. 1947;126:107–110.

  1. Mini-Open Latarjet Procedure for Recurrent Anterior Shoulder Instability

    Directory of Open Access Journals (Sweden)

    Numa Mercier

    2011-01-01

    Full Text Available Anterior shoulder instability is a common problem. The Latarjet procedure has been advocated as an option for the treatment of anteroinferior shoulder instability. The purpose of this paper is to explain our surgical procedure titled “Mini-open Latarjet Procedure.” We detailed patient positioning, skin incision, subscapularis approach, and coracoid fixation. Then, we reviewed the literature to evaluate the clinical outcomes of this procedure.

  2. Audit on necessity of radiographs in anterior shoulder dislocations

    OpenAIRE

    K. Ahmadi, M.D; M. Mofidi, M.D.

    2008-01-01

    AbstractBackground and Purpose: Anterior shoulder dislocation is the most common major joint dislocation. In most cases, this dislocation is being relocated in emergency departments. Routinely, pre and post reduction radiographs are performed. This study was done to determine the necessity of radiographs in the emergency department for management of patients with suspected anterior shoulder dislocation.Materials and Methods: In this case series study, 116 patients suspected of anterior should...

  3. Glenoid Dysplasia in the Recurrent Shoulder Dislocation: A Case Report

    OpenAIRE

    Hamza Sucuoglu

    2016-01-01

    Glenoid dysplasia, which is often ignored, is a rare developmental anomaly. In most cases the patients remain asymptomatic. Although glenoid dysplasia has been diagnosed by incidentally on chest radiograph, also it has been described because of the developing instability of shoulder joint. Our young male patient who has recurrent dislocation of the shoulder-joint 4-5 times a year for last 5 years, dislocation has been reduced in the emergency department and he has been discharged from hospita...

  4. Arthroscopic Shoulder Surgery in Female Professional Tennis Players

    OpenAIRE

    Young, Simon W.; Safran, Marc R.; Dakic, Jodie; Nguyen, Michael L.; Stroia, Kathleen

    2013-01-01

    Objectives: Recent publications have highlighted the relatively poor outcome of other overhead athletes, particularly baseball players, with regard to return to sports at the same or higher level after shoulder surgery. However, true assessment of their ability when returning to sport is not as clear. Further, ability to return to other overhead sports has not been reported. Our objective was to assess outcome and time to return to previous level of function following shoulder surgery in prof...

  5. Injections and physiotherapy for the painful stiff shoulder.

    OpenAIRE

    Dacre, J E; Beeney, N; Scott, D L

    1989-01-01

    Cost effective treatment is needed for common self limiting rheumatological conditions. Periarthritis of the shoulder is an example. There is no consensus for one type of treatment, though local steroids or physiotherapy are conventionally used. Their cost and efficacy were compared in a prospective randomised observer-blind trial--in essence a medical audit of the treatment of a common rheumatological problem. Sixty two consecutive patients presenting with a painful stiff shoulder were studi...

  6. Prions, amyloids, and RNA: Pieces of a puzzle.

    Science.gov (United States)

    Nizhnikov, Anton A; Antonets, Kirill S; Bondarev, Stanislav A; Inge-Vechtomov, Sergey G; Derkatch, Irina L

    2016-05-01

    Amyloids are protein aggregates consisting of fibrils rich in β-sheets. Growth of amyloid fibrils occurs by the addition of protein molecules to the tip of an aggregate with a concurrent change of a conformation. Thus, amyloids are self-propagating protein conformations. In certain cases these conformations are transmissible / infectious; they are known as prions. Initially, amyloids were discovered as pathological extracellular deposits occurring in different tissues and organs. To date, amyloids and prions have been associated with over 30 incurable diseases in humans and animals. However, a number of recent studies demonstrate that amyloids are also functionally involved in a variety of biological processes, from biofilm formation by bacteria, to long-term memory in animals. Interestingly, amyloid-forming proteins are highly overrepresented among cellular factors engaged in all stages of mRNA life cycle: from transcription and translation, to storage and degradation. Here we review rapidly accumulating data on functional and pathogenic amyloids associated with mRNA processing, and discuss possible significance of prion and amyloid networks in the modulation of key cellular functions. PMID:27248002

  7. Myositis ossificans around shoulder following military training programme

    Directory of Open Access Journals (Sweden)

    Mustafa C Kir

    2011-01-01

    Full Text Available The myositis ossificans around shoulder in military recruits are not reported yet. Three young male soldiers presented with complaints of palpable mass at the anterior aspect of shoulder; tenderness around the superior part of deltopectoral groove close to acromioclavicular joint; and restriction of shoulder motion. They also noticed ecchymosis and pain around the coracoid process and anterior shoulder region during regular firing exercises. Plain X-rays and computerized tomography showed extra-capsular, dense, irregular structure in the space between pectoralis and deltoid muscles which correlated with heterotopic bone. One patient refused surgical intervention because of the completion of his military serving period. Surgical excision was performed for the other two patients. During surgical exploration, both ossified masses were found in deltopectoral region and mostly in fibers of clavicular and acromial parts of deltoid muscle. Pathological reports confirmed the structure of masses as mature trabecular bone. Postoperatively indomethacin treatment and active shoulder exercises were started until the full range of motion was regained. Mini soft bag was used on the rifle contact area of the shoulder. No complications or recurrences were observed during the 24 months of followup period.

  8. Shoulder injuries attributed to resistance training: a brief review.

    Science.gov (United States)

    Kolber, Morey J; Beekhuizen, Kristina S; Cheng, Ming-Shun S; Hellman, Madeleine A

    2010-06-01

    The popularity of resistance training (RT) is evident by the more than 45 million Americans who engage in strength training regularly. Although the health and fitness benefits ascribed to RT are generally agreed upon, participation is not without risk. Acute and chronic injuries attributed to RT have been cited in the epidemiological literature among both competitive and recreational participants. The shoulder complex in particular has been alluded to as one of the most prevalent regions of injury. The purpose of this manuscript is to present an overview of documented shoulder injuries among the RT population and where possible discern mechanisms of injury and risk factors. A literature search was conducted in the PUBMED, CINAHL, SPORTDiscus, and OVID databases to identify relevant articles for inclusion using combinations of key words: resistance training, shoulder, bodybuilding, weightlifting, shoulder injury, and shoulder disorder. The results of the review indicated that up to 36% of documented RT-related injuries and disorders occur at the shoulder complex. Trends that increased the likelihood of injury were identified and inclusive of intrinsic risk factors such as joint and muscle imbalances and extrinsic risk factors, namely, that of improper attention to exercise technique. A majority of the available research was retrospective in nature, consisting of surveys and descriptive epidemiological reports. A paucity of research was available to identify predictive variables leading to injury, suggesting the need for future prospective-based investigations.

  9. Amyloid Beta-peptide (25-35) changes (Ca2+) in hippocampal neurons

    DEFF Research Database (Denmark)

    Mogensen, Helle Smidt; Beatty, Diane; Morris, Stephen;

    1998-01-01

    neuroscience, Alzheimer, calcium ion, hippocampal neurons, amyloid-beta-peptide, hydrogen ion, rat......neuroscience, Alzheimer, calcium ion, hippocampal neurons, amyloid-beta-peptide, hydrogen ion, rat...

  10. Amyloid-beta Alzheimer targets — protein processing, lipid rafts, and amyloid-beta pores

    Science.gov (United States)

    Arbor, Sage C.; LaFontaine, Mike; Cumbay, Medhane

    2016-01-01

    Amyloid beta (Aβ), the hallmark of Alzheimer’s Disease (AD), now appears to be deleterious in its low number aggregate form as opposed to the macroscopic Aβ fibers historically seen postmortem. While Alzheimer targets, such as the tau protein, amyloid precursor protein (APP) processing, and immune system activation continue to be investigated, the recent discovery that amyloid beta aggregates at lipid rafts and likely forms neurotoxic pores has led to a new paradigm regarding why past therapeutics may have failed and how to design the next round of compounds for clinical trials. An atomic resolution understanding of Aβ aggregates, which appear to exist in multiple conformations, is most desirable for future therapeutic development. The investigative difficulties, structures of these small Aβ aggregates, and current therapeutics are summarized in this review. PMID:27505013

  11. Amyloid-beta Alzheimer targets - protein processing, lipid rafts, and amyloid-beta pores.

    Science.gov (United States)

    Arbor, Sage C; LaFontaine, Mike; Cumbay, Medhane

    2016-03-01

    Amyloid beta (Aβ), the hallmark of Alzheimer's Disease (AD), now appears to be deleterious in its low number aggregate form as opposed to the macroscopic Aβ fibers historically seen postmortem. While Alzheimer targets, such as the tau protein, amyloid precursor protein (APP) processing, and immune system activation continue to be investigated, the recent discovery that amyloid beta aggregates at lipid rafts and likely forms neurotoxic pores has led to a new paradigm regarding why past therapeutics may have failed and how to design the next round of compounds for clinical trials. An atomic resolution understanding of Aβ aggregates, which appear to exist in multiple conformations, is most desirable for future therapeutic development. The investigative difficulties, structures of these small Aβ aggregates, and current therapeutics are summarized in this review. PMID:27505013

  12. Formation of Toxic Amyloid Fibrils by Amyloid β-Protein on Ganglioside Clusters

    Directory of Open Access Journals (Sweden)

    Katsumi Matsuzaki

    2011-01-01

    Full Text Available It is widely accepted that the conversion of the soluble, nontoxic amyloid β-protein (Aβ monomer to aggregated toxic Aβ rich in β-sheet structures is central to the development of Alzheimer’s disease. However, the mechanism of the abnormal aggregation of Aβ in vivo is not well understood. Accumulating evidence suggests that lipid rafts (microdomains in membranes mainly composed of sphingolipids (gangliosides and sphingomyelin and cholesterol play a pivotal role in this process. This paper summarizes the molecular mechanisms by which Aβ aggregates on membranes containing ganglioside clusters, forming amyloid fibrils. Notably, the toxicity and physicochemical properties of the fibrils are different from those of Aβ amyloids formed in solution. Furthermore, differences between Aβ-(1–40 and Aβ-(1–42 in membrane interaction and amyloidogenesis are also emphasized.

  13. An MRI study on the relations between muscle atrophy, shoulder function and glenohumeral deformity in shoulders of children with obstetric brachial plexus injury

    OpenAIRE

    van Doorn-Loogman Mirjam H; Mullender Margriet G; van Kooten Ed O; van Gelein Vitringa Valerie M; van der Sluijs Johannes A

    2009-01-01

    Abstract Background A substantial number of children with an obstetric brachial plexus lesion (OBPL) will develop internal rotation adduction contractures of the shoulder, posterior humeral head subluxations and glenohumeral deformities. Their active shoulder function is generally limited and a recent study showed that their shoulder muscles were atrophic. This study focuses on the role of shoulder muscles in glenohumeral deformation and function. Methods This is a prospective study on 24 chi...

  14. Partial Volume Correction in Quantitative Amyloid Imaging

    Science.gov (United States)

    Su, Yi; Blazey, Tyler M.; Snyder, Abraham Z.; Raichle, Marcus E.; Marcus, Daniel S.; Ances, Beau M.; Bateman, Randall J.; Cairns, Nigel J.; Aldea, Patricia; Cash, Lisa; Christensen, Jon J.; Friedrichsen, Karl; Hornbeck, Russ C.; Farrar, Angela M.; Owen, Christopher J.; Mayeux, Richard; Brickman, Adam M.; Klunk, William; Price, Julie C.; Thompson, Paul M.; Ghetti, Bernardino; Saykin, Andrew J.; Sperling, Reisa A.; Johnson, Keith A.; Schofield, Peter R.; Buckles, Virginia; Morris, John C.; Benzinger, Tammie. LS.

    2014-01-01

    Amyloid imaging is a valuable tool for research and diagnosis in dementing disorders. As positron emission tomography (PET) scanners have limited spatial resolution, measured signals are distorted by partial volume effects. Various techniques have been proposed for correcting partial volume effects, but there is no consensus as to whether these techniques are necessary in amyloid imaging, and, if so, how they should be implemented. We evaluated a two-component partial volume correction technique and a regional spread function technique using both simulated and human Pittsburgh compound B (PiB) PET imaging data. Both correction techniques compensated for partial volume effects and yielded improved detection of subtle changes in PiB retention. However, the regional spread function technique was more accurate in application to simulated data. Because PiB retention estimates depend on the correction technique, standardization is necessary to compare results across groups. Partial volume correction has sometimes been avoided because it increases the sensitivity to inaccuracy in image registration and segmentation. However, our results indicate that appropriate PVC may enhance our ability to detect changes in amyloid deposition. PMID:25485714

  15. Design and Construction of Large Amyloid Fibers

    Directory of Open Access Journals (Sweden)

    Devin M. Ridgley

    2015-04-01

    Full Text Available Mixtures of “template” and “adder” proteins self-assemble into large amyloid fibers of varying morphology and modulus. Fibers range from low modulus, rectangular cross-sectioned tapes to high modulus, circular cross-sectioned cylinders. Varying the proteins in the mixture can elicit “in-between” morphologies, such as elliptical cross-sectioned fibers and twisted tapes, both of which have moduli in-between rectangular tapes and cylindrical fibers. Experiments on mixtures of proteins of known amino acid sequence show that control of the large amyloid fiber morphology is dependent on the amount of glutamine repeats or “Q-blocks” relative to hydrophobic side chained amino acids such as alanine, isoleucine, leucine, and valine in the adder protein. Adder proteins with only hydrophobic groups form low modulus rectangular cross-sections and increasing the Q-block content allows excess hydrogen bonding on amide groups that results in twist and higher modulus. The experimental results show that large amyloid fibers of specific shape and modulus can be designed and controlled at the molecular level.

  16. Outcomes Study of the TM Reverse Shoulder System Used in Primary or Revision Reverse Total Shoulder Arthroplasty

    Science.gov (United States)

    2016-05-11

    Osteoarthritis; Rheumatoid Arthritis; Post-traumatic Arthritis; Ununited Humeral Head Fracture; Irreducible 3-and 4-part Proximal Humeral Fractures; Avascular Necrosis; Gross Rotator Cuff Deficiency; Failed Total Shoulder Arthroplasty (Both Glenoid and Humeral Components Require Revision

  17. Amyloid-β and Astrocytes Interplay in Amyloid-β Related Disorders.

    Science.gov (United States)

    Batarseh, Yazan S; Duong, Quoc-Viet; Mousa, Youssef M; Al Rihani, Sweilem B; Elfakhri, Khaled; Kaddoumi, Amal

    2016-01-01

    Amyloid-β (Aβ) pathology is known to promote chronic inflammatory responses in the brain. It was thought previously that Aβ is only associated with Alzheimer's disease and Down syndrome. However, studies have shown its involvement in many other neurological disorders. The role of astrocytes in handling the excess levels of Aβ has been highlighted in the literature. Astrocytes have a distinctive function in both neuronal support and protection, thus its involvement in Aβ pathological process may tip the balance toward chronic inflammation and neuronal death. In this review we describe the involvement of astrocytes in Aβ related disorders including Alzheimer's disease, Down syndrome, cerebral amyloid angiopathy, and frontotemporal dementia. PMID:26959008

  18. Dexamethasone for pain after outpatient shoulder surgery

    DEFF Research Database (Denmark)

    Bjørnholdt, K. T.; Mønsted, P. N.; Søballe, Kjeld;

    2014-01-01

    Background Dexamethasone has analgesic properties when given intravenously before surgery, but the optimal dose has not been determined. We hypothesised that a dose of 40 mg dexamethasone would improve analgesia after outpatient shoulder surgery compared with 8 mg. Methods A randomised, double......) or placebo (D0) before surgery. The primary outcome was pain intensity 8 h after surgery rated on a numeric rating scale of 0 to 10. Secondary outcomes were pain intensity, analgesic consumption and side effects during the first 3 days after surgery. Results Data from 73 patients were available for analysis......: (D40: 25, D8: 26, D0: 22 patients). Eight hours after surgery, pain intensity were: [median (interquartile range)] group D40: 2 (1–4), group D8: 2.5 (1–5), group D0: 4 (2–7). There was no significant difference in pain intensity between group D40 and D8 after 8 h (P = 0.46) or at any other time. When...

  19. Hydraulic design of pervious concrete highway shoulders

    Science.gov (United States)

    Grahl, Nathan Andrew

    Stormwater drainage has been a factor in roadway design for years. Now stormwater quantity and quality are also becoming regulated for roadways. As regulations of stormwater management continue to increase so does the need for more viable and effect management practices. The research presented and discussed in this thesis presents the option of using pervious concrete in highway shoulders as a best management practice for stormwater management. Research focused on the hydraulic response of pervious concrete pavements exposed to sheet flowing water. Pervious concrete samples were placed in a hydraulic flume to determine capture discharges, infiltration rates, and by-pass flowrates for a broad range of void contents, across a broad range of pavement cross slopes. The results demonstrate that the capture discharge and infiltration rates are inversely related to the cross slope of the pavement. Results also showed the infiltration rate of the permeable pavement exposed to sheet flowing water, in the model, is significantly lower than the measured infiltration rate. Pervious concrete samples were also tested to determine hydraulic response when exposed to clogging associated with sand used in roadway de-icing. The results of the clogging of the permeable pavements followed similar trends as the unclogged samples, with the only difference being a more significant reduction in infiltration rates at higher applications of sand. Preliminary discussion of a design methodology is included with a design example.

