We treated 12 shoulders in ten patients with irreparable rotator-cuff tears by transfer of the latissimus dorsi. There were nine men and one woman. Their average age was 64.0 years and the average follow-up was 35.6 months (26 to 42).The results were excellent in four shoulders, good in four, fair in one, and poor in three. Active forward flexion improved from a preoperative average of 99°t o a postoperative average of 135°. Osteoarthritic changes appeared in five shoulders and proximal migration of the humeral head progressed in six. EMG revealed that nine of the 12 transferred muscles showed activity which was synergistic with the supraspinatus on external rotation with abduction.We conclude that latissimus dorsi transfer can be effective in restoring shoulder function after massive irreparable tears of the rotator cuff.

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The current studies examine the pore properties and biological effects of DNA-chitosan complexes, which may be useful as scaffolds for tissue engineering. The porosity of the DNA-chitosan complexes was controlled by rinsing them with several different pH 7.2 buffer solutions, including phosphate-buffered saline (PBS), Tris-HCl, boric acid, and N-(2-hydroxyethyl)piperazine-N'-(2-ethanesufonic acid) (HEPES). Rinsing with PBS resulted in 84% porosity, whereas rinsing with Tris-HCl produced 94% porosity. It was further found that daunorubicin hydrochloride complex intercalated with and bound to the groove of the DNA-chitosan complexes, indicating that DNA in the complexes maintains its double-stranded helical structure. The DNA-chitosan complexes were not toxic to MG-63 osteoblast-like cells and caused only a mild tissue response when implanted subcutaneously in the backs of rats. These results suggest that buffer-rinsed DNA-chitosan complexes may be useful as a scaffold material in tissue engineering.

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A novel scaffold material based on an alginate hydrogel which contained carbon nanotubes（CNTs）was prepared, and its mechanical property and biocompatibility evaluated. Soluble CNTs were prepared with acid treatment and dispersed in sodium alginate solution as a cross-linker. After which, the mechanical property （elastic deformation） , saline sorption, histological reaction, and cell viability of the resultant nanocomposite gel（CNT-Alg gel）were evaluated. The CNT-Alg gel showed faster gelling and higher mechanical strength than the conventional alginate gel. Saline sorption amount of freezedried CNT-Alg gel was equal to that of the alginate gel. In terms of histological evaluation and cell viability assay, CNTAlg gel exhibited a mild inflammatory response and non-cytotoxicity. These results thus suggested that CNT-Alg gel could be useful as a scaffold material in tissue engineering with the sidewalls of CNTs acting as active sites for chemical functionalization.

Previously, we presented in vivo evidence for a physiological significance of cAMP-regulated CFTR Cl(-) channels in Ca(2+)-activated Cl(-) reabsorption in the ductal system of the rat submandibular gland. Here, we address the mechanism by which basal CFTR activation contributes to the transepithelial Cl(-) movement evoked by muscarinic stimulation. The Cl(-) concentration ([Cl(-)]) was increased in the final saliva from rat submandibular gland during pilocarpine stimulation when a small interfering RNA for CFTR or a specific CFTR inhibitor, CFTR(inh)-172, was injected retrogradely into the gland's own duct, indicating that basal CFTR activation is involved in Cl(-) reabsorption. Systemically administered propranolol failed to alter the [Cl(-)], suggesting little involvement of a beta-adrenergic pathway in the Cl(-) movement that occurs through basal CFTR activation. Intraductal injection of suramin (a nonspecific P2-receptor antagonist) increased the salivary [Cl(-)], indicating the existence of endogenous purinergic activation. Upon separate intraductal injection, ATP and a P2Y(2)-receptor agonist, UTP, decreased the salivary [Cl(-)] almost equipotently. CFTR(inh)-172 and suramin each prevented these effects, whereas 2',3'-O-(4-benzoylbenzoyl)-ATP (Bz-ATP), a P2X(7) agonist, had no specific effect. Pilocarpine stimulation evoked ATP secretion into the salivary fluid. Immunohistochemistry revealed the partial coexistence of CFTR and P2Y(2) receptors on the luminal surface of epithelial cells in the striated ducts of this gland. These results raise the possibility that muscarinic stimulation-induced Cl(-) reabsorption occurs through basal CFTR activity and that this is regulated by P2Y(2) receptors in the ductal epithelium via stimulation by ATP secreted into the salivary fluid.

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