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Introduction
Although shoulder girdle injuries are frequent, those of the medial part are widely unexplored.
Our aim is to improve the knowledge of this rare injury and its management in Germany
by big data analysis.
Methods
The data are based on ICD-10 codes of all German hospitals as provided by the German
Federal Statistical Office. Based on the ICD-10 codes S42.01 (medial clavicle fracture,
MCF) and S43.2 (sternoclavicular joint dislocation, SCJD), anonymized patient data from
2012 to 2014 were evaluated retrospectively for epidemiologic issues. We analyzed especially
the concomitant injuries and therapy strategies.
Results
A total of 114,003 cases with a clavicle involving shoulder girdle injury were identified with
12.5% of medial clavicle injuries (MCI). These were accompanied by concomitant injuries,
most of which were thoracic and craniocerebral injuries as well as injuries at the shoulder/
upper arm. A significant difference between MCF and SCJD concerning concomitant injuries
only appears for head injuries (p = 0.003). If MCI is the main diagnosis, soft tissue injuries
typically occur as secondary diagnoses. The MCI are significantly more often
associated with concomitant injuries (p < 0.001) for almost each anatomic region compared
with lateral clavicle injuries (LCI). The main differences were found for thoracic and upper
extremity injuries. Different treatment strategies were used, most frequently plate osteosynthesis
in more than 50% of MCF cases. Surgery on SCJD was performed with K-wires,
tension flange or absorbable materials, fewer by plate osteosynthesis.
Conclusions
We proved that MCI are rare injuries, which might be why they are treated by inhomogeneous
treatment strategies. No standard procedure has yet been established. MCI can
occur in cases of severely injured patients, often associated with severe thoracic or other
concomitant injuries. Therefore, MCI appear to be more complex than LCI. Further studies
are required regarding the development of standard treatment strategy and representative
clinical studies.
Clavicle injuries are common, but only few case reports describe combined clavicular injuries (CCI). CCI include combinations between clavicular fractures and acromioclavicular/sternoclavicular joint dislocations (SCJD). We present the first general therapeutic recommendations for CCI based on a new classification and their distribution. A retrospective, epidemiological, big data analysis was based on ICD-10 diagnoses from 2012 to 2014 provided by the German Federal Statistical Office. CCI represent 0.7% of all clavicle-related injuries (n = 814 out of 114,003). SCJD show by far the highest proportion of combination injuries (13.2% of all SCJD were part of CCI) while the proportion of CCI in relation to the other injury entities was significantly less (p < 0.023). CCIs were classified depending on (1) the polarity (monopolar type I, 92.2% versus bipolar type II, 7.8%). Monopolar type I was further differentiated depending on (2) the positional relationship between the combined injuries: Ia two injuries directly at the respective pole versus Ib with an injury at one end plus an additional midshaft clavicle fracture. Type II was further differentiated depending on (3) the injured structures: IIa ligamento-osseous, type IIb purely ligamentous (rarest with 0.6%). According to our classification, the CCI severity increases from type Ia to IIb. CCI are more important than previously believed and seen as an indication for surgery. The exclusion of further, contra-polar injuries in the event of a clavicle injury is clinically relevant and should be focused.
on-healing wounds continue to be a clinical challenge for patients and medical staff.
These wounds have a heterogeneous etiology, including diabetes and surgical trauma wounds. It is
therefore important to decipher molecular signatures that reflect the macroscopic process of wound
healing. To this end, we collected wound sponge dressings routinely used in vacuum assisted therapy
after surgical trauma to generate wound-derived protein profiles via global mass spectrometry.
We confidently identified 311 proteins in exudates. Among them were expected targets belonging to
the immunoglobulin superfamily, complement, and skin-derived proteins, such as keratins. Next to
several S100 proteins, chaperones, heat shock proteins, and immune modulators, the exudates
presented a number of redox proteins as well as a discrete neutrophil proteomic signature, including
for example cathepsin G, elastase, myeloperoxidase, CD66c, and lipocalin 2. We mapped over 200
post-translational modifications (PTMs; cysteine/methionine oxidation, tyrosine nitration, cysteine
trioxidation) to the proteomic profile, for example, in peroxiredoxin 1. Investigating manually
collected exudates, we confirmed presence of neutrophils and their products, such as microparticles
and fragments containing myeloperoxidase and DNA. These data confirmed known and identified
less known wound proteins and their PTMs, which may serve as resource for future studies on
human wound healing
AbstractCold physical plasma is a partially ionized gas that generates various components identified as potential anticancer compounds. Due to its topical application, cold plasmas are suitable, especially in dermatological applications. We, therefore, tested the cold plasma effects in skin cancer cells in vitro. An atmospheric pressure argon plasma jet was used as the plasma source. The plasma exposure alone reduced the metabolic activity and induced lethal effects in a treatment time-dependent fashion in both cell lines investigated. This was accompanied by executioner caspases 3 and 7, cleavage indicative of apoptosis and reduced cell migration and proliferation. Recent research also indicated roles of novel indirubin derivatives with potent anticancer effects. Three candidates were tested, and reduced metabolic activity and viability in a dose-dependent manner were found. Strikingly, one compound exerted notable synergistic toxicity when combined with plasma in skin cancer cells, which may be promising for future in vivo experiments.
