No abstract

We clarified the progress of OSD with MRI. The process of OSD started from the apophyseal stage and a tear appeared in the secondary ossification center, widening to an opened shell-like shape. This damage progressed to an ossicle in some cases. In short, the ossicle was formed from an avulsed portion. It was very difficult to show the course of OSD with radiography. MR images were especially useful for revealing early and progressive lesions of OSD.

The objective of this study was to evaluate the correlations between deformation and displacement of median nerve and flexor tendons during finger motion in the carpal tunnel for both carpal tunnel syndrome (CTS) patients and healthy controls. Sixtytwo wrists of 31 asymptomatic volunteers and fifty-one wrists of 28 idiopathic CTS patients were evaluated by ultrasound. The displacement of the median nerve and the middle finger flexor digitorum superficialis (FDS) tendon, as well as area, perimeter, aspect ratio of a minimum enclosing rectangle, and circularity of the median nerve were measured in finger extension and flexion positions. Deformation indices were defined as the ratios of indices in finger extension and flexion positions. The correlations between displacement and deformation indices were evaluated. There were significant correlations between nerve palmar-dorsal displacement and deformation indices (p < 0.05). The aspect ratio deformation index showed the strongest correlation to palmar-dorsal displacement of the nerve (À0.572, p < 0.01). This study showed that there is a relationship between median nerve deformation indices and nerve palmar-dorsal displacement in the carpal tunnel. Since the highest correlations were between palmar-dorsal nerve displacement direction and aspect ratio deformation index, these parameters may be helpful to understand the pathophysiology of CTS. Keywords: carpal tunnel syndrome; median nerve; displacement; deformation; ultrasound Carpal tunnel syndrome (CTS) is a compression neuropathy of the median nerve at the wrist. The diagnosis of CTS is mostly clinical, and usually confirmed with nerve conduction studies. Recently, cross-sectional ultrasound imaging has been proposed for the diagnosis of CTS. Static ultrasonography can detect pathological changes such as thickening and alteration of the echogenicity of the flexor tendons and flexor retinaculum, synovial proliferation and flattening of the median nerve in the carpal tunnel. 1-7 These findings can distinguish patients with CTS from normal subjects.Peripheral nerve trunks slide over considerable length with movements of the extremity. 8 However, in the case of chronic compression, fibrosis of the perineurium and endoneurial edema 9 may alter the motion and deformation characteristics of the median nerve. Thus, to fully understand the pathophysiology of CTS, to the clinician should consider the deformation and displacement of the nerve and tendons.An ultrasound method to observe the movement of the structures in the carpal tunnel during finger motion has been described, 10 and several ultrasound indices of deformation have been identified which may be helpful in the assessment of patients with CTS. 11 The median nerve shape is affected more by the flexor digitorum superficialis (FDS) tendons than by the flexor digitorum profundus tendons, because the FDS tendons lie closer to the median nerve. There is a changed pattern of median nerve motion in association with middle finger, index, and thumb motion, when co...

The objective of this study was to investigate the feasibility of autologous uncultured bone marrow-derived mononuclear cell transplantation in large full-thickness cartilage regeneration. After fixing with a hinged external fixator, the entire surface of the left tibial plateau was resected and large full-thickness cartilage defects were formed in 48 rabbits. Animals were divided into four groups: autologous uncultured bone marrow-derived mononuclear cells with fibrin gel (BMC), autologous uncultured peripheral blood-derived mononuclear cells with fibrin gel (PBC), fibrin gel alone (GEL), or nothing (CON) transplanted to the articular cavity 7 days after the operation. The rabbits were killed 8 or 12 weeks after the operation. The repair of defects was investigated histologically and scored using a histological and histochemical grading scale that was modified from the International Cartilage Repair Society Visual Histological Assessment Scale. To evaluate the regenerated cartilage, we also morphometrically measured the staining area positive for Safranin-O or type II collagen and calculated the percentages of the positive staining areas with respect to the regenerated soft tissue area. Histological findings showed that the BMC group had superior cartilage repair compared with the other groups, and that the PBC and CON group showed better cartilage repair than did the GEL group. Histological scores and morphometrical measurements also showed the same results quantitively. The transplantation of autologous uncultured bone marrow-derived mononuclear cells contributes to articular cartilage repair. The easy and safe method used in this study is potentially viable for clinical application.

Bone marrow transplantation can lead to osteogenic repair of intractable bone conditions. To achieve optimal clinical results, it is necessary to transplant as many cells with osteogenetic potential as possible. However, approaches involving special equipment and reagents for the extraction and purification of cells are expensive, and the complicated procedures involved are a hindrance to widespread acceptance of bone marrow transplantation for osteogenic repair. To standardize bone marrow transplantation for bone regeneration, a simple, safe, clean, and low-cost system is required. We describe an easy-to-use method using a conventional manual blood bag centrifugation technique traditionally used for extracting buffy coats, for concentration of cells from bone marrow aspirates (BMAs) to obtain osteogenic progenitors.