  20. An Evaluation of the Responsiveness and Discriminant Validity of Shoulder Questionnaires among Patients Receiving Surgical Correction of Shoulder Instability

    Directory of Open Access Journals (Sweden)

    Kyle A. R. Kemp

    2012-01-01

    Full Text Available Health-related quality-of-life (HRQL measures must detect clinically important changes over time and between different patient subgroups. Forty-three patients (32 M, 13 F; mean age  =  26.00  ±  8.19 years undergoing arthroscopic Bankart repair completed three validated shoulder questionnaires (Western Ontario Shoulder Instability index (WOSI, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment form (ASES, Constant score preoperatively, and at 6, 12, and 24 months postoperatively. Responsiveness and discriminant validity was assessed between those with a satisfactory outcome and those with (1 a major recurrence of instability, (2 a single episode of subluxation, (3 any postoperative episode of instability. Eight (20% patients reported recurrent instability. Compared to baseline, the WOSI detected improvement at the 6- (P<0.001 and 12-month (P=0.011 evaluations. The ASES showed improvement at 6 months (P=0.003, while the Constant score did not report significant improvement until 12 months postoperatively (P=0.001. Only the WOSI detected differential shoulder function related to shoulder instability. Those experiencing even a single episode of subluxation reported a 10% drop in their WOSI score, attaining the previously established minimal clinically important difference (MCID. Those experiencing a frank dislocation or multiple episodes of subluxation reported a 20% decline. The WOSI allows better discrimination of the severity of postoperative instability symptoms following arthroscopic Bankart repair.

  1. Kinesio Tape and Shoulder-Joint Position Sense

    Science.gov (United States)

    Aarseth, Lindsay M.; Suprak, David N.; Chalmers, Gordon R.; Lyon, Lonnie; Dahlquist, Dylan T.

    2015-01-01

    Context Joint position sense (JPS) is a key neuromuscular factor for developing and maintaining control of muscles around a joint. It is important when performing specialized tasks, especially at the shoulder. No researchers have studied how Kinesio Tape (KT) application affects JPS. Objective To investigate the effects of KT application and no tape on shoulder JPS at increasing shoulder elevations in athletes. Design Cross-sectional study. Setting University laboratory. Patients or Other Participants A total of 27 healthy athletes who did not participate in overhead sports (age = 20.44 ± 1.05 years, height = 175.02 ± 11.67 cm, mass = 70.74 ± 9.65 kg) with no previous pathologic shoulder conditions volunteered for the study. All participants were from 1 university. Intervention(s) Shoulder JPS was assessed at increasing elevations with and without KT application. Participants attempted to actively replicate 3 target positions with and without the KT and without visual guidance. Main Outcome Measure(s) We examined absolute and variable repositioning errors at increasing shoulder-elevation levels with and without KT application. Results Data revealed an interaction between tape and position for absolute error (F2,52 = 4.07, P = .02); simple effects revealed an increase in error, with KT demonstrating a 2.65° increase in error at 90° of elevation compared with no tape (t26 = 2.65, P = .01). The effect size was medium (ω2 = .135). Variable error showed no interaction of tape and position (F2,52 = .709, P = .50). Further analysis of simple effects was not needed. However, we still calculated the effect size and observed small effect sizes for tape (ω2 = .002), position (ω2 = .072), and tape by position (ω2 = .027). Conclusions At 90° of elevation, shoulder JPS was impaired by the application of KT. PMID:26090707

  2. Ultrasound-guided interventional procedures around the shoulder.

    Science.gov (United States)

    Messina, Carmelo; Banfi, Giuseppe; Orlandi, Davide; Lacelli, Francesca; Serafini, Giovanni; Mauri, Giovanni; Secchi, Francesco; Silvestri, Enzo; Sconfienza, Luca Maria

    2016-01-01

    Ultrasound is an established modality for shoulder evaluation, being accurate, low cost and radiation free. Different pathological conditions can be diagnosed using ultrasound and can be treated using ultrasound guidance, such as degenerative, traumatic or inflammatory diseases. Subacromial-subdeltoid bursitis is the most common finding on ultrasound evaluation for painful shoulder. Therapeutic injections of corticosteroids are helpful to reduce inflammation and pain. Calcific tendinopathy of rotator cuff affects up to 20% of painful shoulders. Ultrasound-guided treatment may be performed with both single- and double-needle approach. Calcific enthesopathy, a peculiar form of degenerative tendinopathy, is a common and mostly asymptomatic ultrasound finding; dry needling has been proposed in symptomatic patients. An alternative is represented by autologous platelet-rich plasma injections. Intra-articular injections of the shoulder can be performed in the treatment of a variety of inflammatory and degenerative diseases with corticosteroids or hyaluronic acid respectively. Steroid injections around the long head of the biceps brachii tendon are indicated in patients with biceps tendinopathy, reducing pain and humeral tenderness. The most common indication for acromion-clavicular joint injection is degenerative osteoarthritis, with ultrasound representing a useful tool in localizing the joint space and properly injecting various types of drugs (steroids, lidocaine or hyaluronic acid). Suprascapular nerve block is an approved treatment for chronic shoulder pain non-responsive to conventional treatments as well as candidate patients for shoulder arthroscopy. This review provides an overview of these different ultrasonography-guided procedures that can be performed around the shoulder. PMID:26313499

  3. Cardiac resynchronization therapy in a patient with amyloid cardiomyopathy.

    Science.gov (United States)

    Zizek, David; Cvijić, Marta; Zupan, Igor

    2013-06-01

    Cardiac involvement in systemic light chain amyloidosis carries poor prognosis. Amyloid deposition in the myocardium can alter regional left ventricular contraction and cause dyssynchrony. Cardiac resynchronization therapy (CRT) is an effective treatment strategy for patients with advanced heart failure and echocardiographic dyssynchrony. We report a clinical and echocardiographic response of a patient with amyloid cardiomyopathy, treated with a combination of chemotherapy and CRT.

  4. Structural network alterations and neurological dysfunction in cerebral amyloid angiopathy

    NARCIS (Netherlands)

    Reijmer, Yael D.; Fotiadis, Panagiotis; Martinez-Ramirez, Sergi; Salat, David H.; Schultz, Aaron; Shoamanesh, Ashkan; Ayres, Alison M.; Vashkevich, Anastasia; Rosas, Diana; Schwab, Kristin; Leemans, Alexander; Biessels, Geert Jan; Rosand, Jonathan; Johnson, Keith A.; Viswanathan, Anand; Gurol, M. Edip; Greenberg, Steven M.

    2015-01-01

    Cerebral amyloid angiopathy is a common form of small-vessel disease and an important risk factor for cognitive impairment. The mechanisms linking small-vessel disease to cognitive impairment are not well understood. We hypothesized that in patients with cerebral amyloid angiopathy, multiple small s

  5. The Effect of Glycosaminoglycans (GAGs on Amyloid Aggregation and Toxicity

    Directory of Open Access Journals (Sweden)

    Clara Iannuzzi

    2015-02-01

    Full Text Available Amyloidosis is a protein folding disorder in which normally soluble proteins are deposited extracellularly as insoluble fibrils, impairing tissue structure and function. Charged polyelectrolytes such as glycosaminoglycans (GAGs are frequently found associated with the proteinaceous deposits in tissues of patients affected by amyloid diseases. Experimental evidence indicate that they can play an active role in favoring amyloid fibril formation and stabilization. Binding of GAGs to amyloid fibrils occurs mainly through electrostatic interactions involving the negative polyelectrolyte charges and positively charged side chains residues of aggregating protein. Similarly to catalyst for reactions, GAGs favor aggregation, nucleation and amyloid fibril formation functioning as a structural templates for the self-assembly of highly cytotoxic oligomeric precursors, rich in β-sheets, into harmless amyloid fibrils. Moreover, the GAGs amyloid promoting activity can be facilitated through specific interactions via consensus binding sites between amyloid polypeptide and GAGs molecules. We review the effect of GAGs on amyloid deposition as well as proteins not strictly related to diseases. In addition, we consider the potential of the GAGs therapy in amyloidosis.

  6. Computational Modelling of the Human Islet Amyloid Polypeptide

    DEFF Research Database (Denmark)

    Skeby, Katrine Kirkeby

    2014-01-01

    When proteins do not fold correctly, it can lead to very serious diseases. One such group of diseases is the amyloid diseases, of which Alzheimer’s disease (AD), Parkinson’s disease, and type 2 diabetes mellitus (T2DM) are members. The amyloid diseases are characterized by the aggregation...

  7. Ligand-binding sites in human serum amyloid P component

    DEFF Research Database (Denmark)

    Heegaard, N.H.H.; Heegaard, Peter M. H.; Roepstorff, P.;

    1996-01-01

    Amyloid P component (AP) is a naturally occurring glycoprotein that is found in serum and basement membranes, AP is also a component of all types of amyloid, including that found in individuals who suffer from Alzheimer's disease and Down's syndrome. Because AP has been found to bind strongly...

  8. Native human serum amyloid P component is a single pentamer

    DEFF Research Database (Denmark)

    Sørensen, Inge Juul; Andersen, Ove; Nielsen, EH;

    1995-01-01

    Serum amyloid P component (SAP) and C-reactive protein (CRP) are members of the pentraxin protein family. SAP is the precursor protein to amyloid P component present in all forms of amyloidosis. The prevailing notion is that SAP in circulation has the form of a double pentameric molecule (decamer...

  9. The Tubular Sheaths Encasing Methanosaeta thermophila Filaments Are Functional Amyloids.

    Science.gov (United States)

    Dueholm, Morten S; Larsen, Poul; Finster, Kai; Stenvang, Marcel R; Christiansen, Gunna; Vad, Brian S; Bøggild, Andreas; Otzen, Daniel E; Nielsen, Per Halkjær

    2015-08-14

    Archaea are renowned for their ability to thrive in extreme environments, although they can be found in virtually all habitats. Their adaptive success is linked to their unique cell envelopes that are extremely resistant to chemical and thermal denaturation and that resist proteolysis by common proteases. Here we employ amyloid-specific conformation antibodies and biophysical techniques to show that the extracellular cell wall sheaths encasing the methanogenic archaea Methanosaeta thermophila PT are functional amyloids. Depolymerization of sheaths and subsequent MS/MS analyses revealed that the sheaths are composed of a single major sheath protein (MspA). The amyloidogenic nature of MspA was confirmed by in vitro amyloid formation of recombinant MspA under a wide range of environmental conditions. This is the first report of a functional amyloid from the archaeal domain of life. The amyloid nature explains the extreme resistance of the sheath, the elastic properties that allow diffusible substrates to penetrate through expandable hoop boundaries, and how the sheaths are able to split and elongate outside the cell. The archaeal sheath amyloids do not share homology with any of the currently known functional amyloids and clearly represent a new function of the amyloid protein fold. PMID:26109065

  10. Correlation between MRI and Arthroscopy in Diagnosis of Shoulder Pathology

    Science.gov (United States)

    Bhonsle, Sachin; Mehta, Sonu

    2016-01-01

    Introduction Shoulder pain can cause significant pain, discomfort and reduce the ability to perform activities of daily living, thus making it the third most common cause of musculoskeletal consultation. The current gold standard diagnostic investigation is arthroscopy. MRI is a proved sensitive and accurate non-invasive tool in investigating shoulder pathology, but false and misleading results are equally reported. Aim The aim of the study is to compare the efficacy of MRI in diagnosing shoulder pathologies in comparison to arthroscopy, considering arthroscopy as the gold standard. Materials and Methods Thirty nine consecutive patients, between 18-80 years of age, presenting with chronic shoulder pain or instability of more than 6 weeks, or with clinical signs of impingement or tear were included in the study. MRI of the shoulder joint was done followed by shoulder arthroscopy. The data collected was analysed for the significant correlation between MRI of shoulder and arthroscopic findings by kappa statistics. Results Out of 39 patients, Rotator cuff (RC) tear was the most common pathology. MRI showed excellent sensitivity in the diagnosis of rotator cuff tears (0.91) and osteochondral defects (OCD), very good sensitivity for Bankart’s lesion (0.8) and had poor sensitivity to detect SLAP tear (0.15). MRI was specific for all shoulder pathologies. MRI detected RC tears with kappa score of 0.73, Bankart’s tear and OCD’s with kappa score of 0.83 and 1.0 respectively and SLAP lesion with kappa score of 0.14. The accuracy of MRI was highest in diagnosing OCD’s (1.0), followed by RC tear (0.9), Bankart’s tear (0.9) and accuracy was least in diagnosing SLAP lesion (0.7). False negative results were more than false positives. Conclusion The present study supports that MRI is effective in diagnosing rotator cuff tears, Bankart’s tear and ostechondral defects but was not found to be helpful in diagnosing SLAP lesions. MRI and arthroscopy have complimentary roles

  11. A clinical and radiological observation of shoulder arthrography

    International Nuclear Information System (INIS)

    The authors analyzed 23 cases of shoulder arthrography performed at Busan National University Hospital and Inje Medical College Paik Hospital for about 2.5 years from March 1981 to September 1983, both clinically and radiologically. The results obtained were as follows: 1. Of the 23 cases, 20 cases (87.0%) were male and 3 cases (13.0%) were female, and the most prevalent age group was second decade. 2. Right shoulder arthrography was performed in 16 cases (69.6%), and left in 7 cases (30.4%). 3. The number of cases which had had certain history of trauma was 13 (56.5%), and remainder of 10 cases (43.5%) had no history of trauma. 4. Frequent symptoms and signs were pain in shoulder region in 16 cases (69.6%) and limitation of motion in 14 cases (60.9%). 5. On plain film findings, 18 cases (78.3%) were normal, and 5 cases (21.7%) were abnormal. 6. On shoulder arthrographic findings, 16 cases (69.6%) were normal, and 7 cases (30.4%) were abnormal. Those abnormal cases were consisted of 2 cases (8.7%) of adhesive capsulitis, 2 cases (8.7%) of chronic shoulder dislocation, 1 case (4.3%) of rotator cuff tear, 1 case (4.3%) of loose bodies in joint cavity, and 1 case (4.3%) of rupture of biceps tendon sheath. 7. Among routine views of shoulder arthrography of normal cases, the external rotation view revealed axillary recess and biceps tendon more distincity, and the internal rotation view revealed subscapular bursa more clearly. In case of double contrast shoulder arthrography, the contour and thickness of the medial segment of the contrast coated humeral articular cartilage were well demonstrated in erect views, with air-fluid levels in axillary recess, biceps tendon sheath and subscapular bursa. 8. The 2 cases of adhesive capsulitis revealed small joint space, obliteration of the axillary recess and subscapular bursa, and failure to fill the bicipital sheath. 9. The 2 cases of capsular deformities by chronic shoulder dislocation demonstrated loss of normal concavity of

  12. Amyloid imaging in Alzheimer's disease: a literature review.

    Science.gov (United States)

    Saidlitz, P; Voisin, T; Vellas, B; Payoux, P; Gabelle, A; Formaglio, M; Delrieu, J

    2014-07-01

    Therapies targeting amyloid-β peptide currently represent approximately 50% of drugs now being developed for Alzheimer's disease. Some, including active and passive anti-Aβ immunotherapy, directly target the amyloid plaques. The new amyloid tracers are increasingly being included in the proposed updated diagnostic criteria, and may allow earlier diagnosis. Those targeting amyloid-β peptide allow identification of amyloid plaques in vivo. We need to gain insight into all aspects of their application. As florbetapir (Amyvid™) and flutemetamol (Vizamyl™) have received marketing authorization, clinicians require deeper knowledge to be rationally used in diagnosis. In this paper, we review both completed and ongoing observational, longitudinal and interventional studies of these tracers, our main objective being to show the performance of the four most commonly used tracers and their validation. PMID:25226113

  13. Development of (F-18)-Labeled Amyloid Imaging Agents for PET

    International Nuclear Information System (INIS)

    The applicant proposes to design and synthesize a series of fluorine-18-labeled radiopharmaceuticals to be used as amyloid imaging agents for positron emission tomography (PET). The investigators will conduct comprehensive iterative in vitro and in vivo studies based upon well defined acceptance criteria in order to identify lead agents suitable for human studies. The long term goals are to apply the selected radiotracers as potential diagnostic agents of Alzheimer's disease (AD), as surrogate markers of amyloid in the brain to determine the efficacy of anti-amyloid therapeutic drugs, and as tools to help address basic scientific questions regarding the progression of the neuropathology of AD, such as testing the 'amyloid cascade hypothesis' which holds that amyloid accumulation is the primary cause of AD.

  14. Prevalence of cerebral amyloid pathology in persons without dementia

    DEFF Research Database (Denmark)

    Jansen, Willemijn J; Ossenkoppele, Rik; Knol, Dirk L;

    2015-01-01

    IMPORTANCE: Cerebral amyloid-β aggregation is an early pathological event in Alzheimer disease (AD), starting decades before dementia onset. Estimates of the prevalence of amyloid pathology in persons without dementia are needed to understand the development of AD and to design prevention studies....... OBJECTIVE: To use individual participant data meta-analysis to estimate the prevalence of amyloid pathology as measured with biomarkers in participants with normal cognition, subjective cognitive impairment (SCI), or mild cognitive impairment (MCI). DATA SOURCES: Relevant biomarker studies identified...... for amyloid positivity. DATA EXTRACTION AND SYNTHESIS: Individual records were provided for 2914 participants with normal cognition, 697 with SCI, and 3972 with MCI aged 18 to 100 years from 55 studies. MAIN OUTCOMES AND MEASURES: Prevalence of amyloid pathology on positron emission tomography...

  15. Development of [F-18]-Labeled Amyloid Imaging Agents for PET

    Energy Technology Data Exchange (ETDEWEB)

    Mathis, CA

    2007-05-09

    The applicant proposes to design and synthesize a series of fluorine-18-labeled radiopharmaceuticals to be used as amyloid imaging agents for positron emission tomography (PET). The investigators will conduct comprehensive iterative in vitro and in vivo studies based upon well defined acceptance criteria in order to identify lead agents suitable for human studies. The long term goals are to apply the selected radiotracers as potential diagnostic agents of Alzheimer's disease (AD), as surrogate markers of amyloid in the brain to determine the efficacy of anti-amyloid therapeutic drugs, and as tools to help address basic scientific questions regarding the progression of the neuropathology of AD, such as testing the "amyloid cascade hypothesis" which holds that amyloid accumulation is the primary cause of AD.

