Adiponectin is a secretory protein of adipocytes that plays an important role in pathological processes by participation in modulating the immune and inflammatory responses. The pro-inflammatory effect of adiponectin is observed in rheumatoid arthritis (RA). In this study, we examined adiponectin plasma levels and the expression of adiponectin in bone marrow tissue samples, synovium samples, and infrapatellar fat pad samples from patients with osteoarthritis (OA) and RA. Additionally we examined the expression of adiponectin receptors AdipoR1 and AdipoR2 in synovium samples and infrapatellar fat pad samples from patients with OA and RA. We also assessed the correlations between adiponectin plasma concentrations, adiponectin expression in bone marrow, synovium, infrapatellar fat pad, and plasma levels of selected cytokines. We found increased expression of adiponectin in synovium samples and infrapatellar fat pad samples from patients with RA as compared to patients with OA. There were no statistically significant differences of adiponectin plasma levels and adiponectin expression in bone marrow tissue samples between OA and RA patients. There were no differences in the expression of AdipoR1 and AdipoR2 at the mRNA level in synovial tissue and the infrapatellar fat pad between RA and OA patients. However, in immunohistochemical analysis in samples of the synovial membrane from RA patients, we observed very strong expression of adiponectin in intima cells, macrophages, and subintimal fibroblasts, such as synoviocytes, vs. strong expression in OA samples. Very strong expression of adiponectin was also noted in adipocytes of Hoffa’s fat pad of RA patients. Expression of AdipoR1 was stronger in RA tissue samples, while AdipoR2 expression was very similar in both RA and OA samples. Our results showed increased adiponectin expression in the synovial membrane and Hoffa’s pad in RA patients compared to that of OA patients. However, there were no differences in plasma adiponectin concentrations and its expression in bone marrow. The results suggest that adiponectin is a component of the inflammatory cascade that is present in RA. Pro-inflammatory factors enhance the expression of adiponectin, especially in joint tissues—the synovial membrane and Hoffa’s fat pad. In turn, adiponectin also increases the expression of further pro-inflammatory mediators.
(1) Background: In this study, two types of implants were compared—a conventional hip stem and a femoral neck prosthesis. (2) Methods: The femoral neck prosthesis study group included 21 patients, while the conventional hip stem control group was 40 patients. The first examination was the pre-op check, while the next ones were performed 6 weeks, 1 year, and 3 years after surgery. The Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Hip Score (OHS), University of California at Los Angeles Activity Score (UCLA), and Visual Analog Scale EQ (VAS EQ) forms were completed at each clinical study visit. (3) Results: The HHS in the femoral neck prosthesis group and the conventional hip stem group 6 weeks after surgery was 68.8 ± 16.47 and 67.6 ± 8.92, respectively, and 1 year after surgery, this was 93 ± 5.58 vs. 90.6 ± 5.17, respectively. The OHS of the femoral neck prosthesis group was 34.8 points after 6 weeks, 45.5 points after 1 year, and 43.9 points after 3 years. The respective values in the conventional hip stem group were 35.5, 41.55, and 42.13 points. The WOMAC values for the femoral neck prosthesis group were 70.6, 92.7, and 86 points, respectively, while for the conventional hip stem group, they were 74, 88.1, and 86.1 points. The UCLA scores recorded in the conventional hip stem group ranged from 3.15 to 5.05 points, but a higher mean value of 5.33 points was obtained in the femoral neck prosthesis group. VAS EQ was equal to 84 points three years after the operation. (4) Conclusions: The study showed no significant differences in the functional scores of both groups, and the new type of cervical femoral stem could be the first choice in younger patients.
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STRESZCZENIEChłonkotok po operacjach ortopedycznych jest rzadko występującym powikłaniem. W pracy przedstawiono przypadek pacjentki, u której obserwowano chłonkotok szyjny jako wczesne powikłanie przecięcia mięśnia pochyłego przedniego (skalenotomii). Skuteczne zatrzymanie chłonkotoku uzyskano przez zamknięcie przewodu piersiowego z użyciem techniki VATS (torakoskopia z wideoasystą), po początkowym nieskutecznym leczeniu zachowawczym.Słowa kluczowe: chłonkotok, skalenotomia, VATS, mięśnie pochyłe SUMMARY Lymphorrhoea is a rare complication after orthopaedic surgeries. This paper presents a case of a patient who demonstrated cervical lymphorrhoea as an early complication of scalenotomy. The lymphorrhoea was successfully stopped through VATS closure of the thoracic duct following initial ineffective conservative treatment. MEDSPORTPRESS, 2014; 6(6); Vol. 16, 669-673 DOI: 10.5604/15093492.1135130 Key words: lymphorrhoea, scalenotomy, VATS, scalene musclesO O r r t t o o p p e e d d i i a a Traumatologia Rehabilitacja © WSTĘPChłon ko tok jest rzad kim po wi kła niem ope ra cji to ra ko chi rur gicz nych, kar dio chi rur gicz nych, oto laryn go lo gicz nych. Mo że wy stą pić rów nież po ka niula cji ży ły pod oboj czy ko wej czy po cew ni ko wa niu lewej po ło wy ser ca [1,2,3]. Po ope ra cjach to ra ko chirur gicz nych wy stę pu je w 0,5-2% przy pad ków [4]. W li te ra tu rze świa to wej opi sa no tyl ko kil ka przy padków je go wy stą pie nia po ope ra cjach or to pe dycz nych, głów nie po za bie gach w ob rę bie krę go słu pa szyj nego z do stę pu przed nie go [5]. Nie le czo ny szyb ko prowa dzi do wy nisz cze nia or ga ni zmu z po wo du hi popro te ine mii, spad ku od por no ści i cię żkich za bu rzeń me ta bo licz nych [2]. Śmier tel ność się ga, we dług ró ż -nych źró deł, na wet 25% przy pad ków. Szyb ka diagno sty ka chłon ko to ku jest nie zbęd na do pod ję cia wła ści wych de cy zji te ra peu tycz nych, któ re chro nią pa cjen ta przed na stęp stwa mi te go rzad kie go po wi kła -nia. Po stę po wa nie zmie rza ją ce do za trzy ma nia chłon -ko to ku obej mu je le cze nie za cho waw cze, po dej mo wane zwy kle ja ko pierw sze, a w ra zie je go nie sku tecz ności le cze nie ope ra cyj ne. Le cze nie za cho waw cze po lega na wstrzy ma niu ży wie nia do ust ne go, uzu peł nia niu pły nów i elek tro li tów oraz dre na żu zbior ni ka chłon ki, na to miast spo śród wie lu me tod ope ra cyj nych naj czę -ściej sto so wa ne jest nad prze po no we pod wią za nie przewo du pier sio we go przez pra wo stron ną to ra ko to mię lub, co raz czę ściej, z za sto so wa niem tech ni ki VATS [3,4,6,7]. Pra ca przed sta wia opis przy pad ku chłon -ko to ku, któ ry wy stą pił ja ko wcze sne po wi kła nie po ope ra cji od bar cze nia ko rze ni C5 i C6 przez prze cię cie mię śnia po chy łe go przed nie go. W opi sa nym przy padku pod ję to pró bę le cze nia za cho waw cze go, któ ra oka za ła się nie sku tecz na, wo bec te go ope ra cyj nie zamknię to prze wód pier sio wy z za sto so wa niem tech niki VATS. OPIS PRZY PAD KU...
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