Case Report: Intraarticular Iliopsoas Tendon causes Groin Pain Following Periacetabular Osteotomy
(2022)
A 43-year-old female patient reported persistent iliopsoas-related groin pain following periacetabular osteotomy (PAO) combined with femoroplasty via a direct anterior approach due to CAM morphology. Concomitantly with the planned removal of screws, hip arthroscopy was performed, and the iliopsoas tendon was found to run intraarticularly, resulting in the tendon being impaired in its mobility and being entrapped. The tendon was arthroscopically released. The patient reported relief of the groin pain after the arthroscopic tendon debridement. During PAO combined with capsulotomy, the postoperatively observed intraarticular position of the iliopsoas tendon should be prevented by careful closure of the joint capsule.
: Human osteosarcoma (OS) is the most common primary malignant bone tumor occurring
most commonly in adolescents and young adults. Major improvements in disease-free survival have
been achieved by implementing a combination therapy consisting of radical surgical resection of the
tumor and systemic multi-agent chemotherapy. However, long-term survival remains poor, so novel
targeted therapies to improve outcomes for patients with osteosarcoma remains an area of active
research. This includes immunotherapy, photodynamic therapy, or treatment with nanoparticles.
Cold atmospheric plasma (CAP), a highly reactive (partially) ionized physical state, has been shown
to inherit a significant anticancer capacity, leading to a new field in medicine called “plasma oncology.”
The current article summarizes the potential of CAP in the treatment of human OS and reviews the
underlying molecular mode of action.
Osteosarcoma and Ewing’s sarcoma are the most common malignant bone tumors.Conventional therapies such as polychemotherapy, local surgery, and radiotherapy improve theclinical outcome for patients. However, they are accompanied by acute and chronic side effectsthat affect the quality of life of patients, motivating novel research lines on therapeutic optionsfor the treatment of sarcomas. Previous experimental work with physical plasma operated atbody temperature (cold atmospheric plasma, CAP) demonstrated anti-oncogenic effects on differentcancer cell types. This study investigated the anti-cancer effect of CAP on two bone sarcomaentities, osteosarcoma and Ewing’s sarcoma, which were represented by four cell lines (U2-OS,MNNG/HOS, A673, and RD-ES). A time-dependent anti-proliferative effect of CAP on all cell lineswas observed. CAP-induced alterations in cell membrane functionality were detected by performinga fluorescein diacetate (FDA) release assay and an ATP release assay. Additionally, modifications ofthe cell membrane and modifications in the actin cytoskeleton composition were examined usingfluorescence microscopy monitoring dextran-uptake assay and G-/F-actin distribution. Furthermore,the CAP-induced induction of apoptosis was determined by TUNEL and active caspases assays.The observations suggest that a single CAP treatment of bone sarcoma cells may have significantanti-oncogenic effects and thus may be a promising extension to existing applications.
Background: Cold atmospheric plasma (CAP) is increasingly used in the field of oncology.
Many of the mechanisms of action of CAP, such as inhibiting proliferation, DNA breakage, or the
destruction of cell membrane integrity, have been investigated in many different types of tumors.
In this regard, data are available from both in vivo and in vitro studies. Not only the direct treatment
of a tumor but also the influence on its blood supply play a decisive role in the success of the therapy
and the patient’s further prognosis. Whether the CAP influences this process is unknown, and the
first indications in this regard are addressed in this study. Methods: Two different devices, kINPen
and MiniJet, were used as CAP sources. Human endothelial cell line HDMEC were treated directly
and indirectly with CAP, and growth kinetics were performed. To indicate apoptotic processes,
caspase-3/7 assay and TUNEL assay were used. The influence of CAP on cellular metabolism
was examined using the MTT and glucose assay. After CAP exposure, tube formation assay was
performed to examine the capillary tube formation abilities of HDMEC and their migration was
messured in separate assays. To investigate in a possible mutagenic effect of CAP treatment,
a hypoxanthine-guanine-phosphoribosyl-transferase assay with non malignant cell (CCL-93) line was
performed. Results: The direct CAP treatment of the HDMEC showed a robust growth-inhibiting
effect, but the indirect one did not. The MMT assay showed an apparent reduction in cell metabolism
in the first 24 h after CAP treatment, which appeared to normalize 48 h and 72 h after CAP application.
These results were also confirmed by the glucose assay. The caspase 3/7 assay and TUNEL assay
showed a significant increase in apoptotic processes in the HDMEC after CAP treatment. These results
were independent of the CAP device. Both the migration and tube formation of HDMEC were
significant inhibited after CAP-treatment. No malignant effects could be demonstrated by the CAP
treatment on a non-malignant cell line.