  16. The role of sensitization in musculoskeletal shoulder pain

    Directory of Open Access Journals (Sweden)

    John Borstad

    2015-08-01

    Full Text Available Introduction: Peripheral and central sensitization are neurophysiological processes that can prolong painful conditions. Painful shoulder conditions are often persistent, perhaps due to the presence of sensitization.Method:This manuscript summarizes six studies that have evaluated those with musculoskeletal shoulder pain for the presence of sensitization.Results:All six manuscripts report evidence of peripheral sensitization, while central sensitization was described in five of the studies. The chronicity of symptoms in subjects who were included in the studies is probably influencing this finding. The primary somatosensory test used to assess sensitization in these studies was Pressure Pain Threshold, a test for lowered nociceptive thresholds.Discussion:It appears that peripheral sensitization manifests consistently in those with musculoskeletal shoulder pathology, probably due to the inflammatory processes related to tissue injury. Central sensitization, while not universally present, was reported in a majority of the manuscripts. Because central sensitization is thought to be a key step on the pathway to chronic pain, evidence for its presence in those with shoulder pain is significant. Clinicians should expect the presence of sensitization with shoulder pathology and make appropriate choices about interventions so as not to exacerbate pain.

  17. Shoulder morbidity after non-surgical treatment of the neck

    International Nuclear Information System (INIS)

    Background and purpose: Reports on shoulder function after non-surgical treatment are not available. In the present study shoulder morbidity after surgical and non-surgical treatment of the neck is determined and compared. Materials and methods: In 100 head and neck cancer patients 174 neck sides were treated by surgery (n = 51) or (chemo)radiation (n = 123). Abduction, anteflexion, endorotation and exorotation were assessed. Subjective measurements were performed using the Visual Analogue Scale for pain, the Shoulder Disability Questionnaire (SDQ) and stiffness reporting. Results: Predictive factors for SDQ-score > 0 (n = 54) were VAS pain score, stiffness, abduction, anteflexion, physiotherapy, low shoulder position and surgical treatment. The SDQ, stiffness and pain scores were significantly higher in the surgically treated group than in the non-surgical group (p < 0.01). Anteflexion, abduction and exorotation were less impaired in the non-surgically treated group than in the surgically treated group (p < 0.01). No differences between neck dissection and neck dissection with post-operative radiotherapy, and radiotherapy and chemoradiation were found for these movements. Conclusions: Shoulder morbidity is often present after non-surgical treatment of the neck, but to a lesser extent compared to surgical treatment. Radiotherapy adds no morbidity to neck dissection and chemotherapy does not add extra morbidity to primary radiation

  18. Wear simulation strategies for reverse shoulder arthroplasty implants.

    Science.gov (United States)

    Langohr, G Daniel G; Athwal, George S; Johnson, James A; Medley, John B

    2016-05-01

    Reverse total shoulder arthroplasty is a clinically accepted surgical procedure; however, its long-term wear performance is not known. The purpose of this work is to review wear simulator testing of reverse total shoulder arthroplasty, to develop a wear simulator protocol for reverse total shoulder arthroplasty, and to test it by performing a pilot study. The review of wear simulator testing in the literature revealed considerable variation in protocols. A combination of our own cadaveric testing and those of other research groups helped in determining the magnitude and direction of joint loading for the development of the present protocol. A MATCO orbital-bearing simulator was adapted using custom fixtures to simulate a circumduction motion of the shoulder under mildly adverse conditions, and a pilot study gave wear rates within the wide range found in the literature. Arguments were presented in support of the currently developed protocol, but it was also suggested that, rather than rely on one protocol, a series of simulator wear protocols should be developed to fully test the implant wear performance in reverse total shoulder arthroplasty.

  19. Wear simulation strategies for reverse shoulder arthroplasty implants.

    Science.gov (United States)

    Langohr, G Daniel G; Athwal, George S; Johnson, James A; Medley, John B

    2016-05-01

    Reverse total shoulder arthroplasty is a clinically accepted surgical procedure; however, its long-term wear performance is not known. The purpose of this work is to review wear simulator testing of reverse total shoulder arthroplasty, to develop a wear simulator protocol for reverse total shoulder arthroplasty, and to test it by performing a pilot study. The review of wear simulator testing in the literature revealed considerable variation in protocols. A combination of our own cadaveric testing and those of other research groups helped in determining the magnitude and direction of joint loading for the development of the present protocol. A MATCO orbital-bearing simulator was adapted using custom fixtures to simulate a circumduction motion of the shoulder under mildly adverse conditions, and a pilot study gave wear rates within the wide range found in the literature. Arguments were presented in support of the currently developed protocol, but it was also suggested that, rather than rely on one protocol, a series of simulator wear protocols should be developed to fully test the implant wear performance in reverse total shoulder arthroplasty. PMID:27160563

  20. Shoulder skin and muscle hemodynamics during backpack carriage.

    Science.gov (United States)

    Mao, Clifford P; Macias, Brandon R; Hargens, Alan R

    2015-11-01

    The purpose of this study was to quantify the effects of loaded backpacks on shoulder muscle oxygenation, skin blood flow, and pain. We hypothesized that backpack load carriage is associated with lower shoulder muscle oxygenation and skin microvascular flow. Near-infrared spectroscopy quantified shoulder tissue oxygenation and laser Doppler flow measured skin microvascular flow. Eight adult volunteers donned a standard backpack without added load, 5 kg load, and 10 kg load for 5 min while standing. An 8 min rest period before each backpack donning condition ensured that all measured parameters returned to baseline. Data were analyzed using a repeated measures ANOVA and significance set at p backpack significantly reduced shoulder muscle oxygenation by 22 ± 23% as compared to the empty backpack control condition (p = 0.023). In addition, a 10 kg backpack load reduced skin microvascular flow by 82 ± 22%, as compared to the empty backpack control condition (p = 0.024). Perceived pain was significantly higher when wearing the 10 kg backpack (level 4 on a 10-maximal pain scale) as compared to the empty backpack (0, 0-no pain) (p backpack loads of 10 kg decrease shoulder muscle oxygenation and skin microvascular flow. PMID:26154207

  1. Predicting sites of new hemorrhage with amyloid imaging in cerebral amyloid angiopathy

    Science.gov (United States)

    Dierksen, Gregory; Betensky, Rebecca; Gidicsin, Christopher; Halpin, Amy; Becker, Alex; Carmasin, Jeremy; Ayres, Alison; Schwab, Kristin; Viswanathan, Anand; Salat, David; Rosand, Jonathan; Johnson, Keith A.; Greenberg, Steven M.

    2012-01-01

    Objective: We aimed to determine whether amyloid imaging can help predict the location and number of future hemorrhages in cerebral amyloid angiopathy (CAA). Methods: We performed a longitudinal cohort study of 11 patients with CAA without dementia who underwent serial brain MRIs after baseline amyloid imaging with Pittsburgh compound B (PiB). Mean distribution volume ratio (DVR) of PiB was determined at the sites of new micro/macrobleeds identified on follow-up MRI and compared with PiB retention at “simulated” hemorrhages, randomly placed in the same subjects using a probability distribution map of CAA-hemorrhage location. Mean PiB retention at the sites of observed new bleeds was also compared to that in shells concentrically surrounding the bleeds. Finally the association between number of incident bleeds and 3 regional amyloid measures were obtained. Results: Nine of 11 subjects had at least one new microbleed on follow-up MRI (median 4, interquartile range [IQR] 1–9) and 2 had 5 new intracerebral hemorrhages. Mean DVR was greater at the sites of incident bleeds (1.34, 95% confidence interval [CI] 1.23–1.46) than simulated lesions (1.14, 95% CI 1.07–1.22, p < 0.0001) in multivariable models. PiB retention decreased with increasing distance from sites of observed bleeds (p < 0.0001). Mean DVR in a superior frontal/parasagittal region of interest correlated independently with number of future hemorrhages after adjustment for relevant covariates (p = 0.003). Conclusions: Our results provide direct evidence that new CAA-related hemorrhages occur preferentially at sites of increased amyloid deposition and suggest that PiB-PET imaging may be a useful tool in prediction of incident hemorrhages in patients with CAA. PMID:22786597

  2. A catalytic surface for amyloid fibril formation

    Energy Technology Data Exchange (ETDEWEB)

    Hammarstroem, P; Ali, M M; Mishra, R; Tengvall, P; Lundstroem, I [Department of Physics, Biology and Chemistry, Linkoeping University, SE-581 83 Linkoeping (Sweden); Svensson, S [Astra Zeneca R and D, SE-151 85 Soedertaelje (Sweden)], E-mail: ingemar@ifm.liu.se

    2008-03-15

    A hydrophobic surface incubated in a solution of protein molecules (insulin monomers) was made into a catalytic surface for amyloid fibril formation by repeatedly incubate, rinse and dry the surface. The present contribution describes how this unexpected transformation occurred and its relation to rapid fibrillation of insulin solutions in contact with the surface. A tentative model of the properties of the catalytic surface is given, corroborated by ellipsometric measurements of the thickness of the organic layer on the surface and by atomic force microscopy. The surfaces used were spontaneously oxidized silicon made hydrophobic through treatment in dichlorodimethylsilane.

  3. Stability and cytotoxicity of crystallin amyloid nanofibrils

    Science.gov (United States)

    Kaur, Manmeet; Healy, Jackie; Vasudevamurthy, Madhusudan; Lassé, Moritz; Puskar, Ljiljana; Tobin, Mark J.; Valery, Celine; Gerrard, Juliet A.; Sasso, Luigi

    2014-10-01

    Previous work has identified crystallin proteins extracted from fish eye lenses as a cheap and readily available source for the self-assembly of amyloid nanofibrils. However, before exploring potential applications, the biophysical aspects and safety of this bionanomaterial need to be assessed so as to ensure that it can be effectively and safely used. In this study, crude crystallin amyloid fibrils are shown to be stable across a wide pH range, in a number of industrially relevant solvents, at both low and high temperatures, and in the presence of proteases. Crystallin nanofibrils were compared to well characterised insulin and whey protein fibrils using Thioflavin T assays and TEM imaging. Cell cytotoxicity assays suggest no adverse impact of both mature and fragmented crystallin fibrils on cell viability of Hec-1a endometrial cells. An IR microspectroscopy study supports long-term structural integrity of crystallin nanofibrils.Previous work has identified crystallin proteins extracted from fish eye lenses as a cheap and readily available source for the self-assembly of amyloid nanofibrils. However, before exploring potential applications, the biophysical aspects and safety of this bionanomaterial need to be assessed so as to ensure that it can be effectively and safely used. In this study, crude crystallin amyloid fibrils are shown to be stable across a wide pH range, in a number of industrially relevant solvents, at both low and high temperatures, and in the presence of proteases. Crystallin nanofibrils were compared to well characterised insulin and whey protein fibrils using Thioflavin T assays and TEM imaging. Cell cytotoxicity assays suggest no adverse impact of both mature and fragmented crystallin fibrils on cell viability of Hec-1a endometrial cells. An IR microspectroscopy study supports long-term structural integrity of crystallin nanofibrils. Electronic supplementary information (ESI) available: ThT fluorescence graphs of buffers and solvents used for

  4. Cerebrospinal fluid analysis detects cerebral amyloid-β accumulation earlier than positron emission tomography

    OpenAIRE

    Palmqvist, Sebastian; Mattsson, Niklas; Hansson, Oskar; ,

    2016-01-01

    See Rabinovici (doi:10.1093/brain/aww025) for a scientific commentary on this article. Cerebral accumulation of amyloid-β is thought to be the starting mechanism in Alzheimer’s disease. Amyloid-β can be detected by analysis of cerebrospinal fluid amyloid-β42 or amyloid positron emission tomography, but it is unknown if any of the methods can identify an abnormal amyloid accumulation prior to the other. Our aim was to determine whether cerebrospinal fluid amyloid-β42 change before amyloid PET ...

  5. [New options in the treatment of painful shoulder syndrome].

    Science.gov (United States)

    Esparza Miñana, J M; Londoño Parra, M; Villanueva Pérez, V L; De Andrés Ibáñez, J

    2012-01-01

    Shoulder pain is a common complaint in clinical practice in Primary Care and affects 20% of the general population. The usual form of treatment is based on NSAIDs, rest, rehabilitation and, as an alternative, a local injection into the joint. There are also radiofrequency techniques on the suprascapular nerve in the cases of refractory pain to these therapies. Radiofrequency can be used in two ways: Conventional Radiofrequency, using high temperatures to the target tissue with the aim of producing a thermal neurolysis and Pulsed Radiofrequency where the temperatures are lower and produces a temporary non-destructive blockage; the latter being the most common technique in the management of shoulder pain. Although the analgesic mechanism of action of Radiofrequency is unknown, recent studies have shown that it is safe, effective and Lasting. Radiofrequency of the suprascapular nerve is a valid, effective and with few complications in the treatment of shoulder pain refractory to other therapies.

  6. Exploring the outcomes in studies of primary frozen shoulder

    DEFF Research Database (Denmark)

    Rodgers, Sara; Brealey, Stephen; Jefferson, Laura;

    2014-01-01

    considered important; and re-examined papers previously obtained for a systematic review of patients' views of interventions for frozen shoulder to investigate their views on outcomes. RESULTS: Thirty-one studies investigated the outcomes range of movement (28 studies), pain (22), function and disability (22......PURPOSE: In our study we explored the need to define a core outcome set for primary frozen shoulder. METHODS: We investigated the outcomes used by studies included in a systematic review of the management of primary frozen shoulder; surveyed which primary outcome measures health care professionals......), adverse events (13), quality of life (7) and other outcomes (5). Many different types of pain and ranges of movement were measured. Function and disability was measured using fifteen instruments, the content of which varied considerably. Function and disability, pain and range of movement (132, 108...

  7. Evaluation of arthroscopic treatment of posterior shoulder instability

    Science.gov (United States)

    Garcia, José Carlos; Maia, Lucas Russo; Fonseca, Juliano Rocha; Zabeu, José Luís Amim; Garcia, Jesely Pereira Myrrha

    2015-01-01

    OBJECTIVE: To provide data for the analysis of arthroscopy as a method of surgical treatment for shoulder and discuss its actual indications and preliminary results. METHODS: We evaluated 15 patients submitted to reverse Bankart arthroscopic surgery. We used the UCLA (University of California at Los Angeles) score to measure the results before surgery and 12 months thereafter. RESULTS: The average UCLA score changed from 26.67±0.25 (SD 0.97) before surgery to 34.20±0.53 (SD 2.04) after surgery. The effectiveness of surgery was 93%. In five cases loose bodies were found. A patient undergoing remplissage was evaluated separately. The data did not change after 24 months post-surgery. CONCLUSION: The arthroscopic treatment of posterior shoulder instability and posterior dislocation of the shoulder has been proved feasible and results in our series followed the same trends as in the literature. Level of Evidence III, Transversal Retrospective Study. PMID:26207089

  8. Acute osseous traumatic lesions of the shoulder girdle

    International Nuclear Information System (INIS)

    Traumatic injuries to the shoulder girdle are common lesions and occur from birth on through the whole life. Depending on the patient's age, localization and type of injury change. Diagnosis of acute osseous traumatic lesions to the shoulder is based on evaluation of trauma mechanism, patient's examination and, as for the most cases, conventional radiographs. Only in certain cases additional radiological examinations are necessary. As a minimum, two to three images in different planes, anteriorposterior, lateral and axillary, are recommended in order to display all components of the shoulder girdle without superposition. Knowledge of common clinical classifications systems is necessary for exact diagnosis in order to permit decision on conservative or operative treatment of injury. (orig.)

  9. On the homology of the shoulder girdle in turtles.

    Science.gov (United States)

    Nagashima, Hiroshi; Sugahara, Fumiaki; Takechi, Masaki; Sato, Noboru; Kuratani, Shigeru

    2015-05-01

    The shoulder girdle in turtles is encapsulated in the shell and has a triradiate morphology. Due to its unique configuration among amniotes, many theories have been proposed about the skeletal identities of the projections for the past two centuries. Although the dorsal ramus represents the scapular blade, the ventral two rami remain uncertain. In particular, the ventrorostral process has been compared to a clavicle, an acromion, and a procoracoid based on its morphology, its connectivity to the rest of the skeleton and to muscles, as well as with its ossification center, cell lineage, and gene expression. In making these comparisons, the shoulder girdle skeleton of anurans has often been used as a reference. This review traces the history of the debate on the homology of the shoulder girdle in turtles. And based on the integrative aspects of developmental biology, comparative morphology, and paleontology, we suggest acromion and procoracoid identities for the two ventral processes.

  10. Hemiplegic shoulder pain: evidence of a neuropathic origin.

    Science.gov (United States)

    Zeilig, Gabi; Rivel, Michal; Weingarden, Harold; Gaidoukov, Evgeni; Defrin, Ruth

    2013-02-01

    Hemiplegic shoulder pain (HSP) is common after stroke. Whereas most studies have concentrated on the possible musculoskeletal factors underlying HSP, neuropathic aspects have hardly been studied. Our aim was to explore the possible neuropathic components in HSP, and if identified, whether they are specific to the shoulder or characteristic of the entire affected side. Participants included 30 poststroke patients, 16 with and 14 without HSP, and 15 healthy controls. The thresholds of warmth, cold, heat-pain, touch, and graphesthesia were measured in the intact and affected shoulder and in the affected lower leg. They were also assessed for the presence of allodynia and hyperpathia, and computed tomography/magnetic resonance imaging scans of the brain were reviewed. In addition, chronic pain was characterized. Participants with HSP exhibited higher rates of parietal lobe damage (P<0.05) compared to those without HSP. Both poststroke groups exhibited higher sensory thresholds than healthy controls. Those with HSP had higher heat-pain thresholds in both the affected shoulder (P<0.001) and leg (P<0.01), exhibited higher rates of hyperpathia in both these regions (each P<0.001), and more often reported chronic pain throughout the affected side (P<0.001) than those without HSP. The more prominent sensory alterations in the shoulder region suggest that neuropathic factors play a role in HSP. The clinical evidence of damage to the spinothalamic-thalamocortical system in the affected shoulder and leg, the presence of chronic pain throughout the affected side, and the more frequent involvement of the parietal cortex all suggest that the neuropathic component is of central origin.

  11. Simple self-reduction method for anterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    Reiner Wirbel; Martin Ruppert; Elmar Schwarz; Bernhard Zapp

    2014-01-01

    Objective:To demonstrate and evaluate a modified simple method about self-reduction of anterior shoulder dislocation for significance in the emergency room. Methods:TheBoss-Holzach-Matter method for self-reduction of anterior shoulder disloaction is described.Patients with an anterior shoulder dislocation were retrospectively analysed concerning age, gender, type of anterior shoulder dislocation, occurrence of associated fractures, time between injury and reduction, reduction time, and method of reduction with its respective success rate. Results:Eighty-six patients(52 men,34 women, mean age49 years) were treated fromJanuary 2010 toJune2014.The reduction time ranged between20 seconds and6 min(mean1.5 min). Subcoracoid type of shoulder dislocation was seen in72 cases(84%), subglenoid type in14 cases(16%).Associated factures were seen in20 cases, proportionally more often in subgleboid dislocations,12 at the greater tuberosity,6 at the inferior rim of the glenoid fossa and2 at both localizations.TheBoss-Holzach-Matter method was used in35 cases with a success rate of 71.5%; dieKocher method and traction/countertraction method with premedication were used in 14 cases and17 cases with success rates of64% and70%, respectively.All other cases and the failed primary attempts required hyponotic medication.All patients older than70(n=16) were not able to perform the self reducing procedure. Conclusion:The presentedBoss-Holzach-Matter method for reduction of anterior shoulder dislocation is a simple method without the need of anaesthesia, but cooperation from patients is crucial.The successful rate is comparable with other established methods.

  12. Corticosteroid Injections Versus Manual Physical Therapy for Treatment of the Shoulder Impingement Syndrome

    Science.gov (United States)

    ... Medicine Summaries for Patients Corticosteroid Injections Versus Manual Physical Therapy for Treatment of the Shoulder Impingement Syndrome The ... Outcome of Subacromial Corticosteroid Injection Compared With Manual Physical Therapy for the Management of the Unilateral Shoulder Impingement ...

  13. 78 FR 36307 - Proposed Information Collection (Shoulder and Arm Conditions Disability Benefits Questionnaire...

    Science.gov (United States)

    2013-06-17

    ... AFFAIRS Proposed Information Collection (Shoulder and Arm Conditions Disability Benefits Questionnaire... Disability Benefits Questionnaire)'' in any correspondence. During the comment period, comments may be viewed.... SUPPLEMENTARY INFORMATION: Title: Shoulder and Arm Conditions Disability Benefits Questionnaire, VA Form...

  14. 78 FR 65451 - Agency Information Collection (Shoulder and Arm Conditions Disability Benefits Questionnaire...

    Science.gov (United States)

    2013-10-31

    ... AFFAIRS Agency Information Collection (Shoulder and Arm Conditions Disability Benefits Questionnaire... Disability Benefits Questionnaire)'' in any correspondence. FOR FURTHER INFORMATION CONTACT: Crystal Rennie... (Shoulder and Arm Conditions Disability Benefits Questionnaire).'' SUPPLEMENTARY INFORMATION:...

  15. Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome

    DEFF Research Database (Denmark)

    Storgaard, Filip Holst; Pedersen, Christina Gravgaard; Jensen, Majbritt Lykke;

    Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome.......Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome....

  16. Anterior dislocation of shoulder in eclampsia:a case report

    Institute of Scientific and Technical Information of China (English)

    Seema Rawat; Sanjay Meena; Shreesh Kumar Gangari; Lalit Kumar Lohia

    2012-01-01

    This case report presents a 25-year-old female patient with anterior dislocation of right shoulder secondary to seizures as a complication of eclampsia.This is an unusual mechanism of injury,but similar to other uncontrolled muscular contractions caused by electroconvulsive therapy,etc.To the best of our knowledge only one such case has been reported in the English literature.Closed reduction under general anaesthesia was successfully achieved.High suspicion in patients complaining of pain over shoulder joint is necessary for early diagnosis of this condition.

  17. MRI of atraumatic sports injuries of the shoulder

    International Nuclear Information System (INIS)

    MRI of operatively or arthroscopically proven atraumatic sports injuries of 12 shoulders were reviewed retrospectively. Although it is difficult to diagnose the lesions localised at the superior glenoid labrum and to decide whether rotator interval is injured or not by MRI, MRI could detect thickening of subacromial bursae or rotator cuff injuries due to impingement syndrome and glenoid labrum injuries, such as Bankart lesion. On our limited experience, MRI was more valuable examination than arthrography and CT arthrography. MRI is a useful modality for screening or preoperative evaluation of atraumatic sports injuries of the shoulder. (author)

  18. Reverse shoulder arthroplasty: radiological and clinical short–term results

    OpenAIRE

    Atalar, Ata Can; Salduz, Ahmet; Cil, Hilal; Sungur, Mustafa; Celik, Derya; Demirhan, Mehmet

    2014-01-01

    Objective: The aim of this study was to examine the radiological and clinical short term results of the patients who underwent reverse shoulder arthroplasty for rotator cuff arthropathy. Methods: The study included 14 (2 male, 12 female) patients who underwent reverse shoulder arthroplasty for rotator cuff arthropathy between 2009 and 2010. The mean age of the patients was 74 (57–80) years and the mean follow–up period was 32 (21–40) months. Radiological methods as well as the range of mot...

  19. Measurement of active shoulder proprioception: dedicated system and device

    OpenAIRE

    Lubiatowski, Przemyslaw; Ogrodowicz, Piotr; Wojtaszek, Marcin; Kaniewski, Ryszard; Stefaniak, Jakub; Dudziński, Witold; Romanowski, Leszek

    2012-01-01

    Proprioception is an essential part of shoulder stability and neuromuscular control. The purpose of the study was the development of a precise system of shoulder proprioception assessment in the active mode (Propriometr). For that purpose, devices such as the electronic goniometer and computer software had been designed. A pilot study was carried out on a control group of 27 healthy subjects, the average age being 23.8 (22–29) in order to test the system. The result of the assessment was the ...

  20. Endovascular treatment of axillary artery dissection following anterior shoulder dislocation.

    Science.gov (United States)

    Fass, G; Barchiche, M Reda; Lemaitre, J; De Quin, I; Goffin, C; Bricart, R; Bellens, B

    2008-01-01

    Injury to the axillary artery is a rare complication of anterior shoulder dislocation. Open surgical repair is technically demanding because of the anatomical position of the vessel and the propensity for concomitant injuries. Standard surgical exposure techniques involve extensive dissection, including a combination of supraclavicular or infraclavicular incision, median sternotomy, and thoracotomy causing significant morbidity and mortality rates. Endovascular techniques may offer an alternative to these surgically demanding procedures. We present a patient with a traumatic dissection of the axillary artery following anterior shoulder dislocation who was successfully managed with an endovascular stent. PMID:18411587

  1. Shoulder arthroplasty. Part 2: Normal and abnormal radiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Sheridan, B.D., E-mail: bdsheridan@hotmail.com [Department of Orthopaedic Surgery, Bristol Royal Infirmary, Bristol (United Kingdom); Ahearn, N.; Tasker, A.; Wakeley, C.; Sarangi, P. [Department of Orthopaedic Surgery, Bristol Royal Infirmary, Bristol (United Kingdom)

    2012-07-15

    Frequently, the decision made by general practitioners or musculoskeletal triage assessment services to refer patients for specialist review is initiated by a radiological report. Following shoulder arthroplasty it is important to ensure that any patient with asymptomatic evidence of a failing prosthesis is referred for review so that revision surgery can be contemplated and planned before the situation becomes unsalvageable. The first paper in this series described the various types of shoulder arthroplasty and indications for each. This follow-up paper will concentrate on their modes of failure and the associated radiographic features, and is aimed at radiology trainees and non-musculoskeletal specialist radiologists.

  2. Functional Hydrogel Materials Inspired by Amyloid

    Science.gov (United States)

    Schneider, Joel

    2012-02-01

    Protein assembly resulting in the formation of amyloid fibrils, assemblies rich in cross beta-sheet structure, is normally thought of as a deleterious event associated with disease. However, amyloid formation is also involved in a diverse array of normal biological functions such as cell adhesion, melanin synthesis, insect defense mechanism and modulation of water surface tension by fungi and bacteria. These findings indicate that Nature has evolved to take advantage of large, proteinaceous fibrillar assemblies to elicit function. We are designing functional materials, namely hydrogels, from peptides that self-assembled into fibrillar networks, rich in cross beta-sheet structure. These gels can be used for the direct encapsulation and delivery of small molecule-, protein- and cell-based therapeutics. Loaded gels exhibit shear-thinning/self-healing mechanical properties enabling their delivery via syringe. In addition to their use for delivery, we have found that some of these gels display antibacterial activity. Although cytocompatible towards mammalian cells, the hydrogels can kill a broad spectrum of bacteria on contact.

  3. Magnetite nanoparticle interactions with insulin amyloid fibrils

    Science.gov (United States)

    Chen, Yun-Wen; Chang, Chiung-Wen; Hung, Huey-Shan; Kung, Mei-Lang; Yeh, Bi-Wen; Hsieh, Shuchen

    2016-10-01

    Accumulation of amyloid fibrils is one of the likely key factors leading to the development of Alzheimer’s disease and other amyloidosis associated diseases. Magnetic nanoparticles (NPs) have been developed as promising medical materials for many medical applications. In this study, we have explored the effects of Fe3O4 NPs on the fibrillogenesis process of insulin fibrils. When Fe3O4 NPs were co-incubated with insulin, Fe3O4 NPs had no effect on the structural transformation into amyloid-like fibrils but had higher affinity toward insulin fibrils. We demonstrated that the zeta potential of insulin fibrils and Fe3O4 NPs were both positive, suggesting the binding forces between Fe3O4 NPs and insulin fibrils were van der Waals forces but not surface charge. Moreover, a different amount of Fe3O4 NPs added had no effect on secondary structural changes of insulin fibrils. These results propose the potential use of Fe3O4 NPs as therapeutic agents against diseases related to protein aggregation or contrast agents for magnetic resonance imaging.

  4. Looking for a generic inhibitor of amyloid-like fibril formation among flavone derivatives

    OpenAIRE

    Šneideris, Tomas; Baranauskienė, Lina; Jonathan G Cannon; Rutkienė, Rasa; Meškys, Rolandas; Smirnovas, Vytautas

    2015-01-01

    A range of diseases is associated with amyloid fibril formation. Despite different proteins being responsible for each disease, all of them share similar features including beta-sheet-rich secondary structure and fibril-like protein aggregates. A number of proteins can form amyloid-like fibrils in vitro, resembling structural features of disease-related amyloids. Given these generic structural properties of amyloid and amyloid-like fibrils, generic inhibitors of fibril formation would be of i...

  5. A Novel liposomal nanoparticle for the imaging of amyloid plaque by MRI

    OpenAIRE

    Tanifum, Eric A; Ghaghada, Ketan; Vollert, Craig; Head, Elizabeth; Eriksen, Jason L.; Annapragada, Ananth

    2016-01-01

    Amyloid binding molecules with greater hydrophilicity than existing ligands were synthesized. The lead candidate ET6-21 bound amyloid fibrils, and amyloid deposits in dog brain and human brain tissue ex vivo. The ligand was used to prepare novel amyloid-targeted liposomal nanoparticles. The preparation was tested in the Tg2576 and TetO/APP mouse models of amyloid deposition. Gd chelates and Indocyanine green were included in the particles for visualization by MRI and near-infrared microscopy....

  6. Neglected Anterior Dislocation of Shoulder: is surgery necessary? A Rare Case with review of literature

    OpenAIRE

    Shah, Kunal; Ubale, Tushar; Ugrappa, Harish; Pilankar, Samir; Bhaskar, Atul; Kale, Satishchandra

    2015-01-01

    Introduction: Shoulder joint is the most frequently dislocated joint. However, it is rarely neglected and treatment is sought immediately. Delayed or neglected shoulder dislocations are difficult to manage and require extensive procedures to obtain good functional outcome. Very few cases are described in literature showing neglected shoulder dislocation with good functional range of movement. We report a case with 3 years of neglected anterior shoulder dislocation with preserved joint functio...

  7. Use of two-axis joystick for control of externally powered shoulder disarticulation prostheses

    OpenAIRE

    Robert D. Lipschutz, BSME, CP; Blair Lock, MS; Jonathon Sensinger, PhD; Aimee E. Schultz, MS; Todd A. Kuiken, MD, PhD

    2011-01-01

    We explored a new method for simple and accurate control of shoulder movement for externally powered shoulder disarticulation prostheses with a two-axis joystick. We tested 10 subjects with intact shoulders and arms to determine the average amount of shoulder motion and force available to control an electronic input device. We then applied this information to two different input strategies to examine their effectiveness: (1) a traditional rocker potentiometer and a pair of force-sensing resis...

  8. ARTHROSCOPIC REPAIR OF BANKART’S LESION USING SUTURE ANCHORS IN RECURRENT ANTERIOR SHOULDER INSTABILITY

    OpenAIRE

    Santosh Kumar; Anant Kumar; Sanjay

    2015-01-01

    BACKGROUND : Shoulder instability and its treatment were described even in ancient times by the Greek and Egyptian physicians. Evidence of shoulder dislocation has been found in archaeological and paleopathological examinations of human shoulders several thousand years old. 1 Many techniques have been described in literature for treatment of recurrent shoulder dislocation. Arthroscopic repair of Bankart’s lesion using suture anchors is a noble technique. A sut...

  9. Clinical Usefulness of Shoulder Stability Exercises for Middle-aged Women

    OpenAIRE

    Choi, Seok-Hwa; Lee, Byoung-Hee

    2013-01-01

    [Purpose] This study examined the clinical usefulness of shoulder stability exercises and the effect of stability exercise on the shoulder pain of middle-aged women. [Subjects] Twenty-two middle-aged female subjects were randomly divided into two groups: a shoulder stability exercise group (Experimental group, n=11) and a control group (n=11). [Methods] Subjects in the experimental group performed a shoulder stability exercise, which was designed to correct abnormal location of the scapula, f...

  10. A multivariable prediction model for the chronification of non-traumatic shoulder pain: a systematic review

    OpenAIRE

    Struyf, Filip; Geeraerts, Jaques; Noten, Suzie; Meeus, Mira; Nijs, Jo

    2016-01-01

    Background: Shoulder pain is the third most common musculoskeletal complaint and many patients have an unfavorable outcome with long-term disability. Only 50% of all new episodes of shoulder pain show complete recovery within 6 months. Little is known about factors that contribute to chronicity of shoulder pain, although such information is needed for the management of patients with acute and sub-acute shoulder pain. Objective: To systematically review the literature for prognostic factor...

  11. Musculoskeletal ultrasonographic findings of the affected and unaffected shoulders in hemiplegic patients

    OpenAIRE

    Fatma Ali; Mona Hamdy; Rasha A Abdel-Magied; Mostafa M Elian

    2016-01-01

    Background There are many sonographic changes in affected and unaffected shoulders in patients with established hemiplegia. Aim The aim of this study was to evaluate the sonographic findings of hemiplegic shoulder in patients after acute stroke and the detection of the correlation between the physical or sonographic findings and early-onset hemiplegic shoulder pain. Patients and methods Shoulders of 30 patients with cerebrovascular stroke (six male and 24 female patients), 18...

  12. Amyloid plaque imaging in vivo: current achievement and future prospects

    Energy Technology Data Exchange (ETDEWEB)

    Nordberg, Agneta [Karolinska University Hospital Huddinge, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Alzheimer Neurobiology, Stockholm (Sweden); Karolinska University Hospital Huddinge, Department of Geriatric Medicine, Stockholm (Sweden)

    2008-03-15

    Alzheimer's disease (AD) is a very complex neurodegenerative disorder, the exact cause of which is still not known. The major histopathological features, amyloid plaques and neurofibrillary tangles, already described by Alois Alzheimer, have been the focus in research for decades. Despite a probable whole cascade of events in the brain leading to impairment of cognition, amyloid is still the target for diagnosis and treatment. The rapid development of molecular imaging techniques now allows imaging of amyloid plaques in vivo in Alzheimer patients by PET amyloid ligands such as Pittsburgh compound B (PIB). Studies so far have revealed high {sup 11}C-PIB retention in brain at prodromal stages of AD and a possibility to discriminate AD from other dementia disorders by {sup 11}C-PIB. Ongoing studies are focussing to understand the relationship between brain and CSF amyloid processes and cognitive processes. In vivo imaging of amyloid will be important for early diagnosis and evaluation of new anti-amyloid therapies in AD. (orig.)

  13. SERF Protein Is a Direct Modifier of Amyloid Fiber Assembly

    Directory of Open Access Journals (Sweden)

    S. Fabio Falsone

    2012-08-01

    Full Text Available The inherent cytotoxicity of aberrantly folded protein aggregates contributes substantially to the pathogenesis of amyloid diseases. It was recently shown that a class of evolutionary conserved proteins, called MOAG-4/SERF, profoundly alter amyloid toxicity via an autonomous but yet unexplained mode. We show that the biological function of human SERF1a originates from its atypical ability to specifically distinguish between amyloid and nonamyloid aggregation. This inherently unstructured protein directly affected the aggregation kinetics of a broad range of amyloidogenic proteins in vitro, while being inactive against nonamyloid aggregation. A representative biophysical analysis of the SERF1a:α-synuclein (aSyn complex revealed that the amyloid-promoting activity resulted from an early and transient interaction, which was sufficient to provoke a massive increase of soluble aSyn amyloid nucleation templates. Therefore, the autonomous amyloid-modifying activity of SERF1a observed in living organisms relies on a direct and dedicated manipulation of the early stages in the amyloid aggregation pathway.

  14. De novo Amyloid Proteins from Designed Combinatorial Libraries

    Science.gov (United States)

    West, Michael W.; Wang, Weixun; Patterson, Jennifer; Mancias, Joseph D.; Beasley, James R.; Hecht, Michael H.

    1999-09-01

    Amyloid deposits are associated with several neurodegenerative diseases, including Alzheimer's disease and the prion diseases. The amyloid fibrils isolated from these different diseases share similar structural features. However, the protein sequences that assemble into these fibrils differ substantially from one disease to another. To probe the relationship between amino acid sequence and the propensity to form amyloid, we studied a combinatorial library of sequences designed de novo. All sequences in the library were designed to share an identical pattern of alternating polar and nonpolar residues, but the precise identities of these side chains were not constrained and were varied combinatorially. The resulting proteins self-assemble into large oligomers visible by electron microscopy as amyloid-like fibrils. Like natural amyloid, the de novo fibrils are composed of β -sheet secondary structure and bind the diagnostic dye, Congo red. Thus, binary patterning of polar and nonpolar residues arranged in alternating periodicity can direct protein sequences to form fibrils resembling amyloid. The model amyloid fibrils assemble and disassemble reversibly, providing a tractable system for both basic studies into the mechanisms of fibril assembly and the development of molecular therapies that interfere with this assembly.

  15. Accumulation of murine amyloid-β mimics early Alzheimer's disease.

    Science.gov (United States)

    Krohn, Markus; Bracke, Alexander; Avchalumov, Yosef; Schumacher, Toni; Hofrichter, Jacqueline; Paarmann, Kristin; Fröhlich, Christina; Lange, Cathleen; Brüning, Thomas; von Bohlen Und Halbach, Oliver; Pahnke, Jens

    2015-08-01

    Amyloidosis mouse models of Alzheimer's disease are generally established by transgenic approaches leading to an overexpression of mutated human genes that are known to be involved in the generation of amyloid-β in Alzheimer's families. Although these models made substantial contributions to the current knowledge about the 'amyloid hypothesis' of Alzheimer's disease, the overproduction of amyloid-β peptides mimics only inherited (familiar) Alzheimer's disease, which accounts for mild cognitive impairment. Using behavioural tests, electrophysiology and morphological analyses, we compared different ABC transporter-deficient animals and found that alterations are most prominent in neprilysin × ABCC1 double-deficient mice. We show that these mice have a reduced probability to survive, show increased anxiety in new environments, and have a reduced working memory performance. Furthermore, we detected morphological changes in the hippocampus and amygdala, e.g. astrogliosis and reduced numbers of synapses, leading to defective long-term potentiation in functional measurements. Compared to human, murine amyloid-β is poorly aggregating, due to changes in three amino acids at N-terminal positions 5, 10, and 13. Interestingly, our findings account for the action of early occurring amyloid-β species/aggregates, i.e. monomers and small amyloid-β oligomers. Thus, neprilysin × ABCC1 double-deficient mice present a new model for early effects of amyloid-β-related mild cognitive impairment that allows investigations without artificial overexpression of inherited Alzheimer's disease genes. PMID:25991605

  16. Counterrotating-Shoulder Mechanism for Friction Stir Welding

    Science.gov (United States)

    Nunes, Arthur C., Jr.

    2007-01-01

    A counterrotating-shoulder mechanism has been proposed as an alternative to the mechanism and fixtures used in conventional friction stir welding. The mechanism would internally react most or all of the forces and torques exerted on the workpiece, making it unnecessary to react the forces and torques through massive external fixtures. In conventional friction stir welding, a rotating pin tool is inserted into, and moved along, a weld seam. As the pin tool moves, it stirs together material from the opposite sides of the seam to form the weld. A large axial plunge force must be exerted upon the workpiece through and by the pin tool and a shoulder attached above the pin tool in order to maintain the pressure necessary for the process. The workpiece is secured on top of an anvil, which supports the workpiece against the axial plunge force and against the torque exerted by the pin tool and shoulder. The anvil and associated fixtures must be made heavy (and, therefore, are expensive) to keep the workpiece stationary. In addition, workpiece geometries must be limited to those that can be accommodated by the fixtures. The predecessor of the proposed counterrotating-shoulder mechanism is a second-generation, self-reacting tool, resembling a bobbin, that makes it possible to dispense with the heavy anvil. This tool consists essentially of a rotating pin tool with opposing shoulders. Although the opposing shoulders maintain the necessary pressure without need to externally apply or react a large plunge force, the torque exerted on the workpiece remains unreacted in the absence of a substantial external fixture. Depending on the RPM and the thickness of the workpiece, the torque can be large. The proposed mechanism (see figure) would include a spindle attached to a pin tool with a lower shoulder. The spindle would be coupled via splines to the upper one of three bevel gears in a differential drive. The middle bevel gear would be the power-input gear and would be coupled to the

  17. Musculoskeletal ultrasonographic findings of the affected and unaffected shoulders in hemiplegic patients

    Directory of Open Access Journals (Sweden)

    Fatma Ali

    2016-01-01

    Conclusion Hemiplegic stroke Results in injury to the affected shoulder and the shoulder on the unaffected side. Musculoskeletal ultrasonography is an essential method in the evaluation of poststroke painful hemiplegic shoulder. However, the US grades did not correlate with the stages of motor recovery.

  18. The role of experimentally-induced subacromial pain on shoulder strength and throwing accuracy.

    Science.gov (United States)

    Wassinger, Craig A; Sole, Gisela; Osborne, Hamish

    2012-10-01

    Shoulder injuries often comprise two separate yet related components, structural tissue damage and pain. The role of each of these components on shoulder function is difficult to ascertain. Experimental pain models allow the assessment of consequences of localized pain when applied to healthy individuals. By understanding the role of pain on shoulder function, clinicians will be able to more efficiently assess and treat shoulder injuries. The objective of the study was to evaluate the role of experimentally-induced sub-acromial pain on shoulder isokinetic rotational strength and throwing accuracy. This was a block counterbalanced, crossover, repeated measures study design utilizing 20 individuals without self-reported shoulder or cervical pathology. Shoulder function was measured with and without experimental pain injection (2 mL of 5% hypertonic saline) in the sub-acromial space. Functional tasks consisted of shoulder rotational strength utilizing isokinetic testing and throwing accuracy via the functional throwing performance index. The hypertonic saline induced moderate pain levels in all participants (4.3-5.1/10). Normalized shoulder internal (t = 3.76, p = 0.001) and external (t = 3.12, p = 0.006) rotation strength were both diminished in the painful condition compared to the pain free condition. Throwing accuracy was also reduced while the participants experienced pain (t = 3.99, p = 0.001). Moderate levels of experimental shoulder pain were sufficient to negatively influence shoulder strength and throwing accuracy in participants without shoulder pathology.

  19. 46 CFR 160.031-4 - Equipment for shoulder gun type line-throwing appliance.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 6 2010-10-01 2010-10-01 false Equipment for shoulder gun type line-throwing appliance... Appliance, Shoulder Gun Type (and Equipment) § 160.031-4 Equipment for shoulder gun type line-throwing... the gun. The line canister shall be secured by clamps or brackets below the barrel of the gun. (c)...

  20. Treatment of myofascial trigger points in patients with chronic shoulder pain : a randomized, controlled trial

    NARCIS (Netherlands)

    Bron, Carel; de Gast, Arthur; Dommerholt, Jan; Stegenga, Boudewijn; Wensing, Michel; Oostendorp, Rob A. B.

    2011-01-01

    Background: Shoulder pain is a common musculoskeletal problem that is often chronic or recurrent. Myofascial trigger points (MTrPs) cause shoulder pain and are prevalent in patients with shoulder pain. However, few studies have focused on MTrP therapy. The aim of this study was to assess the effecti

  1. Responsiveness of the Shoulder Pain and Disability Index in patients with adhesive capsulitis

    OpenAIRE

    Juel Niels; Ekeberg Ole; Tveitå Einar; Bautz-Holter Erik

    2008-01-01

    Background Instruments designed to measure the subjective impact of painful shoulder conditions have become essential in shoulder research. The Shoulder Pain and Disability Index (SPADI) is one of the most extensively used scales of this type. The objective of this study was to investigate reproducibility and responsiveness of the SPADI in patients with adhesive capsulitis. Methods SPADI test-retest r...

  2. Changing Seasonality and the Role of the Shoulder Season - Evidence from Denamrk

    DEFF Research Database (Denmark)

    Sørensen, Nils Karl

    2009-01-01

    the issue of the shoulder season in a time series framework. Departing from a discussion of the nature of types of seasonal variation, a test is set up in order to examine the impact of the shoulder season. The test examines the impact on the mean share of hotel nights in the shoulder season months in two...

  3. Prevalence of amyloid PET positivity in dementia syndromes

    DEFF Research Database (Denmark)

    Ossenkoppele, Rik; Jansen, Willemijn J; Rabinovici, Gil D;

    2015-01-01

    IMPORTANCE: Amyloid-β positron emission tomography (PET) imaging allows in vivo detection of fibrillar plaques, a core neuropathological feature of Alzheimer disease (AD). Its diagnostic utility is still unclear because amyloid plaques also occur in patients with non-AD dementia. OBJECTIVE: To use...... years; noncarriers [n = 77], 7% [95% CI, 3%-18%] at 60 years to 29% [95% CI, 17%-43%] at 80 years. CONCLUSIONS AND RELEVANCE: Among participants with dementia, the prevalence of amyloid positivity was associated with clinical diagnosis, age, and APOE genotype. These findings indicate the potential...

  4. Amyloid-β and Astrocytes Interplay in Amyloid-β Related Disorders

    Directory of Open Access Journals (Sweden)

    Yazan S. Batarseh

    2016-03-01

    Full Text Available Amyloid-β (Aβ pathology is known to promote chronic inflammatory responses in the brain. It was thought previously that Aβ is only associated with Alzheimer’s disease and Down syndrome. However, studies have shown its involvement in many other neurological disorders. The role of astrocytes in handling the excess levels of Aβ has been highlighted in the literature. Astrocytes have a distinctive function in both neuronal support and protection, thus its involvement in Aβ pathological process may tip the balance toward chronic inflammation and neuronal death. In this review we describe the involvement of astrocytes in Aβ related disorders including Alzheimer’s disease, Down syndrome, cerebral amyloid angiopathy, and frontotemporal dementia.

  5. Specific localization and imaging of amyloid deposits in vivo using /sup 123/I-labeled serum amyloid P component

    Energy Technology Data Exchange (ETDEWEB)

    Hawkins, P.N.; Myers, M.J.; Epenetos, A.A.; Caspi, D.; Pepys, M.B.

    1988-03-01

    Highly specific, high-resolution scintigraphic images of amyloid-laden organs in mice with experimentally induced amyloid A protein (AA) amyloidosis were obtained after intravenous injection of /sup 123/I-labeled serum amyloid P component (SAP). Interestingly, a much higher proportion (up to 40%) of the injected dose of heterologous human SAP localized to amyloid and was retained there than was the case with isologous mouse SAP, indicating that human SAP binds more avidly to mouse AA fibrils than does mouse SAP. Specificity of SAP localization was established by the failure of the related proteins, human C-reactive protein and Limulus C-reactive protein, to deposit significantly in amyloid and by the absence of human SAP deposition in nonamyloidotic organs. However, only partial correlations were observed between the quantity of SAP localized and two independent estimates, histology and RIA for AA of the amount of amyloid in particular organs. It is not clear which of the three methods used reflects better the extent or clinical significance of the amyloid deposits but in vivo localization of radiolabeled SAP, detectable and quantifiable by gamma camera imaging, is apparently extremely sensitive. These findings establish the use of labeled SAP as a noninvasive in vivo diagnostic probe in experimental amyloidosis, potentially capable of revealing the natural history of the condition, and suggest that it may also be applicable generally as a specific targeting agent for diagnostic and even therapeutic purposes in clinical amyloidosis.

  6. Early oligomerization stages for the non-amyloid component of α-synuclein amyloid

    Science.gov (United States)

    Eugene, Cindie; Laghaei, Rozita; Mousseau, Normand

    2014-10-01

    In recent years, much effort has focused on the early stages of aggregation and the formation of amyloid oligomers. Aggregation processes for these proteins are complex and their non-equilibrium nature makes any experimental study very difficult. Under these conditions, simulations provide a useful alternative for understanding the dynamics of the early stages of oligomerization. Here, we focus on the non-Aβ amyloid component (NAC) of the monomer, dimer, and trimer of α-synuclein, an important 35-residue sequence involved in the aggregation and fibrillation of this protein associated with Parkinson's disease. Using Hamiltonian and temperature replica exchange molecular dynamics simulations combined with the coarse grained Optimized Potential for Efficient peptide structure Prediction potential, we identify the role of the various regions and the secondary structures for the onset of oligomerization. For this sequence, we clearly observe the passage from α-helix to β-sheet, a characteristic transition of amyloid proteins. More precisely, we find that the NAC monomer is highly structured with two α-helical regions, between residues 2-13 and 19-25. As the dimer and trimer form, β-sheet structures between residues 2-14 and 26-34 appear and rapidly structure the system. The resulting conformations are much more structured than similar dimers and trimers of β-amyloid and amylin proteins and yet display a strong polymorphism at these early stages of aggregation. In addition to its inherent experimental interest, comparison with other sequences shows that NAC could be a very useful numerical model for understanding the onset of aggregation.

  7. Amyloid-β and Astrocytes Interplay in Amyloid-β Related Disorders

    OpenAIRE

    Yazan S. Batarseh; Quoc-Viet Duong; Youssef M. Mousa; Al Rihani, Sweilem B.; Khaled Elfakhri; Amal Kaddoumi

    2016-01-01

    Amyloid-β (Aβ) pathology is known to promote chronic inflammatory responses in the brain. It was thought previously that Aβ is only associated with Alzheimer’s disease and Down syndrome. However, studies have shown its involvement in many other neurological disorders. The role of astrocytes in handling the excess levels of Aβ has been highlighted in the literature. Astrocytes have a distinctive function in both neuronal support and protection, thus its involvement in Aβ pathological process m...

  8. Amyloid β Oligomeric Species Present in the Lag Phase of Amyloid Formation.

    Directory of Open Access Journals (Sweden)

    Martin Wolff

    Full Text Available Alzheimer's disease (AD-associated amyloid β peptide (Aβ is one of the main actors in AD pathogenesis. Aβ is characterized by its high tendency to self-associate, leading to the generation of oligomers and amyloid fibrils. The elucidation of pathways and intermediates is crucial for the understanding of protein assembly mechanisms in general and in conjunction with neurodegenerative diseases, e.g., for the identification of new therapeutic targets. Our study focused on Aβ42 and its oligomeric assemblies in the lag phase of amyloid formation, as studied by sedimentation velocity (SV centrifugation. The assembly state of Aβ during the lag phase, the time required by an Aβ solution to reach the exponential growth phase of aggregation, was characterized by a dominant monomer fraction below 1 S and a population of oligomeric species between 4 and 16 S. From the oligomer population, two major species close to a 12-mer and an 18-mer with a globular shape were identified. The recurrence of these two species at different initial concentrations and experimental conditions as the smallest assemblies present in solution supports the existence of distinct, energetically favored assemblies in solution. The sizes of the two species suggest an Aβ42 aggregation pathway that is based on a basic hexameric building block. The study demonstrates the potential of SV analysis for the evaluation of protein aggregation pathways.

  9. Interaction of amyloid inhibitor proteins with amyloid beta peptides: insight from molecular dynamics simulations.

    Directory of Open Access Journals (Sweden)

    Payel Das

    Full Text Available Knowledge of the detailed mechanism by which proteins such as human αB- crystallin and human lysozyme inhibit amyloid beta (Aβ peptide aggregation is crucial for designing treatment for Alzheimer's disease. Thus, unconstrained, atomistic molecular dynamics simulations in explicit solvent have been performed to characterize the Aβ17-42 assembly in presence of the αB-crystallin core domain and of lysozyme. Simulations reveal that both inhibitor proteins compete with inter-peptide interaction by binding to the peptides during the early stage of aggregation, which is consistent with their inhibitory action reported in experiments. However, the Aβ binding dynamics appear different for each inhibitor. The binding between crystallin and the peptide monomer, dominated by electrostatics, is relatively weak and transient due to the heterogeneous amino acid distribution of the inhibitor surface. The crystallin-bound Aβ oligomers are relatively long-lived, as they form more extensive contact surface with the inhibitor protein. In contrast, a high local density of arginines from lysozyme allows strong binding with Aβ peptide monomers, resulting in stable complexes. Our findings not only illustrate, in atomic detail, how the amyloid inhibitory mechanism of human αB-crystallin, a natural chaperone, is different from that of human lysozyme, but also may aid de novo design of amyloid inhibitors.

  10. Tensile deformation and failure of amyloid and amyloid-like protein fibrils

    Science.gov (United States)

    Solar, Max; Buehler, Markus J.

    2014-03-01

    Here we report a series of full atomistic molecular dynamics simulations of six amyloid or amyloid-like protein fibrils in order to systematically understand the effect of different secondary structure motifs on the mechanical tensile and failure response of cross-\\beta protein fibrils. We find a similar failure behavior across the six structures; an initial failure event occurs at small strains involving cooperative rupture of a group of hydrogen bonds, followed by a slow one-by-one hydrogen bond rupture process as the remaining \\beta -sheets peel off with very low applied stress. We also find that the ultimate tensile strength of the protein fibrils investigated scales directly with the number of hydrogen bonds per unit area which break in the initial rupture event. Our results provide insights into structure-property relationships in protein fibrils important for disease and engineering applications and lay the groundwork for the development of materials selection criteria for the design of de novo amyloid-based functional biomaterials.

  11. Yeast and Fungal Prions: Amyloid-Handling Systems, Amyloid Structure, and Prion Biology.

    Science.gov (United States)

    Wickner, R B; Edskes, H K; Gorkovskiy, A; Bezsonov, E E; Stroobant, E E

    2016-01-01

    Yeast prions (infectious proteins) were discovered by their outré genetic properties and have become important models for an array of human prion and amyloid diseases. A single prion protein can become any of many distinct amyloid forms (called prion variants or strains), each of which is self-propagating, but with different biological properties (eg, lethal vs mild). The folded in-register parallel β sheet architecture of the yeast prion amyloids naturally suggests a mechanism by which prion variant information can be faithfully transmitted for many generations. The yeast prions rely on cellular chaperones for their propagation, but can be cured by various chaperone imbalances. The Btn2/Cur1 system normally cures most variants of the [URE3] prion that arise. Although most variants of the [PSI+] and [URE3] prions are toxic or lethal, some are mild in their effects. Even the most mild forms of these prions are rare in the wild, indicating that they too are detrimental to yeast. The beneficial [Het-s] prion of Podospora anserina poses an important contrast in its structure, biology, and evolution to the yeast prions characterized thus far.

  12. Effects of manual therapy on shoulder pain in office workers

    Science.gov (United States)

    Go, Seong-Uk; Lee, Byoung-Hee

    2016-01-01

    [Purpose] The purpose of this study was to determine the effects of manual therapy on shoulder pain in office workers. [Subjects and Methods] Subjects included 38 office workers who were randomly divided into two groups: a manual therapy group of 19 subjects and a shoulder stabilization exercise group of 19 subjects. All subjects underwent evaluation of the pressure pain threshold in the splenius capitis and upper, middle, and lower trapezius muscles on both sides. The manual therapy used in the study was designed to include soft-tissue mobilization, prone thoracic mobilization, prone selected thoracic mobilization, cervical mobilization, and thoracic manipulation. Both groups underwent training of two 40-minute sessions per week for 6 weeks. [Results] After the intervention, both groups showed significantly increased pressure pain thresholds in the splenius capitis and upper, middle, and lower trapezius muscles on both sides. The manual therapy group showed greater improvements than did the shoulder stabilization exercise group in the splenius capitis on both sides, left upper trapezius, middle trapezius on both sides, and right lower trapezius. [Conclusion] The results of this study suggest that manual therapy for shoulder pain is feasible and suitable for office workers and may be useful in clinical rehabilitation. PMID:27799661

  13. Fretting and Corrosion in Modular Shoulder Arthroplasty: A Retrieval Analysis

    Science.gov (United States)

    Panzram, Benjamin

    2016-01-01

    Tribocorrosion in taper junctions of retrieved anatomic shoulder arthroplasty implants was evaluated. A comparison of the tribocorrosion between cobalt-chromium and titanium alloy stems was conducted and the observations were correlated with the individual's clinical data. Adverse effects caused by metal debris and subsequent elevated serum metal ion levels are frequently reported in total hip arthroplasty. In total shoulder arthroplasty, to date only a small number of retrieval analyses are available and even fewer address the issue of tribocorrosion at the taper junctions. A total of 36 retrieved hemiarthroplasties and total shoulder arthroplasties were assessed using the modified Goldberg score. The prevalence of fretting and corrosion was confirmed in this cohort. Titanium stems seem to be more susceptible to damage caused by tribocorrosion than cobalt-chromium stems. Furthermore, stemless designs offered less tribocorrosion at the taper junction than stemmed designs. A weak correlation between time to revision and increased levels of tribocorrosion was seen. Whether or not tribocorrosion can lead to adverse clinical reactions and causes failure of shoulder arthroplasties remains to be examined. PMID:27433471

  14. Practical Partnerships--Standing on the Shoulders of Scientists

    Science.gov (United States)

    Thorley, Charlotte

    2009-01-01

    "If I have seen further, it is because I have stood upon the shoulders of giants." Whenever the author hears this quote from Isaac Newton, she thinks about the work being done by the Royal Society in schools throughout the country, bringing science to life for their students. Much of it is also cutting edge, and represents the best of the work…

  15. Calcifying supracoracoid bursitis as a cause of chronic shoulder pain.

    OpenAIRE

    Mens, J; van der Korst, J K

    1984-01-01

    A case of chronic shoulder pain is reported with marked limitation of both active and passive elevations and a normal range of motion of the glenohumeral joint. X-ray examination demonstrated cloudy calcification in the coracoclavicular region, presumably indicating calcifying supracoracoid bursitis.

  16. Chondroblastoma: An Unusual Cause Of Shoulder Pain In Adolescence

    OpenAIRE

    Lambert, Julie Marie; Verstraeten, Tom R; Mermuys, Koen P

    2016-01-01

    Chondroblastoma is a rare benign bone tumor, most often localized in the epiphysis of long bones. We report a case of atraumatic shoulder pain in a 17-year old soccer player. This chondroblastoma case demonstrates the difficult differentiation of chondroblastoma from giant cell tumor and clear cell chondrosarcoma and highlights possible pitfalls and clinical importance.

  17. Shoulder dislocation in patients older than 60 years of age

    Directory of Open Access Journals (Sweden)

    Rapariz Jose

    2010-01-01

    Full Text Available Purpose: Recurrent anterior shoulder dislocation in elderly patients is a little studied condition. The goal of this paper is to clarify the role of associated injuries with respect to loss of function and recurrence of dislocation. Materials and Methods: We have conducted a retrospective, descriptive study on 29 patients older than 60 years at the moment they suffered their first dislocation episode. All patients were assessed clinically (Constant test and by imaging testing (X-ray, MRI. Results: Nine (31.03% out of 29 patients had a recurrent dislocation. Four of them required reconstructive surgery to maintain joint stability. Injury to the anterior support (anterior labrum, anterior glenoid rim showed a statistically significant relation to the recurrence of dislocations. The occurrence or non-occurrence of a rotator cuff tear does have an impact on the shoulder function. The degree of rotator cuff involvement on the coronal plane does not significantly affect the shoulder′s functional outcome. The tear extension on the sagittal plane does cause impairment on the Constant test. Conclusions: Labrum and/or anterior glenoid involvement should be suspected in elderly patients presenting with recurrent shoulder dislocation. Recurrence is due to an injury in the anterior support or both (anterior and posterior, even though shoulder function gets impaired when a rotation cuff tear occurs with anterior extension on the sagittal plane. Evidence level: IV Case series.

  18. Does Subacromial Osteolysis Affect Shoulder Function after Clavicle Hook Plating?

    Science.gov (United States)

    Sun, Siwei; Gan, Minfeng; Sun, Han; Wu, Guizhong; Yang, Huilin; Zhou, Feng

    2016-01-01

    Purpose. To evaluate whether subacromial osteolysis, one of the major complications of the clavicle hook plate procedure, affects shoulder function. Methods. We had performed a retrospective study of 72 patients diagnosed with a Neer II lateral clavicle fracture or Degree-III acromioclavicular joint dislocation in our hospital from July 2012 to December 2013. All these patients had undergone surgery with clavicle hook plate and were divided into two groups based on the occurrence of subacromial osteolysis. By using the Constant-Murley at the first follow-up visit after plates removal, we evaluated patients' shoulder function to judge if it has been affected by subacromial osteolysis. Results. We have analyzed clinical data for these 72 patients, which shows that there is no significant difference between group A (39 patients) and group B (33 patients) in age, gender, injury types or side, and shoulder function (the Constant-Murley scores are 93.38 ± 3.56 versus 94.24 ± 3.60, P > 0.05). Conclusion. The occurrence of subacromial osteolysis is not rare, and also it does not significantly affect shoulder function. PMID:27034937

  19. Can shoulder joint reaction forces be estimated by neural networks?

    Science.gov (United States)

    de Vries, W H K; Veeger, H E J; Baten, C T M; van der Helm, F C T

    2016-01-01

    To facilitate the development of future shoulder endoprostheses, a long term load profile of the shoulder joint is desired. A musculoskeletal model using 3D kinematics and external forces as input can estimate the mechanical load on the glenohumeral joint, in terms of joint reaction forces. For long term ambulatory measurements, these 3D kinematics can be measured by means of Inertial Magnetic Measurement Systems. Recording of external forces under daily conditions is not feasible; estimations of joint loading should preferably be independent of this input. EMG signals reflect the musculoskeletal response and can easily be measured under daily conditions. This study presents the use of a neural network for the prediction of glenohumeral joint reaction forces based upon arm kinematics and shoulder muscle EMG. Several setups were examined for NN training, with varying combinations of type of input, type of motion, and handled weights. When joint reaction forces are predicted by a trained NN, for motion data independent of the training data, results show a high intraclass correlation (ICC up to 0.98) and relative SEM as low as 3%, compared to similar output of a musculoskeletal model. A convenient setup in which kinematics and only one channel of EMG were used as input for the NN׳s showed comparable predictive power as more complex setups. These results are promising and enable long term estimation of shoulder joint reaction forces outside the motion lab, independent of external forces. PMID:26654109

  20. Shoulder load during handcycling at different incline and speed conditions

    NARCIS (Netherlands)

    Arnet, U.; Van Drongelen, S.; Van de Woude, L.H.V.; Veeger, H.E.J.

    2012-01-01

    Background The manual wheelchair user population experiences a high prevalence of upper-limb injuries, which are related to a high load on the shoulder joint during activities of daily living, such as handrim wheelchair propulsion. An alternative mode of propulsion is handcycling, where lower extern

  1. Shoulder load during handcycling at different incline and speed conditions

    NARCIS (Netherlands)

    Arnet, Ursina; van Drongelen, Stefan; van der Woude, Lucas H. V.; Veeger, DirkJan H. E. J.

    2012-01-01

    Background: The manual wheelchair user population experiences a high prevalence of upper-limb injuries, which are related to a high load on the shoulder joint during activities of daily living, such as handrim wheelchair propulsion. An alternative mode of propulsion is handcycling, where lower exter

  2. Change in neck circumference after shoulder arthroscopy: An observational study

    Directory of Open Access Journals (Sweden)

    Shrividya Chellam

    2015-01-01

    Full Text Available Background and Aims: Shoulder arthroscopy requires fluid irrigation, which causes soft-tissue oedema around chest, neck, and arm intraoperatively, leading to postoperative airway complications. We decided to study the incidence of increase in the neck circumference in shoulder arthroscopy and its effects on the airway. Methods: We studied 32 cases of shoulder arthroscopies over a period of 1-year, performed under general anaesthesia with interscalene block. The neck circumference of patients before and after the procedure was measured along with other parameters. The endotracheal tube cuff was deflated at the end of surgery to determine air leak around the tube. The negative leak test suggested airway oedema. Results: Thirty out of 32 patients showed positive air leak test. The average change in neck circumference was 1.17 ± 1.16 cm and all could be extubated uneventfully. Two showed negative leak test with an increase in neck circumference by 4.5 and 6.4 cm and were not extubated. Multiple regression analysis for risk factors showed intraoperative hypertension as a single predictor for an increase in neck circumference. Conclusion: Change in the neck circumference beyond 4 cm may suggest airway compromise and below 4 cm, airway compromise is unlikely even in the presence of extensive soft-tissue oedema around the shoulder, upper arm and chest.

  3. Does Subacromial Osteolysis Affect Shoulder Function after Clavicle Hook Plating?

    Directory of Open Access Journals (Sweden)

    Siwei Sun

    2016-01-01

    Full Text Available Purpose. To evaluate whether subacromial osteolysis, one of the major complications of the clavicle hook plate procedure, affects shoulder function. Methods. We had performed a retrospective study of 72 patients diagnosed with a Neer II lateral clavicle fracture or Degree-III acromioclavicular joint dislocation in our hospital from July 2012 to December 2013. All these patients had undergone surgery with clavicle hook plate and were divided into two groups based on the occurrence of subacromial osteolysis. By using the Constant-Murley at the first follow-up visit after plates removal, we evaluated patients’ shoulder function to judge if it has been affected by subacromial osteolysis. Results. We have analyzed clinical data for these 72 patients, which shows that there is no significant difference between group A (39 patients and group B (33 patients in age, gender, injury types or side, and shoulder function (the Constant-Murley scores are 93.38±3.56 versus 94.24±3.60, P>0.05. Conclusion. The occurrence of subacromial osteolysis is not rare, and also it does not significantly affect shoulder function.

  4. Shoulder pain and time dependent structure in wheelchair propulsion variability.

    Science.gov (United States)

    Jayaraman, Chandrasekaran; Moon, Yaejin; Sosnoff, Jacob J

    2016-07-01

    Manual wheelchair propulsion places considerable repetitive mechanical strain on the upper limbs leading to shoulder injury and pain. While recent research indicates that the amount of variability in wheelchair propulsion and shoulder pain may be related. There has been minimal inquiry into the fluctuation over time (i.e. time-dependent structure) in wheelchair propulsion variability. Consequently the purpose of this investigation was to examine if the time-dependent structure in the wheelchair propulsion parameters are related to shoulder pain. 27 experienced wheelchair users manually propelled their own wheelchair fitted with a SMARTWheel on a roller at 1.1m/s for 3min. Time-dependent structure of cycle-to-cycle fluctuations in contact angle and inter push time interval was quantified using sample entropy (SampEn) and compared between the groups with/without shoulder pain using non-parametric statistics. Overall findings were, (1) variability observed in contact angle fluctuations during manual wheelchair propulsion is structured (Z=3.15;pshoulder pain exhibited higher SampEn magnitude for contact angle during wheelchair propulsion than those without pain (χ(2)(1)=6.12;pshoulder pain (rs (WUSPI) =0.41;rs (VAS)=0.56;pshoulder pain. PMID:27134151

  5. Methods on simple radiogaphy of impingement syndrome in shoulder joint

    International Nuclear Information System (INIS)

    To evaluation of patients who have shoulder impingement syndrome is by diagnostic radiography. Shoulder impingement is a problem which occurs in young, active individuals as well as older individuals. In fact, the pain is probably caused by repetitive stress placed on the shoulder joint either through recreational activities of your occupation. Impingement series approach to radiographic examination of the shoulder is take five projections. First anteroposterior oblique projection. Second standard anteroposterior projection. Third superoinferior axial projection. Fourth supraspinatus outlet projection offers a view of the outlet of the supraspinatus tendon unit as it passes under the coraacromial arch. Fifth anteroposterior 30 deg caudal projection will adequately demonstrate the anterior acromial spur or ossification in the coraacromial ligament and more reliable to demonstrate spurring of the anterior acromion than supraspinatus outlet projection. This decreased the need for additional radiographic veiws, reduces the patient's exposure to x-ray radiation and decreases use of film. This can lower the cost of the evaluation and improve patient satisfaction.=20

  6. [Stability versus mobility of the shoulder. Biomechanical aspects in athletes].

    Science.gov (United States)

    Pastor, M F; Smith, T; Struck, M; Wellmann, M

    2014-03-01

    The demand profile of athletes shoulders is high. On the one hand the shoulder has to provide a maximum active range of motion that allows rapid movements of the arm and on the other hand it has to be sufficiently stabilized to decelerate rapid movements and to neutralize the resulting translational forces. Two general types of instability can be differentiated in athletes shoulders: the macroinstability typically occurring in athletes involved in contact sports and the microinstability occurring in athletes involved in overhead sports.Repetitive abduction and external rotation movements of athletes involved in overhead sports lead to adaptation of the glenohumeral joint capsule and ligaments. The anterior capsule becomes stretched while the posterior capsule develops tightness. These adaptations can result in an anterior microinstability as well as posterosuperior impingement (PSI) which implicates a pathological contact of the posterosuperior rotator cuff with the posterior glenoid and which is also associated with SLAP lesions. In contrast the shoulders of swimmers are prone to anterosuperior impingement because the arm stroke involves a forceful combined anteflexion, adduction and internal rotation of the arm.The macroinstability of contact athletes is caused by sufficient trauma and characterized by a structural lesion of capsulolabral or bony lesion. While the empirical recurrence risk of young contact athletes is already high, it can be further impaired by bony defects of the glenoid. In suspected cases, critical glenoid defects should be quantified by computed tomography (CT) scans and treated by bony augmentation of the glenoid. PMID:24604155

  7. The role of shoulder fusion in the era of arthroplasty

    OpenAIRE

    González-Díaz, R.; Rodríguez-Merchán, E. C.; Gilbert, M. S.

    1997-01-01

    The indications, surgical techniques, results and complications of shoulder fusion are described. The indications are bacterial infection, paralytic disorders in infancy, combined deltoid and rotator cuff paralysis, post-traumatic brachial plexus lesions, inflammatory arthritis with severe rotator cuff involvement, failed arthroplasty, recurrent dislocation, after resection of tumours, irreparable rotator cuff tear, painful arthritis in a patient whose activities requi...

  8. Modern Treatment Methods of Habitual Shoulder Dislocation (Literature Review

    Directory of Open Access Journals (Sweden)

    Dlyasin N.G.

    2010-09-01

    Full Text Available In the literature review the groups of the most applicable surgical interventions in treatment of patients with habitual shoulder dislocation are cited. The tendency to increase an application of arthroscopic operations seek to eliminate some realizing factors of dislocation of the humeral head is observed

  9. Coracoid syndrome: a neglected cause of anterior shoulder pain

    Science.gov (United States)

    GIGANTE, ANTONIO; BOTTEGONI, CARLO; BARBADORO, PAMELA

    2016-01-01

    Purpose the present prospective open-label study was designed to gain further insights into a condition thought to constitute a neglected but not uncommon syndrome characterized by anterior shoulder pain and tenderness to palpation over the apex of the coracoid process, not related to rotator cuff or pectoralis minor tendinopathy, long head of the biceps tendon disorders, or instability. The aim was to clarify its prevalence, clinical characteristics, differential diagnosis and response to corticosteroid injections. Methods patients with primary anterior shoulder pain precisely reproduced by deep pressure on the apex of the coracoid process were recruited. Patients with clinical or instrumental signs of other shoulder disorders were excluded. Patients were given an injection of triamcinolone acetonide 40 mg/ml 1 ml at the coracoid trigger point. They were evaluated after 15, 30 and 60 days and at 2 years using Equal Visual Analog Scale (EQ-VAS) and the Italian version of the Simple Shoulder Test (SST). Results between January 1 and December 31 2010, we treated 15 patients aged 26–66 years. The majority were women (86.67%). At 15 days, 6 (40%) patients reported complete resolution of their symptoms, while 9 (60%) complained of residual symptoms and received another injection. At 30 days, 14 (93.33%) patients were pain-free and very satisfied. At 2 years, the 14 patients who had been asymptomatic at 30 days reported that they had experienced no further pain or impaired shoulder function. The analysis of variance for repeated measures showed a significant effect of time on EQ-VAS and SST scores. Conclusions the present study documents the existence, and characteristics, of a “coracoid syndrome” characterized by anterior shoulder pain and tenderness to palpation over the apex of the coracoid process and showed that the pain is usually amenable to steroid treatment. This syndrome should be clearly distinguished from anterior shoulder pain due to other causes, in

  10. Cerebral microvascular amyloid beta protein deposition induces vascular degeneration and neuroinflammation in transgenic mice expressing human vasculotropic mutant amyloid beta precursor protein.

    NARCIS (Netherlands)

    Miao, J.; Xu, F.; Davis, J.; Otte-Holler, I.; Verbeek, M.M.; Nostrand, W.E. van

    2005-01-01

    Cerebral vascular amyloid beta-protein (Abeta) deposition, also known as cerebral amyloid angiopathy, is a common pathological feature of Alzheimer's disease. Additionally, several familial forms of cerebral amyloid angiopathy exist including the Dutch (E22Q) and Iowa (D23N) mutations of Abeta. Incr

  11. Habitat suitability index models: Black-shouldered kite

    Energy Technology Data Exchange (ETDEWEB)

    Faanes, C.A.; Howard, R.J.

    1987-01-01

    The black-shouldered kite inhabits a disjunct range extending from California, Texas, and south intermittently to Chile and Argentina (American Ornithologists' Union 1983). Prior to the 1960's, this species occurred in low numbers across much of its range. Populations of black-shouldered kite have changed considerably within the limited area of its US range. Although considered common and widespread in California in the late 1800's, the species was largely extirpated from much of the state by the early 1900's. Since 1960, the population status and range of this raptor in North America have improved markedly. Today the black-shouldered kite in California is a common species of open and cultivated bottomland. The black-shouldered kite habitat suitability index (HSI) model is intended for use with the habitat evaluation procedures (HEP) developed by the US Fish and Wildlife Service (1980) for impact assessment and habitat management. The model was developed from a review and synthesis of existing information, and includes unpublished information that reflects the opinions of persons familiar with black-shouldered kite ecology. It is scaled to produce an index of habitat suitability between 0 (unsuitable habitat) and 1.0 (optimally suitable habitat). Assumptions used to develop the HSI model and guidelines for model application, including techniques for measuring model variables, are described. Model documentation is provided. This model is a hypothesis of species-habitat relations, not a statement of proven cause and effect. The model has not been field tested. 33 refs., 3 tabs.

  12. Immunotherapy against amyloid pathology in Alzheimer's disease.

    Science.gov (United States)

    Galimberti, Daniela; Ghezzi, Laura; Scarpini, Elio

    2013-10-15

    The first drugs developed for Alzheimer's disease (AD), anticholinesterase inhibitors (AchEI), increase acetylcholine levels, previously demonstrated to be reduced in AD. To date, four AchEI are approved for the treatment of mild to moderate AD. A further therapeutic option available for moderate to severe AD is memantine. These treatments are symptomatic, whereas drugs under development are supposed to modify pathological steps leading to AD, thus acting on the evolution of the disease. For this reason they are currently termed "disease modifying" drugs. To block the progression of the disease, they have to interfere with pathogenic steps at the basis of clinical symptoms, including the deposition of extracellular amyloid beta (Aβ) plaques and of intracellular neurofibrillary tangles. The most innovative approach is represented by the vaccination and passive immunization against Aβ peptide. In this article, current knowledge about concluded and ongoing clinical trials with both vaccination with different antigens and passive immunization will be reviewed and discussed.

  13. Tau/Amyloid Beta 42 Peptide Test (Alzheimer Biomarkers)

    Science.gov (United States)

    ... helpful? Also known as: Alzheimer Biomarkers Formal name: Tau Protein and Amyloid Beta 42 Peptide Related tests: Phosporylated ... should know? How is it used? Tests for Tau protein and Aß42 may be used as supplemental tests ...

  14. Binuclear ruthenium(II) complexes for amyloid fibrils recognition

    Energy Technology Data Exchange (ETDEWEB)

    Hanczyc, Piotr, E-mail: piotr.hanczyc@chalmers.se

    2014-12-05

    Highlights: • Interactions of binuclear ruthenium(II) complexes with amyloid fibrils. • Dimer ruthenium(II) compounds are sensitive amyloid fibrils biomarkers. • Recognition of amyloid-chromophore adducts by two-photon excited emission. - Abstract: Metal–organic compounds represent a unique class of biomarkers with promising photophysical properties useful for imaging. Here interactions of insulin fibrils with two binuclear complexes [μ-(11,11′-bidppz)(phen){sub 4}Ru{sub 2}]{sup 4+} (1) and [μ-C4(cpdppz)(phen){sub 4}Ru{sub 2}]{sup 4+} (2) are studied by linear dichroism (LD) and fluorescence. These ruthenium(II) compounds could provide a new generation of amyloid binding chromophores with long lived lifetimes, good luminescence quantum yields for the bound molecules and photo-stability useful in multiphoton luminescence imaging.

  15. The effect of an active vibration stimulus according to different shoulder joint angles on functional reach and stability of the shoulder joint.

    Science.gov (United States)

    Kim, Eun-Kyung; Kim, Seong-Gil

    2016-03-01

    [Purpose] The purpose of this study was to analyze the effect of an active vibration stimulus exercise according to shoulder joint angles on functional reach and stability of the shoulder joint. [Subjects and Methods] Thirty healthy male students participated in this study. Upper limb length of each subject was measured to obtain normalized measurement values. The exercise groups were as follows: group I (n=10, shoulder joint angle of 90°), group II (n=10, shoulder joint angle of 130°), and group III (n=10, shoulder joint angle of 180°). After warm-up, an active vibration stimulus was applied to the subjects with a Flexi-Bar. The Functional Reach Test and Y-balance test were conducted for measurement of shoulder stability. [Results] Analysis of covariance was conducted with values before the intervention as covariates to analyze the differences among the groups in the two tests. There were significant differences among the groups. According to Bonferroni post hoc comparison, group I showed greater improvement than group III in the Functional Reach Test, and group II showed greater improvement than group I and group III in the Y-balance test. [Conclusion] The effect of the exercise with different shoulder joint angles revealed that the shoulder joint has a certain effective joint angle for its functionality and stability. In addition, application of an active vibration stimulus with a Flexi-Bar can be a very effective tool for improvement of functionality and stability of the shoulder joint. PMID:27134352

  16. Interactions driving the collapse of islet amyloid polypeptide: Implications for amyloid aggregation

    Science.gov (United States)

    Cope, Stephanie M.

    Human islet amyloid polypeptide (hIAPP), also known as amylin, is a 37-residue intrinsically disordered hormone involved in glucose regulation and gastric emptying. The aggregation of hIAPP into amyloid fibrils is believed to play a causal role in type 2 diabetes. To date, not much is known about the monomeric state of hIAPP or how it undergoes an irreversible transformation from disordered peptide to insoluble aggregate. IAPP contains a highly conserved disulfide bond that restricts hIAPP(1-8) into a short ring-like structure: N_loop. Removal or chemical reduction of N_loop not only prevents cell response upon binding to the CGRP receptor, but also alters the mass per length distribution of hIAPP fibers and the kinetics of fibril formation. The mechanism by which N_loop affects hIAPP aggregation is not yet understood, but is important for rationalizing kinetics and developing potential inhibitors. By measuring end-to-end contact formation rates, Vaiana et al. showed that N_loop induces collapsed states in IAPP monomers, implying attractive interactions between N_loop and other regions of the disordered polypeptide chain . We show that in addition to being involved in intra-protein interactions, the N_loop is involved in inter-protein interactions, which lead to the formation of extremely long and stable beta-turn fibers. These non-amyloid fibers are present in the 10 muM concentration range, under the same solution conditions in which hIAPP forms amyloid fibers. We discuss the effect of peptide cyclization on both intra- and inter-protein interactions, and its possible implications for aggregation. Our findings indicate a potential role of N_loop-N_loop interactions in hIAPP aggregation, which has not previously been explored. Though our findings suggest that N_loop plays an important role in the pathway of amyloid formation, other naturally occurring IAPP variants that contain this structural feature are incapable of forming amyloids. For example, hIAPP readily

  17. Amyloid-β positron emission tomography imaging probes

    DEFF Research Database (Denmark)

    Kepe, Vladimir; Moghbel, Mateen C; Långström, Bengt;

    2013-01-01

    , a number of factors appear to preclude these probes from clinical utilization. As the available "amyloid specific" positron emission tomography imaging probes have failed to demonstrate diagnostic value and have shown limited utility for monitoring therapeutic interventions in humans, a debate...... on their significance has emerged. The aim of this review is to identify and discuss critically the scientific issues contributing to the extensive inconsistencies reported in the literature on their purported in vivo amyloid specificity and potential utilization in patients....

  18. Amyloid/Melanin distinctive mark in invertebrate immunity

    OpenAIRE

    A Grimaldi; R Girardello; D Malagoli; P Falabella; Tettamanti, G.; R Valvassori; E Ottaviani; M de Eguileor

    2012-01-01

    Protostomes and Deuterostomes show the same nexus between melanin production, and amyloid fibril production, i.e., the presence of melanin is indissolubly linked to amyloid scaffold that, in turn, is conditioned by the redox status/cytoplasmic pH modification, pro-protein cleavage presence, adrenocorticotropin hormone (ACTH), melanocyte-stimulating hormone (α-MSH), and neutral endopeptidase (NEP) overexpressions. These events represent the crucial component of immune response in invertebrates...

  19. Hereditary Amyloid Cardiomyopathy Caused by a Variant Apolipoprotein A1

    OpenAIRE

    Hamidi Asl, Ladan; Liepnieks, Juris J.; Hamidi Asl, Kamran; Uemichi, Tomoyuki; Moulin, Georges; Desjoyaux, Emmanuel; Loire, Robert; Delpech, Marc; Grateau, Gilles; Benson, Merrill D.

    1999-01-01

    Autosomal dominant hereditary amyloidosis with a unique cutaneous and cardiac presentation and death from heart failure by the sixth or seventh decade was found to be associated with a previously unreported point mutation (thymine to cytosine, nt 1389) in exon 4 of the apolipoprotein A1 (apoA1) gene. The predicted substitution of proline for leucine at amino acid position 90 was confirmed by structural analysis of amyloid protein isolated from cardiac deposits of amyloid. The subunit protein ...

  20. Atrophy of muscles surrounding the shoulder in hemiplegia. Analysis with MRI

    International Nuclear Information System (INIS)

    Decrease of range of motion and subluxation of shoulders are common secondary dysfunctions after the stroke. The purpose of this study is to evaluate the atrophy of muscles surrounding shoulders in hemiplegic patients and to delineate the correlations between those atrophies and shoulder functions. MRI studies were done on bilateral shoulders in 13 hemiplegic patients with shoulder pain. The cross sectional areas of muscles surrounding shoulder, i.e., subscapularis, supraspinatus, infraspinatus, teres minor and deltoid muscle were measured on those images obtained. The degree of atrophies were evaluated by dividing cross-sectional area of the muscle on affected shoulder by that of non-affected shoulder, that is muscle atrophy ratio [MAR], for each muscle in every case. Also, the range of movements [ROM], the degree of subluxation and muscle strength of shoulder flexion were evaluated. All muscle cross-sectional areas on the affected side were significantly smaller than those of muscles on the unaffected side (p<0.01). The means of MARs were 0.68, 0.69, 0.86, 0.72 and 0.69 for subscapularis, supraspinatus, infraspinatus, teres minor and deltoid muscle. The pattern of muscle atrophies, however, varies from case to case. Both correlations of ROM versus supraspinatus MAR and degree of shoulder subluxation versus deltoid MAR were statistically significant (p<0.05). These results indicate the contribution of muscle atrophy to the shoulder dysfunction in hemiplegic patients. (author)

  1. The association between Generalized Joint Hypermobility and shoulder mobility in young, competitive swimmers

    DEFF Research Database (Denmark)

    Junge, Tina; Henriksen, P; Knudsen, H K;

    2015-01-01

    , competitive swimmers, and secondly to describe reference values for HSA among this group. Methods In total, 92 pain-free competitive swimmers (age 10-15 years) participated. GJH was evaluated by the Beighton test (BT) a 0-9 scoring system. GJH was classified at cut points ≥5/9, ≥6/9 and ≥7/9. Shoulder......Shoulder overuse injuries frequently occur among competitive swimmers (Wanivenhaus et al, 2012), however, the aetiology of shoulder dysfunction remains unclear (Zemek et al., 1995). Increased shoulder mobility as well as Generalised Joint Hypermobility (GJH), are both suggested being predisposing...... risk factors for shoulder injuries (Pink et al., 2000, Zemek et al., 1995). An association between GJH and shoulder mobility among young, competitive swimmers has not been studied. The aim of this study was firstly to evaluate the association between GJH and horizontal shoulder abduction (HSA) in young...

  2. Diagnosis of shoulder instability in dogs and cats: a retrospective study

    International Nuclear Information System (INIS)

    The glenohumeral joint is a remarkable articulation providing the greatest range of motion of any joint in the body. Glenohumeral stabilityresults from several mechanisms, including those that do not require expenditure of energy by muscle ('''passive mechanisms'') and those that do (''active mechanisms''). Glenohumeral instability has been recognized in 47 shoulders of 45 dogs and one cat. Cases are presented because of chronic foreleg lameness. Shoulder joint pain is obviated by theorthopedic examination. Only 57% of the involved shoulders presented with degenerative joint disease. Signs of instability are recognized under anesthesia using a craniocaudal or mediolateral drawer sign or both. This report describes the radiographic and arthroscopic findings of shoulder instability. Arthroscopy of the shoulder joint allows identification of all intra-articular pathologies. Shoulder instability notfully recognized in the past, appears to be the most common cause of shoulder lameness in the dog

  3. Force generation by the growth of amyloid aggregates.

    Science.gov (United States)

    Herling, Therese W; Garcia, Gonzalo A; Michaels, Thomas C T; Grentz, Wolfgang; Dean, James; Shimanovich, Ulyana; Gang, Hongze; Müller, Thomas; Kav, Batuhan; Terentjev, Eugene M; Dobson, Christopher M; Knowles, Tuomas P J

    2015-08-01

    The generation of mechanical forces are central to a wide range of vital biological processes, including the function of the cytoskeleton. Although the forces emerging from the polymerization of native proteins have been studied in detail, the potential for force generation by aberrant protein polymerization has not yet been explored. Here, we show that the growth of amyloid fibrils, archetypical aberrant protein polymers, is capable of unleashing mechanical forces on the piconewton scale for individual filaments. We apply microfluidic techniques to measure the forces released by amyloid growth for two systems: insulin and lysozyme. The level of force measured for amyloid growth in both systems is comparable to that observed for actin and tubulin, systems that have evolved to generate force during their native functions and, unlike amyloid growth, rely on the input of external energy in the form of nucleotide hydrolysis for maximum force generation. Furthermore, we find that the power density released from growing amyloid fibrils is comparable to that of high-performance synthetic polymer actuators. These findings highlight the potential of amyloid structures as active materials and shed light on the criteria for regulation and reversibility that guide molecular evolution of functional polymers.

  4. Thermal Stability Threshold for Amyloid Formation in Light Chain Amyloidosis

    Directory of Open Access Journals (Sweden)

    Tanya L. Poshusta

    2013-11-01

    Full Text Available Light chain (AL amyloidosis is a devastating disease characterized by amyloid deposits formed by immunoglobulin light chains. Current available treatments involve conventional chemotherapy and autologous stem cell transplant. We have recently concluded a phase III trial comparing these two treatments. AL amyloidosis patients who achieve hematological complete response (CR do not necessarily achieve organ response regardless of the treatment they received. In order to investigate the possible correlation between amyloid formation kinetics and organ response, we selected AL amyloidosis patients from the trial with kidney involvement and CR after treatment. Six patients were selected and their monoclonal immunoglobulin light chains were characterized. The proteins showed differences in their stability and their kinetics of amyloid formation. A correlation was detected at pH 7.4, showing that less stable proteins are more likely to form amyloid fibrils. AL-T03 is too unstable to form amyloid fibrils at pH 7.4. This protein was found in the only patient in the study that had organ response, suggesting that partially folded species are required for amyloid formation to occur in AL amyloidosis.

  5. Light Chain Amyloid Fibrils Cause Metabolic Dysfunction in Human Cardiomyocytes.

    Directory of Open Access Journals (Sweden)

    Helen P McWilliams-Koeppen

    Full Text Available Light chain (AL amyloidosis is the most common form of systemic amyloid disease, and cardiomyopathy is a dire consequence, resulting in an extremely poor prognosis. AL is characterized by the production of monoclonal free light chains that deposit as amyloid fibrils principally in the heart, liver, and kidneys causing organ dysfunction. We have studied the effects of amyloid fibrils, produced from recombinant λ6 light chain variable domains, on metabolic activity of human cardiomyocytes. The data indicate that fibrils at 0.1 μM, but not monomer, significantly decrease the enzymatic activity of cellular NAD(PH-dependent oxidoreductase, without causing significant cell death. The presence of amyloid fibrils did not affect ATP levels; however, oxygen consumption was increased and reactive oxygen species were detected. Confocal fluorescence microscopy showed that fibrils bound to and remained at the cell surface with little fibril internalization. These data indicate that AL amyloid fibrils severely impair cardiomyocyte metabolism in a dose dependent manner. These data suggest that effective therapeutic intervention for these patients should include methods for removing potentially toxic amyloid fibrils.

  6. Complexation of amyloid fibrils with charged conjugated polymers.

    Science.gov (United States)

    Ghosh, Dhiman; Dutta, Paulami; Chakraborty, Chanchal; Singh, Pradeep K; Anoop, A; Jha, Narendra Nath; Jacob, Reeba S; Mondal, Mrityunjoy; Mankar, Shruti; Das, Subhadeep; Malik, Sudip; Maji, Samir K

    2014-04-01

    It has been suggested that conjugated charged polymers are amyloid imaging agents and promising therapeutic candidates for neurological disorders. However, very less is known about their efficacy in modulating the amyloid aggregation pathway. Here, we studied the modulation of Parkinson's disease associated α-synuclein (AS) amyloid assembly kinetics using conjugated polyfluorene polymers (PF, cationic; PFS, anionic). We also explored the complexation of these charged polymers with the various AS aggregated species including amyloid fibrils and oligomers using multidisciplinary biophysical techniques. Our data suggests that both polymers irrespective of their different charges in the side chains increase the fibrilization kinetics of AS and also remarkably change the morphology of the resultant amyloid fibrils. Both polymers were incorporated/aligned onto the AS amyloid fibrils as evident from electron microscopy (EM) and atomic force microscopy (AFM), and the resultant complexes were structurally distinct from their pristine form of both polymers and AS supported by FTIR study. Additionally, we observed that the mechanism of interactions between the polymers with different species of AS aggregates were markedly different.

  7. Switchable photooxygenation catalysts that sense higher-order amyloid structures

    Science.gov (United States)

    Taniguchi, Atsuhiko; Shimizu, Yusuke; Oisaki, Kounosuke; Sohma, Youhei; Kanai, Motomu

    2016-10-01

    Proteins can misfold into amyloid structures that are associated with diseases; however, the same proteins often have important biological roles. To degrade selectively the amyloid form without affecting the fraction of functional protein is, therefore, an attractive goal. Here we report target-state-dependent photooxygenation catalysts that are active only when bound to the cross-β-sheet structure that is characteristic of pathogenic aggregated amyloid proteins. We show these catalysts can selectively oxygenate the amyloid form of amyloid β-protein (Aβ) 1-42 in the presence of non-amyloid off-target substrates. Furthermore, photooxygenation with a catalyst that bears an Aβ-binding peptide attenuated the Aβ pathogenicity in the presence of cells. We also show that selective photooxygenation is generally applicable to other amyloidogenic proteins (amylin, insulin, β2-microglobulin, transthyretin and α-synuclein) and does not affect the physiologically functional non-aggregate states of these proteins. This is the first report of an artificial catalyst that can be selectively and reversibly turned on and off depending on the structure and aggregation state of the substrate protein.

  8. Human serum amyloid P component is an invariant constituent of amyloid deposits and has a uniquely homogeneous glycostructure.

    OpenAIRE

    Pepys, M B; Rademacher, T W; Amatayakul-Chantler, S.; Williams, P.; Noble, G. E.; Hutchinson, W L; Hawkins, P N; Nelson, S R; Gallimore, J. R.; Herbert, J.

    1994-01-01

    Human serum amyloid P component (SAP) is a normal plasma protein and the precursor of amyloid P component (AP), a universal constituent of the abnormal tissue deposits in amyloidosis, including Alzheimer disease. We show here that its single N-linked biantennary oligosaccharide does not display the microheterogeneity usually characteristic of glycoproteins. The protein and the glycan structures of AP were also invariant, their resistance to degradation suggesting a role in persistence of amyl...

  9. An MRI study on the relations between muscle atrophy, shoulder function and glenohumeral deformity in shoulders of children with obstetric brachial plexus injury

    Directory of Open Access Journals (Sweden)

    van Doorn-Loogman Mirjam H

    2009-05-01

    Full Text Available Abstract Background A substantial number of children with an obstetric brachial plexus lesion (OBPL will develop internal rotation adduction contractures of the shoulder, posterior humeral head subluxations and glenohumeral deformities. Their active shoulder function is generally limited and a recent study showed that their shoulder muscles were atrophic. This study focuses on the role of shoulder muscles in glenohumeral deformation and function. Methods This is a prospective study on 24 children with unilateral OBPL, who had internal rotation contractures of the shoulder (mean age 3.3 years, range 14.7 months to 7.3 years. Using MR imaging from both shoulders the following parameters were assessed: glenoid form, glenoscapular angle, subluxation of the humeral head, thickness and segmental volume of the subscapularis, infraspinatus and deltoid muscles. Shoulder function was assessed measuring passive external rotation of the shoulder and using the Mallet score for active function. Statistical tests used are t-tests, Spearman's rho, Pearsons r and logistic regression. Results The affected shoulders showed significantly reduced muscle sizes, increased glenoid retroversion and posterior subluxation. Mean muscle size compared to the normal side was: subscapularis 51%, infraspinatus 61% and deltoid 76%. Glenoid form was related to infraspinatus muscle atrophy. Subluxation was related to both infraspinatus and subscapularis atrophy. There was no relation between atrophy of muscles and passive external rotation. Muscle atrophy was not related to the Mallet score or its dimensions. Conclusion Muscle atrophy was more severe in the subscapularis muscle than in infraspinatus and deltoid. As the muscle ratios are not related to passive external rotation nor to active function of the shoulder, there must be other muscle properties influencing shoulder function.

  10. Arthroscopic Shoulder Surgery in Female Professional Tennis Players

    Science.gov (United States)

    Young, Simon W.; Safran, Marc R.; Dakic, Jodie; Nguyen, Michael L.; Stroia, Kathleen

    2013-01-01

    Objectives: Recent publications have highlighted the relatively poor outcome of other overhead athletes, particularly baseball players, with regard to return to sports at the same or higher level after shoulder surgery. However, true assessment of their ability when returning to sport is not as clear. Further, ability to return to other overhead sports has not been reported. Our objective was to assess outcome and time to return to previous level of function following shoulder surgery in professional tennis players. Methods: The records of all female tennis players on the Women’s Tennis Association (WTA) professional circuit between January 2008 and June 2010 were reviewed to identify players who underwent shoulder surgery on their dominant (serving) shoulder. Details of the surgery including date, procedures performed, and complications were recorded. The primary outcomes were ability and time to return to professional play, and if they were able to return to their previous level of function, as determined by singles ranking. Pre and post-operative singles rankings were used to determine rate and completeness of return to preoperative function. Their highest ranking pre-injury, post operatively, and the time to return to pre-injury ranking were evaluated. Results: During the study period eight professional women tennis players from the WTA underwent shoulder surgery on their dominant arm. All surgery was performed arthroscopically, 7 out of 8 players had more than one procedure performed during the surgery. In total, 3 players underwent debridement of a partial rotator cuff tear and 2 players underwent repair of a complete supraspinatus tear. Three players had an anterior labral repair or reconstruction for anterior instability, and one player underwent repair of a SLAP lesion. Two players underwent neurolysis of a suprascapular nerve, and three players in total underwent a subacromial decompression. All players (100%) returned to professional play. The mean

  11. Common molecular mechanism of amyloid pore formation by Alzheimer’s β-amyloid peptide and α-synuclein

    Science.gov (United States)

    Di Scala, Coralie; Yahi, Nouara; Boutemeur, Sonia; Flores, Alessandra; Rodriguez, Léa; Chahinian, Henri; Fantini, Jacques

    2016-01-01

    Calcium-permeable pores formed by small oligomers of amyloid proteins are the primary pathologic species in Alzheimer’s and Parkinson’s diseases. However, the molecular mechanisms underlying the assembly of these toxic oligomers in the plasma membrane of brain cells remain unclear. Here we have analyzed and compared the pore-forming capability of a large panel of amyloid proteins including wild-type, variant and truncated forms, as well as synthetic peptides derived from specific domains of Aβ1-42 and α-synuclein. We show that amyloid pore formation involves two membrane lipids, ganglioside and cholesterol, that physically interact with amyloid proteins through specific structural motifs. Mutation or deletion of these motifs abolished pore formation. Moreover, α-synuclein (Parkinson) and Aβ peptide (Alzheimer) did no longer form Ca2+-permeable pores in presence of drugs that target either cholesterol or ganglioside or both membrane lipids. These results indicate that gangliosides and cholesterol cooperate to favor the formation of amyloid pores through a common molecular mechanism that can be jammed at two different steps, suggesting the possibility of a universal therapeutic approach for neurodegenerative diseases. Finally we present the first successful evaluation of such a new therapeutic approach (coined “membrane therapy”) targeting amyloid pores formed by Aβ1-42 and α-synuclein. PMID:27352802

  12. Common molecular mechanism of amyloid pore formation by Alzheimer's β-amyloid peptide and α-synuclein.

    Science.gov (United States)

    Di Scala, Coralie; Yahi, Nouara; Boutemeur, Sonia; Flores, Alessandra; Rodriguez, Léa; Chahinian, Henri; Fantini, Jacques

    2016-01-01

    Calcium-permeable pores formed by small oligomers of amyloid proteins are the primary pathologic species in Alzheimer's and Parkinson's diseases. However, the molecular mechanisms underlying the assembly of these toxic oligomers in the plasma membrane of brain cells remain unclear. Here we have analyzed and compared the pore-forming capability of a large panel of amyloid proteins including wild-type, variant and truncated forms, as well as synthetic peptides derived from specific domains of Aβ1-42 and α-synuclein. We show that amyloid pore formation involves two membrane lipids, ganglioside and cholesterol, that physically interact with amyloid proteins through specific structural motifs. Mutation or deletion of these motifs abolished pore formation. Moreover, α-synuclein (Parkinson) and Aβ peptide (Alzheimer) did no longer form Ca(2+)-permeable pores in presence of drugs that target either cholesterol or ganglioside or both membrane lipids. These results indicate that gangliosides and cholesterol cooperate to favor the formation of amyloid pores through a common molecular mechanism that can be jammed at two different steps, suggesting the possibility of a universal therapeutic approach for neurodegenerative diseases. Finally we present the first successful evaluation of such a new therapeutic approach (coined "membrane therapy") targeting amyloid pores formed by Aβ1-42 and α-synuclein. PMID:27352802

  13. Dynamic posterior stabilization of shoulder hemiarthroplasty in long-standing neglected posterior dislocation of the glenohumeral joint

    OpenAIRE

    Shyam Kumar A; Oakley Jeremy; Wootton Jamie

    2008-01-01

    Posterior dislocations of the shoulder are rare. They account for less than 3% of all shoulder dislocations. The treatment of neglected bilateral posterior dislocation of the shoulder is controversial. We present a novel operative technique to stabilize a shoulder hemiarthroplasty that we used in the treatment of a chronic posterior dislocation of a shoulder with an acute four-part fracture of the proximal humerus.

  14. Dynamic posterior stabilization of shoulder hemiarthroplasty in long-standing neglected posterior dislocation of the glenohumeral joint

    Directory of Open Access Journals (Sweden)

    Shyam Kumar A

    2008-01-01

    Full Text Available Posterior dislocations of the shoulder are rare. They account for less than 3% of all shoulder dislocations. The treatment of neglected bilateral posterior dislocation of the shoulder is controversial. We present a novel operative technique to stabilize a shoulder hemiarthroplasty that we used in the treatment of a chronic posterior dislocation of a shoulder with an acute four-part fracture of the proximal humerus.

  15. Percutaneous neuromuscular electrical stimulation (P-NMES) for treating shoulder pain in chronic hemiplegia. Effects on shoulder pain and quality of life

    NARCIS (Netherlands)

    Renzenbrink, Gerbert J.; IJzerman, Maarten J.

    2004-01-01

    Objective: To evaluate the effect of percutaneous neuromuscular electrical stimulation (P-NMES) of the shoulder muscles on shoulder pain intensity and health-related quality of life in chronic hemiplegia. Design: Prospective, open label design. Setting: The outpatient services of a large teachin

  16. Effect of shoulder taping on maximum shoulder external and internal rotation range in uninjured and previously injured overhead athletes during a seated throw.

    Science.gov (United States)

    McConnell, Jenny; Donnelly, Cyril; Hamner, Samuel; Dunne, James; Besier, Thor

    2011-09-01

    The purpose of our study was to investigate whether shoulder taping affects shoulder kinematics in injured and previously injured overhead athletes during a seated throw. Twenty-six overhead college athletes threw a handball three times with and without tape, while seated on a chair. An 8-camera Vicon Motion Capture system recorded markers placed on the upper limb and trunk during each of the throwing conditions. Scaled musculoskeletal models of the upper limb were created using OpenSim and inverse kinematics used to obtain relevant joint angles. Shoulder taping had no main effect on external (ER) and internal (IR) rotation range (ROM) of the shoulder, but a significant interaction effect was found (p = 0.003 and 0.02, respectively), depending on previous injury status, whereby both the ER and IR ROM of the shoulder in the group of previously injured athletes decreased when taped (143-138° and 54-51°, respectively), but increased in the group who had never been injured (131-135° and 42-44°, respectively). Maximum abduction range and ball velocity were not affected by the application of shoulder taping, regardless of previous injury status. Thus, application of shoulder taping has a differential effect on maximum shoulder ER and IR ROM during throwing depending on previous injury status. These findings have implications for returning athletes to sport after injury and for screening athletes at risk of injury. PMID:21437968

  17. Designed Trpzip-3 β-Hairpin Inhibits Amyloid Formation in Two Different Amyloid Systems.

    Science.gov (United States)

    Hopping, Gene; Kellock, Jackson; Caughey, Byron; Daggett, Valerie

    2013-09-12

    The trpzip peptides are small, monomeric, and extremely stable β-hairpins that have become valuable tools for studying protein folding. Here, we show that trpzip-3 inhibits aggregation in two very different amyloid systems: transthyretin and Aβ(1-42). Interestingly, Trp → Leu mutations renders the peptide ineffective against transthyretin, but Aβ inhibition remains. Computational docking was used to predict the interactions between trpzip-3 and transthyretin, suggesting that inhibition occurs via binding to the outer region of the thyroxine-binding site, which is supported by dye displacement experiments. PMID:24900756

  18. Peripheral Amyloid-β Levels Regulate Amyloid-β Clearance from the Central Nervous System

    OpenAIRE

    Marques, Marcos A.; Kulstad, J. Jacob; Savard, Christopher E.; Green, Pattie S.; Lee, Sum P.; Craft, Suzanne; Watson, G. Stennis; Cook, David G.

    2009-01-01

    Amyloid-β (Aβ) is cleared from the brain by both proteolytic digestion and transport across the blood-brain-barrier into the peripheral circulatory system. To investigate the role peripheral Aβ levels play in regulating Aβ brain clearance, we measured the clearance of [125I]-Aβ-{1-40 injected into the brains of liver-ligated rats that allowed peripheral Aβ levels to be maintained at elevated levels for approximately one hour with/without a single peripheral bolus of unlabeled Aβ-{1-40. We fou...

  19. Shoulder arthroplasty in complex acute and chronic proximal humeral fractures

    DEFF Research Database (Denmark)

    Frich, Lars Henrik; Søjbjerg, J.O.; Sneppen, O.

    1991-01-01

    From 1983 to 1988, 42 shoulder arthroplasties were performed on comminuted acute or chronic proximal humeral fractures. Patients were categorized according to the post-fracture operative delay; there were 15 four-part fractures, with median post-fracture delay of 13 days (range: 7 to 21), and 27......-system and classified into four groups. Pain relief was satisfactory in the acute group, but was unpredictable in the chronic group. The results in the acute group were significantly superior (P less than .05). In the acute group, 3 (20%) patients had an excellent result and 6 patients (40%) had a good result, compared...... instability were seen in shoulders formerly treated with osteosynthesis (one acute and four chronic cases). Two of these cases developed an infection. Good results can be expected after prosthetic replacement in acute proximal humeral fractures. Failed primary treatment reduces the possibility of a good...

  20. Imaging findings in posterior instability of the shoulder

    International Nuclear Information System (INIS)

    Posterior shoulder instability refers to the symptoms and signs resulting from excessive posterior translation of the humerus. Magnetic resonance (MR) imaging is the radiological modality of choice in the diagnostic assessment of posterior instability. Computed tomography (CT) is useful in the evaluation of osseous abnormalities associated with posterior instability. A detailed description of the posterior osseous and labroligamentous abnormalities has evolved recently, and many variant lesions of the posteroinferior labrum and/or capsular structures have been described. As the recommended surgical management of lesions associated with posterior instability is a lesion-specific approach, awareness of the specific lesions that have been described in association with posterior instability helps in pre-surgical planning. The purpose of this article is to review the classification of, and injury mechanisms leading to, posterior shoulder instability and to describe imaging findings associated with posterior instability, with emphasis on MR imaging. (orig.)